By 1LT Barbara Benton
Every year, summer brings out the beach, bathing suits, and BBQs. However, with all these wonderful and cheerful things another deadly thing “raises” its ugly head; heat injuries. Last year, despite the fact that most of our troops were deployed, Fort Bragg reported 107 heat injuries, which are preventable through proper education, training, and implementation of this guidance by unit leadership. Heat injuries include sunburn, heat cramps, heat exhaustion and in the most dangerous cases, heatstroke. Adequate hydration is the single most important factor in reducing the likelihood that you may sustain a heat injury. High temperatures and humidity are major contributing factors for heat injuries; however, there are certain predisposing factors that may increase your risk of becoming a heat casualty. These factors include: lack of acclimation to the heat, poor physical conditioning, fever, current or recent infections, vomiting or diarrhea, sunburn, dehydration, obesity, extremes in age (being old or very young), alcohol intake within 24 hours, drugs containing Ma Huang or ephedra, a history of previous heat injury, and certain medications (such as antibiotics and antihistamines). Personnel with any of these predisposing factors should be extra cautious when conditions favor heat injury. Remember heat injuries may be fatal, but they are preventable. Prevention of heat injuries is accomplished by properly hydrating the body with adequate amounts of water throughout the entire day, including periods of inactivity. Also, a proper diet to avoid electrolyte loss should be maintained. Heavy sweating removes salt and minerals from the body. These are necessary for the body and should be replaced. The easiest and safest way to replace salt and minerals is through your diet. Do not take salt tablets unless directed by your doctor. A liberal amount of water is the single most important factor in reducing the likelihood that you may be a casualty. Individuals can lose as much as one quart per hour (one canteen) if they are in extreme heat and are engaged in heavy labor. Sunburn can prevent the skin from dissipating heat. To prevent this, apply sunscreen 30 minutes before going outdoors and reapply according to package direction. Select SPF 15 or higher to protect yourself adequately. You should also wear loose-fitting, lightweight, light-colored clothes to keep the body cool. You should dress infants and young children in cool, loose clothing and shade their head and faces with hats or an umbrella. If you must be out in the heat, try to plan your activities so that you are outdoors either before noon or in the evening. The most efficient way to beat the heat is to stay in a cooled area. Avoid hot foods and heavy meals; they can add heat to your body. Also, you should never leave infants, children, or pets in a parked car. The best way to monitor the environmental heat is with the Wet Bulb Globe Temperature (WBGT) kit. All units should have the WBGT kit in their field sanitation team supplies and should monitor the WBGT at their perspective training sites. Currently, Environmental Health Services of Womack Army Medical Center monitors the WBGT for garrison use only. The heat category can be obtained by calling 907-HEAT and is only valid within one kilometer radius of the Polo Field. Remember, it is essential to monitor the WBGT at your training site because the temperature will vary from one location to the next. For more information on heat injury prevention or on the WBGT system, please contact the Environmental Health Service at 396-5882 or 2045. We can arrange to provide a NCODP or
ODP brief on this important issue for your unit. LTC Jeffrey Kingsbury, Preventive Medicine, WAMC and LTC Steve Horosko, 18th Airborne Corps Surgeons Office are looking for BN and BDE size elements to provide this valuable training and improve safety for your troops.
Fluid Replacement Guidelines for Warm-Weather Training (Average Acclimated Soldier Wearing Hot-Weather BDU)
Heat Category Degrees Fahrenheit Easy Work Work-Rest Cycle (min) 1 2 (Green) 3 (Amber) 4 (Red) 5 (Black) 78-81.9 82-84.9 85-87.9 88-89.9 >90 No limit No limit No limit No limit 50/10 Water Intake (Qt/h) ½ ½ ¾ ¾ 1 No limit 50/10 min 40/20 min 30/30 min 20/40 min Moderate Work Work-Rest Cycle (min) Water Intake (Qt/h) ¾ ¾ ¾ ¾ 1 40/20 min 30/30 min 30/30 min 20/40 min 10/50 min Hard Work Work-Rest Cycle (min) Water Intake (Qt/h) ¾ 1 1 1 1
* Rest means minimal physical activity (sitting or standing) and should be accomplished in the shade if possible. * The work/rest times and fluid replacement volumes will sustain performance and hydration for a least 4 hours of work in the specific heat category. Individual water needs will vary + ¼ quart per hour. * CAUTION: Hourly fluid intake should not exceed 1 ½ quarts. Daily fluid intake should not exceed 12 quarts. * Wearing body armor adds 5o F to WBGT Index. * MOPP gear adds 10o F to WBGT Index.