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Wound Packing Race Gauze vs XSTAT

Mike Shertz MD/18D

All hemorrhage control is ultimately direct pressure.

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A tourniquet puts direct pressure on an artery.

Wound packing puts direct pressure at the point of bleeding. As long as the pressure is higher than systolic blood pressure, the bleeding will stop. Sometimes that’s easier said than done. XSTAT makes wound packing a lot easier…

Kerlix Gauze packing can generate up to 197 mmHg at the bottom of the wound and 45 mmHg on the sides. 

XSTAT can generate 156 mmHg and 123 mmHg, respectively. 

Although it’s unclear XSTAT is better than gauze packing done by a well-trained packer, it’s essentially an expert wound packer in a tube, and it’s faster.

Bar chart of wound packing pressure in mmHg. At the bottom of the wound, Kerlix gauze reaches 197 and XSTAT 156. At the sides of the wound, Kerlix gauze reaches 45 and XSTAT 123.

Wound packing is a trained skill.
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Reference

Kragh JF, Aden JK, Steinbaugh J, Bullard M, Dubick MA. Gauze vs XSTAT in wound packing for hemorrhage control. Am J Emerg Med. 2015;33(7):974-6. PMID 25934248.

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Mike Shertz MD/18D

Dr. Mike Shertz is the Owner and Lead Instructor at Crisis Medicine. Dr. Shertz is a dual-boarded Emergency Medicine and EMS physician, having spent over 30 years gaining the experience and insight to create and provide his comprehensive, science-informed, training to better prepare everyday citizens, law enforcement, EMS, and the military to manage casualties and wounded in high-risk environments. Drawing on his prior experience as an Army Special Forces medic (18D), two decades as an armed, embedded tactical medic on a regional SWAT team, and as a Fire Service and EMS medical director. Using a combination of current and historical events, Dr. Shertz’s lectures include relevant, illustrative photos, as well as hands-on demonstrations to demystify the how, why, when to use each emergency medical procedure you need to become a Force Multiplier for Good.