The Army trains to fight and win in all weather conditions and environments. Soldiers train when it’s hot, and with some of the hottest years on record recently, they’ve had to train and work in some extreme heat.

Soldiers serving throughout the U.S. Army Central Command’s area of responsibility know the challenges of working and training in extreme heat. Temperatures in Kuwait average around 111 degrees Fahrenheit during the day in the summer months.

Sand can also become a nuisance in some regions. Lt. Col. Megan McKinnon, 1st Theater Sustainment Command surgeon said, “Soldiers can wear their masks to protect them from the sand.” She also recognizes that some activities are better when planned for early morning, evening, or nighttime when the temperatures are not as high.

Heat increases the risk of avoidable, heat-related illnesses (HRI). Soldiers can prevent them by getting enough sleep prior to training, eating nutritious meals and staying hydrated.

How much water should you drink?

According to the Army Public Health Center, Soldiers should consume 1 quart of water per hour during most training conditions and a maximum of 1.5 quarts per hour under very strenuous conditions. They also recommend rehydrating slowly and steadily after training and replenishing salts and nutrients.

However, HRIs still occur and Soldiers should know their symptoms. These heat-related illnesses should be quickly treated and reported.

A Soldier with heat exhaustion could show signs of dizziness, headache, nausea, or weakness. Soldiers may also experience muscle cramps or fatigue and have an elevated core temperatures above 104 degrees Fahrenheit.

Soldiers should be placed in the shade with head gear removed and uniform loosened. According to the APHC, Soldiers should drink 1.5 quarts of water over the span of an hour. If the Soldier doesn’t improve within 20 minutes, seek immediate treatment by a medical professional.

McKinnon has treated Soldiers with HRI, and she encourages Soldiers to start slowly and understand that, “early sweating is a sign of acclimatization.”

Heat stroke is a more severe heat-related illness which must be treated immediately. The primary symptom is a change in mental status. Soldiers might get confused, combative, delirious, or even lose consciousness. They could sweat profusely, vomit, or have convulsions and chills. This is a medical emergency that could lead to death.

The APHC states that Soldiers must be cooled immediately and medically evacuated. All outer clothing should be removed and the body covered with ice sheets except for the face. These ice sheets should be soaked before applying them to the Soldier, and they should be switched every 6 minutes.

Hyponatremia is an illness a Soldier could get if sodium levels in the blood are abnormally low from drinking gallons of water without appropriate nutrition. Sodium helps regulate the amount of water in and around cells, and without the right amount, a Soldier could develop hyponatremia.

This condition can cause a change in mental status, repeated clear vomiting, a distended or bloated abdomen and large amounts of clear urine. Urgent medical attention is needed to check sodium levels. Therefore, this Soldier must be evacuated immediately. The APHC recommends offering salty foods if he is awake.

McKinnon urges Soldiers not to try to lose weight while they are acclimating to a new hot environment, because poor nutrition can lead to hyponatremia. Soldiers can simultaneously suffer from heat stroke and hyponatremia. Both are medical emergencies and require immediate action.

Even though Soldiers can’t always train in ideal weather conditions, they can maintain adequate nutrition, drink water, and modify time outdoors when the mission allows.