QuickClot issues, tourniquets

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Originally published at Notes from the bunker…. You can comment here or there.

I must have lead either an amazingly dull or amazingly lucky life in that I’ve never really seriously injured myself. Never broke any bones, never needed a ride in an ambulance, never damaged myself to the point that someone else had to bundle me into the back of a car and drive me to a hospital. That doesn’t mean it won’t happen, it just means it hasnt happened yet.

Wars and violent confrontations are terrible events but there is one ‘good’ side effect – new developments in trauma treatment that eventually trickle down to the civilian world. One of the more interesting developments in the last few years has been the introduction and development of clotting agents for field use. These products, the most popular being QuickClot (although there are, naturally, other brands) , are applied to a wound to staunch bleeding until the person can get to medical aid. A very important development. A guy who just got shot in the leg can pour some of this stuff into the wound, tie a compress bandage around it and stop the blood loss until such time as he can be extracted. How is that not an amazingly useful development?

Well, theres apparently some issues in the military about whether the cure is worse than the disease.

WASHINGTON — Until more testing can be done, Army medics are being told to stop using a new product just sent to the war front to help control bleeding among wounded troops.

Officials were in the process of distributing some 17,000 packets of WoundStat, granules that are poured into wounds when special bandages, tourniquets or other efforts won’t work. But a recent study showed that, if used directly on injured blood vessels, the granules may lead to harmful blood clots, officials said Tuesday.

At issue seems to be a concern that the loose granules of clotting agent may cause ‘bad’ clots…the kind that cause strokes and embolysms, it seems. The clotting products usually come in two forms – a powder that is poured into the open wound and bandages that are treated with the clotting product. The concern seems to stem from the powder version. I’m guessing the concern is some of this material getting into the bloodstream and clogging up things in a lung or brain. A shame, since these types of products seem to be doing far more harm than good. I have both the powder and the bandages and it ranks right up in my list of things I genuinely hope I never need.

The Russians, naturally, are a more pragmatic people. Theres the story of how when the space race was in its infancy NASA spent thousands of dollars to develop a pen that could write in zero gravity, the Russians simply used pencils.  KaiserVonTexas has a post, with pictures and links, to the Soviet version of QuickClot – the tourniquet. An outstanding photo showing the troops with tourniquets wrapped around their rifle stocks. Also a link to a seller on eBay of the genuine article.

Tourniquets are a mixed blessing. As you know they do indeed shut off the flow of blood to a wound. They also shut off the flow of blood to the rest of that limb which can lead to some very ugly results and amputations. However, it does usually beat being dead. I recall reading somewhere that tourniquets are discouraged in most situations unless its an absolute last resort and even then theres careful instructions to loosen it every so often, etc.

I’m a pragmatist so I have all three – the clotting powder, the treated dressing/bandage, and the barbarous tourniquet. I am more likely to go for the bandage first though. However if theres a nice arterial fountain shooting  out of my thigh I may worry less about a loose clot giving me a stroke and worry more about not dyiing in the next five minutes.

Several companies sell ‘blowout kits’ or specialized kits for treating gunshot type wounds. These kits are almost always a small MOLLE pouch with gauze, compress bandage, clotting agent, sucking chest wound materials and a few other sundries. Its deisgned for one purpose – treating a heavily bleeding wound. Its not bandaids and bactine and it isnt priced like it either. However these kits are probably a good idea to have if theres even the small chance of some very traumatic injury (gunshot , stabbing, penetrating wound, etc).

I keep a packet or two of QuickClot in the first aid kit I carry in my Tactical Tailor bag. I’ll probably swap out one of those packets for one of the treated dressing/bandage units.

Anyway, I thought that the article about the military halting issue of the clotting product may be of interest to some and worth mentioning.

7 thoughts on “QuickClot issues, tourniquets”

  1. tourniquets

    “Tourniquets are a mixed blessing. As you know they do indeed shut off the flow of blood to a wound. They also shut off the flow of blood to the rest of that limb which can lead to some very ugly results and amputations. However, it does usually beat being dead. I recall reading somewhere that tourniquets are discouraged in most situations unless its an absolute last resort and even then theres careful instructions to loosen it every so often, etc.”

    From what I have read of reports from Iraq, tourniquets are quite safe to use as long as time constraints are adhered to. Two hours or less does no damage, and reports of damage requiring amputation were all from use over six hours. I’m a medic for a SWAT team and we use them first if there are other things needing done. We then go back and see if we can control the bleeding by other means.

    medicman

  2. Re: tourniquets

    Our pre-deployment training included the Tactical Combat Casualty Care class, which basically flew in the face of most traditional first aid training, including what we had in boot camp.

    A couple of the primary things that stuck with me from the class… one (and this coming from our battalion surgeon) get tactical control of the situation first, i.e. shoot that guy so that we don’t have more casualties, then move to cover before treating a patient. Two, tourniquets rock and are not as scary as we were lead to believe before. In boot camp, and most traditional first aid training (dating from the ’50’s), as stated above, tourniquets are considered a last resort.

    Now they are saying, if you see arterial bleeding, get that tourniquet on ASAP. Yes, note the time, and yes if you just leave it there untreated, you may have to lose the limb. It was pointed out that orthopedic surgery often takes in the neighborhood of six hours, and for those procedures the artery is clamped off the entire time. It was also noted that CASEVAC to higher echelon medical treatment from the field tends to take in the neighborhood of an hour these days (this was a couple years ago, I’m assuming it’s still similar or better).

    Also, our doctor was a fan of quick clot in cases where a tourniquet could not be applied, and the guy was going to die otherwise, e.g. neck and torso wounds. I have a few of the Tactical Medical Packs from http://www.tacticalmedicalpacks.com/pack_tacpack_qc.html which include a sponge treated with Quick Clot. John may have actually turned me on to them; I don’t recall.

  3. Re: tourniquets

    Hah I didn’t check the link when you mentioned the ‘blowout’ kits. I seem to have given you a link you had just given me. But yes, I agree. I think they are great to have on hand. We keep one in each vehicle inside a more comprehensive first aid along with a CAT (http://www.combattourniquet.com/ – same type we were issued, they are great for being able to put on one handed), as well as another set in the house.

  4. One of the regulars over at Zombie Squad (www.zombiehunters.org ) is a U.S. army medic with a tour in Afghanistan under his belt who is now currently in Iraq.

    He says, flat out, that “tourinents are lifesavers.” He carries, IIRC, about five or six in his kit, and the troops also carry them.

    The reason is that with multiple, traumitic amputations, or near amputations,(spread out over several people) that are commonly caused by IED’s being able to stop bleeding with a torniquent and then go on to the NEXT guy with just as severe an injury is a lifesaver.

    Yeah, you have to know what you are doing to avoid usingn them inappropriately and causing problems, but they have their place.

    I think the move away from torniquents in the peace time civvie first aid world is due to them being inappropriately used. If you know when they are required, and when they aren’t required, they are a good tool to have.

  6. I’m a pragmatist so I have all three – the clotting powder, the treated dressing/bandage, and the barbarous tourniquet. I am more likely to go for the bandage first though. However if theres a nice arterial fountain shooting out of my thigh I may worry less about a loose clot giving me a stroke and worry more about not dyiing in the next five minutes.

    I think this pretty much says it all.

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