hemostatic agents

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280

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does anyone use them?
how are they working?
what brands?
pro or cons?
 
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quik clot, ive seen it used non 911 the guy demonstrating is nuts but it worked=D and i do not believe we are allowed to have it on the ambulance
 
Quick Clot is used here. The paramedics carry it as does my vollie BLS unit. The Medic have 2 documented cases of use, ironically by the same medic. It worked. In one case it saved the woman's leg.

http://www.jems.com/news_and_articl...l;jsessionid=8029B49628946B909F20663265670340

When paramedic McCullough arrived at the accident scene in May of 2007, he observed the victim with a deep wound to the thigh, involving a tear of the femoral artery, a life-threatening injury. Bystanders had applied a tourniquet, which was not working to stem the blood flow.

Calling on his training, McCullough applied QuikClot 1st Response to the wound, and immediately stopped the arterial bleeding. He removed the tourniquet without further bleeding, stabilizing the victim sufficiently to be airlifted to the Westchester Medical Center Trauma Center. According to RPS, the Westchester trauma team attributed the victim’s survival and good outcome to paramedic McCullough’s intervention
Click to expand...
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there are multiple agents in the field,...heres my take on them and their use, this may get a bit longwinded i apologize in advance, its all about the learning right??????

QUIK-CLOT-
initially formed from the weird "star-trek" concept of potatoe starch and ground volcanic rock ( rock due to its anhydrous properties). Good product but when it contacts any Heme agent the catalytic reaction creates HEAT, enough to burn skin and semi-cauterize the deeper cavitataed GSW's. Surgeons hate it because it means more invasive de-briedment for the surrounding tissue but, screw them, the guy is ALIVE right??!
The vacuum sealed packets first came out were good unless you were on a plane, then they werent so vacuumed and blew up in your bag,....love having clotting powder in my BVM (note: that powder clots ANY moist, mucous area,..ventilate that, your gonna kill someone !)
SO,....application of said agent is "tear pour into wound" basically. Well, for sakew of an argument, lets say Femoral GSW. OK, you need to still apply direct pressure, quickly reach in with another gauze (abd pad 5X9 worked best) scoop out the retained blood, otherwise adding quikclot gives you a modified JELLO of blood components and that isn't stopping your hemorrhage. So basically, ( immediate pressure, switch hands scoop/wipe, quikclot, direct pressure, Tourniquet? depending on area of GSW and your local protocol)

It gets hot, and it hurts!!, so the company changed the powder deal because in combat medics/soldiers were ripping open the packets, and, " Lo and Behold", ripping it open makes it airborne in the wind so your eyes, nose, ears, throat (already parched your in a friggin desert...) start to solidify-haha this really sucks and the more water you give to flush eyes or so, the hotter it gets. RIP IT AWAY FROM YOUR FACE AND NOT DOWNWIND FOLKS!!
So, the company went to the Quikclot "Sponge" which is like a 5X9 sealed gauze with quikclot impregnated. MUCH BETTER, it wont aerosolize in your face, and you can push it INTO the GSW eliminating the Scoop/Wipe deal. Quicker -faster-better-evolution. and some weird biologic-pharmaceutical change has reduced the heat by-product of administration.

TRAUMA-DEX: not so hot in temp, stupid applicator, looks like it belongs in a chics scrapbook craft kit. I dont see it working for a good traumatic bleed(ie. non-tourniquetable femoral/axillary GSW)
It does work though.

KITOSAN: ground up substrate from shrimp exoskeletons, made inert so you wont get any anaphylaxis response from those sensitive to seafood or iodine or Radiology Contrast (injectable) Dye.
Military tried it, missed a step in production, multiple million dollar OOPS that resulted in high priced "4X4's" that didnt clot anything. The new version is in most cardiac cath and angio labs.

I know this is long, sorry,....but id rather light 1 candle of thought than curse the darkness!
 
Should also mention:

ActCel - Hypoallergenic regenerated cellulose hemostatic gauze - available OTC and can be used by FR - used by Israelis and by some AMR regions... many SWAT teams as well. This is the most affordable product on the market with the least worries. Saline soluable...

HemCon - chitosan based hemostatic gauze Used by US Military in HUGE amounts. RAVE reviews from Iraq. Very expensive

Celox - Granulated chitosan distributed by SAM medical - used by some ambulance services instead of QuickClot or TraumaDex
 
our agency doenst allow it on our rigs and it isnt mentioned in our local protocols but our regional EMS council is actually in the process of slowly introducing it and starting a study of it..and who knows depending on how the study goes it may be showing up in our protocols..
 
please keep us informed of what products work the best, why or why not.... most have narrowed it to 2 or 3.... thanks #280
 
Quickclot works.
 
I'd pick quikclot over anyting else right now, its down-n-dirty no BS quik fix get the job done. Small secondary issues with it but, if it hurts, that means your still ALIVE! ,.
 
thanks for adding those, i didnt know about them, but gonna check 'em out now !!!!!

Thanks Bro!

From "SUMMIT":
Should also mention:

ActCel - Hypoallergenic regenerated cellulose hemostatic gauze - available OTC and can be used by FR - used by Israelis and by some AMR regions... many SWAT teams as well. This is the most affordable product on the market with the least worries. Saline soluable...

HemCon - chitosan based hemostatic gauze Used by US Military in HUGE amounts. RAVE reviews from Iraq. Very expensive

Celox - Granulated chitosan distributed by SAM medical - used by some ambulance services instead of QuickClot or TraumaDex
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