CAMP LESTER, Okinawa — With tropical Okinawa’s hot, muggy summer approaching, the U.S. Naval Hospital has devised a new way for leaders to monitor heat conditions.

A laminated, pocket-sized “Leadership Guide for Preventing Heat Casualties” soon will be distributed to units throughout the island, said Cmdr. Stan Jossell, the hospital’s community health director, so leaders “can look out for their troops.”

Since last October, Jossell said, the hospital’s emergency room has seen 20 heat-related cases; a few were “borderline heat stroke” but all potentially could have been life threatening. The last heat-related death was last summer.

The pocket guide covers risk factors for heat injury and prevention strategies, acclimatization schedules for island newcomers, hydration and heat stress guidelines and actions to take should heat injuries occur.

Least severe of the injuries caused by heat is cramps, occurring when an individual is dehydrated and loses electrolytes, said Dave Elger, the hospital’s health promotions department head. People with heat cramps should stop all activity, seek shade and drink liquids, he said.

The new guide highlights the two more serious heat injuries: exhaustion and stroke. Signs of heat exhaustion are headache, weakness, dizziness, nausea and “goose bumps,” and the individual may collapse. Heat stroke symptoms include dry, hot skin; confusion; vomiting; involuntary bowel movement; seizure; and possibly loss of consciousness.

The guide advises leaders to respond to such symptoms by having the victim stop the activity, loosen or remove clothing, lie down and elevate the feet and cool down with water, ice and wet towels packed around the neck, groin and underarms. The victim, if conscious, should be given sips of water, and 911 should be called at once.

Once someone has heat exhaustion, “heat stroke can come down rapidly,” Elger said.

He said getting the body used to Okinawa’s climate takes about two weeks — newcomers should work into exercise routines slowly and increase them gradually to build tolerance.

Those taking any kind of supplement are at higher risk, Elger said, and should take in more fluids. Those on diets also should be careful, Jossell said, because their bodies are stressed and “at greater risk.”

Many heat injuries happen before 7 a.m., Jossell said, theorizing that humidity is high because the sun hasn’t risen enough to burn off the moisture. Not eating or drinking fluids before exercising, or having consumed alcohol the night before, also may contribute to early-morning injuries, he said.

“I think that young Marines are just rolling right out of bed … eating no chow and not drinking water,” he said.

Jossell said if leaders schedule physical training later and encourage troops to eat and hydrate, “it could reduce the number of heat injuries.”

He said physical training should take place either from 7 to 9 a.m. or near sunset.

Contact Dave Elger at DSN 645-2620, or elgerdh@oki10.med.navy.mil for more information on how to prevent heat injuries or to receive one of the new leadership guides or a unit briefing.

For more information ...

CAMP LESTER, Okinawa — While the U.S. Naval Hospital Okinawa’s new “Leadership Guide for Preventing Heat Casualties” pocket guide gives leaders instant access to heat injury information, a system has been set up to advise everyone of daily heat conditions — and ideally to prevent heat illnesses in the first place.

Each Marine camp on Okinawa has a “Wet-Bulb Globe Temperature Index System,” according to Cmdr. Stan Jossell, director of the hospital’s community health department director. He said the system evaluates the “relative humidity, radiant heat and ambient temperature” to determine the WBGT.

That reading corresponds to a color-coded flag system that tells those on each camp what the heat condition is and what kind of activities should or should not be performed. Flags are placed throughout each camp to display the heat condition.

With Okinawa’s tropical climate, and camps spread throughout the island, Jossell said flag conditions can, and often do, vary from camp to camp.

Flag conditions can be found online at www.mcbbutler.usmc.mil/default.htm. Conditions for each camp are listed, as well as the time the reading was taken and what the WBGT was at the time of the reading.

Jossell said the hospital displays flag conditions on its intranet site.

— Fred Zimmerman

The flag conditions ...

Flag conditions based on the WBGT and what they mean:

• Green Flag: 80 to 84.9 degrees Fahrenheit: Heavy exercise, for unacclimatized personnel, will be conducted with caution and under constant supervision.

• Yellow Flag: 85 to 87.9 degrees Fahrenheit: Strenuous exercises, such as marching at standard cadence, will be curtailed for unacclimatized troops in their first three weeks. Avoid outdoor classes in the sun.

• Red Flag: 88 to 89.9 degrees Fahrenheit: All physical training will be curtailed for those troops who have not become thoroughly acclimatized by at least 12 weeks. Those troops who are thoroughly acclimatized may carry on limited activity not to exceed six hours per day.

• Black Flag: 90 degrees Fahrenheit and above: All nonessential physical activity will be halted for all units.

(Source: U.S. Marine Corps)