Haemostatics (catastrophic haemorrhage)

Ref Haemostatic agents

Have had varying degrees of success with different products, both with live casualties and live tissue courses. Also I'm a Theatre Tech so conversant with wound packing, implications etc. To play it safe, I currently favor celox trauma gauze (multi-role for burns as well) for packing and use the celox plunger system for difficult access to wounds or ones that would prove difficult to pack due to lack of access. We must remember that it is all very well for surgeons to moan about the use of haemostatics but we (Medics) are here to preserve life and prevent fatalities FIRST in already difficult conditions.
 
MattBlack000 said:
(multi-role for burns as well)
Click to expand...

Careful mate. As much as I like Celox gauze I would not use it for burns. I always am critical of any information coming from the manufacture's website. They will say anything to sell their product.

Burns are best treated with cling film. It's cheap, lightweight and sterile.

I would keep my Celox for bleeds and not waste it for burns.
 
Phecta said:
we use CELOX inside a pad or sterile dressing / Bandage as surgeons here in the UK are quite funny about its use. They tend to throw such a dicky fit when its dirrectly applied to catastrophic wounds. Remember although it gets broken down by the body, this proces takes a long time and a surgeon wants to get in there asap and deal with the wound. They get quite irrity when yougive them a wound that has to be carefully cleaned out as they wont seal a wound in an nhs hospital if they think any foreign material may still be in there as they cannot guaruntee the competence or hygiene of the person applying the agent.

Just something you do with experience.

Saves a lot of hastle. It would be a different story if you knew your casualty was going to be dealt with by a military surgeon as opposed to professor hugle bubble the third lol
Click to expand...

I have to say Phec me old mate, that I personally don't give a fook what some surgeon likes or dislikes. Without detracting from the thread, sounds like they belong to the same golf club and lodge as the Anaesthetists who seem to make it there lifes work to dis paras for intubating.

Even if they're the ones who deploy to sandy places, they're not first there, they don't by choice work in the field and they are very unlikely to be working in isolation.

Most of us operators do all of those things without support, so work on the principle of doing what works with the limited kit you've got.

Having said that, I take your point that in the UK the NHS paras are steered by these narrow mindsets, and unfortunately, have to toe the line, lest they get a corporate shafting up the down only tunnel :eek:

OED out
 
Hey all,
I'm a civilian paramedic and deputy sheriff researching field use of hemostatic agents. Is combat gauze (either QC or Celox) viable for hemorrhaging abdominal GSWs where the location of the bleeding is not visible?
 
Hi Nick, As I'm sure you already know, the challenges posed by penetrating abdo wounds are huge.

Given that your options may be restricted to packing it tight and rapid evac, I would seek any advantage afforded to me whilst carrying out those drills. A haemostatic agent on a gauze carrier is easily removed in theatre. Although the site of the bleed may remain occult, if you pack it tight enough, you can reduce the bleed space / volume significantly. The same principles do not apply for non gauze based haemostatic agents.



Hope that helps.
 
I think its time a surgeon gets into this thread.

Invictus has hit the head on the nail. Controlling non-accesible and (non-compressable bleeds) i.e. GSW/penetrating wounds to the thorax or abdomen needs to be adressed with a hemostatic agent and/or reduction of the space that the bleeding can go into to.
Therefore packing a hem-agent in the depth, additional gauze on the top and compression from the outside is what will get you or the patient actually the farthest.
Remember to read up on your permissive hypotension protocol, as that can limit the bleeding to a certain extent from within.

An old truth about GSW wounds is that the most important liquid in the Prehospital environment is diesel, gasoline or jetfuel.

AND I´M AN SURGEON AND USED TO BE ANAESTETHIST. DINOSAURS DO EXIST....!!!!
As long as you get me a live patient, you wont hear me complaining about how you got them to me

See you in London for the CTI perhaps ??
Invictus said:
Hi Nick, As I'm sure you already know, the challenges posed by penetrating abdo wounds are huge.

..... A haemostatic agent on a gauze carrier is easily removed in theatre. Although the site of the bleed may remain occult, if you pack it tight enough, you can reduce the bleed space / volume significantly.
Click to expand...
 
Last edited:
Back
Top