We describe the case of a patient who was severely hypothermic after 45 minutes of submersion. The patient received about 90 minutes of basic and advanced life support before being connected to extra corporal heart lung assistance (ECHLA). The core temperature was 28.9 degrees C, plasma potassium was 3.7 mmol/l. The patient stabilized and was discharged without significant sequelae after four weeks. This case report describes the importance of basic life support in the hypothermic patient and the use of ECHLA.