Emergency Situation: You’re hiking with some friends in July at Zion National Park. It’s high noon when you begin to feel faint. Sweat pours down your forehead and into your eyes, causing you to stumble down the trail. You’re dizzy. You open your canteen for a drink of water, but it’s empty. Your pulse quickens, and then you collapse.
Solution: First, choose wisely when planning your summer hikes. Walking in the desert at noon puts you at a higher risk for overheating. If you must hike when it’s hotter (noon versus early morning), always carry extra hydration and dress for the expected temperatures.
Now let’s make a distinction: Heat exhaustion is different from heat stroke. This column deals with the former, which can lead to the latter — but they are not the same thing. Heat stroke is a serious condition that can be fatal and demands urgent hospital care. (Recovery requires immediate full-body cooling to avoid permanent brain injury or death.)
Heat exhaustion, while serious, can be field-treated in most cases if you know what you’re doing.
Heat exhaustion is the body’s way of telling you that it’s water- and salt-depleted, typically because of excessive perspiration without proper replenishment. There are numerous signs of the condition: profuse sweating (as the body tries to cool itself), dizziness, fatigue and muscle cramps. Other signs might be less obvious: general confusion, very dark yellow (or even brownish) urine, nausea and a rapid heart rate.
The first step in treating heat exhaustion is to stop, sit and cool down. Next, move to a cool(er) place. If you’re near a swimming hole or an air-conditioned building, go for it. It’s more likely you’re near an air-conditioned car: Use one, if it’s close. If not, move to a shady spot (try a north-facing slope).
Once you cease activity, rehydrate slowly while removing tight-fitting clothing. Water is a good choice. But because heat exhaustion might also be caused by mineral depletion, electrolyte-enhanced sports drinks are also effective. If a banana is available, eat one for added mineral replenishment. Salt tablets can also be dissolved in water, but don’t overdo it … you’re trying to rehydrate, not dehydrate. Rehydrate with a mouthful of liquid at a time. This should eventually lead to urination, a sign that the kidneys are functioning normally and the body is no longer fluid-depleted.
There are additional ways to treat heat exhaustion. Full-body immersion in cool water is ideal. If you have water to spare, cool the victim’s skin with dampened T-shirts. Also, fanning speeds up the skin-cooling effects of sweating. Use a map, book, magazine or hat. A few people fanning the overheated hiker can be helpful.
Recovery times vary for heat exhaustion. Don’t expect someone to take off down the trail after swallowing some Gatorade. Activity should be kept to a minimum. If you need to hike out, wait until it’s cooler and then take your time.
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I would like to expand on a couple of points from the article. I live in So Cal where nearly all of our hiking is hot,dry and mountainous. I have come across people at least two hours in from the trail head, carrying nothing but a pint bottle. Not too smart. Nothing worse than being thirsty.
To me, extra hydration is carrying at least a gallon of water on a day hike, especially if the water sources on the trail are questionable or non existing. When on hikes I will watch my group to ensure they are drinking regularly. I tell them; clear & copious. If you are not peeing every hour, you are not drinking enough water. This applies to both adults and youth.
I highly recommend a decent hat. For me, in hot weather, a baseball cap is less than worthless. It gives zero protection. I have found the best hat is a broad brimmed straw hat. I look for a brim that is as wide as my shoulders. A straw hat will breath and not trap heat or sweat. I call it my portable shade.
Also, placing something cool, like a damp towel or water bottle, over “pulse points” such as arm pits and groin area, in addition to the neck can help to reduce body heat. I was once a victim of heat exhaustion (not scout related), and was alone. It came on suddenly, but I recognized the symptoms. I used every trick I could think of (most mentioned in the article) just to feel well enough to get to my car where I could turn on the A/C. My husband came and picked me up. This was no joking matter and I’m just so glad that I knew what to do. Definitely something all scouts and scouters should watch out for and prepare for!
Even lacking fluids to rehydrate, you can help cool off if you have hand sanitizer. Spread it over the body, the alcohol evaporating quickly can help cool down.
You’re missing my favorite – SPEAK UP. You’re out with *friends*. It was dumb to not plan your water better. But not asking before falling down is worse. Better three or four folks exit the trails dry, then have to carry your buddy out.
“If you have water to spare, cool the victim’s skin with dampened T-shirts. Also, fanning speeds up the skin-cooling effects of sweating.” This is also a great way to make the situation a whole lot worse. If you cool them off and then make them start to shiver since you have soaked them, they will actually raise their body temperature even more. The best way to stay hydrated to to keep drinking. A few sips from a hydration bladder every 5-10 minutes will actually keep you hydrated better than trying to drink a lot of water when you are thirsty. Once you get thirsty, it is already too late.
Here’s a handy way to carry an extra half-liter to liter of water. Fill your water bottle. Then drink the whole thing. Then fill it again. This is what is called at Philmont “cameling up”. You can carry quite a bit of water in your stomach, and that’s water you’ll use up first before you even crack open your water bottle.
I always tell the Scouts “If you’re thirsty, you’ve waited too long to take a drink. Drink before you get thirsty, not after.”
At summer camp, when the weather is hot, we constantly “toast” to encourage water consumption. Scouts entering the area from the trail must drink a toast to someone – mom, president, friend, leaders, etc. Often we stop program, grab a cup or water bottle, and drink toasts, both sincere and silly. While we stand together hoisting the H2O, staff can evaluate the condition of each Scout. It’s fun, it works, and all enjoy it!
Best way is to keep yourself hydrated and stay in shade.