Rescue, Recovery, and Re-warm - The Maritime 3 R's
Date Posted: November 21, 2023
Source: Vincent Pica Commodore, 1st District, Southern Region (D1SR) USC

On the sea, especially in cold water environments, it is all about rescue, recovery and re-warming.  I don't expect that there are many boaters out there on our bays, creeks and littoral areas of the ocean now.  But some are out there.  And the waters are cold now and will still be cold once April 1 comes around and the moorings go back in.  This column is about that.

 

He Fell In And Can't Get Out- Rescue

We've written about the new NYS law that requires PFDs on all boaters in boats under 21' between November 1 and May 1 of the following year and about hypothermia.  When I wrote about hypothermia, I suggested that you conduct a little experiment with the kids (or yourself!) to demonstrate the power of water to draw heat out of you - 25x faster than air of the same temperature.  To prove it, try this experiment with the kids…  get a glass of water to room temperature and drop an ice cube in it; at the same time, lay an ice cube on a napkin next to the glass of water.  When the ice cube in the glass has melted away, there will still only be a small amount of dampness around the ice cube sitting on the napkin…  But, upon further research conducted by cold-water specialists in Canada (where the water is cold all the time, when it isn't frozen), exertion – such as thrashing or swimming – can increase that heat-stealing mechanism up to 10x – that's 250x now!

 

So, if someone falls in, it is critical to get them out ASAP.

 

When Rescue Become Recovery

By USCG standards, a rescue becomes a recovery when the victim has died from the circumstances.  So, if someone just falls in, it is still a rescue, right?  Well, hopefully, but there are circumstances when death can come almost unbelievably quickly.  As has been pointed out here before, cold water – sudden cold water – can be a killer long before hypothermia gets to you:

 

  1. A splash of cold water in your face can cause you to involuntarily inhale water, which is a killer. Not swallowing it down your throat into your stomach but inhaling it into your lungs.  This is the "gasp reflex."
  2. In some people, the reaction doesn't get that far into their bodies. They hit the cold water and, as soon as it touches the back of their throat, it closes up.  The spasm stops the water from getting into the body, which is the biological intent, but it also stops air from getting to the lungs.  The person bobs back to the surface (their lungs are full of air) and they suffocate in the open water, unable to breathe due to a blocked air passageway.  This is what is now called "dry drowning."  There is no water in the lungs, nor is there any oxygen.  I've seen a BoatUS report that stated that 15-20% of all drownings are "dry drownings."
  3. When the difference between your body temperature and the water temperature is greater than 30-degrees, the chance of a heart attack from the sudden immersion goes up dramatically.
  4. Even something as simple as a racing heart from shock and fear can create hyperventilating on the part of the victim. Dizziness followed by unconsciousness results as the ratio of oxygen/carbon dioxide changes in the victim's blood system.

 

If you are the victim, remember this: an initial deep and sudden gasp followed by hyperventilation that can be as much as 600-1000% greater than normal breathing can be deadly.  You must keep your airway clear or run the risk of drowning.  Cold Shock will pass in about 1 minute.  During that time concentrate on avoiding panic and getting control of your breathing.  Wearing a lifejacket during this phase is critically important to keep you afloat and breathing.

 

OK- We Have Them In the Boat – Now What? – Re-Warm!

Believe it or not, if you apply heat directly to the arms and legs of a hypothermic person you just pulled from the sea, you can kill them.  It is called the "After Drop" – you force cold blood that has pooled in the arms and legs (constricted blood vessels) back toward the heart and brain and that lowers their body temperature.  Apply heat (hot water bottle, towels that have been microwaved, heating pads, your warm, dry hands) to the head, neck, chest and groin.  Of course, you need to get them into a warm or at least dry environment as part of the rescue.  Lie them on their back or side (not face down.)  This person is dying so there is no time to be squeamish or bashful.  Lie on top of them and wrap a blanket around you both.  There are two schools of thought on getting them out of the wet clothes.  Some believe that the little bit of water that you can warm with your body can aid in their recovery.  My own experiences lead me to believe that, if the alternative is wet clothes or just a blanket around a naked body, go with the wet clothes and cover them up with blankets and your warm body.  If they are conscious, give them warm – not hot – liquids.  Add sugar for energy.  No alcohol and avoid caffeine if possible.

 

Bring 'em back alive, captain.

If you have questions on this column or you are interested in being part of USCG Forces, email me at [email protected] or go directly to the US Coast Guard Auxiliary "Flotilla Finder" at  http://www.cgaux.org/units.php and we will help you "get in this thing."

Comment Submitted by Vincent Thaddeus PICA - December 21, 2023
JR, it is a good point. When we were caught 300nm off Cape Hatteras in an '83 tropical storm, one of the crewmen did go over the side, with his safety strap keeping him attached to us - but he was getting a good beating alongside the hull. I believe he would have given out before the safety harness did. We hauled him back in and applied necessary first aid. I was injured the next day when a rogue wave came back through the storm and sent us from a port tack to a starboard tack in seconds, and then back to the port tack as the wave passed by and the wind took over again. Slammed against a brass hatch runner. Still proudly point to the scar, but 40 years have worn it down to almost invisibility... Say safe.
Comment Submitted by Vincent Thaddeus PICA - December 21, 2023
Linda, I think I covered that point with "It is called the "After Drop" – you force cold blood that has pooled in the arms and legs (constricted blood vessels) back toward the heart and brain and that lowers their body temperature" but it never hurts to reemphasize things that put people into mortal peril.
Comment Submitted by J R Rowell - November 23, 2023
If the boat is a type to unlikely to capsize, the number one rule is to stay on the boat, wet maybe but on the boat. First stay attached to the boat when there is a possibility of falling or being swept into the water. Even if you are not alone on the boat, your chances when going into the water are not good. I am unimpressed with the typical jack line setup. While it will keep you attached to the boat, It is often too stretchy to keep you aboard. Dangling off the side of the boat is not a massively better than being in the water. I recommend non-stretchy jack line. The least expensive, and most functional, I have used is stainless steel cable from bow to stern with swagged eyes at each end. A small amount of hi-tech cord is laced at the ends to bring it tight. The line lays flat on deck so it has minimum chance of causing a slip or trip. Cheers, and stay dry.
Comment Submitted by linda - November 22, 2023
May be a good idea to mention, when stating the dangers of warming limbs first, to also state this can cause cardiac shock when the cold blood enters the heart so quickly, which may lead to cardiac arrest.
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