- IIRC the only granular hemostatic that was shown to cause emboli was WoundStat. WoundStat is a fundamentally different material than the zeolite comprising early QuikClot. Too bad too, 'cuz WoundStat worked incredibly well at achieving fast hemostatis. It formed into a putty-like material that was fantastic for sealing up a torn artery without heat.

- Chitosan hemostatics with shrimp shells are made such that the protein in some seafoods that affects certain people is not present. You will not have a seafood reaction to Chitosan.

- Here in my county where I worked for years at EMS, we now have CAT tourniquets on the trucks. I have old pals who successfully used the CAT on a dialysis pt whose fistula split open. They tried direct pressure first but it didn't work. Recently a deputy sheriff was shot in the thigh with a 40S&W resulting in a bad femoral bleed. His partner used a CAT carried in an ankle holster to save his life.

- Complete amputations are not the most catastrophic injury to cite in an effort to champion direct pressure. A complete amputation is actually LESS serious (in terms of bleeding) than a fat artery that has been torn lengthwise. Completely amputated vessels often clamp off pretty well (at least for a while) on their own as the smooth muscle encasing them spasms in response to the trauma. The effect is greater with a sharp clean cut, less so with a ragged/shredded wound (like a blast injury). This is a 'grace period' that gives you time to get to the hospital, so some EMS providers overlook it and think the 5 minutes of direct pressure they applied did the trick. Not all cases, of course.

I worked a motorcycle wreck where the rider got T-boned by a car. The rider's lower leg was cleanly cut off when it got pinched between the motorcycle and the car's bumper. We were looking right at the exposed bone and flesh. It only oozed, it barely bled. He would have bled a lot more had his popliteal artery been shredded by a rifle round instead.