Stops bleeding. Saves lives.

• Dressing to stop life-threatening bleeding (“haemostatic agent”).

• For use by trained emergency responders.

• Not a drug.

What is Celox?

• Based on the material chitosan. • Chitosan in Celox is a highly purified

derivative of shrimp shells.

• All UK MoD military medics; • Paramedics;• HART - Hazardous Area Response Teams;• Other emergency services;• Trained responders at work.

Who uses Celox?

Celox Granules• The original form for

versatile use.• Simple: pack and

press.

Celox Gauze

• Gauze with Celox granules bonded to surface.

• Preferred format of military and most emergency services.

• Can be used in challenging environments.

US Military test results 2012

Survival.

Most recent test by US Department of Defense to re-evaluate choice of haemostat.

Ref: Rall J et al. Technical Report, NAMRU-SA, April 2012.

Clinical field reports• Italian Army,

Afghanistan1. • 21 Gunshot Wounds.• Treated with Celox

granules.

• 21/21 cases successful.• 18/21 within one

minute.

(1) Pozza M, Millner R, Eur J Emerg Med. 18:31-33 (2011).

Location of injuries 1

Upper limb Lower limbShoulder Neck

• Dutch military and Civilian HEMS use2.• Celox Gauze.• Stopped bleeding where

pressure dressings / gauze failed.• No re-bleeding in transfer.• No leakage throughout

monitored period – up to 24 hours.

Dutch experience.

(2) Tan ECTH, Bleeker CP, MCI Forum .3/4-2011.

• High energy trauma to cyclist hit by car.

• Venous bleeding, left side of neck.

• Normal pressure bandage did not help.

Example case: Road traffic accident

• Celox gauze stopped bleeding.• Transport to hospital and care

in hospital with no leakage.

Tan ECTH, Bleeker CP, MCI Forum .3/4-2011.

Celox in contact with bleeding site.

Positively charged chitosan attract negatively charged red blood cells, locking them together in a plug.

Pressure applied allows the gel plug to form and stop bleeding.

How it worksA compound on the surface of the gauze interacts directly

with red blood cells to form a plug at the site of the injured vessels

Using Celox gauze (adopted from UK MoD training)

This is ideally a two-person technique

Operator 1 Operator 2

Apply pressure into the wound through

dressing.

Open a fresh bandageOpen Celox Gauze

Now work closely together

Remove dressing 1

2

3

Insert Celox Gauze, packing wound tightly

Apply pressure through bandage for 3 minutes.

Packing gauze

• Identify bleeding site.• Pack directly onto source of

bleeding maintaining pressure on bleed point.

Pack as taught in controlling severe bleeding for first aid courses – don’t wrap.

• Used to stop bleeding from limbs, groin, shoulder, neck, face, scalp.

• Abdomen (considered “incompressible”) – depends on level of experience.

• Thorax: most protocols indicate Chest Seal only.

Where?

Final steps....

• Transfer patient to medical help as soon as possible.

• Show the pack to the receiving team – attach it to the patient if possible.

• Does not rely on the body’s clotting mechanism;

• Works on hypothermic blood1;• Works on blood containing “blood thinners”2;• The most effective haemostat in military tests;• Safe.

Advantages

(1) Koksal O et al. Turk J Trauma & Emerg Surg. 2011; 17 (3):199-204.

(2) Milner R, Lockhart AS, Marr R. Ann R Coll Surg Engl 2010: 92

• No shellfish allergic reaction: tested on subjects with known shellfish allergy.

• No heat generated.• Composed of substances that occur naturally in the

body, or have a proven history of medical use.• Left over chitosan is broken down and excreted by

the body.

Safety testing

Now Celox Rapid, reduces treatment time.

60 second compression.

3 minute gauze Celox Rapid0

1

2

3

4

packing compression

Minutes

• Proven success in life-threatening bleeding.• Chosen by multiple NATO forces as well as civilian

emergency services.• Stops hypothermic bleeding as found in severe

traumatic injuries.

Conclusion