First Aid For Surfers

You can’t improvise being a doctor; you won’t fool anyone. They do a wad of training before they are let loose on the public after all, but there are some simple rules you can follow that could make a big difference. It’s a natural human instinct to want to save or help someone in distress… 

Before we start we need to make things clear: First Aid is all about preventing a situation from getting worse until help arrives. When confronted with a medical emergency situation, always call for professional help if at all possible. The experts are just that, but you will not always be near a phone or an ambulance service, so on we go...

We will start with two essential first aid techniques that are performed usually when the person in need isn’t breathing, and possibly without a pulse. This little summary is not intended to replace a proper first aid course and you and your mates would be absolute legends if you did a few evening classes to get proper training…

Rescue Breaths (new name for mouth-to-mouth resuscitation).
You’ve seen it on Baywatch, sure, but it’s not as easy as it looks. It has nothing to do with snogging an attractive stranger with false titties; it is all about keeping the patients blood, and hence brain, oxygenated. This is serious stuff. 

It maybe enough to get the casualty breathing again on its own, but if it doesn’t you need to combine rescue breaths with CPR.

1- Place the patient on their back. 

2- Kneel beside the patient’s head. Place one hand on the forehead and gently tilt the head back. Check the throat for obstructions, such as vomit, dentures or a swallowed tongue. You can’t get air in if the airway is blocked.

3- Pinch the soft part of the nose with your fingers, (avoids any loss of air through it) with the hand that was on the forehead. Then open the mouth with your other hand on the chin.

4- Inhale two breaths then apply your mouth to the patient’s ensuring a good seal.

5- Exhale for two-seconds; watch the patient’s chest as it lifts. Get your breath back whilst watching the chest go down again.

6- Repeat this once and check for signs of circulation by watching for movement or breathing if there is no circulation start CPR.

CPR – Cardiopulmonary Resuscitation
This is the big one, reviving the dead… Some people will tell you that you can kill someone by thrashing their ribs whilst performing CPR, but keep in mind that CPR is usually performed as a last resort and as mentioned above, you should only perform it yourself if no professional care is to be expected or available. Otherwise always call a medic first!

1- Lay the casualty on their back on a hard surface. Kneel beside them and get rid of the clothing on the chest. 

2- Find the casualty’s lowermost rib with your lower hand. Place your middle finger where the rib meets the breastbone, with your index finger above it. Slide the heel of your other hand to meet the index finger. Place first hand on top of the other and interlock fingers.

3- Press down vertically with straight arms. Do not rock.

4- Depress the breastbone one third of the depth of the chest, generally around 4 or 5 cm.

5- Release the pressure. Compress 30 times in total at a rate of 100 compressions a minute. Compression and release should be of equal duration and your hands should not leave the breastbone.

6- After every 30 compressions give 2 rescue breaths taking one second for each breath.

7- Continue until the casualty responds or trained help arrives.

CPR is hard work, and some training on a proper dummy makes a big difference, you’ll know how it feels and what kind of pressure to exert. I know we are banging on about it, but a CPR course really is a good idea!

Drowning
Obviously the first thing for a surfer to know about: Being able to react appropriately in order to rescue a drowned person. A body, full of water, turned blue, still attached to its leash is a traumatic sight. 5 minutes under water for a normal person without any oxygen is a maximum, after that time severe complications are to be expected if the person is brought back to life.

Remember, you can drown in 20 cm of water as well as under a 6-metre set wave. The body naturally responds to inhaling water by closing the throat so water inhalation is rare, but you are still suffocating…

1- Get the person out of the water as fast as possible…check for breathing and pulse. At all times keep the casualty’s head lower than the body to prevent inhalation of fluids.

2- If the victim is unconscious, not breathing and has a weak pulse, put them facing the ground and push the jaw forward. Then lift the waist above the head and the chest. Hit the back of the victim strongly to evacuate water from the trachea and from the bronchial tubes. You don’t need to perform this longer than 40 seconds. It’s important to remember because if you do rescue breaths straight away you could push water deeper into the lungs and kill the person. 

3- If the casualty is still not recovering start assisted breathing. If the victim has blue lips and pale skin colour proceed with CPR. Always check for neck or spinal injuries before moving the victim or before performing CPR.

A tricky, but useful bit of information.

Deep cuts
You can take care yourself for minor cuts or scrapes. But what do you do if the cut is deep and bleeding plenty? We’ve already seen what fins can do… Learning to deal with a major gash or loss of blood can save lives. Surfers have died from cuts to femoral arteries.

So what to do?

1- Apply direct pressure to the wound with a sterile dressing if possible or palm of hand.

2- Raise the wound higher than the heart to reduce the blood pressure and loss of blood.

3- Get the victim to lie down to avoid the risk of injury from fainting.

4- Ensure the wound is clean. If you need to pull something out (fibreglass, coral etc.) use a sterile tool (sterilise the scissors or tweezers by putting them in the flame of a match). If removing the foreign object will make the bleeding worse then leave it.

5- Apply a sterile dressing if possible. Blood clots after few minutes of bleeding, it’s a natural protective response, 10 minutes of pressure or more are usually necessary.

6- Stitches and proper medical attention are next… without it infection and complications are possible.

7- If that’s not possible change the dressing twice a day, to avoid reopening the wound, wet the bandage.

Hypothermia
A real issue for Northern European surfers- hypothermia is when the body cannot keep itself warm and the core temperature drops. Signs to look out for– shivering, slurred speech, clumsiness, pale skin, slow, shallow breathing. If unchecked, loss of consciousness and death follow…

After a long winter session you may find yourself mildly hypothermic, the dizzy euphoria you get is the onset of hypothermia’s early stages.

1- Remove the casualty from the hostile environment.

2- Warm the casualty gradually, with blankets and a warm environment. If at all possible put them to bed. In emergencies the warmth of another body or two does the trick.

3- Do not put the casualty in a bath or by a fire. This will cause them harm.

4- Seek medical attention.

With all this First Aid for surfing emergencies we’ve given you, you should be able to keep a cool head if a drama happens. Maybe even bring a little bit of knowledge to a scene that could make a big difference. In any case, if you have the opportunity to follow a first aid course, do yourself and your friends a big favour…

Legalese: Please note that this article is for preliminary educational purposes, hopefully to make you want to learn more about emergency medicine. It is not intended as a substitute for professional medical training, diagnosis or treatment. Always seek professional medical help if possible… Think we’ve covered our asses there?