SHARK ATTACK

A random splash or a darting shadow. The slightest of triggers can turn a fun surf into one that’s at risk of being ruined by a background level of anxiety and fear. Shark attacks are horrible, there’s no getting away from it. They’re terrifying in their intensity, merciless, bloody and a horrific emotional experience for all that are unfortunate enough to witness.

They are however really rare and are no more horrific than the experiences thousands of unlucky people suffer on the roads world-wide every day. Car crashes, like shark attacks, are also horrible and equally terrifying in their brutality and mutilation. Unfortunately the countries with warm barrels that surfers often like to travel to, also have significantly more road accidents. You’ll never hear a British surfer question going on a particular surf trip abroad because they’re concerned about the high rate of deaths on the road in that region. Obviously sharks, and the risk of being munched by one, does get a mention.. It’s the ultimate surfing paranoia. Shark biscuits- stand up and be counted!

On walking into the foyer of an Indonesean hospital recently, I noticed a graph on the wall showing the biggest causes of death in that area. Over 70% were caused by trauma on the road. A sobering thought when I considered the van and the journey that had just brought me to the hospital..

Why is it then, when I book a trip to a remote location like that, one of the first things I think of is ‘is it Sharky?’

It’s because I’m an idiot and a wimp. I’ve tortured myself over the years reading endless harrowing accounts of shark attacks. I hate the thought of being eaten alive, and like most of us on the road, I’m arrogant enough to think ‘I’ll be alright’. And that is exactly why I got in that van with bald tyres that pulled heavily to the left when it breaked, and travelled over a volcano at night, fast, on a pot-holed dirt track, driven by a local who seemed to be more focused on apparently texting the complete works of JK Rowling to his wife. A one & a half tonne Great White on wheels.

I AM a wimp and an idiot. But its not my fault though right? A dorsal fin is a lot easier to recognise that a dodgy motor.

How to avoid road accidents is common sense. This article is about the more interesting, but less relevant,  topic of shark attacks. Trauma and major blood loss, whether from a shark attack or a car crash, has a similar theme for its management. Car crashes obviously also have the added issues of things like head and spinal injuries that must be considered.

This article is going to discuss what basic medical (and little) stuff there is to consider when dealing with a shark attack victim.

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THE ATTACK.  BITE Vs TASTE?

It’s often said that sharks (especially great whites) generally bite surfers out of curiosity. That the act of biting gives the shark’s senses enough information to work out what we are. It’s a comforting thought. It’s just a shame that a taste can rip off limbs and cause massive haemorrhage.

There are, however, other theories about the bite. Sharks species have survived since the dinosaurs for a reason. They’re built well, but they behave well too. Attacking an animal that can cause you harm puts you at risk yourself.  Sharks are also cannibals. Even a small bleeding wound inflicted on them by their prey during feeding can signal other sharks to dine on them too. The ‘bite and spit’ that surfers have been described as suffering can also be seen demonstrated by sharks on bigger, more dangerous prey, such as Sea Lions. Allowing your prey to bleed to death, to then consume it at your leisure is a much safer option.

This is perhaps why there are comparatively very few reports of people that bravely try to rescue victims of shark attacks, also being attacked themselves. Sharks seem to stay focused on their original victim and wait (with variable patience) to eat. This is an encouraging thing to bear in mind if paddling furiously towards a stricken friend. Surfing with others incidentally is shown to significantly reduce your risk of being attacked. There are theories about how this influences the hunting behaviour of the shark. Sadistically  you should draw comfort from the fact that if there are two of you in the water, no matter how unlikely the chances of an attack, they have also been reduced by 50%!

Another theory for the munch and run behaviour is that the jaws of juvenile Great White Sharks are actually too weak to sustain an attack and kill marine mammals. It’s believed that they let go of their prey to prevent damage to their jaws caused by sustained pressure & forces generated by their bite. Click here for a detailed article on this theory that was published in the Journal of Biomechanics.

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SELF-SELECTING INJURIES

There’s a theory that if someone suffers a heart attack out of hospital, and survives long enough to make it into hospital alive, that they are part of a self selecting group of survivors/patients. If your genetics have dealt you a bad hand, and given you a weak cardiovascular kit, then you probably wouldn’t have made it in to hospital.

The same grave theory can be applied to shark attacks. If the poor victim manages to make it to the safety of shore alive (not killed immediately), then the severity of their injuries are likely to be moderate enough to mean that they have an encouraging chance of survival.

You don’t have to have any medical experience to recognise that the major problem is of massive haemorrhage and shock.

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MANAGEMENT OF MASSIVE HAEMORRHAGE AND SHOCK

Probably important to point out that haemorrhage and shock, no matter how severe puts the victim at serious risk of drowning.

All attention after should be placed upon preventing further blood loss:

• Keep the victim immobile (to reduce desire of heart to pump more)
• Try and keep damaged limbs above the heart.
• Keep the victim warm with blankets. Blood loss/shock causes hypothermia even in warm climates. Hypothermia stops your blood clotting well.
• Any material used for applying direct pressure to wounds is better than nothing.
• Apply (constant) pressure to the wounds. Small grazes may be encouraged to clot by this and larger ones will experience less blood loss due to the increased pressure you create around the wound (you reduce the perfusion of the wound).
• Use tourniquets. Leashes are everywhere, as are strong leash straps. Use more than one on effected limbs if you can.
• If you know your anatomy try putting pressure on the pulses of the effected limb on the heart side of the wound.
• The risk of death is so high that it removes any concern about damage caused by tourniquets or wound infection.
• Give oxygen early if you have access to it.
• Don’t be tempted to give the victim food or drink. Chances are they’re about to need an operation under general anaesthetic.

When emergency services arrive it’s ideal to be able to start giving replacement fluids ASAP. This has the effect of increasing the circulating volume of blood in the victim and their ability to keep oxygen going to their heart and brain. It is argued that victims of massive haemorrhage that die in transit to hospitals can sometimes die because they are transported. Where possible stabilisation should be attempted on the scene. Having said that often definitive surgical intervention is often required. The judgement of medical professionals at the scene should be followed. It’s certainly worth waiting for an ambulance if one is on the way rather than bundling the victim in the back of a car.

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IT’S TRYING TO TASTE ME!

The Florida Museum of Natural History has the following instructions if you should ever find yourself face to face with evolution;

‘If one is actually under attack by a shark, we advise a proactive response. Hitting a shark on the nose, ideally with an inanimate object, usually results in the shark temporarily curtailing its attack. One should try to get out of the water at this time. If this is not possible, repeat bangs to the snout may offer temporary restraint, but the result likely become increasingly less effective. If a shark actually bites, we suggest clawing at its eyes and gills, two sensitive areas. One should not act passively if under attack – sharks respect size and power.’

Quite clear instructions really. If the shark literally wants a piece of you, unleash the fury. Like there’s no tomorrow..

Mike Coots in his interview below demonstrates impressive strength of character by cooly describing his savage experience when a Tiger Shark tried to kill him. He describes how showing aggression himself, he saved his life..

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BUT, ARE THEY COMPLETELY MISUNDERSTOOD?

Free diving with a White Pointer:

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I THINK THEY PROBABLY ARE

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A FEW THINGS TO GET YOU THINKING

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Have a read of this BBC article exploring the cause and the possible solutions for the high number of fatal shark attacks in Recife, Brazil.

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IN CONCLUSION

The purpose of this article is to get people thinking about their safety whilst abroad, specifically when travelling on motorbikes and in dodgy vehicles. The risk that these motors put you at may not be more horrific than a shark attack, but they are far more likely to cause you harm. Looking after someone that has just been in a major traffic accident can leave you haunted for life. In order to save help save their life (as with shark attack victims) there are a few simple things that can be done to help prevent catastrophic blood loss.

Remember. If you don’t want to be eaten by a shark. Stay on land. The further you are away from a major hospital, the less your chances will be if you get spat out after a major mauling.

Sharks are however really cool animals. They’re breathtaking to watch underwater. Go diving and see for yourself if you’re not sure!

I’d much rather be chewed to death doing the sport I love, no matter how unlikely or horrific, than be crushed to death behind the wheel and be another sad statistic on our roads. I’m going to make a conscious effort to put in out of my mind from now on. No more scary shark stories for me..

AUTHOR: Dr Dave Baglow

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Disclaimer

There is no substitution for being examined and treated by a medical professional. The intention of the articles on this website is to inform anyone who reads it of medical issues encountered on surf trips.

This website is designed to provide general practical information not specific medical advice.