Why Not Use Quik-Clot

[jomill2000]

Gentleman,

I work for HemCon Medical Technologies and I wanted to take a moment to clear a couple of things up. As for the shellfish allergy issue, there really is not one. It is true that the active ingredient, chitosan, is derived from shrimp shells, but the iodine and shrimp proteins have been removed. In over 2 million deployments of the bandage, there has never been a reported case of shellfish allergy. The original bandage was a wafer style, but you might want to check out the Chitogauze product. It is a gauze substrate with chitosan baked onto it.

If I can answer any future questions, please let me know. You can reach me at joe.hemcon@gmail.com.

Warmest Regards,

Joe

[sosborne25]

Hello, I'm also a combat medic, Army Reserve, just back from a deployment. Many of you have hit the nail on the head. Other than the occasional remaining supply, Quik-Clot power is no longer being used. The reasons have already been mentioned. Is does heat up to approx. 180 degrees causing secondary burn injury. It CAN cause a thrombosis (you are after all placing a clotting agent directly into on open vessel). In windy conditions (constant in theatre) it can blow into the eyes causing eye injury. It has been replaced by a Quik-Clot brand gauze in most medic's bags called Combat Gauze. Its basically a roll of kerlix treated with a clotting agent called Koalin. It worked very well every time I've used it. Look it up. Some medics do like and prefer the HemCon, I liked the Combat Gauze. Combat Gauze used with an Emergency Trauma Dressing will even eliminate the need of a tourniquet in many cases.

Cheers

[ffscm72]

I asked about quikclot when I first started and my Med. Director told me the stuff works great at stopping bleeding, but the reason we don't use it is that it's darn near impossible to remove the quikclot without pulling the clot underneath it with it. Which restarts the bleeding and places the patient back into a critical situation. Only this time the patient is in an ED, or if they are lucky an OR/Trauma lab. He told me that they have eliminated the thermal burns with the current generation.

We've just been allowed recently. Heard the same thing. As part of our protocol it is a last resort. Even after tourniquets.

DE BLS protocol (& i beleive ALS as well<--don't hold me to this though, I'm tryin to stir the hornets nest saying I know all about ALS just because I'm BLS...lord knows)

direct pressure
elevate
tourniquet
hemostatic agent

[RyanEMVFD]

We carried it on our ambulances for two years and no one ever used it, which is strange for the type of calls our system runs. It got pulled after the stuff expired. We were only doing a study on it but like I said it never got used.

I only had one call where it could have been used and that happened about two weeks before we got the stuff.

[ffscm72]

We carried it on our ambulances for two years and no one ever used it, which is strange for the type of calls our system runs. It got pulled after the stuff expired. We were only doing a study on it but like I said it never got used.

I only had one call where it could have been used and that happened about two weeks before we got the stuff.

I've only used it once. Lady somehow pulled her shunt out of her arm bled everywhere. Couldn't get the bleeding to stop w/ a tourniquet. oddly enough that monkey mess worked & well. I wouldn't have taken it off. Buy a box place one package in each unit maybe. Ya never know when you'll need it & wish you had it.

[Carichey]

Army medic and civilian EMTP chiming in:

I was in when we had both the powder crap, and now the new Combat Gauze stuff. I have used both, (live tissue labs, and in theater.) I strongly prefer the gauze. It worked like a champ.

The powder on the other hand didn't seem as effective, but my skill with it (or lack there-of) may have been a factor. It became a bit of a mess.

Trauma management strategy between military and civilian has always been very divided. For example the use of Tournaquets are almost first line in military, but on the civilian side TQs are considered a last ditch effort.




From my experience a TQ is the most effective care for life threatening extremity bleeding control, and regardless of the environment, it's almost always my first line choice. A properly applied TQ virtually ALWAYS works... unless the artery has withdrawn beyond the reach of the TQ (which is also very rare). I have yet to encounter an MD who disagrees with me.

As far as the use of chemical agents - from my experience, I have found them rarely indicated. They are for life threatening bleeding when you can't apply a TQ. How often do you REALLY see that? A gunshot wound to the abdomen? Think about it... Will Quick Clot fix that? No. The bleeding is from the organs within the peritoneum... Quick clot will NOT reach that. The only thing that will save that person is a surgeon. That goes for most penatrating wounds to the core or neck.

They are expensive, and with economics being what they are, I don't hold it against a fire department for not ordering them.

[Bizlibati]

The way I see it that military equipments are for extreme needs. Firefighters can find a more civilized solution to their injuries.

[fallujahff]

As far as the use of chemical agents - from my experience, I have found them rarely indicated. They are for life threatening bleeding when you can't apply a TQ. How often do you REALLY see that? A gunshot wound to the abdomen? Think about it... Will Quick Clot fix that? No.

+1 on that.

Quick Clot can only be used on extremities and is no where near as effective as a properly placed TQ on amputations (no matter how ragged). You are right though--there is a trick to it.

[UKSF]

+1 on that.

Quick Clot can only be used on extremities and is no where near as effective as a properly placed TQ on amputations (no matter how ragged). You are right though--there is a trick to it.

As a former Soldier (British Army, don't hate me!) I have some experience with Hemostatic agents. We started with HEMCON, which was an impregnated sponge that you pressed into the wound. Not fantastic, and the sponge was a bit bulky. We quickly moved onto Celox (Celex?) Gauze which was 100 times better. Pack the gauze directly into the bleed, nice and tight and bandage it all up.

TQ are great for stopping bleeding, I've had to use them, but you can't TQ a neck, armpit or groin. I have however used both Hemcon and Celox in these situations, with mostly successful outcomes.

And as for the burning, I think the newer products that use Chitosan don't have this problem.

[6Duron1]

I work for DOD and we can't use it. One of the stumbling blocks we've run into in Michigan was the reluctance of the manufacturers to actually say what's in their product. Products like Quik-Clot and the Rapid-Cool? burn gel are fantastic products. However, if your patient develops a reaction, the Docs need to know what they're potentially treating.

My brother is a retired Army Doc working in a civilain hospital now. I'll shoot him an e-mail and see what he thinks. Expect a reply in about 2 weeks.

didn't the army invent it?

[johnsb]

didn't the army invent it?

The only things the Army invented is the Cluster#uck and FUBAR. (Ask me how I know) Most of these kind of things are done by companies under government contract. The Army does do a lot field testing which shows how well things do in real world situations, but they don't actually do much with inventing. They usually express a need and find some entity to come up with a solution.