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Knife Tip: First Stop The Bleeding

Image: Wikipedia

Knives are sharp. Humans are clumsy. Put the two together and you’re going to eventually cut yourself, or be around someone else who’s cut themselves. (You’ll notice that I didn’t use a nauseating wound graphic to illustrate this.)

Most accidental cuts are minor wounds that only require routine first-aid: direct pressure, followed by a good cleansing and a bandage. Maybe even some neomycin to kill whatever germs the soap and water didn’t flush out. More serious wounds, however, require more serious treatment.

You may end up having to treat a wound (your own or someone else’s) that goes beyond ‘Hey, I just cut my finger!’ and makes your knees go wobbly just looking at it. In that dire strait, it helps a lot if you’re just a little bit prepared.

Direct pressure is the advice given in the Boy Scout Handbook, but you don’t always have enough spare hands available. A tourniquet is a fairly extreme resort, and should be used only for the most severe injuries to extremities. Luckily, there are two products on the market that can stop even severe bleeding almost instantly: Celox and QuickClot.

Celox is a granular coagulant made from chitosan, an organic substance found in shellfish exoskeletons. It combines with blood to form a thick gel-like clot that stops even extreme bleeding very quickly. It’s available in granular form, or as treated gauze wound pads. A box of ten small granule packets runs about $40.

Chitosan clotting generates no heat, but there are concerns that it could trigger allergic reactions in patients sensitive to shellfish. Published research and clinical outcomes do not indicate such allergic responses, however.

QuickClot is a mineral coagulant with similar wound-treating effectiveness as Celox. It’s a mineral so there are no concerns about allergic reactions, but it does generate heat as the mineral agent combines with blood to form thick clots. It’s sold as treated gauze wound pads, but medical professionals can also get it as a wound powder.

Early formulations of QuickClot (used in the Iraq/Afghan wars) could produce enough heat to cause 2nd-degree burns. New versions on shelves now won’t heat up past 120 degrees F. This may be a little uncomfortable (or then again, maybe not) but it won’t add burn injuries to the laceration you’re trying to treat.

I can’t personally say how well these work, because I haven’t witnessed any severe lacerations since I stocked up on coagulant pads. Nonetheless, my survival bag includes a couple of QuickClot wound pads, and our home first aid kit has several more. They’re not cheap, at around $15 each, but it’s nice knowing that even an unskilled responder can use them to stop severe, life-threatening bleeding that doesn’t respond to direct pressure.

Note: this article isn’t intended as a first-aid course (click here for that). Emergency treatments like these are designed to control immediate blood loss and prevent death. Once the bleeding has slowed or stopped, there’s still tissue and organ and blood vessel and nerve damage to deal with, as well as infections to prevent. As soon as anybody has a free minute to talk to the 911 operator, it’s time to call for that quick but expensive ride to the ER and a trauma surgeon.

Discussion

10 responses to ‘Knife Tip: First Stop The Bleeding

  1. I have used new skin and super glue w/ some effectiveness. I am not recommending those mind you. Just sayin I have used them and lived to tell the tale. Also, altitude and medications should be kept in mind. Many anti-infalmmitories reduce the bloods ability to coagulate. Altitude does the same.

  2. The Celox might cause an allergic reaction in some. It might not
    but why take the chance. Both Celox and QuickClot stop bleeding
    but only where the materials falls. You could still possibly have
    internal bleeding issues. So you still need to put pressure on the
    wound and bandage (and go to the ER). Once applied, both act
    very quickly. QuickClot works by adsorbing the plasma,
    concentrating the blood cells and platelets. Celox bonds to blood
    cells and platelets essentially making a gel to thick to bleed.
    Both are intended for emergency use only. They can be left on/in
    the wound for extended periods but they should be washed off
    before suturing and more permanent bandaging. QuickClot cannot
    be absorbed by the body. Celox can be but you still should wash it
    off. When you wash off QuickClot use copious amount of water
    quickly. A trickle will cause the exothermic reaction more time to
    irritate the wound.

    Both have a shelf life of 3 years, so keep an eye on your packs. Take
    care to protect the packets too. Being super absorbent a pin hole can
    be a pathway for moisture in the air to render them useless. Both
    products come in either granulated form or impregnated gauze.

    I carry QuickClot in my EMT kit but rarely use it. I also carry
    Israeli bandages. These things are awesome, especially out in the
    field. Sanitary napkins and ace bandages also work in a pinch. It’s
    also not a bad idea to carry a tourniquet that can be used with one
    hand.

  3. Just as an aside. Keep a sharpie with your tourniquet in your first aid kit. If you ever do need to use it, try and write the time you applied te tourniquet either on the tourney, or on skin around it. Thats important if youre able to make it to an er.

  4. Now that the heat issue is fixed, no first aid kit in an area where major trauma is a reasonable possibility should be without QuikClot.

  5. I’ve had a couple good cuts at work, but never enough to require a tourniquet or quik-clot. One time I was messing around with my Skyline and sliced off a potion of my left index finger pad about an inch long. It was hanging on literally by a thread, about the width of 2 or 3 finger print ridges. Took about 25 minutes for me to get it all bandaged up. My coworkers were freaking out and I was all calm since I am pretty much the only one that was on that day that had some sort of training (boy scouts). Another time I was cutting some plastic off of a pallet. I couldn’t reach the last part with my knife so I went to tear it apart. Well, I didn’t put my knife away and my arm slipped right into it. Benchmade Torrent went about 1/4″ into my arm. Couple butterflys later and I was good to go. It’s been almost a year since that one. I figure I’m due for one soon

  6. Also a great idea to have 1 or 2 of the celox a applicators. They look just like a tampon and push the celox into deep wounds. If you get hit with a arrow, bullet, or knife, this thing is probably the device most likely to keep you alive.

    There are reports of it stopping major arterial bleeds. Pretty much anything femoral artery or smaller.

  7. Are there any issues regarding getting the granules of these products in the blood stream that may potentially result in internal free floating clots that could potentially cause death?

    • There was concern about these hemostatic agents causing clotting distant form the wound site, but the literature doesn’t indicate that these are actually a problem. Both of these products have been used on thousands of trauma patients in Iraq and Afghanistan, and secondary thrombosis hasn’t proven to be a significant concern where these agents are used.

      The Celox website addresses this concern directly with some references to medical studies; I don’t recall if the QuickClot website does.

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