What Happens During Cold Water Immersion?

Accidental cold water immersion (CWI) can be a terrifying experience, especially when caught off guard. While many believe that CWI immediately leads to hypothermia, it actually involves a series of stages before that happens. Let’s explore the four stages of cold water immersion to understand what happens when you find yourself submerged in frigid water.

1- Cold Shock Response

The first three to five minutes are crucial in CWI. During this time, the body experiences the initial cold shock response, triggering involuntary gasping, hyperventilation, and vertigo. These reactions stem from water inhalation and the risk of drowning. Additionally, the shock causes dramatic changes in heart rate and blood pressure, leading to the next stage: cold incapacitation.

To minimize the shock, it’s important to control your breath and avoid making sudden movements in the water.

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

Within three to thirty minutes, the second stage of CWI, known as cold incapacitation, sets in. The duration varies depending on the individual’s initial cold shock response. During this stage, handgrip strength, manual dexterity, and swimming speed decrease by sixty to eighty percent. These impairments make it challenging to pull yourself out of the water or keep your head above water in rough conditions.

3- Hypothermia

After approximately thirty minutes of submersion, long-term immersion hypothermia can occur. However, the timing can be influenced by factors such as water temperature, clothing, and behavior in the water. Hypothermia happens when your body loses heat faster than it can produce it, impacting your organ function. This can eventually lead to unconsciousness or even death, with or without drowning.

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4- Circum-Rescue (Post-Rescue) Collapse

The fourth stage of cold water immersion occurs before, during, or after rescue. While struggling to survive, stress hormones surge through your body, aiding your survival efforts. However, once the immediate threat diminishes, your body relaxes, reducing the output of these hormones. Consequently, your blood pressure drops, and your muscles lose functionality. In some cases, this can lead to cardiac arrest while still in the water.

Even after being rescued, there is a risk of collapsing due to arterial blood pressure, potentially resulting in sudden cardiac arrest. Additionally, water inhalation can damage your lungs and cause issues for your heart as cold blood from your extremities is released into your core.

Understanding the four stages of cold water immersion is crucial to prepare yourself for worst-case scenarios. For more information on staying safe during water activities, visit the 5 WS blog archives to find informative content.


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