QuickClot Use in Current Medical Practice
The original zeolite-based QuickClot is no longer recommended due to significant safety concerns, but the newer kaolin-based QuickClot Combat Gauze remains a widely used and recommended hemostatic agent in both military and civilian settings. 1
Evolution of QuickClot Products
The original zeolite-based QuickClot caused severe complications:
- Burns and tissue damage occurred from exothermic reactions reaching temperatures of 93.3°C at the tissue interface, with one documented case requiring skin grafting 2, 3
- Patients experienced mild to severe pain and discomfort from the heat generated during application 2
- Foreign body reactions and scar formation complicated intracorporeal use 2
- Despite these issues, the zeolite version showed 92% efficacy in controlling hemorrhage when applied correctly 2
Current Recommendations for Hemostatic Dressings
Modern hemostatic agents (including newer QuickClot formulations) are first-line interventions when standard hemorrhage control fails:
- Apply hemostatic dressings when direct manual pressure for 5-10 minutes does not achieve hemostasis, particularly for severe arterial bleeding in compressible locations 1
- The American Heart Association reports a 90.8% success rate in achieving hemostasis with current hemostatic dressings 1
- 73% of cases achieve bleeding cessation in under 3 minutes with proper application 1
Proper Application Technique
The critical steps for effectiveness include:
- Pack the dressing directly into the wound at the source of bleeding and maintain firm pressure for a minimum of 3 minutes 1
- Do not repeatedly lift to check for bleeding cessation during the initial pressure application 1
- Complications occur in only 3% of cases with proper technique 1
Clinical Context and Agent Selection
Current guidelines recommend selecting hemostatic agents based on bleeding characteristics:
- Mineral-based agents are recommended for external bleeding in prehospital settings 1
- Chitosan-based agents (like Axiostat) are recommended for venous and moderate arterial bleeding, particularly when access to the bleeding site is difficult 4
- Collagen-based agents directly trigger platelet aggregation and are effective when other hemostatic mechanisms are compromised 5
Military and Civilian Experience
QuikClot Combat Gauze (the kaolin-based version) has demonstrated effectiveness:
- 79-93% success rates reported in military field use without the thermal complications of the original zeolite version 6, 7
- Successfully used in 30 civilian prehospital cases with 22 complete cessations of bleeding and no reported side effects 6
- The US military recommends QuikClot Combat Gauze as the first-line hemostatic agent for severe hemorrhage 8