MARINE CORPS BASE CAMP LEJEUNE, N.C. -- On July 8, 1999, Lance Cpl. Giuseppe Leto participated in an eight-mile company hike aboard MCB Camp Lejeune. The company commander marched the unit too quickly with no rest periods in the near-90 degree heat. During the course of the hike, fellow Marines observed Leto vomiting and sweating excessively, and after the hike, he wandered off from the unit, only to be found dead hours later. The resulted cause of death was heat-related.
While the garrison Marine of Marine Corps Base Camp Lejeune and the deployed Marine in Helmand province, Afghanistan, share few daily similarities, one thing is parallel, especially during the current time of year: heat. While the differences in terrain are obvious, the men and women in uniform in both locations are required to take measures to guard against the oppressive heat, or become another statistic.
“Some people think ‘I’m hydrated, so I’m protected,’” said Cmdr. Steve Blivin, physician with the Family and Sports Medicine Department of Naval Hospital Camp Lejeune. “There are many more factors in guarding yourself against heat-related injuries, not just hydrating when you feel like it.”
With the summer season quickly making its presence known aboard MCB Camp Lejeune, the possibility for heat casualties is on the rise, having already struck various service members aboard the base unlucky enough to exercise unprepared.
“No one wants to get the infamous silver bullet (rectal thermometer),” said Blivin. “But further, no one wants to end up dead.”
While rare, death can be the result of a culmination of heat-related effects on the body, and while Marines may not necessarily die if they under-hydrate or do not properly prepare for physical training in the heat, there is a multitude of unpleasant outcomes.
“The spectrum of exertional heat injuries ranges from simple ‘heat cramps’ to life threatening ‘heat stroke,’” said Blivin. “Common sense and an understanding of (these injuries) are essential to their effective identification, prevention, and treatment.”
There are four types of heat-related injuries dictated by two major risk factors. Judged by a marriage of environmental and personal determinants, such as types of clothing worn, working out with others rather than alone and inadequate sleep, all contribute to how one’s body can be effected by the hot weather. The four types of heat-related injuries and their remedies are as follow:
Heat cramps: Painful muscle spasms of the legs, arms and torso caused by under-hydration. Can be treated with salty foods and proper fluids.
Heat syncope: Fainting or collapsing caused by blood pooling in the legs (not properly circulating to the brain). Occurs commonly after running if the runner does not take a cooldown walk/jog. Can be treated with shade, water and laying flat with the legs elevated.
Heat exhaustion: Fatigue, headache, nausea, vomiting, cramps, rapid breathing, rapid heart rate or dizziness may occur. Can be treated by elevating the legs above the heart, properly hydrated, minimizing clothing and resting in a cool place.
Heat stroke: Collapsing or mental status change, such as being uncommonly giddy, agitated or combative, and occurs with little to no signs and is the most serious of the four. Can be treated by maintaining the casualty’s airway, removing him from the heat and sun, removing all clothing while keeping necessary undergarments on and dousing with water until a corpsman or other medical attendant arrives.
In the past five years, there have been a recorded 628 heat-related injuries events aboard MCB Camp Lejeune and Marine Corps Air Station New River alone, with a total of 564 casualties in 2010.
“There are some treatment steps in every instance, but the most important thing in guarding against these injuries is to prevent them beforehand,” said Blivin.
There are a number of safeguards on every installation to help protect against heat-related injuries, such as the heat flag activity system and various water coolers placed along running paths, but the prevention steps ultimately start and end with the individual service member. Taking into consideration such factors as proper sleep, proper clothing, balanced hydration and knowing one’s own physical limitations will help defend against said heat injuries.
“One of the biggest things we try to stress is to watch what you drink,” said Blivin. “Alcohol has no role in sports performance – you don’t need to be drinking it before working out.”
Energy drinks are also something to watch out for. In moderation, caffeine is a performance enhancer, but taking too much will adversely affect the body. Water is also something to be kept in moderation, for while the concept of excessive hydration is thought by some to to be sufficient, it will in fact over-hydrate the body, causing hyponatremia, or water intoxication.
“Drink to your thirst, but definitely no more than three gallons per day, or 12 liters,” said Blivin. “I was involved in an investigation with a heat-related death, and the victim, prior to working out, drank 18 liters of water.”
The welfare of the Marines, sailors and civilians aboard MCB Camp Lejeune is of the utmost importance, and even though the base takes a variety of measures to guard against such things as heat injuries, it is reliant on the individual person to ensure he or she does not fall victim to the rising temperature. Knowing one’s limits, preparing beforehand and properly ensuring the right measures have been taken are all part of keeping the garrison Marine healthy at home so he can be advantageous overseas.