下面这篇是从一个划艇运动的户外网站上找来的，供大家参考（本人翻译水平有限，且缺乏专业知识，注意以英文原文为准）
网址：http://www.canoevillageworld.org/hypothermia%20e.htm
Hypothermia - Prevention and Care
低体温症――预防和治疗
What is it?什么是低温症？
Hypothermia is probably responsible directly or indirectly for more deaths than all other factors combined. Although death by drowning may be the coroner's verdict in many kayaking and canoeing deaths, the actual
cause of drowning is frequently unconsciousness due to hypothermia. Because it is the number one killer, it is vital that hypothermia be thoroughly understood so that early symptoms can be readily recognized and appropriate precautions be taken when paddling in cold climates.
低体温症直接或间接地造成死亡，也许比其它各类因素加起来还要多。尽管验尸官会在许多死亡安全中宣布死因是溺水，但实际原因是因为低温症造成失去意识，而导致溺死。因为低温症是第一杀手，所以在进入到寒冷气候之前对它进行彻底了解，包括早期症状、适当的预防措施等，都是非常必要的。
There are two basic types of hypothermia:
低温症分为两种类型：
1, exposure (gradual) - steady heat loss in a cold environment through respiration, evaporation (sweat, wet clothes) or inadequate insulation (radiation)
2, immersion (acute) - rapid heat loss through conduction to cold water, characterized by fast onset (10-30 minutes in ocean water)
Type A hypothermia can occur easily enough during any outdoor excursion, especially in wilderness situations where weather conditions may deteriorate unexpectedly or where travelers may become lost, injured or exhaust their food supplies prematurely.Outdoor activities involving water presents the added possibility of immersion, or Type B hypothermia. In almost all weather conditions, the body cools up to 25 times faster in water than in air. In 10 degrees C waters, immersed persons without thermal protection become too weak to help themselves after about 30 minutes. Even if rescued, the chances of survival after an hour in the water are slim.
1、暴露型（逐渐地）――在寒冷环境下通过呼吸、蒸发（汗湿或潮湿的衣物）或者没有适当保温造成的热量逐步散失。
2、浸泡型（突发地）――因为冷水传导造成热量快速丧失，表现为快速发作（海水中仅为10-30分钟）
前一种类型的低温症易发于任何一种户外活动，特别是在气候易变的野外，或在旅行者迷路、受伤或食品供给不足的情形下发生。包括水上运动在内的户外活动，也会有落水或者后一类型的低温症的危险。差不多在所有的天气状况下，在水中身体冷却的速度，要比在空气中快25倍。在10摄氏度的水中，如果没有热保护装备，人们在30分钟后就会失去自救的能力。即使获得救援，浸在水中1小时后，能够生存的机会也微乎其微。
Faced with a cold environment, the body tries to defend itself in two ways:
我们的身体在遇到寒冷环境时，会有两种自我保护方式：
1, shivering, to increase muscle heat production
2, and blood shunting, to reduce heat loss by diverting blood flow away from the body extremities to the body core.
Mild hypothermia occurs as the body's core temperature drops below it's normal 37 degrees C (98.6 degrees F). In the early stages, vigorous shivering is usually accompanied by increased pulse and breathing rates. Cold, white hands and feet (as the blood vessels in the skin constrict) are the first signs of blood being shunted away from the body's extremities.
1、颤抖，产生肌肉热量。
2、血液放慢流动，以防止从身体核心部位的热量通过血流往肢端而丧失。
较轻的低温症会在身体核心部位的温度低于它正常的37摄氏度时发生。在早期阶段，伴随着脉搏和呼吸节奏的加快，会产生剧烈的颤抖。冰冷的、发白的手和脚（因为皮肤下的血管收缩）是肢体的血流放慢的第一个征兆。
Irrationality and irritability are early behavioral signs of hypothermia. Hence it is not safe to rely on members of your group recognizing the onset of hypothermia in themselves. In cold conditions, keep watch for symptoms in everybody. Pay close attention to anybody who is confused, abnormally clumsy, paddling off-course, or otherwise behaving erratically.
不理性和易于兴奋是早期行为征兆。因此依靠队伍的成员来自己发现低温症并不安全。在寒冷条件下，要观察每一个人的表现。密切关注那些有糊涂、反常地笨拙、划空桨，或者其它不正常的行为的人。
Severe hypothermia results as the body temperature drops below 33 degrees C. Shunting of blood continues, manifesting as blue-ish (cyanotic) lips and fingertips from poor oxygenation of the tissues near the body surface. Decreased circulation also results in a buildup of acid metabolites (waste products) in the muscles of the extremities until shivering stops and is replaced by muscular rigidity. The pulse and respirations begin to slow as the body core cools to 30 degrees C.
严重的低温症会在体温低于33摄氏度时发生。血液继续放慢流动，嘴唇和指尖等身体表面器官因为缺氧呈青紫色。血液循环降低同时导致手足的肌肉里产生酸性代谢物（废物），直到颤抖停止，取而代之的是肌肉僵硬。身体核心温度低至30摄氏度时，脉搏和呼吸开始放慢。
Below core temperature of 33 degrees C, the vital organs are beginning to get cold. As the brain cools, brain cell metabolism slows, resulting in impaired brain function. The level of consciousness deteriorates from confusion and despair to disinterest, incoherence and eventual unconsciousness. Below 30 degrees C, signs of life are very difficult to detect and the patient may be mistaken for dead. The pupils of the eyes will be dilated and fixed. The pulse may be undetectable. Occasional gasps of respiration at a rate as low as 4 or 5 per minute may be the only clue that the patient is still alive. A victim who has not already drowned through unconsciousness or loss of dexterity may die by means of heart failure.
身体核心温度降到33摄氏度以下时，重要器官开始变冷。因为大脑变冷、大脑细胞新陈代谢减慢，导致大脑功能削弱。意识程度开始降低，从困倦和绝望变为不感兴趣、语无伦次，甚至丧失意识。在30摄氏度以下，生命的特征已经难以发现，病人易被误认为已死。瞳孔放大，无反应。脉搏没有感觉。呼吸断断续续，每分钟呼吸频率低于4到5次，也能这是仅能证明病人还存活的唯一线索。那些没有因为丧失意识或灵敏度而溺死的病人，也可能因为心力衰竭而死。
Treatment治疗
Mild Hypothermia
较轻的低温证
If the casualty is conscious, talking clearly and sensibly and shivering vigorously, then: encourage physical activities to generate muscle heat get the person out of the water to a dry sheltered area replace wet clothing with dry layers, covering the head and neck apply hot packs, water bottles, or warm campfire rocks wrapped in hot, wet towels to the groin, head, neck and sides of the chest supply hot caffeine and alcohol-free drinks
如果病人有意识，谈吐清楚，且在明显地颤抖，那么应尽量进行身体运动以促使肌肉产生热量。将病人带到干燥的地方，脱去其湿衣服，换上干燥衣物，盖住头部和脖子，将热的袋子、水瓶、热营火石用热而湿的毛巾包住，在病人的腹股沟、头部、脖子和胸部两侧进行热敷，喝热咖啡和无酒精的饮料。
Severe Hypothermia
严重的低温症
1, A victim of advanced hypothermia must be treated as a medical emergency. If the victim is getting stiff and is either unconscious or showing signs of clouded consciousness such as slurred speech or severe loss of coordination, transport the patient to a medical facility where aggressive re-warming can be safely initiated, or radio for help.
1、患重低温症的病人应当作急救处理。如果病人正在变得僵硬，或者丧失意识，或者表现出诸如意识不清、发音含糊或严重丧失协调性等特征，要立即送病人去有加温医疗设备之处，或者通过无线电寻求求援。
2, Ordinarily, let the hospital re-warm a severely hypothermic person due to physiological complications. However, on a trip, you will not likely have immediate access to medical facilities. Wrap the person warmly and transport to safety. Carry the victim as gently as possible, perhaps in the kayak or canoe, to shelter. Jostling the patient may cause cardiac arrest.
2、一般情况下，因为低温症的复杂性，要让医用的加温装备来处置低温症患者。但是，在旅程中，一般无法迅速得到医疗设施。要温暖地包住病人，送往安全之处。尽可能地在运送病人的过程中保持轻柔，也许可以用皮划艇或独木舟。猛烈碰撞病人可能导致心脏停止。
3, Remove wet clothing. Place in a dry sleeping bag and join him or her to maximize heat generation. Once shivering has stopped, the patient has lost the ability to generate heat, so simply wrapping in a cold bag will not help. He or she needs a gentle source of heat, like another human body. Apply hot packs to the neck, armpits, sides, chest and groin. Keep the head covered. Warm the victim's lungs by mouth-to-mouth breathing.
3、脱去湿的衣物。放置到干燥的睡袋中，以使病人产生热量。一旦颤抖停止，病人就丧失了自己产生热量的能力，所以简单地把病人放入一个冷睡袋里并没有帮助。病人需要一个温和的热量来源，比如另一个人的身体。把热敷袋放到病人的脖子、腋窝、两侧、胸部和腹股沟。盖住头部。通过嘴对嘴的人工呼吸暖和病人的肺。
4, Do not warm, rub or stimulate the severely hypothermic patient's extremities. This may bring cold, stagnant blood from the body surface to the body core, resulting in cardiac arrest. Hot drinks are also dangerous as they draw warm blood away from vital organs. Nearly 3 gallons would be needed to raise core body temp 1 degrees C.
4、不要加热、磨擦或刺激严重低温症病人的四肢。这可能导致体表冰冷的、停滞的血液流到身体核心部位，造成心脏搏动停止。热的饮料也是危险的，因为它们会使温暖的血液带离身体重要器官。使身体核心温度升上一度，几乎需要近3加仑热饮料。
5, Things to look out for as you re-warm a severely hypothermic person include a condition called temperature afterdrop which occurs as the body is re-warmed and cold blood from the extremities returns to the body core, resulting in another 1-2 degrees C core temperature drop. Acidosis occurs as the acid waste products from cell metabolism in the extremities is returned to the heart, which may result in re-warming shock. Both afterdrop and acidosis may precipitate cardiac arrest.
5、当用加温装置使严重低温症病人复温时，需要警惕几种情况。一种是体温后降，因为身体被加温后，肢体的冷血会回到身体核心部位，造成核心部位体温降低1-2摄氏度。另一种是酸毒症，因为低温下肢体细胞新陈代谢放慢而产生的酸性废物，会回到心脏，可能会导致复温休克。体温后降和酸毒症都可能引起心脏骤停。
6, Bystanders may be tempted to start CPR on a severe case as it is very difficult in the field to distinguish between severe hypothermia and cardiac arrest. But chest compressions or any other rough handling of a severely hypothermic person are particularly likely to convert a slow, low output heart rhythm into ventricular fibrillation, a form of heart attack. Check for any body movement or respiratory effort, both of which are lacking in a heart attack victim, and feel for a carotid pulse (in the neck, to the side of the windpipe) for a full minute before initiating CPR.
6、在难以区别严重低温症和心搏停止的情况下，旁观者可以尝试进行心肺复苏术。但是，对于严重的低温症病人来说，胸部按压或者任何其它的粗暴处理，都应转化为缓慢的、低速的心脏按摩，类似于对待心脏病发作的一种方式。在开始进行心脏复苏术后，观察病人的身体的动静或者呼吸，感受颈部的脉搏（在脖子气管的边上）满一分钟。
Surviving a Dunking从落水中生存
The parts of the body with the fastest heat loss are (in order):
身体的如下部位易快速丧失热量
1, the head
2, neck
3, sides of the chest
4, groin.
1、头
2、脖子
3、胸部两侧
4、腹股沟
Therefore, to reduce heat loss, protect these areas.
因此，要避免热量丧失，要保护好上述部位。
1, If you capsize and wet exit, try to get back into your boat, or at least back onto it.
2, Drownproofing doesn't work in cold water.
3, Keep your head out of the water and your hat or hood on.
4, Treading water may be OK if you wear a wetsuit, but you will last twice as long if you just hold still.
5, Swimming is only good for very short distances - depending on water temperature you may get 10 yards or half a mile.
6, Best to wait quietly if help is at all close by.
7, Use HELP (Heat Escape Lessening Position):
arms folded across the chest
ankles crossed
thighs close together
knees bent.
1、如果你落水，尽量回到船上。
2、浮水法不适用于冷水中。
3、头部露出水面，并用帽子盖住。
4、如果你穿着潜水服，踏水是可以的，但是只要你不动，你只能维持两次。
5、短距离可以游泳――取决于你游10码或半英里的水温。
6、如果附近有救援，最好是安静地等待。
7、寻求救援。（保持热量的姿势）：
手臂折叠在胸前，脚踝相扣，大腿并拢，膝盖弯曲。
Know Your Paddling Partners了解你的伙伴
Susceptibility to hypothermia depends not only on the conditions of exposure but also on body size.
易于患低温症，并不仅在于所处环境，而且与身体有关。
Children are considerably more susceptible than large adults.
Older folks generally more than young.
Thin people are more susceptible than fat.
Men more so than women due to a generally smaller subcutaneous fat layer.
Alcohol and drugs may impair shivering or dilate surface blood vessels, thereby masking symptoms or interfering with blood shunting.
Certain medical conditions may make a person particularly susceptible to hypothermia, such as:
hypothyroidism, in which too little thyroid hormone (regulates cellular metabolic rate) is produced (older people);
diabetes (low blood sugar problems);
psychiatric disorders (epileptics); so know who you're paddling with.
孩子比成人易于患低温症。
老人比年轻人易患。
瘦人比胖人易患。
男人比女人易患（因为皮下脂肪较少）
饮酒和吸毒会使削弱颤抖或者血管扩张或，所以导致低温症状不明显，或者血液流动不放慢。
特定的疾病使人易患低温症，如：甲状腺功能减弱，其过低的甲状腺激素（管理细胞新陈代谢频率）；糖尿病（低血糖）；精神失调（癫痫病）
Summary of Symptoms低温症症状简述
1, Uncontrollable shivering and inability to warm up.
2, Confusion, irritation, clumsiness, slurred speech.
3, Erratic paddling and inability to maintain course (disorientation).
4, Blurred vision and lack of coordination.
5, Despair and disinterest.
6, Ashen white face and hands.
7, Shivering replaced by muscle rigidity.
8, Paradoxical stripping of clothes as cold impairs thermoregulation center of brain.
9, Incoherence and collapse; unconsciousness.
1、不受控制的颤抖和不能变暖。
2、糊涂、愤怒、笨拙、说话含糊。
3、奇怪举止，丧失方向感。
4、视力模糊，丧失协调性。
5、绝望和漠不关心。
6、脸和手呈灰白色。
7、肌肉僵硬取代了颤抖。
8、乱脱衣服（因为大脑的体温调节系统被寒冷削弱）。
9、语无伦次，虚脱，丧失意识。
Prevention预防
Hypothermia is preventable through common sense. Potentially hypothermic situations must be managed before they become serious.
低温症可以通过常识来加以预防。潜在的低温症情况必须在变得严重之前就得到控制。
1, Recognize the environmental conditions leading to hypothermia.
2, Wear appropriate clothing for cold and wet conditions. Wear a hat at all times. Use polypropylene underwear to wick water away from the skin, wool on top and a wind- and waterproof covering. Acrylic is better than wool for insulation in a dunking. Even better is a wetsuit or immersion (survival) suit with a hood to minimize heat loss.
3, Physical fitness, continuous exercise, high-calorie food and a hot thermos of tea or hot chocolate will prevent the onset of mild hypothermia.
4, Avoid exhaustion by knowing your limits. If you are lost, avoid panic and other energy-depleting activities.
5, In wilderness settings, carry fire-starting materials and some form of improvisational shelter.
6, Pack a VHF radio and know how to use the emergency Channel 16 to call for help.
7, Carry chemical hot packs and a thermometer in your first aid kit.
8, Know your paddling partners.
9, Learn to recognize the early warning signs of hypothermia
1、知道导致低温症的环境。
2、在寒冷湿润的环境下，穿适当的衣服。所有时间内戴帽子。穿排汗快干内衣，迅速带走皮肤上的水份，上面穿绒料或毛料，最外面是防风防水衣服。
3、保持身体健康，经常锻炼，高热量食物和热茶或热巧克力将帮助预防轻低温症。
4、知道自己的极限，避免透支。如果迷路，避免惊慌和其它消耗能量的活动。
5、在野外，带火种和一些宿营设备。
6、携带特高频对讲机，而且知道如何使用紧急频道来寻求求援。
7、在急救包里带化学加热袋和温度计。
8、了解你的同伴。
9、学习判断低温症的早期症状。 |
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发表于 2007-7-15 11:31:57
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