Come on in, the Water's ... Freezing!!
April 12, 2001 -- You'd think swimmers in balmy Miami wouldn't
need to fear the cold.
In fact, though, even in the summertime the emergency room at
Miami's Baptist Children's Hospital treats three or four children a month for
hypothermia -- a condition that results when the body's temperature falls
significantly below normal.
"Even though we have mild water here, we still do see kids
with lowered core body temperatures every summer," says Francisco Medina,
MD, director of emergency services at the hospital. "The water in this area
is about 75 to 80 degrees, while normal body temperature is 98.6 or so, so
that's still quite a difference. Young people have a greater surface area in
proportion to their body mass, so they're at increased risk for heat
Most of the children who come into the emergency room with
hypothermia have prolonged exposure combined with a fall or some other trauma
or accident in the water. Milder cases can be treated at home -- just wrap the
"Take their temperature rectally, because you want to
measure core body heat," Medina says.
Competitive athletes and others who swim in lakes, rivers, or
the ocean also can lose too much body heat, without realizing it. And it's
impossible to say exactly how long is too long, says Jamie Musler, MS, ATC.
"Everyone reacts differently. People who are better trained
and more fit can last a longer time in a cold environment. People with a higher
percentage of body fat tend to maintain body temperature for a longer
time," says Musler, athletic training program director and coordinator of
clinical education at the Bouve School of Health and Athletic Training at
Northeastern University, in Boston.
Organizers of competitive swimming events need to stay alert to
potential signs of distress, Musler says.
"Athletes tend to be highly motivated people, and because
they're so focused on performance they may override warning signs of
hypothermia. At distance-swimming events there should be well-designed
emergency procedures in place. Observers should watch for changes in swimming
patterns to identify when someone may be in trouble."
As the body cools, blood moves to the central organs to
maintain core temperatures. This means hypothermic swimmers may get numb
fingers and toes, which affects their ability to grasp objects. As the brain
receives less oxygen, the swimmer can become confused and disoriented, so
someone who's in need of rescue may not follow directions well.
If someone is shivering and has blue lips, but no other
problems, they just need to be warmed, Musler says. But don't put them in a
warm shower or tub.
"In the field, use blankets and clothing to maintain body
temperature. Once they're indoors, you may sit them in a warm room, but not
right next to a heat source. Use normal temperature blankets at first, and then
perhaps use warmed blankets. Rewarming should be a slow, steady, gradual