Popáleniny u dětí

16.8.2013

popaleniny-u-deti.jpg - kopie
popaleniny-u-deti.jpg - kopie
Popáleniny u dětí vznikají nejčastěji působením tepla. K tomu dochází nejčastěji opařením horkou vodou, čajem, či při hře se zápalkami. Děti představují až 40% všech popálených ročně. Vzhledem k tomu, že děti mají menší tělesný povrch, považujeme již popálení 5% tělesného povrchu za závažný stav. Popálené plochy je vhodné chladit a sterilně krýt pro riziko zanesení infekce.

Popáleniny u dětí

Lékaři rozdělují popáleniny do jednotlivých skupin - popáleniny horkou vodou, ohněm, elektrickým proudem, chemikáliemi a sluncem; podle závažnosti rozlišují popáleniny prvního, druhého a třetího stupně. Popáleniny prvního stupně jsou nejméně závažné, projeví se zčervenáním a někdy otokem postiženého místa. Při popáleninách druhého stupně se tvoří puchýře. Popáleniny třetího stupně jsou obvykle bílé nebo zuhelnatělé a vážně poškozují hluboké vrstvy kůže nebo svalů. Popáleniny třetího stupně nebo rozsáhlé popáleniny vyžadují okamžitou lékařskou péči.

Kdy volat lékaře

Když se dítě popálí, je třeba jednat rychle, aby příliš netrpělo bolestí a možnými komplikacemi. Při ošetřování popálenin se řiďte následujícími radami:

  • Je-li popálenina na horní nebo dolní končetině, pouštějte na postižené místo okamžitě několik minut studenou vodu. Na popáleniny na ostatních částech těla přiložte na několik minut studené vlhké obklady. Na popáleniny nepřikládejte led, může způsobit ještě větší Škodu.
  • Odstraňte oděv z okolí popáleného místa.
  • Pokud popálenina nemokvá, překryjte ji sterilním gázovým polštářkem.
  • Na popáleniny nikdy nepoužívejte máslo, tuk, vazelínu nebo jiné mastné látky, protože zadržují teplo v pokožce a stav zhoršují. Nepoužívejte masti nebo spreje první pomoci obsahující benzokain, neboť může vyvolat alergickou reakci.
  • Mokvající popáleninu nechtě odkrytou nebo ji jen lehce překryjte sterilní gázou a okamžitě odvezte dítě k lékaři.
  • Zčervenání, otok, zápach nebo výtok signalizují infekci, kterou musí ošetřit lékař.
  • Je-li popálenina bolestivá, dejte dítěti prášek proti bolesti, například paracetamol nebo ibuprofen (nikdy ne aspirin) a na popáleninu přikládejte opatrně chladné, vlhké obklady.

Spáleniny sluncem

Těmto spáleninám se dá nejsnadněji předejít. Jediné spálení sluncem v dětství zvýší nebezpečí vzniku maligního melanomu, smrtelné formy rakoviny kůže, později v životě. Časté nadměrné slunění rovněž zvyšuje náchylnost dítěte k méně vážným formám rakoviny kůže. Slunění je velmi nebezpečné pro děti se světlou pletí.

Omezením doby, kterou dítě stráví na slunci, používáním opalovacího krému od 6 měsíců věku dítěte a vhodným oblečením, které zakrývá horní i dolní končetiny a hlavu, snížíte budoucí nebezpečí onemocnění rakovinou kůže.

Dodržujte následující preventivní opatření:

  • Dítě do 6 měsíců pokud možno chraňte před sluncem.
  • Vyhýbejte se nadměrnému slunění mezi 10. hodinou dopoledne a 3. hodinou odpoledne, kdy je sluneční záření nejintenzivnější, dokonce i když je obloha zatažená.
  • Má-li být dítě na slunci 30 minut nebo déle, použijte opalovací krém s ochranným faktorem nejméně 30. Ochranný faktor 30 znamená, že dítě může zůstat na slunci 30krát déle než bez něj, aniž by se spálilo. Při nákupu si pečlivě přečtěte etiketu a ujistěte se, že opalovací krém chrání proti oběma typům ultrafialových paprsků - typu A (UVA) a typu B (UVB) - a že je vodě odolný. Nepoužívejte opalovací krémy obsahující kyselinu paraaminobenzoovou (PABA), neboť dráždí pokožku a u dětí, které užívají penicilin, může vyvolat alergickou reakci. Opalovací krém aplikujte dítěti na pokožku nejméně 20 minut předtím, než jde ven, aby se krém stačil vstřebat.
  • Podle pokynů na obalu aplikujte krém každé 3 až 4 hodiny.
  • Dávejte dítěti sluneční brýle. Měly by je nosit i malé děti. Ne všechny sluneční brýle však poskytují stejnou ochranu. Zabarvení skel neurčuje stupeň ochrany. Kupujte pouze brýle označené „absorpce UV do 400 nm", „maximální nebo 99% ochrana nebo blokáda UV", „speciální účel". Také klobouky sníží účinek slunečních paprsků až o 50 %.

Jestliže se dítě na slunci spálí tak, že se mu udělají puchýře, měli byste navštívit lékaře. Ošetření méně závažných spálenin sluncem:

  • Oblékněte dítěti volný oděv, který bude udržovat jeho tělesnou teplotu.
  • Na zmírnění bolesti a zápalu dejte dítěti ibuprofen podle návodu na obalu.
  • Naneste na spáleniny neparfémovaný zvlhčující krém, ne však pleťovou vodu, která může obsahovat alkohol.
  • Udělejte dítěti chladnou koupel nebo mu několikrát denně přikládejte chladné vlhké obklady na spálená místa.
  • Nedovolte dítěti, aby si propichovalo puchýře nebo slupovalo kůži; narušil by se tak proces hojení.

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