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combat gauze

Adam Sigal, Anthony Martin, Adrian Ong
OBJECTIVE: To understand the translation of one innovation in trauma care from the military to the civilian setting, the adoption of topical hemostatic agents in the Emergency Medical Services (EMS) community and in Trauma Centers in Pennsylvania. METHOD: We utilized an anonymous electronic survey of EMS Agency Administrative Officers and Trauma Center Coordinators. RESULTS: We received responses from 23% (93/402) Advanced Life Support and Air Medical agencies in the State...
2017: Open Access Emergency Medicine: OAEM
Jonathan Bar, Alexa David, Tarek Khader, Mary Mulcare, Christopher Tedeschi
Introduction The use of direct oral anticoagulants (DOACs) such as rivaroxaban (Xarelto) is increasingly common. However, therapies for reversing anticoagulation in the event of hemorrhage are limited. This study investigates the ability of hemostatic agents to improve the coagulation of rivaroxaban-anticoagulated blood, as measured by rotational thromboelastometry (ROTEM). Hypothesis/Problem If a chitosan-based hemostatic agent (Celox), which works independently of the clotting cascade, is applied to rivaroxaban-anticoagulated blood, it should improve coagulation by decreasing clotting time (CT), decreasing clot formation time (CFT), and increasing maximum clot firmness (MCF)...
June 19, 2017: Prehospital and Disaster Medicine
Steven G Schauer, Michael D April, Jason F Naylor, Andrew D Fisher, Cord W Cunningham, Kathy L Ryan, Krista C Thomas, Daniel B Brillhart, Jessie Renee D Fernandez, Mark A Antonacci
BACKGROUND: QuikClot® Combat Gauze® (QCCG) was fielded in 2008 to replace previous generations of hemostatic products. To the best of our knowledge, despite nearly a decade of use, there are no published data on use among US combatant forces. We describe the use of QCCG by ground forces in Afghanistan and compare patients who received QCCG compared with the remaining population in the database who did not receive QCCG. METHODS: Data were obtained from the Prehospital Trauma Registry (PHTR)...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Jung Ho Noh, Jae Woo Lee, Young Joon Nam, Ki Yong Choi
BACKGROUND: To assess the hemostatic effect of QuikClot Combat Gauze (QCG) compared to that of standard gauze during cruciate-retaining total knee arthroplasty (TKA). METHODS: Sixty knees underwent TKA using a pneumatic tourniquet in this prospective randomized study. After implantation of the femoral and tibial components and hardening of the bone cement, the tourniquet was deflated and QCG (group 1) or standard gauze (group 2) was packed into the joint cavity for 5 minutes for hemostasis...
March 2017: Clinics in Orthopedic Surgery
Apurva Chaturvedi, Matthew B Dowling, John P Gustin, Thomas M Scalea, Srinivasa R Raghavan, Jason D Pasley, Mayur Narayan
BACKGROUND: Currently, the standard of care for treating severe hemorrhage in a military setting is Combat Gauze (CG). Previous work has shown that hydrophobically modified chitosan (hm-C) has significant hemostatic capability relative to its native chitosan counterpart. This work aims to evaluate gauze coated in hm-C relative to CG as well as ChitoGauze (ChG) in a lethal in vivo hemorrhage model. METHODS: Twelve Yorkshire swine were randomized to receive either hm-C gauze (n = 4), ChG (n = 4), or CG (n = 4)...
January 2017: Journal of Surgical Research
Z Adamiak, D Bukowiecka, P Jastrzębski, M Jałyński, P Holak, J Głodek, G Gudzbeler
Hemorrhaging from large vessels poses a serious problem in emergency situations when blood loss needs to be immediately controlled. The aim of the study was to compare the effectiveness of two hemostatic dressings in controlling bleeding from a surgically punctured femoral artery. The study was performed on thirteen pigs divided into two groups, of six and seven pigs, respectively. Combat gauze covered with ChitoClear hqg 95 chitosan and Protanal LF10/60 FT sodium alginate was used in the first group, seton covered with identical substances was uses in the second group...
September 1, 2016: Polish Journal of Veterinary Sciences
I Otrocka-Domagała, P Jastrzębski, Z Adamiak, K Paździor-Czapula, M Gesek, M Mikiewicz, T Rotkiewicz
The purpose of this study was to examine the safety of the long-term application of QuikClot Combat Gauze, ChitoGauze PRO and Celox Gauze using a swine model. The study was conducted on nine pigs weighing approximately 30 kg, which were randomly divided into three groups. Under deep anesthesia, the pigs underwent complete transverse cutting of the femoral artery in the groin region. Hemostatic dressings were left in the wound for 24 hours. The animals were euthanized 24 hours after dressing application. In each group, macroscopic and microscopic severe changes and shock symptoms were observed in the lungs, liver, kidneys and heart...
2016: Polish Journal of Veterinary Sciences
Rachel L Choron, Joshua P Hazelton, Krystal Hunter, Lisa Capano-Wehrle, John Gaughan, John Chovanes, Mark J Seamon
BACKGROUND: Intra-abdominal packing with laparotomy pads (LP) is a common and rapid method for hemorrhage control in critically injured patients. Combat Gauze™ and Trauma Pads™ ([QC] Z-Medica QuikClot(®)) are kaolin impregnated hemostatic agents, that in addition to LP, may improve hemorrhage control. While QC packing has been effective in a swine liver injury model, QC remains unstudied for human intra-abdominal use. We hypothesized QC packing during damage control laparotomy (DCL) better controls hemorrhage than standard packing and is safe for intracorporeal use...
January 2017: Injury
Jennifer Leonard, John Zietlow, David Morris, Kathleen Berns, Steven Eyer, Kurt Martinson, Donald Jenkins, Scott Zietlow
BACKGROUND: Life-threatening hemorrhage is a leading cause of preventable mortality in trauma patients. Since publication of the Hartford Consensus statement, there has been intense interest in civilian use of commercial hemostatic gauze and tourniquets. Although the military has studied their use on soldiers with wartime injuries, there are limited data on patient outcomes following civilian prehospital use and no data on the use in rural trauma. METHODS: We performed a multi-institutional retrospective analysis of clinical outcomes following prehospital use of QuikClot combat gauze (QC) and combat application tourniquets (CATs) from 2009 to 2014...
September 2016: Journal of Trauma and Acute Care Surgery
James R Baylis, Alexander E St John, Xu Wang, Esther B Lim, Matthew L Statz, Diana Chien, Eric Simonson, Susan A Stern, Richard T Liggins, Nathan J White, Christian J Kastrup
Hemorrhage is the leading cause of preventable death in trauma, and hemorrhage from noncompressible junctional anatomic sites is particularly difficult to control. The current standard is QuikClot Combat Gauze packing, which requires 3 min of compression. We have created a novel dressing with calcium carbonate microparticles that can disperse and self-propel upstream against flowing blood. We loaded these microparticles with thrombin and tranexamic acid and tested their efficacy in a swine arterial bleeding model without wound compression...
September 2016: Shock
Huixi Li, Lin Wang, Amjad Alwaal, Yung-Chin Lee, Amanda Reed-Maldonado, Taylor A Spangler, Lia Banie, Reginald B O'Hara, Guiting Lin
BloodSTOP iX Battle Matrix (BM) and QuikClot Combat Gauze (CG) have both been used to treat traumatic bleeding. The purpose of this study was to examine the efficacy and initial safety of both products in a swine extremity arterial hemorrhage model, which mimics combat injury. Swine (37.13 ± 0.56 kg, NBM = 11, NCG = 9) were anesthetized and splenectomized. We then isolated the femoral arteries and performed a 6 mm arteriotomy. After 45 s of free bleeding, either BM or CG was applied. Fluid resuscitation was provided to maintain a mean arterial pressure of 65 mmHg...
April 12, 2016: International Journal of Molecular Sciences
Sean P Conley, Lanny F Littlejohn, Jose Henao, Sara S DeVito, Gregory J Zarow
OBJECTIVE: Uncontrolled hemorrhage from junctional wounds that cannot be controlled by traditional tourniquets accounts for one in five preventable battlefield exsanguination deaths. Products for treating these wounds are costly and require special training. However, chemically treated gauze products are inexpensive, potentially effective, and require only minimal training. This study was designed to assess the efficacy of three hemostatic gauze products following brief training, using a consensus swine groin injury model...
November 2015: Military Medicine
Przemysław Kluj, Dawid Aleksandrowicz, Waldemar Machała, Tomasz Gaszyński
Hemostatic agents are currently used in the form of special granules or soaked gauze. Their use is particularly advantageous in difficult body location (e.g. on neck, armpit or groin), where other methods of bleeding control are impossible to use or fail. In a tactical environment tranexamic acid received first class recommendation for use in case of severe bleeding in the US Army. Its application should be considered in case of traumatic amputation, penetrating chest and abdominal trauma or hemorrhagic shock...
September 2015: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Avi Shina, Ari M Lipsky, Roy Nadler, Moran Levi, Avi Benov, Yuval Ran, Avraham Yitzhak, Elon Glassberg
BACKGROUND: Hemostatic dressings are advanced topical dressings designed to control hemorrhage by enhancing clot formation. These dressings may be effective when used on injuries sustained in junctional zones. The Israeli Defense Forces Medical Corps (IDF-MC) chose to equip its medical personnel with the QuikClot Combat Gauze. There is a paucity of data describing clinical use and results of hemostatic dressing especially at the point of injury. The purpose of this article was to report the IDF-MC experience with prehospital use of the QuikClot Combat Gauze in junctional zones in a case series retrieved from the IDF Trauma Registry...
October 2015: Journal of Trauma and Acute Care Surgery
Stéphane Travers, Hugues Lefort, Eric Ramdani, Sabine Lemoine, Daniel Jost, Michel Bignand, Jean-Pierre Tourtier
To report the use and describe the interest of hemostatic dressings in a civilian setting, we provided medical prehospital teams with QuikClot Combat Gauze (QCG) and asked physicians to complete a specific questionnaire after each use. Thirty uses were prospectively reported. The wounds were mostly caused by cold steel (n=15) and were primarily cervicocephalic (n=16), with 19/30 active arterial bleedings. For 26/30 uses, hemostatic dressing was justified by the inefficiency of other hemostasis techniques. Those 30 applications were associated with 22 complete cessations of bleeding, six decreases of bleeding, and ineffectiveness in two cases...
October 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Alexander E St John, Xu Wang, Esther B Lim, Diana Chien, Susan A Stern, Nathan J White
BACKGROUND: Hemostatic gauzes, which must be packed into wounds and compressed for several minutes, may be of limited use for noncompressible wounds in junctional anatomic locations. Rapid mechanical wound sealing is an alternative approach that seals the wound at the skin, allowing internal clot formation. We evaluate wound sealing for junctional hemorrhage control using a hemostatic clamp (iTClamp). METHODS: Severe junctional hemorrhage was induced in anesthetized immature female swine using a 5-mm femoral arteriotomy...
August 2015: Journal of Trauma and Acute Care Surgery
Jose Garcia-Blanco, Brian Gegel, James Burgert, Sabine Johnson, Don Johnson
BACKGROUND: The purpose of this study was to compare the effectiveness of QuikClot(®) Combat Gauze™ (QCG) to a control wound dressing to withstand movement in a porcine model with hemodilution and hypothermia. DESIGN: This was a prospective study with a between-subjects experimental design. Twenty-six Yorkshire swine were randomly assigned to two groups: QCG (n = 13) or a control dressing (n = 13). METHODS: The subjects were exsanguinated to 30% of the blood volume; hypothermia was induced for 10 minutes...
2015: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Don Johnson, Douglas M Westbrook, Deanna Phelps, Jose Blanco, Michael Bentley, James Burgert, Brian Gegel
OBJECTIVES: The aims of the study were to 1) determine the effectiveness of QuikClot Combat Gauze (QCG); 2) determine the arterial blood pressure at which rebleeding occurs; 3) determine how much intravenous fluid could be administered before hemorrhage reoccurred, and 4) determine the number extremity movement on rebleeding when QCG was used. DESIGN: This was a prospective, randomized, experimental study. SUBJECTS: Adult Yorkshire pigs were randomly assigned to two groups QCG (n = 10) or control (n = 10)...
2014: American Journal of Disaster Medicine
Don Johnson, Sheri Bates, Sofiya Nukalo, Amy Staub, Aaron Hines, Taylor Leishman, Jennifer Michel, Dusti Sikes, Brian Gegel, James Burgert
Hemorrhage is the leading cause of death from trauma. Intravenous (IV) fluid resuscitation in these patients may cause hemodilution and secondary hemorrhage. In addition, hypothermia may interfere with coagulation. The purposes of this study were to compare the effectiveness QuikClot Combat Gauze (QCG) to a control group on hemorrhage in a hemodiluted, hypothermic model, and to determine the effects of IV volume resuscitation on rebleeding. This was a prospective, between subjects, experimental design. Yorkshire swine were randomly assigned to two groups: QCG (n = 13) or control (n = 13)...
June 2014: Annals of Medicine and Surgery
Genevieve R Hillis, Crystal J Yi, David L Amrani, Troy W Akers, Richard Schwartz, Ian Wedmore, John G McManus
BACKGROUND: Uncontrolled hemorrhage remains one of the most challenging problems facing emergency medical professionals and a leading cause of traumatic death in both battlefield and civilian environments. Survival is determined by the ability to rapidly control hemorrhage. Several commercially available topical adjunct agents have been shown to be effective in controlling hemorrhage, and one, Combat Gauze (CG), is used regularly on the battlefield and for civilian applications. However, recent literature reviews have concluded that no ideal topical agent exists for all injuries and scenarios...
2014: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
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