When the first TCCC Guidelines were published in 1996, there were no hemostatic dressing options approved by the FDA, and recommendations to research potential solutions was prioritized. As a result, by the 2003 edition of the Guidelines, two agents were approved and recommended for use by the CoTCCC: the chitosan-based bandage HemCon® and the zeolite powder QuikClot®. However, because an exothermic reaction when QuickClot powder was activated led to some burns, it was a second-line agent. Once additional options became available, it was no longer recommended.

Subsequently, several new agents have been developed and extensive evidence has been gathered that has allowed the CoTCCC to reliably recommend the use of QuikClot Combat Gauze®, ChitoGauze®, and/or Celox Gauze®. All participants with shellfish allergy tolerated the HemCon® bandage without reaction.

As mentioned when talking about wound packing principles, CoTCCC-recommended hemostatic gauze dressings must be packed into the wound to maximize contact at the active source of bleeding (in order to effectively form a clot at the site of the bleeding), with direct pressure applied over the wound for at least 3 minutes.

Hemostatic dressings should not be packed into chest wounds.