QuikClot

[Sneaky SF Dude]

Anybody using this stuff?

[static]

not too many units are using quick clot due to the thermal burns that it induces. this being its primary means of stopping a massive bleed such as a femoral, kinds of makes the doc wonder what's worse. if the means of transport are there, ie helo, then a tourniquet is a much better option. quick clot burns the ends of the artery and everything else it touches.

[SOTB]

Sneaky,

Other than you guys giving me my recent cert on being able to mouth-to-mouth teenage girls, I really recognize that I am not anyone to comment on medical stuff.

Having said that (and basically sticking my nose in anyway), I was reading on this stuff -- both on the board and in other areas. I have read nothing good about it. Appears that, bottom line, it does not hold up under the pressure of arterial bleeds. This burning issue seems to be another problem also (I had not read about this earlier).

I did read here on SOCNET some posts from a couple of our medics (Rangers, I think), that also didn't like it, and gave alternatives.

You know, if he has a Harley, you could just let him bleed out then stake claim over the bike...........

[RsovRanger]

Marines use it, and hate it, and are sorry they got it.

Rangers and all our "buddies" don't use it. the Hemicon keitisen <i can't spell right now> dressing is about a billion times better than the quickclot. I've seen the hemicon dressing stop an arterial bleed in 2 minutes on live tissue. never seen quickclot work.

[Sneaky SF Dude]

Thanks for the feedback. Rsov, can you PM a POC for those dressings when you get a little time?

[frogstyle]

I use Avitene on myself for fights, and on occasion Adrenaline in 1/100 saline.

Obviously not good for anything buts guoges and cuts.

[RsovRanger]

shit, don't want to bleed in a fight and you have a cut? get lidocane with epi... lol

[frogstyle]

RVRGR,
Youre close. The French fighters use cocaine mixed with pomade!

[SHYTE]

Does Avitene hold for a period of time or does it stop bleeding? I've never actually used the stuff, only read about it. Isn't this the same type of stuff that is used in surgeries?

[Chris Mac]

I'm over here at Regiment right now and I get to play with some of the stuff we have here. I will tell you that we do have some form of a quick clot bandage that they want to put into use. I just saw boxes of it in the back one time and my doc was telling me that it causes the blood to coagulate rapidly. We didn't really get into too much detail about it and what it was called, but I'll get back to you on it.

Take Care

[mac3982]

has anyone tried dermabond?......its been in use in the er a work in for awhile... works well some found its way in my jump bag....

[mac3982]

sorry about the grammer can't spell dermabond in the er that i work in..

[TerribleTed]

Yeah, I've used it. But not to stop bleeding with, just to close simple lacerations. I haven't made up my mind if I like it better than throwing in a few sutures.

Kids always wiggle whenever you get close to them with anything.

[mac3982]

it doesn't work well on lacs with alot of meat, but it works for just about anything else..... we use alot of skin staples also, just not on the face, sept for this one time a med student put it across the forehead.....but nothin beats a little needle and thread if you got the time..............but most of the time its tooooo busy to stitch, got to move the pts..........we just had a doc get stabed in the face for "makin the pt wait to long"..........but thats a whole nother story........

[RsovRanger]

according to all the guys I work with, dermabond is the best thing since sliced bread in terms of dealing with various cut's lacerations and general idle ranger sharpening a knife type incidents.

[Bandaid]

Dermabond is an excellent method for obtaining closure of wounds that can heal by primary intention. Meaning wounds that can be closed with a close and intimate relationship between the wound edges. This is true for external "skin' lacerations as well as internal (ex. intraoral) mucosal lacerations. As stated already....It is not for hemostasis. In a clinic environment I use surgicell, gelfoam, direct pressure, suturing, heat/electric cautery and as a last resort vessel ligation are hemostasis options. Out in the field, find someone hardcore like Frogstyle to heat up his knife and cauterize things for you John Wayne style! :cool:



BTW- Dermbond works wonders for placing a protective coating over ulcers/abrasions/minor burns inside your mouth and will knock out the sensitivity.


Unless you are going to suture/close a wound or are injecting Epi BEFORE the wound is actually made to decrease blood flow in the area you are working, Epi will only be a temporary fix at best. It would be dangerous to imply that one can simply inject epi, say "hey that stopped the bleeding", and then send them back out into world. It will almost always begin bleeding again later. I know that is not what Frog was saying. I just didn't want anyone to misunderstand what he said.

[Doc T]

Originally posted by Bandaid
In a clinic environment I use surgicell, gelfoam, direct pressure, suturing, heat/electric cautery and as a last resort vessel ligation are hemostasis options. Out in the field, find someone hardcore like Frogstyle to heat up his knife and cauterize things for you John Wayne style! :cool:


what kind of clinic work do you do that you use surgicel and gelfoam or the bovie? I have used both often in the OR as well as avitene...prefer fibrin glue at present but that is just a personal opinion...

cannot imagine a clinic patient needing this kind of treatment... or an ER patient for that matter...

just curious...

doc t.

[RIT_MEDIC]

Subscribing to this one.

Also curious about the surgigel...



James D

[Bandaid]

Good Morning Doc T :
(sorry about that spelling error in my last post):o



In my clinic, I use the referenced techniques during surgery procedures.

I use surgicel or gelfoam rolled in w/tetracycline (preferred method) as a postpoperative wound packing with high success.
The main areas that require this are postop surgical sites where I pack the gelfoam into the boney socket or defect and then suture over it with a figure 8 technigue. This obtains two important things for me, reapproximation of the wounds edges and positional stability of the hemostatic agent in the wound. This technique is used on most of my complicated exodontia that had required substantial alveolar bone removal for access as well as for preprosthetic surgeries such as alveolplasty for bone recountouring in conjuction with multiple extractions. Gives good clotting and allows for fewer postop complications IMHO.

Sometimes, as you may know, those little bleeds from the bone can't always be swedged completely closed or the tissues around the wound ooze slowly after direct pressure therefore the surgicel/gelfoam work perfectly. That combined with the fact that most of my patients are either on coumadin/plavix/aspirin or some combination of them. Now you see why I want to give them every opportunity to obtain a stable blood clot in the wound. That with careful prep by ordering labwork and getting the INR values between 2 -2.5.

Your right, most GP doctor's clinic would probably not need these techniques and materials because they would send the patient to the ER. But we "SacaMuelas", we intentionally cause the trauma with our procedures so we have to repair it. :D

Dr Mac

[CPTAUSRET]

Originally posted by Bandaid
Good Morning Doc T :
(sorry about that spelling error in my last post):o



In my clinic, I use the referenced techniques during surgery procedures.

I use surgicel or gelfoam rolled in w/tetracycline (preferred method) as a postpoperative wound packing with high success.
The main areas that require this are postop surgical sites where I pack the gelfoam into the boney socket or defect and then suture over it with a figure 8 technigue. This obtains two important things for me, reapproximation of the wounds edges and positional stability of the hemostatic agent in the wound. This technique is used on most of my complicated exodontia that had required substantial alveolar bone removal for access as well as for preprosthetic surgeries such as alveolplasty for bone recountouring in conjuction with multiple extractions. Gives good clotting and allows for fewer postop complications IMHO.

Sometimes, as you may know, those little bleeds from the bone can't always be swedged completely closed or the tissues around the wound ooze slowly after direct pressure therefore the surgicel/gelfoam work perfectly. That combined with the fact that most of my patients are either on coumadin/plavix/aspirin or some combination of them. Now you see why I want to give them every opportunity to obtain a stable blood clot in the wound. That with careful prep by ordering labwork and getting the INR values between 2 -2.5.

Your right, most GP doctor's clinic would probably not need these techniques and materials because they would send the patient to the ER. But we "SacaMuelas", we intentionally cause the trauma with our procedures so we have to repair it. :D

Dr Mac

You practice oral surgery?

Terry

[Bandaid]

Yes... If you check my profile you will see I am not a MD but a D.M.D. (same as D.D.S. which is a Doctor of Dental Surgery) . Wasn't trying to confuse anyone as to my background . I have to control hemmorage routinely during surgical procedures and have vast personal experience with the materials being discussed in this thread. Was just adding my $.02
Hope that clears up the confusion.... I guess it did sound odd trying to place my last comments coming from the field medic/EMT/MD perspective!!! LOL

[CPTAUSRET]

One of my best friends is retired Chief of Oral Surgery, Iowa City VA:

Nancy's first husband, (deceased cancer victim) invented Nitinol wire, still the highest grossing patent the University of Iowa has ever had:

As you are relatively new to the boards, you probably are not aware of who Nancy is, go to a search engine, and do a search for Nancy Andreasen (my wife):

Terry

[Bandaid]

Thanks Terry...I will research her name on here.

Royalties..........now that is the way to make money the right way!!! :D

[CPTAUSRET]

Originally posted by Bandaid
Thanks Terry...I will research her name on here.

Royalties..........now that is the way to make money the right way!!! :D Bandaid:

I meant a search engine outside of SOCNET, ie Google, Net Ferret, etc:

And George Andreasen, donated all the royalties back to Iowa:

One thread on SOCNET that you would find interesting, "Vietnam vet in President Clinton's Oval Office", it relates the 45 minutes I spent in Clintons Oval Office on Nancy's coattails. She was being awarded "The National Medal of Science" America's version of the Nobel Prize:

I can direct you to the thread if you can't find it, just let me know:

Terry

[Bandaid]

I was reading those posts as you typed......searched your name and hers.
thanks terrry


your wife sounds like a terrific person...I will search the net next.


Somehow, I feel feeble and Unimportant now after my reading.... I need to go do something important! :D

[CPTAUSRET]

Originally posted by Bandaid



Somehow, I feel feeble and Unimportant now after my reading.... I need to go do something important! :D

Bandaid:

I know how you feel, my career is history, Nancy is still saving the world:

Interesting sidelight Nancy attended Oxford on a Fulbright, taught English Lit at age 19, attended med school five years later:

Ph.D. is in English Lit:

Terry

[Bandaid]

That is IT!!! I can't handle it anymore.... I used to dream what it would be like to be "Doogie Howser M.D./prodigy talent" and you wife just decided to actually become the real living version!

I pale in comparison....I need to go save the world too. !! HAhAHAHA LOL ;)

She is very impressive..... bet you don't win the JEDI mind control games in your marriage. :p

Beaux

[CPTAUSRET]

Originally posted by Bandaid


She is very impressive..... bet you don't win the JEDI mind control games in your marriage. :p

Beaux

No I don't:

Sometimes I even embarass her in public when I offer to kick the ass of some liberal assed military baiting schmoe:

It has happened more than once:

Terry

[Bandaid]

Just to clarify Terry...

I'm a general practioner DMD who performs vast amounts of oral surgery by choice. Take a lot of CE in it and it is my favorite discipline. I reread your original question to me and don't want to mislead you as to my credentials. In dentistry, General guys can legally do anything they have been trained to perform and feel competant in completing. Was starting to feel like a poser when I reread your prior postings with you assuming I was an oral surgeon verses performing a lot of actual oral surgery. :o
But, I like to think I know my Stuff!! LOL


did that make sense? hope so.
Beaux

[CPTAUSRET]

Originally posted by Bandaid
Just to clarify

did that make sense? hope so.
Beaux

Bandaid;

Makes perfect sense:

Glad you found your way to SOCNET:

Terry

[CPTAUSRET]

Sorry for Hijacking your thread, guys:

Knockin em out:

Terry

[Doc T]

have any of the Medics on this board used Rapid Deployment Hemostatic (RDH) bandages?

people are starting to study using them intra-abdominally and was wondering how people find they work on extremites where it now has FDA approval...

thanx.

doc t.

[RsovRanger]

We use hemcon dressings, don't know if it's the same thing.

[Moran 'doc']

The quick clot is used by the Mariens in all there truama kits as well as special ops The product has a severe down fall for the Jar heads the package is exactly the same as a pound cake . The consistancy is that of old paper isulation . The burns are just the chemical reaction of the water (in the blood) cause in exothermic reaction . The clott starts as the chemical reaction is initiated . The burns are minor to the exterior of the wound but can be quite painfull . If it is a minor wound that is being misstreated with QC that is were the bad rap comes from . Much better off with the field dressing onto preasure. It is designed for big blood moving fast out of PT.
One of the biggest downfalls is using it as a old fashion sulfa product and dumping into wound . It needs to be packed like John wayne putting chaw in a wound and covered with a tight dressing . The saving grace is the "isralie " bandage it is a ace wrap with a maxi pad attached and at the end a placstic raised bar that at the end you fold over to make it tighter. That is also in the trauma package.
The fibinogen bandage is a diferent animal in the same barn it works like a graft from the fibrn to the fibrinogen clotting process great for Forward Surgical Teams or BAS not practical for medics too much $ . the QC is dirt cheep . There is some great studies on hogs being gaffed and QC TX made me think of bacon . Hey medics please read my post in theis section looking for ideas . Doc Moran

[Moran 'doc']

have any of the Medics on this board used Rapid Deployment Hemostatic (RDH) bandages?

people are starting to study using them intra-abdominally and was wondering how people find they work on extremites where it now has FDA approval...

thanx.

doc t.

FST teams have them

[RsovRanger]

Hey doc, we've got those Hemcon dressings now, minimum 2 per medic... from what field experience we have with them they are worth the cost.

We just got them when we went to OIF.

[Moran 'doc']

RsovRanger sorry butchard the name in last post you became the kosivo ranger. The best was to descibe those is waiting in line at a state inspection station in a state the says no holes in the car. In the hands of a body work guy(surgion) with cutting toches all opened and exposed he could pull it off before the guy in front of him finished . But for a person to try to slap a quick patch on it may not work/ look the best. Sorry auto mechanics and medacine have always been the same to me. DOc Moran

[RsovRanger]

I don't care what you call me, as long as I know I'm being talked to :)

It's better to slap a patch that may not be pretty but gets the job done than leave the hole in the oil pan, know what I mean?

[Moran 'doc']

That is true but better to insert a tampon in the hole and spend the time to treat the exit wound. The comparison I made was to use the Quick Clot as apposed to the treated bandage. Beleve me Im not an expert but I have a fortay in Medicaine . To practice as a special ops medic is hard these days my family keeps me Conus for deployments my last oconus tour was the section Sgt. of a FST team that we pulled an active duty trace to the 10th MT.
Now I do the next best thing is teach the "witchcraft. "Working as an inner city Paramedic helped for the last 11 years. But on my worst day as a civillian, with murphys law in full affect I can sit there and grin. DOc Moran