17 March 2017

Freezing and paralysed: Skerries race to the rescue of a hypothermic swimmer

When Skerries sea-swimmer Sean O'Kelly became hypothermic during a swim around Colt Island, he didn’t quite believe it. 'I could hear a voice saying: "Are you alright?"' he recalls. 'I kept saying: "Yeah" - but I wasn’t.'

At the end of October, the Frosties year-round swimming group based in Skerries embarked on a swim from the mainland, around an island just offshore called Colt Island, and back again. They’d done this route - and longer - previously, but this time Sean got into difficulty.

Into the cold

Cardiac Nurse and Scuba Diving Instructor Catherine McMahon was swimming with Sean that day and describes what happened: 'Weather conditions were really nice. The sea was particularly warm for this time of the year - the water must have been about 10ºC. It only goes up to about 13ºC here anyway, so that was really good for us.

'There were about seven of us that day and we swam in smaller groups. It was on spring tides [which tend to bring stronger currents compared to neap tides], but we were swimming at slack tide [when the water is the most still between high and low tide] and we’re well-used to the currents here. When you’re at the island you are sheltered from it by sticking right in close to the shore.

‘There’s a big channel between Colt Island and Red Island where the speed picks up - that’s where you want to avoid. We leave at the top point of the island, aiming up the current for a landmark called the Captains and cross it, while using the flow to drift in to our exit point. We’ve done that loads of times. If the current is strong, you just go with it along the beach a little and swim back in to a different exit point.’

Sean with Colt
Island in the background, to the left, and the channel directly behindPhoto: RNLI/Anna Burn
Sean with Colt Island in the background, to the left, and the channel directly behind

Sean had completed the circuit many times without incident, but when another swimmer in the group got into difficulty near the island, it unwittingly set the stage for his own predicament on the return leg.

Catherine continues: ’We swam together and had a shore marshal. When we got to the far side of the island we stopped and I reminded everybody to stay close to the island so they wouldn’t be pulled by the current. However one of the guys got caught in it and was starting to be dragged out.’

What went wrong?

Wanting to ensure their companion was safe, Sean, Catherine and another swimmer got out onto the island. 'I roared at our swimmer to swim sideways across the current and to keep coming,’ Catherine explains. ‘Eventually, after about 15 minutes, he made it back but we were out of the water in the wind chill all that time, getting colder. This is what I think caused problems for Sean on the swim back.’

For Sean - a cold water veteran - the onset of hypothermia was disconcerting: 'I'd never been hypothermic before, despite swimming year-round with the Frosties for the last 5 years. I felt completely out of control of my body. I couldn’t make any headway.

'We're all really competent swimmers but I think getting out and then back in made things worse, with the wind chill.'

Sean, who
suffered from hypothermia that dayPhoto: RNLI/Anna Burn
Sean, who suffered from hypothermia that day

Sean had experienced a phenomenon called afterdrop, a sudden decrease in body temperature upon exiting the water.

‘I felt completely out of control of my body. I couldn’t make any headway.’
Sean O'Kelly
Rescued by Skerries RNLI

Already dangerously cold, Sean’s core temperature continued to fall on the swim back. He began to experience numbness and loss of coordination. ‘I knew I was in trouble,' he remembers. 'I had to stop every minute and tell my shoulders to work. They were seizing up and I could feel my legs dragging in the water.’

Catherine noticed Sean falling behind as the current pulled him towards the next island along, Red Island. 'I couldn't see Catherine anymore but I could hear a voice saying: "Are you alright?"' Sean recalls. 'I kept saying: "Yeah" - but I wasn’t. I was being dragged and couldn’t get over how far I was drifting with the current each time I stopped. Eventually I said: “No, I’m not.”’

Catherine alerted the shore marshall and instructed the other two swimmers to continue on, before swimming back to be with him.

Cardiac nurse
and year-round swimmer, Catherine, with Colt Island in the background Photo: RNLI/Anna Burn
Cardiac nurse and year-round swimmer, Catherine, with Colt Island in the background

'You can see when people are getting hypothermic,’ Catherine explains, drawing on her professional experience.‘Before too long, your every stroke becomes an effort, then your breathing becomes laboured and eventually your mental capacity declines - you have to concentrate really hard on what you’re doing.

'You can look at somebody and see right away that there’s a problem there. Sean was floating okay and wasn’t panicking but his legs weren’t responding well, he didn’t seem to have control of them.’

Echoing Sean's own experience, she adds: 'He just wasn’t moving forward.’

At the station

Skerries RNLI Crew Members Gerry Canning and Steven Johnston and Helm Peter Kennedy (PK) were undertaking casualty care training at the lifeboat station, when they heard the call to the Coast Guard.

Skerries Crew
Member Gerry CanningPhoto: RNLI/Anna Burn
Skerries Crew Member Gerry Canning

'The skipper of a nearby fishing boat called the Coast Guard to say there were some swimmers who weren’t making any headway,' Gerry explains. 'There are people swimming here all year so we didn’t know who it was or how bad the situation might be, but as soon as you hear there is someone in the water the adrenaline starts. It heightens your awareness because a person in the water is serious. With other kinds of shouts you might have longer to get there, but time is of the essence when someone is already in the water.

’We were sitting in the station doing our casualty care training right as the call came in. So we’d been talking about Big Sick and Little Sick and the key indicators of: alert; voice; pain; and unresponsive.

'If someone is alert and proactively talking to you then you know they’re alright. If they’re voice-responsive it means they will talk to you but you actually have to prompt them - that’s an indicator that they’re going downhill and you need to act fast.’

The shout

Crew Member AJ Hughes jumped on the tractor and they launched their Atlantic 85 inshore lifeboat, Louis Simson, with PK at the helm and Steven and Gerry behind.

‘You won’t get a much quicker launch than when there’s already a full crew in the station training,’ says Gerry. 'Speed of response is crucial in cases like this as the effects of cold water can cause a casualty’s condition to worsen quickly.’

'It’s hard not to think of the worst,’ PK admits.‘It was a cold day and a person in the water isn’t going to last very long. To be honest, it’s a bit of a relief when you get there and they’re conscious.’

Skerries Helm Peter Kennedy (PK)Photo: RNLI/Anna Burn
Skerries Helm Peter Kennedy (PK)
‘Another few minutes and he may have been totally unresponsive’
Steven Johnston
Crew Member, Skerries RNLI

Crew Member Steven joined the crew after a friend of his drowned tragically out of Skerries. He knows all too well the impact losing someone to drowning can have on loved ones and a local community.

He recalls reaching Sean and Catherine: ’It was lucky we were at the station - another few minutes and he may have been totally unresponsive. Sean was keeping himself afloat but you could tell by his eyes that he was shook. He was just staring into space.’

‘They did right, sticking together and looking out for each other,' PK adds. 'I don’t think there’s much else they could have done. Catherine climbed in the boat quickly, but we had to pull Sean in because he was very weak by that point. Gerry got into the water to help push him up and over the sponson.’

Once everyone was in the boat, Steven started the warming process. ‘Sean was dazed and he just sat there,’ he says. ‘There was a bit of speech out of him at first but not much after that, only shivering. You’d ask him a question and he’d just look at you. I wrapped him in tarpaulins to keep the wind off of him and held him the whole way back to get a bit of heat into him.’

Skerries Crew
Member Steven JohnstonPhoto: RNLI/Anna Burn
Skerries Crew Member Steven Johnston

Nearing the Captains, where the rest of the swimmers had exited the water, Catherine jumped back in to update everyone and gather Sean’s clothes.

‘If left untreated, hypothermia can cause cardiac or respiratory arrest and death’
Dr Seamus Mulholland
GP and Lifeboat Medical Advisor, Skerries RNLI

‘Catherine was fine to go back,’ says PK, ‘but there was no way we were returning Sean to the shore, he needed to come to the station. The last thing we wanted to do was drop him back and find he’d worsened after we left him.’

Back at the station, they were greeted by GP Dr Seamus Mulholland. He explains: ‘Our patient Sean is a very fit, active, regular swimmer who got into difficulty due to currents.

'Hypothermia is a medical emergency, which occurs when the body temperature falls below 35°C. When this happens, vital organs including the nervous system and the heart don’t function normally.

'If left untreated, hypothermia can cause cardiac or respiratory arrest and death. Some of the symptoms include shivering, dizziness, difficulty speaking, confusion, slurred speech, shallow breathing and lack of coordination.’

GP and
Skerries Lifeboat Medical Advisor, Dr Seamus MulhollandPhoto: RNLI/Anna Burn
GP and Skerries Lifeboat Medical Advisor, Dr Seamus Mulholland

At the station all of Sean's wet clothing was removed and replaced with dry blankets to gradually re-warm him. His breathing, level of consciousness, temperature, blood pressure and pulse rate were continuously monitored. He was also given tea and warm soup. After approximately 90 minutes, he was deemed fit to be allowed home.

'I’d never had a scare like that before'

After his experience, Sean has an even deeper respect for the water. 'When they said to Catherine: “You’re okay to go back,” and dropped her back to shore, but told me I needed medical help it brought it home how serious the situation was. I’d never had a scare like that before and it has made me a little bit more nervous.'

‘I’ve been going shorter distances,’ he says, adding emphatically: ‘and I make sure I can get out before I get cold!’

This rescue features in Saving Lives at Sea, a 12-part BBC series on the RNLI’s lifesaving work. Get more stories from the series here.