NEAR DROWNING ON THE RUSSELL FORK

The Russell Ford River is a steep, obstructed stream located in Western Virginia near the Kentucky border. It is known for an obstructed riverbed and severely undercut rocks and contains many Class IV and V rapids. Whitewater releases in the fall make the run quite popular. On the day of the accident there was an 800 cfs release and 300 cfs of natural flow, making the river somewhat higher than usual.

The incident occurred at the first drop of Triple Drop, a river-wide ledge creating a surprisingly sticky hydraulic. Many paddlers prefer to run to the right side of the horseshoe-shaped hole, but on October 6, 1996, this line was causing difficulties. Ken Ross was following another boater in his party down an alternate left line when he was caught in the hydraulic and surfed to the center, where the hole is very deep and nasty. After four or five minutes of aggressive surfing he bailed out and tried to swim to safety. He was recirculated in the hole 5-7 times, each trip taking about 20 seconds. At one point he straddled his kayak but could not hold on. Numerous ropes were thrown, but he was unable to see or reach them. As he lost consciousness a rope landed upstream of the hole and was carried down to him by the current. Ross's hand reappeared, holding the rope. Rescuers quickly took up the slack and pulled him to shore. Where they laid him out on a rock shelf.

Ross’s skin was pale blue and cold to the touch; his eyes were open and unfocused. After searching unsuccessfully for a pulse, rescuers began, but Ross's PFD was still on and the compressions were probably ineffective. Then, assisted by Dr. Richard Sullivan, a paddling physician, they cut the drysuit gaskets, cleared the airway, and continued rescue breathing. Once the neck gasket was cut a carotid pulse could be detected. After 5-10 minutes, Ross started breathing weakly on his own. Forty-five minutes later he was in a weak, semi-conscious state. His skin color returned and his pupils responded to light, though he was unable to speak except to give short answers to questions like whether he was cold. Though he knew he was on the Russell Fork, he had no memory of his swim and asked, “What happened?” and “Am I dreaming?” Additionally, Ross could not move.

Dr. Sullivan worked to expel water and keep Ross’s airway clear. A commercial outfitter radioed for help, and two paramedics from nearby Haysi, Virginia, were ferried across the river in rafts at Garden Hole, then ran 2 miles down the tracks to the accident site where they administered oxygen and medication to Ross. They called a helicopter. After the pilot made a daring landing on a large rock in Triple Drop,  Ross was transported to a regional hospital in Bristol, Virginia where he spent several days in the Intensive Care Unit, then several more in the wards before being released. He was still feeling tired and battered two weeks later.

SOURCE: David Cos and Dr. Richard Sullivan, who were on the scene and posted accounts to rec.boats.paddle

ANALYSIS: (Walbridge) 1. This rescue was a magnificent example of what happens when boaters act quickly to deal with an emergency. Without this prompt and effective response Ross surely would have died.

2. Keeping in mind that his effort successfully saved a life, I offer several thoughts about the way CPR was administered:

Ross was wearing a drytop, which along with the effects of cold water made finding a carotid or radial pulse very difficult. The drytop seals should have been cut, or, at the very least pulled away, before trying to get a pulse. This is important because CPR carries some risk of injury and should not be started unnecessarily.

The group did not remove Ross’s life vest before beginning CPR. In the opinion of medical people I consulted, this made the cardiac compressions ineffective. A person must be placed on a hard surface and the chest should be exposed so the proper spot to place your hands can be seen. Failure to do this can cause injury. The life vest was a pullover model which was not easily removed. It should have been cut off with a knife. Unfortunately no one nearby was carrying one.

Because the resuscitation efforts were successful despite these two lapses, I believe that Ross was probably brought back by the rescue breathing administered to him, not by cardiac compressions.

3. Jim Snyder, commenting on the accident in Rec.Boats.Paddle, recommended popping the sprayskirt and to continue surfing as the best way to exit a bad hole. As the boat fills with water, it sinks, allowing the main current to push it out.