What Every Officer Needs to Know About Heat Stroke and Dehydration

June 11, 2018
Heat related illness are well-known mitigating factors to an officer or a soldier’s health and performance. Law enforcement officers who work outdoors in the heat are at a far greater risk for these illnesses than is the general public.

According to a 2016 National Weather Service report, more people have lost their lives as a result of heat than all other weather events including; hurricanes, lightning, tornadoes, floods and earthquakes. There were 134 heat-related deaths in 2017.  94% of all heat-related deaths occur during May–September. 

Heat related illness are well-known mitigating factors to an officer or a soldier’s health and performance. Law enforcement officers who work outdoors in the heat are at a far greater risk for these illnesses than is the general public. Additional significant risk factors include; age, hypertension, glaring sun, triple digit temperatures, carrying additionally heavy equipment and body armor (which decreases sweating) while performing physically demanding work.  

Hyperthermia is a serious medical condition in which the body's temperature reaches higher than normal levels, often due to prolonged exposure to heat or excessive physical activity. Heat stress incidents can be fatal.  When body temperatures are above 104 °F (40 °C) it is considered life-threatening. At 106 °F brain death begins.  At 113°F death is nearly certain.

The most dangerous condition is heat stroke. It is essential that officers be aware of the symptoms and first­-aid of heat stroke not only for themselves, but to recognize them in their partners, detainees, and citizens.  Failure to do so can lead to death.

Heat Stroke:  AKA Sun Stoke

It occurs when the body becomes unable to control its temperature: the body's temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. Heat stroke is anytime when the body reaches over 103 °F. When heat stroke occurs, the body temperature can rise to 106 °F or higher within 10-15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not given promptly.  Symptoms of heat stroke:

·        The hallmark symptom of heat stroke is a core body temperature above 104 degrees Fahrenheit. But fainting may be the first sign.

·         Hot, dry skin or profuse sweating OR lack of sweating despite the heat

·         Chills.

·         Throbbing headache

·         Confusion/dizziness

·         Seizures/convulsions

·         Temporary blindness

·         Coma.

·         Red, hot, and dry skin

·         Muscle weakness or cramps

·         Nausea and vomiting

·         Rapid heartbeat, which may be either strong or weak

·         Rapid, shallow breathing

·         Behavioral changes such as confusion, disorientation, hallucinations or staggering

·         Unconsciousness

True heat stoke requires that the individual is admitted to the hospital. The goal is to lower the body temperature as quickly as possible. Heat stroke may resemble symptoms of excited delirium or the subject may act drunk. They may become combative. Keep this in mind before you put them in a hot patrol car or transport them to a holding cell/ jail.

First Aid for Heat Stroke:

1.       Call for an ambulance and notify your supervisor.

2.       Move your subject to a cool shaded area.

3.       Cool using methods such as: soaking their clothes with water, spraying, sponging, or showering them with water and fanning their body.

4.       If conscience, provide cool (not cold) water.

Heat Exhaustion

Heat exhaustion is the precursor to heat stroke. It is the body’s warning system related to an excessive loss of the water and salt, usually through excessive sweating. Experiencing heat exhaustion and not intervening ASAP makes someone more likely to develop heat stroke, which can be deadly.

·         Heavy sweating

·         Extreme weakness or fatigue

·         Dizziness, confusion

·         Nausea

·         Clammy, moist skin

·         Pale or flushed complexion

·         Muscle cramps

·         Slightly elevated body temperature

·         Fast and shallow breathing

First Aid for Heat Exhaustion

1.       Have them rest in a cool, shaded or air-conditioned area.

2.       Have them drink plenty of water or other cool, nonalcoholic beverages.

3.       Have them take a cool shower, bath, or sponge bath.

4.       Utilize other cooling methods as outlined above.

Officers are also at risk for developing heat rash; AKA vest rash. Heat rash is a skin irritation caused by excessive sweating during hot, humid weather.  Symptoms generally include red clusters of pimples or small blisters on the neck and upper chest.  Officers are particularly prone to heat rash due to their bullet resistant vest.  Shirts that are even slightly wrinkled and wet will create rash lines under the vest which are susceptible to both fungal and bacterial infections.  Let the affected area dry out completely. Powders and creams are effective treatments and provide comfort.

15 Tips for Officers to Prevent Heat Related: Illnesses

Know your personal risk factors for heat illness: age (the elderly and the young are at the greatest risk), pre-existing health conditions, degree of acclimatization, overall health, water, alcohol and caffeine consumption, and use of prescription medications that affect the body's water retention or other physiological responses to heat.

1.       Check the heat index and temperature/humidity forecast before each shift.

2.       In extreme conditions use the buddy system.

3.       Humidity matters; although you sweat about the same in Florida as you do in Arizona humidity does not allow the sweat to evaporate off your body, so you are literally drenched in sweat.  Plan accordingly. Have a back-up vest carrier, change that out and launder it regularly. Bring additional shirts.

4.       Invest in a body armor cooling ventilation airflow tactical vest or a body armor cooling insert.

5.       Wear a moisture wicking shirt which is designed to move sweat away from the wet areas, and into the dry areas through capillary action.  Some officers report that these shirts cause their vest to ride up and choke them. 

6.       A mesh vent in the back of the uniform shirt also encourages airflow for increased cooling and evaporation, and the garments provide protection against sunburn with a UPF rating of 50, which means that very little UV radiation can pass through the fabric.

7.       If you have a choice related to uniforms, wear a white shirt or tans.  Totally black or navy uniforms just make the hot summer sun worse.  Loosen your clothing to allow for perspiration to evaporate, aiding in the cooling process.

8.       Stay in your patrol car as much as possible with the AC vents pointed at you.  If you can’t be in your car find shade, take cool-down rests in the shade for a period of no less than five minutes as needed.

9.       Sunburns raise your temperature and damage your body’s ability to cool itself – not to mention increasing your risk for skin cancer. Use a broad-spectrum sunscreen with an SPF of at least 30. Apply generously and remember to reapply every two hours.

10.   Wear a hat; a baseball cap or a wide-brimmed boonie that shades your face and neck.

11.   Buy an emergency heat stress kit, or ask command to provide one, and carry it in your patrol car.  These come with instant cold compress ice packs, electrolyte replenisher tablets, water packets and forehead thermometers.

12.   Keep bottled water in a cooler, and away from the sun.

13.   Keep cool water on your head; a wetted sweat band works fine.  Hats and caps are also recommended.  Wear sunscreen.

14.   Avoid hot foods and heavy meals, they add heat to your body.

15.   Never allow yourself to become dehydrated. 

Dehydration

Dehydration is the body being deprived of water. Estimates indicate that 75% all people walk around dehydrated every day. First responders are especially prone to dehydration due to the nature of their work. Physical symptoms of dehydration include: fatigue, vertigo, headaches, minimum urine output, dark yellow urine, cravings, heart racing, bad breath, dry skin, muscle pain, and major digestive problems. Dehydration can also have major psychological effects; mood problems, more irritable, fatigue, tension, anxiety, poor judgement, difficulty concentrating, memory and lack of judgement. 

Dehydration Guidelines

To calculate your daily water requirement, multiply your weight by 2/3 (or 67%). For example, if you weighed 175 pounds you would multiple that by 2/3 and learn you should be drinking about 117 ounces of water every day. Additionally, figure in your activity level. Add 12 ounces of water to your daily total for every 30 minutes that you work out. So, if you are the above 175-pound officer and you work out for 45 minutes daily, you would need to add 18 ounces of water to your daily intake, for a total 135 ounces of water – a gallon (4 liters).

Heat stroke and dehydration are preventable events, they are also treatable if recognized early enough. Just like any other life-threatening situations you always need to be aware or your surroundings; including extreme heat and/or humidity. Plan accordingly and have a safe summer. And NEVER “stay thirsty my friend”.

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