This enthusiastic study is the first published case series on the use of a novel local haemostatic. “QuikClot” is a mineral product which acts as a molecular sieve and rapidly absorbs water. Its primary mechanism of haemostasis therefore is via the concentration of platelets and clotting factors, promoting rapid clot formation.

The authors report on the results of 103 surveyed users. These users were comprised of 69 military personnel, 20 civilian trauma surgeons and 14 civilian first responders (police officers/firefighters/EMS personnel). The application of the device was intracorporeal in 20 cases. Its current indication for use, as described in the US military module of pre-hospital trauma life support course, is in the situation of failure of a pressure dressing to control haemorrhage.

The authors report an overall efficacy of 92%. They comment that the Army medics and Navy corpsmen reported 100% efficacy whilst the medical officers and trauma surgeons noted some ineffectiveness in controlling bleeding. The reasons for this difference in efficacy are explained by the observation that 6 of the 8 failures in the latter group were in patients who were moribund at the time of device use. The other reason given was because the device was not delivered to the source of haemorrhage (acetabular & pelvic fractures).

There were 4 documented complications in the series including 3 burns (the use of the device involves development of a local exothermic reaction), one of which required skin grafting. The one serious complication of these was ureteric obstruction caused by scarring possibly as a result of a local foreign body reaction of the QuikClot granules. The free granule version has now been superceded by a bag format called “QuikClot Advanced Clotting Sponge”, a further version of which operates at lower exothermic temperatures.