First Aid on the Water

MurraySafety in the outdoors

“Hmmm… I hadn’t planned on that!”  Sound familiar?

The following article was originally published on NRS by Kyle “Smitty” Smith

Where is the second half of my crew? I’m wedged in the boiling eddy below a fierce, rock-jumbled rapid. Too much time has gone by. Something isn’t right. In the blink of an eye, I see a bright orange flash rounding the bend; it’s an empty kayak, followed by a paddle blade, then flotsam. I know what’s coming next. Kira is stumbling through the Lodgepole pines on river left, bleeding and confused. She looks like a boxer that just got her bell rung in the seventh round. Her eye is gaping at the brow, bleeding profusely—as head wounds do—down the side of her face. It’s nothing life threatening, but it’s nasty and a concussion is likely. We are miles from vehicle evacuation.

With a large number of paddlers ranging from Idaho to North Carolina to Argentina, nearly 20 boats slid into the Secesh that morning in the thicket of the Idaho wilderness. We split into two different groups to navigate a run that has been compared to an isolated North Fork Payette. We already had one person swim underneath a log and the pace was only going to pick up. Routing through one rapid after the other with little beta, Kira, as well as a number of other boaters, was left side surfing violently in random hydraulics. The edge of her kayak caught a rock, flipping aggressively, dumping Kira’s cranium into space preoccupied by Idaho batholith, some of the state’s oldest granite.

The next minute was a blur. Her boat tumbled on top of her while she recirculated in the hole for a few seconds, adding insult to injury. Tired from the violent throttling, swimming to shore amidst some of Idaho’s steepest class V was brutal. It’s a good thing that she is, as the kids say, a “B.A.” Luckily, there were a lot of hands on deck, some of which were barreling downstream without any eddies to catch amongst the chaos.

In the pool below me, pieces were collected quickly and the intensity of the moment began to quiet. Recalling the Wilderness First Responder training from my Desert Mountain Medicine course, I rifled through my kayak for my comprehensive first aid kit. Like a swift slap to the face, I remembered leaving all of my heavy overnight bags in the car that would meet us at the confluence of the South Fork Salmon and the Secesh. To make paddling this steep class V a little easier, I left the unnecessary items such as sleeping bag, water filter, shelter, food… Damnit! In the back of the Subaru, miles away, in one of those bags was my comprehensive first aid medical kit. Of course today would be the one day that I forgot it. I kicked myself. Literally.

Fortunately, statistics were in our favor. It was likely that at least one of the 20 paddlers on the water were not total shmucks. After asking around, I concluded that there were, indeed, 19 shmucks. The sole medical kit amongst all of us was sparse, but it had what we needed: Betadine, triple antibiotic ointment, a syringe, steri-strips and butterfly bandages.

I cringed with Kira while blasting her facial laceration with disinfectant from the irrigation syringe. I could practically see the skull… practically. My face hurts just thinking about her grimace every time I pressed the syringe down as hard as I could to remove all of the mucky river and bushwhacking debris out.

We closed the laceration with streri-strips and applied triple antibiotic to reduce the chance of infection. A bandage topped it off to prevent grime from getting into the wound during the inevitable hike out.

That day, we lucked out—one out of 20 people had a first aid kit. Kira got to definitive medical care after a six-mile hike to the Subaru. The doctor approved of the treatment and assured minimal scarring and low risk of infection due to the quick medical response.

When heading to the river, boaters of all disciplines check the obvious list: helmet, life jacket, dry suit, paddle/oars, throw-bag, etc. However, often times we don’t think about the next level. What happens when things don’t go as planned? What happens if I dislocate my elbow falling during a portage? What happens when the group loses a boat and at least one of us is subject to spending a night out in the elements? This is the next level checklist and one that needs to be completed if we, as boaters, are going to truly push our skills.

I have not left my med kit behind since that day on the Secesh. It’s a bit heavier than I would like and takes up more space than I would prefer during long overnight paddling missions, but I make it work. And when the situation arises, I am relieved to have it packed into the bottom of one of my float bags along with some basic medical training packed into the back of my brain.