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原作者: Brian Corwell,翻译:李辉 文章来源: 《中华急诊医学杂志》编辑部 发布日期:2014-07-29

 Title: Drowning
Author 作者: Brian Corwell
翻译:李辉 校正:肖锋

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.
溺水的本能反应—由Francesco A. Pia博士命名,即人们在水中如何避免实际或感觉到的窒息。
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“海岸警卫队现场”杂志 “溺水看起来不像溺水”一文中对溺水的本能反应是这样描述的:
• “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.
• 除非在罕见的情况下,溺水者在生理学上是不能呼救的。呼吸系统原本是用于呼吸。讲话只是次级或叠加的功能。在说话之前必须有呼吸。
• 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.
• 溺水时人的嘴交替地沉没于水下或再出现于水面上。溺水者的嘴浮出水面的时间不足以呼气、吸气,以及呼救。溺水者的嘴高于水面时,他们迅速地呼气和吸气,因为他们的嘴已开始沉下水面。
• 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.
• 溺水的人不能挥手呼救。自然本能的力量强迫他们向两侧伸开手臂打压水面。打压水面可以使身体上浮,所以他们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.
• 溺水本能反应的全过程中,溺水者不能自主地控制手臂的运动。生理学上,溺水者在水面上挣扎时不能停止溺水以及执行随意的运动如振臂呼救、向救援者移动、伸手去够一块急救设施等。
• 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.”
• 从头到尾,溺水者的本能反应都是身体垂直于水面,无任何迹象表明需要急救。除非是被训练有素的急救员救起,溺水者在淹没之前通常只能在水面上挣扎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
• 头低于水面,口在水面上
• Head tilted back with mouth open
• 头后仰嘴巴张开
• Eyes glassy and empty, unable to focus
• 眼睛呆滞,空旷,不能聚焦
• Eyes closed
• 眼睛合上
• Hair over forehead or eyes
• 头发盖住前额或眼睛
• Not using legs—vertical
• 不使用腿——呈直立状
• Hyperventilating or gasping
• 呼吸急促或喘气
• Trying to swim in a particular direction but not making headway
• 试图朝某个方向游但却无前进
• Trying to roll over on the back
• 试图翻转身体
• Appear to be climbing an invisible ladder
• 仿佛在爬一个看不见的楼梯
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.

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