UPPER RUSSELL FORK (FLANAGAN DAM TO GARDEN HOLE)
Date: 10/6/18 Victim: Brannen Proctor Age: 67
River: Russell Fork Section: Upper, Flanagan Dam to Garden Hole
Location: Small rapid just above Johnny Rock Gauge: 920 cfs Difficulty: II/III+
Cause: Slipped on a rock
Injury Type: Broken proximal femur (broken hip), Partial hip replacement on 10/7/18 Factors: Rocks were slippery, poor traction on shoe soles
Private/Commercial: Private party
Experience: Experienced paddler Boat type: Esquif Nitro
We were going through a small, technical ledge just above Johnny Rock when Brannen's boat got broached on a couple of small rocks and got stuck. He was okay, head's up and stable, but unable to get the boat moving again. He carefully stepped out of his boat onto a rock so that he could move the boat to a better position and then reenter it when his feet went out from under him and he landed hard on the rock. His face immediately went white and he was unable to get back up and get in his boat.
We were just above a reasonably sized eddy so he just slid off of the rock with his boat. Once we got him and his boat into the eddy he was unable to stand up or walk and was in a great deal of pain. Liz, who had joined our group at the put in, happened to be an ER physician. She got out of her boat to talk to Brannen and asses his injury. It became apparent that Brannen would not be able to paddle or walk so I got out of my boat and went downstream to scout Johnny Rock rapid and see what our options were for evacuation. I found a route that I thought would work for the evacuation but it would involve walking and lining the canoe through the water and around rocks as well as sliding the boat over rocks in one place where there wasn't any other good way to get the boat downstream.
I went back to where the rest of the group was to see how things were going there. Liz told Brannen that if he had come to the ER with the same complaints of pain and immobility that he was currently experiencing she would be 99% sure that his hip was broken. Liz had a cell phone on her and, miraculously, it had service even though we were down in a gorge. She had contacted 911 and had them on the phone. They asked if we needed evacuation but there was nowhere to put a helicopter, no good way to get Brannen across the river and up the gorge to the railroad tracks and it would take hours to wait for a raft to launch from the top to pick him up. We told 911 that we would evacuate him ourselves but requested that they meet us at Garden Hole to take him to the hospital.
Brannen was still in too much pain to move so, since we had already established that he wouldn't be able to paddle or drive, I suggested that we give him some pain medication that I carry for just such an occurrence. Liz agreed that the pain pills were a good idea so we gave them to him. After about 20 minutes the medication started to help and we were able to move him a bit. We decided to use the boat/saddle to both transport him and immobilize his hips/legs. We helped him up and into the canoe backwards. We sat him on the bottom of the canoe with his back against the air bag and his legs on either side of the saddle. This gave him some back support and each leg was braced between the saddle and the side of the boat which effectively splinted the injured area and prevented unwanted movement.
Once we were at the bottom of Johnny Rock, Robert and I divided up my hand paddles and rafted up with Brannen. We each held on to Brannen's canoe with one arm and had a hand paddle on the other side. We ran the next three or four rapids in this fashion. When we arrived at Garden Hole we had a welcoming committee: we had the ambulance crew, the Haysi, VA police chief and about 6 deputies. They were all wonderful!
WE WERE SO LUCKY! The weather and water were warm so hypothermia wasn't a big concern. We had an ER physician, a former Paramedic/current ICU RN (me) and a respiratory therapist on this trip. We had pain medication adequate to the task. We had a cell phone and actually had service. We had a group big enough to provide the needed man power for the operation.
I LEARNED FROM THIS: Group size is important - no, we don't always need ten people but it was nice to have them this time. If we had been a group of two we would never have been able to pull the evacuation off. I did not have my phone today. I couldn't even get cell service at the hotel so I assumed that there wouldn't be any way we could get service on the river and I left it in the car. I will never again be on the water without my cell phone -
I cannot over emphasize how much help it was to have a welcoming committee at the take out waiting for us. The gear you choose to take/wear is important. I was really glad to be wearing my 5/10 water tennies when it was time to start crawling around on the rocks. Have your first aid kit with you - you never know when you are going to need something. I've carried heavy duty pain medication "just in case" for a long time but this was the first time in 12 years that I've used it.