The Offshore Voyaging Reference Site

Broken Skipper—What We Did Right

In the last article I covered the story of my accident. In this one I’m going to go over some of the things we did correctly, both before and after the accident:

Clothing

As is our habit whenever we hike, we were both dressed right, not only for the prevailing conditions but for any deterioration in the weather or the need to be stationary for some time: Smart wool and capilene next to the skin, a quick drying layer over that, topped with fleece. In the pack were Gortex outer layers, gloves and warm hats.

Even though my rescue took over four hours, neither of us was ever really cold, albeit in my case thanks in part to the blankets brought by the rescuers. The story could have been different if we had been wearing the jeans and tee shirts you see so often on the trail. Cold and shock are a dangerous combination. Probably not life threatening in this case, but it is not for nothing that Yosemite Mountain Rescue call cotton “death cloth”.

First Aid Kit

Even though the trail was comparatively short, we were carrying a full wilderness level first aid kit. We only used one item, but, as we shall see, that was vital.

Good Comms

We were carrying a CDMA cell phone, which Phyllis used to call for assistance. Had the phone been GSM, she would have had to walk out for help. That we had the right phone was no accident. We had selected our phone based on our intended area of travel. The phone also contained a GPS and I had loaded a topographical map of the area on to it. Both helped Phyllis explain exactly where we were.

By the way, even if your GSM phone is theoretically capable of using a CDMA signal, like the new iPhones, don’t assume that your carrier will actually let you do so, many block this feature. Test before you go.

If we had been in an area with no cell service we would have been carrying our personal rescue beacon, as we did in Greenland and Baffin Island last year. However, after this event, I will seriously consider carrying our Iridium phone when out hiking in wilderness areas. We, like many voyagers, own a satellite phone for weather reception and email, and the newer ones, like ours, are little bigger than the cell phone of a few years ago; so why not carry it?  The benefits of actually being able to explain your emergency to rescuers are hard to overestimate.

We have the numbers of the relevant rescue coordination centers programmed into the Iridium on speed dial.

Wilderness First Aid Training

Last year we did a wilderness first aid course. This training may have saved my life since it enabled us to evaluate the injury (femur break) and immediately understand that we had a life threatening situation on our hands.

Using our training, we made the decision, before I stiffened up, to move me a few feet to a more stable position and at the same time get me on top of the plastic tarp that we were carrying in the first aid kit. Not only did this assist us in keeping me warm, by separating me from the cold damp ground, but the tarp was a vital part of moving me onto the back board without further damage for the carry out.

Also, being trained gave us immediate credibility with the rescuers, so that when we said what was broken and that I was already partially stabilized, they believed us. And it was interesting to note that the several people in the rescue group that were wilderness first aid trained were the ones that instinctively understood the situation.

It is really important to understand that wilderness first aid is very different than general first aid training. If you spend several days in a classroom being PowerPointed to death, getting a first aid certification, you are simply not qualified for the wilderness.

Real wilderness first aid training takes place in the woods, preferably in the dark with rain and black flies. You are presented with horrible scenarios with your fellow classmates acting as screaming, shivering, blood covered victims and you must make decisions in a world where there are no clean right and wrong answers, just common sense and probability—much like being at sea. It is, in my opinion, the very best training for cruisers.

Have the Right Partner

Phyllis was absolutely calm and competent throughout the whole ordeal. She sat motionless in an awkward position stabilizing my leg for over two hours in a situation where even the slightest movement produced screams from me—I did not suffer in silence. And her reassurance kept me going, even in the blackest moment when I realized that I was to be carried out on a board through rough terrain with no analgesics. Thank you, My Love.

In the next post, I will write about one big mistake that I made.

Comments

Have you had a medical emergency at sea or in the woods? If so, please tell us about it and what you learned from it in the comments.

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Sigurdur Jonsson

Thanks again for keeping this fantastic website alive and well, and for many informative articles…

In our operation we try to get as many guides and boat crews as possible through “Wilderness First Responder” training. This is probably the best wilderness specific first aid training. It´s different (and in many ways probably more relevant) than the normal ship captains medical training.

Here is one training facility and description of the courses: https://www.nols.edu/en/wilderness-medicine/why-nols/ but I´m sure there are others. Here in Iceland the national rescue teams to this training under the rules of WFR.

All the best // Siggi

Carolyn Shearlock

You only touched briefly on having the phone numbers programmed into the phone, but that was HUGE. I’ve seen so many emergencies where people had a phone but not the numbers they needed (no 911 in these areas).

Another big one was that you happened to be in an area that spoke English (or to put it another way, a language you were fluent in). Having to get a translator can also really degrade communications.

Paul Mills

Hi John,

It’s really great that you had the foresight of good preparation combined with the right kit and training to help you both manage things so well.

It’s very pertinant that you mention so strongly Phyllis’ role and how her calmness and focus was a massive factor in you coping well with the kind of situation that we all hope never to experience. I have a friend who was severely hurt severel years ago in a chainsaw accident. He remembers very little of the hours after the incident – apart from the voice of the guy (a complete stranger) who found him, helped him and stayed with him all the way to the hospital.

Here’s hoping for a swift and comfortable recovery

Paul

Patrick

I was raised in the wilderness of the Rocky Mountains since childhood and learned to butcher animals of all types along side my grandfather. Hunted pheasant, grouse, rabbits and squirrels beginning as a child of 7 with a single shot Remington 22 learning winter survival skills directly.
Nevertheless, I foolishly walked into a snowmass of 10″ to cross a mountain meadow that had not melted by early July.
As I walked across this meadow, the snow gradually became deeper until before I knew it had walked out into snow that was almost chest deep but too soft to hold my weight.
Thinking I could traverse it, and being waist high for a few more yards I misjudged, its continuing depth and the icy snow compacted in ice particles.
Wearing a thin denim jacket, corduroy shirt, denim pants and calf high lace boots, I begin to feel the initial stages of hypothermia with about 150-175 yards snow yet to cross with an equal amount reverse, I gathered my wits and decided to roll across that expanse. By rolling, my stretched body spread its weight across my body length remained above the snow.
Hence, I was able to to cross that expanse of snow in about 20 minutes without immersing myself in the semi-soft snow that had become minature crystal globules of ice snow. I was wet arriving on the other side, nevertheless, not with the hypothermia I would have suffered if I had waded thru it.
Hard earned lesson not to attempt the foolhardy without firm knowledge of the exact depth of of late unmelted snowbanks. Much safer to go around such snowbanks despite the added time to encompass the perimeter.

Ben

Great summaries John – and wonderful to hear the training was so good. I train regularly with Blair at the Halifax Regional Search and Rescue base (Blair was our internal training officer for many years, and essentially built the training program we now use – he is also now one of our key ground SAR managers), and I can emphatically second all you’ve said about the training, and Blair specifically. There is absolutely nothing like experiential training to get you prepared for this sort of thing. hmm. maybe I need a refresher! Looking forward to hearing more about this event-
bg

Kettlewell

Get well soon. Sounds like you did all the right things. Accidents can happen to anyone. One thing I have found in more popular cruising areas is that there are always doctors and nurses in the fleet (why do so many doctors go cruising?) and almost every medical supply you can imagine, and many you can’t. This includes many prescription medications. Obviously, you shouldn’t be sharing prescriptions, but sometimes you are a long way from any source. I have been involved in a few relatively minor medical emergencies and putting out a general call via VHF or SSB has always resulted in good advice and assistance, though the Iridium phone has also proved invaluable.

Evan Gatehouse

Even our small day hike first aid kit contains some strong prescription painkillers. In some situations you may have to get to civilization on your own legs (barring broken femurs) – and something stronger that Advil can help.

RobertB

John,

At least in the U.S., the drugs (all, including over the counter) carried by rescue groups are controlled by the medical authority responsible for their actions, typically a hospital and a specific emergency physician. The places I have worked generally didn’t permit using analgesics until a Doctor had seen the patient for fear of masking symptoms. At times we were given permission to administer them, but under extenuating circumstances and not very often. Rescuers are working under a Doctor’s license and Doctors will tend to be conservative with any kind of drugs when they can’t see the patient themselves. It’s rough on the patient sometimes.

They can’t stop you from taking it yourself though. You do, however, take that on as a personal responsibility.

Robert

RobertB

John,

After several years of professional search and rescue in a large National Park, I think the rescuers were probably grateful to you as well. The times that I had calls to people that were experienced generally went much smoother and calmer, which resulted in better decisions all the way around. Just having the patient know what to expect made a huge difference. Professional rescuers are usually experienced enough to not panic, thought it does happen and it is usually with a patient (or multiples) that absolutely looses it. Panic spreads like wildfire once someone does it – and spreads even to the most experienced and calm rescuers. As a rescuer, it’s a very strange feeling to be calm one minute and suddenly feel very anxious due to a chain reaction of panic in others (might not even be that bad of a call)….and scary watching it spread in a group of experienced professionals. That said, if you understand that this is a human response to those around you, the anxiety can be dealt with effectively and not interfere with the operations.

So I believe your preparedness, which instills a quiet confidence in those around, helps the rescuers do a job better and concentrate on the tasks of stabilization and extrication. They look in good spirits hauling you out! That’s a great sign.

I’ll also add another endorsement for the Wilderness add-ons to a medical certificate. They are available for Advanced First Aid, First Responder, EMT and Paramedic….and worth every minute you put into it.

Robert

Donna R

You asked for stories…
We kayak out of Whittier Alaska, loading our boats with gear for week or so, and paddle off to adventure. This trip, we had a charter company drop us off at one of our favorite sites, Surprise Cove.
http://dnr.alaska.gov/parks/aspunits/kenai/surprisecvsmp.htm
We intended to camp, explore, and then paddle back. It was the end of May, and we had had a cooler than normal spring, so there were still mounds of snow, and the thaw-freeze cycle was going on every day and night. I had just put all of the food and toiletries away for the night in the steel bear locker and was walking back to camp on the boardwalk. The sunny day had thawed the snow, and the evening cool had refrozen it into a thin transparent ice layer. I (just like your accident), had my mind on other things, like the anticipation of my warm sleeping bag, snuggled into my comfortable tent with my family members, and I slipped on the ice. Down I went with the full force of impact on my right wrist as I put out a hand (the wrong thing to do), to break my fall. I knew by the nausea that engulfed me, and the pain when I stood back up, that something was terribly wrong. I grabbed a handful of snow, pressed it around my wrist, hugged it to my chest, called for help, and walked out of the woods onto the beach as others came running. I was set on a log as my partner, Bill, started to assess the situation, look for blood, ask me questions, and I passed out. While I was out, he had my daughter, who was 16 years old, run for a sleeping bag, radios, and the first aid kit. He thought he could get a Sam’s Splint on my arm before I woke up, because he knew after I did, I probably wouldn’t let him touch me again. I awoke to lying on the sandy beach, looking up into the trees, wondering why I was there, who woke me up, and what was my arm doing by being held straight up. Realization came crashing in as the pain re-erupted, and the memory of falling broke through the haze of being in shock. Bill was correct, I didn’t want anyone to handle me, and he wrapped an ace bandage around my back and secured my arm to my torso and it became one with my chest as he wrapped me up like a mummy and stabilized it so that I couldn’t move anymore. The only pain meds we had in the kit were aspirin, acetaminaphen, and AC&C’s from Canada. (for those unfamiliar, ACC = Aspirin/Caffeine/Codeine or Tylonel 3) I took 2 ACC’s, and by this time it was about 10:00pm, and we had to decide what to do next.

You have to keep in mind that in Alaska, it is still daylight at 10 at night, so we were not trying to do all of this in the dark, no flashlights needed. Also, Whittier is a very small community built on the other side of a mountain range, nestled in a bay in Prince William Sound, and the only way in and out by land, is through a one-way tunnel. The tunnel closes at 11:00pm, and we were about 20 miles away in a camping spot only accessible by watercraft, and our watercraft was human powered.

http://www.dot.state.ak.us/creg/whittiertunnel/
http://www.youtube.com/watch?v=O6V9mk2SMPo

We decided since it was late at night, and I was still in quite a bit of pain, but stabilized, that we would try to get as comfortable as we could, spend the night in the tent, and call the charter company in the morning for a pickup. If we had called for an immediate pickup, we would be paying excessive rates for an emergency call-out to the charter company, and when we got back to Whittier in the middle of the night, we would have had to spend the night in the truck before the tunnel opened in the morning. I suppose if it had been a life-threatening situation, that we could have been airlifted by helicopter out of Whittier back to a hospital in Anchorage, but our situation didn’t warrant that drastic of a measure. We were also experiencing gusts to 40kts, some small craft advisories, seas to 4feet, and we knew that a small water shuttle may have some difficulties reaching us, and there was going to be no-way that Bill would be able to tow me in our respective kayaks back to Whittier.

I took several more ACC’s and tried to get some sleep. I was very uncomfortable in the prone position as gravity was pulling on my arm in the wrong direction, but we found that when we ratcheted my thermarest sleeping pad into a semi-prone position, it would relieve the pressure on my shoulder, and I fell asleep. I slept fairly well until 7:00am. For those unfamiliar with thermarest, they have a cover, which can convert your sleeping pad into a chair.
https://www.thermarest.com/ca/seating/chair-kits/trekker-chair/trekker-chair.html?srd=true&lang=en_CA

This was our first excursion with a SAT phone, and it proved it’s worth for communication right away. Our line-of-sight handheld marine radio, though one of the best, would have been totally inadequate to get in touch with anyone, especially since there were some adverse conditions going on in the Sound, and we would have had to wait for a passing vessel to hear our call for help. In the morning, we called our kayak water-taxi service with the pre-programmed number, told them the situation, that it was not life-threatening, that we had to break camp, and to come pick us up in a couple of hours. We ate breakfast, Bill and my daughter broke camp, packed up, and the boat came and took us back to Whittier for our drive to Anchorage and the doctor’s office.

For our lessons learned, several items that you mentioned are top of my list also.

Have the right partner. I couldn’t agree more. My partner Bill, is calm, thinks through situations, trained, prepared, and thoroughly competent. We are preparing to take on the “cruising” lifestyle, and though I haven’t had much sailing experience, (training and studying like mad), he has been sailing all of his life, and I am very confident in his knowledge and experience.

Be prepared for whatever. We had everything we needed, except the stronger meds. Since I was prescribed all kinds of things at the time of my accident, I didn’t really need them after the operation I had to put my wrist back together. I found that Tylenol extra strength was enough for me, so now we have several different strong meds for the first aid kit.

Wilderness first aid training and beyond, is a must. It is very difficult to get into these courses here, as everyone wants them. If you find out one is going to be offered, you must register immediately, before it fills up. This is on my bucket list of items that must be accomplished before I take on the new lifestyle. I want to have the same confidence and knowledge that my partner has in case I need to use it for him. No one is invincible to accidents, they happen.

I am fairly new to this “sailing thing”, and I have spent time during several summers on our boat in Prince William Sound. I was born in Alaska, and I am probably biased, but I love it here, and I can identify with the northern clime sailing that is dominant in your writings. I really enjoy your website, your insights, knowledge, and your contributors. Thanks for having an area that appears to have the lack of trolls, the misinformation, and the drama that plague others. I am already making a list of must haves that I have learned from you, though I know Bill is way ahead of me in that area.

Donna R

Well, it could have been worse. We had most of the necessary ingredients to take care of the situation. The kayak charter company now uses us as an example in their safety speech, as an example of how to be prepared. And I now have a wrist made out of titanium plates and screws. However, I don’t ring the machines at the airport, yay. Happy healing to you.

Mathieu

Hi John
You missed a typo:”We were carrying a CMDA cell phone”