Overflow Resuscitation
Written as told to Adam Herzog
On March 27, 2021 a 66-year-old man was successfully resuscitated at Overflow’s Marginal Monster. He has decades of class V experience and has run Overflow dozens of times without incident. He was wearing an older, high coverage, fiberglass helmet. He was struck in the lower right parietal area of his head, and he was knocked unconscious.
Overflow Creek in north Georgia was running a perfect 1.5. Sunny clear skies and warm temps whispered of the oncoming Spring.
The group of three experienced, class V boaters arrived at the great Marginal Monster on their second lap of the day. The first two paddlers ran Marginal without incident. A second group was scouting and watched from shore as the last paddler spun out above the main drop and went over sideways. He flipped at the bottom and hit his head. They did not see him attempting to roll and ran downstream. He floated near his friend who quickly realized he was still in his boat. He and the members of the second party pulled the victim out of his boat. He had no signs of life, no respiratory effort.
One of the rescuers is an RN with years of ER experience. He immediately began chest compressions, foregoing rescue breathing (as is currently recommended by the American Heart Association). Within 5 to 10 minutes the victim began breathing and regained consciousness. He was initially confused and asked repetitive questions, but within twenty minutes his mental status improved.
NB: Adam Herzog talked to Dr Jack Ditty about the rescusitation effort. Apparently "Compression only" CPR is preferred in settled areas, but rescue breathing is still indicated for drowning victims.
A runner was sent downstream to call for help from a cabin. The rest of the team began a prolonged extrication effort. Their knowledge of the local egress points and trail system proved invaluable. Several more paddlers got word of the extrication and arrived to assist. The victim was intermittently able to ambulate on his own, but at times he required assistance. He complained of shortness of breath. His breathing sounded labored and noisy. He had aspirated water. A car was driven to the Three Forks Trail and Rabun County EMS and search and rescue teams began hiking into the gorge. They had a rugged, lightweight, titanium stretcher with a center bike wheel designed for wilderness settings.
They intercepted the extrication effort and evacuation became more efficient with the stretcher. The patient was transported to the hospital and was discharged 36 hours later neurologically intact (alert, walking, and speaking normally). Attending trauma physicians said his high level of fitness worked in his favor, and helped speed his recovery.
Return of spontaneous circulation after a whitewater drowning is exceptionally rare. The team knew how to perform CPR and knew their way around the gorge. Without their rapid response this incident may have been fatal. All paddlers should be trained in basic first aid and CPR, and have a solid understanding of trail networks and access points along the river corridor.
