A drowning victim is always considered hypothermic. Those with a history of metabolic or endocrine disorders, hypoglycemia, hypothyroidism, hypoadrenalism, hypopituitarism might all be at risk of hypothermia. An altered sensorium or physical disabilities may prevent the patient from protecting themselves from heat loss. Symptoms also include altered level of consciousness as manifested by slurred speech, staggering gait, decreased mental skills, apathy, and ataxia. Depending on the degree of hypothermia, shivering can be violent or non-existent.
Vital signs are depressed and cardiac dysrhythmias occur.
The J wave occur at the junction of the QRS complex an the ST segment Also noticeable are T wave inversions and prolongation the PR, QRS, and QT intervals. These all can be attributed to the His-Purkin system being more sensitive the cold than the myocardium Conduction velocities decrease and electrical signals disperse. When the conduction time longer than the absolute refractory period reentry currents can produce circus rhythms which lead to ventricular fibrillation. Peripheral vasoconstriction initially causes central hypervolemia to which the kidneys respond by putting out large amounts of dilute mine. Alcohol and cold water immersion worsen this process.