HEALTH Strings Under the Big Sky - Explore Big Sky

wilderness mediCine
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Dehydration is a numbers game
Facebook relationship: “it’s complicated”
by dave mCevoy
aerie backcountry medicine
To understand dehydration, read
about the financial turmoil in the
world. Being in massive debt hurts.
It makes you irritable, weak and
crampy. It gives you a headache and
makes you susceptible to infections.
Worst of all, it causes you to make
bad decisions, jeopardizing yourself
and those with you.
Dehydration from sweat is a numbers
game. Sweat is 99 percent water.
This water comes directly from your
blood, where you have roughly five
liters in circulation. Yet only half of
your blood is water, meaning you
only have 2 – 3 liters of water to
sweat.
For obvious reasons, like death, having
no water in your blood would be
very bad. To avoid this, your body
begins running a tab on water, borrowing
it from the tissues, where
you have over 30 liters in reserve.
This is a normal part of a healthy
body process. Rest, drink and eat,
and your body replenishes the loss.
Trouble comes when you ignore the
deficit and continue running the tab.
If dehydration were in a relationship
on Facebook, it would have
the descriptor “it’s complicated.”
Because we borrow water from all
body tissues, dehydration can be felt
in isolated muscles or lead to a bodywide
crisis. You might feel like you
have anything from a pulled muscle
to the flu, and not know what part
dehydration is playing in any of it.
To keep it simple, focus more attention
on avoiding water debt than on
treating it.
PreVenTion Do’S
acclimatize
It takes your body 6-10 days to acclimatize
to a warm environment,
after which time you sweat more efficiently,
radiate heat more readily,
and feel a lot better exercising in the
heat. To best acclimatize, you need
to break a sweat every day for about
an hour during this process.
moderate activity
Short, frequent breaks in the shade
are essential to prolonged activities,
particularly with high temperatures
and humidity. Don’t mistake this as
wimpy advice for pampered people.
Everyone, from soldiers in combat to
extreme athletes, needs to periodically
reduce activity when working
hard in a hot environment.
drink enough to pee clear and
often
This usually means 2 – 6 liters of
water over the course of each day of
strenuous outdoor activity. That’s
more than we’re accustomed to
drinking but is critical to avoid going
into water debt with your tissues. It
is possible to drink too much water.
This condition, called hyponatremia,
typically happens during endurance
events with participants pushing
themselves at high levels for many
hours and significantly exceeding
the above fluid recommendations.
Wear proper clothing
The key is wearing materials with
little or no insulating value that allow
airflow over the skin.
Consider adding electrolytes to
your water
Endless debate surrounds the efficacy
and need to supplement drinking
water with electrolytes. While
electrolyte solutions with less than
8 percent carbohydrates can help
prevent and treat some forms of heat
illness (particularly when a well-balanced
diet isn’t possible) they aren’t
a substitute for eating well and
resting. By the way, recent evidence
refutes an old theory that electrolytes
help prevent hyponatremia.
PreVenTion Don’TS
don’t rely on pounding water
It doesn’t work. You won’t absorb
most of it and instead will feel sick
or vomit. Instead, drink about a halfliter
per hour of activity, as well as a
liter before and after activity.
don’t rely on adding electrolytes
to water
Electrolytes are essential for basic
function, and adding electrolytes
to water can be very helpful, but
we get most of what we need from
food. Don’t believe the hype about
expensive drinks at the expense of
thinking about drinking water and
eating well.
don’t rely only on thirst to guide
fluid consumption
Thirst is triggered only when you’re
significantly dehydrated, meaning
by the time you feel crappy and
thirsty, you’re already well behind
and hours from recovery.
don’t think your body will get
accustomed to dehydration
It won’t, and it will punish you for
treating it that way.
TreaTMenT Do’S
stop activity and slowly hydrate
If a dehydrated person is conscious but
weak, tired, nauseated, has a headache
and/or muscle cramps, stop the activity
for at least a few hours, take off restrictive
clothing, move him into the shade,
lay him down, get some cool water onto
him, and slowly hydrate him. Nausea
will seriously limit the amount he can
drink, which is usually about a quarter
to a half-liter per hour. Adding electrolytes
and massaging cramping muscles
can be beneficial.
Cool off aggressively and plan for
immediate evacuation
If a dehydrated person is hot, hallucinating,
unresponsive and unable to walk,
cool him as quickly as possible; the fastest
means of cooling him often includes
spraying with water and fanning air. He
also needs an immediate trip to a hospital.
Until proven otherwise with tests in
that hospital, this is heat stroke, which
is a life-threatening emergency with a
very high mortality rate. It can come on
quickly, without much warning.
explorebigsky.com
Big Sky Weekly
TreaTMenT Don’TS
don’t think recovery will be fast
Remember, it can take hours to
fully replenish water and electrolyte
losses.
don’t underestimate how many
ways dehydration can affect you
Dehydration affects all body systems,
making a person feel tired,
crampy, nauseated and irritable.
As such, it’s a contributing factor
to many of the most common
and serious backcountry illnesses
and injuries. Preventing it is fairly
simple. Treating it can be long and
challenging. It’s an easy choice!
David McEvoy is a paramedic and
the director of Aerie, a wilderness
medicine training organization based
in Missoula. Aerie teaches Wilderness
First Aid, Wilderness First
Responder and Wilderness EMT
courses at MSU in Bozeman.
aeriemedicine.com
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June 29, 2012 55