[Ansteorra-chirurgeon] FW: [SCA-Chirurgeon] Digest Number 759

[Richard Threlkeld]

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This was posted to the SCA-Chirurgeon list, but it is very appropriate
for us. The only thing I would have mentioned more prominently is
that the secret for preventing all these is hydration. The fighters and
non-fighters (my most severe heat problem was with a non-fighter)
need to drink every time someone offers them water. We need to
make sure they are constantly offered water.

In the Texas/Oklahoma heat fighters should be drinking 1-1.5 liters
of water each hour. Tell them if they don't have to pee every hour
or two they are not drinking enough (our secret is on a truly hot
day when you are exercising you cannot drink enough to need
to pee - it all goes into sweat).

When you are drinking that much water, you can wash out some
of the necessary electrolytes. So use diluted Gatorade *some*
of the time or eat pickles or other items that can restore some
electrolytes.

Prevention is much, much better than treatment.

In service,
Caelin on Andrede
Kingdom Chirurgeon, Ansteorra


-----Original Message-----
From: SilverLoon2001 at aol.com [mailto:SilverLoon2001 at aol.com]
Sent: Thursday, April 04, 2002 2:54 PM
To: SCA-Chirurgeon at yahoogroups.com
Subject: Re: [SCA-Chirurgeon] Digest Number 759


The following was posted to Garb for Dummies.  I thought it might prove
useful here.  Any info that should be changed/corrected?

Gennevote.
+++++
-----Original Message-----
From: countessdulcia [mailto:sweetsheep at earthlink.com]
Sent: Tuesday, April 02, 2002 11:25 AM
To: trimaris-temp at yahoogroups.com
Subject: [trimaris-temp] As the weather warms up.... Just a reminder
for everyone.


Some of you may remember that last year at TMT I suffered a bout of
heat stroke.  I have since learned that I will never be the same
again.  For years here in Trimaris I wore full Elizabethans in the
heat of summer, and although I was hot (like everyone else), I
suffered no adverse affects.  I remember one TMT when I wore a full,
high necked, long sleeved heavy linen chemise, fully boned corset,
three layers of petticoats, linen under and overskirts, and a (blue,
of course!) plaid, long sleeved Eliz. bodice, all topped with a
proper linen coif...  My friends took great amusement from touching
me because I was sweating so much the bodice was wet to the touch.
And I was okay.  =)  Two weekends ago, I went to the Largo Ren Fair
with friends and wore a moderate weight Elizabethan (not one of my
winter ones) on an 80 degree day, and after a few hours became dizzy,
disoriented, nauseous, and ill.  (For those I saw earlier in the day,
I spent the remainder of the day in my gauze shift, corset and one
petticoat!  What a harlot!!!!)

So what's the point of all this?  We are rapidly heading into the
time of year when heat syncope, heat exhaustion and heat stroke are
realities of life in the SCA.  We should constantly remind ourselves
of the symptoms of these potentially life threatening illnesses.  We
also need to remind ourselves and each other, that once you suffer
from heat stroke, you are FAR FAR FAR more susceptible to it in the
future.  You may not be able to do the things that you used to do at
summer events (and BOY am I irritated about it!!!!  No Bethans and
probably not much rapier in the summers!) but in the long run, it's
better to be healthy and play (or wear your fancy garb) another day.


The brain is one of the hardest hit organs in any heat problem, so
keep three things in mind.

      First, it has been proven over and over that even professional,
experienced athletes have problems recognizing heat warning signs in
themselves. Watch out for the other guy. If you think you may be
seeing a problem, warn the other guy. And if someone warns you, take
it seriously.

      Second, two groups are at special risk for not recognizing
their own problems with heat: Children (who don't have the experience
to know what to look for and are having too much fun to care), and
Fighters (who have the adrenalin going, and are having too much fun
to care). They especially need others to look out for them. (I would
add a third group to that - garb-a-holics.  'Nuff said...)

      Third, because the brain is hard hit, mental confusion is
common. Mixed with adrenaline the result may be severe irritation and
belligerence. This makes a fighter unsafe, but usually means he is in
no mood to be told as much. If a tactful warning to a fighter is met
with anger, don't push it. A person is often able to take advice from
friends better than strangers, so quietly ask his comrades-in-arms to
keep an eye out for him. They are familiar with him, and so in better
position to judge a significant change in condition or mood, and have
a better chance of reasoning with him if something is really wrong.
If you are still worried, notify the marshal.

      All heat disorders are a result of varying degrees of loss of
fluids and salt (by sweat), and accumulation of excessive heat
(despite sweat). Heat disorders are a spectrum, ranging from mildly
annoying to life-threatening. On paper, they are arbitrarily divided
into three categories, but in real life, the division is not so neat.
Symptoms overlap, and one slides into the next if left untreated. It
is also rare for a person to present all the classic symptoms.



1) HEAT SYNCOPE (fainting). Unconsciousness due to heat with little
loss of fluid or salt (Heat expands blood vessels in the arms and
legs, resulting in not enough blood to the head).

Symptoms: light-headedness, muscle-weakness. If untreated,
unconsciousness.
Examination: pale skin, sweating, rapid pulse, hypotension.
Treatment: The victim usually recovers rapidly (a few minutes),
especially if treated before fainting. Remove to a cool, shaded
place. Have lie with legs up (to got blood to the head). Loosen armor
or hot clothes. Wet cloth or cool (not icy) water over head, neck,
and wherever also patient wants it. Fluids need only be drunk to cool
down.



2) HEAT EXHAUSTION. Due to heat plus salt and water loss.

Symptoms: mental (headache, irritability, confusion, visual
disturbances, drowsiness), loss of appetite, nausea, vomiting.
Examination: pale skin, excessive sweating, rapid pulse, hypotension,
mild fever.
Treatment: Takes a few hours of rest AFTER fluid volume is replaced.
As for heat syncope, remove to a cool place, raise legs, etc. Fluids
and salt MUST also be replaced. This means an IV at a hospital if the
patient is too irritable to drink, or can't because of vomiting. If
the victim is able to drink, he should be given lots of fluid and
salt (like Gatorade).



3) HEAT STROKE. This is a life threatening medical EMERGENCY! It is
the endstage of too much heat and severe salt and fluid loss.
Essentially, the body is overwhelmed.

Symptoms: headaches, disorientation, confusion, dizziness, and
numbness. If ignored, may end up in delirium, unconsciousness,
convulsions, coma, or DEATH.
Examination.- NO SWEATING -- this is the major danger sign. Also,
flushed skin, rapid pulse and respiration, high fever.
Treatment. Start IMMEDIATELY, and call a chirurgeon fast. The body
core temperature is out of control , and the victim is literally
frying his brains out. Untreated, this is 100% fatal. Even with
prompt, correct treatment, 1/3 may die And 1/3 may suffer permanent
brain damage.

      The object of treatment is to cool the Patient to normal body
temperature as fast as possible. Get into the shade and out of hot
armor and clothing. Douse with, COLD water, alcohol swabs, and ice.
Massage extremities. Monitor temperature (if victim is unconscious,
NOT orally) so as not to overcool the patient. If conscious, give
fluids and salt. Watch for shock. Be prepared to give artificial
respiration or CPR.



MISCELLANEOUS COMMENTS:

Call a chirurgeon for all heat disorders.
Never give fluids (by mouth) to an unconscious person.
Don't put food (salt tablets) or breakables (thermometers) in an
unconscious person's mouth.
Be wary of stripping an unconscious fighter of armor -- could you
really be dealing with a head injury? If even the smallest doubt and
the person is still breathing, wait for a chirurgeon. Cooling water
can still be poured over the body (NOT the head) through chinks in
the armour.
Myth has it that ice should never be used on a victim of a heat
disorder. If the victim is still conscious and/or still sweating,
avoid it for your own health. I know I would be tempted to punch out
someone I don't know who put ice down my tunic. Besides, cool to
lukewarm water is fine if the body can still sweat. HEAT STROKE is
another matter. Ice is encouraged, even up under the armpits, since
the alternative may be death or permanent brain damage. Besides, ice
usually feels good to a heat stroke victim.
Replacing salt and fluids,
Is best done as a preventative measure. Give your body a chance to
regulate itself. Start over-salting food a week before the War, and
indulge your salty junk-food cravings.
Drink lots of fluids.
Fluids does not mean alcohol abuse. A few beers can replace
electrolytes, but hard liquor dehydrates. If you intend to
overindulge, especially the night before heavy fighting, drink a
couple of quarts of water before passing out. This has the added
advantage of lessening a hangover.
NO SALT TABLETS! Consider salt tablets a prescription drug, to be
given out only by chirurgeons. This is because a salt tablet taken 5
minutes before fighting is of no use (except to upset your stomach)
unless it is immediately chased by a quart of water - which means
fighting on a full bladder. Besides, if you don't mind drinking a
full quart of water before a battle, why burden your body with the
chore of having to dissolve a salt tablet? Far better to...
Drink (Gatorade, or a similar- balanced salt drink. In these
preparations, the salts are already dissolved, and include potassium
along with sodium. All these solutions should be diluted in half--
which is both better for you and cheaper. Besides, if you don't like
the taste, you can dilute it with something you do like-- OJ,
lemonade, Tang, Kool-aid.
      This brings us to the current myth - that Gatorade is bad for
you. The basis of this rumor is that Gatorade contains some sugar in
order to make it vaguely palatable. Sugar may be bad for your teeth,
but is as easily digested by the body as salt, and an active fighter
can probably use a few extra calories. If you are into an all organic
diet, you may decide not to drink Gatorade. Just remember that most
other balanced salt drinks cost more and taste atrocious. (Trust me -
I was given one last year at TMT.  Old, fermented sweat socks found
in the bottom of the fighter's bag would have tasted better.  By
comparison, the Gatorade I was given to drink tasted GOOD.)

Okay - lecture over. ;)




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