It’s the sort of situation no one ever wants to be in, stranded on an isolated beach while someone – maybe a friend or loved one – bleeds to death after a shark attack. But what if you had the tools to help?

For many of us the 'S 'word remains the great unmentionable. A word only to be uttered out of necessity when a big one is sighted and it’s time to issue a warning. However, Dr Jon Cohen has decided to take a different approach. Acknowledging the risk allows one to be better prepared. Inspired by recent events in WA, Dr Cohen has developed the ‘Calm As’ Shark Bite First Aid Kits designed specifically for shark attack victims. Below he explains why learning to tie a tourniquet is an invaluable skill and how having this kit on hand can be the difference between life and death.

What inspired the creation of the kit?
The Shark Bite First Aid Slam Packs were created specifically for the crew down in Esperance, WA, who wanted to have a no-nonsense, single-purpose kit that anyone could use to stop people bleeding to death after shark attacks. The first run of kits were made for the local crew there. The idea was born while I was giving a lecture on shark bite management down there, and teaching the local crew how to put on tourniquets. I was out there working in the local hospital the same week Gary Johnson, a local recreational diver was tragically struck by a great white in January 2020. That town has suffered more than it's share of tragedy in the water. They have an extremely proactive group called the "Ocean Safety Group" that organised the venue and everything for us to do that teaching session and got the funds together to put the kits into production.

Can a kit like this be the difference between the loss of a limb or even a life?
Absolutely. The majority of shark-related deaths are from major hemorrhage. If the bite is on an arm or a leg (the majority of bites), the victim can bleed to death in a matter of minutes. This kit was designed using only military and hospital grade products but laid out in a way to take all of the guesswork out of what to do in what is always going to be an extremely stressful situation. The idea is that being prepared ahead of time means there will be less panic and uncertainty in the event of a bite, hence the name "Calm As". That's like the mantra for our line of First Aid Kits for ocean lovers, including this Shark Bite kit. Time is blood, and blood is life. There are really only two things someone needs to be able to do to save a life - identify life-threatening bleeding and whack on a legit military tourniquet. 5 minutes of training, a clear head and the right gear. That's our recipe, and it's really that simple.

Having a kit like this really means owning up to the possibility of an attack. It’s no longer just something pushed to the perimeters of the mind.
This is really a personal choice. Most of my surf buds in WA have that sort of an attitude, and it's worked for them. There may even be something to the notion that not being worried about sharks is in itself a preventive strategy - if you're fear is controlled, your breathing, heart rate and movements stay a bit more smooth. For me, as an emergency room doctor with many first and second-hand accounts of major limb hemorrhage and life-ending shark attacks, having it completely out of my mind simply wasn't an option. However, as you say, taking ownership of the situation, acknowledging the risk and meeting it head-on by arming myself with the gear and knowledge required to stop the bleeding and hence the dying, puts my mind at ease when I'm in the ocean, and kind of puts me more in that slightly more oblivious state that some of my mates prefer to surf in. That being said, rest assured that all of my surf buds (and anyone else who will listen;) know damn well how to put a tourniquet on now!

Have there been any incidents of practical application already?
For sure. Tourniquets have saved over 1000 lives of civilians and combatants since the start of the "Global War on Terror". In the surfing world examples abound. Most recently, the bloke up in Queensland who was hit about a month back survived to hospital because his mates were quick-witted and new they needed to get the tourniquet on. Sometimes in all the panic, the victim, highly adrenalised, is the only one who can keep it together and literally needs to engineer their own survival. When giving a lecture on shark bite management at the Surfing Doctors conference a couple of years back we were privileged enough to have a guest speaker give us his account of how he engineered his own survival by instructing his mates on how to improvise a tourniquet after nearly losing his arm up in Gnarloo awhile back. Stories like his were what inspired me to make something immediately accessible and easy enough for even little kids to use. Not everyone is as switched on as that bloke is, and there's almost no one else I've met who'd reliably be as cool under pressure as he was. 

Are the steps simple to follow?
Yes, extremely. And they're printed both on waterproof cards attached to the kits, and in massive font on the towel that all the gear is wrapped up in. 

The instructions are all in IKEA-style cartoon instructions so there's no language barrier.

If you read through the instructions once or twice and have a play with the kit now and again, it should be as easy as taking apart some basic IKEA furniture that you've already assembled and disassembled a bunch of times. An open-book test.

It’s one thing to know what to do but another to act under pressure.
Definitely. "Human Factors" is what we call it in critical care medicine. All the knowledge in the world doesn't guarantee someone won't crack under pressure. However being armed with the knowledge that you've got the absolute best gear, and simple, expert advice about what to do printed right on your rescue gear gives people the best possible chance at being able to keep it together and rising to the occasion. That's what this "Calm As" line of products is all about - getting the worry out of the way well before anything happens and turning that worry into preparedness. Breathing deep and keeping calm when shit goes down is so much easier when you know you've got the gear and skills to sort it out.

What’s a common mistake do people may make in the instance of a shark attack when trying to help?
Group Paralysis. Everybody thinking someone else knows what to do. Someone just needs to step up and stop the bleeding. More important than getting help. Stop that bleeding. That's what's going to save their life - not a chopper ride, not robotic microsurgery in Sydney or Perth, not fancy dressings or betadine. Just clear thinking and some basic first aid.

Do you suggest a dress rehearsal with any of the equipment?
100%. After you're comfortable using the gear, having a look at the instruction card every now and again, or even better teaching one of your surf buds how to use the gear, is ideal. 

Putting on a tourniquet is really the highest yield first aid you can learn. In an era of mass casualty incidents and shootings, Obama launched a "Stop the Bleed" initiative a few years back, with the goal of every American being able to pop one on. Propeller injuries, animal bites, car crashes, industrial accidents, sword fights, even just drunken window punchers - I've personally seen people survive to hospital from all of these types of injuries due to someone popping on a tourniquet before hospital.

While the kit has a very specialised purpose does it double as a handy first aid kit for surf travels?
We made this kit to do one thing and do it better than any other kit ever created. It's to help you stop someone dying from a shark attack. While it can be used for other major bleeding from stuff like fin chop, prop injuries etc, the stuff in our Calm As Coastal Cruiser Kit covers all of the stuff you're more likely to come across on an average day of searching for waves, as well as attacking heavier waves overseas. 

Snake bites, dislocated shoulders and fingers, busted wrists, ankles, and ribs, sand in the eye, urchins, fin chop, reef rash, burns from exhaust pipes, etc. The Coastal Cruiser Kit can handle major bleeding as well, but my setup is to actually have the Shark Bite Slam Pack inside the Coastal Cruiser in the back of the ute. If I'm surfing somewhere remote or there's a sharky feel, I just take the slam pack down and keep it on the beach, with the rest of the gear in the boot just in case it's needed for any of the other bumps and bruises.

What’s one medical consequence of a shark attack people may not think of? 
Psychological. Not just for the victim either, but the rescuers and bystanders.Being as involved in this whole scene as I have been over the past number of years, I've been privy to a lot of first-hand stories from survivors and bystanders. Watching someone die and not being able to do anything about it, especially a loved one - man. When I hear these stories and put myself in their wetsuit for a minute, I'm just amazed at how strong mentally some people can be.

This project is underway to help stop these psychological knock-on effects as well, teaching people what to do, helping them know that they've done everything they could've in an absolutely terrifying and horrible situation. 

We're also hopefully helping people get in the water who otherwise might be a bit too spooked out by all of this shark talk. I can't imagine what a fucked up individual I'd become if I was forced to stay out of the water for an extended period of time. I don't think I'd be very popular.