Lets just recap the principles of First Aid:

To preserve life
To protect the casualty from further harm
To promote recovery

Remember here that it also goes past the ‘find it, fix it’ to after care. Keep looking out for delayed symptoms and general health following the incident.

Good river guides come across this on a daily basis.

It’s about client care first and foremost.

This short tale from raft guide trainer Mark Hirst highlights the issues.

Dirty First Aid - Part 4

Green room is a classic technical three drop rapid, if you get the first drop wrong, you will flip in the second drop and your customers will swim down the 3rd drop normally giving swimmers a good 10 seconds of downtime.

During our inspection of the rapid always communicate with the customers that they have the option to walk around the rapid if they wished. For those who fancied the rapid a detailed briefing of what to do and what not to do was given. The main message was to keep calm and relax if you “Go Deep”.

Rafts 1 and 2 came through pretty clean. Raft 3 missed the line. A few swimmers fell out of the raft in the second drop. Whilst I was in my kayak downstream I made a head count just before the customers went deep.

It was pretty common that the customers would come up pointing to their ears as they had been pushed down to almost 9 meters under the water. The customers would sometimes take a few big gulps of water too so they would come up coughing and spluttering.

We got the swimmers out of the river and eventually back to the raft. We asked if everyone was ok. A few pale faces looked up and nervously smiled back to us and so the trip continued.

We would check here for flush drowning.

Then two weeks later we got a phone call at the base from a Swedish doctor telling us that one of his patients had been rafting with us and had not slept for 3 weeks due to the flashbacks of his swimming experience. The patient wanted to know what he had done wrong and was there anything else he could have done. We reassured the doctor that his patient had done nothing wrong and there was nothing he could have done.

Lets keep relationships with the casualty ongoing.



Old man river Darren Clarkson-King (DAZ) will be supplying a series of ‘Dirty First Aid’ articles for river runners.

Darren offers in-house training in the Himalaya and is a consultant for Nepal Association of Rafting Agents (NARA) making a blue print for an Industry standard.

He also paddles a bit.