Drowning in the Desert

Water intoxication (called hyponatremia) — once rare — is occurring more frequently as more recreational walkers, runners, cyclists and orienteering enthusiasts conquer marathons, 24-hour mountain bike races and other long-distance events. Drinking so much water and sports drink that they dangerously dilute the sodium concentration in their blood, jeopardizing vital body functions.

“It’s a real problem and it’s more dangerous than dehydration,”  says Albert Siegel, MD, chief of internal medicine at McLean Hospital in Belmont, Massachusetts, and assistant professor of clinical medicine at Harvard Medical School in Boston. Several runners have died from hyponatremia in recent years, he adds.

Signs, symptoms and how to help hyponatremia victims

  • confusion
  • difficulty breathing
  • nausea
  • vomiting

“Get the person to a hospital,” said Riva Rahl, MD, director of the Cooper Wellness Program at the Cooper Clinic in Dallas. “There’s nothing you can do [on the scene] for overhydration, but the hospital can treat him with a concentrated saline solution IV.”

“You have to prevent hyponatremia,” says Ken Phillips, chief of emergency services at Grand Canyon National Park in Arizona. “We see hyponatremia quite frequently here. People are exerting themselves in a hot environment and replacing what they sweat off with straight water,” while they should be rehydrating with fluids containing electrolytes and eating salty foods, Phillips says.

Because water intoxication looks so much like heat exhaustion in its early stages and can mimic heatstroke once seizures begin, emergency medical rangers at the Grand Canyon carry portable equipment to test the blood sodium concentration of fallen hikers before giving aid. Patients determined to be water-intoxicated are taken by helicopter to hospitals for intravenous (IV) treatments, he adds.

If you haven’t been able to prevent it from happening, he says, there are a few things you can do while waiting for help to arrive:

  • Sit the person up — to ease intracranial pressure.
  • Watch for vomit — aspirating vomit can kill.
  • Increase sodium levels slowly — if possible give salt, chips, concentrated bouillon.
  • Keep the person calm — anxiety may interfere with breathing.
  • Watch for seizures — if the person has a seizure, rest him gently on his side and remove hard objects from the immediate area. Don’t put anything in his mouth.

The take-home message: Drink when you are thirsty and stay ahead of the sodium curve. Eat something salty like chips or pretzels as you drink, or bring along salt tablets to swallow with your regular water. Sports drinks alone won’t replenish your sodium if you have been exercising for many hours in hot conditions.

Paraphrased from story by Allison Wright-White

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