Hemostatic Vs. Non-Hemostatic Gauze (what you need to know)

hey guys my name's sam and welcome to prepmatic in this week's video we're going to discuss regular gauze versus two different kinds of hemostatic gauze [Music] so having a hemostatic agent such as combat gauze quick clot or cellox rapid ribbon has been kind of a tactical intervention but there is a lot of misinformation about this gauze especially when it's compared to regular packing gauze so in this week's video i want to go in depth a little bit on what these gauzes do what their capabilities are and what we've shown with peer-reviewed research before i get too in-depth into this video this is not going to be a deep dive into literature i'm not going to be citing individual studies or really looking at what these studies found i'm have kind of compiled all the data that i've found and match those up with the recommendations for the committee for tactical combat casualty care now i will link some useful studies down below in the description and i'll also leave a link to deployed medicine's website that website has pretty much all the literature that goes in into the committee for tactical combat casualty cares approval process for different interventions such as cell x cause and quick clot so as many of you know wound packing is a critical intervention for somebody that's bleeding heavily from a junctional site so in this case we're talking about the base of the neck the armpit and then the groin basically places where you cannot place a tourniquet if you're interested in learning more about wound packing specifically or stop the bleed i do have two videos going over both those topics in depth that you can check out i'll leave the card somewhere up here now when we're talking about what we're packing the wound with a lot of people have said that quick clot combat gauze or cell axe guys we have to be using a hemostatic agent and for the most part i agree with that these have long been the standard of care for bleeding control however these are often hyped up to be something they're not and in a lot of situations regular gauze that doesn't have any kind of hemostatic agent will get the job done a lot of people don't know that both your quick clot combat gauze and your celox gauze use different active ingredients to achieve clotting in the body your quikclot combat gauze uses a mineral called kaolin which is a clay oftentimes found in lawn products as well as some skin care routines the kaolin will actually activate factor 12 of your clotting cascade as it comes in contact with the wound your clotting cascade is a very complex series of steps that your body takes to achieve homeostasis your celix gauze on the other hand uses a mineral or a material called chatocin which is traditionally ground-up crustacean shells put onto the gauze they do have a synthetic version of this that they're using for the production of celox cause now however now celex cause works by cross-linking red blood cells to form a muco-adhesive barrier a lot of the pathophysiology behind chatosin and why it promotes clotting is yet unknown however obviously your standard gauze does not carry any kind of material to promote clotting this relies purely on pressure and that is actually a trait that all three of these gauzes share is that they combine whatever ingredient they have with direct pressure to promote that clotting process and we've really found that the direct pressure is what's making the biggest difference for patients now there are some other uh items on the market that you can buy and i think the most common one and what i see in the comments a lot is people asking about the granular powders while they did use those in the military and they were approved for a short period of time what they found in the early generation powders is that they would cause an exothermic reaction and would actually burn patients relatively badly when it was placed in the wound they fixed that issue with a couple different products and it was no longer burning patients but soldiers in the field were finding that on your really deep and narrow lacerations with arterial bleeding it was really hard to get the powder all the way down into the wound to the wound site to actually stop the bleeding and then if it was a very windy day a lot of the powder would be blown out of the wind out of the wound or out of the bag before they could even apply it which is why we have gone to impregnated gauze with the material right on it now the literature that covers quick clock combat gauze and celex gauze might surprise you we have demonstrated without a shadow of a doubt that both of these impregnated gauzes will stop bleeding quicker than your standard gauze however there has yet to be any demonstration of quick clock combat gauze or celex gauze actually lowering mortality or morbidity after the fact essentially while these are stopping bleeding quicker we have not shown that these are actually saving lives there was one study done in the uk very recently that is heavily flawed that has shown that there is a hemostatic agent that has decreased mortality or morbidity but it has yet to be repeated and a lot of the medical community refutes some of its findings based on how it was presented now i recommend that people if you can afford it go out and get your quick clock combat gauze in your cell axe cause and follow the triple c guidelines that being said both of these are relatively expensive in the 20 to 30 dollar range and while i would say that your life is probably worse worth 20 to 30 dollars that's not in the capability of everybody looking to build a kit so if you can't afford these or if you're not uh quite sold on them you can go with a normal s-rolled gauze now you can't use tampons you i would probably recommend going against any kind of large weave fabric because you do need something that's relatively dense but these gauzes are a lot cheaper i believe this one's less than a dollar from north american rescue store and it's just z-fold gauze you can open it up and pack it into a wound and it'll work relatively well like i said there is still some controversy and there has not been huge studies done a lot of the numbers are relatively limited obviously it is kind of hard to evaluate the effectiveness of this cause just in the nature of what it's treating so in the future i do fully expect one to be more products on the market that are doing more and two to have some demonstrated ability to save lives with these products in the meantime these remain the gold standard and your z-fold regular standard gauze will work if that's all you have before i finish up this video i want to address a couple quick myths when it comes to your hemostatic agents the first myth i hear is that the trauma surgeon will absolutely hate you if you pack a wound with combat gauze or celox that's false these gauzes have a line down the middle that's radio opaque so when they go to image the patient they will actually see the gauze in the body cavity and be able to remove it very quickly back when it was granules that caused a little bit more of an issue for surgeons because they would have to evacuate the wound completely and especially when it caused an exothermic reaction there was obviously other damage they had to address they couldn't just suture it up so those did cause a problem the new agents the generation 2 and the generation 3 agents do not cause that problem the second issue i hear about and the last one i'm going to touch on is that this is going to cause strokes that is completely false there was an issue very early on um with some of the hemostatic agents causing some cerebral vascular accidents but with these new generation ones you don't have to worry about anything these are not going to cause clots that carry to your brain or anything like that anytime you have massive bleeding or any massive trauma you are at an increased risk of clotting so that's not to say your patient will not experience a stroke of some kind or a showering of blood clots throughout the body but it was not the hemostatic agent's fault if you have any questions guys please leave them in the comments down below and i will see you next week you

Channel: PrepMedic

Views: 42,433

Rating: 4.9788461 out of 5

Keywords: Hemostatic gauze, gauze, First aid, Medical, Medicine, Medical care, Paramedic, EMT, 911, Combat gauze, quick clot, clot, stop the bleed, Wound packing, AHA, Emergency care, Medic, Ambulance

Id: p41qvnFn--c

Length: 8min 24sec (504 seconds)

Published: Sun Aug 16 2020