The signs and symptoms of heat injuries

Next year will mark the ten-year anniversary of the sad passing of three reservists, during special forces selection on the Brecon Beacons on 13 July, 2013, after succumbing to exertional heat illness. 

The Irwin Mitchell Military Team went on to represent one of the families, in a fatal accident claim against the Ministry of Defence.

Service inquiry findings

Those familiar with the incident may recall the service inquiry which the MoD published approximately four years after. It concluded that the key causal factors which led to the incident were:

• All three reservists died from hyperthermia, caused by exertional heat illness, because of a combination of heat generated by the intensity of the physical activity and an inability to lose this heat, which was compounded by the climatic conditions.
• The Reserve Units did not train its candidates to the same level as the Signals candidates and were less prepared.
• Due to a lack of understanding of the risk involved with exercise with the reserve candidates, the Signals Regiment failed to provide a safe system of training to reduce the risk
• The panel concluded that the exercise planners and even chain of command did not understand exertional heat illness or its treatment plan.

Signs and symptoms of heat injury

Despite the introduction of the Joint Service Publication 539 on Heat Illness and Cold Injury in 2013, there are still frequent instances of heat injury. 

Recent cases seem to demonstrate that there is still a lack of insight and awareness on heat illness itself, with many not recognising what to undertake in terms of first aid. 

Many soldiers are being pushed to extremes on exercises in hot climates, but some course instructors are failing to prepare adequate risk assessments for their routes. It is understood that many exercises are also acting contrary to guidance within JSP 375 Vol 1 Chapter 41 on the timings for acclimatisation abroad, i.e. that personnel should only be considered fully acclimatised at 15 days after arrival in theatre.

Where an individual is suffering from potential heat stroke, their symptoms can include:

•  a high body temperature (in excess of 39.4°C),
• headaches,
• dizziness and confusion,
• nausea and/or
• staggering or episodes of collapsing and losing consciousness.

These symptoms should be combatted immediately by the removal or loosening of clothing, using ice and cooling blankets to lower their temperature or using evaporation cooling techniques.

In serious cases of injury, or where there have been inadequate attempts to lower the core temperature during the first aid process, untreated heatstroke can quickly lead to organ failure. It is imperative that the MoD look to refresh training on this area in order to combat against the serious risk of injury.

Many are failing to recognise the immediate symptoms of heatstroke and by its nature, the longer this goes untreated, the more seriousness the long-term damage can become. In addition, there continues to be a disparity between the training which reservists undergo in this area, in comparison to regulars.

Global temperatures on the increase

Across the population as a whole, between 2001 and 2020, there were an additional 108,722 extra hospitalisations associated with warm days in comparison to the baseline statistic of 12,086. 

The Office for National Statistics has said that its findings confirm that the warming trajectory predicted by climate scientists is already affecting the population’s health in England and Wales. 

July 2022 is set to feature above average temperatures suggesting at least 70 per cent chance of hotter conditions than normal and there are therefore concerns that there will be an increase in service-related heat injury.

Find out more about Irwin Mitchell's expertise in supporting members of the Armed Forces affected by a heat injury or other injuries at our dedicated military injuries section.

Birmingham and Solihull coroner Louise Hunt was highly critical of how the march that led to the deaths of Corporal James Dunsby and Lance Corporals Craig Roberts and Edward Maher was run.

She said there was a “catalogue of very serious mistakes made by many people” and “systematic failings” and neglect contributed to the deaths.”