Bites and Attacks A medical guide to handling interactions with marine creatures By Joseph Becker, M.D., and Paul Auerbach, M.D., M.S. Part 4 (This article has been re-formated to fit our Facebook page format.) Care of the Bite/Attack Victim If the unavoidable (or totally unexpected) occurs, traumatic injuries caused by marine life can present challenges both to immediate and longer-term medical management. Shark attacks in particular can result in significant trauma and substantial blood loss. Initial focus should be on providing basic life support as necessary, followed by stabilizing the patient for transport to definitive emergency care. Begin by assisting the victim out of the water. Apply direct pressure to any bleeding sites as quickly as possible. A barrier such as a cloth or gauze pads may be helpful, and gloves should absolutely be worn whenever possible to protect against bloodborne disease. Do not release pressure to check on the wound for at least 10 minutes, and if a bandage soaks through with blood, place another directly on top of it and continue to hold pressure. If the injured area is on an extremity, elevate the body part above the level of the heart. It is important not to apply bandages in a fashion that restricts circulation beyond the dressing. The tips of fingers and toes should be pink, not pale or purple. Almost all bleeding will stop with sustained direct pressure and immobilization; however, some wounds, particularly those involving amputation or damage to large blood vessels, may bleed uncontrollably. In these cases, a tourniquet should be considered. It is highly recommended that you have training in applying tourniquets before attempting to do so, as tourniquets are potentially hazardous interventions that risk loss of limb. Nearly anything may be used as a tourniquet: a length of rope, cord or webbing, but it must be well-padded to reduce the risk of severe local tissue injury. Apply the tourniquet between the heart and the injury as close to the bleeding site as possible. Tighten it only until bleeding is controlled. Loosen tourniquets for a moment every 10 to 15 minutes to assess whether they are still necessary for bleeding control. If the bleeding is brisk, retighten the device. If bleeding has ceased to the degree it can be readily controlled by direct pressure, remove the tourniquet and apply direct pressure, though keep the tourniquet handy in case it needs to be reapplied. To be continued... From Alert Diver Online Website.
Posted on: Sun, 18 Aug 2013 04:25:49 +0000