Overview of Agents Used for Emergency Hemostasis

Abstract

Context:In today’s modern world, despite the multiple advances made in the field of medicine, hemorrhagic shock is still the main cause of battlefield mortality and the second most prevalent cause of mortality in civilian trauma. Hemostatic agents can play a key role in establishing hemostasis in prehospital situations and preventing hemorrhage-associated death. In this respect, this article aims to review different aspects of known hemostatic agents.Evidence Acquisition:A comprehensive search of the academic scientific databases for relevant keywords was conducted; relevant articles were compiled and assessed.Results:Hemostatic agents can establish hemostasis by means of different mechanisms, including concentrating coagulation factors, adhesion to the tissues, in which traumatic hemorrhage occurred, and delivering procoagulant factors to the hemorrhage site. Presently, these hemostatics have been significantly improved with regard to efficacy and in adverse consequences, resulting from their use. Several hemostatic dressings have been developed to the degree that they have received FDA approval and are being used practically on the battlefield. In addition, there are currently several case reports on the use of such hemostatics in the hospital setting, in conditions where commonly known approaches fail to stop life-threatening bleeding.Conclusions:The use of hemostatic dressings and agents is one of the main advancements achieved in recent decades. However, it can be claimed that the ideal hemostatic has not been recognized yet; therefore, this topic needs to be brought into focus and further addressed.

Facilitators and constrainers of civilian–military collaboration: the Swedish perspectives

“…The use of hemostatic agents is one of the latest measures for the emergency control of traumatic hemorrhages and is reported to decrease the associated mortality and morbidity. However, the search for the perfect hemostat is an ongoing process and its prehospital use is not fully developed in the civilian setting [43].…”

Hemostatic agents for prehospital hemorrhage control: a narrative review

“…The past decade has seen tremendous development of local/topical hemostatic agents for hemorrhage control in prehospital settings [20,132,133] as well as in trauma and emergency surgery [134,135]. The latest hemostatic products and methods include [136] Combat Gauze (Z-Medica Corporation, Wallingford, CT, USA; http://www.…”

“…Despite these great successes, there are safety concerns with the prehospital or in-combat use of local hemostatic agents [30,135,205]. Although no adverse events have been reported in human studies with the use of Combat Gauze, HemCon, Celox Gauze, Celox granules, ChitoGauze and QuikClot ACS+ [54,204], these studies are relatively short-term observational studies.…”

Effects of Microporous Polysaccharide Powder in a Model of Dilution on Viscoelastic Characteristics of Clot Formation - An In-Vitro Study

“…The use of these agents is common in the prehospital as well as in the hospital setting and application of topical haemostatics is well reported [9][10][11] .…”

“…al. 10 . Following groups of agents can be discriminated: 1) Factor concentrators: work through fast absorption of blood water content concentrating the cellular and protein components resulting in clot formation.…”