Hydration

Normal hydration should be 64 to 88 ounces per day. A general rule is to drink one glass of water before meals and physical training and after calls that require donning bunker gear. However, on extended emergency operations with high metabolic demands, it is recommended to drink one liter or water per hour to replace fluids. Water replacement should be followed by drinks containing electrolytes. Avoid caffeine and energy drinks during emergency operations as they have a diuretic effect which can increase dehydration.

Manage the scene.

As conditions allow, move patients, suspects or bystanders you are interacting with into the shade, or air-conditioned vehicles or buildings. For EMS providers, move patients off the street or out of their hot home and into the air-conditioned ambulance sooner than you might otherwise.

PPE removal and rehab.

When safe to do so, remove PPE layers, such as masks, helmets or hats, turnout gear and body armor, to improve heat loss through radiation, conduction, evaporation and convection. When the ambient air temperature is in the high 90s or 100s, passive heat loss is ineffective, so enhance cooling with misting fans, ice packs, cooling towels or immersion.

Watch your partner.

Your partner is also at risk when the temperatures climb. Early signs of dehydration, heat exhaustion and heat stroke include lethargy, confusion and other personality changes. If your partner seems “off,” take a water break out of the sun and humidity, and consider further assessment of their pulse rate, respiratory rate, mental status and recent water consumption.