The Surfers Medical Association offers a class called, “The Barefoot Doctor”. The class is deeply rooted in teaching Surfer’s Wilderness First-Aid. The class is open to all, particularly those without any formal medical training. The class is held on a single day at a beach location that allows both land and water training, and lasts for approximately 7 hours. This course fits directly into the underlying mission of the SMA by:
- Educating surfers about health issues in order to maximize our surfing time and minimize the time needed to see doctors (focus on preventative medicine for surfers).
- Educating about the unique trauma and disease problems of surfers in order to create a better care system (focus on specific injuries that occur in a surfing wilderness environment).
- Adding more people to the global network of surfing health care professionals (more Barefoot Doctors in the water means more surfers who have the ability to help other surfers in the event of an emergency).
Our objective is to assure safety by educating surfers to intelligently respond to oneself and to a fellow surfer in need of medical attention. We do this by teaching various aspects of Wilderness Medicine that are more specific to injuries that can occur in a surfing environment, many of which occur in remote settings. The Wilderness Medicine Institute (WMI) characterizes Wilderness Medicine as differentiated from Urban Medicine by five important factors:
- Time: Caring for a patient is greater than in an urban pre-hospital setting.
- Environment: Exposure to heat, cold, wind, rain, and the distance covered for evacuation.
- Improvisation: Equipment needed for treatment and evacuation will have to be improvised.
- Communication: Rescuers may have to make decisions without having any assistance from outside communication.
- Prevention: Knowing how to prevent injury ahead of time goes a long way in remote settings because of limited resources, exposure to the elements, and time it takes for patient care and for evacuation.
For the class, we cover the following main subjects:
- Addressing Medical Emergencies
- Preventative Medicine
- Water Rescue
Addressing Medical Emergencies
The class on New Brighton State Beach, Santa Cruz, California. Michael Allen (left) and Bill Jones (center). Photo by Julie Allen
For addressing medical emergencies, we covered the following subjects:
- Bleeding – controlling bleeding from lacerations
- Dehydration – hydrating an alert patient
- Puncture wounds – tetanus shot every 10 years. Discuss when not to remove an object.
- Irrigation of wounds – Proper cleaning of wounds
- Laceration to scalp – tying hair together to close wound
- Hypothermia – get warm, drink warm liquid
- Heat Exhaustion – usually goes hand in hand with dehydration – increase electrolytes, cool down.
- Sun Burn – using Aloe leaf for treating sun burn – cool skin down, hydrate, get out of the sun
- Dental Injuries – how to avoid them, what to do if they happen
- Shoulder Dislocation – Herring-Bone method
Preventative Medicine
What is preventative medicine? These are the topics that will keep you safe, and help to “prevent” the eventual need for medical attention. Keeping alert, taking “preventative” measures before something happens takes much less time than having to “treat” for a Wilderness Medical Emergency. For example, when properly prepared, it is easier to keep warm when entering a cold environment, than to attempt to warm up after becoming cold from lack of preparation. Additionally, why have sharp fins when a serious laceration may come from it. In Surf Survival, The Surfers’s Health Handbook there is a section devoted to reducing risk of injury by making sure your fins are smooth and rounded, and making sure that the nose on your board is not shaped like a “harpoon.”
Wilderness Surfing Preventative Medicine topics include but are not limited to the following:
- Sun protection
- Staying hydrated
- Eye protection during peak sun hours
- Surfing safely – surfboard fins, rubber nose guards
- Observing your environment: Tide, shallow areas, rocks, safe entry and exit from the water
- Keeping warm in cold environments
Water Rescue
The final part of the Barefoot Doctor course is in the water. We put on our wetsuits and take our shortboards and longboards into the water to train with.
We review:
- Putting a conscious/unconscious person onto your surfboard to bring them back to shore
- Spinal stabilization on the board once they are on shore and following evacuation
- Rescue breathing while still in the ocean
- Keeping yourself safe from a struggling swimmer
- Using a surfboard leash as a tourniquet
Bill Jones on shore teaching how to use a leash as a tourniquet. Photo by Julie Allen
Michael Allen teaching how to perform a water rescue pulling a victim on top of a board in order to get them back to shore. In this version a shortboard is used. Water Photo by Dayne Allen
Michael Allen instructing prior to doing the water rescue using a longboard as a backboard for spinal
stabilization for a surfer with a possible spinal injury. Photo by Julie Allen
Michael Allen with students teaching the use of duct tape in spinal stabilization with a longboard. Photo by Julie Allen
Student supporting the longboard for evacuation and assuring the patient is comfortable and secure. Photo by Julie Allen
Final Comments
Having basic training can go a long way towards keeping you calm in an emergency as well as being able to help out a fellow surfer in need. Remember the buddy system and always keep in mind Preventative Medicine before you go out surfing. Help is usually a lot further away when surfing, but with more surfers trained, we can help immediately to provide comfort and safety, and in the most severe cases, can do what we can to save a life.
Be safe and get trained!