NEVER leave pets & children in hot cars

NEVER leave pets or children in a closed, parked vehicle; even for "a few minutes." Children, elderly adults, or disabled individuals left alone in a vehicle are at particular risk of succumbing to heat stroke. When the outside temperature is 70 degrees Fahrenheit, the temperature inside the car can exceed 120 degrees in minutes, even with the windows slightly open. Pets are even more susceptible than humans to heat stroke in cars, as dogs, cats and many other animals cannot produce whole body sweat.

Heat stroke can be fatal and occurs when the body gives up on trying to cool down. As temperatures climb, your heart beats faster to whisk away internal body heat via the blood stream to keep your insides and your brain at 98 F. Your skin sweats (dogs pant) to aid the removal of heat from the blood just beneath the skin.

If you've ever had a fever with a cold (or raised an infant) then you'll know that our body has very little tolerance for internal temperate change. Heat stroke is defined as an internal temperature of 104 F; that just 5.4 degrees above normal. At that temperature the brain can become confused and internal organs can become damaged. The body will work very hard to keep you below that limit but it's a losing battle when the air itself is hotter than 104 or when exposed to heat for a long time and you run out of sweat (dehydrated) or the heart becomes exhausted and just flutters rapidly instead of rapid pumping. One sign of heat stroke is the LACK of sweat.

For heat stroke call 911 and get help. Shade and water will help with heat exhaustion but with heat stroke the body is in serious trouble. The Mayo Clinic says,

Heatstroke treatment centers on cooling your body to a normal temperature to prevent or reduce damage to your brain and vital organs. To do this, your doctor may take these steps:

• Immerse you in cold water. Your doctor may put your body in a bath of cold water or ice water to quickly lower your temperature.
• Use evaporation cooling techniques. Some doctors prefer to use evaporation instead of immersion to lower your body temperature. In this technique, cool water is misted on your skin while warm air fanned over your body causes the water to evaporate, cooling the skin.
• Pack you with ice and cooling blankets. Another method is to wrap you in a special cooling blanket and apply ice packs to your groin, neck, back and armpits to lower your temperature.
• Give you medications to stop your shivering. If any treatments to lower your body temperature make you shiver, your doctor may give you a muscle relaxant, such as a benzodiazepine. Shivering increases your body temperature, making treatment less effective.

Medical Myths

“Fire, water and government know nothing of mercy.”
- unknown

I just started a new lecture series on CD titled, Medical Myths, Lies, and Half Truths: What We Think We Know May Be Hurting Us. So far I've enjoyed the first disc. Much better than the prior series on the Dead Sea Scrolls which used a lot of words to say very little.

Amusingly the first topic on the Medical Myths was hiccups which I discussed two days ago in this blog. Dr. Novella dismisses all the folk remidies and says medical research only endorses three drugs and direct neural stimulation or blocking for serious cases of hiccups which won't stop.

His second lecture covers hydration - do we really need to drink 8 cups of water a day? No. An old government guideline recommended 64-80 oz of water a day. But 20% of this will come from the food you eat. This leaves 6 1/2 cups which most people will drink normally.

Does coffee and caffinated sodas count as water? Many say no, but the professor says yes. The caffine will cause more peeing but not enough to cancel out all the water in the beverage. So perhaps it can count as 80% of a cup?

Another tidbit. The higher the elevation, the drier the air. At 6000 ft you exhale twice as much moisture as normal. At 10,000 ft, three times as much. This explains why people who fly experience thirst and why dehyration is serious for hikers and climbers in the mountains.

Bottom Line

For more information see my earlier blog:
http://perpetualpreparedness.blogspot.com/2008/08/how-much-water-is-enough.html

Sports Drinks

“Sports do not build character. They reveal it.”
-John Wooden

Are Sports Drinks helpful for children? Perhaps.

According to a story in the New York Times, the University of Connecticut’s Department of Kinesiology examined youth at summer soccer and football camps. They found that the young athletes, aged 9-16, didn’t drink enough water. While the campers thought they were drinking enough, by the end of the camp between 50 and 75 percent of the 128 kids studied were at least “significantly” dehydrated.

In a Canadian laboratory cycling study, kids voluntarily drank 45% more when offered grape-flavored water instead of plain water. When offered a sports drink (6 percent carbohydrates and electrolytes) they downed 91% more than water alone.

Since sports drinks are not cheap, the Times provides this recipe:

Sports drink recipe from “Nancy Clark’s Sports Nutrition Guidebook”

1/4 cup sugar
1/4 teaspoon salt
1/4 cup orange juice
1/4 cup hot water
2 tablespoons lemon juice
3 1/2 cups cold water

In a quart pitcher, dissolve the sugar and salt in the hot water. Add the remaining ingredients and the cold water. The drink contains about 50 calories and 110 mg of sodium per 8 ounces, approximately the same as for most sports drinks.

Bottom Line

Sugary water, juice, and sports drinks may encourage more drinking and prevent dehydration but they also pack on calories. Sports drinks are intended only for active individuals who are sweating from sports or exercise. If you’re a couch potato or glued to a computer screen, these drinks will only make you fat.

How Much Water is Enough?

“It is better to rise from life as from a banquet -- neither thirsty nor drunken.” - Aristotle

It has become accepted wisdom: "Drink at least eight glasses of water a day!" This is equivalent to 2 to 2.5 quarts or 64-80 onces per day. But a study in 2002 suggests that this is an urban legend: Dartmouth Professor Finds No Scientific Evidence for '8 x 8'. Heinz Valtin, MD, believes that the water obsession can be linked to a recommendation in 1945 by the Food and Nutrition Board of the National Research Council for "1 milliliter of water for each calorie of food." What most people don't realize is that the next sentence in the same recommendation states, "most of this quantity [of water] is contained in prepared foods."

So how much water is enough?
There is an excellent chart on the site http://www.survivaltopics.com/survival/how-long-can-you-survive-without-water/ which shows how long you can survive at different max daily temperatures. With rationing and shade, the chart indicates that 2 quarts will allow you to survive 9 days in temperatures up to 90 F / 32.2 C. Water needs vastly increase as the temperature increases; the same 2 quarts will only keep you alive two days at 120 F / 48.9 C.

Many preparedness sites recommend a great deal of water, the Red Cross and FEMA say one gallon of water per day per person in their “Preparing for Disaster” pdf (on page 8). The site http://www.72hours.org/ says "three gallons per person per day will give you enough to cook and for limited personal hygiene.” The average person in the United States uses about 65 gallons per normal day with toilets, showers, dishwasher, lawn sprinkler, etc. Storing gallons of water is great for home storage but not practical for go kits or backpacks. A gallon of water weighs just over 8 pounds so a three-day supply is about 25 pounds per person.

In emergency situations you should separate water in to three categories:

1. Water safe enough to drink and put into your mouth (i.e. teeth brushing)
2. Water safe to cook with after boiling. This includes washing dishes.
3. Grey water used for body/clothes washing but not safe to consume

Given the weight of water, I personally plan on using found water for items 2 and 3 and applying filters, iodine, boiling, etc. I carry bottled water only for item 1 - drinking. How much? Answers vary on conditions. A minimum is 1 quart per day. Some sites recommend at least 2 quarts (perhaps biased by the 8x8 glasses of water meme). Many, like the National Park Service (NPS), recommend 4 quarts or 1 gallon per day. The NPS offers this warning for hiking in the Grand Canyon, "During the summer months, your fluid/electrolyte loss can exceed two quarts per hour if you hike uphill in direct sunlight during the hottest part of the day. Because the inner canyon air is so dry and hot, sweat evaporates instantly making its loss almost imperceptible."

Recommended Reading...
http://www.scribd.com/doc/2218172/Survival-Water-Storage

Dehydration

“Dig your well before you are thirsty.” - Proverb

The third rule in the Rule of Threes is that you can survive only three days without water. Recall that the rule for shelter was just three hours. Ideally a good shelter will also provide water nearby. If you become weak or ill in the wilderness, you don't want a long or difficult hike to water. It may be necessary to build a few temporary shelters before finding the perfect location. Future posts will cover ways to find water and how to make water traps to catch dew and rain water.

The human body is 75% water which is constantly being depleted by breathing, sweating, menstruation, digestion and urination. Dehydration occurs when you consume/drink less fluid then you emit. Mild dehydration begins when you lose about 2% of your body water. For a 200 pound person this is 3 lbs of water or 1.5 quarts. Fluid loss can be quite rapid with vomiting and diarrhea - two possible symptoms if you're eating strange plants when lost. It is far better to remain hungry than to acquire food poisoning wilderness.

Environment and Water Needs

Surprisingly, very cold environments can be as dry as the driest desert. Cold air cannot hold much moisture; it drys your body with every breath you take. Cold dry air also robs your body of moisture from exposed skin - for example: chapped lips. You may become severely dehydrated without even realizing the danger you are in.

Wind also play a role in dehydration. A dry wind on exposed flesh can suck the water right out of a person. The remains of mummified animals and people are often found in desert regions, their bodies totally dried out.

Symptoms
See http://www.symptomsofdehydration.com/ for a detailed list of symptoms at increasing stages of dehydration. Muscle cramps can occur with 5% loss of body fluids. Dehydration becomes deadly at 10% fluid loss with seizures and loss of consciousness.
If the patient becomes confused or lethargic; if there is persistent, uncontrolled fever, vomiting, or diarrhea; contact a doctor.

Treatment

• Drinking fluids is usually sufficient for mild dehydration. It is better to have frequent, small amounts of fluid (using a teaspoon for an infant or child). Drinking too much fluid at once can bring on vomiting.
• Electrolyte solutions or freezer pops are especially effective. These are available at pharmacies. Consider also clear broths and jello. Sport drinks contain a lot of sugar and can cause or worsen diarrhea. For infants and children, avoid using water as the primary replacement fluid.
• Intravenous fluids and hospitalization may be necessary for moderate to severe dehydration. The doctor will try to identify and then treat the cause of the dehydration.

The Mayo Clinic has recommendations on preventing dehydration.

Bottom Line
As discussed in the last two posts, dehydration increases the risk of Heat Stroke in hot/humid weather. Heat Stroke will kill you faster than dehydration - hence the importance of establishing shelter before water. Don't kill yourself searching for water.

Additional Sources
http://www.medicinenet.com/dehydration/article.htm
http://www.nlm.nih.gov/medlineplus/ency/article/000982.htm
http://www.mayoclinic.com/health/dehydration/DS00561

Hyperthermia (Heat Stroke)

"I will have nought to do with a man who can blow hot and cold with the same breath" - Aesop (620 BC - 560 BC), The Man and the Satyr

Hyperthermia (too much internal body heat) is the opposite of Hypothermia. The early stage is more commonly called Heat Exhaustion (up to 104°F), the advanced, life threatening, stage is Heat Stroke (105°F and above). Heat Stroke can permanently damage the brain and internal organs.

Under normal conditions the body can sweat away and radiate away the heat we produce inside. When the air temperature is higher than your body temperature (98.6 degrees) heat radiation is greatly impacted. You can also be affected by lower air temperature if you're exercising or exerting yourself vigorously and generating heat faster than the body can shed it. Both high humidity and dehydration can reduce the ability to sweat effectively. (Hence the importance of drinking fluids.) Antihistamines and certain types of medication for high blood pressure or depression can increase the risk of over heating. Tea, coffee, soda and alcohol can lead to dehydration and should be avoided when heat illness is likely.

Symptoms of Heat Stroke

• hot, DRY skin that is flushed but NOT sweaty
• a high body temperature
• rapid heart beat (flutter)
• headache or dizziness
• disorientation, agitation or confusion
• hallucinations
• sluggishness or fatigue
• seizure
• loss of consciousness or coma
• death

Note: some individuals can develop symptoms of heat stroke suddenly and rapidly without warning. Symptoms may differ per individual.

The symptoms for Heat Exhaustion are quite similar to Heat Stroke with one vital exception: with Heat Exhaustion the body is sweating profusely. If sweating stops, it's Heat Stroke - seek medical care immediately. If a person with Heat Exhaustion is unable to drink or vomiting back the fluids, call for medical help.

How to treat Heat Stroke
Heat stroke can cause permanent damage or death. Call 911 and apply these first aid measures while waiting for help to arrive:

• Get the person indoors
• Have the person lie down in a cool area with their feet slightly elevated (to prevent shock)
• Remove clothing and gently apply cool water to the skin followed by fanning to stimulate sweating. Do NOT use an alcohol rub.
• Apply ice packs to the groin and armpits
• If the person is able to drink without vomiting or choking, give cool fluids such as water or sports drinks (but not anything caffeinated)

Intravenous fluids are often necessary to compensate for fluid or electrolyte loss. Bed rest is generally advised and body temperature may fluctuate abnormally for weeks after heat stroke.

Bottom Line

Take precautions when exposed to prolonged hot and/or humid conditions.

1. Drink plenty of non-caffeinated, non-alcoholic, fluids
2. Wear loose, lightly-colored clothing
3. Wear a hat or use an umbrella
4. Take frequent breaks to cool down and drink
5. Mist yourself with a water spray or wear a wet hat or wet shirt
6. If sweating heavily you'll want to refresh your electrolytes (such as sodium). Eat a cracker or consume a sports drink
7. Have a shelter you can retreat to for shade