For Gavin Pitt – This weeks winter swimming advice post forms the foundation block of our winter swimming recovery process at SwimYourSwim. It has been written by the amazing Heather Massey from Portsmouth University and has helped us provide a safe and proven recovery procedure for 90 ratified Ice Milers and hundreds of winter swimmers. We hope you’ll find it helpful.
Winter Swimming Safety – Hypothermia
In extreme sports there is always an element of risk. Mitigating this risk through training and education and providing the framework for swimmers to complete their swims after appropriate coaching, medical assessment and cold water acclimatisation is vital.
Unfortunately no matter how careful and thorough this process is, things can and do go wrong for a multitude of reasons. If you find yourself in a situation whereby a fellow swimmer is in trouble with hypothermia here are sensible steps to take.
If you are in any doubt at all about the health and welfare of the swimmer call the emergency services immediately.
Dealing With Hypothermic Open Water Swimmers
Hypothermia occurs when the body loses heat faster than it can produce it and deep body temperature falls below 35OC(95O F). Left untreated, it can be life threatening.
Hypothermia is often caused by exposure to cold air and/or immersion in cold water. Swimmers are at increased risk if also exhausted or dehydrated. Once the swimmer is out of the water, their deep body temperature will continue to cool. Therefore prompt appropriate first aid is important. This guide provides a quick reference for first aid treatment of a mildly hypothermic cold-water swimmer. Some explanations for these guidelines are discussed in further detail and are marked in the sections below with a *.
Signs and symptoms of hypothermia
| Uncontrollable shivering * |
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What to do
- Quickly remove excess water from the swimmers skin and hair. *
- Allow the swimmer to remove wet swim-wear (ideally with some privacy).
- Cover the swimmer in dry clothes and blankets, including hats and gloves.
- If the swimmer can walk, walk them to a place of shelter (out of the cold, wind and rain, preferably evacuate in to a warm room).
- If going indoors isn’t possible, insulate the individual from the cold ground and protect them from the cold air, wind and rain.
- If the swimmer is mobile, encourage them to stay mobile, if they aren’t able to stay on their feet help the clad swimmer in to a survival bag. *
- Offer the person warm (not hot), sweet, non-alcoholic drinks.*
- Talk to them, you can assess their mental functioning from their answers and speech.
- Be aware swimmers will continue to cool even once out of the water. Be patient, hypothermic swimmers will take time to gradually rewarm. *
- If the swimmers symptoms worsen quickly having taken the above steps, or they become unconscious call an ambulance.
What not to do
- Don’t leave them in the cold.
- Don’t use foil/ space blankets*
- Don’t rub or massage the swimmer to try to warm the skin. *
- Don’t give them hot water bottles to put on the skin. *
- Don’t use an aural infrared thermometer.*
- Don’t give them alcohol.
- Don’t let them smoke and don’t allow others to smoke around them. *
Explanations
In: Signs and symptoms of hypothermia
Shivering aids heat generation, but can stop if body temperature continues to fall and the muscles become stiff and rigid.
In: What to do
- Remove excess water from the swimmers skin and hair.
Humans lose the greatest proportion of heat through evaporation, removing the water from the skin will reduce further evaporative heat loss.
- If the swimmer is mobile, encourage them to stay mobile, if they aren’t able to stay on their feet put the swimmer wrapped in clothes in a survival bag. *
Being wrapped in clothing and keeping mobile/moving around will help to generate heat. If the person is not mobile but is shivering, this will help to heat generation, but you should insulate them as much as possible to prevent further heat loss.
- Offer the person warm (not hot), sweet, non-alcoholic drinks.
People who are cold may find inhaling the steam and drinking warm fluids feels very comforting. The small volume of warm liquid will not rewarm the swimmer on it’s own, but may reduce further deep body cooling.
- Be aware swimmers will continue to cool even once out of the water. Be patient, hypothermic swimmers will take time to gradually rewarm. *
This continued cooling is sometimes also called after drop, whichever term is used, this is a phenomenon whereby the deep tissues continue to cool despite rewarming of the skin occurring, the rewarming process takes time to penetrate the deeper tissues of the body and reverse the deep body cooling. Therefore it is important to monitor the swimmer for a long time after removing them from the water. Please also note that the larger the swimmer is the longer they will take to rewarm as the conductive rewarming pathways take longer to occur.
In: What not to do
- Don’t use foil/space blankets*
They reflect heat, so the infrared (heat) radiating from the surroundings doesn’t help to warm the (cold) swimmer.
- Don’t rub or massage the swimmer to try to warm the skin. *
This has the effect of drawing blood to the skin surface and will aid heat loss. In this cold state, the swimmer will like to have warm skin however; it is the deep body temperature that should be the main concern.
- Don’t give them hot water bottles to put on the skin. *
As above.
- Don’t use an aural infrared thermometer.*
Swimmers have ears full of cold water. The IR ear thermometers do not accurately read the deep body temperature of someone with cold water in their ears. The RNLI commissioned research in this area and Portsmouth University are soon to publish this work. This advice will be refreshed when the work is published.
- Don’t give the swimmer alcohol.
Alcohol consumption can increase heat loss.
- Don’t let the swimmer smoke and don’t allow others to smoke around them.
Apart from being a good general health message, smoking can impair blood flow responses and may delay the rewarm process of the hypothermic swimmer.
14.7.2015
Heather Massey
PhD, FHEA
Lecturer in Sport, Exercise and Health
Department of Sport and Exercise Science
University of Portsmouth