Prehospital use of hemostatic dressings by the Israel Defense Forces Medical Corps: A case series of 122 XXXX .

@entity130 @entity1 @entity548
BACKGROUND: Hemostatic dressings are advanced topical dressings designed to control @entity548 by enhancing clot formation. These dressings may be effective when used on injuries sustained in junctional zones. The Israeli Defense Forces Medical Corps (IDF-MC) chose to equip its medical personnel with the QuikClot Combat Gauze. There is a paucity of data describing clinical use and results of hemostatic dressing especially at the point of injury. The purpose of this article was to report the IDF-MC experience with prehospital use of the QuikClot Combat Gauze in junctional zones in a case series retrieved from the IDF @entity130 Registry. METHODS: All IDF @entity130 Registry documented cases of prehospital use of hemostatic dressings in the IDF-MC between January 2009 and September 2014 were retrieved. Data collection included injury mechanism, wound location, reported success of hemostatic dressing, tourniquet use, lifesaving interventions, mortality, and caregiver identity. RESULTS: A total of 122 @entity1 on whom 133 hemostatic dressings were applied were identified. Median age was 22 years. Of the @entity1 , 118 (96.7%) were male and 2 (1.6%) were female (missing, n = 2). Injury mechanism was penetrating in 104 (85.2%), blunt in 4 (3.3%), and combined in 14 (11.5%) @entity1 . Seven @entity1 (5.9%) died. Thirty-seven dressings (27.8%) were used for junctional @entity548 control (pelvis, shoulder, axilla, buttocks, groin, neck), and 92 dressings (72.1%) were placed in nonjunctional areas (missing, n = 4). Nonjunctional dressings included 63 (47.4%) applied to the extremities, 14 (10.5%) to the back, and 4 (3%) to the head. Hemostatic dressing application was reported as successful in 88.6% (31 of 35 available; missing, n = 2) of junctional @entity548 applications and in 91.9% (57 of 62 available; missing, n = 1) of extremity @entity548 applications. CONCLUSION: Hemostatic dressings seem to be an effective tool for junctional @entity548 control and should be considered as a second-line treatment for extremity @entity548 control at the point of injury. LEVEL OF EVIDENCE: Therapeutic study, level V.
