RETIRED CHIEF WARRANT OFFICER 4 DENSMORE BARTLY
Department of Commerce
Washington, D.C.

Foot marches and land navigation training involve a great deal of walking while wearing a rucksack and other required equipment. These types of physical activities induce significant sweating and fatigue, which can lead to heat illnesses. It’s important that leaders are aware of common heat illnesses associated with these activities, as well as preventive measures to minimize the risk.

Preventive planning

Soldiers and leaders must take a proactive approach to reduce or eliminate the occurrence of heat illnesses during road marches and land navigation training. When applying risk management to these activities, remember the five P’s: proper planning prevents poor performance. Safety must be considered from the beginning to the end of the plan. The following control measures will help ensure a safe training event:

• Identify and assess the risks for heat illness before the training event or mission. Leaders must ensure the decision to accept any identified risk is made at the appropriate level.
• Identify prior heat casualties and monitor them closely. According to Harvard Medical School, suffering from heatstroke in the past increases the risk of heatstroke in the future.
• Adhere to prescribed work/rest cycles for high-heat categories, as outlined in the Fluid Replacement and Work/Rest Guide, which can be found at https://www.moore.army.mil/MCoE/MCoE-Safety. Plan rest breaks and take them in the shade when possible.
• Monitor and enforce hydration standards outlined in the Continuous Work Duration and Fluid Replacement Guide. Ensure Soldiers carry full canteens for water replacement and place well-marked water stations throughout the training area. Leaders can monitor individual hydration by using the Riley (water) card or Ogden Cord method.
• Use adequate sun protection such as sunscreen rated at SPF 15 or higher. Ensure the uniform is worn properly to limit exposed skin. Also make sure the uniform is properly fitted, to include footwear.
• Ensure Soldiers are well rested and fed before the training event.
• Ensure first aid kits and/or combat lifesaver bags are equipped with moleskin and other remedies needed to treat foot injuries.
• Plan the placement of leaders to observe and react to any illness.

Active prevention

Certain control measures must be fully developed to ensure they play an active role in heat-illness prevention. Establishing a sufficient quantity of water points in designated locations is an important step. Soldiers must be able to refill their canteens or CamelBaks often enough to meet the fluid intake guidance in the Fluid Replacement Guide. Equally critical is briefing Soldiers on the location of these points.

Early identification of heat illnesses allows medical personnel to render first aid that can, in many instances, reduce the severity. In addition to first aid kits, having iced sheets readily available is a key measure. In the event of heat illness onset, wet sheets kept in coolers of ice can provide immediate relief and treatment. Leaders and cadre of training events must know the location of these coolers and ensure there is a plan to get them where they are needed quickly.

Training, planning and implementing risk management measures greatly reduces the likelihood of heat illnesses. It’s important, however, to remember heat illnesses can develop suddenly and have fatal results if treatment is not immediate and effective. Quickly identifying a heat illness or recognizing warning signs of a Soldier about to succumb to one are key to keeping Soldiers safe while engaging in foot marches and land navigation exercises.

One final tool that can play a critical role in heat-illness prevention is the buddy system. Based on the type of training, environmental conditions and terrain, leaders should seriously consider assigning buddy teams as a heat-illness control measure. Doing so may keep these preventable illnesses from affecting your formations.

FYI

Heat illnesses can occur in both warm- and cold-weather environments. The following are some common heat-related illnesses that can affect Soldiers during foot marches and land navigation training.

• Sunburn occurs when skin is overexposed to ultraviolet radiation. This overexposure causes the top layers of the skin to release chemicals that cause the blood vessels to expand and leak fluids, causing inflammation, pain and redness.
• Heat rash is an irritation of the skin caused by excessive sweating during hot and humid weather. Heat rash appears as clusters of red pimples or blisters on the skin that occur in areas such as the neck, upper chest, groin, under the breasts and in elbow creases.
• Heat cramps are muscular pains and spasms caused by a combination of heavy exertion and exposure to heat. They usually involve cramping in the abdomen, arms and calves.
• Heat exhaustion is a condition caused by fluid loss, which, in turn, causes decreased blood flow to vital organs. This reduced blood flow can lead to an induced form of shock.
• Heatstroke is a condition caused by the body overheating, usually as a result of prolonged exposure to or physical exertion in high temperatures. This most serious form of heat illness, heatstroke can occur if the body temperature rises to 104 degrees or higher. The condition is most common in the summer months. Heatstroke requires emergency treatment. Untreated heatstroke can quickly damage the brain, heart, kidneys and muscles. The damage worsens the longer treatment is delayed, increasing the risk of serious complications or death.
• Dehydration is a condition caused when the body loses more fluid than it takes in. Fluid loss may be due to frequent urination, reduced food and/or water intake, sweating, diarrhea or vomiting.
• Overhydration (hyponatremia) occurs when someone drinks an excessive amount of water and/or loses too much salt from the body in a short time. Drinking an excessive amount of water overwhelms the kidneys and they are unable to process and eliminate the water fast enough, so the amount of sodium in the blood drops too low.