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Thread: Tourniquets and quick clot 2019

  1. #1
    TANSTAAFL awp_101's Avatar
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    Tourniquets and quick clot 2019

    Thanks to 5 DVTs in just under 10 years, my wife is now permanently on blood thinners and I need to get serious about vehicle med bags with a focus on tourniquets and quick clotting agents.

    For the house I've got some "quick clotting band aids" on the way as well as a couple of styptic pencils for nicks and small cuts but I don't have anything for serious bleeding in the vehicles and given her long daily commute, that's the biggest concern right now.

    If more information is needed, I'll answer what I can.

    Thanks!
    Do the right thing. It will gratify some people and astonish the rest. - Mark Twain

    Nothing is over until we decide it is! Was it over when the Germans bombed Pearl Harbor? Hell, no!

  2. #2
    10.3" Master Race TGS's Avatar
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    There's really no changes for 2019.

    Hemostatics:

    There's some suggestions that chitosan based hemostatics may work better with coagulopathic patients on blood thinners (your wife), but there's nothing definitive saying that it's better than Combat Gauze (the entire success story of CG is based on coagulopathy). Both are considered acceptable and are treated interchangeably within the medical field. So, Quickclot Combat Gauze and any chitosan based "gauze" such as ChitoGauze, Celox, or HemCon. Go with chitosan based ones if the marketing gives you the warm and fuzzy.

    You want to avoid any granular, sponge, or applicator based mediums of the above. Stick with full-sized gauze forms, and not reduced size versions such as the QuickClot EMS.

    Tourniquets:

    Both the SOF-T-Wide and Gen 7 CAT are the current front runners. The SOF-T-Wide is indestructible. We've started reissuing CAT's with the Gen 7 coming out, FWIW, but myself and many others still prefer the SOF-T Wide, simply because of its no nonsense durability and long standing track record. The CAT, on the other hand, was banned within the SOCOM umbrella for a number of years due to its issues (which they've hopefully addressed after 7 generations).

    Both are considered acceptable devices within the TCCC community. Other alternatives do not have the track record that either of these have, whether in actual field use or large scale testing.

    Training:

    This is the more important part.

    Simply using a hemostatic gauze isn't the solution. Knowing how to use it is more important, as the technique is really what determines its effectiveness. If anyone tells you "just pack to the bone and don't worry about it," go elsewhere for information.
    Last edited by TGS; 02-06-2019 at 09:51 AM.
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  3. #3
    Site Supporter SeriousStudent's Avatar
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    I am a big fan of Quik-Clot and tourniquets. For TQ's, the two recommneded styles are CAT and SOFT-W

    Be very, very careful where you buy them. The TQ's on Amazon and eBay are frequently Chinese counterfeits.

    Two reputable sellers are Tacrical Medical Solutions and Chinook Medical.

    This is an excellent turn-key solution: https://www.tacmedsolutions.com/TacM...auze-options=3

    More linkie's:

    https://www.tacmedsolutions.com/SOF-...ourniquet-Wide - I like the orange model, since it shows up in a scene or patient survey. Also, because P-F.

    The blue model is the same thing, but frequently used for practice. GET A PRACTICE TQ AND TRAIN WITH IT REGULARLY.

    These bandages are excellent, and can perform multiple tasks with a properly trained user: https://www.tacmedsolutions.com/OLAES-Modular-Bandage

    And I prefer this version of Quik-Clot: https://www.tacmedsolutions.com/Quik...olded-Military

    It has a radio-opaque thread which shows up on an x-ray.

    All of these items need instruction. The good news is that National Stop The Bleed month is coming up,. and you can get free local instruction. PM me your location, and I'll help you track down a class.

    Hope that helps.

  4. #4
    Site Supporter SeriousStudent's Avatar
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    ETA: What TGS said. We must have been typing at the same time.

    And the folks that make the SOF-T_Wide showed off a new model at SHOT, I think. Caleb Causey of Lone Star Medics told me about it, and it looks slightly faster to deploy now. I'm going to grab a pair and play with them.

    I'm also doing a Tactical Medicine EDC class with him this weekend, and will report back. If you or your spouse have a chance to take a class with either Caleb or with Kerry Davis at Dark Angel Medical, jump on it.

    And good luck with the DVT's. My dad was on Coumadin for the last half of his life. I always kept plenty of gear around, and taught him how to do self-aid.

  5. #5
    Site Supporter RoyGBiv's Avatar
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    Quote Originally Posted by SeriousStudent View Post
    This is an excellent turn-key solution: https://www.tacmedsolutions.com/TacM...auze-options=3
    Thanks! Neat kit. Will be attending STB this Thursday. We'll see what freebies and for-sale goodies they have on hand before buying this.
    "No free man shall ever be debarred the use of arms." - Thomas Jefferson, Virginia Constitution, Draft 1, 1776

  6. #6
    Site Supporter SeriousStudent's Avatar
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    Quote Originally Posted by RoyGBiv View Post
    Thanks! Neat kit. Will be attending STB this Thursday. We'll see what freebies and for-sale goodies they have on hand before buying this.
    I'll be over in Fort Worth doing Caleb's EDC class all day Saturday.

    If only I knew someone in Fort Worth who liked whiskey and first aid gear.........

  7. #7
    Site Supporter RoyGBiv's Avatar
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    Quote Originally Posted by SeriousStudent View Post
    I'll be over in Fort Worth doing Caleb's EDC class all day Saturday.

    If only I knew someone in Fort Worth who liked whiskey and first aid gear.........
    PM sent
    "No free man shall ever be debarred the use of arms." - Thomas Jefferson, Virginia Constitution, Draft 1, 1776

  8. #8
    Member EMC's Avatar
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    Besides touniquets and clotting agent gauze, what are the thoughts on having something for those times when an incident is not quite an arterial level bleed but still serious?

    I picked up some 4" OLAES bandages recently because I liked the concept of a versatile pressure dressing that also contains some chest seal material, eye cup, and extra gauze material for both entry and exit wound coverage. Seems like a well thought out design.
    Last edited by EMC; 02-06-2019 at 01:46 PM.

  9. #9
    Quote Originally Posted by TGS View Post
    There's really no changes for 2019.

    Hemostatics:

    There's some suggestions that chitosan based hemostatics may work better with coagulopathic patients on blood thinners (your wife), but there's nothing definitive saying that it's better than Combat Gauze (the entire success story of CG is based on coagulopathy). Both are considered acceptable and are treated interchangeably within the medical field. So, Quickclot Combat Gauze and any chitosan based "gauze" such as ChitoGauze, Celox, or HemCon. Go with chitosan based ones if the marketing gives you the warm and fuzzy.

    You want to avoid any granular, sponge, or applicator based mediums of the above. Stick with full-sized gauze forms, and not reduced size versions such as the QuickClot EMS.

    Tourniquets:

    Both the SOF-T-Wide and Gen 7 CAT are the current front runners. The SOF-T-Wide is indestructible. We've started reissuing CAT's with the Gen 7 coming out, FWIW, but myself and many others still prefer the SOF-T Wide, simply because of its no nonsense durability and long standing track record. The CAT, on the other hand, was banned within the SOCOM umbrella for a number of years due to its issues (which they've hopefully addressed after 7 generations).

    Both are considered acceptable devices within the TCCC community. Other alternatives do not have the track record that either of these have, whether in actual field use or large scale testing.

    Training:

    This is the more important part.

    Simply using a hemostatic gauze isn't the solution. Knowing how to use it is more important, as the technique is really what determines its effectiveness. If anyone tells you "just pack to the bone and don't worry about it," go elsewhere for information.
    All great info. Only thing I'd add is that the evidence for the utility of QuikClot/other hemostatic agents in the prehospital management of external hemorrhage isn't exactly resounding. It might be helpful, but debatable how much it adds vs. traditional gauze dressing. See here for more. It's unlikely to be harmful, though, so if you don't mind paying the premium over regular gauze then go for it.

  10. #10
    Quote Originally Posted by EMC View Post
    Besides touniquets and clotting agent gauze, what are the thoughts on having something for those times when an incident is not quite an arterial level bleed but still serious?

    I picked up some 4" OALES bandages recently because I liked the concept of a versatile pressure dressing that also contains some chest seal material, eye cup, and extra gauze material for both entry and exit wound coverage. Seems like a well thought out design.
    IMO nothing beats Coban and a bunch of 4x4s for the temporary dressing of a laceration (Telfa non-adhesive are nice to have on hand, too). Gauze rolls are also nice and can be used for wound packing, too.

    Big abdominal pads like the OLAES for severe penetrating trauma are cool, but not as versatile as gauze rolls/pads and coban. Much more useful for field dressing common lacerations, etc that might require suturing but aren't big enough to need an abdominal pad.
    Last edited by Nephrology; 02-06-2019 at 01:38 PM.

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