In going through some old links on the BWA site as Hanley had requested, I found this old article regarding a fatality that occurred on the Ocoee several years ago. I do not know the author or the victim as this occurred before I joined the BWA although I am sure some of you do. I do know that a lot of us were out on the BSF yesterday and that the water temps were on the cold side. Take a few minutes to read this and make sure that you have the right gear for cold weather paddling.

Bowlines Nov/Dec 1997
Emergency Preparedness: A Wake-up Call
Jim Daniels

I was on the scene shortly after they pulled Mike Reisman out of the Ocoee on that fateful Saturday, November 1, 1997. I know how hard those good samaritans were working to save Mike, against ever increasing obstacles. While I watched in the cold rain, it kind of dawned on me that a lot of us who have been paddling for a while take the inherent risks for granted. After all, this was just the Ocoee, a river that most of us on the scene, including Mike, had paddled many times. I realized that this isn’t an amusement park, although it seems like it sometimes, and that OSHA hadn’t been here to assure its safety. Although I don’t know what he was wearing while he was paddling, Mike was now lying on that rock dressed only in a long sleeved poly top and shorts. He was barefooted, as I was, since we both were paddling RPM's. I was getting cold, and I had on a long sleeved polartec top under a drytop, with long wetsuit pants. I kept kicking myself for not having already purchased that space blanket I had been thinking about for cold weather paddling. I surmised that hypothermia must be exacerbating the problem of Mike going into shock and subsequently, cardiac arrest. Yet no one had anything to offer that could have been used to keep the elements off of him.

This tragic accident occurred in a river near a heavily traveled road, with emergency help only moments away. I estimate Mike was in the ambulance within 45 minutes after he was pulled from the water. It exemplifies how fragile we humans are when injured and how fast life deteriorates under extreme stress. Most of us paddle in winter conditions that are much more remote than the Ocoee. Most of us are not even remotely prepared for dealing with an accident victim under these conditions, or even if we are hurt our-selves. This incident should be a wake-up call for all of us to be prepared for situations where members of our boating family could perish.

After I got home, I purchased that space blanket (two bucks at Walmart, and it only weighs a couple of ounces). It will be in the first aid kit in my boat from now on, and I will replace it with a new one every year. We should all get back into the habit of carrying throw ropes, and knowing how to use them. We should all be trained in CPR and First Aid. We should all take a whitewater rescue course and practice the techniques we learn. We should dress like we are going to take a swim, even if we haven’t taken one for a while. We should wear full coverage helmets.

These are just the bare minimums. If we paddle really remote areas, we should consider taking EMT training. I don't know if I had been carrying a space blanket on that day, it would have made any dif-ference. I would like to be able to turn the clock back and see.

Allen

Here is a great article from Larry Cable.

Thoughts on Survival Gear
By Larry Cable January 28, 2005

There has been a lot of talk on Boater Talk and American Whitewater lately about what to take as survival gear for winter paddling trips. while I don't profess to be an expert, I've spent my fair share of time sleeping out rolled up in my poncho, so let me give you some of my lessons learned.

What is Wilderness Survival? At the basic level, it's keeping the body within an acceptable temperature range, reasonably hydrated and with enough fuel to adequetely support normal body functions. It important to understand what body functions take priority and address those issues.

Simply put, you will die of hypothermia/exposure before you die of thirst, you will die of thirst before you starve to death. The military survival courses (and the Boy Scouts) give ther priority of work as first aid (they are assuming an aircraft crash), shelter/protecton from environement, water and then food. From a boater's point of view and the time frame that we are talking about, only the first three really effect us, particularly shelter/protection from the environment and water. Lets take a look at these individually.

When we talk about shelter/protection from environment, what we are really trying to prevent is hypothermia. So how does the body lose heat? The basic mechanisms of heat lose are conduction, evaporation, convection and radiation. So how do we prevent and/or slow these processes? The first and most important step is to dress for the environment. For winter and early spring boaters, in my opinion, a minumum level of dress should be drytop, layered pile/poly, neoprene or fuzzy rubber pants, and decent shoes. A farmer john is under the drytop is better, a drysuit is even better and a goretex/breathable drysuit is ideal. Remember that drysuits do not insulate, so wear the proper layers under it. If you can't wear shoes in your boat, get a different boat for winter creeking. Carry a helmet liner and a spare pair of pile of poly glove, you lose a lot of heat throught your head and hands. As a side note, if you are hiking, carry a full rain suit, a pile or wool hat and a pair of gloves.

I carry water pirifications tablets with me on river trips. While you can probably survive for several days without water, especially in the southeast, dehydrations effects preformance fairly quickly and makes you a lot more likely to become hypothermic,so water becomes a survival issue a lot soon that most people realize. Take the tablets along and stay hydrated. A good alternative is a water bottle with the built in filter. Then all you need to do is scoop and drink. Be aware that silty water with clog a filter in a heartbeat, as will high tannin levels. I would still carry the tablets as a backup even with one of these units. Pur makes a chlorine based tablet if you are sensitive to iodine.

So what do I carry in my survival kit? A survival blanket called a "heat sheet", LED flashlight, butane lighter, 2 "Wetfire" firestarters, a candle, water purification tablets (Potable Aqua), a small tube of sunscreen/bug repellant (this isn't a critical item in the winter, but I leave it in there anyway, a Fox whistle, a small compass, a piece of aluminum foil (wrapped around the candle), backpackers toilet paper (my single concession to civilized standards) and some kind of energy bar. All of this fits into a 32 oz Nalgene bottle with a bit of room to spare and weights around a pound. I prefer the "heat sheet" to a "space" blacket because it's a bit larger and the outside is blaze orange. Any of these aluminized poly film blankets to an excellent job of slowing radiant heat loss and help with evaporative and convective heat loss by blocking the wind. They do very little to prevent conductive heat losses, something to keep in mind if you end up trying to sleep in one overnight. The "wetfire"tinder blocks are small, burn hot, and will light when wet, and important issue if you are trying to start a fire with wet wood. An alternative to these are "esbit" fuel bars. They are small and will also light when wet, although not as easy as the former. The candle is a back up, it puts out surprising amount of heat if you sit it between you legs and block the wind with the survival blanket. You can actually heat water over it if you have a canteen cup (you can fabricate a cup to heat water with out of the aluminum foil in a pinch). The sound of a Fox whistle is supposed to carry farther than the standard, but this is something that I haven't tested. The compass I carry is a small Silva compass that will cIip to a pocket. I use a Princeton LED flashlight because of the size, brightness and long battery life. This kit is easy to throw into your butt pack or day pack if you decide to go for a hike too.

I carry a seperate first aid kit in a drybox, although it is easy enough to put these items into a Nalgene bottle (the cheapest reliable dry storage). I carry a CPR shield and gloves in the pocket of my PFD, along with a whistle and a knife, my preference is a folding Spyderco Rescue. I carry a basic pin kit in a seperate small drybag (pin kit= 2 prussik loops, 2 carabiners, and 15' tubular webbing) plus a 5/16" spectra throwrope to complete my basic creeking gear.

A couple of parting thoughts if it comes to the point that you are going to have to walk out/spent the night on the river. Walking out in the dark can be very dangerous and it's very easy to get lost if you are not on a clearly defined trail. Find or build some shelter and settle down for the night and walk out the next day. Be familar with the basic orientation of the area that you are paddling, where the roads and access points are and how to get to them. If you seperate from the rest of the party, they paddle out and you can't, have a plan on where you are going to meet and what the contingency plan will be if you aren't at the meeting. Learn how to build a fire when the wood is wet (hit: only the outside of the wood is wet generally, shave it off and burn the dry part. The dead limbs close to the trunk of standing trees are often dry even after a rain. If you end up sleeping out, try to insulate yourself off of the ground with dry leaves or dry grass, it helps with conductive heat loss into the ground.

Hope this helps if you ever find yourself in one of these situations.

Allen

Allen,
I was paddling with Jim that day on the Ocoee.
This accident was really sad. We helped where we could. I ferried the floating stretcher from the ambulance out to the middle of the river and we helped get the victim back up the bank while maintaining rescue breathing. '
This was the second cold weather fatality I had witnessed. The other was a rafting customer on the Gauley. After a total yard-sale raft flip, Lloyd Funhouser and I helped get an unconscious lady back into the raft where the guides took over with CPR.
Witnessing these events was profound to say the least. Mother Nature will gain our respect one way or another.
-Beel

Bill,
You are right about Mother Nature and the respect that we have to pay. Sorry that you had to experience the deaths of fellow boaters.

Allen

Not much that I would add to the original article, but a couple of notes.

Don't panic about hypothermia. It's definitely a killer, but a lot of the stuff you hear just isn't true. Humans can survive quite a long time in cold water before it kills them and the stuff about it killing you in 10 or 15 minutes just isn't true. Now it will start effecting your physical and mental abilities much quicker, but a swim in cold water won't kill you or all of us old timers would be dead.

OTOH, on a cold day after being wet all day, hypothermia is a distinct possibility with paddlers. If you start feeling chilled and start shivering, or you notice you buddy shivering, stop and treat it as the beginning stages of hypothermia. Heat, beat and eat. Start a fire, get the person moving and feed them. Make sure they are hydrated.
The first sign of real hypothermia is often referred to as the "umbles", grumbling (mode change), mumbling and stumbling. Don't let it get to that point.

One last comment. The article was prompted by a Red River Trip that Chris Hellman and I were on when one of the other paddlers got on the river with a repetitive shoulder injury and dislocated again, actually about four different times during the day. So a couple of lessons from this trip. One, think about your physical condition before you jump on a remote run in cold weather. Days are short and a lot of the winter runs are real buggers to walk out. Two, if you do get injured on the river, you owe it to your paddling companions to give them a honest to god, no shit assessment of your condition. A lot of the delay on the above mentioned trip seemed to stem from the fact that the paddler was female and didn't want us to think she was a "Girl". Forget that nonsense. I've walked and/or ferried a lot of big tough guys off the river. If you are hurt, let you paddling buddies know and set down and make a reasonable evacuation plan.

Getting down off my soapbox now.

Larry

Larry Cable

A really interesting discussion. I'll back Larry up pretty much on what he says. I've got a really good hypothermia story that was posted by John Svendsen on the Old Forum before we lost it. I retrieved it from the Google cache and saved it because it was so good. I'll post it next.

Meanwhile, here's the accident report on the Ocoee incident being discussed here. Pretty interesting read. Evidently a serious head wound and a knife wound in the thigh played a major part in this event.

http://www.americanwhitewater.org/content/Accident/detail/accidentid/465/

Hanley

Here's that story I was talking about. It really illustrates true hypothermia and how it progresses. It's kind of long, but a really good read.

Hanley

From the old forum:

*****************************************************

The beautiful upper Red River is a siren song for unsuspecting boaters.
Bruce Layne

By John Svendsen (Johns) on Monday, January 31, 2005 - 09:58 pm:
Well with all the recent information on preparing oneself for a cold weather paddling trip I can't help but to share with you a tale of woe and misfortune as to what can happen when what is not quite prepared for an adventure -- so without further adieu --

Spring Break on the Upper Red River Gorge -- A tale of alcohol, stupidity and hypothermia.

March 1982 - Out on spring break, my good friend Steve Hedges and I decide to do a little bit of canoe camping. Our goal was to take 4-5 days to paddle a 30-40 mile stretch of Rockcastle Creek in central Kentucky. We had a large 17+ foot "special age-hardened, stretch-formed aluminum alloy" Grummann canoe -- you remember these beasts? -- and probably a hundred pounds of equipment--tent, sleeping bags, and provisions. Unfortunately when we got to Bee Rock it was raining hard and heavy so we spent the night there at the campground hoping the rain would cease during the evening. Unfortunately it did not--in fact it just kept raining--all the next day without a break. So we set on the banks comforting ourselves by drinking beer all day watching the rain come down and the river turn muddy and rise. No big deal--we had all week to paddle. But the next morning it was still raining--less so--but still a constant drizzle--leaving us with another day on the bank drinking beer and singing the same old songs. Fortunately, by the third day the sun was trying to poke out of the clouds and the rain had stopped. Only problem was the river was in flood and certainly no longer offering us the opportunity to paddle and camp. Hmm--what to do?

"I know, Steve! Let's drive up to the Red River Gorge. Maybe it hasn't rained as much up north. And if we put in on Highway 746 and paddle the upper gorge we can still put together a 20-30 mile trip and camp along the way." "Yeah let's do that!" So we broke camp and drove up to the Red River Gorge. We entered the lower gorge through the Nada tunnel and drove the road that parallels the river. The scenery was absolutely beautiful -- tall cliffs, rock arches, stands of virgin hemlock and an understory of rhododendron and mountain laurel. We pulled out a fifth of whiskey and went to sipping as we drove up the valley, back to the parkway and to the put-in. We'd catch glimpses of the river as we drove--it was high and muddy but certainly didn't look threatening--we could do this! But little did we know the upper gorge and lower gorge are two entirely different animals.

By the time we got to the put in we were already a bit tipsy -- but ever so excited to finally get on some water. Our spring break was looking much better even though the clouds were again building up and blocking the sun. We loaded the boat--strapping the gear in tightly--as we knew the upper gorge was considered to be a true "whitewater stream". Seemed to be a perfect test for our youthful tesosterone --

Now I know you are all "in the know" but for those who have yet to paddle the upper Red River let me interject here the AWA's and Chris Chaney's description of the upper Red River Gorge reach:

"The Upper Red River Gorge is one of the more sought after white water runs in the state. From the beautiful river wide Calaboose Falls to the large boulder garden just before the Narrows to the last stretch of white water through the house sized boulders below Clifty Creek you won't ever forget the beauty and grandeur contained within the Upper Red River Gorge. A kayak or white water canoe is the best choice for the exhilarating trip through the boulder gardens and trackless stretches of forest the Upper Gorge has to offer. Many flat water canoes piloted by inexperienced boaters are lost or ruined every year. The Upper Red is not the place to learn white water paddling or a place to take the wooden canoe you inherited from your grandpa. Experience in a white water environment and first aid training of some kind are highly recommended before attempting this or any remote white water run. Rescues in the Upper Gorge are long in coming and difficult to execute. The Upper Gorge is 9-10 miles of rough terrain surrounded by high cliffs and dense hardwood forests. This combined with a mostly winter and spring season make for a serious undertaking to say the least. Be certain of your abilities before tackling this spectacular run."

"The difficulty level of this river varies a lot depending on water level. At low flows the river is suitable for advanced beginning kayakers. Tight manouvering through boulders is required though, which would be difficult for a canoe. At high flows the rapids become more straightforward to navigate, though they are pushy and powerful, and some holes need to be avoided. At very high water the Red is extremely dangerous."

Karl Whipp further testifies:
"EXTREMELY remote. Once you're in, the only way out is downriver."

OK so now you know what Steve and I are about to get ourselves into and this was back in a time when the only whitewater experience I had had was paddling on some relatively pleasant Class II streams in Arkansas. As for Steve I think this was his first time on "moving water".

So anyway we down the rest of the whiskey, high five one another and jump in the boat just as it begins to rain once again.... The first couple of miles finds us enjoying the scenery like bumbling drunks but the rain which is now turning to sleet was beginning to sober us up a bit when we hit the first Class III rapid. Now I can't recall what went wrong but we soon found ourselves swimming along side a capsized canoe -- we beached the boat, "squeeged" the cold water from our long johns and levi pants and still somewhat happy with alcohol we were quickly on our way again.

As our teeth began to chatter we decided we would pull out at the next spot flat suitable to set up camp. Now the problem is -- in the upper gorge there are no flat spots to camp along the river--rather the bluffs come right down to the water--and any land adjacent to the creek is nothing but a rhododendron thicket that was now slowly being covered by like a 1000cfs of muddy flooding waters pouring through the gorge. Soon we entered the Narrows where the gorge collapses in on the river and there is continuous Class II-III pushy, pushy water. Soon thereafter we broach the boat mid-stream on a large rock. Water quickly fills the boat as it begins to wrap on the rock. "Please No!!" We jump onto the large SUV size rock in the middle of the stream and begin to panic as the sleet now turns to snow. Its obvious that in order to free up the boat we will have to empty it of all our camping gear.

As the rock on which we are centered is not big enough for both us and our gear Steve elects to swim ashore with the idea that I would unload the canoe and then toss the gear 10 feet or so across a rushing channel to him to deposit on the bank. So Steve jumps into the raging current -- but he's not swimming! Rather I see him being tossed about as he bounces downstream through a Class III boulder garden and is dumped into a quiet pool some 50-60 yards downstream. He swims to shore and crawls up onto the beach. Now he has to make his way back upstream to where I am -- and this is no easy task -- in essence its a steep Class V rock scramble across the face of a ice-covered bluff. Seems like nearly a half hour passes before he makes his way back upstream where he perches himself on a rock on the shore as close as he can get to me. I toss over the first big bag of gear -- "Dam! Be Dam!" it falls short and Steve makes a desparate grab for it and loses his balance falling off the rock and into the cascading water below. Again I watch him bump his way through the boulder garden, dog paddle out of the froth, crawl ashore and wait for him to climb the bluff back upstream to where I again wating and shivering. We make a pact that he is not to jump in again--"if it happens again Steve, just let it go!" We finish emptying the boat without further incident except for the last large bag--the "kitchen bag" -- the one with our "food, stove and lighter". It falls short -- I see Steve begin to jump and I scream to him "let it go, just let it go" -- we're happy to see it still floating as it reaches the recirculating pool down stream moving and bobbing about. Got to be fast--get down stream before it goes under--I rock and bend and twist the boat, pull it off the rock, drain it and climb in heading downstream as fast as I can go to retrieve the "kitchen" but by the time I get there it is too late--no bag can be found--our kitchen is at the bottom of a deep recirculating pool. Moreover all the rest of our gear is now upstream and has to be portaged down to the boat--a most horrendous task in the cold, in the snow, and in wet clothes. But the work keeps us busy and warm.

With our gear piled about the boat and snow lightly falling we were no longer smiling--not even close. Our sleeping bags and dry clothes were now soaking wet -- another lesson learned: plastic garbage bags aren't a very effective dry bag in these type of conditions. But the real icing on our nose was it was getting dark and cold and a fierce wind was building momentum and biting our exposed flesh. We were soaking wet and shivering and had no dry clothes or even a way to start a fire. And we were "up the creek without a paddle"--somewhere in all the confusion we had lost one of our paddles. In a panic we felt there was only one way out of our dilemma -- we had to push on to the take out as quickly as possible -- albeit we knew that the worst part of the river lay ahead -- something we had heard referred to as the "Falls of Little Red".

So with wet gear stowed in the bottom of the boat, Steve shivering and paddleless in the front and with me paddling in the back we headed onward in pitch black darkness--our continued descent measured only by the snow hitting our faces. We passed through several cascades without incident--cascades we couldn't see, only hear--when we could begin to hear the dreadful roar of the "falls". All we could do was try to stay midstream, lay low in the boat and cross our frozen fingers. I think I could also hear Steve praying as we reached the falls. Lesson 2: The symptoms of hypothermia usually develop so gradually that neither the person himself nor others realize what is happening.

In the darkness I have no idea what happened other than we hit rocks--lots of rocks--and the boat came to a stop, flipped violently and threw us both overboard. I swam -- we're talking like a "swim for your life" swim. I finally reached the bank on river right but tired and worn out I was unable to climb the bluff to higher ground. And somewhere in the darkness I could hear Steve scream for help. But cold, frozen and empty of all resources all I could do was just lie on the bank trying to keep the water from lapping up on me. Slowly it got very quiet and I fell into a dream state--not quite a sleep but certainly deprived of my full sensory innervation. I closed my eyes. Lesson 3: As body temperature falls further, shivering stops and movements become slow and clumsy, reaction time is longer, thinking is blurred, and judgment is impaired.

I don't remember how long I layed there when all at once an light shone in my face--up above me high on the bank an angel was shining down on me. I could hear feet scrambling down the hillside and all at once a bunch of hands and arms pulled me up the steep slope. Such strength, such stamina, I was awed! A voice said "Is anyone with you? We thought we heard someone else screaming for help." I shake myself to life and respond, "Yes, Steve. Steve is out there somewhere". "Wait here"... and the light and the arms and legs disappeared into the darkness. I lay back down on the snow covered ground.

Soon thereafter the arms and legs return and with them Steve -- this awakens my senses and I find that we had been recovered from the river by two other students that happened to be camping on the river for spring break. They took us back to their camp--I remember trying to keep up with there one rapidly dimming flashlight as it dashed about over the snow covered ground--slipping and sliding and falling but happy that we had been rescued. But it seems not all was well.

When we reached their camp--I found that they were in just about as bad shape as we were. Their little 2-man Wal-Mart special one-season pup tent was lying on the ground--wet with rain and now covered with slush and snow. They too had been having a miserable evening when they heard Steve's call for help and it was only with considerable reluctance and hesitation did they even considered to venture out to look for us. And now that they had found us they had little to offer--no dry clothes, no warmth and no food other than a pack of peanuts, soggy chips and a half of case of beer. Their heroism was taking a back seat to their personal comfort and they really wanted nothing more to do with us. They stumbled about in the darkness trying to some way to prop up their tent with a few sticks. They were eager to find shelter -- "Sorry man but we gotta get some sleep". Getting to the trailhead--some 4-6 miles distant--in the dark, in the snow was deemed impossible. And as they crawled into their tent all at once what ever lasting little piece of fire that existed inside me was quenched -- with their apologies they gave Steve and I a piece of Visqueen as they zipped up the tent and their flashlight went out dead.

In the darkness Steve and I crawled into a rhododendron thicket, wrapped the Visqueen around ourselves, and hugged one another tightly. Very very tightly. And the snow kept falling.

Soon I fell into a peaceful sleep--one of those sleeps that if there is no one to shake you up the next morning that you might just completely forget to wake up. Fortunately someone did shake me--I opened my eyes. Steve was gone but I finally saw one of our rescuers -- he look miserable. He was trying to get a fire going without success -- a week of rain and snow had saturated everything. He explained to me that he had been asked to stay behind while his buddy helped Steve back to the trailhead. Their goal was to drive back up to the put-in and retrieve our car. Meanwhile, we were to break camp and meet them at the trailhead.

Now all I wanted to do was sleep--but I knew I was only a few hours away from the warmth of the car. I had to hang in there. Moreover now that my clothes were frozen stiff--they really didn't feel near as cold. And the snow covered ground was beautiful--inspiring me--motivating me. I could do this--obviously Steve could--but by the time camp was broken down I was already exhausted. The march out was more than I could do as I stopped every 40-50 feet begging to just lay down and wait for help. Lesson #4: As the body temperature continues to drop the person may fall, wander off, or simply lie down to rest. If body temperature continues to fall, shivering stops, which is an ominous sign. At that point, the person becomes more sluggish.

My rescuer pushed me on with threats of "leaving my ass out there to freeze". ..."so be it!" I thought yet I trudged on...the trail along the river is always rough as it skirts up and down over rocks but it never seemed so long...I was beginning to doubt if I could make it -- in fact, it was getting fairly obviously that I was nothing but a liability -- constantly stopping, constantly falling down, constantly closing my eyes -- sleep walking. After probably covering only half the distance I was again saved when the second rescuer came walking up the trail coming in to offer additional assistance. With an arm around each of em and with one of them holding me by my pants they walked me out. Lesson #5: Movement and exercise in a patient with hypothermia moves the colder peripheral blood back to the body core and exacerbates the condition and can contribute to heart arrythemias and induce coma. Somewhere on the hike back I passed out.

I woke up lying in a hospital bed in Stanton Kentucky. A thermal blanket covered my trunk and a warm IV solution was trickling into my arm. My body was blue and magenta with deep black bruises covering my legs, arms and trunk. I hurt everywhere. My core temperature had dropped to 92 degrees and they were making every attempt to warm me back up. I shivered uncontrollably as a nurse fed me a warm broth. By that evening my temperature was back to normal and wife drove over from Louisville to bring me back home.

I slept all the way home or at least tried to as my wife scolded me -- all our camping gear that we had accumulated over the past 2-3 years by selling plasma and working odd jobs was gone--the boat that I borrowed from a close friend was gone--and that I had been foolish and reckless and stupid...and now I needed to find a way to pay off the hospital bill. I closed my eyes and the hum of the road did the rest.

The next day I could again feel pain -- both Steve and I looked like someone had taken a baseball bat and pounded every square inch of our bodies -- bruised, blackened and swollen from the pounding we took in the shoals. Moreover I couldn't swallow...so much pain! Lesson #6: when you get hypothermia all the blood is shunted to the internal organs and brain depriving the extremities and external tissues of nourishment -- the body's goal is to preserve the core. In this case, the mucosal lining of my mouth and throat had been frozen and "starved of blood" and was now dying and sloughing. I coughed up mucus and blood and tissue remnants for several days...between sips of cold water and bites of ice cream--yes now I was looking for something cold!

Later that first day home I went outside and laid on the porch--it was now in the 50s and with the sun beating down on my aching, bruised body I could feel each ray of light restoring my body back to health. For several days thereafter I grimaced in pain with each swallow, each step, each movement--but learned a most valuable lesson along the way. I have since spent many days camping at high altitude in sub-zero weather and have been cold and wet for hours on end but from here on out I'll never put myself in a position of not being able to affect a self-rescue (or having someone there I can depend on)-- for had it not been for those two kids--whose name I never got and who maybe be reading this right now and recalling those events from over a decade ago -- I probably would still be sleeping in the upper Red River Gorge of Kentucky.

Hanley,
I remember the story about the fatality on the Ocoee. I just never had a name to put with it. Everyone should read the accident report. It just shows how quickly one thing can lead to another until the situation is out of control. I think the moral of the story is to be prepared because the gear that you carry might actually be used to save your own life.

Allen

I think it also says something about remaining calm and composed and thinking carefully about your actions when attempting a rescue. Now, I want to be clear that I absolutely am not accusing anyone of acting rashly. First off, I wasn't there and I don't know. Secondly, I've been in those situations and I know how hard it is to maintain your composure, a lot like your first 50 or so combat rolls. Only the experience of going through those situations can prepare you for them. Still, when using a knife or a rope on the river it is always important to try to make a conscious effort to think about what you're about to do and the possible consequences and this report illustrates why.

Again, I'm not saying that anyone involved failed to think about those consequences. I'm sure everyone acted within the boundaries of the situation in the most effective manner they were capable of. Circumstances dictate actions. I'm just saying that it's something to think about and keep in mind when things go bad.

Hanley

PS: For my money, about 10 times more bad things happen from would-be rescuers improperly introducing a rope into a rescue than anything else. Carry a rope, but learn how to use it properly.

Good stuff. I cannot fathom how a physician could make such a huge error as to cut the femoral artery unless he just panicked and cut without thinking. As Hanley said, slow down enough to think about what you are doing. Very few skirts will not come off if you just grab and pull at one of the front corners. If you must cut, as a last resort only, then cut behind the victim. You cannot cut anything of significance if you just cut the skirt behind them! Takes the legs / groin totally out of the picture. If you cannot get behind the victim for some reason, then make a very careful cut along the rim - more risky than cutting behind because the knife could slip off of the rim but pretty safe if you're careful. There is NEVER any reason to cut inside the rim in front of the victim! Also, consider a safe knife. I like the NRS Pilot knife. My second choice, and the knife I will get Brit would be the Bear Claw. Hard to do something bad with it ... but it's an excellent emergency rope cutter.

I also couldn't figure out why they weren't working on getting the Ocoee victim to shore as soon as they had him upright and accessed he was breathing and with a pulse. On a rock in the middle of the river is a pretty crappy place to do CPR. I'm not exactly sure where they were, but I wonder if maybe they could have made a quick catamaran with 2 other kayaks, paddles and the victims boat to ferry him across. If possible, move the victim to a better place while they are reasonably stable so if they become unstable you are in a better able to provide more effective aggressive care. That would have totally eliminated the waiting on the raft. There is some risk of C-spine injury in that scenario. If someone has a sam splint you can make a quick collar with it. Otherwise, get enough folks there to provide neck stabilization while you move them to a warmer place. Someone could have maybe even been building a fire on the shore while you are moving them. A good reason I suppose to always carry the means to make fire, even on the Ocoee!

In the Fall/Winter/Spring I travel with a 500mL thermos of hot tea in my boat and Brit has one of hot cider in hers. It's an easy and fast means to warm someone up quickly if they start to chill.

Last year at the Wilderness Medicine conference for the first time I took the optional workshop "Surviving the Unexpected Night Out". I commented on this last year the day after the course on this forum and found it very helpful indeed. Many cool survival tips.... these stories have motivated me to go and review them again.

I rarely boat in what I would call a wilderness area in marginal conditions, but I do think it's high time I put together a survival kit. One thing I would recommend is the space blanket bivy instead of just the blanket. It's actually pretty hard to get yourself wrapped up in the those mylar blankets, but at least with the bivy you can crawl in and seal it up. They happen to be on sale at Mountain Gear:

[www.mountaingear.com]

Maybe more later as I review my notes from my course. Be safe out there and when you become a rescuer / first aid provider, remember the Hippocratic Oath: First, Do No Harm!
Wes