CHAPTER 2

INDIVIDUAL PREVENTIVE MEDICINE MEASURES

Section 1. Heat Injuries

DRINK PLENTY OF WATER

Depending on the heat, you may need to drink from 1/2 to 2 quarts of water per hour- 4 gallons or more per day in hot dry climates.

Drink extra water before starting any mission or hard work. Cool water (50° to 55°F) is absorbed faster than cold water.

NOTE

If your urine is dark yellow, you are not drinking enough water! Thirst is not a good indicator of dehydration.

USE WORK/REST CYCLES

Work and rest as your leader directs.

Work and rest in the shade, if possible.

EAT ALL MEALS TO REPLACE SALT

Take a salt solution only when directed by the medical personnel.

RECOGNIZE THE RISK OF MOPP/BODY ARMOR/ARMORED VEHICLES

MOPP/body armor increases your heat stress. You must:

You are at a greater risk of heat injuries when in armored vehicles-you must drink more water.

MODIFY YOUR UNIFORM

If directed/authorized by your commander:

If the threat from biting insects is high, leave shirt sleeves down, and pants bloused in boots.

NOTE

See GTA 8-5-45, heat injury prevention and first aid and FM 21-11, first aid for soldiers, for information on heat injury prevention and first aid.

Section II. Cold Injuries

WEAR UNIFORM PROPERLY

Wear the clothing your commander directs.

Wear clothing in loose layers (top and bottom). Avoid tight clothing including tight underwear.

Keep clothing clean and dry. Remove or loosen excess clothing when working or in heated areas to prevent overheating that causes sweating.

Wear headgear to prevent body heat loss.

Avoid spilling fuel or other liquids on clothing (or skin).

KEEP YOUR BODY WARM

Keep moving, if possible.

Exercise your big muscles (arms, shoulders, trunk, and legs) frequently to keep warm.

If you must remain in a small area, exercise your toes, feet, fingers, and hands.

Avoid the use of alcohol.

Avoid standing directly on cold, wet ground, when possible.

Avoid tobacco products. The use of tobacco products decreases blood flow to your skin.

Eat all meals to maintain energy.

Drink plenty of water and/or warm nonalcoholic fluids. Dark yellow urine means you are not drinking enough fluids! You can dehydrate in cold climates too!

PROTECT YOUR FEET

Bring at least five pairs of issue boot socks with you.

Keep socks clean and dry.

Change wet or damp socks as soon as possible. Beware of wet socks from sweating!

Wash your feet daily, if possible.

Avoid tight socks and boots (lace boots as loosely as possible).

Wear overshoes to keep boots dry.

PROTECT YOUR HANDS

Wear gloves (with inserts) or mittens (with inserts).

Warm hands under clothing if they become numb.

Avoid skin contact with snow, fuel, or bare metal.

PROTECT YOUR FACE AND EARS

Cover your face and ears with a scarf or other material, if available.

Wear your insulated cap with flaps down and around your chin.

Warm your face and ears by covering them with your hands.

Exercise facial muscles.

PROTECT YOUR EYES

Wear sunglasses to prevent snowblindness.

Improvise sunglasses (slit goggles) if actual glasses are not available.

PROTECT YOUR BUDDY

Watch for signs of frostbite on his exposed skin- pale/gray/waxy areas.

Ask him if his feet, hands, ears, or face are numb and need rewarming.

Do not let him sleep in or near the exhaust of a vehicle with the engine running or in an enclosed area where an open fire is burning (carbon monoxide poisoning). Do not allow him to sleep directly on the ground.

NOTE

See GTA 8-6-12, adverse effects of cold, cause and symptoms and FM 21-11, first aid for soldiers, for information on cold injury first aid procedures.

Section III. Arthropods and Other Animals of Medical Importance.

USE INSECT REPELLENT

Use on all exposed skin: face, ears, neck, arms, and hands.

Use where clothing fits tightly, such as: upper back, buttocks, and knees. Apply to all openings of the uniform (collar, cuffs, shirt front, waistband, and boot tops).

Reapply a thick coat immediately if you get wet or--

Read the label for directions and precautions before using.

WEAR UNIFORM PROPERLY

Wear uniform as your commander directs.

Wear headgear to protect the top of your head.

Wear loose fitting uniform, not tightly tailored, repair tears/holes.

When the arthropod threat is high--

KEEP UNIFORM CLEAN

Wash your uniform frequently to remove arthropods and their eggs. If the situation permits, use the quartermaster laundry. Otherwise, use a can, stream, or lake.

FOLLOW MEDICAL ADVICE

Take malaria pills when directed by your commander.

Use insect powder/cream/shampoo when prescribed by medical personnel.

PROTECT YOURSELF AT NIGHT

Use your bednet when sleeping. Tuck net under sleeping pad/sleeping bag so there are no openings.

Use an aerosol insect spray inside the bednet after it is tucked (or in your tent if it can be sealed). Spray for only 1 or 2 seconds. AlloW at least 10 minutes for aerosol to disperse before occupying the bednet or tent.

Repair holes in your bednet.

PROTECT YOURSELF FROM OTHER MEDICALLY IMPORTANT ANIMALS

Spiders--

Scorpions--

Snakes--

DOMESTIC AND WILD ANIMALS OR BIRDS

Avoid handling or approaching so-called "pets."

Exclude such animals from your work and living areas, unless cleared by veterinary personnel.

Do not collect or support (feed or shelter) stray, domestic, or domestic-like animals/birds in the unit area, unless cleared by veterinary personnel.

Section IV. Poisonous Plants and Toxic Fruits

Avoid contact with poisonous plants by properly wearing the uniform.

Avoid areas where poisonous plants grow.

Do not eat plants or parts of plants which might be unsafe. If you do not know, do not eat it.

Do not put field or turf grasses or woody twigs or stems in your mouth.

Section V. Food/Waterborne Diseases/Illness

WATER

Fill your canteen with treated water at every chance. When treated water is not available, you must disinfect water in your canteen using one of the following methods.

PREFERRED METHOD-IODINE TABLETS

Fill your canteen with the cleanest water available.

Put one tablet in clear water, or two in cold or cloudy water. Double these amounts in the 2 quart canteen.

Place cap on canteen, wait 5 minutes, then shake. Loosen the cap and tip the canteen over to allow leakage around canteen threads. Tighten the cap and wait an additional 25 minutes before drinking.

ALTERNATE METHODS

CHLORINE AMPULES

Fill your canteen with cleanest water available.

Mix one ampule of chlorine with one-half canteen cup of water, stir the mixture with a clean device until contents are dissolved. Take care not to cut your hands when breaking open the glass ampule.

Pour one-half plastic canteen capful or one NBC canteen capful of the above solution into your canteen of water.

Place the cap on your canteen and shake. Slightly loosen the cap and tip the canteen over to allow leakage around threads. Tighten cap and wait 30 minutes before drinking.

TINCTURE OF IODINE

Fill canteen with cleanest water available.

Add 5 drops of 2 percent Tincture of Iodine per canteen/quart. If water is cold or cloudy, add 10 drops.

Mix thoroughly by shaking canteen. Slightly loosen the cap and tip canteen over to allow leakage around threads. Tighten cap and wait 30 minutes before drinking.

Very cloudy or cold water may require prolonged contact time. Let stand several hours or overnight if possible.

HOUSEHOLD/COMMON BLEACH

Fill canteen with cleanest water possible.

Read label on bleach bottle to determine amount of available chlorine. Liquid chlorine laundry bleach usually has 4 to 6 percent available chlorine.

Drops to be Added to a One Quart Canteen

Available Chlorine Clear Water Cold or Cloudy Water
1% 10 20
4-6% 2 4
7-10% 1 2

Place cap on canteen and shake. Slightly loosen the cap and tip canteen over to allow leakage around threads. Tighten cap and wait 30 minutes before drinking.

When chlorine or iodine is not available, boil water for 5 to 10 minutes.

In an emergency, even boiling water for 15 seconds will help. Boiled water must be protected from recontamination.

FOOD

WASH YOUR HANDS

After using the latrine.

Before touching eating utensils or food.

After eating.

WASH YOUR MESS KIT

A sure way to get diarrhea is to use a dirty mess kit. Protect yourself by washing your mess kit--

BURY YOUR WASTE

Always bury your waste immediately to prevent flies from spreading germs from waste to your food. Also, burying your waste helps keep unwanted animals out of your bivouac area.

Section VI. Personal Hygiene, Physical, and Mental Fitness

KEEP PHYSICALLY FIT

Physically fit soldiers are less likely to get sick or injured.

Use caution when exercising in extremely hot weather, heat injuries can occur. Actively participating in physical fitness training aids in your becoming acclimatized to the field environment.

NOTE

See FM 21-20, physical readiness training, for more information.

PREVENT SKIN INFECTIONS

Bathe frequently, take a full bath at least once every week, if showers or baths are not available, use a washcloth daily to wash:

Keep skin dry:

Wear proper clothing:

PREPARE FOR THE FIELD

All soldiers need to bring toilet articles such as: soap, shampoo, washcloths, towels, toothbrush, dental floss, and toothpaste. Do not share items, prevent infections.

Male soldiers need a razor and blades.

Female soldiers need sanitary napkins or tampons.

Some soldiers need talcum powder and/or foot powder.

Remember, in Combat You May Not Be Able to Easily Obtain These Items If You Run Out. Bring at Least a ONE Month Supply.

PREVENT DENTAL DISEASE

Go to the dentist at least annually for examination and treatment.

Brush at least once a day. If available, toothpaste helps but it is not a necessity.

Use dental floss at least once a day.

Rinse your mouth with potable water after brushing and flossing.

PREVENT GENITAL AND URINARY TRACT INFECTIONS

For males:

For females:

NOTE

Some individuals don't drink enough fluids and tend to hold their urine due to the lack of privacy in field latrines. Urinary tract infections are one of the most frequent medical problems females face in the field. Drinking extra fluids will help prevent these infections.

SLEEP WHEN YOU CAN

Follow your leaders' instructions and share tasks with buddies so everyone gets some time to sleep safely.

Sleep whenever possible (6 to 9 hours per 24 hours).

Take catnaps whenever you can, but expect to need a few minutes to wake up fully.

Sleep as much as you can before going on a mission which may prevent sleep.

After going without sleep, catch up as soon as possible.

Learn and practice techniques to relax yourself quickly.

NOTE

Do not sleep where you may be run over by vehicles or on other unsafe areas.

MEASURES AGAINST THE EFFECTS OF SLEEP LOSS

If you cannot sleep because of the mission, discomfort, or mental tension, don't worry about it--sleep loss does NO permanent harm to body or mind.

Protect against the temporary effects of sleep loss on alertness, mood, and task performance.

Watch out for your mind playing tricks (seeing things that are not there) when very tired, and check strange observations before acting.

Do not let bad dreams frighten you into staying awake--they are a normal way your mind has of dealing with combat experiences.

IMPROVE RESISTANCE TO STRESS

Fear and physical signs or symptoms of stress are normal reactions before and during combat or other dangerous/life threatening situations. You should not let fear or stress keep you from doing your job.

Talk about what is happening with your buddies, especially during after action debriefings.

Learn ways to relax quickly.

Welcome new replacements into your group and get to know them quickly.

If you must join a new group, be active in establishing friendships.

Give each other moral support if things are tough at home or in the unit.

Care for your buddies and work together to provide everyone food, water, sleep, and shelter, and to protect against heat, cold, poor sanitation, and enemy action.

NOTE

See FM 21-11, first aid for soldiers, for first aid procedures.

Section VII. Noise

RECOGNIZE THE TYPES OF NOISE

Impact noise--very loud-short burst of noise such as small arms fire, cannon, or gun fire.

Continuous noise--loud, steady noise such as wheeled vehicle, tracked vehicle, aircraft, and other equipment operations.

RECOGNIZE THE EFFECTS OF NOISE

To the soldier--

PROTECT YOURSELF AND YOUR MISSION FROM NOISE

Wear ear plugs such as single flange; triple flange; and hand formed.

Use on vehicle headgear such as helicopter crew helmet; armor crew helmet; or earmuffs for others.

Keep earplugs and muffs clean to prevent ear infections.

Avoid noise or limit time around noise to only critical tasks.

NOTE

If you have to raise your voice to be understood, it is too noisy. Put on hearing protectors.

Section VIII. Toxic Chemicals NonNBC

RECOGNIZE THE TOXIC CHEMICAL NONNBC THREAT

Carbon monoxide from gasoline engines and fuel space heaters.

Hydrogen chloride from rocket system exhaust.

Bore/gun gases such as lead, carbon monoxide, and other gases from ammo propellent.

Solvents, greases, and oils from vehicle maintenance and repair.

RECOGNIZE THE INJURY

Carbon monoxide is colorless, odorless, and tasteless. It causes headache, sleepiness, coma, and death.

Hydrogen chloride is a very irritating gas that reacts with water (body fluids) to produce hydrochloric acid in the throat, lungs, and eyes. It causes coughing, tissue acid burns, and flu-like lung disease.

Bore/gun gases cause the same effects as carbon monoxide and hydrogen chloride.

Solvents, greases, and oils cause skin rash, burns, drying, and infections. They cause damage to the liver, blood, and brain. Also many are poisons that may cause cancer.

PROTECT YOURSELF AND YOUR MISSION FROM TOXIC CHEMICALS NONNBC

Carbon monoxide

Hydrogen chloride

Bore/gun gases

Solvents, greases, and oils

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