Medical Advice for Riverland Paddling Marathon

The cold and wet conditions that often confront paddlers during winter adds an extra dimension to the challenge of Marathon canoeing/kayaking. Cold conditions can undermine the performance of even the strongest paddlers. Everyone is at risk of hypothermia and exhaustion, however, with training, planning and preparation you can be comfortable, safe and competitive in most adverse conditions.

The RPM events are extremely demanding and medical emergencies may occur. For your safety and wellbeing we ask you to fill out the Confidential Medical Form to enable immediate and appropriate treatment to be given should it be required.


Hypothermia is a potentially fatal reduction in the body’s core temperature below 35°C due to a failure of its warming mechanisms to maintain a normal temperature. Victims may show signs of severe shivering, glassy stare, apathy, abnormal or poor coordination and stumbling, slurred speech, irritability and pale, cool skin.

Predisposing factors that contribute to the onset of hypothermia include:

  • Hunger
  • Dehydration
  • Fatigue
  • Exertion
  • Low body fat
  • Low ambient temperature
  • Wind (high wind chill)
  • Inadequate clothing (ineffective insulation, unprotected head)
  • Wet clothes (rain, immersion, sweat, spray)
  • Alcohol
  • Underlying disease or illness
  • Age < 14 years or > 50 years
  • Injury

Preventing Hypothermia – Planning & Preparation

  1. Know your limitations and those of your paddling partner
    • Have you trained for this distance?
    • Have you trained in these conditions?
    • Have you experienced river paddling?
    • Is your seat comfortable?
  2. Are you prepared to pull out?
    • If you are unwell?
    • If you are unsure of your ability?
    • If you are uncomfortable with your boat?.
  3. Have you “read” the river conditions?
    • Is it likely to be a head wind?
    • Will there be waves you can cope with?
    • Will it rain?
    • Will I cope if I have to paddle alone?
  4. Have you got the right gear?
    • Do you have the appropriate Life Jacket?
    • Will your clothing keep you warm?
    • Will your spray jacket keep you dry and protected from wind?
    • ill your spray deck shed wave wash?
  5. ·Is your boat in good order?
    • Have you checked for leaks lately?
    • Is your floatation adequate?
    • Is your rudder system maintained and working reliably?
  6. Are you in good order?
    • Have you eaten adequately to support the distance and to stay warm?
    • Are you carrying enough of the “energy” liquid and food you have been training on, to sustain you for extended periods of effort in adverse conditions?


Hyponatraemia, is a condition where the level of sodium in the bloodstream drops to a critical levels which cab cause fluid to build up in the brain and lungs as can affect muscle functions.

The symptoms can be confusion, coughing and muscle cramping. It is a recognised medical condition in marathon athletes who have been exercising for over 3 hours.

The recommended was to try and avoid the condition is too drink an electrolyte drink such as Gatorade as well as water during the event and to be careful not to drink too much caffeine such as Coke or tea as they can flush the sodium from the blood in the urine. Carrying a small an mount of V8 Vegetable juice with you in the boat as well as water and Gatorade can also be of value.

Japanese encephalitis – including symptoms, treatment and prevention

Japanese encephalitis is a rare but serious disease caused by the Japanese encephalitis virus.

It is spread to humans by infected mosquitoes.

Japanese encephalitis virus (JEV) has been detected in South Australia, including ten cases in people in SA. to December 2023, with two deaths also reported Japanese encephalitis was not known to occur in southern Australia

Japanese encephalitis has been detected in mosquitoes and animals in the following local government areas, such as Loxton Waikerie

Prevention of Japanese encephalitis virus

“People should reduce their exposure to mosquitoes by covering up with light-coloured, long sleeved, loose-fitting clothing, regularly applying insect repellent to all exposed areas of skin, eliminating water that mosquitoes breed in around your home, and ensuring accommodation is suitably fitted with mosquito screens over doors and windows,” SA Health said in a statement.

Chief public health officer Professor Nicola Spurrier urged people planning to visit the River Murray and Lower Lakes to be extra vigilant, particularly between dusk and dawn when mosquitoes are most active.

For more information visit the Fight the Bite page.

Tips for Paddlers

Participants are required to carry food and drink to sustain them during each stage of the event. Have a good breakfast before the beginning of each stage, ideally with foods of low GI (glycaemic index) such as oats, cereals, nuts, etc. While paddling, food and drink with high energy are good, such as sugary drinks or energy bars, biscuits etc. Don’t make sudden or radical changes to your regular diet before the race.

Wear your water resistant and windproof paddling jacket if it is windy. If it is cold, wear a hat or a beanie – most of the body’s heat loss radiates from the head. Warm, close fitting thermal layers, ideally made of polypropylene, polyester or wool is best for winter paddling as these fabrics continue to insulate when wet. Avoid cotton clothing for winter paddling.

In addition to Life Jacket, food, drink and paddling attire, paddlers are required to carry the following items in a waterproof container- see “Rules and Conditions”

  • An additional energy snack
  • An extra thermal top layer
  • A windproof/water resistant jacket (if not already wearing)
  • Thermal emergency blanket

In the event of a capsize

  • Keep calm but very much alert.
  • Stay on the upstream or upwind side of your craft.
  • Be aware of your responsibility to assist your partner (in the case of pairs).
  • Follow your rescuers’ instructions.
  • Leave your craft only if this improves your safety. If rescue is not close at hand and the water is dangerously cold or worse rapids follow, then swim in the appropriate direction for the nearest point of personal safety. The loss of the finest craft is not worth even the risk of personal safety.
  • If swept into a rapid, then swim feet first on your back. Keep your head clear of the water for good visibility.