Soldiers who may be deploying in the future should learn the symptoms of heat injuries, despite being exposed to a different kind of heat in Southwest Asia.

“Here at Fort Bragg they train in a humid environment, but once they deploy, it’s to a hot environment without the humidity,” explained Ken Ferrell, chief of the epidemiology clinic for preventive medicine. “So it’s a different kind of heat they’re exposed to.”

He pointed out that most Fort Bragg Soldiers have faced multiple deployments in temperatures that commonly reach more than 120 degrees and have no problems with heat injuries.

“Then they come back to Fort Bragg and the humidity, along with the heat is so much different,” he said. “The humidity is the big factor. They should be aware of the fact that they’re going to be exposed to high temperatures and they shouldn’t take it for granted. They should drink plenty of water and eat properly so that they’ll replenish any salt they may lose.”

Ferrell said another important factor is remembering that if they had a heat injury here at Fort Bragg, they are more susceptible to having another episode during deployment.

He said if Soldiers suspect that their battle buddy may be suffering from heat exhaustion, they should move them to a cool area, loosen all constrictive clothing (around the wrists, ankles, belt line and neck area) take off the shirts and place the victim in a position similar to one for treating shock (elevating feet).

“Pour water on them or at least give them a drink of water,” Ferrell said. “Let them drink plenty of water, about a quart within an hour’s time. Stop their activity and just let them cool down.”
He added that if they lose consciousness, it’s important to make sure that the individual goes to the emergency room.

For heat stroke, Ferrell said, the first priority should be to take the steps necessary to lower the individual’s body temperature. Remove all constrictive clothing and pour water all over the individual, he added.

“More than likely, they won’t be able to drink water because their altered mental state won’t allow them to drink any water, without running the risk of having them choke,” Ferrell said. “If an ambulance or emergency medical system personnel can get to them, that’s ideal.”

He said in remote locations, such as Camp Mackall, the victim should be rushed to the nearest emergency room as soon as possible.

Ferrell said heat exhaustion and heat stroke are the most common injuries, but they are not the only two that could affect the Fort Bragg community.

There is a condition called rabdo myolysis, which according to Ferrell, is similar to heat stroke in the way it affects the liver and kidneys and it also features elevated enzymes. However, it is an exertional injury that includes very intense cramps or spasms.

“These individuals are in a lot of pain,” he said. “They’ll suffer the worst muscular cramps that you could imagine, like a muscle cramp intensified maybe eight to 10 times, usually in the big muscles like the thighs, their back or their arms.”

He said the cramps are caused by enzymes being released into the muscles.

Ferrell added that it’s important for Soldiers to remember that they are susceptible to heat injuries, regardless of their fitness level.

“Soldiers will not quit,” he explained. “The thing they need to be mindful of it that it is not a sign of weakness to stop and say, ‘I don’t think I can make it.’ They need to know that sometimes these heat injuries can be career altering events.”

Ferrell said drinking plenty of water during the summer months and acclimating themselves to their environment during deployments or reassignments will help lessen the probability of heat injuries.

“They need to stay hydrated,” explained Robert Oyler, also of Womack’s preventive medicine, who is the Army’s authority on heat injuries. “They’re out physically exerting themselves and if they’re not hydrated as they exercise, they burn up water and if they get too low, they’re going to have a heat injury.”

Oyler said he has seen about 3,000 heat injuries in his 13 years of experience. Of those, about 40 percent are heat stroke, he added.

Oyler explained that exposure to heat on successive days may also be a contributing factor in heat injuries. He said unit leaders should pay close attention to their Soldiers as they plan various events, such as ruck sack marches, change-of-command ceremonies and long physical training runs on successive days.

“They really need to look at their Soldiers and do what they can to mitigate or prevent heat injuries by enforcing water discipline, which makes it mandatory that they drink water,” Oyler said.

(Editor’s note: This is the final part of a two-part series on heat injuries and how to prevent them.)

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