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

當你患上運動型熱中暑會發生什麼？ - 道格拉斯 J. 卡薩

譯者: Siyun Zhou 審譯者: Yongming Luo

In 1985, 16-year-old Douglas Casa,

1985 年，16歲的道格拉斯•卡薩

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

在帝國賽事中跑10公里冠軍賽

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

突然，在離終點線還有200米時， 他倒下了

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

爬起來，然後在最後直線衝刺時 又再倒下

with his body temperature at dangerous levels.

此時他體溫處於危險水平

He had suffered an exertional heat stroke.

他患上了運動型中暑

Fortunately, with immediate and proper treatment,

幸運的是，經過及時恰當的治療

he survived the potentially fatal episode

他於潛在致死性發作中存活

and has since helped save 167 people in similar circumstances.

並從那時起幫忙救助了167名 處於相似情況的人

From ancient soldiers on the battlefield

從戰場上的古代士兵

to modern day warriors on the gridiron,

到運動場上的現代戰士

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

運動型中暑，或日射病， 一直都是一個嚴重的擔憂

And unlike classical heat stroke, which affects vulnerable people

還有和一般的中暑不同， 一般的中暑只影響易感人群

such as infants and the elderly during heat waves,

例如在酷熱中的嬰兒和長者

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

運動型中暑由在酷熱中劇烈運動導致

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

是運動員和士兵 在訓練中死亡的三大殺手之一

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

在運動時，你消耗的將近80%的能量

is transformed into heat.

會轉化為熱量

In normal circumstances, this is what's known as

在通常情況下，這稱為

compensable heat stress.

有償性熱應激

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

你的身體可以在熱量 剛聚集的時候就散發掉

through cooling methods like the evaporation of sweat.

通過冷卻方法，例如揮發汗水

But with uncompensable heat stress,

但是無償性熱應激

your body is unable to lose enough heat

你的身體由於在潮濕環境中 過度運動或高溫

due to overexertion or high temperatures in humidity,

不能失去足夠熱量

which raises your core temperature beyond normal levels.

導致你核心溫度升高超過正常水平

This causes the proteins and cell membranes to denature,

這會導致蛋白質和細胞膜變性

creating cells that no longer function properly

產生功能不正常的細胞

and begin to leak their contents.

還有開始洩漏它們的內容物

If these leaky cells proliferate through the body,

如果這些洩漏的細胞在整個人體中富集

the results can be devastating.

能造成毀滅性的結果

Including liver damage, blood clot formation in the kidneys,

包括肝損傷，腎臟血凝塊形成

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

胃腸道損傷，甚至重要器官壞死

如何診斷運動型中暑？

So how do you diagnose an exertional heat stroke?

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

主要標準是人體核心溫度高於40攝氏度

observed along with physical symptoms

同時觀察身體症狀

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

例如心跳加速，低血壓和呼吸急速

or signs of central nervous system disfunction

或者中央神經系統功能失調的跡象

such as confused behavior, aggression or loss of consciousness.

例如行為混亂，帶有攻擊性或者失去意識

The most feasible and accurate way to assess core body temperature

最可行和準確地探測核心體溫的方式

is with a rectal thermometer

是使用直腸溫度計

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

因為其他常用溫度探測方法 在這些情形下並不準確

As far as treatment goes,

在進行治療的時候

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

最重要的事情是記得先冷卻，再轉移

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

因為人體在忍受核心溫度高於40攝氏度

for about 30 minutes before cell damage sets in,

大約30分鐘時細胞會產生損傷

it's essential to initiate rapid cooling on site

所以在現場開始盡快 快速降低人體溫度很重要

in order to lower it as quickly as possible.

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

在移除患者所有運動或保護裝備后

place them in an ice water tub while stirring the water

將他們放置在冰水浴缸裡 同時持續攪拌水

and monitoring vitals continuously.

和監測生命體徵

If this is not possible,

如果不具備上述條件

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

給患者全身淋灑冰水 和提供濕毛巾也有幫助

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

但在你開始任何救助前， 必須先撥打急診服務電話

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

在等待時，保持患者冷靜非常重要

while cooling as much surface area as possible

同時盡可能多地冷卻患者體表

until emergency personnel arrive.

直到急診人員抵達

If medical staff are available on site, cooling should continue

如果旁邊有醫護人員

冷卻必須直到核心體溫 達到38.9攝氏度

until a core temperature of 38.9 degrees Celsius is reached.

The sun is known for giving life,

太陽被認為是生命之源

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

但是如果我們不小心它也能夠奪取生命

even affecting the strongest among us.

甚至影響我們之間最強大的人

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

利維克博士關於運動型中暑 在1859年寫道

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

「它打擊它全副武裝的受害者。

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

年輕，健康和強壯的人都不能抵抗它的力量。」

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

但是雖然這種情況是 運動三大死亡成因之一

it has been 100% survivable with proper care.

如果處理得當它的存活率是100%