Seal Survival Guide

by Cade Courtley

  • Sweaty but cool (clammy) skin

  • Pale skin

  • Restlessness, nervousness

  • Thirst

  • Loss of blood (bleeding)

  • Confusion (or loss of awareness)

  • Faster-than-normal breathing rate

  • Blotchy or bluish skin (especially around the mouth and lips)

  • Nausea and/or vomiting

  It’s a tough thing to witness when you come upon a guy who just fell sixty feet from a helicopter while rappelling and has two broken legs with bones sticking out of the skin. This requires incredible focus to get into action and help. As horrified as I was to see such a thing happen to a fellow SEAL, I had a job to do. You owe it to the person who needs your help to remain calm and go to work, reassuring him by your demeanor that he is in good hands. If a victim of trauma sees fear in your eyes, it will only accelerate the fear in him and bring on life-threatening panic. Your fear could actually make it worse. If a person is injured and he sees that you are panicking, this, in fact, can cause him to go into shock.

  Treatment/Prevention

  If you see these early warning signs, you can prevent shock by having the person lie down on their back. Elevate the feet higher than the heart, and loosen clothing, such as a tight belt or the collar of a shirt. Remember: Do not move the casualty if you suspect fractures, and do not elevate the legs if there is a head injury or abdominal injury. If you are in a cold climate, do what you can to warm them up and keep them warm. Use a blanket or extra coats; you can even warm them with your body heat. If in a warm environment do what you can to keep them cool by placing them in shade, but closely monitor this person. Don’t let them cool off too much, which can happen easily with someone who is in or going into shock. Do not give the person any food or drinks. Also, if the person is unconscious, turn their head to the side, as this will prevent the possibility of choking if vomiting occurs. In all instances, you must reassure the person that you are in control and show no fear or panic. Be authoritative by showing self-confidence, because you are now the key to this person’s survival. Commit to this as if the roles were reversed and your life depended on them. Your mental and physical toughness is being shared and your only mission is now this person’s survival.

  HEAT INJURIES

  Someone can die from heat when they engage in physical activity when the heat production within their body exceeds the body’s ability to lower its own temperature adequately. This results in a rise in inner body temperature to levels that interfere with normal body functions. There are many environmental factors that contribute to this condition, such as air temperature, humidity, wind speed, and sun exposure. Additionally there are individual factors that increase your chance of a heat injury, like fitness level, dehydration, preactivity hydration, higher body fat levels, and the use of some medications. It’s important to understand that a heat injury can occur after walking for 5 minutes in 120-degree weather as well as exercising for 60 minutes in 80-degree weather; it all depends on the factors above.

  I’ll never forget desert warfare training in the midsummer heat at the Special Warfare Center facility near Yuma, Arizona. It was so hot that we had to keep our rifles high ported (pointing to the sky) because rounds in the chamber were cooking off on their own. There was no way to drink enough water. My brain and body were in a constant state of “drunken” delusion. My piss looked like orange juice. Unfortunately, when we go to war it’s never at a Club Med. The desert is without a doubt one of the harshest environments on the earth. Like I said, they never send you to war where they serve drinks with little umbrellas in them.

  The primary goal in treating a heat injury is to cool down the human body and get it closer to the baseline norm of 98.6 degrees. Artificially re-regulating an individual’s body temperature until their body can once again self-regulate is what we’ll be doing here.

  Dehydration

  Dehydration stems from a sudden loss of body fluids. If not enough water is consumed, or there is severe diarrhea, vomiting, or sweating, dehydration can occur. The body can go weeks without eating but only a few days without water. In the short term, you will feel thirsty and hot. In the long term, the best indicator that you are becoming dehydrated will be the color and frequency of urination: Less frequent and darker in color is bad.

  TREATMENT AND PREVENTION

  Prevention is simple: Drink water constantly and not occasionally. Additionally, avoid beverages that are high in sugar when hydrating. Electrolyte-enhanced waters are great, or if unavailable you can make your own by adding a teaspoon of salt and some fresh-squeezed orange, lemon, or lime juice to a liter of water.

  Pickles (and pickle juice) are higher in electrolytes than beverages like Gatorade or Powerade and have been shown to reduce cramping caused by exertion in high temperatures. The acetic acid in pickles and pickle juice is considered superior to the citric acid found in commercial sports drinks, at least when it comes to rehydration properties.

  Fresh produce has a very high water content, so it’s a great way to hydrate without having to drink a ton of water. For example, an apple is up to 85 percent water by volume. Again, remember to avoid any food that is high in sugar or contains caffeine.

  Heat Cramps

  This is when you experience a painful cramping in a large muscle. It could happen in your legs, arms, or abdomen. This stems from a sudden and excessive loss of salt, due to heavy sweating or several hours of nonstop exertion.

  Heat Exhaustion

  This is displayed by a sudden amount of profuse sweating. You may experience a pounding headache or tingling sensation, or feel lightheaded, or vomit. What’s happening is that the body temperature has risen to between 99 and 104 degrees, and it’s attempting to regulate the surface temperature of your skin.

  Heatstroke

  If your body temperature reaches more than 105 degrees, then the entire nervous system could malfunction. This is marked by an absence of sweat in a person and can lead to organ damage and death.

  TREATMENT

  The immediate goal in all three of these cases is to cool down the body by performing as many of the following functions as possible:

  1. Get to a shaded environment.

  2. Lie down and elevate the legs.

  3. Loosen clothing.

  4. Take sips of fluid, but don’t gulp or guzzle.

  5. Remove most clothing.

  6. Fan a cold-water mist over the body, which increases evaporation.

  7. Wrap the victim in a water-soaked blanket.

  8. Put ice packs under the groin or on the back of the neck.

  COLD INJURIES

  The body doesn’t like being exposed for prolonged periods to cold temperatures, since our ability to generate heat, or to limit heat loss, is quite limited. The body works very hard to maintain its core temperature, which means it burns a lot of calories performing this function. Of primary importance is staying dry when facing cold conditions. A wet layer against your skin, like a sweat-soaked shirt, will greatly reduce your body’s ability to stay warm. Whenever possible ensure you have a dry layer that you can put on.

  SEALs say: “If you’re wet, you’re dead.”

  Cold injuries can also occur with only brief exposure to extremely cold conditions. You must pay close attention to forecasting weather conditions to make for better planning and to know what equipment will be essential. Thorough preplanning can greatly reduce the chances of incurring a cold injury.

  Hypothermia

  Hypothermia is defined as a decrease in the core body temperature to a level at which normal muscular and cerebral functions are impaired. Many conditions can contribute to hypothermia: cold temperatures, improper clothing and equipment, wetness, fatigue and exhaustion, dehydration, poor food intake, and alcohol consumption. Another huge risk factor can be a lack of knowledge about hypothermia and inability to read the terrain and environment correctly, so practice situational awareness, and always be prepared.

  MI
LD HYPOTHERMIA

  When the body temperature drops from the normal 98.6 to 96 degrees, an involuntary shivering occurs. This is the body’s only way of trying to generate heat, which is fairly ineffective. However, it still will not interfere with or impair motor functions, so you can still ice climb or ski, for example, and walk and talk coherently.

  MODERATE HYPOTHERMIA

  When the body temperature dips to between 95 and 93 degrees, you begin to feel dazed and will lose fine motor coordination, particularly in your hands. You’ll find that you can’t zip up your parka, for example, which is due to restricted peripheral blood flow. You’ll experience slurred speech, more violent shivering, and even irrational behavior. I’ve seen a weird phenomenon take place during such circumstances that I call paradoxical undressing. When freezing to death, a person starts to take off clothing, and a strange “I don’t care” attitude comes into play.

  SEVERE HYPOTHERMIA

  If the body goes down to between 92 and 86 degrees or below, death is imminent. Shivering will then occur in waves. It will be extremely violent and then pause. The pauses get longer until shivering finally ceases. The person falls to the ground, can’t walk, and curls up into a fetal position. The skin turns pale, pupils dilate, and the pulse rate decreases to a faint beat. The person looks dead, but at this point, they remain alive for an indeterminate amount of time.

  As a SEAL, you just come to realize that hypothermia is part of the job. In addition to the constant physical demands of Hell Week, like endless running with a coat on your head, the most physically demanding thing your body goes through is trying to maintain its minimal, functioning core temperature. A couple of doctors did a study on a class going through Hell Week and realized that students were burning more than twenty thousand calories every twenty-four hours, largely due to the body’s effort to stay warm. That’s the equivalent of eating forty McDonald’s Quarter Pounders with Cheese every twenty-four hours. Super-size that!

  TREATMENT FOR MILD AND MODERATE HYPOTHERMIA

  The basic idea is to get the person warmed up, conserve the heat they have left, and find a way to replace the fuel they are burning up.

  1. If the person is in wet clothes, get them off and replace them with dry layers. At this early stage, physical activity will generate heat, so keep the victim moving at least minimally. Attempt to find shelter or build one.

  2. It is essential to stop and forestall hypothermia by eating and drinking hot liquids, if available. Carbohydrate-rich foods are best, and even candy can add a quick release of needed fuel into the bloodstream for a sudden brief heat surge. Avoid alcohol, caffeine, and tobacco.

  3. Generate heat from an exterior source, such as a fire. Get into a sleeping bag and create a heat cocoon generated by your own heat. You can do like the penguins do and huddle up, because body-to-body contact also generates heat.

  TREATMENT FOR SEVERE HYPOTHERMIA

  Even at this point, the body can warm itself more effectively than can warmth from an exterior heat source. This method involves creating a hypothermia wrap.

  1. Wrap the person in as many warm layers of blankets or sleeping bags as are available, forming a shell of total insulation at least four inches thick. If possible, once the person is encased, also try to raise the person off the cold ground or create some barrier between them and the ground, so as not to lose heat or have more cold come in from below.

  2. Get fuel into the victim. When experiencing severe hypothermia, the stomach shuts down and will not digest solid foods. The best way to give them energy is by heating water and adding sugar to it. Feed a cup of this mixture to the hypothermic every fifteen minutes.

  3. Get the person to urinate. This may sound odd, but the body spends a lot of its heat resources to keep urine warm while it’s in the bladder. The more they can urinate, the quicker the body’s resources can be used to heat other vital organs.

  4. Try to transfer heat to the person by placing hot stones, wrapped in towels or cloth, at major arteries, such as at the neck or under the armpits. Remember, there is also another artery near the groin, called the femoral artery, which can quickly distribute heat to the vital organs.

  5. If no external sources of heat are available, transfer heat to the person by pressing your own, warmer hands to these points. Do not rub the victim’s skin, as they may also be suffering from frostbite and you might injure them further.

  6. A person with severe hypothermia needs to be handled with care (gently) because they are very susceptible to cardiac issues.

  Frostbite

  Frostbite occurs when body tissue actually freezes. Typically affecting the hands, feet, nose, ears, and cheeks—though other areas of the body may also be affected—frostbite can lead to death or necrosis of tissue, requiring amputation or removal.

  You know if frostbite is setting in if you feel a dull pain or tingling sensation. Oftentimes the area feels itchy and will turn colors. At first, it could be red, but then the frostbitten area becomes white or grayish-yellow. The skin will look waxy until it goes numb. When lost to frostbite, the area affected turns black and hard, as the skin tissue has died.

  TREATMENT

  1. Get the person warmed up with external means (fire) or personal means (cocooning the frostbitten areas). But unless absolutely necessary, do not make the person walk on frostbitten toes or feet.

  2. Submerge the extremities in warm water (105 to 110 degrees—no hotter).

  3. Try to use a heated, moist towel and gently apply to the skin until the red color returns.

  4. If you have no water, then your warm breath can be used. Make a cup with your hands over the area and breathe into it. Also, you can place your hands under the armpits or on the stomach.

  5. Do not place anything hot, such as heating pads, directly on the area.

  6. Don’t add heat and then remove it from the frostbitten area, as this warming and then reexposure to cold air can worsen the damage.

  7. Don’t rub at the frostbitten area, as the skin will blister and more damage will be caused.

  8. When dealing with severe frostbite, the goal is a gradual rewarming process in 100-degree water over a period of twenty-five to forty minutes.

  9. As the affected areas warm, there will be some severe burning sensations, change of skin color, and maybe blistering/swelling. Do not try to treat/burst the blisters. Severe frostbite will remain black in color.

  10. Dress fingers and toes individually; use cotton balls or other spacers to keep digits from touching and give acetaminophen or ibuprofen, not aspirin, to reduce the pain.

  TRENCH FOOT

  It’s been said that one reason Napoleon had to retreat from his 1812 invasion of Russia was due to footwear—the ultimate wardrobe malfunction. His soldiers became immobilized by what later came to be called trench foot. Soldiers in World War I, World War II, and even Vietnam suffered from this condition. When boots are constricted, get wet, or become soaked with the wearer’s own perspiration, a fungal infection forms on the feet. The condition can appear in as few as eighteen hours. The foot will turn red, then blue, and itch like mad. The skin begins to actually smell and die. Trench foot leads to gangrene, and amputation is the only cure if it’s left unattended.

  Treatment

  The best way to prevent trench foot is to take off wet socks, air out footwear, and be attentive to your feet by examining them regularly.

  In the movie Forrest Gump, the character Lieutenant Dan summed it up: “Change those socks every chance you get.”

  CHOKING

  Choking is one of the top causes of accidental death in America. Anything, though it’s usually food, can get stuck in the airway and cut off breathing. It happens so fast that trying to self-administer first aid is nearly impossible, though it can be done. When an airway is obstructed, the person cannot speak or call out for help. Without first aid, brain damage and death by asphyxiation are the end results of choking.

  Treating a Choking Victim

  1. Make sure the
person is actually choking. By this I mean you must determine if it’s complete airway obstruction. If the person is able to speak or is making actual coughing sounds, then they have only a partial airway blockage. You want to monitor it, but allow them to try to cough up the item causing the problem.

  2. If you are able to look into the mouth and see the obstruction, then manually remove the obstruction with your fingers for an immediate resolution.

  3. If the obstruction remains, use the Heimlich maneuver.

  a. Get behind the person and grab them at their stomach, just below the rib cage and above the navel.

  b. Apply pressure by delivering inward and upward thrusts until the blockage is cleared.

  If you are alone and begin to choke, find a chair or hard surface and ram your stomach, below the rib cage, at the hard surface multiple times until the blockage is clear. You have only moments of consciousness, so if you are alone and choking, act quickly but with purpose.