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Medical Facts for White Water Rafting
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Essential Eligibility Criteria:
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There are some nondiscriminating essential eligibility criteria that all participants have to meet. In
some cases these responsibilities can be met with the assistance of a companion.
For raft trips each participant must have the ability to:
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- Wear all protective equipment recommended/required by industry standards.
- Enter and exit the raft independently or with the assistance of a companion.
- Remain seated and balanced with the use of adaptive equipment, which does not fundamentally alter the activity, if necessary. Adaptive equipment cannot impede nor lessen the effectiveness of the safety procedures or equipment. No one may be strapped nor belted into a water craft.
- In the event of capsize: get out from under the water craft, remain face up in the water with the aid of a personal flotation device, and identify and make progress to and ascend upon the shoreline.
- For trips including overnight camping: mobility about the campsite independently or with the assistance of a companion.
- Refrain from illegal drug or alcohol use for at least six hours before the trip.
- Participants must be able to access the New River putin at Cunard with or without the assistance of a companion, this consists of about fifty steps. While a bypass road exists we are frequently unable to obtain the gate combination from the National Park Service.
- At least one person in duckies must have the ability to move it through the water in a stable manner.
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No participant may pose a direct threat to the health or safety of others
(42 USC 12182(b)(3). A " direct threat" means a significant risk to the health or safety of others that cannot be eliminated by a modification of policies, practices, or procedures or by the provision of auxiliary aids or services.
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Consider Before Rafting:
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While on your raft trip, you may be several hours away from professional medical help. While many of our guides and Trip Leaders have advanced qualifications, such as Wilderness First Responder, Wilderness First Aid, EMT, RN,as well as Multimedia First Aid and CPR, they may not be equipped to deal with your specific medical problem. Remember that you are responsible for your own safety at all times while on your trip and you must come prepared for dealing with any physical problems you may have.
Please remember that, in accordance with West Virginia state law, you are required to inform both your guide and your trip leader of any medications you are carrying and of any physical or psychological problems that may affect your safety or that of the trip.
We do not administer drugs..even aspirin...because of possible reactions.
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| Potentially Serious Medical Problems or Conditions: |
We've prepared the following list of potentially serious medical problems or conditions that are frequently found among our rafters. The list is NOT all-inclusive and you should get your doctor’s advice if you wonder whether you are physically and psychologically capable of taking a wilderness whitewater raft trip.
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Asthma
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We recommend that you do not go rafting if you have severe asthma. If you decide to go despite this warning, you should bring a minimum of two full relief inhalers. You should keep one on your person and give the other to your guide. Do not bring a single inhaler and give it to your guide as you and your guide (and inhaler) might become separated during a long swim.
Normally, when you inhale, your chest wall expands, increasing lung volume and breathing capacity. Air flows freely through the airways. With asthma, airways become partially obstructed and trap air in the lungs. Asthma is an inflammatory disease and airway constriction, swelling, and damage to the lining of the airways are often the result of this inflammation.
More than 14 million Americans have asthma and nearly 6,000 die from it each year.
Aspirin and other non-steroidal, anti-inflammatory drugs can worsen an asthmatic condition and cause sudden severe attacks. Tylenol-type drugs are apparently OK. Some medications for high blood pressure, glaucoma, migraine headache, heart, thyroid or liver conditions can also aggravate an asthmatic condition. Beta-blockers can cause airway restriction.
Cold weather activities such as skiing, hockey, scuba diving and whitewater rafting are very likely to aggravate asthma. Eighty to ninety percent of asthmatics have difficulty breathing during vigorous exercise. These attacks, called Exercise Induced Bronchospasm (EIB), are most likely due to cooling of the airways and drying of the airways from loss of water. Breathing cold, dry air seems to make attacks worse. Symptoms may peak about 5 to 10 minutes after cessation of exercise and will usually take 20-30 minutes to go away. The attacks can occur even if the proper medication is being properly taken.
Prevention of Asthma Attacks:
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- Do not smoke. Smoking irritates and inflames your airways. Breathing secondhand tobacco smoke can trigger an attack.
- Drink 6 to 8 glasses of water daily.
- Use anti-inflammatory preventers on a regular basis. These are slow-acting and may take hours or even weeks to work. Corticosteroids are known to be the most effective preventers but they must be used on a regular basis and do not have immediate effects. This means that these preventers have no value in an emergency.
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Emergency Aid:
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- Have the victim stop all activity.
- Keep the victim in an upright position. Sit them with legs crossed and elbows on the knees. This will help relax the shoulders and may help the breathing. Do not lay the victim on his or her back.
- Talk to the victim in a reassuring and calm manner.
- Supply the appropriate medication from the victim's inhaler. We do not carry inhalers! Generally, give 6 to 8 puffs from an inhaler. Repeat every 4 minutes if little relief is noticed. It is more detrimental to withhold the medication than it is to not supply it when needed. Bronchodilators/relievers are used to relieve the bronchoconstriction. It has been shown that frequent, regular use of bronchodilators may actually worsen asthma. The most common bronchodilators are albuterol (Proventil, Ventolin) and pirbuterol (Maxair). Salbutanol is also recommended. These are not long-term solutions and may be overused. Australian authorities also recommend Respolin, Bricanyl, Asmol and Respax. Salmetrol (Serevent) is a long-acting bronchodilator but takes longer to act and is not recommended for emergency use. Maximum daily use of a bronchodilator is generally two puffs every four to six hours. Once the medication wears off, asthma returns with more severe wheezing. Overuse also risks toxic drug levels that may lead to irregular heartbeat or, in rare cases, to a seizure.
- In case of respiratory arrest, begin CPR.
- Do not drink a lot of water, just the normal amount.
- Do not breathe warm moist air from a shower.
- Do not breathe into a paper bag held over the nose.
- Do not use over-the-counter cold remedies without the advice of your doctor.
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The above information is from selected web sources. We cannot guarantee the accuracy of this information. We recommend that you see your doctor or, at least, do your own search.
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Osteoporosis
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This is a disease in which bones become fragile and more likely to break. Any bone can be affected but of special concern are fractures of the hip and spine.
Women are four times more likely than men to develop osteoporosis. See www.nof.org/osteoporosis/osteoporosis.htm for more information.
Rafting involves sudden movements of the raft as it is pushed by waves, bounced over (or into) rocks, etc. People get bumps and bruises and even lacerations from paddles, coolers, D-rings and valves on the raft, etc. Bones can be broken and this risk increases in cases of osteoporosis. Smoking hinders the bones ability to heal. If you have osteoporosis, we recommend that you restrict your rafting activities to the Upper New River.
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Physical and Psychological Impairments to Swimming
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On rafting trips, people are often thrown from the raft in turbulent water. Rafting is not a good way of overcoming fear of the water. Persons with physical impairments to swimming are at increased risk. ACE provides several trips which are less demanding and, while we do take impaired persons on all river sections, it is only with knowledge and belief on the part of the individual that he or she understands and accepts the greater-than-normal risk.
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Heart Disease
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We recommend against rafting if you are a good candidate for a heart attack.
You should consider not rafting if you have had a heart attack in the last 6 months or if you are male ( 30 -40 ) or female ( 40-50 )with 2 of the following risk factors or male over 40 or female over 50 with one of the following risk factors:
Some risk factors are:
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- Diagnosed high blood pressure
- Smoker
- Diabetic regulating medication
- High cholesterol level or lipid abnormality
- Parent / sibling family history of heart attack coronary bypass or sudden cardiac death
before age 55
- Unexplaned chest pains, pressure, shortness of breath, palpitations, sweats, exertional dizziness, or fainting spells.
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Seizure Disorders
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These are wilderness trips and you may be several hours from a hospital. If you feel that you must go on a raft trip, please instruct both your guide and your Trip Leader as to what to do if you have a seizure.
You should maintain fuel and fluid status to minimize dehydration and low blood sugar effects on the brain. Please reconsider rafting if you have had a seizure during the last year or if you are not current on your medication.
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Diabetes (brittle and coma)
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Persons with brittle diabetes should carry a container of fruit juice in case their blood sugar becomes too low.
Diabetics who are bringing insulin or other medicine should tell both their guide and trip leader what, if any, special arrangements should be made to accommodate their needs.
Persons with uncontrolled blood sugar levels or persons with recurrent hospital visists for elevated or low blood sugar levels should not consider rafting. |
Hemophilia
Hemophilia is a genetic disorder of the blood-clotting system. This disorder can cause the person to bleed freely.
On a raft trip, we are not prepared to provide emergency care for this disorder. If you insist on rafting, you must instruct your guide and Trip Leader how to deal with an incident.
Hearing Impairment
The hearing impaired must realize that they must watch the paddler in front of them and mimic that paddler's actions. For example, when the person in front changes from a forward to a back stroke in response to the guide's command, the hearing impaired person must also make the change. If possible, hearing impaired persons should sit directly in front of the guide.
Vision Impairment
On occasion, we do take blind paddlers on the river. A blind paddler must understand that your risk, should you fall out of the boat, is considerably higher than that of a sighted person.
Blind persons, not being able to anticipate hits, are more likely to fall out of the boat. Blind swimmers can not determine exactly where to swim to safety and are at much greater risk during a whitewater swim.
Pregnancy
You should get your doctor's advice and permission to raft. Remember to tell the doctor that rafters are likely to be severely jostled and even thrown out of the raft. Extended rough swims, including bouncing off rocks, are common on river trips.
Bee Stings (other allergies)
Because we are not allowed to administer drugs due to possible reactions, we don’t carry Epi-pens or any other drugs to deal with bee stings. If you are allergic, we strongly recommend that you bring multiple quantities of whatever medicine you use. Because you may become separated from the rest of your party, carry at least one dose on your person and give the others to your guide and Trip Leader. Bees will usually be most prevaelent at Lunch.
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