1. 1 Hydration and Nutrition Pakistan ICITAP

2. Learning Objectives Learn the principles of dehydration Recognize the danger signs and symptoms of dehydration Learn techniques for adequate hydration Recognize the importance of proper nutrition 2

3. Water accounts for about 75% of a person’s body weight 3

4. Dehydration The body needs water to properly function Dehydration occurs when the amount of water leaving the body is greater than the amount being taken in The body is always changing and this is especially true with water levels in the body 4

5. Hydrated/Dehydrated cells A picture of a hydrated cell and a dehydrated cell 5 5

6. What is Dehydration? We lose water routinely when: We breathe and moist air leaves the body We sweat to cool the body We urinate or have a bowel movement to rid the body of waste products During the day, a person has to drink a large amount of water to replace this routine loss 6

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8. Causes of Dehydration: Diarrhea Diarrhea is frequent or excessively watery bowel movements. It is the MOST common reason a person loses excess water. Prolonged diarrhea is both uncomfortable and dangerous. A large amount of water can be lost with each bowel movement. World wide, more than 4 million children die each year because of dehydration from diarrhea 8

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10. Causes of Dehydration: Vomiting Vomiting is the act of forcible emptying of food and liquid in the stomach Constant vomiting can be a serious cause of fluid loss It is difficult for a person to replace water if they are unable to tolerate liquids 10

11. During a very hot day, a fast walk will generate up to a ½ kilo of sweat 11

12. Causes of Dehydration: Sweat The body can lose large amounts of water by cooling itself through sweat. This occurs during: Working or exercising in a hot environment Fever due to an infection will cause the body to use a large amount of water 12

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14. Causes of Dehydration: Diabetes Diabetics have higher sugar levels in their blood. This higher sugar levels cause some sugar to enter the urine, and water in the body follows. This can cause dehydration in the body For this reason, diabetics often suffer from frequent urination and excessive thirst to replace their lost fluids 14

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16. Causes of Dehydration: Burns The skin helps control fluid and temperature levels in the body When the skin is seriously injured or burned, it loses its ability to control these fluid levels The person becomes dehydrated when the fluids travel into the damaged skin 16

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18. Causes of Dehydration: Inability to Drink Fluids Lack of available water Lack of strength to drink enough water These factors along with the body’s natural fluid loss can contribute to dehydration 18

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20. Signs and Symptoms of Dehydration Symptoms range from mild to life- threatening The body’s FIRST response is a signal to the brain to increase thirst and raise the body's fluid level The next response is decreased urination to conserve water. The urine will become cloudy and darker yellow in color. 20

21. Signs of Dehydration As water loss increases, other symptoms may appear, such as:  Increased thirst  Dry mouth  Dry eyes  Lack of sweating  Muscle cramps  Nausea and vomiting  Heart palpitations  Lightheadedness (especially when standing) 21

22. Complications of Dehydration With severe dehydration, the brain and other body organs will receive less blood. As a result, confusion and weakness will occur. When the body's fluid supply is severely depleted, shock is likely to occur If the dehydration does not get treated, finally, coma and organ failure will occur 22

23. Severe dehydration is a life- threatening condition that requires immediate medical care! 23

24. Age and Dehydration The young and elderly are especially susceptible to dehydration Adults over the age of 60 who drink only when they are thirsty probably get only about 90% of the fluid they need An infant can become dehydrated only hours after becoming ill. Dehydration is a major cause of infant illness and death throughout the world. 24

25. Identifying Dehydration Evaluate mental status: Is the patient awake, alert and aware?  Vital Signs: Pulse Rate may increase  Skin: As dehydration gets worse, the skin loses its water content and becomes less elastic Check for presence of sweat and the degree of elasticity.  A final diagnoses of dehydration can only be made through blood and urine tests from a medical professional 25

26. How is dehydration treated? Fluid replacement is the treatment for dehydration. This may be attempted by replacing fluid by mouth, using frequent small amounts of clear fluids. If this method fails, intravenous fluids (IV) may be required. 26

27. After just 1 ½ hours without enough water, you’ve reduced your muscle endurance drastically You may be lagging and feeling uncomfortable After another hour, you’ll begin to feel the advance stages of heat stress: headaches, nausea, and serious fatigue 27

28. Heat Stress Dehydration is the #1 factor in Heat Stress In severe Heat Stress, you can easily lose more than a liter of water per hour Replacing body fluid lost in sweating is the single most important way to control heat stress and keep yourself effective, alert, and focused 28

29. Maintain your focus To insure that you are performing at your peak, use the one-liter rule: drink 1 liter for every hour you're out Drink frequently a few sips every 15-20 minutes By the time you're thirsty, you're already dehydrated 29

30.  Add heat, humidity, and full gear into the picture, and the danger of heat illness is magnified  Ensure that all persons are drinking water  Look for signs of dehydration, heat exhaustion, heat stroke  Ensure that water plan is part of pre-mission assessment Heat Stress 30

31.  Work: rest times and fluid replacement volumes will sustain performance and hydration for at least 4 hours of work in the specified heat category  Rest means minimal physical activity (sitting or standing), accomplished in shade if possible  CAUTION: Hourly fluid intake should not exceed 1 litre  Daily fluid intake should not exceed 12 litres Dehydration 31

32. Complications of dehydration This condition, which is also called physical collapse, is characterized by pale, cool, clammy skin; rapid heartbeat; and shallow breathing 32

33. Nutrition Not eating enough calories to meet your body’s energy needs causes weight loss This can lead to loss of body fluids and degrade your performance 33

34. We must all ensure that police personnel are eating and drinking appropriately! Our strength and safety may depend on it! Remember.. 34

35. Nutrition Restriction of food and nutrients leads to rapid weight loss which leads to: Loss of strength Decreased endurance Loss of motivation Decreased Mental Alertness 35

36. Questions? 36

37. Class Practical Exercise Practice some of the skills shared in this presentation 37