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ORANGE COUNTY SHERIFF'S OFFICE TRAINING BULLETIN Effective Date: October 20, 2017  Amends - TB 13 -1 (December 13, 2013) Number: 13-1 Distribution: All Personnel Review Month: March Reviewing Authority: HRD / Training Subject: Celox™ – Rapid -Hemostatic Z -Fold Gauze The purpose of this training bulletin is to provide guidelines for the proper use of the issued Celox™ – Rapid -Hemostatic Z -Fold Gauze. Celox™ Rapid gauze is treatment for life - threatening bleeding. Celox™ granules are very hig h surface area flakes. When they come in contact with blood, Celox™ swells, gels, and sticks together to make a gel like clot, without generating any heat. It works independently of the body’s normal clotting mechanism, works in hypothermic conditions and clots blood containing the blood -thinning drug heparin. Celox™ Rapid Gauze is suitable for wound packing :  Severe high pressure bleeding  Arterial and venous bleeding  Bullet, blast, knife and shrapnel wounds Do not use Celox™ Rapid gauze in the following l ocations:  Open head wounds where the skull is or may be penetrated  Mouth, nose, or any other portion of an airway  Eyes How to use: 1. Tear open pack, remove the Celox™ Rapid gauze, and hold one end of the gauze. 2. Tightly pack the unfolding Celox ™ directly t o the source of the bleeding. Pack remaining wound cavity with Celox™ or standard gauze. Excess Celox™ can be torn or cut if necessary. 3. Apply FIRM pressure directly to the wound for a least one minute or until bleeding stops. 4. For major bleeding, full com pression for three minutes is required. This gives the Celox™ gel plug time to form and strengthen to hold back major bleeding. 5. Wrap and secure in place with a bandage so as to maintain pressure on the wound and to contain Celox™ within the wound . 6. Discard any remaining Celox™. 13-1, Page 2 of 3 7. Transfer patient to medical facility as soon as possible. 8. Show empty pack to medical personnel. 13-1, Page 3 of 3