Replay>>Your Body Warns You Long Before Heat Stroke Hits with Chris Tolan

Heat doesn’t wait for you to finish the workout. One minute you feel a little “off,” the next you’re cramping, dizzy, confused, or watching your heart rate climb and refuse to come down. That’s why we brought back this conversation with Chris Tolan, a firefighter, paramedic, and search and rescue instructor, to give you a clear, real world guide to heat illness before summer training ramps up. 

We walk through what heat injury actually is: your body losing the ability to cool itself, especially when heat and humidity trap sweat on the skin. Chris explains what first responders look for in the field, why dehydration is only part of the story, and how electrolyte balance powers everything from muscle function to the heart’s electrical system. We also talk hyponatremia (yes, “water drunk” is a thing) and why pounding plain water can backfire without sodium and other electrolytes. 

You’ll learn the four stages of heat-related illness and what separates a manageable problem from a medical emergency: heat cramps, heat syncope (fainting), heat exhaustion, and heat stroke. We cover practical warning signs like leg cramps, mouth breathing earlier than normal, nausea and vomiting, dizziness, and trouble answering simple questions. Chris also shares how medics cool patients on marathon courses, when IV fluids like normal saline come into play, and why heat stroke can spiral into dangerous rhythms and cardiac arrest without rapid cooling and urgent care. 

If you train outdoors, mow the lawn, work in heavy gear, or simply want a smarter hydration strategy, this will sharpen your instincts and your plan. Subscribe so you don’t miss upcoming episodes, share this with a training partner, and leave a review with the heat warning sign you want to get better at noticing.

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Transcript

Welcome And Why Heat Matters

SPEAKER_01 0:15

Hello and welcome back to Overthe Next Hill Fitness Podcast. I'm Carla Coffee, your coach and host for today's program. I do want to thank all of you who have continued to buy me a coffee. That is very kind of you. For those of you who have been rating and sharing the program, I know it takes a minute to go on there and give me five stars, but I really appreciate the fact that you've done that. And you can also leave a comment if you'd like, but that's also not necessary. Just giving me those five stars really helps. I do want to uh let you know that I am on YouTube as well. Today's recording um will be there only as a recording. I am going to share with you a previous recording of Chris Tolen. He talks about uh heat injury and all the things related to it, how to know um if it's very severe and what to do. Um Chris is a firefighter and he teaches search and rescue, so he is a great source for me to have gone uh to, so I wanted to replay that episode since we are starting to get into summer and some higher temps. So let's listen in and see what we can learn. Welcome back to Over the Next Hill Fitness Podcast. I'm Carla Coffee, your coach and host of today's program. This program is sponsored by CoffeeCrew Coaching.com. Today we are talking to Chris

What Responders Watch For First

SPEAKER_01 1:46

Toland. Chris is a paramedic, a firefighter, and he teaches at the firefighting academy. He teaches search and rescue. Welcome to the show, Chris.

SPEAKER_02 1:57

Hey Carla, good to be here.

SPEAKER_01 1:59

Thanks so much for being here. I wanted to get you on the phone because you are a professional firefighter and paramedic, and with the heat coming in all the states and finally Wisconsin, we need to talk about heat distress. So first of all, what do you teach the paramedics and firefighters about heat-related illnesses?

SPEAKER_02 2:25

Well, it's pretty simple on our end. I mean, once we have the base knowledge of the human body and symptomologies, we can look at the conditions outside, we can see what the day is going to look like and what we can expect for patients. Um what I teach them to look for, obviously, is anything out of the or out of the normal. So it's gonna be vital signs. Um we expect that if you are being overcome with heat, your body just can't cool itself enough, you're dehydrated, your body is working harder than it needs to, even in an extreme condition like marathon running or Iron Man uh contest or whatever you may be doing, pushing your body. We're gonna look for a hyper-elevated blood pressure, we're gonna look for a hyper-elevated uh pulse rate. So those are gonna be things like your pulse rate is normal conditions, just resting, your heart rate is above 100. Um, if you're the elite athlete or extreme athlete uh like you, we would expect to see that maybe 130, 140, maybe even up into 160. And for the athlete, that may be okay, but for the regular person, it probably isn't. So I say regular person, and I just want to hit this key. There's a lot of people that get that January 1st resolution of I'm gonna get in shape, and they do that. They lose a little bit of weight, maybe they get uh they get to the gym and then they say, I want to run that 5K or I want to run that marathon. Those are the ones that we really look at or we really expect to see during one of those events. We expect to see them pushing their body, they don't know their body, they don't know how to respond to the body telling them some stuff is wrong. And so I'll say that to start us out trust your body. And we can deep dive into that a little deeper.

SPEAKER_01 4:22

What um when you say trust their body, is it just being thirsty? What are some of the things um that someone would look for? Whether they're running mowing the lawn, I suppose is it could be a factor. Your your firefighters, they probably run into some heat related things too.

SPEAKER_02 4:47

If the temperature is above eighty-two degrees and the humidity is above ninety, that's when we expect to see the heat injuries. And the heat injury simply is that your body just can't cool itself efficiently. And that's for a number of reasons.

Salt, Electrolytes, And Humidity Traps

SPEAKER_02 5:02

Uh either you're dehydrated or you are uh hyponutremic. So hyponutremia is just going to be a lack of sodium or a lack of salt in your body. You've basically sweated that out, and everybody knows that when you sweat, it's salty. You can feel it running through your eyes, it burns your eyes. That's why it burns your eyes, because it's heavily salinic. Um so when you sweat, you lose that salt. In the old days, in the shops, they used to put salt tabs out for employees right next to the water cooler or the water fountain. And so you knew you were pouring sweat all day when you went to get a drink of water, you had to drink some water and take a salt tap too. If you didn't, you're gonna get dizzy and you're gonna faint on the line, and then they're gonna pull you off the line and keep going with their production. But yeah, salt. That's a that's a big one. Um, as well as the rest of the electrolytes. Our body runs on electrolytes, our heart runs on electrolytes. Your heart um has electro electrical activity because of the exchange of electrolytes in these small little vessels in your heart. That's how we create an electric or the heart creates an electrical charge, is the exchange of those electrolytes. When we deplete those, the heart doesn't know what to do, it doesn't have its firing source. So we have to do that. For the extreme athlete, you know your body, you can you can trust your body, but you probably have trained yourself to recognize some science. You've probably trained yourself to um maybe remind yourself to have a drink of water or have some electrolytes, and I'm sure there's various ways you can take electrolytes.

SPEAKER_01 6:47

Yeah, one of the things I do is I have my watch set to remind me to drink. Because when you, you know, we always joke that you can't do math while you're running, you right? At at some point while you're running, there's just nothing. You we call it runner brain. And so I set my watch so when it beeps, oh yeah, take a drink. Take you. Sometimes it's you know, eat some sugar or whatever, depending on how long the run is. So yeah, I do have to set a timer for that just because at some point I I'm not always thirsty, but I know that I need to drink something because it's been however many minutes or miles.

SPEAKER_02 7:28

Do you find that when you're done running, do you find that you crave sweets? You crave chocolate, you crave something sweet?

SPEAKER_01 7:37

Sometimes, um, depending on the distance. Um I just finished some marathons recently, and I always uh pre-pre-prepare a recovery um drink, and I I drink that because I'm not always hungry or thirsty, but it's got some good things in it to replenish myself. And then a lot of times after an hour later, man, I'm you know, I'm ready to yes, very bad. So yeah, it just kind of depends on the distance of the mileage, but yeah, some days it's really bad. So what is the first stage um or first symptoms that we're looking for for heat um symptoms?

SPEAKER_02 8:26

Heat injuries. Yeah, so we there's four levels, and we're gonna look at the first level being heat cramps, the second

Hydration Timers And Runner Brain

SPEAKER_02 8:34

level will be heat syncopy or fainting, uh, and then you get heat exhaustion would be the third, and lastly, heat stroke. And heat stroke, the it sounds very ominous in the name. A stroke is a bad thing, right? Stroke means brain damage, uh, muscle damage, nerve damage potentially. So those are the four levels, and we can expand upon those a little deeper. The first thing that we're gonna see, we're or we would expect to see either as a runner or as a responder to somebody with a heat injury is gonna be heat cramps. And that's just like it sounds. You're gonna feel muscles cramping up, probably in your legs first. Um, that's telling you, hey, you need to pay attention to what's going on. Now, I've always heard if you have leg cramps, eat a banana. Right? Well, that banana is pretty high in potassium. That is one of the uh essential uh nutrients for our body. Our bodies need that, and that's your body telling you you've depleted potassium. You're starting to get cramps in your legs, uh, and that's really your body telling you you're starting to feed off of your muscle, trying to find more nutrients or more electrolytes. When it can't find it, it says, hey, slow down, pull over. You need to sit down, you need to figure this out. You need to get some water in you, get some other electrolytes in you, take a little rest. That should be your indicator. But as an elite runner, you know most of you are gonna say, Oh, yeah, I'm just my I I got muscle tenderness, or I'm my muscles are sore, that's all it is. I just need to stretch it out, keep running. And you just ignored that first sign. Right? So the fix to the heat cramps, again, pull over. Get some salt into you, get some water into you, maybe just have a a little snack, something you might carry with you or something they have along the the run, pull over and and take that opportunity. Get it in you.

SPEAKER_01 10:34

Okay. Yeah, I know um I've always thought of leg cramps as more physical, right? That it's just tired, it's just a tired muscle. I hadn't thought of it as being um dehydration symptoms. So thanks for that. That little tip.

SPEAKER_02 10:54

Yeah, again, trust your body. But on both ends of the spectrum, the newbie trying to get out there and run their first 5k or run their first actual marathon versus the elite runner who's trained for this. Uh you probably run hundreds of miles in a year, right? I mean, I mean I mean you're you may be up in the thousands at some point. For those that are newbies, they don't, right? They they may be at a hundred miles versus your thousand miles for the year, and they don't trust their body. What they think their body is saying is, hey, stupid, you should not be running. This isn't you. You shouldn't be exercising like this. This isn't normal. Remember, we're supposed to be sitting on the couch, or we're supposed to be doing whatever. And what are you doing out here? So they ignore that. No, I gotta run through this pain, I gotta work through this. I'm gonna do this. They've ignored that sign, and now they have an issue. Again, heat cramps, not a big deal. Pull over, get some water, get some salty snack, probably will rectify itself, and you may be out of the race. Your body may just say, No, I got nothing left in the tank for this. We have to recover the body first before we can start doing this stuff. Uh, next would be heat syncope. So heat syncope is heat fainting. That's where your brain doesn't have enough oxygenated blood to sustain the computer working anymore. And the computer says, shut off. Um, anytime in life, if the computer shuts off, that is really your body saying, Did you try to turn it off and turn it back on again? Right? Your body's telling you, hey, stupid, stop doing what you're doing. Oh, you don't want to stop doing what you're doing. Okay, blink, you're out, you're on the ground. Now you stop doing what you were doing, won't you? Or didn't you? So then you wake up from that, and it's time to start fixing that. Fluid replacement, uh, some good snacks, rest, get in the shade. And really, this is all expected in in extreme heat conditions. So again, above 82 degrees Fahrenheit, uh, humidity above 90. That's what makes our body sweat more. And the reason our body sweats is to cool us. And it's really that condition of uh having

The Four Levels Of Heat Injury

SPEAKER_02 13:16

fluid or liquid on the surface of your skin and blowing ambient air over that liquid, it creates a sensation in our nervous system that uh tells our brain lower the body's temperature. Okay, and it's a it's a vicious cycle because lowering the body's temperature is to continue sending uh sweat into the skin and evaporating that sweat off the skin. Uh in extreme humidity and extreme heat, it's gonna be worsened. So you're you're gonna find yourself craving more water. I want to drink more water because man, I'm just losing it too quick. But you may ignore those signs. Like you said, you have to set a reminder for yourself. I will I will uh extrapolate just a little bit on that sweating. You may find if you're running in arid regions, maybe the mountains or the the um the deserts,

Heat Cramps And Early Fixes

SPEAKER_02 14:09

if you're running in those conditions, you're you may not notice that you're sweating. You're you're sweating so quickly that the or you're sweating uh as much as you should be to try to cool yourself, but your the your sweat evaporates so quickly off the skin because of the dry air, you don't even realize it. So you may think, man, this is uh this is going really good. I'm not I haven't been uh I haven't been sweating very much, I'm doing good, but that's when you're gonna start seeing those signs of hyponeia. You're gonna start seeing the leg cramping, the uh maybe increased breathing, maybe you're fighting to breathe. You you may you may find that man, I I'm I'm mouth breathing now, and I don't normally mouse breathe at breathe at uh mile six. I I I don't do that, I breathe through my nose. But man, I'm really I'm really really trying to breathe now. That's a pretty good sign. Your body's saying, hey, we we aren't doing well. You need to pay attention to me.

SPEAKER_01 15:06

Now, um to just to touch on the hyponeatremia, can you get that um loss of sodium by drinking too much water without the salt tabs, like you had mentioned for the the workers? Is that a possibility too?

SPEAKER_02 15:20

It is. And and there is a pretty simple term for it. It's uh it's water drunk.

SPEAKER_01 15:25

Oh wow.

SPEAKER_02 15:26

You you drink so much water that you wash out the sodium, you wash out the salt, you wash out some of your other electrolytes, and you are just saturated in water, H2O, and your body doesn't function on water alone. Your body functions on water, several nutrients, and the electrolytes. And again, those electrolytes are very precarious for our heart. If our electrolyte balance is off, that's when we start seeing heart injury, muscle injury to the myocardium, um, as well as brain injury. Your brain runs on uh primarily water, but also uh sugar, salt, right? All the nutrients that our body needs, and your brain needs that too. In heat syncope, really heat syncope, heat fainting is your body trying to get blood to the core. Those vital organs that need uh blood, need those nutrients, need the oxygen, need to get rid of the carbon dioxide. Your body's starting to shunt. It's sending blood to the core. So the core being your heart, your lungs, and your brain. If that happens, that blood uh isn't gonna the blood that you're circulating to your lower extremities isn't gonna get back to the heart efficiently because your body is shutting those vessels down. So blood pooling in your legs is when you're gonna see that. Hey, pay attention. Oh, you don't want to pay attention? All right, we'll just reboot you then. And that's where you faint, and it's time to fix those things. For us, that heat syncope responding to that, we're probably just going to um get you into some some cool area. We might put you in the back of an ambulance with some air conditioning, and we may give you fluid replacement via IV. Um now the IV that or other the intravenous solution that we might use would be uh

Heat Syncope And When You Faint

SPEAKER_02 17:17

a 0.9% uh saline solution. Just a regular normal saline IV. So we replace that with you. We might tell you to drink some uh sugar, and we've got some handy little packets that give you sugar and some other electrolytes, get it in you, you're probably gonna feel better. We don't have to take you to the hospital potentially, but you're gonna be out of the race today.

unknown 17:42

Okay.

SPEAKER_01 17:43

So that's stage two then is the fainting. So the first stage we're looking for is heat cramps. Yep. And um then the second stage is uh fainting. So had we taken care of it in the beginning, we wouldn't get to this stage.

SPEAKER_02 18:00

Right. Listen to your body.

SPEAKER_01 18:01

Yeah. Okay. So and then what's the next stage?

SPEAKER_02 18:04

The next stage is gonna be heat exhaustion. This is when we're gonna see those vital signs really changing. Heat exhaustion is your body telling you, I can't go on. Stop pushing me. And here's a reminder of that. You're gonna have an elevated uh pulse rate. Like I said, for the extreme athlete, you may be thinking, man, this is just a try and run today. I'm really having to push myself again. The heart rate is increasing, the breathing rate is increasing, and you may just be mouth breathing and going, well, I'm just having a weird day. Maybe there's an incline, maybe this is why I'm mouth breathing. That's your body telling you, hey, your body's not able to keep up with whatever you're putting on it. So you've lost those fluids. Maybe you ran through that heat cramping if you had any. You may not have had the heat cramping. Um, maybe you ran through the heat syncope, maybe you just kind of shook it out and kept running and were able to maintain enough adequate flow until you can't. And then we're gonna see uh again, elevated heart rate, elevated breathing, maybe nausea, maybe vomiting. Uh interesting thing that the body does even when dehydrated or even uh when lacking uh electrolytes is it's gonna be nauseous and maybe vomit. Really just fulfilling the the problem or or extrapolating the problem unnecessarily, right? And then uh dizziness and certainly fainting could be present there.

SPEAKER_01 19:34

So I ran a hundred miler not too long ago, and I've also um paced someone in a hundred miler, and the person was that I was pacing, she couldn't keep anything down. So chances are that was because she waited too long to take anything in, do you think?

SPEAKER_02 19:56

It may be.

unknown 19:57

Yeah.

SPEAKER_02 19:58

Yep, and they and there there there may be underlying causes too. You know, when the heart is having issues, uh, one of the sci or one of the common signs of a heart attack is going to be nausea and vomiting, along with chest pressure or chest pain. But in women specifically, women present differently, and certainly women that have have uh buried children present different differently for heart-related problems. You may not have chest pain, you may not have trouble breathing, you might have abdominal pain or back pain, you might even have leg pain and not make a correlation to this is my heart causing the problem. So very well she could have just been ignoring the signs, or she wasn't presenting with normal signs until it may it was too late. So she just kept vomiting. You tried to put fluids in her, she just kept vomiting it up. Yeah. Yeah, she took it.

SPEAKER_01 20:49

Yeah, she took a half-hour um break and was finally able to get some food in, and then she was able to continue the race. Um, and I've seen people on longer runs um get sick um and didn't and I I know it doesn't necessarily mean it was because they were dehydrated, but I I now will look at that differently than oh, they put too much in. They might not have put enough in. I and I hadn't ever thought of that.

SPEAKER_02 21:45

Yeah, very potentially. The body's gonna try to remind us however it can before it shuts the computer down. And that's one of the ways it's gonna remind us. When I was in the army, certainly in boot camp, we we did forced runs. So we would run uh uh at 4 or 30 in the morning, eight, maybe ten miles up and down these hills in the mountains of uh or the foothill mountains of Alabama. And it was not uncommon to see four or five guys pull over to the side of the road, hurl up their nothing in their system, and then keep trying to run. Right? Now, in the in the army, uh, we always had a full canteen of water. So every so often say, Stop, drink water, and you would drain that quart of water out of your canteen and carry on with your day. Um the other thing, too, is there is some some physiological triggers when you're uh when you're breathing too fast. When your heart rate's too fast, one of the things that may be um triggered is your gag reflex. And once that gets going, you know, it's kind of a vicious cycle of its own. I just can't keep anything down. What we would do for that, responding to somebody that was vomiting and couldn't stop vomiting. We have some drugs we can give intravenously or even uh intramuscular, uh zofran being a very common one, and that should alleviate the nausea. It's just gonna shut that trigger off, that brain trigger of nausea. Then hopefully we can do some fluid replacement and you won't progress further.

SPEAKER_01 23:16

Gotcha.

SPEAKER_02 23:17

Well, yeah.

SPEAKER_01 23:18

Okay. So now that's the third one. The heat exhaustion. That's interesting that it's not all heat exhaustion. That's you know what I mean? I you have to work up to that level, and there are other things you can look for before you finally get to the heat exhaustion. I hadn't thought of that, so thank you for that. And so what's our last one?

SPEAKER_02 23:39

Yeah, yeah, and that's a last one's gonna be heat stroke, and again, the it's right in the name, right? Stroke sounds very bad. Um, that's gonna be uh lots

Heat Exhaustion Signs And Nausea

SPEAKER_02 23:50

of, I mean, you're gonna be heavy sweating, humid conditions potentially, and then when we find these patients, they aren't sweating. Their clothing may be wet because they've been sweating, but their body is not, their body's dry. That's gonna be a pretty heavy indicator. They're probably gonna be semi-conscious or unconscious. Their response to our neural questions are gonna be weird. Uh, what day is it? Well, I don't like that question because I work 24-hour shifts, I rarely know what day it actually is. I can give you a guess. But things like how many quarters are in a dollar? Um, who's the president of the United States? Where are you at right now? Those are the questions we'll ask. And generally, if they are in this condition and they can respond to us, it's not gonna be good responses. So we know they're neurological. You said earlier, um, runners' brain. You can't do math when you're running, right?

SPEAKER_00 24:48

Right.

SPEAKER_02 24:49

Uh same thing here. That's that's exactly what's going on. And then when we're testing the neural response, that's what we're looking for. Is your brain functioning? And the brain's gonna do the same thing that the body's doing, it's gonna try to shut down, send everything, all resources to surviving. Um, that's why you're probably gonna be unconscious when we find you during the heat exhaustion. Uh, other things we're gonna look at are gonna be uh super elevated pulse rate. Again, I said for the elite athlete, you're probably gonna be normally between between 100 and 130 when you're on an active run. That's normal for you. You know that. But you also know that if you slow down, change your pace, maybe take a quick break, your pulse rate should fall pretty quickly. You should get back into your normal range. And your normal range is probably gonna be lower than the average human. You're probably gonna be maybe 50 to 70 beats per minute is your normal, whereas the average human's gonna be 60 to 90 is their normal range, depending on their health. So it's those that we can't slow, or that they can't slow the pulse rate down. They've they've gotten to that exhaustion point where their body is now just in survival mode. So the body's gonna try to elevate that pulse rate, elevate the blood pressure. And the elevation of blood pressure is really your body's vessels constricting to force more pressurized blood back to the heart and brain. Um for us, that's pretty serious. You get into a syndrome called supraventricular tachycardia, that's where your heart is beating so fast that it can't keep up with the flow. So you're sending fluid out to the system, but the system can't efficiently return that blood back to the heart to get rid of those waste products like CO2. It can't uh send the nutrients out that uh efficiently that are needed. So you get in that stagnation mode. If you're in that superventricular tachycardia that above 150 beats per minute, your your heart effectively is dry firing. And it can only do that for so long before you'll go into cardiac arrest. It's gonna be respiratory arrest first. So you'll stop breathing, your brain's gonna shut down, uh, you'll be unconscious, and then yeah, you're going to go into just your heart's not gonna fire anymore. Uh obviously we have some things to help fix that. Um if somebody's in SVT, we have some drugs that can can stop that SVT. Uh we have uh electricity as well. We can send electricity into the body externally and stun that heart, and hopefully uh by a process of automaticity, we can get your heart back to firing normally. The problem with that is we have to then worry about those electrolyte imbalances. So I have to give you some other fluids. Um pre-hospital, I'm just gonna give you normal saline, get you to the hospital. In hospital, they're gonna give you probably a banana bag, which is gonna be an electrolyte IV. They're gonna do active cooling, so they're gonna probably put you in a cooling blanket, which is a pretty cool device. Pre-hospital, we're gonna cool you as well. We're probably gonna put cold packs in your uh sensitive areas, your armpits, your groin. We're gonna get that the excess clothing off of you. We may even soak a sheet down with water and put it around you, hopefully to cool that system down. Again, the brain, or I should say the brain is the regulator of heat in the body, heating and cooling. The skin is the thermostat, so to speak. So the skin should tell the brain what to do. Send more fluid, cool the system down until you just don't have enough fluid and it can't cool the system down, then you get into problems. Uh and certainly in heat stroke, it's probably going to be a combination of not enough fluid, not enough electrolytes, but also um elevated temperature. So pyrexia. You have a fever of above 103. And for the adult human, you don't do well with a fever of 103. Anybody that had the COVID back over the last three years probably had that high pyrexia, that high fever above 103. Um, for most adults, you probably were stumbling around the house trying to get to a bed to lay down. You probably were confused, probably mumbling, and just didn't feel good at all. Imagine that while you're on a run, you're gonna have those same symptoms. So we got to actively cool you. If you stay in that pyrexia mode, you're basically gonna burn the brain up. The brain is gonna lose a lot of cells. Um, and if we don't cool you enough, you're going to have some injury to the brain. Again, um,

Heat Stroke, SVT, And Rapid Cooling

SPEAKER_02 29:42

it's in the name, heat stroke. Imagine the deficits you can get from having a uh a blood clot or a brain bleed, and uh and what you would expect to see from that, you may see some of those same things from heat exhaustion, or I'm sorry, heat stroke.

SPEAKER_01 29:57

Wow. So, yeah, catching it early, not ignoring those signs, that's key. So it doesn't elevate to that. Um, so you have been on some marathon courses um in your paramedic days?

SPEAKER_02 30:12

I have. Yep. I've I've been able to work the uh Detroit uh free press marathon.

SPEAKER_00 30:18

Oh, cool.

SPEAKER_02 30:19

Uh which was pretty cool. Well, they uh the runners get to run onto uh Belle Isle, which is a cool little island that's attached to the city of Detroit. Uh then they get to run across the Windsor River and go into Canada and then run back. It's a pretty cool thing. And uh sponsored by hospital, a couple of hospitals sponsored by several businesses. So the hospital provides uh aid tents along the route. Uh they may have a they generally have a centralized mash hospital type spot where um people that go down on a course can be taken to and treated, and that'd be for the the the first, second, and tertiary, you know, up to heat exhaustion, you may be able to go to those mash tents and get some recovery, and that's where we're gonna get more advanced fluid replacement, maybe the banana bags, active cooling. So we're gonna have uh igloo coolers with fans attached to them and they're misters. You've I'm sure you've seen them.

SPEAKER_00 31:16

Yeah.

SPEAKER_02 31:16

But we're gonna blow cool uh literally ice water. We're gonna blow ice water mist onto the onto the patient and hopefully get them cooled down. More advanced, you may be in the back of an ambulance with lights and sirens on the way to an ER.

SPEAKER_01 31:32

So you actually have seen people get to that point where they weren't able to fix them on the course.

SPEAKER_02 31:38

Yes. Yeah. And of course, you get the the those people that may not know they have a heart condition and they end up having the heart attack on the course, and that may not be electrolyte, that may not be uh it may it just be aggravated by what you're doing. You're taxing your body that it's not used to it, and you trigger that cardiac event. Um I've had to do CPR on a marathon course. Uh it just happens.

unknown 32:04

Wow. Okay.

SPEAKER_01 32:06

Now, one of the things um that I do, I don't know if other runners do it, um, but for instance, if it's 50 degrees out, I dress as if it's 70. So we have like this 20-degree rule so that I don't overdress. Now, that being said, all of my friends that are listening are laughing because I always overdress when it's chilly out because I don't like to be cold. But I will make a loop back after a couple miles and drop off a shirt or a jacket or whatever so that I do get down to the minimal um clothing. Um do you do that with like the firefighters um if they're going out? Because you guys have a lot of heavy gear um for whatever I obviously you can't take off your fireproof things, but for what's going on underneath, do you dress less in order to help them stay cool for the amount of time that they're going out, or it's like, no, we just suck it up?

SPEAKER_02 33:00

Yeah, a lot of times it is just suck it up uh initially. Uh, you know, we dress in uniforms, so I wear a uniform. I'm lucky at my current job that I get to wear shorts in the summertime, which is nice. Um first time in my career I've ever been able to do that. Um we wear a polo shirt as our as our uniform top in the summertime. So yeah, I mean we we kind of are dressed for being in the warm temperatures. However, when you put that fire gear on, which is anywhere from 50 to 70 pounds worth of gear, uh, and then you put an air pack on, which is another 25, 30 pounds of weight, and you grab some hose bundles, which may be 20, 30, 40, 50 pounds, and probably a tool like an axe or a halligan tool, you're gonna be a pretty heavy dude or woman going into a very hot environment. Now imagine going into a burning building, you are stepping into um a campfire.

SPEAKER_01 33:59

Oh, sure.

SPEAKER_02 34:00

Uh the the superheated conditions inside those, we call it ideal age, in immediate danger to life and health. So when we're in those environments, we know that we potentially could get burned if we put water too quickly on uh on that superheated environment, and we're inside, we're gonna create a steamover condition where you're going to be fried or uh boiled like a crab and right through your gear. It's not your gear's not going to protect you from a steam over. Um, and then there's obviously all kinds of other conditions that fire can cause. For us, we have a bottle rule. So our bottle rule is you can go through two bottles and then you have to come out. You have to sit down, you have to take rehab. And rehab can be 10, 15, 20 minutes potentially. Let your heart rate get down, drink some fluid, um, maybe drink some Gatorade. I'm not a Gatorade person, but uh we always have it on standby. Um, and then some snacks. We've always got some snacks, might be granola bars, might be um velve. That's a pretty common one. We we kind of like that in the fire service. At least I do.

SPEAKER_01 35:10

So potentially you don't let anyone get past stage one.

SPEAKER_02 35:16

No, we're gonna have an eye on it. Now you've always got those people that uh push themselves, uh, that don't pay attention, they want to get in there and fight that fire. I mean, that's what we do, right? We're fire fighters. It's in the name. That's what we wanna do. So yeah, we we take a uh we take a break, get out of there, sit down, recover, take your gear off. Um and we and we will. We'll we'll take our our our top off, our coat off, we'll take our our pants down, let your body cool

Marathon Medical Tents And Real Emergencies

SPEAKER_02 35:51

down before you go back in there. Um the other thing we do uh ahead of time is we take a baseline vital set uh prior to any of these events. We do that a couple times a year. So we know what every individual uh should look like normally for their vitals. And then when we're in these superheated conditions or we're in these high activity conditions during rehab, we can check those vitals and we know, hey, you you you're not slowing down to your normal, you're not coming down, you're not gonna go back in for right now. Drink some more water, rest, but we're all the same way. We're all type A personalities. We want to do the job, we want to get in there and fight fire, and right. And it's not just fires. We're out on uh a trauma scene on a car accident, it's it's a hot day out, humid, and we're doing and we're still in that gear, we're just actively working. Um, we have to consciously remind ourselves to to pay attention to the signs, but how we do that is kind of through the body system. Hey, get out of there. You've been in too long, you've been working too long. Look at you, you're sweating, you're pouring sweat, or even worse, you're not sweating now.

SPEAKER_01 37:01

Yeah, so that's a a good lesson for everybody, whether you're looking at your neighbor who's been working out in the yard all day or you are exercising, doing whatever type of exercise outside is to to know yourself, but also look at your buddy and make sure they're okay. Yeah, those are just little things that you don't think about um when you're out there doing it, but I th really knowing yourself, I think, is key and being humble enough to say, Oh, I gotta pull the plug on this race, or I can I can't finish mowing the grass, you know, and it's I've only done half the lawn, I always can do the whole lawn, but it's you know, just you know, being humble and and saying, Yep, I've got to pull the plug today. Wow.

SPEAKER_02 37:49

Cool. Yeah, and I think we as humans now, we as humans now we're at a point in society where we have so much going on anyway, we have so much external input into our lives. We have a we have a computer in our hand, uh, and and most people are on that computer for a uh a lion's share of their day. But it's not just the computers, it's just everything, life is busy. So you ignore those signs, and it's not just you're doing extreme conditions or you're doing extreme uh athletic things, it can be mowing the law and it can be just doing your normal stuff. And you may just go, man, I just feel off today. I don't feel right today. Um certainly for for most people, most people will ignore those little indicators. So yeah, it's good to have somebody paying attention to you other than yourself.

SPEAKER_01 38:42

Yeah, for sure, having that buddy. All right. Any last little things we should know about our heat um symptoms or injury uh that we didn't touch on?

SPEAKER_02 38:57

I'm sure there's a bunch we didn't touch on, and I I'm long-winded when it comes to medicine, so I I'll I'll just be simple. Um look for the the basics. If you get that cramping, that first sign of uh heat cramps, the first condition of or the first uh symptomology of heat-related illness. Hey, it's not just your muscles are are tightening, it's your body telling you that you need electrolytes, you need salt. Uh, next was the heat syncope, that blood pooling in your extremities, and you faint. That's an indicator. Don't get up and keep going. You have to recover. Uh heat exhaustion, where your heart rate is elevated and can't come down. You got nausea, potentially vomiting, you're dizzy, you can't concentrate, you can't do simple math. That may be an indicator. Stop doing what you're doing. And then that last one of heat stroke, that's the serious one. That's the one that's going to send your body potentially into cardiac arrest. Those things, watch your body, watch yourself, pay attention. I like your idea of setting an alarm to tell yourself it's time to drink some water or it's time to take a snack. Um, but just listen to yourself, listen to your body. When you're training for extreme athletic events, you need to know what your body's going to tell you about what you're doing. So pay attention to it.

SPEAKER_01 40:17

Thank you. Such great advice. All right. Well, I

Firefighter Rehab Rules And Final Takeaways

SPEAKER_01 40:20

think that's wrap on this one. Those of you listening, please follow, share, and rate this podcast wherever you are listening. If you would like to reach out to Chris to perhaps be a paramedic, a firefighter, whatever, um, you can find his information in the show notes. You can reach me at Carla at CoffeeCrewCoaching.com. You can follow me on Instagram as well as Facebook under coffeecrew coaching.com or welcome back. I mean, over the next tale fitness podcasts. It's been a long day. And um that's all for today. Thanks so much, Chris, for being here, and we'll see you later.

SPEAKER_02 40:57

Thanks for having me, Carla. This has been fun.

SPEAKER_01 40:59

Great. Bye bye.

SPEAKER_02 41:01

Bye.