By: Luis DeRosa Jr., Acting Associate Nurse Manager, Trauma Resuscitation Unit at Ryder Trauma Center
South Florida has an abundance of water-related activities to enjoy. Whether it’s boating, snorkeling, diving, spearfishing or riding a jet ski, South Florida does not let you down. But all these fun-filled moments come with a high risk of injury.
According to the U.S. Coast Guard 2016 recreational boating statistics covering 2015 to 2016, deaths increased 12 percent from 626 to 701; injuries increased 11.1 percent from 2,613 to 2,903; and the total number of accidents increased 7.3 percent from 4,158 to 4,463.- 15 percent of the recorded deaths included alcohol use as the leading contributing factor. But here is the kicker. All those statistics are national numbers. When we break it down by state, Florida tops the list in all categories. As a trauma resuscitation nurse at Jackson Memorial Hospital’s Ryder Trauma Center, this does not come as a surprise.
Although our trauma center is considered one of the most experienced and busiest in the nation, the most challenging injuries my colleagues and I deal with are injuries due to recreational water sport accidents such as boating. Why are water-related traumas so hard to deal with as a provider? For one, these patients go from having one of the best days of their lives to the worst, in a split second. They wake up in our trauma unit as I am looking down at them trying to save their lives. Secondly, the time that it takes from when someone is injured, to their arrival at a local trauma center is increased due to prolonged rescue times. Simply put, it’s harder to get to a victim when they’re five miles or more out at sea.
Spearfishing is one of the most dangerous activities that can cause serious, traumatic injuries. Spearfishing rods are made to impale its target and not come out due to a barb at the tip of the spear. Patients injured in accidents with them must undergo complicated surgeries to remove these spears from their bodies and at times, even their heads. A rule of thumb to follow is that you should never enter a boat with your speargun charged. Patients frequently confess that they entered the boat with their speargun already loaded or ready to shoot.
Another commonly seen recreational water sporting injury is caused by boat propellers. We have a name for them, “prop-chops.” These are brutal accidents, by far the bloodiest and often they could be fatal as well. The most common predicament is when the driver unknowingly turns on the engine while people are at the rear of the boat – which usually happens in a sandbar environment. If this was to occur, licensed boat drivers should be trained on direct pressure techniques using clothing or gauze until first responders are able to transport the individual to the hospital. And if a limb is amputated, it would be helpful if someone is ready and trained to apply tourniquets for bleeding control.
Last but not least, jet-ski accidents are a water version of a motorcycle crash on land. These riders can have multiple injuries when crashing into docks, boats, or other jet skiers. But by far the most tragic and occult, meaning not readily seen injury that occurs to these thrill seekers are perineal injuries from the hydrostatic jet-stream (which propels the watercraft). This means that an injured rider, usually a female passenger, falls off the jet ski towards the back exposing their perineum – the genitals and rectum – to the hydrostatic jet stream. This contact with this jet stream is like exposing yourself to a pressure washer. The rider may not have obvious injuries but may complain of abdominal pain with some vaginal or rectal bleeding. These patients need to be transported to a trauma center immediately to repair the internal damage to their organs caused by the jet stream. Safety points would be to wear protective garments that can protect the perineal region and to ride with caution, especially when riding with another individual.
Wear a life jacket, never have a speargun loaded outside the water, don’t swim near the rear boat engines, take a boating or jetski safety course if possible and of course don’t drink while operating any watercraft. Increase the chances of having uninterrupted fun this summer.