An American surfer was left in intensive care after being attacked by a shark in Bali on Monday morning.

The surfer, so far identified only as Ryan from San Diego, was surfing at Balian Beach on Bali’s west coast when he was bitten on his elbow and forearm at around 7 am. He was able to ride a wav back to shore before being helped to safety by local surfers.

Australian surfer Twiggy Van Ryan, now a resident of Bali, was on the beach at the time of the attack and rushed to the victim’s aid.

“It was a pretty heavy wound, maybe four inches either side of the tip of the elbow,” he told Stab Mag. “Basically his whole elbow had gone into the sharks mouth and it was pretty badly damaged as the shark pulled back. Really messy. We wrapped the wound properly and he went into shock – kind of a short blackout. Then the locals and myself tied the top of his arm to slow the bleeding and then got him in a car and he was taken to hospital.”

Elaborating further to news.com.au, Van Ryan said the surfer “blacked out on the beach for a little while, less than a minute,” due to loss of blood. “I guess the most unnerving thing was that there have been a few attacks up here in Bali. This one was what I would refer to as a more aggressive manner. […] Other people had been bitten on the hand or foot in murky water, this one had more of an aggressive undertone to it.”

Van Ryan later wrote on his Facebook account that he had spoken “to friends of the bite victim and he is recovering well after surgery, good news they say no ligament damage just heaps of stitches and major bruising, muscle tears etc.”

This week’s incident is thought to be the fifth such attack at the rivermouth spot in the last five years, and occurred, like most of the others, at a time when the sea was particularly murky due to outflow from the river. The general consensus is that the shark in question was most probably a bull shark, a species known for its fondness for hunting in and around rivermouths.

“[Water visibility at Balian] was shocking six weeks ago,” wrote one Facebook commenter. “Water was like choc milk and the Bulls were thick, saw four or five breaches one morning, reasonable sized sharks too up to about eight foot.” Which is comforting to know, isn’t it?