Evidence strengths and limitations
The evidence for use of tranexamic acid for significant haemorrhage following trauma comes from a large high-quality RCT with a relatively low risk of bias.
The CRASH-2 RCT was well-conducted study with more than 99% of patients followed up and high internal validity.
Participants in the trial were appropriately randomised with allocation concealed and assessors and patients all blinded to treatment group.
 Roberts I, Shakur H, Ker K et al. (2011) Antifibrinolytic drugs for acute traumatic injury (Review). The Cochrane Collaboration 1.