What happens in Stage 3 of cold water immersion?

Accidental cold water immersion (CWI) is one of the worst situations to encounter, especially when you aren’t prepared to deal with it. You need to realize that despite the common misunderstanding about CWI, it doesn’t directly cause the person to experience hypothermia. 

In reality, a couple of serious events occur before hypothermia starts setting in. In total, there are four stages of cold water immersion, including:

1. Cold shock response
2. Cold incapacitation
3. Hypothermia
4. Circum-rescue (post-rescue) collapse

In this blog post, we’ll keep our focus on the four stages of cold water immersion to understand what happens when you find yourself submerged in frigid temperature water.

1- Cold Shock Response

The initial cold shock occurs in the first three to five minutes, causing the person to experience involuntary gasping, hyperventilation, and vertigo. All of these conditions are the result of water inhalation and drowning. Moreover, the cold shock leads to sudden heart rate and blood pressure fluctuations, transitioning towards the next CWI stage – cold incapacitation.

However, by controlling your breath and not making any overhasty movements in the water, you can minimize the shock to a significant extent.

2- Cold Incapacitation (Short-Term ‘Swim Failure’)

The second stage usually occurs within three to thirty minutes following the cold water immersion, based on the individual’s initial cold-shock response. Your handgrip strength, manual dexterity, and swimming speed decreases by sixty to eighty percent during this period, which is not enough to pull yourself out of the water or even keep your head above water under rash water conditions.

3- Hypothermia

The long-term immersion hypothermia sets in after approximately thirty minutes of submersion in the cold water. However, the time factor also depends upon the exact water temperature, your clothing, and your behavior in the water. 

In simple words, hypothermia is the resulting factor when your body starts to lose heat faster than producing it, cooling your organs and leading to unconsciousness or death – with or without drowning. 

4- Circum-Rescue (Post-Rescue) Collapse

The fourth stage of cold water immersion happens before, during, or after the rescue. While you fight to stay alive in the cold water, the stress hormones surge through your body to help you survive. However, once the imminent threat minimizes, your mind relaxes, decreasing those hormones’ output. As a result, your blood pressure drops, and your muscles lose their functionality. It often leads to cardiac arrest while the person is still in the water.

Even when you’re out of the water, you can still be in danger of collapsing due to arterial blood pressure, leading to sudden cardiac arrest. Moreover, water inhalation can damage your lungs and cause problems to your heart as the cold blood from your arms and legs gets released into the body’s core.

Learning about the four stages of cold water immersion is the first step towards preparing yourself for the worst conditions. For more information regarding keeping yourself safe while indulging in various recreational water activities, you can visit our blog archives to surf through the informative content.

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Every year, many drowning and boat related fatalities are the direct result of a fall overboard or a boat capsizing in cold water.

Why is cold water immersion so dangerous? Because cold water literally "shocks" the body and causes it to slowly shut down, making drowning much more likely.

As a boater, you want to avoid cold water whenever possible and take extra caution whenever boating in cold water environments.

You also need to know some survival tips in the event of an emergency situation where you do end up in cold water. We'll review these tips, as well as the stages of cold water immersion, in more detail in next.

For now, remember that your priority in the case of cold water immersion is to get yourself out of the water as quickly as possible using whatever means available.

Now let's look at the different stages the body goes through when immersed in cold water. This will help you understand why cold water is so serious.

Cold Water Immersion Stages and Physiological Response

When a person falls into cold water, their body experiences a variety of physiological responses that relate both to the temperature of the water and the amount of time they are in contact with the water. When immersed in cold water, the body goes through the following stages.

When a person first falls into cold water, their initial reaction will be a “gasp reflex”. This reflex often includes hyperventilation and muscle spasms, and, as a result of gasping for air, can lead to the inhalation of water. It can also lead to changes in heart rate and blood pressure. These first effects usually last about two to three minutes at which point the body starts to experience more serious changes.

It only takes a few minutes for your body to start losing basic motor skills when immersed in cold water. After as little as three minutes, you may start to lose strength and sensation in your hands, which will also affect your ability to swim, regardless of how good a swimmer you are. Boaters often drown as a result of swimming failure even before hypothermia has had the chance to set in.

After about 30 minutes of cold-water immersion, the body's core temperature will drop below the safe normal level. This is called hypothermia. The core temperature will continue to drop until it has reached the same temperature as the water, and the person will lapse into unconsciousness.

A drop in blood pressure resulting from hypothermia may cause the person to become unconscious, or even stop breathing, even several hours after the rescue. For this reason, a person suffering from hypothermia needs to receive medical attention as soon as possible following rescue from the water.

A person suffering from hypothermia should receive medical attention as soon as possible.

Cold Water Immersion Prevention

Boats capsizing and falls overboard are the leading causes of cold-water immersion.

Capsizing is most often caused by overloading, unsafe boat handling, improper anchoring, or the loss of power or steering. Falls overboard are most often caused by slips or falls while moving around a boat.

These emergencies can be prevented by always staying low and stable while moving about your boat and by taking care to follow the guidelines for safe loading and operation in bad weather.

These are important guidelines at all times but especially in cold water environments, where the consequences of a fall overboard or capsizing can be much more serious.

Cold Water Immersion Survival and Recovery

If you fall overboard or your boat capsizes in cold water, your number one priority is to get yourself out of the water as soon as possible. Hopefully, there will be another boat nearby to come to your aid. If not, you may be able to get out of the water by either climbing onto your capsized boat or any other floating objects; or swimming to shore if it is within reach.

Before attempting to swim to shore, remember that your ability to swim may begin to be affected in as little as a few minutes and you'll lose the ability to swim within 30 minutes.

If you're in the water and awaiting rescue, you should do your best to conserve energy and body heat.

The following tips will help you conserve heat and energy in cold water.

It is recommended that you practice these cold water immersion recovery techniques so that you can remain calm in the case of an emergency.

1. Wear your lifejacket or P-F-D. Without a lifejacket, you'll expend valuable energy treading water. Your chance of survival in cold water is far decreased without a lifejacket.

2. Use the "HELP" or Heat, Escape, Lessening Posture. This posture involves bringing your knees close to your chest and wrapping your arms tightly around them. This will prevent as much heat from escaping as possible. This posture requires a lifejacket to be effective.

Learn a Cold Water Immersion Recovery Technique That Works and Practice it

If you're going to be operating in cold water temperatures, you may also want to look into wearing additional cold water protection, such as:

• A floater suit, which is a full nose-to-toes style PFD.
• An anti-exposure work suit, which is a PFD with a thermal protection rating.
• A dry suit, which is used with a flotation device and thermal liner.
• A wetsuit, which traps and heats water against your body, and which is also combined with a PFD; or
• An cold water immersion suit, which is used in extreme conditions or upon abandoning your boat, and is typically for offshore use.

Remember, in most situations your most important piece of cold water protection is to wear your lifejacket at all times.