{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T20:23:33Z","timestamp":1786998213184,"version":"build-2736575974"},"reference-count":81,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,9,1]],"date-time":"2019-09-01T00:00:00Z","timestamp":1567296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>Sudden death during whitewater recreation often occurs through understandable mechanisms such as underwater entrapment or trauma, but poorly defined events are common, particularly in colder water. These uncharacterized tragedies are frequently called flush drownings by whitewater enthusiasts. We believe the condition referred to as cold water immersion syndrome may be responsible for some of these deaths. Given this assumption, the physiologic alterations contributing to cold water immersion syndrome are reviewed with an emphasis on those factors pertinent to flush drowning.<\/jats:p>","DOI":"10.1016\/j.wem.2019.03.005","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T08:57:50Z","timestamp":1559811470000},"page":"321-327","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Cold Water Immersion Syndrome and Whitewater Recreation Fatalities"],"prefix":"10.1177","volume":"30","author":[{"given":"David J.","family":"Farstad","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine, UCHealth Medical Center of the Rockies, Loveland, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Division of Surgery, UCHealth Medical Center of the Rockies, Loveland, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,9,1]]},"reference":[{"key":"bibr1-j.wem.2019.03.005","unstructured":"Plyler JL American Whitewater Accident Study: covering non-motorized human powered craft 1995\u20131998. 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