The Navy ordered sailors to watch fitness test participants more closely for signs of distress and allow do-overs for those having a "bad day," following a string of deaths over the past year, including two young female recruits who collapsed during the tests.
Four sailors have died in the past year during "seemingly normal physical fitness exercise," the Navy said in an administrative memo issued late last week.
"One loss is too many, and it is critical that every Sailor understands the risk factors for exercise-related death and the strategies to minimize those risks," the memo states.
New guidelines call for halting participants' physical activity when they show unusual distress or fatigue and allowing them to make up the training or test later.
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Everyone who takes part in rigorous exercise should also be monitored during a 10-minute cool-down afterward, the new policy states.
CPR-trained personnel with defibrillators must be present during a Physical Readiness Test, or PRT, and any training that involves moderate exercise must be conducted within an ambulance's normal emergency response area, the memo mandates.
"No one should risk their life by pushing through life-threatening conditions during a PRT," the Navy said in the memo.
Seaman recruits Kelsey Nobles, 18, and Kierra Evans, 20, both collapsed during their final physical fitness tests at Naval Station Great Lakes, Illinois -- Nobles in April and Evans in February. Both were about a week from graduating.
The Navy is investigating the causes of their deaths.
The similar circumstances in the fatalities raised questions for Nobles' father, he told an Alabama TV station at the time of her death.
"For me, I'm just like, 'What's wrong?' These young people are so excited about serving their country and going into the military," Harold Nobles told WKRG News. "Are they doing enough to check them? Does physical testing need to be more in-depth?"
The Navy pointed to personal risk factors that can cause overexertion, including:
- Illness, accumulated fatigue or dehydration
- Poor conditioning or excessive body fat
- Underlying heart condition
- Exercise-induced asthma
- Sickle cell trait
- Poor performance on a past fitness test.
External factors, including heat, humidity, high altitude and ingesting supplements or energy drinks with stimulants, can cause further strain, the Navy said.
Three syndromes that can heighten the chance of a fatal collapse are cardiac arrest, heat stroke and exertional collapse associated with the sickle cell trait, the Navy's memo states.
"When sailors observe an emergency during physical training, rapid recognition of symptoms with a timely and accurate response is critical," according to the memo.
Because the sickle cell trait is more common among blacks, the Navy is advising black sailors who do not know their sickle cell status to check with a medical provider to better understand their risk factors.
It also requires command fitness leaders, first responders, corpsmen, recruit division commanders and supervisors to watch videos related to sickle cell awareness online at https://www.hprc-online.org/articles/sickle-cell-trait-awareness.
To put personal safety over test scores, commanders are encouraged to exercise a liberal "bad day PRT" policy for those who display clear signs of distress, the Navy said.
The sailor won't fail the test for not finishing it and can take it again after being examined by a medical professional, the new policy states.
Sailors will have seven days to make up the test after getting medically cleared and must complete the test within the fitness assessment cycle, no more than 45 days after their body composition is measured.
Any sailors who fail to pass a fitness test for a second time must be screened by medical professionals for a possible medical waiver or enrollment in a fitness enhancement program, the Navy said.