It is important to understand that science has not yet isolated the compounds essential in the production of fairy dust. Modern hemostatic agents require proper technique and training to function properly. Simply placing these products onto or into wounds does not solve all of your problems. If members of your organization are issued hemostatic agents, it is essential that they are trained on the agents and fully understand their limitations.
There are four steps you ought to follow when using hemostatic agents:
1) Prep your equipment. Set yourself up for success by having all required components ready before addressing a bleed (i.e., agent, gauze, and bandage).
2) Identify the bleed. Placing or pouring an agent onto or into a wound without identifying the bleed is unwise. If you have a large cavity that requires hemostatic agent, you must make sure the agent is placed DIRECTLY ONTO THE damaged vessels in order for it to work. Otherwise, you are wasting blood cells and agent.
3) Proper placement. After identifying the bleed, you must ensure the agent is placed DIRECTLY ONTO THE BLEEDER. If you do not, you run the risk of creating a “crust” made of blood and agent above the vessels. In so doing, you have visibly stopped the bleeding by forming a large clot, but it has not stopped the bleed.
4) Pressure. Hemostatic agents do not relive you of the basics that are required for hemorrhage control. After using a hemostatic agent, you MUST place gauze behind it in order to create pressure, so as to allow a clot to form. Otherwise, you run the risk of the agent being washed away or of a “crust” forming and creating a hematoma. It is also necessary to use the gauze to hold the agent in place and prevent it from shifting during patient movement. A minor shift during movement can cause a re-bleed which could be fatal if overlooked during re-assessments
1) Can the basics stop the bleed?
2) Is the casualty hypothermic? If so, clotting is a factor.
3) External environmental factors. For example, wind (or rotorwash) may blow a powder agent into the casualty’s or your eyes.
4) Location of injury (e.g., face, neck, abdomen).
5) Staying basic with the basics
6) Training is a must. If end-users (i.e., medics, operators, officers) do not know the basics of hemorrhage control, then using hemostatic agents is not wise.