Management of patients following cold water immersion

Abstract

Sudden immersion in cold water results in a number of physiological changes within the human body. This disruption of homeostasis can have a detrimental effect on normal body function and lead to life-threatening consequences including drowning, hypothermia and sudden death. This article will examine the changes in physiology from the point of initial immersion through to rescue or death. Particular attention is given to the profound effects upon the respiratory, cardiovascular and neurological systems as a consequence of cold water immersion. This is then reviewed and observed from the perspective of paramedics practising within the United Kingdom, who may face challenges that arise from this phenomenon. The pre-hospital assessment of immersed patients will be discussed in order to identify and address potential and immediate life threats, with specific focus on rewarming hypothermic patients post immersion.