In many parts of the country, the water right now is cold enough to be fatal. Here’s what to do if you fall in.
As the winter dockmaster at the Orienta Yacht Club on Mamaroneck Harbor in New York, I manage the dozen or so boats still in the water. My job includes periodically heading down to the snow-covered docks to ensure that the ice-eaters are churning away to keep the surface waters from freezing.
One recent morning, I made my rounds under blue-gray skies and reminisced about the bookends to winter wet storage. I remembered when the transducer on my Nordic Tug 42 read a warmish 64 degrees Fahrenheit.
While this may not sound very cold, being submerged in 64-degree water for 15 to 20 minutes can be deadly.
Cold water moves heat from our bodies four times faster than cold air, leading to cold water shock within a few minutes. Initially, we’ll lose muscle control. The ability to tread water diminishes as our hands cannot close and our feet cannot paddle. Pulse and breathing rate rapidly increase. The initial plunge with a sudden gasp for breath can fill our lungs with 5 ounces of water, increasing our risk of drowning. Rather quickly, our ability to think, respond and take action slips away.
Some cold-water deaths happen instantly. Others take hours, generally progressing through four stages. Understanding each stage—and wearing proper clothing, including a life jacket—will help you stay calm, remain focused and be prepared until help arrives.
Stage One
Cold shock happens the moment cold water contacts your body. Clothing rapidly soaks up the frigid water, immersing your chest, back and abdomen. Cold shock can trigger involuntary gasping with rapid breathing, and unless you can control your reactions, the potential for inhaling water increases the likelihood of drowning. For individuals with pre-existing conditions, an increased heart and breathing rate can lead to a heart attack or stroke. For some, the sudden plunging into cold water can cause immediate panic, fear and stressful reactions that impair decision-making.
Stage Two
Incapacitation is the rapid cooling of muscles to a point where you can no longer move your hands, arms or legs. It can take a few seconds or a few minutes. You become progressively exhausted. A life jacket or flotation device that keeps your head above water means the difference between life and death in this situation. Without one, rescue becomes nearly impossible.
Stage Three
Hypothermia begins when our body core temperature drops below 95 degrees Fahrenheit. Without taking proper action, our body core temperature will continue to fall. Our vital organs will become cold, with increasing physical and mental impairment. Hypothermic individuals appear stuporous, are unresponsive, become comatose and succumb to cardiac arrest.
Stage Four
Core temperature afterdrop and circum-rescue collapse begin as heat is transferred from the warmer core to the cooler extremities, with cooler peripheral blood returning to the central circulation and heart. Any action or passive extremity movement—such as allowing the person to stand or walk—or immersion in warm water will increase the amount of cold blood returning to the heart, leading to cardiac instability. Circum-rescue collapse may occur before, during and after removal from cold water. Nervous system mechanisms allow blood to pool in the extremities, leading to reduced blood flow to the heart, profound low blood pressure, cardiovascular collapse and death.
What to Do
If you find yourself or others in cold water, stay calm. The goal is to get out of the water as soon as safely possible. If you cannot get out, then conserve your energy and await rescue. Immediately place yourself in the Heat Escape Lessening Posture to protect critical body areas and slow down heat loss.
Once someone is out of the water, try to prevent further heat loss. Immediately move the individual to a warmer place and call 9-1-1 or a mayday on your VHF radio. Remove all wet clothing and dry the individual, avoiding rubbing the person’s skin. Do not apply direct heat for warmth or offer alcohol or caffeinated beverages. Instead, use a hot water bottle or chemical hot packs wrapped in a towel. Warm the core (trunk and abdomen) first, not the extremities, as this can cause an after-drop shock. Be mindful not to warm the person too quickly, and do not place the person in warm or hot water; rapid warming can cause dangerous heart arrhythmias.
Victims of hypothermia who are cold, stiff and a bluish color (cyanotic) with fixed, dilated pupils and inaudible heart tones without visible chest movements can be resuscitated once they are warmed.
Staying in your boat or on the dock is the best prevention for cold water immersion and hypothermia. Wear proper seasonal clothing and a life jacket or flotation device. If you find yourself immersed in cold water, stay calm, take measures to preserve your core body temperature, and know that you can survive to enjoy boating another day.
