Rescue teams talk about trying to save a Lithuanian man trapped while rafting down the Franklin River in Tasmania

Dan Lack teaches physicians how to provide life-saving health care in the world’s most challenging wilderness environments.

Providing primary health care in extreme conditions is complex, he says, and the decision by Tasmanian emergency medical teams to amputate a man’s limb to save his life was a “rare escalation”.

“The complexity of something like this cannot be overstated,” Dr. Lack said.

A man wearing a hat and rain gear, seen from above, holds on to a rope while partially submerged in water. — The man first called 911 around 3:30 p.m. on Friday afternoon and spent the night in the water. (Delivery: DPFEM)

On Friday afternoon, a team of rescuers worked to rescue a Lithuanian adventure tourist who was stranded in the Franklin River for more than 20 hours while rafting with 10 other Lithuanians.

When the 65-year-old’s condition began to deteriorate and hypothermia began to appear, in order to save his life, the decision was made to remove his left leg above the knee.

The man is in a critical condition at the Royal Hobart Hospital.

A man in professional rock climbing equipment climbs a steep cliff while a river flows far below. — Dan Lack, lecturer and expedition medicine coordinator at the University of Tasmania, teaches doctors how to provide health care in extreme conditions. (Provided by: Dan Lack)

Dr Lack lectures in expeditionary medicine and remote healthcare at the University of Tasmania.

He said most health care in the desert is “basic.”

“No one practices amputating a leg in the middle of a river in the Tasmanian desert,” he said.

“The improvisation, extra thought and extra stress that the amputee went through really escalated significantly.”

Dr Lack said the psychological impact of the rescue would be a key consideration throughout the operation and would continue to have an impact on those involved.

“The psychological dimension of this situation in the case of this poor man who lost his leg and is in hospital – he will have to live with it for the rest of his life. It’s a tragedy,” he said.

“What the first responders had to go through to make this decision, it’s going to really impact them.

“The environment saps your energy, increases your stress, and creates a situation where you have to be very careful to assess people’s mental state as the situation unfolds.”

You need to process 13 tons of water per second

Two rescuers in hi-vis and outdoor equipment walk on the rocky river bank. — A multi-agency response was necessary to save a Lithuanian tourist stuck in the Franklin River. (Delivery: DPFEM)

About 30 people from several different agencies took part in the rescue mission, including Tasmania Police, the National Emergency Service, the Tasmania Fire Service, the Tasmania Ambulance Service and Surf Life Saving Tasmania.

Tasmania Police Western District Commander Stuart Wilkinson said 53 winches were involved in the rescue, a record number for a single operation in Tasmania.

“A lot of people had to get down there and bring in equipment… in a very remote location in Tasmania,” Commander Wilkinson said.

Swift water rescue technician from Surf Life Saving Tasmania Ace Petrie said the area where the man was trapped was “probably the most inaccessible” part of the Franklin River.

Petrie said it was one of the most difficult rescues he had undertaken, with about 13 tons of water per second flowing down the river.

A bald, middle-aged man with a serious face, wearing a red polo shirt, talks to the media. — Ace Petrie of Surf Life Saving Tasmania, one of the first rescuers on the scene, described the rescue as “confrontational”. (ABC News: Jasmine Snow)

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“The water flow was interrupted where you were trapped due to the rock formations and everything that was there, but there was still quite a strong current and tide,” he said.

“If you imagine pulling the plug out of the bathtub and feeling the Venturi effect trying to suck you in, that’s exactly what you would feel.”

Petrie said the man’s preparedness saved his life.

“He was wearing a life jacket, which I think saved him from being dragged under the rock,” he said.

“I think the outcome would have been very different had he not been wearing a wet suit and a personal flotation device.”

The language barrier increases the difficulty

A man between large rocks in the river holds on to one end of a yellow rope — The man, whose name has not been released, is pictured during the rescue operation. (Supplied by: Tasmania Police)

Rescuers said the man was in good spirits throughout Friday afternoon, but on Saturday morning his condition began to deteriorate due to hypothermia.

“From three o’clock in the afternoon his condition slowly began to deteriorate, but his will to live was exceptional. If he had the strength, he would have tried to twist and get out,” Petrie said.

The rescue operation was further complicated by the language barrier between the man and the rescuers.

“It was a bit confronting because there was a lot of silence at times. You couldn’t get involved, you couldn’t take his mind off the situation,” Petrie said.

“You sit there holding his hand while you do, say, one rescue scenario to try to free him, and then there’s a period of silence that lasts all night.”

Rafters on the Franklin River in Tasmania, a World Heritage Site. — The Franklin River is an extremely popular destination for adventure seekers. (Vaughan Cruickshank)

Hypothermia helped with the amputation

After several attempts to free the man using specialized equipment lasting more than 20 hours, medical workers said the “difficult decision” had been made to amputate his leg.

“We got to the point where we had exhausted most of the rescue attempts, and then the patient’s condition started to dictate, ‘OK, now it’s time,'” Petrie said.

– We have to get him out.

Tourniquets were applied and the man was lifted 3 meters from the river using a rescue frame.

“At that time he lost consciousness, the doctor on the spot performed the amputation,” he said.

“That hypothermia inhibited blood flow, so that worked to his advantage.”

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