A Warning Re Quikclot

[FGYT]

I think super glue was invented around ww2 time specifically for binding wounds together fast..hence why it works so damn well on our fingers.

as an aside the inventor died this week

http://www.washingtonpost.com/local...tor-dies-at-94/2011/03/28/AF20mrqB_story.html

 

[EdS]

you have got to bear in mind the impregnated and bandaged and the granuals are 2 completely different beasts.

Either way if it is bad enough to require their use you are very unlikely to be able to apply them yourself. And how are you going to manage Hypovolemic shock?

An untrained, but well meaning individual with quickclot etc will kill you quicker than someone with a good basic knowledge / training and a bandage.

 

[rik_uk3]

Stick to direct pressure, the Israeli bandages are superb for this purpose.

I'd listen to Martyn, he has many years in the trade and knows his stuff, like Clint Eastwood said "Every man needs to know his limitations."

 

[Martyn]

The point I was trying to make is simply that, if things really were that bad, you could use a bone-through-the-nose or eye of newt and wing of bat approach if it got me out the other end still breathing.

I am not arguing for or against in favour of a particular product or of the military's methods.

In the early nineties I was in Holland for several months working and two of us were wandering around Amsterdam sightseeing when a down-and-out went under a tram. I've seen some nasty accidents with the mountain rescue team when I was younger but they are still relatively standard fodder; the kind you would expect. In this instance the guy was either drunk, high or both and his legs were severed just above the knee when the tram rolled over them.

That was the longest 10 minutes of my life (his too I imagine) and all we could do was use our belts as a crude tourniquet and T shirts to staunch the blood. He squealed and screamed like a stuck pig the entire time until the ambulance crew arrived and we looked like we'd just run amok in a slaughterhouse.

I doubt that any standard kit we might have had in other circumstances might have helped in such an extreme case, but the point still stands that sometimes, almost anything can be acceptable if it doesn't decrease the chance of casualty survival.

I'm not a medical expert or professional (only ever did St John's and various emergency courses) but I have a deep seated interest in the preservation of my own life and the lives of those around me by any means necessary or possible. I am guessing this goes for the majority who probably care less about the treatment and how it was administered than coming out the other end still breathing.

Barry, what I'm obviously having trouble explaining, is that haemostatic agents are not the magic wands everyone seems to think they are. You would have needed a bucketful of quikclot and a wheelbarrow of celox bandages to treat your amputated vagrant and he would probably still have needed a tourniquet tyo save his life and then he would have had a goopy mess on the end of his stumps which would mean removal of tissue to get it back to something they could work with. Your crude tourniquet was possibly the best treatment anyone could have used, quick clot or not. The stuff is used, not because it's the best thing available, but because the bloke using it cant spend 40 minutes sitting there applying pressure, because there is a load of 7.62mm metal flying round and he probably needs to go see another cas anyway. He wants to apply a fast treatment and get his head down. Haemostatic agents are a compromise, they attempt to do the same job, but do it chemically instead of physically. They are not used in civvi medicine because the medics (and first aiders) have the time and safety to do the job properly. Elevation and pressure is not a poor alternative, it's the best treatment!

 

[leon-1]

As an ex serviceman and medic trained, Celox looks good.

As a civilian and contributor to the thread, celox looks good if you have been trained in it's use and understand the implications and complications of using it. What ramifications there are can only really be exposed after the event, however I have always believed that you shouldn't bother carrying what you don't know how to / are not trained to use.

As a moderator please keep it civil and please be aware that although some of us have used and have been trained in the use of Heamostatic solutions others here have not and can be influenced by the older and bolder of us.

 

[juhirvon]

A few years back I fell pretty bad on my bike (mountainbiking down hill and slid off the narrow path into the undergrowth). Tore a 20 cm long gap from knee to the ankle. Having shorts on, I could see the blood bursting out every heartbeat (surprisingly low due to shock or surprise). Fumbled with the first aid kit from my pannier back (easily accessed in a side pocket), the kit open, the Celox pack from there and bit my lip when trying to open it. Probably inhaled half the stuff when the package finally tore. Poured the rest on the wound (probably incorrectly, didn't remember to read the instructions). The blood flow was sufficient to drain what little Celox there was away from the wound to coagulate on the back of my shin (hurts like hell when you pull it off, it sticks well enough to take half the hairs off too).

By this time I was shaking, although didn't realise it at the time. Managed to open a roll of gauze and press that against the biggest source of bleeding. A few minutes later a friend reached me, and found a punch of butterfly sutures from my kit and put those on and retied the gauze.

My friend later told me I was mumbling incoherent words repeatedly and explained that I need to fetch some water (for what, don't know. Had a almost full camelpak on me still) about half an hour before "snapping out of it". I remember being surprised my friend was there, so some blackout/phasing out happened.

I suspect I might have not managed to apply more Celox even if I had it, and the first patch didn't go that well either.

Got to a hospital some six hours later, where they cleaned the wound and redressed it. Gave me a 3 day course of antibiotics and a 20-pack of codeine for the pain and sent me home, so obviously not that bad a wound.

I don't carry Celox any more when cycling or pack packing (but do have the few sachets in my home medicine cabinet), figured it wasn't worth the money, although I did read the instructions afterwards and asked the doctor about it who explained it's proper usage pretty well.

-jh

 

[Ronnie]

As an ex serviceman and medic trained, Celox looks good.

As a civilian and contributor to the thread, celox looks good if you have been trained in it's use and understand the implications and complications of using it. What ramifications there are can only really be exposed after the event, however I have always believed that you shouldn't bother carrying what you don't know how to / are not trained to use.

As a moderator please keep it civil and please be aware that although some of us have used and have been trained in the use of Heamostatic solutions others here have not and can be influenced by the older and bolder of us.

Thanks, Leon - I understand that giving medical advice on an internet forum to a legion of unknown people entails sticking my neck out a little. However, I firmly believe that individuals should be able to make their own decisions as to how they manage their own risk, and take responsibility over their own welfare and that of their friends and family. The membership of this forum are predominantly independent and resourceful types and I felt that any information I imparted would be received in a sensible and thoughtful way and allow some members of the BCUK community to make informed choices about their FAK inventory. The majority of feedback on this thread suggests to me that this information has been well received.

The entire point of this thread was not to advocate the use of any product or treatment, but rather as a warning to avoid a specific type of haemostatic product - as per the thread title.

That being said, people can choose to put anything they like in their FAK, and I reserve the right to do the same.

 

[daryl]

Hi

I see these threads regularly on a few different forums and it always makes me giggle. However in all seriousness there are several points on here I agree with and some I dont plus a few facts being touted which are not entirely correct. Direct pressure for virtually all non tactical situations is first line action for all types of catostrophic haemorrhaging. Tactical medicine is a different kettle of fish as Martyn has stated. However virtually all ambulance services in the UK, now use critical bleed packs including CAT's, sam slings, haemostatic agents such as quik clot/celox and military pressure bandages. The JRCALC (Joint Royal College Ambulance Liason Committee) is currently reviewing these with the aim of introducing officially the use of tourniquets and haemostatic agents as best practice in certain situations.

Tourniquets are a last resort in the majority of bleeding, with the exception of amputation related haemorrhage where it tends to be so massive and difficult to control with direct or indirect pressure.

Having said that, as with advice to anyone, if you choose to use any tools to treat anyone, make sure you know exactly how to use them properly otherwise its just not worth it!!
I would also remind anyone of the reasons for any first aid treatment the 3 P's Preserve life, prevent condition worsening, Promote recovery on top of that, also remember whatever actions you take, will be judged by the court or coroner if it goes wrong.

Just a reminder though to those dissenters of tourniquet use, at least one life was saved during the london bombings by the application of an inpromptu tourniquet by a untrained layperson.

So for the right situation it could be a useful tool, although a situation unlikely to be encountered by the majority and one that the laypersons will be unlikely to judge correctly and therefore could possible mis apply.

Haemostatics agents are in my eyes generally a waste of time and expense. A good trauma dressing such as an israeli ffd and a CAT tourniquet for exanguinating haemorrhage when far from help or there are multiple casualties if you learn how to use it correctly.

Remember direct pressure first!!

 

[Xunil]

My last attempt: I am NOT arguing in favour or against any particular product or its use.

I am NOT agreeing or disagreeing with those who clearly demonstrate greater knowledge, nobody has failed to get their point across and nor am I influenced by anyone to immediately march out and get my hands on any of the mentioned products. I'd be pretty stupid to 'try my hand' with something I know nothing about.

I found the thread interesting and informative, and I stand by my 'anything goes in extreme circumstances' mentality provided the outcome is positive.

Simply put, it's the "all else has failed" scenario of the least likely string of events that lead to an entirely bizarre conclusion that everyone always says "that could never happen".

Believe me, if you have my luck, it probably could, and if it does, feel free to use anything to pull me out the other end with a pulse.

 

[789987]

well at worst if you have already bought it youve got the potential for an amusing practical joke when you mate leaves his pint to use the toilet.

 

[johnboy]

My last attempt: I am NOT arguing in favour or against any particular product or its use.

I am NOT agreeing or disagreeing with those who clearly demonstrate greater knowledge, nobody has failed to get their point across and nor am I influenced by anyone to immediately march out and get my hands on any of the mentioned products.

Don't worry it's just a forum thing... Things ebb and flow in and out of acceptability and favour. What was cool and Gucchi to have in your FAK back in 2004 and wouldn't raise a comment is now seen as being a bit OTT..

 

[SCOMAN]

Of note regarding the use of tourniquets, the RNLI has been training it's crews in their use for the last 3 years. With all the shouts and people rescued that have occurred in that time, bearing in mind 2009 was the busiest year ever, tourniquets have only been used in anger once. And yes they saved a life although I can't remember what happened to the limb and whether it was saved.

 

[FGYT]

Of note regarding the use of tourniquets, the RNLI has been training it's crews in their use for the last 3 years. With all the shouts and people rescued that have occurred in that time, bearing in mind 2009 was the busiest year ever, tourniquets have only been used in anger once. And yes they saved a life although I can't remember what happened to the limb and whether it was saved.

the Police or at least Hampshire have been issued with tourniquets

 

[greeneggcat]

I think the point is that Quickclot granules have a side effect/consequence for the user that could be unsuspected/intended. This may not be common knowledge ( as it relates to a design defect ) but is relevant to all who carry such items as an EMERGENCY agent. I dont mean " Oh how bad jim has scratched his finger, quick get the CAT and QUICKCLOT out. "

Any of us are liable to find our selves in an unexpected situation involving extreme trauma, terrorist attack, car crash, suicide attempt, severe self harm, cutting accident, chopping accident etc etc ad nauseam. The point is items like this are carried for extreme circumstances. Also I know people who would rather die than have a blood transfusion. That is their choice and they are entiltled to it. These haemostatic agents are designed for extreme situations, where quality lifesaving first aid is a requirement. They are designed to be used responsably not as gucci sudstitute for a PLASTER/FIRST AID TRAINING. No one knows what the future holds and the world, including our little isle is not as safe as we like to pretend.

It only takes a small misshap to render our safety net useless, better it is to prepare for that than sit there scratching your head as loved one dies and you blame society for a human failure in a very delicate line.

 

[Itzal]

the Police or at least Hampshire have been issued with tourniquets

All police or just specialists like firearms?

 

[Martyn]

I think the point is that Quickclot granules have a side effect/consequence for the user that could be unsuspected/intended. This may not be common knowledge ( as it relates to a design defect ) but is relevant to all who carry such items as an EMERGENCY agent. I dont mean " Oh how bad jim has scratched his finger, quick get the CAT and QUICKCLOT out. "

Any of us are liable to find our selves in an unexpected situation involving extreme trauma, terrorist attack, car crash, suicide attempt, severe self harm, cutting accident, chopping accident etc etc ad nauseam.

How many times in your life have you had a severe arterial bleed ...or witnessed a severe arterial bleed? Do you know anybody who has seen one? Thankfully, they are actually very, very rare. The catchment for our hospital is vast and covers a long stretch of the M6 as well as a large urban conurbation and a good chunk of national park area. Almost all the severe bleeds we see are as a direct result of RTC's and they are still very rare. No bombs, bullets or IED's you see. Having or even witnessing a severe arterial bleed is not a realistic risk. It's your money and you can spend it how you like, but lets be clear, we are talking about carrying something in your rucksack that is designed to be used in highly specific circumstances, that you dont know when or how to use properly, for a condition you will almost certainly never even see your entire life. There is nothing wrong with being prepared for an emergency, but as i said earlier, it's a bit like walking round wearing a parachute in case you happen to fall off a tall building.

...and you are still missing the point ...elevation and direct pressure works just as well if not better and it's free!

 

[ashes1627]

Thank you Ronnie for the warning, I have now taken quickclot off my list of things to buy and put in my FAK.

 

[Martyn]

One final hypothetical....

Any of us are liable to find our selves in an unexpected situation involving extreme trauma, terrorist attack, car crash, suicide attempt, severe self harm, cutting accident, chopping accident etc etc ad nauseam.

OK, lets assume you come across one of the above, you've conducted an assessment and you think a haemostatic agent is indicated for some reason, what product are you going to use and more importantly, how much of it will you need? Or to put it another way, what kind of injury are you hoping will be fixed with a 15g sachet of celox? How much do you need for a traumatic amputation? What about a severed femoral artery?

 

[Martyn]

Here's another example of ally military kit. Intra osseous cannulation device...

[video=youtube;iEOLm2e6ovc]http://www.youtube.com/watch?v=iEOLm2e6ovc&feature=related[/video]

Not just military, according to the resus council, there are only two acceptable methods of drug delivery during a cardiac arrest now, IV and IO (ET has been binned). That said, I doubt you'll find the IO route used much in the NHS or at least not as a first choice. The military on the other hand, teach IO insertion routinely because it's fast and field expedient and you dont have to fanny around looking for a vein, just stick it in the sternum or shin. One for the FAK?

 

[21st century pict]

In my tracking kit Ive only 1 Celox 15g Haemostat Granuales, 1.NATO emergency trauma bandage, and 1 Resusitation face shield (CPR).There is also a Heatsheets emergency bivvy bag in my pack 2 for 1 and all that.
By the way i tried the superglue trick once on my finger it got infected and two days later i had to burst it open to let the **** out The 5 minuets looking at it first was by far the worst bit .