SAF outlines measures to prevent heat injures following death of NSF who had heatstroke

The Singapore Armed Forces said that soldiers with temperatures above 37.5 deg C will not be allowed to participate in training. PHOTO: ST FILE

SINGAPORE - The Singapore Armed Forces (SAF) outlined on Thursday evening (May 3) the measures it has in place to prevent heat injuries among its servicemen.

This comes after full-time national serviceman Dave Lee Han Xuan, 19, died on Monday after he suffered heatstroke.

In a statement, SAF said that to prevent heat injuries in the organisation, "we ensure that our servicemen are well prepared for strenuous training".

This includes ensuring servicemen have the appropriate build-up training, adequate rest and hydration before participating in strenuous activities, and ensuring that servicemen feel well enough to take part.

The measures are as follows:

1. Temperature taking regime

SAF said that 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, such as diarrhoea, that may not be picked up during temperature taking.

Soldiers with temperatures above 37.5 deg C will not be allowed to participate in training.

When a soldier's temperature rises above 37.5 deg C, he should rest for 10 minutes before having his temperature retaken. If the temperature remains above 37.5 deg C, the soldier must seek medical attention.

2. Hydration regime

First-year soldiers undergoing SAF courses, or in units undergoing training to turn operational, must have supervised water parades.

When engaged in strenuous activities, SAF said that servicemen must drink additional water before, during and after the training activity, up to the point of thirst.

Adequate water points will also be made available for training activities.

3. Work-rest cycle based on wet globe bulb temperature

A work-rest cycle that is based on readings of a wet globe bulb temperature allow prolonged strenuous activities to be done in a sustainable and safe manner, said SAF.

The ratio of work compared to rest is dependent on the wet globe bulb temperature readings. High readings will result in a high heat load on the body.

So, in general, higher readings mean that a soldier has to reduce the training tempo and factor in rest in between training periods.

4. Progressive training

SAF said that the volume of training for servicemen should be progressive in nature, varying in intensity to allow soldiers to acclimatise in a safe manner.

SAF also spelt out how it treats heat injuries in its statement on Thursday night. It said that should a serviceman have a heat injury during training, on-site cooling measures - such as removing his clothes and applying ice or water - will be administered based on established protocols.

The duty medic on site is also equipped with a combat medic bag that contains medical equipment for additional treatment and resuscitation, such as intravenous drips to rehydrate heat injury casualties.

If the heat injury and the condition of the affected serviceman deteriorate despite the steps taken, the duty medic also has an automated external defibrillator and airway adjuncts he can administer on the soldier to stabilise his condition.

After treatment on site, the injured serviceman will be quickly evacuated to the nearest medical facility, such as the medical centre in a military camp, where he will be put under a body cooling unit to further reduce his body temperature. He will also be closely monitored at the same time.

The body cooling unit sprays a mist of water over the serviceman's body which is dispersed continuously by a fan. This can be repeated over several times to help reduce the injured person's heat load and facilitate cooling by evaporation.

Medical officers and medics are also trained and equipped to resuscitate an unstable heat injured serviceman, such as through intubation and artificial ventilation, if the casualty develops complications such as totally losing consciousness.

Once the serviceman has been sufficiently stabilised, the medical team will transfer him to an ambulance to be evacuated to the nearest hospital for further treatment.

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