Surfing and Improvised Tourniquets

April 22, 2018 0 Comments

Surfing and Improvised Tourniquets

Emergency Tourniquet Defined:

A device for stopping the flow of blood through a vein or artery, by encircling a limb with wide, flat, strong webbing that incorporates a mechanical advantage mechanism to compress a limb to stop bleeding.

Surfers and First Aid equipment have historically been at odds.

This relationship can be attributed to surfing's inherently risky nature. In order to surf, surfers are required to embrace a certain amount of risk in order to reap the rewards of riding waves, and getting barreled. Slowly since surfing evolved towards mainstream and worldwide adoption more and more surf safety equipment has been developed, implemented, and their use normalized. For example, when Pat O’Neill introduced surfboard leashes also known as leg ropes in the 1970's he was laughed at, and they were labeled, "Kook Cords." Once the design of surfboard leashes became a combination of neoprene, webbing, Velcro, and polyurethane cords more people regularly used them, and now everyone uses one. Since then not much has changed, and aside from improved wetsuits, and inflatable vests there’s not been a surf accessory that’s fulfilled a specific first aid requirement for surfers that wasn’t for drowning. That is until OMNA was founded in 2014.

Makeshift Tourniquets:

According to numerous organizations such as the Australian Resuscitation Council, Committee on Tactical Emergency Casualty Care (CoTECC), and others the current guideline for makeshift also known as improvised tourniquets is to use them only as a last resort, and most importantly only when a legitimate emergency tourniquet is not available. When surfers hear makeshift tourniquet, they think leash cord or leg rope immediately, and 99.9% of surfers have no idea that makeshift tourniquets have a 75% - 84% failure rate.

Why do makeshift tourniquets have such a high failure rate?

Simply put, using whatever materials you have on hand doesn’t equate to an actual medical device. Commercial Pre-hospital tourniquets are extensively tested, designed, and developed for their specific use. This quality control and developmental processes ensure that the emergency tourniquet you have will work as designed, when you need it to work; which is also why you should avoid counterfeit tourniquets sold on Ebay and any medical professionals that tell you to buy from Ebay because those counterfeits will get you killed.

If leash cords aka leg ropes make poor tourniquets, why does the online and TV news media also say that this or that persons surf leash was used as a tourniquet in news stories?

Shark Encounters that cause injury to a surfer, or diver make great news because they captivate your attention. News media organizations exploit that; they want ratings, which requires viewers. Psychologically, pretty much any human can empathize about how terrifying it would be to see a large creature with razor sharp rows of teeth swimming towards them for a bite. It’s terrifying, even if the odds are remote, and your surfboard fins are more dangerous. Sometimes you can improvise materials into a makeshift tourniquet that works, but you have no idea what pattern of pressure gradient you actually have, if bleeding is really controlled, or if you are actually making matters worse by creating complications, which makeshift tourniquets are known to do.

In a recent conversation a surfer who had both his legs mauled by a great white shark and leg ropes used as makeshift tourniquets stated that the leg rope on his left leg worked ok, but the leg rope on the right leg kept coming undone, loosing pressure, making him lose more blood. He furthermore stated that he’d wished he had a real tourniquet that was immediately accessible so he could of gotten it on sooner on his way in to the shore, and kept more blood in his body, since its of a limited supply.

Explain Why Leg Ropes (Leashes) Make Poor Tourniquets?

  1. They are made from a material with a high elongation rate. Polyurethane is made to stretch and return to its shape. If you are able to maintain a max load to reach max elongation you may be able to temporarily introduce sufficient limb compression. However, since there is no locking mechanism and no mechanical advantage you most likely won’t be able to introduce sufficient pressure, and or maintain sufficient compression to control bleeding. Once you release tension and even after you’ve maxed out the amount of force you can hold, the material itself is going to be retracting back to its original state at the molecular level, which over time means loss of compression and more bleeding, which you won’t catch right away.
  2. 98% of all surf leashes (Leg Ropes) are made in Chinese factories, which is fine, they do a good job. These companies may even have some form of internal quality management system that is sufficient to make sporting goods, but they do not have the required quality management systems, certifications, government approvals, and the like to make a medical device. Therefore, the intended use is not to ever be a tourniquet, and you have no assurance that it will work as a tourniquet.
  3. Surf Leashes can’t be improvised into a makeshift tourniquet quickly. The longer it takes to reach occlusion pressure if you are able to do so with a makeshift tourniquet, the more blood you are losing. The average adult has roughly 5 liters +/- of blood in their body. When you lose more than 1/5 of your blood supply you enter into a conditions known as Hypovolemic Shock, which means your heart no longer has sufficient blood volume to supply your body, so it begins to shunt blood to essential systems, and organ. As hypovolemic shock manifests it begins to cause organ failure, and eventually leads to death. This is what actually kills people, and why seconds matter. It only takes about 10 seconds to get an OMNA Tourniquet on your limb and they’ve been designed for surfers by surfers, so it’s going to work.

What Should You Look For In A Tourniquet?

Your tourniquet should be designed for you and the environment you will most likely find yourself. We’ve learned that windlass bar style tourniquets are not conducive to life saving in the water for a number of reasons such as their materials, lack of width, fine motor skill requirements to twist a bar that becomes progressively more difficult as the device gets tighter.

(Figure 2)

If you are a surfer, paddle boarder, kite surfer, windsurfer, body boarder, and the like the ideal tourniquet for you is the OMNA Tourniquet Leash (Leg Rope). The innovative water sports leash integrates a ratcheting tourniquet as the cuff of your leash, thus providing you with immediate access to a legitimate tourniquet at all times in the water or on the beach. It’s even going to be in your car when you are driving to and from the water, where you may be involved in or witness a car accident, and be able to use your tourniquet leg rope to save a life.

A lot of common tourniquets make their tourniquets and package them in plastic with instructions for use. They also typically have the symbol you see above in (Fig. 2) which means single-use. More importantly in the fine print, most tourniquet warranties are voided immediately on you taking the device out of the plastic. Maybe that doesn’t bother you because you’ll have the tourniquet in your office, or home, but if you are going to be in the outdoors, and especially the ocean you want a tourniquet that doesn’t void its warranty when you take it out of the plastic. At OMNA we make our tourniquets rugged enough to be exposed to the ocean environment and still work. Check out this video of our OMNA Tourniquet being tested soaked in saltwater and covered in sand below:

Take Away From This Article?

There is no substitute for a real tourniquet

Tourniquets should be selected with environment of use in mind

Tourniquet Leg Ropes are the go to surf safety medical device