have rafted the Wenatchee River in WA, CLASS III, twice with professional outfitters. I signed up for the White Salmon trip with a work club/guide group. I have no idea the experience level of the guides and their rescue and first aid training, and failed to ask. It seems to be a casual group, yet they guide trips for the inexperienced. After a brief instruction we launched in a raft holding six passengers and one guide, on the White Salmon during Class III-IV conditions. After some discussion, it appeared that the guide on the raft I was on had not been on this river in several years. One passenger had no rafting experience and another, sitting directly in front of me, exhibited difficulty following instruction as he paddled sporadically against the rest of the crew. We rafted/practiced for a few miles on the river over Class III-IV rapids. We docked the rafts for lunch, discussed going over Husum Falls, a CLASS IV-IV+ waterfall, re-launched and practiced our positioning for the fall. We stopped again to view the fall we planned to raft over. After watching it and a group discussion we decided to raft it. We briefly reviewed the training and instruction from earlier, launched the raft, and headed for the fall. Just before the fall, per the guide’s instructions, we assumed the positions to ride over the fall. Once we entered the fall, my view was completely obscured by the falls; I felt the momentum and then slammed into what felt like a solid rock full force. After exiting the fall and scanning the scene for fellow rafters I noticed I was bleeding from the mouth area, my teeth and jaw were severely offset, and my jaw was in pain. Other passengers verified my teeth and jaw were out of place and I was bleeding significantly. We guided the raft to shore where I sat for 10-15 minutes with no medical attention from the guide. We then walked up to the road, sat on a random trailer and waited for the trip leader, arriving 10-15 minutes later. The leader arrived with a small first aid kit and clumsily cut a small piece of pad for me to place on my bleeding face. The guides discussed whether or not to drive me to a local hospital or call an ambulance, and eventually decided to call an ambulance. While waiting I lightly put pressure on the sides of my lower jaw and noticed it was very unstable/unsecure and quite painful. 10-15 minutes later an ambulance arrived and for the first time since the injury, I was evaluated by a trained medical professional (EMT). I seriously question whether any of the guides for this group of seven rafts are currently trained in rescue, first aid, cpr, etc. I am fully aware of the risks of outddor recreation, but what happens to the next injury victim after the injury is incurred! Who the heck is going to provide emergency medical attention at the scene!