What is the Israeli Emergency (Combat) Bandage and what is the U.S. Army’s equivalent hemorrhage‑control dressing?

Israeli Emergency Bandage and U.S. Army Hemorrhage Control Dressings

The Israeli Emergency Bandage

The Israeli Emergency Bandage (also called the Israeli Combat Bandage or Emergency Bandage) is an elastic adhesive pressure dressing that combines a sterile gauze pad with an elastic wrap and a built-in pressure applicator bar. This design allows for immediate, effective, and sustained hemorrhage control without compromising distal blood flow 1.

Key Design Features

• Elastic adhesive construction that wraps around body surfaces with integrated pressure application 1
• Pressure bar mechanism that creates focused compression directly over the bleeding site 1
• Self-adherent properties that maintain pressure without requiring continuous manual compression 1
• Versatile application successful even over body surfaces normally difficult to compress (junctional areas like neck, axilla, groin, pelvis) 1, 2

Clinical Performance

• Success rate of 88.6% for junctional hemorrhage control in combat settings 2
• Effective in 91.9% of extremity hemorrhage applications 2
• No complications or compromise of distal blood flow reported in field use 1
• Particularly valuable during transport by ambulance or helicopter where continuous manual pressure is impractical 1

U.S. Army Equivalent: Combat Gauze

The U.S. Army's primary hemorrhage control dressing is QuikClot Combat Gauze, which is the hemostatic dressing of choice recommended by the Committee on Tactical Combat Casualty Care 3. Every U.S. soldier carries this dressing in their first aid kit 3.

Combat Gauze Characteristics

• Hemostatic agent-impregnated gauze that combines surgical gauze with kaolin (an inorganic mineral material) to enhance clot formation 4, 3
• FDA-approved for external hemorrhage control 4
• Designed for wounds where tourniquets cannot be applied or standard pressure dressings are insufficient 4, 3

Clinical Effectiveness

• 79-93% success rate in controlling hemorrhage in combat casualties 4
• Effective for both junctional and extremity wounds including head, neck, axilla, buttocks, abdomen, back, pelvis, and extremities 4
• No adverse events or complications reported in field use 4
• Particularly effective when applied with firm pressure for at least 3 minutes directly into the wound at the bleeding source 5

Key Differences Between the Two Systems

Mechanism of Action

• Israeli Bandage: Mechanical compression through elastic pressure and pressure bar design 1
• Combat Gauze: Chemical hemostasis through kaolin-enhanced clot formation plus mechanical pressure 4, 3

Application Technique

• Israeli Bandage: Wrapped around the body surface over gauze pads until sufficient pressure achieved 1
• Combat Gauze: Packed directly into the wound at the bleeding source with firm pressure maintained for minimum 3 minutes 5, 4

Primary Use Case

• Israeli Bandage: Optimal for surface wounds requiring sustained pressure dressing, especially during transport 1
• Combat Gauze: Preferred for deep wounds, junctional hemorrhage, and situations where direct wound packing is needed 4, 2, 3

Clinical Recommendations

For severe external bleeding, the 2020 International Consensus on First Aid Science recommends using hemostatic dressings with direct pressure as opposed to direct pressure alone 6. Both the Israeli Bandage and Combat Gauze fulfill this recommendation through different mechanisms 1, 4.

When to Use Each

• Use pressure dressings (Israeli-style) when continuous manual pressure cannot be maintained and a self-sustaining compression system is needed 7, 1
• Use hemostatic dressings (Combat Gauze-style) when standard hemorrhage control fails after 5-10 minutes of direct pressure, particularly for severe arterial bleeding 5, 7
• Both achieve hemostasis in 73-90% of cases when properly applied 5, 2

Common Pitfalls to Avoid

• Do not repeatedly lift the dressing to check for bleeding cessation during the initial 3-minute pressure application period 5
• Do not use insufficient pressure - firm, sustained pressure is critical for both systems 5, 1
• Do not delay tourniquet application if these methods fail for life-threatening extremity bleeding 7
• Do not remove initial gauze if bleeding continues; add more material on top 7