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ER doctors reveal Baltimore bridge victims' tragic fight for survival: Shock, hypothermia and exhaustion - plus a 185ft drop would've felt like 'hitting concrete'
ER doctors fear the nearly two dozen people who plunged 185ft from the Baltimore bridge last night may not survive - as they revealed their biological race against time.
Around 1.30am on Tuesday, the Singaporean-flagged cargo ship Dali crashed into the Francis Scott Key Bridge, launching at least 20 people into the cold water of the Patapsco river below.
These include six construction workers who were on foot on the bridge and people in five cars. Two people have been saved so far, while another is in critical condition, officials announced.
Tragically, doctors told DailyMail.com that those on foot faced an agonizing drop that would feel like 'hitting concrete' and result in major injuries like broken bones and a ruptured heart, with a small chance of survival.
Once in the 47-degree water, hypothermia would kick in, causing hyperventilating, loss of motor control, confusion, and organ failure, starting in just three minutes.
And those in cars would have just two minutes to escape from their cars before drowning.
Baltimore officials are on a race to save up to 20 people who plunged into the Patapsco River after a Singaporean cargo ship crashed into the Francis Scott Key Bridge
Hypothermia is a medical emergency that occurs when the body loses heat faster than it can produce it.
A normal human body temperature is generally considered 98.6 degrees Farenheit (37 degrees Celsius), though it can range from 97 to 99 F (36.1 to 37.2 C).
However, exposure to cold air or water can cause body temperature to gradually drop. A temperature of 95 F or less is considered hypothermia.
Dr Jared L Ross, an emergency medicine physician, told DailyMail.com: 'At these water temperatures, without protective clothing such as an immersion suit or drysuit, we would expect the effects of hypothermia to set in quickly,' he said.
Dr Ross estimated that in just three to five minutes, a person with hypothermia may suffer impaired motor skills or clumsiness.
'Exhaustion would occur within 30-60 minutes with a loss of consciousness expected by the end of the first hour,' he said.
Though Dr Ross noted that someone with 'floatation and access to fresh air to breathe' could survive up to three hours, those without it can suffer deadly organ failure in about an hour.
In about three to five minutes, heart rate and blood pressure drop as the person is too cold to pump normal blood flow around their body.
The result of not getting enough blood, oxygen and nutrients around the body is nerve damage, which can set in after as little as 20 minutes.
The bridge spans 9,000 feet across the Patapsco River and is 180 feet above the water
Nerves start to die, which can lead a patient to think they are burning up rather than freezing, causing them to strip off their clothing.
And after 30 to 60 minutes, a person may lose consciousness organs like the heart, lungs, and brain start to shut down.
Several factors can impact how long a person can survive hypothermia.
Dr LouAnn Giangreco, emergency medicine physician and Chief Medical Officer of American Family Care, told DailyMail.com that children in particular may have an advantage because they have a higher body surface area (BSA) than adults, which allows the body to better maintain core temperature.
'This may allow a child to survive up to one hour when submerged in very cold water less than 40°F (4°C),' Dr Ross said.
It's unclear if any children were involved in the bridge collapse in Baltimore.
Dr Giangreco also noted that individuals who are more physically fit also may survive longer due to their bodies being able to adjust to harsh conditions faster.
'While treading water can greatly extend survival in warmer water, in cold water exhaustion will set in quickly and swimming ability will not significantly increase survival,' Dr Ross said.
A person's weight can also determine how fast they succumb to hypothermia. Researchers have found, for example, that those with visceral fat - which lies deep within the abdominal wall - can maintain a normal core temperature longer than those with lower levels of it.
However, subcutaneous fat, which is just underneath the skin, does not have the same effect.
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For those standing on the bridge, such as the construction workers, Dr Giangreco said she 'would not expect' them to survive plummeting 185 feet.
This is due to the high speed at which a person falls, also known as velocity, and hits the water.
According to the Federal Aviation Administration (FAA), the maximum rate someone can survive a fall into water is about 100 ft per second (68.2 mph/109.8 kph). This is the equivalent of 186 feet.
'With the bridge being about 185 feet above the water, this is at the upper limit of survivability for a fall,' Dr Ross said.
'Falls from this height can cause severe blunt trauma, especially when the person lands on their chest or abdomen.'
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This includes internal organs rupturing, namely the aorta, which is the largest artery in the body and carries blood from the heart to the rest of the body.
Dr Ross noted that this can cause death within seconds.
Some evidence suggests that the human body can only sustain a significantly shorter dive.
A 2022 study from Cornell University the average threshold a person can survive is eight meters (26.2 feet) head-first, 12 meters (39.4 feet) hands-first, and 15 meters (49 feet) feet-first.
For those who were trapped in their cars, time is of the essence.
'Generally cars completely fill with water within 30 seconds to 3 minutes, and sink within a few minutes after filling,' Dr Ross said.
'In order to survive you need to escape from your car within 30 to 120 seconds.'
However, this depends on if the windows were open, as well as the make and model of the car.
Dr Giangreco said that hypothermia treatment depends on the severity of the condition, though it largely involves bringing the body back up to a normal temperature.
This includes passive rewarming, which involves giving a person warm fluids and heated blankets.
In more severe cases, a patient may be given warm intravenous fluids and undergo blood rewarming, which is when blood is drawn, warmed, and recirculated in the body.