Nautical First Aid

By Greg Stoll - Turner, Oregon - USA

 

Heat Disorders

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 or cranky.

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.

Heat Cramps

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.

Heat Exhaustion

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

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.

Prevention

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?

Greg Stoll
http://grantconsulting.biz/