By Tom Vines
Published Wednesday, December 28, 2011
On Oct. 12 at approximately at 1100 HRS, the Skamania County Sheriff's Office received a 9-1-1 call reporting that a kayaker had been injured on the Lewis River, located in the Gifford Pinchot National Forest in the southwestern portion of Washington State. The call was made by the injured kayaker’s friends who had been unable to get cell phone reception at the site of the accident, forcing them to travel by vehicle to another area about 10 miles away to make the 9-1-1 call.
Within five minutes, the Skamania County Sheriff's Office dispatched North Country EMS ALS Medic 51, a Sheriff’s Office sergeant, and Skamania County Fire District Engine 6. Engine 6 was the closest unit at 19 miles and arrived on scene at about 1145 HRS.
The Lewis River flows south of Mount St. Helens. In most places, the canyon flanking the river is relatively wide and accessible by a forest service road. As such, upon arrival the Engine 6 EMT was able to immediately gain access to the patient and provide a size-up to the other responding units.
The EMT reported that the patient was positioned on a rock shelf and supine at the edge of the water. He was conscious, alert and orientated. His chief complaint was lower back pain with increased pain upon deep inspiration.
In this particular area, the river cascades down a series of three falls. The accident site was at the Lower Falls. The 19-year-old male, an experienced kayaker, had ridden down a 60' lower waterfall. But instead of entering the bottom pool at an angle, his kayak hit the bottom pool flat and hard, causing him immediate pain. The other two kayakers brought him to the shore, helped him out of the kayak, and placed him flat on the rocky ledge.
Medic 51 arrived at 1230 HRS. The paramedic accessed the patient, conducted a further assessment and began initial treatment. The responders stabilized the patient on a spine board and placed a C-collar.
The Volcano Rescue Team Members with Rescue #53 arrived at 1300 HRS. The rescuers placed the backboared patient in a plastic basket litter and secured him in with 1" tubular webbing tied in a zigzag fashion.
To get the patient to a flat area and access the ambulance, they first had to raise him up a near vertical 15' cliff and then up a steep slope of another 200 feet.
To ensure that the patient would not slide down in the litter—and to be able to adjust his position as needed—the rescuers tied a Purcell Prusik between the middle of both sides of the backboard and the head of the litter. To the head of the litter they tied 8-mm rope in a figure 8 on a bight. To this, they tied 11.5-mm main and belay lines and anchored the lines to a large Fir tree at the top using 1" tubular webbing tied in a wrap 3/pull 2 configuration. They rigged the lines with a change-of-direction pulley to route the ropes around intervening trees. For a belay, they used a 540-degree device.
For a haul system, rescuers used a 3:1 MA (“Z-rig”) constructed of pulleys and Prusiks. They used four litter tenders—two tied into the litter with adjustable Prusiks and two not tied in.
At 1429 HRS, the ambulance transported the injured kayaker to the Peace Health Medical Center in Vancouver, Wash., arriving there at 1612 HRS. Physicians determined that the patient had suffered a compression fracture of L1, L2 and L3.
Sources: North Country Emergency Medical Service Assistant Chief Tom McDowell and Rescue Level Member Mike Williams provided information for this report. Some additional details were taken from The Columbian.
Lessons Learned/Lessons Reinforced:
As with extreme skiers and snowboarders who are running increasingly extreme slopes, kayakers are trying higher and more extreme waterways and falls. These areas are often in gorges and canyons where, if someone is injured, will require high-angle rope access. Responders who have such sites in their response area need to preplan for potentially challenging rescues of this nature. They should also make contact with the local kayaking community so that when an incident occurs, both groups understand one another’s needs.
Chief Tom McDowell provides the following comments: “From my perspective, once on scene, everything went smoothly. There were enough resources: The nine Volcano Rescue Team members, three ambulance crewmembers, a Sheriff’s Office sergeant and the kayaker’s friends, all able to handle the patient packaging, litter tending and setting up and managing two raising systems.
The Volcano Rescue Team is an all-volunteer unit of North Country EMS and an accredited member of the Mountain Rescue Association (MRA). Only a month before, it had successfully completed the MRA reaccreditation testing. All members were up on their skills leading to a safe and expedient operation.”
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Tom Vines
Rescue Editor Tom Vines is the co-author of "High Angle Rescue Techniques" and "Confined Space and Structural Rope Rescue." He operates a rope-rescue consulting group in Red Lodge, Mont. Read Full Bio
The paramedic accessed the patient, conducted a further assessment and began initial treatment. The responders stabilized the patient on a spine board and placed a C-collar. Photo Courtesy North Country EMS Chief Ben Peeler
The Volcano Rescue Team Members with Rescue #53 arrived at 1300 HRS. The rescuers placed the backboared patient in a plastic basket litter and secured him in with 1" tubular webbing tied in a zigzag fashion. Photo Courtesy North Country EMS Chief Ben Peeler
To ensure that the patient would not slide down in the litter—and to be able to adjust his position as needed—the rescuers tied a Purcell Prusik between the middle of both sides of the backboard and the head of the litter. To the head of the litter they tied 8-mm rope in a figure 8 on a bight. To this, they tied 11.5-mm main and belay lines and anchored the lines to a large Fir tree at the top using 1" tubular webbing tied in a wrap 3/pull 2 configuration. They rigged the lines with a change-of-direction pulley to route the ropes around intervening trees. For a belay, they used a 540-degree device. Photo Courtesy North Country Emergency Medical Service Assistant Chief Tom McDowell
