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Critical Crazy
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Bump for the latest discussion.
Our regional protocols now specifically discuss and allow hemostatic gauze and wound packing, and prohibit powdered/granulated hemostatics. Tourniquet first if tourniquet is necessary.
With respect to hemostatics, here is a good overview of the current agents:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869418/
Additional reading tells me that sponges (e.g., Quickclot ACS+) and power/granule hemostatics (e.g., Celox A or Traumadex powder) are inferior to hemostatic gauze
I've also gleaned that if one is going to believe that hemostatics are superior to gauze (there are studies showing nonsuperiority), that Celox Rapid is superior to other Celox or Quickclot products.
I've used a regenerated cellulose gauze in the past (ActCel) and this study shows Bloodstop iX BattleMatrix (mouthfull) as superior to QuickClot Combat gauze (kaolin mineral based): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849001/
I've not found a good study comparing say Celox Rapid to a regenerated cellulose gauze. Cellulose and chitosin products are much easier to remove from a wound than products using kaolin which usually requires surgical debridement.
Our regional protocols now specifically discuss and allow hemostatic gauze and wound packing, and prohibit powdered/granulated hemostatics. Tourniquet first if tourniquet is necessary.
With respect to hemostatics, here is a good overview of the current agents:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869418/
Additional reading tells me that sponges (e.g., Quickclot ACS+) and power/granule hemostatics (e.g., Celox A or Traumadex powder) are inferior to hemostatic gauze
I've also gleaned that if one is going to believe that hemostatics are superior to gauze (there are studies showing nonsuperiority), that Celox Rapid is superior to other Celox or Quickclot products.
I've used a regenerated cellulose gauze in the past (ActCel) and this study shows Bloodstop iX BattleMatrix (mouthfull) as superior to QuickClot Combat gauze (kaolin mineral based): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849001/
I've not found a good study comparing say Celox Rapid to a regenerated cellulose gauze. Cellulose and chitosin products are much easier to remove from a wound than products using kaolin which usually requires surgical debridement.
