# heat stress relief.



## Frisco (Apr 4, 2008)

Well all this talk of heart attacks got me thinking that It would probably be nice to get some nurse/doc/med opinions on the best way to cool off or signs to watch out for during summer training.. 



Like two or three years ago I went to Summer Leadership School.. and during the more physical out door activities one of the ways we started cooling off was to pour cool water over the interior side of our forearms.. I donno how good of and idea it was as far as physically, but it definitely cooled me off..


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## surgicalcric (Apr 5, 2008)

*Well if we are going to talk about heat illnesses lets talk about them...*

There are 3 classes (major ones) of heat illness which one may encounter while working outside in the heat, during physical training or real world operations. I have added a couple of the more minor ones.

I will briefly run down their s/s and treatment of each.  Remember the best treatment is prevention.  Proper hydration and acclimatization to the environment you are working/training/operating in is the key to avoiding the illnesses listed below. The only exception to this is the first illness.  That being said:

*Prickly Heat:* 
*s/s:*
1) Red rash that develops over actively sweating skin
2) Prickly sensation/pain over same area (caused by dysfunction of the sweat glands when blocked by salt crystals)

*tx:*
1) Cool and dry affected area
2) DO NOT apply creams to the area
3) Wash area with soap and a loufa(sp?)
4) If itching is severe, 25mg Benedryl PO q 4-6 hours for itching 


*Heat Syncopy:* 
*s/s:*
Self-explanatory

*tx:*
1) Cool victim and give cool fluids (powerade/gatorade, cut 50/50 with water) once he/she is alert and awake. The colder the fluid the better as its more easily absorbed by the stomach, however warm fluids are better than no fluids.


*Heat Cramps:*
*s/s:*
1) Painful muscle cramps which generally occur in the more heavily worked/exercised muscle groups
2) Onset during or immediately after work/training

*tx:*
1) Move to a shaded/cool area
2) Rest
3) Drink cool fluids (powerade/gatorade, cut 50/50 with water)


*Heat Exhaustion:*
*s/s:*
1) Malaise, headache, weakness, nausea, vomiting (flu-like symptoms)
2) Tachycardia (rapid pulse > 100 bpm) 
3) Sweating (usually profusely)
4) Temp usually normal (100.4 to 102.2 range)
5) Normal mental status

*tx:*
1) Move to shaded/cool area
2) Remove tight clothing
3) Drink cool fluids (powerade/gatorade, cut 50/50 with water)
4) Place ice/cold packs on the neck, groin, chest wall, under arms, in groin (dont place ice directly on skin)


*Heatstroke:*  This is a true medical emergency and should be treated as such.  The death rate is 80% when not treated effectively and properly.
*s/s:*
1) High temp (usually over 105)
2) Confused, disoriented, seizures, unconsciousness
3) Rapid breathing
4) Rapid pulse (over 100 BPM) and often very weak
5) Sweating may be present or absent

*tx:*
1) Call 911 if you are in an area where they can reach you.  (Obviously this precludes operational environments as well as many training environments, however if training you should have an emergency plan ICO an accident.)
2) RAPID cooling (the faster the better).  Place ice/cold packs on the neck, groin, chest wall, under arms, in groin (dont place ice directly on skin) or immerse in cool water if possible only until body temp has fallen to 102.2
3) Maintain the airway / NOTHING by mouth 
4) Administer IV fluids (1-2 liters NS)
5) Treat for shock 


*Hyponatremia:* Caused by drinking large volumes of h2o or other hypo-osmotic fluids.  Often times it can be difficult to differentiate hyponatremia from heat exhaustion/stroke in a field setting because of the over lap of s/s.  The most major difference is hyponatremia patients generally have a normal temp (less than 101) and heat exhaustion patients are generally greater than 102.  This is a true medical emergency as well.
*s/s:*
1) Weakness
2) Lack of appetite
3) Nausea/Vomiting
4) Muscle Cramps
5) Lethargy, apathy, confusion, agitation, seizures, disorientation, unconsciousness

*tx:*
1) Call 911 if you are in an area where they can reach you.  (Obviously this precludes operational environments as well as many training environments, however if training you should have an emergency plan ICO an accident.)

---------------------------------------------------------------------
HTH,

Crip


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## Typhoon (Apr 5, 2008)

Thanks for the great breakdown of heat related illness, SC. 

A couple of small hydration tricks to remember when you are exercising in the heat:
First, make sure that you weigh yourself before and after your training session. As a general guideline drink two cups of water for every pound that you lose during your work out.

Second, Gatorade has a fair amount of carbs in it, which I understand actually prevents the absorption of electrolytes into your system. For a number of years NFL players have been drinking infant Pedialyte during training camp to improve electrolyte absorption. The Pedialyte doesn't have any carbs in it, so it doesn't taste as good as Gatorade. However it comes in flavors so it isn't terrible to drink.

Finally, remember that when the Temperature Humidity Index becomes 103 degree f. or more, you have to slow down no matter how fit you are or how accustomed to the heat you are...


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## Frisco (Apr 6, 2008)

Thanks for the good imput Crip and Typhoon.. awesome information.. 

But I was wondering why Crip was cutting the Gatorade/Powerade 50/50 with water.. is that because the above mentined, carbs preventing the electrolites being absorbed? 

Or are their other reasons against Gatorade/Powerade?

 I quit drinking the them in turn for just water during and whey protein + milk after my workout, because I was told that unless I was training for a marathon or something that I wouldn't lose anything that water couldn't replace while I was working out..


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## Typhoon (Apr 6, 2008)

> that I wouldn't lose anything that water couldn't replace while I was working out..


Gatorade does serve a purpose, however. When it is extremely hot you can also drink too much water and end up causing yourself problems because you are diluting your system and not replacing electrolytes. An extreme example would be the woman who literally drank herself to death by consuming too much water a couple of years ago in order to win a radio station contest...


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## EMSDoc (Apr 6, 2008)

Awesome posts Crip/Typhoon,

Straight gatorade has too many carbs that is correct.  It can actually dehydrate you, as it is hyperosmotic and will pull fluids into your GI tract.  In some cases this can actually cause diarrhea (or worsen it if you have a GI bug).  Drinking a concentrated protein solution will actually do the same.

This is the reason behind the 50/50 mix.  A 50/50 mix should nearly match a physiologic electrolyte solution such as pedialyte which is deigned to be iso-osmotic and readily absorbable from the GI tract.  Plus it is more palatable than pedialyte (I always wonder why these products designed to be taken by kids taste so awful... but I digress).

Some other tips... really cold fluids on a warm day or if you are overheated can stimulate the vagus nerve, which is a big nerve that runs along your esophogus through your chest.  The vagus nerve controls your parasympathetic nervous system, which will slow your HR and lower your BP.  Hence, ice cold fluids = vaso-vagal episode = possible syncope.  Cool fluids are best.  Warm fluids will hydrate you fine, just probably not taste as good on a warm day!  The temperature of the fluid before it hits your stomach will not have an effect on the absorption.

Remember... oral hydration is the same physiologically as IV hydration... so the only reason to give IV fluids is if the person cannot tolerate oral fluids (i.e. vomiting or altered mental status).

Crip's point about hyponatremia is well heeded.  Sweat contains electrolytes such as sodium... so if a person hydrates with just straight water, his or her blood sodium level will fall.  This causes swelling of the brain.  The blood brain barrier prevents the movement of salt out, so the blood will have more water than salt, and therefore water will shift into the brain, causing edema.  The problem is... as a responder you will be faced with a warm confused patient, and it is easy to presume heat stroke as the cause and rapidly infuse fluids.  Rapid correction of hyponatremia can make the condition worse.  It is very important if you are in charge of the health of your team to ensure rehydration with physiologic electrolyte solutions to prevent this from occurring, because treatement and ID in the field is exceedingly difficult.

And as for the major's original post... any method of keeping yourself cool and hydrated is okay, within the guidelines we have discussed here... so your method was fine.

EMSDoc :cool:


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## x SF med (Apr 6, 2008)

Hyponatremia and hypokalemia and hyper or hypo calcemia are all very closely tied together  as these are the 3 major electrolytes in the human body - plus the sodium/potassium pump in the nephrons not only needs those 2 eltrolytes, but calcium and water to work properly.  the body is a balancing act - and under stress the balance can be very skewed.

Too much or too little of any one can throw off the absorbtion or excretion of either or both of the others - or even water...


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## AWP (Apr 6, 2008)

Having been a "victim" of hyponatremia I can say that it sucks.


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## Frisco (Apr 6, 2008)

What about putting a small amount of salt (like a pinch) in a gallon of water.. would that work to maintain proper sodium levels.. 

I also heard something about throwing in a banana too, something about the potassium helping with the diffusion of salt through the cells or something.. I'm not talking about cramps persay as heat cramps aren't necesserely caused by a potassium deficiency, but it can cause other problems.. Hypokalemia?  could that be an issue just from the heat, or would there have to be underlying factors to provoke something like that..


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## Invictus (Apr 6, 2008)

C/Maj. Francisco said:


> Hypokalemia?  could that be an issue just from the heat, or would there have to be underlying factors to provoke something like that..


Well you could experience a loss of Potassium through diarrhea and vomiting.


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## pardus (Apr 6, 2008)

I had a guy going down due to heat one exercise, no medics around as we were too far forward for pussy medics to be there 

I made the affected guy drink a full canteen with one MRE packet of salt and one of sugar mixed in within one hour, it turned him around nicely, no problem after that.


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## Frisco (Apr 6, 2008)

> Hypokalemia: Potassium losses (hypokalemia) become apparent after the acidosis is corrected. If severe, it can cause weakness, muscle cramps, and heart rhythm disturbances (such as premature beats). Your body will move potassium out of the cells to partially correct the loss. It may take hours to correct. You'll get potassium from yogurt, bananas, and (a tiny bit) from sport drinks. If you're taking some types of blood pressure medicines or diuretics (water pills) potassium loss can be a problem.



http://www.utahmountainbiking.com/firstaid/heatstrok.htm

True that diarrhea and vomiting CAN be causes, I was just inquiring to the possibility that it can be onset by Heat Stress..


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## x SF med (Apr 7, 2008)

Francisco-
we will give you initial guidance and point you in the right direction - you have to do your own research and legwork - sorry.

New assignment - find five possible long term effects of a moderate to severe heat injury and figure out if any of them can become life long disabilities.


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## EMSDoc (Apr 7, 2008)

Low potassium can be a pre-exisiting condition due to diet, or can be induced by vomiting/diarrhea.  Potassium can be lost in sweat, and there are many electrolyte shifts that occur when homeostasis in the body becomes affected by any stress (heat being one of them).

As for "homemade" electrolyte replacement solutions... ideally commercial ones are best because they are specifically designed for that purpose, however MacGuyer-ing a solution at times is all that is practical.  The best answer is if you can prepare and bring gatorade or pedialyte beforehand, 50/50 gatorade or pedialyte are preferred.  But if you are in the trenches or it is not practical to carry cases of gatorade with you... then you have to do the best with what you have.  Another option... there are commercially available dry packets available that don't take up much space that you can add to any source of water to make an electrolyte solution.

Doc :cool:


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## DoctorDoom (May 18, 2008)

Prevention is always best.

I always made sure to get people into shade and check on them on hot days.


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## pardus (May 18, 2008)

Does anyone have stats as to how many people have been lost to Hyponatremia and to heat stroke etc...

I'd like to see a comparison between the two.

I'm still more than a little uneasy with the whole 'drink lots of water' mentality of the Military nowadays, goes against all my training.
The body can be trained to operate on small amounts of water, which is IMO vital to certain types of troops.


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## digrar (May 19, 2008)

Dinosaur... Tell us about the leaches/bleedings and brandings you got at the RAP and what drill is like with a SMLE.


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## pardus (May 19, 2008)

digrar said:


> Dinosaur... Tell us about the leaches/bleedings and brandings you got at the RAP and what drill is like with a SMLE.




Leeches have valuable applications and the SMLE is the best bolt action military rifle ever made, I have three with me now (including a Lithgow).

So fuck you!   

You are all water drinking pansies, In the words of Chopper, Harden the fuck up!


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## Typhoon (May 19, 2008)

> You are all water drinking pansies, In the words of Chopper, Harden the fuck up!


Hahahahahahahahahahaha... 

Good one, Pardus!


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## Bones (May 19, 2008)

Lets say you have a heat injury such as exhaustion, but you are drinking plenty of water.  You vomit, but its mostly clear water as your stomach is full.  How can you get the body to absorb the water faster to prevent the injury?

or are you just S.O.L.?

Also while im at it, How long would you say it takes the average person to climatize to an area?  If your only there 1-2 weeks, can you acclimitaze? If not again, are you just S.O.L.?


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## pardus (May 20, 2008)

Bones said:


> Lets say you have a heat injury such as exhaustion, but you are drinking plenty of water.  You vomit, but its mostly clear water as your stomach is full.  How can you get the body to absorb the water faster to prevent the injury?
> 
> or are you just S.O.L.?
> 
> Also while im at it, How long would you say it takes the average person to climatize to an area?  If your only there 1-2 weeks, can you acclimitaze? If not again, are you just S.O.L.?



The medics will give a more technical answer but an IV is the best way to rehydrate.

The fitter you are the easier it is to aclimatise, I forget the timeline now but its quite short IIRC.


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## LibraryLady (May 20, 2008)

Bones said:


> Lets say you have a heat injury such as exhaustion, but you are drinking plenty of water.  You vomit, but its mostly clear water as your stomach is full.  How can you get the body to absorb the water faster to prevent the injury?
> 
> or are you just S.O.L.?
> 
> Also while im at it, How long would you say it takes the average person to climatize to an area?  If your only there 1-2 weeks, can you acclimitaze? If not again, are you just S.O.L.?




Your first sentence doesn't make much sense.  If you are drinking plenty of water then you probably don't have an heat injury.  That's what an heat injury is - the heat has caused an inbalance/shortage in your fluids, basically.

However if you mean to say, you have a heat injury and you're drinking to replace and you vomit, then IV is the way to go for replacement.  Like Pardus says, IV is the quickest way to replace, period.

LL


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## Paddlefoot (May 21, 2008)

One week after we hit the ground in Saudi, our CI section received a new soldier to their section, right out of Huachucha.

One week after _that_, he was medevaced out of our camp and country, to Germany. He suffered complete kidney failure and was on dialysis last we heard. Can't even remember his name.

What I _do_ remember is that he ignored everybody and failed to drink the requisite amount of water necessary to survive in the desert, especially in those first few days that your body is getting acclimated. It got to the point that his NCOs started to threaten him with UCMJ action.

In the end, it didn't matter. Dumbass got a one way ticket home and a lifetime of either being hooked to a machine or a kidney transplant. Either way, he was fucked.

Drink water, people!


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## pardus (May 21, 2008)

Paddlefoot said:


> One week after _that_, he was medevaced out of our camp and country, to Germany. He suffered complete kidney failure and was on dialysis last we heard. Can't even remember his name.




....


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## x SF med (May 21, 2008)

With acclimatization - hardening up is best done by smartening up.
If you have the time - 1 week of normal activity with lots of water/elctrolyte replenishment will get you ready for dropping your fluid intake slowly.  Each person is different - if you sweat a lot - you need to drink a lot.  If you don't pee enough, you aren't getting enough fluids to flush the junk out of your system.  If you are peeing dark yellow or brown from lack of fluids - you have a problem.


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## car (May 21, 2008)

There are plenty of witch doctors here, so I'll defer from passing my deep, deep knowlege of drinking, and therefore, being dehydrated at key times.

Oh yeah, having said that, plan ahead.


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## Rabid Badger (May 22, 2008)

car said:


> There are plenty of witch doctors here, so I'll defer from passing my deep, deep knowlege of drinking, and therefore, being dehydrated at key times.
> 
> Oh yeah, having said that, plan ahead.



I gotsta go with SGM here.

I drank 1 canteen of water per 12 mile ruckmarch with no problems. I hate water but always had plenty.

Your metabolism will dictate when you need to drink water or whatever you choose to drink and nothing else. Experience with the green tick on your back will let you know how much and when.

:2c:


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## EMSDoc (May 24, 2008)

PO and IV hydration actually have equal efficiacy.  In fact, there is good military data that using the gut is the best physiologic way to stay hydrated.  NG tubes as a method of hydration are sometimes used to this effect.

This being said, if you are vomiting, or cannot tolerate oral fluids for some reason, or are so dehydrated that you aren't going to chug 3L of fluids, then an IV is the way to go.

Doc :cool:

P.S.  I agree prevention is the key -- plan ahead, so you won't be left behind!


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## pardus (May 27, 2008)

I question for those in the know...

I read that sea water diluted with the same amount of fresh water (50/50) is safe to drink.

Thoughts?


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## Bones (May 27, 2008)

sorry about the delay.  I was just in FL for 2 weeks and was called a heat exhaustion casualty.  I was drinking from my camelbak all morning.  We ran the obstacle course and I pushed myself for a good time which i got.  We stopped and ate lunch before moving to the LRC course.  I had finished at least 3/4, probably more of my camelbak, I drank 2 20 ounce gatorades by then and keep going downhill.  I sat down and didn't participate in the course.  I was feeling like shit, headache, weird kinda disoriented effect on my eyes.  Just miserable.  I was coherent and I was sweating.  I finally got sick and vomited.  The first was my spaghetti MRE, the 2nd 3rd and 4th or however many I did. Was clear so I assume the camelbaks worth of water I had been drinking for the last couple hours.  Seems like my body just wasnt processing the water into my system quick enough which caused me to go down and eventually vomit the water i had in my stomach back out.   

I am no doctor but that is my interpretation of it.  I was told my veins were still large and visable, not retracted.  I had moist cool skin when I got to the TMC.   I took 2 bags of fluids and then they were ready to release me.  After standing for abotu 10 minutes I got sick and vomited bile. I stayed the night for observation, returned to my unit the next day and was fine from that point on.

I am now labeled a heat casualty.

Hope that clears my statement up.


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## HoosierAnnie (May 27, 2008)

Bones said:


> We stopped and *ate lunch *before moving to the LRC course.  I had finished at least 3/4, probably more of my camelbak, I drank 2 20 ounce gatorades by then and keep going downhill.  I sat down and didn't participate in the course.  *I was feeling like shit, headache, weird kinda disoriented effect on my eyes.  Just miserable.*



Considering of course that none of us actually saw you and could eval your symtpoms in person (plus I will defer to our resident "doc with a glock") I was wondering if there could also be a component of gut flu or food poisioning to this scenario.  Just the 2 cents of a nurse who's triaged many gut bugs over the years


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## EMSDoc (May 28, 2008)

1/2 ocean water 1/2 fresh water... eeew.  The salinity of the ocean is much higher than that of gatorade, you would need to dilute it much more fresh water than that.  And if you have that much fresh water why are you drinking ocean water anyway?  LOL.

I agree with Hoosier Annie... sounds like a GI bug -- not heat illness.

Doc :cool:


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## pardus (May 28, 2008)

EMSDoc said:


> 1/2 ocean water 1/2 fresh water... eeew.  The salinity of the ocean is much higher than that of gatorade, you would need to dilute it much more fresh water than that.  And if you have that much fresh water why are you drinking ocean water anyway?  LOL.
> 
> Doc



We need a shaking head smilie. 

Eeew is hardly the scientific answer I was looking for. Gatorade? :uhh: focus Doc lol

Lets try this again...I had read that if _needed_ i.e. survival situation etc... that it was OK/safe to drink sea water if it is diluted 50%  

I trust that answers your last question.


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## EMSDoc (May 30, 2008)

The salinity of salt water is too high to be safe for human consumption.  It would need to be diluted with such a large quantity of fresh water, that it would make more sense to just drink the fresh water.  You would need to dilute each part sea water with 70 parts fresh water to make it drinkable.  Therefore to make 500 mL of sea water drinkable (i.e. the amount in a poland spring bottle), you would need to dilute it with 35 liters of fresh water.

Doc :cool:

From http://www.onr.navy.mil/Focus/ocean/water/salinity1.htm :

"Different bodies of water have different amounts of salt mixed in, or different salinities. Salinity is expressed by the amount of salt found in 1,000 grams of water. Therefore, if we have 1 gram of salt and 1,000 grams of water, the salinity is 1 part per thousand, or 1 ppt.

The average ocean salinity is 35 ppt. This number varies between about 32 and 37 ppt. Rainfall, evaporation, river runoff, and ice formation cause the variations. For example, the Black Sea is so diluted by river runoff, its average salinity is only 16 ppt.

Freshwater salinity is usually less than 0.5 ppt. Water between 0.5 ppt and 17 ppt is called brackish. Estuaries (where fresh river water meets salty ocean water) are examples of brackish waters.

Most marine creatures keep the salinity inside their bodies at about the same concentration as the water outside their bodies because water likes a balance. If an animal that usually lives in salt water were placed in fresh water, the fresh water would flow into the animal through its skin. If a fresh water animal found itself in the salty ocean, the water inside of it would rush out. The process by which water flows through a semi-permeable membrane (a material that lets only some things pass through it) such as the animal's skin from an area of high concentration (lots of water, little salt) to an area of low concentration (little water, lots of salt) is called osmosis.

This is also why humans (and nearly all mammals) cannot drink salt water. When you take in those extra salts, your body will need to expel them as quickly as possible. Your kidneys will try to flush the salts out of your body in urine, and in the process pump out more water than you are taking in. Soon you'll be dehydrated and your cells and organs will not be able to function properly."


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## EMSDoc (May 30, 2008)

Haha that WAS a stream of consciousness post...

In my previous posts I noted that gatorade needs to be diluted 50% to be a practical rehydration solution.  This is more due to the sugar content than the salinity.  That is where gatorade came from in my former post...

Doc :cool:


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## Paddlefoot (May 30, 2008)

x SF med said:


> With acclimatization - hardening up is best done by smartening up.



I wish I had saved the article, I think it was in Outside magazine, with a table that showed exactly how much water the human body required for survival in the desert, factoring in such things as temperature, shade, how many miles walked (per *night*), body weight, etc.

The one thing that was stressed, though, was that there was no such thing as rationing your water, lowering your intake to make it last. You either had enough to survive or you didn't, it was that simple. It would take very little time to find yourself royally fucked if you found yourself short of the wet stuff.

So in a movie like Lawrence of Arabia, where Peter O'Toole tells his bedouin guide that he'll drink when the guide does, he's taken the first step toward dehydration and his (quick) eventual death. Made for a good movie moment, but it was totally unrealistic. 

Water is life.


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## pardus (May 30, 2008)

Thank you Doc for the scientific answer, that's what I was after even If I don't nessasarily accept what you wrote 

I'm talking particulary about a survival situation not day to day living to make my intent clear.

This is old I know but this is what I was getting at...




> THE AMERICAN JOURNAL OF Clinical Nutrition
> JULY 1970
> Editorial
> VOLUME 23 NUMBER 7
> ...



http://www.ajcn.org/cgi/reprint/23/7/861.pdf


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## EMSDoc (Jun 1, 2008)

Pardus,

I guess if you are going to die and have no other choice, you do what you can do.  It is an interesting concept that there may be a small amount of sea water that one could drink and be able to survive without causing kidney failure.  But this theory is wildly untested, and only a few researchers have done limited investigations into it.

Interestingly there is a French doctor who was adrift at sea for 65 days -- Alain Bombard -- to prove that one could survive on sea water.  However, he also drank rainwater and ingested water from fish.

http://www.nytimes.com/2005/07/24/obituaries/24bombard.html

http://www.caske2000.org/survival/survivesea.htm

I'm not convinced that drinking sea water is a good idea in any circumstance, but there is no really good data either way, so hey maybe you are right you do what you can in a survival circumstance.

If it were me however, I would exhaust my freshwater supply first before I took to drinking sea water.  I would also try to collect rainwater, or catch and eat fish.  I would leave sea water as my last resort.

That being said... let's just hope neither of us is ever shipwrecked!

Doc :cool:


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## Invictus (Jun 1, 2008)

That being said, I don't want to sound...disgusting, but would your own urine be a more viable source of hydration than sea water?

I understand that there are toxins, but the question would be, what is the better alternative?


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## pardus (Jun 2, 2008)

Invictus said:


> That being said, I don't want to sound...disgusting, but would your own urine be a more viable source of hydration than sea water?
> 
> I understand that there are toxins, but the question would be, what is the better alternative?



The question is kind of moot because if you are thirsty/dehydrated you aint going to be pissing enough volume to do much good any way.

Though there is a famous SAS guy who survived on his urine during WWII in the North African desert.

I'll see If I can dig that up.


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## Invictus (Jun 2, 2008)

pardus762 said:


> The question is kind of moot because if you are thirsty/dehydrated you aint going to be pissing enough volume to do much good any way.
> 
> Though there is a famous SAS guy who survived on his urine during WWII in the North African desert.
> 
> I'll see If I can dig that up.



Roger.  That would be an interesting story to read if you can find it.


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## pardus (Jun 2, 2008)

I can't find it...

It's not well known and little is written about it.

The guy's name was Jack Stilleto he was I believe a Sgt with the SAS.

He E&Ed for 200miles behind enemy lines in the Sahara desert in 1942, pissing into an empty sardine can and drinking it.


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## Crusader74 (Jun 2, 2008)

pardus762 said:


> I can't find it...
> 
> It's not well known and little is written about it.
> 
> ...




I have the book some where!..Actually it was a bully beef tin;)  He threw away the bully beef coz he knew it would make him sick due to his already dehydrated state and if he got sick he would lose more fluids.


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## pardus (Jun 2, 2008)

Cool, thanks Irish.


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## Serenity (Sep 24, 2017)

Useful thread and I appreciate the mention of Jack Stilleto.

For anyone interested, below is a 2016 article I found that mentions him in a review of a book titled: Rogue Heroes.

Why the first SAS soldiers were mad, bad - and VERY dangerous to know | Daily Mail Online


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## CQB (Sep 25, 2017)

Bloody Neville Bartos.


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