There are three main clotting agents. The most well known is Quick Clot, the second is
TraumaDEX, the third is Hemcon or Celox (chitosan).
1. Quick Clot – a synthetic substance which removes water from the blood making the
clotting cells in the blood more concentrated – comes in powder form.
Pros: nonallergenic, most field experience, most readily available, cost similar to
TraumaDEX, cheaper than chitosan,
Cons: due to the rapid absorption of water, causes large production of heat which can
burn the tissues and be difficult to remove from the wound after, powder needs to be kept
dry, no applicator – more difficult to use (though they are coming out with new versions to
address this)
2. TraumaDEX – made from potato starch which also works by removing water from the
blood, concentrating the clotting cells comes in powder form in two size applicators (2gm
for 4 inch area, 5gm for 10 inch area)
Pros: nonallergenic, much less heat production than quick clot, biodegradable so does
not need to be removed from the wound after, easier to use applicator, cost similar to
Quick Clot, cheaper than chitosan
Cons – powder needs to be kept dry, not as much experience in the field
3. Chitosan (Hemcon or Celox) – a substance derived from shellfish which has
mucoadhesive properties (able to adhere to wet surfaces) allowing for strong adherence
to tissues, sealing the wound. May also have some effect on helping clotting cells.
Comes in bandage form.
Pros: easy to use in bandage form, easy to remove, can be used in wet situations.
Cons: not as much experience in the field, theoretical possibility of allergic reactions in
persons allergic to shellfish, most expensive.
***None of these is first line treatment for any injury. ***
Compression and elevation is first line. If that doesn’t control the bleeding, second line is
a tourniquet if the wound is in a place you can use one. If the bleeding is still not
controlled, then and only then should any of these be considered. The best chance of
these products being effective is to know how and when to correctly use them. (This can
be a future topic.)
Every one of these products has been used both by those who swear it is a life saver
and those who swear it does nothing. All the products have controversy and have both
advantages and disadvantages. In the end, if you are out of options, it doesn’t matter
which product you happen to have, they have all saved someone’s life.
The ideal product should be easy to use, be inexpensive, be effective and have low risk
of side effects. It’s up to you to look objectively at all those available and make your own
choice – there is no wrong choice.
Note: The chance of any of us seeing a wound that cannot be controlled with
compression and tourniquet is extremely small- consider this as well when determining
whether or not to purchase these products.
TraumaDEX, the third is Hemcon or Celox (chitosan).
1. Quick Clot – a synthetic substance which removes water from the blood making the
clotting cells in the blood more concentrated – comes in powder form.
Pros: nonallergenic, most field experience, most readily available, cost similar to
TraumaDEX, cheaper than chitosan,
Cons: due to the rapid absorption of water, causes large production of heat which can
burn the tissues and be difficult to remove from the wound after, powder needs to be kept
dry, no applicator – more difficult to use (though they are coming out with new versions to
address this)
2. TraumaDEX – made from potato starch which also works by removing water from the
blood, concentrating the clotting cells comes in powder form in two size applicators (2gm
for 4 inch area, 5gm for 10 inch area)
Pros: nonallergenic, much less heat production than quick clot, biodegradable so does
not need to be removed from the wound after, easier to use applicator, cost similar to
Quick Clot, cheaper than chitosan
Cons – powder needs to be kept dry, not as much experience in the field
3. Chitosan (Hemcon or Celox) – a substance derived from shellfish which has
mucoadhesive properties (able to adhere to wet surfaces) allowing for strong adherence
to tissues, sealing the wound. May also have some effect on helping clotting cells.
Comes in bandage form.
Pros: easy to use in bandage form, easy to remove, can be used in wet situations.
Cons: not as much experience in the field, theoretical possibility of allergic reactions in
persons allergic to shellfish, most expensive.
***None of these is first line treatment for any injury. ***
Compression and elevation is first line. If that doesn’t control the bleeding, second line is
a tourniquet if the wound is in a place you can use one. If the bleeding is still not
controlled, then and only then should any of these be considered. The best chance of
these products being effective is to know how and when to correctly use them. (This can
be a future topic.)
Every one of these products has been used both by those who swear it is a life saver
and those who swear it does nothing. All the products have controversy and have both
advantages and disadvantages. In the end, if you are out of options, it doesn’t matter
which product you happen to have, they have all saved someone’s life.
The ideal product should be easy to use, be inexpensive, be effective and have low risk
of side effects. It’s up to you to look objectively at all those available and make your own
choice – there is no wrong choice.
Note: The chance of any of us seeing a wound that cannot be controlled with
compression and tourniquet is extremely small- consider this as well when determining
whether or not to purchase these products.
| Hemostatic Agents |
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