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Fact sheet: Singapore Armed Forces (SAF) Management of Heat Injuries
Others | 04 May 2018 09:38 (GMT+8)

Safety Precautions and Prevention of Heat-Related Injuries

The SAF places an utmost importance on the safety and well-being of its servicemen and we will spare no efforts to ensure that safety precautions are taken for our soldiers. The SAF adopts various strategies and precautions, including educating commanders and servicemen through training and medical advisories to recognise the symptoms of heat injuries.

To prevent heat injuries in the SAF, we ensure that our servicemen are well prepared for strenuous training. This includes ensuring they have had the appropriate build-up training, adequate rest and hydration before commencement of the strenuous activities, and checking to ensure that our servicemen are feeling well enough to participate.

Soldiers are trained progressively to minimise risk of injuries. This includes using a Heat Acclimatisation Regime to safely acclimatise soldiers to the training environment, as well as suitable work-rest cycles based on training tempo and ambient temperature to allow periods for rest and hydration in between. 

Measures Description
 Temperature Taking Regime

Soldiers who are physically unwell have a higher risk of suffering from heat related injury. Before soldiers undergo any activity, a temperature taking regime allows units to detect soldiers who are unwell, but are not willing to take themselves out of such training activities and duties. However, temperature taking may not be fool-proof as there are mild afebrile illnesses (e.g. diarrhoea), that may not be picked up through temperature taking.

Soldiers with temperatures above 37.5C will be disallowed from participating in the training activity. When a soldier's temperature is above 37.5°C, his commander must verify the reading as follows:
    
(1)    The soldier should rest for 10 mins before having his temperature retaken;
(2)    Should the temperature remain above 37.5°C, the soldier must be made to seek medical attention.
 Hydration Regime

First-year soldiers undergoing courses or in units undergoing training to turn operational must have supervised water parades to ensure adherence to the hydration regime. When engaged in strenuous activities, servicemen are to consume additional before, during and after activity, up to the point of thirst.

There will also be provision of adequate water points made available for training activities.
 Work-Rest Cycle (WRC) based on Wet Globe Bulb Temperature (WGBT) WRC based on WGBT readings permit the conduct of prolonged strenuous activities in a sustainable and safe manner. The ratio of work vs rest is dependent on the WBGT readings. High WBGT readings will result in a high heat load on the body. Hence, in general, higher WBGTs will mandate a soldier to reduce the training tempo and cater for rest in between training periods.
 Progressive Training The volume of training should be progressive in nature varying in intensity to allow soldiers to acclimatise in a safe manner.

 

Treating Heat Injuries

Should a heat injury occur during training, on-site cooling measures (i.e. removal of clothes, application of ice or water), will be administered based on established protocols. The duty medic is also equipped with a combat medic bag that contains medical equipment for additional treatment and even resuscitation. These include intravenous drips to rehydrate heat injury casualties. Should the heat injury progress and the casualty rapidly deteriorates despite the above, the duty medic also has an automated external defibrillator (AED) and airway adjuncts at his disposal, which can be administered onto the casualty on-site for further stabilization. 

Following on-site treatment, the casualty will be rapidly evacuated to the nearest medical facility (i.e. medical centre in camp) where he will be put under the body cooling unit to further reduce the body temperature, while undergoing close monitoring. The body cooling unit sprays a mist of water over the casualty’s body with continuous dispersion of the mist by a fan. This can be repeated over several cycles to aid in the dissipation of the heat load, and the evaporative cooling of the casualty. The medical officers and medics are also trained and equipped to resuscitate an unstable heat injury casualty with life-saving interventions like intubation and artificial ventilation, should the casualty develop progressive complications (e.g. total loss of consciousness). Once the casualty has been sufficiently stabilised, the medical team will transfer the casualty to the ambulance for expedient evacuation to the nearest hospital for further treatment.

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