Question: I have both the old and the new sport quick-clot paks. I have read the old system causes burns and the newer type is safer. I also have the combat gause roll [I presume the QuickClot combat gauze–Grouch] that is to be packed into a wound. Can you give a quick-post on the correct application of those products for us?
There is indeed a difference between “old” (before 2009) and “new” (current) QuickClot.
The old stuff was a powder, which was poured into the wound, and set up an exothermic reaction that could cause burns, etc; it also hardened, making it both more effective, and harder to deal with once you arrived at the hospital.
The new stuff uses a different formulation, and is attached to gauze, making application and removal easier.
The company cites clinical studies here.
Some love, some hate, some have had the company come back to try and correct them.
Please see the accompanying video; it looks like it works. And can work well. Warning: lots of blood, and a real animal is cut to test the product:
Training video on how to use the new gauze:
I would only add that you should not view QuickClot as magic, despite the title of this blog. Rely first on pressure, then tourniquet, then QuickClot as backup.
Second that Doc. Anyone who has the old Quick Clot (powder). Throw it in the trash and burn it. DOD gave the last they had to the Afghan Army. The stuff worked but it did indeed cause burns to the wound being treated and the operators hands that used it. We had to double glove and have a cloth barrier between hands and wound to prevent this when used in the field. The second problems were that it was a bitch to clean out of a wound when the surgeons finally received the patient and small particles of it were found in distal places in the vascular system and it is suspected may have caused a few thrombotic events.
As Doc Grouch says, use direct pressure and lots of it for an arterial bleed. If you have a large artery that is gushing and can get a hemostatic agent into it, great. Then pack the wound with gauze or anything that is compressible, hadji’s headscarf if thats all you have. Just be sure to follow it with at least five minutes of pressure while someone is getting a tourniquet ready to use next. If you do a good job with the pressure dressing and immobolize the limb you may not need the tourniquet but it will be nice to have it in place should you need it.
I have seen it with my own eyes, TCCC works and saves lives.
Thanks. I’ll go thru and toss that old stuff out. It was re-issued to me via a friend who commandeered it from the trunk of a .gov cruiser years back. Gonna keep the I dressing and molle pack though. You just saved me or some unlucky soul some misery.
Doc and SF medic,what if all you had was old quick clot,would you still toss or say a man made/natural disaster of long term nature would you save as a last resort or is it even then more damaging then worth keeping.I have none but am wondering about folks tossing it,perhaps keep as a final option or not?
James, if it were me, I would NOT use it. What I try to show students is that you can do just about as well with just packing the wound with gauze and holding hard direct pressure. As Doc mentioned, quick clot is not a magic bullet, it is simply an “aid” to increase clotting. Do you remember Black Hawk Down ? The medic spent a long time fishing around the soldier’s femur for an artery that had retracted (they do that when severed) so he could clamp it. What he needed to do was pack the wound with whatever he could find and put some pressure on it. That particular battle is what launched the investigation into why our modern combat medicine was not working. The science behind TCCC is now ongoing with the best medical and military minds at work full time. Throw out your old powder quick clot. Get some new impregnated gauze or just aggressively pack the wound and hold pressure. Once bleeding stops, usually with in 5 minutes, reinforce the dressing with tight ace wrap or an Isreali bandage. Have a tourniquet ready in case it restarts. Immobilize the extremity.
Dave is spot on. If I can add, if you don’t have hemostatic gauze, pack that extremity wound tight with Kerlix or Kling gauze and put massive amounts of pressure on it as well. The hemostatic agents help your body create a clot a lot faster than just the regular gauze, but if regular gauze is all you have, it’s still going to help.
Thanks Dave and Mike,had no old quick clot so for me not a issue and seems not worth saving.As I try to build up knowledge and supplies like many am on a tight budget and thus anything that can safely re used would try and save,seems not the case here.The quick tutorial on stopping bleeding appreciated,not looking to cut corners supply wise as perhaps lives literally at stake,just need to do it as economically as possible with a lot more knowledge the first thing my hunting/travel pack is in need of.
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Does the same go for Celox and similar Chitosan products?
Yes and No. Celox and similar products are not exothermic and do not have the heat generating properties Quick Clot powder did. Being made of shrimp shells they have an entirely different mechanism of action. Each hemostatic agent has its own benefits and drawbacks.
Any granular product has the potential to enter that circulatory system and create a thrombosis.
The trauma registry demonstrated an increased risk of deep vein thrombosis with the powdered quick clot.
As noted above it was often hard to use in the field. As of this writing I have 2 of the powder packets on the flatbed with all the trash going to the dump.
Current testing demonstrates the best results with combat gauze. The findings however are barely statistically significant compared to chitosan impregnated gauze.
In patients with coagulpathy, chitosan performed better.
I would use a gauze impregnated product and not a powder or wafer and certainly not cyan peppers.
combat gauze is what I carry because I get it for free. If I was buying it I would get chitosan gauze As my coagulpathic patients need it most.
Packed tight kerlex works. I packed 6 rolls with tails hanging out into a deep arterial bleed inguinal wound with good hemostasis.