One of the more common medical emergencies at sea is bleeding. Bleeding can be caused by many things but the most common causes at sea are fish hooks, knives, deck equipment, punctures, fish bites and broken glass (think broken beer bottle).
External bleeding is one of the most easily recognizable medical emergencies but it is often the one that makes people feel the queasiest. On occasion, even people who are OK seeing another person’s blood may not be OK at the sight of their own blood and may require medical assistance.
Let’s start at the beginning. The average adult has between five and six quarts of blood in their body. Most people can lose a small amount of blood with no problem. However, losing a quart or more in a short period of time could lead to shock or even death. Blood loss is responsible for about 40 percent of the deaths following traumatic injury.
When blood is visible, begin by determining the source of the wound. After locating the wound, place a sterile bandage or cloth on it and apply pressure until the bleeding stops. If the victim is able to hold the bandage in place, let them. If not, the person rendering aid should help only after putting on personal protective equipment (PPE) such as medical exam gloves and safety glasses. As much as possible, avoid direct contact with another person’s bodily fluids, especially blood as blood has the potential to transmit HIV or Hepatitis C.
If after applying a bandage and pressure the wound is still bleeding, apply more bandages and more pressure. Repeat the process several times if necessary. Do not open the bandage to look at the wound. This could disturb the blood clotting, which will tear open the wound and start the bleeding all over again.
I recently purchased an Israeli emergency bandage for the first aid kits in my car, home and boat. The Emergency Bandage made by First Care is easy to use and is now part of my onboard CPR AED First Aid classes. These bandages cost about $6 each, have a long shelf life, are vacuum sealed to stay airtight and watertight, and take up little space. These are much easier and faster to use then gauze 4x4s and medical tape. Plus they can be easily made tight or loose as needed. Check out the many YouTube videos online to see how fast and easy they are to use. The Emergency Bandages can also be used as a type of tourniquet or a splint.
Hemostatic agents also can provide temporary control of life-threatening external bleeding by speeding up the body’s natural clotting process. Any first-aid supply store will offer hemostatic agents such as Celox, HemCon and QuickClot. These can be especially useful when an injury is located in an area where a tourniquet is not effective or possible, such as the shoulder, torso or pelvis. With proper training, these could be a useful item in the yacht’s first aid kit.
A panel of experts in prehospital trauma care convened by the American College of Surgeons recommended the prehospital use of topical hemostatic agents in conjunction with direct pressure for controlling hemorrhage in injuries where direct pressure alone is ineffective or not practical. Although not endorsing the use of a specific hemostatic product, the panel recommended that responders select a product with demonstrated efficacy that is available in bandage form versus the powder form.
Finally, let’s talk about tourniquets. A tourniquet is a constricting band used to control bleeding to an arm or leg. As the tourniquet is tightened, it applies pressure to cut off the blood flow. Please note that a tourniquet should be used only as a last resort, only when direct pressure over the wound and all other methods have failed to control the bleeding. The reason is because a tourniquet left in place too long will kill the tissue and most likely lead to amputation of the limb. Only use a tourniquet if the bleeding cannot be stopped and the person will die without it. Loss of limb is better than loss of life.
Now, think about what would happen if someone were injured onboard, bleeding badly. Have all the crew recently had their first aid training? Ideally all should go through a refresher class at least every two years. Has the first aid kit been checked recently? Does it have enough bandages, medical exam gloves and goggles? What about the rest of the first aid supplies and equipment? Is everything up to date and easy to access quickly? Time is critical with most medical emergencies, so prepare today to be ready tomorrow.
Trained as an emergency medical technician, Keith Murray now owns The CPR School, which provides onboard CPR, AED and first-aid training as well as AED sales and service (www.TheCPRSchool.com). Comments are welcome at firstname.lastname@example.org.