First Aid

I just returned from taking a first aid refresher course. The Montana Board of Outfitters requires that each outfitter and guide maintain a current first aid card. Except for several hook removals, in all my years of outfitting and guiding I have never had a serious injury or accident except once and it quite serious. We were floating the upper canyon in my drift boat and the river was running about 35oo cfs which means it was rolling along at a pretty good clip. The guy in front who is an avid fisherman suddenly stopped fishing and was looking from side to side as in some kind of trance. I asked if he was okay and he nodded yes but I kept my eye on him and it’s lucky I did. In another couple seconds he went to stand up and totally collapsed off the side of the boat. I managed to grab him by his vest and hung on for dear life as we were going through some fairly heavy water. All I could do is hang onto him with my right hand and with my left on the oar keep the boat going straight through the rapids. His friend in the back tried to climb over me and was screaming that he was hemmoraging as blood was frothing from his mouth. She was right on top of my back and I told her in no uncertain terms to sit down. I have an anchor system with a foot release but I didn’t dare drop it in that heavy water as it would swamp the boat immediately. Fortunately the rapids in this canyon are short with deep pools in between. The most important thing was to keep the boat straight because if we had t-boned one of those big boulders it would all be over. As soon as we got into the pool I stepped down on the anchor release. It’s also fortunate I had this type release as these boats come with the option of a right side hand release or the foot release. As soon as the boat stopped I pulled him in. He wasn’t completely out with just his head and shoulders hanging over the side. He was a big man and it took some effort to get him all the way in and while I was pulling him in it was obvious he was suffering from a massive seizure. The blood frothing from his mouth caused by him biting his tongue. I laid him across the front bench of the boat, put a life jacket under his head and simply let him continue with the seizure as I was taught in First Aid Class by the EMT’s. You never try to restrain them or worse try to put something in their mouth such as your finger. Art was behind me a ways and in a few moments pulled along side. I had one of his passengers get in the front of my boat with him and told Art to row as fast as he could to the landing and go to this nearby house and call 911. He started to settle down and I got under way pushing on the oars as hard as I could. He was just semi conscious and his breathing was shallow. At one point I thought I was going to have to stop the boat and start CPR as he quit breathing for a few seconds but then started again. When we got to the landing I kept him laying in the boat, made him as comfortable as possible and waited for the ambulance.

This person had never had a seizure before and I have known him a long time. He spent that night in ICU and by the next afternoon was well enough to be released. The hospital had done what ever tests they do and could find nothing. Late that afternoon I drove him and his friend to the airport as he wanted to get home asap and see some specialists. He had absolutely no recollection at to what happened and kept apologizing for making such a mess. He said that actually the last thing he really remembered was having that gourmet shore side lunch, subsequently no more gourmet lunches.

Had he gone completely overboard in those rapids the outcome would have been dire to say the least. This creates a scenario I would like to present. Lets say he went overboard while having this seizure and you were rowing the boat, what would you do? If you jump in after him and you know the other person in the boat is panicky and has no idea how to handle a boat especially in rapids, they might be lost and you might drown trying to save him.
What would you do? Love to hear some comments.

5 Comments:

  1. Geez, that’s a tough one. I would have to say that you’re best bet would be to try and make it through to smoother water before moving close to shore and dropping the foot anchor. Since you have another person on board, you can still use their help. But having them row, is completely out of the question. You’re best bet is to try and pass the victim down the side of the boat towards the back so that the other person can hold onto them until you can get to smoother water. They don’t have to pull him out, just keep his head above water and from hitting rocks and other hazards. Having a second boat along also saved you alot of time, since you sent Art ahead down river to call for help. Smart move. Just out of curiosity, do you carry a first-aid kit along on the boats?

  2. Roger Oettli

    Leaving for Arizona this next week. Will give you a call and get an update from Divide beyond your web site. Hope all is well with you and Art, along with the animals.\Later R.

  3. Al –
    Stay in the boat. I know YOU weren’t wearing your PFD. Was the client? If you jump in, you might die. He will probably die, and the client’s wife may also die. That is a lot of flotsam drifting down the bighole.

    Given the riffle, run, pool nature of the Big Hole, there really isn’t a rapid that lasts more than a 30 seconds or so. Even if unconscious, your guy has a good chance of making it through the rapid (if he doesn’t get impailed on a stone). If I lost him, I would first throw him the PFD that he should have been wearing, instruct the other client to put hers on, then row as fast as I could through the rapid, such to gain position on him when he hit slackwater. After the run, you would have good position to snatch him out of the pool – and worst case scenario, you could anchor and swim.

    Remember that the captain’s charge is his crew and ship – and that he is always the last one to leave the boat. It is easier to command from the pilot house – rather than from beneath the keelson.

  4. I say a combo of jason and buggerman’s approach. Put the boat in position so the rear person can grab him and hold on or get him out, be extra careful about rocks through the rapids, and then do just as you did. No way do you leave the boat, nor do you want the victim pinballing alone through the rapids–you might never see him again.

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