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Backcountry Dehydration

This article was published May 2014 in the "Backcountry Safety" column of the Hunt Alaska Magazine.

Story by Jon Hunt

Last season, the Tier 1 Unit 13 caribou hunt was slim picking.  Fish and Game opened the season with bulls only, and it seemed we could only find the cows.  Apparently, we should have been in Eureka, instead of on the Denali Highway.  Nevertheless, we had a great hunt, and eventually found a few straggler bulls to fill the freezer.

Early on in our hunt, we were frustrated with the lack of caribou.  This motivated us to wake up earlier, glass longer, ride a few ATV trails to their end, and hike some areas that we had never explored.  On day three of the hunt, our enthusiasm outweighed the urge for breakfast.  We broke camp in such a rush I even skipped my morning coffee (a rare occasion indeed).  In our frenzy to fill our tags we settled on a granola bar for lunch, and somehow even skipped dinner.  Late that evening we got back to basecamp, and as we were preparing a long awaited dinner, one of the hunters in our group started having severe abdominal cramps.  Despite the fact that we had hunted together for years, this was the first time we had ever seen him have cramps.  His severe pain forced him to skip dinner and lay in bed curled in a ball.  Attempts to defecate were unsuccessful (no shit!).  In reflecting upon the day, we realized that we had eaten hardly no food, and had drunk little water.  It seems ridiculous that we so easily neglected our basic human needs.

Although this was not the case in our scenario, diarrhea significantly affects hydration level and should be carefully monitored in the backcountry.  Common causes of diarrhea are: parasites (such as Giardia or Cryptosporidium), food allergies, viruses, stress/anxiety, and bacteria.  Dr. Eric Weiss, in his book Wilderness and Travel Medicine, suggests to “seek medical attention when diarrhea is accompanied by blood or mucus in the stool, a fever greater that 101° F, severe abdominal pain or distention, moderate to severe dehydration, or diarrhea that lasts more than three days.   The fluids and electrolytes lost from diarrhea can be potentially fatal in children and devastating for in adults.”

What is dehydration?

Mayo Clinic defines dehydration as, “Dehydration occurs when you use or loses more fluid than what you take in, and your body doesn’t have enough water and other fluids to carry out its normal functions.”  This often occurs during significant physical exercise, in a hot environment, during heat-related emergencies, and after experiencing severe vomiting or diarrhea.

Dr. Weiss stresses, dehydration causes blood vessels in the skin to constrict and prevent the body from cooling itself, sweating, and evaporating heat.

Ginny Grupp, co-author of 3 Steps to Your Best Body in Record Time, and founder of AlaskaFit, cautions Alaskans that dehydration does not only happen in warm, dry climates.  Keep in mind is that we live in a very dry climate.  Every time we exhale, we are losing hydration, especially on cold, dry days.

Field assessment of dehydration:

  • A headache is often an early sign of dehydration.
  • Dr. Weiss states, dehydration is observable by an increase in frequency and looseness of bowel movements.
  • Thirst is not a reliable way of measuring hydration.
  • An easy tool for monitoring hydration levels is to observe urine color.  Normal urine color is clear to light yellow.  If your urine is not clear, drink more water.  (some vitamins or medicine turn urine a yellow/orange color.)  When hydration is inadequate, urine color becomes yellow, dark yellow and even brown color.  As dehydration intensifies, urine output becomes less frequent.
  • Jennifer McKinnon FNP, Nurse Practitioner at LaTouche Pediatrics, advises that an easy assessment of children is to make sure they are able to urinate at least once every 12 hours as well as being able to generate saliva.
  • Dr. Weiss suggests that severe dehydration may be accompanied by drowsy or lethargic behavior, dry mucus membranes, sunken eyes, no urine, no tears, and signs of shock (rapid pulse or one that is thready or difficult to feel).”
  • Volume Shock is possible as a result of dehydration.  In severe cases, mental functioning and level of consciousness diminish.  Pulse and respiration initially increase, but eventually the blood pressure will drop and the level of responsiveness can diminish to the point of unresponsiveness.

Field treatment of dehydration:

  • If dehydration is suspected, it is critical to administer fluids and electrolytes.  Water is often not enough, once dehydration depletes the body of the essential elements it needs to function on a cellular level (sugar/glucose, salt/sodium, and potassium).  Oral rehydration solutions; electrolyte tablets; and foods high in simple sugars, potassium, and sodium (such as bananas, raisins, potatoes and rice) may be helpful.
  • Continue to monitor the color and frequency of urination as well as signs of shock.
  • Cool water (not too hot, not too cold) is easiest for your body to assimilate.  Slow sips of water will help prevent vomiting.
  • Drinks that are high in carbohydrates (such as fruit juices or Gatorade) should be diluted at least 50% with water to help the body absorb the fluids and nutrients, as well as to prevent stomach cramping.
  • Severe dehydration may require intravenous fluid replacement and immediate evacuation.

Prevention of dehydration:

  • Maintain hydration and balance of electrolytes.  Drink before you get thirsty.  Thirst is not a reliable measure of your hydration.
  • Keep your water bottle easily accessible to encourage hydration.  I prefer Platypus Water Bottles with the hydration hose to make staying hydrated easy.  Dr. Weiss’ suggestion is to “drink at least 0.5 liter of water every 20 minutes while hiking to avoid dehydration.”  Adults typically need to consume at least 1 gallon (about 4 liters) of water per day. 
  • Always carry an easy means of water purification so you have drinkable water on long trips.  I always pack iodine water treatment tablets or chlorine dioxide tablets on my person along with a water storage device (in my Backcountry First Aid & Survival Kit made by Frontier Safety and Supply).
  • Keep in mind that dehydrated meals (such as Mountain House) are not prepared with enough water to completely rehydrate the food.  If you eat freeze-dried food, you need to be consuming additional water.
  • Avoid coffee, alcohol, caffeine or excessively sweet drinks, they work against your body.  If you are a coffee drinker be sure to drink extra water to counteract its dehydrating effects.
  • Don’t get overheated.  Rest regularly.
  • Wear clothing that wicks moisture from your body and breathes.

Special Considerations:

  • Diabetics are greatly affected by hydration levels.  Even diabetics who normally maintain excellent control of blood sugar levels are impacted significantly by vomiting, diarrhea, or changes in diet and exercise.
  • Children, elders or people with chronic diseases are especially vulnerable to dehydration.

Why is dehydration such a big deal?

In review, mild to moderate symptoms of dehydration include: lethargy, headache, dry sticky mouth, sleepiness, tiredness, thirst, constipation, dizziness or lightheadedness.  While these may be annoying at home, in the backcountry, they could be deadly.  Dizziness and tiredness lead to poor decision-making and possible falls or delayed reaction time to emergency situations.  In severe cases of dehydration the body’s fluid supply is severely depleted and volume shock is likely to occur.

Hopefully this is a friendly reminder to stay well hydrated; you will certainly avoid unnecessary suffering and enjoy your hunt much more.  Don’t forget to remind your buddies to stay hydrated or you may have to listen to them whine all night, or even worse, end your hunt early.