By Mike Harte
Coyote Camp Fireline Chow

AP Photo/Shiho Fukada N.Y firefighters drink water to cool off after working on a manhole explosion last summer.

"How many times have you peed today? What color is your pee?" Questions that are a bit too personal, perhaps? Not on a fire line! Hydration is one of the most important personal-care tasks we can do on a fire.

Improper hydration — such as dehydration — leads to headache, dizziness, nausea, fatigue, and overall diminished function. Having such symptoms is unhealthy for the individual and for the team. They can lead to poor decision-making on the part of a leader; they can lead to poor performance on the part of a firefighter. The combination of both can have very negative consequences regarding the outcome of firefighter safety and the fire event.

Interestingly, at the other end of the hydration-dehydration spectrum is a condition to which few of us in fire operations give much thought — that of over-hydration, or hyponatremia. I'd not given this any thought until taking a Wilderness EMS class recently. After all, who would think of such a possibility in firefighting conditions where many are sweating buckets? But hyponatremia is a possibility on the fire line. While in the bigger picture it's perhaps not as common as dehydration, nevertheless it remains a definite possibility.

Think about it: you're working a 15 hour operational period , in 90-plus degree heat, performing arduous physical tasks — and you are sweating buckets! During these periods of high intensity output, while you’re sweating profusely, the sodium in your body is also lost — leading to a decreased sodium concentration in your bloodstream.

But wait! You're hydrating, right? You're drinking water from your canteen, camelback, or water bottle regularly. So, why are you experiencing symptoms similar to dehydration — nausea, cramping, confusion, and overall diminished function?

Problem compounded
At this point, you may think you're still dehydrated, and so naturally you drink more water. But, you may actually be compounding the problem, because water alone will increase the problem of hyponatremia, where you have too much water and not enough of the electrolyte sodium in your bloodstream.

At its most extreme, hyponatremia may cause seizures, coma and/or death. In January, a Californian woman who took part in a water-drinking contest run by a radio station to win a video game system died of water intoxication. Maybe you've watched some of your fire buddies doing the 4-4-40, drinking 4 quarts of water in 4 minutes or less and holding it for 40 seconds before vomiting, extreme behavior that should not be practiced on the fire line.

No matter the circumstances that lead to hyponatremia, treatment is relatively straightforward. Upon noticing the first signs and symptoms in yourself or a peer, such as  nausea, cramps, disorientation, drink or provide a sodium-containing sports drink and/or eat salty foods, assuming the person is conscious and has a patent airway.

Of course, the best way for a firefighter to avoid the problem is to plan ahead: Use sodium-containing sports drinks and eat salty foods before and during energy intensive firefighting ops, provided there is no previous history of  hypertensive medical conditions.

Firefighters should hydrate sensibly and include electrolyte-containing products in their hydration-nutrition-sustenance efforts. Remember, everyone's hydration needs differ — it's important for firefighters to know their own hydration requirements.

Author Mike Harte has been a firefighter for 30 years and is the owner of Colo.-based Coyote Camp Fireline Chow, which offers food designed for use in firefighting environments, SAR events and disaster relief efforts.