Coral Reef Injuries: What Surfers in Hawaiʻi Should Know

Coral and reef injuries are familiar risks for surfers, paddlers, divers, and other ocean users in Hawaiʻi. A wound can look minor at first but still contain coral fragments, sand, or other debris, and infection can develop afterward.

What to do right away

Get out of the water safely and rinse the wound thoroughly. Remove visible debris only if it can be done easily and safely. Clean the area well, control bleeding with direct pressure, and cover the wound with a clean dressing.

Avoid sealing obvious debris inside the wound. Deep punctures, retained fragments, significant bleeding, or injuries involving a joint, tendon, eye, face, or other sensitive area deserve prompt medical evaluation.

Watch for infection

Increasing redness, warmth, swelling, drainage, worsening pain, fever, red streaking, or symptoms that are getting worse rather than better are reasons to be evaluated.

Ocean-associated wounds can involve organisms that are different from those in an ordinary scrape. The need for antibiotics, imaging, tetanus vaccination, or more extensive wound care depends on the injury, the patient's health history, and the clinical findings.

Who should have a lower threshold for care

People with diabetes, immune suppression, poor circulation, chronic liver disease, or other conditions that increase infection risk should have a lower threshold for medical evaluation after a significant marine wound.

The practical takeaway

Most minor reef injuries heal well with good cleaning and observation. The important part is not dismissing a wound just because it looked small when it happened. Clean it carefully, watch how it changes, and get help if something does not look right.

— Nora Phillips, DNP, APRN Central Health | Wahiawa, Hawaiʻi