# HEMOSTATIC Preferences?



## Diamondback 2/2 (Sep 16, 2012)

I wanted to get some input on what the medics think is good or bad, what they prefer and why. I am stocking up on medical supplies and I am trying to figure out which direction I should go. What I am looking at right now is:

CELOX Gauze for wound packing and CELOX granules for deeper arterial bleeds.
Vs
Quick Clot Gauze & Granules for the same, just wondering the differences in effectiveness between the two.

I am also looking at Hemcon bandages for arterial bleeds, trying to decide if the 2x2’s would be a good choice or if I should go with 4x4’s (about a $120 difference between the two). I have 2 Hemcon bandages from my old IFAK’s but both are expired, do I need to replace them or with they still be serviceable (they are properly sealed and have been stored in the IFAK’s).

Also I have some of the older Israel bandages, all of them are expired but are still sealed and in good shape. Should I replace these as well? Would you recommend restocking the same bandage or something else, like the H compression bandages, etc.

I do have 5 or 6 H&H compressed gauze and roughly 10 assorted ace wraps as well, should I build up on these, instead of buying a specific bandage?


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## x SF med (Sep 16, 2012)

The old school medic in me says stock up on kerlix, ab pads, plain 4x4/6x6, regular roll gauze and a couple or 4 tourniquets first... then go with the Celox set for next level........... I do like the older Israeli bandages too.

Sealed packages of non impregnated bandages are generally good for 3 years or more past the dates as long as they havent gotten wet or exposed to extreme temps/sunlight... the impregnated ones, well they'll be good for a while after expiry but will not be as effective as the fresher ones.

ETA...  H bandages are good too.


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## policemedic (Sep 16, 2012)

Short answer- I like Combat Gauze and OLAES; more later.


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## TLDR20 (Sep 16, 2012)

Combat Gauze, celox applicator.


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## Diamondback 2/2 (Sep 16, 2012)

I had to look up the celox applicator and the OLAES bandage, good shit.

What's the thoughts on the Hemcon pads? Are they worth the money?


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## Muppet (Sep 16, 2012)

We (tac med. team) and my squad I work for use combat guaze and found it to be good. IMHO, hemmcon is really expensive, as you know but I never used it. I would not waste the money. Buy more tourniquets and combat guaze.

F.M.


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## Ranger Psych (Sep 16, 2012)

JAB said:


> I had to look up the celox applicator and the OLAES bandage, good shit.
> 
> What's the thoughts on the Hemcon pads? Are they worth the money?


 
Hemcon works, civ-side I would say getting it while unexpired and sealed, at a discount... yeah, worth tossing in. But, combat gauze + Celox cover the same group, basically.


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## surgicalcric (Sep 18, 2012)

Pack, Pressure, and Pray is my preferred hemostatic.


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## TLDR20 (Sep 18, 2012)

JAB said:


> I had to look up the celox applicator and the OLAES bandage, good shit.
> 
> What's the thoughts on the Hemcon pads? Are they worth the money?



Hemcon pads suck! You need to hold sirect pressure for 5 mins, making it difficult to really hold pressure. Best bet is either Chito Gauze( like combat gauze) or combat gauze in conjunction with kerlix and ace wrap.


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## amlove21 (Sep 18, 2012)

I used to swear by the Celox applicator, but I have since moved away from it to the Chito gauze (radio opaque) and the OLAES. I can not say enough about the OLAES- best piece of kit out in the last couple years. Small, light, multi use, actually useful- there is definitely a place for kerlix and ace wrap, but if you have the money to spend, OLAES is the ferrari.

And x2 on the HEMCON patches. Those things lick balls (and not in the good way).


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## Diamondback 2/2 (Sep 18, 2012)

Thanks guys, great info as always... just made an order of 4 each (4" & 6") OLAES from TacMed. Where can I get chito gauze?


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## TLDR20 (Sep 18, 2012)

The Olaes bandage is just ace wrap, with an eye cup and Velcro throughout, save your money and get kerlix ace-wrap and some good instruction on how to use them, then transition to combat gauze in conjunction with kerlix an ace wrap. Then i would move onto more advanced stuff. Before any of that should come tourniquet application.


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## Diamondback 2/2 (Sep 18, 2012)

That’s a pretty good point and something worth discussing IMO.

How should  you properly pack a wound, and at what point do you apply a hemostatic product?

For deep open wounds with hemorrhaging I was taught (CLS & Adv CLS, I’m not a medic) to immediately apply pressure to the wound with a kerlix roll, apply a tourniquet if the wound is on a limb, pull the kerlix back and try to identify the source of the bleed. If able to ID the bleed, apply quick clot or hemcon, and then use kerlix to pack towards the bleed, filling the entire wound cavity. After filling the wound cavity, apply a pressure bandage over the packed wound, or use an ace wrap.

I am guessing that this is dated info, being that the hemcon pads & quick clot granules are no longer issued in the IFAK or CLS kits (at least that’s what I was told a few weeks ago). Is there a different or better way of dealing with this type of wound? How would you (Medics) deal with a deep open wound that is hemorrhaging (let say it’s a leg or arm)?


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## TLDR20 (Sep 18, 2012)

There are non tourniquet able hemorrhages that are what most of your hemostatics are for. Upper arm upper leg stuff. Anything outside of that, for on the X bleeds a tourniquet is what you want, followed by a bandage over the wound site in later parts of evac. I as a medic am going to TQ, direct or maintain a stop-gap while checking Airway and breathing, occluding chest wounds, then applying a pressure dressing to a non TQable bleed and possibly directing BLS and C-spine. That is pretty much the standard I think as far as a initial assessment of bleeding would go for me.


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## policemedic (Sep 18, 2012)

policemedic said:


> Short answer- I like Combat Gauze and OLAES; more later.





surgicalcric said:


> Pack, Pressure, and Pray is my preferred hemostatic.





x SF med said:


> The old school medic in me says stock up on kerlix, ab pads, plain 4x4/6x6, regular roll gauze and a couple or 4 tourniquets first... then go with the Celox set for next level........... I do like the older Israeli bandages too.
> 
> Sealed packages of non impregnated bandages are generally good for 3 years or more past the dates as long as they havent gotten wet or exposed to extreme temps/sunlight... the impregnated ones, well they'll be good for a while after expiry but will not be as effective as the fresher ones.
> 
> ETA... H bandages are good too.


 
And this is why I tagged this for later.

The trick--if it's a trick at all--to managing wounds is to have good solid basic skills.  Fancy tech like Combat Gauze and space age bandages are great adjuncts, but only serve to increase the efficiency of properly executed bleeding control techniques-they don't substitute for them.

With that said, if I'm packing I use Combat Gauze first to get the hemostatic agent directly onto the bleeder(s), then use non-hemostatic gauze to fill the rest of the cavity/create additional pressure, etc.


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## Diamondback 2/2 (Sep 18, 2012)

Hey guys I really appreciate the info and I agree 110% on training and learning the proper way vs relying on new tech, etc. I am not a medic, not an expert, I’ve only packed 1 wound and I am sure it was piss poor job compared to any of you medics… The main reason I posted this thread was to get some info on what is the best stuff to buy for hemostatic, so that I can update my med supplies (mainly my range first-aid bag for classes I put on) and find out what is working the best.

Based on the info here I’ve ordered OLAES bandages, two of the celox applicator and two Z packed Combat Gauze. I have more than enough kerlix gauze and other assorted gauze. I will order some Chito Gauze in a few weeks (just to have/try out on a deer this season or something).

I really appreciate the info…

One last question on the training end, would taking the TC3 course be something worth doing? I’m enrolled to take the EMT-B course Jan/Feb, and then start the EMT-P course next summer. However, there is a group down here that puts on the TC3 course, would it be worth taking before the EMT-B?


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## policemedic (Sep 19, 2012)

Cypress Creek?


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## TLDR20 (Sep 19, 2012)

Shit you come to NC I will give you a tc3 class.


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## Muppet (Sep 19, 2012)

cback0220 said:


> Shit you come to NC I will give you a tc3 class.


 
Hell, can you get me TC-3 instructor cert.?

F.M.


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## Diamondback 2/2 (Sep 19, 2012)

Cback PM sent.


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## Diamondback 2/2 (Sep 19, 2012)

policemedic said:


> Cypress Creek?


 
Strategic Skills Training Institute is the group I was talking about the TC3 course.

The EMT-B & P courses are at a local college.


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## Etype (Sep 20, 2012)

cback0220 said:


> The Olaes bandage is just ace wrap, with an eye cup and Velcro throughout, save your money and get kerlix ace-wrap and some good instruction on how to use them, then transition to combat gauze in conjunction with kerlix an ace wrap. Then i would move onto more advanced stuff. Before any of that should come tourniquet application.


The olaes has a lot of gauze in it, and the eye cup can be used as a pressure cup.


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## TLDR20 (Sep 20, 2012)

Etype said:


> The olaes has a lot of gauze in it, and the eye cup can be used as a pressure cup.



IMHO the gauze in an Olaes is not enough to get a good pressure ball let alone enough to pack a wound.


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## Etype (Sep 20, 2012)

I'm a big fan of the H&H compressed gauze, it's a lot in a small package.  The olaes is a bit big for a non-medic.


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## AWP (Sep 20, 2012)

Great thread, even for the non-medics among us.


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## policemedic (Sep 20, 2012)

cback0220 said:


> IMHO the gauze in an Olaes is not enough to get a good pressure ball let alone enough to pack a wound.


 
Agreed.  But it still has come in handy for me.


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## Diamondback 2/2 (Sep 20, 2012)

Etype said:


> I'm a big fan of the H&H compressed gauze, it's a lot in a small package. The olaes is a bit big for a non-medic.


 
I keep 4 H&H's in my IFAK. I think they are great for BOK/IFAK...


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## Etype (Sep 21, 2012)

JAB said:


> I keep 4 H&H's in my IFAK. I think they are great for BOK/IFAK...


My med pouch is the size of an M4 mag pouch.  It has an H&H, an ace bandage, an NPA, fentanyl lolli, and two tourniquets banded to the outside.  If that doesn't fix it, then I need the medic's help.


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## Diamondback 2/2 (Sep 21, 2012)

Etype said:


> My med pouch is the size of an M4 mag pouch. It has an H&H, an ace bandage, an NPA, fentanyl lolli, and two tourniquets banded to the outside. If that doesn't fix it, then I need the medic's help.


 
I use an issue IFAK, I just pack mine different. 4 H&H, NPA, Decompression needle, Halo chest seal, 2” ace wrap, Israel Bandage, a roll of athletic tape, Hemcon pad and a casualty care card, with my personal info filled out. I keep EMT shears and a SOFTT rubber banded to my armor.

I also have a HSGI bleeder/blowout pouch that I keep on my Molle belt (I wear it for teaching classes), 1 H&H, 1 Israel bandage, 1 NPA, 1 CAT tourniquet, roll of athletic tape and EMT Shears.

My Aid bag is like a CLS kit but better stocked and is primarily for range use, as well as my truck aid kit. I also have a Storm box at the house that I stocked with a bunch of first aid stuff.

Only having 1 medic per plt in the Infantry, your more likly to be worked on by a buddy/CLS and most of the CLS kits are pretty small. I like having my IFAK well stocked, that way I don't have to wait on someone to go grab a CLS bag.


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## kaja (Sep 23, 2012)

policemedic said:


> Agreed. But it still has come in handy for me.


Yup, quite handy indeed. You can use it as Emergency bandage or when you don't need to control haemorrhage the gauze is handy for smaller wounds/ stuff. Also I'm not sure that Emergency bandages have these small strips of velcro which prevents having wrap everywhere in case it falls off your hands.
Only flaw may be vacuum packing, which in my personal experience fails sooner than EB...

BTW: They finally make the FLAT PACKED OLAES-  it works for those flat-type IFAKs.


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## Texas_Medic (Sep 29, 2012)

policemedic said:


> Cypress Creek?


HAHA, it's funny to see someone else mention Cypress Creek.  I did some ride time with them. 

JAB, is that TC3 course in San Antonio?


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## Diamondback 2/2 (Sep 29, 2012)

Texas_Medic said:


> HAHA, it's funny to see someone else mention Cypress Creek. I did some ride time with them.
> 
> JAB, is that TC3 course in San Antonio?


 
As far as I know, I have not contacted them as of yet. I found out about these guys through a friend, kind of second word of mouth stuff. I've decided to hold off on the TC3 course until I finish EMT-B, but I can get you a POC if you want?


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## Texas_Medic (Sep 29, 2012)

Hate to say it but EMT-B is going to disappoint you very badly. Paramedic will be a little more fun but it is more medical than it is trauma.  I did some google-fu on that company, I'm in the market for a better paying job.  Good luck with your courses. If you need any help just ask.


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## Muppet (Sep 29, 2012)

JAB: Once you finish EMT-B, take a PHTLS (Prehospital Trauma Life Suport) lass. Its ok for trauma stuff, depends on who teaches it if they delve into pentretrating trauma alot or mostly blunt trauma. I am an instructor in that and we taught both.

F.M.


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