Quick Clot: A Necessity or Overkill?

[ssssnake529]

Heavy bleeding is one of the few serious injuries that you can actually treat in the field. Heavy bleeding is also one of the serious injuries that is foreseeable when you're out hunting. Makes sense to me to carry clotting agent. Weighs very little, potentially life saving.

 

[4ester]

Thanks for everyone's input. I know we all try to lighten our packs as much as possible, but I think this is one thing that will stay. Better safe then sorry.


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[ajroussell]

FWIW, as a paramedic for 9 yrs. and TCCC experience I'd steer clear of any old powdered quick clot products out there....they are antiquated and work in a different fashion than the current hemostatic impregnated bandages. That said, unless you know how to pack a wound, I'd stick with TQ, either CAT of SOFT-wide and Israeli type bulky dressings for 99% of the penetrating trauma one could expect. And don't listen to the old wives tales about losing a limb in an hour, etc. or using tampons...case studies from the wars have shown full recovery of a TQ limb after 6 hrs. having one in place. Like so many things, these are just tools in a toolbox...can do more harm than good without some simple training in their use. Cheers, and good luck this season!

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[ctwiggs1]

Former Combat Medic here with some desert time.

Quikclot is great - I recommend the bags or the combat gauze over the powder. Don't make the mistake of not holding pressure. Read the instructions and watch the videos. This stuff works and it's insanely good. I had combat gauze on every mission and plenty more in the truck waiting if I needed it.

A CAT or SOF-T tourniquet is a great thing to have in pack. I'm all for cutting ounces but these literally stop the wound from being a problem, and they don't necessarily increase your chances of losing the limb. An SF guy went something like 30+ hours with a tourniquet and had full use of his arm 1 year later. Mind boggling but I read it in the Journal.

A Chitosam is OK for some wounds but I think the combat gauze is superior. A Chito I have felt works good for areas where your vascular system is closer to the surface, so you don't have to get down as deep to promote coagulation. The one time I saw it used well was on a deep laceration on the bicep. It probably wasn't necessary but it definitely worked. I have felt that a Quikclot product is superior because it can handle more situations than a Chitsam. If you haven't seen the Quikclot pig "Black Hawk Down" scenario, YouTube it and imagine trying to stuff a Chitosam down there. It'll make better sense then.

Israelis are great, love them and I think they're a great compliment to something like QuikClot or Combat Gauze. Get that stuff in there, pack it in nice and tight, then wrap it all with an Israeli for the ride or walk out.

Mike7, here you go: Tourniquets in the military historically were about 1/2" wide, which is not enough to stop the bleeding in the majority of situations. The Surgeon General for the US Army in WWII commented that a tourniquet is a waste of time, and if someone needed it, to move on. They didn't know the real issue, and it wasn't addressed. By Vietnam, we had upgraded to a better tourniquet, but we didn't know how to treat casualties that had already had tourniquets on. Tourniquets were carried and folks were taught how to use them, but they were discouraged from using them because they were seen as an absolute last resort, ONLY in situations where you had to choose between life and limb. Hindsight is 20/20, but really think about the pressure they were putting on an 18 year old infantryman who had to try and figure out just how serious this wound was while in a combat scenario.

Fast forward to the late 90s, when we realized after much research into Vietnam casualty statistics, the majority of preventable deaths in Vietnam could have been prevented with a simple tourniquet. After further study, we found that our ERs were able to handle a tourniquet patient even better and it didn't even mean they would necessarily lose the limb. In the last 20 years, we've expanded that even further because of all the limb injuries and losses related to IEDs (making lemonade out of lemons no doubt).

Personally, I don't think you'll get treatment from anyone but yourself within the golden hour if you're back country. Carrying this stuff on a backcountry trip is exactly what it's designed for. I agree that phone service is critical but if it takes 2-3 hours for a helicopter to get your butt out of there, you better hope you know what you're doing in the meantime.

CasNed - I am not sure what your experience is with those HyFin's but I definitely preferred those over the ACS. If you're going to invest in these, definitely go HyFin, not ACS. ACS's suck. I don't carry any vented product because I never really found it to be necessary (just basing that on stats, I haven't had enough chest trauma experience in the field to see the difference between vent and no vent), but I do make sure my products are still in their plastic so I can use that for thoracic or abdominal wounds.

 

[ctwiggs1]

I wonder how wounds were treated before quick clot became commercially available?

More people died. Overall though the old boyscout method - direct pressure, elevation, pressure points, bandage, pressure bandage, and absolute worst case scenario... tourniquet.

New training for most emergency personnel is.... If it's an extremity wound, just put a tourniquet on. It buys time immediately.

 

[LBFowler]

I wonder how wounds were treated before quick clot became commercially available?

your probably right, sometimes I pine for the good ol' days too.

 

[ATX762]

Yeah the anti-TQ stuff dates from the 1990's and domestic/urban trauma medicine. I worked in an urban trauma center in those days and TQ's were seen as the enemy. Then 9/11 and GWOT comes along and the thinking changes. I carry a TQ, an Israeli bandage, a big needle for needle decomp, plus some random other wound dressing stuff so if a finger gets cut bad no one has to leave the field. And if I'm really nervous I carry a pair of chest seals. My first aid kit weighs at least a pound, but I'm generally the only one in my group with any medical training, so I don't mind having it.

I think in the end it's what life saving gear do you know how to use and what can you improvise. I like the idea of quick clot but I think I read some study that showed it was only slightly more effective at stopping bleeding than simply packing a wound well.

 

[PNWGATOR]

Appropriately applied direct pressure is what you want to stop bleeding. Wound packing, pressure dressing, tourniquet, definitive care i.e. surgical intervention is what stops life threatening surviveable hemorrhage. I have been a paramedic for about 11 yrs and have considerable experience with penetrating trauma and how to effectively manage life threatening injuries in the prehospital environment. Hemostatically impregnated dressings are marginally more effective than non impregnated dressings, but that said we don't use them on our Engine or in rescue task force operations (criminal mass causality incidents, high risk warrants, etc) and I don't personally pack them in any first aid kit or afield.
For penetrating trauma to the torso we use HALO chest seals and may perform a needle thoracostomy depending on the circumstances.

 

[mrbillbrown]

Appropriately applied direct pressure is what you want to stop bleeding. Wound packing, pressure dressing, tourniquet, definitive care i.e. surgical intervention is what stops life threatening surviveable hemorrhage. I have been a paramedic for about 11 yrs and have considerable experience with penetrating trauma and how to effectively manage life threatening injuries in the prehospital environment. Hemostatically impregnated dressings are marginally more effective than non impregnated dressings, but that said we don't use them on our Engine or in rescue task force operations (criminal mass causality incidents, high risk warrants, etc) and I don't personally pack them in any first aid kit or afield.
For penetrating trauma to the torso we use HALO chest seals and may perform a needle thoracostomy depending on the circumstances.

You guys are missing out brother. With 22yrs as a Paramedic and 17yrs in the Fire Service I've been more than impressed with the Quick Clot impregnated dressings. We've used them in numerous situations with great success. Granted, it's not a perfect solution for major bleeding control but works great as an adjunct when it's appropriate. Conversely, I've had poor experiences with the HALO chest seals and prefer good old fashion Vaseline gauze for penetrating chest trauma that may require "burping".

 

[Boudreaux]

we don't use them on our Engine or in rescue task force operations
I don't personally pack them in any first aid kit or afield.

First paramedic I have ever herd say this. Everyone else I talk to tells me to carry it. I think I will carry it.

Thanks,
Boswell

 

[ctwiggs1]

First paramedic I have ever herd say this. Everyone else I talk to tells me to carry it. I think I will carry it.

Thanks,
Boswell

That's because most of them haven't had the change in doctrine yet.

The stuff works. Ask any seasoned combat medic.

 

[Where's Bruce?]

Like most of you I am always looking for ways to lighten my pack.

I was going through my medical kit and one item that I question is quick clot. Is it truly a necessity or overkill?

If it changes anything, I rarely hunt alone more then 4-5 miles from the truck, I do not carry a spot or inreach. We do typically have cell service on most of the ridges and peaks. The guy I typically hunt with also packs quick clot.

I do carry the quick clot sport , which I believe is a little lighter. Another option: Could I possibly take a partial pack? Maybe put it in a small vacuum sealed bag?

Looking for opinions and/or other solutions.

Matt


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I carry it expecting some asshat to accidentally shoot me. There are idiots out there that shoot when a bush moves. Cheap insurance. That said, I also carry a DeLorme Explorer. I come from the "better to have it and not need it" crowd. You can bleed out quickly from a variety of injuries. Like many items in my pack, I carry stuff in case i walk up on an emergency. I would wanna help if I found someone badly hurt in the backcountry.

 

[ctwiggs1]

Here is the Black Hawk Down study guys.

Field eXpedients: Quik-Clot Life Saving Powder-and Now Gauze - YouTube

 

[Where's Bruce?]

Here is the Black Hawk Down study guys.

Field eXpedients: Quik-Clot Life Saving Powder-and Now Gauze - YouTube

That was impressive. Thanks for sharing.

 

[Michiganhunter]

That quick clot stuff is amazing I think I'm gonna start carrying it just in case.

 

[Mtslackcountry]

Never used it but always carry it. I don't know why the hell you wouldn't it weighs next to nothing.