During the summer months there is a heightened awareness of the importance of proper hydration. Unfortunately as the weather gets cooler people are not as cognizant of the significance of proper hydration. Event organizers and medical personnel need to be aware that it is still important to make sure the participants are properly hydrated even during the cooler months. In the summer months everyone is aware of the devastating “one, two punch” of dehydration and extreme heat which if unchecked can rapidly deteriorate into heat exhaustion or worse, heat stroke. The profound and rapid deterioration noticed in a person suffering from dehydration in the summer months are not as common in the cooler months. Make no mistake, dehydration is still a major concern, but the symptoms are harder to spot. Instead of a rapid decline, a more gradual regression often presents.

As in the summer months dehydration among older adults and children can exacerbate existing health issues. As people add layers of clothing in an attempt to stay warm and move around they sweat more profusely than previously thought and lose fluid. Chris Solomon, author of the article“How winter conspires to dehydrate you” states, “skiers who are wrapped in layers often have no idea just how much they’re sweating. A normally-attired skier exercising moderately to heavily at 32 degrees can lose 4 pounds of sweat in just one hour”

Another culprit is the weather which removes moisture from your body by way of the skin, nose, and throat. This is why complaints of both dry skin and mucus membranes increase during the winter months as the wind and sun cause the moisture to evaporate.

Concerns for EMS

If we take a moment and recall from our training the pathology of perspiring. The act of the body “perspiring” pulls liquid from the bloodstream to the surface of the skin. Once on the surface it evaporates causing a cooling of the body. Perspiring without replacing the fluid causes the blood volume to drop and the heart to work harder to maintain adequate circulation.

Hypothermia caused by the evaporation of the perspiration is a cause of concern to the medical provider. An early sign of hypothermia is shivering which is caused by the body rerouting blood from the extremities to the core. This coupled with the decline of the volume of water available to the body can cause diminished circulation resulting in premature fatigue and lapses in judgment. These two factors can contribute to cause accidents resulting in devastating life altering injuries.

What to do

The current guideline for proper hydration in summer time heat is that a person should consume enough fluids to urinate every 45 minutes to an hour, or a minimum of 2 liters of fluid a day. This is still a good rule of thumb even in the cooler months. Your medical response should not over look the need for proper amounts of water for participants just because it may not be scorching hot. If you find your service protecting a cold weather event, you should use to passive interview method, described in the book “Special Events Medical Services” to gauge a participant’s orientation and general cognitive comprehension. If there is a cause for concern, then proceed to the next step in your jurisdiction medical treatment protocols.

Prior to the event take time and familiarize yourself with the signs and symptoms of hypothermia, dehydration and the treatment modalities for both. This is especially important if you don’t deal with cold weather emergencies often. Make sure that you are prepared for the weather’s effects by reading your protocols – even if you feel you know what to expect.

Ensure that you have plenty of water and blankets on hand. Make sure every jump bag has at
least 1 to 2 emergency blankets and have a practiced plan and designated location for rewarming.

By taking simple steps you can reduce the need for medical assistance dramatically. It’s always
better to be overly prepared for weather related health issues than not.

related links

http://www.backcountry.com/store/newsletter/a42/Cold-Sweat-Winter-Dehydration.html