Public Release: 

Comic relief for stressed emergency teams

London School of Hygiene & Tropical Medicine

Researchers at the London School of Hygiene & Tropical Medicine have created a comic influenced by the Japanese manga style to help busy medical staff who treat patients suffering from bleeding.

Professor Ian Roberts devised a storyline to highlight the latest research into the life-saving benefits of tranexamic acid (TXA) in a way which he hopes will appeal to doctors, nurses and paramedics on the front-line of medicine.

The comic by professional artist Emma Vieceli and colourist Paul Duffield sets the scene in a busy emergency department as staff rush to treat people following two explosions.

As well as referencing established facts such as the importance of administering TXA within three hours of injury, the cartoon heroes also flag up new findings published on bmj.com which show that the drug can benefit a wide range of patients and should not be restricted to the most severe cases.

Amid the drama, doctors treating a patient say: "We have to do something about that bleeding. Get me an IV line and one gram of tranexamic acid now."

Prof Roberts said: "Health professionals are inundated with information and treatment guidelines so it can be difficult to keep track of all the latest developments. Our research has demonstrated how lives can be saved by this cheap and effective drug and the new paper shows that it can benefit all levels of severity if given within three hours of injury. We want to make sure that message comes through loud and clear and we hope this comic will get people interested and talking about TXA."

Cambridge-based Emma Vieceli, who is inspired by a fusion of many different styles of comic, said: "I am delighted to have been able to work on this project. It was an unusual challenge for me as I don't often get asked to illustrate medical themes. I hope people enjoy reading it and that patients benefit."

TXA, which was invented in Japan in the 1960s, helps reduce clot breakdown and is given to women as a treatment for heavy periods.

The potential for helping trauma patients was studied by Prof Roberts and an international team of collaborators in the CRASH-2 trial and is also currently being trialled in women at risk of haemorrhage in childbirth through the WOMAN trial.

Before making his foray into "graphic medicine", Prof Roberts experimented with another creative method of making an impact. Last year he produced an animation called TRAN-MAN to help spread the word around the world about the results of CRASH-2, which showed that TXA could prevent thousands of accident victims from bleeding to death.

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Notes to Editors:

Author list for the BMJ paper: Ian Roberts, Pablo Perel, David Prieto-Merino, Haleema Shakur (all LSHTM), Tim Coats (University of Leicester), Beverley Hunt (Guy's and St Thomas' NHS Foundation Trust), Fiona Lecky (University of Sheffield), Karim Brohi (Barts and The London School of Medicine and Dentistry, Queen Mary University of London), Keith Willett (University of Oxford).

CRASH-2 was a large, randomised trial involving over 20,000 adult patients in 274 hospitals across 40 countries, and was funded by England's National Institute for Health Research (NIHR) Health Technology Assessment programme.

TXA is an off-patent clot stabilising drug, manufactured by a number of different companies. The cost per gram is about £3 ($4.50).

For more information about the CRASH-2 trial and related publications visit: http://crash2.lshtm.ac.uk/

The TRAN-MAN animation can be viewed at http://www.thelancet.com/crash-2-2010

Other work by Emma Vieceli includes Vampire Academy: Frostbite (2012) for Penguin books, Avalon Chronicles: Once in a Blue Moon (2012) for Oni Press, Marvel Girl Comics (2010) and Dragon Heir: Reborn (2010).

About the London School of Hygiene & Tropical Medicine:

The London School of Hygiene & Tropical Medicine is a world-leading centre for research and postgraduate education in public and global health, with 4000 students and more than 1300 staff working in over 100 countries. The School is one of the highest-rated research institutions in the UK, and was recently cited as one of the world's top universities for collaborative research. The School's mission is to improve health and health equity in the UK and worldwide; working in partnership to achieve excellence in public and global health research, education and translation of knowledge into policy and practice. www.lshtm.ac.uk

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