Another shark attack , Troncones

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No leash ,no trunks,no wettie(what the heck are you DOING out in public ???)

Here in Cali. there’s usually loads of kelp around…I bet that would make a nice turnnie.

True…but would a knot hold in kelp? Slippery stuff. Besides, anybody who’s going that far on the ‘back to nature’ riff - y’know, they’d prolly welcome a chance to be part of the food chain.

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A turnnie can cause some major probs…I was taught 15min. max on a turnnie…but that might have changed by now.

That’s what they taught me too - best to loosen it some now and again so you don’t kill the limb. And like you mentioned, major arteries are gonna be a problem.

Really, that’s why this quikclot stuff struck me as something good. Especially for something like what got this guy, major wounds that , say, one direct pressure ( or pinching off the artery at a pressure point ) really wouldn’t do much for. Best of all, it’s something that’s unlikely to do any real harm if it was used in a situation where it wasn’t really called for.

As Ryan mentioned and Herb alludes to - a tourniquet is a Last Resort, when maybe losing the limb is figured against almost certainly losing the victim. You hear how starting CPR immediately is good, on account of how a very few minutes without oxygen makes your brain damaged? Think of how it’d affect meat. And nerve tissue. That’s what these things do.

For that matter, a longer quote, from http://en.wikipedia.org/wiki/Emergency_bleeding_control#Tourniquet :

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Another method of achieving constriction of the supplying artery is via the use of a tourniquet - a tightly tied band which goes around a limb to restrict blood flow. Tourniquets are routinely used in order to bring veins to the surface for cannulation, although their use in emergency medicine is more limited, and is restricted in most countries (with France being a notable exception) to professionals such as physicians and paramedics, as this is often considered beyond the reach of first aid and those acting in good faith as a good samaritan. A key exception is the military, where many armies carry a tourniquet as part of their personal first aid kit. Most Police in Australia are also authorised to apply a tourniquet to bleeding victims, which is often the case if they arrive onsite before ambulance personnel do. This is reflective of the higher chance of receiving massive trauma (such as amputation) and the increased time involved in reaching definitive care.

Improvised tourniquets, however, usually fail to achieve force enough to compress the arteries of the limb and thus do not only fail to stop arterial bleeding but actually increase bleeding due to the impaired venous bloodflow. Some argue that tourniquets should never be used in the pre-hospital setting, not even for amputations. Evidence from mine-infested areas also show a higher mortality for mine victims treated with tourniquets pre-hospital. An emergency tourniquet should in any case never be applied to the forearm or lower leg since the arteries in these locations run between bones and can not be compressed.

(Italics mine) I’ll also note that there was a time ( late '40s, early '50s?) when there were a lot of them used, mostly when they didn’t need to be. Which meant some people lost limbs that they didn’t have to lose.

Amputation-TraumaticAlso, from the NIH, an article on is interesting in respect to this.

But to get back to basics;

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There’s not enough of this info. out in the general public and it needs to be.

Absolutely! And there’s lots of first aid courses out there, I can’t reccommend 'em too strongly. And after all, the life ya save might be mine.

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Doc’s King here,

Not at all, I just put in a little time as a fireman and tried to keep up with it all. On the other hand, you’ve had to do it for-real…

doc…

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Plus,a turnnie won’t work on a Femoral artery that has been severed.

That’s because the artery retracts up into the pelvis…not much good a turnnie will do for you there.

Yuck! I’ve talked to medics who tell stories of reaching into limbs to pull major vessels out so they can clamp them. I suppose if the vessel is severed far enough out, you could get pressure closer to the body to help but every situation is different.

Wow. That scenario is so major and foreign to most of us it’s hard to even imagine having to deal with something like that. There was a good Holywood example of that in Blackhawk Down where the guy has a bad wound at the top of his thigh and the medic couldn’t get to the femoral artery because it retracted. Sorry, that was a greusome scene. Way too real.

It is good for people to have a basic idea of how to deal with injuries. Some basic principles can really help. Red Cross offers all sorts of classes for a good price. Then some places like REI can get you hooked up with wilderness medicine and things like that.

I’m not surfing with a tourniquet either. But I think that brand recommended might have a place in some first aid kits. As does that clotting agent Doc mentioned. That stuff is miraculous.

The thinking on tourniquets for many years was that they do more harm than good but people are seeing that in certain grave situations they may be the only means of survival. Better to lose a leg than your life. I’m not up on current technique but I do know they aren’t wound as tightly as you might think.

AJ Heightman is an EMT. He saw this stuff everyday and so he might be one extreme. Some firefighters won’t sleep above a second story because they’ve run into burning high rises and lost friends to them. Seems paranoid to some but it’s what they do for a living. If AJ surfed, he’d probably have an IV and oxygen with him too! With RESCUE emblazoned on the back of his wettie!

I’m glad there are people like that out there. And like Herb said, more people should be aware. I’m definitely taking a closer look at my first aid kit this weekend. Great thread!

C

Nothing like giving Rescue breaths , only to have the victim PROJECTILE Vomit in …well you get the picture…ya…it’s happened to me.

Thank God it was along time ago and the contents was basically saltwater !..yuk.

Now days, If you plan on giving CPR/RESCUE BREATHS…there’s several types of oneway valve masks that are available to the public.

I carry one on my key chain and one in the visor of my car.

I am a active licenced California Nurse and am required to give EMS at the site of any accident/victim I come upon,until help arrives…That’s by law.

I’m also licened in ACLS and carry a electronic defib machine…

Can you say, “CLEAR !”.

Please, if you read this thread, look into some info on firstaid/life support…like Doc says the life you could save might be his!

If you think this is deep into the subject,No…we’ve just cut the surface,my friends.

H

Ohhh yeah. No fun finding out if somebody chews thoroughly.

A little additional on a few things Herb mentioned:

http://www.cpr-savers.com/Industrials/Cpr%20prod/cprkeychain.html - the keychain version.

Also, an option on Birdwell Beach Britches is a little pocket with Velcro closure that was designed for lifeguards to carry the mask in.

The Good Samaratin laws vary a little from state to state ( US, I dunno about elsewhere ) but health professionals are both required to assist and held to a higher standard of assistance than somebody ‘just off the street’.

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If you think this is deep into the subject,No…we’ve just cut the surface,my friends.

As an illustration of that, if you’ve been following this then you’ll remember Herb mentioning defibrillating a heart with the recoil from a shotgun.

That’s not an instance ‘dumb luck - it worked’, that’s a demonstration of some pretty deep knowledge of how the process works, the forces involved, the anatomy and more -way beyond what I know, by the way - using what was available 'cos there wasn’t an alternative.

If you’ve got an interest in this stuff, you can go on learning more and learning updated information and techniques forever. And it is fascinating stuff.

Plus the opportunity to really help somebody when they need it.

Which could well be me. Or somebody you really, really care about.

doc…

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If you’ve got an interest in this stuff, you can go on learning more and learning updated information and techniques forever. And it is fascinating stuff.

Plus the opportunity to really help somebody when they need it.

Which could well be me. Or somebody you really, really care about.

And if you really don’t care about other people, having any level of this type of skill and knowledge can help yourself. Very few people are infallible and perfect. If you mountain-bike your ass off a trail and down a gully and break your leg and your cell phone breaks too, it helps to know what to do to get stabilized and help yourself back into the world.

And if you are certified (and maintain them) in first aid and cpr and lifesaving you will help yourself by putting that on job applications. Accidents in factories and heart attacks in the offices…they happen, and it’s a fright how businesses respond in this Era of the Zombie. Not to mention the general situation in modern hospitals where budget is king and staffing issues breed discontent.

Nels

just a note from dream land,

unfortunate circumstances

do indeed crop up

and as many trained

aid givers as there may be

in attendence and absent

the crowd of bystanders

and others remaining

truely positive to the core

wishing others well

especially the injured

can turn the marginal

proceedure’s outcome

into an unqualified success.

Toki was in a car wreck

the guy that was talking to

him stuck in the wreck

was baron von lunchmeats

Toki survived to a ripe old age.

whenever you mentioned lunchmeat

to toki the bond remained

one version of the story was that the

para’s gave up on him

but lunchmeat kept chatting him up.

Lunchmeats conversational

skills and excesses

have proven valuable

in history.

…ambrose…

praise to apparatus

yet all in the vacinity

play a part

trained

and untrained

be there .

where never was heard

a discouraging word

and the skies were not cloudy all day.

That ambrose…such a classic

I might have to drive all the way up to that Swayholic’s deal just so I can shake your hand.

You’re crazy.

In the right way.

Keep it coming.

Sometimes an act of blind, luck, fear…

…Can look like an act of skilled,bravery.

H

Yeah ambrose… that was the first thing I thought about the day I read of the Trocones attack… just read my blog…

Also, they’d have to measure the bite radius and tooth patterns in both victims… unless the “wolf-pack” theory of more than one attacker comes into play here.

Great thread on application of tourniquets. The Global War on Terror and the advent of Tactical Combat Casualty Care (since 1996) has dispelled many of the myths concerning tourniquet usage. There has been an incredible amount of studies done since 2001 to present, and a libral use of tourniquets within our military. The CAT is the number one recommended Tourniquet for out of hospital use, and no documented cases of perminent morbidity or limb loss as a result of tourniquet use when it is left on for under two hours. Reference Journal of Trauma, Feb. Supplement 2008; “[=1]No association was seen between tourniquet time and morbidity. There was no apparent association of total tourniquet time and morbidity (clots, myonecrosis, rigor, pain, palsies, renal failure, amputation, and fasciotomy). No amputations resulted solely from tourniquet use.” "[ 1]Morbidity risk was low, and there was a positive risk benefit ratio in light of the survival benefit. No limbs were lost because of tourniquet use, and tourniquet duration was not associated with increased morbidity. Education for early military tourniquet use should continue."[/][/]

[=1][ 1][/][/]

[=1][ 1]"[ 2]Improvised tourniquets were ineffective 67% of the time (10 of 15 limbs, 15 patients, 16 tourniquets) with 10 morbidities (6 amputation injuries, 3 fasciotomies, 1 palsy), and seven limbs continued to bleed. The wider improvised tourniquets (cravats and windlass type,especially when two were used side by side) were effective in 42% (3 of 7) of limbs, whereas the narrower ones (strings, i.v. tubing) were effective in 25% (2 of 8) of limbs. The mortality rate in patients with improvised tourniquets was 0% (0 of 15), and the amputation rate was 40% (6 of 15, all 6 were traumatic amputations). Tourniquet ineffectiveness, (visible bleeding or distal pulse remained), and morbidities corresponded. Eighty three of 309 (29%) limbs were still bleeding upon presentation or had a persistent distal pulse, and 10 patients were pulseless and receiving chest compressions on arrival and stopped bleeding prehospital after they had exsanguinated…Effectiveness: Combat Application Tourniquet Was the Best Prehospital Tourniquet"[/][/][/]

[=1][ 1][ 2][/][/][/]

[=1][ 1][ 2]All in all, many pre hospital textbooks (EMT and Paramedic), are changing their views on tourniquets because the negative results do not exist (reference PHTLS and ITLS), when using commercially available tourniquets. [/][/][/][=1][ 1][ 2]If you leave the tourniquet on for under four hours (+ a few hours) you are not going to lose your limb because of the tourniquet. From the above studies trying to improvise a tourniquet is not easy or that effective. There are only two tourniquets that met DOD standards for a self applied tourniquet per the Institute of Surgical Research - The CAT and SOFT T, which stopped lower and upper extremity bleeding 100%. For the purposes of outdoor/adventure/surfing use, the CAT is the only one that doen’t have metal / mechanical parts to deteriorate with salt water, and has the smallest cubic footprint.[/][/][/]

[=1][ 1][ 2][/][/][/]

[=1][ 1][ 2]When discussing hemostatic agents like quickclot, hemcon, combat gauze etc., be careful of what you choose, and know the limitations and proper use. When utilizing these (and other) agents on live tissue models, they are labor intensive and require technique for efficacy. [/][/][/]

[=1][ 1][ 2] [/][/][/]

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speaking of attacks-most recent up off lompoc and almost one right in front of my eyes.(well, almost). couple days back, late afternoon two friends were circled several times by a good sized shark at a spot somewhere between c-street and rincon.about two months ago the wife and i got chased out of the water at same spot by something large,grey and circling around the line up.scetchy stuff for such a place.