Immersion in cold water represents a particular risk. This may occur when a boat capsizes, is swamped, or a participant falls into the water from a launch or pontoon.
This guidance note accompanies the MRC Cold Water Rowing Rules, and is intended to support all members in the recognition and basic treatment/first aid approach to hypothermia.


Accidental hypothermia in adults
(Literature review current to: Oct 2016)


Mild hypothermia is characterised by fast breathing/feeling of breathlessness, fast pulse rate, initial hyperventilation, unsteadiness, slurred speech, impaired judgment, shivering, and "cold diuresis" – an urge to urinate.


Moderate hypothermia is characterised by reduction in pulse rate, shallow/slow breathing, central nervous system depression (confusion and sleepiness) and loss of shivering.


Passive external rewarming is the treatment of choice for mild hypothermia. After wet clothing is removed, the person is covered with blankets or other types of insulation.
Room temperature should be maintained at approximately 28°C (82°F), if possible (e.g. using a warm fan). Tepid/warm shower is suitable, but NOT hot. Similarly, warm drinks are OK, but NOT hot.
Active external rewarming is the treatment for moderate hypothermia, or mild hypothermia that does not respond to passive external rewarming. It is also used as an
adjunct in severe hypothermia (in which circumstance the casualty should be under direct medical care). It consists of some combination of warm blankets, radiant heat, or
forced warm air applied directly to the skin. Rewarming of the trunk should be undertaken BEFORE the extremities to minimize the risk of further core temperature
drop, low blood pressure and potentially dangerous blood metabolic change.
Anything more than mild hypothermia (as described above) would mandate a 999 call. If any casualty with mild hypothermia does not respond to passive external re-warming, dial 999.


Please also refer to British Rowing ‘Cold Water Immersion & Hypothermia’


http://www.rowhow.org/free/cold_water_course/story_content/external_files/Cold%20Water%20Immersion%20&%20Hypothermia%20v2.1.pdf


Issue v1.0 20-Nov-2016