Dehydration

N

NeuralNet

Longterm Registered User
I noted the discussion on analgesia in a hot climates and Starlight’s comment on dehydration which I absolutely agree with.

One of the most interesting features of dehydration is vomiting.

Why do dehydrated patients vomit?

The body is good at preserving fluid; it stops sweating and reduces urine output.

Yet the dehydrated body still vomits, why?

The problem for the body is the gastric acids continue to be secreted and becomes so concentrated that the individual is forced to vomit.

The vomit in the dehydrated patient is very concentrated smelly thick bile.

Treatment becomes difficult as you are unable to give oral fluid to the vomiting patient and IV saline becomes the treatment of choice.

Dehydrated patient lose very little potassium so 0.9% Saline is acceptable in the first instance.

Over the next few summer months I will see many individuals who aren’t drinking enough or too much

I use a simple way of assessing adequate fluid intake.

Urine output:
Passing water more frequently than every 60 minutes are they drinking too much?
Passing water less frequently than every 3 hours are they drinking enough?

Interested to hear comments from members working in hot climates

NN
 
Good post and totally agree.

A balanced diet with water is a great prevention. A pinch of salt on your meal in hot climates.

I've seen a few operators go down due to drinking too much water and flushing / sweating all their electrolyte out.

Equally, guys have over compensated, drinking just gatorade, taking sachets of concentrated gels and even rehydration powders when it is not necessary.

There needs to be a salt / water balance!

If operating in hot climates in full gear, an improvised drink to keep the balance could be 1 sachet of salt, 1 tea spoon of sugar to a litre of water.

Rotate, rest and de kit where and when possible.

Stay safe.
 
the reason for the vomiting is because the casualty is going into shock through the loss of circulatory body fluids. As has already been stated, drinking too much can be a problem and may result in operatives being unable to fulfil their role in much the same way as people who do not drink enough.

Its not just about drinking, its also about the dietry needs of the body being adjusted to meet high work routine or temperature differences as well as the fitness of the individual.

alcohol also plays a part, as although very nice having a cold beer on a hot day, too much and the following day you begin work already de-hydrated.

If someone is vomiting or feeling nausiated, then start an IV Fluid Regieme Titrating the fluids, also administer Metroclopromide IV to help prevent the nausea and vomiting. Remember to get them out of the heat and ensure that when they are able to drink that they are also able to eat food as well.
 
so is it right that drinking warm drinks such as say tea etc is better in hot weather as opposed to say a cold beer? Just curious as to whether that is some old wives tale or not. And is the salt to replace what is sweated out? Just curious is all
 
annie said:
so is it right that drinking warm drinks such as say tea etc is better in hot weather as opposed to say a cold beer? Just curious as to whether that is some old wives tale or not. And is the salt to replace what is sweated out? Just curious is all
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depends annie, drinking a really cold drink can cause cramps but your average cold drink isnt a problem. the problem with any alcohol in cold climates is that the alcohol will dehydrate someone even further.

There should not be a requirement to increase salt intake through salt tablets or salt drinks. Salt drinks can induce vomiting especially on someone who is already feeling nauseated. The individuals should alter their diet to ensure they have sufficient salt and fluid uptake and should take note of any special dietry recomendations for the theatre they operate in.
 
Hi Guys.....

Just curious....I work in aviation security and searching, etc, and with the amount of pax in one space and with the weather as it is here in the UK, not hot but sticky and also i think the air-con has gone in the building (surprise, surprise).....

How much should my staff and I be drinking a day and how often because some of us are going down with dizziness and headaches?

I've seen some agents stand at the water cooling and down three cups of water then not touch it for about two hours....I know this don't seem right.....

Also just out of personal interest how much does our water intake need to double-by (i'm guessing) in hot climates?

Sorry if it seems bone questioning....

Romeo Alpha
 
fluid intake depends on several factors such as
1. The individual - fitness, hydration level when commencing work and health.
2. Climate - are they exposed to hot temperatures over a long period? is the heat constant or does it fluctuate?
3. do they get breaks? do they leave the environment for their breaks?
4. What fluids are they drinking and how often do they drink?

If your staff are going down with headaches and dizziness, then they are not sufficiently hydrating themselfs throughout the day. It is no good taking onboard fluids only when you start to feel unwell, its too late then.

A good hydration regime will have individuals begin their hydration from the time they start their work to the time they finnish and beyond.

supplying water may not be good enough, they need to be encouraged to drink and have breaks away from the environment. long term your production will not suffer through giving more breaks as staff will feel more able to work between breaks and your sickness levels will drop.

If you are in the UK, then there is Health and Safety Legislation governing working in hot and cold conditions, so read the guidance it may help.
 
Home made sports drinks for Operational Hydration

Phecta said:
There should not be a requirement to increase salt intake through salt tablets or salt drinks.
Click to expand...

I am all for a balanced diet and prevention as per previous post but it depends on the environment. Working in 50 degree heat, with helmet, flight suit, body armour, gloves and carrying 80lbs of kit (water, ammo, med kit, radio etc) or being stuck in an armoured vehicle with poor air con or worse still on heli ops being buffeted by hot dry air all day (upto 12-18 hours) and working around the boss's schedule - it may not be possible to eat a quality meal and blokes are certainly sweating out more than water (white crusty t - shirts at the end of the day).

The blokes are disciplined and 'where possible' de kit and get in the shade but this isn't always possible on hostile environment CP ops. They also drink gallons of water which is good discipline but then send the balance the other way (dilutional hyponatraemia / hyperhydration - which can both kill)

The military provide sports drinks and gels to mix with water to maintain the balance but when these are not available (normally the truck driver bringing them in has been blown up en route) the docs always indicated 'home made' sports drinks; water with added salt, sugar, fruit juice were the way ahead. Providing the balance is right with the amount of water. Too much unecessary salt will go the opposite way (hypernatraemia) causing an equal amount of complications.

It is surely better to regulate your own intake (salt /water balance) than have to be canulated and have salt water pumped in? By this stage it is too late and the operator and team are operationally ineffective, either because they have a reduced security foot print while rendering care or because a team member is ill and needs to be CASEVAC'd / MEDEVAC'd.

Obviosuly we are talking extreme temperatures for prolonged periods with extra equipment and not a warm summers day in UK, where a good meal and a NAAFI break are around the corner.
 
annie said:
so is it right that drinking warm drinks such as say tea etc is better in hot weather as opposed to say a cold beer? Just curious as to whether that is some old wives tale or not. And is the salt to replace what is sweated out? Just curious is all
Click to expand...

You know what p's me off.

They say don't drink alcohol in cold climates, vaso-dilates

Don't drink alcohol in hot climates because alcohol is a diuretic.

NN



No one ever says

Warm climate, if you have the fluid, small amount of alcohol, vaso-dilate perfect, helps you cool.

Freezing your b*llocks off, come into the warm, vaso-constricted, small amount of alochol, vaso-dilate, perfect.

Just feel the circulation return to those fingers and toes.

Alcohol not all bad.


Question: Why isn't alcohol used as a diuretic?
Answer: It causes mental confusion
 
I always kept a few salt packets from the DFAC with me. If I thought I was starting to dehydrate I would pour salt onto the back of my hand and lick it. If the taste didn't make me cringe then I knew I was dehydrating. (When you dehydrate you start to crave salt)

I also kept glucose tabs with me that I could dissolve in my water to help counter it. And, of course, always check the colour of your pee. The more orange it is, the more dehydrated you are.

The older you are, the more aware you need to be, if like me, you're middle aged, wearing 60lb of kit in 45 - 50C it's gonna get you sooner or later unless you look after yourself....Oh, another good point, EAT properly!
 
Guy's very useful info on the old hydration subject. Just wish I could get my Ugandan Guard Force to listen. They think drinking 5-6cans of Ripit's, Pepsi & Wild Tiger is re-hydrating themselves. Then who am I to tell them any better, I'm only a silly Westerner after all. lol
 
Lol - i have the same problem here. Locals think 5 mugs of mud thick coffee a day is classed as 'fluid intake'

Keep the faith
 
The dehydrated (from whatever reason) also vomit as their gut transit slows and eventually halts, leaving the gastric and other upper gut secretions only one way to move - up! The metoclopramide acts as a pro-kinetic, getting things moving the right way again, as well as stopping the nausea/vomiting.
 
It seems to be a universal problem,when it comes to the hot months,particularly here in africa where people think that coke and other soft drinks are the order of the day,espcially on construction sites where theyre in the sun for 10 hours a day.
my absolute favourite is our sporting enthusiasts who drink litres of energy drinks and cant understand why their legs are covered in watery brown fluid,and incessantly refuse to believe that they have dehydrated themselves and dont understand the simple logic of electrolyte imbalances.they argue incessantly and think theyre the professionals,and what do i know im just a f***ing stretcher bearer,so without further ado a 14g cannula is subsequently thrust menacingly into the nearest and most appropriate vein ,and if it tissues" oh dear? looks like i'll have to try the other arm now!!! sorry sir,i beg thee forgiveness as i am unskilled and have no bloody idea as to what im doing!!""
sorry they get to me, almost as bad as the ignorant,dont worry you dont need your bags just a stretcher,oh and tell me is someone going to sit with him in the back?
"no ma'am if he needs a glass o water he can ring the fooking bell"
 
Trying_________to______________answer, but__________much_________too_____________weak. WATER__________WATER. Is_______that_________ you_________ mother :rolleyes:
 
Dehydration... even in temperate zones we all just simple don't do enough.

In 2002 I took part in the Sapper Games held at Bergan Belsen (Hohne) at the Assault Course Competition (important to note as anyone who has been ther will know the surrounding area of the course has tree cover), anyway as with these games generally comes squadron drinking the night prior and heavy partying after. Now on the morning in question it was a clear getting hot day in germany, by the time my event took place it was roughly 11 am and the race was two laps of the assault course including regain. Anyway as it was I had this guy from another unit ragging me up to the finishing point at the first lap only to via off and colapse as I went past. By the time I finished the race there was panic and loads of this being said over by where this guy colapsed, at the time they put it down to dehydration and the medics (both worse for wear themselves) got a stretcher to put this guy on having stripped his tops and boots off, however still not in the shade until a SNCO told them too, and then under the SNCO's demand poored water down his throat from a water can and then after he threw up poored the rest on his body when this guy started to fit and then die only to be revived and die twice again before they gave up.

My pont is this, dehydration can get you anywhere no matter what climate zone and I'm very quick to point it out these days after seeing this guy die, I didn't learn until a few years ago that this guy pretty much skipped 4 phases of dehydration and went into shock and then death and had those medics (RAMC CMT's) been clear headed that day they may have been quicker off the mark and may have stopped him reaching Heat Syncope. He could still be alive today!
So please all Medics everywhere if your on in the morning please don't be on it the night before, its keeping your wits while all others are loosing theirs that saves lifes.
And try enforce water parades, yes they're bullshitty but at least you know the guys have had at least x amount of fluids in your presence that day.
 
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