HEMCON for QUICK CLOT?
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JANES, you could pm your helpful post and I could post it for you.
I don't have first hand knowledge of HemCon use. I played with it, but never used it. Everything I know is what I have read or heard from Marine Corpsmans I worked with in Afghanistan.
Chitosan based dressing were tried by the US Navy and Marines. It comes in a 4x4x1/4 inch square wafer. To apply, you press the Chitosan against the area of bleeding.
As for invasiveness, you would have to press the dressing up against the bleeder.
For simplicity of use, Quicklot is easier (basically, just pour in), it is also cheaper. As for effectiveness, I believe they found Chitosan to be more effective, but that is in OR tests, and I have no references handy. There are no immediate side effects with Hemcon dressings (they don't heat up and burn) but there is a small chance of someone with a shellfish allergy reacting poorly to the dressing.
My unsubstatiated opinion is that Hemcon would be more invasive as you need to push a chunk of the material into the wound and against where the bleeding is coming from.
I don't have first hand knowledge of HemCon use. I played with it, but never used it. Everything I know is what I have read or heard from Marine Corpsmans I worked with in Afghanistan.
Chitosan based dressing were tried by the US Navy and Marines. It comes in a 4x4x1/4 inch square wafer. To apply, you press the Chitosan against the area of bleeding.
As for invasiveness, you would have to press the dressing up against the bleeder.
For simplicity of use, Quicklot is easier (basically, just pour in), it is also cheaper. As for effectiveness, I believe they found Chitosan to be more effective, but that is in OR tests, and I have no references handy. There are no immediate side effects with Hemcon dressings (they don't heat up and burn) but there is a small chance of someone with a shellfish allergy reacting poorly to the dressing.
My unsubstatiated opinion is that Hemcon would be more invasive as you need to push a chunk of the material into the wound and against where the bleeding is coming from.
signalsguy said:
I feel the need to comment on this article. The article is old.
Ref the Hemcon (Chitosan), it is now available to foreign and non-military personnel (with a perscription!, how does that work???). The other disadvantage is that it is relatively small and you need a few of them for a larger wound. That can get expensive fast, not that cost matters given that situation, but for the people buying it, it does. As soon as the dressing gets wet it sticks. When it touches blood, it sticks. It will adhere to the wound and start clotting. Deep bleeder? Who knows? You can download their video on their website.
The article states Quick Clot is good for "intrathoracic" wounds. I would question this as it is not for interenal use. Probably not a god idea to get a funnel out and start pouring this stuff into someones chest through a bullet hole. They might get a little heartburn. I can see it being perfect for maybe an intercostal bleed or possible a subclavian bleed treated by pouring it on the surface, if the woud is open, but for an actual intrathoracic bleed, which sounds to be like you are pouring it inside the chest cavity, that sounds kind of scary.
Also Quick Clot has solved their cumbersome packaging issue.
All the Red Cross Fibrin-based Dressings have been recalled. When they were available, they cost about $1000 each.
Favtor VIIa is a long way off due to temperature stability and cost.
For all out there who are wondering which is better, the Hemcon or the Quick Clot, I would say they both have their disadvantages and advatages. And both need to be used in a specific way. They are both good products and good tools in the toolbox, if you educate yourself on how they work and why they work.
I will also offer this. We may see somthing better than both of them in the very near future
. But what do I know, I have an empty profile!
medicineman
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Armymedic said:
No different than pouring into that wide open pig`s groin in the video. ;D
Just to add, I havent heard of anyone carrying the Hemcons issued besides SF types. I believe the cost is prohibitive for them to be handed out in individual first aid kits for the entire army if Quickclot does the job for alot less money. They also don't have a very long expiry date.
The Hemcon dressings shelf life was supposed to be incresed from 18 to 36 months. I'm not sure whether this has happened yet or not. They cost $100 USD's per dressings. Temp storage is rated up to 50 C. Hard to distiguish sides through NVG's. Ineffective if they get wet. Not to be used intra-abdominally, though intitial tests on pigs had them stuffed into lacerated livers saving pigs with an injury that was previously untreatable. There is the shellfish allergy issue too, though none have occured to date. After placement the dressing stays on for 48 hours. Be cautious of aggressive fluid resus post application, as it may "pop the clot" even with the dressing on. And everyone (US Army) is supposed to eventually get one in their IFAK (improved first aid kit). Here's my reference for that one: http://www.usmedicine.com/column.cfm?columnID=217&issueID=83 Para 14ish, that should keep some of you happy!
Each Marine gets a Quick Clot, and so does every deployed CDN soldier.
Each Marine gets a Quick Clot, and so does every deployed CDN soldier.
Hijust a couple more points on Hemcon. Anecdotally, hemcon outperforms quikclot in the field, the worst bleeders seem to 'wash away'the quikclot. It (hemcons) dressing does not heave a CE approval, that is coming, this autumn, and will help with the approval process in Canada (not currently approved for use WITHIN Canada). one of the main draw backs of hemcon is its relatively inflexible, sort of like high density foam. They are trialling a kerlex type guaze impregnated product which shows promise. Now all the proceeding is from my discussion with the company reps, so is obviously biassed. But I will put this out to any movers and shakers, ie multi bar on shoulder +, they offered to allow access to their live tissue lab in Portland Oregon to use whatever products we wanted, as long as we tried their products as well.
Quick Clot won't wash away if used properly, and I think thats the problem with the anecdotes, especially the field report from 03, was that tourniquets or indirect pressure were not applied first and the blood in the wound not soaked up. Those are the bigest problems with the Quick Clot, not what it does, but how it is used. If used properly - stop the bleeding above the wound with a tourniquet or indirect pressure, then soak up the blood, then apply the Quick Clot, then apply a dressing and pressure - there should be no problems, and theoretically better than the Hemcon because it can be used on large multlilated wounds which are the norm. Then you can release the tk or the pressure point and it should hold. Of course it will wash away and not work if the wound is pouring blood. And if you pour it in a big pool of blood, then it will heat up. The bad press Quick Clot got was from lack of instruction and lack of understanding of how it works. The little 4x4 Hemcon don't stand a chance against large shrapnel wounds and blast injuries. I'm not saying that the Hemcon is no good though. Trust me though, there's a new one in the works that might just beat them both!
Well I'm glad your self imposed exile was short lived. I know quikclot's probs are mostly due to improper use, I'm just passing on what I got. It is pertinent however, because it will often be used improperly. what do you think about the quikclot in the mesh bag? As for heating, I know that the studies have said it burns I believe 4mm of tissue surrounding, worst case, and independant med pers have wondered if that may be theraputic cautery. I was impressed by hemcon's pitch, and their passion. It's early days in development, and i share your faith that better products are on the horizon. I think they both serve a purpose, and both should be made available. It would definitely take some ingenuity to make hemcon work on the nasty wounds you mention, but you can fold em cut em and stack em like shingles, and the product literature is pretty inventive. They basically glue together, and will form a large sheet, but it would be a costly dressing.
My opinion of the mesh bag is mixed. On one hand it will burn less because less of it will be exposed to the wound at a slower rate. It also solves the problem of cleaning it out of the wound. On the other hand it limits the application to the size of the mesh bag. I wonder if it will work like a sponge that you can dab on the wound, or more likely if the clot will adhere to the mesh bag, then you can't turn it over and use the rest of the quickclot in the bag on the other half of the wound. It will be interesting to see real use data come back from these.
A little more info on the QC sponges. They are currently only being trialed by a select few (US & CDN) in theatre. Initial reports are good. They talk about less heat, and that you dab the dressing, so apparently it doesn't adhere to te wound. Not sure how you can apply pressure if you're dabbing. So far looks good, but thats just the word on the street. No hard facts. Still isn't Health Canada approved (the sponge).
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I saw an article in this months Soldier Magazine the offical magazine of the British Army and thought that it was on subject and would be pertinent.
http://www.soldiermagazine.co.uk/mag/kitstop.htm
MEDICAL scientists have turned to Mother Nature in their efforts to stop life-threatening bleeding from front-line injuries.
QuikClot and Hemcon are simple to use and ideal when a field dressing fails to stop haemorrhaging, the wound has a curved or irregular shape or it is so high up a limb it’s too difficult to apply a tourniquet.
The Hemcon dressing is impregnated with chitosan, a substance with powerful sticking properties taken from crushed shrimp shells.
Once applied to severely bleeding arteries or penetrating wounds, Hemcon forms a strong but flexible antibacterial barrier that seals the injury for up to two hours and reduces the risk of infection.
The dressing is safe to use on soldiers who are allergic to shrimps and is easily removed with water. QuikClot is a powder made from volcanic rock that can be poured into any shape of wound. It works by speeding up the body’s natural blood-clotting process, which can be too slow to stop a large volume of blood escaping from an injury. The powder also rapidly sucks up the water in blood, leaving behind clotting components such as platelets to form a plug that stops further blood loss.
When QuikClot comes into contact with blood it generates a lot of heat so medical teams should carefully consider whether it is safe to use on certain injuries.
Both products are now being used by medics to treat combat injuries sustained in theatre.
http://www.soldiermagazine.co.uk/mag/kitstop.htm
MEDICAL scientists have turned to Mother Nature in their efforts to stop life-threatening bleeding from front-line injuries.
QuikClot and Hemcon are simple to use and ideal when a field dressing fails to stop haemorrhaging, the wound has a curved or irregular shape or it is so high up a limb it’s too difficult to apply a tourniquet.
The Hemcon dressing is impregnated with chitosan, a substance with powerful sticking properties taken from crushed shrimp shells.
Once applied to severely bleeding arteries or penetrating wounds, Hemcon forms a strong but flexible antibacterial barrier that seals the injury for up to two hours and reduces the risk of infection.
The dressing is safe to use on soldiers who are allergic to shrimps and is easily removed with water. QuikClot is a powder made from volcanic rock that can be poured into any shape of wound. It works by speeding up the body’s natural blood-clotting process, which can be too slow to stop a large volume of blood escaping from an injury. The powder also rapidly sucks up the water in blood, leaving behind clotting components such as platelets to form a plug that stops further blood loss.
When QuikClot comes into contact with blood it generates a lot of heat so medical teams should carefully consider whether it is safe to use on certain injuries.
Both products are now being used by medics to treat combat injuries sustained in theatre.
HemCon has come out with a thinner more plyable dressing with the same effectiveness. They have also pretty much completely solved the quality control issue they had a few years back that some people still talk about. They are also making smaller sizes at a much more affordable price.
And to get back to the initial post. I would say that HemCon is a safer less invasive product. I have heard that surgeons are having to do some serious debridment of wounds that QC was poured into, to the point of actually cutting away burnt tissue. This is still probably a training issue. They are both good products and both have their place, but HemCon is no doubt safer. Quick Clot is a last resort.
And to get back to the initial post. I would say that HemCon is a safer less invasive product. I have heard that surgeons are having to do some serious debridment of wounds that QC was poured into, to the point of actually cutting away burnt tissue. This is still probably a training issue. They are both good products and both have their place, but HemCon is no doubt safer. Quick Clot is a last resort.
