Dehydration

Here it is, hot on the heels of Part 1 (Food and hygiene-related illness), the much sought after, Part 2.

Dehydration.
Dehydration occurs when body fluids we loose exceeds the amount that we take in. We lose water every day just by breathing, an important task I think you'll agree, the breath we exhale has water vapour in it, breath out hard in the cold... that's a mini cloud in front of your face. There is also loads of the stuff in our sweat, urine, and stool, that's poop to you and me. Along with the water, small amounts of salts and sugars are also lost. When we lose too much water, our bodies may become out of balance or dehydrated. Severe dehydration can lead to death, usually a condition that is best avoided.

So what causes it? There are loads of things that can cause dehydration, here are a few...
  • High temperature, and excessive exercise
  • Vomiting, Gobi Guts (see part 1) and increased urination due to infection.
  • Diabetes
  • No access to safe drinking water
  • Major injuries to skin, such as burns, or severe skin diseases or infections. (This includes blisters)
...and how do you know you are dehydrated?

The signs and symptoms of dehydration range from minor to severe.
  • Increased thirst with an extremely dry mouth
  • Increased or constant vomiting for more than a day (Gobi, any vomiting I want to know)
  • Temperature over 38C (101F)
  • Diarrhoea for more than two days (Gobi, any diarrhoea at all and I want to know)
  • Feeling weak and dizzy
  • Palpitations (feeling that the heart is jumping or pounding)
  • Confusion (normal for some, so know your team)
  • Sluggishness, even fainting
  • Inability to sweat
  • Unexplained and sudden weight loss
  • Decreased urine output.
  • Colour If urine is deep yellow or even orange, you may be dehydrated.
If you have any of these symptoms, go to your Doctor, if you are a member of the Gobi 2011 Expedition and you have any symptoms, you guessed it, I want to know.
It's vital that I know about these things immediately, because if your symptoms get worse, (see below) you're in trouble.
If you ever feel these symptoms, or more likely, notice them in somebody else, get to hospital, because A+E can get fluids into you faster than you can say Bactrian Camel. In the Gobi, there is a chance I could run out of fluids before I've got enough in you, not good!

The following symptoms (in combination with those above) are bad news and must be dealt with Now if not sooner!
  • Temperature higher than 39C (103F)
  • Lethargy
  • Headache
  • Seizures
  • Difficulty breathing
  • Chest or abdominal pains
  • Fainting
  • No urine in the last 12 hours
Try to get people who are dehydrated (even those who have been vomiting) to take in fluids in the following ways:
  • Sip small amounts of water.
  • Drink carbohydrate/electrolyte-containing drinks. (Gobi 2011 team members will be treated to a Steve Special Cocktail*, this will taste fantastic, and I have been known to tell fibs) Good choices are sports drinks or prepared replacement solutions.
  • Suck on ice lollies made from juices and sports drinks. (I'll stop Kubla Khan the icecream mhan as he passes)
Try to cool the person, if there has been heat exposure or if the person has an elevated temperature, in the following ways:
  • Remove any excess clothing and loosen other clothing. Keep them out of the sun or they will end up like a rasher of bacon!
  • Air-conditioned areas are best. If air conditioning is not available, (it won’t be) increase cooling through evaporation by placing the person near fans or in the shade. (Fans? Shade?)
  • Place a wet towel around the person.
  • If available, use a spray bottle or misters to spray luke warm water on exposed skin surfaces to help with cooling by evaporation.
  • Avoid exposing skin to excessive cold, such as ice packs or ice water. This can cause the blood vessels in the skin to constrict and will decrease rather than increase heat loss. Exposure to excessive cold can also cause shivering, which will increase body temperature. Strange but true!
Medical treatment
(You'll need an A+E Dept for this bit)
If your core body temperature is greater than 40C (104F), doctors will cool the entire body. They may promote cooling by evaporation with mists and fans or cooling blankets and baths. Now your beginning to see why I don’t want dehydrated people in the desert. If there is no nausea and vomiting, fluid replacement begins. You are asked to drink electrolyte/carbohydrate-containing fluids along with water, not a Steve Special
If there are signs of significant dehydration (elevated resting heart rate, low blood pressure), fluids are generally given through an IV. I could do this in the Gobi if I had the right kit but I don’t fancy hauling loads of saline bags and giving sets around just in case, and you’re not having my drinking water, but lets not go there eh!
 
Medications
If high temperature is a cause of dehydration, the use of paracetamol or ibuprofen may be used. This can be given by mouth if you are not vomiting.
 
As with all medical conditions, if you can avoid it, that is far better than me trying to treat it, agree? So… 

Prevention. 
  • Anticipate the need for increased fluid intake.
  • Keep yourself well hydrated with plenty of water.
  • Watch for signs of dehydration in yourself and others.
  • Avoid drinking alcohol
  • Tell me if you notice anything I have mentioned above
  • Wear the clothing Ripley will recommend, light coloured, loose fitting at a guess

Steve Special Cocktail
1 Ltr water+teaspoon of salt+4-6 teaspoons of sugar Yum!

Comments

Lauren said…
Hey Steve,

Just stumbled onto your blog. Going in my RSS feed now! Todd and I from Globetrooper hope to join the Gobi 2011 expedition and your posts will really help in the preparation. Looking fwd to fitness problems.
Steve said…
Hi Lauren,
Thanks for your comment, I know Health & Safety can bore people to death but I'll try and keep it light-hearted. Thing is, a bit of Knowledge and Preparation up front can save heart-ache in the desert. And the more medical kit I can bring back home unused, the more kit I can donate to 'Alan'. You'll learn more about Alan later in one of my blogs, but for now, just be assured that Alan is a worthy cause ;o)

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