Recovery of a 62-year-old Man From Prolonged Cold Water Submersion, ,

Recovery from prolonged cold water submersion is well documented in children but rare in adults. In the few adult cases reported, significant body cooling occurred (rectal temperature ranging from 22° to 32° C) and the victims were relatively young (<40 years). We report a case of a 62-year-old man who was submersed in 2° to 3° C water for 15 minutes (time from initial submersion to intubation=22 minutes). At the time of rescue, he had no vital signs, received prehospital Advanced Life Support, and was transported to hospital. On arrival at hospital, the patient remained in full cardiopulmonary arrest with an agonal ECG rhythm and had an initial pH of 6.77. Initial rectal temperature was near normal (36° C) but subsequently dropped to 33° C. The patient was resuscitated, rewarmed by forced-air warming, and treated for acute myocardial infarction, pulmonary edema, and generalized seizures. He was discharged after 27 days with minor neurologic abnormalities. Given the near-normal initial rectal temperature, preferential brain cooling may have been at least partially responsible for the positive neurologic outcome. [Chochinov AH, Baydock BMS, Bristow GK, Giesbrecht GG: Recovery of a 62-year-old man from prolonged cold water submersion. Ann Emerg Med January 1998;31:127-131.]