With Missouri’s hot and humid summertime weather merely days away, Maneuver Support Center of Excellence training leaders met April 30 in Lincoln Hall Auditorium to learn more about the prevention, mitigation, recognition and treatment of heat injuries.
According to a U.S. Army Training and Doctrine Command heat report, there were 50 days in 2023 warm enough to be considered a heat risk.
Oscar Powers, Maneuver Support Center of Excellence safety director, said leaders at all levels must control hazards linked to rigorous military training by using the tools available to them.
“There are many different options on Fort Leonard Wood, such as the heat monitoring devices that anyone can check out from training support, the arm immersion prevention method, ice from the Ice House operations and the Directorate of Plans, Training, Mobilization and Security weekly forecast report planning tool,” Powers said.
Brigade surgeon, Lt. Col. Vikki Nunnery, from the 14th Military Police Brigade, explained the prevention, identification and assessment of heat injuries.
Nunnery stressed proper preparation, education and training as the best ways to prevent heat illnesses.
“We want zero cases, but of course we know that is not realistic,” Nunnery said. “Everyone is at risk; everyone needs to know how to minimize the risk.”
She said some of the main ways unit leaders can mitigate risks is by monitoring heat conditions; ensuring service members get enough sleep; being prepared with cooling techniques; modifying uniforms; ensuring water, ice and supplemental snacks and beverages are available; planning alternate training; and marking prior hot-weather injuries and high-risk service members with some sort of identification, like an armband or beads on their boot.
“When it is about 75 degrees or higher, we need to make sure we are planning to evaluate and check Soldiers every hour,” Nunnery said.
People most susceptible to heat injuries, according to Nunnery, are not acclimated to the heat, have had a previous heat injury, are overweight, use alcohol or nicotine, are lacking in quality sleep, have a cold or injury, are above 40 years old, are dehydrated or have skin disorders, such as a rash, scarring or sunburn.
“Make sure Soldiers are sipping frequently throughout the day, not guzzling, but sipping,” Nunnery said. “Also, watch out for highly motivated service members. They are ones that will ignore signs they are overheating because they are pushing themselves to be the best.”
Nunnery said medications, such as antihistamines, decongestants, diuretics, beta blockers, calcium channel blockers and psychiatric mediations, can interfere with heat regulation.
The Army has an acronym — HEAT — to help when trying to prevent heat injuries, Nunnery noted:
• High heat category, especially on several sequential days (measure the wet bulb globe temperature, or WBGT, index when the ambient temperature is higher than 75 degrees Fahrenheit).
• Exertional level of training, especially on several sequential days (the past 72 hours must be considered).
• Acclimatization — most individuals’ physiological responses to heat stress improve within 10 to 14 days of exposure to heat and regular strenuous exercise.
• Time (length of heat exposure and recovery time).
Nunnery also explained some of the differences between heat exhaustion and heat stroke and provided some of the symptoms to look for.
Heat exhaustion symptoms include excessive sweating with pale, moist, cool skin; headache or dizziness; cramps; loss of appetite; and nausea (with or without vomiting).
First aid for heat exhaustion includes loosening the uniform and removing head gear; placing the individual in a shady area; and having them drink no more than 1 to 1.5 quarts of water per hour. The individual should be constantly monitored and evacuated for medical treatment if symptoms worsen or do not improve after rest and rehydration.
Heat stroke is caused by exposure to high temperatures and a rise in body temperature, with a failure in the body’s cooling mechanisms, Nunnery said.
Symptoms include confusion, weakness, dizziness, headache, seizures, nausea, stomach cramps or pain, red or hot skin and rapid and weak respiration and pulse. Unconsciousness and collapse may occur suddenly.
First aid for heat stroke includes removing the individual’s outer clothing and using ice sheets to attempt to rapidly cool the individual. Cadre should report a suspected heat stroke victim to range control and evacuate them immediately to the nearest emergency room via ambulance, while maintaining cooling techniques and constant monitoring of their mental status — ask questions, such as their name, where they are or what year it is — level of consciousness, breathing and pulse.
Master Sgt. Shane Hill, from DPTMS’s ICE House operations in Bldg. 821, said the facility produces about 275 bags of ice each day.
“These are 20-pound bags. The ice is potable, so you can use it in your water sources,” Hill said. “We also have 12- to 14-pound blocks that will keep your water buffalo cool by melting slowly.”
Speaking about his unit’s heat injury prevention, Lt. Col. Ari Fisher, 2nd Battalion, 10th Infantry Regiment commander, said his unit focuses on treating Soldiers like athletes.
“The three domains we focus on are nutrition, physical and mental,” Fisher said.
In the first phase of basic combat training, his unit invites dieticians to teach trainees about what they should be eating.
For physical, they make sure to acclimate trainees to Missouri’s weather by taking them out of the air conditioning and conducting some classes outdoors.
“They are not being physically active, but just sitting outside helps their bodies acclimate,” Fisher said.
For mental, he said they bring their battalion aid stations to the training areas and ranges with the trainees. And when a trainee needs to go to sick call, they stay at the BAS instead of being shuttled back to an air-conditioned facility for care.
“It is good training and mentally prepares the trainees to not get to go back inside. They have to build resilience for what they are going through,” Fisher said.
In addition to the information provided at the forum, the event concluded with a “Soldier-down” demonstration on MSCoE Plaza by Soldiers from the 3rd Chemical Brigade and 1st Engineer Brigade. In the demonstration, a Soldier collapsed, and two cadre members responded. After assessing the potential for a heat stroke, cadre removed the Soldiers outer clothing and applied ice sheets in anticipation of medical evacuation to the nearest emergency room.
More information on preventing heat injuries is available on the Defense Centers for Public Health website.
