Article Review: Cold-Water Immersion

Death caused by sudden immersion in cold-water is often misdiagnosed as cold-water immersion hypothermia. Giesbrecht and Pretorius from the University Mannitoba report in a recent article published in the Wilderness and Environmental Medicine Journal that most cold-water deaths occur quickly and are assumed to be the result of rapid onset
hypothermia. The authors argue that this assumption and general misunderstanding may result in an underestimation of possible survival time in a cold-water immersion accident. If a victim believes that they only have a very short time for survival in a cold-water immersion accident (such as a snow mobile breaking through the ice) they may experience increased panic which often results in poor decisions and may lead to a potentially preventable death. Laurence Gonzales in his book
Deep Survival indicates that a panic mind is a useless mind and that you should have a deep knowledge of your environment such that you have the
ability to perceive what’s really happening and act accordingly. Based on the results of a survey completed by 661 individuals ranging from Wilderness Medicine Conference attendees, snow mobile groups, military and law enforcement personnel, Giesbrecht and Pretorius determined that many people, including rescuers, have a poor understanding of the time course for hypothermia during cold-water immersion accidents. As discussed in Wilderness Medicine (Auerbach, 2007) clinical hypothermia is the third phase of cold- water immersion and occurs after 30 minutes of immersion (wearing winter clothing). In addition, under these conditions victims would most likely remain conscious for up to 60 minutes. Giesbrecht and Pretorius argue that accurate public education is key to better understanding of the associated risks and responses to cold-water immersion. They suggest a new slogan ” 1-10-1″ indicating that you have ” 1 minute to get your breathing under control, 10 minutes of meaningful movement and 1 hour before you become unconscious due to hypothermia”.

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