[Paramedic40]

My CLS provider used it on a 5.56mm exit wound, R bicep/shoulder 'blown out' with brisk bleeding from fascia, muscle, and what appeared to be a blood vessel, plus a 'gouged' bone that appeared to be the result of a 5.56 travelling along the shaft and bouncing out. Pt also sustained 5.56mm entry wound directly over T5 [my shot, strange angles] that severed his spinal cord and probably took out one or both great vessels. 16-17 y/o M. It worked fairly well- in all honesty, it was not a critical intervention at all. My care was a chest seal over the back wound and attempted rapid evacuation, secured airway and ventilations with BVM and Combitube. Considered performing a needle-chest decompression, but I had positive breath sounds on both lungs with bilateral movement. I ceased resuscitative efforts approximately 20 mins post-shooting and presumed him dead. My CLS guy nearly puked from the whole thing.

Even with limited bloodflow, the clotting properties were readily apparent- the IPs had difficulty removing the gauze from the wound. I was fairly impressed with it, although I wish that it was slightly easier to open.
I can see difficulties with some of the other available hemostatic agents, like the 'bag of hemcon' Quickclot sells on the civilian side. The Combat Gauze was fairly easy to work with. For this wound, the old powder would have been difficult.