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MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 1 of (14)
US Army Medical Research and Materiel Command
Heat Stroke in the Military Population
George W. WeightmanMajor General, Medical Corps
Commanding General
22 October 2008
https://mrmc-www.army.mil/
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 2 of (14)
BRIEFING TOPICSBRIEFING TOPICS
WE ARE A NATION AT WAR
HISTORICAL PERSPECTIVE
THE WAR ENVIRONMENT
CURRENT WAR ENVIRONMENT
PREVENTIVE MEDICINE DOCTRINE
HEAT STROKE IN TODAY’S US MILITARY POPULATION
WE ARE A NATION AT WAR
HISTORICAL PERSPECTIVE
THE WAR ENVIRONMENT
CURRENT WAR ENVIRONMENT
PREVENTIVE MEDICINE DOCTRINE
HEAT STROKE IN TODAY’S US MILITARY POPULATION
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 3 of (14)
U.S. Army Research Institute of Environmental Medicine (USARIEM)
U.S. Army Research Institute of Environmental Medicine (USARIEM)
USARIEM MissionConduct research to sustain / enhance performance (physical &
cognitive) & minimize medical problems during military operations at
environmental extremes of heat, cold, & high terrestrial altitude.
Support Military Materiel Developers (clothing, equipment, food &
pharmaceuticals) & Health Hazard Assessments regarding thermal &
hypoxic stress.
Thermal & Mountain Medicine DivisionCore Areas
Cold Stress Physiology
Heat Stress Physiology
High Altitude Physiology
Environmental Illness (Cold & Heat Injury & Mountain Sickness)
Hydration
Research TopicsAcclimation & Acquired Tolerance
Exposure Guidelines / Decision Aids
Environmental Injury / Illness Susceptibility
Hydration & Nutrition
Performance Optimization
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 4 of (14)
WE ARE A NATION AT WARWE ARE A NATION AT WAR
Protection of our soldiers against heat stroke is critical to military success
Protection of our soldiers against heat stroke is critical to military success
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 5 of (14)
HISTORICAL PERSPECTIVEHISTORICAL PERSPECTIVE
Heat stress and illnesses have caused profound and catastrophic consequences on military operations from biblical to modern times
US Army heat stroke hospitalization rates increased >7-fold over the past 20 years (Carter 2005)
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 6 of (14)
THE WAR ENVIRONMENTTHE WAR ENVIRONMENT
““A soldier fighting is not as simple a A soldier fighting is not as simple a situation as an athlete running a situation as an athlete running a marathon. The soldier is exposed to the marathon. The soldier is exposed to the environment not knowing for how long, environment not knowing for how long, with minimal food and water. The with minimal food and water. The soldier suffers tremendous sleep soldier suffers tremendous sleep deprivation, fear, hard work and deprivation, fear, hard work and exposure to exposure to heatheat and cold.” and cold.”
The ScientistThe Scientist, 2004, 2004
Wars are Fought Outdoors with Extended Exposure Wars are Fought Outdoors with Extended Exposure to Harsh Environments and Exhaustive Workto Harsh Environments and Exhaustive Work
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 7 of (14)
Heat Stress Has an Operational Impact Heat Stress Has an Operational Impact
““Within initial 72h of Within initial 72h of battle, 10% of engaged battle, 10% of engaged infantry (40 cases) were infantry (40 cases) were evacuated and treated for evacuated and treated for dehydration at BAS.”dehydration at BAS.”
Battle of Najaf, Iraq (August 2004)Battle of Najaf, Iraq (August 2004)1LT Dean Stulz, 1-5 CAV, 1LT Dean Stulz, 1-5 CAV, Battalion PA (After Action Brief)Battalion PA (After Action Brief)
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 8 of (14)
BAGHDAD WEATHERUSA Today, Tuesday 8 August 2006
CURRENT WAR ENVIRONMENTCURRENT WAR ENVIRONMENT
““That summer an average soldier That summer an average soldier on an 8-10 hour mission drank on an 8-10 hour mission drank from 2-4 gallons (8-16 qts) of from 2-4 gallons (8-16 qts) of water, and another half gallon (2 water, and another half gallon (2 qts) during the remainder of the qts) during the remainder of the 24-h period while back on base.”24-h period while back on base.”
SFC Larry Larson, Summer Iraq Operations SFC Larry Larson, Summer Iraq Operations (email, 4 April 2005)(email, 4 April 2005)
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 9 of (14)
Rate of Heat Stroke / Injury Among Active Duty Army, 1 Jan 2000 - 30 Apr 2008*
Rate of Heat Stroke among AD Army, 01Jan 2000 - 30 Apr 2008*
20.3
37.3 38.7 35.1
50.9
42.6
36.1
40.6
13.9
0.0
10.0
20.0
30.0
40.0
50.0
60.0
2000 2001 2002 2003 2004 2005 2006 2007 2008*
Year
Rate
per
100,0
00 p
ers
on
-years
Data Source: Defense Medical Surveillance System (DMSS)Prepared by Armed Forces Health Surveillance Center (AFHSC), as of 26-JUN-2008
Rate of Heat Stroke / Injury Among Active Duty Army, 1 Jan 2000 - 30 Apr 2008*
*Current as of 30 April 2008
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 10 of (14)
Long-term Effects of Heat Stroke?Long-term Effects of Heat Stroke?
Soldiers hospitalized for heat stroke subsequently had increased mortality (2-4 fold within 30 years) from cardiovascular, liver, and kidney diseases.Wallace et. al., Environ. Res., 2007
?
?
?
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 11 of (14)
PREVENTIVE MEDICINE DOCTRINEPREVENTIVE MEDICINE DOCTRINE
http://chppm-www.apgea.army.mil/heat
http://www.armymedicine.army.mil/index.cfm
http://www.usariem.army.mil/
TB MED 507/AFPAM 48-152(I)
TECHNICAL BULLETIN
HEAT STRESS CONTROL AND HEAT CASUALTY MANAGEMENT
APPROVED FOR PUBLIC RELEASE; DISTRIBUTION IS UNLIMITED.
HEADQUARTERS, DEPARTMENT OF THE ARMY AND AIR FORCE
7 MARCH 2003
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 12 of (14)
USA Today, Tuesday August 8, 2006
The Doctrine is Effective and We Are Operating EffectivelyThe Doctrine is Effective and We Are Operating Effectively
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 13 of (14)
CPT Erik J. Bergeson APA-C DMO Ranger Training Brigade Surgeon (Briefing of November 2006)
Heat Stroke & Heat Exhaustion Cases Before & After Heat Mitigation Intervention
Heat Stroke & Heat Exhaustion Cases Before & After Heat Mitigation Intervention
YEAR(S) # of Classes # of Students Heat Stroke Cases Heat Exhaustion Cases
2002 11 2,658 35 (1/75 students) 42 (1/63 students)
2003-2006 38 11,964 15 (1/797 students) 24 (1/498 students)
2002 – Before Heat Mitigation Interventions by USARIEM2003-2006 – After Heat Mitigation Interventions by USARIEM
> 10-fold decrease 8-fold decrease
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 14 of (14)
HEAT STROKE IN TODAY’S US MILITARY POPULATIONHEAT STROKE IN TODAY’S US MILITARY POPULATION
Continues to be a major problem for US forcesNon-deployed soldiers in 2007:
329 incident cases of heat stroke1,853 incident cases of heat exhaustion
Fort Bragg 7 Nov 07 - 8 Oct 08:Heat Stroke:
92 cases of heat stroke 137 soldiers on restrictions (8 Oct 08)
Heat Exhaustion:66 cases of heat exhaustion 45 soldiers on restrictions (8 Oct 08)
Heat illness/stroke related restrictions:US soldiers may be non-deployable for over a yearIsraeli and French soldiers are reevaluated at 6 to 8 weeks
The return-to-duty/play issues you will be discussing are critical to military success
MG George Weightman/MCMR-ZA (301-619-7613) (DSN 343)/George.Weightman@us.army.mil UNCLASSIFIED 04/18/23 17:58Slide 15 of (14)
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