TraumaDex

Discussion in 'Survival Medicine' started by melbo, Nov 20, 2006.


  1. melbo

    melbo Hunter Gatherer Administrator Founding Member

    Have a packet in my hand and was wondering if anyone had any thoughts on it. Kindof like Quik-Clot but not caustic....

    Review: TraumaDEX

    March 2003, MERGINET - I have been known to say, “All bleeding always stops, one way or the other.” However, better one way than the other, and the sooner the better, especially if you are the patient or the prehospital provider. Thus, in this review, we look at TraumaDEX™.



    TraumaDEX is an innovative wound-dressing agent developed by Medafor Inc. and distributed in the United States by Emergency Medical Products. It controls bleeding within seconds. Its hemostatic technology uses microporous polymer particles that have been naturally synthesized from a plant-based polysaccharide source—you got it: potatoes. When applied to a bleeding wound site, it initiates coagulation within seconds. The particles act as molecular sieves to absorb fluids in the blood, attracting and concentrating proteins and platelets and accelerating the natural clotting process.




    According to my investigation, no product currently available for emergency medical services is comparable to TraumaDEX. Materials and devices that are considered comparable to TraumaDEX technology are largely used in surgical applications, but do not have characteristics compatible with the requirements of EMS providers (e.g., low cost, good adhesion, minimal prep time). TraumaDEX has been shown to be highly effective as a topical dressing for the local management of severely bleeding wounds. This makes it appropriate for use on cuts, lacerations, abrasions, and puncture wounds.
    TraumaDEX researchers include no less than the Transfusion, Coagulation and Cardiopulmonary Bypass Research Group at Mayo Clinic. They studied TraumaDEX technology extensively, and their experience demonstrated that TraumaDEX hemostatic particles provide robust and highly effective control of otherwise difficult to control bleeding.
    A Mayo Clinic study of 30 volunteers found that the coagulant with applied pressure produced instant clotting of small forearm incisions in 77 percent of incisions, compared to a median bleeding time of approximately six minutes at identical control incisions. To manage bleeding at the control sites one inch from the treatment site, the researchers applied pressure alone.
    In addition to speeding up the clotting process, the topical agent offers a desirable alternative to collagen-based and other animal-derived hemostats, which can cause allergic reactions in some patients. Made of purified potato starch processed to produce porous, spherical micro-particles, the new coagulant eliminates this allergy risk. Also, the large surface area of the particles gives the hemostat its extraordinary dehydrating action. At the same time, the small size of the individual particles allows the body's own enzymes to rapidly break down the hemostat. According to laboratory findings, virtually all traces of the substance disappear within hours.
    The concept behind the packaging is simple, consisting of pre-packaged bellows applicators filled with the potato-based wound-dressing agent. TraumaDEX comes in two sizes:
    • A two-gram bellows applicator provides up to four square inches of wound coverage, enough for a 16 x 1/4 inch incision
    • A five-gram bellows applicator provides up to 10 square inches of wound coverage, enough for a 40 x 1/4 inch incision
    I wanted to put this product to the test for myself, but I really struggled with how I would go about it. I just could not see slashing my carotid or participating in self-mutilation. After all, I would have to conduct the test. What I needed was a “patient.” As I sat in my living room pondering the problem, I heard my wife, Debby, in the kitchen checking her blood sugar by sticking her finger. Her wound was just what I needed. I told her my idea and she agreed to be my “patient”; now, that’s dedication! She produced a wound on herself by sticking herself several times with a lancet and I then applied TraumaDEX, followed by direct pressure. I found that the wound clotted almost instantly. It was as if the beads of TraumaDEX had formed a scab over the wound. After this firsthand experience, I believe this product deserves a position in your lineup of trauma care supplies.
    TraumaDEX worked so well that my wife suggested it could be a product our daughter, Vanessa, may want to have on hand for our granddaughter. Abby, like most three-year-olds, gets the occasional “boo-boo.” This product would be great to use on her and other children, because it works almost instantly and is painless. While TraumaDEX is prescription use, Bleed-X was developed and is marketed by Medafor Inc. for over-the-counter use. It would certainly fit the bill to have on hand in the home. I highly recommend it.

    TraumaDEX™ is a topical dressing for the control of severely bleeding wounds from traumatic injuries including cuts, lacerations, and puncture wounds. It is distributed in the US for prehospital customers by EMP, Inc. of Waukesha , Wisconsin at www.traumadex.com .

    Bleed-X™ is distributed worldwide by Medafor, Inc., 5201 East River Road, Suite 312, Minneapolis, Minnesota 55421. Phone 1-877-MEDAFOR (633-2367). Internet: info@medafor.com or www.medafor.com
    The 2-gram bellows applicator of TraumaDEX may be purchased from Emergency Medical Products for $10.95, (a case of 50 applicators costs $518.49). For more information on TraumaDEX and to obtain a free sample from Emergency Medical Products, go to www.traumadex.com. For more information on Bleed-X, visit www.medafor.com.
    Greg Schaffer, BA, EMT-P, has worked in emergency services for more than 20 years, with more than 10 years as an educator and public speaker. Greg is currently an EMS manager in metropolitan Atlanta , Georgia and travels extensively, presenting training programs on EMS and emergency communications. Greg's web site is www.gregschaffer.com.
     
  2. monkeyman

    monkeyman Monkey+++ Moderator Emeritus Founding Member

    Looks interesting but I didnt see where it said anything about how it effected healing after the fact. Dose it simply do like it would if it scabbed over, that it may break back open easily and resume bleeding but will heal naturaly or dose it basicly make it more like if it cauderized and not close over as well or dose it improve healing? Also I would be curious about how it effects it say if a significant blood vessel is cut. Would it cause a high risk of setting a blood clot into the blood stream, seal the vessel potentialy causing long term loss of important blood flow, help the vessel to resume normal function or what?

    It looks like it would definatly have its uses but I would want to have more info on it and its uses/effects before keeping it on hand just to be sure when to use it and when it might be best not to.
     
  3. phishi

    phishi Psy-Ops Moderator Emeritus Founding Member

    Melbo and I were discussing this last night MM, here is what we figure it could be used for, with some basis for discussion first:

    1) IMO: This product is used to buy you some time. It is not an end use item that you apply and forget about. Rather, it slows and/or stops the bleeding while you figure out where the hole is and what you are going to do about it. If I understand correctly,the product will eventually be reabsorbed by the body and if you have not figured out how to stop the bleeding by then (few hours time), you are back at square one. (Note: I am talking about a major bleed, someting that squirts because it has pressure behind it, not just a small laceration.)

    2) This product has a self life of a few years, at least 2. It could possible go longer, but I would be afraid that it might not work as well past that date.

    3) This product is not cheap at around 100.00 for 6 packs, IRRC.

    4) Most bleeding can be controled with direct pressure and/or a tourniquet. http://survivalmonkey.com/forum/showthread.php?t=3640

    5) With all of these factors in place, the product still has a use. Multiple wounds, multiple patients, amputations, and crushing injuries are just a few that come to mind. Due to cost I would not use it for just any wound, it would have to be pretty big before I would pull this out. Due to shelf life, I would not stock a lot of it for my med kit.

    Finally, I have never used, nor seen used, this product. We don't stock it at my hospital, I'm not even sure its used on the street in my area. I believe that there are indications/contraindications for its use, but I do not know what those are. Some training on this would be good to know, as it would help develop SOPs on when you should apply the product vs. when you should apply pressure. In other words, if you can afford it, get some. Just make sure you know when/how to apply and when not to.

    Just my .02,
    phishi
     
  4. monkeyman

    monkeyman Monkey+++ Moderator Emeritus Founding Member

    Yeah, I was basicly figureing it sounded like it would definatly be something that would have its uses and its place in a well stocked kit, I was just figureing it would be like a lot of meds and such though that unless you know all pertenant info on it or have been directed to use it by someone who dose then it would probably be best to use something you DO know.

    If it was massive trama with arterial bleeding (the spurting) however and especialy multiple such wounds, severed limb/amputation or some such then by all means I would say that it you dont already have someone THERE (not 100 yards away but THERE on the scene) then it kind of becomes more an issue of do something even if its wrong because doing nothing makes sure they die while a screw up only MAY kill them and if you get it right even by accident then all is well.
     
  5. Bear

    Bear Monkey+++ Site Supporter+++ Founding Member Iron Monkey

    Interesting thread.... I've got a pretty well stocked emergency kit.... Phishi... any idea how this compares to the quik clot?.... I would only use these for some pretty serious wounds....
     
  6. TnAndy

    TnAndy Senior Member Founding Member

    From what I read, QuickClot heats up to do it's thing, and can even cause burns......TraumaDex isn't supposed to do that.

    Either one is likely a 'deal of last resort'.....but I plan to keep a few squirt vials of TraumaDex around. Shock from blood loss is a big killer too.
     
  7. phishi

    phishi Psy-Ops Moderator Emeritus Founding Member

    Bear, +1 too what TnAndy said. It should not cause the burns that QuickClot has been reported too. Both will stop the bleeds, both have been credited with saving lives, both are expensive, and IMO both have there place in a med kit. Just a med kit that has more money invested in it then mine :D .

    MM, there is a potential problem with your line of thought. There is the potential of causing greater harm by doing the wrong thing. For instance, what if by using this product in an improper manner you end up sealing in bacteria that then leads to infection? Now instead of the patient dieing a relatively quick death, they last for a month, are a strain on the resources at hand, and end up dieing anyway. When your number is up, there is not much you can do about it. Please don't hear me saying that the individual isn't worth saving, it just needs to be done in the right manner with the big picture in mind. (Note: The above is hypothetical, in no way do I wish to imply that I know what this product's indications/counterindications are. The situation described was used to make a point, only.)

    Just my .02,
    phishi
     
  8. monkeyman

    monkeyman Monkey+++ Moderator Emeritus Founding Member

    I can see your point, the only thing I was refering to was NOT at a minor wound level but at a level where the person will be dead in the next 10-30 minutes or less if nothing is done, then if you do the 'wrong' thing then the most that happens is they loose 10 minutes, if you do something right then they survive and do well, if it is in between then they most likely gain the time to get to some one/some place where they can treat the initial problem and hopefuly fix anything you screwed up. Kind of like the 'traditional wisdom' I had always heard on turniquets, if you use the tourniquete the limb is most likely lost especialy if not done exactly right, but even if the limb is lost its better than leaving them to bleed out IF the wound is such that the bleeding can not be otherwise controled.

    If it is something that can wait untill more qualified or better treatment can be administered then BY ALL MEANS do so, I just figure if it is a situation where either treatment or death will occure within minutes then go for whatever treatment is at hand.

    As far as if by doing so you seal bacteria in the wound, it seems to me that you would then have a decent chance at being able to come up with antibiotics or get to where you already have them and treat for that where if you do nothing (say when a leg is severed at the upper thigh) then they wont make it to any better treatment. Before hand is definatly the time to do all you can to become informed on how to treat it right and if it can wait for more qualified personel then do so but I have to say NEVER watch someone die while you wait for more qualfied personel to get to them (or to get them to the more qualified personel) just because you may not be sure exactly what to do. I can unfortunatly say from experience that it will haunt you for a long time to come, and my experience was within 100 yards of whats supposed to be an excelent trauma ER.

    I do agree though, and probably didnt make that clear in the earlier post, that if it is not imediately life threatening (or say within the hour since even in populated areas an ambulance will very often take 30 minutes to arive for an emergency call) then that SHOULD be left to someone who knows what they are doing if at all possible. I was refering only to situations where doing nothing means the patient WILL be dead within an hour or less.
     
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