A Warning Re Quikclot

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jonajuna

Banned
Jul 12, 2008
701
1
s
as we are talking (generally with the nature of the forum) bushcraft rather than combat or teotwawki, wouldn't 99.999% of major haemorrhage be due to a sharp blade cut or internally due to a fall?

would a haemostat be any real use in this? surely with a clean cut arterial bleed, the pressure would be too great for a haemostat to pug the gap (vs a blast type trauma which tends to be a ragged wound which bleeds at far less speed as far as i know (retraction of artery, constriction of muscle tissue etc), internal bleeds are well, beyond all bar a surgeon

maybe see the benefit of a haemostat bandage as best of both worlds, but is there real benefit vs the added risk for the situations us civvies are in?

would've thought, short of tying off the limb, if you dont get blood in and and a clamp on the artery within an hour (and subsequent surgery) it'll be ni nights anyway, so these scenarios of being in the backabeyond, are perhaps all a bit beyond limits

personally, i've nursed 2 arterial bleeds, both from clean cut wounds (but then, years in acute psychiatry gives you that opportunity) direct pressure and elevation stemmed the flow (although still painted me red) for the 30 minutes it took for the paramedics to come and take over
 

tenderfoot

Nomad
May 17, 2008
281
0
north west uk
Thought it might be something like that but couldnt track it down online.
Quite useful ( for me anyway ) ill probably use that.
ta martyn
It's a mnemonic, an acronym that helps you do a thorough and systematic exam of the airway, neck and chest.

FLAP is Feel Look/Listen Auscultate Percuss.
TWELV-E is Trachea, Wounds, Emphysema, Larangeal crepitis, Veins and EVERYTHING (have you checked TWELV?).

It's basically a chest exam - like when you go to the doc and he feels round your neck, listens to your chest with a stethoscope and taps the back of his fingers, he's basically doing a mini flap twelv. The acronym is in common use with paramedics and ER staff as it kind of hold their hand through airway and chest assessments.
 
A

Adi.

Guest
A very interesting thread, a good read.

When I am asked about Haemostatic products I tell people that it was designed to help the medic and not the casualty!

Let me expand on that a little.
You are doing your primary DRAB assessment. You are at the very first stage, D for Danger. Are you in a hostile environment were you can be shot at if you stay in one location for any length of time? If the answer is Yes then by all means use a Haemostatic product such as Celox.
If you are not in a location that is likely to mean you are a target for someone armed with an AK47 then there is little need for products like this because you have time on your side to elevate and apply direct pressure.

As a side note. Celox is available to the NHS and paramedics and is being used quite effectively in the UK.

NHS Supply Chain
News article
News article

But, that does not mean the rest of us need to carry it in our kits when elevation and direct pressure has the same results.
 

EdS

Bushcrafter (boy, I've got a lot to say!)
Celox gauze / bandages are used by a number of organisations in the UK. The problems mainly relate to the powders and granular. The Celox bandages work like an extra absorbent normal bandage. Also the mechanism of CElox and Qikclot is different (or at least way).
 
Aug 8, 2011
3
0
Lancashire
Folks,

An interesting read and a further interesting mix of opinions some based on fact and some based on hear say I think.

I’ll give you a bit of an insight into my medical background before I start trying to put anything into perspective.

I joined the army in 1979 as a boy soldier where I became a Parachute Regiment Soldier serving all over the world and in various conflicts. In 1990 I became a military medic and then in 1994 I left the Parachute Regiment and joined 23 Parachute Field Ambulance as an RAMC medic again serving in various conflicts and peace keeping mission throughout the word.

I completed my Paramedic training whilst with 23 PFA and then went on to do a 3 year civilian course (Courtesy of the Army) to become an Operating Dept Practitioner at Southampton General Hospital. I left the Army in 2002 after a good career with plenty of medical qualifications and quickly become involved in the work of the Private Security industry working as a security operator/medic. First in Nigeria and later on in places such as Iraq, Jordan, Kuwait and Afghanistan. I currently work between working on board ships in the Gulf of Aden as protection against Somali Pirates and the UK teaching for security organisations that provide body guard courses etc.

Whilst in Iraq I was the senior medical advisor/instructor for a private security company of some 2,000 men and women who worked for the US Dept of Defence. It was my job to insure the correct medical training was given to all members of the company, the correct implementation of current medical protocols and update the use of current medical equipment and tactics, such as QUICK CLOT/HEMCON/CELOX/CAT.

With regards to any massive haemorrhage or arterial blood control, the simple things work first time every time and that should never be forgotten!

When we first went out to Iraq we were still using First Field Dressings (FFD) and SAMWAY tourniquets which had been in service well before I had joined the army in 1979 and it wasn’t until around 2004/5 that we started to get issued the new Israeli dressing (Favoured by the US Armed forces) which is a far better dressing for the job.

We were further issued a new tourniquet system in the form of the Combat Army Tourniquet (CAT) which again was a major leap forward in medical intervention in the field and indeed as of about 12 months ago the UK NHS ambulance service have adopted these devices for themselves.

You have to remember that Haemostatic agents such as QUICK CLOT where introduced as a result of major battlefield trauma which involved massive limb and lower torso trauma. It was not introduce as some may think, to replace the tourniquet! It was in fact introduce for use in areas where a tournquet could not be used, such as high up in the groin or the arm pit, places where you just couldn’t hope to apply a patent tourniquet to your casualty!

As has been mentioned, there are indeed risks or post use complications to using QUICK CLOT and if people where only to read the product information it would save major dramas on the ground!

QUICK CLOT once introduce to fluid of any kind will generate a heat approximate to that of a boiling kettle of water for approximately 15 seconds. It is made of sand, magnesium and iron. The chemical mix is what generates the heat and the sand aids coagulation of the blood. Once applied correctly the excess granules must be washed clean from the wound to avoid any potential for embolisms.

QUICK CLOT comes in two forms!

• QUICK CLOT granules
• QUICK CLOT T Bags (4 bags attached in a line)

As has been mentioned the granules cause great heat and potential tissue destruction as well as the possibility for an introduction of an embolism into the circulating system which could lead to a Stroke, Heart attack, etc.

The T Bag version on the other hand was introduced a couple of years after the granule version because the manufacturer realised based on post op medical reports, that the product was perhaps not the best.

SAFETY CONSIDRATIONS:

QUCIK CLOT MUST NOT BE USED IN THE FOLLOWING ANATOMICAL AREAS:

• Eyes
• Nose
• Mouth
• Cranial cavity
• Thoracic cavity
• Or any are of the body where there is unintentional exposure to a mucus substance

Its main function is to stem the flow of blood from a massive arterial bleed when a tourniquet cannot be used!

As you can see QUICK CLOT is perhaps not the best haemostatic agent that has ever been introduced and indeed it has mixed reviews in the medical circle. I myself withdrew it from service from our medical trauma bags because it introduced too many negatives rather than positives for saving lives!

The biggest problem with introducing too many new “SHINEY” medical products on both the battlefield and the civilian side of trauma care is that the user is drawn away from the basic medical protocols of treatment. Treatment which works well and works FIRST TIME! EVERY TIME!

So in closing I would urge you all to forget about these nice new shiny items which look like they do the work for you, and instead urge you to KISS (Keep It Simple Stupid).

After all you cannot guarantee that in any given emergency situation that you will have any medical equipment with you let alone haemostatic agents such as QUICK CLOT! So learn the basic medical intervention protocols and stick to them because your knowledge and use of the simple things around you are all you can guarantee to have on the day it may happen to you. Isn’t this what BUSHCRAFT is all about?

I hope this was informative without being lecturing guys, but going off half cocked can get someone killed regardless of environment, and from the Medical Legal side of things can land you in prison for medical mall practice and negligence at best. It takes approximately 30 seconds for someone to bleed to death in your arms! It can take longer than that to mess around opening the packet and application of the product!!!!!

Cheers all

Kenny


P.S. I have not replied on the subject of other Haemostatic agents because this thread is about QUICK CLOT and i didn't want to end up writting WAR & PEACE and boring th pants of you all.:D
 

Ronnie

Settler
Oct 7, 2010
588
0
Highland
I have not replied on the subject of other Haemostatic agents because this thread is about QUICK CLOT and i didn't want to end up writting WAR & PEACE and boring th pants of you all.:D

Excellent post, Kenny. Now tell us about the other haemostat products please!
 

Mikey P

Full Member
Nov 22, 2003
2,257
12
52
Glasgow, Scotland
Standard field dressing (or more than one) is sufficient for nearly every injury where something like Quickclot would be used. Substances like Quickclot were developed for situations such as deep penetrative gunshot wounds and traumatic limb amputation where combative had to be immediately stabilised as much as possible and then removed under fire. There is, therefore, a risk associated with the use of these kinds of 'quick-fix' solution. You must assess the the risk and act accordingly - if you screw it up, you have to live with the consequences. Know the risks of getting granules in your eyes and mouth. Make your own call.

PS - Great post Kenny and great to see someone with such experience continuing to push home KISS. FFD and knowledge - the way forward!!!
 
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rik_uk3

Banned
Jun 10, 2006
13,320
24
69
south wales
Very very good post Kenny, much of what you said has been posted by an A&E manager and fell of deaf ears and sad to say most won't listen to you either (although your post is 100% spot on), the lure of new kit overcomes common sense so often :(
 

Mikey P

Full Member
Nov 22, 2003
2,257
12
52
Glasgow, Scotland
Very very good post Kenny, much of what you said has been posted by an A&E manager and fell of deaf ears and sad to say most won't listen to you either (although your post is 100% spot on), the lure of new kit overcomes common sense so often :(

Heh heh! And Quickclot's not even shiney!
 

Paul_B

Bushcrafter through and through
Jul 14, 2008
6,154
1,546
Cumbria
Interesting all the acronyms and medical stuff but it kind of comes down to (in my mind at least) if you are not trained to use or do something don't do it!! There was another thread about how superglue was originally developed for wounds for the army (actually developed before then for others but the for the Vietnam War bit has stuck). I thought the conclusion is not to use that if you don't know what you are doing. I think the same applies to those QC type products. There are obviously medics both civvie and military trained and paramedics and it wouldn't surprise me if some doctors have appeared or will. All these people probably have the training and experience to use fancy kits with chemicals to clot blood or close wounds or whatever. That is good for them but IMHO if you haven't used or trained to use something then don't use it.

All these discussions on a site like this is good information among those with higher levels of training but this is a site for all. Perhaps it is not the place to discuss higher techniques than the general public get trained to do. It might lead some into carrying it in their kit just in case and even using it when perhaps its not right to use it. Ignorance is everywhere and ignorance in major trauma surely is not good.

Well I've given my viewpoint. I'll stick to the usual dressings and plasters in my kit and leave QC and superglue and other things like that to the medics.
 

Ian S

On a new journey
Nov 21, 2010
274
0
Edinburgh
....I've given my viewpoint. I'll stick to the usual dressings and plasters in my kit and leave QC and superglue and other things like that to the medics.

Yup, my way of thinking as well. I carry a 10 person HSE refill from Screwfix, which is a decent kit and costs £7. I know how to use everything in it and I (or another user....) won't be tempted to go too far with Gucci kit.

Cheers
 

cave_dweller

Nomad
Apr 9, 2010
296
1
Vale of Glamorgan
It's a mnemonic, an acronym that helps you do a thorough and systematic exam of the airway, neck and chest.

FLAP is Feel Look/Listen Auscultate Percuss.
TWELV-E is Trachea, Wounds, Emphysema, Larangeal crepitis, Veins and EVERYTHING (have you checked TWELV?).

It's basically a chest exam - like when you go to the doc and he feels round your neck, listens to your chest with a stethoscope and taps the back of his fingers, he's basically doing a mini flap twelv. The acronym is in common use with paramedics and ER staff as it kind of hold their hand through airway and chest assessments.

Is that a new mnemonic? Just asking 'cos wifey (an ED consultant) had never heard of it when I asked about it! Maybe she need to go on a refresher...
 

spoony

Need to contact Admin...
Oct 6, 2005
1,402
12
54
tyne and wear
www.bike2hike.co.uk
Very good thread this, although the original posted tried to warn you not to use quick clot, upon reading the info on the celox site they actually sell family kits for home fak, so cant sell the prob of having one of these in your pack, I would get one for my stalking fak. Only the bandage type not granules.
 

nigeltm

Full Member
Aug 8, 2008
484
16
54
south Wales
Is that a new mnemonic? Just asking 'cos wifey (an ED consultant) had never heard of it when I asked about it! Maybe she need to go on a refresher...
I dont know about the FLAP part (new to me) but TWELVE has been around for a while and is part of the Casualty Care training for Mountain Rescue. There is a slight difference in that the "E" is for "oEdema" (originally based onthe American spelling) rather than "Everything".
 

cave_dweller

Nomad
Apr 9, 2010
296
1
Vale of Glamorgan
I take it that is sarcasm? :rolleyes: I think it's a military thing, I havent heard it much, I had to google it the first time. :D

No - not sarcasm, honest! It was a genuine question, because I know that these things change a lot (witness - ABC, then ABCD, then ABCDE, then someone says "primary survey-catastrophic hemorrhage-ABC" etc, and I really thought it might be something newfangled. I'm an engineer, not a medic Jim:D

My first aid ticket is years out of date, so I try to keep up in the worst, most dangerous way - by reading about it!
 

cave_dweller

Nomad
Apr 9, 2010
296
1
Vale of Glamorgan
I dont know about the FLAP part (new to me) but TWELVE has been around for a while and is part of the Casualty Care training for Mountain Rescue. There is a slight difference in that the "E" is for "oEdema" (originally based onthe American spelling) rather than "Everything".

Thanks for that. I shouldn't be surprised that different services use different protocols based on environment, equipment, timing and so on - by the time somebody gets to the ED, if the first parts of the ABCDE.... haven't been done, the patient is probably dead. Wifey keeps telling me that if she was to be found seriously ill by the side of the road, she'd want to be found by a paramedic and final year ED Registrar - not by a consultant. The registrar would have 'up to date' training, and the paramedic would probably be the most accustomed to dealing with a 'real' (pre-hospital) emergency.
 

fast but dim

Nomad
Nov 23, 2005
317
6
52
lancs
great thread. It seems to me there are a few of posters who genuinely know what they are talking about from a medical perspective, and a load more who are wasting their money and risking their health by carrying celox with no idea of how to use it properly.

I work in the fire service, i'm a trained trauma tech ( apparantly ) and i would claim to have no more than a very basic understanding of first aid backed up with common sense, and enough exposure to serious injury to not panic when faced with nasty injuries.

Please listed to the professionals, not the first aiders / bushcrafters with little or no hands on experience of dealing with trauma.
 
I just use Yarrow...

I didn't want this post to get lost in the horrors that is Quickclot.

When I was working as an expedition medic for the "hoods in the woods" programme, I had a casualty with epistaxis that wouldn't stop. I tried all of the tricks short of an inflated foley catheter. I remember reading about the haemostatic properties of Yarrow and in an act of desperation I found some Yarrow, crushed it into a pulp and shoved it up his nose.

The bleeding stopped in twenty minutes.

Yarrow is also used for internal bleeding as well.
 

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