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Offshore Emergencies: Treating Serious bleeding



Ellinger Leadin

    You motor out of your port under the cover of darkness and make an uneventful run to an area about 45 miles offshore. It’s a beautiful day on the fishing grounds with light winds and about 2-foot seas. You have been chumming heavily for an hour or so and are ready for your first bite of the day when disaster strikes. As you are walking across the deck with a bait knife in-hand, you slip on a rag and fall forward, plunging the knife deep into your partner’s lower leg. In the commotion following the knife is violently removed from your partner, leaving a gaping, uncontrollably bleeding wound.
    Although a fictional story, this scenario is certainly plausible. Do you know how would you handle this situation? Do you have proper knowledge, training and skills to save your fishing partner’s life? Do you have the correct supplies onboard to aid your partner?
    Being prepared for a trip offshore entails more than just making sure your boat is sound and your gear is ready. Understanding the dangers that arise when someone is bleeding, having first aid supplies and knowing what to do are just as important. Let’s take a look at bleeding emergencies and what to do about them.

    CLOSED-LOOP SYSTEM
    In many ways, the circulatory system of the body is akin to the hydraulic system of a vessel. Both are closed-loop systems that consist of a pump (the heart), hydraulic lines (arteries and veins), and fluid (blood). When either suffer an incident that leads to leaking of fluid (bleeding) the ‘machine’ can have catastrophic issues. The biggest dangers of uncontrolled bleeding are exsanguination, or severe blood loss, and shock. Shock is simply a condition that results when there is not enough circulating blood volume to reach all of the body’s organs and meet its metabolic demand.
    Shock is typically accompanied by dizziness, changes in mental status, confusion, unresponsiveness, pale, cool and sometimes sweaty skin. If you were to feel for a pulse it would likely be very fast and weak. Bleeding, if left uncontrolled, will lead to ‘running the pump dry’ which is the characteristic sign of shock. If bleeding isn’t controlled and shock treated, death may quickly follow.
    The treatment of shock is very limited outside a hospital setting. The priority is to stop any external bleeding. In most circumstances shock treatment and bleeding control can be accomplished simultaneously. Patients who are bleeding profusely or show signs and symptoms of shock should lie down on their back and be kept warm. Although taught for many years in first aid courses, raising a victim’s legs by 6 to 12 inches has not be proven to be beneficial in the treatment of shock. The victim should not be given anything to eat or drink.
    If a medical evacuation from the vessel is needed, the US Coast Guard should be hailed on VHF 16 and the nature of the emergency and requested assistance relayed.

    TYPES OF BLEEDING
    Capillary bleeding is the least threatening type of bleeding that can be encountered and is usually not considered an emergency. An abrasion, such as from a skinned knee would be a common example of capillary bleeding. In this situation small capillaries below the surface of the skin are disturbed and slow, oozing of blood occurs.
    Veins are responsible for returning “used” deoxygenated blood back to the right side of the heart so it can be moved along through the lungs to offload carbon dioxide and load oxygen before returning it to the heart so it can be distributed to the entire body. Bleeding from a vein – venus bleeding – generally appears as a steady flow and blood is dark in color because of its lack of oxygen. Venus bleeding can be life-threatening if not addressed, especially from the jugular vein in the neck.
    Bleeding from ruptured varicose veins of the legs may appear to be squirting. That is because varicose veins are under higher pressure than normal veins. Occasionally, severe bleeding of varicose veins of the legs can be life-threatening if not controlled.
    Arterial bleeding is a life-threatening emergency and needs immediate treatment. Arteries carry oxygenated blood away from the heart, delivering oxygen-rich blood to all of the cells and organs in the body. Because arteries carry blood with a higher oxygen level the blood appears bright red. Arterial bleeding is characterized by spurting. This is because the vessels are under a great deal of pressure as blood is distributed throughout the body as the left lower chamber of the heart squeezes. Arteries are responsible for the pulses in your body.

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