QUIKCLOT Combat Gauze is made from kaolin, a mineral that does not contain animal or human proteins or botanicals. QUIKCLOT Combat Gauze is indicated for temporary external control of catastrophic bleeding, QUIKCLOT Combat Gauze is flexible and recommended by the Committee on Tactical Combat Casualty Care Committee. QUIKCLOT® has been proven on the battlefield.
The reality of managing a major trauma victim who has lost a lot of blood is they need blood. Without whole blood responders are just buying time.
Importance of QuikClot:
- 24% of combat deaths pre-hospital were potentially survivable and 90.9% of those (21.6% of total) were due to haemorrhage.
- Primary sites for lethal haemorrhage are truncal (67%), junctional (groin, axilla and neck, 19%) and extremities (14%)
- While tourniquet is best for extremity bleeds, junctional and truncal bleeds need something else
Haemostatic dressings including QuikClot can be classified through their generation:
HemCon and QuikClot granules
QuikClot Combat Gauze, WoundStat and Celox Granules
Celox Gauze and Chito Gauze
Mechanism of Action:
Hemostatics including QuikClot Work through a few mechanisms including:
- Rapid Dehydration
- Ionic reaction
The main benefit for Chitosan Products is they work via a different pathway to normal clotting so it’s more effective with patients on blood thinners
Future technologies include new generation haemostatic dressings, styptics, CO2 insufflation, intra-peritoneal self-expanding foam and synthetic blood are providing alternatives when whole blood transfusion is not available.
Discussion of chitosan-based dressings will address their benefit in current combat scenarios, their mechanism of action, and the particular benefits they may have in certain populations. Similarly, mini sponges present an interesting and optimistic measure to tamponade bleeding.
Carbon dioxide insufflation and intra-peritoneal self-expanding foam infiltration works by preventing an intervention to slow closed intra-abdominal bleeding through the tapenade of blood vessels. This keeps the patient alive long enough to evacuate them to surgery.
HemoPure is a synthetic blood product derived from bovine haemoglobin currently being trialled. It is sterile, very heat stable and has a long shelf life. This allows for replacement of fluids with oxygen carrying capacity rather than saline in the pre-hospital fluid.
Recombinant Factor Seven (rFVIIA) is a protein that despite having no significant decrease in mortality has been shown to reduce the amount of blood transfusions a patient requires.
TXA is an antifibrinolytic that works by interfering with the normal fibrinolysis pathway, competitively inhibiting the activation of plasminogen at high concentrations and non-competitively inhibits plasmin.
- Bennett BL, Littlejohn L. Review of New Topical Hemostatic Dressings for Combat Casualty Care. Military Medicine. 2014;May 179:497-514
- United States Food and Drug Administration(USFDA). FDA allows marketing for first-of-kind dressing to control bleeding from certain battlefield wounds [Internet]. USA: USFDA; 2014 Apr 3. Available from: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/