Ch. 23 - Hydration Flashcards
True or False. Hydration, by itself prevents heat exhaustion, heat stroke, or altitude sickness?
False. It is a myth that hydration alone can prevent heat and altitude related illnesses. The only condition hydration can prevent/treat is dehydration. Hydration can help us tolerate difficult environmental conditions like heat, cold, and altitude, but it does not fix these issues.
True or False. When we are in a cold environment, we lose water in the process of moistening the cold/dry air we are breathing?
True. Although we may lose less water in the form of sweat in cold environments, there are cases where adaptation to the cold results in more fluid consumption.
How do we assess dehydration during the patient exam?
The L in SAMPLE stands for Last Ins and Outs. We ask about fluid intake over the last few days, because dehydration can be cumulative.
The signs and symptoms are similar to those indicating shock, altitude sickness, hypothermia, fatigue, and heat exhaustion. ALWAYS suspect dehydration for a patient in the backcountry.
What are the general symptoms of a Negative Water Balance?
Fatigue, heat oppression, thirst, irritability, dizziness, dark smelly urine, and headache.
What are the signs and symptoms associated with a seriously dehydrated patient?
Rapid pulse; pale, cool, clammy, skin; pale mucus membranes; weakness and nausea.
Mental deterioration may occur. Signs include loss of balance or changes in mental awareness.
Tenting is also a bad sign. If you pinch the skin and it does not snap back into place it is serious.
What will we experience with a 2% fluid deficit?
Mental deterioration, decreased group cooperation, vague discomfort, lack of energy and appetite, flushed skin, impatience, sleepiness, increased pulse rate, and nausea.
What will we experience with a 12% fluid deficit?
Inability to swallow, swollen tongue, sunken eyes, decreased neurological function Dizziness, tingling in the limbs, lack of salivation, and slurred speech.
What will we experience with fluid deficits greater than 15% ?
Potentially lethal! Delirium, Vision disturbances, and shriveled skin.
What considerations exist when treating a Mildly Dehydrated patient?
Regular water is the best option. Electrolyte replacement drinks may help, but they often contain sugar, which increases the time it takes for fluid to be absorbed by the stomach.
Coffee, Tea, and Alcohol should be avoided.
Cool water is absorbed faster and is easier to drink quickly.
How should we treat a severely dehydrated patient?
Once someone reaches severe dehydration they will have an electrolyte imbalance and cannot be rehydrated in the field. Evacuate and get them and IV>
What is HYPONATREMIA? What are signs and symptoms?
If we drink too much water we reach a point where our hydration level is good, but the ratio of sodium in the blood is diluted. Hyponatremia is water intoxication as a result of relatively low blood-sodium levels.
Patient may appear to have heat exhaustion: headache, weakness, fatigue, lightheadedness, muscle cramps, nausea, with or without vomiting, sweaty skin, normal core temp, and normal to slightly elevated pulse and breathing rates.
To recognize this, make sure your history is thorough. Be suspicious if the patient has had high fluid intake - several liters in the last few hours.
How might we treat Hyponatremia?
If there is suspected Hyponatremia and altered mental status, commence evacuation.
If patient has mild to moderate symptoms but normal mental status, the treat in the field. Have them rest in the shade, with little to no fluid intake and a gradual intake of salty foods while the kidneys re-establish sodium balance in the blood. Brisk urine production usually indicates things are moving in a positive direction.
Oral electrolyte replacements usually are high in water and low in sodium, rendering them UNHELPFUL.
According to the NOLS guidance, how many liters of water should hikers drink per day in the summer?
3-4 liters of fluid per day of summer hiking is the reference point. However, know thyself, drink when you are thirsty!
