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43 Chapter 5 ■ Symptoms of Hypothermia Learn to recognize the symptoms of hypothermia. They are listed here in order of severity. 1. Shivering, slurred speech, and blurred vision 2. Bluish lips and fingernails 3. Loss of feeling in extremities 4. Cold, bluish skin 5. Confusion 6. Dizziness 7. Rigidity in extremities 8. Unconsciousness 9. Coma 10. Death Stages of Cold Water Immersion Cold Shock Swim Failure Immersion Hypothermia Post-Immersion Collapse Personal Injuries Proper response to accidents results from good training and common sense. If an injury is minor, treat it immediately. If an injury is major, make the victim as comfortable and safe as possible until medical personnel arrive, assuming you have a way to call for help. Cold Water Immersion and Hypothermia 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° Fahrenheit. 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. ◆ 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, invol- untary 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 to 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 of surviving cold water immersion depends on having sufficient flotation to keep your head 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. 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 put it on immediately. Don't take your clothes off unless absolutely necessary. A layer of water trapped inside your clothing will help insulate you. BOATER'S TIP Don't ever think that boating activities won't expose you to the risk of hypothermia. Wear rain gear when it rains. A windbreaker over a fleece jacket works very well to protect against the wind. Hypothermia can occur on what begins as a warm, sunny day. In remote areas, carry matches and go ashore if you need to build a fire. Also carry an extra jacket, hat, and blankets. Remember that, as a responsible operator, you should tell your passengers what to bring along for the outing. Copyright © 2014 Boat Ed, www.boat-ed.com

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