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Management of heat emergencies in the military setting

05 September 2011
Volume 1 · Issue 1

Abstract

The Australian Defence Force (ADF) has long battled in hot and arduous environments. From the trenches of Tobruk during World War II and the thick jungle of Vietnam through to current theatres of war such as the rugged mountains of Afghanistan. Australian soldiers are exposed to the constant threat of heat illness, and while avoidable in training settings, it cannot be prevented in some combat situations. Prevention however, is a key factor in the exclusion of heat illness cases, a matter that the ADF has worked hard to highlight through mandatory annual training. It is for this reason that military heat casualty rates remain low in the ADF. This article provides some useful assessment tools which help to differentiate between the different levels of heat illness; and furthermore, underlines the critical stages of heat illness and includes literature on the aetiology, pathophysiology, clinical manifestations and prehospital care management of heat illness.

Australians are well adjusted to the harsh sun, and most stay indoors or under shade on excessively hot days. However, there is a small portion of the population who are required to work through the heat of the day in order to complete time sensitive missions or training, and for these few, heat illness is a real risk. Heat illness is a complex illness and has many different stages of deterioration, all requiring different treatment approaches.

This article will outline the different stages of heat illness, listing the appropriate clinical manifestations and will also provide treatment options based on current evidence-based practice. The health professional will gain an understanding of heat illness aetiology, pathophysiology and prehospital management, including associated drug therapies where applicable.

Heat-related illness represents a continuum of disorders from minor syndromes such as heat cramps, heat syncope, and heat exhaustion to the severely life-threatening disorder known as heat stroke. Heat illness is a major cause of wilderness-related morbidity and mortality, and is common in the military combat setting (Lugo-Amador et al, 2004).

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