Thursday, October 8, 2020

Clotting Agents

 A reader asked my opinion on one of the clotting agents on the market and I had to answer that I had no experience with them but would look into it. We do take requests here, so if you have a topic that you'd like us to cover feel free to drop us a note in the comments or on our MeWe* page and we'll see if anyone can cover it. I'm going to limit myself to the topical of external agents since I don't have access to a full pharmacy and the thickeners that are used for internal bleeding. 

Clotting agents are anything that will help blood clot and stop bleeding. The military took a serious look at them and fielded QuikClot as part of combat first aid kits, but that was well after my time in service. Anything that can help stop bleeding increases the chances of surviving large wounds and makes smaller ones easier to treat. Remember that this is first aid, not treatment of a wound, and so once you've got the bleeding stopped you still have to get the patient to medical professionals who will repair the damage.

Blood clots when platelets (a type of blood cell) and proteins in blood bind together and form a gelatinous blob that inhibits blood flow. That gelatinous blob will eventually dry out and form what we see as a scab, sealing wounds and protecting them against infection. Clotting agents aid the platelets and proteins by providing a sterile and inert framework for them to bind to, which creates a blockage faster and over a larger area. Sterile and inert are key features since you don't want to do anything to a wound that will cause more problems in the future. There may be times where you don't have any other options, but your first choice should always be to do no further harm.

There are a few common types of clotting agents for sale right now: Chitosan, Kaolin, and Zeolite.

Derived from the chitin (shells) of shellfish like crabs and shrimp, chitosan is a polysaccharide somewhere between a complex sugar and a starch. Because it is a natural material derived from crustaceans it is biocompatible with very low chances of rejection or adverse reaction in humans, and biodegradable which means that your body will eventually break it down. People with shellfish allergies are commonly allergic to the meat of shellfish, but according to the FDA the chitin won't trigger that allergy.
  • Chitin by itself has been tested as a clotting agent and works well, but is coarser and more abrasive than chitosan.
  • Chitosan is chemically treated chitin, usually soaked in a strong base like sodium hydroxide, which makes the chitin easier to handle and has some reported wound healing effects along with the clotting. 
  • Several types of chitosan bandage have been approved by the FDA. Some even have added chemicals for improved antibacterial action.
  • Their packaging indicates a shelf-life of 2 to 3 years. 
  • Celox uses chitosan as its active ingredient.

A fine white clay named after the Kao-ling mountains in China where it has been mined for centuries, kaolin binds with the platelets and fibers in a clot and speeds up the clotting action. Hydrated aluminum silicate, the main ingredient in kaolin, also triggers one of the chemical reactions in the formation of clots, further speeding up the process. One study I found showed that 200 patients with the same surgical wound averaged ~5 minutes to stop the bleeding with a kaolin-infused bandage versus ~25 minutes for a plain bandage.
  • Kaolin is also the main ingredient in several anti-diarrhea medications (like Kaopectate) because of its ability to bind to toxins and chemicals. If it's safe enough for internal use, it will be safe for topical use. Some brands add silver as an antibacterial agent; you'll have to check the packaging for that. 
  • Shelf-life is 1 to 3 years from purchase, but since it is a mineral and not biological I would feel safe extending that quite a bit.
  • QuikClot products use kaolin now, but they switched from zeolites a few years back. 

Zeolites are a family of minerals commonly found in water filters and simple cat litter. They have a very porous surface and trap or bind chemicals and biologicals as they are exposed to them. They can also release sodium and potassium ions, thereby facilitating certain chemical reactions.
  • The first generation of zeolite coagulants were in the form of fine sand that was poured into a wound. This didn't work very well because it was difficult to remove from the wound during further treatment, and it also generated enough heat through chemical reactions with blood to cause low-level burn damage. Remember when I said "Do no further harm"? Avoid these if you can.
  • The newer zeolite kits use a mesh bag containing zeolite beads and a few other clotting aids. The mesh bag is placed over the wound and pressure is applied. The new formulation avoids the heat damage ,and the bag is a lot easier to remove once the patient is in a hospital.
  • Shelf-life is advertised in the same 2 to 3 year range but, like kaolin, it's a ground up rock and it should last a lot longer than that.

Prices vary by source and quantity bought, just like everything else. None of these are cheap ($20 for two compress bandages is common), so you'll have to decide if your personal circumstances merit the purchase.

* Facebook decided that our blog is spam and has blocked us from linking to it, so we've moved our social media presence over to MeWe. In true prepper fashion, we have redundant systems in place, and with the loss of FB we'll probably look at some of the other media sites to retain that level of redundancy.

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