Quickclot used on trauma patient

[NYMedic37 22]

Recently, I had a patient that went thru a plate glass window with numerous cuts and one major laceration. The left arm, from the mid forearm up the elbow to the mid upper arm. Cut down to the bone. The wound was about 8 inches long and very deep with moderate blood loss. I used 1 large "quickclot" dressing with 3 rolls of kling wrap to start. To my surprise, the wound continued to bleed although I feel that the Quickclot slowed down the bleeding. I continued to use 4x4's, 5x9's and more kling wrap to control the bleeding. This was my first time using Quickclot and I feel that the dressing was too small for the wound. In the future, I would use 2 or 3 quickclots on a similar injury to cover the inside of the wound as well as the entire exterior of the wound. Has any one else had any good or bad experiences with quickclot?

Paul Aiello

EMT Paramedic

[Dondestro 9]

I have not used one but heard and done some research on them. I believe HemCon® Bandage is a little bit more popular but much more expensive which has the same concept just made by another company. my understanding is they only make 2x2 and 4x4 versions of both brands .

My question is being that when blood becomes in contact they become extremly sticky, how is the process of taking them off a wound?

I have also seen a prodect that you pore into a wound to slow the bleeding(not sure who makes it or if it is still used) but you would pore it into it and then wrap it up real tight.

[NYMedic37 22]

I watched the trauma doc remove the quickclot along with all of the 4x4, 5x9 & kling. He didn't have any problem removing it. The quickclot absorbed most of the water from the wound hence clotting with some residual bleeding ...... not perfect but helped slow down the bleeding. In the future, I would use 2 or 3 quickclots on this 8" long (very deep) laceration.

[TR54 239]

Did some training on QuikClot last week at the firehouse. The Dept is interested in this product.The US Military is very pleased with using it on our injured troops.

More information on the manufacter used by the US Marines & soon my FD.

http://www.z-medica.com/index.asp

[Goose 188]

TR54,

Just curious if you guys trained on the granulated product or the bandage product. Did you guys find/learn anything interesting about the product?

NYMedic,

Any word on how much heat the bandage generated? I had heard that heat was a byproduct of the application of this product....likewise, did the MD have anything to say about it?

[TR54 239]

TR54,

Just curious if you guys trained on the granulated product or the bandage product. Did you guys find/learn anything interesting about the product?

NYMedic,

Any word on how much heat the bandage generated? I had heard that heat was a byproduct of the application of this product....likewise, did the MD have anything to say about it?

Goose,

The bandage product only. The power Point training program was very informative. Fairview FD (Greenburgh) and Greenburgh Police SWAT medics should have the bandage in the trauma bags soon.

We discussed the reaction of the clot product and the burn risk. That is definetly a concern.

[Guest alsfirefighter]

Gents: I have done training, used and currently conduct training on the uses and actions of the 3 major hemostatic agents on the market. Being QuikClot, Celox and HemCon.

NY Medic, when you say the large QuikClot bandage, was it the 50 gram? They do make a 100 gram bandage which is very large. And you are correct, if you had another you could have used additional if necessary.

As far as the exothermic reaction. QuikClot's newer formula boasts it averages 105 degrees F. Much lower then previously which were reports of 130 degrees and higher. When I teach my presentation I wet a new bandage for students to hold. IMO it is cooler then the heat packs you can buy to put in your pocket. As far as adherance, it is generally a non factor and is easily removed with a little saline if need be.

As far as the powders, they work but are susceptible to wind. HemCon at one time had issues where each bandage has a varying degree of clotting ability.

Also they are not the same principle. QuikClot uses a mineral Zeolite to form strong hydrogen bonds which attracts and pulls the water out of the blood to concentrate the clotting factors. Celox and HemCon utilze a shrimp shell based material known as Chitosan. As far as popularity, QuickClot seems to be out there alot. Over 1000 law enforcement agencies and federal agencies utilize it. The Marine Corps has used it since 2003. The key to understand here is that it is not as simple as pouring or packing the wound with the agent and then wrapping it. Every manufacturer in their directions dictate that direct pressure is till needed for some time. As a tactical medic I use Israeli Trauma Bandages in conjuction with the the hemostat and a roll of kling that is kept rolled up. I also use this similar technique for civilians. Immediate direct pressure, if the laderation is arterial or heavy venous bleeding that is still active after a few minutes of BLS hemorrhage control, I will use a hemostat, (tactically I have all 3 at my disposal, street level I have celox) then the roll of kling on top of that, then wrapped with an Israeli Trauma Bandage. The kling adds a level of direct pressure loss without using a hand.

I have used personally QuikClot (old formula) and Celox. I like Celox but it only currently comes in powder form. The new forumla Quikclot I will have no issues using. The old formula did cause some thermal injuries to 2 patients I used it on. HemCon works wonders, I've seen it used but I haven't gotten to yet. The only thing I keep in mind is that it doesn't conform as well as the QuikClot bandage and you have to ensure you put the correct side to the wound.

Edited December 9, 2007 by alsfirefighter

[NYMedic37 22]

TR54,

Just curious if you guys trained on the granulated product or the bandage product. Did you guys find/learn anything interesting about the product?

NYMedic,

Any word on how much heat the bandage generated? I had heard that heat was a byproduct of the application of this product....likewise, did the MD have anything to say about it?

Hey Goose,

We used the Dressing / bandage type. Not the powder. The patient never complained of any burning sensations and when the trauma doc removed it there were no signs of any type of burns. All in all, I'd say that it was a good device to use but next time I would use 3 or 3 quickclots to cover the entire surface area of the wound (This patient's wound was about 8 inches long and cut thru to the bone).

[NYMedic37 22]

Gents: I have done training, used and currently conduct training on the uses and actions of the 3 major hemostatic agents on the market. Being QuikClot, Celox and HemCon.

NY Medic, when you say the large QuikClot bandage, was it the 50 gram? They do make a 100 gram bandage which is very large. And you are correct, if you had another you could have used additional if necessary.

As far as the exothermic reaction. QuikClot's newer formula boasts it averages 105 degrees F. Much lower then previously which were reports of 130 degrees and higher. When I teach my presentation I wet a new bandage for students to hold. IMO it is cooler then the heat packs you can buy to put in your pocket. As far as adherance, it is generally a non factor and is easily removed with a little saline if need be.

As far as the powders, they work but are susceptible to wind. HemCon at one time had issues where each bandage has a varying degree of clotting ability.

Also they are not the same principle. QuikClot uses a mineral Zeolite to form strong hydrogen bonds which attracts and pulls the water out of the blood to concentrate the clotting factors. Celox and HemCon utilze a shrimp shell based material known as Chitosan. As far as popularity, QuickClot seems to be out there alot. Over 1000 law enforcement agencies and federal agencies utilize it. The Marine Corps has used it since 2003. The key to understand here is that it is not as simple as pouring or packing the wound with the agent and then wrapping it. Every manufacturer in their directions dictate that direct pressure is till needed for some time. As a tactical medic I use Israeli Trauma Bandages in conjuction with the the hemostat and a roll of kling that is kept rolled up. I also use this similar technique for civilians. Immediate direct pressure, if the laderation is arterial or heavy venous bleeding that is still active after a few minutes of BLS hemorrhage control, I will use a hemostat, (tactically I have all 3 at my disposal, street level I have celox) then the roll of kling on top of that, then wrapped with an Israeli Trauma Bandage. The kling adds a level of direct pressure loss without using a hand.

I have used personally QuikClot (old formula) and Celox. I like Celox but it only currently comes in powder form. The new forumla Quikclot I will have no issues using. The old formula did cause some thermal injuries to 2 patients I used it on. HemCon works wonders, I've seen it used but I haven't gotten to yet. The only thing I keep in mind is that it doesn't conform as well as the QuikClot bandage and you have to ensure you put the correct side to the wound.

Hey ALSFF,

I used 1 100 G Quickclot on this patient. We carry the 25 and 100 G Quickclots on our trucks.

Paul

[Guest alsfirefighter]

Wow...that had to be some friggin Lac bro. Nice job either way.

If it was where I work he would have gotten a large packet of Celox dumped in it.

Also for those carrying the QC bandages, if the lac is large and you don't have a big enough bandage or you are out, always aim for the area with the most significant active bleeding.

[NYMedic37 22]

Wow...that had to be some friggin Lac bro. Nice job either way.

If it was where I work he would have gotten a large packet of Celox dumped in it.

Also for those carrying the QC bandages, if the lac is large and you don't have a big enough bandage or you are out, always aim for the area with the most significant active bleeding.

Thanks for the advice. We usually carry 3 QC (1 - 100 G and 2 - 25 G) in the bag so next time I think I'll use either 2 or 3 depending on the situation.

[WAS967 97]

Being shrimp shell based, what are the chances of a shellfish based Allergic Reaction to the hemostatic agents?

[ny10570 745]

It should be extremely low. The vast majority of shellfish allergies is a result of a protein in the muscle. Some have an allergic reaction to a protein contained in the shell but is much rarer and processing has been shown to denature the protein to a point where it no longer stimulates a reaction.

[Guest alsfirefighter]

QuikClot isn't chitosan based, it uses a mineral called Zeolite so for their product, none. Its the zeolite and adsorption of water that causes the exothermic reaction.

Celox and HemCon are chitosan based and list in their literature that there are no allergy concerns whatsoever and on their packaging are listed as such. They wouldn't be able to do that unless it was factual being they are all FDA approved.