Bufofo bua neje (Photokeratitis) mu mpata ne dikuba dia mêsu dia tshianana¶

Bufofo bua neje, budi bumanyike mu malu a luondapu bu keratite ultraviolet anyi photokeratite solaire mbualu budi buosha bikole mu mêsu ne mu mêsu bidi bifumina ku nsese mikole ya ultraviolet (UV-B ne UV-A) idi ipatukila ku neje, ku mabue a mashika, ku mabue a muulu anyi ku mâyi adi kaayi ne tshintu. Bu mudi neje mipiamipia ileja 80 too ne ku 90 pa lukama ya nzembu ya dîba idi ifumina panshi eku bule bua bungi butekesha tshitupa tshidi tshikuba lupepele, bantu badi babandila mikuna, badi benda pa mikuna, badi benda pa neje, badi benda pa mikuna mu muvu wa mashika, ne badi benza ngendu ku muelelu wa mâyi badi mua kuikala ne disama dikole dia mubidi didi mua kunyanga mubidi mu minite mikese too ne ku 300 too ne ku **900 tshibuikidiji tshia mêsu tshidi tshipangisha UV, nansha muinshi mua ditutu dibuikila anyi mu lupuishi lua butoke bua "whiteout".

Tshidi tshienza bua bufofo bua neje buikale bua pa buabu mu tshipela ntshia tshikondo tshia mêba 4 too ne ku 12. Muntu udi ubanda mikuna anyi udi wenza manaya a ski udi ujimija manyanu ende pa tshibandabanda tshia mabue a mashika mu midi kena umvua kanyinganyinga nansha kamue mu mapingaja to, anu bua kujuka mu ntenta wende pa midi ne kanyinganyinga kakole ne bipese bia mêsu bidi biuwule, bidi binyanguka (blepharospasme) bidi kabiyi mua kukangula. Kuikala mpofu udi kayi wenza mudimu pa mukuna, pa tshibandabanda tshia mabue a mashika, anyi pa njila wa mu muvu wa mashika udi kayi mua kujika kudi kukudimuna disama dia mu mêsu didi mua kupingana mu njiwu ya lufu ne dikuluka dia lukasa. Mukanda ewu udi umvuija malu a mu lupepele, dikola dia bimanyinu, dilama dia mêsu dia mu mpata, dienza dia makalashi a stenopeic slit a mu mushindu wa bena Inuit, ne mishindu ya kupatula bantu badi kabayi bafue.

Enza nunku mpindieu¶

1. Patuka diakamue mu dîba ne mu neje: Diakamue padi muntu yonso wa mu tshisumbu tshienu umona ne: mêsu ende adi maume, adi atamba kuela mêsu, adi ne buôwa bua butoke (ditshina dia butoke), anyi udi umona ne: manyanu ende a munya anyi a ski mmajimine anyi matshibuke, udi mua kuya mu ntenta udi ne mundidimbi, mu tshina tshia neje, mu tshisasa tshia muitu, anyi uvuale tshilamba tshia mêsu tshidi tshimueneka diakamue. Kuindidi bua kanyinganyinga katuadije: dîba didi mêsu ebe asama, tshitupa tshia mu mêsu tshidi tshimane kuosha ne tshienda tshipatuka.
2. Umbusha bintu bia kumona nabi mêsu diakamue kumpala kua bipese bia mêsu kujika: Bikala muntu udi ne disama edi muvuale bintu bia kumona nabi mêsu, umulombe bua kuowa mâyi anyi kusukula bianza biende ne umbusha bintu bia kumona nabi diakamue padiye utshidi mua kukangula mêsu ende. Kushiya biamu bia kumona nabi mêsu bikuate pa mutu pa dikasa didi diosha kudi radiation kudi kupangisha tshitupa tshia oxygène, kukuata bactérie (Pseudomonas), ne kufikisha ku disama dikole dia keratite.
3. Kukoki meso nansha kakese: Tshitupa tshia mêsu tshidi katshiyi tshilengeja tshidi tshimueneka anu bu nsenga mikole anyi dikala dia panshi didi dikuate muinshi mua bipese bia mêsu. Kukosa mesu kudi kumbusha mabeji a basal epithelial cells adi mashale ne kudi kukolesha disama.
4. Ikisha mu mîdima mikole ne bintu bia mashika, bia mashika ne mafuta adi kaayi ne tshintu tshidi tshilama bintu: Teka mubedi mu ntenta udi ne mîdima anyi ubuikile mêsu ende ne tshilamba tshifiike, tshilamba tshia ku mutu, anyi tshilamba tshia ku mêsu tshibidi bua dîsu nansha dimue kadikadi dienzejibua kudi butoke (Bualu bua mêsu onso abidi adi adisangisha pamue ku diambuluisha dia **tshiamu tshia mêsu ** tshidi tshikenka mu butoke bumue dîsu didi kadiyi dilengeja didi difikisha ku disama dia iris mu dîsu didi ditapa). Ela tshilamba tshikezuke tshilengeja ne mayi mashika (kuteke neje anyi neje buludiludi pa bipese bia mêsu to, bualu ebu budi mua kufikisha ku disama dia mashika) ne ela binsonji bia tshianana bidi kabiyi ne tshintu tshidi tshilama anyi mafuta a mêsu adi kaayi ne tshintu kunyima kua mêba 1 anyi 2.
5. Kufila manga a kanyinganyinga ka mukana: Kukanda kanyinganyinga kakole ka mu tshiadi ne disama dia mishipa ya mu tshiadi ku diambuluisha dia ibuprofen (400 too ne ku 600 mg kunyima kua mêba 6 anyi 8 ne biakudia) ne/anyi acetaminophen / paracetamol (500 too ne ku 1000 mg kunyima kua mêba 6) bua mubedi ikale mua kulala tshitupa tshia mubidi tshidi tshipingana mu mêba 24 too ne ku 72.
6. Emba manyanu a stenopeic slit shi udi ne tshia kupatuka diakamue: Shi mvula wa tshipepele, njiwu ya dikuluka dia mabue, anyi disama dia muaba mule dienzeja tshisumbu bua kuenda kumpala kua mêsu a mubedi kuondopibua, enza 1-millimetre horizontal slit goggles ne duct tape, karton, tshilamba tshia kulala, anyi tshilamba tshia kulala (mu tshikoso tshidi kuinshi eku) anyi ulombole muenji wa ngendu mufofo pa tshilamba tshipi tshia bulunda. Bikila nimero ya njiwu ya muaba unudi (911 mu États-Unis ne Canada, 112 mu Union européenne mujima, 999 mu Royaume-Uni; mona bionso nomba ya tshimpitshimpi) anyi enza mudimu ne satellite SOS beacon weba shi udi mu njila wa njiwu.

Backcountry Snow Blindness Triage & Evacuation Decision Tree¶

flowchart TD
    Start["Dimueneka dia UV dia mu mpata / Dijimija dia bukubi bua mêsu<br/>anyi disama dia mêsu dikole mu tshitudilu"] --> Stage{"Tangila nsombelu udiku mpindieu"}

    Stage -->|"Dikuba dia tshimpitshimpi:<br/>Manyanu a munya adi majimine anyi matshibuke pa neje;<br/>Katshiena ne bimanyinu to"| BuildNow["ENZA BIDIMU BIMPAKANE DIAMUE<br/>Kuendeshi kabidi minite 15 kuyi ne mêsu<br/>Kosa 1 mm (0.04 in) mu tshitupa tshia 1 mm (0.04 in) mu duct tape, mu karton,<br/>anyi mu tshilamba tshia foam; kufiika tshitupa tshia munda ne makala/mupuya"]

    Stage -->|"Bimanyinu (mêba 4 too ne ku 12 panyima pa dipetangana):<br/>Diumvua dia nsenga mikole, binsonji, ditshina dia munya dikole,<br/>mêsu makunze, disama dia mêsu didi kadiyi disua (blepharospasm)"| RedFlags{"Tshibuelelu tshia mabenda makunze adi anyanga tshimuenekelu"}

    RedFlags -->|"Ku luseke lumue (anu dîsu dimue) kunyima kua lupepele/ditamba dikuma,<br/>dipatuka dia pus, dipanga dia pupil, anyi mutu usama bikole/halos"| AltDiag["KUELA MU MUTU WA MUSHI, MUBIDI WA BUALU,<br/>ULCER, NANSHA GLAUCOMA WA ANGLE-CLOSURE CUTE<br/>Kukuba dîsu kakuyi dienzeja; kulongolola dipatuka dia lukasa dia baminganga"]

    RedFlags -->|"Mêsu abidi (mêsu onso abidi) kunyima kua luendu lua neje/glacier/mayi;<br/>dipanda dia patoke, disama dia nsongo dia muomumue"| TreatCamp["PHOTOKERATITIS (SNOW BLINNDNESS) PROTOCOL<br/>1. Umbusha bintu bia kumona nabi diakamue<br/>2. Kukosa mesu nansha kakese; kuena ne tshia kuenza mudimu ne matonshi a anesthesie<br/>3. Ela binsonji bia tshianana/mafuta + Ibuprofen/Acetaminophen wa ku mishiku"]

    TreatCamp --> EvacChoice{"Muaba wa tshitudilu udiku muimpe bua kuikalamu munkatshi mua mêba 24 too ne ku 48 anyi?"}

    EvacChoice -->|"Eyowa (Tshitudilu tshimpe, mafuta/biakudia bia bungi, tshikondo tshimpe)"| ShelterRest["KUSOKOKA MU MUABA BUA MEBA 24 TO NE 48<br/>Lama mêsu onso abidi mabuikila mu ntenta mufiike ne bilamba bia mashika<br/>Epithelium wa cornée udi upingana lukasa mu meba 24 to ne 72"]

    EvacChoice -->|"Tòo (Tshibandabanda tshidi tshimueneka patoke, njila wa mabue a mvula, HAPE/HACE, anyi tshipepele tshikole)"| BlindEvac["ENZA MUSHINDU WA KUAMBULULA NE MUSHINDU WA KUENZA<br/>Bikalaku mushindu wa kunzulula ndambu: ela 1 mm pinhole/slit goggles<br/>Bikala mêsu mafube kanga: funda mêsu onso abidi ne wenze mudimu ne Rigid Trekking-Pole<br/>Buddy Tether anyi Short-Roped Formation"]

Fizike ne disama dia mêsu dia bufofo bua neje¶

Kujingulula mushindu udi nzembu ya ultraviolet ikuata dîsu kudi kumvuija bua tshinyi matutu kaena akuba muntu nansha umue ne bua tshinyi bimanyinu bidi bimueneka mêba makese panyima pa dibuela dia dîba:

1. Tshiamu tshia Albedo tshia misangu ibidi ne tshivudiji tshia bule¶

• Albedo wa neje mupiamupia (80% to 90% UV Reflection): Bisonsa, buloba, ne mabue mafiike bidi bikuata 90 to ne 95 pa lukama ya nzembu ya UV ya dîba, idi ileja anu 3 to ne 10 pa lukama muulu. Bishilangane, neje mipiamipia idi ileja 80 too ne ku 90 pa lukama ya UV-B (280 too ne ku 315 nanomètres) ne UV-A (315 too ne ku 400 nanomètres) kuulu kumbukila panshi ku nseke yonso. Nansha wewe muvuale tshilamba tshia baseball anyi tshilamba tshia dîba, mitoyi ya UV idi ipatukila pa neje buludiludi muinshi mua tshilamba ne pabuipi ne nseke miunzulula ya makalashi a dîba a mu njila buludiludi pa mêsu ebe.
• Tshivudiji tshia bule bua UV: Bua 1,000 metres (3,280 feet) ya bule bua pa mutu pa mbuu, bukole bua nzembu ya UV ya mu lupepele budi buvula ne 10 too ne ku 12 pa lukama bualu kudi lupepele lukese ne aérosol wa stratosphère bua kutangalaja butoke bua bule bua mavuala makese. Ku 4,000 metre (13,100 feet) pa tshibandabanda tshia alpine, UV muulu pamue ne 85 pa lukama wa UV udi umueneka kudi neje udi uteka tshimuenekelu tshia mêsu tshidi katshiyi tshikuba ku misangu mipite pa 2,5 ya nzembu ya ultraviolet ya ku muelelu kua mbuu.
• Bua tshinyi matuku a matutu a "Whiteout" adi akebesha bilumbu bia bungi: Too ne ku 80 pa lukama ya nzembu ya dîba ya UV idi ibuela mu matutu makese anyi a pa tshibidilu ne lupuishi lua mu mikuna. Mu tshikondo tshia whiteout, butoke budi bumueneka budi bupueka kakese (budi buenza bua mêsu ebe atangalake bikole), ne butoke bua UV budi buenda buenda buenda bujika pankatshi pa neje udi umueneka ne plafond wa ditutu ditoke (the optical diffusion box effect). Bantu batu benza manaya a ski ne badi babanda mikuna badi bumbusha makalashi abu a glace mu butoke bua kumona bimpe neje batu bapeta disama dia neje dikole mu mêba abidi.

2. Bua tshinyi disama didi dituadija kunyima kua meba 4 too ne ku 12¶

Tshitupa tshia mêsu tshia muntu tshidi ne bungi bua bungi bua ndekelu ya mijilu idi isama (nociceptors idi ifumina ku tshitupa tshia mêsu tshia mijilu ya trigeminal, CN V1) ya tshitupa tshionso tshia mubidi, pabuipi ne misangu 300 too ne ku 600 ya mijilu ya kanyinganyinga ku milimetre kare kupita dikoba. 1. Mêba 0 too ne ku 2 (Dinyanguka dia ADN mutoke): Padi foton ya UV-B ikuma tshitupa tshia pambelu tshia 5-cell-thick layer wa cornea (the corneal epithelium), idi miangatshibue kudi ADN wa selile, yenza pyrimidine dimers ne reactive oxygen species. Bualu ebu budi tshienzedi tshia photochimie pamutu pa kuosha kapia, kuena umvua tshintu nansha tshimue padibi bienzeka to. 2. Mêba 4 too ne ku 12 (Apoptose ne dinyanguka dia tshitupa tshia mubidi): Mêba anayi too ne ku 12 kunyima kua dimanyisha, selile ya tshitupa tshia ku mêsu idi minyanguke bikole idi ipita mu lufu lua selile (apoptose) ne **idi inyanguka mu bitupa bikese (dinyanguka dia tshitupa tshia mubidi) mu tshimpitshimpi, dipatuka dia tshimpitshimpi sub-basal nerve plexus buludiludi ku lupepele ne ku tshitupa tshia munda tshia tshilamba tshia dîsu. 3. Mêba 12 too ne ku 24 (Dibungama dia pa mutu ne disama dia tshiadi): Dîba dionso didi tshilamba tshia dîsu tshituta ku ndekelu kua mijilu idi kayiyi ne tshintu, bidi biumvuika bu ne: dibeji dia nsenga didi dikosa tshitupa tshia dîsu. Muonji wa trigeminal udi ufila tshienzedi tshinene tshia bukubi ku muonji wa mpala (CN VII), udi ukanga mishipa ya orbicularis oculi mu tshipupu tshia patupu, tshidi tshifuanangane ne tshiamu tshia mpala (blepharospasm) eku wenda uwuja dîsu ne binsonji bia reflex (epiphora) ne ukanga disu (ciliary spasm). 4. Mêba 24 too ne ku 72 (Dilengejibua dia lukasa dia selile ya nshindamenu): Diakalenga, selile ya nsongo ya limbal ne selile ya nsongo ya nsongo idi ku muelelu kua dikasa idi itapuluka ne ipitshila mu tshitupa tshia muinshi mua buloba ne lukasa. Bikalabu bakubibue ku butoke bua UV, ku dikosa ne ku disama, tshitupa tshia mêsu tshidi tshipatuka nkayatshi mu mêba 24 too ne ku 48 ne butoke buonso budi bupingana mu mêba 72.

Dishilangana dia tshikebelu: bufofo bua neje ne masama makuabu a tshimpitshimpi a mêsu¶

Mu miaba ya mashika, ya lupepele, ya muulu, malu a bungi a mu mêsu adi afuanangana ne bufofo bua neje. Ingidija tshibambalu etshi tshia difuanyikija dia malu a luondapu bua kujadika disama diebe:

Diondapangana dia ku tshitupa ku tshitupa dia mu mpata bua disama dia bufofo bua neje¶

Padi muntu wa mu tshisumbu ujuka anyi wimana mu njila ne disama dia neige dikole, londa ndondo wa luondapu elu:

Tshitupa 1: Dipatula dia lukasa dia tshiamu tshia kutangila natshi mêsu ne dikonkonona dia malu ne bupole¶

• Lekela mubedi asombe munda mua ntenta anyi mu tshiibi tshia lupepele tshidi ne mundidimbi pambelu pa neje yonso.
• Shi bipese bya meso bikanga bikole mu blepharospasm, teka tshilamba tshia mashika, tshitoke pa mesu makanga mu mîdima munkatshi mua minite 10 bua kujikija tshienzedi tshia trigeminal, pashishe upuekesha bitekete bitekete tshipese tshia kuinshi bua kumbusha tshiamu tshionso tshia kutangila natshi mêsu. Lama bintu bia kutangila nabi mu tshibombi ne kubueja kabidi bintu bia kutangila nabi mêsu nansha matuku 7 kunyima kua diondapibua dionso.
• Shi tshibombi tshieba tshidi ne bipese bia fluorescein bia mudimu umue ne muendu wa bule (anyi muendu wa mutshi), dilengeja dia mêsu dia mubedi udi kayi umona neje didi dileja tutotshi tua vert tudi tutangalake mu tshitupa tshia interpebral zone (diffuse superficial punctate keratitis), bidi bijadika UVtitis pamutu pa ulcer deep anyi landritic deep.

Tshitupa 2: Dilengeja dia mesu ne dikuba dia masama¶

• Mulongo wa kumpala wa tshibuikidiji tshia luya: Ela binsonji bia tshianana bidi kabiyi ne tshintu tshidi tshilama bintu (bibombi bia carboxymethylcellulose anyi hyaluronate bia mudimu umue) kunyima kua mêba 1 anyi 2 paudi mutabale, NANSHA Ela **0.5-centimetre (0.25-inch) wa sterile lubrithmique ointment (mutoke) petrolatum / mineral oil) anyi mafuta a mêsu a antibiotic (bu mudi erythromycin 0.5% anyi mafuta a bacitracin/polymyxin B) mu tshibombi tshia kuinshi tshia mêsu kunyima kua mêba 4 anyi 6.
• Bua tshinyi mafuta adi apita matonsi makese butuku bumue: Mafuta a ku mêsu adi makole adi afuka mijilu ya mu mêsu bu mudi tshilamba tshikole bua tshitupa tshia munda tshia mêsu tshienda tshienda bimpe pa mutu pa tshitupa tshia mêsu tshidi katshiyi tshibuikila kakuyi tshidi tshikosa mu tulu tua Rapid Eye Movement (REM).

Tshitupa 3: Dikisha dia mêsu abidi ne dilengeja dia dîsu dimue¶

• Bua tshinyi udi ne tshia kufiika mêsu onso abidi: Njila idi ilombola dikosa dia mesu (Edinger-Westphal nuclei) idi mishindame mu buongo bua munkatshi. Wewe muele anu dîsu dia balume ne mushiye dîsu dia bakaji kadiyi dibuikila kudi neje mutoke, butoke budi bubuela mu dîsu dia bakaji budi buenzeja malu onso abidi a dia bakaji ne a dia balume bua kukanga musangu umue (the consensual pupillary reflex), bienza bua misunyi ya ciliaire ikale ne kanyinganyinga kakole mu dîsu didi ditapike.
• Mukenji wa matuku etu aa wa dilengeja dia mêsu: Malongesha a mu lupitadi adi aleja ne: dilengeja dia mputa ya mu mêsu ne dia UV keratitis kadiena diondapa dia lukasa to, ne didi mua kulengeja dîsu dikanga, dikolesha dikola dia bactérie. Pamutu pa kuela tshilamba tshikole pa dîsu dimue, enza bua mubedi alale mu ntenta mufiike muvuale tshilamba tshia mikoko tshifiike, tshilamba tshia kulala natshi tshia soie, anyi tshilamba tshia kujingila mêsu tshibidi tshikanga pa mêsu onso abidi makanga ne tshilamba tshimpe tshia mashika pa mpala ne pa bipese bia mêsu.

Tshitupa 4: Programe wa diondopangana dia mubidi¶

Matoyi a lubricant a pa mutu adi alengeja pa mutu, kadi disama dikole dia mu tshiadi didi dilomba luondapu lua mukana ludi lulongolola bua kujikija misanshi ne bua kujikija kanyinganyinga (tuela meji ne: mubedi kena ne disama dia allergie, disama dia tshiadi, disama dia mu tshiadi anyi malu adi kaayi mua kuenza to): - Ibuprofen (NSAID): Udi ukepesha disama dia prostaglandine dia mu mêsu ne disama dia mu tshiadi (tshilele tshia bantu bakole tshia tshianana: 400 mg too ne ku 600 mg ku mishiku kunyima kua mêba 6 anyi 8 ne biakudia ne mâyi). - Acetaminophen / Paracetamol: Udi wenza mudimu munene bua kupangisha ditangalaka dia kanyinganyinga (tshilele tshia bantu bakole tshidi katshiyi ne tshisalu: 500 mg too ne ku 1,000 mg ku mishiku kunyima kua mêba 6 katshiyi tshipita 4,000 mg mu mêba 24 to). Kusangila ibuprofen ne acetaminophen mu bikondo bishilangane kudi kufila disulakana dimpe kakuyi dilengeja dia mubedi mu tshikondo tshia mashika (bishilangane ne manga a opioïde, adi apangisha dipuyakana ne anyangakaja dilongolola dia luya padi muntu muulu).

Mushindu kayi wa kuenza manyanu a Glacier (Stenopeic Spectacles)¶

Munkatshi mua bidimu binunu ne binunu, bena Inuit, bena Yupik, ne bena Aleut bavua baloba nyama mu Arctique bavua benza manyanu a neje (ilgaak anyi iggaak) ne mitshi ya driftwood, ne nsengu ya caribou anyi ne meno a nyama wa walrus ne tshitupa tshikese tshia nsongo. Makalashi aa kaena enza mudimu ne dikala dia mvinyo to; badi benza mudimu ku diambuluisha dia mikenji ibidi ya optique: 1. 95% ya dipuekesha dia butoke buonso: Kukanga muaba wonso wa kumona pa kumbusha tshitupa tshia 1-millimeter (0.04-inch) tshidi tshitangalake kudi kukepesha butoke buonso bua ultraviolet ne butoke budi bumueneka budi bufika ku tshimuenekelu tshia mêsu ne bia pa lukama 90 too ne ku 95, bijimija dipetu dia neje idi kuinshi ne muulu. 2. The Stenopeic Pinhole Aperture Effect: Kutangila mu tshitupa tshia 1-millimetre kudi kumbusha dinyanguka dia tshitupa tshia ku mpenga ne kudi kufila butoke buludiludi pa macula, mbuena kuamba ne: nansha muendeshi wa pa mikuna uvua mujimije manyanu ende anyi biamu bia kutangila nabi mêsu neamone tshitupa tshia neje tshia 1-millimetre tshidi ne dishilangana dinene mu tshitupa tshia 1-millimetre kupita ne butoke dîsu.

Mishindu inayi mijadika mu budimi bua kuenza mudimu ne bintu bidi mu tshibombi tshieba¶

flowchart TD
    M1["Tshitupa 1: Kukosa tshilamba tshia kujika natshi mêsu (15 cm x 6 cm / 6 in x 2.5 in)<br/>Wenza mudimu ne tshiamu tshia kuela natshi bintu misangu ibidi, tshiamu tshia foam tshia tshiamu tshikanga,<br/>Kazubu ka biakudia bia mu karton, anyi tshibombi tshia biakudia tshia pa mabeji"] --> M2["Tshitupa 2: Tangila tshitupa tshia ku mishiku ne tshia ku matama<br/>Kosa tshitupa tshia V mu tshitupa tshia kuinshi tshia pankatshi bua tshilamba tshia ku mpala<br/>tshikale tshilamakaja ku mifuba yebe ya ku matama (kupangisha dibuela dia neje muulu)"]

    M2 --> M3["Tshitupa 3: Kufiika tshitupa tshia munda<br/>Kuela makala a nkunyi, lupuishi lua tshioshelu, anyi tshimanyinu tshifiike tshia kashidi<br/>munda mua tshilamba tshia ku mpala bua kuimanyika ditangalaka dia butoke bua munda"]

    M3 --> M4["Tshitupa 4: Kosa bitupa bibidi bia 1 mm (0.04 in)<br/>Kuata tshilamba tshia ku mpala bua kuleja muaba udi mulongi menemene<br/>Ikala wenza mudimu ne nsongo ya muele bua kukosa bitupa bia 1 mm mu bule ne 25 mm mu butshiama<br/>(Anyi mulongo mule wa 1.5 mm bua kupeta bukole bua tshipepele tshikole)"]

    M4 --> M5["Tshitupa 5: Lamakaja tshingoma ne tshilamba tshia ku luseke<br/>Ela mabulu a bande mikolesha ku ntempelo yonso ibidi<br/>Lamakaja paracord, tshiamu tshia menu, anyi tshilamba tshia ku makasa kunyima kua mutu"]

Kupatula muena mudimu udi kayi umona neje mu tshitupa tshia malu a tekiniki¶

Shi mubandi wa mikuna anyi muendeshi wa ski udi kale ne disama dia bufofo bua neje ne bipese bia mêsu bikanga mu blepharospasm, kuindila mêba 24 too ne ku 36 mu tshitudilu tshia bukubi kudi kuambuluisha mishiku yende bua kuondopibua bikumbane bua kupatuka muinshi mua tshimuenekelu tshiabu. Kadi, pikala tshipepele tshikole tshienda tshisemena, mafuta a tshioshelu adi enda akepela, njiwu ya dibutuka dia mabue, anyi disama dia muulu (AMS, HAPE, anyi HACE) bidi bikengela kupatuka diakamue padi mubedi mufofo mujima:

1. Tshilamba tshikole tshia kuendakana natshi (kuendakana anyi kuendakana pa neje)¶

Kutetshi nansha kakese bua kulombola muendeshi wa mpofu pa mabue adi kaayi makane, pa mabue a neje, anyi pa njila mikese pa kumukuata ku tshianza anyi kumusuika tshingoma tshidi tshitekete pankatshi pa bimono biebe (tshidi katshiyi tshifila diandamuna dia njila too ne padibu bamane kulenduka). - Twi-Pole Rigid Harness Technique: 1. Mulombodi udi umona udi wenda buludiludi kumpala kua muendeshi wa mpofu (anyi ku luseke ne ku luseke pa buloba bunene). 2. Mulombodi udi ulombola udi mukuate mashinyi a kumpala a mitshi ibidi mialabale (umue ku tshianza tshia bakaji, mukuabu ku tshianza tshia balume), uleja mitshi ya mitshi panyima payi. 3. Muendeshi wa mpofu udi mukuate nsongo ya tshibombi ya mitshi yonso ibidi mikole ku bianza biende bia bakaji ne bia balume, wenda mutantshi wa metre 1 (3.3 feet) panyima pa mulombodi bu mudi mashinyi a kawulu adi alondangana. 4. Instantaneous 3D Kinesthetic Feedback: Dîba dionso didi mulombodi ubanda pa dibue, ubaluluka ku dia bakaji, upuekesha lubilu, anyi upita mu tshina, mitshi mikole idi mifuanangane idi ituma diakamue dishintuluka dia angle ne dia bule mu bianza bia muendeshi wa mpofu, pamue ne dibikila dia terrain dia mêyi didi dienda dikola (Sp" mu 30 centimetre 3 2, 1... neje mutoke bua 10 paces"*).

2. Tshisumbu tshia "Sandwich" tshia bantu basatu (tshia kuendakana pa ski anyi pa mabue a mashika)¶

Paudi upuekela pa ski anyi usabuka tshibandabanda ne muena tshisumbu tshiebe udi mpofu: - Lead Guide (Point): Udi utshibula njila, ukeba miaba idi mipatuke, ne udi ubikila patoke njila ne bintu bidi bimupangisha. - Mubedi mufofo (munkatshi): Muteka pa tshingoma tshipi tshikole 3 too ne ku 5 metre (10 too ne ku 16 feet) panyima pa mulombodi, mukuate mukila wa tshibombi tshia mulombodi anyi mitshi mikole ya kuendesha pa mikuna idi kayiyi minyanguke. - Tail Anchor Guide (Rear): Muteka 3 too ne ku 5 metre (10 to 16 feet) panyima pa mubedi mufofo pa tshingoma tshikole tshia mu tshiadi/tshipi bua kuenza mudimu bu frein wa lukasa pikala muendeshi wa ski mufofo muteketa pa tshilamba tshikole anyi mujimije nkatshinkatshi.

Mulongo wa malu a bukubi bua mêsu mu mashika ne mu muvu wa mashika¶

• Vala makalashi a tshitupa 3 anyi 4 (anyi makalashi a ski a 100% UV400): Bua kubandila mikuna mitumbuke ne ngendu ya mu muvu wa printemps/été, vuala Kategori 4 (VLT 3% to 8% Visible Light Transmission) makalashi a tshijengu adi ne tshiseba tshia TP, anyi UV400 polycarbonate bimanu bia ku luseke ne tshilamba tshia ku mishiku tshidi tshikumbanangana bimpe. (Dimanya: Bintu bia mu tshitupa tshia 4 mbikandika kudi mikenji bua kuendesha mashinyi bualu bidi bifiike bikole bua mundidimbi wa mu njila).
• Ikala ne makalashi a UV400 anyi a tshiamu tshia kukuba natshi mêsu tshia Mylar mu tshibombi tshionso: Makalashi a dîba adi mua kukuluka bipepele mu bipese bia mabue, kupuekeshibua ku mikuna, anyi kusomba munda mua ntenta. Ikala ne manyanu a ski adi kaayi ne bujitu bua bungi anyi bintu bia kukuba nabi mêsu bia post-mydriatic UV munda mua tshibombi tshiebe tshia diambuluisha dia kumpala.
• Ikala ne makalashi mu tshikondo tshia matutu ne butoke butekete: Ikala ne makalashi abidi a ski adi ne dikala dia jaune, dia rose anyi dia ambre (tshitupa tshia 1 anyi 2) tshidi anu tshifila bukubi bua 100 pa lukama bua UV400 (400 nanomètre) bua wewe kubenga kuendakana ne mêsu patupu.
• Ikala ne binsonji bia tshianana ne mafuta a erythromycin: Lama ampoule ya mafuta a mêsu a dose umue munda mua tshibombi tshia munda bua kayiyi ikola mu luya lua muinshi mua zero.

Nkonko itubu bela misangu ya bungi¶

Miaba mifumina¶

• Tshisumbu tshia baminganga tshia mu tshipela (WMS, États-Unis): Mibelu ya malu a luondapu bua kuepuka ne kuondopa mputa ya mêsu ne ya ultraviolet keratitis mu tshipela.
• Tshilongelu tshia bena Amerike tshia malu a mêsu (AAO, États-Unis): Photokeratitis (Ultraviolet Keratitis / Snow Blindness) Tshidi tshikebesha, Dimanya, ne Dilama dia tshitupa tshia mêsu.
• Bulongolodi bua makanda a mubidi pa buloba bujima (OMS): Tshimanyinu tshia UV tshia dîba tshia pa buloba bujima, Altitude ne Snow Albedo Ultraviolet Reflexion Physics, ne Ocular UV Radiation Health Effects.
• Tshibambalu tshia buloba bujima tshia dipandisha dia mu mikuna (ICAR MEDCOM): Mibelu ya luondapu lua ku mikuna bua malu a tshimpitshimpi a mêsu a mu mikuna ne diambuluisha dia dipatuka dia bantu mu mikuna.
• Tshilongelu tshia baminganga ba mêsu ne tshibambalu tshia malu a bukola bua mubidi tshia ditunga (NHS, Royaume-Uni): Mibelu ya dilama dia disama dia Photokeratite ne dia Keratite dia pa mutu.

Malu adi apetangana¶

• Tshintu tshia bende tshia ku mêsu, dikoseka dia mêsu, ne dipetu dia disuika
• Ditapa dia mêsu ne diosha dia mêsu ne manga
• Dikala dia mashika mu tshipela ne mashika
• Disama dia muulu: AMS, HAPE, ne HACE
• Dinaya dia ski, dia snowboard, ne njiwu ya pa mikuna
• Mukanda wa nomba ya tshimpitshimpi