Haemostatic Dressings

Haemostatic dressings are used in life-threatening bleeds like stab wounds, gunshot wounds, explosions, amputations, penetrating trauma and any catastrophic bleeding. They are not used on other bleeds as direct pressure and the application of a pressure dressing are advised unless these do not work.

They come in many different brands and we cannot cover them all in this video but we will look at the main ones.

It is worth stating that they are not a drug; they are a haemostatic agent that reacts with the blood to form a clot.

They can be used on most of the body apart from open head wounds and open chest wounds.

They have improved in recent years and they are easy and safe to use. They do not produce heat and they are naturally broken down in the body. Haemostatic agents can be used along with a tourniquet to stop a bleed.

There are two main types:  Celox and Quick Clot. Celox is made from Chitosan, which is a granular derivative of shrimp shells. It is safer to use even on people who are allergic to seafood as the allergen has been removed and they are non-allergenic.

Quick Clot is made from kaolin which is an inorganic mineral that accelerates the body’s natural clotting ability.

Haemostatic agents come in different formats for different uses and injuries. The first one we will look at is a pad type that is applied directly to the wound like a normal dressing and the agent reacts and will stop bleeding. Pads have a use, but in serious injuries, they may not be enough as you will need to pack the dressing into the wound.

This is Celox and comes in a gauze format which is ideal to pack into a wound. There are the standard and the Rapid types.

Celox is also available in an applicator which can deliver 6 grams of Celox deep inside a stab wound, gunshot wound or similar deep injury. The applicator is applied to the wound and gently pushed as it is removed to apply the Celox in the hole to stop the bleed.

Haemostatic powders are applied directly to the wound and then covered with a dressing.

We are now going to look at how Celox works. It works by absorbing fluid, which concentrates the blood and forms a gel. The granules attract to the red blood cells and platelets as they are electrostatically attracted which locks them together in a plug. This works by the Celox being positively charged and the blood being negatively charged. Then direct pressure allows the gel plug to form on the bleed site which stops the bleed.

Recent research has shown that the use of Celox in treating military injuries gives the highest survival rates and the lowest blood loss compared to other treatments.

Bleeding can be controlled in just 3 minutes with standard dressings and with the Celox, rapid bleeding can be controlled in just 60 seconds. Both these times are much better than conventional dressings in the same situation if indeed they even stop the bleed. During this time direct pressure is being applied. There are some brands that take longer than 3 minutes, so make sure you read the instructions. Once the time is up, we look at the bleed to see if it has stopped. If not, apply pressure for a further 3 minutes. When it has stopped, bandage in place, tucking the haemostatic dressing wrapper under the bandage for the hospital to see.

Whichever type you use, the Haemostatic agent is removed in the hospital by a Doctor and not by first aiders.