Surfer Tourniquet Leash - Bleeding Control

Surfing Bleeding Control White Paper: Efficacy of the OMNA tourniquet Surfboard Leash For the Surf & Surfers

December 29, 2018 0 Comments

Surfing Bleeding Control White Paper:

Efficacy of the OMNA tourniquet Surfboard Leash For the Surf & Surfers

 

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:

  • Traditional tourniquets when removed from packaging void their warranties, and require the user to twist a windlass bar, which is an unnatural motion, further complicated by water, trauma, and surf.
  • Traditional tourniquet exposure to a normal everyday environment has been shown to have a dramatic drop in effectiveness by as much as 40% - 50%6.
  • Ratcheting buckles have been shown to be 28% more intuitive than windlass bars in studies 7.
  • Tourniquets have been associated with loss of compression after application8, which would be further complicated by water from or in the marine environment.

 

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.

OMNA Tourniquet Surfboard Leash Femoral Arterial Occlusion

OMNA Tourniquet Surfboard Leash Brachial Arterial Occlusion

Makeshift Tourniquet Surfboard Leash Occlusion Failure

References:

  1. Taylor DM, Bennett D, Carter M, Garewal D, Finch CF. Acute injury and chronic disability resultingfromsurfboardJSciMedSport.2004Dec;7(4):429-37.PubMedPMID:15712498.
  2. Andrew NathansonClayton EverlineMark Renneker. Surf Survival: The Surfer’s Health Handbook, 2019.
  3. Kragh JF Jr, Walters TJ, Baer DG, Fox CJ, Wade CE, Salinas J, Holcomb JB. Practical use of emergency tourniquets to stop bleeding in major limb trauma. J Trauma. 2008 Feb;64(2 Suppl):S38-49; discussion S49-50. doi: 10.1097/TA.0b013e31816086b1. PubMed PMID: 18376170.
  4. Taylor, Nicholas, Lamond, David. (SHARC) Stopping Haemorrhage by Application of Rope tourniquet or inguinal Compression, 2018.
  5. Clinicalfeaturesof27sharkattackcasesonLaRéunionBallasR,SaettaG,PeuchotC, Elkienbaum P, Poinsot E. J Trauma Acute Care Surg. 2017 May;82(5):952-955.
  6. Weppner,,Lang,M.,Sunday,R.,&Debiasse,N.(2013).Efficacyoftourniquetsexposedtothe Afghanistan combat environment stored in individual first aid kits versus on the exterior of plate carriers. Military medicine, 178(3),334-337.
  7. Valliere MJ, Wall PL, Buising CM. From Pull to Pressure: Effects of Tourniquet Buckles and Straps. J Am Coll Surg. 2018 Sep;227(3):332-345. doi: 10.1016/j.jamcollsurg.2018.06.005. Epub 2018 Jun 30. PubMed PMID: 29966694.
  8. Mary R P Rometti and Piper L. Wall and Charisse M. Buising and Yvonne Gildemaster and James W Hopkins and Sheryl M. Sahr. Significant Pressure Loss Occurs Under Tourniquets Within Minutes of Application. Journal of special operations medicine : a peer reviewed journal for SOF medical professionals, 2017, volume 16(4), 15-26.
  9. Sharma, J. P., & Salhotra, R. (2012). Tourniquets in orthopedic surgery. Indian journal of orthopaedics46(4), 377-83.



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