Your life hinges on cold-water readiness
Posted on 01 April 2011
Written by Dieter Loibner
There's little I have done for as long as I have sailed. I'm well into my fourth decade. Still livin' it, still lovin' it. But me being me, I also think I know my stuff. Until someone comes along and politely tells me that, um, I don't.
In late January, at the end of US Sailing's National Sailing Programs Symposium in Clearwater Beach, Fla., such a moment arrived. It came courtesy of Cecilia Duer and Jerry Craddock, who taught the course "Beyond Cold Water Boot Camp USA Rescue, Recover, Re-Warm." Duer is the executive director of the National Water Safety Congress (www.watersafetycongress.org), an organization that educates about safety issues for recreational water use. Craddock, the program and instructor training coordinator, has been a firefighter for 26 years with special expertise in dive and water rescue and kayaking experience, too. They are based in Mentor, Ohio, on Lake Erie, which has plenty of cold water to test theory and practice.
"We looked at the risk of small-boat accidents combined with new knowledge about hypothermia," Duer says, referring to the origin of the material. Since they started in 2008, they have distributed more than 14,000 educational DVDs to first responders in eight different countries. The scientific background was provided by Dr. Michael Tipton, who co-authored the book "Essentials of Sea Survival," and Dr. Gordon Giesbrecht, a professor of thermophysiology at the University of Manitoba in Winnipeg where he studies human responses to exercise and work in extreme environments. Nicknamed "Dr. Popsicle," Giesbrecht is based in Canada, a nation full of cold-water geeks. Quoting the Lifesaving Society, the Canadian Cold Water Boot Camp Web site (www.coldwaterbootcamp.com) says 94 percent of victims in the 410 drownings recorded in 2004 perished in water of 70 degrees or less, that 43 percent of them were within seven feet of reaching safety (meaning shore, dock or boat) and two-thirds were within 45 feet of safety. Only 12 percent wore a life jacket properly.
To me, four things in the class stood out: 1) I could drown within inches of safety. 2) I could die after being pulled to safety. 3) It takes a while before hypothermia becomes severe enough to kill. 4) It's all preventable.
Let me break down the essentials.
What's cold? If you putter about in water temperature of 70 F or less, you are boating in cold water. The benchmark is not subjective sensation, but the average core temperature of a healthy human, which is 98.6 F. Once in the water, the body's temperature will eventually drop to that of the surroundings. The colder the water and the less protection worn by the victim, the faster the cooling. (More body fat helps here.) When body temperature drops to about 86, consciousness is lost; below 77 there is cardiac arrest.
Dialing 1-10-1: Going from high and dry in 80-degree air one moment to treading 55-degree water the next results in a cold shock and hyperventilation. That's why people gasp when they fall into cold water. "Try to stabilize your breath within one minute," Craddock says. "Then you might have about 10 minutes of meaningful movement for self-rescue." If that fails, Craddock adds, "a victim has approximately one hour before succumbing to hypothermia." The 1-10-1 rule for falling into icy water is 1 minute to get your breathing under control, 10 minutes of useful efforts at escape before you run out of energy and 1 hour before your heart stops. The body wants to stay warm, which it does by shivering and shutting down blood circulation to the extremities, which is called vasoconstriction. If you have to wait for rescue, don't flail or start swimming willy-nilly. Instead, help your body preserve core temperature with the Heat Escape Lessening Posture (HELP): draw your knees to your chest and keep your chin above water.
Wear a life jacket: As you fall in, your fate might be sealed by the first two gasps. If you wear a life jacket that keeps your head above water, the first gulp might be water, but the second will be air. Once you realize you have air, you can calm down, gain control over your breathing and get on with your rescue. Without flotation, chances are you'll guzzle enough water to get incapacitated. That's when real trouble starts. At the very least, it greatly diminishes your chances of self-rescue or helping others to pull you out in time. "It is important to stress that you won't die from hypothermia within five or 10 minutes," Duer says. "Incapacitation can lead to drowning if you don't wear a life jacket."
Dress for success: Watching videos of trained volunteers struggling to swim a few yards to shore in icy water without a life jacket or protective clothing, forgetting to pull a rip cord to inflate a flotation device, collapsing before reaching safety or failing to put on a float jacket that's thrown to them illustrates the realities of cold-water immersion. When suiting up, let your choice be guided by water temperature, not air. Balancing comfort with protection is key, especially for paddlers or dinghy sailors who try to stay cool. Duer and Craddock recommend layering with moisture-wicking polypropylene, breathable outer shells and using life jackets that won't need manual inflation.
The 3 Rs: Emphasizing Rescue, Recovery and Rewarm, the slideshow in class cited incidents of downed airmen who died after rescue from long exposure to cold water or shipwrecked fishermen who collapsed and died after they were pulled to safety because of a lack of proper treatment after rescue. The rules, telegram style: Slow is pro. Handle the victim gently and keep the body horizontal as you lift the person out of the water with a net or two slings. Support the neck, don't jostle and don't rub the skin to avoid ventricular fibrillation, or v-fib, which is an abnormal heart rhythm that leads to cardiac arrest. If the victim is unconscious, check for a pulse before initiating CPR. Put the victim in a stable horizontal position, wrap the body in a plastic sheet that acts as vapor barrier and put the person in a rescue bag (or a large sleeping bag). Start the rewarming process by applying insulated heat packs on chest and under the arms. If the person is conscious, provide warm sugary (high-calorie) drinks. Remove wet clothing only when the victim is in a warm and dry environment.
Communication & preparation: Most boaters are not first responders with specialized equipment, yet they still can rescue a hypothermic victim. Before entering the water, the first order is staying safe, i.e. tethered to shore or boat. "As rescuer, you have to be part of the solution, not the problem," Duer and Craddock emphasize. Contact authorities via 911 or VHF channel 16, Duer recommends. They will ask questions and talk you through the steps while help gets under way. She advises keeping basic safety gear on the boat and practicing its proper use during rescue drills.
"Learning the exact process of hypothermia gave me a new respect for safety and risk management in and around cold water," says Charlie Zechel, executive director at Community Boating Inc. in Boston, who attended the Boot Camp class. "We will integrate things [we] learned."
Closer to the front lines is Capt. Joe Frohnhoefer, founder and CEO of Sea Tow. "Keeping victims horizontal, working gently, rewarming - we use [Cold Water Boot Camp] every time. It does work. Less jostling is better; it's stablilizing people."
There is much more to learn in this hands-on class, but the common failures that presage disaster remain the same: lack of preparation, inexperience and negligence.
Forty-plus years of fun with boats made me complacent. But in this class, I quickly recognized that it's never too late to learn a good lesson.
For information, visit www.coldwaterbootcampusa.org. To request educational DVDs or to schedule an 8-hour training class, contact
or jerrycraddock@watersafety congress.org.
This article originally appeared in the Connecticut and New York Home Waters Section of the April 2011 issue.