# Other Injuries & Illnesses

Part of the Lifesaving Merit Badge Digital Resource Guide: [Introduction & Overview](https://merit-badge.university/merit-badges/lifesaving/guide/index.md)

*Spinal Injury & Resuscitation*

> **17.** With your counselor, discuss causes, prevention, and treatment of other injuries or illnesses that could occur while swimming or boating, including hypothermia, dehydration, heat-related illnesses, muscle cramps, sunburn, stings, and hyperventilation.

Water emergencies are not limited to drowning. Swimmers and boaters face a range of hazards — from the sun beating down overhead to the cold water below, from invisible jellyfish to the body's own reaction to overexertion. Understanding these conditions will make you a more complete rescuer and a safer Scout.

### Hypothermia

**What it is:** A dangerously low body temperature (below 95°F / 35°C) caused by prolonged exposure to cold. Water conducts heat away from the body 25 times faster than air, so hypothermia can set in even in water that does not feel particularly cold.

**Causes:**
- Extended time in cold water (below 70°F)
- Falling into cold water unexpectedly (cold-water immersion)
- Wet clothing combined with wind or cold air
- Exhaustion reducing the body's ability to generate heat

**Signs and symptoms:**
- Uncontrollable shivering (early stage)
- Confusion, slurred speech, poor coordination
- Shivering stops (this is a dangerous sign — the body has lost the ability to warm itself)
- Drowsiness, loss of consciousness

**Prevention:**
- Wear a wetsuit or appropriate insulation in cold water
- Limit time in water below 70°F
- Get out of the water and dry off if you begin shivering
- Keep a dry set of clothes available for after swimming

**Treatment:**
- Remove the victim from the water immediately
- Remove wet clothing and replace with dry layers or blankets
- Warm the core first — warm drinks (not alcohol), warm compresses on the chest, neck, and groin
- Handle gently — rough movement can trigger a dangerous heart rhythm in severely hypothermic patients
- Call 911 for moderate or severe hypothermia

> **Safety First!**
>
> Cold-water shock is different from hypothermia. When a person suddenly enters cold water (below 60°F), the body's gasp reflex can cause them to inhale water within seconds. Even strong swimmers can drown from cold-water shock before hypothermia ever sets in.

![Scouts near a lake, one wrapping up in a towel after swimming, another drinking from a warm thermos, demonstrating cold-water safety practices](https://ik.imagekit.io/doulacoop/tr:w-800/mbu-assets/merit-badges/lifesaving/guide/hypothermia-prevention?v=2eb6730b)

### Dehydration

**What it is:** A deficit of water in the body. It sounds contradictory — getting dehydrated while surrounded by water — but it happens regularly to swimmers and boaters who forget to drink.

**Causes:**
- Physical exertion while swimming generates sweat (you just do not feel it in the water)
- Sun exposure increases fluid loss
- Not bringing drinking water on boat trips
- Assuming you are not sweating because you are wet

**Signs and symptoms:**
- Thirst, dry mouth
- Dark-colored urine
- Dizziness or lightheadedness
- Headache, fatigue
- Muscle cramps

**Prevention and treatment:**
- Drink water before, during, and after swimming
- Bring water bottles on all boating trips
- Take regular water breaks during swim practice

### Heat-Related Illnesses

**Heat exhaustion** and **heat stroke** affect people who are active in hot, sunny conditions — exactly the kind of weather that brings people to the pool or beach.

**Heat exhaustion:**
- Heavy sweating, cool and clammy skin
- Nausea, dizziness, weakness, headache
- **Treatment:** Move to shade, cool down with water, drink fluids, rest

**Heat stroke (medical emergency):**
- Body temperature above 104°F
- Hot, red, dry skin (sweating has stopped)
- Confusion, seizures, loss of consciousness
- **Treatment:** Call 911 immediately. Cool the person aggressively — ice packs on neck, armpits, and groin. Immerse in cold water if possible.

> **Tip**
>
> The difference between heat exhaustion and heat stroke is critical. Heat exhaustion is uncomfortable but manageable. Heat stroke is a life-threatening emergency. The key indicator: if the person stops sweating and their skin becomes hot and dry, it is heat stroke — call 911.

### Muscle Cramps

**What they are:** Sudden, involuntary contractions of a muscle that cause sharp pain. In the water, a cramp in the calf, foot, or thigh can be frightening and dangerous.

**Causes:**
- Overexertion or fatigue
- Dehydration and electrolyte imbalance
- Cold water
- Swimming with unfamiliar or intense techniques

**Prevention:**
- Stay hydrated
- Warm up before swimming
- Stretch regularly
- Build swimming endurance gradually

**Treatment:**
- Float on your back and gently stretch the affected muscle
- For a calf cramp: flex the foot upward (pull toes toward shin)
- For a thigh cramp: straighten the leg and gently pull the ankle
- Move to shallow water or exit the water as soon as possible

> **Be Prepared! Leg Cramp While Swimming in Deep Water**
>
> You are 30 feet from shore and your calf suddenly seizes with a cramp. You cannot kick effectively.
>
> - **Do not panic.** You can float without kicking.
> - **Roll onto your back** and float while you address the cramp.
> - **Grab your toes** and pull them toward your shin to stretch the calf.
> - **Massage the muscle** if you can reach it.
> - **Use your arms** to scull and slowly move toward shore.
> - **Call out to your buddy** for assistance if needed.

### Sunburn

**What it is:** Skin damage from ultraviolet (UV) radiation. A serious sunburn is painful, blistering, and increases the risk of skin cancer over a lifetime.

**Causes:**
- Extended sun exposure without protection
- Reflected UV rays off the water surface (intensifies exposure)
- Cloudy days — UV rays penetrate clouds

**Prevention:**
- Apply broad-spectrum SPF 30+ sunscreen 15 minutes before going outside
- Reapply every 2 hours and after swimming
- Wear a rash guard or UV-protective shirt while swimming
- Wear a hat and sunglasses when out of the water
- Seek shade during peak sun hours (10 a.m. to 4 p.m.)

### Stings

**What they are:** Painful injuries from jellyfish, sea urchins, stingrays, bees, wasps, or other stinging creatures encountered in or near the water.

**Jellyfish stings:**
- Rinse with vinegar (for most species) or saltwater — never freshwater, which can trigger more stinging cells
- Remove visible tentacles with tweezers (not bare hands)
- Apply heat (hot water, 110–115°F) for 20 minutes to neutralize the toxin

**Stingray stings:**
- Immerse the wound in hot water (as hot as tolerable) for 30–90 minutes
- Clean the wound and seek medical attention

**Insect stings (bees, wasps):**
- Remove the stinger by scraping sideways with a flat edge (credit card)
- Apply cold compress
- Watch for signs of allergic reaction (swelling of face/throat, difficulty breathing) — this is anaphylaxis and requires 911 and an epinephrine auto-injector

> **Safety First!**
>
> If anyone in your group has a known allergy to insect stings, make sure they carry an epinephrine auto-injector (EpiPen) and that everyone in the group knows where it is and how to use it. Anaphylaxis can become fatal in minutes.

### Hyperventilation

**What it is:** Rapid, deep breathing that blows off too much carbon dioxide from the blood. In swimming, this is especially dangerous when done deliberately before an underwater swim.

**Why it is dangerous:** Some swimmers intentionally hyperventilate before a breath-hold dive, believing it will let them hold their breath longer. It does delay the urge to breathe — but it does NOT increase oxygen levels. Instead, it suppresses the body's warning signal (the urge to breathe). The swimmer may lose consciousness underwater with no warning. This is called **shallow-water blackout** and it is frequently fatal.

**Prevention:**
- Never hyperventilate before an underwater swim
- Never hold your breath for extended periods in the water
- Always swim with a buddy who is watching you
- Lifeguards should be alert for swimmers who are hyperventilating before going under

> **Did You Know?**
>
> Shallow-water blackout caused by hyperventilation before breath-hold swimming kills experienced swimmers — not beginners. It is most common among competitive swimmers, free divers, and military trainees who are trying to push their breath-hold limits. The victims are often strong swimmers who simply never come back up.

[CDC — Healthy Swimming](https://www.cdc.gov/healthy-swimming/about/index.html): Comprehensive information about staying healthy and safe while swimming, including injury and illness prevention.

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