y’know, if I was going to be surfing someplace remote, sharks or no sharks, I might bring along some of this:
http://www.z-medica.com/quikclot/index.asp
I’m neither a medical guy nor a first responder/paramedic, but the stuff seems to be relatively easy and simple to use on really major wounds with really major blood loss where bleeding to death is a probability and direct pressure hasn’t worked or can’t work, as in the case of this guy who died in Mexico.
It’s over-the-counter in the US. Maybe not at your pharmacy, but REI carries it.
Stay safe, y’know?
doc…
you are a steady stream of useful information, sir.
Not all that steady, and frequently useless.
What this little bit progresses from is several things.
To begin with, in the '70s I was a volunteer fireman, which got me started and gave me a vague knowledge of the subject. At the time, I had a roommate who was going through one of the very first firefighter/paramedic programs in the US, so I picked up a little more. Especially when they practiced starting IVs…on me. We’re a half hour by ambulance from the nearest emergency room if the traffic’s not bad - in summer you can double that, so the Robert Wood Johnson foundation funded this experimental program to train paramedics to keep people alive on the ride.
Then, commercial fishing. If somebody gets hurt out there, well, it’s a minimum of several hours before anybody can get there do do something by helicopter, and sometimes it’s longer. And then ya gotta get back. If it’s a really stupid thing, like doing something dumb around a winch hauling back heavy wire, that’s not gonna cut it. Limbs converted to ground round are like that. Kept up my interest in the subject, as it were.
Considerably later - I was on a little surf expedition with about a dozen friends. One of them was a very, very brave man, an ER/trauma surgeon. He was brave 'cos if one of us got hurt, he could patch us up…and did…but if he got hurt, the next guy was me.
The island was remote; around a half hour by boat to the mainland, if the tide was right and lots longer if it wasn’t, plus a ride over bad roads to a small Navy base which may have had something like what the US Navy calls an ‘independant duty corpsman’…and it may not.
An independant duty corpsman, like a special forces medic, can pretty much deal with anything that doesn’t involve opening the cranium, or so I’m told. But a third world Navy medic may well not be anywhere’s near that standard.I never had to find out. The nearest major hospital? Hours away by road, helicopter evac even chancier than out offshore.
So, stabilizing somebody who got hurt, good enough so they could get to that big, good hospital - that’s a subject that was of considerable interest. Still is.
And, reading that the guy in Mexico got major leg lacerations, prolly did in the femoral artery, too far from trained help, that rang a bell. Shooting the breeze with an ER guy not long ago, I think he mentioned QuikClot, and I had been reading about it in use with military trauma treatment. Like guys who get arms blown off - as close to a shark attack as it gets. Or getting an arm torn off in a winch, or getting a leg chewed up by a propeller.
I figured it was available to paramedics and emergency rooms and the like, but looking it up online today I was surprised to see that it’s available to the general public through outlets like REI, and available there in a form that’s very user friendly, including marginally-trained-user-friendly: a surgical sponge impregnated with the stuff.
It’d be difficult to misuse it in that form…the powder form might be more problematic… and kill somebody with it unless you stuffed it down their throat, it even comes in a surgical sponge form with a silver compound added to have an anti-bacterial action, if you had to stuff some in and cover the wound and then travel some distance to a medic without doing a really good job of cleaning up said wound… which is and should be a concern in tropical areas like many out of the way surf destinations. Nasty bacteria in the tropics.
Stuff has a three year shelf life ( kept sealed, out of direct sun, that is ), it’s sterile in and of itself, is unlikely to cause allergic reactions ( and if it’s maybe that or bleeding to death for sure, that’s an easy choice ) - and it’s even fairly cheap.
I may have to throw a little in my boat kit for use around here…which is at least half an hour from the nearest emergency room… 'cos it might keep me alive and conscious long enough to get a boat to the pier if I manage to ding myself fairly good. I work alone out fishing these days.
So, that’s how all that came together. Basicly, a whole lot of years of directed curiosity and self interest:
no big thing, really.
doc…
…same shark…
I am thinking about that…
…ambrose…
Interesting you say that, this was in today’s OC Register and it makes some sense…
As the Newport Beach lifeguards towed the blue whale carcass out to sea, they would slow the boat to make sure the great white shark followed.
It would be a quarter mile behind the whale – and within seconds, it was hitting the whale.
“It did this throughout the early evening. An almost full moon let us see the sharks after dark,” recalled Brent Jacobsen, who was on the boat.
As you’ve probably heard by now, a man was killed last week just south of Orange County in Solana Beach by a great white as he trained with a group of other swimmers for a triathlon.
First let me say – my deepest condolences to Dr. David Martin’s family. I couldn’t imagine what they’re going through with their loss.
There’s been a lot of talk lately about great whites off our shore here in Orange County, with a handful of sightings being reported in the past few months. One guy from Manhattan Beach said his surfboard got nailed by one at Dog Beach in Huntington, and an expert confirmed that it was indeed a great white that bit into it.
The recent shark attack also sparked memories of the 2002 sharks that came to feed on the dead whale. Jacobsen said he was just a few feet from the shark as he snapped the photos. One thing is for sure - I would have been freaking out. Here’s how he described it:
“The blue whale corpse was found at the Newport Harbor Sea buoy, located about 300 yards off the end of the West Jetty (The Wedge Jetty). Several sharks were eating the whale. The biggest was a great white that was more than 15 feet long. The great white was between half and two thirds the length of the 30-foot lifeguard boat. We towed the whale corpse south, toward the 14-mile bank. At about 1 a.m. the whale was set adrift with several sharks still eating the corpse. The next day we found the whale with several sharks eating it. Eventually, the whale drifted to shore. We believe it is the same whale that was buried at San Onofre State Beach.”
According to stories, the great whites hung out in San Onofre for a while – one of them even nicknamed “fluffy.”
Sean Collins, chief forecaster of Surfline.com, remembers the sharks down at San Onfore.
“These white sharks eating the whale off Newport in 2002 obviously followed it to San Onofre where it was buried. But the whale oil in the water even after it was buried continued for months afterward, ruining many surfers’ wetsuits. There continued to be multiple white shark sightings at the whale’s buried location in San Onofre for more than a year after it was buried, as well as new white shark pups in the area. Another pup was just sighted less than a month ago in the same area.”
I’m no expert, but it’s about this point that I’m going to mention that a few whales have been buried recently in Huntington Beach. The first one was a 50-footer at Brookhurst Street in October, and the latest one was buried, a 15-footer, was buried at Beach Street in March.
I’ll let you decide whether the recent Huntington reports are connected to the whale burials. See you in Newport!
eh, What’s “burying” a shark all about? I never heard of that before. what’s it cheaper that towing it out to sea?
They buried the whale not the shark.
Instead of sinking at sea the whale washed back up onto the beach and was buried.
At least they didn’t try to eliminate it with explosives…
I was there last month and there is a small town, you don’t feel like it is totally remote. They have a few taxi cabs for the town if you don’t have a car rental. My understanding is this did not occur at the point at Manzanillo Bay but at the beach near the main town of Troncones. He was staying at Mi Casa Su Casa which is near the bridge when you come into town. Crazy they couldn’t get him to a hospital 30 minutes away in time. I guess you need to know what to do in an emergency. More common is they type of accident where you split your head open and need stitches.
Wow, doc - thanks for the link. I never even knew that product existed and will never take another trip without it.
As for the time it took to get to the hospital - it’s Mexico. Plus, I believe the closest hospital is either about one hour south toward Ixtapa or two hours plus north to Lazaro. Unfortunately, you’re on your own.
In multi-type wounds that are gross is frank red blood(hemorage).
I doubt that quick clot would help much,topically.
Even sulphas won’t clot major hemoraging wounds.(Hemorage = 450cc’s or more of frank red blood loss in a minute.That’s equal to a continual pouring out a full can of coke).
If you want something quick and cheap to use try sugar in a salt water base.The sugar will increase the osmotic pressure ,especially around the wound…
…oh ya…you’ll need to give that … I.V.
So,a I.V. kit will be needed.
There’s some other tricks to survival I’ve learned like using spiderwebbing to clot wounds or using gunpowder as well.
H
I guess you need to know what to do in an emergency.
Couldn’t agree more and here’s a little help in that direction:
http://www.redcross.org.au/ourservices_acrossaustralia_firstaid_default.htm
http://www.redcross.org.uk/TLC.asp?id=76599
http://www.redcross.ca/article.asp?id=000620&tid=021
http://www.redcross.org/services/hss/courses/
more available: http://en.wikipedia.org/wiki/List_of_Red_Cross_and_Red_Crescent_Societies
http://www.ifrc.org/publicat/profile/ (profiles in depth of national societies )
Including; http://www.panama.cruzroja.org/cr-programas.html
Also, many schools, universities , fire departments and hospitals offer courses. It doesn’t take long, it’s not very expensive, and who knows, you might keep somebody from dying or something…
doc…
I know this is a serious topic, which I fully appreciate since I used to be an EMT, but as I was reading the posts I was struck once again my afoaf’s avatar.
Am I the only one that gets a minor cring when they scroll through and catch that glimpse?
Sorry. I digress.
Hi Herb -
No doubt IV fluids are going to help in a big way.
I got on the website and clicked around. Early pre-clinical studies on pigs reveal that even with completely divided Femoral Arteries and Veins, they were able to stop the bleeding.
http://www.z-medica.com/newsroom/zmedica_articles_details.asp?articleID=5
Other similar products:
http://www.sammedical.com/celox.html
A good first aid kit and knowing what to do with it is always a good plan when traveling.
Great points Doc. You’re a wise man to realize the seriousness of the situations you wind up in. A “real emergency” aid kit doesn’t consist of bandaid’s, white tape and a gauze pad. Scrapes don’t kill people.
Some other good things to have for serious stuff:
large gauze packed in milar so you can tape the wrapper as an occlusive dressing in the case of a sucking chest wound.
Activated charcoal in case of accidental poisoning. Syrup of Ipecac incase you know vomiting is safe like with med’s or food.
Oropharyngeal airway. Small and simple for use with swollen tongue or crushed jaw. Especially if unconscious.
Space blanket for shock.
Benadryl for allergic reactions. Might slow onset of anaphylactic shock.
This is just to name a few small things that can make a real difference in critical situations. These can all fit in a small box or pouch. A lot of other stuff like tourniquets and splints can be improvised. Then there’s the typical bandages and tapes to fill it out.
I need to update my kit. My good one got stolen when my car got broken into.
Oh yeah. I kinda divide things into two categories: stuff I can fix myself and continue and stuff that needs to be dealt with by somebody with real training and equipment.
I’d add ( if I was packing a kit for several people on a remote trip ) a few things
an epi-pen, self administerable epinephrine injector for bad allergic reactions and anaphalactic shock.
For minor allergic reactions, benadryl is very useful - and lots of little water creatures sting. As it happens, I’m very allergic to some of them. Likewise, it helps with sun poisoning.
Benadryl is also a good sedative.
Broad spectrum antibiotics and some sort of ‘liquid cork’ to prevent dehydration if there’s a bad stomach bug or major food poisoning. Gatorade powder or similar , mix with water to prevent dehydration and/or heatstroke.
Steri-strips and tincture of benzoin ( makes bandages and such stick better ) or suture kit with lidocaine and a small syringe if you know how to use it. Plus betadine ( topical anti-infection stuff ) plus hydrogen peroxide ( same ) and antibiotic ointment - I like a little of all three on coral cuts and the like in hot climates.
Lots more besides that, of course. Plus training. A good reference is Advanced First Aid Afloat by Peter Eastman, MD. But read it before you need it, y’know? It’s kinda hard to concentrate on reading the index with somebody screaming - it’s really annoying.
doc…
Oh ya,
A quickject of atropine is a good thing to have in the bush !
Nice to see this kind of info. passed on here.
We all love our funstuff-times,but sometimes w/ fun comes tragedy.
Knowledge,skill and keeping your wits about you will keep you and yours alive…it has for me… many times over.
H
Did your homework I see John,
Good on you my man !
I.V.'s are King for most life saving appt.'s.
Heck,back in the days…I even de-fibbed a heart w/ a shotgun.
The govt. trained me very well.
After they SPENT LOTS OF $$$$$ teaching me how to kill …
…They spent lots of $$$$$ teaching me how to survive.
H
Hi Herb -
“Heck,back in the days…I even de-fibbed a heart w/ a shotgun.”
I couldn’t find anything on that one but I believe you brotha.
Hi Herb -
“Heck,back in the days…I even de-fibbed a heart w/ a shotgun.”
I couldn’t find anything on that one but I believe you brotha.
I’m guessing fired with the butt on the sternum using recoil as a serious chest thump to disrupt the fibrillation. That’s just a guess. I’m sure Herb will fill us in. Serious stuff though.