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BloodSTOP, BleedX, and TraumaDEX: Blood clotting agents for a FAK

Discussion in 'General EDC Discussion' started by noosphere, Jan 17, 2007.

  1. noosphere

    noosphere Empty Pockets

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    Just found another interesting thread on the equipped.org forum. Most of the thread is about BloodSTOP gauze, which does what the name says (see the thread for more discussion of this product).

    Someone in the thread also mentioned another product called TraumaDEX, which they described as being superior to QuikClot, because "it's not supposed to heat up as I understand Quikclot does". But there was no followup or details on the product in the thread. So I just searched around and found a couple of interesting articles on TraumaDEX:

    - A review of various clotting agents including TraumaDEX, QuickClot, and HemCon at military.com
    - A review of TraumaDEX at MergInet

    From the first article I learned that all three products are now used on the battlefield, and that HemCon is prohibitively expensive: "with a standard bandage running at $200 a piece".

    From the second article I learned that TraumaDEX is only available by prescription (which might be worth getting next time you go in for a physical), and that the company that maked TraumaDEX has a similar over the counter product called Bleed-X. This product comes in powder form which is applied to the wound to stop the bleeding. Some instructions on its use are available here.

    This is the cheapest source of Bleed-X that I've been able to find, at $6 for a 1.5 gram tube, where 0.5 grams is enough for "1 square inch wound coverage or a 4"x1/4" incision 1mm deep".

    If these products work as advertised they might make handy and possibly lifesaving additions to one's FAK. Has anyone tried any of them?

    ::noosphere::
     
  2. Jumpmaster

    Jumpmaster Banned

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    The QuikClot ACS (Advanced Clotting Sponge) is supposed to be better than other granulare clotting agents (including the original QuikClot) as the granules are contained, making irrigation easier once the victim gets to the hospital.

    JM-99
     
  3. GQGeek81

    GQGeek81 Loaded Pockets

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    I saw these in Pop Sci a few years ago and at the time wanted one for my backpacking/canoeing first aid kit but cost and availability were an issue. These other options sound interesting.
     
  4. noosphere

    noosphere Empty Pockets

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    How about the issue of QuickClot heating up to unpleasant or dangerous levels when used? Have you tried it?

    ::noosphere::
     
  5. Jumpmaster

    Jumpmaster Banned

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    I haven't had to use it yet, thank God, but did read it may heat up under certain circumstances. The reviews I read on the original QuikClot didn't seem to indicate it was a problem and only happened when using excessive amounts of it.

    It appears that their new formulation reduces the problem further:


    Here's another article...

    Maybe the others are better if they truly do not heat up in use...but even if they do, I think given the choice of uncontrollable, arterial bleeding or a little heat, I would choose heat.

    Let me add that I carry QuikClot (among other things) in my own FAK for a field medic to use on me, if necessary.

    JM-99









    edit: Shortened links. Please have a look here on how to do this yourself: How to shorten a link to just a word or phrase. :gz:
     
  6. noosphere

    noosphere Empty Pockets

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    Yes, the new QuickClot products do sound like they've improved, if they really do decrease the amount of heat given off to safe levels. Do you know if these new QuickClot products are available for over the counter purchase?

    One thing I noticed about the new QuickClot products is that they're all sponges, not powders as the original QuickClot was. I imagine the sponges could have some of the same disadvantages compared to powders that the New Scientist article you link to mentions when it compared the HemCon bandage to the original QuickClot powder: "HemCon has its own problems: because it comes in a bandage, it is difficult to apply to deep or oddly shaped wounds... Being a powder, [the original] QuikClot can be poured into any shape of wound." Since TraumaDEX and Bleed-X are powders they might still have a leg up on the new QuickClot products in this respect.

    According to the original equipped.org post TraumaDEX doesn't have the problems with heat that the original QuickClot does. According to this, Bleed-X is "pain free upon application - no stinging or burning". And, according to the military.com article I linked to earlier, the original QuickClot "is the 'hottest' of the products".

    (Update: According to this, TraumaDEX has "no exothermic reaction" (it does not heat up during use), but "in case studies, TraumaDEX does not perform as well [as the original QuickClot] in cases of severe arterial and venous bleeding.")

    I agree, but it sounds like you don't have to make that choice if you use TraumaDEX or Bleed-X. But I haven't tried any of the products myself. It's a pity that these kinds of products are so difficult to "try before you buy". :)

    ::noosphere::
     
  7. outdoorsman1911

    outdoorsman1911 Loaded Pockets

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    Red cayanne pepper.

    cheap,burns like hell.
     
  8. Jumpmaster

    Jumpmaster Banned

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    Really...do you have any articles where it says that will stop arterial bleeding?

    JM-99
     
  9. rik

    rik Loaded Pockets

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    An obvious question is where do we get hold of this stuff? Another good one is where do we get hold of it on the other side of the Atlantic?
     
  10. webley445

    webley445 Loaded Pockets

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    I've seeb Quikclot for sale from Galls (public safety supplier).
    Also have kits with Quikclot.
    Galls
     
  11. noosphere

    noosphere Empty Pockets

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    BloodSTOP gauze
    Bleed-X

    You need a prescription for TraumaDEX, and I imagine one for HemCon (if it's even available outside the military).

    I also remember seeing some kind of "blood stopping" bandages in my local pharmacy... but I don't remember what kind they were. So something like this should be pretty commonly available.

    That's a good question. I haven't been able to find anything by these names available overseas. But sometimes products are rebranded when sold abroad. So they may be available, just under a different name.

    ::noosphere::
     
  12. billym

    billym Empty Pockets

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    I spoke with an ER DR and they said in 20+ years in an ER only once did direct pressure fail to stop even the most severe bleeding.
    Hemostatic applications are really meant for military and LEO applications. Other than a major injury like from a chain saw (the only time I even considered carrying QC) you don't need it. One should first learn the basics before using the magic bullet.
    Quick clot changed to the sponges because medics in Iraq were complaining about it blowing around when medivac choppers were landing near them. It would burn their eyes.
    If you want a more user friendly product try Celox from Sam Medical. Works like Quick Clot without heat and is easier to remove in the hospital. If you leave QC on too long you need to cut it off the wound.
    It is a lot like sutures; they don't belong in the average FAK carried by untrained individuals.
     
  13. noosphere

    noosphere Empty Pockets

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    A trained professional will know where and how to apply pressure to stop bleeding. A typical hiker out in the woods may not.

    I'm all for learning the basics, but it would be nice to have some magic bullets with me, just in case. :)

    Yes, I've read about the problem of the original QuickClot blowing around when deployed in windy conditions. I think this is because the original QuickClot is powder packaged in a bag. When you tear open a bag of powder to pour over a wound you probably don't have as much control of where it lands as the wind does.

    TraumaDEX and Bleed-X are also powders, but according to the review and their brochures, they've tried to get around this problem by packaging the powder in a bellows-shaped container with a nozzle that allows the powder to be injected directly in to the wound, so it doesn't blow around by the wind or is otherwise wasted.

    [​IMG]

    I haven't tested it (in any conditions, much less windy ones), so I don't know how well it actually works.

    Ah, cool. I've never heard of Celox. Definitely going to have to check that out.

    (Update: From what I can see, it doesn't look like Sam Medical sells Celox to consumers. If someone finds that it does, or if there's another source of Celox that does, please post a link on this thread.)

    Didn't know that about QC either. Seems that that's another area where TraumaDEX and Bleed-X have an advantage over QC:

    According to this review of TraumaDEX, "the small size of the individual particles allows the body's own enzymes to rapidly break down the hemostat. According to laboratory findings, virtually all traces of the substance disappear within hours."

    And according to this, Bleed-X (the over the counter version of TraumaDEX) "dissolves naturally - no need to remove after use".

    ::noosphere::
     
  14. webley445

    webley445 Loaded Pockets

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    What are the shelf life of these products?

    My concern is if carried in a car FAK. How will the heat from being in the vehicle affect the product?.
     
  15. noosphere

    noosphere Empty Pockets

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    According to this, TraumaDEX has an "extended shelf life (3-5yrs)" and QuickClot has "extended shelf life (3 yrs)".

    I don't have specific information on the shelf life of Bleed-X, but since it's the OTC version of TraumaDEX based on "the same MPH technology" I expect its shelf life is pretty similar to TraumaDEX, but it might be worth contacting the manufacturer to make sure.

    According to this:

    "Does Bleed-X™ require any special storage conditions?

    Bleed-X™ is an extremely stable product and does not require any special storage conditions. Keep packet sealed until ready to use."

    And, according to this:

    Bleed-X is made of "stable base materials with extended shelf life", it should be stored at room temperature, and one should "maintain [it] in a dry environment prior to use".

    ::noosphere::
     
  16. noosphere

    noosphere Empty Pockets

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    I finally found some sources for Celox: ebay, Emergency Medical Products, and By Dezign.

    Unfortunately, according to this, Celox is made from shrimp shells. That makes it potentially deadly to apply to someone with the relatively common shellfish allergy. I'm not allergic to shellfish myself, but if I keep some in my kit, I might get in to a situation where I have to apply it to someone who is... so I think I'd rather stock a hemostat not made out of shellfish. That means HemCon is out too, by the way, even if I could afford paying $200 per bandage, since I also read that it's made out of shellfish as well.

    In researching all this I happened on to another hemostat called "QR Powder" (with "QR" supposedly standing for "Quick Relief"). It's hypoallergenic (made from pottasium salt and plastic), and has been tested and approved by the FDA for over the counter sale. Cabela's seems to be the cheapest online source. Safety Plus Products stocks it too. And I hear Wallmart is an even cheaper source of it than Cabela's.

    Here're another couple of articles on QR Powder: one, two And a video.

    I also ran in to some other interesting articles on hemostats:

    Advances in Hemostatic Bandages, which covers QuikClot, HemCon, TraumaDEX, QR Powder, and something called RDH (Rapid Deployment Hemostat) Bandage, which I haven't been able to track down a vendor of online.

    Carry This Or Die! The One Kit You Must Have To Survive A Trauma Injury! which has just a brief mention of the various hemostats, but lots of interesting recommendations for a FAK, like carrying safety pins "to secure a patient’s tongue to their lip or cheek to maintain it out of the airway and reduce airway blockage". Have to remember that... :)

    SWAT medics report their findings on high-tech hemostatic dressings used to stop bleeding when seconds count has an overview of a bunch of hemostats, and is pretty damning of the original QuikClot:

    On the bright side, I finally found an online supplier of the new QuikClot. But unfortunately, the product is too new for there to be many (any?) reports of its actual use in the field.

    ::noosphere::
     
  17. webley445

    webley445 Loaded Pockets

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    I found a sample pack of the QR at work. It is a packet made for nose bleeds. Has a swab that you are supposed to apply inside the nose then pinch.
     
  18. noosphere

    noosphere Empty Pockets

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    There are a bunch of QR products, one for nosebleeds, another for kids, another for minor lacerations, and a further one or two for major wounds. I don't know if that's just marketing or if they really differ in composition and effect.

    ::noosphere::
     
  19. SERT

    SERT Empty Pockets

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    Hmmm...I'm seeing a lot of the usual rumors surface on this one. I have used QC, Hemcon and QC ACS in the field on Massive Hemorrage wounds. I am a contract consultant to a large tactical medicine training company. I'd like to preface this post by saying that I'm not trying to ruffle any feathers here, I'm a new guy and I happen to have relevant information. I cannot stress enough that without the proper instruction, none of these hemostatic agents will work! You could possibly do more damage than good...that said, here's my 2c...

    QC granular powder; Probably the best of the bunch. When applied properly, it can stop a major pumper like a severed femoral artery (I've done it myself). It will burn your patient and, if you're not careful, you too! The only reason for losing a limb with QC is inadequate follow up at the hard site medical facility (or if the limb was too damaged in the initial trauma). This guy (see below) was obviously untrained in the use of the product;

    "Lt. Bruce Webb, Battalion Surgeon, 2nd Tank Battalion attached to the 1st Marine Expeditionary Force, saw action in central Iraq from March 20 to May 30, 2003 and reported to us his first-hand battlefield experience with QuikClot. In one instance, the product dried the wound but then flaked off so much that gauze was used more effectively. In another case, blood gushed out of a female patient’s wound so profusely that the product was always flushed out of the wound. The victim died. In Webb’s experience, QuikClot is not very effective on the battlefield. “It doesn’t stop bleeding as advertised in the real world,” he says. “We are better off focusing on the established techniques of pressure, packing, and dressing.”

    Webb also found that 25 percent of the packets he received had leaked and absorbed water so they were unusable. What he found most worrisome, however, was the potential for burns resulting from use of the product. “Exothermic reactions can cause second-degree burns on surrounding tissue. It is impossible to dry the wound enough to prevent burning. If you can dry the wound that well, you don’t need QuikClot.”

    QC is designed to be used after applying pressure, removing pooling blood and being applied directly to the severed artery. Follow it up with direct pressure until the clot forms, a pressure bandage over the wound site and voila! You're good for transport.

    QC ACS; Nice in theory. Works on high volume upper level bleeds (shallow). The problem is getting the sponge to conform to the wound site. Also, the name "sponge" is a misnomer. The ACS is nothing more than a mesh bag containing spheres of QC. trimming the ACS will just result in spilling thousands of tiny spheres all over the place (I suppose you could use it like granular QC in this case, but I wouldn't suggest it).

    Hemcon; I have yet to see it work on a major pumper. That doesn't mean that it won't, I just don't have confidence in it. The shape of the product doesn't lend itself well to application.

    Traumadex, Celox and the rest I don't have practical knowledge of these, so I will withold comment.

    Overall; If you don't have the training or can't get it, don't carry this stuff! Using a hemostatic agent on an accident victim could land you in a LOT of hot water, even if you do save a life. I carry QC to use on myself, my buddies and any Soldier/Marine that I see in a world of hurt. Everybody else gets a lot of gauze, direct pressure and my sincerest wishes for a speedy recovery.

    I hope this helps,
    SERT out...
     
  20. ppfd

    ppfd Loaded Pockets

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    Hey fellas,
    let me chime in as a 17 year Paramedic. First, these items are not in many EMS protocols. Why I don't know. I also cannot answer technical questions on any of these devices. I do have to say that direct pressure and elevation of the effected limb will stop the majority of bleeding cases. I just finished a trauma life support class for my certification renewal and the text spoke about tourniquets making a comeback? Again no advice here and each of us "has to do what we have to do."

    I will say that if you use quick clot, trauma Dex or any of these products. Have the empty package with you or the subject you used it on available. In other words Do not throw away the empty package!! We need the instrcutions on removal of the substance. More for the ED than EMS.

    And I don't think anyone would any of you for using it to save your life of some one close to you. I don't think I'd use it on a perfect stranger myself. (too many lawsuits possibilities)