Q: What are your thoughts regarding Quickclot? One of the kids in my program recently had a fairly severe laceration to the knee and the bleeding was hard to control/messy. If the stuff works, it seems it may reduce possible contact with blood borne pathogens to staff.
“…the stuff works..” or “…they make a difference…”, those are the suppositions that get to the heart of the matter. I have written previously about clot enhancers and have expressed my unabashed skepticism.
In the last few years, the original QuikClot that was supposed to stop all bleeding without any harmful effects has been reformulated to be cooler because of concerns about burns. Reengineered again, it is available, impregnated in gauze. But do any of these really work? There are anecdotal reports and animal studies. The claims made by Z-Medica that their products have saved hundreds of lives seem hyperbolic and unsubstantiated by anything more than individual or pooled testimonials. Each new animal trial shows the new product to be better than the prior one, the one that was supposed to stop all bleeding.( http://www.z-medica.com) This is not science, this is marketing. I am not aware of any clinical trials that look at important human outcome in any meaningful way. The fact that someone, like the army, is using something does not make it efficacious or safe. And in addition to burns, there have been other problems reported with the older formulations. I don’t believe that the science with the other leading products (chitosan-based: e.g., http://www.celoxmedical.com) is any better.
I completely understand why the military wants a product that will stop bleeding easily. Think about it. As with all combat, bleeding is the major pathway to death. Field treatment has improved significantly but who wouldn’t want to do better for otherwise healthy young women and men? What could be better than being able to pour something into an exsanguinating wound and have the bleeding stop, especially where a tourniquet cannot be applied? It does not work that way with any product on the market. It does seem that the gauze formulations of each have some promise. They can be wrapped around a wound or tightly stuffed into deeper ones and then secured by a tight pressure wrap. Assuming that the product added is safe and effective, it could enhance what already works.
What should you do? We know that bandaging that is visually directed toward the bleeding site (well-aimed), stuffed in for deeper wounds, and then secured by a pressure wrap have a good track record. This is certainly true for the vast majority of wounds we are likely to see in non-combat, civilian events. There are no confounding substances and anyone can buy these materials easily and inexpensively. On the other hand, the least expensive of either of the major clot enhancing products retail for about 10$ US and many are 25$ US and more. But wouldn’t it be worth it to decrease exposure to potential m thinking FG and OHbloodborne pathogens? If there is bleeding, there is blood around. Whether you use the sachet containing QuikClot or either gauze impregnated product, you still have to apply it manually and hold it in place like plain gauze until secured. Gloves, eye protection, and clothing are still your best protection. And what are you going to use if you haven’t got a clot enhancer with you?
It is difficult to know how to respond to H1N1. Last spring schools were closing with the first whiff of a possible infection. Now, kids who are sick are segregated until they can be sent home. Schools are unlikely to be closed unless the numbers of absentees are large enough to prevent normal function or vulnerable populations are put at risk.