Doctor’s ‘brilliant’ new first aid technique can stem blood loss after shark attack
An emergency department doctor says he has developed a simple new way to help save the lives of shark attack victims in the crucial moments after a bite.
The technique is described in a paper published today in the journal of Emergency Medicine Australasia and works by closing off the femoral artery to prevent a person from rapidly bleeding out.
Applying the technique relies on a second person making a fist and pressing it into a person’s groin at the central point between the hip bone and the genitals.
From there they only need to lock their arm straight and use their bodyweight to apply pressure until blood flow from the wound stops.
Following these steps then buys the victim time while help can be sought.
Dr Nicholas Taylor, Associate Dean of the ANU Medical School, surfer and lead author on the study said he began to develop the idea after a family holiday to Western Australia at a time when there had been a spate of shark attacks.
“I was looking for a few ways to make myself a bit more shark proof,” he says.
After speaking to surf life savers and surfers he found most would instinctually react to a shark bite wound by placing direct pressure on it or attempting to make a tourniquet from material they had on hand.
Dr Taylor said his emergency room training told him that this would be a mistake.
“A shark bite is a terrible sawing motion and putting pressure on it wouldn’t work,” he said. “And it would be great if every surfer carried a tourniquet, but it isn’t going to happen.”
A better solution, he thought, would be to cut the blood flow from the femoral artery as taught in medical schools and performed in emergency departments.
To test the effectiveness of the technique, Dr Taylor helped organise a study of 34 healthy volunteers. While the sample size was small, it was more than double the 16 participants a pilot study recommended was required for it to be statistically significant.
Participants were given no prior training or instruction in how to apply the manoeuvre before attempting it, and the results were compared to the effects from using a makeshift tourniquet from surfboard leg rope.
Closing off the femoral artery stopped all blood flow to the leg in three out of four participants while using the tourniquet reduced blood flow by 43.8%. An ultrasound was used to gauge the rate of blood flow through the artery and into the limb.
The researchers also tested whether a wetsuit might make it more difficult but found it made no difference.
Now Dr Taylor says he wants to see the technique incorporated into first aid training – and to help he has developed a mnemonic for remembering the process: “push hard between the hip and the bits”.
However, for that to happen it would first need to be endorsed by the Australian Resuscitation Council and incorporated into their guidelines for managing bleeding wounds.
Dr Anthony Brown, a professor of emergency medicine at the University of Queensland who was not involved in the study said the novel approach was “brilliant” and should be considered for inclusion in first aid training programs, particularly for surf-life saving and the surfing community at large.
“It’s a fantastic life-saving idea. Nothing else helps,” Dr Brown said. “By the time you need to give mouth-tomouth or CPR during a shark attack, it’s too late. It means the person has exsanguinated [drained of blood].”
Compared to applying pressure on the wound itself, Dr Brown said that
this technique would be more effective as it would avoid potentially re-opening arteries that may have closed off by spasm.
“Your sole priority needs to be to stop the bleeding and wait for help,” he said. “You’re a bit buggered if you’re the only one there, but generally speaking there is someone else there to help. Nobody surfs alone.”