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Wed Aug 15 14:27:06 BST 2007

Has anyone had any experience with HemCon?  It is a hemorragic control bandage that stops arterial/venous bleeding in 2 mins with steady presssure. It is made from Chitosan--a protein from Artic shrimp shell; it is very impressive and seems to do what it says it will do.  The Army did a lot of R and D in conjunction with the company "HemCon".  Deployed Army soldiers are carrying several in their packs and medics are carrying at least 5.  Check-out the web-site at HemCon.com
Let me know if you have any questions about it.
My e-mail is :  suzanne.thornburg at Cardinal.com                        

-------------- Original message -------------- 
From: "Stephen Richey" <stephen.richey at gmail.com> 

> Dr. Wigle, 
> I'm finishing up a final revision of a literature review on tourniquets and 
> one of the things I have encountered is evidence that they can be left on 
> for several hours, I believe twelve hours being the longest I have seen 
> described without serious complications. However that was in a cold 
> environment during WWII, so I don't know how well that could be extrapolated 
> to the deserts of the Middle East. Most likely, whomever told you 24 hours 
> was either misinformed or at least relying upon evidence I do not have 
> access to. Even I, one of the most staunch supporters of their use under 
> appropriate circumstances, would cringe at such a suggestion. But then 
> again, I know how well the military takes to having inconsistencies or 
> errors being pointed out by people outside of positions of 
> authority.....that is a topic for another time though. 
> 
> However, if you are familiar with the article by Rasmussen et al regarding 
> vascular injuries presenting to Balad, there were few, if any, cases of 
> extremely prolonged field times associated with those who presented with 
> tourniquets in place. The vast majority of patients were in the Theater 
> Hospital within an hour of being wounded. I don't have that paper directly 
> in front of me at the moment, so that is why I can't speak in absolute terms 
> regarding it. 
> 
> Also interestingly I should point out that the one of my experiences with 
> QuikClot was a laceration on my thumb and I figured it was a good chance to 
> try out a sample of it that I had received on a half inch laceration without 
> arterial injury or other complicating issues. It did not even seem to do 
> anything worthy of note. However, your mileage may vary. 
> 
> > 
> > ------------------------------ 
> > 
> > Message: 2 
> > Date: Tue, 14 Aug 2007 05:03:05 -0700 (PDT) 
> > From: Richard Wigle MD FACS 
> > Subject: Re: Quik-Clot 
> > To: "Trauma &, Critical Care mailing list" 
> > Message-ID: <43009.1129.qm at web38806.mail.mud.yahoo.com> 
> > Content-Type: text/plain; charset=iso-8859-1 
> > 
> > AS Far as I know Quikclot is still being used in the Iraqi 
> > theater. I've been retired about 5 months now and so have 
> > been out of the loop. My personal experience with it wasn't 
> > especially impressive other than having to clean it up, the 
> > thermal problems were, again in my experience, annecdotal. 
> > 
> > As Stephen notes I think one of the major problems with it 
> > and some of the other products is that they tend to become 
> > an excuse for incomplete training and, when introduced at 
> > the lowest levels, become a wonder cure for all that ails 
> > you. I saw the same thing with tourniquet use and, while 
> > there is absolutely no doubt that tourniquets have saved 
> > many lives in Iraq, they were being applied in place of 
> > proper dressing (granted that in the field proper dressing 
> > sometimes becomes a luxury). At any rate I was actually 
> > told as part of my training (same as the enlisted folks 
> > got- one size fits all but it was enlightening)that 
> > touriquets could be left in place for 24 hours and when I 
> > suggested that perhaps this was not the way to go I was 
> > told not to upset the apple cart. 
> > 
> > Anyway we have to remember that many of these products are 
> > being touted by people with a personal stake in there use. 
> > I recently pulled out a couple of reviews on all the 
> > products. I'm on the road at present and my computer has 
> > crashed so I'm relying on internet cafes and hotel access 
> > points but if anyone is interested once I get someplace 
> > stable I will be happy to forward them, they're not hard to 
> > find with google scholar. 
> > 
> > I'm sure others out there have had different experiences 
> > with all of these products 
> > 
> > R Wigle 
> > --- Stephen Richey wrote: 
> > 
> > > I am not certain if it is still being used in Iraq and 
> > > Afghanistan or not. 
> > > I have only anecdotal evidence (n= ~5) for the use of 
> > > Quikclot in my 
> > > personal experience (in civilian situations), but I have 
> > > to say I wasn't 
> > > that impressed by it. It just seems to make one heck of 
> > > a mess of things 
> > > but not really do much in the way of hemostasis beyond 
> > > what you would 
> > > normally get from a pressure dressing. I used to teach 
> > > the US Army combat 
> > > lifesaver course (last time I taught it was in 2003) and 
> > > I personally 
> > > deemphasized (I covered it but put a word of caution in 
> > > the presentation 
> > > about the hazards of relying upon such agents when more 
> > > efficacious methods 
> > > exist) the use of currently available hemostatic agents 
> > > in favor of 
> > > aggressive use of pressure dressings and tourniquets for 
> > > immediate 
> > > hemorrhage control on extremities, particularly in a care 
> > > under fire 
> > > setting. 
> > > 
> > > If I can offer any further information on the US 
> > > military's training, please 
> > > let me know. If I don't have a solid answer for you, I 
> > > can put you in touch 
> > > with some contacts of mine who might be better positioned 
> > > to advise you. 
> > > Feel free to contact me off the list. Have a nice day. 
> > > 
> > > 
> > > -- 
> > > Stephen L. Richey, CRT 
> > > 
> > > "It is better to know some of the questions than all of 
> > > the answers."- James 
> > > Thurber 
> > > -- 
> > > trauma-list : TRAUMA.ORG 
> > > To change your settings or unsubscribe visit: 
> > > http://www.trauma.org/index.php?/community/ 
> > > 
> > 
> > 
> > 
> > 
> > 
> > 
> ________________________________________________________________________________ 
> ____ 
> > Be a better Globetrotter. Get better travel answers from someone who 
> > knows. Yahoo! Answers - Check it out. 
> > http://answers.yahoo.com/dir/?link=list&sid=396545469 
> > 
> > 
> > ------------------------------ 
> > 
> > Message: 3 
> > Date: Wed, 15 Aug 2007 08:39:06 +0100 
> > From: "JOSE SUAREZ PELAEZ" 
> > Subject: Re: Estimated fluid and blood losses classification. 
> > To: "Trauma & Critical Care mailing list" 
> > Message-ID: <002901c7df0f$5e3084d0$2501a8c0 at pc> 
> > Content-Type: text/plain; format=flowed; charset="iso-8859-1"; 
> > reply-type=original 
> > 
> > Thanks for your help. 
> > Yes, that is what i was looking for but i just need to know where it was 
> > publiclated by the first time by American College of Surgeon. 
> > 
> > 
> > ----- Original Message ----- 
> > From: "S Schecter" 
> > To: "Trauma &, Critical Care mailing list" 
> > Sent: Tuesday, August 14, 2007 12:40 PM 
> > Subject: Re: Estimated fluid and blood losses classification. 
> > 
> > 
> > Is that what you were looking for 
> > 
> > On 8/12/07, JOSE SUAREZ PELAEZ wrote: 
> > > 
> > > I can´t find the first publication of the "Estimated fluid and blood 
> > > losses" classification. Does anyone can help me? 
> > > 
> > > J.Suález-Peláez. 
> > > -- 
> > > trauma-list : TRAUMA.ORG 
> > > To change your settings or unsubscribe visit: 
> > > http://www.trauma.org/index.php?/community/ 
> > > 
> > 
> > 
> > 
> > 
> > 
> -------------------------------------------------------------------------------- 
> > 
> > 
> > > -- 
> > > trauma-list : TRAUMA.ORG 
> > > To change your settings or unsubscribe visit: 
> > > http://www.trauma.org/index.php?/community/ 
> > 
> > 
> > 
> > ------------------------------ 
> > 
> > -- 
> > trauma-list : TRAUMA.ORG 
> > To change your settings or unsubscribe visit: 
> > http://www.trauma.org/index.php?/community/ 
> > 
> > End of trauma-list Digest, Vol 50, Issue 22 
> > ******************************************* 
> > 
> 
> 
> 
> -- 
> Stephen L. Richey, CRT 
> 
> "It is better to know some of the questions than all of the answers."- James 
> Thurber 
> -- 
> trauma-list : TRAUMA.ORG 
> To change your settings or unsubscribe visit: 
> http://www.trauma.org/index.php?/community/ 

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