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Home > Health & Wellness > Immersion and Drowning

Immersion and Drowning

Cold water immersion from falling overboard in water under 25 °C is a major risk.  Numerous physiological responses occur and the ability to cope with him will have a big influence on survival.  Additionally, an injury may have occurred in the fall complicating matters.  A heart attack may have occurred which may have caused the fall. Immersion can subsequently lead to drowning

Below we summarise Events (indicating bodily response & symptoms) and Actions to take to deal with an immersed victim and first aid response

Time of Immersion

0-3 mins


Initial response: Cold Shock

  • Rapid Pulse
  • Increased blood pressure
  • Uncontrolled Breathing
  • Possible inhalation of water


  • Don’t panic
  • Escape from entrapment
  • Manually inflate life jacket & deploy spray hood
  • Don’t attempt to swim
  • Hold onto anything that is floating
  • Adopt HELP (Heat Escape Lessening Procedure) position. Cross and Bend legs as close to chest as possible and warp arms around yourself

3-30 mins


Short Term response

  • Manual dexterity impaired
  • Loss of muscle strength and co-ordination
  • Body feels numb
  • Cramps – inability to swim


  • Inflate life jacket & deploy spray hood, fasten clothing
  • Activate EPIRB
  • Turn against wind & waves
  • Do not attempt to swim too far

≥ 30m mins


Long term exposure

  • Hypothermia – onset will be swift in particular in cold water and may be fatal if rescue is delayed
  • Dehydration
  • Low pulse & blood pressure
  • Death if not rescued


  • Maintain HELP posture
  • Get as much of the body out of the water if possible, using available flotsam
  • Believe you will be rescued

≥ 60m mins



  • Low blood volume & dehydration
  • Low pulse & blood pressure
  • Hypothermia
  • Muscle weakness
  • Phycological Stress


  • Rescue in horizontal position
  • ABC Assessment
  • Give O2
  • Give IV fluids if blood pressure very low
  • Remove wet clothing and treat hypothermia
  • Treat injuries/illness
  • If conscious warm drinks


Treatment for Drowning

  • Asses ABCDE immediately & Asses any current illness
  • Do not waste time attempting to get water out the lungs
  • Stomach may have entered the stomach which will likely result in vomiting. If vomiting, turn patient over on to side and clear mouth of vomit ensuring airway is open and clear
  • Treat Hypothermia and keep patient dry and warm as possible
  • Continue resuscitating until patient temperature is more than 32 °C and is breathing.

Continue until medical help arrives or until point of exhaustion until you cannot continue

Once revived, get to a medical advice and get to a medical facility immediately.  Water in the lungs can result in acute lung injury effecting breathing, causing shortness of breath/fast breathing, coughing, a rapid pulse and possible collapse, leading to secondary drowning and pneumonia



Nick Stael Von Holstein