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沈意清
2018.03.30 小兒抽筋、癲癇不慌張 物品塞口中防咬舌是錯誤觀念
2018.03.30 小兒抽筋、癲癇不慌張 物品塞口中防咬舌是錯誤觀念
2018.03.30 小兒抽筋、癲癇不慌張 物品塞口中防咬舌是錯誤觀念
By
沈意清
Senior Account Executive
・
Yilan County, Taiwan
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日前羅東博愛院急診收治一名7歲江姓男童,因全身抽筋且意識不清,嚇得爸爸心肌梗塞發作。小兒科段必純醫師說,若遇到小朋友抽筋時不要慌張,務必鎮定讓孩子側躺、維持呼吸道暢通,待抽筋停止即可。不過當抽筋時間超過五分鐘還未停止就要送醫,但切勿在口中塞入任何物品防止咬舌,這是錯誤觀念。 羅東博愛醫院小兒科段必純醫師表示,判斷小朋友病狀為熱痙攣或癲癇主要依據為,發生的年齡、是否發燒及發作的次數等。小兒熱痙攣主要發生於6個月至5歲的幼兒,通常抽筋並伴隨發燒的情況。至於癲癇的定義則是必須抽筋發生2次以上,發作的時間需間隔超過24小時,且沒有伴隨發燒。而此個案的江小朋友為第一次發作,且年齡為7歲,最後診斷為抽筋,但後續還是必需持續追蹤觀察。 段必純醫師提醒,民眾對抽筋時最常見的錯誤觀念為,擔心病人抽筋發作時會咬斷舌頭,因此將物品塞入口腔,但根據文獻記載並沒有因癲癇發作而將舌頭咬斷的案例,若強行塞入反而會造成患者牙齒斷裂、下顎受傷。 當身邊有人發生癲癇狀況,只要遵守以下步驟即可: 一、家屬請保持鎮定。 二、讓患者側躺,避免被口水嗆傷造成吸入性肺炎。 三、保持患者呼吸道暢通,可將患者頸部稍微後仰,並鬆開患者的衣領或領帶。 四、為避免阻塞呼吸道,嚴禁於口中塞入任何物品。 五、在做完以上措施後,可拿起手機錄攝患者抽筋情況,以便醫師判斷抽筋的型態,有利於患者後續用藥考量。 六、如果發作時間超過5分鐘,且沒有停止的跡象,就要趕緊送往離家最近的地區醫院治療。 羅東博愛醫院小兒科段必純醫師呼籲,若小朋友診斷為癲癇,家長一定要告知學校老師小朋友的情況,除了孩子在學校發作時有利於老師當下緊急處理及判斷外,也可以與老師一起互相叮嚀小朋友規則服藥。段必純醫師表示,癲癇在臺灣非常普遍,不需要去標籤或歧視,且現代治療癲癇的醫療很進步,且多數是可以治癒的,提醒家長不要被錯誤的觀念影響。
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沈意清
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Published: Apr 29th 2019
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