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Source: Diana Hacker (Boston: Bedford/St. Martin’s, 2007).
Adapted from Victoria E. McMillan (Boston: Bedford/St. Martin’s, 2006).
Biology Paper, CSE Style (Martin)
Hypothermia, the Diving Reflex,
and Survival
Briana Martin
Biology 281
Professor McMillan
April 17, XXXX
Full title, writer’s
name, name of
course, instructor’s
name, and date
(all centered).
Marginal annotations indicate CSE-style formatting and effective writing.
This paper follows the style guidelines in Scientific Style and Format: The CSE Manual for Authors, Editors, and
Publishers, 7th ed. (2006).
Source: Diana Hacker (Boston: Bedford/St. Martin’s, 2007).
Adapted from Victoria E. McMillan (Boston: Bedford/St. Martin’s, 2006).
ABSTRACT
This paper reviews the contributions of hypothermia and the
mammalian diving reflex (MDR) to human survival of cold-water
immersion incidents. It also examines the relationship between the
victim's age and MDR and considers the protective role played by
hypothermia. Hypothermia is the result of a reduced metabolic rate
and lowered oxygen consumption by body tissues. Although
hypothermia may produce fatal cardiac arrhythmias such as
ventricular fibrillation, it is also associated with bradycardia and
peripheral vasoconstriction, both of which enhance oxygen supply
to the heart and brain. The MDR also causes bradycardia and
reduced peripheral blood flow as well as laryngospasm, which
protects victims against rapid inhalation of water. Studies of
drowning and near drowning of children and adults suggest that
victim survival depends on the presence of both hypothermia and
the MDR, as neither alone can provide adequate cerebral protection
during long periods of hypoxia. Future research is suggested to
improve patient care.
INTRODUCTION
Drowning and near-drowning incidents are leading causes of
mortality and morbidity in both children 1 and adults 2. Over the
past 30 years, there has been considerable interest in cold-water
immersion incidents, particularly the reasons for the survival of
some victims under seemingly fatal conditions. Research suggests
that both hypothermia and a “mammalian diving reflex” (MDR)
may account for survival in many near-drowning episodes 3.
However, the extent to which these two processes interact is not
Hypothermia and Diving Reflex 2
Page header
contains abbrevi-
ated title and the
page number.
Headings, centered,
help readers follow
the organization.
The abstract
indicates the
writer’s purpose
and scope and
summarizes
the research cited.
Statistics are cited
with endnotes.
Research is cited
with an endnote.
Source: Diana Hacker (Boston: Bedford/St. Martin’s, 2007).
Adapted from Victoria E. McMillan (Boston: Bedford/St. Martin’s, 2006).
fully understood. Controversy also exists regarding the effect of
the victim's age on the physiological responses to cold-water
immersion. In this paper, I provide an overview of recent research
on the protective value of hypothermia and the MDR in cold-water
immersions. I also examine hypotheses concerning the effects
of age on these processes and conclude with suggestions about
future lines of research that may lead to improved patient care.
Hypoxia during drowning and near-drowning incidents
The major physiological problem facing drowning victims is
hypoxia, or lack of adequate oxygen perfusion to body cells 1,4.
Hypoxia results in damage to many organs, including the heart,
lungs, kidneys, liver, and intestines 4. Generally, the length of
time the body has been deprived of oxygen is closely related
to patient prognosis. Only 6-7 s of hypoxia may cause
unconsciousness; if hypoxia lasts longer than 5 min at relatively
warm temperatures, death or irreversible brain damage may
result 5. However, some victims of cold-water immersion have
survived after periods of oxygen deprivation lasting up to 2 h 4.
. . .
[The student goes on to highlight the major controversies and to
add interpretation and analysis.]
CONCLUSIONS
Recent research on cold-water immersion incidents has
provided a better understanding of the physiological processes
occurring during drowning and near-drowning accidents. Current
findings suggest that the cooperative effect of the MDR and
Hypothermia and Diving Reflex 3
The thesis states
the writer’s
three main goals
and indicates
the paper’s
organization.
Subheadings
separate distinct
parts within a
section.
The writer provides
an overview of
research, cited
with endnotes.
The writer provides
a summary and an
analysis of research.
Source: Diana Hacker (Boston: Bedford/St. Martin’s, 2007).
Adapted from Victoria E. McMillan (Boston: Bedford/St. Martin’s, 2006).
hypothermia plays a critical role in patient survival during a
cold-water immersion incident 3. However, the relationship
between the two processes is still unclear. Because it is
impossible to provide an exact reproduction of a particular
drowning incident within the laboratory, research is hampered
by the lack of complete details. Consequently, it is difficult to
draw comparisons among published case studies.
More complete and accurate documentation of cold-water
immersion incidents--including time of submersion; time of
recovery; and a profile of the victim including age, sex, and
physical condition--will facilitate easier comparison of individual
situations and lead to a more complete knowledge of the
processes affecting long-term survival rates for drowning victims.
Once we have a clearer understanding of the relationship
between hypothermia and the MDR--and of the effect of such
factors as the age of the victim--physicians and rescue personnel
can take steps to improve patient care at the scene and in the
hospital.
ACKNOWLEDGMENTS
I would like to thank V. McMillan and D. Huerta for their
support and suggestions throughout the research and writing of
this paper. I am also grateful to my classmates in Biology 281
for their thoughtful comments during writing workshops. Finally,
I thank Colgate University's interlibrary loan staff for helping
secure the sources I needed for this review.
Hypothermia and Diving Reflex 4
The writer provides
suggestions for
future research.
With permission,
the writer
acknowledges
people who helped
with the paper.
Source: Diana Hacker (Boston: Bedford/St. Martin’s, 2007).
Adapted from Victoria E. McMillan (Boston: Bedford/St. Martin’s, 2006).
Cited References
1. Kallas HJ, O’Rourke PP. Drowning and immersion injuries in
children. Curr Opin Pediatr. 1993;5(3):295-302.
2. Keatinge WR. Accidental immersion hypothermia and
drowning. Practitioner 1997;219(1310):183-187.
3. Gooden BA. Why some people do not drown--hypothermia
versus the diving response. Med J Aust. 1992;157(9):629-632.
4. Biggart MJ, Bohn DJ. Effect of hypothermia and cardiac arrest
on outcome of near-drowning accidents in children. J Pediatr.
1999;117(2 Pt 1):179-183.
5. Gooden BA. Drowning and the diving reflex in man. Med J
Aust. 1972;2(11):583-587.
6. Bierens JJ, van der Velde EA. Submersion in the Netherlands:
prognostic indicators and the results of resuscitation. Ann
Emerg Med. 1999;19(12):1390-1395.
7. Ramey CA, Ramey DN, Hayward JS. Dive response of children
in relation to cold-water near drowning. J Appl Physiol.
1987;62(2):665-688.
Hypothermia and Diving Reflex 5
The writer lists
and numbers
all sources in the
order they appear
in the paper.
Double-spacing is
used throughout,
with no extra
spacing between
entries.
For a book (not
shown here) the
author and title are
followed by the
publisher’s city,
state, and name
and the publicaton
date (e.g., London:
Academic Press;
2001.).
Authors’ last
names are followed
by first and middle
initials.
For a journal
article, author’s
initials are followed
by the article title,
abbreviated journal
title, publication
date, volume or
issue number, and
page numbers.

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CSE sample paper

  • 1. Source: Diana Hacker (Boston: Bedford/St. Martin’s, 2007). Adapted from Victoria E. McMillan (Boston: Bedford/St. Martin’s, 2006). Biology Paper, CSE Style (Martin) Hypothermia, the Diving Reflex, and Survival Briana Martin Biology 281 Professor McMillan April 17, XXXX Full title, writer’s name, name of course, instructor’s name, and date (all centered). Marginal annotations indicate CSE-style formatting and effective writing. This paper follows the style guidelines in Scientific Style and Format: The CSE Manual for Authors, Editors, and Publishers, 7th ed. (2006).
  • 2. Source: Diana Hacker (Boston: Bedford/St. Martin’s, 2007). Adapted from Victoria E. McMillan (Boston: Bedford/St. Martin’s, 2006). ABSTRACT This paper reviews the contributions of hypothermia and the mammalian diving reflex (MDR) to human survival of cold-water immersion incidents. It also examines the relationship between the victim's age and MDR and considers the protective role played by hypothermia. Hypothermia is the result of a reduced metabolic rate and lowered oxygen consumption by body tissues. Although hypothermia may produce fatal cardiac arrhythmias such as ventricular fibrillation, it is also associated with bradycardia and peripheral vasoconstriction, both of which enhance oxygen supply to the heart and brain. The MDR also causes bradycardia and reduced peripheral blood flow as well as laryngospasm, which protects victims against rapid inhalation of water. Studies of drowning and near drowning of children and adults suggest that victim survival depends on the presence of both hypothermia and the MDR, as neither alone can provide adequate cerebral protection during long periods of hypoxia. Future research is suggested to improve patient care. INTRODUCTION Drowning and near-drowning incidents are leading causes of mortality and morbidity in both children 1 and adults 2. Over the past 30 years, there has been considerable interest in cold-water immersion incidents, particularly the reasons for the survival of some victims under seemingly fatal conditions. Research suggests that both hypothermia and a “mammalian diving reflex” (MDR) may account for survival in many near-drowning episodes 3. However, the extent to which these two processes interact is not Hypothermia and Diving Reflex 2 Page header contains abbrevi- ated title and the page number. Headings, centered, help readers follow the organization. The abstract indicates the writer’s purpose and scope and summarizes the research cited. Statistics are cited with endnotes. Research is cited with an endnote.
  • 3. Source: Diana Hacker (Boston: Bedford/St. Martin’s, 2007). Adapted from Victoria E. McMillan (Boston: Bedford/St. Martin’s, 2006). fully understood. Controversy also exists regarding the effect of the victim's age on the physiological responses to cold-water immersion. In this paper, I provide an overview of recent research on the protective value of hypothermia and the MDR in cold-water immersions. I also examine hypotheses concerning the effects of age on these processes and conclude with suggestions about future lines of research that may lead to improved patient care. Hypoxia during drowning and near-drowning incidents The major physiological problem facing drowning victims is hypoxia, or lack of adequate oxygen perfusion to body cells 1,4. Hypoxia results in damage to many organs, including the heart, lungs, kidneys, liver, and intestines 4. Generally, the length of time the body has been deprived of oxygen is closely related to patient prognosis. Only 6-7 s of hypoxia may cause unconsciousness; if hypoxia lasts longer than 5 min at relatively warm temperatures, death or irreversible brain damage may result 5. However, some victims of cold-water immersion have survived after periods of oxygen deprivation lasting up to 2 h 4. . . . [The student goes on to highlight the major controversies and to add interpretation and analysis.] CONCLUSIONS Recent research on cold-water immersion incidents has provided a better understanding of the physiological processes occurring during drowning and near-drowning accidents. Current findings suggest that the cooperative effect of the MDR and Hypothermia and Diving Reflex 3 The thesis states the writer’s three main goals and indicates the paper’s organization. Subheadings separate distinct parts within a section. The writer provides an overview of research, cited with endnotes. The writer provides a summary and an analysis of research.
  • 4. Source: Diana Hacker (Boston: Bedford/St. Martin’s, 2007). Adapted from Victoria E. McMillan (Boston: Bedford/St. Martin’s, 2006). hypothermia plays a critical role in patient survival during a cold-water immersion incident 3. However, the relationship between the two processes is still unclear. Because it is impossible to provide an exact reproduction of a particular drowning incident within the laboratory, research is hampered by the lack of complete details. Consequently, it is difficult to draw comparisons among published case studies. More complete and accurate documentation of cold-water immersion incidents--including time of submersion; time of recovery; and a profile of the victim including age, sex, and physical condition--will facilitate easier comparison of individual situations and lead to a more complete knowledge of the processes affecting long-term survival rates for drowning victims. Once we have a clearer understanding of the relationship between hypothermia and the MDR--and of the effect of such factors as the age of the victim--physicians and rescue personnel can take steps to improve patient care at the scene and in the hospital. ACKNOWLEDGMENTS I would like to thank V. McMillan and D. Huerta for their support and suggestions throughout the research and writing of this paper. I am also grateful to my classmates in Biology 281 for their thoughtful comments during writing workshops. Finally, I thank Colgate University's interlibrary loan staff for helping secure the sources I needed for this review. Hypothermia and Diving Reflex 4 The writer provides suggestions for future research. With permission, the writer acknowledges people who helped with the paper.
  • 5. Source: Diana Hacker (Boston: Bedford/St. Martin’s, 2007). Adapted from Victoria E. McMillan (Boston: Bedford/St. Martin’s, 2006). Cited References 1. Kallas HJ, O’Rourke PP. Drowning and immersion injuries in children. Curr Opin Pediatr. 1993;5(3):295-302. 2. Keatinge WR. Accidental immersion hypothermia and drowning. Practitioner 1997;219(1310):183-187. 3. Gooden BA. Why some people do not drown--hypothermia versus the diving response. Med J Aust. 1992;157(9):629-632. 4. Biggart MJ, Bohn DJ. Effect of hypothermia and cardiac arrest on outcome of near-drowning accidents in children. J Pediatr. 1999;117(2 Pt 1):179-183. 5. Gooden BA. Drowning and the diving reflex in man. Med J Aust. 1972;2(11):583-587. 6. Bierens JJ, van der Velde EA. Submersion in the Netherlands: prognostic indicators and the results of resuscitation. Ann Emerg Med. 1999;19(12):1390-1395. 7. Ramey CA, Ramey DN, Hayward JS. Dive response of children in relation to cold-water near drowning. J Appl Physiol. 1987;62(2):665-688. Hypothermia and Diving Reflex 5 The writer lists and numbers all sources in the order they appear in the paper. Double-spacing is used throughout, with no extra spacing between entries. For a book (not shown here) the author and title are followed by the publisher’s city, state, and name and the publicaton date (e.g., London: Academic Press; 2001.). Authors’ last names are followed by first and middle initials. For a journal article, author’s initials are followed by the article title, abbreviated journal title, publication date, volume or issue number, and page numbers.