{"id":11385555,"date":"2009-10-15T00:00:00","date_gmt":"2009-10-14T22:00:00","guid":{"rendered":"https:\/\/alertdiver.eu\/uncategorized-cs_cz\/dekompresni-onemocneni-dci-mozku-a-michy\/"},"modified":"2009-10-15T00:00:00","modified_gmt":"2009-10-14T22:00:00","slug":"dekompresni-onemocneni-dci-mozku-a-michy","status":"publish","type":"post","link":"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/dekompresni-onemocneni-dci-mozku-a-michy\/","title":{"rendered":"Dekompresn\u00ed onemocn\u011bn\u00ed (DCI ) mozku a m\u00edchy"},"content":{"rendered":"

Pot\u00e1p\u011b\u010dsk\u00e9 plavidlo bylo vzd\u00e1len\u00e9 sedm hodin od nejbli\u017e\u0161\u00ed pevniny. DAN pom\u00e1hala zajistit vrtuln\u00edk z\u00e1chrann\u00e9 slu\u017eby pro evakuaci pot\u00e1p\u011b\u010de do nejbli\u017e\u0161\u00ed nemocnice a hyperbarick\u00e9 komory.<\/p>\n

Pot\u00e1p\u011b\u010d<\/strong>
Jednalo se o 58-let\u00e9ho mu\u017ee, instruktora pro p\u0159\u00edstrojov\u00e9 pot\u00e1p\u011bn\u00ed, kter\u00fd m\u00e1 ji\u017e 30 let p\u0159\u00edslu\u0161n\u00e9 opr\u00e1vn\u011bn\u00ed k veden\u00ed pot\u00e1p\u011b\u010dsk\u00fdch kurz\u016f. B\u011bhem sv\u00e9 kari\u00e9ry v tomto oboru uskute\u010dnil stovky ponor\u016f (jen za posledn\u00ed rok jich absolvoval v\u00edce ne\u017e 100). I kdy\u017e m\u011bl vzhledem ke sv\u00e9 v\u00fd\u0161ce m\u00edrnou nadv\u00e1hu, vedl aktivn\u00ed zp\u016fsob \u017eivota. Ob\u010das jej pobol\u00edvala z\u00e1da, ale pravideln\u011b neu\u017e\u00edval \u017e\u00e1dn\u00e9 l\u00e9ky, jen ob\u010das ibuprofen proti bolesti.<\/p>\n

Ponory<\/strong>
Tento pot\u00e1p\u011b\u010d se rozhodl pro pot\u00e1p\u011b\u010dskou dovolenou na ostrovech nedaleko Spojen\u00fdch st\u00e1t\u016f. B\u011bhem dvou dn\u016f uskute\u010dnil \u0161est ponor\u016f. Prvn\u00ed den byl jeho nejhlub\u0161\u00ed ponor do hloubky 110 stop (34 metr\u016f). To jej p\u0159ivedlo do dekomprese.
Druh\u00fd den provedl t\u0159i ponory: prvn\u00ed dva do hloubky 100 stop (30 metr\u016f) a t\u0159et\u00ed ani ne 81 stop (25 metr\u016f). V\u0161echny t\u0159i ponory byly v\u00edce\u00farov\u0148ov\u00e9; b\u011bhem druh\u00e9ho dne nebyla pot\u0159ebn\u00e1 \u017e\u00e1dn\u00e1 dekomprese. P\u0159i v\u0161ech ponorech pou\u017e\u00edval sv\u016fj pot\u00e1p\u011b\u010dsk\u00fd po\u010d\u00edta\u010d, d\u011blal bezpe\u010dnostn\u00ed zast\u00e1vky, pou\u017e\u00edval stla\u010den\u00fd vzduch a p\u0159i vzestupech nem\u011bl \u017e\u00e1dn\u00e9 probl\u00e9my s v\u00fdbavou, ani se nep\u0159ihodilo nic mimo\u0159\u00e1dn\u00e9ho.<\/p>\n

Komplikace<\/strong>
Asi 20 minut po vyno\u0159en\u00ed se po sv\u00e9m posledn\u00edm ponoru a odlo\u017een\u00ed v\u00fdstroje poc\u00edtil n\u011bco jako \u017ealude\u010dn\u00ed k\u0159e\u010d; bolest b\u0159icha postupn\u011b stoupala k hrudi a roz\u0161i\u0159ovala se kolem doln\u00ed \u010d\u00e1sti trupu. Znecitliv\u011bn\u00ed a slabost v lev\u00e9 pa\u017ei byly prov\u00e1zeny bolest\u00ed zad.
Pos\u00e1dka lodi zaznamela jeho zv\u00fd\u0161enou nervozitu a skute\u010dnost, \u017ee nen\u00ed schopen \u00fa\u010dinn\u011b komunikovat. Okam\u017eit\u011b mu nasadili kysl\u00edkovou masku a kontaktovali DAN se \u017e\u00e1dost\u00ed o pomoc p\u0159i organizov\u00e1n\u00ed evakuace na americkou pevninu. Pot\u00e1p\u011b\u010dsk\u00e9 plavidlo bylo v tu chv\u00edli sedm hodin od nejbli\u017e\u0161\u00ed pevniny. DAN pomohla zajistit vrtuln\u00edk z\u00e1chrann\u00e9 slu\u017eby pro evakuaci pot\u00e1p\u011b\u010de do nejbli\u017e\u0161\u00ed nemocnice a hyperbarick\u00e9 komory schopn\u00e9 poskytovat p\u00e9\u010di posti\u017een\u00fdm pot\u00e1p\u011b\u010d\u016fm. <\/p>\n

L\u00e9\u010dba<\/strong>
Pot\u00e1p\u011b\u010d se dostal do nemocni\u010dn\u00ed p\u00e9\u010de p\u0159ibli\u017en\u011b \u0161est hodin po vyno\u0159en\u00ed se nad hladinu. P\u0159i p\u0159\u00edjmu poci\u0165oval slabost v nohou, nemohl chodit ani st\u00e1t, ale komunikoval s okol\u00edm a jeho nervozita a stres se v\u00fdznamn\u011b sn\u00ed\u017eily. Bolesti b\u0159icha a znecitliv\u011bn\u00ed i slabost v lev\u00e9 pa\u017ei t\u00e9m\u011b\u0159 pominuly.
Brzy po p\u0159\u00edjmu se mu dostalo terapie podle Tabulky 6 americk\u00e9ho n\u00e1mo\u0159nictva (viz n\u00ed\u017ee p\u0159\u00edslu\u0161n\u00e9 vysv\u011btlen\u00ed). Druh\u00fd v\u00fdkon podle Tabulky 6 byl aplikov\u00e1n tent\u00fd\u017e den o n\u011bco pozd\u011bji a t\u0159et\u00ed (rovn\u011b\u017e podle Tabulky 6) den n\u00e1sleduj\u00edc\u00ed. Po ka\u017ed\u00e9m z\u00e1sahu se pacientovi p\u0159\u00edznaky pon\u011bkud zm\u00edrnily. Nakonec zmizely v\u0161echny krom\u011b bolesti zad. V z\u00e1v\u011bre\u010dn\u00fd den pacient absolvoval dvouhodinovou terapii, aby se odstranily zm\u00edn\u011bn\u00e9 bolesti zad. Tento probl\u00e9m se v\u0161ak nevy\u0159e\u0161il a pacient byl propu\u0161t\u011bn s p\u0159etrv\u00e1vaj\u00edc\u00edmi m\u00edrn\u00fdmi bolestmi zad.<\/p>\n

Diskuse<\/strong>
Jedn\u00e1 se o v\u00e1\u017en\u00fd p\u0159\u00edpad paralytick\u00e9 formy dekompresn\u00ed nemoci (DCS), kter\u00e1 m\u00e1 n\u011bkdy za n\u00e1sledek trvalou neschopnost. Zde se v\u0161ak neurologick\u00e9 p\u0159\u00edznaky odstranily t\u00e9m\u011b\u0159 beze zbytku, krom\u011b pot\u00e1p\u011b\u010dovy m\u00edrn\u00e9 bolesti zad, co\u017e bylo z\u0159ejm\u011b d\u016fsledkem podr\u00e1\u017ed\u011bn\u00ed star\u00e9ho d\u0159\u00edv\u011bj\u0161\u00edho zran\u011bn\u00ed\/ probl\u00e9mu. \u00dapln\u00e9 zbaven\u00ed se nov\u00fdch p\u0159\u00edznak\u016f lze z\u0159ejm\u011b p\u0159i\u010d\u00edst blahod\u00e1rn\u00fdm \u00fa\u010dink\u016fm kysl\u00edku, kter\u00fd byl posti\u017een\u00e9mu pot\u00e1p\u011b\u010di pod\u00e1n na lodi brzy po vyno\u0159en\u00ed se nad hladinu a tak\u00e9 b\u011bhem p\u0159epravy do nemocnice.<\/p>\n

M\u011bl \u0161t\u011bst\u00ed, \u017ee se sehnala rychl\u00e1 pomoc a je\u0161t\u011b za denn\u00edho sv\u011btla se uskute\u010dnila p\u0159eprava vrtuln\u00edkem do pom\u011brn\u011b vzd\u00e1len\u00e9 nemocnice.
U p\u0159\u00edpad\u016f DCS a s t\u00edm souvisej\u00edc\u00ed paral\u00fdzy se p\u0159edpov\u00eddaj\u00ed kone\u010dn\u00e9 v\u00fdsledky velmi nesnadno, ale tomuto pot\u00e1p\u011b\u010di zcela jist\u011b v\u00fdznamn\u011b pomohlo: rychl\u00e9 a spr\u00e1vn\u00e9 vyhodnocen\u00ed situace, kysl\u00edkov\u00e1 terapie a p\u0159eprava do komory b\u011bhem n\u011bkolika hodin od zji\u0161t\u011bn\u00ed p\u0159\u00edznak\u016f. Po uplynut\u00ed doporu\u010den\u00e9 doby na zotavenou se mohl k pot\u00e1p\u011bn\u00ed i k instruktorsk\u00e9 \u010dinnosti vr\u00e1tit.<\/p>\n


Co znamen\u00e1 ta Tabulka 6?<\/strong>
L\u00e9\u010dba podle Tabulky 6 trv\u00e1 nejm\u00e9n\u011b 4 hodiny a 45 minut a pou\u017e\u00edv\u00e1 se v\u017edy, kdykoliv je dostupn\u00fd kysl\u00edk, nebo\u0165 d\u00fdch\u00e1n\u00ed kysl\u00edku za sou\u010dasn\u00e9ho p\u016fsoben\u00ed tlaku v komo\u0159e pom\u00e1h\u00e1 vyplavit z tk\u00e1n\u00ed dus\u00edk. Dobu l\u00e9\u010debn\u00e9ho z\u00e1sahu lze prodlou\u017eit a\u017e na osm hodin – podle intenzity a v\u00e1\u017enosti p\u0159\u00edznak\u016f. B\u011bhem t\u00e9to terapie po\u00e1p\u011b\u010d d\u00fdch\u00e1 stoprocentn\u00ed kysl\u00edk prost\u0159ednictv\u00ed masky podobn\u00e9 t\u00e9, kterou po\u017e\u00edvaj\u00ed piloti nadzvukov\u00fdch st\u00edha\u010dek, nebo se m\u016f\u017ee pou\u017e\u00edt voln\u011bj\u0161\u00ed kukla, kter\u00e1 obklopuje celou hlavu.
 <\/p>\n

Terapie podle Tabulky 6 za\u010d\u00edn\u00e1 “sestupem” na tlak odpov\u00eddaj\u00edc\u00ed hloubce 60 stop mo\u0159sk\u00e9 vody \/ 18 metr\u016f mo\u0159sk\u00e9 vody (d\u00e1le jen smv \/ mmv). Po ur\u010dit\u00e9m \u010dase je pot\u00e1p\u011b\u010d postupn\u011b vystavov\u00e1n tlaku odpov\u00eddaj\u00edc\u00edmu 30 smw \/ 9 mmv rychlost\u00ed 1 smv \/ 0,3 mmv za minutu. Nejdel\u0161\u00ed \u010d\u00e1st l\u00e9\u010dby se str\u00e1v\u00ed p\u0159i tlaku 30 smv \/ 9 mmv. N\u00e1sledn\u011b pot\u00e1p\u011b\u010d “vystoup\u00e1 ” na tlak na hladin\u011b – op\u011bt rychlost\u00ed 1 smv \/ 0,3 mmv za minutu. Jestli\u017ee p\u0159\u00edznaky p\u0159etrv\u00e1vaj\u00ed, m\u016f\u017ee se terapie opakovat, ale zpravidla se jedn\u00e1 o krat\u0161\u00ed doby.<\/p>\n","protected":false},"excerpt":{"rendered":"

Pot\u00e1p\u011b\u010dsk\u00e9 plavidlo bylo vzd\u00e1len\u00e9 sedm hodin od nejbli\u017e\u0161\u00ed pevniny. DAN pom\u00e1hala zajistit vrtuln\u00edk z\u00e1chrann\u00e9 slu\u017eby pro evakuaci pot\u00e1p\u011b\u010de do nejbli\u017e\u0161\u00ed nemocnice a hyperbarick\u00e9 komory. Pot\u00e1p\u011b\u010d…<\/p>\n","protected":false},"author":1,"featured_media":11374112,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[384],"tags":[],"authors":[1193],"class_list":["post-11385555","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clanky","authors-joel-dovenbarger-cs_cz"],"acf":[],"yoast_head":"\nDekompresn\u00ed onemocn\u011bn\u00ed (DCI ) mozku a m\u00edchy - Alert Diver<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/dekompresni-onemocneni-dci-mozku-a-michy\/\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Dekompresn\u00ed onemocn\u011bn\u00ed (DCI ) mozku a m\u00edchy - Alert Diver\" \/>\n<meta property=\"og:description\" content=\"Pot\u00e1p\u011b\u010dsk\u00e9 plavidlo bylo vzd\u00e1len\u00e9 sedm hodin od nejbli\u017e\u0161\u00ed pevniny. 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