The Use of TRAUMAGEL® for Hemorrhage Control in a Complex Head Laceration: A Case Report.

Abstract

Prehospital geriatric falls account for approximately a fifth of emergency medical services (EMS) call volumes nationwide, with a significant proportion involving head injuries and lacerations. Managing these injuries and associated hemorrhage requires substantial resource utilization, including personnel, time, and supplies. Complicating care is that many geriatric patients are maintained on long-term oral anticoagulant or antiplatelet therapy, making hemorrhage control more difficult. Failure to achieve adequate hemostasis in the field can delay critical assessments and further intervention. This case report describes the prehospital use of a novel hemostatic gel (Traumagel) in managing a complex head laceration. Traumagel achieves rapid and reliable hemostasis in complex wounds that may not be amenable to other hemostatic techniques. Deploying this gel alone or in combination with traditional methods enables emergency medical providers in the field to shift their focus to advanced patient care, allowing for earlier transport to definitive care. In this case, an elderly patient on chronic antiplatelet therapy (Clopidogrel) sustained a complex, open scalp laceration following a ground-level fall. EMS controlled a mixed venous-arterial hemorrhage unresponsive to direct pressure and traditional hemostatic interventions using Traumagel. Effective field hemostasis helped avoid trauma activation and potential operative intervention. The wound was successfully repaired in the emergency department without complication. This report underscores the importance of EMS providers integrating traditional techniques with emerging hemostatic technologies to optimize outcomes in moderate to severe trauma-related hemorrhage.