Wound Stat

[Team Sergeant]

Originally Posted by LeapingGnome

Gents,

I met the TramaCure/WoundStat folks at SOMA last year and have spoken at length with them over the past year. They were very helpful and sent me all of the literature, studies, videos, etc. to review. This morning I called John Duke, one of the sales directors, to get some more direct information about the study and the ALARACT. He has seen this thread and is obviously keeping up to date on the developments and said that anyone can feel free to contact him for more information, or with any questions about the issue. He is going to be working through the holidays and said feel free to contact him at any time:

John A. Duke

Director of Sales, N. USA

TraumaCure

PHONE: 240-497-0910 • FAX: 240-497-0911

jduke@traumacure.com

(615) 790-2872 O.

(615) 791-8919 F.

(615) 330-5740 C.

www.traumacure.com

Looks like Mr Duke is on board and I've cleared him hot so he can post now if he likes.

Welcome aboard Mr Duke.

Team Sergeant

[29G31]

Originally Posted by Dub

RF1: I am wondering if WS has made it into the civillian practice?

The Professor who is the major researcher responsible for WS's development gives a talk on it in one of his biochemistry lectures for M1s, as of this year he said it has been used in the MCV ER and is being carried by an ambulance department in Virginia - cannot remember which ambulance department.

If by civilian you mean EMS/FR we were using it on our Tacmed team. I just removed it after hearing the presentation given at SOMA. We never had an opportunity to test it on an actual patient. I am looking at replacing all of our stock with Combat Gauze. I like this option because it looks like regular dressing when in the wound.... could get away with using on regular trauma calls. When I was at SOMA the manufacturer of the OLAES dressing was even discussing making the first few yards of their packing in their bandage GC. This would be a great product.. everything all in one package.

The system I work in only allows hemostatics and tourniquets to be used by SWAT medics. This decision was made by the trauma surgeons board and the agency medical directors all follow suite. I can understand their issue with hemostatics that are granular based but products like QC ACS+ and CG are easy to remove from the wound. I also understand that we have relatively short transport times but the use of a military type tourniquet seems to make perfect sense.

We are at a distinct disadvantage on this side by not having the benefit of live tissue training/testing when it comes to hemostatics so we try to get information from sources like this forum and SOMA. We have several local department members that were corpsmen who have used some of these products and given us good feedback. I always appreciate any information I get from you guys in the field.

Steve

[swatsurgeon]

Originally Posted by 29G31

If by civilian you mean EMS/FR we were using it on our Tacmed team. I just removed it after hearing the presentation given at SOMA. We never had an opportunity to test it on an actual patient. I am looking at replacing all of our stock with Combat Gauze. I like this option because it looks like regular dressing when in the wound.... could get away with using on regular trauma calls. When I was at SOMA the manufacturer of the OLAES dressing was even discussing making the first few yards of their packing in their bandage GC. This would be a great product.. everything all in one package.

The system I work in only allows hemostatics and tourniquets to be used by SWAT medics. This decision was made by the trauma surgeons board and the agency medical directors all follow suite. I can understand their issue with hemostatics that are granular based but products like QC ACS+ and CG are easy to remove from the wound. I also understand that we have relatively short transport times but the use of a military type tourniquet seems to make perfect sense.

We are at a distinct disadvantage on this side by not having the benefit of live tissue training/testing when it comes to hemostatics so we try to get information from sources like this forum and SOMA. We have several local department members that were corpsmen who have used some of these products and given us good feedback. I always appreciate any information I get from you guys in the field.

Steve

Steve,
If your trauma docs are wondering about human use in and out of the operating room for the quik-clot...tell them to email me. I have used it 7 times in the body in the operating room and 12-15x in the resuscitation bay. Would be happy to educate them.
ss

[afo417]

The Quik Clot First Responder Sponges, which I understand are the same as the ACS ... Are still safe to use?

[Surgicalcric]

Its still safe to use.

[afo417]

Thank you for the info.

I am putting together a blow out kit for my TAC Vest. I rec'd my EMT - B a few months back.

Should I include any NPA's or OPA's? Are they really used that often? If so, which ones and what are the advantages of one over the other?

I am paying for everything out of pocket, kind of thought about a combitube or King LT, not really easy to carry on a vest and a little pricey.

I have a CPR mask, Quik Clot, sponges, old style field dressings, asherman dressings, petroleum guaze, elastic wraps, EMT Shears, 4x4's, some rolled guaze, a CAT, and some ABD pads. Mostly concerned about gunshot or stab wounds.

[Surgicalcric]

afo417:

The search button is your friend; use it. This topic has been covered extensively and as such no need in rehashing it.

Crip

[afo417]

Thanks will do

[rcm_18d]

I teach TCCC utilizing a very realistic technique and have used the WoundStat on patient models. From a TFR(Tactical First Responder) or RFR(Ranger First Responder) standpoint the WoundStat seemed to be very effective on major bleeds. I understand the treat of Emboli is a real concern. The only places I would, and teach to use the hemostatic agents (regardless of the agent) are the places that a tourniquet will not work (i.e. Groin, Pelvis, Armpit). Tourniquets are the only option that should be considered for the extremities. Just because you place a tourniquet on the extremity doesn't mean they will loose that extremity. If they arrive at a CSH or med facility within 4 hours they have a very good chance of keeping the limb. There have been cases in theater of 6+ hours with a tourniquet and no limb loss. As it stands, with SOCOM, right now the standard is Combat Gauze. The agent that I, personally, have had the most success with is Celox. When used correctly I have had 100% success. When talking Hemostatic agents the training is more important than the agent. The operator, whoever they are, has to be able to identify where the blood is leaking out of the vessel, gain control with direct pressure apply the agent directly to the vessel and follow it up with direct pressure never letting up and finish with a pressure dressing. That whole two to three minutes of direct pressure after application and letting up is impractical in the tactical world. Out of all the hemostatic agents, the only agent I have had issues with it's use in the past is QC. It does work but it does cause massive tissue death in the wound. The QC ACS+ tea bag is OK but it has its issues as well. I like the powder forms of the agents best. When we did the invasion we had HD (Hemostatic Dressings). They were made from human blood products. All the clotting factors were impregnated onto a 4x4, but they took 32 man hours to make and cost $1000 a piece. Anyone seen these since '03.

[swatsurgeon]

Originally Posted by rcm_18d

I teach TCCC utilizing live tissue and have used the WoundStat on patient models. From a TFR(Tactical First Responder) or RFR(Raqnger First Responder) standpoint the WoundStat seemed to be very effective on major bleeds. I understand the treat of Emboli is a real concern. The only places I would, and teach to use the hemostatic agents (regardless of the agent) are the places that a tourniquet will not work (i.e. Groin, Pelvis, Armpit). Tourniquets are the only option that should be considered for the extremities. Just because you place a tourniquet on the extremity doesn't mean they will loose that extremity. If they arrive at a CSH or med facility within 4 hours they have a very good chance of keeping the limb. There have been cases in theater of 6+ hours with a tourniquet and no limb loss. As it stands, with SOCOM, right now the standard is Combat Gauze. The agent that I, personally, have had the most success with is Celox. When used correctly I have had 100% success. When talking Hemostatic agents the training is more important than the agent. The operator, whoever they are, has to be able to identify where the blood is leaking out of the vessel, gain control with direct pressure apply the agent directly to the vessel and follow it up with direct pressure never letting up and finish with a pressure dressing. That whole two to three minutes of direct pressure after application and letting up is impractical in the tactical world. Out of all the hemostatic agents, the only agent I have had issues with it's use in the past is QC. It does work but it does cause massive tissue death in the wound. The QC ACS+ tea bag is OK but it has its issues as well. I like the powder forms of the agents best. When we did the invasion we had HD (Hemostatic Dressings). They were made from human blood products. All the clotting factors were impregnated onto a 4x4, but they took 32 man hours to make and cost $1000 a piece. Anyone seen these since '03.

RCM_18D
You have hit the nail on the head...it is the operator, not the product that makes the largest significant difference...that being said, not all operaqtors are created equal as you well know.....make something idiot proof and they make a better idiot.
Free powders have inherent risks to the provider...ever get one of them in your eyes?? Ever try the debride it out of tissue when it has been in there for 1-4 hours. The Wound stat product, like all others have a down side. I have used most of them (except wound stat) and found inside the human body the new formulation of quick clot in the bags as well as their combat gauze and gauze sponges do a superior job of providing hemostasis. Like I tell people, you have to be convinced not by marketing but by practical APPROPRIATE use under the correct circumstances...an agent that has the least associated bad consequences and provides the most benefit for the indicated use is the one you should be using.

ss

[rcm_18d]

I do have experience with the surgical side of QC. During Anaconda in '02 numerous soldiers were MEDEVACed to K2 with QC in their wounds. Some of the soldiers did not have major bleeding associated with the wound. The GSW Major and Minor debridement of the wounds was extensive. Some of those kids are probably still in physical or occupational therapy. The product was distributed to soldier as a magic fairy dust that wound stop any bleeding (Mark Wahlberg in “Shooter”). I am not saying QC doesn't work, I am simply stressing training. I don't like the tea bags ACS+ because I want something I can get into every wound without having to rip open to much.
There are very few places that one can really receive the proper training from individuals that understand the duress that the operator will be under during the application(KISS-Keep It Simple Stupid). I would go so far as to say without proper training on the actual uses of the specific product it will do more harm than good. Idiot proof and unbreakable are non-existent!!
Swatsurgeon
Have you used Celox?
Anyone heard anything from Biopure on their Hemopure (Synthetic Bovine Hemoglobin) product? Our Vets still use it at their clinics but South Africa is the only place I have heard where it was used on humans. If it works and the FDA has put it off this long somebody should pay. I have been hearing about it since 2000.

Ryan

[rcm_18d]

Sorry read more. I have not had the experience of QC in the eye. I have seen someone else and figured I could skip the experience. I have had Celox in the eye and not a big deal. If you are ever around the vendors they will eat it to prove a point. I always ask them over and over to see how muany times I can get them to eat it. It must not be good on the guts!!

[Razor]

Originally Posted by rcm_18d

I always ask them over and over to see how many times I can get them to eat it.

I think we'd get along rather well.

You mention Tactical First Responder and Ranger First Responder in your post. That's the first I've heard of RFR; can you teach me about the difference?

[rcm_18d]

Tactical first responder is what the Navy (Group 2 East and Group 1 West) calls the TCCC course. There is some difference in East and West curriculum. They also require some additional requirements in the course, like environmental injuries. During their 6 month train up for their floats or deployments they are required to get TFR qualified. RFR is obviously the US Army Ranger version and I think it was the first. This was started by some awesome individuals after Solomia. This is a course taught to every young hooah during or after RIP prior to their first deployment. I believe they get retrained on the course once a year if possible.

Cpt Butler(Navy) and Col Bellamy(Army) were the driving force behind the whole movement.

http://www.au.af.mil/au/awc/awcgate/...med-butler.htm

[Razor]

Thanks! Are there specific procedures added to RFR that go beyond TFR, or CLS for that matter?