Concur.

This is meatball trauma management, frequently by un/under-trained personnel, not professional care at a Level 1 Trauma Center.

Hmm, die in 15 minutes from exsanguination, or use a dangerous clotting agent or a tourniquet till they can get me out of here?

I have seen the former with a friend of mine, he sucked up 13 bags of IV solutions till he was circulating pink Kool-Aid and died enroute to a hospital, I'll take my chances with the latter, please.

Just my untrained .02.

TR

you all seem to read what you want rather than what is written...

again... he said he would not use it if there was an alternative, not that he wouldn't use it at all....

and as i wrote...better than nothing.

His point was its not an alternative to pressure or possibly a tourniquet because the damage seen may ultimately lead to an amputation based on the treatment. As was written earlier in this thread, it should be a last line of treatment..not the first.

doc t.

for more accurate literature, get hold of this months Police magazine (not sure of the exact name) We published a review on all of the products. I can email a longer version of the article to anyone that wants to read it. It was not funded/influenced by any company.
I have used traumadex in the OR....worked very well. The reported problems both as listed here as well as from their own video/literature...I would stay away from it. Traumadex is relatively inexpensive, inert and functional as advertised (I have no affiliation with them)

last post wasn't clear....the problems with the video/literature was with quik-clot........

QuikClot

I have known this man for 20 years. He was an SF Medic and my mentor as a PA during my rotation before graduation. This is all I need to know about this HCA.

a few good points here.....first, tourniquets DO NOT work when there is a bone in the way, it needs circumferential soft tissue and when places above the ankle and around the popliteal fossa, the tibia at the anke and the patella or tibia at the knee will prevent the tourniquet from performing its intended duty.....need to refresh the anatomy and placement of tourniquets with the medics!!
IMHO, a touniquet over gauze at the site of injury 'most likely' would have taken care of this. Yes, quik clot will stop the bleeding and he didn't sustain a burn most likely because the field was very dry...it remains as he describes a LAST DITCH EFFORT/PROCEDURE. That is the most important point

Agreed sir. Last resort.

Quickclot DCU Battle Pack
 

http://www.1starmy.com/viewproduct.asp?productno=1622

BMT

Yeah, I have tried to order some of those for the Boyz here. We'll see if we get them.

Do we know that company BMT?

Sarnt:

Brad has the QC in stock here at Bragg. I am sure he has them on the site as well.

HTH.

Crip

Is this product similar to TraumaDEX?

http://www.biolife.com

My niece has Glanzmann's Thrombastenia and frequently gets nosebleeds, sometimes severe. My sister is checking with her Pediatric Hematologist, because they've never recommended any kind of HCA, just packing, and recombinant factor VII when she goes to the ER.

It's not battlefield trauma, but I can never get used to how much she bleeds out through her nose, and anything to stop it faster would be great.

VSVO, yes the products are made by the same company, packaged differently.

on the quik-clot subject (figured out I'm not a fan of its use?)
I couldn't remember where I read this until I came across it again looking for something else.....
Oct 2005, Journal of Trauma, study done by US army institute of surgical research: "Comparison of Hemorrhage Control Agents Applied to Lethal Extremity Arteial Hemorrhages in Swine"

to summarize...
animal model developed that had 100% motality if used standard gauze (army field bandage) application and manual compression.
3 products: hemcon (chitosan dressing), fibrin sealant dressing, and quikclot each applied twice with 3 minute comprssion time. All applied on active bleeding site through a pool of blood (realistic, unlike the quikclot video which has a DRY field to apply through...very UNREALISTIC).
Results: fibrin sealant dressing superior. hemcon showed "some hemostatic benefit. The exothermic reaction of quikclot was significant and resulted in gross and histologic tissue changes of unknown clinical significance...it showed NO hemostatic benefit"
Until another product comes out I believe this thread merits no more time spent discussing Quik clot: it doesn't work unless the field is dry (I haven't seen too many (none) wounds that have an exsanginating injury that are dry...if they were, my technique to stop the bleeding is working so why would I apply quikclot.
Gentlemen of all biases and beliefs....leave quikclot out of the picture....the last ditch effort I mentioned in a previous post means I have tried EVERYTHING else available to me and I have nothing to loose and oh, by the way, we could try quikclot for lack of ANYTHING else to try.

ss

I forgot to mention....you give me 1 week and alot of animals and a cadaver, I can teach the 18D how to control just about every vascular bundle in the body...think back to the vascular injury portrayed in 'Blackhawk Down', if the medic knew how to get into the retroperitoneal space, the iliac artery and vein are right there and can be compressed or clamped....or split the inguinal ligament and clamp there....there are other ways that in the civilian world we would not teach to non-docs, but for you guys I would be willing, as should your medical superiors, teach you these methods...they can and do save lives.
Don't mistake what I'm suggesting as teaching to every 'regular' soldier, this is for the combat medic.

ss

ss

Thanks, Doctor!

I know this is a really old thread, but was looking around and came across it.

The new stuff being put out by Eagle First Responder (the new CLS. At least at Campbell) is to tourniquet FIRST for any major hemhorrage i.e. GSW, major avulsion, big lac, amputation, etc. Their thought process being there have been too many fatalities due to blood loss that the benefits of immediate tourniquet outweigh the potential risks. Also, suppossedly, there has been a significant advance in the ability to save the limbs distal to the tourniquet.

Has anyone else seen this put out yet? This seems bassackwards to what I was taught and I had a hard time wrapping my head around it, but they say it works better this way. Also, as far as the CLS stuff they're putting out, they're shying away from having CLS guys start IV's in the field. The most they want them to do is start the port but don't push any fluids till they've been evaluated by a medic.

Any thoughts?

Wow, talk about a necro post...

This past week was spent discussing hemorrhage control here in class. The current line of thinking here in the SOCM/18-D/IDC world is place a tourniquet on the guy (provided the bleeding is bad enough ie: large veins or arteries...) til the wound can be bandaged and dressed. Then remove the tourney slowly and examine the wound/dressing for signs of bleeding. Easier to see what you are working with when you dont have squrters hitting you in the face. Its also easier to place the tourney on a guy under fire than bandage and dress a serious wound.

In the next few weeks we will be seeing all the HCA's in use. I will get back to this thread after I watch a few of them at work.

Crip

My how things change.

Make the wound as dry as possible before using them.

TR

HCAs
 

We had an updated combat first aid class prior to my rotation in the desert. We were issued will all sorts of new gear, like the quikclot, airways and one handed tourney's (which are also in our survival vests now).

The medic giving the class had told us about keeping the area dry before using the quikcot to prevent burning. I asked about traumadex, and she said she'd read about it, but hadn't used it yet.

The AF is still teaching us to use the tourney as a last resort when all else fails.

Keeping the "area dry before applying" sounds a lot like "do a tactical reload during a lull in the fight". I've never seen either a dry field or this lull of which they speak - at least not in cqb.:)

HCA
 

Exactly! That's what the medic said. She said how are you going to manage this? Your hands are probably wet with water and blood, the area of the wound is covered in the same, and you have to dry up any excess before using the quikcot.

Her advice is just do your best. Get the bleeding stopped, be careful and get the job done.

I think the early tourniquet is a good idea. It should help dry the field a little.

quick clot info
 

Hello every one! I'm a new member and I recently worked with a few doctors at portsmouth naval hospital in VA. we had 24 pigs and tested the quick clot powder and the new ACS. The ACS had a spike of 150 degrees F. on innitial contact. acording to my class I attended, it is a last resort. A lot of people don't know how to properly use this.

Doc:

Thanks for the input, we have a couple of trauma surgeons here and some pretty good PAs and SF medics as well, so you will be in good competent medical company.

You need to do some reading of the stickies and intros and introduce yourself in the proper place before posting again.

Thanks.

TR

It has taken a little while for us here in the UK to push the principles of early massive haemorrhage control, but we are getting there. Although there are many HCA products on the market, I still find that the best solution to haemorrhage control is the same as any other aspect of soldiering - 'basic skills done well'. That is to say, a fast application of a combat arterial tourniquet with elevation, giving further attention to the wound ie. direct pressure dressing, as you naturally progress through the primary survey. We are looking at hemcon and quickclot as a means to give the soldier on the ground a further option when he is faced with a non-compressible haemorrhage to the abdomen, or any other wound where a tourniquet cannot be applied. They are most certainly not to be considered as an alternative to good, basic skills.

Hope this helps.

I'm a little out of my lane since I am not a dedicated Doc but only a first responder. However I have friends that are 91W1's and 18D's to include SOMC instructors and I have discussed this with them several times in an effort to educate myself on another "tricky internet topic".

Quick Clot was reciently added to the standard medical kit to be carried by SOF units in USSOCOM. This is IN ADDITION to the Hem-com dressing that was already required for carry by every SOF member.

In a recient SOF evaluation, QC stopped 9 of 10 live tissue bleeds and Hem-com stopped 10 of 10 bleeds.

According to what I was told QC and Hem-com stop bleeding in different ways and that there is no thermal reaction with Hemcon.

According to the new USSOCOM policy, QC is to be applied AFTER a TQ(if would site allows) and Hemcon dressing have failed to stop the bleeding. As stated before, it is meant as a last resort after other methods have failed to stop an uncontrolled bleed.

As a senior 18D stated to me last week. "QC works and I would use it if I had to, but I know that if somebody used it on me I would have the ass.....That S**T gets HOT!"

Proper QC usage has been added to SOF paramedic refresher.

Hope this helps,

Cheers

introduction
 

Hello,
Sorry for the improper intro. I'm a navy corpsman with a Marine corps company (support) in NH as a reservist. I'm currently a National Registry EMT-Intermediate with 11 yrs and have been in the navy for 7.5 yrs. I love the medical field and love supporting the special teams for different evolutions. I have attended CONTOMS tactical medic program, Corpsman combat casualty care course, various other trainings and will be attending OEMS this September. I'm always telling people that i'm like a sponge and absorbing as much med. info as I can. I hope this is enough info. If anyone wants more info, just let me know.

doc buxton

Quik Clot
 

I spoke to the medic that gave the class yesterday when I went in to fly.

She threw a monkey wrench into the works:

"What if it's raining?"

She really teaches a great class and gets you thinking about what to do in emergency situations. Has a lot of first hand experience thru her civilian job and combat deployments.

Uh, you pull out a poncho, or rain parka, or anything else you can use to cover yourself and the wound site (caveat: this is an idea coming from someone untrained in medicine)?

Adapt, improvise, and overcome...

I think Razor's idea would work just fine, but I'm not an expert.

Dry wound field
 

That's what I suggested. Or if you don't have that, lean over and try to cover as much as you can with your upper body.

Grab the "fuckin" thing first! The protocols of treating a bleeder are out there...

Loss of blood+time=OH FUCKIN SHIT!

Take care.

Bloodloss
 

I definitely have to use that equation at my next class! It's perfect!

Don't use this shit in an "academic" world.:D


Take care.