How to Choose the Best Hemostatic Gauze

how to choose hemostatic gauze

Massive bleeding is one of the greatest threats to life with traumatic injury; that's why choosing the best hemostatic gauze to keep in your trauma kit is so important. Hemostatic gauze can be used on a junctional or truncal injury that’s flowing or spurting with blood. For an extremity arterial hemorrhage (on an arm or a leg), a tourniquet is the first line of defense, though hemostatic gauze can be used in place of standard wound packing gauze in combination with a tourniquet.

In contrast to regular gauze, hemostatic dressings are impregnated with agents (“hemostatic agents”) that activate the body’s natural clotting ability, stopping severe bleeding faster. Having the right type of dressing and the knowledge to use it can enable you to control bleeding in yourself or someone else, potentially saving a life.

The Top Hemostatic Gauze Products for Controlling Blood Flow

There are several types of hemostatic gauze on the market that cater to different situations and injuries. Although all hemostatic dressings offer similar characteristics, some suit certain injuries and situations more than others.

1. QuikClot Bleeding Control Dressing

QuikClot uses a derivative of kaolinite clay as its hemostatic agent; this is the same as the agent used in military-grade hemostatic gauze. This gauze works swiftly to accelerate the clotting process, helping blood clot much faster than it would on its own. Severe bleeding can be controlled within minutes of application.

Use for: The QuikClot Bleeding Control Dressing is suitable for more severe bleeding than some of its competitors, and comes with four yards of gauze to control larger or more severe wounds.

2. QuikClot Combat Gauze

QuikClot Combat Gauze is also impregnated with the clay compound kaolin. Although this is one of the oldest products on the market, its proven effectiveness has made it the first-line hemostatic agent recommended by the US military’s Committee on Tactical Combat Casualty Care (CTCCC) for “use in treatment of severe hemorrhage that cannot be controlled by a tourniquet.”

Use for: As the name suggests, Combat Gauze is designed to stop life-threatening bleeding quickly when every second counts.

3. NuStat 4x4

Made with dual-fiber technology, NuStat 4x4 hemostatic gauze controls bleeding through absorption at the site of the injury, resulting in the physical aggregation of blood cells and the clotting factors contained in blood plasma.NuStat 4x4 was designed with public safety in mind and is intended for use in industry, sports, homes, schools, workplaces, recreational settings, and travel. 

Use for: NuStat is a great option for everyday injuries and severe injuries alike, at home or at work, including cuts, lacerations, punctures, abrasions, and incisions that require more than a band-aid.

4. Celox Rapid

Celox uses chitosan as its hemostatic agent. Though this agent is derived from shrimp, it is suitable for people who are allergic to shrimp and other kinds of seafood. Celox is the hemostatic agent chosen by the UK military and the Celox Medical website claims that Celox Rapid can stop bleeding from major injuries with just 60 seconds of compression. In high-risk situations or when third-party assistance isn’t available, the ability to reach hemostasis within a minute is a huge plus.

Use for: The fast time to hemostasis makes Celox Rapid ideal for self-application and use in high-pressure environments.

Celox Rapid vs QuikClot Combat Gauze

In an experiment conducted by Johnson and Johnson (2019), Celox Rapid and QuikClot Combat Gauze were compared in their ability to cause hemostasis in punctures to the femoral artery. Both types of gauze were placed on the wounds as specified in the guidelines.

The Results

QuikClot Combat Gauze performed significantly better in the tests than Celox Rapid, with researchers reporting that 100% of QuikClot Combat Gauze subjects achieved hemostasis as opposed to 70% of those using Celox Rapid. QuikClot Combat Gauze also had 15.9 times greater odds of success than Celox Rapid over a period of one hour.

Different Kinds of Hemostatic Gauze Are Better for Different Situations

  • Best for high-pressure environments: Celox Rapid. When you need a wound to clot fast, the 60-second clotting time of Celox Rapid is an advantage.
  • Best for serious wounds in low-pressure environments: QuikClot Combat Gauze. In situations where you have a few minutes and there’s someone to maintain pressure on the wound, QuikClot Combat Gauze appears to provide the best results.
  • Best for large wounds: QuikClot Bleeding Control Dressing. The length of this dressing makes it ideal for especially large, long, or deep wounds.
  • Best for home and work: NuStat 4x4. NuStat is a good option to have at home or in the workplace for less serious injuries, providing excellent pre-hospital protection for all types of bleeding wounds.

Because they are so effective on serious wounds, the premium options for the True Rescue bleeding control kit and Stop the Bleed® kits come with the QuikClot Bleeding Control Dressing (or the option of a NuStat 4x4 dressing for the Stop the Bleed® kit). However, we recommend having a variety of hemostatic gauze types on hand, especially if you live or work in an environment with a high risk of injuries.

Other Things to Consider When Choosing Hemostatic Gauze

Because hemostatic gauze is applied in life-threatening situations like the battlefield or for prehospital hemorrhage control, look for these characteristics when selecting hemostatic gauze for your trauma kit:

  • Be as large as possible; this way you can pack a large or more severe wound
  • Be easy to unfold and apply. Gauzes packed in a "Z-fold" style are especially quick to unpack. 
  • Be able to control blood loss quickly and effectively in a wide range of conditions, and from a wide range of wounds, within two minutes. The gauze should be effective even when applied through a pool of blood.
  • Be able to maintain hemostasis for several hours when used on the battlefield or in remote areas. This is essential for people who are engaged in combat, who live far from a hospital, or who pursue hobbies such as hunting.
  • Be easy to remove without leaving a residue
  • Be easy to use for people with little or no medical training under challenging conditions
  • Be easy to store and carry
  • Have a long shelf-life (more than two years) even under extreme conditions


  • When choosing hemostatic gauze, also invest in—at the very least—a pressure bandage to finish the application of the gauze.
  • Trauma kits include everything that you need to provide effective prehospital care for traumatic bleeding. 
  • Though most hemostatic gauzes on the market contain known hemostatic agents and adhere to minimum standards, it’s worth comparing brands and checking if your gauze is the right one for you and your lifestyle.

Any Brand of Hemostatic Gauze Is Far Better Than None

While the different hemostatic gauze products on the market have their pros and cons, they are all far more effective than regular gauze for controlling severe bleeding. If in doubt, start with a high-quality bleeding control kit and add at least one heavy-duty hemostatic gauze (if the kit doesn’t already have one) and one or two NuStat 4x4 squares. 

Once you have the right tools, make sure that you also have the knowledge and skills that you need to use them effectively in an emergency. Stop the Bleed® training, combined with a well-stocked bleeding control kit at home, work, and in the car will ensure that you are ready to act when every second counts.

Brian Graddon
Article written by

Brian Graddon

Brian is a former Firefighter Paramedic who also worked as a SWAT Medic, Engineer, and Captain over a 15-year career. Brian is devoted to providing life-saving information based on his first hand experience in life-saving application of tourniquets, hemostatic gauze, chest seals and other bleeding control products.

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