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Swim PilotingMedical Issues

Medical Issues


The biggest risk to swimmers in San Francisco Bay is hypothermia. Signs of hypothermia include: 

  • Deteriorating and slowing swim stroke 
  • Trouble speaking
  • Confusion – Losing sense of direction. Swimming off course.
  • Inability to answer questions
  • Grey skin color.

If you suspect the swimmer is starting to suffer from hypothermia, look for difficulty in speech. Ask questions which require some thought: 

  • What is your name.
  • What are you sighting on? 
  • Simple arithmetic. What is 9+6

When swimmers get tired and cold, they may start feeling alone, scared, irrational or even combative. But as swimmers progress further into hypothermia, they may lose awareness of the severity of their condition. A confused swimmer is likely to be in worse condition than a frightened swimmer. 

When you spot a swimmer becoming hypothermic, it’s time to pull them out of the water. See Rescuing Swimmers

Management – In the Boat

Once in a boat, a swimmer will continue to cool down and this may be particularly acute if the air is cold and the wind is blowing. It’s important to get the swimmer dry and wrapped in blankets as soon as possible. Do this before racing back to the dock. 

Management – At the Club

When a hypothermic swimmer is brought back to the club, always have someone accompany them to the sauna. 

Rapid rewarming has its own risks. Swimmers that need assistance should be placed on the lower bench of the sauna to allow for a gradual rewarming. Someone must stay with them until they’re warmed.

When to Call 911

Most swimmers exiting the water after a long swim will be in some state of hypothermia. Most cases can be managed at the club, but there comes a time when paramedics may be needed.

  • Shivering stops
  • Greater lack of coordination
  • Heavily slurred speech
  • Confusion    
  • Progressive loss of consciousness    
  • Weak pulse; shallow breathing

Animal Bites 

Heart Attack


Asthma / Breathing Problems