Clinical features of 27 shark attack cases on La Réunion Island
In a recent study Ballas et al., determined that pre-hospital tourniquet use is a determining factor in patient survival from shark attacks. They conducted this because there had not been a large clinical study regarding shark attacks to date. Previously, there had only been case reports, and qualitative data collected from victims, physicians, and the like. Their study focused on shark attacks that occurred in the territorial waters of France from January 2000 to September 2016. It did not included shark attacks from around the world, which during the same time period averaged 87 per year, with and average fatality rate of 8.82 deaths (Ballas et al, 2017).
During this same time period France averaged 3.6 shark attacks a year with 1 in Wallis-and-Futuna, 11 in French Polynesia, 20 in New Caledonia, and 27 in La Réunion Island (Ballas et al, 2017). Taking into account population they determined that there have been 3.11 shark attacks per 100,00 inhabitants of Réunion. The population of Réunion in 2013 was 835,103 (Ballas et al, 2017). These numbers mean that La Réunion Island had the highest shark attack rate in the world. Comparatively, this rate was 15 times higher than South Africa, 14 times higher than the USA, and 3 times higher than Australia (Ballas et al, 2017). At the time they estimated that there were 500 Réunion water sports participants, which means that roughly 6% of the water sports participants experienced shark attacks. 6% might seem insignificant, however, if you were one of the 30 out of 500 to be attacked the relative significance would likely change.
La Réunion Island’s 3 trauma centers equipped to handle traumatic injuries of this nature are the following:
- Centre Hospitalier Gabriel Martin de Saint- Paul
- Centre Hospitalier Universitaire de La Réunion
- Groupe Hospitalier Est Réunion
Of the 27 unprovoked shark attacks only 21 were used for the study. One of 6 that were excluded was because the person was deceased before the shark arrived. The remaining 5 that were excluded were physically unharmed, but their water sports equipment was damaged. This included: 2 surfboards, 1 body board, 1 Hawaiian kayak, and 1 Jet Ski (Ballas et al, 2017). Average age of victims was 29.8 +- 11.4 years, effectively an age range of 13 to 51 years old. The victims were also roughly 90% Male, and only 10% Female (Ballas et al, 2017).
The species of shark responsible for Réunion attacks was also investigated. Bull sharks were responsible for 11 of the attacks, with 6 of them fatal or 55% fatal. Tiger sharks were responsible for 4 of the attacks, with 1 of them fatal. The species responsible for the remaining 6 attacks were unidentified (Ballas et al, 2017). 2 of the 21 attacks occurred between the hours of 9AM. 7 of the 21 attacks were between noon and 3 PM, and the remaining 12 attacks occurred after 4 PM. Lastly, 17 of the 21 attacks occurred during Austral Winter (Southern Hemisphere Winter), which may have something to do with migratory patterns.
8 (38%) of the 21 shark attack victims were fatal (Ballas et al, 2017). Many of the victims also had more than one injury. 9 people had 1 injured site, 5 had 2 injured sites, 7 had 3 or more injured sites, and the remainder were not factored due to missing body, severing at the trunk, or long delay of body recovery (Ballas et al, 2017). In addition, 2 people were treated in the emergency room, while 13 others were treated in surgery by a combination of orthopedic or vascular surgeons, with only 1 unlucky man requiring the assistance of an urologist for a groin injury (Ballas et al, 2017). Among the 13 survivors, six required limb amputation, including 2 double amputations (Ballas et al, 2017).
A commercial pre-hospital limb tourniquet was used on 4 of the 5 survivors (80%) (Ballas et al, 2017). None of the 8 total victims who died received a tourniquet (Ballas et al, 2017). A tourniquet was also used on 2 victims with vascular injuries that did not require a tourniquet, and in both cases did not make the injury worse or create new injuries (Ballas et al, 2017).
Hypovolemic shock was the most common cause of death. Hypovolemic shock occurs when a person loses 20% or 1/5 of their blood. Essentially, the heart does not have the blood volume to pump blood to the brain and body. The body begins to shunt blood from extremities, shock worsens, and organs begin to fail. Since a person has a limited blood supply it is imperative that they control bleeding as rapidly as possible. It is currently estimated that a person can bleed out in as little as 3 minutes. The aforementioned number does not take into account loss of consciousness that occurs more rapidly than death. For example, there is a video of a bank robber being shot in the leg on our FAQs page. The bank robber is rendered unconscious and incapacitated on the ground in roughly 30 to 40 seconds. If you do the math on 3 minutes you find that this estimate is verifiable.
3 Minutes = 180 Seconds
Average Human Blood Volume = 5 Liters
180 / 5 = 36 Seconds
This means you could lose 1/5 of your blood supply in roughly 36 seconds, which if you did, you would be beginning Hypovolemic Shock. Sure you could try to improvise a tourniquet out of random materials on-hand, but with an estimated 75% failure rate (Improvised Tourniquets), requiring the use of 2-hands, in a dangerous situation, in the water, requiring you to swim for safety, does that sound like a good idea? No, its not and you’re most likely already dead. Having a legitimate pre-hospital tourniquet with you at all times is mandatory, and not those cheap counterfeit tourniquets on Ebay. Why? Because they break on first use out of the package (Imagine after repeated exposure to saltwater and UV Rays), aren’t made by a legitimate manufacturer, and the cheap Omni-tape Velcro comes undone in the water. All those counterfeiters do is provide you a false sense of psychological safety until you need it, and then you’re dead.
Whenever you enter the water or go to the beach you need a legitimate, commercial, marine-grade tourniquet with you at all times. OMNA Inc. makes the world’s only marine-grade tourniquet called the Amphibious Tourniquet. It is specifically designed for use in and out of saltwater for all manner of maritime applications from scuba diving, freediving, spearfishing, boating, sailing, and the like. OMNA also makes the worlds only Tourniquet Leash (Leg Rope) for surfboards, body boards, paddleboards, and underwater photography. FDA-Registered, CE-Marked, and TGA Certified, backed by ISO 9001 & 13485 quality management means you’re getting the highest quality tourniquet available on the market today. Furthermore, its available immediately because its part of your leash, or your wearing it on your body or equipment. You don’t even need a pouch to carry it, which means you’re saving that much more of your hard earned money. Whether its in the water, commuting to the water in your car, land, sea, or air OMNA Inc. wants you to have the best tourniquet for your preferred activities and profession.
A commercial pre-hospital limb tourniquet was used on 4 of the 5 survivors (80%) (Ballas et al, 2017). None of the 8 total victims who died received a tourniquet (Ballas et al, 2017).
Link to study: Clinical features of 27 shark attack cases on La Réunion Island
References
Ballas et al., 2017: Clinical features of 27 shark attack cases on La Réunion Island, Wolters Kluwer Health, Inc. 2017; Trauma Acute Care Surgery, Volume 82, Number 5
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