The finding of the HemCon as being no more beneficial than the use of standard gauze does not address if the conditions (trauma wounds) of the test subjects is similar to what is seen with battlefield trauma. It is one thing to lacerate with a scalpel and control hemorrhage of a major artery/vein of a test subject and another to control hemorrhage of a gunshot, shrapnel or traumatic amputation seen on the battlefield.



Having been involved with animal studies for over 32 years, I can tell you it is not uncommon to eliminate certain study animals from the final study for a number of valid reasons. Many animal studies rely upon the common genotype (genetic makeup) and phenotype (the physical characteristics) of a group of animals. For the most part the variables of genotype and phenotype are minimized in mice and rats, where either through genetic selection (in-breeding) or through the use genetic modifying techniques (transgenic, knockout selection, etc.) populations of these species can be highly regulated. Now with larger species, including pigs, there has been some use of genetic modifying techniques, but the genetic and phenotype variation of these species is much greater the with mice and rats.

The elimination of the outlier may have been due to many factors, which may have been legitimate in nature or not, but the article does not cite the reason why the investigator(s) chose to eliminate this animal, so immediately it must be due some nefarious reason.



Whether or not HemCom is a valid medical device or not, is really not the issue. The issue is, if the same parameters of testing medical devices, medicines and techniques before implementation in battlefield conditions can be fairly equated with the evaluation process used in civilian medicine. My humble opinion, and experience is no. Ask a medical instructor, a general practice physician, an emergency medical physician and a field EMT or Paramedic the same questions regarding the effectiveness of a medical device or technique and most likely you will get very different answers. Teaching medicine, medical practice in a hospital and “street” medicine all provide a very different prospective of what works and what doesn’t. All have value in their respective environments.

Medical devices, medicines and techniques will always be evolving as information regarding their effectiveness or lack thereof is gleaned through use. A good example of this in EMS was the use of Military Anti-Shock Trousers (MASTs). When I first became an EMT back in 1978, MASTs were touted as the greatest thing for traumatic shock. Use during the Viet Nam War and subsequent transfer to civilian EMS providers seemed to provide a tool for use in treating traumatic shock. All types of SOPs were established and MASTs became widely distributed in EMS. The idea of MASTs is they would auto-transfuse blood from the lower extremities into the truck and stem both internal and external hemorrhaging of the lower extremities and pelvis. After years of use, the statistical benefit vs. risk factors led to the disuse of MASTs in most situations and many/most jurisdictions have removed them from use. I doubt whether or not a new EMT or Paramedic would even know what a MASTs is or the SOPs for use.

Pete