EMTs and Medical Responders -- Quick Clot?

[Ben]

For any of you First Responders: What can you tell me about Quick Clot?

I've read good things about it, but have not seen any in person, nor seen use demonstrations. I was thinking of ordering some for our field medical packs at work, but product use would have to be somewhat idiot-proof because, well, you know...

Opinions?

[cfabe]

I'm not a medical professional at all, but from what I've heard it might not be the best idea to put in a first aid kind of kit because untrained people will tend to use it on cuts that are not immeadiately life threatening. I believe it's intended use is to stop massive bleeding on patients who would bleed out before getting them to help, but in the process it does some damage to surrounding tissue as well. So if your work conditions post this kind of threat, get some, but get people trained on when to use it and when to use normal bleeding control techniques (direct pressure, elevate, arterial pressure point, etc).

[Azrael256]

but product use would have to be somewhat idiot-proof

GAH!  That statement by itself is terrifying!  cfabe is right on.  If you need first aid kits beyond an alcohol swab and a band-aid, you need training.  Go find the red cross, or a fire station, or a boy scout camp or somesuch, and get set up for some first aid training for anyone who needs it.

As for Quick Clot itself, it is only for really serious bleeding.  Ideally, you shouldn't use it by itself.  You want to use it on arterial bleeding, like femoral artery spewing blood, and in conjunction with a pressure dressing.  In fact, you can buy dressings with the stuff already on them.  Basically, it is to be used when a hemostat is not available, or you don't know how to clamp a spewing artery.  Clamps are better, but this stuff will buy you the five minutes you'll need for the EMTs to get there to dress a wound for real.

If you want a good first aid kit, find Dionysusigma.  We spent an hour or so making a list of first aid stuff for a good kit.  His dad (MD) chimed in and edited the list a bit.  The only thing I recall being missing from his list was a ratcheting strap clamp like you use to make furniture.  They make great torniquets.  Everything on his list should fit into a musette bag or something similar.

[Ben]

Actually I was being somewhat facetious on the idiot comment. This would be going in med kits for vessel and flight crews, and we all have training ranging from Basic First Aid through EMT. We have the training, but it is rarely used, so I wanted to get opinions from experts who deal with major stuff every day regarding not only Quick Clot's effectiveness, but ease of use for someone who may have First Aid training, but has not had to use it in a major situation where panic can easily come into play and fumbling around is detrimental to the victim. I'm already aware of not using this compound on minor stuff. I'm looking at it as an option for big, gaping, bleeding wounds when rescue is 100 miles away. It would be kept in First Responder kits, which are separate from our standard first aid kits available to crew and passengers for day to day stuff.

[Azrael256]

Whew!  That's a relief.

For the sort of scenario you describe, I would still go with a hemostat and some training.  The standard bleeding control methods would come in a close second.  Short of that, it's pretty much the only option.  It will stop major bleeding, and keep it stopped for awhile.  It is also difficult to make the stuff work.  Poke around for the manufacturer's training video, and you'll see what I mean.  It took several people, and a whole bunch of the stuff to make it work.

There are some HUGE downsides to it.  If you dump it in a big wound, and it's going to be some hours before proper care is available, your patient stands a decent chance of losing whatever limb it is used on.  This stuff will do MASSIVE damage inside a wound, particularly if it's sitting in there all day.  On the other hand, I'd rather lose an arm than five quarts of blood.  It is, by no means, a substitute for properly cleaning and dressing a wound.  Because it creates a physical barrier, it will go a long way to prevent any further infection of a wound, but it is not sterilizing, so it won't clean out whatever is already growing in there.  

So, in summation, I would put it in your med kits.  It is not the greatest bleeding control tool in the world (only a skilled surgeon in an operating room would qualify), but it is a good thing to have in addition to other tools.

[Azrael256]

Yeah, lemme dig up his phone number.

Ok, I can't find it.  I'm sure he'll drift in.  I'll try shooting off a PM.

[S. Williamson]

Unfortunately at this moment, I am on the other side of the city at a friend's place... far away from the list--which I must admit was pretty dang extensive and all-inclusive.  As soon as I possibly can, I will post it in its entirety.

I must admit, though... the admittedly tiny FAK I carry with me everywhere I go only consists of:
(4) 1.5cm x 7.6cm strip bandages
(2) 1cm x 4.7cm strip bandages
(2) 1.5 x 2 " non-adherent pads
(1) antiseptic towlette
(1) 1g 3-in-1 antibiotic ointment
(1) Half-book of paper matches (10 total)
Leatherman Original MultiTool (well-sharpened)

And occasionally a small bottle of CA glue if for some reason I forget I have it with me

Essentially, all the items listed above I would feel quite confident in using if some small emergency arose.  However, if something occurred and the above listed items were not enough, I probably would've needed help anyway.

Complete, family-doctor-and-OA-member-approved list coming soon...

[Ben]

Thanks for the info Azrael. I'm looking at the Quick Clot alternative fully aware it's not a "miracle" tool. I'm pretty much looking at it along the lines of your post -- as an "if all else fails" solution under specific circumstances. From reading I've done I understand the stuff actually creates an exothermic reaction in tissue surrounding the wound. Nevertheless, as you pointed out, if it comes down to it,  it's probably better to lose a limb than to lose all that red stuff.

[S. Williamson]

Alrighty--for whoever wants it, here're the recommended/approved contents:

First Aid Kit:
2 oz Hand Sanitizer
6 Safety Pins
Hand Soap
2 Pair Latex and/or Nitrile Gloves
Conforming bandage 6" x 5 yards
2 Bandage, gauze 2" x 6 yards
Pill Bottle
2 Bandage, gauze 1" x 6 yards
Irrigation Syringe
2 6" elastic bandage
2 First Aid Cream
4 3" x 4" sterile sponges
2 Triple Antibiotic
2 Dry gauze bandage 3" x 8"
2 1" Tape
15 Alcohol Wipes
1 Triangular Bandage 36" x 36" x 56"
15 Iodine Wipes
15 Antiseptic Wipes
15 Clean Wipes
EMT Shears
Magnifying Lens
5" Stainless steel Hemostat
Tweezers
Cotton Tip Applicator
Airway
Field Dressing 11 sq in
Medical scissors (1)
1"x 6 yds. gauze bandage (2)
Sling/kerchief (1)
2-pack cotton-tipped applicators (1)
Cold pack (1)
11-3/4" field dressing (1)
Safety pins
1/8 oz. burn gel
First-aid cream (1 dose)
Triple-antibiotic ointment (1 dose)
Plastic bandage strips (10)
Sterile eye pad (1)
2"x6 yds. gauze (1)
Medical tape roll (1)
Alcohol prep pads (24)
Providone-iodine USP prep pads (6)
Benzalkonium chloride antiseptic towelette pad (26)
Instant wash-up towelette pad (6)
3"x18" Vaseline gauze (1)
Medical cotton batting roll (1)
3" Ace bandage (2)
3"x3" sterile sponges (2)
FSN 6510-201-7425 V-30 field dressing
Assorted sheer strip bandages with non-stick pads
Gauze six ply bandages measuring 4.5" by 4.5 yards
Insect bite, iodine, alcohol, sanitizer towelettes
Instant cold packs
Burn gel 1/8 oz packets
Acetaminophen, ibuprofen, and aspirin
Various wound dressings and sterile tape
Eye wash
Military bandage (1)
2" Steripad (2)
3" Steripad (2)
Sterile sponges (2)
Adhesive tape roll (1)
3/4"x3" adhesive bandage (15)
1-1/2"x7/8" adhesive bandage (5)
4"x4.5 yds. elastic bandage (1)
Antibiotic ointment (2)
Alcohol Prep Pad (4)
Iodine PVP prep pad (2)
Small sugar packs (3)
2-pack of cotton balls (2)
4 oz CA Super glue
Potassium Iodide 65mg potassium iodide 200 tablets

Sorry if there is some redundancy... it's a compilation of 3-4 different lists.  Everything in there is useful, though, so I doubt if one could go wrong.  

[SMLE]

I would suggest substitution nitrile gloves for the latex. Too many people are allergic to latex. I work in EMS and all we carry are the nitrile gloves.

My rule of first aid kits is; "If YOU can't use it, don't even carry it!"  This applies not only to things you aren't trained to use, but to things that you lawfully can't use.  As an EMT, I can administer Epi, but ONLY when I'm at work and under med control.  Even though I KNOW how to draw it up and administer it, I can't carry it around with me in my personal FAK.

PS: I will ask around about quik-clot. We don't carry it, but I try to find any first hand info I can.

[Guest]

Even though I KNOW how to draw it up and administer it, I can't carry it around with me in my personal FAK.

Things may have changed but, in the past if one could get a prescription from a physician you could include controlled medication in a kit. Physicians are willing to write prescriptions for this purpose, you generally have to know them pretty well though. We included a number of prescription injectibles in a medical kit for our sailboat, of course my mother was a pharmacist and knew plenty of doctors.

[S. Williamson]

Alrighty, list edited to include Nitrile gloves.

My rule of first aid kits is; "If YOU can't use it, don't even carry it!"

Since this is a list Dad came up with, there are a few things on there that I've never heard of.  They include:

First Aid Cream - what exactly is this stuff? Hydrocortizone, triple antibio, burn gel, what?
Field dressing - unsure about this too.  What is it?
Potassium Iodide 65mg - some sort of vitamin?
Airway - plane tickets?

[SMLE]

Alrighty, list edited to include Nitrile gloves.

Since this is a list Dad came up with, there are a few things on there that I've never heard of.  They include:

First Aid Cream - what exactly is this stuff? Hydrocortizone, triple antibio, burn gel, what?
Field dressing - unsure about this too.  What is it?
Potassium Iodide 65mg - some sort of vitamin?
Airway - plane tickets?

The first aid creme is probably one of the comercial non-petrolatum based anti-septic cremes. I think Bandaid still makes one that you can get a wal-mart walgreens eckerd etc.

The field dressing would be military issue wound dressings of various sorts, the FSN numbers are a hint.

Potassium Iodide would be for treatment of radiation. That kind of dates when your dad came up with this list.

The "airway", could be any number of airway adjuncts like  the Guedel Oral airways seen here
 

Or the nasal airways(AKA "nose hoses") seen here:



You may not want to mess with these airways as a "good samaritan" first aider.  Look up you local American Heart Association chapert and talk to one of their CPR instructors.  

FWIW AHA CPR is WAY better the ARC's. It usually costs less and you get a 2 year cert. instead of a 1 year.

[K Frame]

Regular corn starch or flour can form an effective, temporary clotting compound, although probably not against arterial bleeding.

Several months ago my brother's dog severely cut its one paw (took the main pad almost completely off) and was bleeding heavily. I took a tea towel, filled it with Pillsbury, and wrapped it tightly around the wound, and we took off for the vet.

By the time we got there, the bleeding had almost completely stopped, until the doctor started cleaning off the flour.

Vet said had I not used the flour, the dog probably would have bled out.