October 29, 2008
My good friend Capt. Rob and I were recently having a couple of beers and discussing common medical emergencies that happen at sea. One of the more common is bleeding. Bleeding can be caused by many things but the most common causes at sea are fish hooks, knives, deck equipment, punctures and fish bites.
External bleeding is one of the easiest medical emergencies to recognize but it is often the one that makes people feel the worst. 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.
The average adult has five to six quarts of blood in the body. Most people can lose a small amount of blood with no problem. If you lose a quart or more in a short period of time, it could lead to shock or even death.
When you see blood, you need to determine the source of the wound. After you locate 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 do this. If not, offer help after you put on medical exam gloves. You want to avoid direct contact with another person’s bodily fluids, especially blood. In addition to medical exam gloves, eye protection is recommended.
If after applying pressure the wound is still bleeding, apply more bandages and more pressure. Repeat the process several times. If several attempts have failed and the bleeding is still severe, elevate the wound above the victim’s heart to slow down the bleeding. Do not open the bandage to look at the wound. This could disturb the blood clotting process, which will tear open the wound and start the bleeding all over again.
If after more pressure, more bandages and elevation the wound is still bleeding, apply pressure to the nearest major pressure point. Pressure points are located on either the inside of the upper arm between the shoulder and elbow or in the groin area where the leg joins the body. Direct pressure should be your first choice because it only stops blood circulation at the wound. Pressure points can affect the blood flow to the entire limb.
Let’s talk about tourniquets. A tourniquet is a constricting band used to control bleeding to an arm or leg. 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 if you restrict blood too long, tissue begins to die and is likely to lead to amputation of the limb. You should only use a tourniquet if the bleeding can’t be stopped. Loss of blood will, of course, kill a person. Loss of limb is better than loss of life.
If you look at a first aid catalog you will find one or more hemostatic agents listed, such as Celox, HemCon and QuickClot. These products are designed to treat battlefield injuries where blood loss causes 90 percent of the fatalities. These hemostatic agents can provide temporary control of life-threatening external bleeding by speeding up a person’s natural clotting process. Hemostatic agents can be especially useful when an injury is located in an area where a tourniquet is not effective or possible, such as the shoulders, torso or pelvis. With proper training, these could be useful in your first aid kit.
Think about what would happen if someone were injured, bleeding badly and you had to help. Have you had first aid training recently? When was the last time you checked your first aid kit? Do you have enough bandages? Medical exam gloves? Goggles? What about the rest of the supplies? Is everything up to date and easy to access quickly? Time is critical with most emergencies, so plan to be ready.
Consider taking a CPR, AED and first aid class on your vessel. Shipboard classes are helpful because it allows the crew to develop plans, review first aid supplies, and talk about emergencies as they relate specifically to your vessel, crew, passengers and ports of call.
Keith Murray, a former Florida firefighter EMT, is the owner of The CPR School, a mobile training company that provides CPR, AED and first aid training. He also sells and services automated external defibrillators. Contact him at +1-561-762-0500 or keith@theCPRschool.com . Comments on this column are welcome at editorial@the-triton.com .
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