Hypothermia from prolonged immersion: biophysical parameters of a survivor.
We report a case of survival following prolonged immersion and hypothermia. The patient survived for over 9 h in open water, after his vessel capsized and sank in the Pacific Ocean off the coast of Northern California. Water temperature on the day of the sinking was 14.4 degrees C (58.0 degrees F). Although he did have adequate flotation, the patient did not wear a survival suit. On initial physical examination in the Emergency Department (ED), the patient's rectal temperature was 30.0 degrees C (86.0 degrees F). With active rewarming, his temperature returned to normal (37.0 degrees C (98.6 degrees F)) within 5 h. Body fat of the patient was 19.6%, near the 50th percentile for his age (19.0%). Surface/volume ratio of the patient (.0228 m(2)/L) was 19% smaller than a predicted average (.0282 m(2)/L). We believe that the patient's large body habitus contributed to survival and that surface/volume ratio was likely the biophysical variable most closely associated with decreased cooling.
Nuckton
Thomas J
TJ
Division of Pulmonary and Critical Care Medicine and the Cardiovascular Research Institute, University of California, San Francisco, California 94143, USA.
Goldreich
Daniel
D
Rogaski
Kenneth D
KD
Lessani
Tonia M
TM
Higgins
Paul J
PJ
Claman
David M
DM
D000328:Adult; D001824:Body Constitution / Q000502:physiology*; D015992:Body Mass Index; D001831:Body Temperature; D006801:Humans; D007035:Hypothermia / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D007101:Immersion / Q000009:adverse effects*; D008297:Male; D017694:Rewarming / Q000379:methods*; D013534:Survival