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Cold Water Immersion and Hypothermia in People

Cold water immersion kills in several ways. The colder the water, the greater the chance of death. However, the initial reaction to cold water immersion can occur in water as warm as 77°F. By understanding how your body reacts to cold water, you can prepare for and be better able to respond appropriately, thus increasing your chance of survival. It's important to protect yourself, and your human and canine passengers. 
There are four stages of cold water immersion.
Stage 1: Initial "cold shock" occurs in the first 3-5 minutes of immersion in cold water. Sudden immersion into cold water can cause immediate, involuntary gasping; hyperventilation; panic; and vertigo-all of which can result in water inhalation and drowning. Immersion in cold water also can cause sudden changes in blood pressure, heart rate, and heart rhythm, which also can result in death.
Stage 2: Short-term "swim failure" occurs 3-30 minutes following immersion in cold water. The muscles and nerves in the arms and legs cool quickly. Manual dexterity, hand grip strength, and speed of movement all can drop by 60% - 80%. Even normally strong persons can lose the strength necessary to pull themselves out of the water or even keep their head above water. Death occurs by drowning.
Stage 3: Long-term immersion hypothermia sets in after 30 minutes, at a rate depending on water temperature, clothing, body type, and your behavior in the water. Cold water robs the body of heat 25 times faster than cold air. Hypothermia occurs when your body loses heat faster than it produces it, cooling the organs in the core of your body. Hypothermia eventually leads to loss of consciousness and death, with or without drowning.
Stage 4: Post-immersion collapse occurs during or after rescue. Once rescued, after you have been immersed in cold water, you are still in danger from collapse of arterial blood pressure leading to cardiac arrest. Also, inhaled water can damage your lungs, and heart problems can develop as cold blood from your arms and legs is released into the core of your body.
  • Your chance, and your dog's chance, of surviving cold water immersion depends on both having sufficient flotation to keep your heads above water, controlling your breathing, having timely rescue by yourself or others, and retaining body heat.
  • Prepare for boating in cold water conditions by always wearing a secured life jacket. Your dog should wear one too, specific for canine use. Also wear layered clothing for insulation. Equip your boat with a means for re-entry (ladder, sling, etc) to use if you should fall into the water.
  • Of course, the best prevention is to take all measures necessary to avoid capsizing your boat or falling into cold water in the first place. If you do fall into or must enter cold water:
    - Don't panic. Try to get control of your breathing. Hold onto something or stay as still as possible until your breathing settles down. Focus on floating with your head above water until the cold shock response abates.
    - When your breathing is under control, perform the most important functions first before you lose dexterity (10-15 minutes after immersion).
    - If you were not wearing a PFD when you entered the water, look to see if one is floating around you and out it on immediately. Don't take your clothes off unless absolutely necessary. A layer of water trapped inside your clothing will help insulate you.
    - Focus on locating and getting everyone out of the water quickly before you lose full use of your hands, arms and legs. Try to reboard your boat, even if it is swamped or capsized, or anything else that is floating. Get as much of your body out of the water as possible. Even though you may feel colder out of the water, the rate of heat loss will be slower than if immersed in water.
    - If you cannot get out of the water quickly, act to protect against rapid heat loss. In as little as 10 minutes, you may be unable to self-rescue. Your focus now should be to slow heat loss.
    - Stay as motionless as possible, protecting the high heat loss area of your body, and keep your head and neck out of the water.
    - Safety typically looks closer than it actually is, so staying with the boat is usually a better choice than swimming.
    - Adopt a position to reduce heat loss. If alone, use the HELP (Heat Escape Lessening Posture) position; or if there are others in the water with you, huddle together.
    - If you must swim, conserve energy and minimize movement. Swim on your back with your upper arms against the sides of your chest, your thighs together, and your knees bent. Flutter-kick with your lower legs. Since this would be an impossible command to give your dog, the best course of action is to protect your dog from going overboard in the first place. Keep a life jacket on your dog at all times to help keep him afloat until help arrives, or help him swim to safety.
    - Be prepared at all times to signal rescuers.
  • When treating victims of cold water immersion, you should:
    - Get the victim out of the water as soon as possible. Remove the victim from the water gently in a horizontal position.
    - Prevent further heat loss.
    - Treat the hypothermia victim gently and to your level of training. Be prepared to provide basic life support.
    - Seek medical help immediately.
This content is approved by the National Association of State Boating Law Administrators and recognized by the U.S. Coast Guard.

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