Hemostatic dressings accelerate clotting where a tourniquet can't go — the neck, axilla, groin, and deep extremity wounds. CoTCCC-recommended kaolin and chitosan agents, supplied in the gauze form doctrine now favors over loose granules.
Hemostatics are part of the M in MARCH. They are packed into a wound and held under pressure — pair with wound packing technique and pressure dressings.
Hemostatic gauze does not replace the clotting cascade — it concentrates and accelerates it at the bleeding source. Kaolin is an inert mineral that activates Factor XII and the intrinsic pathway on contact, driving rapid fibrin formation. Chitosan, derived from shellfish, works independently of the cascade by carrying a positive charge that binds negatively charged red cells into a mucoadhesive plug — an advantage in a casualty who is anticoagulated or coagulopathic.
Current doctrine favors impregnated gauze over loose granules or powder. Gauze can be packed directly against the bleeding vessel deep in a wound, holds pressure, and is fully removable. Loose agents are harder to direct, can wash out of a high-flow wound, and earlier exothermic formulations risked tissue burns — which is why the original granular products were retired from recommendation.
| Agent | Mechanism | Note |
|---|---|---|
| Kaolin | Activates the intrinsic clotting pathway | The most widely fielded recommended agent |
| Chitosan | Charge-based mucoadhesive plug | Works even with impaired clotting |
It is used to control compressible bleeding that a tourniquet cannot reach, such as wounds to the neck, armpit, groin, and deep in an extremity. The gauze is packed onto the bleeding source and held under firm pressure.
Kaolin activates the body's own intrinsic clotting pathway, while chitosan forms a charge-based adhesive plug that works even when clotting is impaired. Both are CoTCCC-recommended in gauze form.
Gauze can be packed directly against the bleeding vessel, holds pressure, and is fully removable. Loose granules are harder to direct, can wash out, and earlier exothermic versions risked burns, so they were retired from recommendation.
Hold firm, direct pressure for at least three minutes. The hemostatic agent needs sustained contact time with the wound to form a stable clot before you secure it with a pressure dressing.
Yes. Hemostatic dressings carry an expiration date and should be stored sealed and within temperature range. Check the date on each product and rotate stock so field kits carry in-date dressings.
MED-TAC International Corp. is a clinician-founded, veteran-led tactical medicine provider. Product references to CoTCCC reflect committee recommendations and do not imply FDA approval or certification. This content is educational and is not a substitute for hands-on training or medical direction.
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