BY CORY JONES
DIRECTOR OF
HIGHLAND EXPERIENCES
HTTPS://HIGHLANDEXPERIENCES.COM

Bio

Cory is an experienced outdoor educator, expedition leader, and Director of both the First Aid Training Co-operative and Highland Experiences Ltd. With over 25 years of working across the UK and internationally, he specialises in first aid training for remote environments and is also a mental health first aid trainer. A seasoned paddler, Cory is a Paddle UK Endorsed guide. He has guided sea kayaking and canoe trips in Scotland, Canada, Baja and East Africa.

Cory is also a regular contributor to Wee Wild Adventures, where he blogs about paddling journeys, remote travel, and practical field skills for outdoor enthusiasts.

To download a free copy of our Outdoor First Aid manual, follow this link: https://firstaidtrainingcooperative.co.uk/download-your-free-digital-first-aid-manual/

First Aid for Paddlesports (part two): Immediate issues

Part 1 of this series on first aid for paddlesports looked at incident management and basic casualty assessment. In Part 2, we proceed to examine how to address immediate issues and threats that arise during the initial incident procedure. Whether you are sea kayaking, stand-up paddleboarding or running whitewater, these are issues every paddler should be prepared for.

Scenario 1
A kayaker has taken a nasty swim in a river or in the surf. When you reach them, they are not breathing. CPR for drowning.

Drowning is a time-critical emergency. If a paddler is pulled from the water and is not breathing, immediate action must be taken to revive them. Cold water immersion can cause cardiac arrest or laryngospasm (airway closure). In some cases, people can be revived even after prolonged submersion – especially in cold water.

Initial Steps:

• Check for responsiveness by shouting and gently shaking their shoulder.
• If there’s no response, check for normal breathing for 10 seconds.
• If they’re not breathing or breathing is abnormal (gasping), start CPR immediately.

Performing CPR for a drowning casualty:

• Begin with five rescue breaths. Tilt the head back, pinch the nose, and give five full breaths into the mouth.
• Then alternate 30 chest compressions and two rescue breaths. Chest compressions should be performed at a rate of 100–120 compressions per minute and with a depth of 5–6 cm.
• Continue until the casualty starts breathing, professional help arrives, or you are too exhausted to continue. Remember, other team members can also assist in performing CPR.

Important: In suspected drowning, rescue breaths take priority. Providing oxygen is vital. If an AED (automated external defibrillator) is available, follow its voice prompts. If the chest is still wet, dry it quickly before applying the pads.

Call for emergency help early. Use 999/112, radio Channel 16 or a personal location beacon.­­

Scenario 2
A paddler has capsized rock hopping in heavy swell or surfing into a beach landing. As you approach, you can see the red colour of blood in the water.

Major blood loss

• A deep laceration – perhaps from a rock, fin or blade – can cause significant blood loss. Major bleeding needs to be stopped as quickly as possible.
• Apply direct pressure using a sterile dressing or the cleanest cloth available. Maintain pressure continuously. Elevate the limb if practical and not fractured.
• Cohesive bandages (e.g., Vet Wrap) are especially useful in wet environments, as they adhere to themselves without the need for adhesives and can maintain pressure. If blood loss is heavy and unmanageable, call for emergency help immediately. In remote areas or expeditions, carrying blood-clotting (haemostatic) bandages can be considered.
  

Scenario 3
Descending a river, your buddy capsized in a rapid but managed to roll back up. They complain they banged their head while trying to roll up. Head knock and potential concussion.

Falls in whitewater or surf can lead to blows to the head – whether from rock, boat or paddle. A head injury on the water can be serious, even when symptoms are subtle. Helmets are invaluable, but don’t prevent concussions. After a collision, assess for signs such as confusion, nausea, headache, sensitivity to light or sound, sluggishness, or short-term memory loss. The person may not remember banging their head. If you suspect a concussion, consider how to end the activity safely or at least cut it short and seek medical attention. If in doubt, treat it as a concussion and get out of the water.

Watch for delayed symptoms too. These include vomiting, balance issues, difficulty concentrating, blurred vision, and irritability. Monitor them for at least 24 hours.

Helmets can be removed, especially if the casualty’s airway is compromised, they’re vomiting and unconscious, or you need to control severe bleeding under the helmet. Always support the head and neck while removing it.

Scenario 4
A novice paddler has fallen into the sea. It is a cold day, and they were already tired when the incident took place. They are shivering when you get them back into their kayak. Immersion hypothermia.

Cold water strips heat from the body much faster than cold air. Immersion hypothermia is a risk throughout the year, especially in open water, surf zones or shaded gorges. It’s not just a winter hazard. As cold water cools the surface of your body, the cold blood from the skin surface moves to the body’s core, causing core cooling. This is hypothermia.

The progression of immersion hypothermia is divided into three stages, which typically follow these phases in cold water:

• Cold shock response (0–60 seconds): Sudden immersion can cause uncontrolled gasping, panic and hyperventilation. Inhalation while submerged increases the risk of drowning.
• Short-term immersion (1–10 minutes): Fine motor skills fade, making it hard to grip or re-enter your boat. Muscle strength drops quickly.
• Long-term exposure (10+ minutes): The core temperature falls. Shivering stops, mental confusion sets in and the casualty may drift into unconsciousness.

Immediate First Aid Response
Short exposure: Strip off wet clothing and replace with dry, insulated layers. Wrap them in dry clothing, sleeping bags, foil blankets or use a group shelter. Offer them food and a warm drink if available. You can warm these casualties quickly.

Prolonged exposure: Remove the casualty from the water horizontally if possible. Wrap them in dry clothing, sleeping bags, foil blankets, or use a group shelter. Insulate underneath (with a foam pad, drybag or rafted boat) to prevent heat loss through conduction. Rewarm passively; avoid direct heat to limbs or rapid handling. Offer warm sugary drinks only if they are alert and able to swallow. If they are unconscious or shivering has stopped, assume severe hypothermia and call for emergency help immediately.

This is the second part of a three-part series covering first aid for paddlesports. In Part 3, we cover how to deal with more specific injuries, some that develop more slowly.