Research is needed to determine how patient selection and intercurrent treatment affect safety and efficacyClinicians involved in the resuscitation of severely injured patients face a dilemma. On one hand, since publication of the landmark CRASH-2 (Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage 2) study in 2010, there has been an international push for inclusion of tranexamic acid (TxA) in trauma management protocols. On the other hand, the need for more evidence to solve ongoing knowledge gaps has been emphasised, especially evidence of who benefits and whether anyone is harmed when TxA is administered to patients treated to modern civilian and military trauma standards. While both views represent well intentioned efforts to improve care, they create conflicting priorities that must be reconciled before patients can properly benefit...