Nautical First Aid
Jim had worked spent the better part of a winter’s
worth of evenings and weekends working on his boat.
It was a beautiful wooden skiff, 16’ long, built
for lazy days of fishing with his family. He was excited
that his two boys, now 6 and 8, were old enough to
spend half a day in the boat without getting too bored
Jim had taken the boat out a couple of times by himself
to get the feel for it before taking his wife and
kids. Everything checked out, and one balmy Friday
he was able to talk his wife into going for her first
trip out with him. The day started out nicely, and
the boys were excited to be fishing with Jim in his
new boat that they had helped build. Jim’s wife
sat in the front, curled up with a book.
By noon the boys were getting hungry, and Jim took
the boat to shore for a lunch break. After a meal
of sandwiches and tortilla chips, Jim decided it was
time for more fishing. The boys were more excited
about swimming than fishing, and Jim’s wife
wanted to wait on shore to keep an eye on them. Jim
set back out on his own.
Fishing was slow, and by 4:00 Jim was feeling sleepy
and weak. He somehow made it back to the ramp (although
he doesn’t remember it exactly) and got the
boat onto the trailer. It was when he was loading
the boat back up that he passed out and collapsed
in the parking lot. An ambulance came and took Jim
to the local hospital, where he was diagnosed with
Heat Stroke, treated and released that night.
Have you ever been Jim?
This month we will deal with a seasonal problem:
Heat Disorders. Heat disorders tend to crop up during
the summer, when the weather is hot and folks are
outside. I’m sure at least a few of us have
felt tired and weak after a long day of boating. Most
likely it was some form of heat disorder. Let’s
take a look at the three main disorders.
Believe it or not, many functions of your body are
kept in good working order by salt. Salt (sodium)
and other electrolytes (minerals present in small
amounts in your body) allow nerve impulses and small
bits of energy to travel from the brain to the muscle
and back again. The function of these electrolytes
in your body’s cells is similar to the function
of a car battery, with different concentrations creating
a small electrical current. The electrolysis we experience
with boats in salt water is another similar case.
Heat cramps are caused by a person overexerting themselves
in hot weather and not replacing fluids and electrolytes
(mostly salt). An imbalance of electrolytes in the
body results, which causes some muscle cells to contract
but not let go. The result is cramping.
Treatment is fairly simple: take the person out of
the heat (or at least in the shade) and give them
fluids and electrolytes. Sports drinks are good for
replacing electrolytes, but are awfully sweet and
a little hard on the body. Many recommend drinking
one quart water for every quart of sports drink. While
heat cramps are painful, they are generally not serious
and respond well to treatment.
Moving up in the order of severity, we next have
heat exhaustion. Heat exhaustion is caused by the
same set of circumstances as heat cramps; overexertion
coupled with poor rehydration. The problem has been
taken to the next level and is starting to affect
more parts of the body than the muscles.
People with heat exhaustion will often feel faint
and may pass out temporarily. They will feel anxious
and have rapid, shallow breathing. Their pulse will
feel weak due to low blood pressure caused by the
dehydration. The body’s temperature will be
mildly elevated, and the skin will feel cool and clammy
(wet and cold).
These folks could be having a true emergency and
should be moved to a cool, shady area immediately.
Don’t actively cool them with ice packs, but
rather allow them to cool naturally in the shade.
Feed them fluids at the same ratio as above (1 part
sports drink to 1 part water). If the symptoms don’t
respond to treatment within a half hour or so get
the person some professional medical help. Depending
on your circumstances this could mean a ride in an
ambulance or a private car.
Heat stroke is the most severe form of heat disorder.
Again, it is caused by the same scenario as above,
but it has remained untreated for a long time.
Folks with heat stroke will be weak, have an altered
level of consciousness and may pass out. Their breathing
will be rapid and shallow, but will slow as they succumb
to the disorder. The pulse will be very rapid, often
over 120 beats per minute; it will beat even faster
when they stand up. You may not be able to feel their
pulse on the wrist due to low blood pressure. The
main difference, however, is this: their skin will
be hot and dry. The body is so dehydrated that it
can’t sweat anymore.
If you see someone who has been physically active
outside and hasn’t been drinking many fluids
and exhibits the signs and symptoms above, call 911.
They need rehydration quickly and need to be seen
at an Emergency Room. Lay them down with the feet
elevated. Be prepared for them to vomit, and turn
them on their side if they do.
Now that we’ve seen what can happen, let’s
talk a little about how to prevent all this.
First and foremost, stay hydrated. Drink plenty of
water when working (or rowing) outside on a hot day.
Take breaks every hour or two, and take them more
often as the mercury rises. A close second to staying
hydrated is not drinking alcohol. I realize I’m
stepping on sacred ground here, but alcohol does cause
increased dehydration due to higher urine production.
In other words, it makes you pee more.
You can judge how well hydrated you are fairly easily
by evaluating how often you urinate during the day.
If you’re urinating less than once every 2 hours,
you are probably somewhat dehydrated. The darker the
urine, the more dehydrated you are. If you’re
drinking alcohol and still not urinating very often
then you are most surely dehydrated.
Hopefully we’ve discussed some useful information
that will help you keep out of the hospital and keep
your family safe and happy. After all, who will drive
the boat back to the ramp if you’re passed out?