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Any diver with a severe bleeding injury will be in a life threatening situation - such as when blood is spurting out of a wound.
This help guide contains advice for scuba divers about emergency first aid response procedures for trauma injuries that lead to acute loss of blood (haemorrhage).
Time is critical. Severe blood loss becomes a matter of life and death in less than five (5) minutes.
In addition, there are three different types of bleeding to learn about:
Blood that spurts from an artery will be bright red in colour (because of the oxygen) and it will be a medical emergency.
Severe bleeding wounds and serious lacerations are hazardous scuba diving injuries that divers rarely see. They're not a frequent cause of scuba fatalities. But, profuse bleeding underwater has serious implications.
Here's the thing:
Scuba divers get close to many of the hazards in marine environments, such as the crown of thorns starfish sting, or the deadly bite of a blue-ringed octopus.
The following information and expert advice is most appropriate for the immediate treatment of traumatic bleeding injuries caused by:
A constrictive bandage (at least 5 centimetres wide) may be used as a last resort if other methods used to control life-threatening bleeding from a limb have failed.
If transportation of the victim is unavoidable, do so with them laying down and their legs elevated. Handle them as gently as possible.
Large open skin wounds involve profuse arterial bleeding. Typical causes for divers and snorkelers include injuries sustained in boat propeller accidents and falls from height.
If you know how to apply a tourniquet (e.g. a compression bandage) you may be able to halt life-threatening blood loss.
Most scuba first aid equipment supplies will have an emergency tourniquet. The design allows for rapid application, such as when a limb is missing.
But, you must use the device appropriately to prevent further blood loss and avoid additional tissue damage. Thus, a tourniquet is:
It is safe to characterise life-threatening arterial bleeding as the strong pulsing flow or spurting of bright red blood. Whereas, a significant flow (continuous) of dark red blood indicates venous bleeding (which can also be fatal).
The design will determine the exact deployment method. But, the general procedure should include preparation of the injury site, the application, band tightening, and then locking the device in place.
Following that, you may begin to address any other serious injuries, such as symptoms for shock, and arrange the prompt transportation of the patient to the nearest medical centre.
Pro Tip: The loss of blood outweighs the potential hazards that applying a tourniquet may create. The DAN diving organisation has more information about first aid for diving injuries.
A first aider's priority is to manage the external bleeding by applying direct pressure to the site. Use pads and bandages to maintain the pressure and try to raise the injured limb so it's higher than the heart.
In fact, you should never go diving if you have an open wound (including the gap created by a recent tooth extraction). You should also avoid scuba diving and snorkeling if you have an infection or you feel sick.
Pro Tip: Clean open wounds with soap and water and wearing an exposure suit will help to protect the skin from further cuts and scrapes while you're diving.
The common cause of a nosebleed after scuba diving is middle-ear barotrauma (MEBt). Failing to equalise can cause tiny ruptures in the blood vessels inside the lining of the nose.
In fact, deep vein thrombosis (DVT) is not associated with diving. But, scuba divers are known for traveling to different dive sites around the world. Thus, their exposure to the risk of having DVT is increased.
Important: The short tutorial video [1:25 seconds] presented by the American Red Cross explains how to control bleeding with the use of tourniquets or other materials until medical help arrives.