KALISPELL (AP) -- In the moments after Jacob Feightner awakens from a nap, the 3-year-old starts frantically dog paddling. It is the sole manifestation of a river accident that left him clinically dead for two hours.

''It was an unsurvivable event ... We pulled out all the stops," said trauma coordinator and registered nurse Derek Starker at Kalispell Regional Medical Center.

It worked.

Jacob and his family from Utica, Ohio, were on a long-planned vacation last month, stopping in all the national parks they could on their way to the West Coast. When they arrived at the Middle Fork of the Flathead River at the Essex bridge, they decided to put in their canoe for a short trip.

Jacob, his brother, Jonathan, 5, and his father, John, 38, put on their life jackets. His mother Lori Feightner, 38, took pictures and then drove their vehicle downstream to pick them up as they had done on many rivers before.

The wisdom of their plan is debatable, given the temperature and speed of the river. But they had checked out the river in advance and heard that there were no rapids in that section and the kids would be safe.

''The river looked like what it said on the map. We did not take this lightly. I don't want people thinking Ohioans are ding-dongs," Feightner said.

She left her sons with her usual warnings. ''Listen to Daddy. Be careful. If you fall in the water, get on your back."

She left for the drive downstream. Her family hit some choppy water.

''John said he was scared and he knew it would be rough getting through," Lori said.

The second stretch of rough water did it.

''It flipped them over," she said. ''Jonathan popped up next to John. He never did see Jacob," she said.

Her husband got their eldest son to the river bank. Someone in a nearby cabin must have heard John's cries for help.

Someone called 911 and rescuers mobilized. Two women from Oregon were there. They took Jonathan into their vehicle to warm and dry him. Lori saw an ambulance go by, unaware of the drama going on upstream.

Rangers from the Walton Ranger Station rushed to the river, along with search and rescue crews, police and others. The next two hours would deliver a series of events that would leave rescuers in disbelief.

Kevin Hammonds and two other backcountry rangers had just returned from a three-day trek in the wilderness. They were at dinner when Ron Sullens of the Halfway House restaurant and a member of the Middle Fork Quick Response Unit was notified of the accident.

The rangers took off for the station at Walton, gathered rescue gear and rushed to the river near the Essex bridge. Hammonds, a passionate kayaker, launched his vessel. On the bank, John Feightner came running toward him, yelling that his son was still missing. While other rescuers searched the banks, Hammonds paddled downstream, looking for a little boy in a life jacket.

''I was really hoping to see him resting on the side of the river, scared and maybe crying," he said.

But the more Hammonds paddled, the dimmer his hopes became.

As he scanned the banks and river for a mile or so, Hammonds reviewed CPR steps in his head. He turned a corner and ''made out a life jacket in the distance."

Jacob was precariously hung up on a large rock just below the water surface on the left bank. He grabbed the boy and headed for a flat rock on the shore to begin CPR.

Jacob was dead by any definition, but Hammonds compressed his chest and breathed for him as he had been taught.

Five minutes later, a helicopter from Kalispell Regional Medical Center landed on a nearby beach.

Hammonds turned Jacob's care over to the helicopter crew, including flight nurse Marcus Wilsey.

''My first impression was that he's dead. He was white, pulseless, breathless -- zero" life signs, Wilsey said.

There is a saying in emergency medicine that hypothermia victims ''aren't dead until they're warm and dead." Immersion in cold water, particularly for children, can slow their body functions and their need for oxygen to almost nothing. No one was going to give up on Jacob until he was warmed.

Crews continued CPR all the way to the hospital, but Wilsey said the boy still showed no signs of life on arrival.

A trauma team was assembled and waiting at the hospital. Trauma coordinator Derek Starker had been prepared for the worst, but was still struck by Jacob's condition.

''He was clinically dead," Starker said. Jacob had no pulse, no respiratory rate. His pupils were fixed and dilated. His body temperature was 69 degrees.

''He was like a little ice cube," said Dr. Scott Rundle, emergency room physician.

The Feightners first glimpse of their son since he got in the canoe would be his still, pale shape in the emergency room. They agonized.

''We're both killing ourselves," Lori said. ''I should've never let them go."

Rundle wasn't going to mislead the family. It couldn't be much worse, he told them. He hooked Jacob's parents up with the hospital chaplain.

''The doctor told us it doesn't look good," Lori said.

Rundle assembled a team with nurses Starker, Karen South and Jen Giesbrecht and paramedic Laurel Smart. Rundle's colleague, Dr. Greg Harrah, took every other patient in the busy emergency room. Surgeon Dr. David Fortenberry came in, along with pediatrician Dr. Lynn Dykstra.

''People came off the floors to help," said Jim Oliverson of the hospital administration.

What Rundle was about to do was an intense, aggressive attempt to save a little boy.

While CPR continued for the second hour, Jacob was given warmed oxygen to breathe. He used chest tubes to bathe Jacob's heart and lungs with warm fluids. The same procedure was used to warm his bladder.

''We were prepared to go all night," Rundle said.

But he worried while he worked.

''I had a sinking feeling. I hope I'm not bringing back a brain-dead kid," Rundle said. ''I had a feeling we could get the heart back. I wasn't sure about the brain."

Jacob's youth would help. It still wasn't clear whether the water temperature of the river was going to be Jacob's doom or his salvation. After more than an hour in the hospital, Jacob's heart answered the questions. When his temperature rose to a still-low 74 degrees, it started beating. Rundle was disbelieving.

''I said, Yeah, right. Not yet. He's too cold."

Then it got better: Jacob opened his eyes.

Rundle wanted Jacob's parents there to ''let them see him coming to life and hopefully staying there."

When his parents entered the room, Jacob did the most remarkable thing.

''He turned his head to us and fluttered his eyes. There were tears in the doctor's eyes," Lori said.

Late that night, Jacob was put on a helicopter to Sacred Heart Hospital's pediatric intensive care unit in Spokane, Wash.

His parents drove the six hours to Spokane.

At the hospital, ''Everybody came in and said, Here's that little miracle boy," Lori said. ''He asked us, Why are you all looking at me?"

Within 48 hours, Jacob had made a full recovery. Allison Meilicke of the emergency room was jubilant to tell the rescuers the news.

''Allison came and got me out of a room to say, He's moving. I cried. That's a story, I said," Wilsey recalls.

Hammonds, who spent a sleepless night after finding and rescuing Jacob, was just as astounded.

''That's unbelievable," he said. ''It's pretty gratifying."

''This is a moment I think everybody will remember for their entire careers," Starker said.

''Everybody did their job perfectly," Starker said. If one little piece had fallen out, it all would have..."

''Collapsed," Wilsey finished for him. ''He's been given a gift, that little kid."

Jacob has been discharged from the Spokane hospital without a single ill effect from his ordeal, except his tendency to awaken in a swimming action.

''Right now, he's the same little boy he was when he jumped in the canoe," Lori said. Her ''tough, rotten, ornery, total boy" was back and intact.

Lori wishes she could thank her son's rescuers in person, but does not want to come back to Montana.

''I want to thank them for not giving up," she said. ''One of the charge nurses here said that if it happened in Spokane, they don't know if they would have tried that long. ... I want to thank them from the bottom of my heart."