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Sea Kayaks Techniques Bulletin Board
larynixospasm
Posted By: don flowers In Response To: Re: Cold water reactions (Carl Tjerandsen)
Date: Friday, 24 May 2002, at 12:58 p.m.
The last swift water rescue course I took mentioned larynixospasm which is similar to the diver's reflex. If I have not gotten things too confused, in some cases this does result in a complete shut down in reaction to cold water. Consequently, no air will go in. CPR is ineffective. It may relax when a person goes unconcious or it may remain in spasm. If it remains in spasm, you don't even have an organ donor because chest compressions or, the now frowned upon abdominal thrusts, won't work. In the words of the instructor, if it happened at the hospital, the person would still likely perish. I have hesitated posting this because I have not gotten this from any of the first aid courses and have not had an opportunity to discuss it with our local kayaking physician, just from three skilled rescue people plus an ambulance attendent. Seems to me even if the info is correct slicing open the throat below the larynix and inserting a tube would give a chance but that is a pretty drastic measure and I don't know if I would have the confidence to do it in a field situation. Anyway, one more thing to add to the mix -- fortunately, a relatively rare thing.
You have to ask yourself, do you really want to paddle with someone who contemplates slicing open your throat?
don
: Perhaps the physiologists have enlarged our understanding of these phenomena,
: since I last looked into the literature, but I'm wondering if you are
: mixing the dive reflex into a situation where it doesn't belong. People
: with bronchospasm don't hyperventilate. They hypoventilate. The phenomenon
: Brian aptly describes is most likely due to the sudden shock and pain of
: abrupt cold immersion, a sympathomimetic response, which would tend to
: open the bronchioles. The hyperventilation reflex will greatly reduce your
: breath holding time (rolling time-by as much as 75%), produce reduced
: cerebral blood flow and dizziness, with some loss of muscle coordination
: during the 5 minutes or so it usually lasts. Maybe you are confusing vocal
: cord spasm (which can happen in dry drowning and I believe the dive
: reflex) with bronchospasm.
: Please instruct me, if I've managed to get some part of this wrong.
: Regards,
: Carl Tjerandsen
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