Extremity bleeding from traumatic injuries in the water, especially surfing makes up roughly 50% of surf trauma injuries1. While sharks account for only a small percentage of surf injuries they are sensationalized by the media, which can have negative economical, tourism, and local quality of life effects 2. Contrary to public perception, fatalities from shark encounters are generally not from the shark bite, most shark bites are investigational, but the damage incurred to a human limb can be severe. The actual cause of fatalities in these incidents is massive blood loss because the time from injury in the surf, to shore, to life saving application of a commercial pre-hospital tourniquet either takes too long, and or there is no tourniquet immediately available, and present, which is why reports of makeshift / improvised surf leashes are often reported, but said reports are anecdotal, and when further research is conducted the effectiveness of the makeshift tourniquet is often found to be in question. According to medical studies from the likes of Kragh et al, 2008, makeshift / improvised tourniquets have a > 75% failure rate 3. Implementing a fast, effective means for surfers to self apply a tourniquet to control bleeding is therefore paramount, because the time it takes to get out of the water allows a surfer to lose too much blood, and interventions such as pressing your knee into the inguinal canal to compress the femoral artery in the water is impossible and ineffective4. Furthermore, lifesaving interventions on shore like bleeding control stations are ineffective for many beaches and surf breaks. Considering that, Ballas et al, 2017, concluded that the single determining factor of shark attack survival is how fast a commercial pre-hospital tourniquet can be applied to a limb 5 , the integration of a marine-grade tourniquet with water sport leashes is the most logical and implementable solution.
Carrying a commercial, pre-hospital tourniquet in the surf and marine environment has been a challenging endeavor due to a variety of factors such as durability, loss of efficacy from exposure, size, weight, and ability to carry. For example:
Even though the FDA, TGA, and the like classify tourniquets as class 1, low-risk, medical devices, myths like losing a limb if you apply a tourniquet, or that a tourniquet should be loosened periodically still permeate the civilian populace. Tourniquets are routinely used in orthopedic surgery everyday; their effectiveness and safety is well-established 9. Outside of the hospital, and in the water is where things change. Water complicates everything, breaking waves amplifies water complications.
The integration of a tourniquet made for the marine environment that can withstand repetitive ocean exposure without significant loss in efficacy, directly with a surfboard leash also known as a leg rope or surf rope to some is the ideal solution. The surfer does not have to remember to bring any extra gear, it is immediately available, present at all times in the surf, is lightweight, rugged, durable, and its marine ratcheting buckle design is optimum for surfer use while still maintaining control of their surfboard or other water sports equipment.
In 2016, OMNA Inc. tested the first and only tourniquet surfboard leash. The OMNA Tourniquet Leash efficacy was clearly superior to existing combat tourniquets, and the testing of makeshift / improvised surf leash cords were determined to be ineffective in achieving arterial occlusion pressure. Doppler Ultrasound images from the study are presented below.
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