January/February 2011  ISSN-1059-6518  Volume 24 Number 1

Using Hemostatic Agents to Control Severe Bleeding

Brad L. Bennett, PhD, NREMT-P, WEMT, FAWM

Captain, US Navy (Ret.)

Member, Committee on Tactical Combat Casualty Care

SOLO Wilderness Medicine Instructor

Tidewater Search & Rescue, Virginia

Member, Committee on Tactical Combat Casualty Care


Historically and still currently today, severe hemorrhage remains the leading cause of death in combat. In civilian trauma, it is the second cause of preventable death after head trauma. Before I get into the discussion about the use of a hemostatic agent for controlling major arterial bleeds, let’s be aware that we should judiciously use direct pressure as the first line of defense to control bleeding from external bleeding sites. With effective direct pressure along with proper wound packing, these two approaches can stop severe bleeding in most cases. This is true even for major vessels such as the carotid or femoral arteries. Casualties with such injuries often bleed to death despite attempts at direct pressure.

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