Symptoms of Hypothermia due to cold water exposure include:

1. Numbness in Lips and Extremities: Numbness can occur even if the swimmer is not hypothermic,  but is one of the first signs that a swimmer’s condition is deteriorating.  The swimmer may experience “claw hand” where his or her hand cramps and distorts itself.  Lips may become numb, making it difficult to speak. The swimmer may also to begin to take in water due to his or her inability to seal the lips, in which case the swimmer should be pulled.

2. Uncontrollable Shivering: Shivering is the body’s natural response to being cold. While you may shiver even before the swimmer technically enters hypothermia,  it is the uncolntrollable shivering and shaking that spells trouble.  Even more dangerous is if the shivering stops, meaning the body has stopped trying to warm itself.

3. Body Color: Blue lips and/or a grey or ashen appearance is a common symptom.

4. Slurred or Impaired Speech: The swimmer may begin to slur his or her words or have difficultiy forming sentences.  It is important to distinguish between impaired mental function and issues caused by numbness when deciding if the swimmer is hypothermic.

5. Disorientation and Impaired Motor Skills: The swimmer may appear glassy-eyed, have difficulty answering simple questions (such as what day were you born?) and staying alert, and dump/fumble with his or her feeds.  Also look out for steep decreases in the swimmer’s stroke rate, as this can be a sign of hypothermia, as well as cause the swimmer’s condition to worsen.

Symptoms of hyperthermia and heat exhaustion due to warm water exposure include:

1. Excessive Cramping: If the swimmer is experiencing excessive cramping that is not alleviated by increasing fluids and elocrolyte consumption, the swimmer may be experiencing hyperthermia and heat exhaustion.

2. Insufficient Urination: A swimmer that is well hydrated will urinate at least once every hour or so.  If the swimmer is not urinating regularly, he or she should be encouraged to increase fluids when feeding.  Insufficient urination can also lead to toxin build-up and can be a sign of serious problems.

3.  Headache, Dizziness, and Nausea: A headache is one of the first signs that a swimmer is dehydrated. Later a swimmer may feel dizzy and about to pass out, or may feel nauseous or experience vomitting.

4.  Impaired Mental and Motor Function: Much like hypothermia, a swimmer experiencing hyperthermia and heat exhaustion may appear disoriented, show poor judgement, and may experience a drop in stroke rate.