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Fact: Immersion in cold water kills more sea kayakers than any other factor in the sport. Cold water is the single most serious threat to the survival of an unprepared paddler.

Fact: Hypothermia is not normally the issue in cold water paddling, but rather a predictable series of shock reactions that first impair, then quickly preclude, effective self-rescue actions.

Fact: A review of 6 fatal and 12 near-fatal accidents (1985) noted that all but one involved water temperatures of 50°F or less. A more recent review of 20 accidents, 19 involving immersion of 26 people in cold water noted that 10 died before they could be rescued and the remainder had varying degree of hypothermia.

Fact: "Cold Water Kills" is the introduction to the medical safety section of the annual Cold Water Workshop held by Atlantic Kayak Tours. Our goal is to provide you, the beginning, intermediate or advanced paddler with the information you will need to keep yourself safe, healthy and enjoying paddling no matter what the season

Atlantic Kayak Tours

What is killing the kayakers?

For years, most paddlers thought that the foremost danger in cold water paddling was hypothermia, and mistakenly concluded that cold water drownings were caused by hypothermia. Mistakenly because new evidence suggests otherwise. So what is it? What is happening to the kayakers found upside down, still inside their boats, apparently never making attempts to exit or self rescue themselves? What happened to the 9 physically fit and tough U. S. Marines who capsized their boat one frigid winter day on the Potomac River, not one making it to shore alive? What could have happened to these paddlers? Did they drown? Did they die of hypothermia? Did they die of shame? Well, the answer may be both yes and no to all of these questions. What we can surmise though is that some sudden disabling event happened to precipitate these casualties. Most likely the injuries were part of a series of complex events that combines aspects of cold shock, hypothermia and drowning.

  Top of Page

      Table of Contents

  1. Introduction
  2. Cold Shock
  3. Hypothermia
  4. How Your Body Regulates Core Temperature
  5. Types & Signs of Hypothermia
  6. Treatment of Hypothermia
  7. Cold Water Equipment

Next Page: Cold Shock

Interactive Thermometer

Interactive Thermometer

98.6 degrees

97 degrees

93 degrees

90 degrees

82 degrees




As body temperature starts to drops below 98.6.

Move victim to dry shelter and warmth.

Handle gently.

Remove wet clothes.

Insulate body, head, and neck.

Apply mild heat to body core to rewarm gradually.

Note: Move mouse over temperature to find condition and treatment.


Mild Hypothermia


Prevent further heat loss and let body rewarm.

Give warm, sweet drinks; no alcohol or caffeine.

Keep victim warm for several hours.


Moderate Hypothermia


Apply gentle heat to stabilize temperature.

Offer drinks only after victim is fully conscious.

Have victim checked by doctor if possible.


Severe Hypothermia


Avoid jarring victim; handle gentle.

Ignore pleas to be left alone.

Lay victim on back; keep immobile.

Apply mild heat.


Critical Hypothermia


Assume patient is revivable; don't give up.

Look, listen, and feel for breathing and pulse for 2 minutes.

Medical help is imperative.