Foods That Help Hydrate While In The Orient

A student wrote:

“My Husband and I will spend a month in Southeast Asia in January.  I am concerned that I will have issues with the hot, huumid climate.  We will only have air conditioning in the hotel and bus.  I have lightweight clothes, colling bandana, big hat, and know to drink lots of water.  Is there anything else I can do, such as eat certain foods, ie, salty snacks, boullion, etc.?”

Well this is a great question!  After a little research I’ve got great news.

It turns out that not only can you add one type of food to your diet, there are three types of food that will help you stay hydrated or rehydrate especially if you or someone you know is NOT a big drinker of water.  The following VideoBlog should help answer this question and at the bottom of this post, I’ve included the source where I found some helpful information on different foods that help you stay or get better hydrated.

I hope this helps and thanks for sending the question.

Have fun in Southern Asia and let me know how it went when you get back.

Zai Jian(Goodbye)

Roy

royonrescue@gmail.com
Tweet: @royonrescue

Foods That Hydrate

Impact Sports and Rib Injuries!

Hello Everyone,

In this royonrescue blog entry I wanted to address a particularly familiar problem associated with sports of all kinds but especially common with high impact sports and the new uptick of people getting into Martial Arts, Judo, Brazillian Jiu-Jitsu and MMA.  For anyone who has been involved in any of these sports you know that it takes a lot of time, energy, work, determination and discipline to get to a point where you’re not just trying to get into shape but trying to improve your game.  All the months and years of training hard, working out and testing your skills all to have them come to a screeching hault when your fell a rib “pop”.   This term “popped  a rib” is coined for the explanation of any type of injury having to do with the rib cage but is mostly found in the anterior or posterior region of the lower rib cage, ie. floating or hanging ribs.  These are the ribs that are low and out to the sides of the abdominal region.  They are called hanging or floating due to the fact that they are not connected to the sternum and only the spine.  Because of this feature they are usually very flexible and can take a lot of pressure.  When a person gets hit hard, leans over a railing wrongly or maybe takes a punch, kick or a knee on stomach from another sparring partner or teammate, they can damage the rib causing everything from dull to severe pain.

Now when I say from dull to severe I mean from the scale of pain everthing from .5-10 on the scale.  Some of this depends on the severity of the rib fracture and some of it depends on if it is an actual rib fracture or if it’s a muscle or cartilage injury.  The pain can be only sensitive to pressure or additional bumps or it can hurt when a person breaths but either way, when the injury is present it definitely makes itself known and can really screw up sleep, let alone your normal training routine.

Because I couldn’t find a lot of good advice or explanation all in one location, I thought I’d add my two cents to the whole thing and maybe help someone out.

Question:  Is a rib fracture dangerous?

RoyOnRescue Reply:  It is not usually a dangerous injury unless the rib is fractured completely and sharp bone end punctures an organ or muscle. If the rib is broken from a wrong movement it is probably not as potentially dangerous as when it’s broken from a severe force.  Severe force strong enough to break a rib high up in the chest cavity may be strong enough to cause trauma to lungs, heart or other parts of the body.   At it’s worse here’s what trauma.org says about rib fractures:  Fractures of the lower ribs may be associated with diaphragmatic tears and spleen or liver injuries. Injuries to upper ribs are less commonly associated with injuries to adjacent great vessels. This is especially true of a first rib fracture, which requires a significant amount of force to break and indicates a major energy transfer. A fracture of the first rib should prompt a careful search for other injuries. Note also that the rib cage and sternum provide a significant amount of stability to the thoracic spine. Severe disruption of this ‘fourth column’ may convert what would otherwise be a stable thoracic spine fracture into an unstable one.(http://www.trauma.org/index.php/main/article/399/)Normally the biggest complication is that it impairs breathing deeply which can lead to respiratory infections or pneumonia and it’s hard to rest lying on your side or back depending on the location of the injury.

Question:  Do I Have to Stop Training?

RoyOnRescue Reply:  Do you want the true answer or the one I wanted to hear when I hurt my ribs the last time?   Either way, I’m going to give it to you as straight forward as possible.  Usually there isn’t much therapy for a broken/bruised or strained rib injury.  If it hurts or makes it hurt worse with activity, stop the activity and give the injury time to heal.  Usually 6-8 weeks has been the consensus from my research.  If you can tolerate the workout without reinjury then you may be able to keep training.  If it seems to make it worse and you are re-injuring the rib, you may need to stop and give it the time required.  If in doubt, talk to your medical professional for advice.  As for me, I train as long as I can tolerate it and try to not re-injure the same problem injury.  If I do, I take time off.

Question:  How Can I Treat The Inury to Help Healing?

RoyOnRescue Reply:  Most research is going to tell you to rest as much as you can, drink lots of water and stay hydrated and try not to re-injure the same site.  Cold packs applied to the area being careful not to place directly against the skin will help to decrease swelling and help aid the healing circulation.  Some say that an ace wrap around the injured area of the chest may help support the area to decrease movement and pain.  And of course most people will take some form of analgesic or non-steroidal anti-inflammatory medicine like Aspirin or Ibuprofen.  Please refer to your doctor for prescriptions that would apply to you and be careful of allergies.

Question:  How Do I Know If I Need To See A Doctor?

RoyOnRescue Reply:  If you have any problem with Airway, Breathing or Circulation, Shock or Shock symptoms, internal pain that is increasing with or without moving, numbness or unable to move any part of your body, headache that is increasing or not going away, chest pain that is severe or for any reason you feel like you should see a doctor, it is always a good idea to be seen.  Better to be safe than sorry and find out that you ignored an internal injury with severe bleeding or other complications.  If the rib injury is causing any life threatening problems, call 911 immediately.

So to all my fellow rib injuries out there, I hope you feel better sooner than 6-8 days let alone weeks, don’t do what ever you did the first time to get hurt and get well soon.

I hope this helped and if you have any other questions or comments for RoyOnRescue.com be sure to email them to:  royonrescue@gmail.com

Until next time, go fourth and rescue,

Best Wishes,
Roy

RoyOnRescue.com

royonrescue@gmail.com

8 Dead, More Dying, Even More Injured 2 Part Episode

Hello Everyone,

This question came in from my friends out in California.(I’m not sure if they wanted to be named and I haven’t asked them yet.) They had many patients and only their small team of volunteer rescuers without transportation services to organize a serious mass casualty incident.
They were on scene first when an all terrain racing vehicle left one of the desert roads and launched into a crowd of spectators.  There were many killed, many more injured and to top it all off, no response from EMS transportation services for more than an hour!  The team of volunteers had to work fast and hard to help organize absolute chaos. They were wondering if I could share my opinion on how to organize bystanders and volunteers during a situation like this. In this RoyOnRescue episode I give some of my ideas combined with advice from several of my colleagues working in dispatch, quality assurance, risk management and EMS response.  My answer to how to organize volunteers and bystanders to help in a triage situation where there are mass casualties took a total of two videos in order to fit them onto YouTube.  There’s a lot covered here but I really have only scratched the surface of a very important topic.  I hope it helps.  If you need me to spin off onto one given section of this subject and cover it more in depth, please email me at:  RoyOnRescue@gmail.com.

Best Wishes,

Roy

RoyOnRescue.com

Part 1

Part 2

Person Falls Face Down, Unresponsive!

On this episode of RoyOnRescue we take a closer look at a questions a person had about what to do if a person falls, has a potential neck injury, is face down and is unresponsive.  This can be a complicated scenario when it comes to assessing the person for airway,  breathing and circulation. Watch this episode to hear one way to respond to a person in this situation, treat them without causing further harm and maybe save a life.

How to Hit Your Head on Pavement at 17MPH and Survive!

Imagine riding your road bike and as you near a curve in the bike trail hitting speeds of around 17 miles per hour your front tire instantly goes flat.  Now you’re trying to corner on a metal rim sliding across the pavement which has as much traction as an ice skating rink.   This is exactly what happened to Tom Monett, cycling enthusiast, big mountain skier, hiker and mountain climber.  As Tom’s bike slid out from underneath him, he didn’t have enough time to catch himself let alone think about what was about to happen.  As his head hit the pavement, and his ribs began to break, his wisdom to ride with personal protective equipment most likely made the difference between life and death.  Watch this episode of royonrescue to see the full interview and hear his story about surviving a high speed cycling crash.

Concussion

Warning!  Video contains graphic pictures of injuries and accidents.

Video Gallery of Actual Bike Accidents

“Head and Shoulders, Knees and Toes…”

A student emailed a question regarding the Head to Toe exam.  Though this is normally performed as a secondary survey in a more advanced setting, I do think there are times where knowing how to check a person for other injuries is a good idea.  Take a look at the video blog and I hope this helps.
Best Wishes,
Roy

Shock and the Capillary Refill Test

In this RoyOnRescue Video Blog, a student had emailed Roy a question about explaining the Capillary Refill Test and how it may relate to determining if someone is suffering from shock.
Be sure to watch this episode of RoyOnRescue and learn a new trick that could either tell you if someone is going into shock, or that their hands are simply cold.
There are three main reasons why a person may have more than a 2 second capillary refill time:
1. Shock
2. Peripheral Vascular Disease
3. Hypothermia or cold hands
This slow capillary refill time of more than 2 seconds should only be an indication that we should check for other problems. Please don’t assume simply because someone has a slow cap. refill that they are going into shock. It is simply a quick and easy test to help point a first aider in the right direction and to tell us we should check for other issues.

Knitting Needles and Puncture Wounds?

Knitting Needles can be the source of warm mittens, cozy scarves and comforting winter sweaters.  They can also become sharp pointed weapons or injury causing spikes when fallen upon or when they are thrust into the face, neck, chest or abdomen due to a car accident or accidentally falling onto them.  In this RoyOnRescue episode, we take a look at the hidden danger of sharp pointed objects that usually remain harmless but when not respected and carried safely, they could cause great harm.  Learn about the dangers of pointed objects and how to keep knitting needles a source of pleasure not pain.

Asthma Attack and No Medication!

One of the scariest feelings is not being able to breath.  This is exactly what is happening during a severe asthma attack.  I received an email from a person who stated that they have been trained in CPR and First Aid multiple times and though it covers the basics of asthma it never really talks about what to do in depth.  They gave me a scenario where a person may be having an asthma attack and EMS is quite some ways away.  What’s worse, there isn’t any medication for the asthma attack!  Now what?

In this episode we take a look at what asthma is, and how we can confidently handle it even if there isn’t any medications and EMS/911 is delayed.

Asthma Guide
Asthma Symptoms
ProFirstAid.com Training (Allergic Reactions)

Is Milk or Water Better For Treating Dehydration?

I received an email today asking if milk would be just as effective as water for rehydrating a two year old after they’ve been in the heat and lost fluids.   The research I found was eye-opening.

Here’s my reply to the email. The name and personal information was deleted for personal privacy.

Thank you for your question.

My original hunch that water is still the best home remedy for replenishing vital lost fluids still seems to be the general consensus for most medical professionals(Source).  But there is an interesting study that was done in the UK where skim-milk was used for re-hydration and the study revealed that based on urine output, the skim milk may have been better absorbed than any other liquid.(Source)

There was a study that showed that milk did not replace fluids as well as water because of the fat content found in all milk.  Probably why the above study calls for skim milk instead of 2% or Whole Milk.  Skim is the lowest fat content of all the options.

Let’s take a look at what the study found.

“It is likely that the presence of sodium along with a relatively large quantity of potassium (approximately 45 mmol/l) in milk accounts for the effectiveness of milk at restoring fluid balance following exercise-induced dehydration,” they said.

“The results suggest that milk is more effective at replacing sweat losses and maintaining euhydration than plain water or a commercially available sports drink following exercise-induced dehydration by approximately two per cent of initial body mass,” added the researchers.

“Given that hypohydration results in an increase in cardiovascular and thermoregulatory strain, and a reduction in exercise capacity in the heat, it is important to ensure that fluid losses accrued during exercise are replaced prior to the performance of a subsequent exercise bout,” they concluded.

Commenting on the research, Judith Bryans, director of The Dairy Council, said: “This study joins the growing volume of literature which suggests that skimmed milk is a natural and effective post exercise recovery aid. Drinking milk is not only a valuable way to re-hydrate the body but also provides an excellent source of energy, protein and a vast array of different vitamins and minerals essential to the good health of hardworking sportspeople and the population as a whole.”

In the UK, semi-skimmed, or half-fat milk, now accounts for 60 per cent of total milk sales. Skimmed milk is also growing in popularity, now accounting for a further 14 per cent of the total.

Source: British Journal of Nutrition
Volume 98, Pages 173-180
“Milk as an effective post-exercise rehydration drink”
Authors: S.M. Shirreffs, P. Watson, R.J. Maughan
What’s important to remember in all of this is that unless there is a situation where prevention is not possible, like being lost in the wilderness,  a plane crash, a disaster,  etc… prevention is the way to combat most of the de-hydration problems.  The goal is to have persons drink at least 8-12oz. of hydrating fluid every hour during hot temperatures and during exertion and replace what we lose whenever needed.

In order to recognize the symptoms of dehydration we should probably take a look at some of the symptoms.

Mild to moderate dehydration is likely to cause:

* Dry, sticky mouth
* Sleepiness or tiredness — children are likely to be less active than usual
* Thirst
* Decreased urine output — fewer than six wet diapers a day for infants and eight hours or more without urination for older children and teens
* Few or no tears when crying
* Muscle weakness
* Headache
* Dizziness or lightheadedness

Severe dehydration, a medical emergency, can cause:

* Extreme thirst
* Extreme fussiness or sleepiness in infants and children; irritability and confusion in adults
* Very dry mouth, skin and mucous membranes
* Lack of sweating
* Little or no urination — any urine that is produced will be dark yellow or amber
* Sunken eyes
* Shriveled and dry skin that lacks elasticity and doesn’t “bounce back” when pinched into a fold
* In infants, sunken fontanels — the soft spots on the top of a baby’s head
* Low blood pressure
* Rapid heartbeat
* Fever
* In the most serious cases, delirium or unconsciousness

Unfortunately, thirst isn’t always a reliable gauge of the body’s need for water, especially in children and older adults. A better barometer is the color of your urine: Clear or light-colored urine means you’re well hydrated, whereas a dark yellow or amber color usually signals dehydration.

Treating severe dehydration
Children and adults who are severely dehydrated should be treated by emergency personnel arriving in an ambulance or in a hospital emergency room, where they can receive salts and fluids through a vein (intravenously) rather than by mouth. Intravenous hydration provides the body with water and essential nutrients much more quickly than oral solutions do — something that’s essential in life-threatening situations.
Source

Now that we know what dehydration looks like and the best way to treat it is to prevent it, how much water might be needed to prevent dehydration?

Let’s take a look.

Different Bodies, Different Needs
There are a multitude of factors that impact a person’s individual fluid needs – from concrete factors like age, weight, height, and genetic make-up, to more variable aspects like overall health, and environmental conditions. Given these differences, it is not hard to believe that each of us may have our own personal fluid requirement. So, while some people may in fact need eight glasses of water every day, chances are most do not. But, brace yourself – there is a very good chance that some of us actually need even more.

Eight is Just an Estimate
So, if eight isn’t the magic number for water needs, how do we actually know what we should be drinking? Unfortunately, there isn’t an easy answer. This is likely why the “8 x 8 rule” has been so popular simply because it made an otherwise complicated issue a little easier to manage. However, after careful review of the scientific literature, researchers from the University of Pennsylvania recently determined that there was no real basis for such a general recommendation. Regardless, given the fact that the average adult loses around 10 cups of water daily through their breath, sweat, feces, and urine, along with the estimate that most people meet 20% of their fluid needs through food; drinking 8 cups of water seems to be a pretty reasonable guideline. Still, it is just that – a guideline. Additional guidelines established by the Institute of Medicine take into account all beverages (including juices, coffee, tea, etc.) and suggest that men should drink approximately 13 cups of total fluid and women should drink around 9 cups of total fluid every day. Wow! And you were overwhelmed by 8?

Your Body Will Tell You What You Need
It is all a bit confusing. But, the good news is that your body does provide some clear indicators of what is best for you. Thirst is an obvious sign that your body needs more fluids, and a clear warning that you need to drink. But it isn’t always the most sensitive indicator, especially for older adults whose thirst mechanisms are not as sharp. This means that some older individuals don’t truly become thirsty until they are near dehydration. This can be dangerous because it is easier to prevent dehydration, than to try to catch up on fluids when you are already running low. A better means of assessing your fluid intake is through the color of your urine, with clear or pale yellow urine indicating a healthy fluid balance, and dark yellow or amber urine indicating dehydration. Another way of assessing your hydration status is simply by how you feel. Thirst, dizziness, confusion, fatigue, fever, and dry mouth are all symptoms of dehydration.

Water Works Wonders
You might be thinking, “What’s the big deal?” This seems to be a common response for most people, as we often take water for granted. That is of course until we are at a ball game or an amusement park, feeling parched, and our only option is to buy a four dollar bottle of water. Then, we realize just how valuable water can be! But, its value goes well beyond the amount that we shell out per bottle. The real wonder comes from all of the essential roles that water plays in the body including aiding with digestion, elimination, blood flow, and temperature regulation just to name a few. If you are not well hydrated, your body can’t work as efficiently, and you simply won’t be at your best.

Tips for Meeting Your Daily Water Needs
Although determining your fluid needs can be a bit of a challenge, actually meeting them doesn’t have to be. Here are a few tips:

* Fill a pitcher with 6-9 cups of water (based on you own personal needs) every night before going to bed and put it in the fridge to chill. When you wake up, start you day with a big glass of cold water, and continue drinking from the pitcher throughout the day until it is gone.
* Add slices of citrus fruit to your water (lemon, lime or orange) to give it a little extra flavor with no extra calories.
* Eat juicy foods like fruits and vegetables including melon, grapes, tomatoes, lettuce, and squash.
* Dilute juices and soda with 25% water, gradually increasing to 50% water as your taste buds adjust.
* Cool off beverages like coffee, lemonade, or tea with lots of ice cubes.
* Limit alcoholic beverages because they are diuretics and actually increase your fluid needs.

When the heat is on, make water your first choice. Instead of worrying about how many cups you should be getting, pay more attention to how you feel. By drinking regularly and staying ahead of thirst, you are sure to get the amount that is just right for you, no debate about it.
Source
References

* Dan Negoianu and Stanley Goldfarb. Just Add Water. J Am Soc Nephrol. 2008; 19: 1041-1043.

* Mayo Clinic Staff. Water: How much should you drink every day?  MayoClinic.com. April 19, 2008. retrieved 7/21/08 LINK

* Mayo Clinic Staff. Dehydration. MayoClinic.com. Jan. 3, 2007. retrieved 7/21/08 LINK

Well John,  I hope this helps.  As we move into the warmer months I’m sure that we will all need to remember some these tips on recognizing, treating and preventing dehydration.  And by the sounds of it, if you want to give your two year old skim milk because they like it more, and then follow that up with water, it appears that some research actually allows for that too!

Thanks for the great question and go fourth and rescue!

Best wishes,

Roy