# Quick Clot



## Armymedic (29 Oct 2005)

Here is usage info for Quick clot.

It is not apporved for use here in Canada at this time, but selected medical personnel are allowed to use it.

See dicussion here:

http://forums.army.ca/forums/threads/26415/post-167526.html#msg167526

Posted for info only, this does not enititle you to acquire it or use it. (edited for readability)

http://www.chinookmed.com/qc_training_procedures.pdf

Procedures for First Responders'application of
QuikClotÃ‚® hemostatic agent

December 28, 2004
LABEL INFORMATION

 §QuikClotÃ‚®
Adsorbent Hemostatic Agent
Controls moderate to severe blood loss by promoting coagulation
Supplied by:
Z-Medica
4 Fairfield Blvd., Wallingford, CT, 06492

For Emergency Use Only & For External Use Only
as a Temporary traumatic wound treatment to stop moderate-to-severe bleeding

What is QuikClotÃ‚® hemostat, how does it work, and why use it?
 § QuikClotÃ‚® hemostat is a derivative of volcanic rock that is laboratory
recreated and acts as a selective sponge. It is chemically inert and works
from physical, not chemical, action. QuikClotÃ‚® hemostatic agent does not
absorb into the body but is safe to leave in the wound for as long as
necessary. Fluid molecules are adsorbed by the QuikClotÃ‚® hemostat
granules. This causes rapid localized coagulation and the formation of a
stable blood clot in a variety of wounds.

 § For emergency response professionals, the most significant use
of QuikClotÃ‚® hemostat is to stop traumatic bleeding. Achieving hemostasis
helps to stabilize the patient and provides a longer time-window to transport
the patient to further medical treatment.

 § QuikClotÃ‚® hemostat is typically used upon determination that conventional
methods have been inadequate to stop bleeding.


Protocol procedures for QuikClotÃ‚® hemostat :
 § ...are supplemental to the standard operating procedures of your
local and state emergency response guidelines.

 § ...are to be used with the guidelines of your formal emergency
medical technician training and your State's prescribed priority
procedures for emergency medical services.

 § ...can be used as supplement standard BLS (Basic Life Support)
Guidelines, which include Assessment, Major & Multi-system
Trauma, Amputations, and Musculoskeletal injuries.

 § ...may be incorporated into standard EMT/EMS therapies as an
adjunct for injuries where other methods fail to achieve hemostasis.


1. Apply direct, firm pressure to wound using sterile gauze dressing or best
available substitute.
2. If bleeding is stopped or nearly stopped after 1 minute of pressure, wrap
and tie bandage to maintain pressure on wound and seek medical care.
3. To prevent burning from exothermic reaction, assure area around wound
is dry and free from water droplets. (See Addendum B)
4. If moderate to severe bleeding continues after 90 seconds, hold
QuikClotÃ‚® hemostat package away from face and tear open at tabs.
5. Remove previously applied bandages making certain to
wipe away as much excess blood and liquid in wound area
as possible. (See addendum of special precautions.)
6. Immediately begin a gradual pour (DO NOT DUMP) of QuikClotÃ‚®
hemostatic agent in back-and-forth motion onto source of bleeding (see
Addendum C). QuikClotÃ‚® hemostat changes from its dry light beige color
to a dark color as it adsorbs moisture and performs clotting.

Training Procedures
Continued...
Also see package directions

7. Stop pouring promptly when you see a dry layer (original lighter color)
of QuikClotÃ‚® hemostatic agent on wound indicating that there is no
more blood to adsorb.
8. Immediately reapply direct pressure for one to two minutes, then wrap
and protect area with compression bandage, or best available
bandage to maintain pressure.
NOTE: As some heat may be released from wound while QuikClot Ã‚® hemostat performs its
coagulation, protect hands with gauze or similar insulating material while applying
pressure.
9. Transport patient as soon as possible to medical facility.
10. Be certain QuikClotÃ‚® hemostat package accompanies patient so
physician or medical staff can follow directions to remove QuikClotÃ‚®
hemostat properly.

Training Procedures (cont'd.)

Conditions such as those that can occur with the following
types of wounds may require more attention:
 § Sucking chest wounds: Use particular care around sucking
chest wounds to prevent QuikClotÃ‚® hemostat from being
aspirated into lungs.

 § Spurting blood from small diameter wounds such as small -
caliber 'entrance-only' bullet wounds require more careful
evaluation and treatment, since the source of bleeding may not be
at the same location, see Addendum A.

 § Head and scalp wounds produce profuse volumes of blood that
can cause discomfort from exothermic reaction during application
of QuikClotÃ‚® hemostat, see Addendums B & C.

Patient Precautions - Certain Conditions

 § Do not ingest or inhale QuikClotÃ‚® hemostat.
- If ingested, drink two or more glasses of water and seek
medical help.
- If inhaled, move to open air or a well-ventilated space.

 § Keep away from face when opening or pouring.

 § Do not use bare hands to apply pressure immediately following
application of QuikClotÃ‚® hemostatic agent .

 § If adsorbing granules cause heat discomfort to skin, promptly
brush away and/or flood with water.

 § Sterility not guaranteed if package is damaged or opened. Safely
discard damaged open packages.

 § Keep away from children.

Caregiver Precautions

 § The caregiver should be aware that continuously spurting blood
from a small diameter puncture wound can create a high pressure
exit path. The source of such bleeding may be too far away from
the entry point for QuikClotÃ‚® hemostat to be effective.

 § For small diameter entry wounds use particular care to slowly and
gently pour QuikClotÃ‚® hemostat onto wound to avoid exothermic
reaction and follow standard application directions.


While there is a certain amount of thermal reaction when treating a bleeding wound, there is measurably more
thermal reaction in the presence of water. Thus to reduce possibility of excess thermal reaction, attempt to
remove supplemental moisture on or near the wound prior to applying QuikClotÃ‚® hemostat.

 § As QuikClotÃ‚® hemostatic agent adsorbs fluid molecules, energy
in the form of heat can be released. This temperature spike is
very short in duration (see Addendum B).

 § The thermal increase is directly proportional to the ratio of
QuikClotÃ‚® hemostat granules to the volume of blood. Care
should be taken when applying QuikClotÃ‚® hemostatic agent to
see that the ratio stays below two parts of QuikClotÃ‚® hemostat to
one part of blood.

 § Following these guidelines may necessitate application of
additional granules should the early amounts of QuikClotÃ‚®
hemostat fail to achieve hemostasis.
ADDENDUM - C
Nature of exothermic reaction

ADDENDUM - D
Standard package instructions
Basic Instructions for QuikClotÃ‚® hemostat Usage - Please Read Carefully
Warning - Avoid contact with wet skin. Product reacts with small amount s of water and can cause burning. Stop burning by brushing away granules and
flooding area with large volume of water. If ingested, immediately drink 2 or more glasses of water.

DIRECTIONS - READ BEFORE USE
1 Apply direct, firm pressure to wound using sterile gauze dressing or best available substitute.
2 If bleeding is stopped or nearly stopped after approximately 1 minute of pressure, wrap and tie bandage to maintain pressure on wound and seek
3 If moderate to severe bleeding continues after 90 seconds, hold pack away from face and tear open at tabs.
4 Use wiping motion to remove gauze and excess blood - immediately start a slow pour of QuikClotÃ‚® hemostat directly onto wound. Stop pour as soon
as dry granules cover wound area. Use only enough QuikClotÃ‚® hemostat to stop bleeding.
5 Reapply firm pressure to QuikClotÃ‚® hemostat -covered wound using sterile gauze. Wrap and tie bandage to maintain pressure.
6 Seek MEDICAL CARE immediately. Discard unused granules and show empty pack to medical personnel.

FOR MEDICAL PERSONNEL
1 Remove all loose granules prior to irrigation and wound treatment .
2 Fully flood entire wound area with irrigation solution.
3 Proceed with normal irrigation and/or suction until all granules are removed.

WARNINGS
 · Sterility not guaranteed if package is damaged or opened. Discard damaged or open packages.
 · Avoid breathing dust or getting in eyes. Dust may irritate eyes, nose, throat and skin. If inhaled, get to fresh air. Flush ey es with water for 15
minutes. Product contains trace amount of quartz.
 · Long term biocompatibility has not been determined.
 · Keep away from children.

CAUTION - Do not store QuikClotÃ‚® hemostat packages in direct sunlight.


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## 2Charlie (30 Oct 2005)

It works but only after applying lots of pressure and most likely a Tq to slow the bleeding.  Once under control, literally fill the wound, put pressure over it and hang on.  Fast bleeding will just wash it away.


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## nsmedicman (1 Nov 2005)

I am not really familiar with this product; I can only relate what I have read from military and tactical medics who have used it in actual field conditions. Severe bleeding will wash it away, but will tend to work in cooperation with other methods of tamponading bleeding (direct pressure, TQs, etc). Most recommended pressure dressings and rapid evacuation.


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## medicineman (1 Nov 2005)

I tried acquiring some in Haiti last summer from the Americans - they'd actually been ordered to stop using it.  People were relying on it too much instead of using a TK or pressure dressing/pressure point control first - the arterial pressure was washing it away.  Funny how the basic stuff still works well if used properly and promptly...

MM


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## Fraser.g (1 Nov 2005)

Quick Clot MAY be a good idea IF it is used by TRAINED pers who are AUTHORIZED to use it in the CORRECT cercumstances.

The last I herd was that it was not authorized for use by first responders or any other pers unless directly authorized by the MO on the ground.

All this has been covered at lenghth in other threads http://forums.army.ca/forums/threads/26415.0.html


SPECOPS IDC HM 8491/HM 8403 JSOMTC: USE OF THE HEMOSTASIS PRODUCT QUIKCLOT MADE BY Z-MEDICA

1. UNTIL FURTHER NOTICE ALL USSOCOM PERSONNEL ARE PROHIBITED FROM
USING THE HEMOSTASIS PRODUCT QUIKCLOT (TM) MADE BY Z-MEDICA.

2. QUIKCLOT (TM) IS A COMMERCIAL OFF-THE-SHELF PRODUCT WITH FDA
APPROVAL FOR EXTERNAL USE TO ACHIEVE HEMOSTASIS (CONTROL
HEMORRHAGE). THIS PRODUCT WAS PURCHASED IN QUANTITY BY THE ARMY AND
USMC MEDICAL AGENCIES BECAUSE OF THE EARLY FDA APPROVAL AND THE
BLOOD CLOTTING POTENTIAL OF THE PRODUCT. SMALL QUANTITIES OF THE
QUIKCLOT (TM) HAVE FOUND THEIR WAY TO USSOCOM MEDICS THROUGH
SERVICE CONTACTS AND DIRECT FROM THE VENDOR FOR THE SAME REASON
SERVICES ORIGINALLY PROCURED THE PRODUCT

3. WHEN QUIKCLOT (TM) GRANULES ARE POURED INTO A HEMORRHAGING WOUND
A REACTION BEGINS HEATING THE BLOOD TO TEMPERATURES FROM 90-100
DEGREE CENTIGRADE (194-212 DEGREE FAHRENHEIT). THIS TEMPERATURE
COAGULATES (CLOTS) THE BLOOD, BUT ALSO HEATS LOCAL SKIN, MUSCLE,
AND NERVE TISSUE TO BOILING TEMPERATURES.

4. ARMY AND AIR FORCE MEDICAL RESEARCH LABS HAVE REVIEWED QUIKCLOT
(TM) AND RECOMMEND NOT USING THE PRODUCT.

5. UNTIL APPROVAL BY SERVICE MEDICAL RESEARCH LABS, DEVELOPMENT OF
POST USE PROCEDURES, AND CONCURRENCE OF USSOCOM COMMAND SURGEON;
QUIKCLOT (TM) IS PROHIBITED FROM USE BY USSOCOM PERSONNEL.

6. POC IS LT COL J. R. LORRAINE, USSOCOM:SOCS-SG, DSN
299-5051/5442. Submitted by: HMCM Gary E. Welt, USN SEA, JSOMTC,
FT. Bragg, NC Comm: (910) 396 - 0089 Ext. 145 DSN: 236 Fax: 396 -5395

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Field Report Marine Corps Systems Command Liaison Team
Central Iraq 20 April to 25 April 2003

QuikClot by Z-Medica ~ 2D Tank Battalion Surgeon LT Bruce Webb
(USN) stated that Quik-Clot was ineffective (specifically, it was
ineffective on arterial bleeding). Battalion Corpsman attempted to
use Quik- Clot in three separate occasions:

Wounded Iraqi civilian. Shot near brachial artery. Quik Clot was
applied >per the instructions. The substance dried but was
flaking off. Standard direct pressure applied by corpsman proved
more effective on the patient.

Iraqi civilian shot in back with punctured spine. Quik-Clot
applied to severe bleeding. Pressure from bleeding sprayed
Quik-Clot away. According to LT Webb, "Quik-Clot was everywhere
but the wound".

Iraqi civilian, female, shot in femoral artery. She suffered
severe arterial bleeding. Patient bled out. Quik-clot unable to be
applied effectively due to pressure of blood >flow from wound.
Patient died.

An LAR Marine was shot in the femoral artery. Quick Clot was
applied to >the heavily bleeding wound. The pressure from the
blood soon caused the quick clot to be pushed >out of the wound and
rendered ineffective. A tourniquet was applied instead. The patient
died. Quik Clot may work if applied in a "buddy system" manner. One
individual applies the Quik Clot substance while another individual
 quickly applies the sterile gauze to the wound. However, applying
the Quik-Clot as directed proved ineffective. Direct pressure and
tourniquets were used instead. (note: different opinion from the
MEU MO interviewed. Recommend further study on this item).

From the above thread.

GF


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