BINGO!

I have had the unfortunate luck (profession) to have been in that posistion but if I am standing there I want to know there ARE NO MORE OPTIONS. I still hate that feeling. I think thats why during and emergency situation, people that I work with / hang out with beat themselves up so badly when we loose a soul. Hell - if I thought it would do any good, I would dance naked (ewwww) in the middle of a field to save a life. Some of my buddies that see my kit, look at me like I lost my mind, but they always like to have me around when things get bad.

Nice to be wanted but damn...

One point of dissent - the Israeli bandage isn't intended as a tourniquet.

That being said, some interesting articles/further reading:
http://www.jems.com/resources/supplements/the_war_on_trauma/tourniquet_first.html
http://www.jems.com/resources/supplement...niquet_use.html

The orange tourniquet shown is the same as the standard issue USGI one, but that's in tacticool black.

I'm at work right now, but will be trying to find some other resources to support my initial post.

I guess I should have been more clear on what I use: an Isreali issue tourniguet. It looks just like the tourniquet in the Jems artical but in tacti-cool black. I am glad that you sent me that link because I now have the instructions in English (since I cant read Isreali).

Correct, but technically the specific powders that were phased out were the old formula of QuickClot and WoundStat.

It should be noted that Celox was never used by the military in it's powered form, at least not service wide (some units may have used it) and Celox has not been linked to any of the complications of the QuickClot or Woundstat.

From a practical point of view, the powders are a poor choice for most applications vs. the impregnated dressings.

i assume the Quick Clot was being breathed in and that caused lung problems years later and not that it was put on an open wound?

Actually, it was WoundStat not QuickClot that had the issues with future PEs... and it isn't from inhaling the powder. One of the problems found with with WoundStat is that could damaged the inside of blood vessels causing allowing clots to form on the dammaged tissue. These clots have the potential of breaking off and lodging elsewhere, like the lungs. I was unable to find a reference to QuickClot or Celox having similar complications and NONE of the hemostatic agent impregnated gauze products have these issues.

The information I have indicates that the next TCCC (2011) will likely have a new powdered hemostatic as a last resort treatment if the Combat Gauze failed to work.

I'm pretty sure the only impregnated gauze still being purchased is the Combat Gauze mentioned earlier. Though I would assume the powder would be worse than the impregnated bandages.

The few articles I could find on it did indicate it damaged vessels, perhaps due to the exothermic reaction (one article mentioned real bad adhesions when it was used intra-operatively)

I said I'd offer some proof... here's a convenient article. From this month's Journal Of Trauma:
"Safety Evaluation of New Hemostatic Agents, Smectite Granules, and Kaolin-Coated Gauze in a Vascular Injury Wound Model in Swine
Kheirabadi, Bijan S. PhD; Mace, James E. MD; Terrazas, Irasema B. MS; Fedyk, Chriselda G. MS; Estep, J. Scot DVM; Dubick, Michael A. PhD; Blackbourne, Lorne H. MD
.....
.....
Results: No differences were found in baseline measurements. Thrombelastography showed similar hypercoagulability of the final blood samples when compared with baselines in all groups. All vessels treated with KX or CG were patent and had no thrombus or blood clot in their lumen. In contrast, seven of eight carotid arteries and six of eight jugular veins treated with WS developed large occlusive red thrombi and had no flow. Small clots and WS residues were also found in the lungs of two pigs. Histologically, significant endothelial and transmural damage was seen in WS-treated vessels with luminal thrombi and embedded WS residues.

Conclusion: WS granules caused endothelial injury and significant transmural damage to the vessels that render them nonviable for primary surgical repair. The granules can enter systemic circulation and cause distal thrombosis in vital organs. More relevant in vitro and in vivo safety tests should be required for clearance of new hemostatic agents."

Obviously edited out the gist of the article. Everything is quoted however. Yeah, small sample size, some small study flaws, but provides some evidence for my original post.

Having never used blood clotting granuals I do have a few questions if I may...
Does the granual completely clot the wound and hemostasis of the vessle or does it just promote platelet aggregation? If these granual were to get into the blood stream, would that not thrombos the closest distal vessel? What I am getting at is that this should have been pulled out of the field a lot sooner then (what I am assuming is) very recently? I mean if all patients that clotting granuals suddenly developed PE or DVT's or even something as benign as echymosis distal to a wound, shouldnt someone have questioned it long before it was adopted into the military theater? I am not trying to be disrespectful asking this, but I am truely concerned as this is not common knowledge as quite a few of my friends carry the granules in their first aid kits.