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  • 現在位置是:首 頁 >> 急診學科 >> 院前急救 >> 推薦文章

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    原作者: Brian Corwell,翻譯:李輝 文章來源: 《中華急診醫學雜志》編輯部 發布日期:2014-07-29

     Title: Drowning
    Author 作者: Brian Corwell
    翻譯:李輝 校正:肖鋒

    Happy Memorial Day! With all the recent attention in the news about swimming and drowning I thought I would share this article
    The Instinctive Drowning Response—so named by Francesco A. Pia, Ph.D., is what people do to avoid actual or perceived suffocation in the water.
    溺水的本能反應—由Francesco A. Pia博士命名,即人們在水中如何避免實際或感覺到的窒息。
    And it does not look like most people expect.
    There is very little splashing, no waving, and no yelling or calls for help of any kind.
    To get an idea of just how quiet and undramatic from the surface drowning can be, consider this:
    It is the No. 2 cause of accidental death in children, ages 15 and under (just behind vehicle accidents)—of the approximately 750 children who will drown next year, about 375 of them will do so within 25 yards of a parent or other adult.
    In some of those drownings, the adult will actually watch the child do it, having no idea it is happening.
    Drowning does not look like drowning—Dr. Pia, in an article in the Coast Guard’s On Scene magazine, described the Instinctive Drowning Response like this:
    Pia博士在“海岸警衛隊現場”雜志 “溺水看起來不像溺水”一文中對溺水的本能反應是這樣描述的:
    • “Except in rare circumstances, drowning people are physiologically unable to call out for help. The respiratory system was designed for breathing. Speech is the secondary or overlaid function. Breathing must be fulfilled before speech occurs.
    • 除非在罕見的情況下,溺水者在生理學上是不能呼救的。呼吸系統原本是用于呼吸。講話只是次級或疊加的功能。在說話之前必須有呼吸。
    • Drowning people’s mouths alternately sink below and reappear above the surface of the water. The mouths of drowning people are not above the surface of the water long enough for them to exhale, inhale, and call out for help. When the drowning people’s mouths are above the surface, they exhale and inhale quickly as their mouths start to sink below the surface of the water.
    • 溺水時人的嘴交替地沉沒于水下或再出現于水面上。溺水者的嘴浮出水面的時間不足以呼氣、吸氣,以及呼救。溺水者的嘴高于水面時,他們迅速地呼氣和吸氣,因為他們的嘴已開始沉下水面。
    • Drowning people cannot wave for help. Nature instinctively forces them to extend their arms laterally and press down on the water’s surface. Pressing down on the surface of the water permits drowning people to leverage their bodies so they can lift their mouths out of the water to breathe.
    • 溺水的人不能揮手呼救。自然本能的力量強迫他們向兩側伸開手臂打壓水面。打壓水面可以使身體上浮,所以他們能使嘴高于水面呼吸。
    • Throughout the Instinctive Drowning Response, drowning people cannot voluntarily control their arm movements. Physiologically, drowning people who are struggling on the surface of the water cannot stop drowning and perform voluntary movements such as waving for help, moving toward a rescuer, or reaching out for a piece of rescue equipment.
    • 溺水本能反應的全過程中,溺水者不能自主地控制手臂的運動。生理學上,溺水者在水面上掙扎時不能停止溺水以及執行隨意的運動如振臂呼救、向救援者移動、伸手去夠一塊急救設施等。
    • From beginning to end of the Instinctive Drowning Response people’s bodies remain upright in the water, with no evidence of a supporting kick. Unless rescued by a trained lifeguard, these drowning people can only struggle on the surface of the water from 20 to 60 seconds before submersion occurs.”
    • 從頭到尾,溺水者的本能反應都是身體垂直于水面,無任何跡象表明需要急救。除非是被訓練有素的急救員救起,溺水者在淹沒之前通常只能在水面上掙扎20-60秒。
    This doesn’t mean that a person that is yelling for help and thrashing isn’t in real trouble—they are experiencing aquatic distress. Not always present before the Instinctive Drowning Response, aquatic distress doesn’t last long—but unlike true drowning, these victims can still assist in their own rescue. They can grab lifelines, throw rings, etc.
    Look for these other signs of drowning when persons are in the water:
    • Head low in the water, mouth at water level
    • 頭低于水面,口在水面上
    • Head tilted back with mouth open
    • 頭后仰嘴巴張開
    • Eyes glassy and empty, unable to focus
    • 眼睛呆滯,空曠,不能聚焦
    • Eyes closed
    • 眼睛合上
    • Hair over forehead or eyes
    • 頭發蓋住前額或眼睛
    • Not using legs—vertical
    • 不使用腿——呈直立狀
    • Hyperventilating or gasping
    • 呼吸急促或喘氣
    • Trying to swim in a particular direction but not making headway
    • 試圖朝某個方向游但卻無前進
    • Trying to roll over on the back
    • 試圖翻轉身體
    • Appear to be climbing an invisible ladder
    • 仿佛在爬一個看不見的樓梯
    So if a crew member falls overboard and everything looks OK—don’t be too sure.
    Sometimes the most common indication that someone is drowning is that they don’t look like they’re drowning.
    They may just look like they are treading water and looking up at the deck.
    One way to be sure?
    Ask them, “Are you all right?” If they can answer at all—they probably are.
    If they return a blank stare, you may have less than 30 seconds to get to them.
    And parents—children playing in the water make noise. When they get quiet, you get to them and find out why.

    References 參考文獻: