Work has begun

                                     The raft guide handbook

For a while now I have wanted to produce a handbook that contains all of the relevant information for raft guides and safety kayakers as a point of reference. I have found that death by power point is not the way forward when running guide training courses. I want to produce a book that a raft guide can use time and time again.

For this Project I have teamed up with Darren Clarkson King who already has already produced a number of excellent guide books.

The book will contain chapters all relevant to the work of a raft guide.

Here is where you come in. I would like you to send in any stories or anecdotes you may have from your time on the water.

We are really interested in your learning outcomes and how the said experienced became a learning process  for you future trips .

below is a example from one of my own experiences along with the learning out comes.


Location: Nottingham uk
Early in my raft career I was working on a artificial slalom course in the UK. I myself was the trip leader and had delivered the safety talk. I had asked the customers if they had any medical conditions if so they had to inform me.
 During the session we had a flip I was the downstream raft so I ended up picking up the pieces from the notorious merry go round eddy. I noticed that one customer was floating with his whole body and head submerged under the water. He had a correctly fitting PFD but it was not floating him correctly.
Once I got the customer and he got his breath back I asked him why he was floating so awkwardly?

He replied to me " My false leg filled with water and weighed me down"  He also promptly replied "My amputated leg is not a medical condition. I had not seen his prosthetic limb under his wetsuit.

Learning outcomes:

• Add asking for prosthetic limbs is now part of my pre trip medical screening.   
• People are not always forthcoming with their medical history. 
• A prosthetic limb can a fill with water and render the swimmer with extra weight on top of their normal weight when swimming.
   

please email you stories to Info@lapinkoskikoulu.com. The stories with the best learning opportunities will be published in the book 

regards 

mark 

Wilderness medical training & medical kits

One question that I am constantly asked is do I offer first aid courses. The answer is currently no. I am working on it though. Running first aid courses are a  big part of my plans in the future to offer courses aimed specifically at kayakers & rafters.
One of the reasons that I do not offer first aid courses is that I am yet to find a syllabus that I feel delivers enough training and skills to offer kayakers & raft guides who are leading groups into the wilderness where they will be a minimum of 1 or 2 days away from any type of professional medical help.

Wilderness first aid training 
I have seen plenty of companies that try to offer this but unfortunately normally the training falls short of the required standard.

Saying that I have found 2 companies that actually do deliver a gold standard wilderness training in my opinion.

Picture from here.

Wilderness medical training (UK & Europe), short WMT have been offering training to those heading overseas into situations where they will be far from help for 20 years now.
I use WMT for my own personal first aid training, I feel that their 4 day advanced wilderness medicine course has given me the knowledge, skills & confidence to deal with problems when they occur (tried and tested).
The thing that sets WMT apart from other courses is fact that their courses are so much more than a first aid course, they really do prepare you to work in the wilderness. The WMT course covers a  multitude of skills that you never get taught on a standard wilderness course. Here are a few of the subjects covered

• Advanced wound mangament (wound closing using staples & glue)
• Giving fluid therapy through subcutaneous re hydration
• Intramuscular injections to administer Adrenalin,local anesthetic, pain killers
• Advanced fracture and dislocation management
• Oxygen therapy
• Use of prescription only antibiotics

This is very good and well I can hear you thinking. But where can I get access to the medications that I have just learnt how to use. WMT have an excellent relationship with Nomads travel clinic in London where you can then purchase prescription only medications along with all of the other medications that you need to build your own expedition medical kit.
WMT will enforce the point that prescription only medications (POMS) are not to be used in the UK or where medical assistance is close to hand.

One of the fundamental skills I learnt on the courses I have taken with WMT is to always carry their excellent field guide booklet whilst on my travels. You will be amazed how much you forget through skill fade when you are faced with having to deal with an emergency situation.

The Advanced wilderness medicine course is taught over a 4 day residential course and is delivered by professional healthcare practitioners from the national health service in the UK along with some seasoned expedition leaders. The course allows you to learn advanced techniques with like-minded individuals. The price for the course can be expensive but you cannot put a price on saving a human life plus you are also arming yourself with skills for life.

The WMT advanced medicine field manual.

On the other side of the pond in the USA their approach to wilderness first aid training is a little more structured & unified than in Europe. The professional standard for people venturing into the wilderness is to hold the wilderness first responder certificate. By law all first responder courses must last for a minimum of 75 hours. The WFR teaches you how to understand the human body and its systems. Group scenarios play a big part in the WFR syllabus allowing the course students to get hands on practice of the skills learnt in the class room sessions. I would personally recommend Sierra Rescue in California. The Sierra Rescue tutors all come from a river guiding back ground. Sierra Rescue are also the regional provider of Rescue3 courses in California.

Picture from here. 

Medical kits 
One thing that really boils my blood when I am working on rivers around the world is the complacency from river guides towards their own and company first aid kit.
In my eyes the standard of first aid kit on a commercial rafting trip is a direct reflection of the company offering the trip. I normally find too that poor first aid kits normally go hand in hand with poor guide first aid skills.

Moldy damp wet out of date first aid kits are no excuse when you are charging your customers a premium rate for rafting.  After all your first aid kit is a massive part of your customer service. All first aid kits should be clean, dry well marked & well stocked. You should be proud of your first aid kits.

Paddle Nepal first aid kits.

A few of the professional companies that I have worked for have allocated 1 guide to be responsible for the up keep of the first aid kits. This generally seems to work.

During my travels I have learnt the lesson the hard way and have discovered that carrying my own first aid kit is normally the best option. The question I have to ask myself is what to carry?

I tackled this question by creating 2 first aid kits.
Kit #1

Kit#1 is the kit I use when I am heading off with groups where I know I will be far from help. Kit#1 is classed as my base camp kit. I will explain a little about the kit.

First off I carry the kit in a Pelican case. Peli cases are air & water tight. Peli cases have a reputation for being hard wearing and extensively used by the armed forces and medical profession.I have used conventional dry bags before but they always manage to get wet plus there is a high chance the contents will get squashed at some point.

All of my antibiotic medications, pain killers and injectables including all of the hardwear to go with them are stored in pouches that are attached to the lid of the case by velcro.

To make double sure that my kit stays dry and dust free I have grouped the medications together and then placed them into clearly marked ziplock bags.

Here is a list of what I carry in kit #1.

Antibiotics & Medications 

Azithromycin 500mg 

Prednisolone 5mg 

Ciprofloxacin 250mg 

Doxycycline 100mg  

Clarithromycin 250mg 

Diclofenac 50mg 

Prochlorperazine Buccal 3mg 

Fluorescein sodium 1% minims 

Chloramphenical eye ointment 

Tetracaine eye drops (local anaesthetic)

Chlorphenamine 4mg antihistamine

Bactroban antibiotic cream 15g

Hydrocortisone cream 30g

Tramadol capsules 50mg 

Tramadol for injection 50mg 

Prochlorperrazine stemetil 12.5mg 

Adrenaline 1;100 1ml amp

Hydrocortisone injection 100mg | 1ml amp

Lidocaine 1% 5ml local anaesthetic

Paracetamol 500mg 

Asprin 300mg 

lemsip cold and Flu 

Ibuprofen 400mg 

Co-Codamol capsules 

Loperamide Hydrochloride 2mg (imodium)

Movicol (laxative)

Wound management 

Liquiband human tissue glue

Trauma fix Military field dressing 

3M skin stapler & remover 

steri strips 

Compeeds 

Assorted plasters 

Non adhesive dressings (selection)

adhesive dressings (selection)

Suture kit 

Wound cleansing wipes 

Bandages 

Triangular bandages

compressed dressings no 15 

Eye dressing 

Tubigrip roll 

Elasticated bandage 

XL sams splint x2

crepe bandage 

Burns dressing 

Cool therm burns dressing base camp kit assorted dressings

Paranet dressing

Hardwear

Ventolin Inhaler 

Zinc oxide tape 

Savlon spray

Deep heat cream 

Sterile eye wash 

Q tips 

Trauma sheers 

Digital thermometer 

E45 cream

Sterile gloves 

Foil survival blanket 

Injectables hardwear, needles,syriinges,giving set,butterfly needles.

Aqua tabs water purification 

Rehydration powder 

Sharps disposable pad 

Stethoscope

Sphygmomanometer

Cotton wool 

Povidone Iodine antiseptic solution 

glucose tablets 

pen & note pad 

1L Saline infusion (sodium chloride 0.9%)

Face guard CPR

WMT Field guide 

Oxford university expedition and wilderness medicine handbook.

Kit # 2

This is my small day kit that I use on short day trips or when I know that help is nearby. The main aims of the kit are the following:

• Stop bleeding 
• Clean & dress a wound 
• Temporary wound closure 
• Support an injured/fractured limb
• Deal with a small burn 
• Mild pain relief
• Rehydration 
• Eye wash  

Kit#2 is normally stored in a watershed dry bag.

Case study  

I was travelling through Morocco to run a guide course in the Atlas mountains. I was travelling light as I was going to be on the road for 1 month in various countries. All I had with me was kit #2. One of the guests had been on the roof of the bus unloading some kayaks. Whilst climbing down from the roof he slipped and cut his ankle on the way down. We were 7 hours away from the nearest medical help in a dubious back country clinic. Ideally the ankle could have done with a few stitches.

By using my field guide & small first aid kit I managed to clean the wound and steristrip it back together. One of the key points we learnt on the advanced medicine course was to document as much as possible in case of later repercussions. In Kit#2 I had exactly what I needed to initially treat the wound and change the dressings and keep it clean for the next few days.

The injured ankle 48 hours after the accident.

Summary

Spend some extra cash and attend a first rate first aid course that gives you the level of training for the areas you will be operating in. Don't cut corners on your training.

Take some time to build your own medical kit and make sure it is secured in a suitable container.

Carry a field guide if possible. Also have a pen handy. Remember "No Notes is No defense". Take pictures, make notes, film if you can any first aid treatment given as you may need to recall on them at a later point.

Remember kis kis: keep it safe & keep it simple. After all prevention is better than cure.

Safe adventures
Mark  

Lapin Koskikoulu: ''Present & The Future''

Second video now live about our company! Filmed in Kuusaankoski, Laukaa during the WRT course this summer. Thanks again to Zok Sabijan from ZTM Productions. 
‪#‎IRF‬ ‪#‎Rescue3Europe‬ ‪#‎Rescue3‬ ‪#‎WRT‬

International Rafting Federation Workshop Morocco 2015

A great little video from Yann at Berber Rafting Morocco highlighting the great adventure we had on this years course. Our course for 2016 is already starting to fill up! 

Top tips about Prusik knots

On my travels working and teaching raft guides & safety kayakers around the world I have noticed a reoccurring issue. When under pressure most people struggle to correctly tie a Prusik knot.

I have devoted this post to providing some hints on how to tie the Prusik first time every time. I am going to divide the post into a few key areas. 

1. What is a Prusik & what is it used for?

2. Prusik choice

3. Prusik knots  (3 wrap, French, Klemheist)

4. Summary

1. What is a Prusik & what is it used for? 

Prusiks allegedly first appeared  in an Austrian climbing manual in 1931 as a way to ascend a rope on a climbing route. The Prusik hitch was first used by Karl Prusik.

In a whitewater & rope  rescue background the Prusik is mainly used as a rope grab to attain progress capture in a rope system, normally a Mechanical advantage system.

A Prusik is simply a thin piece of chord or webbing tied into a loop normally with a double fisherman's knot. The Prusik is then tied onto the thicker rope in such a way that it will not slide down the rope when loaded by pressure.

2 Prusik loops both tied with a double fisherman's knot.

2.Prusik choice 

A selection of different Prusik loops 

Prusik loops can come in all shapes and sizes. Some are joined with a knot, some can be pre-sewn.

The thickness of the chord you use to make you Prusik loop is quite important though.

The chord you use to tie your Prusik loop with needs to be thinner than the rope that you are tying the Prusik to. So its a good idea to know the thickness of your throwbag rope or other ropes that you normally  carry on the river. An ideal thickness for a standard Prusik is between 6-8mm.

A good way to test this is by using the Pinch test. Simply pinch a section of your Prusik into a loop. The diameter of the loop should not be thicker than the line in which you would like to attach the Prusik too.

8mm chord for thicker ropes greater than 8mm.

7mm chord ideal for all ropes greater than 7mm (most throw ropes).

Sterling ropes 6mm flat sewn sling. Ideal for thin ropes. The sterling Prusik also has a massive 22kn breaking strain.

3.Prusik knots 

There are many different way to tie a Prusik knot. I have chosen the 3 most popular methods. A working knowledge of these 3 methods will help you in most situations.

A: The 3 wrap Prusik

The 3 wrap is probably the most widely used Prusik knot. It is simple to tie and can be used in most applications.

Simply hold the rope with the double fisherman's knot close to the rope.

You then need to make a girth hitch with the Prusik making 3 turns on the main line.

2 turns

3 turns. Be sure to dress the knot to make it work first time every time.

B: The French Prusik 

Perhaps the most simplest of Prusiks to tie. Simply wrap the Prusik 3 times around your main line and clip the ends together.

1 turn

2 turns

3 turns & clip into your carabinner.

C: The Klemheist Knot

The Klemheist is a variation of the French Prusik and can be tied with webbing too. The Klemheist is best located at the load end of your system closer to your load (pinned kayak or raft) as it is hard to work with a Prusik minding pulley.

Keep your webbing as flat as possible and make 3 wraps around your mainline.

Leave a shorter loop at the end closer to your load (pinned raft or kayak).

Pass the longer end of your loop through your shorter loop and clip in.

 4. Summary

1. Check the diameter of your throwbag. Your Prusik chord needs to be thinner in order for it to grip the rope.

2. Make sure that your Prusik knot is dressed properly and tightened before you use it.

3. Don't make your Prusik loop to long as you will lose any progress capture during a system re-set.

Having your Prusik too long will result in a loss of progress capture.

A snug fitting Prusik will prevent you losing progress capture during a re-set.

5. Practice, Practice,Practice

See you on the river
Mark

Further reading can be found at Animated Knots. 

The rumble in the Thai jungle

As I took my seat on  Finnair flight from Helsinki bound for Bangkok,Thailand I had to take a reality check to see if this was really happening. In the matter of 2 short weeks and a few emails I was heading to Thailand to run the first ever IRF workshop deep in the jungle close to Chiang Mai.

Ex-kayak freestyle world champion Eric Southwick had invited me to run an IRF guide and trip leader workshop for his newly established company 8adventures in Chiang Mai, northern Thailand. 

Rafting operations on the Mae Tang river in Chiang Mai only started around 20 years ago but the area now has around 14 companies. 8adventures is the leading company in the area, offering a professional operation to the hoards of tourists wanting to experience the jungle.

Eric had kindly picked me up from Chiang Mai airport and given me the lowdown on the job ahead. My first priority was sleep. After a good night’s sleep at the 8adventures camp it was time to crack on and start the 5 day workshop. To assess the river do a check out run so I joined onto a trip and was pleasantly surprised by 2 things

• The Mae tang was super high due to recent rain. We had a solid 2km section of class 4-5 rapids to test us on all week.

• The team at 8adventures were slick. Eric and his co-owners Sak & Oat had a tight operation. This was a pleasant surprise.

Eric demonstrating the whitewater swimming position.

I had planned the workshop over 5 days to allow for extra teaching. None of the guides had ever participated in any type of structured teaching course. I also had to allow for language barriers so the plan was to take things nice and slowly and move at a speed that suited the students on the course. The 5 days were mapped out in the following way.

• Days 1 &2 were dedicated to personal rafting & kayaking skills. I needed to spend time observing each guide running the river. This worked out really well as we had commercial trips every morning so I got to see the guides with real customers.

• 

• Day 3 was set aside to focus on whitewater rescue skills & safety kayak skills such as dealing with panicked swimmers & unconscious swimmers.

  

  Keep your swimmers in a place where you can help them most & remember to smile.

  

  Eric & Sak take it all in. It's not every day I get to teach a former 2x World Champion & a Thai national champion about kayaking.

  

  A safety kayaker dealing with an unconscious swimmer.

  

  Same bank entrapment drill

  

  Live bait exercise 

  

  gotya 

  

  Swim test

  

  2 point raft tether exercise 

  

  Throwbag skills test 

  

  Rescue harness operation demonstrated by using a V Lower.

• Day 4 was used for trip leader assessments.

  

  A flipped raft stuck in a boily eddy was used in one of the TL scenarios. (Can you spot the surprise underneath the raft that awaits the rescue team?)

  

  One of the safety kayakers dealing with a stranded customer on the TL scenario.

  

  Mock body entrapment scenarios

• The days were long as they are on all workshops. We started early in the morning and finished late in the evening. The Thai guides really took an interest in the whitewater rescue aspect of the workshop. They had lots of gear and wanted to know how to use it. Now was the time to introduce them to my favourite mnemonic that I find myself using time and time again on workshops 
  
  
  KIS, KIS: Keep it safe, Keep it simple 
  The Nature of the Mae Tang river really keeps the guides on their toes. The river is full of Bamboo strainers mixed in with some fatal sieves. I needed to ensure that the guides really took their time and use the self, team, victim principle to ensure their own safety not only during the workshop simulated rescues but also when on the river operating commercial trips.

This picture sends shivers down my spine just looking at it.

The Locals like to build as close to the river as possible.

The extra time spent developing the rescue skills of the guides & safety kayakers really helped out during the trip leader scenario tests. Not only had the guides progressed in their understanding of rescue skills and principles. Their team work had improved dramatically. Having skilled safety kayakers really made the life of the trip leaders a lot easier during the test.

To sum things up. Thailand now has its first IRF certified guides, safety kayakers & trip leaders. The bonus is the fact they all work daily together for the same company. We shared an inspiring week together. New friends were made and the IRF now has active guides in Thailand.

The Participants of the first ever International Rafting Federation workshop in Thailand. 

I boarded my flight home tired and happy. As I sat down I realized it would all be starting again in 7 days time. This time I would not be in the river deep in the jungle but in the high mountains of the Indian Himalaya on the mighty Zanskar river.

Happy paddling, Mark