Precautions-

first, buy some protection
No, not that protection, this is about Safe Paddling, not Safe S*x, but wearing the right stuff can still make a big difference. That means a wetsuit or drysuit. Protecting the front of the torso and back of the chest will have the most profound effect on moderating the respiratory responses, while protecting the extremities has the greatest benefit in moderating the cardiac responses. Most of these responses are worsened by head immersion, which also markedly hastens the progression of hypothermia(if you manage to survive the cold shock), so head protection is important. Since both cold shock and later hypothermia inhibit effective swimming, wearing a PFD is essential to keeping the head out of water and prolonging survival.



does practice make perfect?
A definite maybe. It does appear that repetitive immersions in cold water will allow the body to adapt and moderate the cold shock response. After 6 - 8 immersions (daily, each time long enough for core temperature to drop>2o), the cardiac responses are substantially reduced. The breathing problems unfortunately are much less responsive to such efforts at training. An more important type of practice is to actually try out your cold water clothing in a variety of conditions. The studies referenced in this article seem to show a fairly consistent set of responses across a range of water temperatures from 0o to as high as 60o . There is individual variation though, and gear that works for your paddling partner may not be adequate for you. Most people find it very revealing to try floating in 30, 40, or even 50 degree water.


make mine dry, very dry
In the wetsuit/drysuit debate I readily admit that I am a dry suit chauvanist, finding a drysuit much more comfortable. For the prevention of cold shock a well fitting wetsuit will be more than adequate, provided it is truly well fitting and substantially slows the contact of cold water with your torso. If loosely fitting, with overgenerous neck and arm openings there may still be a sufficient gush of frigid water to trigger these cold shock responses. Even with a well fitted wetsuit many find that first cold water flush unpleasant, and for long term survival in cold water a drysuit with appropriate insulation can be 2 -3 times more effective in staving off hypothermia. The newer lycra/fleece wetsuits can however be a very comfortable, moderate cost, no-excuse-for-not-wearing-it form of protection if you are confident that your paddling does not put you at risk of prolonged immersion.



what about hypothermia?
There are many excellent resources on prevention, recognition, and management of hypothermia. Some internet resouces are listed below so just a few points. Recognize and manage hypothermia early - thought processes become quickly impaired and can rapidly lead to decision making which turns an unpleasant situation into a dangerous one. In a non-immersion situation, the greatest heat loss is through the head and neck, insulation for these areas is most important. In maintaining extremity function good head protection has been shown to be more useful than better gloves or socks. Get out of the water! Water will cool 20 - 30 times faster than air. Movement in the water, such as swimming, will make this even worse. Severe hypothermia is a medical crisis. The victim must be handled gently and knowledgably. “No previously healthy person should die of hypothermia after he has been rescued and treatment has been started.” (Cameron C. Bangs, M.D.).

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