Medical Supplies


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I asked this question on the thread about bug out bags but thought I would give it a thread of it's own to get some feed back. I am trying to put together a first aid kit and was wondering if any of you especially those with a medical back ground had any thoughts about adding a clotting agent such as Celox or Quick Clot. I know they both work a little different.

I am actually not familiar with either of these products. I will see if I can find out anything for you. I am sure you have already thought of this, but I always keep some butterfly bandages handy. They do a pretty good job of holding a laceration together.
I have been unable to find a great deal of information. However, if you truly have a major artery severed I don't see how you could have a lot to lose. You have probably already read this but here it is. Thanks for bringing this up.

Should be in every medical kit Date: August 2, 2007
Pros: Extremely Effective & Cheaper than Other Products

"During a live tissue lab I saw several hemostatic products used to stop a femoral bleed. Celox was extremely impressive, and stopped the bleeding very effectively. My experience is relatively limited - (used it once in real life, and it worked great) but I have talked to a lot of military medics coming back from the gulf who swear by it. In my experience, 99.9% of bleeding can be manually controlled, however for that 0.01%, Celox will save your patient's life.

We have head dozens of stories from clients (mostly medics and physicians) about how great Celox is, and after a careful literature review of all the options, Celox is the choice for our med support group."

This one is they way I think I would go.
Here is another option you may already have. Super glue. I think this is actually a slight variation of super glue, but it might still work. Just an idea.

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Sorry, the link required a log in. So I copied the article

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Medscape Medical News
"Super-Glue" Embolization Feasible, Effective in Acute Arterial Hemorrhage CME

News Author: Laurie Barclay, MD
CME Author: Désirée Lie, MD, MSEd

To earn CME credit, read the news brief along with the CME information that follows and answer the test questions.

Release Date: July 16, 2004; Valid for credit through July 16, 2005

This activity has expired.
CME in this activity indicates that it was developed according to ACCME guidelines and was certified for credit by an accredited CME provider. Medscape cannot attest to the timeliness of expired CME activities.

July 16, 2004 — N-butyl cyanoacrylate (NBCA) embolization is feasible and effective for controlling acute arterial hemorrhage, according to the results of a small study published in the July issue of the Journal of Vascular & Interventional Radiology. The investigators suggest that familiarity with NBCA is worthwhile, but that further experience with safety and efficacy are needed for specific recommendations.

"NBCA is an alternative permanent liquid embolic material and tissue adhesive that was approved by the US Food and Drug Administration for use in cerebral arteriovenous malformations in 2000," write John William Kish, MD, and colleagues from the University of Southern California Medical Center in Los Angeles. "It has been used effectively as treatment for intracranial arteriovenous fistulas and pseudoaneurysms."

This case series reports the initial clinical experience with NBCA for embolization of acute arterial hemorrhage from varied etiologies and at anatomic sites including the gastrointestinal (GI) tract, kidney, liver, uterus, adrenal gland, extremity, and chest wall.

Of 16 patients with active extravasation of contrast material and/or arterial abnormality who underwent NBCA embolization, standard coil or particulate embolization had previously failed in 10 patients, and NBCA was used as the initial embolic agent in the remaining six patients. After treatment, serial hematocrit levels, transfusion requirements, and clinical signs and symptoms of end-organ damage were evaluated.

In 12 (75%) of 16 patients, NBCA embolization was successful, with complete cessation of bleeding, but in four patients (25%), this procedure was of no benefit. Two of these patients (12.5%) had recurrent bleeding after NBCA, and two patients (12.5%) died within 24 hours of NBCA. None of the 16 patients developed clinical signs of end-organ damage or iatrogenic ischemia caused by NBCA.

"In this initial limited series, NBCA embolization was shown to be a feasible and effective method to control acute arterial hemorrhage," the authors write. "NBCA embolization was able to stop arterial bleeding even when previous coil or particulate embolization had failed."

Risks of NBCA include bowel infarction when used for the treatment of GI tract hemorrhage, nontarget embolization, abscess formation, and entrapment of the delivery catheter within the embolized artery.

"NBCA use is likely to be limited to difficult or refractory cases because of its current high cost," the authors conclude. "Specific recommendations as to where and when NBCA should be used will require further experience to confirm its safety and efficacy."

J Vasc Interv Radiol. 2004;15:689-695
Learning Objectives for This Educational Activity
Upon completion of this activity, participants will be able to:

* Compare the use of NBCA with other embolic methods in the treatment of arterial hemorrhage.
* Describe the efficacy of NBCA in controlling arterial hemorrhage in a group of high-risk patients.

Clinical Context

Treatment options for arterial hemorrhage include percutaneous transcatheter embolization, open surgical intervention, and vasopressin therapy for GI tract bleeding. Limits of percutaneous embolization include inability to administer an embolic agent at the bleeding site, recanalization of the bleeding vessel, and uncorrectable coagulopathy. Considerations for choosing an embolic occluding agent include speed and reliability of delivery, duration of effect, and preservation of normal tissue. Typically, embolization is performed using metallic coils, gelatin sponge, or particulate agents. Coils require placement at the bleeding site which may not be possible where multiple small or tortuous vessels are involved or lesions are distal or multiple. Particulate agents may clump and are not radiopaque making documentation of the site of occlusion problematic.

NBCA is a liquid embolic tissue-adhesive agent admixed with ethiodized oil, which was Food and Drug Administration approved for embolization of cerebral vascular malformations in 2000. Success for the treatment of arteriovenous intra-abdominal fistulas and ruptured pseudoaneurysms when combined with other embolic agents has been reported by Yamakado and colleagues in the January 2000 issue of the Journal of Vascular and Interventional Radiology. Compared with the other liquid, low viscosity, embolic agent absolute ethanol (which is not radiopaque), NBCA does not permeate easily to the capillary level and result in tissue infarction. It is radiopaque and, thus, allows localization of the site of occlusion. However, it is more expensive than other embolic agents.

This is a small unblinded case series describing the outcomes of using NBCA embolization on high-risk patients with angiographic arterial extravasation, the majority of whom had already failed one treatment method. Most patients received a combination of embolic agents.
Study Highlights

* Inclusion criteria were documented signs of acute hemorrhage including acute decrease in hematocrit level, blood transfusion, angiographic evidence of extravasation, and age older than 21 years.
* 12 men and 4 women were included, of whom 4 had upper GI tract bleeding, 1 had lower GI tract bleeding, and 7 had retroperitoneal or intraperitoneal bleeding.
* Mean age was 49 years (range, 21 to 69 years).
* Standard metallic coil or particulate embolization had already failed in 10 patients, and NBCA was used as the first method of choice in the remaining 6 patients.
* All patients received diagnostic angiography and patients with abdominal hemorrhage received an aortogram in addition.
* Superselective NBCA embolization was performed using a 1:4 to 1:5 ratio of ethiodized oil:NBCA under continuous fluoroscopic visualization. Typically, less than 1 mL of NBCA was needed to achieve embolization. Arterial size ranged from 1 to 3 mm. During the period of the study, a total 149 embolization procedures were performed at the institution.
* NBCA was used in conjunction with another embolic material in 13 of the 16 patients in this study. The remaining 3 patients received NBCA only.
* Primary outcomes using retrospective chart review were postembolization serial hematocrit levels, transfusion requirements, and serial blood pressure and heart rate measurements. Other outcomes were end-organ damage and tissue infarction.
* Follow-up was until death or discharge or last available outpatient visit. Mean follow-up was 41 days (range, 24 hours to 9 months).
* Twelve patients (75%) exhibited immediate stabilization of hematocrit levels, and none of them required postprocedural transfusions. Two of the 12 patients subsequently died of causes unrelated to the procedure.
* None of the 16 patients required repeat embolization.
* Four of the 16 patients had no benefit from NBCA embolization, of which two died within 24 hours from overwhelming multiple organ failure, before serial hematocrit levels could be measured. The remaining two had documented recurring hemorrhage with declining hematocrit levels and need for transfusion. One patient underwent subsequent surgery.
* There were no major complications related to NBCA embolization.

Pearls for Practice

* NBCA embolization is technically feasible in controlling arterial hemorrhage when other embolic methods have failed.
* Combination of NBCA with other agents may be efficacious in preventing recurring arterial hemorrhage.

About News CME
News CME is designed to keep physicians and other healthcare professionals abreast of current research and related clinical developments that are likely to affect practice, as reported by the Medscape Medical News group. Send comments or questions about this program to [email protected].

Medscape Medical News 2004. © 2004 Medscape
Legal Disclaimer
The material presented here does not necessarily reflect the views of Medscape or companies that support educational programming on These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

* This activity has expired.

The accredited provider can no longer issue certificates for this activity. Medscape cannot attest to the timeliness of expired CME activities.
* CME Information

Medscape is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Medscape designates this educational activity for 0.25 category 1 credit(s) toward the AMA Physician's Recognition Award. Each physician should claim only those credits that reflect the time he/she actually spent in the activity.
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Thanks for the info. I have had a little medical training as a tech in a county E.R. but it was way back in the 70's. I may try and get some more training if I can find the time.
what size

kit are we talking? i am putting one together myself. i am always finding stuff i need and then find out that my kit is not big enough. my kit is in a big tool box {clean!!} blackwater has a article on tactical first aid kits. i 'll retrieve some links and post them within the next few days.
First Aid

kit are we talking? i am putting one together myself. i am always finding stuff i need and then find out that my kit is not big enough. my kit is in a big tool box {clean!!} blackwater has a article on tactical first aid kits. i 'll retrieve some links and post them within the next few days.

Something that would fit in or on a medium size back pack. A little more than a minor kit but not a whole e.r. room.

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