A Better Way to Stop Bleeding: QuikClot Combat Gauze Gives Providers Fast Flexibility

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Last summer, an unfortunate Texas tree trimmer’s leg got caught between a large limb and the fork of a tree, leaving him hanging entrapped. His leg nearly severed, he was bleeding heavily and in dire straits despite three tourniquets applied by responders. It took a field amputation to free him.

On the ground, the bleeding grew worse. “Now he was supine, not inverted,” recalls Mark Escott, MD, FACEP, medical director for the local Montgomery County Hospital District EMS. “In that circumstance, we had to utilize five QuikClot dressings to control the bleeding. And he survived and did very well.”

Those dressings—specifically the z-folded QuikClot Combat Gauze from Z-Medica—represent an emerging standard of care in the treatment of severe hemorrhage. Part of Z-Medica’s range of hemostatic products for EMS and others, it comes in 3-inch by 4-yard strips of nonwoven hydrophilic gauze impregnated with kaolin, an inorganic mineral that accelerates the body’s clotting cascade.

For prehospital providers, it’s a leap forward in the treatment of junctional wounds and other injuries not suited to tourniquets and pressure. Escott became a fan as a tactical physician.

“It became apparent to me,” he says, “that this was a product that was effective, and for which we had no real alternative currently on our ambulances. We thought it was time to roll it out to mainstream EMS.”

MCHD providers trialed the gauze in animal labs before embracing it systemwide a couple of years ago. Recently improved through feedback from the U.S. military, it now comes z-folded to prevent the dropping/contamination that might befall rolls, and with an x-ray-identifiable strip to make sure it’s detected in the OR. Like other QuikClot products, it’s pliable and contours to any wound. The Committee on Tactical Combat Casualty Care recommends QuikClot Combat Gauze as its preferred hemostatic agent for compressible hemorrhage not amenable to tourniquets.

For MCHD, the Combat Gauze has been one component of a revamped trauma resuscitation approach that also includes Combat Application (CAT) Tourniquets and hypotensive resuscitation strategies for fluid management. The combination has contributed to a notable difference in lives saved.

“The key point is, there’s no substitute for what this stuff does,” says Escott. “We’re at a stage now in civilian EMS where we need to be able to provide the same level of care as we can on the battlefield. Step 1 of that was to utilize tourniquets, which is now standard of care. The next step is to use hemostatic dressings. To me we’re at a stage where it shouldn’t be an option anymore—they should be an expected piece of equipment on all ambulances.” 

For more information, visit www.z-medica.com.