Grand Canyon Evacuation
by Christina King
Photos by Christina King, Scott McCollough and Bob Marley
On Day 3 (May 6, 2004) of an 18-day Grand Canyon trip, I had an accident resulting in a broken leg. I am writing this account to share with others my experience and help them know what to expect for a medical accident (in a remote area) and what happened during my subsequent evacuation. I am deeply disappointed that the accident happened and am grateful to our river group for first aid and helping me get out. I am also grateful to those who helped take care of me afterwards.
Our trip started out uneventfully and we had just stopped at Nautiloid Canyon (on Day 3) to have lunch and hunt for those pesky Nautiloids. We have stopped at this particular canyon on most of our trips and I was familiar with the slick rock walls and short walk to the fossils. Right after lunch we started up the trail and reached a slick rock area. I tried to be extra safe in crossing the slick rock area by scooting on my behind to avoid falling. No sooner had I started to slide down a short incline (with my legs in front to catch me) when I caught my rubber (grabby) Teva sandal on the slick smooth rock. My lower leg (tibia and fibia) bone gave a loud snap as it bent in front of my eyes. In fact, those in front and behind me heard it also. My leg kept going straight but my Teva brought my ankle around and to the right. There was not doubt that me leg was broken in an instant. My first words were "I broke my leg" and second comment was to apologize to Bob for allowing this to happen.
I know what a medical problem and evacuation does to a group and knew it would shock our entire group. Two years ago we had to evacuate one of our Grand Canyon participants for a dislocated shoulder. That experience convinced us that we had to have a satellite phone on future trips. I just never thought it would be me that would need the evacuation!
I moved my broken right leg to get out of the awkward position I was in at the bottom of the incline and saw that the leg moved independently of my foot. Not a good sight. Fortunately, nothing was poking out of my leg and in fact there was not a scratch on me. Andrew (our EMT) quickly got to my side and with Richards help was able to stabilize and line up my leg and foot for comfort. A backboard was quickly gotten from the Canyon REO boats to provide shade (and later drop me down to the beach area). Andrew proceeded to monitor my vitals (relaying all to Suzanne our doctor) and apply a SAM splint to my leg. Andrew asked me the pain (1-10) question but at this time it was only in the 2 range or so. Im sure I was a bit shocky but the pain was not bad. It did hurt when the foot and leg were not moved together but everyone had a soft touch and moved slowly and carefully. Once the splint was on it was much more stable. I was not given any food, water or medications for pain. I had just eaten and drunk a lot of water for lunch and it was best that I not have anything by mouth until help arrived. The rest of the group began coordinating my evacuation with the Grand Canyon National Park Service (NPS). Note: 911 does not connect to a local dispatch on a satellite phone. Always have the local dispatch numbers located with the phone (with the satellite phone number clearly labeled). I have put the emergency numbers on our website for reference.
The accident happened at 1 pm. NPS was notified quickly, called us back saying that they would delay 20 minutes due to strong gusting winds. While waiting for the helicopter the group strapped me to the backboard and lowered me down the slickrock (about 15-20 feet) and carried me to the shade near our designated landing zone. I know iw was an awkward and difficult traverse for the group (over ankle busting rocks) but they got me safely to the shade. The NPS helicopter arrived at the perfect landing zone (selected by Richard our former Fire hotshot jumper) about 1:45 pm. It was a relief to see the helicopter land and know that my evacuation would happen. They shut off the helicopter while assessing me, documented my vitals, attempted a few IVs until they finally got an IV in my left hand for the ride out. The NPS crew changed my rollatable legs/SAM splint/duct tape splint to a vacuum splint that they had on board (for comfort reasons) as they were planning on flying me to the South Rim and then by ambulance (1.5 hours) to Flagstaff.
Suzanne warned me that I might have to have surgery (yes, I did) and smiled with me when the pilot went through the crash landing safety talk. All I could think of was how impossible it would be to wriggle out of anything, much less a small rectangle window. They did allow me to take a dry bag which was great news. Susan had already gotten my wallet/backpack but having a dry bag with clothes made it a lot easier when I was in the Flagstaff hospital. I cant tell you how proud I am of our group that made my rescue a perfectly coordinated (and calm) event. It made such a difference.
I am a believer in the satellite phone (worth every penny). The group later told me that no one else (commercial or private) had passed that day. If we would have had to rely on the signal mirror my bet would be that I would have spent the night in the canyon with a broken leg. That would have been awful!
Right before we took off, someone (Susan or Lorie?) handed me my camera and I was able to shoot some pictures on the flight out. The paramedic told me that the ride would be bumpy (it was) and that we would take the scenic way out. I told him that the quickest would be okay and he smiled and said that the quickest was also the most scenic. I am usually the first one to feel carsick, seasick, etc so the pilot gave me an air sickness bag just in case. I surprised myself by not feeling sick at all, especially since I was riding backwards. The paramedic pointed out the different viewpoints, features, etc and I even spotted the Tonto trail, Clear Creek, Phantom Ranch, remains of the smoking forest fires near the South Rim, Grapevine and Sockdologer rapids. After the 25 minute flight we landed at the South Rim. The helicopter ride was exciting but I would NEVER pay to do this for fun.
As I was being moved by gurney into the ambulance the helicopter crew got a serious call describing a man on the Bright Angel Trail (not breathing) and rescue breathing had been occurring for 10 minutes. They threw my dry bag out of the helicopter, started up the rotors and left immediately. I was their 2nd rescue of the day. That really put my accident in perspective for me. At least all I had was a broken leg! The ambulance started the 1.5 hour drive to Flagstaff. The pain level escalated to about 5 and the paramedic recommended a morphine dose in my IV since he wanted to be sure the pain was managed appropriately. I agreed and the morphine really did work. Once again I was happy that I wasnt feeling sick. This was the first pain medication I had up to this point, but was ready for it. About halfway to Flag, we stopped and I was transferred to another ambulance (on the side of the road). They only have one ambulance permanently stationed at the South Rim and wanted to decrease the travel time for the primary ambulance. I can just imagine what the people in the cars that whizzed by us thought when they moved me from one ambulance to another.
I got to Flagstaff around 5-6 pm or so and immediately had x-rays. They had called a surgeon in and after reviewing the xrays, he quickly recommended surgery (rods/screws) as the best way to repair the break. My right tibia (big lower leg bone) and fibia (puny lower leg bone) were shattered completely through. After quick phone call messages to Pete in Woodland Park, the surgeon took me into surgery. The surgeon called Pete and gave him an update. Supposedly I got on the phone after the surgery and in a brief conversation, told Pete I broke my leg, asked him to drive safely and then informed Pete that it was time for me to go to bed, then hung up on him. Funny what that anesthetic does to you. I dont recall any of this.
Pete arrived the next day just before lunch about 3 minutes before I threw up my first Percocet pill. True love prevailed and he gave me a hug and took me home the next day in a two day (drug- enhanced) drive home with my leg up. Thank goodness for sleeping pills and Pete! I never had a cast put on and the bruising is quite lovely. The scaring is only a few inches (where the rod and screws were inserted). I wore a walking boot (but was not allowed to walk on it) and spent the next 10 days giving myself anti-blood clotting shots in the stomach and laying in bed with my leg above my heart for 23 out of 24 hours a day. Physical therapy for range of motion in my ankle and knee started two weeks after the injury and I went back to work 18 days later.
Our Grand Canyon group continued on with the help of everyone and Bob was able to use our satellite phone to get his (boatman) son to hike in at Phantom and run my boat.
Richard did a great job of teaching Andrew how to row my boat until Phantom Ranch. However, Richard had only so much vacation and had to keep to his original plan on hiking out at Phantom. I think it was a relief to the group to have Scott hike in at Phantom. Bob called a few times to see how I was doing and let me know that they made it through Lava okay. It also helped with coordinating plans to get our vehicle and boat home. My insurance processed the numberous claims with minimal hassle and Im very fortunate to have great primary and secondary insurance. FYI: the Flagstaff hospital stay (including surgery) was $21,000 and ambulance ride was $1,800. I never did get a NPS helicopter evacuation bill (probably because they came and didn't send their outsourced helicopter service) . This was not an inexpensive accident.
In December 2006, more than two years after the accident I voluntarily had my rod removed. The total insurance expense for that surgery is approximately, $10,200.
I cant thank the river group, NPS, Flagstaff Hospital, family, friends and coworkers enough. Everyone has been very helpful from first aid, rescue, surgery, dinners, favors, waiting on my hand and foot and sympathy. Most of all I thank Pete for waiting on my hand and "foot" for the past months.
Moral of the story: Be EXTRA careful when in remote areas and most injuries happen OFF the river.
Helpful Hints for a medical emergency and evacuation: