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Discussion Starter · #1 ·
Hello friends,
I’ve spent what seems to me to be more than a lot time working on this post/request than what is necessary, but the more I think about it, the more I think this kind of specific request can help a lot more folks than just me. That’s’ what we’re here for, right? Also know that I’ve made a run at searching mtnbuzz to see if this has been brought up before and searched online as well.
I’m looking to check in and get feedback with respect to raft-worthy/compact carry out options that I can add to my rescue first/advanced aid ensemble. Backdrop: a year or so ago we had a situation where we were hiking up a low risk, non-technical approach to the Slickhorn Canyon on the San Juan River. Not too far along, we had a participant trip and fall and it was clear we needed to take the victim (one tough momma – broken tib, fib, 5th meta tarsal on other leg-yikes!) back to the raft. Not especially far, but not optimal either. No problem, right? We had the stuff of most raft trips/groups – or more – would have in this situation: tables, frame decking, straps, able-bodies, meds, etc. (most important– all ended well, she is one tough mo-fo!). We hauled her part of the way on a version of the same ‘backboard’ that many say they would use in a carry-out situation. Along the way, we made re-evaluations of the risks, took into consideration the patient’s comfort level, considered the rescuer’s exposure, etc. Bottom line, she got out ok and is good to go right now.
My desire/the question I have is to learn about litters or other apparatus that I can purchase and include in my rescue equipment should a similar situation arise in the future. What I can say is this is my first go-round at an evac where we put into play an existing table-top as backboard/etc. and if there is something better I can add to my gear that would be compact yet still have a higher level of function, I’d like to get it.
Thus, as a starting point, I have two questions, that no doubt could/may expand into broader discussions:
• What commercially available breakdown litters are available to rafters that would be appropriate fits for private boaters.
• What have others done in situations where they have had to evacuate a real, live person out of the situation where they have been harmed to a place on the river where they are no longer in harm?

thanks in advance all...
 

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This is what cavers use in a rescue situation. It's called a SKED. It is compact and can be used for vertical lifting situations too. A lot of falls require you to isolate the back of the patient from mobility so you combine it with an OSS. (Oregon Spine Splint) Over the years a lot of variations and improvements have been made to the original design, but we still have both in our cave rescue stashes around the state.

https://www.karstsports.com/skedco-...SBSKZqpK3QZDHRNPhW4kw6-wlIbcQdfRoCsB4QAvD_BwE

https://www.karstsports.com/oregon-spine-splint-ii/
 

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Never really thought about it but for compact solutions oars run through a sewn long loop tunnel, canvas sheet deal.Something to do if you know someone good at sewing.Maybe make some kind of bolt on crossbars to maintain width and more tension on the canvas. Custom but probably pretty comfortable and compact.

Oars, camstraps looped around oars for support, sleeping pad, sleeping bag would be another lightweight option, I guess.
 

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This is what cavers use in a rescue situation. It's called a SKED. It is compact and can be used for vertical lifting situations too. A lot of falls require you to isolate the back of the patient from mobility so you combine it with an OSS. (Oregon Spine Splint) Over the years a lot of variations and improvements have been made to the original design, but we still have both in our cave rescue stashes around the state.

https://www.karstsports.com/skedco-...SBSKZqpK3QZDHRNPhW4kw6-wlIbcQdfRoCsB4QAvD_BwE

https://www.karstsports.com/oregon-spine-splint-ii/
I think you answered the question in the thread perfectly. How much training is necessary to become proficient with spine splint. I raft with the same bunch all the time and those might be a perfect group purchase for the major med kit.
 

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My last two WFR certs they are definitely moving away from hard flat spine boards which can cause problems, and toward the vacuum mat style (google vacuum spine board). You basically take a raft pump and remove the air to create a molded ridged spine immobilization. Most people won't afford to buy or carry one but you could ask for this in your evac request if your patient can't pass a focused spine assessment.
 

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Discussion Starter · #7 ·
My first question is: what did you like/ not like about the system that you employed?
Good question. The plywood board that we used was a cover over a drop bag and was not mine. My setup has a tall table in that spot which could be used, but not really a very good option. Stability was an issue, the victim certainly did not feel comfortable that they weren't going to roll off. Carrying the board was less than ideal - no hand holds, we used straps, but locations were awkward and contributed to overall stability issues. Of course you can (and we did) make all this work. A couple of folks have pointed to the Sked stretcher which looks like exactly what I had in mind. Thanks.
 

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It's been a decade ago, but Malloypc wrote about a rescue he was involved with on the Rogue. The text color didn't show up when I just looked, so you might have to highlight the text to see it.


https://www.mountainbuzz.com/forums/f11/rogue-river-tr-with-rescue-and-evac-32467.html if the hyperlink doesn't work.



Of note was the utility of the strap holes to help stabilize the patient.


For what it's worth, I've heard from Malloypc about how well the patient ended up recovering beyond all expectation.
 

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Probably 30 years ago, my Uncle was involved in a bad wreck at Crystal on the Colorado.
Had to be helivacked out.(pre sat-phone, they were able to use signal mirrors to reach planes flying over)
They used oars with a combination of life jackets, and I believe empty dry bags, to make a litter to get him down to the boats and then some distance down stream to a spot suitable for a helicopter to land.

As mentioned above, I'd thing a canvas sling, with maybe some crossbars between two oars would be a good solution.
 

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They used oars with a combination of life jackets, and I believe empty dry bags, to make a litter to get him down to the boats and then some distance down stream to a spot suitable for a helicopter to land.

As mentioned above, I'd thing a canvas sling, with maybe some crossbars between two oars would be a good solution.
If your patient has a positive MOI for spine and doesn't pass a focused spine assessment then this kind of MacGyver solution could paralyze them.

If they don't have spinal injury and you just want to get them from A to B this might be alright.

Either way I would highly recommend training so you can make these determinations. A 9 day WFR is typically less than $1,000.
 

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The thing with all these extra devices that you can carry need to be used correctly or they can cause more damage.

I'm with Mania. Take a WFR or another way to get the training is volunteer at a local ski hill with National Ski Patrol. They'll put through OEC which I feel is a pretty good course. Pretty winter sport centric but skills that translate to being outside.

There's a lot of different ways to handle a lot of different injuries and illnesses. All of which when outdoors is immediate care designed to keep someone alive until they can be transitioned to a higher level of care.

With PLBs with SOS functionality, I think the best training would be to help people know when to push the button.

For evac like in the OPs question, you could look at a Kendrick, SKED, a few different quick litters, etc. Really, the best "equipment" you can buy is the training and then think through injuries at home and have a plan to work with what you have on your raft. Some people buy all the rescue gear and then want to use it even if not appropriate for the injury. Saw way too many people try to traction breaks that shouldn't be as an example.

I'm lucky in that I have a good amount of outdoor rescue and aid training and would be one of the more knowledgeable on a lot of trips. But my boating circle has some flight nurses and medics and ER docs. So with diminished responsibilities, I get to party more.
 

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Or instead of spending $1000 on a SKED just cut holes in the drop bag plywood cover like you would see on a actual backboard. Next search the interwebs for spider straps and wham bam for about $40 you have a backboard with real straps that will hold someone in place, plus a drop bag cover and a table. That’s practical and multifunctional! For a added bonus throw in some loops of webbing that can be attached to the backboard and put over the litter carriers shoulder for added comfort. Most importantly use lots of padding on the patient and never strap over the knees. Being on a backboard will always suck but with some practice and thought you can make it tolerable.
 

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Why would anyone buy those items to bring along on a private raft trip?

Accidents happen whether on Class 2 trips like the San Juan or 3 weeks in GC or a hike in the woods or a hut trip or a bike ride, but not near the frequency that warrants bringing that level of rescue equipment. We can and should leave that to the pros who mobilize while we in the field stabilize our own situation.

The OP did their job, which was to get their injured cohort back to camp using improvised plans and techniques based on what they had available. There wasn't elaboration of how she got to the ER, but they got her out with what they had. Even if they only got her back to camp and had to await outside help for extraction they still did their job. If the party is in such poor condition they need a SKED and spinal contraption, higher levels of professional medical/rescue care need to be involved than are on the majority of the trips we are talking about.

In short, no, you do not need to bring litters and spine stabilizers of this level on your private raft trips. Just keep cool heads and use common sense when these rare instances arise.
 

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awesome post, dostep. Couldn’t agree more.

Sometimes a little knowledge from a little course and getting a little certificate ,in the right hands, can save a life.

Sometimes a little knowledge from a little course and getting a little certificate ,in the wrong hands, can turn trips or injuries into an absolute shitshow.
 

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How much training is necessary to become proficient with spine splint. I raft with the same bunch all the time and those might be a perfect group purchase for the major med kit.
To answer your question. The spine splint itself isn't that hard to figure out to put on a patient. All the straps and buckles are color coded. They have tried to make it as idiot proof as possible. The trick is how to move the patient and support the correct parts of the neck and head while you are attempting to mate it to the patient. I would not want to be the in charge medical person calling the shots. I would try like hell wait until real help arrived and concentrate on making the person as comfortable as possible if your thinking of installing an OSS.

In the outside world you have this option. In a cave, by the time a SKED and OSS reaches a patient, you will have a ton of trained rescue and medical personnel around you working in teams, so installing it is kind of a moot point. In NCRC cave rescue classes show you how to do it and pad the person to make them as comfortable as possible in it. Practicing within your group would be the key to success and that what us cavers do. We as a group in our state try and offer intro to cave rescue classes for new cavers, SAR, and fire depts. on a yearly basis, jumping back and forth from the western slope to the front range.

Back to the OP's problem of finding a compact litter for carrying a person, a SKED would have worked perfectly for getting the patient back to the boats. It does require patient packaging training and lot's of padding and such to make the person as comfortable as possible, knowing how to lift, move, and not injure the person more during transport. Things like laying a line of bodies down over rocky rough terrain and passing the SKED over the top of everybody. Putting a harness on the patient if you have to go vertical along the way. So as others have suggested. Training within your group and getting outside rescue classes under your belt before you need to use a SKED or other extraction device is your key to success. Good luck and don't be afraid to ask a caver to join your trip. They come with a unique bag of tricks.
 

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Rope Litter

If you have a throw bag and standard camping supplies you have a litter. Practice in your family room using something that approximates a human, or use a human. Be careful not to pull a loop through as this can really mess with you. If you need more rope in a loop, carefully saw it down from the top. Hint, use an unequal loop figure eight at the bottom as the start and then the tail can be tied to the other loop to finish it off. If you need it to be semi-rigid, add anything that is stiff under lots of camp pads but make sure their are no pokies...especially i fyou actually have someone with a spinal injury as this can cause Autonomic dysreflexia. As with anything, test it with an uninjured person for comfort and stability first.

https://www.youtube.com/watch?v=LQApoA9n6PI

http://https://www.youtube.com/watch?v=f1PYnel1g14
 

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Evacuation litter, etc.

It's either going to be a bit of river kit that gets redesigned for use in a rescue situation,
or a piece of rescue equipment that gets redesigned for daily use on the river.
The better the design for daily use, the more likely it will be you'll have it with you.
The better the design for rescue work, the more grateful you'll be if yours is the trip that really needs it.

It's kinda like a pistol ... most of us will go our whole lives and never need the thing. Those of us who do, will need it very badly, and will have no time to wait. (Cities ... yuck!)
This being considered, each of us tends to go "naked" and hope someone else has one with the skills to use it if it's ever needed.
It's like CPR, etc. I learned it for you. Please; learn it for me too. Thank you!
Somewhere around here I have a heavy canvas evacuation sling ... a 7' long piece of really heavy canvas with strap handles. I know it worked for me.
Strap handles on a Paco Pad maybe?
 

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Two uses for a SKED
A way for three or four people to collect a bunch of firewood and carry it back to camp.
A way to take the drunk that passed out next to the fire, carry them to their tent and slide them inside for the night. .
 

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SKED's are handy, but I'm never going to carry one on a river trip. And nobody is strapping one to their backpack for day trips/side hikes anyways.



It's been said many times before, but the best piece of medical equipment you can bring is the right training. Instead of buying a tacticool piece of gear, learn how to use what you have. A couple of oars and some cam straps would make a bomber gurney, especially with a paco pad and maybe a SAM splint if you have C-spine concerns. Much easier than a couple dudes whose only real memories of their 2004 WFR course was the female instructors ass trying to make a gurney out of their throw bag.


Take a course, and refresh your skills every couple of years. A certification card in your wallet is next to useless without the muscle memory that comes from practice.
 

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SKED's are handy, but I'm never going to carry one on a river trip. And nobody is strapping one to their backpack for day trips/side hikes anyways.



It's been said many times before, but the best piece of medical equipment you can bring is the right training. Instead of buying a tactical piece of gear, learn how to use what you have. A couple of oars and some cam straps would make a bomber gurney, especially with a paco pad and maybe a SAM splint if you have C-spine concerns. Much easier than a couple dudes whose only real memories of their 2004 WFR course was the female instructors ass trying to make a gurney out of their throw bag.


Take a course, and refresh your skills every couple of years. A certification card in your wallet is next to useless without the muscle memory that comes from practice.
I totally agree. I don't ever see myself dragging a SKED along on a river trip and training is the key to success.

Playing armchair rescuer, lets look at what is in camp to help haul a person who is hurt, back to camp.

If it was a child or small adult, maybe you could put them in a camp chair and two people carry them back in it. Maybe someone has a cot along, how about strapping oars to it to make a litter? Looking over on the beach you see a ducky and a SUP. How about utilizing one of those as a gurney?
 
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