The recognition and management of body temperature disturbances in Royal Navy personnel

摘要

This article discusses hypothermia and hyperthermia, described together as thermal illness. These conditions are seen within the United Kingdom (UK) Armed Forces population at home and abroad and may endanger life, with significant implications for both the individual and the chain of command. Recognition and management from initial presentation to return to duty is discussed and guidance given on occupational considerations. Introduction In the summer of 2013, three Service personnel died from heat illness during a training exercise in Wales (1). This highly publicised event on UK soil reminds us of the risk to Service personnel from thermal illness, even in relatively benign conditions. In the United States of America (USA), heat illness claims an average of 448 lives a year and contributes to the deaths of a further 240 individuals, whilst hypothermia results in 1,301 deaths per year (the USA has around 2.5 million deaths per year) (2). Review of the Naval Service Incident Notification Cell database reveals that between June 2012 and June 2013, there were ten reported thermal illness cases in the Royal Navy (RN) alone, distributed evenly between hypothermia and hyperthermia. These occurred on board ships and submarines, and in the field. Extremes of heat and cold can be fatal, but survivors can also suffer significant long-term problems, even from a single incident and despite optimal management. Prevention is therefore preferable and the chain of command must be given robust advice from the medical branch, which has a key role. Individuals can also help protect themselves both by preparation and discipline in the field.