What happens when you get heat stroke? - Douglas J. Casa

Šta se dešava kada dobijete toplotni udar? - Daglas Dž. Kasa (Douglas J. Casa)

Prevodilac: Mile Živković Lektor: Dejan Vicai

In 1985, 16-year-old Douglas Casa,

1985, šesnaestogodišnji Daglas Kasa

ran the championship 10,000 meter track race at the Empire State Games.

trčao je na 10.000 metara na Empajer stejt igrama.

Suddenly, with just 200 meters to go, he collapsed,

Odjednom, kada mu je ostalo samo 200 metara, srušio se,

got back up and then collapsed again on the final straightaway,

ustao i ponovo srušio na poslednjem delu staze,

with his body temperature at dangerous levels.

a telesna temperatura mu je bila na opasnom nivou.

He had suffered an exertional heat stroke.

Pretrpeo je pojačani toplotni udar.

Fortunately, with immediate and proper treatment,

Srećom, uz trenutno i odgovarajuće lečenje,

he survived the potentially fatal episode

preživeo je potencijalno smrtonosan napad

and has since helped save 167 people in similar circumstances.

i od tada je pomogao da se spasi 167 ljudi u sličnim uslovima.

From ancient soldiers on the battlefield

Od drevnih ratnika na bojnom polju

to modern day warriors on the gridiron,

do modernih ratnika na terenu,

exertional heat stroke, or sunstroke, has long been a serious concern.

pojačani toplotni udar ili sunčanica je odavno ozbiljan problem.

And unlike classical heat stroke, which affects vulnerable people

Za razliku od klasičnog toplotnog udara, koji pogađa ranjive osobe

such as infants and the elderly during heat waves,

poput odojčadi i starih tokom toplotnih talasa,

exertional heat stroke is caused by intense exercise in the heat,

pojačani toplotni udar izaziva intenzivan fizički napor na vrućini

and is one of the top three killers of athletes and soldiers in training.

i to je jedan od tri vodeća uzroka smrti kod sportista i vojnika na obuci.

When you exercise, nearly 80% of the energy you use

Kada vežbate, skoro 80% energije koju koristite

is transformed into heat.

pretvara se u toplotu.

In normal circumstances, this is what's known as

U uobičajenim okolnostima, ovo se zove

compensable heat stress.

nadoknadivo toplotno opterećenje.

And your body can dissipate the heat as quickly as it's generated

Vaše telo može da rasipa toplotu brzinom kojom se ona stvara

through cooling methods like the evaporation of sweat.

kroz metode hlađenja poput isparavanja znoja.

But with uncompensable heat stress,

Kod nenadoknadivog toplotnog opterećenja,

your body is unable to lose enough heat

vaše telo ne može da izgubi dovojno toplote

due to overexertion or high temperatures in humidity,

zbog prekomernog iscrpljivanja, visokih temperatura ili vlažnosti

which raises your core temperature beyond normal levels.

koji dižu vašu telesnu temperaturu iznad normalnih nivoa.

This causes the proteins and cell membranes to denature,

Zbog ovoga se denaturišu proteini i membrane ćelija

creating cells that no longer function properly

i nastaju ćelije koje više ne funkcionišu normalno

and begin to leak their contents.

i iz kojih počinje da curi sadržaj.

If these leaky cells proliferate through the body,

Ako se ove šuplje ćelije rašire po telu,

the results can be devastating.

rezultati mogu biti užasavajući.

Including liver damage, blood clot formation in the kidneys,

Tu je oštećenje jetre, krvni ugrušci u bubrezima,

damage to the gastrointestinal tract and even the failure of vital organs.

oštećenje trakta za varenje i čak i otkazivanje vitalnih organa.

So how do you diagnose an exertional heat stroke?

Kako dijagnozirati pojačani toplotni udar?

The main criterion is a core body temperature greater than 40 degrees Celsius

Glavni kriterijum je toplota tela veća od 40 stepeni

observed along with physical symptoms

zajedno sa fizičkim simptomima

such as increased heart rate, low blood pressure and rapid breathing

poput pojačanog rada srca, niskog krvnog pritiska i brzog disanja

or signs of central nervous system disfunction

ili znakova otkazivanja centralnog nervnog sistema

such as confused behavior, aggression or loss of consciousness.

poput zbunjenog ponašanja, agresije ili gubitka svesti.

The most feasible and accurate way to assess core body temperature

Najizvodljiviji i najprecizniji način da se utvrdi temperatura tela

is with a rectal thermometer

je putem rektalnog termometra

as other common temperature-taking methods are not accurate in these circumstances.

jer druge česte metode merenja temperature u ovim slučajevima nisu precizne.

As far as treatment goes,

Što se lečenja tiče,

the most important thing to remember is cool first, transport second.

najvažnije je zapamtiti da prvo treba hladiti, pa transportovati.

Because the human body can withstand a core temperature above 40 degrees Celsius

Ljudsko telo može da izdrži temperaturu od preko 40 stepeni Celzijusa

for about 30 minutes before cell damage sets in,

oko 30 minuta pre nego što nastane šteta,

it's essential to initiate rapid cooling on site

pa je ključna stvar započeti brzo hlađenje na licu mesta

in order to lower it as quickly as possible.

kako bi se temperatura što pre spustila.

After any athletic or protective gear has been removed from the victim,

Nakon što se sa nastradalog svuče sva sportska ili zaštitna oprema,

place them in an ice water tub while stirring the water

stavite ga u kadu s ledenom vodom dok vodu mešate

and monitoring vitals continuously.

i stalno pratite znake života.

If this is not possible,

Ukoliko ovo nije moguće,

dousing in ice water and applying wet towels over the entire body can help.

može da pomogne ako peškire natopite hladnom vodom i prekrijete telo.

But before you start anything, emergency services should be called.

Ali pre nego što počnete bilo šta, treba pozvati hitne službe.

As you wait, it's important to keep the victim calm

Dok čekate, bitno je da nastralog smirujete

while cooling as much surface area as possible

dok hladite što je više moguće površine

until emergency personnel arrive.

dok ne stigne osoblje hitne pomoći.

If medical staff are available on site, cooling should continue

Ukoliko na licu mesta postoji medicinsko osoblje, treba nastaviti

until a core temperature of 38.9 degrees Celsius is reached.

s hlađenjem dok se ne dostigne temperatura od 38,9 stepeni Celzijusa.

The sun is known for giving life,

Sunce je poznato po tome što daje život

but it can also take life away if we're not careful,

ali može ga i uzeti ukoliko ne pazimo

even affecting the strongest among us.

i pogoditi i najjače među nama.

As Dr. JJ Levick wrote of exertional heat stroke in 1859,

Kako je napisao dr Dž. Dž. Levik 1859. o pojačanom toplotnom udaru:

"It strikes down its victim with his full armor on.

"On napada svoju žrtvu pod punim oklopom.

Youth, health and strength oppose no obstacle to its power."

Mladost, zdravlje i snaga ne predstavljaju prepreku za njegovu moć".

But although this condition is one of the top three leading causes of death in sports,

Ali uprkos tome što je ovo oboljenje jedan od tri najčešća uzroka smrti u sportu,

it has been 100% survivable with proper care.

stopa preživljavanja je 100% sa pravilnom negom.