Medical

Hemostatic Agent

A chemical agent, typically in gauze form, that accelerates blood clotting.

In the Field

We reach for a hemostatic when a tourniquet is not an option. This is where people realize fast whether they actually trained or just watched a video. The chemistry behind Combat Gauze, Celox, and ChitoGauze is different, but from a training standpoint the deciding factor is what your team drills with, not what is in the package. What fails is shallow packing and not holding pressure long enough to matter.

Common Mistake

Packing the wound too shallow instead of down to the source of the bleeding and not applying direct pressure correctly.

Technical Detail

Hemostatic dressings are topical hemorrhage control products designed for junctional wounds, truncal wounds, and other injuries where a tourniquet cannot be applied. The CoTCCC currently recognizes Combat Gauze, Celox Gauze, and ChitoGauze as field-approved hemostatic products.

Application requires direct wound packing: the gauze is pressed into the wound down to the source of bleeding, packed until the wound is completely filled, then held with direct pressure for a minimum of three minutes or per manufacturer guidelines. Compressive bandaging follows.

Field-approved hemostatic agents fall into two chemistry classes, each with a distinct mechanism of action. Kaolin-based agents (Combat Gauze) accelerate the body's natural clotting cascade. Chitosan-based agents (Celox Gauze, ChitoGauze, ChitoSAM) work independently of the clotting cascade by forming a mucoadhesive barrier. The clinical implication is that chitosan can remain effective in patients whose clotting function is compromised, including those on anticoagulants or in hemorrhagic shock.

For detailed chemistry, mechanism, and clinical selection considerations, see the Kaolin and Chitosan entries.

Loose powder and granular hemostatic products earlier on the market are no longer recommended for field use due to application issues and, in some cases, thermal injuries from exothermic formulations.