^ The sudden shock of cold water causes a gasp reflex. This is an involuntary intake of 2-3 quarts of air - or water, if the victim's head is under water. The victim that breathes in water may quickly drown.
^ Cold water shock can cause hyperventilation, breathlessness, or irregular breathing.
^ Another danger is the "gag reflex" in which spasms in the throat can prevent air or water from passing into the lungs, causing asphyxiation or "dry drowning."
^ Sudden immersion in cold water can trigger a heart attack (cardiac arrest).
^ Cold water entering the ear canal can cause vertigo and disorientation, actually causing victims to swim down to their death, instead of up, toward safety.
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