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Surfer’s first aid lecture at BWRAG Summit 2019

During the Big Wave Risk Assessment Group’s (BWRAG) inaugural visit to Australia, Calm As…First Aid founder Dr Jon Cohen was fortunate enough to receive an invitation to not only attend the course, but share his medical expertise in the field of surfer’s first aid.

While Jon has done stints as the medic on duty at some reasonably heavy waves, teaching specifically Big Wave chargers posed a great opportunity to broaden the scope of his thinking.

People surf everyday. People don’t get to surf huge waves everyday. As an emergency doctor in Australian coastal towns, Jon gets to see minor surf injuries most days. With the number of cars and ladders out there, it’s most days he gets to see pretty significant trauma as well. But the number of serious surf injuries that come in? Probably not much more common than them running the Eddie.

The forces involved in Big Wave surfing are enormous. This opens up the possibility not just of drowning, spinal injuries, and head injuries, but also the incredible task of performing water rescue in extremely challenging environments. Emergent management like performing chest compressions can’t be performed on a ski sled. It’s pretty hard getting yourself onto a ski-sled with a dislocated shoulder. How do you immobilise someone’s C-spine when there are waves with 30 foot faces racing towards you?

The value of the BWRAG summits, it seems, is not just in the course, the content, the common language and practical skills stations that we run through. While all of those aspects were put together incredibly well, it was a lot of the stuff that happened between the lines that really made the experience next-level. The stories, the tips, the experience and the possibility for collaborating on new ways of thinking made the weekend really glow for me.

I focused my lecture time on a few things very real to Australian surfers – shark bite management and snake bite management. Pretty much everyone at the course left with a tourniquet to keep in their skis or cars, but more importantly the skills and mindset to use them should the need ever arise.

The lecture quickly shifted to my approach to the trauma patient. This was adapted from a general top to toe approach that we employ in the emergency department, but presented in a way that we can apply it on the shore, on a boat in the channel, or in dire straits, the back of a sled. Taking general skills that I almost take for granted after 10 years working in the Emergency Department as a doctor and applying it to a heavy situation with minimal resources was a great mental trip for me. It felt like a blessing to be able to put it together in a room full of Big Wave experts.

There was enormous interest when we shifted over to my preferred technique for popping a shoulder back in – scapular manipulation. Tom Carroll in particular was front and centre, clearly having been on more than a trip or two where someone in the lineup or in his camp was met with this common surfing injury. The surprise for me, was an amazing technique shared by Greg Long on how to pop your own shoulder back in, by yourself, in the water, in life or death, sink or swim situations. Hats off to you Mr Long, I’ve been spreading that technique around at nearly every lecture I do, of course citing it as the technique you taught me during my lecture on that amazing weekend down in Austinmer.

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