A Fabulous Fall Meeting

Fortunately, meeting success is not a function of the number of people in attendance. Such was the case with Grand Canyon River Guides’ Fall Meeting held on Saturday, October 30th, at the oars warehouse in Flagstaff. Traditionally a much smaller event than our spring Guides Training Seminar, our Fall Meeting was an unqualified success with a core group of river guides, outfitters and speakers participating and enjoying the day. Our Fall Meeting may be the “scrappy little brother” to the big Guides Training Seminar (gts), but it’s a great event nevertheless and one you should consider attending in the future!
Here are some important highlights for those of you who may have missed the meeting:

Whale Foundation
Sandy Nevills Reiff spoke about their new emphasis on post=traumatic stress as a direct result of the rash of river tragedies this year that impacted quite a number of river guides. You’ll see an article about this elsewhere in this newsletter.

River Incidents
Sherrie Collins of Grand Canyon National Park reported on 39 total commercial river trip incidents during the 2004 river season, with 33 helicopter evacuations. These 39 incidents break out to fourteen medical and 25 trauma, not including twenty cases of gastrointestinal illness. Gcrg has been working for years to impress upon the Park how important this information is for river guides, providing them with a direct means of optimizing safety through prevention measures. Knowledge is power, as they say, so pay attention now…
The fourteen medical incidents were as follows: one seizure, one chest pain, two urinary blockages, one sepsis, two infection/abscess, one respiratory distress, two dehydration (with one of those alcohol induced), one stroke, and one tooth abscess.
The 25 trauma incidents were as follows: one un-witnessed drowning at night, eight boating accidents (meaning people getting hurt on boats, not boats bashing into each other!), five falls while hiking, two hand injuries while hiking resulting from “rolling boulders,” three falls in camp, two falls on shore, two falls jumping from the boat, one torn bicep, one dive into shallow water.
As for the gastrointestinal illness (note the total of twenty, down from 46 in 2003): nine commercial trips were infected.
Overall, river guides have been doing a fabulous job. Dehydration incidents were exceedingly low and there were no reports of hyponatremia. Bravo! This clearly demonstrates how far education can aid prevention. What else can you take away from this recap of river incidents? Get the safety message out to your passengers as often as possible. Falls seem to be the biggest contributor to the trauma numbers, whether occurring on hikes, in camp, on shore, or even jumping from the boat. And use your common sense. Place guides on difficult sections of a trail while hiking. Be aware of the comfort and skill levels of your guests; they don’t have to go on every single hike to get a true Grand Canyon experience.
Additionally, we were introduced to Adam Kramer, the new nps Public Health Consultant. He knows volumes about public health issues such as Norovirus, but he is new to the river so say hello and introduce yourself when you get the opportunity. His easy-going demeanor will go far to assist commercial river trips through education and prevention measures. As he pointed out, you must chlorinate your water, because filtering alone is not sufficient to kill viruses. A few drops of bleach will do (follow established guidelines). If done correctly, your water will be safe to drink, with less chlorine than is often found in our regular tap water. As an aside, putting the chlorine in your jug before adding water helps with aeration and eliminates the chlorine smell.

Medical Control
Ah, where to begin. Undoubtedly the most contentious talk of the day (ironically too, considering the crmp talk later in the day), the discussion of the murky depths of the medical control issue were plumbed to the best of our ability. Points and counterpoints, comments and rebuttals —all these were swirling madly primarily between gcrg representatives (yours truly, Drifter Smith, John O’Brien), Sherrie Collins of Grand Canyon National Park, and Garrett Schniewind of Canyon Explorations/Expeditions. Nevertheless, the discussion was a calm and rational one revolving around guide responsibility, liability, and company policy. To give you a glimpse of the discussion, here are a few important viewpoints that were raised:
• Good Samaritan laws. As a working river guide, you are not covered by the Good Samaritan clause, since Grand Canyon National Park requires you to have this training and you are paid to do the job.
• Liability policies. You are not covered under your employer’s liability policy should you be sued for using medical training that requires medical control.
• Dueling lawyers and diametrically opposed views Our source, an attorney for the Wilderness Medical Society and recreation liability specialist, was very clear that any time you adopt standards outside of basic first aid (such as invasive procedures or administering drugs), you must do so only under the advise and control of a physician. Garrett Schniewind’s source, on the other hand, discounted “medical control” as a concept that was fabricated by wilderness medicine providers to cover their companies legally while noting that not all wfr providers include or discuss medical control as part of their training. His legal source tells him that more trouble lies in “failure to act”, which could include not getting the requisite training.
• Not all protocols are created equal. There are many protocols in wilderness medical training that do not require medical control with up to seventy percent of the wfr training falling into this category. It is the remaining thirty percent of wilderness protocols which include “medical control” as a condition that must give guides pause to consider. Some of these include deep wound care, administering medications such as epinephrine, and reducing fractures or dislocations.
• Buyer beware. Not all wilderness medicine courses are created equal either. The quality of courses can vary widely so do your homework and make sure that the class you are planning to take is a quality course that covers the situations you may encounter in the Grand Canyon environment.
• Call early, call often. This is a great motto and one that Grand Canyon National Park enthusiastically espouses for emergency situations. However, do not confuse this with medical control. The park can only offer advice; they cannot and will not define your scope of practice or act as a medical control officer.
• We’re not in the same boat. Sherrie Collins of gcnp noted that “we’re in the same boat” with wfr training. Yes, we may have the same training, but the similarity ends there. Grand Canyon National Park has medical control (through Flagstaff Medical Center). Most commercial outfitters, and therefore, most commercial guides, categorically do not. In the field, a guide needs to know what he/she can and should be doing without the distraction of wondering what the legal ramifications might be. This is the fine line where “using your best judgment” moves beyond ethics into legalities in crisis situations where seconds count. This is an unfair burden for river guides doing the best they can in oftentimes harsh wilderness conditions with extended care times. And that brings us to another point…
• Outfitter policies. Of the thirteen outfitters we were able to informally poll, the vast majority did not have medical control. A few thought they did, but were mistaken. This highlights both difficulties of finding a consulting physician to act as medical control, as well as some general confusion about what constitutes medical control. For example, a doctor licensed outside Arizona doesn’t fit the bill. Additionally, there has been a nearly universal reluctance among commercial outfitters to provide first aid policies in writing. Add to that the fact that policies (such as those regarding the use and availability of epinephrine) vary from outfitter to outfitter, and you end up with a very convoluted situation. Garrett Schniewind made a case at the meeting for not having written rules that cover all situations. To his credit, he has made a concerted effort to ensure that he is not asking his guides to do something unreasonable. Unfortunately, considering the confusing nature of this issue, who is to say what might be reasonable (and legally defensible) if not even lawyers can agree? Most companies have written policies for their employees covering everything from alcohol and drug use, to sexual harassment. Does it make sense to you that they wouldn’t have written first aid policies for their guides unless they realized what a legal “hot potato” this really is?
• Here a lawsuit, there a lawsuit. Sherrie Collins stated that there have never been any lawsuits brought against river guides in this kind of situation and felt it unlikely for anyone to initiate one. Garrett, as indicated previously, felt that “failure to act” was more dangerous legally than using the training without the requisite medical control. Our point is simply this—we live in a litigious society and people often sue over just about any darn thing imaginable. That doesn’t make it right, but that’s the harsh reality. Just to say it hasn’t happened yet is no reason to consider this a non-issue (which is the gist of the arguments from Grand Canyon National Park and from other quarters).

So, where does all this leave river guides? It leaves you with some real thinking to do and some questions to ask. So often in this complex world it is vital to question rather than taking issues at their face value. “I’ve got this great training,” you say, “and I’m ready to go; just point me at a medical emergency on the river and I’m all over it.” Well, think again, my friend, and think hard. Above all, ask questions—ask them of your wilderness medicine instructor and ask them of your employer. If you are not sure how something is supposed to be handled, don’t wait till you find yourself caught in that situation. Ask questions and get answers. Do not assume that your training legally allows you to perform everything that you’ve learned. Educate yourself. That won’t solve all the problems, of course. Medical control is still a bit of wishful thinking for the guiding community in Grand Canyon and the wfr “standard” produces an uncomfortably un-standard response among companies and guides when it comes to dealing with actual first aid emergencies in the canyon. Gcrg will continue asking questions. You should too.

Historic Boats
As many of you know, Brad Dimock has been diligently working with the Grand Canyon National Park Foundation (gcnfp) to get their Historic Boat Project off the ground (pun intended). Conserving these historical gems of river running will provide a compelling learning tool for future generations. The gcnfp Masquerade Ball fundraiser following our Fall Meeting brought the project that much closer to being a reality. Look for an article about it in this issue of the bqr!

Colorado River Management Plan
It was unfortunate, to say the least, that Grand Canyon National Park eventually declined our invitation to speak about the Draft crmp at our Fall Meeting. Apparently lawyers got in the way (sound eerily familiar?). The Park’s solicitors have cautioned them that the public process (meaning their public meetings) and the Park’s website are the appropriate venues for discussing and answering questions concerning the plan. They also felt that individual meetings with any single constituency could be perceived as preferential and that, according to the rules, they must provide all interested stakeholders with the same information. Well now, it doesn’t seem to be a very “public” process does it? Nevertheless, we forged ahead with our own discussion, raising our own questions only to receive no answers, or at least until the public meetings commence. Drifter Smith did a masterful job of summarizing what’s in the plan and the lack of clarity on a number of issues. His eye for detail and balanced interpretation provided attendees with a good overview of the Draft Alternatives (primarily the preferred alternative, the weighted lottery and split allocation). Drifter will outline gcrg’s thoughts on the Draft crmp elsewhere in this issue so I will not reiterate them here.

Knowing Grand Canyon…So What?
Larry Stevens gave us a thought provoking and somewhat existential talk about what we think we know about Grand Canyon. Larry’s key points included:
1) Many of us know something about Grand Canyon, but we see it through the filter of our assumptions and world views. Humility and good planning are key to communicating to our audiences.
2) The problem of many people thinking they know and understand Grand Canyon is exacerbated at the level of the amwg and Park managers, who similarly operate through the fog of agency policy and assumptions. In the case of humpback chub management, several embedded biases cloud judgment on management options, including:
a) Humpback chub is a good “umbrella species” for ecosystem management. It does not appear to be so, as its life history is not much related to pikeminnow or other native fish, or any terrestrial species.
b) Managing for humpback chub is constrained by unknown population status in the pre-dam river.
c) Managing the river for humpback chub will bring us a temperature control device on the dam that may exacerbate, rather than improve, conditions for Humpback chub in the mainstream.
3) The assumptions and biases are deeply fixed in the psyches of the constituent publics, and although many of those beliefs are dubious or not supported by data, the beliefs clearly have become part of the river socioecosystem. Ultimately, this cannot improve management, even though the amwg program is probably the best collective river management program in existence. Management can only be improved by conducting studies that challenge our assumptions, and using that information to update and revise our belief systems.
The Grand Canyon Science Show
Matt Kaplinski provided an overview of the decline of camping beaches in Grand Canyon, the possibility of a November 20th flood flow, and the effects of the trout removal experiments. We also got to see some nifty psychedelic maps of the topography of the bottom of the river channel. A few salient facts from Matt’s talk(s) are:
• It is ironic that the Draft crmp preferred alternative focuses on an overall increase in use at a time when the campable area along the Colorado River in Grand Canyon is continually decreasing.
• Campsite area at 31 study sites has decreased by 55 percent from 1998 to 2003.
• The rate of campsite loss is greater than the loss to the sand bars in Grand Canyon primarily due to vegetation encroachment.
• Monitoring of rainbow trout spawning activity indicate mortality rates of 23 percent in 2003 and 28 percent in 2004. This occurred primarily at the end of the flow fluctuations, when inter-gravel temperatures reached lethal levels.
• Spatial and seasonal patterns in young rainbow trout suggest that, in 2004, the majority of the trout fry probably came from Glen Canyon. In other words, rainbow trout in Grand Canyon are “leaking” out of Glen Canyon and not spawning in significant numbers downstream—at least in 2004.
• The trout population in Glen Canyon is at, or near the amp target level of 100,000 fish and the recent decrease in the trout spawn (see above) will further decrease the adult population when that year class is recruited into the adult population. However, amwg recommended that the experiment should continue in 2005. It is curious that the flows will continue, even though we have reached the target levels of the population and that high fluctuating flows export about 150 percent more sediment than “normal” dam operations. However, when you consider that these high flow fluctuations generate considerable power revenues to the depleted basin fund, it all starts to make sense. Perhaps we should call them “power generation enhancement flows” instead of trout suppression flows.
• Preliminary results from the non-native removal efforts in the vicinity of the Little Colorado River show that the program has been successful and removed about half of the rainbow trout population. But, an assessment of whether this removal will improve humpback Chub population dynamics will not be known until at best 2006, but most likely 2007.
• Hoopnet catch-rates of humpback chub are inconclusive relative to the survival of the humpback chub.
• The two storms we had in October put us 85 percent of the way towards the requisite sediment “trigger” we need for a flood flow. Lower flows leading up to this period have conserved the sand in the system. If we have a “flood flow” it will occur on or around November 20th for 60 hours, at a level of 41,000 cubic feet per second.

So, there you have it. I know some trips were still on the water at the time of our meeting, and other guides have already scattered to parts unknown—that’s what makes the Fall Meeting somewhat of a challenge attendance-wise. But as you can see, it was a dandy day, and quite enlightening from a variety of standpoints. Martha Clark plied us with her fabulous food and we even had more beer than we could finish (say it’s not so!) donated by Cork n’ Bottle in Flagstaff. Our speakers were fabulous and very well received. Many people volunteered their time to make this event a success, and of course the biggest thanks go to Regan and Ote Dale of oars for letting us descend upon them and use their warehouse for our meeting. Thanks to everyone who helped make this event a success.
If this overview of our meeting wets your whistle, you simply must attend the Spring gts, March 26–27, 2005, at Hatchland. Or come next October, whenever and wherever we hold our next Fall Meeting. Grand Canyon River Guides’ meetings are always “grand.”

Lynn Hamilton