BACKGROUND: General hypothermia (deep body temperature <35 degrees C) has been implicated in immersion-related deaths, but many deaths occur too quickly for it to be involved. We investigated changes in swimming capability in cold water to find out whether such changes could lead to swim failure and drowning. METHODS: Ten volunteers undertook three self-paced breaststroke swims in a variable-speed swimming flume, in water at 25 degrees C, 18 degrees C, and 10 degrees C, for a maximum of 90 min. During each swim, we measured oxygen consumption, rectal temperature, swim speed and angle, and stroke rate and length. Swim failure was defined as being unable to keep feet off the bottom of the flume. FINDINGS: All ten swimmers completed 90 min swims at 25 degrees C, eight completed swims at 18 degrees C, and five at 10 degrees C. In 10 degrees C water, one swimmer reached swim failure after 61 min and four were withdrawn before 90 min with rectal temperatures of 35 degrees C when they were close to swim failure. Swimming efficiency and length of stroke decreased more and rate of stroke and swim angle increased more in 10 degrees C water than in warmer water. These variables seemed to characterise impending swim failure. INTERPRETATION: Impaired performance and initial cardiorespiratory responses to immersion probably represent the major dangers to immersion victims. Consequently, treatment should be aimed at symptoms resulting from near-drowning rather than severe hypothermia.

Adult↗

PubMed1998

Going out on a limb. Louisville doctors announce the first "successful" hand transplant before they even lift a scalpel.

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Cadaver↗

PubMed1997

Mechanisms of body cooling in submersed victims.

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Adult↗

PubMed1997

Fed up with the constant carnage he deals with in his emergency room, a doctor pleads with the nation's youth. Drop your guns!

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Adolescent↗

PubMed1979

The effectiveness of pediatric nurse associates as clinical instructors of medical students.

Pediatric nurse associates (PNAs) have provided health care services for children, taught physical diagnosis to first-year medical students, and acted as role models for students and residents. Their role as clinical instructors has not been measured objectively. This study evaluated the effect of PNA interaction with medical students in a pediatric clerkship. Students taught by PNAs had higher gains in factual knowledge and greater skills in physical examination as measured by a videotape of a patient encounter. The PNAs demonstrated that they can be effective instructors of medical students.

Clinical Competence↗