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valkyrie182
12-05-2004, 23:47
I recently heard about some funky new stuff that rapidly clots on contact with a bleeding wound. The website for the stuff says it clots and can stop arterial bleeding, and can prolong the window of survivability for another hour or so. Apparently, it has seen use in Iraq, and with good results. I was curious if any EMS units use this particular product and how effective it actually is. I am sure the manufacturer's website is going to be tooting its own horn quite loudly. Does anyone have any experience with this stuff?

MDT
12-06-2004, 00:11
There is a product called Quick-Clot that has been used to some degree of success, however.....
there has also been many reports of this product causing significant burns resulting from the exothermic reaction of the product. There was a fairly extensive review by a trauma surgeon Dr. Syd Vail, and it didn't fare too well. I'll try to get the source.

The bottom line for these products is if you are within a reasonable transport time to an ED (and most of us are), these products will not help you. You can do more with direct pressure, pressure proximal to the wound, or if your protocol allows use of a tourniquet (in select cases).


MDT

N2DFire
12-06-2004, 08:21
Seen the demo video on the "stuck pig" seemed to work great but that's always the case with "Movie Magic".

I've read/heard that the military has been (may still be) using it.
Also some good info. here:
http://cms.firehouse.com/forums2/showthread.php?s=&threadid=34279&highlight=Traumadex

LtTripMD
12-06-2004, 08:45
Originally posted by MDT
There is a product called Quick-Clot that has been used to some degree of success, however.....
there has also been many reports of this product causing significant burns resulting from the exothermic reaction of the product. There was a fairly extensive review by a trauma surgeon Dr. Syd Vail, and it didn't fare too well. I'll try to get the source.

The bottom line for these products is if you are within a reasonable transport time to an ED (and most of us are), these products will not help you. You can do more with direct pressure, pressure proximal to the wound, or if your protocol allows use of a tourniquet (in select cases).


MDT

what he said.

MDT always beats me to the punch!

trip.

MDT
12-06-2004, 12:03
Thanks Trip!;c

I saw the stuck pig video as well. The things that were the most glaring were:

1. A surgical incision to the femoral artery. I dont think a bullet makes such a clean margined wound.

2. Try as the surgeon might, even with several suction tips, that blood was POURING out of the femoral artery. When they cut to the shot where they applied the Quick-Clot, the surgical field seemed rather "clean". Almost too clean (this is only my assumption, I certainly don't know for sure).

Interesting products, and if they can save a soldiers life, all the better. I just don't like to think that the manufactuers might manipulate things to advance their product (never happens, right;g ?).

MDT

GeoEMTP
12-06-2004, 14:25
Our SWAT medics have Traumadex for use in the tactical hot zone. They haven't had to use it yet thankfully!

Traumadoc
12-07-2004, 07:43
since you asked...(yes, this is S.V.) the article we wrote was in Police Magazine:
Blood Clotters. Police: The Law Enforcement Magazine, August 2004;28:pg 52-59.
I have used Traumadex in the operating room and it worked on a shattered liver to stop bleeding until my usual techniques could be used...I wanted to try it as it might be used in the field. I am waiting to try it on a GSW that is "hemorrhaging externally" but as of yet the patients aren't cooperating!!
Quik-clot as we point out in the article has some quirks that the video doesn't bring out. The medics in Iraq and A-stan should not be using it unless there are NO alternatives, which is unlikely but not impossible. We've spoken to military medics and docs that give some info and it wasn't overly favorable (sorry, can't give more details).
Traumadex worked well also on deep 'roadrash' and a nasty scalp laceration that we didn't have time to suture...these injuries are typically a high volume blood loss for trauma patients and we needed control without giving up the manpower to suture/hold pressure for 15-20 minutes.
Civilian world, direct pressure, rapid transport should always work....as I teach in our tactical medical course ( www.tacticalmedicine.com ) I believe tourniquets should be utilized in the field under certain circumstances. I'm trying to get our SOP's changed to allow our medics to use them.

MDT
12-07-2004, 13:09
SV (Traumadoc)

Howdy! You may not remember me but I took the HK Tacmed I recently. You and I were discussing some medical issues w/ the Saudi paramedic (remember that guy?) at the dinner you guys threw for us.

Glad to see you on the board here. I know you will have valuable info for all of us here.

MDT

N2DFire
12-07-2004, 14:04
Hey Dr. Vail,
Glad to see you here. Haven't had the pleasure of speaking with you In a while. I'm a Medic in Franklin Co. and was at one of the Trauma lectures you presented. E-mailed you the pic of the car being squished by the Ladder Truck outrigger.

I've been wanting to get up to H&K and do some training with you folks but right now time & budget do not permit (Well that & the fact that right now The Powers that Be in Franklin County are not accepting volunteer Medics for SWAT use - only FCDPS Career Staff) but that's a rant for an entirely new thread.

Back to topic - I'd like to see more real world testing before I started using this stuff in the field for "everyday" stuff, but I can see where it has it's applications in special circumstance (SWAT, Military, last resort, etc.) otherwise I'd have to agree with Dr. V that that from a pure EMS standpoint we can better control bleeding the "old fashion way".

As a side note, I have found that some E.R. doc's who would have a duck fit if you brought in a Pt. with a tourniquet on don't bat an eye if you wrap an extremity w/ a B/P cuff and call it a "pressure dressing"

Traumadoc
12-07-2004, 14:28
of all places to catch up with people.....
I agree, the BP cuff wouldn't get anyone's attention but the policy and procedure manual forbids tourniquets at this point in time. I'm on a mission to reverse that. Appropriately used it can be a life saver. In the civilian world, especially in a rural area like ours, the medic needs to be using both hands...why we have 2 instead of 1 I assume, to continue both evaluating and treating the patient.
We know for a fact that pressure dressings for the most part are a great way to collect A LOT of blood outside of the vessel and serves nbo purpose related to keeping the blood inside the vessel. As per the Trauma Combat Casualty Care manual utilized by the armed services, tourniquets can make the difference in saving a life, the #1 difference in combat care in the field...I grant you that during war, the medic's hands may need to be on their gun and not on the patient but there is a corrolation to the civilian world that we (I) need to exploit.

N2DFire
12-08-2004, 13:27
Originally posted by Traumadoc
of all places to catch up with people.....

Ain't that the truth *L*

Good to see you are still around these parts. I was afraid H&K was going to steal you away from us.

Also glad to see you're still pushing for some changes in the way Trauma gets handled around here. Nice to know someone is looking after the rural folks who have more than a 10 minute transport time (more than 30 min to an hour sometimes)

Keep up the good work & I look forward to crossing paths with you again sometime.