5 Oct 2026
CRASH-4: Can Early TXA Save Lives After a Fall with Prof Ian Roberts
A fall from standing height can have devastating consequences in an older adult. In this episode, Professor Ian Roberts joins the Pre-Hospital Care Podcast to discuss CRASH-4, a major randomised trial investigating whether giving intramuscular tranexamic acid (TXA) within three hours of injury can reduce intracranial bleeding, disability and death following symptomatic mild traumatic brain injury in older adults.
The trial is particularly relevant to pre-hospital clinicians because TXA can be administered by paramedics at the scene or during transport, before the presence of intracranial haemorrhage is known. CRASH-4 follows on from the findings of CRASH-3 and addresses an important unanswered question: could giving TXA even earlier, before the CT scan, improve outcomes?
In this interview, Ian discusses the rationale behind CRASH-4, the evidence that led to the trial, the practicalities of administering IM TXA, what the study has learned so far, and what the results could mean for the future management of older patients with head injury.
CRASH-4 Trial: Official CRASH-4 study website (https://crash4.lshtm.ac.uk/?utm_source=chatgpt.com)
Study protocol – Version 3.0: Read the full CRASH-4 study protocol (https://thebloodtrials.org/wp-content/uploads/Protocol_C4_v3.0_02Jul24-compressed.pdf?utm_source=chatgpt.com)
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🎙️ EMS2027 – European EMS Congress
The Pre-Hospital Care Podcast is heading to Ireland.
I’m excited to announce that I’ll be in Killarney in April 2027 as the official podcast host for EMS2027, the European EMS Congress.
📅 13–15 April 2027
📍 The Gleneagle, Killarney, Ireland
🎯 Theme: “Connecting Care Across Communities”
EMS2027 will bring together clinicians, researchers, educators and leaders from across Europe and beyond to explore the future of EMS, with a programme covering innovation, technology, sustainability, human factors, research and the future of integrated emergency care.
I’ll be there with the Pre-Hospital Care Podcast, bringing you interviews and conversations with speakers, clinicians, researchers and EMS leaders — capturing the ideas, experiences and discussions shaping contemporary pre-hospital care.
If you work in EMS, emergency medicine, pre-hospital care or healthcare, make sure you have 13–15 April 2027 in your diary.
I’ll see you in Killarney!
Find out more and register with EMS Europe – EMS2027. (https://www.emscongress2027.org/)
