Cold-water immersion in a 22-year-old service member.

Cold-water immersion can include aspects of both hypothermia and near drowning. We present a case of a 22-year-old active duty service member who became a victim of cold-water immersion in Alaska. His rescue by the U.S. Coast Guard and subsequent treatment in a small community emergency room are reviewed using a case management format. Care of the cold-water immersion patient with limited resources is highlighted and the potential complications of cold-water immersion are emphasized. Disturbances in acid base balance, pulmonary function, and cardiac rhythm are discussed. Changes in some of the hematological indices seen in the cold-water immersion patient are reported for the first time.