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.

- QuikClot Combat Gauze is a non-woven material impregnated with kaolin, an inorganic mineral that activates Factor XII, which accelerates the body’s natural clotting ability.
- ChitoGauze dressing is composed of polyester/rayon blend non-woven medical gauze that is coated with chitosan, where an electrostatic interaction between the negatively charged cell membranes of erythrocytes and the positively charged chitosan forms an adherent gel, which tamponades the wound, but also accelerates the wound healing process by stimulating inflammatory cells, macrophages, and fibroblasts.
- Celox Gauze is also chitosan-based and shares the same mechanism of action. Although chitosan is derived from Chitin, which is found naturally in crustacean exoskeletons, it will not cause an allergic reaction in casualties with a shellfish allergy.

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.