Field Management of Accidental Hypothermia During Diving

6 min read · 14 March 2026

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Field Management of Accidental Hypothermia during Diving is a 1990 technical report by Sterba on recognizing and managing unintended cooling in diving settings. The subject matters because immersion and cold exposure can impair both physical performance and decision-making, while the dive environment complicates assessment and care.

Why is hypothermia a particular concern during diving?

Water draws heat from the body more effectively than air at the same temperature. The rate of cooling depends on factors such as water temperature, exposure time, clothing and equipment, a diver’s exertion, and individual physiology. Cold stress may develop during a dive or persist after leaving the water.

Cooling can affect coordination, strength, sensation, alertness, and judgment. These changes can make routine tasks harder and interfere with safe responses to an evolving problem. In diving, a medical issue may also arise while a person is wearing restrictive equipment or is far from immediate assistance.

Accidental hypothermia refers to an unintended fall in core body temperature. It is distinct from simply feeling cold: assessment considers the person’s condition and the possibility of systemic cooling, not discomfort alone. A field-management perspective therefore links prevention, recognition, extraction from exposure, and care after the dive.

What happens to the body as it cools?

The body normally balances heat production against heat loss. Immersion increases heat transfer away from the skin, and cold water can overwhelm the body’s ability to maintain its internal temperature. Shivering is one response that generates heat, but it can also increase fatigue and interfere with precise movement.

As cooling progresses, neurological and muscular function may deteriorate. A diver may become less dexterous or less able to make sound decisions; more severe cooling can affect consciousness and vital functions. These effects matter not only medically but operationally, because a cold-impaired diver may have difficulty communicating, handling equipment, or assisting a companion.

Temperature readings can help clinical assessment, but conditions in the field may make measurement and interpretation challenging. Symptoms, exposure history, and the person’s overall state must be considered together. A suspected serious case calls for urgent medical evaluation rather than reliance on a single sign.

What does field management need to address?

Field care begins with ending continued heat loss and moving the person to a safer environment. Wet clothing, wind, ongoing immersion, and unnecessary exposure can contribute to further cooling. Handling and warming decisions depend on how unwell the person appears and what care is available.

Important considerations in a diving setting include:

Recognition: identify cold exposure alongside changes in movement, coordination, alertness, or responsiveness.
Protection: limit additional heat loss and insulate the person from cold surroundings.
Assessment: monitor the person’s condition and arrange appropriate medical care.
Context: account for the dive, the equipment, the route to assistance, and other injuries or illnesses.

These are general principles, not an individual treatment plan. The appropriate response can vary with the severity of cooling and the circumstances, so suspected hypothermia—especially with impaired consciousness or worsening condition—requires prompt professional medical assessment.

How does this topic fit into diving medicine?

Accidental hypothermia sits at the intersection of environmental physiology, dive planning, rescue, and emergency medicine. It is connected to familiar diving concerns such as exposure protection, workload, fatigue, and the practical limits of providing care at a remote site. Treating cold exposure as part of the whole dive-system problem helps connect prevention with response.

A technical report focused on field management belongs to a practical strand of diving medicine: translating physiological concerns into questions that arise before, during, and after an incident. The subject is relevant to recreational divers, scientific divers, dive teams, and clinicians who may assess someone after cold-water exposure.

The report’s 1990 publication date places it in the historical development of diving-medicine literature, while the underlying problem remains pertinent wherever divers face cold water or prolonged exposure. Current decisions should reflect present-day clinical practice and the specific circumstances, rather than treating an older technical work as a substitute for medical guidance.

What should divers and clinicians take from the subject?

For divers, the central lesson is that cold is not merely a comfort issue. It can compromise the abilities needed to complete a dive safely, and its effects may continue after surfacing. Exposure protection and a plan for prompt assistance are therefore part of risk management.

For diving physicians and hyperbaric clinicians, the topic calls for attention to the exposure history, the person’s neurological and physical condition, and possible coexisting problems. Assessment and care should be guided by qualified medical judgment. A diving-medicine physician should be consulted when questions concern an individual’s fitness, symptoms, or return to diving.

Frequently asked questions

What is accidental hypothermia?

It is an unintended fall in the body’s core temperature caused by heat loss exceeding heat production. In diving, immersion and cold exposure are important circumstances to consider.

Can cold affect a diver before a dive ends?

Yes. Cooling can impair sensation, coordination, strength, and judgment during exposure, potentially making equipment handling and other tasks more difficult.

When is medical assessment important?

Prompt assessment is important when a person has suspected significant cooling, worsening symptoms, altered alertness, or difficulty functioning. Individual care decisions belong with qualified medical professionals.

Citation details

Title: Field Management of Accidental Hypothermia during Diving
Authors: Sterba, JA
Year: 1990
Identifiers: ADA219560, NEDU-1-90
Record type: Technical report
Repository record: Rubicon Research Repository, handle 123456789/4248

This page is an original summary written by the Rubicon editors from the publication’s bibliographic record. It does not reproduce the paper, its abstract or its data; consult the publication itself for its methods and findings.