Quickcloth

[Van Canna]

Bill,

Will it work?

http://www.aeromedix.com/aeromedix_arti ... letter0208

When it comes to controlling severe bleeding, QuikClot is the best thing since sliced bread.

QuikClot is a very small beaded material that absorbs smaller water molecules from the blood leaving platelet and clotting factors that stops even severe arterial and venous bleeding. Experiments on pigs with lacerations of the femoral artery in the groin showed a reduction of fatalities in this almost always fatal wound by 50%.


(This exact type of injury occurred to a local veterinarian working on a horse by himself near our office. He unfortunately died at the scene. I will always wonder if he would have been saved if QuikClot had been available.)

QuikClot is particularly useful whenever bleeding cannot be stopped by a tourniquet or direct pressure like the head, neck, chest and abdomen, the material aids homeostasis (control of bleeding) in the limbs with a tourniquet or direct pressure.

Instructions for use are basic–pour the granules over the wound until you can see a layer of the beads. More than than is not necessary.

For the impregnated sponge type, just stuff the sponges into the wound. The material is removed by irrigation when the appropriate definitive medical care can be delivery.

Only the amount of QuikClot that is necessary to cover the wound should be used since the material creates some heat.

This is not a big problem and the amount of material is directly related to the amount of heat. Once the beads cover the wound, do not put any more on. Once the QuikClot absorbs the fluids, the heat stops so it the heat only lasts for a few seconds.

Unfortunately, once a package is opened, it cannot be used later since the absorption of humidity renders QuikClot inactive. The package can be used on multiple wounds or multiple patients once opened.

The shelf life of an unopened package is three years with the only restriction being not to leave it in direct sunlight. It can be exposed to ambient heat and cold.

When it first came out a few years ago for military use, I wanted Aeromedix to carry it but they only sold in large quantities unsuitable for individual use. Z-Medica, the manufacturer, has now recognized the consumer and EMS market so they have made packaging consumer friendly.

Aeromedix only carries the prescription level QuikClot beads and the QuikClot ACS which is a fabric sponge impregnated with the beads, not the over the counter formulation, which does not work as well.

I recommend everyone carry QuikClot in their first aid kit and have it on the self in every shop where injuries can occur. This stuff is truly lifesaving!

[Bill Glasheen]

It's an interesting idea. I'll have to read the literature to see if I can find some experiments done with it.

One thing is clear. It's no substitute for basic first aid.

Back in a bit.

- Bill

[Greg]

Canna Sensei,

QuikClot does in fact work well (in animal models and anecdotally from combat medics) at stopping hemorrhage. It's one of the 'miracle agents' that have been deployed in the past few years in Iraq and Afghanistan; the other major one being “HemCon.” QuickClot [QC] was developed in conjunction with the Naval Research labs and was fielded to the Marines and HemCon [HC] developed by the Army and deployed with [some] soldiers. QC is made of zeolite powder, which is similar to volcanic rock, and HC is made from chitosan derived from shrimp shells.

The major drawback to QC is that there is a pretty dramatic exothermic (heat producing) reaction when using the product that has the potential to cause full thickness 2nd or 3rd degree burns. The instructions direct the user to ‘wipe away’ excess blood before applying the QC to minimize the heat generation, but this obviously can be difficult with a severe hemorrhage. A recent improvement in the product is an impregnated sponge of sorts that you can quickly slap onto the wound and bandage in place, eliminating the need to pour the QC into the wound (at least one negative field report mentioned the difficulty of keeping the product in a wound when hemorrhage was forcing it out). Also Z-medica is reportedly working to develop a version of QC that produces less heat on application.

Most of those who have had direct experience with QC had favorable things to say on the balance, whereas HC has had less positive reviews. A couple of 18Ds (special forces medics) told me that they had traded out their Army issued HC for QC – they had used both and felt the QC was far superior. A very recent animal study showed that HC reduced bleeding to 33% of the original hemorrhage in a femoral wound while QC reduced the bleeding to 8%. Interestingly, another hemostatic bandage composed of chitosan (CELOX) stopped the bleeding entirely, promising even better products in the future.

The things that QC has going for it is that it is extremely inexpensive; $10 per application for the military and comparable cost for the civilian products, and that it is relatively simple to use. The problem comes largely from the potential for burns. One can argue that even a severe burn is preferable to bleeding out, which is certainly true, but the problem is that invariably when products like this are sold to the general public, they are often used inappropriately. The most common example of this in real world application has been the use of QC on relatively minor wounds that could have been managed with direct pressure and without the resultant burns.

Anyhow, probably more than you wanted to know… but overall I think the product is worthwhile.

Greg

[Bill Glasheen]

Thanks for posting here, Greg.

It's been a while since I've been in the surgical research lab. We had things like this available to us when we screwed up, but they generally weren't that good. It appears the technology has improved a lot.

Anyhow, probably more than you wanted to know…

Not for this forum. We are a pretty eager and fairly educated audience. So go for it!

A very recent animal study showed that HC reduced bleeding to 33% of the original hemorrhage in a femoral wound while QC reduced the bleeding to 8%.

Those are impressive statistics.

For those who aren't familiar with anatomy, the femoral artery is a major artery that exposes itself in the front fold of your hip. Cardiologists access it in the cath lab to route a catheter up to your heart to perform typical diagnostic and therapeutic procedures for the heart muscle circulation.

A femoral wound is usually fatal in the field unless you have someone with a hemostat who can clamp it on the spot. Blood will come out like a geyser.

The major drawback to QC is that there is a pretty dramatic exothermic (heat producing) reaction when using the product that has the potential to cause full thickness 2nd or 3rd degree burns. **** One can argue that even a severe burn is preferable to bleeding out, which is certainly true, but the problem is that invariably when products like this are sold to the general public, they are often used inappropriately. The most common example of this in real world application has been the use of QC on relatively minor wounds that could have been managed with direct pressure and without the resultant burns.

This was my concern.

No amount of technology takes the place of good first aid training and common sense.

Thanks, Greg!

- Bill