On a sunny day one of the members of your group of four paddlers capsizes and wet exits into the cold water. They are wearing boots, polypropylene long johns, shorts and a short sleeve cotton shirt. They are having difficulty climbing back into their boat and they keep falling back into the water even though one of the group is stabilizing this paddler's kayak. The paddler in the water is showing visible signs of being too cold due to the water temperature. What is your course of action?

Considerations & actions from Wayne Horodowich:

Givens from the scenario being presented:

Sunny Day
Four paddlers in the group
One paddler capsizes and wet exits into cold water
Not wearing proper clothing for cold water immersion
Difficulty in getting back into kayak (repeated attempts)
One in the group is stabilizing the kayak
Visible signs of hypothermia

Considerations for each given:

Sunny Day
Sun can possibly supply some heat

Four paddlers in the group
You have a number of people to possibly help
There could be a chance that another capsizes
One paddler capsizes and wet exits into cold water
Why did they capsize?

Not wearing proper clothing for cold water immersion
Initial cold shock (gasping, hyperventilation, and shortness of breath)
Quick loss of body heat while in the cold water
Sudden cold effects on individuals with heart conditions
Why did this paddler go unprepared?
Why did you go with them?

Difficulty in getting back into kayak (repeated attempts)
Why can’t they get in on their own?
Why didn’t someone else come to help sooner?
One in the group is stabilizing the kayak
Leaves two paddlers to provide additional assistance

Visible signs of hypothermia
They need to get out of the water immediately
They need to begin generating body heat
They need to reduce any further heat loss
They may not have the strength to help
Reducing heat loss from the trunk and head are your greatest priorities

General considerations not mentioned:
Are there any other complicating illnesses/injuries?
How well prepared is the group with additional clothing?
Do you have fuel (food) for the internal furnace?

Courses of Action for the cold water capsize scenario:
The course of action is simple in theory. Get the swimmer out of the cold water and then dress them appropriately to reduce further heat loss. Then have them get active (begin paddling) to start generating more body heat. In addition, get some food into them, which can help provide energy. It is important to get the wet cotton shirt off of the cold paddler. If you have the cold paddler’s boat rafted between two kayaks, it is stable enough for a clothes-changing party. A long sleeve fleece top and fleece cap is great to have along for this type of occurrence. It is important get a wind shell over the paddler to help build up the heat inside the shell.

Since there are some signs of hypothermia setting in, you need to have a number of different rescue options. Loss of strength and coordination may be occurring. We already know this person cannot get into their kayak on their own so whatever is being done is not working. After the first missed attempt a second helper should have been there to assist the swimmer in getting back into their kayak. A stirrup should be used and/or the scoop rescue if the second helper cannot help the swimmer up onto their kayak.

I am more concerned about getting into this situation in the first place. I think it is irresponsible for paddlers to be out on cold water and not dressed for some immersion time. If you have a dummy in the group, one would hope that the rest of the group would apply enough peer pressure to keep this from occurring. One has to wonder about this group of friends.

If you are paddling in cold water, away from the shore, it is nice to have some food and clothing accessible while you are in your cockpit. I keep a large (Garden size) plastic trash bag in my first aid/repair kit. It has many uses. If you need a wind shell to put over a cold paddler, you can easily cut out head and arm holes. It can fit over the PFD so it can get on quickly. As mentioned above, at the very least, a long sleeve pile shirt and cap is nice to have for a cold victim to get next to their skin. Then the wind shell can go over it. My black garbage bag helps absorb a little heat on this sunny day.

Suggestions to avoid the situation:
Dress properly for your expected immersion time.
Practice your recovery skills because the faster you can get into your kayak the less time you spend in the water.
If a second person would have helped sooner, it may have kept this scenario from becoming a hypothermic one.
Don’t paddle with those who choose to dress inappropriately
Learn the causes, symptoms and treatment for hypothermia

Lessons learned:
Everyone in the group dresses for immersion
More than one should be there to help in the recovery
Practice your recoveries
Choose your partners wisely
Have extra clothing and food along that are accessible while on the water

See the following USK articles that are relevant to this scenario:
My Immersion Ensemble
Stirrup Recoveries (assisted)
Utilizing the Group During Recoveries
Dressing for Immersion
Recovery Theory
Group Paddling Creed

Response(s) from our readers:

Steve from California writes:
There are several things I would do. First, I would pull my rescue sling out and try to get them back in the boat that way.

If that didn't work, I would either try having them come across my deck first (it should be lower than their's), try a scoop rescue, or last resort, just have them lie across my back deck to get them out of the water.

I would also attempt to get the cotton T shirt off of them and replaced with a synthetic fabric. Next to last resort, would be to give them my paddling jacket, which I almost always carry, but rarely wear. Final option would be to use the big plastic trash bag I carry as a poncho to keep the air off their wet body.

Gary from California writes:
This scenario illustrates an all too common error in that at least one of the group members has dressed for the weather (a sunny day) rather than the water temperature (cold) and now finds himself underdressed for immersion. The cold water is quickly sapping the swimmer’s strength and coordination. Two related problems are also present. The swimmer keeps falling back into the water, which means repeated failed attempts, yet only one of the group is helping. Presumably the remaining two group members are simply watching the situation deteriorate. Now is the time for the others to get out of the “one victim – one rescuer” mindset. Rescuer #2 could come alongside rescuer #1, reach across his kayak while using it for support, and help pull the victim onto his back deck to assist his reentry. The second rescuer could also position himself along one side of the victim’s kayak helping to stabilize the victim and his kayak while the victim performs a wet reentry with an Eskimo bow recovery using the bow of rescuer #1 on the opposite side. This would require less balance and motor skill from the swimmer than an “over the back deck” reentry. The wet reentry would mean pumping out more water from the swimmer’s kayak, but that can be assisted as well.  Alternately, since the cold will affect the swimmer’s hands and arms quicker than the legs, a stirrup recovery would make good use of the swimmer’s stronger leg muscles before they weaken. Whatever option is chosen, the group must act quickly and decisively for the sake of the swimmer. If this group is unsuccessful at getting the swimmer out of the water by other means or before he is seriously impaired, the scoop rescue would be a fallback option.

Once the swimmer is back into his boat and it is pumped out and made seaworthy again, the matter of the swimmer’s wet clothing remains. Since his pants are polypro and will be beneath his sprayskirt below deck, they present a lesser problem. However, he’ll need to get rid of the wet cotton shirt. He is already cold, but will be getting colder from the evaporative cooling effect of the wet cotton. There’s good reason cotton has been given the nickname “death cloth.” It’s time for someone (hopefully more prepared than the swimmer) to pull a dry fleece top out of their day hatch or a drybag in their cockpit. If the former swimmer is now able to continue unassisted, that’s good. If not, he will need a tow. While being towed, he should also be encouraged to paddle if possible, since the activity will generate heat to help re-warm him. If the former swimmer has been significantly debilitated, the group needs to look for a landing spot to safely rest and re-warm their friend and consider the possible need for medical attention.

Stuart from Scotland writes:
First requirement is to get the casualty out the water. 2 of the remaining 3 paddlers raft up with casualty’s boat in middle. Put casualty on outside of 3 kayaks, empty boat in centre. Hook a karabiner onto casualty’s BA and the two paddlers haul him/her across deck of kayak and manhandle* casualty into their cockpit, apply spraydeck and pump out. 4th paddler holds paddles.

*Additional comments from USK:
I would be very careful about manhandling anyone who is hypothermic. Cold victims need to be treated gently in case they are in severe hypothermia.

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