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

中暑后我们应该如何应对? - 道格拉斯 J. 卡萨

翻译人员: Han Zhang 校对人员: zicheng zhou

In 1985, 16-year-old Douglas Casa,

1985年，16岁的道格拉斯 卡薩

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

正在帝国赛事的万米长跑中竞赛。

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

突然，在离终点只有两百米时， 他倒下了。

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

他爬了起来， 可是在最后冲刺时又倒下了

with his body temperature at dangerous levels.

他的体温处于危险水平。

He had suffered an exertional heat stroke.

他因运动过度而中暑了。

Fortunately, with immediate and proper treatment,

可幸的是， 由于他及时接受了适当的治疗

he survived the potentially fatal episode

道格拉斯活了下来

and has since helped save 167 people in similar circumstances.

并从此，救活了167名 由于类似原因受伤的人。

From ancient soldiers on the battlefield

从古代战场上的士兵

to modern day warriors on the gridiron,

到现代球场上的战士

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

运动型中暑，也称日射病， 一直是他们的一大担忧。

与传统型中暑不同的是， 它不止会伤及脆弱的人群

And unlike classical heat stroke, which affects vulnerable people

such as infants and the elderly during heat waves,

例如热浪波及的老人与婴儿。

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

运动型中暑是在酷热中 激烈运动所造成的

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

并且是运动员与受训军人的 三大杀手之一。

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

当你在运动时，你所用掉的 百分之八十的能量

is transformed into heat.

被转化为热量。

In normal circumstances, this is what's known as

正常情况下，这被称为

compensable heat stress.

可偿性热应激。

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

此时，你的身体可以通过 挥发汗水等方法

through cooling methods like the evaporation of sweat.

将转化出来的热量及时散去。

But with uncompensable heat stress,

但是如果你得了无偿性热应激

your body is unable to lose enough heat

你的身体将无法 及时散发热量，

due to overexertion or high temperatures in humidity,

原因可能是运动过度 或环境炎热、潮湿。

which raises your core temperature beyond normal levels.

这会使你的体核温度 超出正常水平。

This causes the proteins and cell membranes to denature,

这使细胞膜中的蛋白质变质，

creating cells that no longer function properly

使细胞无法正常运作

and begin to leak their contents.

并开始泄露内含物。

如果这些漏水的细胞遍布体内

If these leaky cells proliferate through the body,

the results can be devastating.

后果将不堪设想。

Including liver damage, blood clot formation in the kidneys,

有可能造成肝脏受损， 肾脏内血栓，

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

肠胃损坏，甚至内脏衰竭。

要如何诊断运动型中暑呢？

So how do you diagnose an exertional heat stroke?

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

主要是看体核温度 是否超过40摄氏度

observed along with physical symptoms

其他症状包括

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

心跳加快，低血压以及呼吸急促

or signs of central nervous system disfunction

或是中枢神经系统失调的迹象

such as confused behavior, aggression or loss of consciousness.

例如行为混乱， 具有攻击性或丧失意识。

The most feasible and accurate way to assess core body temperature

最可行且准确的 测量体核温度的方法

is with a rectal thermometer

是使用直肠体温计

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

因为其它测温方法 在这种情况下并不准确。

就治疗而言

As far as treatment goes,

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

要记住：先冷却，后移动。

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

人体核心温度高于40摄氏度 的时间上限

for about 30 minutes before cell damage sets in,

大约是30分钟。 在此之后细胞将开始损毁。

it's essential to initiate rapid cooling on site

所以务须当场着手降温

in order to lower it as quickly as possible.

才能确保体温能迅速降下来。

先把患者身上的防具 与运动装备卸下来，

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

place them in an ice water tub while stirring the water

再将患者浸入冰水之中， 并不停搅动冰水

and monitoring vitals continuously.

同时持续观察生命迹象。

如果无法做到这点，

If this is not possible,

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

那么用冰水冲刷病患以及 用湿毛巾覆盖全身也有所帮助。

但在施救前， 记得传呼急救服务。

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

在等待救护的时候， 要确保患者保持冷静

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

while cooling as much surface area as possible

同时尽可能冷却患者全身

直至急救专员到达现场。

until emergency personnel arrive.

If medical staff are available on site, cooling should continue

如果在场有医疗人员， 冷却应该继续

until a core temperature of 38.9 degrees Celsius is reached.

直到体核温度降至 38.9摄氏度为止。

The sun is known for giving life,

人们说太阳赋予了我们生命

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

但若我们不够谨慎， 它也能夺走生命

even affecting the strongest among us.

就连我们之中最坚强的人也一样

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

正如 JJ 勒维克医生 在1859年写到的一样：

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

“运动型中暑 连全副武装的患者也能打倒。

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

青春，健康与气力 都无法抵挡它的力量。”

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

可是尽管运动型中暑 是体育界的三大死因之一

it has been 100% survivable with proper care.

在得到妥当治疗的情况下 存活率却是百分之一百。