ESO GUIDELINE FOR CONDUCTING | Page 203

controlling measures include; monitoring living area temperatures of 74 degrees +/- 2 as outlined in AR 420-1; decreasing the distance and/or pace of unit runs; and changing the training schedule if strenuous events are scheduled, especially if they are scheduled to occur outdoors in category CAT IV or V conditions. >           >                 (6)  For Soldiers who are at increased risk for heat illness, pre- and post-activity weighing is an excellent tool for monitoring their hydration level and managing their risk.  Weigh Soldiers the same time each day, after using the bathroom, before showering, and in underwear.  Any weight lost in 24 hours represents loss of water.  If weight has been lost, have the Soldier drink water or an electrolyte drink at the rate of one pint of water per pound, not to exceed hydration guidelines.  If weight has been gained, have the Soldier eat a salty snack, and do not require him or her to drink more water.  If feasible and if sufficient numbers of scales are available, weigh all Soldiers during CAT IV and V conditions. >           >               (7)  For treatment of suspected heat casualty, the use of iced sheets is mandatory.  Although guidance from TR 350-29 states that ice sheets should be applied anytime the Soldier has a change in mental status, err of the side of caution and always apply ice sheets to Soldiers showing any signs of environmental heat overexposure.  Any change to this regulation needs prior approval from DCG IMT.  The use of bed sheets cooled with ice water has been proven to significantly improve the recovery and outcome of persons suffering from heat stroke.  Insulated ice chests can be maintained at training sites by DSs/CLS; carried on ambulances; and/or maintained at troop medical clinics.  Prepare and apply iced sheets as follows: >           >                   (a)  Soak normal bed sheets in insulated ice chests full of iced water.  The sheets can be kept in resealable plastic bags ready for use, or kept immersed in the water.  Commanders should plan on a minimum of eight sheets per company. >           >         (b)  Remove Soldier's outer clothing, down to underwear. >           >                   >         cold (c)  Cover as much of the exposed skin as possible, and the top of the head, with the ice sheets. >           >                   (d)  When the sheets warm up, remove them and replace them with fresh iced sheets. >           >                   (e)  Heat related illnesses may occur at any temperature and iced sheets may be carried at >         the discretion of the commander.  However, iced sheets will be maintained at the training site whenever a wet bulb is present. >               >              (8)  All IMT cadre including Drill Sergeants, Platoon Sergeants, Squad Leaders, Company Leadership, and support personnel involved in training Soldiers in a field environment will view the video “Death of a Soldier: Heat Can Kill,” on an annual basis in order to ensure all cadre are trained on hot weather injury prevention.  The video can be found at:  https://www.us.army.mil/suite/doc/29636707 >           >            c.  Rhabdomyolysis or "rhabdo," is the breakdown of muscle fibers and release of muscle fiber products into the circulation.  Some of these products are toxic to the kidney and frequently result in kidney damage.  In some cases, rhabdo has resulted in kidney failure and death.  Rhabdo can be caused by extreme exertion in a person who is