Effectiveness of hemostatic agents to control external bleeding in military health

Introduction: The use of new hemostatic agents to control hemorrhage in military environments is growing. Objectives: To synthesize and analyze the available evidence about the effectiveness of the different hemostatic agents utilized in tactical environments that are transported by army fighters. Development: A narrative review of articles published in English and Spanish, in Medline (PubMed), Cochrane and Web of Science, and magazines, protocols, books, and manuals in the field of emergency and battlefield emergencies, who analyzed the study phenomenon and met the inclusion and exclusion criteria. After searching and selecting the studies, 7 articles were included in the narrative synthesis. In the studies, the following hemostatic agents were used QuikClot®, HemCon®, Celox®, and ChitoGauze HemCon®, in most studies, hemostatic agents were more than 88 % effective in stopping, reducing, and controlling external hemorrhage in combat victims, especially in union areas, also decreasing morbidity and mortality. Only QuikClot® had negative side effects causing burns. The correct handling of hemostatic agents requires prior training, which avoids administration mistakes. Conclusions: Hemostatic agents are effective for treating external hemorrhage in combat victims and increasing their survival. It is necessary to train professionals to avoid mistakes in their handling. Future studies should investigate which of these agents is more effective.