An Evidence Based Word on Recommended Hemostatics
Click Image to Open NAMRU Hemostatics Study .PDF (Right Click to Save As)
After posting the warning about foreign hemostatic agents of unknown quality (probably fraudulent) we received a comment (from someone associated with an Indian hemostatic manufacturer, curiously enough) asking what hemostatic agents we recommended. Although our quick reply of QuickClot and Celox gauze was accurate, a recent study, “Comparison of Novel Hemostatic Gauzes to QuickClot Combat Gauze in a Standardized Swine Model of Uncontrolled Hemorrhage” by the Naval Medical Research Unit San Antonio provides timely support for our recommended hemostatics.
Firstly, our primary recommendation for hemostatics for blow-out and the trauma modules of first-aid kits is that they be in gauze form. Hemostatic impregnated roller-gauze has several advantages, among them reducing both the space needed for vital equipment and the tasks that must be performed while rendering aid. It takes less room to pack a single hemostatic gauze roll, than separate hemostatic and roller-gauze required for wound-packing, and it takes less time to complete a proper application when the administration of hemostatic is integrated into the wound packing step. In terms of Self-Care in the Tactical Environment, this reduction of space and action is invaluable, making it easier for the individual to carry the high value tools in limited space, and reducing his or her task demands for performing effective self care. This means increased likelihood of both having the tools at hand, and of successfully performing self care despite injury deficits.
The question remains, as raised, what particular products do we recommend? Our answer has long begun with QuickClot. QuickClot has been the industry leader for as long as there has been an industry for tactical hemostatics, and for good reason. QuickClot Combat Gauze is the current standard of care for the Military, and many other users. However, there are other products on the market in roller gauze form that are often wondered about, namely Celox and Hemcon. Based on prior studies and field reports, we had expanded our recommendation to include Celox. The results of the Naval Medical Research Unit, San Antonio, study examined here support those recommendations, as well as displaying the effectiveness of HemCon gauze.
The NaMRU study compares four other FDA-approved hemostatic gauze products to Combat Gauze. The other gauzes compared were QuickClot Trauma Gauze XL, Celox Trauma Gauze, Celox Gauze, and HemCon ChitoGauze.
In short, the this brief study show the efficacy of FDA-approved hemostatic gauzes from QuickClot, Celox and Hemcon as similar. In some cases, original QC-Combat Gauze was outperformed. The individual purchasing their own hemostatics for personal use, should be able to buy any of these products with a high level of confidence. The most likely candidates among these are probably the QuickClot and Celox products, due to lower cost and higher availability versus the Hemcon product.
A further interesting, and perhaps vital, note from this study is the increased effectiveness of the larger gauzes. Both QuickClot XL and Celox Gauze provide more physical material than their counterparts, and both displayed more effective performance. Whether this is due to the increase in hemostatic agent, or increased tamponade provided by greater material volume is not established within the NaMRU study. Either way, this increased effectiveness is something to consider when selecting products for our own kits. Although the larger rolls will take up somewhat more space, and weigh more than twice what their smaller counterparts weigh, the increased performance may make that well worth it.
Take the time to read the study, it’s only 22-pages, and digest the information within.
(This post is based on professional medical research, but does not constitute professional medical advice. This interpretative analysis is not to be used in place of professional medical consult, and BFE Labs and its authors bear no responsibility for misuse of this information. Please consult a licensed physician before administering or preparing to administer any medical treatments.)