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Hypothermia – Cold Water Survival | Know the Signs and be Prepared

Hypothermia – Cold Water Survival

Hypothermia prevention and preparedness is the key to survival. Plan your trip and “think smart”. Know the water temperature and weather forecast before setting out. Keep your body well fueled with high carbohydrate foods and lots of water.  Take along safety equipment like a waterproof  shake or crank flashlight that floats in case you need a signaling device.

Insulate Your Body. Dress for immersion in cold water. Avoid wearing cotton clothing when paddling in cool temperatures. Dress in layers using synthetic fabrics such as polyester fleece to prevent getting overheated or chilled from perspiration. Carry a waterproof jacket, designed for splash and/or rain protection.

Anytime the water temperature is less than 60 degrees Fahrenheit, wear specialized insulating clothing (wetsuit or dry suit) capable of protecting you while in the water. Keep in mind that the warmth and comfort range of a dry suit can be flexible based on the clothing worn underneath. Wear a warm hat that will stay on your head in the water. A fleece-lined skullcap is ideal.

Watch Out for Your Group

Know your emotional and physical limitations. Group members need to constantly assess the behavior of others in their group. Look for changes in behavior, withdrawal, sluggishness, talking less or a member not eating enough. These are symptoms of fatigue and may suggest a problem that the group needs to address.

Hypothermia Assessment

The most typical symptoms of hypothermia (in order of onset) are:

  • Shivering
  • Impaired judgment
  • Clumsiness
  • Loss of dexterity
  • Slurred speech
  • Inward behavior
  • Shivering stops
  • Muscle rigidity
  • Unconsciousness
  • Death

Hypothermia Treatment 

Mild Hypothermia (victim shivering but coherent). If possible, take action before this stage. You may still have time to either stop the trip or take out early. Planning for an early take-out and/or shuttle half-way pays dividends.

 Move victim to place of warmth. Remove wet clothing; give warm sweet drinks (no alcohol or caffeine). Keep victim warm for several hours. The window of opportunity is closing fast. By this time you are already well on your way to experiencing hypothermia.

 Moderate Hypothermia (shivering may decrease or stop)

 Victim may seem irrational with deteriorating coordination. Treat the same as mild hypothermia, but no drinks. Victim should be kept lying down with torso, thighs, head, and neck covered with dry clothes, coats or blankets to stop further heat loss. See medical attention immediately.

 Severe Hypothermia (shivering has stopped).

 Victim may resist help or be semiconscious or unconscious. Removed from water, victim must be kept prone on back and immobile. Victim must be handled gently. Cover torso, thighs, head and neck with dry covers to stop further heat loss. Arms and legs must not be stimulated in any manner. Cold blood in extremities that suddenly returns to the core may induce cardiac arrest. Seek medical attention immediately.

 Victim appears dead (little or no breathing, no pulse, body rigid)

 Assume victim can still be revived. Look for faint pulse or breathing for 2 minutes. If any trace is found, do not give CPR. It can cause cardiac arrest.  Medical help is imperative. If pulse and breathing is totally absent, trained medical personnel should start CPR.

 Content originally published in American Canoe Association pamphlet. Visit for information on a variety of water sport activities.

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