CHAPTER 4 - BASIC SURVIVAL MEDICINE
Foremost among the many problems that can compromise a survivor's ability to return to safety are medical problems resulting from parachute descent and landing, extreme climates, ground combat, evasion, and illnesses contracted in captivity. Many evaders and survivors have reported difficulty in treating injuries and illness due to the lack of training and medical supplies. For some, this led to capture or surrender. Survivors have related feeling of apathy and helplessness because they could not treat themselves in this environment. The ability to treat themselves increased their morale and cohesion and aided in their survival and eventual return to friendly forces. One man with a fair amount of basic medical knowledge can make a difference in the lives of many. Without qualified medical personnel available, it is you who must know what to do to stay alive.
REQUIREMENTS FOR MAINTENANCE OF HEALTH
To survive, you need water and food. You must also have and apply high personal hygiene standards.
Water
Your body loses water through normal body processes (sweating, urinating, and defecating). During average daily exertion when the atmospheric temperature is 20 degrees Celsius (C) (68 degrees Fahrenheit), the average adult loses and therefore requires 2 to 3 liters of water daily. Other factors, such as heat exposure, cold exposure, intense activity, high altitude, burns, or illness, can cause your body to lose more water. You must replace this water.
Dehydration results from inadequate replacement of lost body fluids. It decreases your efficiency and, if injured, increases your susceptibility to severe shock. Consider the following results of body fluid loss:
- A 5 percent loss of body fluids results in thirst, irritability, nausea, and weakness.
- A 10 percent loss results in dizziness, headache, inability to walk, and a tingling sensation in the limbs.
- A 15 percent loss results in dim vision, painful urination, swollen tongue, deafness, and a numb feeling in the skin.
- A loss greater than 15 percent of body fluids may result in death.
The most common signs and symptoms of dehydration are--
- Dark urine with a very strong odor.
- Low urine output.
- Dark, sunken eyes.
- Fatigue.
- Emotional instability.
- Loss of skin elasticity.
- Delayed capillary refill in fingernail beds.
- Trench line down center of tongue.
Thirst. Last on the list because you are already 2 percent dehydrated by the time you crave fluids.
You replace the water as you lose it. Trying to make up a deficit is difficult in a survival situation, and thirst is not a sign of how much water you need.
Most people cannot comfortably drink more than 1 liter of water at a time. So, even when not thirsty, drink small amounts of water at regular intervals each hour to prevent dehydration.
If you are under physical and mental stress or subject to severe conditions, increase your water intake. Drink enough liquids to maintain a urine output of at least 0.5 liter every 24 hours.
In any situation where food intake is low, drink 6 to 8 liters of water per day. In an extreme climate, especially an arid one, the average person can lose 2.5 to 3.5 liters of water per hour. In this type of climate, you should drink 14 to 30 liters of water per day.
With the loss of water there is also a loss of electrolytes (body salts). The average diet can usually keep up with these losses but in an extreme situation or illness, additional sources need to be provided. A mixture of 0.25 teaspoon of salt to 1 liter of water will provide a concentration that the body tissues can readily absorb.
Of all the physical problems encountered in a survival situation, the loss of water is the most preventable. The following are basic guidelines for the prevention of dehydration:
- Always drink water when eating. Water is used and consumed as a part of the digestion process and can lead to dehydration.
- Acclimatize. The body performs more efficiently in extreme conditions when acclimatized.
- Conserve sweat not water. Limit sweat-producing activities but drink water.
- Ration water. Until you find a suitable source, ration your water sensibly. A daily intake of 500 cubic centimeter (0.5 liter) of a sugar-water mixture (2 teaspoons per liter) will suffice to prevent severe dehydration for at least a week, provided you keep water losses to a minimum by limiting activity and heat gain or loss.
You can estimate fluid loss by several means. A standard field dressing holds about 0.25 liter (one-fourth canteen) of blood. A soaked T-shirt holds 0.5 to 0.75 liter.
You can also use the pulse and breathing rate to estimate fluid loss. Use the following as a guide:
- With a 0.75 liter loss the wrist pulse rate will be under 100 beats per minute and the breathing rate 12 to 20 breaths per minute.
- With a 0.75 to 1.5 liter loss the pulse rate will be 100 to 120 beats per minute and 20 to 30 breaths per minute.
- With a 1.5 to 2 liter loss the pulse rate will be 120 to 140 beats per minute and 30 to 40 breaths per minute. Vital signs above these rates require more advanced care.
Food
Although you can live several weeks without food, you need an adequate amount to stay healthy. Without food your mental and physical capabilities will deteriorate rapidly, and you will become weak. Food replenishes the substances that your body burns and provides energy. It provides vitamins, minerals, salts, and other elements essential to good health. Possibly more important, it helps morale.
The two basic sources of food are plants and animals (including fish). In varying degrees both provide the calories, carbohydrates, fats, and proteins needed for normal daily body functions.
Calories are a measure of heat and potential energy. The average person needs 2,000 calories per day to function at a minimum level. An adequate amount of carbohydrates, fats, and proteins without an adequate caloric intake will lead to starvation and cannibalism of the body's own tissue for energy.
