The heat is on Published July 19, 2011 By Lt. Col. John Duda 21st Space Wing Safety Office PETERSON AIR FORCE BASE, Colo. -- When I was in college, I worked during the summer on a coke battery. Coke is refined coal used for steel-making. The work was dangerous because you were exposed to extreme heat, required to remove sulfur from coal and the machinery could injure or kill you in the blink of an eye if you weren't paying attention. Oddly enough, with all the danger from burning coal at high heat to purify it, the most likely cause of lost time for a worker was a heat-related injury. During an eight-hour shift, we would produce more than 348 tons of coke. Toward the end of a shift on a 95 degree day with 95 percent humidity, I began to get severe muscle cramps - to the point where I could no longer lift a shovel. During my military career, I had two opportunities to deal with heat-related injuries. One was during a training mission where an individual did not stay hydrated throughout the day and required an ambulance and intravenous fluids to stay alive. The other was my own dance with dehydration because I became so engrossed with establishing a site and participating in the exercise, I didn't monitor myself for heat stress. Fortunately, two bottles of a sports drink fixed me up immediately, although it was miserable until I re-hydrated. So, what does this have to do with the Knights of the 21st Space Wing? Well, it is summer. I am pleased to see all the people staying active with their summer activities like running, swimming, bicycling and other sports. However, I know as part of our "push the envelope" culture, we sometimes need to be reminded of things to watch for in the heat. Our office has collaborated with our medical teammates to put the following guidance out for you - consider these as some rules of engagement: Types of heat injury and treatment Heat cramps - Heat cramps are painful contractions of muscles of the limbs, abdomen or back, and are usually caused by large salt losses through sweating. Symptoms include severe stomach, leg or arm cramps, pale wet skin, dizziness, and extreme thirst. First aid by non-medical personnel should consist of letting the victim rest in a cool shady area and drinking fluids. If cramps persist or recur, seek treatment by medical personnel. Heat exhaustion - Heat exhaustion is the inability to continue to work in the heat due to the loss of body salts and fluid through excessive sweating. Cramping may occur as an early symptom. Other symptoms include pale wet skin, extreme fatigue, nausea, dizziness, giddiness, and rapid breathing. The person may appear drunk due to decreased blood flow to the brain and other vital organs as a result of fluid loss. If fluid loss is severe, the person may faint. First aid should include removing the victim from the heat, laying the victim flat on their back in a cool place, elevating the feet, and loosening the clothing. Cool the victim by fanning and applying cold packs or wet fabric next to the victim's skin. Give the victim one-half glassful of water to drink every 15 minutes, only if the victim is conscious. Without prompt care, heat exhaustion can quickly become heat stroke. Heat stroke - Heat stroke is a life threatening medical emergency. The victim's body has lost its ability to cool itself. The victim's body temperature can rise rapidly and cause brain damage or death if the victim is not cooled quickly. Signals of the onset of heat stroke are dry, hot skin, a high body temperature, nausea, headache, progressive loss of consciousness, a fast weak pulse, and fast shallow breathing. Suspected cases require immediate cooling and immediate evacuation to a medical facility. Wet the victim's clothing or wrap the victim in damp lightweight fabric such as a sheet. Fan the wet victim while en route to a medical facility. If the victim is conscious, give sips of cold water to them. Do not try to give water to an unconscious victim. Prevention of heat injury Water - Adequate water intake is the single most important factor in avoidance of heat injury. Water loss from sweat can be as high as two quarts per hour. To maintain proper body fluid the average person should drink at least four quarts of water per day. Frequent drinks are more effective than intake of the same amount of water all at once. Bigger people need more water. Salt supplements are not necessary for most people. Individuals should eat three meals a day and lightly salt their food. Eating high potassium foods, such as bananas and citrus fruits, is encouraged. Clothing - The type, amount and manner of wearing clothing has a marked effect on the heat load imposed on the body and its ability to dissipate heat. Clothing prevents radiant heat of the sun from being absorbed by the body. Loose fitting clothing allows circulation of air and enhances the cooling evaporation of sweat. Predisposing factors - There are numerous conditions and stresses which cause a person to be more susceptible to heat injury. Avoidance of these factors is important to reduce the chance of heat injury. Predisposing factors to heat illness include: Alcohol intake (within 24 hours) Medications (diuretics, antihistamines, tranquilizers) Fatigue, lack of sleep Dehydration Recent immunizations Recent infections Previous heat injury You remain our most important asset! Stay hydrated, and remember: mission first, safety always!