Hemostatic agents.

Haemostatic Agents

Hey Guys

I don't see any mention of CELOX here, I have used both Celox and Quikclot on arterial bleeds and find that the T-bag application of the Quikclot needs to be very near the bleed where as application of the CELOX is a 'cover-all' application and it stops major bleeds!

Medic 1
 
Right now the two leading hemostatics are the combat gauze and woundstat...all the rest are being phased out.

As for TQ's that CAT is light weight and effective...when it doesn't break. Personally I like the old Ranger Ratchet it's a bit cumbersome and yeah there is a bit of tissue damage, but it WORKS! Plus it holds a special place in my aid bag since we came up with and deployed with them back in '01
 
Guys, just wanted to let you know that I'm really enjoying reading this thread. Since all of my experience is on the "in house" side of the ER doors, its nice to learn more about what goes on out in the field. Besides, now I know who to ask when I have Q's about the typical sequence of events from evac chopper to surgery "in theater"
 
Doc. P.: Thanks.
Hooiser: I am glad I got the replys that I did. It always helps to get the info. from the" horses mouth" / from the heros that are using the stuff. I did not have all this good stuff when I was in with the 82nd. / mid 90's. Thanks to all who gave the info and thanks for what you are doing.

Firemedic.
 
hey guys i made some calls and did a little more research hope this info help.

1. I called a friend who is a medic for the ATF Special Respond Team. He does not carry any hemostatic's. his take is that state-side he is so close to surgical intervention that hemostatic agent will make the surgeons job more difficult and really do very little good.(A friend of mine had his SEAL career ended by an over zealous 91W that poured quickclot on a GSW that the hemorrhage was already controlled. He ended up loosing a great deal of muscle tissue from the debridment of the embedded quickclot.
2. The official haemostatic for naval special warfare is combat gauze and wound stat.

TQ.
1. I carry CAT midline under my mag pouches, SOF-T blow out (IFAK) kit. Two CAT and one SOF-T in my med bag. The two CATs I keep to help with moving TQs and converting in secondary care. I carry the extra SOF-T just in case my day really goes south.
2. If I had my choice for a state-side TQ I would look at the cool inflatable brands on the market that can be titrated to the exact mmHG I need.

Firemedic- teabag refers tot the packaging of the quickclot. Before it came loose in a pour and hope version, now it is contained it a permeable cloth that look just like teabag. This teabag makes it more easily packed in to a wound.

Medic1- dude I liked celox also, but you have got to try the woundstat I think you will like it
 
Sunny: Thanks fot the info. Of course my mind went dirty regarding tea bag. Your ATF friend makes a good point and I will pass that along. In the big picture, just because "we" are issued the toys does not mean that it is right to use or good for our patients. Thanks for painting that picture. I did see the new packaging regarding quick clot and I don't know how effective that would be with the tea bag.

Firemedic.
 
Firemedic said:
(1): Tea Bag! Am I missing something?
Click to expand...

You guys are the pros, but I worked for my dentist uncle as an assistant, while in college. After doing a particularly difficult extraction, my uncle would recommend that after an hour or so, if the socket was still bleeding, the patient get a tea bag, and bite down gently.

There is some sort of natural coagulant tea. (He also recommended a large shot of bourbon held in place over the socket for at least 30 seconds - if there was pain...}:-))

I used it (tea bag) after they used a chisel to break one of my wisdom teeth for extraction. Stopped the bleeding pretty quickly.
 
Car: I have heard of that also. I was referring to the other tea bag. When I was in, I knew some knuckleheads that were talking about the tea bag when they got drunk on a saturday night @ the 2/325. That is why I did not dring alot when I was in.

Firemedic.
 
Firemedic said:
Car: I have heard of that also. I was referring to the other tea bag. When I was in, I knew some knuckleheads that were talking about the tea bag when they got drunk on a saturday night @ the 2/325. That is why I did not dring alot when I was in.

Firemedic.
Click to expand...


RGR! :p
 
tea bag

Sorry guys, should have made my self clear.........the tea-bag I meant was the Quick-Clot bag [looks like a tea bag], and yes the tissue disruption with the heating effect of the Q-C is not a nice effect. The CELOX, when presented in the OR/ Trauma Room just removes from the wound with no detrimental tissue effect, just like pulling out a sponge.

Medic 1
 
I concur with whats been said about WoundStat. I still have a few QC packets laying around but same them for injecting into wound tracks (using a 60cc syringe). Other than that its QC sponge and Woundstat for my guys (both are easy to use and Bravo proof for the most part).

Celox isnt bad but I found the WS to be more user friendly...

Firemedic, I worked in upstate SC for 14 years as a firefighter/paramedic... Now I am a NGSF bum.

RGR= Roger/got it/good-to-go/okay

Crip
 
Crip, I have yet to use the woundstat, but had several instructors at BCT3 say they couldn't get it to work on the goats. what say you? I think our unit will wind up going with combat gauze and celox or woundstat. as for TQs, I like the CAT for it's weight and ease-of-use, I don't like that it's only good for 70-80% of people. anyone tried the NATO Tourniquet? it's basically a strap, 2 rings, and an aluminum securing device. seems to work pretty well, haven't tried that one on a human yet, though, except in practice. the MAT is shit. don't bother. the Ratchet TQ works, even if it is like using a sledgehammer to kill a fly.
 
HeloMedic1171 said:
Crip, I have yet to use the woundstat, but had several instructors at BCT3 say they couldn't get it to work on the goats. what say you? I think our unit will wind up going with combat gauze and celox or woundstat. as for TQs, I like the CAT for it's weight and ease-of-use, I don't like that it's only good for 70-80% of people. anyone tried the NATO Tourniquet? it's basically a strap, 2 rings, and an aluminum securing device. seems to work pretty well, haven't tried that one on a human yet, though, except in practice. the MAT is shit. don't bother. the Ratchet TQ works, even if it is like using a sledgehammer to kill a fly.
Click to expand...

I have used WS on several patient role models and its worked well on each occasion, ORMV though. I like the stuff personally. I have a wide assortment of HCA's lying around and use different ones on different wounds every chance I get and since I get to do LTT nearly monthly I get alot of practice.

As for TQ's, every guy on my ODA carries two, one centerline and the other in his BOK. One is a SOFT-T and the other a CAT. Most of the guys have the CAT centerline save a couple of the larger guys who have two SOFT-T. Everyone practices with both, with both hands with their eyes closed... Practice saves lives.

The MAT is crap!

I carry a couple ratchet TQ's for those pesky hard to control femoral bleeders. Not sure I would call them overkill but they do take up some place in the aidbag...

I have seen the NATO TQ but havent felt the need to seek one to test. I may very well do that this SFAUC class and will let you guys know what I think afterwards.

my .02
 
Can't wait to hear your take. I didn't get a chance to use woundstat or the NATO TQ in BCT3, but i did use everything else. it's good to hear input from others who get better practice than I do. :)
 
well, im not saying anything new here at all, but i roll with 2 CATs on my LBE (below mag pouch and IFAK, and 2 more in the ruck. If i have problems with the CAT (which i havent, which means i simply need to see more patients) I improvise from their clothing.

As for the hemo's, i have used celox (eh) and quickclot AND quickclot AST (double eh) and the HEMCON dressing (not too shabby better than the other two) but have to give the ole FNG stamp of approval to the CG. Its the shit, you can pack the hell out of it, and it actually works pretty good superficially if you do it right.

My 1:2c:
 

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