QuikClot is a brand of hemostatic wound dressing that contains an agent that promotes blood clotting. The brand is owned by Teleflex. [1] It is primarily used by militaries and law enforcement to treat hemorrhaging from trauma.
QuikClot is a brand of hemostatic wound dressing that contains an agent that promotes blood clotting. The brand is owned by Teleflex. [1] It is primarily used by militaries and law enforcement to treat hemorrhaging from trauma.
The use of a sterilized molecular sieve material, such as zeolite, in a binding material to treat wounds was patented by Frank Hursey in 1989. [2] Following the September 11 attacks, the US armed forces conducted a study comparing different antihemorrhagic technologies, in which QuikClot received the best score. [3] Another study found that when used to treat lethal groin injuries in swine, the treated animals had a 100% survival rate. [4] Following these tests, the US armed forces approved its use in Afghanistan and Iraq.[ citation needed ]
The original formulation of the product contained the active ingredient zeolite, which promoted blood clotting. The zeolite would have an exothermic (heat-releasing) reaction with blood during the clotting process, which could cause second-degree burns. [5] Because of this, the product was not available for retail and was only used in emergency scenarios, such as in combat. Newer zeolite formulas come pre-hydrated, which produce less heat, and can be used more safely to pack wounds and stop hemorrhage.[ citation needed ]
By 2009, QuikClot devices were made of gauze impregnated with kaolin instead of using zeolite. The kaolin device performed equivalently to previously developed hemostatic bandages. [6] Kaolin doesn't trigger skin allergies due to its inert (nonreactive) characteristics. [7]
QuikClot was originally available as a granulate to be poured directly on a wound to stem bleeding.[ citation needed ]
The Kaolin in QuikClot Interventional bandages absorb the water molecules in blood, leaving behind the relatively bigger platelets and clotting factor molecules. The higher concentration of these remaining cells and molecules cause them to naturally clot faster. [8] Kaolin activates factor XII, a protein factor which assists in the initiation of the coagulation cascade, a protein chain reaction which promotes blood clotting as a result of trauma. Later, QuikClot was formulated using zeolite beads, which promoted clotting directly through activation of the coagulation cascade. [9]
In the Tactical Combat Casualty Care Guidelines published by the CoTCCC (Committee on Tactical Combat Casualty Care) in 2014, QuikClot Combat Gauze was listed as the ideal hemostatic dressing to be used for external hemorrhage not amenable to tourniquet use or as an adjunct to tourniquet removal if evacuation time is anticipated to be longer than 2 hours. [10] In the TCCC Guidelines published in 2021, Combat Gauze remained the choice hemostatic dressing for such an injury. [11]
Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagina or anus, or through a puncture in the skin. Hypovolemia is a massive decrease in blood volume, and death by excessive loss of blood is referred to as exsanguination. Typically, a healthy person can endure a loss of 10–15% of the total blood volume without serious medical difficulties. The stopping or controlling of bleeding is called hemostasis and is an important part of both first aid and surgery.
A first aid kit or medical kit is a collection of supplies and equipment used to give immediate medical treatment, primarily to treat injuries and other mild or moderate medical conditions. There is a wide variation in the contents of first aid kits based on the knowledge and experience of those putting it together, the differing first aid requirements of the area where it may be used, and variations in legislation or regulation in a given area.
Battlefield medicine, also called field surgery and later combat casualty care, is the treatment of wounded combatants and non-combatants in or near an area of combat. Civilian medicine has been greatly advanced by procedures that were first developed to treat the wounds inflicted during combat. With the advent of advanced procedures and medical technology, even polytrauma can be survivable in modern wars. Battlefield medicine is a category of military medicine.
In biology, hemostasis or haemostasis is a process to prevent and stop bleeding, meaning to keep blood within a damaged blood vessel. It is the first stage of wound healing. This involves coagulation, which changes blood from a liquid to a gel. Intact blood vessels are central to moderating blood's tendency to form clots. The endothelial cells of intact vessels prevent blood clotting with a heparin-like molecule and thrombomodulin, and prevent platelet aggregation with nitric oxide and prostacyclin. When endothelium of a blood vessel is damaged, the endothelial cells stop secretion of coagulation and aggregation inhibitors and instead secrete von Willebrand factor, which initiate the maintenance of hemostasis after injury. Hemostasis involves three major steps:
Coagulation factor XII, also known as Hageman factor, is a plasma protein. It is the zymogen form of factor XIIa, an enzyme of the serine protease class. In humans, factor XII is encoded by the F12 gene.
Internal bleeding is a loss of blood from a blood vessel that collects inside the body. Internal bleeding is usually not visible from the outside. It is a serious medical emergency but the extent of severity depends on bleeding rate and location of the bleeding. Severe internal bleeding into the chest, abdomen, retroperitoneal space, pelvis, and thighs can cause hemorrhagic shock or death if proper medical treatment is not received quickly. Internal bleeding is a medical emergency and should be treated immediately by medical professionals.
The Expert Field Medical Badge (EFMB) is a United States Army special skills badge first created on June 18, 1965. This badge is the non-combat equivalent of the Combat Medical Badge (CMB) and is awarded to U.S. military personnel and North Atlantic Treaty Organization (NATO) military personnel who successfully complete a set of qualification tests, including both written and performance portions. The EFMB is known for its adherence to its testing standards and, as such, requires strict attention to detail from candidates in order to receive a "GO" on its combat testing lanes. The pass rate for FY 2017 was 7%, making the EFMB one of the most difficult and prestigious Army special skill badges to earn.
Casualty evacuation, also known as CASEVAC or by the callsign Dustoff or colloquially Dust Off, is a military term for the emergency patient evacuation of casualties from a combat zone. Casevac can be done by both ground and air. "DUSTOFF" is the callsign specific to U.S. Army Air Ambulance units. CASEVACs by air today are almost exclusively done by helicopter, a practice begun on a small scale toward the end of World War II; before that, STOL aircraft, such as the Fieseler Fi 156 or Piper J-3 were used.
Coagulopathy is a condition in which the blood's ability to coagulate is impaired. This condition can cause a tendency toward prolonged or excessive bleeding, which may occur spontaneously or following an injury or medical and dental procedures.
An antihemorrhagic (antihæmorrhagic) agent is a substance that promotes hemostasis. It may also be known as a hemostatic agent.
A hemothorax is an accumulation of blood within the pleural cavity. The symptoms of a hemothorax may include chest pain and difficulty breathing, while the clinical signs may include reduced breath sounds on the affected side and a rapid heart rate. Hemothoraces are usually caused by an injury, but they may occur spontaneously due to cancer invading the pleural cavity, as a result of a blood clotting disorder, as an unusual manifestation of endometriosis, in response to Pneumothorax, or rarely in association with other conditions.
A dressing or compress is a sterile pad applied to a wound to promote healing and protect the wound from further harm. A dressing is designed to be in direct contact with the wound, as distinguished from a bandage, which is most often used to hold a dressing in place. Many modern dressings are self-adhesive.
Thromboelastography (TEG) is a method of testing the efficiency of blood coagulation. It is a test mainly used in surgery and anesthesiology, although increasingly used in resuscitations in Emergency Departments, intensive care units, and labor and delivery suites. More common tests of blood coagulation include prothrombin time (PT) and partial thromboplastin time (aPTT) which measure coagulation factor function, but TEG also can assess platelet function, clot strength, and fibrinolysis which these other tests cannot.
Negative-pressure wound therapy (NPWT), also known as a vacuum assisted closure (VAC), is a therapeutic technique using a suction pump, tubing, and a dressing to remove excess exudate and promote healing in acute or chronic wounds and second- and third-degree burns. The therapy involves the controlled application of sub-atmospheric pressure to the local wound environment using a sealed wound dressing connected to a vacuum pump. The use of this technique in wound management started in the 1990s and this technique is often recommended for treatment of a range of wounds including dehisced surgical wounds, closed surgical wounds, open abdominal wounds, open fractures, pressure injuries or pressure ulcers, diabetic foot ulcers, venous insufficiency ulcers, some types of skin grafts, burns, sternal wounds. It may also be considered after a clean surgery in a person who is obese.
Combat medics of the United States military may put themselves at greater risk than many other roles on the battlefield. In recent conflicts, the enemies faced by a professional army may not have respect for the laws of war and may actively target combat medics for the significant value they have in keeping the unit combat-effective. Since the non-combatant status granted to medics may not always be respected, modern combat medics carry weapons for personal defense and in most Western armies are virtually indistinguishable from regular infantrymen.
Peter Meong Rhee is an American surgeon, medical professor, and military veteran. During his 24 years in the United States Navy, Rhee served as a battlefield casualty physician in Afghanistan and Iraq.
The Emergency Bandage or Israeli bandage is a specially designed, first-aid device that is used to stop bleeding from hemorrhagic wounds caused by traumatic injuries in pre-hospital emergency situations. First used for saving lives during a NATO peacekeeping operation in Bosnia and Herzegovina, the bandage was successfully used during operations Enduring Freedom and Iraqi Freedom. The bandage was nicknamed "Israeli bandage" by American soldiers and has been "the bandage of choice for the US Army and special forces." The Israeli Bandage was included in the first aid kits of emergency personnel and first responders at the 2011 Tucson shooting, and was used to treat some victims of the shooting.
Tactical Emergency medical services (TEMS) is out-of-hospital care given in hostile situations by specially trained practitioners. Tactical support provided through TEMS can be applied in either the civilian world, generally with special law enforcement teams such as SWAT and SERT, as well as with military special operations teams. Tactical EMS providers are paramedics, nurses, and physicians who are trained to provide life-saving care and, sometimes, transport in situations such as tactical police operations, active shooters, bombings, and natural disasters. Tactical medical providers (TMPs) provide care in high risk situations where there is an increased likelihood for law enforcement, civilian, or suspect casualties. TEMS units are also deployed in situations where traditional EMS or firefighters cannot respond. TMPs are specially trained and authorized to perform live-saving medical procedures in austere and often times unconventional environments. TMPs are also expected to be competent in weapons safety and marksmanship, small unit tactics, waterborne operations, urban search and rescue, and HAZMAT. TMPs also serve to train their respective teams in complex medical procedures that may be performed in their absence. TEMS providers are sometimes sworn police officers cross trained as paramedics, paramedics that are operators trained and integrated into the SWAT Team, or medical providers trained in tactical EMS who are then integrated into law enforcement or military units.
Tactical Combat Casualty Care are the United States military guidelines for trauma life support in prehospital combat medicine, designed to reduce preventable deaths while maintaining operation success. The TCCC guidelines are routinely updated and published by the Committee on Tactical Combat Casualty Care (CoTCCC), which is part of the Defense Committees on Trauma (DCoT) division of the Defense Health Agency (DHA). TCCC was designed in the 1990s for the Special Operations Command medical community. Originally a joint Naval Special Warfare Command and Special Operations Medical Research & Development initiative, CoTCCC developed combat-appropriate and evidence-based trauma care based on injury patterns of previous conflicts. The original TCCC corpus was published in a Military Medicine supplement in 1996. TCCC has since become a Department of Defense (DoD) course, conducted by National Association of Emergency Medical Technicians.
Hasan Badre Alam is a trauma surgeon, surgeon-scientist, and a medical professor in the United States. He is the Loyal and Edith Davis Professor of Surgery, the Chairman of Department of Surgery at the Feinberg School of Medicine (FSM)/Northwestern University, and the Surgeon-in-Chief at Northwestern Memorial Hospital (NMH) in Chicago.
The hemostatic pad is a hemostatic dressing made of soft, white, kaolin impregnated gauze, configured in a 1½" long by 1½" wide by ½" thick multi-layer pad.