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Cold water immersion kills in several ways. The colder the water, the greater the chance of death. By understanding how your body reacts to cold water, you can be more prepared and thus increase your chance of survival.

There are four stages of cold water immersion.

  • Stage 1: Initial “cold shock” occurs in the first 3-5 minutes. Sudden immersion into cold water can cause immediate, involuntary gasping; hyperventilation, panic; and vertigo—all of which can result in water inhalation and drowning.
  • Stage 2: Short-term “swim failure” occurs 3-30 minutes after immersion in cold water. Even normally strong persons can become unable to pull themselves out of the water. Death occurs by drowning.
  • Stage 3: Long-term immersion hypothermia sets in after 30 minutes. Initial symptoms include shivering, slurred speech, and memory loss. Hypothermia eventually leads to loss of consciousness and death, with or without drowning.
  • Stage 4: Post-immersion collapse occurs during or after rescue. The effects from being immersed in cold water can lead to cardiac arrest.