Evaluation of online information on the cold shock response to accidental immersion in cold water

Many of the UK open water accidental deaths have been attributed to the initial responses to cold water immersion (CWI) collectively known as the cold shock response (CSR). The aim of this study was to analyse the publicly available internet information on CWI and CSR for accuracy and quality compared to the ‘gold standard’ published, peer-reviewed research. Seventy-eight webpages which provided information in English on unexpected CWI and CSR were evaluated. Webpages were accessible, widely available, and had appropriate readability scores. Webpage accuracy was suboptimal including only presenting on average 10 (range 3-16) CSR components out of 19. Quality of information also was poor with only 3 webpages meeting the JAMA benchmark for high quality. In addition, 19 webpages had incorrect statements, and 15 had dangerously incorrect statements. To increase public awareness and prevent drowning, webpages should include all the physiological responses and dangers of the CSR as well as practical mitigations