Actually, the DoD has moved to combat gauze, an impregnated Kerlix-type of bandage. The granules have several issues in the military setting (probably not the civilian as much)
- getting the granules to the site of blood loss is difficult the deeper you go. Hard to keep "gravel" on the end of a gushing hose, you know?
- the granules have been known to migrate and cause embolisms down the road.
Specifically, it was WoundStat that was causing secondary emboli not Celox. I have heard of no cases of Celox having this issues, it is probably the safety of all the hemostatics available. The biggest issue with loose granules of any kind is that the tend to end up anywhere except the wound (and this is the primary reason CoTCCC recommends only gauze based hemostatics). Hemostatic gauze is easier to apply and keep in the wound.
From research and personal experience using multiple hemostatic agents, I have Celox of some form in all my IFAKs (mostly gauze and the new Z-fold.).
I have attached below two protocols for bleeding control. Basically, the best practice is to use hemostatics when direct pressure doesn't work and a tourniquet can't be used (or is ineffective).
(note: the "no" beneath "massive uncontroled bleeding" should be a "yes")
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