MAY 14, 2019 – The U.S. Navy released NAVADMIN 108/19, May 10, alerting Sailors and command leadership of the importance of universal training precautions (UTP) to reduce the risk of exercise-related collapse and death during physical exercise, to include the Physical Readiness Test (PRT) and command physical training.
As part of military readiness, Sailors are expected to maintain a high level of fitness. With PRT season ongoing throughout the Navy, this guidance is especially critical to ensure the safety of all Sailors.
It is imperative for commanders and key leadership personnel, including command fitness leaders (CFL), to foster an exercise culture that promotes UTP, recognizes the early signs of distress and promptly terminates exertional activity when individuals display clear signs of distress. All personnel present during a training evolution or PRT can encourage good performance, but should be on guard for signs that a participant is struggling and be ready to terminate the evolution.
The Navy’s PRT portion of the Physical Fitness Assessment is intended as a measure of long-term health and wellness – not of individual athletic prowess. No one should risk their life by pushing through life-threatening conditions during a PRT.
Some highlights from the NAVADMIN are listed below, but every Sailor should read the full message.
Personal risk factors for exercise-related collapse include:
- Lack of appropriate environmental or exercise acclimatization
- Recent or current illness, accumulated fatigue or dehydration
- Poor baseline conditioning or excess body fat
- A predisposing or underlying cardiac condition
- Exercise-induced asthma
- Sickle cell trait (SCT)
- Prior poor performance on the PRT
Environmental/external risk factors include:
- Exercise at altitude
- High ambient temperature and humidity
- Use of dietary supplements containing stimulants to include energy shots and drinks
If you don’t know if you have SCT, find out. SCT disproportionately affects African-Americans.
Commanders are encouraged to exercise a liberal Bad Day PRT policy for those Sailors displaying clear signs of distress during the PRT, allowing Sailors to prioritize personal safety over a PRT score. Sailors who fail to complete any portion of the PRT or demonstrate any early signs of exercise distress are authorized a Bad Day PRT and are required to be examined by medical professionals before attempting the PRT again.
Additionally, Sailors must complete the follow-on PRT within seven days following medical clearance, within 45 days of the body composition assessment date and within the current Navy Physical Fitness Assessment cycle. Any Sailors who fail to complete the Bad Day PRT for a second time must be screened by medical professionals for the possibility of a medical waiver or enrollment in the Fitness Enhancement Program (FEP).
When Sailors observe an emergency during physical training, rapid recognition of symptoms with a timely and accurate response is critical. Some syndromes result in rapid collapse while others may slowly evolve to an initial conscious collapse.
Understanding the syndromes that can lead to exercise-related collapse can assist in guiding treatment. Three syndromes to be aware of are Sudden Cardiac Arrest (SCA), Exertional Collapse Associated with SCT (ECAST) and Exertional Heat Stroke (EHS). Read more about the specifics of these syndromes in the NAVADMIN.
Additionally, after participating in the PRT, participants should be observed for no less than 10 minutes after the test, during an active cool-down period.
All PRT evolutions shall be monitored by cardiopulmonary resuscitation (CPR) trained personnel with an Automated External Defibrillator (AED) readily available. All physical training evolutions (e.g., command physical training, fitness enhancement program (FEP) or Sailor 360) involving moderate exercise shall occur within the Emergency Medical Service (base or 911) response area of an ambulance equipped with a defibrillator, oxygen and hydration.
Finally, all CFLs, first responders, corpsmen and supervisors are strongly recommended to view the videos and other training resources available on the Uniformed Services University’s Consortium for Health and Military Performance (CHAMP) website:
- Informational videos for Sailors with SCT, first responders, and sickle cell trait awareness for medical personnel can be found at: https://www.hprc-online.org/articles/sickle-cell-trait-awareness.
- Guidance on heat injury prevention and treatment can be found at: https://www.hprc-online.org/articles/heat-illness-prevention-treatment-and-recovery.
- Supplement guidance is available through Operation Supplement Safety, the Department of Defense dietary supplement resource, at: https://www.opss.org/.
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From Chief of Naval Personnel Public Affairs