EMS: Use of Quikclot for bleeding control

[NYMedic37 22]

Does anyone have any experience using hemostatic agents like "QuikClot" powder, dressings/bandages for moderate to severe bleeding in EMS? One of the two EMS agencies that I work for is going to stock our ambulances wih QuikClot dressings soon (after completing training). I know that it has been used in military applications and I would greatly appreciate comments from anyone who has used it.

Paul Aiello

EMT-Paramedic

[Guest]

I've heard good things about it from the military world. I think its actually a combination of minerals and compounds that does the job so well. I haven't used it personally, however i have expressed interest in it, but was told it would "create too much of a mess" for the ED. Either way, it seems pretty simple, open, dump on the wound and bingo. Best of luck with this new product, let us know how it works out!

[Guest partyrock]

I'm assuming you work in the tri-state area. Has your agency discusssed this with your local recieving hospitals? For the most part we're within 10 minutes of an ED around here so I've never thought there was much of a need for hemostatics. Just make sure The local trauma centers are ready to start seeing this stuff come in the door. You're probably going to be the only agency using it.

Just out of curiosity, what prompted you guys to go this route?

[Oswegowind 17]

I did some research on this when I was at Empress and then I got a new career before I ever tried to bring it in. This stuff is cool, is quick, easy, and does the job! A lot of the training EMT's and Medics receive were designed on the battle front and just modified. This is one that should be considered, especially for jobs were bleeding control is an immediate factor as to life and death. So sorry for the ED's out there (my wife is an ER NURSE) but it is too bad if the field personnel have an awesome tool and they don't like it! It is what is best for the patient not what is best for the rest!!!

[Guest]

Just did some quick research, and there is actually a new version of QuikClot out, its called ACS - Advanced Clotting Sponge.

From Z-Medica:

    *  Effective packing into high-pressure bleeding wounds.

    * Can be applied rapidly, saving precious seconds and further limiting blood loss.

    * Goes where it’s placed. Will not blow around in windy environments.

    * Works where it’s placed – directly on the bleeding tissue.

    * Can be applied to wound from any angle.

    * Fast, clean removal in post trauma.

    * Two 50 gram sponges, packed in a heavy-grade foil.

NYMedic37, any idea if thats what your using? It appears that this solves many of the "messy" characteristics of the original product.

[Guest partyrock]

Its not that its a mess for the poor ED staff. The problem is the time it takes to clean that crap out and the associated complications vs the blood lost without it. That stuff was designed for the long travel time from the battlefield to the hospital. There was another great product, mast pants that are amazing when used right. They were so infrequently used and when they were used, used wrong that NYC removed them from their protocols.

The sponges sound like a good substitute for the powder.

[Guest]

Its not that its a mess for the poor ED staff.  The problem is the time it takes to clean that crap out and the associated complications vs the blood lost without it.  That stuff was designed for the long travel time from the battlefield to the hospital.  There was another great product, mast pants that are amazing when used right.  They were so infrequently used and when they were used, used wrong that NYC removed them from their protocols.

The sponges sound like a good substitute for the powder.

←

When i say mess, i'm talking about the task of removing the material from the wound before treatment can begin.

[NYMedic37 22]

I work in New York City and in Westchester and the agency that I work for in Westchester is the one instituting QuikClot (the 3rd version - it is in a dressing/bandage form so it will not be a loose powder and should not present a problem for the area ER's/Trauma center). Our local ER medical director approved it's use for us and all of the area hospitals in Westchester are aware that we will be using QuikClot. I already attended the CME class on the use of hemostatic agents and after the class the instructor showed me a video of its actual use on a severed femoral artery (a typical pumper). Two quikClot's were used. The first was actually inserted into the wound and the second placed over the first. Then a regular pressure bandage was applied. The wound stopped bleeding almost immediately. I was very impressed. Althugh we may have a short transport time to a local ER or trauma center....should you get a call on the top floor of a high rise with moderate to severe bleeding you must take into account the "transport time" also includes getting the patient down to the ambulance.

Paul Aiello

EMT-Paramedic

* I'll keep you upated on our actual experiences (pros / cons) using QuikClot.

[paratrooper75 41]

We carried them in the army. They are great and simple to use but they are messy to clean out once at the hospital. They solved that problem with the sponge that was mentioned in the other post. Other things we carried that worked well were Israeli dressings, asherman chest seals, and ratchet tourniquets.

Israeli Dressing:

http://www.ps-med.com/bandage/description_fcp01.html

Asherman chest seal:

http://www.firstrespondersupplies.com/acs.htm

Ratchet tourniquet:

http://www.chinookmed.com/index.cfm/fa/pro..._Tourniquet.cfm

[Guest partyrock]

Sounds great paul. I'm looking foreward to the updates.