Why is it in the combat triage literature but not used on the private side?

In general terms it is because combat injuries usually occur in a, relatively, healthy younger demographic with a general baseline healthy outlook compared to the public population with a myriad of possible health issues not vetted during MEPS, e.g.
Studies show an increase in thromboembolic events (strokes, MI's, pulmonary emboli, etc.) in general populations.
The CRASH-2 study showed a number between 70,000 and 100,000 patients may be saved by the administration of Tranexamic Acid.
There are lab tests that can help predict the susceptibility to the embolic results but take 30 minutes at a minimum and up to 4 hours to get results.
That being said I believe there is a place for TXA to be used judiciously in the pre-hospital setting if a set of accurate guidelines can be developed.

ETA: MedicManDan who is backing your study and is the data going to be available in the near future?
I am very interested in the outcome of the study as it pertains to something I have been assigned to.

Thank you, I hope the study proves the theory in the pre-hospital setting. Combine TXA with HemoSpan, or similarly effective product, and I see trauma deaths being significantly reduced.
The website said it is a three year study, when did it start?

ETA: I am waiting on this to be approved Abdominal foam in pre-hospital settings

Flight services around here are using it. We're trying to start using it too.

While not EMS, we are starting to use TXA for lots of ortho surgeries. I think its going to be the next big thing. In the orthopedic literature it is showing it really cuts down on blood loss.

We also avoid use in anyone who would have a reason to create a bad clot. I would imagine that someday it will be standard on trauma patients of a certain type.

We use it frequently for ortho and trauma here, but I don't know if our air teams carry it.

FWIW, I've seen seizures and subsequent PEA possibly resulting from high dose TXA. Mechanism unclear, as that's still in literature case-report territory.

Not common in my area yet. Discussions have happened between me and a certain M.D., but not anytime soon for us.

How are they having you administer it? Our unit switched from 1G in 100cc over 10 mins to a 10cc 1G slow IV push bolus.

I think we're still getting IVPB bags & a timed infusion, at least if administration hasn't happened before they hit the OR.

That makes sense, in a civilian setting that would be the safest method. Our protocol was based off the British seeing no negative side-effects from just doing one push over a few seconds. Again, that was in healthy adults, not the civilian populace where everyone has some sort of health issue.

Blast from the past. Used to give that stuff when I worked with cardiac anesthesiologists. Or was it aprotinin. Or was it one, then we switched to the other because of side effects.
Fuck, I can't remember. Amicar!!! That was it!! Or was it?

Pretty awesome that it's being used frontline EMS.  In for eventual study results.