In the critical moments after a shark attack, immediate and decisive action can significantly increase a victim's chances of survival. Emergency medicine physician Dr. Kenneth J. Perry has outlined essential first aid steps, emphasizing bleeding control as the paramount concern.
Immediate Steps After an Attack
The first priority is to remove the victim from the water to prevent further bites and mitigate the risk of drowning. Once on land or a boat, the focus must shift to controlling blood loss. "Shark bites vary in intensity and severity, but the main issue that all of them share is the need to stop the bleeding," Perry stated. Shark teeth can cause severe damage to arteries, veins, and tendons, making uncontrolled hemorrhage the most immediate life-threatening risk.
Tourniquet Application for Severe Injuries
For severe limb injuries, applying a tourniquet is essential. Perry advises that tourniquets must be placed above the wound and tightened with sufficient pressure to completely stop arterial blood flow, to the point where a pulse can no longer be felt distal to the application. He noted that while this may be painful, it is a necessary measure, aligning with trauma protocols that stress firm compression to cease arterial flow.
Adapting for Delayed Medical Care
Tourniquets are intended for temporary use, ideally no longer than two hours, due to the risk of tissue damage from lack of oxygenated blood. If emergency medical transport is delayed, Perry recommends using a pressure dressing. This involves placing folded gauze directly over the bleeding site and wrapping it tightly. While not as effective as a tourniquet in completely stopping blood flow, a pressure dressing carries a lower risk of tissue necrosis during prolonged waits.
Managing the Victim and Secondary Risks
Beyond physical first aid, bystanders should help the victim remain calm and still. Panic can elevate heart rate and blood pressure, thereby accelerating blood loss. Perry also pointed out that unconsciousness after an attack can stem from a sudden drop in blood pressure or, if the victim surfaced rapidly from depth, from a pressure-related diving injury like arterial gas embolism or barotrauma.
Long-term recovery from a shark bite involves combating potential infections. Marine bacteria can cause aggressive skin and soft-tissue infections such as cellulitis. Once patients are stabilized at a medical facility with fluids and blood products, aggressive antibiotic treatment typically follows.