Joe Heneghan, editor of Ambulance Today, offers his impressions of WoundClot haemostatic gauze, now available for arborists in individual packs or as part of STEIN bleed-control kits.

AT first glance, WoundClot looks like nothing different on the market. The gauze material visually holds so much in similarity to other haemostatic gauzes, you could be forgiven for completely overlooking what is a truly massive step forward in emergency trauma care.

This gauze has three main immediate features going for it. It holds up to 2,500 per cent of its own weight in blood and is actively absorbent for up to 24 hours. Secondly, WoundClot has a truly remarkable wound surface adhesion. The pliant 3D gel matrix adheres to surrounding tissues in the wound and will not be dislodged by patient movement, wound manipulation, or high-pressure bleeding, while remaining easy to remove without causing rebleeding.

WoundClot’s third attribute is the ability to create an environment that is conducive to clotting by the concentrating platelets, red blood cells, and clotting factors in its 3D gel matrix. This leads to a clotting ability which has, so far, had any individuals working in trauma care or surgical theatres unanimously stunned.

Forestry Journal:

WoundClot utilises multiple mechanisms of action to stop bleeding. It is made from cellulose, a natural fibre product found in plants. It is the only non-oxidised, non-regenerated cellulose structure (NONRCS) product in the world, meaning that it possesses the highest safety profile of any haemostatic gauze available, while requiring little to no triaging to use effectively.

READ MORE: How Realism Training is providing realistic first aid training for the forestry industry

A further testament to its truly remarkable and game-changing nature, WoundClot is also notably small, available in 5 x 10 cm, 10 x 10 cm, 8 x 20 cm and 8 x 100 cm sizes. Another very important point to note is that, on average, WoundClot can be left in the wound, with no need to extract or irrigate later. It’s broken down by the body and absorbed fully within 7–10 days, with any unabsorbable amounts of cellulose simply being expelled by the patient via urination.

There have been many examples of the proficiency of WoundClot of late, which show just how revolutionary this product is and how vital it is to have in any kit. It may look like a run-of-the-mill gauze, but it isn’t.

One such story is a sad one, as the subject in question died after being transported to hospital. Recently, in Pittsburgh, a case occurred where an armed attacker stabbed two women, seemingly at random, at a downtown bus shelter. One escaped with a non-fatal wound to the mouth. The first victim, however, was much more unfortunate, suffering a stab wound directly in her carotid artery. As quickly as he could, the responding police officer detained the attacker and then swiftly ran to the first woman, placing his finger within the wound to try to stem some of the arterial spurting.

At around the same time, a representative of WoundClot had been in Pittsburgh training police staff on the application of the gauze, which had recently adopted it as part of their standard kit. While riding with members of their SWAT team, she attended this call. Finding an off-duty paramedic attending, and understandably struggling to control the catastrophic bleeding, she offered a simple 3 x 39-inch piece of gauze (just a little over 3 feet long). The catastrophic bleeding from the carotid artery was stopped within 15 seconds. Each first responder and ER physician involved in the case was completely stunned at how quickly the bleeding had been controlled.

Forestry Journal: When WoundClot gauze is applied to the site of bleeding, it rapidly converts from a dry, flexible gauze to a thick, expanding 3D gel matrix.When WoundClot gauze is applied to the site of bleeding, it rapidly converts from a dry, flexible gauze to a thick, expanding 3D gel matrix.

It is a terrible thing that this poor woman never made it. But the applications of this revolutionary advancement in haemostatic gauze cannot, and must not, be overlooked. Here, it was clearly a matter of time. The chances of surviving a punctured or severed carotid artery are amazingly slim, and they get even slimmer as every second passes. But it’s clear to see that if this product, compact and easily carried, were adopted as a vital part of every emergency kit, then application could be employed much quicker. I would personally go a step further and say that these should be made readily available on the street in the same way that AEDs are. That they should be given out to older children in schools with a very simple and easy to follow demonstration on how they should be applied.

According to the US Army Institute of Surgical Research (ISR), 84% of potentially survivable injuries ended in fatality due to uncontrollable haemorrhage. Of these, 67% of the injuries did not allow for sufficient access to the traumatic wound for the attending medics to be able to either place compression or fix a tourniquet.

To be perfectly honest, I am quite convinced that adopting this new and revolutionary product is not just a logical obligation, but an ethical must.

www.fletcherstewart.com

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