The early symptoms of fatigue-induced hyponatremia are similar to those of mild heat exhaustion. Stomach discomfort, cramps, fatigue, headache, dizziness, nausea, and vomiting are indistinguishable from symptoms, and they are the most frequently occurring in hot days. (greater than 4 hours) in outdoor sports such as crossing the Grand Canyon or the desert. There are also marathon and triathletes who suffer from this disease. If the patient is treated with light heatstroke to drink water and rest, the patient's condition will worsen in case of tired hyponatremia. A newly recruited training camp at an army base in the United States recently misjudged mild heat stroke and forced drinking in patients with severe hyponatremia, resulting in a recruit who died of cerebral edema and pulmonary edema (cerebraland pulmonaryedema) induced by this.
Since the symptoms are indistinguishable and there is no blood analysis equipment, we can only judge from the time before the disease. Therefore, those who love to walk to the mountains or the desert in the summer should better understand the cause of tired hyponatremia and the difference from mild heat stroke. Hyponatremia refers to blood sodium concentrations that are too low, less than 135 milliequivalents/liter (mEq/liter) or 3.10 grams/liter (g/liter). The normal range is 138-142 milliequivalents/liter or 3.17-3.27 grams/liters. The full name of exertional hyponatremia is exercise-induced dilute hyponatremia. Its old name was waterintoxication.
Etiology
The risk population of fatigue-induced hyponatremia is a long summer (greater than 4 hours) outdoor trekkers or marathon and triathletes. These people all know that drinking more water during exercise is critical. It is also known to supplement the salt lost in the sweat, so drink a sports drink or electrolyte drink, such as Gatorade. But many people have no appetite on hot days and eat very little or only some energy bars on foot. And eat less when dehydrated or uncomfortable.
The sodium concentration of sweat can be as high as 90 milliequivalents/liter and the maximum sweat rate can be as high as 3.7 liters/hour. In the above campaigns, sodium and water need to be taken at a rate of 35 milliequivalents per hour and 1 liter per hour to supplement the loss of sodium due to sweat. Among the sports drinks used, Gatorade contained the highest sodium concentration, 20 milliequivalents/liter. Far below the required 35 milliequivalents/liter. If enough water is added, but there is no corresponding salt, the total amount of sodium in the body to the total bodily water content (total bodaywater) will be too low to cause hyponatremia.
The composition of the salt is 25% to 40% sodium. A 140-pound person has only 40 grams of salt in his blood. If you sweat one liter per hour, you will lose 1.75-3 grams of salt. Lost 7-12 grams of salt in four hours. 7-12 grams of salt seems to be very small, but it is a lot relative to 40 grams.
Administrators at the Grand Canyon in the United States are now using a portable blood chemistry analyzer to measure the patient’s blood sodium level to determine whether it is mild or exhausted hyponatremia. We will not have such conditions in the wild. We can judge from the pre-illness period. If there is a lot of sweat, we will always drink water. However, if we do not eat for a long time, it may be fatigue-induced hyponatremia. During the ambulance, the patient must maintain a seated position and gradually add saline. Lying down will increase intracranial pressure and may accelerate brain edema.
prevention
In more than 4 hours of walking, it is necessary to prevent dehydration and prevent low sodium. When you drink water or sports drinks and electrolyte drinks without forgetting to add salt, you can eat some high-salt snacks. To maintain balance, too much salt can lead to dehydration. The usual high-salt, high-energy (non-high-fat) junk food is a healthy food in outdoor sports. American snacks such as pretzel and cheezit contain more salt, and Chinese mustard are probably the most common.
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