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July 2000 |
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August 2000 |
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In the mountain rescue community here in Washington we understand and deal with Hypothermia on rescue missions in the Cascade and Olympic Mountains. But how many have had to deal with Hyperthermia, otherwise known as heat exhaustion or heat stroke. Of the energy that is produced as we burn our food, seventy-five percent is in the form of heat. As most of us know the body loses heat in four ways: radiation, convection, conduction, and evaporation. If the body cannot rid itself of the excess heat it will cook the brain and other vital organs. Of the four methods of heat loss, the first three will work only when your body is warmer than its surroundings. You will actually gain heat on a hot day from the radiation of the sun; Convection will work only if there is a cool wind blowing and Conduction works only when the body is in contact with something colder than the surrounding environment. If the temperature of the air is equal to or greater than your skin temperature you will sweat and lose heat through Evaporation.
A 150 pound male individual has around 40 liters of water in his body or approximately 60 percent. Of the 40 liters three are in the blood. When your body starts to lose water you can sweat up to four liters an hour; it doesn't take long to dehydrate. When your body loses 3 or more liters of water it will stop shunting blood to the skin because it is needed for the vital organs. At this point sweating does little or no good as the body's heat is not reaching the surface of the skin. Heat illness can occur in temperatures as low as 70 F if you are exercising vigorously.
During rescues or exercising in a hot climate replacing the fluids that you have lost is vital. It is recommended that you drink one quarter liter every twenty minutes. While most people can drink a half liter of water comfortably at one time it takes time for that to pass into the blood. One and a half liters of water per hour can pass into the blood, and cool water, 50 F, is easier to absorb than warm water.
While some of us like to flavor our water to make it more palatable, soft drinks and coffee and tea should be avoided. Soft drinks contain sugar and they must be digested; this slows down the time it takes to absorb the water. Coffee, tea and alcoholic beverages contain caffeine, a diuretic that can cause increased water loss through urination. Your sweat and urine contain electrolytes such as potassium and sodium. These are essential in that they control the movement of water in and out of the body's cells. Most heathy individual's diets have more than enough sodium in them to meet the body's needs. Unless you are sweating a lot for a day or more sodium loss is not a problem. If you are experiencing cramps in hard working muscles there is probably an electrolyte deficiency. If you decide to drink some of the commercially available drinks such as Gatorade to replace your electrolytes, dilute them half strength to reduce the sugar content.
As stated earlier your body's main source of cooling is sweating; however, sweat can only cool the body if it evaporates. In a humid environment where the air is already saturated with water vapor, the sweat will just roll off the skin without cooling the body. As a rule the higher the relative humidity the lower the temperature at which the risk of heat illness can occur. Heat risk is reduced if the rescuer can get out of the heat and rest or lie down comfortably to ease the stress on the circulatory system. You can also reduce the risk by wearing loose clothing that allows air to circulate .
Some risk factors that may make you vulnerable are being more than 50 years old , obese, fatigued and out of condition or unaccustomed to the heat; many medical conditions and medications can also increase heat production or suppress sweating.
If you stand in the heat for very long the heat will draw your blood to your limbs and skin surface. This can result in a lowering of your blood pressure and cardiac output resulting in fainting. Exercising in a hot environment can result in dehydration and heat exhaustion by basically overloading your circulatory system. A person suffering from heat exhaustion will have a normal core temperature, but will be sweating profusely and have clammy skin. Other symptoms may include headache, confusion and nausea, which are all related to a poor blood supply to vital organs by an overtaxed circulatory system. At body temperatures of 106 F or higher cell membranes leak and sodium ions accumulate inside; this will stimulate or increase heat production and can result in heat stroke.
Rescuers involved in strenuous activities (such as high angle and mountain rescue) can generate enough heat to go into exertional heat stroke in as little as 15 minutes. Symptoms include profuse sweating, bounding pulse and behavioral changes that can range from slight disorientation to irrational or aggressive behavior. In severe cases the individual can lapse into a coma in less than an hour.
The best treatment is to cool the body down by getting into a cooler environment and drink plenty of liquids to rehydrate yourself. In the latter stages of heat illness such as heat exhaustion and heat stroke, ice baths or bags of ice placed in the armpits and groin and on the sides of the neck may be required . Of course, in severe cases hospitalization may be required..
Though we live in a cool climate, be alert for the signs and symptoms of heat illness.
You're climbing with a group of your friends and you've just made the summit and hiked only a few hundred yards down the mountain when a member of your group loses his footing on a snow-covered rock and goes airborne. He comes down with all of his weight on his right ankle, and his lower tibia snaps with a loud crack, like a breaking pine bough and leaves him writhing in the snow. Your friend needs urgent medical attention, but the trailhead is a five-hour hike down the mountain in good conditions. There was no way you could carry him that far on your back down the mountain. Heck, you'd be lucky if you could lug him the two miles back to camp before dark! What would you do if you were in this position? Would you make a heroic effort to carry your friend out of the wilderness ? Would you try to get him back to camp? Or would you find shelter, settle in for the night, reassess the situation in the morning? In this scenario, the last option is the most prudent one, although an argument could be made for carrying your injured buddy back to camp if you felt up to the task and were familiar with one-rescuer evacuation techniques. Any attempt to carry him all of the way off the mountain that afternoon would end in tragedy. There is no formula that will tell you precisely what to do in every rescue situation, but you can use the following guidelines to help you map out a sound strategy for dealing with a wilderness evacuation problem.
Any accident or emergency is a traumatic experience for the people involved. You can usually separate emergencies into 2 classes: Class A. Any emergency that is life threatening and could result in permanent disability or disfigurement . Class B. Non life-threatening emergencies, such as loss of contact with a group or individual over 24 hours, or any injury requiring medical attention . Anyone with a minor injury, or an upper extremity injury, should be able to walk back to camp or to the trailhead under his own power. Most people with leg or foot injuries can be carried out. Anyone with multiple fractures or with spinal, chest or abdominal injuries may need to be evacuated by litter or helicopter. A strong, fit man may be able to carry an injured adult on his back for a mile or two, but two or more people will be needed for longer transports, especially over rugged terrain. Never leave an unconscious, confused, or otherwise helpless person unattended; erect a shelter and mark it so that it will be easily visible to the rescuers. Generally, the wisest course is to wait with the victim while someone goes for help,.
Be familiar with the itineraries of other climbers in your area .Never set out on an evacuation at night or in severe weather. Don't create additional victims by placing yourself or others in a dangerous position during a medical evacuation. If you elect to send for help, dispatch the fittest member of the group with a map showing your location, trails, natural landmarks, and a note specifying the number of victims, their ages, the nature of their injuries, their condition, treatment given, supplies needed and the urgency of the situation. After the runner has reached the trail head he or she should be familiar with local pay phone procedures and have the proper coins on hand. Never hang up first after phone contact is made with the outside agency. Always have them leave a phone number where they can be reached. After the local Sheriff and or Search and Rescue teams arrive, the runner should be prepared to accompany them back to the accident site.
Identify the persons or agencies that need to be notified. Local volunteer rescue organizations, paramedical support and the need for helicopter evacuation will need to be obtained through local agencies. The primary emergency response agencies in the U. S . A . are usually the local Sheriffs department. They are responsible for any emergency within their jurisdiction and must be notified of any rescue operation. Within National Parks and Monuments, contact the Park Service. These agencies are generally the chief resource through which additional support is obtained and coordinated. They will also appoint an official spokesperson if they decide it's appropriate . In the event of death, the Coroner or Deputy Coroner will also be contacted. If practical, they will need to inspect the scene before the body is removed. They will also take care of the notification of next of kin . Just keep your head and follow these simple rules. Remember your brain is your best survival tool.
These minutes as published are unofficial and subject to approval at the next regularly scheduled board meeting.
Convened 19:40
BOARD MEMBERS PRESENT: Alan Givotovsky, Fran Martoglio, John Kirkman, Gus Bush, Russ Brinton, Stan Kartes, Chris Berryman, Ken Capron, Bill Weber, Rick Wire, Jeff Sharp.
OTHER MEMBERS PRESENT: Lee Tegner, Jim Andrues, Tim Greminger, Talis Abolins, Steve Medeiros.
TREASURER'S REPORT: Victor Caro
KIT REPORT: Tracy Berryman
OPERATIONS REPORT: Gus Bush
TRAINING REPORT: Russ Brinton
EQUIPMENT REPORT: Ken Capron
COMMUNICATIONS: Stan Kartes
SAFETY & EDUCATION: Rick Wire
MEMBERSHIPS REPORT: Chris Berryman
FINANCE REPORT: Bill Weber
AIR OPERATIONS: Jeff Sharp
S.A.R. COUNCIL: Fran Martoglio
MAST: Bill Weber
OLD BUSINESS:
NEW BUSINESS:
Adjourned at 20:50
Respectfully submitted
The following members attended the Kit party on the 1st of June
The Kit parties are held from 7:00 to 9:00 P.M., the first Wednesday at the Cache. If you need directions, call 531-2120. We need your help.
There will be no Kit Component Party in July.
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