title: Topical hemostatic agents and dressings in the prehospital setting.
abstract: OBJECTIVE
  Death from exsanguinating hemorrhage remains a priority in the management of combat casualties and civilian trauma patients with truncal and junctional injuries. Appropriate use of hemostatic agents and dressings in the prehospital setting may allow for earlier control and an improved survival rate.
  
  
  RESULTS
  Third-generation chitosan-based hemostatic agents and dressings appear to be equally efficacious to the dressing currently deployed by the US military forces in the management of hemorrhage not amenable to tourniquet placement. Unfortunately, a lack of clinical trials places a heavy reliance on anecdotal reports and laboratory studies in agent selection and application.
  
  
  CONCLUSIONS
  Efficacy of currently available hemostatic agents and dressings appears to have plateaued in recent years although new agents and delivery mechanisms under development may improve control in cases of severe hemorrhage.
authors: aDepartment of Anesthesiology, University of Maryland School of Medicine, R. Adams Cowley Shock Trauma Center bU.S. Air Force Center for the Sustainment of Trauma and Readiness Skills, R. Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.
authors: Thomas E
authors: TE
authors: Grissom
authors: Raymond
authors: R
authors: Fang
mesh_terms: D000818:Animals; D001458:Bandages; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D004632:Emergency Medical Services / Q000379:methods*; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006487:Hemostasis; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans
chemical_list: D001779:Blood Coagulation Factors; D006490:Hemostatics