Hemostatic materials that can rapidly control bleeding without causing secondary damage or sharp pain upon removal are receiving increasing demands in acute trauma treatments and first-aid supplies. Here, we report the development of a dynamic silicone hydrogel coating on medical gauze to enable rapid hemostasis and synergistic anti-blood adhesion properties. The silicone hydrogel can spontaneously form oriented cross-linked structures on fibrous medical gauze through a solution-processing method to achieve macroscopic superhydrophobicity with microscopic surface slipperiness, resulting in excellent anti-blood adhesion with the on-wound peeling force at ~0 millinewton. The development of dynamic silicone hydrogel coating on medical gauze enables a unique integration of advanced features including instant bleeding control, excellent anti-blood adhesion, and excellent air permeability. The proposed strategy is also suitable for scalable production, making it promising in the applications of trauma management.