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FIrefighter Pre-Hydration – Fight Fire like a Marathon Runner

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Has anybody else noticed that it’s sweltering outside? There’s no other way to describe the oppressive heat we’ve been facing without trotting out the word “sweltering.” The word itself is almost fun to say. I recommend that you work it into as many conversations as you are able these days while you toil outside in the intense heat. It won’t keep you any cooler, but at least you’ll be adding to the vocabularies of the other sweaty people working around you. It sure beats asking them if it’s “Hot Enough” for ‘em. That gets annoying.

In the last few weeks here in Southern Wisconsin we’ve been having some terrible fires requiring response from multiple area departments. Some of them have been heat related and some of them have just come at a bad time, but all of them have had one common denominator. They’ve all been dangerously hot. Not just the fires themselves, but the oppressive, dangerous, and potentially deadly heat on the fire ground due to the weather conditions has contributed to multiple firefighter injuries. Thankfully, most of the injuries have been minor and heat-related but some of them have been worse. I don’t know if the heat contributed to all of the injuries suffered by those brave firefighters, but it certainly couldn’t have helped.

In times like these, all firefighters need to remember the fact that active firefighting activities are nearly the same as competitive sporting events. Firefighters working on active fire grounds have the same or higher demands put upon their bodies as do athletes on the playing field. It is of extreme importance to remember that fact and take appropriate action to keep yourself and your brothers and sisters safe. Extreme weather is a great equalizer. It affects all of us no matter our station in life. Everyone on the scene has the responsibility to recognize the risk they’re taking by exerting themselves outside in these conditions and take appropriate steps to protect themselves. Nobody wants to see their fellow firefighters fall ill and even less than nobody wants to be the firefighter who goes down themselves.

By design, firefighting personal protective equipment provides an effective barrier to thermal energy. This becomes a problem in hot weather because it doesn’t allow for the shedding of excess body heat and raises the core temperature of the wearer quite sharply. While after years of promoting rehab, even the staunchest believer in their own invincibility can usually be coerced or threatened enough to go to rehab after heavy work on the fire ground, rehab is of even more importance during hot weather because it allows the firefighter to shed his or her PPE and allow that body heat to escape. However, it is important to remember in times of extreme hot weather like we’re facing now that rehab after working is not enough to keep you safe from heat-related injuries and illness. It’s simply too hot for normal people to work effectively without prior planning and preparation. Athletes spend days preparing themselves before competing in physical events by resting adequately, storing up calories and carbohydrates, and pre-hydrating. We should as well.

While it is important to keep yourself nourished with healthy food, I don’t recommend that firefighters load up on calories and carbohydrates before every shift like runners before a race. I do recommend pre-hydration. To pre-hydrate is to drink water before you need it and it is important to realize that one should drink water before they are thirsty to maintain normal hydration. While the adequate daily intake of water for healthy adults varies due to temperature conditions, levels of activity, and other factors, the Institute of Medicine (IOM) recommends that adult males take in 3 liters of water per day and adult females take in 2.2 liters. The water doesn’t need to come only from drinking water, and can come from water stored in food we eat. The IOM says that if a human is producing around 1.5 liters of pale yellow to clear urine per day and is urinating at least once every 3-4 hours they are at close to normal hydration levels. However, many factors affect our hydration and it is easy for a person to become dehydrated without realizing it. Dehydration leads to fatigue, headaches, tachycardia, low blood pressure, and other nastier symptoms that greatly affect firefighting performance and safety. It has been stated that it is not uncommon for firefighters to lose two liters of water through sweat while working on the fire ground in full PPE. If you start to sweat that much when you are already dehydrated, you will not be effective for very long.

Pre-hydration is all about keeping your water tank full before you respond and is as simple as drinking water throughout the day and maintaining your hydration levels. Since fighting a fire in full gear can be compared to running a marathon, we may want to emulate their guidelines. Marathon runners are taught to drink 20 to 32 ounces of water 2 to 3 hours before running and then to drink 8 to 10 ounces of water every 20-30 minutes before they run. While actually running, they are advised to drink 8-10 ounces of water every 20-30 minutes as well. It is not advisable to intake a large amount of water before engaging in strenuous activity because it takes time for the water to move from the stomach to the large intestine and be absorbed into the blood stream. Too much water in the stomach at once can lead to nausea and vomiting during periods of strenuous activity. Sports drinks with electrolytes like Gatorade, Power-ade, and others like them should be consumed occasionally to replace any electrolytes lost through sweating however there is no need to pre-load yourself with them as the body does not store more electrolytes than it needs and excretes any excess quite rapidly. Replacing lost electrolytes through food is of great value, and most can be replenished by eating fruit like a banana. In addition, avoid soda pop, carbonated beverages, or beverages that contain high amounts of caffeine and/or sugar as these drinks can actually contribute to dehydration by acting as diuretics.

It is easy to encourage pre-hydration among your crews. People need to drink water before they feel thirsty, and should continuously drink small amounts of water through the day. Place water in conspicuous areas throughout the station and the living quarters. Water that is out of sight is out of mind and can be forgotten. By placing water right in the line of sight of everyone, they are reminded of the need to have a glass or two. You can make the drink more attractive by adding commercial flavorings like lemonade, crystal light, or Mio mixes that add taste without adding too much sugar. Another trick is to place the bottles of water in the engine next to every staffed seat and encourage every firefighter to drink a bottle during any response to a working incident.

By pre-hydrating, you will ensure that you and your fellow firefighters hit the fire ground with full water tanks and can perform at peak levels in this oppressive heat. Keep yourself hydrated and stay safe out there. We’ve sickened and injured too many firefighters lately and I don’t want it to keep up. Turn the tide and drink up. You’re worth it.

5 tips for beating the summer heat – An EMS and Medical Stock PSA

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Hey EMS agencies: Looking to help spread the word about staying safe in the heat? Cut and paste this stock PSA to your own site or simply link to this page from your agency's social media page. Here are 5 tips on how to stay cool and healthy that not everyone has heard before.

You probably don’t need us to tell you this, but it’s really hot out there. It’s blazing hot, dangerously hot even. The heat our area is experiencing is affecting everyone, whether we feel it directly or not. While you probably know the basics on how to stay cool and healthy during heat waves such as this one, there are a few things that you may not have thought of yet that can help make this epic heat wave just a little bit more tolerable. Here’s what you need to know:

  1. You’re losing a lot more water than you realize – “Insensible” water loss, or water we lose through breathing, sweating, and keeping our skin, eyes, and mouth from drying out is markedly increased in hot temperatures. Humans lose a shockingly high amount of water this way during a heat wave. You have to proactively replace this loss of water and the fact is that most of us don’t. While the old adage that a person should drink “at least 8 glasses” of water a day may not hold up to scientific study, the Institute of Medicine still recommends that adults consume at least 91 ounces of water on any given day. It doesn’t all have to come from drinking it in, as some of this fluid comes from the foods we eat, and some fruits and vegetables are very high in water content and can hydrate you almost as well as a glass of water can. Drink more water and avoid soda pop and alcoholic beverages, as these can actually contribute to dehydration. The best way to measure hydration level is to monitor your potty breaks. You should be going to the bathroom for a “number one” at least four times per day and the color of the urine should be clear to a faint yellow. When your body is dehydrated it concentrates your urine. The darker your urine is, the more dehydrated you are. Keep it clear.
  1. Watch your kids too – Kids lose a lot of water in the summertime. Even short bursts of outdoor play can burn a lot of water off of a little one. Push fluids and encourage your kids to drink water, tea, and lemonade. Creative ways to get more water in your kids include supplying popsicles and Jell-O, which are both mostly water with a little flair. You can also have fresh strawberries, celery stalks, and watermelon which both add fruits and veggies to their diets while being an excellent source of quality hydration.
  1. Watch for dehydration and heat-related illness – In this heat you can become dehydrated quickly without realizing it. Dehydration is a serious medical condition that can sneak up on a person and make them sick before they know it’s happening. Mild cases of dehydration show symptoms after about 2% of one’s body water is lost. These symptoms can be a moderate to severe headache (like a hangover), dizziness or fainting when standing up, loss of appetite, dry skin, and constipation. You can also feel fatigued and generally ill. In more serious cases, you may experience a rapid heart rate and flushing of the skin. If you notice any of these symptoms, drink water and cool down. You’ll be amazed at how much better you’ll feel. Watch for confusion, weakness, and an absence of sweating because these could be signs of heat exhaustion or heat stroke, which are serious medical conditions. If you believe that you or someone else is experiencing these symptoms, move the patient to cooler temperatures and encourage them to drink cool fluids to replace what they’ve lost and bring down their body temperature. In serious cases, seek medical attention or call 911.
  1. Wear shoes – Invariably, when the sun blazes down this hard, the emergency rooms start seeing burns to people’s feet caused by walking barefoot on hot concrete. In fact, one ER in the state just had a case of significant burns a patient suffered from walking on hot sand at the beach. When the sun is this strong, resist the urge to go barefoot when you’re walking outside. Burns on the feet are more than just painful, they take a long time to heal and make walking anywhere less than pleasant. Be careful.
  1. Be smart about sunscreen – Most instruction labels on sun-protection products advise that you should apply before you go into the sun, and allow some time for the product to absorb into the skin and start protecting it. Read the label on your favorite sunscreen and follow the directions for the first application as well as the schedule for reapplying it. We’ve all been burned in the past but we can prevent it from happening again if we’re careful. You also should put on a hat and find some shade from time to time. A cherry-red hue isn’t in style this season..

Have fun this summer, but stay cool and be careful. Watch each other and make sure people are taking the heat seriously. It is dangerously hot out there. If you need us, we're here 24 hours per day to take care of any emergency needs. We’ll be here, but we hope that you can avoid us altogether by keeping yourself and your family cool and comfortable. Stay safe

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