winter boating scene
winter boating scene

Gasp! The Four Stages of Cold Water Immersion

What you should know about cold water immersion.

Falling into cold water is more than just an inconvenience, it's downright dangerous.

For example, your body may react to the cold water or sustained immersion in cold water, in uncontrollable ways. Experts have described what happens to the body when immersed in cold water and have summarized the features and characteristics into four distinct stages. Failure to recognize this, can lead to hypothermia, a serious condition which is the abnormal lowering of internal body temperature that should be treated only by medical personnel or specially trained individuals.

  1. Cold Shock - Falling into cold water provokes an immediate gasp reflex. If your head is under water, you'd inhale water instead of air and it is unlikely you'll resurface if you're not wearing a life jacket. Initial shock can cause panic, hyperventilation, and increase heart rate leading to a heart-attack. This stage lasts 3-5 minutes and at this point you should concentrate on staying afloat with your head above water.
  2. Swimming Failure - In just 3 -30 minutes, the body will experience swimming failure. Due to loss of muscle coordination, swimming becomes a struggle and the body tends to go more vertical in the water making any forward movement increasingly difficult. That's why it is not recommended to swim for help, but remain with the boat or something else that floats while keeping your head above water while awaiting rescue.
  3. Hypothermia - True hypothermia sets in after about 30 minutes. Most victims never make it to this stage since 75% of individuals succumb and die in the earlier stages of cold water immersion. At this stage, regardless of your body type, size, insulation of clothing, acclimatization and other factors, your body's core temperature gets dangerously low. Your survival chances are greatly lessened at this stage. Victims are usually rendered unconscious in this stage.
  4. Post Rescue Collapse - A rescued victim must be handled very carefully. When a person is removed from cold water, the body will react to the surrounding air and the body position. Blood pressure often drops, inhaled water can damage the lungs, and heart problems can develop as cold blood from the extremities is released into the body core. Proper medical attention is essential to re-warm the body safely.
hypothermia symptoms

What to Do? And What Not to Do!

Any victim pulled from cold water should be treated for hypothermia - this is the very dangerous and important stage of survival which is a result of cold water immersion. At this point, you should seek trained medical treatment immediately. Symptoms of hypothermia may include intense shivering, loss of coordination, mental confusion, cold and blue (cyanotic) skin, weak pulse, uncontrolled breathing, irregular heartbeat, and enlarged pupils. Once shivering stops, core body temperature begins to drop critically. Try to prevent body cooling and get the victim to a medical facility immediately.

  • Gently move the victim to a warm shelter.
  • Check for breathing and a heartbeat. Start CPR if necessary.
  • If you have dry clothes or a blanket, remove the victim's wet clothes. Use a minimum of body movement, since rough handling can cause cardiac arrest. Cut the clothes off, if necessary.
  • If possible, keep the victim in the same position as he was rescued to prevent a stroke caused by moving them incorrectly. If moving is necessary (such as from a boat to shelter), carefully lay the victim in a level face-up position with a blanket or some other insulation underneath.
  • Wrap the victim in a dry blanket or dry clothes. If possible, warm the clothes first. If a stocking cap is available, put it on the victim's head since a great deal of heat is lost from the head.
  • If the person is awake and coherent, give him or her warm (not hot) liquids. Warm hot tea with sugar or honey or slightly-cooled hot chocolate are good since sugars can still be absorbed even if the stomach has shut down.
  • NEVER give a hypothermic person alcohol. Alcohol dilates (opens) your veins, which will make the body lose heat more rapidly. Also, do not give food or drink to unconscious victims.
  • DO NOT apply heat to the arms and legs. This forces cold blood from the arms and legs back toward the heart, lungs and brain, lowering core body temperature and causing "after drop" which can be fatal.
  • DO NOT massage the victim or give the victim a hot bath. Cardiac arrest is a frequent result of hypothermia, and moving the victim roughly can be a catalyst for this condition.