July 18, 2003
Saving lives, one QuikClot at a time
by Chris Walz
Pentagram staff writer
The Defense Department has spent decades trying to find ways to transport blood during war and, more recently, trying to develop a blood substitute to handle the rigors of war.
Human blood is extremely delicate -- it has a short shelf life and uncompromising temperature needs -- and causes major logistical issues when war planning.
Military planners recognized long ago that shortening the time to a field hospital and stopping blood loss from a gunshot wound on the battlefield are the best ways to reduce fatalities. Uncontrolled bleeding is a major cause of death in combat -- military experts estimate about 50 percent of battlefield fatalities bleed to death in minutes before they can be evacuated to an aid station.
"We've always been interested in ways to stop bleeding on the battlefield and we realized how badly we needed it after Somalia," said Capt. Sandra Reed, director of Expeditionary Medicine at the Navy Bureau of Medicine and Surgery in Washington. "In a perfect world, we wouldn't need it because there wouldn't be any bloodshed. But, reality is we fight wars and there is a lot of risk associated with it. We want to save as many lives as possible."
Researchers, however, have grown increasingly frustrated with bovine-based substitutes because they offer only slight improvements over human blood -- a far cry from the quantum leap they believed synthetic blood would make on the battlefield.
But, Defense Department officials have turned their attention away from synthetic blood for the time being and focused closely on stopping blood loss completely.
Troops in Afghanistan and Iraq have been issued a powder that can instantly stop blood loss in potentially life-threatening wounds.
Defense Department officials claim the clotting agent, called QuikClot, saved 19 war-fighters instead of labeling them as "Killed In Action" statistics. Each marine carried a small packet of QuikClot in their rucksack, but the Army issued the powder only to field medics.
The Associated Press reported the product saved a marine, who was shot through the neck -- the bullet apparently tore part of his carotid artery before exiting the back of his skull. The marine lost grave amounts of blood before QuikClot was applied to his wound. The powder sealed it immediately and his fellow marines at the scene said they believe it saved his life.
QuikClot's battlefield data is still being collected, but Reed said she expects to see the report in a few months and hopes it will provide evidence of the drug's effectiveness.
Reed said initial reports indicate the product was used on many casualties in Afghanistan and Iraq, but four cases weren't successful. She said the report hopefully answers whether the product faulted or if the wound, like a headshot, was too severe for QuikClot to work.
"There's no perfect product for all circumstances and for all types of wounds," Reed said. "But, we want as many tricks in our bag as we can have because it increases the likelihood we can save someone's life."
The blood-absorbing product has caught the eye of Defense Department brass because it doesn't require refrigeration -- a major concern for field hospitals operating in hot desert weather like Iraq -- and has no possibility of transmitting diseases like human-based synthetic blood may. QuikClot can also be self-administered to extremity wounds in the arm or leg because the package is easy to open one-handed.
Z-Medica, the company that makes QuikClot, claims it is the "breakthrough product that dramatically stops massive bleeding [and] will save untold lives -- beginning with U.S. [troops] in Afghanistan and Iraq."
QuikClot is made of a granulated mineral substance that is biologically and botanically inert, leaving little chance of allergic reaction. The company hopes to put a devastating dent into the countless trauma victims who would otherwise have bled to death before getting to a hospital.
The Navy and Marines helped the small Connecticut company develop and test the product.
QuikClot was researched and tested at the University of Connecticut, the Marine Corps Warfighting Laboratory, the Marine Corps Systems Command and the Office of Naval Research.
The absorptive material, when poured directly into an open wound, acts like a super sponge and instantly extracts fluid from the blood in and around the wound. All that's left in the wound is concentrated clotting materials -- allowing the blood to clot very quickly and preventing severe blood loss.
In advance of the War on Terrorism, researchers tested various blood clotting products with various battlefield wounds. Some, like QuikClot, work like a sponge while others plug blood vessels to keep wounds from bleeding out. Each bandage has its strengths and weaknesses, according to officials, but research is still too early to determine a single unanimous blood-stopping product. In fact, they say, there will most likely never be a single product that is best in every situation.
"Some organizations aren't completely sold on QuikClot because there wasn't a very big population or sample size," Reed said. "But, the Navy feels like this is the best overall product and works very well in the environments we plan to use it."
Army brass is one organization looking at other blood clotting bandages -- seeking better ways to meet soldiers' needs.
The Army has teamed with the Red Cross to develop several hemostatic alternatives. One such bandage, the Fibrin bandage contains two blood-clotting proteins fibrinogen and thrombin. The other is called the Chitosan bandage, which is made from a biodegradable carbohydrate found in the shells of shrimp, lobsters and other animals. Chitosan bonds with blood cells to form a clot.
