USDA Approves XSTAT Wound Plug For Civilian

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The United States Food and Drug Administration has approved the use of the XSTAT-30 Rapid Hemostasis System for use on humans. XSTAT is a product of RevMedX, which has been in use with the military for a few years, helping prevent death by exsanguination (ie bleeding out).

Think of it as a tourniquet, but for wounds that where a tourniquet would not be useful like the armpit or groin. It is extremely useful for gunshots, which have a tendency to cause massive internal bleeding through trauma, tearing, and cutting.

Uncontrolled hemorrhage is the most likely cause of death for military casualties due to battlefield injuries. In WWII, it was estimated 40% of casualties could have been saved if they received care within four hours. The XSTAT is rated to stop bleeding for four hours.

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Its use is simple. Insert into wound and let the sponges swell to put immediate pressure on the sources of bleeding. According to RevMedX, the sponges work within 20 seconds of contact. For certain applications, it will be a literal life-saver, but it is not appropriate for certain wound types and locations “the pleural cavity; the mediastinum; the abdomen; the retroperitoneal space; the sacral space above the inguinal ligament; or tissues above the clavicle.”

To ensure nothing is left behind after surgical care, each sponge has an X-ray marker.

No word if the XSTAT will be available for direct civilian sale, despite approval for civilian use, but I am sure the company will offer it, if allowed.



Nathan S.

One of TFB’s resident Jarheads, Nathan now works within the firearms industry. A consecutive Marine rifle and pistol expert, he enjoys local 3-gun, NFA, gunsmithing, MSR’s, & high-speed gear. Nathan has traveled to over 30 countries working with US DoD & foreign MoDs.

Nathan can be reached at Nathan.S@TheFirearmBlog.com

The above post is my opinion and does not reflect the views of any company or organization.


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  • Andrew

    Just what civilians always wanted – a $100 tampon.

    • CommonSense23

      Except possibly helpful for wounds unlike a tampon.

      • Stephen Maro

        Tampons are helpful for wounds and have been for years. Most medics carry them to plug GSW’s.

        • CommonSense23

          No there are not. Rip apart a tampon and compare the amount absorbent to that of a roll of gauze. Also notice the absorbent is not making direct contact with the wound. There is a reason 18Ds, PJs don’t carry them. It’s bad info. Kinda like tourniquets are a last resort.

          • Jeffrey Scott Boyer

            After being a paramedic for 18 years they are now teaching to use tourniquets first especially in active shooter situations. So please brush up on your CEUs.

          • CommonSense23

            That’s what I mean. Tourniquets should be used immediately. But they still have a bad rep from years of bad info.

          • Bill

            That’s exactly how I read your comment, and matches the training I’ve received.

          • JumpIf NotZero

            Vietnam.

          • Vanns40

            Along the tourniquet line, IBD’s are great.

            I guess I should spell it out – Israeli Battle Dressing

          • nova3930

            I don’t have any medical training and know how silly an idea it is. Just think about what they’re designed for and it’s entirely logical why they would not work for a GSW. Any woman that would bleed like a GSW during *ahem* that time, would be dead.
            I’d try it if had absolutely no other option, but literally anything would probably work better.

          • iksnilol

            I dunno, pads saved my arm when I slashed it open.

          • Ben Gauci

            I can vouch for this! I have also used the gf’s pad to stop a gash lol

          • Doom

            “to stop a gash” AYYY LMAO!

          • SoulInvictus

            Hilarious.

          • David J. Stuehr

            They worked when I was an HM.

          • “Rip apart a tampon”
            Well, that’s enough internet for me today.

          • Edeco

            Pfft, lightweight.

          • Doom

            He only meant tear it apart if it was already used I am sure. tearing apart a fresh one would be a waste of money!

          • JumpIf NotZero

            Look, someone who has had some TCCC training.

            Tampons are good for nosebleeds, but have no place in an IFAK.

        • Bill

          Most medics don’t. I’ve never had a period, nor a GSW, but no one has ever died of menstruation.

          In the past, some of us carried maxi pads, that would be new, in the wrapping maxi pads, in the brims of our hats for use in applying direct pressure, but those days are long gone and while better than nothing, there are far better technologies on the market.

          • Stephen Maro

            Every Corpsman I knew in teh field carried them. They say they applied pressure in the wound (not so much to absorb all teh blood. Pressure dressing were placed over them (depending on gsw location of course. I’ve been OUT almost 20 years now, so I’m sure they are carrying better stuff now (various quick clots, etc…) but for people l;ooking to put something ogether on a budget the old school stuff is better than nothing. I carry quick clot granules, sponges, etc… these days, but I can only afford so many. several of my backup and cache kits contain tampons.

          • CommonSense23

            Your corpsman didn’t know what they were doing.

          • iksnilol

            I prefer pads for wounds.

            Though getting the real deal (gauze and quick clots and whatnot) is probably better.

        • David J. Stuehr

          I was an HM in the navy. We had the tiny unit-1. I always carried tampons for GSWs. An old HMC used them in ‘nam and swore by them in some conditions. Not perfect but better than nothing. And better than stuffing all your roller gauze into one casualty. It worked for me several times. Glad that combat medicine has progressed a bit.

      • Phillip Cooper

        You REALLY need to brush up on your first aid…

        • CommonSense23

          I am going to guess I have more relevant training than you do.

          • … wrong reply.

          • CommonSense23

            What?

          • Replied to the wrong comment, deleted what I wrote due to it.

        • BillC

          I think he might have meant to reply to Stephen Maro, beneath your first post.

      • Wyatt Earp

        As a retired medic, I carry tampons in my go bag. Great for stopping bleeding. Although, for me, Quik Clot has just about replaced them.

        i never would have seriously considered using tampons before I retired. The best way to “save” a trauma patient is to get him to the OR. That means, ‘scoop and swoop” in a ground ambulance or call a helo.

        • CommonSense23

          They are not good for stopping bleeding that requires medical care. They might appear to be, but they are not.

      • cwolf

        The issue is not that tampons/pads are better than trauma dressings. They are not.

        If you’re in a mass casualty situation, time is critical. Even 3-5 casualties would overload local supplies or the avg home-brew trauma kit.

        Therefore, folks need to mentally prepare re what field expedient stuff they can use: t-shirts, tampons, pads, belts, socks, fingers, whatever. Sterility at that point is secondary.

        And, of course, training is essential.

        • CommonSense23

          Tampons on ineffective to begin with. They are not going to do anything to help with bleeding. Stuffing the wound with strips from a T Shirt or applying direct pressure is going to be more effective than a tampon. It’s bad outdated info to use a tampon.

        • Wyatt Earp

          The best way to get around being ‘overloaded’ is to triage effectively.

          I’ve been triage officer on mass casualty incidents involving up to 40 people over the age of 60 y/o. 4 ALS & 4 BLS ambulances. Everyone lived.

          Interestingly, at the critique of the incident, I was criticized by the ‘expert’ for not triaging two of the most serious out. Everyone lived, but she was the expert, so I got it in the neck.

          I live in the middle of a National Forest that covers 1 million acres, which abuts up to a wilderness complex that covers another million acres. About 90% of the NF and 100% of the wilderness is trackless. No vehicles. In the wilderness, not even any helos. In the backcountry, I’d urinate on a spark plug if I thought that would help me get a patient to a helo. (I WOULD never stick something into a puncture wound, I used tampons for external bleeding. Like Quik Clot, they can cause blood to coagulate faster.

          Of course, if your patient develops DIC or something, you’re kind of screwed in the field.

          • cwolf

            Agree, triage is critical.

            I was trying to address the self-care/buddy care issue before the EMT/SWAT doc/et al arrive. Which, depending on the scenario, can be quite a while. The avg citizen can only hope to stop the bleeding; they can’t really decide who gets nothing (encouraging words but you’re dying) or set evac priorities, etc.

            During that timeframe (before the pros arrive), almost anything is better than nothing. Stopping the red salt water from leaking out is critical. Stick a finger in a carotid. Agree, whatever it takes.

            The tactical situation may well dictate events. I am glad to see SWAT docs as options (although a long gun really gets in the way; your hands are full and all casualties aren’t always calm). Most ex-military medics would willingly go into a tactically unsecured situation.

            Dialogue is good. Cheers.

  • Phillip Cooper

    Really? The US Department of Agriculture is approving medical devices now? Uh, no…..

    • DIR911911 .

      they had to make sure you couldn’t get high off them first.

  • Bill

    “Civilian” is misleading – it’s highly unlikely that these will be available at Walgreen’s. I believe that the manufacturer will make them available to “civilian” trauma docs, paramedics and EMTs after they receive the appropriate training. Note the long list of Thou Shall Nots that the average, untrained person isn’t going to understand.

    • DIR911911 .

      I’d bet money in less than a year these will be offered to everyone , especially with the increase in adventure and thrill sports that take people possibly too far away from emergency medical services. these could also be issued to lifeguards in areas of shark attack. it’s not like you can get high off of this , not really any reason to limit access. remember , use as directed.

    • JumpIf NotZero

      There isn’t much to understand about furnishes here. But you definitely don’t use this for a chest wound, Xstat is for groin or areas a tq can’t be applied.

      They won’t be at Wallgreens because right now the 30mm is $350 or so per pop. I do plan on getting some of the 12mm when available.

      The company RevMedX has been very good about civilian sales.

      • Robert Harper

        It’s just like when Celox and the others first came out, expensive but the price will come down. Just wish I could still have supply order my gear for “acquisition.”

  • Matrix3692

    I thought some one told me that this was suppose to be “bio-degradable” inside human bodies, which remove the need of having of removing it afterwards……

    • Ronny Randall

      I cannot imagine why one would forgo medical care and leave the guff in. It does not belong in the body, it needs to be removed. Gunshot wounds need cleaning out anyway – hair, skin, metal, detritus etc.

      • marathag

        One of the other sites on this product stated that they were made to stand out in XRays

  • nova3930

    “Uncontrolled hemorrhage is the most likely cause of death for military casualties due to battlefield injuries. In WWII, it was estimated 40% of casualties could have been saved if they received care within four hours. ”
    Better battlefield medicine is the primary reason we’ve seen so many disabled vets from Iraq and Afghanistan. In wars past getting an arm or leg blown off had a much higher probability of ending in a KIA. More guys are surviving those injuries and coming home now….

    • iksnilol

      I am going to hell for this:

      The prosthesis industry is making money over limb.

      • Bill

        You’re right, you’re going to hell 😉

        • iksnilol

          I only regret not knowing how the idiom goes. Is it arm over limb? :/

          • Bill

            It’s normally “hand over fist,” which, when I think about it, doesn’t make much sense.

          • iksnilol

            Thanks. If it doesn’t make sense means that my butchering of it isn’t too bad either. 😀

      • Wyatt Earp

        You mean limb or limb?

    • Bill

      There’s an argument to be made also that the homicide rate is dropping because of trauma treatment techniques from the .mil trickling into civilian trauma centers and hospitals, and pre-hospital treatment. People who would have been murder victims in the past are now assault victims. The same principle is being credited for saves at the Boston Marathon bombings.

      • Wyatt Earp

        No, there’s a huge argument to be made that decreased mortality/morbidity from better crash engineering is making a huge difference in the number of traffic deaths.

        Penetrating wound treatment is the same as it’s always been–those who make it to a surgeon have a much greater chance to live than those who don’t.

        • Bill

          While I agree with you point about better-engineered autos, we didn’t have things like the Hartford Consensus, TCCC and Combat Lifesaver before tech current conflicts. What we know about pre-Hospital trauma care is light years ahead of what we new in 2000. If you don’t believe me, ask that trauma surgeon.

          • Wyatt Earp

            I am not going to set about trying to control the hemorrhage of a patient who doesn’t have a patent airway, isn’t breathing and has no circulation. Such a patient, in a triage situation, is, most probably, going to be ‘expectant.’

            Hemorrhage

          • cwolf

            Yet, some hunters still do what they call “sound shots” and shoot another hunter.

            And folks who go out in the woods to do target shooting don’t always check their backdrop and manage to shoot some camper/hiker downrange.

            Stuff happens.

          • Wyatt Earp

            So, you’re saying that someone getting shot in a hunting accident or someone getting shot while target shooting is equivalent to an active shooter incident?

            Interesting.

          • cwolf

            No….. Just saying gunshot wounds happen lots of places.

        • cwolf

          True, seat belts, air bags, crash design testing, etc. have made a huge contribution.

          It is also true that improved ambulance technologies, improved EMT training/certification, direct commo with ER, and various technologies (portable defib), et al have also contributed.

          RAND published a review of the impact of local emergency planning/coordination, and mass casualty exercises as also being important.

          I realize this varies by locale. NYC is different than Lost in the Woods, CO.

          • Wyatt Earp

            I’m not lost in the woods in the Northern Rockies in Montana. Colorado is just too urban for us.

        • Kivaari

          Yep. It isn’t just improved car passenger restraint systems, which are very important, but increased road engineering. There are NO ACCIDENTS, as someone in the chain of events from building the car to designing a new crash barrier has human influence.

    • Wyatt Earp

      I think the fact the war in Iraq dragged on for 10 years and the war in Afghanistan might be factor.

      However, the single most important improvement in battlefield medicine is dust off helicopters.

      • cwolf

        Actually the Forward Surgical Teams have increased survival as well.

        Speed is critical; closer is better,

  • DIR911911 .

    I’m a little more concerned with that top picture , looks like complete plunger failure and none of that’s coming out 🙁

    • JK

      That.

  • jaimeintexas

    Let’s see. Puncture wound that is bleeding internally. Compression or tampon? Bleed to death or a chance to get to proper emergency help?
    For a few pennies I’ll have the tampon, a few of them, in an emergency kit.

    • CommonSense23

      Why wouldn’t you just buy gauze that actually works when you pack a wound instead of wasting space and money on tampons.

      • jaimeintexas

        Yes, them too and duct tape but space and weight are a concern in an emergency kit. Tampons are already a sunk cost. All I have to do is raid the wife’s stash.

        • iksnilol

          And get brutally maimed when she needs them.

          😛

          • jaimeintexas

            LOL. Good thing that when I take the emergency kit with me I am gone, at least, all day.

        • Sulaco

          John Ringo calling Ghost…John calling Ghost.

          • patriotism-matters

            Gosh do they come in camo too?

        • Compressed gauze fits more gauze in the same space than a Tampon.

          More gauze = better for wound packing.

    • jaimeintexas

      Tactical tampons, dual use. 😉

      • SoulInvictus

        Tactical tampons…
        Counting the days until someone’s branded that on an overpriced box.
        Wonder if they “reload” quicker…

    • Bill

      Clearly you have never witnessed a woman bolt for the bathroom when, ahem, something doesn’t fit quite right. And I’d hate to see the tampon that could take on a gushing artery, or more accurately, I hate to see the woman who would need a tampon that could handle a gushing artery.

    • jaimeintexas

      Thank you all for your concern for my safety. I am moved. Relax, I will never leave my woman stranded (she only uses tampons for certain situations) and I am yet to need my emergency kit … except for that time the hook went through my thumb but the wire cutters (and rubbing alcohol) were called on that one.

    • Edeco

      The string would be convenient.

  • tony

    There have been incidents where guys bleed to death due to knife wounds in the upper leg area where the major artery is. Very hard to control that type of bleeding by applying external pressure. This will save lives for sure

    • Bill

      There’s a new inguinal tourniquet on the market for just such injuries. It looks like some bondage device, and I bet it hurts like hell, if having a leg severed off doesn’t hurt enough.

      • jaimeintexas

        “bondage device”

        😯

      • iksnilol

        You had me at bondage device.

    • Rick5555

      You hit the artery….and you have roughly 3-6 mins to live. The device in the aforementioned article isn’t going to help. This isn’t some miracle device per se. It’s going to have it limitations. Sticking a device in the wound doesn’t equate to where the bleeder is coming from. Or you could have multiple bleeders. I would like to peruse the studies…controlled and blind studies. Before I consider using these. That’s even if there’s an application pertaining to surgery.

      • iksnilol

        Yeah, but if you cut the blood flow to the artery then you possibly can’t bleed out from the artery?

        Trust me on this one. Will ya hold my beer? [in case you didn’t get it I was joking]

  • Bill

    Today’s firearms trivia: the plug used to seal the muzzle of old-school artillery pieces is technically referred to as a “tampon.” I also used to refer to those orange plastic breech blocker things S&W used to pack with each pistol as tampons, until the Chief told me to stop it.

    • marathag

      most times called tampion in the USN or tompion in the Royal Navy

  • Dougboffl

    I sayin “na aha jose” I cap some dude cuze he shorts me on my deal, cause dat’s how I roll, an now u sayin you might save his azz! I ain’t havin it! I’m callin somebody, an I know my rights, this is messed up. U feelin me?

    • Kyle_D

      Is this english or am I having a stroke?

      • Porty1119

        You’re not the one having a stroke.

    • iksnilol

      I… I don’t feel you.

  • RICH

    WHERE CAN I GET A COUPLE OF THESE FOR MY MED KIT ? ? ?

  • drizd

    One can only imagine the howling that the poor sot is doing while you stick that dildo looking thing into a fresh wound. channel Do they give any sort of anesthesia prior or just hold him down ?

  • lordmorgul

    Naturally they would only approve this for physicians to purchase, not anyone wanting medical supplies for emergency situations.

  • That wound plug would be a big hit in Chiraq, Baltimore, and Detroit !!

  • Ivo Shandor

    Should’t the headline read FDA and not USDA? Pretty sure the Department of Agriculture has nothing to do with this.

  • Wyatt Earp

    That thing looks like it’s several inches around. A wound from a 7.62×39 or x51 is .30 inches. Are they advocating enlarging the wound cavity to stick this monstrosity in? Bullet cavities aren’t that shallow or large in diameter. If only wound cavities were as wide and shallow as the illustration.

    As I have said here, again and again, primary cavities are what kill people. Exsanguination happens rapidly if you hit certain structures in the body–carotid artery; heart; lungs; aorta; vena cavae; iliac arteries or veins; femoral arteries and veins; the liver; fractured femurs; etc. You can’t stick a syringe full of sponges through a small or big hole and stop bleeding in these structures, the patient won’t live that long. If they do, good luck finding the laceration in some guy’s liver with you blunt nosed object.

    If you get gut shot, you’ll probably live; although you’ll have one helluva case of peritonitis and may have a colostomy bag. You’ll probably live from isolated limb trauma, too. Although you might lose the limb to amputation.

    For external trauma, Quik Clot is much better. I’ve treated everything from bear maulings to backhoe maulings to external trauma due to MVAs.

    Another problem: I can’t find a website for XSTAT.

    • cwolf

      revmedx (apparently any note with a URL gets “pending review”)

      The device injects the sponges.
      The device doesn’t go into the wound.
      The device is basically only for muscle wounds (not chest, abdominal, etc.).

      • Wyatt Earp

        Thanks for the info. I didn’t know that.

        I discussed the whole issue of clotting adjuncts with a Navy Dr. friend of mine who served with the Marines at a Battalion Aid Station in Iraq.

        He doesn’t think clotting adjuncts are necessary. A severely wounded man needs a surgeon and will die without one. That’s it. Any 20 y/o healthy male who gets hit hard enough to have no vitals is unrecoverable. He also related that body armor pretty much protects you from trunk trauma and that extremity GSWs are survivable–without adjuncts. Using direct pressure, elevation, tourniquets, etc.

        He feels the number one adjunct on the battlefield that saves lives are helos. In civilian pre-hospital care of trauma victims, I’d have to agree with him.

        • cwolf

          Yes body armor has shifted wound locations and saved lives. It also keeps folks in combat longer so it gets complicated. It may in a sense increase other problems.

          Medevacs are important. In linear combat, the Forward Surgical Teams are highly effective. In a FOB-based war, it still falls on the Medevac.

          Although FOB-based war creates other issues. After 200 years, the military still has poor sanitation systems,

  • Archie Montgomery

    Sounds like it might be handy for EMT and such in the non-warfare arena. I can see the gunshot wound treatment for both lawmen and suspects who have sustained a gunshot or stab wound. It may – as is or with some development – also be useful in treating injuries from automotive or industrial accidents.