Představte si, co všechno se na ulici může stát. Jdete z práce, obtěžkáni nákupy, s hlavou plnou starostí, co vše je ještě potřeba zařídit, komu zavolat… Náhle, přímo před Vámi, padá člověk k zemi. Objevuje se krev z rozbité hlavy. Chvíli se zmítá v křečích…
Že se Vám to nemůže stát? Ale kdeže, uvádí se, že u nás trpí epilepsií asi 70 000 lidí. Riziko popsané situace je tedy více než reálné. Sama jsem zasahovala u podobného záchvatu na tramvajové zastávce.
Řekněme si nejdříve, jak by to vypadalo, kdybychom neznali zásady první pomoci. „Musíme vyndat jazyk, aby se nepokousal a nějak zastavit křeče, nejlépe tak, že si na postiženého lehneme nebo ho chytneme za ruce a nohy, aby se neporanil.“ Takto zní většinou odpovědi lidí, kterých se zeptáte, jak postupovat při epilepsii. Celý postup je ovšem špatně. Pro lepší pochopení proč, se pokusím popsat alespoň základní charakteristiku této nemoci.
Epilepsie je neurologické onemocnění postihující centrální nervový systém. Není nijak omezena věkem. Může být součástí genetické poruchy, následkem onemocnění mozku, projevem nádoru. Dále existuje poúrazová epilepsie a můžeme se setkat i s provokovanými záchvaty (diskotéky, blikající monitory), atd… Epileptické záchvaty jsou v úzkém vztahu ke struktuře lidského mozku a funkcí některých jeho částí. Její vznik souvisí s abnormální elektrickou aktivitou mozku. Záchvaty jsou vyvolány právě touto nadměrnou aktivitou a trvají do doby, než se mozek „vybije“. Řádově se jedná o několik málo minut.
Existují různé typy epileptických záchvatů. Při vyslovení slova epilepsie, vytane lidem na mysli většinou velký záchvat, provázený mocnými křečemi, pěnou u úst a dalšími příznaky. Tento záchvat nemocného nejvíce ohrožuje na životě a v následujících odstavcích se dozvíme proč.
Jak tedy vypadá „klasický“ epileptický záchvat?
nejčastěji se jedná o záchvat (generalizovaný tonicko – klonický), který je provázen dvěma typy křečí: nejdříve je celé tělo propnuté „do luku“, následují prudké záškuby končetin a celého těla
- Postižený vykřikne a kácí se na zem v bezvědomí – nebezpečí poranění při pádu.
- První křeče (celé tělo napnuté), může se objevit pěna u úst, pacient modrá v důsledku nedostatku kyslíku.
- Tělo ovládají další křeče: pacient s sebou hází, prudké pohyby končetin – velké nebezpečí zranění, pacient se často pomočí, pokouše, může se začít dusit zapadnutým kořenem jazyka.
- Končí celý záchvat. Pacient se nadechne, propne celé tělo a chvíli nedýchá (apnoická pauza). Následuje uvolnění a samovolný výdech, vrací se přirozená barva.
- Zvýšená elektrická aktivita v mozku se „vybila“. Pacient zůstává zhroucený na zemi v bezvědomí.
- Probírání může trvat i desítky minut. Poté je postižený zmatený, dezorientovaný, bezcílně přechází či se stále upravuje.
- Návrat do normálního stavu.
Jak mohu pomoci já a proč?
- Odstraňte všechny předměty z dosahu nemocného – hrozí zranění
- Nenechte pacienta mlátit hlavou o dlažbu – podložte hlavu alespoň kusem oděvu
- Nebraňte křečím a záškubům těla – při použití větší síly můžeme nemocného zranit
- Nic nikdy nevkládejte do úst – křeče jsou příliš silné – hrozí minimálně pokousání!
- Stabilizovaná poloha – po odeznění záchvatu ukládáme nemocného na bok, zakloníme mu hlavu!
- Zjistěte přidružená poranění – např. ošetření otevřeného poranění hlavy – sterilní krytí
- Voláme rychlou záchrannou pomoc (155) – pokud je záchvat velmi dlouhý (více než tři minuty), jedná se o první záchvat, či se nemocný při pádu poranil
Více informací či podrobnosti k uvedenému onemocnění lze také nalézt na www.epistop.cz nebowww.epilepsie.cz.
Nejen zásady první pomoci při epilepsii, ale i ostatní, život ohrožující stavy, jsou probírány na kurzech první pomoci. Mnohdy zachrání život i málo…
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