3rd MAW 'docs' teach heat illness prevention

27 Nov 2007 | Sgt. C. Nuntavong

Deployment in the Middle East during the summer months has led to several heat related illnesses during Operation Iraqi Freedom.  Surgeons and corpsmen here are teaching service members how to stay healthy in the hot weather.

This week Cdr. J. C. Dunn II, Marine Air Control Group 38 group surgeon, conducted classes on the symptoms and prevention of heat related illnesses.  These classes were conducted to inform service members of the dangers of the heat.

"We have had temperatures between 113 and 160 degrees outside," said Dunn, "and temperatures between 120 and 130 degrees in the shade."

According to Hospital Corpsman 2nd Class (Fleet Marine Force) John C. Jucutan, 3rd Marine Aircraft Wing corpsman, a healthy body temperature is maintained by sweating, which is controlled by the nervous system and by the blood flow to the skin, also called thermoregulation.

"As body temperature increases, the body tries to maintain its normal temperature by transferring heat," said Jucutan.  "When the body has more heat than it can lose, a heat-related illnesses occurs."

Heat exhaustion is the most common form of serious heat illness, said Dunn.  Heat exhaustion occurs when heart and blood vessels cannot meet increased cooling demands due to two factors:  Increased heat production either external

(ambient heat, humidity, weather) or internal (muscular work increases heat production); and loss of plasma volume and electrolytes.

"Heat exhaustion casualties retain the ability to cool spontaneously if removed from the heat stress circumstances," he said.

Symptoms of heat exhaustion are:

* Fatigue

* Nausea

* Headaches

* Excessive thirst

* Muscle aches and cramps

* Weakness

* Confusion or anxiety

* Drenching sweats, often accompanied by cold, clammy skin

* Slowed or weakened heartbeat

* Dizziness

* Fainting

* Agitation

According to Dunn, if a person is suffering from heat exhaustion, first remove the person from the heat and into a cool environment.  Then replace water and electrolytes orally and induce intravenously if necessary.

Heat stroke can be a serious form of heat illness, said Dunn.

"Heat stroke is a life-threatening medical emergency," he said.

Heat stroke occurs when the body loses the ability to adequately regulate the temperature in a hot environment, he said.  It can cause significant injury to the brain, blood, liver, kidneys and muscles.

Heat stroke usually develops rapidly and can cause permanent brain damage or death if not treated promptly.

"Heat stroke can occur suddenly, without any symptoms of heat exhaustion," said Jucutan. 

The symptoms of heat stroke are:

* Nausea and vomiting

* Headache

* Dizziness or vertigo

* Fatigue

* Hot, flushed, dry skin

* Rapid heart rate (160 to 180 beats per minute)

* Decreased sweating

* Shortness of breath

* Decreased urination

* Blood in urine or stool

* Increased body temperature (104 to 106 degrees Fahrenheit)

* Confusion, delirium, or loss of consciousness

* Convulsions

"If a person is experiencing symptoms of heat exhaustion or heat stroke, obtain medical care immediately," said Jucutan.  "Any delay could be fatal."

You should seek emergency medical care for anyone who has been in the heat and who has the following symptoms:

* Confusion, anxiety, or loss of consciousness.

* Very rapid or dramatically slowed heartbeat.

* Rapid rise in body temperature that reaches 104 to 106 degrees Fahrenheit.

* Either drenching sweats accompanied by cold, clammy skin (which may indicate heat exhaustion); or a marked decrease in sweating accompanied by hot, flushed, dry skin (which may indicate heatstroke).

* Any other heat-related symptom that is not alleviated by moving to a shady or air-conditioned area and administering fluids and salts.

"With constant temperatures of 100 degrees and above, even the best conditioned Marine is at risk," said Dunn.

Primary prevention for heat related illnesses are hydration and cooling, according to Dunn.  Service members should aggressively hydrate with cool water and electrolyte replacement fluids, and take regular breaks to cool off in air conditioning.

Other heat related illness prevention tips are:

* Schedule outdoor events and work for non-peak heat hours.

* Outdoor physical training is not recommended between the hours of 0900 to 1800 and if black flag conditions extend beyond those hours.

* Avoid using supplements.  Supplements increase the risk of kidney injury if you are poorly hydrated.

Be aware of the symptoms of heat-related illnesses and know appropriate treatment measures. Do not become dehydrated. The amount and color of your urine can indicate whether you are properly hydrated, according to Jucutan. You should urinate every 2 to 4 hours during an activity if you are staying hydrated.