A case series describing thermal injury resulting from zeolite use for hemorrhage control in combat operations

Four cases are presented to illustrate cutaneous burns sustained with the use of zeolite in the treatment of major hemorrhage secondary to combat wounds. Zeolite, a microporous crystalline aluminosilicate granular hemostatic agent, can cause secondary thermal injuries through an exothermic reaction that is likely related to the absorption of free fluid at the hemorrhage site. Understanding of this process may help both military and civilian EMS personnel avoid or minimize secondary thermal injury while still benefiting from zeolite's hemostatic capabilities.