Achieving hemostasis, also known as rapidly stopping bleeding, is a crucial skill that the survival medic must master. In survival situations, bleeding can stem from a range of sources, including falls on rough terrain or confrontations with hostile groups. If bleeding wounds are not treated effectively, it can result in avoidable fatalities among survivors.
Blood clothing basics
Blood clotting, or coagulation, is a complex process that involves multiple steps and various components of the blood. The primary function of blood clotting is to prevent excessive bleeding after an injury, but it can also lead to the formation of clots in the blood vessels, which can cause serious health problems.
When a blood vessel is damaged, the body responds by constricting the vessel to reduce blood flow to the site of the injury. This vasoconstriction is followed by the activation of platelets, which are small cells in the blood that help to form clots. Platelets adhere to the site of the injury and release certain chemicals that attract more platelets to the area. These platelets then begin to aggregate and form a temporary plug to stop the bleeding.
The next step in the clotting process is the activation of the coagulation cascade. This involves a series of chemical reactions which convert a protein called fibrinogen into fibrin, a stringy protein that forms a mesh-like network over the platelet plug. The fibrin network reinforces the platelet plug and forms a stable clot that seals the injured blood vessel.
The coagulation cascade involves many different proteins and factors that work together to ensure that the clotting process is effective and controlled. Some of the most important proteins involved in the cascade include prothrombin, thrombin, and fibrinogen.
Prothrombin is a protein that is produced in the liver and circulates in the blood. When the coagulation cascade is activated, prothrombin is converted into thrombin, an enzyme that plays a key role in converting fibrinogen into fibrin.
Fibrinogen is a protein that is also produced in the liver and travels in the blood. When the coagulation cascade is triggered, fibrinogen is cleaved by thrombin to form fibrin.
In addition to platelets and the coagulation cascade, the clotting process also involves the action of several natural anticoagulants that help to prevent excessive clotting. These include antithrombin III, protein C, and protein S.
Stop the bleeding to save lives
It was estimated that close to 25 percent of combat deaths in military conflicts could have been survivable with prompt and appropriate actions. A skilled survival medic equipped with the right knowledge, training, and tools can save lives in such situations. For instance, a caregiver equipped with a tourniquet is more likely to be successful than one without.
Hemorrhage control agents, also known as “hemostatic” agents, are available commercially and can effectively stop heavy bleeding. However, the ideal hemostatic agent should work quickly, be portable, have few complications, not interfere with tissue healing, and be reasonably priced. Unfortunately, the most effective dressings, such as QuikClot, Celox, and ChitoSam, are costly, making it challenging for the average person to stockpile enough to manage multiple bleeding wounds. Prices can vary depending on the specific product and the quantity purchased, but they can range from around $20 to $50 per unit.
However, it is important to note that these products can be highly effective at stopping bleeding and could potentially save a life in an emergency situation. The cost of these products may be worth the investment for individuals who may face potential trauma scenarios or for those who live in remote areas where medical care may not be readily available.
But in austere settings where commercial supplies are scarce, improvisation is crucial.
Direct pressure on the wound with both hands and the full weight of the body may be effective, but what if it isn’t?
In an environment where resources are scarce, the solution may lie in certain plants that are known for their blood-clotting properties. It is essential to either cultivate them in a medicinal garden or know where they can be found in the wild. While some of these items lack solid scientific proof of their effectiveness, they may be the only option when commercial materials are unavailable.
Plant-based blood clotters
Cayenne pepper, or Capsicum annuum, as many preppers learned, is not just a spice for their food, and it is also thought to have coagulating properties for mild bleeding and some antibacterial effects due to its capsaicin content.
To achieve hemostasis, a significant amount of potent cayenne pepper powder should be used. Apply the powder directly to the wound, cover it with gauze or other cloth, and apply pressure for several minutes. Repeat the process if necessary. While some people may be concerned about cayenne pepper causing pain, I can attest that the burning sensation is usually minimal.
Yarrow, also known as Achillea millefolium, was used in ancient times for its ability to stop the flow of blood from wounds. It was so highly regarded for this purpose that it was referred to as “herba militaris,” and the Greek hero Achilles was believed to have carried it during the Trojan War.
Yarrow is found almost everywhere in the Northern Hemisphere, from sea level to altitudes of more than 10,000 feet, and is commonly used as a powder made from dried leaves and flowers to stop bleeding. However, fresh plant material in a poultice can also be used to achieve hemostasis. To use yarrow, cover the wound with the poultice and apply pressure while elevating the affected limb if necessary.
Black or green tea, also known as Camellia sinensis, can be used for dental bleeding following an extraction. Teas contain tannins, which can cause blood vessels to constrict and help the blood to clot. They may also have antiseptic properties. Caffeinated teas are thought to be more effective.
To use tea for hemostasis, take a tea bag that has been steeped and cooled, wrap it in thin gauze, and place it on the bleeding area with pressure. If the bleeding is from a tooth extraction, ask the person to bite down on the tea bag. If the bleeding is inside the mouth, place the tea bag against the bleeding area and apply pressure from outside the mouth with it closed.
I’ve also used tea compresses with mild external cuts on the skin, and they do a fairly decent job. Press a dry tea bag against the wound, cover it with a cloth, and apply pressure.
Witch hazel, a North American shrub, has an astringent effect when distilled, which tightens the skin, constricts small blood vessels, and promotes clotting. Apply a small amount of pure witch hazel to a compress and press it onto the wound. Witch hazel can be found in most drugstores and you can easily order it online.
Other plants, such as plantain, rose, and horsetail, can also have an astringent effect. However, some people may be allergic to certain plants, so it is important to monitor closely for signs of an allergic reaction.
Blood clotters which are not plant-based
Contrary to popular belief, the main ingredients in expensive commercial blood-clotting products are not plant-based. In fact, they are made from two surprising sources: clay and the shells of shrimp and other crustaceans. These non-plant substances have been shown to effectively stop bleeding in various medical settings.
QuikClot, the popular commercial hemostatic agent, owes its effectiveness to kaolin clay, which is the main ingredient. When kaolin comes in contact with blood, it activates Factor XII, a crucial element in the clotting process, and immediately stops bleeding. This has been scientifically proven.
Kaolin clay can be purchased commercially in powder form and can be applied directly to a bleeding wound or on a dressing. Cotton gauze or cloth can also be dipped in water, covered in kaolin powder, and allowed to dry to create improvised kaolin dressings. For kaolin to have a full effect you need to apply direct pressure on the area for several minutes.
One important note is that kaolin does not cause burns, unlike its predecessor, zeolite, which is why QuikClot made the switch to kaolin.
Chitosan – A Natural Blood-Clotting Agent
Chitosan is a natural component of the exoskeletons of crustaceans such as shrimp. It is processed to prevent reactions in those allergic to shellfish and is highly effective as a blood-clotting agent. It can be found in products like ChitoSam and Celox.
When chitosan comes into contact with blood, it bonds with it and forms a gel plug that acts as a clot. This is beneficial because, unlike kaolin, chitosan does not use up the body’s clotting factors, which is important for those who may have a deficiency of these substances.
Chitosan can be purchased in powder form, and to make hemostatic dressings, moisten gauze pads with vinegar and dip both sides into a bowl of the powder. One can also use a dehydrator or oven on low heat to make their own dressings.
Tranexamic acid is a medication that works by preventing the breakdown of blood clots, thus helping to stop bleeding. It is commonly used in medical settings, such as in surgeries or for treating heavy menstrual bleeding, and is also available in oral and topical forms for home use.
Tranexamic acid is generally considered safe for use in most people, but like any medication, it may have side effects and interactions with other drugs, so it is important to consult with a healthcare provider before using it.
Ice can help in reducing swelling and allowing a clot to form quickly in minor bleeds. It constricts small blood vessels, similar to some astringent plants. To use ice to stop minor bleeds you will need to wrap it in a clean (preferably sterile), dry cloth and apply only gentle pressure on the wound, thus avoiding traumatizing the skin.
While not a typical choice, granulated sugar can actually help to stop bleeding in a pinch. Sugar crystals can help to promote clotting and also have antibacterial properties
Sugar has been used as a home remedy to control bleeding for many years. When applied to a wound, sugar can help form a protective layer that can promote the formation of a clot. Sugar is also believed to be able to draw moisture out of the wound, creating an environment that is less favorable for bacterial growth.
To use sugar as a hemostatic agent, clean the wound thoroughly and then apply a small amount of granulated sugar directly to the bleeding area. The sugar should be kept in place by applying pressure to the wound with a clean, dry cloth or bandage.
Some antiperspirants contain aluminum chloride, an astringent that might constrict small blood vessels. In a scientific study, even low concentrations (as low as 5%) of aluminum chloride were deemed effective in promoting clotting. Aluminum sulfate, which is found in styptic pencils used to treat bleeding from shaving cuts, is a related product.
A styptic pencil is a small, rod-shaped tool that is used to stop bleeding from small cuts and nicks. It contains an astringent ingredient, such as aluminum sulfate or potassium alum, that causes the blood vessels to constrict and stop bleeding.
To use a styptic pencil, wet the tip of the pencil and then apply it to the bleeding area. Apply gentle pressure to the wound until the bleeding stops. Styptic pencils are commonly used for shaving nicks and can be found in most drugstores or online.
For shallow cuts, petroleum jelly can be an option to slow down the bleeding. It is commonly used by boxing managers to treat their fighter’s injuries. Apply a layer on the wound with direct pressure. When the bleeding stops, remove the jelly and clean the wound.
Tampons and pads
Tampons can be an option for controlling bleeding in certain situations, such as nosebleeds or other minor bleeding. However, it is crucial to keep in mind that they should never be used as a substitute for professional medical care, especially in cases of severe bleeding or trauma.
It’s important to use only sterile tampons for this purpose to avoid introducing bacteria into the wound, which could cause infection. Tampons are designed to absorb menstrual blood and can absorb up to about 15 grams of blood. Therefore, they are useful in managing small amounts of bleeding.
But, if the bleeding continues or is more severe, it is essential to seek professional medical attention immediately. Delaying medical care could lead to more significant health complications, including shock, organ failure, or even death.
In addition to tampons, pads can also be an option for controlling minor bleeding. They are designed to be worn externally and can absorb blood from wounds. Like tampons, it’s crucial to use only sterile pads to avoid introducing bacteria into the wound. Pads can be an option for managing small amounts of bleeding until professional medical care is available.
It’s important to remember that these options should be used with caution and only for minor bleeding. In cases of severe bleeding, it’s crucial to seek immediate medical attention. Delaying medical care could lead to more significant health complications, and in severe cases, it could be life-threatening.
Although improvisations such as sugar, styptic pencils, kaolin, and other items can help control minor bleeding, they do not match up to the efficacy of high-tech commercially-made hemostatic dressings. Products like QuikClot, Celox, and ChitoSam undergo standardized production processes and assure sterility, making them the ideal choice for treating moderate to severe bleeding.
However, in times of emergency or when commercial products are not readily available, improvisations can still save lives. It is crucial to have some commercial hemostatic dressings stored in your medical kit, especially in off-the-grid situations where the risk of infection is higher. Nevertheless, it is better to use improvisations than nothing at all when no other options are available.
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