Can anyone with professional experience tell me what the best emergency wound packing material is? I am thinking in terms of a material that won't leave any fibers behind when removed. There must be a best practice type of gauze or something that can be used to that effect. I saw some wound packing gauze that comes in small plastic bottles, but I don't think that is for bloodstopping on larger deeper wounds, but I could be wrong. I know about QC Combat Gauze but I am trying to find something that has no expiration date.

Try this old thread.

This one also may help, pardon my initial rant here.

Then there is this.

Good luck.

PS. When all else fails, feminine hygiene pads work really well also. I have seen more than one soldier injured (not wounded) that had an issue kotex pad wrapped to a major laceration.

I'm thinking that almost anything "invasive" will have an expiration date for the purpose of sterile packaging integrity?

Those Israeli bandagaes are on the marketplace forum on sale, if I read correctly.

Lots of talk about quick clot , just a reminder that the granular version is exo-thermic (creates heat when in contact with water, lots of heat) and they require special removal, keep the packaging with the victim for post trauma responders so they know what it is.

But they have really improved their dressings to not only lessen the heat factor but to make removal easier. I think the zeolite versions are a very interesting alternative, and they offer a good variety, even a pet specific dressing.

Has anyone had success with quik clot?

This is one of the great medical myths. I blame my profession for it, along with the marketing departments of the vendors. Rant follows:
Sterile is sterile. Loss of sterility is event related, not time related. To render a sterile product non-sterile, you gotta penetrate the packaging and put some microorganisms on it. Sterile items remain sterile as long as the packaging is intact. Intact means not perforated and dry. During WWII, the OR at columbia-presbyterian hospital was short of cotton sterile wraps, so the wrapped some of their sets in newspaper and autoclaved them. These sets found their way to the back of the closet, and were rediscovered in the '60's. Opened and tested, the sets were proven to still be sterile, Presumably because the wrappers were intact, not because the microbes died of old age. Sterile products become unsterile before the expiration date if contaminated by breach of packaging, and stay sterile long after expiration if the package is intact. Expiration dates are applied to such by folks who don't look at the science.

"Wound packing" is an interesting term. IME, it is applied to treatment of a draining wound to maintain an opening to permit drainage to continue. If a boil/abscess is lanced, the wound will be packed with iodoform or plain gauze ribbon(or a latex drain), so that the wound does not close and trap infected material or blood inside, causing another abscess or hematoma. Stopping the bleeding, or hemostatsis, involves bulky dressings and pressure-Kerlix sponges, abdominal pads, tampons (generic term for big rolls of gauze), surgical sponges, wrapped up in ace bandages, or with manual pressure.

There is another approach to hemostatsis. Many of us carry locking forceps as a matter of course.One of the original purposes of this device was hemostasis-some folks call them hemostats. The procedure is, you look in the wound, identify a big artery or vein, and then clamp it off. Easier if you are a surgeon, and have just cut the vessel, and are working in an OR with bright lights, sterile surroundings, and OR staff to hand you the clamp. Harder if you are upside down in a ditch, in the dark, in the snow, all by yourself. Which is why paramedics are paid better than surgeons...you say they're not paid better than surgeons?...something is terribly wrong...

Lawyers or beancounters...

If a wound is so severe that it genuinely needs packing, fuzz from the packing is the least of your concerns in terms of debris. Such a wound will require full surgical debridement anyway.

American SOF medics have used Kerlix for decades to pack wounds. Click here for a video showing how, as taught by a former SF 18-Delta.

This pretty much hits it on the head as far as I've seen. However, Kerlix or 4x4s I've heard work well. But, technically, pressure is the approved blood-stopping procedure. The problem with packing is that, while it may work, at some point you have to remove it... along with the clot... and you're back to square one.

As for expiration dates, I kind of feel the same way - useless. I bet it's an FDA thing more than a sterility thing. I've personally used an IV that was 2 years past prime, and nothing bad happened. Well, besides the hangover, but that was the reason I had it in the first place.

Like the others have said, kerlex is the way to go. I personally like the Z-PAK Dressing which is basically a kerlex roll vacuum packed down into a smaller package that is no bigger then a stack of 20 4"x4" gauze pads. I can fit 4-6 of these in the same space as one 4" Kerlex roll.

Wound packing in the field for emergency care isn't the same as wound packing for long-term care/treatment. The goal is simply to stop bleeding, and some wounds are too big for bleeding to be controlled with other means. A patient requiring this, as others have stated, are usually in a bad way and need a surgeon and removal of the dressing and cleaning of the wound would more then likely be low in the priority list for this patient.

To paraphrase one of the medics who was in Solmolia for the Battle of the Black Sea; "You can never have enough Kerlex".

Good points, Alan. N.A. Rescue markets a similar product they call S-rolled gauze that I've trained with. H&H's Pri-Med gauze is even more compact but it is still rolled, not stacked.

I've been to two severe wound situations as a civilian - once when I was like 13, the other a few years later

Great video, but as I said in my comment, it's way too clean, and it's NOT attached to a screaming body, that won't hold still. That makes it a tad harder to do in real life - getting 1-2 other people to help hold the person being treated still sure helps

I hope someday to take my EMT classes, but with my health, I doubt it - I will encourage both my kids to at least take advanced first air/wilderness first aid, if not EMT, even if they don't intend to become one

Yep, you made my point, NurseMike- they put an expiration to insure it's used before the packaging is compromised. If the packaging isn't compromised, still sterile, in theory, so still usable, so the original poster shouldn't have to worry.

And you coud be right, Mdinana, even medical oxygen is given an expiration date (per USP guidelines, but enforced by FDA).

A (IV) line and a liter ( of saline) cures a multitude of ills. I had the opportunity in 1980 to assist in decommissioning a civil defense hospital ( WWII or korean war surplus, maybe)that was stored in the local post office cellar/fallout shelter. It was like unwrapping christmas presents. There was a portable x-ray machine and table, an ether-anesthesia machine, a whole bunch of morphine syringes, and assorted IV equipment, including 30 year old glass liter bottles of dextrose, saline, and ringers. The iv fluids looked fine, until inverted-then the particulates at the bottom of the bottle floated around-presumably rubber from the decay of the cork. Like fine wine, iv bottles should be stored horizontally to keep the cork moist. I wish I had been permitted to keep the anesthesia machine for my first aid kit-while most modern anesthetics are tough to make at home, di-ethyl ether can be produced with sulfuric acid and ethanol, as I recollect.

I would submit that the 18D cadre knows a thing or three about real world medical care and how to teach it to people. Still, they may bear your comment in mind.

I'm sure they do, it was more meant for other people watching - One of the big things they can use that we can't - morphine, and 1-2 other big guys holding the wounded guy down