Yeah, I know, kind of a cop-out answer. But it’s the truth. Let me explain what “hemostatic gauze” is and why you should care about it. To do this, we’ll need to go back in history a bit, and explain some basic emergency medicine.To get more news about Hemostatic granules, you can visit rusunmedical.com official website.
First, though, you probably want to know who I am. As a firefighter and the lead medic for my SWAT team, I not only have experience teaching about and using hemostatic agents, but have also been the point man when choosing the hemostatic agent for my team, and as such I have (quite literally) done my research.
Tourniquets are fairly self-explanatory, and chest seals we can get into in another discussion, but packing the junctions is where hemostatic gauze comes into play. It serves as an adjunct to wound packing, decreasing the time it takes the body to clot off the injury. This CoTCCC Committee-on-TCCC video shows how to pack a wound with hemostatic gauze.
Also worth a mention is the fact that in the past, people used powders to provide hemostasis in field conditions, but these are now largely regarded as a Bad Choice. They require manual debridement in the surgical suite (i.e., scrubbing…inside the wound…), fly everywhere in the wind (clotting powder in the eyes sucks), and generally don’t go where you want them to and make a mess. Impregnated gauzes are the gold standard for field hemostatic agents, and have been for a few years.
There are two major manufacturers of hemostatic agents, and if you’ve done any research into hemostatics, you’ve probably heard of them: QuikClot and Celox. I’m going to talk about both, but please note this is not an exhaustive discussion.
I will explain the current technologies and their merits and drawbacks, but you may recall that some earlier hemostatic agents (including early zeolite-based QuikClot) caused thermogenesis (heat) when applied to blood and caused massive issues with burns and pain. Current products on the market do not, by and large, suffer from these drawbacks.The big advancement in wound packing and hemostatic agents (at least in the emergency/tactical context) came in 2008, when Z-Medica, the maker of QuikClot, integrated a hemostatic agent into gauze. All the current well-regarded products on the market follow this general model.
Celox uses Chitosan (or Chito-R in the case of their “Rapid” product). Chitosan is derived from shrimp, and interestingly enough has no issues in populations allergic to shellfish. Celox is the standard hemostatic agent supplied to the U.K. military, among others.
QuikClot, on the other hand, uses a kaolinite (a type of clay) derived material, and is the standard issue hemostatic agent supplied to all branches of the U.S. military, which could be an endorsement or a point of concern, depending on whom you ask.
As far as advertisement goes, Celox-R is advertised as being capable of stopping a bleed with as little as 60 seconds of compression, a massive advantage in any kind of emergency situation where time is critical.The other big piece of information in favor of Celox is its re-bleed data after patient movement, something that can be extremely important in an EMS or tactical situation. Apparently “Hoggarth A, Hardy C, Eason G, Lyon A, Marsden C.” published a presentation on this topic in 2011 at ATACCC. I have been unable to find their original presentation, but the data they published indicated that:
“[Porcine] femoral artery injury models were treated [with hemostatic gauze] and then the models were driven over rough ground for approximately five minutes to simulate a casualty movement, before being examined for evidence of re-bleeding.” In this test, 60% of the QuikClot models developed some kind of re-bleed, but none of the Celox Rapid models did.Another interesting piece of information from this same presentation concerned a lethal injury to the femoral artery of Yorkshire swine, an injury that was treated with either Celox Rapid or QuikClot. “Celox Rapid had 75% haemostasis with no compression, compared to 38% for Combat Gauze. After one-minute compression, the results were 83% and 50% respectively.”
This has some interesting implications for tactical environments, as well as anywhere patient care may be interrupted or the provider may otherwise not be able to maintain pressure on the injury.
Celox also advertises a faster application time, but this is due to the shorter length but increased bulk of the product, which is fine if your wound is small, but could be problematic if the wound is larger or oddly shaped. I’ll leave this “merit-or-not” for the reader to decipher.
Yeah, I know, kind of a cop-out answer. But it’s the truth. Let me explain what “hemostatic gauze” is and why you should care about it. To do this, we’ll need to go back in history a bit, and explain some basic emergency medicine.To get more news about Hemostatic granules, you can visit rusunmedical.com official website.
First, though, you probably want to know who I am. As a firefighter and the lead medic for my SWAT team, I not only have experience teaching about and using hemostatic agents, but have also been the point man when choosing the hemostatic agent for my team, and as such I have (quite literally) done my research.
Tourniquets are fairly self-explanatory, and chest seals we can get into in another discussion, but packing the junctions is where hemostatic gauze comes into play. It serves as an adjunct to wound packing, decreasing the time it takes the body to clot off the injury. This CoTCCC Committee-on-TCCC video shows how to pack a wound with hemostatic gauze.
Also worth a mention is the fact that in the past, people used powders to provide hemostasis in field conditions, but these are now largely regarded as a Bad Choice. They require manual debridement in the surgical suite (i.e., scrubbing…inside the wound…), fly everywhere in the wind (clotting powder in the eyes sucks), and generally don’t go where you want them to and make a mess. Impregnated gauzes are the gold standard for field hemostatic agents, and have been for a few years.
There are two major manufacturers of hemostatic agents, and if you’ve done any research into hemostatics, you’ve probably heard of them: QuikClot and Celox. I’m going to talk about both, but please note this is not an exhaustive discussion.
I will explain the current technologies and their merits and drawbacks, but you may recall that some earlier hemostatic agents (including early zeolite-based QuikClot) caused thermogenesis (heat) when applied to blood and caused massive issues with burns and pain. Current products on the market do not, by and large, suffer from these drawbacks.The big advancement in wound packing and hemostatic agents (at least in the emergency/tactical context) came in 2008, when Z-Medica, the maker of QuikClot, integrated a hemostatic agent into gauze. All the current well-regarded products on the market follow this general model.
Celox uses Chitosan (or Chito-R in the case of their “Rapid” product). Chitosan is derived from shrimp, and interestingly enough has no issues in populations allergic to shellfish. Celox is the standard hemostatic agent supplied to the U.K. military, among others.
QuikClot, on the other hand, uses a kaolinite (a type of clay) derived material, and is the standard issue hemostatic agent supplied to all branches of the U.S. military, which could be an endorsement or a point of concern, depending on whom you ask.
As far as advertisement goes, Celox-R is advertised as being capable of stopping a bleed with as little as 60 seconds of compression, a massive advantage in any kind of emergency situation where time is critical.The other big piece of information in favor of Celox is its re-bleed data after patient movement, something that can be extremely important in an EMS or tactical situation. Apparently “Hoggarth A, Hardy C, Eason G, Lyon A, Marsden C.” published a presentation on this topic in 2011 at ATACCC. I have been unable to find their original presentation, but the data they published indicated that:
“[Porcine] femoral artery injury models were treated [with hemostatic gauze] and then the models were driven over rough ground for approximately five minutes to simulate a casualty movement, before being examined for evidence of re-bleeding.” In this test, 60% of the QuikClot models developed some kind of re-bleed, but none of the Celox Rapid models did.Another interesting piece of information from this same presentation concerned a lethal injury to the femoral artery of Yorkshire swine, an injury that was treated with either Celox Rapid or QuikClot. “Celox Rapid had 75% haemostasis with no compression, compared to 38% for Combat Gauze. After one-minute compression, the results were 83% and 50% respectively.”
This has some interesting implications for tactical environments, as well as anywhere patient care may be interrupted or the provider may otherwise not be able to maintain pressure on the injury.
Celox also advertises a faster application time, but this is due to the shorter length but increased bulk of the product, which is fine if your wound is small, but could be problematic if the wound is larger or oddly shaped. I’ll leave this “merit-or-not” for the reader to decipher.