Beyond Cold Water Bootcamp


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The procedure highlighted below is designed to be carried out in a protected environment and normally would be used when transport to hospital will take longer than 30 minutes. This procedure should occur in conjunction with normal First Responder checks for A, B, C’s, spinal and other secondary injuries.


Upon arrival at the site, and while maintaining the victim’s horizontal position, attempt to determine the degree of hypothermia the individual is experiencing:

  • If they are shivering, mentally alert and able to move their extremities, they are mildly hypothermic.

  •  If they are incoherent, unconscious or are not shivering, they are moderately and possibly severely hypothermic.


35-32°C • Shivering.
• Some impairment of fine and major motor skills.
• Mentally coherent.

Treatment for Mild Hypothermia

Unwrap the insulation and vapour barrier and proceed to cut off the victim’s clothing. Gently blot the skin dry being careful to avoid rubbing or patting. Provide dry insulation. If shivering is present, external heat is preferable, but not absolutely necessary.


32-28°C • Visible impairment of fine and major motor skills.
• Shivering decreasing, waxing and waning.
• Generally Incoherent.
• Shivering Stops/Unconscious at approximately 30°C.



< 28°C • Victim is rigid.
• Responses are absent.
• Vital signs are reduced or absent.

Treatment for Moderate and Severe Hypothermia

Unwrap the insulation and vapour barrier. If the victim is unconscious, check for a pulse for a full minute. It is vital to be sure, because the cold may have significantly slowed the victim’s heartbeat to only a few beats per minute. If no pulse can be detected, ventilate the patient for 3 minutes; this may oxygenate the heart and increase its strength and rate, thus making it more likely that a pulse may be detected. Take one more minute to check for a pulse again. If a pulse is still not detected, begin CPR. It is important to take this extra time to ensure, as much as possible, that there is no heart beat before starting CPR. Beginning chest compressions on a victim with even a faint pulse can cause ventricular fibrillation.

If a pulse is present, proceed to cut off the victim’s pfd and clothing. Gently blot the skin dry, being careful to avoid rubbing or patting. In these cases, external heat is preferable because the victim has a very low metabolic rate and will not warm up spontaneously.

application_of_external_heatTransport and Monitoring

Gently transfer the dry victim horizontally onto an open dry sleeping bag or insulated warming bag using a standard two-person carry.  Before securing the insulation around the victim, place external heat sources (if available) in the underarm and chest area to promote rewarming. For more information on Transport techniques, click here.
Continue to monitor the victim’s
condition/responsiveness until the
ambulance arrives on scene.

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