Dealing with cold water immersion

By John E. Keshishoglou

Saturday, September 13, 2008 10:17 PM EDT

This article is one in a series offering tips on boating skills and seamanship prepared for The Citizen by the U.S. Coast Guard Auxiliary.
This column first appeared in last year's series. It deals with falling in cold water and ways to deal with it. With the water temperature going down and many boaters and anglers still out there, I decided to share this information with you again.

Many boaters confuse cold water immersion with hypothermia. To obtain accurate information on this topic, I interviewed fellow Auxiliarist Dr. Joseph Sopko, professor of Medicine at Case Western Reserve University.

“Indeed there is a general misconception regarding cold water immersion. It is commonly confused with hypothermia,” pointed out Sopko. “Cold water immersion occurs when the body is suddenly immersed in cold water. It results in cold shock commonly known as gasp reflex.”

What is gasp reflex? The gasp reflex is the involuntary rapid intake of breath that occurs when the body is suddenly immersed in cold water. Understanding gasp reflex may help you deal with panic during the first crucial moments after falling in cold water.

While your body plunges through the water, it is essential not to inhale.

This is easier said than done since panic forces a person to try to breathe. Any attempt to breathe air can cause the “breathing” in of water and may result in drowning. To put it in another way, when you hit the water and go under, your body reacts by making you gasp.

By gasping for air you suck water and it is all over.

A story online refers to Dr. Michael Tipton, a leading expert in cold water immersion who has shown that the gasp reflex from sudden immersion has led to more deaths than previously known. The reaction causes a sudden uncontrollable gasp, followed by 1-3 minutes of hyperventilation.

The initial gasp can cause one to inhale up to four pints of water causing drowning. Unless the person is wearing a personal flotation device (PFD), he is likely to sink and not re-appear.

Brad Shepard (online posting) who jumped in 38 degree water to save a boy, had this say: “I thought I was going to die because I could not move my limbs ... unable to cry out (due to bronchospasm) to my brother only a few feet away. The overpowering gasp made me glad my head was on its way out of the water.” He was wearing a wetsuit!

If the gasp reflex doesn't get you initially, you still face the effects of hypothermia.

Hypothermia occurs when the body “core temperature” drops to 95 degrees or less. This condition takes between 20-30 minutes to occur, depending on water temperature and a person's physical condition, following cold water immersion. So protect yourself by trying to keep your head above water (easier done when wearing a PFD) and try to control your breathing while you are in the water so you do not hyperventilate.

In 40-50 degree water, it only takes a few minutes before losing the use of your hands, so try to get as much of your body as possible out of the water while you can. Fix yourself to an object because, eventually you are most likely going to lose consciousness. The objective is to keep your head above water at all times and as much of your body as possible out of the water.

“A person is not dead until he is warm and dead is a standard adage in the emergency room,” Sopko added.

In near drowning situations, the human body may mimic death. This is due to the mammalian diving reflex, whereby the body tries to protect the brain, heart and lungs by drastically minimizing blood flow to these organs. Hence, the person is cold and looks very dead. When the body is heated, in many cases, these functions return and the victim becomes a survivor. Therefore, rescue attempts should continue until the body is warmed.

Hypothermia can set in even in 70 degree water if you are in it long enough.

People who experienced cold water immersion know how rapidly debilitating cold water is.

In concluding remarks, Sopko emphasized that the first goal in cold water immersion is to attempt to stay alive. The second is to minimize the risk of dying from hypothermia. Wear a PFD and live.

John E. Keshishoglou is the IP flotilla commander of the Ithaca Flotilla 22. He can be reached at (607) 273-7175

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