KAYAKER SWIMS TO HIS DEATH ON THE CASCADE RIVER

Near Marblemount, WA : July 17, 1994

Gradient 81 fpm; Level 2 feet; Classification IV-V

DESCRIPTION:  The Cascade River is located approximately 2 hours northeast of Seattle, Washington . The run starts at the Marble Creek Campground and ends at the state fish hatchery a mile upstream of the confluence with the Skagit River . The trip has 5 rapids rated at class V or greater and many rapids at class IV. The river was at 2 feet on the

On Sunday July 17, 1994 kayaker Jim Cothern, 38 died after a long swim. Jim was paddling a Corsica kayak with full gear, including a dry top and polypro long underwear, wetsuit shorts, a Type III PFD and a good helmet. He was travelling with a paddle raft guided by a Swiftwater Rescue Instructor. Jim had traveled from the Methow area the night before and did not get to sleep until 3:00 or 5:00 am. 

As he entered 'Starts With A Bang' (a 300 foot long narrow class V drop with a series of ledges and holes) witnesses described his descent as 'wobblly'. He ran the first major hole to the river left and flipped. After two roll attempts he swam out of his boat. A rope was thrown to him; he caught it at the lip of the next drop and grabbed his kayak. It took 2 people on the shore end of the rope to hold him. After a moment he let go of the kayak, but he was at the brink of the next drop. The shore crew could no longer hold onto him and he swam through the next set of ledges.

Our party had been scouting the next set of drops when we saw the rope thrown to Jim. With me were 2 professional river guides. When Jim swam over the ledge in front of us he was head first on his stomach, actively swimming. He disappeared under the water and then surfaced. I hit him on the head with a throw bag and the other guide came within 6 inches of his head, but he made no attempt to grab hold. At that point our kayaker got in his boat and started to chase after him. I started to run after him along the right bank. Jim swam to his kayak and lay on it. His boat was upside down and 10 to 20 feet away from him, about the same distance as a good eddy on river right or left. Our safety boat stopped above 'Bridge Drop' (Class V) and did not continue without backup. A group of catarafts came down. We yelled that there was a swimmer down stream, but they didn't hear us. The time was about 12:30.

Jim floated through 'Bridge Drop', a good sized pool, and through set of class IV until he stopped in a river left eddy floating face down. His party found him at about 12:45 and moved him to shore. He had no respiration or  pulse, and they began CPR. We arrived at 1:10 and helped with the resuscitation efforts. There was still no pulse and his eyes had dilated. We stripped off his paddling jacket and maintained body temperature with blankets. At about 1:20 we sent a runner out to call EMS . We told them we were going to transport the patient a quarter mile downstream to an old foot bridge near an old helicopter landing zone. The patient was then moved slowly but carefully over the water to a waiting oar rigged raft. Jim was placed on a thwart with a board under him. The raft was paddled downstream while a second person continued CPR.

Just downstream of the logging bridge the rafts were pulled over and CPR was continued. A group began to clear a trail to the landing zone (LZ). At the LZ the group then began to clear trees from the area. We met a ranger from the National Park Service who was arranging helicopter transport. We were then joined by the Ambulance staff from Marblemont. Using an auto defibrillation unit the patient was found to be in an asystole pattern (flat line on the heart monitor). IV's were started, and the patient was intubated. Adrenaline was not effective in restarting Jim's heart.  After organizing a caterpillar pass up the hill we transported the patient about 500 yards and 500 vertical feet to the LZ.  Due to the late hour and the distance we had to travel, patient care was turned over to the medics and we all began the long trip down the rest of the Cascade River . It was now about 4:30.

WRITER: Rocco Altobelli

ANALYSIS:  This river, while requiring solid class V skills, was within Jim's ability.  He had successfully run the river the week before at about the same level.  What caused this tragedy was not any one thing, but a combination of events. 

First, Jim's lack of sleep the night before probably contributed to 'wobbly' descent and several errors in judgment.

Second, he should not have made such an effort to hold on to his gear above 2 long, closely spaced class V rapids. You should never put yourself at risk to save equipment. This mistake was repeated when he swam to his boat instead of the shore.

Rescue efforts were well coordinated within his group. They could gotten him with their throw rope if he had let go of his boat sooner. No one else was in position to back up his groups' rescue. The decision by our Safety Boater not to chase Jim through 'Bridge Drop' was the proper one.

CPR was effectively done throughout the 3+ hour evacuation. This is a credit to the 20 to 30 people who helped with the evacuation. 

The coroners report later found that the patients lungs were full of water, and no matter how effective CPR was there was nothing we could have done for him in a wilderness environment. CPR is not a cure for sudden death; it is a technique we use to buy time until Advanced Life Support (ALS) arrives. Only ALS (heart drugs and monitor) can revive a clinically dead person, and it must arrive quickly to be effective. Even when CPR is initiated with 4 minutes and ALS arrives within 16 minutes the patient only has less than a 10% survival rate.

In recent years the effectiveness of CPR in wilderness situations has been questioned, with some wilderness first aid protocols allowing rescuers to stop CPR after 30 to 45 minutes. Clearly the people trying to revive Jim went to extraordinary lengths to bring him back.

The group believed that a helicopter would be able to lower a litter to them on the river and then raise the patient into the helicopter for transport. Helicopters are ideal for transporting patients to a hospital, but not for performing rescues. When we sent our runners out this was our last chance to communicate with EMS . Moving the patient to the trail head near the LZ was the only practical option, given the fact that a helicopter pilot would probably decline to participate in a dangerous river rescue with an unknown group of boaters. We knew we could meet ALS at the trail head and than an airlift to the hospital could be arranged. We could have been there for hours if we would have waited for EMS to come to us.

Everyone who helped out during the rescue did an excellent job, and really knew their stuff. The boating community should be proud of the outstanding effort made trying to save Jim. A special thanks should go to the Marblemount Ambulance Service and the paramedics on the scene. They were extremely well trained and equipped; one of the best rural EMS programs I have seen.