"Hemostatic Powders Don’t Work"

That was the title of an article on an austere medicine blog, by a physician, no less.  If that’s actually the case, we really want to know.  If they don’t work, we won’t waste time and money with them when our efforts will be better spent elsewhere. 

Let’s figure things out.

Let’s consider the original article itself before going any further.  This is the article in its entirety:

We recently discovered “active shooter kits” being marketed to agencies and schools containing granular hemostatic agents. Granular or powdered hemostatic agents fell out of favor over ten years ago as they “wash out” of actively bleeding wounds, are hard to get to the point of bleeding deep inside a wound, and in military settings, frequently blow into everyone’s eyes and faces with rotor wash. For this reason, hemostatic gauze is the preferred option. There is no hemostatic granular/powdered agent recommended by TCCC.

Hemostatic powders or granules do not work with a massive hemorrhage, which is usually deep and spurting blood, because it is difficult to get the powder to the source of the bleeding inside the body and because the spurting blood will wash it away.  Most people buying Celox or chitosan powder are doing so with the intent of treating massive hemorrhage within the abdominal cavity or an extremity.  And in these cases the hemostatic powder will not work.  People buy the granules and powder because they promise a solution to a problem we fear we won’t be able to control on our own, in this case, massive hemorrhage. 

So why are these expensive hemostatic powders on the market?  Because they can be invaluable.  As already established, they do not work well for massive hemorrhages.  However, we may encounter a lot of bleeding that happens to be more externally located.  An elderly family member may be on blood thinners.  A simple cut that would clot quickly on the rest of us may be a gusher for them.  In this case, kaolin powder and pressure may serve quite well.  As Dr. Joseph Alton notes, cayenne or cinnamon powder and direct pressure should be effective on minor wounds.[1]  They may not work so well to stop a nosebleed. (I can just imagine the fear on my husband’s face as I bring him a cayenne-covered square of gauze to stick up his nose.)  A little bit of chitosan or kaolin impregnated gauze will be more desirable.  (Use kaolin gauze for those on blood thinners.)

Other occasions when a hemostatic powder may be used include: varicose vein rupture, fractures, and other traumatic injuries that cause a lot of bleeding, just not a massive hemorrhage.  Perhaps, like me, you’ll realize that you don’t need to buy the expensive powders.  Maybe you’ll want to purchase the Celox and QuikClot gauzes that are already packaged and ready to use.  Or maybe you’ll become comfortable with the idea of buying chitosan and kaolin and rayon gauze and making your own.

References:

https://www.crisis-medicine.com/hemostatic-powders-dont-work/

Links to related posts:

Bleeding  

DIY Chitosan Gauze  

DIY Kaolin Gauze

Preparing for a Ruptured Varicose Vein

Stopping Seriously Gushing Nosebleeds  

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[1] Dr. Joseph Alton, Survival Medicine Handbook, 4^th Edition, 2021, 440.