Patients commonly present to the Emergency Department with epistaxsis (nose bleed). Standard first aid measures such as applying pressure can often stem bleeding however in more severe cases of epistaxsis further treatment is required. These treatments range from the use of vasoconstrictors to cauterisation and eventually to nasal packing.
It is well documented that patients who require nasal packing find this procedure uncomfortable and painful despite its ultimate effectiveness. The NoPac trial is investigating the novel use of tranexamic acid* (TXA) to reduce the need for nasal packing. Recruited participants will receive application of TXA or a placebo before nasal packing is considered. Identifying an effective alternative to this procedure would provide clear patient benefits.
EMERGE hope to commence recruitment to NoPac in spring 2017.
*TXA is a drug that has a good evidence base for the treatment of haemorrhage in trauma. EMERGE is currently involved in two other clinical trials of TXA,
1. Ambulatory Device, Rocket Pleural vent insertion
2. Standard Treatment, Aspiration +/- chest drain
Primary Outcome Measures
To assess whether use of an ambulatory device (Rocket Pleural Vent) and treatment strategy reduces hospital stay. Total length of stay in hospital up to 30 days post randomisation. Up to 30 days post randomisation.
RAMPP trial - Randomised Controlled Trial: Pleural vent (rocket) V standard care in Primary Spontaneous Pnuemothorax
This is a study looking at incidence and risk factors for poor ankle functional recovery, and the development and progression of post-traumatic ankle osteoarthritis after significant ankle ligament injury.
SALI study - Significant Ankle Ligament Injury