Where there is a catastrophic bleed that is too high up the limb for a tourniquet, e.g. a high injunctional wound at the groin or armpit, or somewhere other than a limb, or even if you have judged the bleed not to be catastrophic but is still significant, then a haemostatic gauze can be used.
Haemostatic gauzes are gauze bandages that have a substance called chitosan applied/impregnated into them. Chitosan will clot blood, even where the blood’s own clotting factors are reduced due to other wounds being present or are inhibited by drugs such as warfarin or heparin.
Click on the button below for a video demonstrating the Prometheus Chitogauze XR Pro that you will have seen in your training.
The Prometheus Chitogauze XR Pro comes z-folded for ease of use and the gauze is simply packed into the wound. The process of packing the gauze into the wound means that the gauze reaches and helps the blood form clots at the point of bleeding of the blood vessel. Also the packing creates additional pressure at the wound site that also helps stem the flow (which slows bleeding and helps clots form).
Keep the pressure on as each fold is packed into the wound, then apply direct pressure over the top for at least five minutes. (Note – the video says 2 -3 minutes, but five will give you much greater confidence of success and a more robust clot.)
DO NOT use haemostatic gauze for chest cavity or head wounds.
With either tourniquets or haemostatic gauzes, if you’ve used your equipment up already or don’t have any with you, and you still need to control a catastrophic bleed, then you can improvise:
For a tourniquet, a triangular bandage may be sufficient with something strong (like a spanner) as the windlass. The item used as the strap needs to be strong and supple (belts are not very good as they are too stiff to twist).
To pack a wound, the packing from an Olaes bandage can be used, or indeed, any flexible gauze. But remember, there is no clotting agent, so clotting is reliant on the casualty’s own blood to do the work.