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Fitness

Dangers of Open Water Swimming: Hypothermia and Hyperthermia

If you practice open water swimming, you should know the dangers involved. This includes the occurrence of hypothermia or hyperthermia. Learn how to recognize and treat these deadly situations.

Hannah Caldas

Written by Hannah Caldas Last updated on January 3, 2013

Open water swimming presents a myriad of variables that pool swimmers usually don’t need to deal with. From living creatures, visibility, sun exposure, chaffing, feeding, currents, and waves, the list goes on. But there is one variable that received a lot of attention in the last few years and called for a specific committee to establish regulations to ensure the safety of open water swimmers. I am talking about water temperature.

Water temperature played a part in the death of world-class swimmer Fran Crippen at FINA’s 2010 10K series in the United Arab Emirates. In the wake of his death discussions resulted in guidelines that must be followed for an event to be sanctioned by FINA (Federation Internationale de Natation). But while most swimmers don’t need to really know what these guidelines are, recognizing the symptoms and knowing the appropriate medical response to adverse temperature conditions could be a lifesaver, whether in a race, training, or just while swimming open water for fun.

There are two potential scenarios when it comes to water temperature: the water can be too hot or the water can be too cold. With those two scenarios come two body responses: hyperthermia and hypothermia.

Hypothermia

There is a broad range for normal human body temperature, and hypothermia is defined as a temperature below that of the accepted normal human body temperature. While in a body of water, the levels of hypothermia fall into definitions of mild, moderate, and severe.

  • Mild hypothermia has two levels of severity. Between 96-99F the symptoms are shivering and impairment to perform coordinated tasks. The basic treatment consists of simple re-warming by blankets and removal from the exposure. If removal is not practical an individual can be wrapped in towels and covered with sand. Between 91-95F the symptoms are shaking, shivering, and mild impairment of the central nervous system indicated by slow thinking and speech difficulty. The basic treatment is the same as the other type of mild hypothermia, but it will take longer to reverse. In addition a warm shower could be beneficial, and the swimmer should be watched closely during recovery.
  • Moderate hypothermia is classified as when the body temperature is between 86-90F. At this temperature shivering slows down and stops and there is profound slowing of mental function. Confusion may include hallucinations and paradoxical undressing. Also commonly observed is muscle rigidity, along with jerky motions and irregular heartbeats. The basic treatment in this case includes prevention of further heat loss with the basic measures described above. No aggressive re-warming should be attempted since this results in shunting cold blood into the core and may further drop the core temperature. Evacuation should be considered, to a place where warmed IVs may be performed.
  • Severe hypothermia occurs when body temperature is below 86F. The symptoms are drastic and include coma, falling blood pressure, and life-threatening cardiac irregularities. In this situation time is of the essence and this is a true emergency. Evacuate the swimmer and protect him or her from further heat loss. Further attention should be performed by a medical professional.

Hyperthermia

open water swimming, swimming dangers, hypothermia swimming, hyperthermiaHyperthermia is elevated body temperature that occurs when the body absorbs more heat than it dissipates (in the case of a swimmer). Extreme temperature elevation then becomes a medical emergency requiring immediate treatment to prevent disability or death. There are several conditions associated with hyperthermia:

  • Heat Edema – The main symptom is the swelling of the hands, which usually resolves spontaneously after several days of acclimatization.
  • Heat Syncope – Dizziness to the point of fainting in an unacclimatized athlete. It manifests when the swimmer stands up quickly, usually in a state of dehydration. Keeping the swimmer in the supine position with legs elevated, cool liquids (but not iced) and resting in a cool place are the primary ways to care for the swimmer.
  • Heat Cramps – Manifest as painful cramps and spasms and are usually cared for by massage, rehydration, and attention to electrolytes. If this is unsuccessful then be attentive to blood sodium content as well as other electrolytes.
  • Heat Exhaustion – Usually associated with fatigue, weakness, lack of coordination, mild confusion, agitation, headache, sweating, nausea, vomiting, diarrhea, muscle pain, and cramping. It is associated with a body temperate of less than 104F. Care for this condition includes all the measures described for the milder conditions above, in addition to protection from further exposure by removal to an emergency facility where advanced treatment will be available. During transport spray the swimmer with lukewarm water in a setting of cooling fans and perform cool oral rehydration.
  • Heat Stroke – Skin is dry and very warm, there is profound confusion and loss of coordination, and also possibly seizures, coma, and hallucinations. This is a true medical emergency that requires immediate transfer to an emergency facility. Gradual central cooling will be conducted with close attention to organ function and damage.

Prevention of hypothermia and hyperthermia is the key. One of the ways swimmers prepare is by acclimatization to the water they are going to swim in. But in the end, if the water temperature is too high or too low it may be impossible to prevent a drop or increase of body core temperature. Safety is in the prevention, but if you ever find yourself in this situation the measures above should help you stay safe until you can seek medical attention.

Photos courtesy of Shutterstock.

Hannah Caldas

About Hannah Caldas

Since returning to swimming in 2010 after an 8 year retirement, Hannah Caldas has claimed FINA masters world records in 3 different relays and USMS National Records in the 50m Breaststroke and 50 and 100m Freestyle. She was awarded USMS 2010 and 2011 Pool All Star, earned All-American status in over 20 individual events, and was ranked as the fastest masters female swimmer in the world over 30 by FINA in the 50 and 100m Freestyle in 2011.

In 2012, Hannah was an Olympic hopeful for Portugal in the 50m Freestyle, but fell short of the qualifying time for London by 0.3s. She made a debut in Open Water Swimming in the Maui Channel Crossing Race, as a member of the Mixed Relay team in 2011.

Hannah started CrossFit in the summer of 2011, and in 2012 competed in the CrossFit Open and Southwest Regionals while simultaneously training and competing in swimming. She swims 4,000 meters per day, 2 hours per day, 6 days a week, and CrossFits 5 days a week, with one active rest and one full rest day.

In addition to her impressive athletic background, Hannah served as Associate Professor of Neurosurgery at Wake Forest University from 2006 to 2010. Since leaving academia, Hannah has lived in Phoenix, AZ, where she devotes her time to being a full time athlete. More recently, she has started applying her knowledge of functional fitness to help other swimmers and triathletes.

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