Friday, December 11, 2015

Quackery



Ars Technica link: Like science, but stupider: The XSTAT30.

It’s a wonder product that can almost instantaneously stop bleeding from gunshot wounds. It does not heal the wound, but it plugs it temporarily to avoid significant blood loss until the wound is treated. The device looks like a syringe full of tablet-sized sponges that expand after injection to the wound. Within 20 seconds, the expanded sponge then fills the cut, preventing blood loss and giving the patient a higher chance of survival. Each sponge last for up to four hours and absorbs up to a pint of blood. . . XSTAT 30 is manufactured by RevMedX, Inc., in Wilsonville, Oregon.

If the article got it right (which is far from certain given general and specialist media obtuseness) it's a wagonload of bullshit.
If it isn't cleared for use in "certain" parts of the chest, abdomen, and pelvis, WTF good is it? Jack and shit.
You're making a device that will be applied by 110-hr wondermedics with basic EMT certs, or at best by 6-month paramedics, and you're going to have them play "Do we or won't we?" games with the exact parts of the anatomy where tourniquets don't work?
Which have unhelpfully been blown open by bullets??
Total hype, hokum, and horseshit.

If you shoot that thing into a head wound, and it swells with blood collected, you've produced an unreduceable hematoma in the cranial vault. Stroke, and/or pushing the brains down through the spinal foramen (the hole at the bottom of the cranium where the brainstem lives and connects to the spinal column). The only more effective way to kill someone would be to pull their brains out with a crowbar and then stomp on it.

You can't put it into the chest, because it could tamponade the heart or major vessels, and they then have an unsolvable heart attack, or a hemothorax that a needle thoracotomy won't fix.

Ditto for the neck, where it could choke off blood flow to the brain, or block airways.

Put in inside the digestive tract, and you have a bowel obstruction that won't resolve. Ditto if it ends up in the bladder.

That eliminates 85% of the human body where it can't be used.


So when you eliminate the head, neck, chest, abdomen, and pelvis ("certain parts"?? I repeat, total horseshit) you're left with the arms and legs: IOW the exact places where the CAT and SOF-T tourniquets are expressly designed to shine, and have done for near 15 years. At one-third the list price!

And on an anatomical note, the sponges (92 of them) are designed to absorb "up to a pint of blood" each. So what they've designed is a device to exsanguinate the entire body at the speed of blood loss, since you only have 10-14 pints of blood in your entire body.

So as the blood flows out the holes and into the sponges, it is removed from circulation permanently, to form a cluster of clotted sponges full of blood, and your veins and arteries are sopped entirely dry. Rapid and profound shock, coma, and death result, in short and irreversible order.
Fucking genius, that. If you're a mortician looking for a handy way to prep the body for burial.

On the spectrum from Shineola to shit, this appears to be a truckload of the latter. An utter abortion, without legs.

Absolute best case: You might could use it on groin and armpit wounds.
If the bladder/lung isn't punctured. I suppose you'd need your handy field ultrasound machine to make that call. Which no one has, because it doesn't exist.
And if the wound's so bad you can tell they are punctured without your nonexistent field ultrasound machine, you can't use it. QED

So still worthless bullshit in search of a purpose. And government and institutional dollars.
While it clogs your kit with something of dubious, if not even non-existent, utility.
That thing's a CAT or Israeli bandage you didn't bring, both of which actually work.
And priced at the DoD friendly $100@.
Comedy gold.
"Mr. Shoddy: Dewey, Cheatham, & Howe are calling about patent infringement..."

Maybe in the new gender-bender military, it could find use as a field marital aid, and ad hoc birth control device.
"Introducing the SpermStopper 2000!"

That analysis is based purely on the article, but I can't imagine where you'd usefully shove it with the restrictions stated in the article, or how they expect field medics to utilize it under such recockulous restrictions under actual conditions. (I could suggest a place for the manufacturer to shove it, which you can probably guess that without further hints, but they'd have to pull their heads out first.)

If I hear or see more about it, and the maker has a better-than-the-Underpants-Gnome explanation of its function, utility, and restrictions that makes more any sense, I'll revise that opinion.
Comments are open.

Elucidation and explanation is welcome.

12 comments:

Anonymous said...

My daughter was funeral director for a few years (and likely will be again after she's done with some more schooling), and when she read and got to your part about the mortician she started laughing. :)

The the problem is, she described the embalming process to me again .. and I'd happily forgotten most of it.. oh man, you know. Can I say "wanted to hurl all over again" here? I just did. Sorry!

Anyhow, yeah, these things seem fairly useless, but look.. neat-o X-Ray detectable markers!!

Anonymous said...

Oops.. sorry for my poor typing above. I forget to proofread when I'm both laughing and grossed out simultaneously ;)

Fifty Cal said...

With the amount of stuff that thing has, unless you have been hit with a 23mm cannon, I imagine the "cure" would hurt worse than the wound.

Anonymous said...

I don't know if the article has been edited, but it states "Together, the sponges can take in about a pint of blood..."

Aesop said...

That's an edit.
They originally stated "a pint of blood each, hence my response.

The new statement is even stupider: If all you want to do is soak up a single pint of blood, you can buy a standard trauma dressing, or a handful of gauze 4x4s for one helluva lot less than $100.

It's STILL a load of horseshit.

Crusader said...

I keep four Quickclot combat gauze on hand along with a CAT TQ for gunshot wounds that require it along with various dressings. I have read of preppers stocking up on tampons but will not be adding them to the kit until I have heard from medical professionals. If I get the thumbs up, I will raid my wife's stash. Would you mind weighing in on the utility of tampons to plug a gunshot wound?

Aesop said...

Mostly if not totally worthless. If it did anything useful, they'd tell you to shove a (gloved) finger in there. So the only person it will help will be someone who has stock in tampon manufacturing and retailing companies. Not the patient. Advice to use tampons for penetrating trauma is the prepper equivalent of an old wives' tale. Anyone who seriously suggests it has medical credibility of nil.

The point of Combat Gauze and the like is that if you shove enough in there, eventually we hope it'll get to the source of the bleeding, and form a barrier clot, keeping the blood in tissue and the blood system, and circulating.
This is the function of the kaolin/chitosan additive, not the gauze mesh in CG.
Absorbing blood, especially with something super-absorbent like a tampon, only sucks it out faster, while still removing it from a person's circulating volume, permanently. Hence worthless.

The utility of the old military pressure dressing was the pressure provided, sometimes by the tourniquet action of the ties if applied around an extremity.
The absorbency was secondary; the idea was to apply pressure diffusely, not pinpoint (which kills tissue).

The new products like the Israeli Bandage do the direct pressure thing. CATs and SOF-Ts shut blood flow off to extremities. Combat Gauze is mainly to replace a barrier inside the body that traumatic application of knives, bullets, shrapnel, etc. has inconveniently punctured or stripped away.

(Think of it in reverse: if something pokes a hole in the hull of a ship below the waterline, would you want to put buckets of kitty litter on it? The point is to keep fluids where you want them in either case, whether it's inside the body's circulation, or outside the ship.)

So if simple wads of tampons (let alone maxi-pads) would suffice, we wouldn't have needed all those 21st century trauma products, would we? If you need to stop bleeding, and Combat Gauze won't do it, you need trauma surgery.
With or without that, remember the following medical rule:
All Bleeding Stops, Eventually.

Tampons don't stop bleeding; they merely provide someplace (other than your circulatory system) for the blood to be. This is seldom medically helpful.

A tampon is to keep a menstruating female from soiling her clothing all day during the one week a month of menstruation.
The only similar product is the short compacted cotton wads dentists use during procedures, to soak up saliva and blood, while shoving the cheek away from the teeth so they can work.
Don't use those for "plugging bullet holes" either.

Avoid knife and gun fights as much as possible, wear body armor, carry the proper supplies, learn circulatory pressure points, and find someone who can provide secondary medical treatment for traumatic injuries.
And leave your wife's stash of tampons alone.

Anonymous said...

Waiting on your "The Force Awakens" review :) Hope you get a chance to see it soon!

Daniel Barger said...

It's a tool....a tool that might keep you alive long enough for the docs to worry about fixing the issues it might cause, that is all it is. It's use is dependent on a lot of factors. Use it proprely and lives are saved, use it incorrectly and it can harm....the same can be said for ANY tool. The key is knowledge, training and experience. The key is to keep the patient alive long enough for REAL medical care.

Aesop said...

It won't keep anyone alive five seconds longer, and in fact will probably kill you quicker due to rapid internal exsanguination. The blood will leave the circulatory system, and become permanently (albeit briefly, for the patient) trapped in the sponges.
So I have to ask: Did you read the post, or what?
It doesn't do anything else new, and it costs three times the price of the better tools that do the exact same thing.

It's nothing but a con job in search of a sucker.
Ideally, one with a .gov purchase order.

3 to 1 it's designed by someone with an uncle in .gov purchasing, and both uncle and Uncle will buy 400,000,000 of them, "just in case".

Anonymous said...

..........Nice..^_^v............

Old Fool said...

We used to use paperclips as markers on GSW X-rays. Maybe if that gizmo could follow up those sponges with a paperclip it would have some utility. You are right on regarding your assessment of tampons for trauma. That trick never worked back in the day!