RiverMedic171

06/08/2026

RIVER SAFETY QUESTION:

 Do you think the average raft customer, for example, your typical suburban family who’s never rafted before, has the knowledge or experience to make an informed decision about whether or not they need a helmet on the Nantahala river?

06/07/2026

HELMETS ON THE NANTAHALA - 2026 Update

My sources tell me the outfitters have agreed to require helmets for all commercial customers and guides this year. I have heard it's all outfitters, but one source says all but one. I can confirm NOC and Rolling Thunder personally, but no others. However, every commercial trips I've seen so far this year has been fully helmeted.

Some of my friends have said this is because of me. I cannot take credit for it. I am only one person who has been having discussions on social media and with raft companies for years. The real credit goes to people in the paddling community who responded in support of helmets on my many social media posts and to those who had conversations with raft company management behind the scenes. The raft companies, as are most businesses, very sensitive and cognizant of social media. Thank you to all the private boaters, guides and industry professionals who made this culture change happen. If it saves one life or prevents one injury, it's worth the cost to the companies to buy helmets.

What surprised me the most was the small, but vocal minority of rafting industry professionals who were adamantly against helmets. The most common arguments against helmets were "we don't need them, there haven't been any head injuries" (not a factual argument), and "we don't have enough for everyone and they're expensive'. The entirety of the individual comments would make this post too long. By and large the Gorge outfitters are very safety compliant and I'm not sure how the "no helmets" culture came about, but I'm pleased to see it changing.

03/26/2026

RiverMed snippet for the day. I carry these instead of oral glucose for hypoglycemia. Why?
They are roughly the same calorie and carbohydrate content of the more expensive and less tasty oral glucose. When they expire, I just eat them. They aren’t paste, so you have to chew them. If you can’t chew them, your mental status is likely decreased enough that I shouldn’t put something in your mouth.

They’re also nice if someone has a cold swim. It gives them a tasty treat and some energy. One has caffeine, one doesn’t. I usually save the no caffeine one for me and the other for med uses.

02/26/2026

I'll admit I hadn't really thought of this as a hazard of carrying your knife on the outside of your PFD. Bizarre freak accident, great response on the part of his fellow students. I carry my folding knife inside my PFD. I have previously done outside carry, but it's been a long time.

An accident during a training exercise left Noah Pressler bleeding from the neck. His fellow first responders stepped in with bleeding control skills.

01/22/2026

Good case study.
Would you manage it the same way?

The Setting

12/23/2020

Raft Guides and Outfitters, I have a question.

What is the minimum first aid and medical training requirement for commercial raft guides in your state?

Also, if you have any information on what is required in medical kits, that would be appreciated. I'm doing a little personal curiosity research. Thanks.

12/07/2020

Today’s quick and dirty river gear suggestion. This is one of my solutions for a compact pin kit. It fits into the Astral throw bag pouch. I had an extra one. I know some don’t care for the rope, so this is a great way to repurpose the pouch. Contents list:

15’ 9/16” tubular webbing for anchor.

3 prusiks. For a z-drag, you only need two, but they’re handy to have, like extras snacks.

2 pulleys. A third is nice for change of direction, but not mandatory. We’re keeping it light here.

3 carabiners. You can do a z-drag with 2, but an extra is handy. One is a mini-munter carabiner. The Munter Hitch is a useful and cool knot.

Throw in a good rope and you’ve got a system to unpin some boats. If you go for 1/4” ropes, I suggest Spectra and no poly due to strength concerns.

This is a light duty kit, intended for kayaks or small raft. It you pin an 18 foot gear boat, you’re going to need some big boy toys.

10/30/2020

Yes, they need to go away. The science doesn’t support the old dogma.

Explore alternative spinal stabilization strategies.

10/30/2020

Good article on C-Collars. I hope they soon will be gone, like backboards.

Much like backboards, the evidence is mounting against their frequent use.