OneSignalSDK.js

!function(e){var t={};function n(i){if(t[i])return t[i].exports;var r=t[i]={i:i,l:!1,exports:{}};return e[i].call(r.exports,r,r.exports,n),r.l=!0,r.exports}n.m=e,n.c=t,n.d=function(e,t,i){n.o(e,t)||Object.defineProperty(e,t,{configurable:!1,enumerable:!0,get:i})},n.r=function(e){Object.defineProperty(e,"__esModule",{value:!0})},n.n=function(e){var t=e&&e.__esModule?function(){return e.default}:function(){return e};return n.d(t,"a",t),t},n.o=function(e,t){return Object.prototype.hasOwnProperty.call(e,t)},n.p="",n(n.s=91)}([function(e,t,n){"use strict";var i=this&&this.__awaiter||function(e,t,n,i){return new(n||(n=Promise))(function(r,o){function s(e){try{u(i.next(e))}catch(e){o(e)}}function a(e){try{u(i.throw(e))}catch(e){o(e)}}function u(e){e.done?r(e.value):new n(function(t){t(e.value)}).then(s,a)}u((i=i.apply(e,t||[])).next())})},r=this&&this.__generator||function(e,t){var n,i,r,o,s={label:0,sent:function(){if(1&r[0])throw r[1];return r[1]},trys:[],ops:[]};return o={next:a(0),throw:a(1),return:a(2)},"function"==typeof Symbol&&(o[Symbol.iterator]=function(){return this}),o;function a(o){return function(a){return function(o){if(n)throw new TypeError("Generator is already executing.");for(;s;)try{if(n=1,i&&(r=i[2&o[0]?"return":o[0]?"throw":"next"])&&!(r=r.call(i,o[1])).done)return r;switch(i=0,r&&(o=[0,r.value]),o[0]){case 0:case 1:r=o;break;case 4:return s.label++,{value:o[1],done:!1};case 5:s.label++,i=o[1],o=[0];continue;case 7:o=s.ops.pop(),s.trys.pop();continue;default:if(!(r=(r=s.trys).length>0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0)for(var s=0;s0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]=0;i--){n[i]===t&&n.splice(i,1)}},e}();t.WorkerMessengerReplyBuffer=p;var h=function(){function e(e,t){void 0===t&&(t=new p),this.context=e,this.replies=t,this.debug=!0}return e.prototype.broadcast=function(e,t){return i(this,void 0,void 0,function(){var n,i,o,s;return r(this,function(r){switch(r.label){case 0:return u.default.getWindowEnv()===l.WindowEnvironmentKind.ServiceWorker?[3,1]:[2];case 1:return[4,self.clients.matchAll({type:"window",includeUncontrolled:!0})];case 2:for(n=r.sent(),i=0,o=n;i Page] Broadcasting '"+e.toString()+"' to window client "+s.url+"."),s.postMessage({command:e,payload:t});r.label=3;case 3:return[2]}})})},e.prototype.unicast=function(e,t,n){return i(this,void 0,void 0,function(){return r(this,function(i){switch(i.label){case 0:if(u.default.getWindowEnv()!==l.WindowEnvironmentKind.ServiceWorker)return[3,1];if(!n)throw new a.InvalidArgumentError("windowClient",a.InvalidArgumentReason.Empty);return f.default.debug("[Worker Messenger] [SW -> Page] Unicasting '"+e.toString()+"' to window client "+n.url+"."),n.postMessage({command:e,payload:t}),[3,4];case 1:return[4,this.isWorkerControllingPage()];case 2:return i.sent()||f.default.debug("[Worker Messenger] The page is not controlled by the service worker yet. Waiting...",self.registration),[4,this.waitUntilWorkerControlsPage()];case 3:i.sent(),f.default.debug("[Worker Messenger] [Page -> SW] Unicasting '"+e.toString()+"' to service worker."),navigator.serviceWorker.controller.postMessage({command:e,payload:t}),i.label=4;case 4:return[2]}})})},e.prototype.listen=function(e){return i(this,void 0,void 0,function(){return r(this,function(t){switch(t.label){case 0:return d.default.supportsServiceWorkers()?u.default.getWindowEnv()!==l.WindowEnvironmentKind.ServiceWorker?[3,1]:(self.addEventListener("message",this.onWorkerMessageReceivedFromPage.bind(this)),f.default.debug("[Worker Messenger] Service worker is now listening for messages."),[3,3]):[2];case 1:return[4,this.listenForPage(e)];case 2:t.sent(),t.label=3;case 3:return[2]}})})},e.prototype.listenForPage=function(e){return i(this,void 0,void 0,function(){return r(this,function(t){switch(t.label){case 0:return e?[3,3]:[4,this.isWorkerControllingPage()];case 1:return t.sent()||f.default.debug("("+location.origin+") [Worker Messenger] The page is not controlled by the service worker yet. Waiting...",self.registration),[4,this.waitUntilWorkerControlsPage()];case 2:t.sent(),f.default.debug("("+location.origin+") [Worker Messenger] The page is now controlled by the service worker."),t.label=3;case 3:return navigator.serviceWorker.addEventListener("message",this.onPageMessageReceivedFromServiceWorker.bind(this)),f.default.debug("("+location.origin+") [Worker Messenger] Page is now listening for messages."),[2]}})})},e.prototype.onWorkerMessageReceivedFromPage=function(e){var t=e.data;if(t&&t.command){var n=this.replies.findListenersForMessage(t.command),i=[],r=[];f.default.debug("[Worker Messenger] Service worker received message:",e.data);for(var o=0,s=n;o=0;a--){var u=i[a];this.replies.deleteListenerRecord(t.command,u)}for(var c=0,l=r;c=0;a--){var u=i[a];this.replies.deleteListenerRecord(t.command,u)}for(var c=0,l=r;c0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1] to the first element in ."))}},e.getNotificationTypeFromOptIn=function(e){return 1==e||null==e?1:-2},e.wasHttpsNativePromptDismissed=function(){return"dismissed"===d.default.getItem("onesignal-notification-prompt")},e.markHttpPopoverShown=function(){sessionStorage.setItem("ONESIGNAL_HTTP_PROMPT_SHOWN","true")},e.isHttpPromptAlreadyShown=function(){return"true"==sessionStorage.getItem("ONESIGNAL_HTTP_PROMPT_SHOWN")},e.checkAndTriggerNotificationPermissionChanged=function(){return i(this,void 0,void 0,function(){var e,t;return r(this,function(n){switch(n.label){case 0:return[4,c.default.get("Options","notificationPermission")];case 1:return e=n.sent(),[4,OneSignal.getNotificationPermission()];case 2:return t=n.sent(),e===t?[3,5]:[4,l.triggerNotificationPermissionChanged()];case 3:return n.sent(),[4,c.default.put("Options",{key:"notificationPermission",value:t})];case 4:n.sent(),n.label=5;case 5:return[2]}})})},e.getNotificationIcons=function(){return i(this,void 0,void 0,function(){var t,n,i;return r(this,function(r){switch(r.label){case 0:return[4,e.getAppId()];case 1:if(!(t=r.sent()))throw new s.InvalidStateError(s.InvalidStateReason.MissingAppId);return n=u.default.getOneSignalApiUrl().toString()+"/apps/"+t+"/icon",[4,fetch(n)];case 2:return[4,r.sent().json()];case 3:if((i=r.sent()).errors)throw f.default.error("API call %c"+n,l.getConsoleStyle("code"),"failed with:",i.errors),new Error("Failed to get notification icons.");return[2,i]}})})},e.getSlidedownPermissionMessageOptions=function(){var e=OneSignal.config.userConfig.promptOptions;return e?e&&!e.slidedown?e:{actionMessage:e.slidedown.actionMessage,acceptButtonText:e.slidedown.acceptButtonText,cancelButtonText:e.slidedown.cancelButtonText}:null},e.getFullscreenPermissionMessageOptions=function(){var e=OneSignal.config.userConfig.promptOptions;return e?e&&!e.fullscreen?e:{autoAcceptTitle:e.fullscreen.autoAcceptTitle,actionMessage:e.fullscreen.actionMessage,exampleNotificationTitleDesktop:e.fullscreen.title,exampleNotificationTitleMobile:e.fullscreen.title,exampleNotificationMessageDesktop:e.fullscreen.message,exampleNotificationMessageMobile:e.fullscreen.message,exampleNotificationCaption:e.fullscreen.caption,acceptButtonText:e.fullscreen.acceptButton,cancelButtonText:e.fullscreen.cancelButton}:null},e.getPromptOptionsQueryString=function(){var t="";if(e.getFullscreenPermissionMessageOptions())for(var n=e.getPromptOptionsPostHash(),i=0,r=Object.keys(n);i0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]{{prompt.native.grant}}{{prompt.native.grant}} to receive notifications"),this.text["message.action.unsubscribed"]||(this.text["message.action.unsubscribed"]="You won't receive notifications again"),this.text["dialog.main.title"]||(this.text["dialog.main.title"]="Manage Site Notifications"),this.text["dialog.main.button.subscribe"]||(this.text["dialog.main.button.subscribe"]="SUBSCRIBE"),this.text["dialog.main.button.unsubscribe"]||(this.text["dialog.main.button.unsubscribe"]="UNSUBSCRIBE"),this.text["dialog.blocked.title"]||(this.text["dialog.blocked.title"]="Unblock Notifications"),this.text["dialog.blocked.message"]||(this.text["dialog.blocked.message"]="Follow these instructions to allow notifications:"),this._launcher=N,this.state=e.STATES.UNINITIALIZED,this._ignoreSubscriptionState=!1,b.default.emitter.on(e.EVENTS.SUBSCRIBE_CLICK,function(){x.dialog.subscribeButton.disabled=!0,x._ignoreSubscriptionState=!0,b.default.setSubscription(!0).then(function(){return x.dialog.subscribeButton.disabled=!1,x.dialog.hide()}).then(function(){return x.message.display(h.default.TYPES.MESSAGE,x.text["message.action.resubscribed"],h.default.TIMEOUT)}).then(function(){return x._ignoreSubscriptionState=!1,x.launcher.clearIfWasInactive(),x.launcher.inactivate()}).then(function(){return x.updateState()})}),b.default.emitter.on(e.EVENTS.UNSUBSCRIBE_CLICK,function(){x.dialog.unsubscribeButton.disabled=!0,b.default.setSubscription(!1).then(function(){return x.dialog.unsubscribeButton.disabled=!1,x.dialog.hide()}).then(function(){return x.launcher.clearIfWasInactive(),x.launcher.activate()}).then(function(){return x.message.display(h.default.TYPES.MESSAGE,x.text["message.action.unsubscribed"],h.default.TIMEOUT)}).then(function(){return x.updateState()})}),b.default.emitter.on(e.EVENTS.HOVERING,function(){x.hovering=!0,x.launcher.activateIfInactive(),x.message.shown||x.dialog.shown?x.hovering=!1:x.message.contentType!==h.default.TYPES.MESSAGE?new Promise(function(e){if(x.message.queued.length>0)return x.message.dequeue().then(function(t){x.message.content=t,x.message.contentType=h.default.TYPES.QUEUED,e()});x.message.content=c.decodeHtmlEntities(x.message.getTipForState()),x.message.contentType=h.default.TYPES.TIP,e()}).then(function(){return x.message.show()}).then(function(){x.hovering=!1}):x.hovering=!1}),b.default.emitter.on(e.EVENTS.HOVERED,function(){x.message.contentType!==h.default.TYPES.MESSAGE&&x.dialog.hidden&&(x.hovering&&(x.hovering=!1,x.message.waitUntilShown().then(function(){return c.delay(h.default.TIMEOUT)}).then(function(){return x.message.hide()}).then(function(){x.launcher.wasInactive&&x.dialog.hidden&&(x.launcher.inactivate(),x.launcher.wasInactive=null)})),x.message.shown&&x.message.hide().then(function(){x.launcher.wasInactive&&x.dialog.hidden&&(x.launcher.inactivate(),x.launcher.wasInactive=null)}))}),b.default.emitter.on(b.default.EVENTS.SUBSCRIPTION_CHANGED,function(t){return i(x,void 0,void 0,function(){var n,i=this;return r(this,function(r){switch(r.label){case 0:return 1!=t?[3,2]:(this.badge.shown&&this.options.prenotify&&this.badge.hide(),null!==this.dialog.notificationIcons?[3,2]:[4,u.default.getNotificationIcons()]);case 1:n=r.sent(),this.dialog.notificationIcons=n,r.label=2;case 2:return b.default.getNotificationPermission(function(n){i.setState(t?e.STATES.SUBSCRIBED:"denied"===n?e.STATES.BLOCKED:e.STATES.UNSUBSCRIBED,i._ignoreSubscriptionState)}),[2]}})})}),b.default.emitter.on(e.EVENTS.STATE_CHANGED,function(t){x.launcher.element&&(t.to===e.STATES.SUBSCRIBED?x.launcher.inactivate():(t.to===e.STATES.UNSUBSCRIBED||e.STATES.BLOCKED)&&x.launcher.activate())}),b.default.emitter.on(b.default.EVENTS.NATIVE_PROMPT_PERMISSIONCHANGED,function(){x.updateState()}),this.updateState()}}return Object.defineProperty(e,"EVENTS",{get:function(){return{STATE_CHANGED:"notifyButtonStateChange",LAUNCHER_CLICK:"notifyButtonLauncherClick",BELL_CLICK:"notifyButtonButtonClick",SUBSCRIBE_CLICK:"notifyButtonSubscribeClick",UNSUBSCRIBE_CLICK:"notifyButtonUnsubscribeClick",HOVERING:"notifyButtonHovering",HOVERED:"notifyButtonHover"}},enumerable:!0,configurable:!0}),Object.defineProperty(e,"STATES",{get:function(){return{UNINITIALIZED:"uninitialized",SUBSCRIBED:"subscribed",UNSUBSCRIBED:"unsubscribed",BLOCKED:"blocked"}},enumerable:!0,configurable:!0}),Object.defineProperty(e,"TEXT_SUBS",{get:function(){return{"prompt.native.grant":{default:"Allow",chrome:"Allow",firefox:"Always Receive Notifications",safari:"Allow"}}},enumerable:!0,configurable:!0}),e.prototype.showDialogProcedure=function(){var e=this;this.dialog.shown||this.dialog.show().then(function(){c.once(document,"click",function(t,n){e.dialog.element.contains(t.target)||(n(),e.dialog.shown&&e.dialog.hide().then(function(){e.launcher.inactivateIfWasInactive()}))},!0)})},e.prototype.create=function(){return i(this,void 0,void 0,function(){var e,t,n,i,o=this;return r(this,function(r){switch(r.label){case 0:return this.options.enable?[4,b.default.context.dynamicResourceLoader.loadSdkStylesheet()]:[2];case 1:return 0!==r.sent()?(g.default.debug("Not showing notify button because styles failed to load."),[2]):(this.container&&c.removeDomElement("#onesignal-bell-container"),c.addDomElement("body","beforeend",'
'),c.addDomElement(this.container,"beforeend",'
'),c.addDomElement(this.launcher.selector,"beforeend",'
'),c.addDomElement(this.launcher.selector,"beforeend",'
'),c.addDomElement(this.launcher.selector,"beforeend",'
'),c.addDomElement(this.message.selector,"beforeend",'
'),c.addDomElement(this.launcher.selector,"beforeend",'
'),c.addDomElement(this.dialog.selector,"beforeend",'
'),c.addDomElement(this.button.selector,"beforeEnd",''),[4,b.default.isPushNotificationsEnabled()]);case 2:return e=r.sent(),[4,b.default.getSubscription()];case 3:return t=r.sent(),[4,u.default.wasHttpsNativePromptDismissed()];case 4:return n=r.sent(),i=e?"small":this.options.size,[4,this.launcher.resize(i)];case 5:if(r.sent(),"bottom-left"===this.options.position)c.addCssClass(this.container,"onesignal-bell-container-bottom-left"),c.addCssClass(this.launcher.selector,"onesignal-bell-launcher-bottom-left");else{if("bottom-right"!==this.options.position)throw new Error("Invalid OneSignal notify button position "+this.options.position);c.addCssClass(this.container,"onesignal-bell-container-bottom-right"),c.addCssClass(this.launcher.selector,"onesignal-bell-launcher-bottom-right")}if("default"===this.options.theme)c.addCssClass(this.launcher.selector,"onesignal-bell-launcher-theme-default");else{if("inverse"!==this.options.theme)throw new Error("Invalid OneSignal notify button theme "+this.options.theme);c.addCssClass(this.launcher.selector,"onesignal-bell-launcher-theme-inverse")}return this.applyOffsetIfSpecified(),this.setCustomColorsIfSpecified(),this.patchSafariSvgFilterBug(),g.default.info("Showing the notify button."),[4,(e?this.launcher.inactivate():c.nothing()).then(function(){return b.default.getSubscription()}).then(function(t){return!e&&t||null!==o.dialog.notificationIcons?c.nothing():u.default.getNotificationIcons().then(function(e){o.dialog.notificationIcons=e})}).then(function(){return c.delay(o.options.showLauncherAfter)}).then(function(){return c.isUsingSubscriptionWorkaround()&&t&&!0!==n&&!e&&!0===b.default.config.userConfig.autoRegister&&!u.default.isHttpPromptAlreadyShown()?(g.default.debug("Not showing notify button because popover will be shown."),c.nothing()):o.launcher.show()}).then(function(){return c.delay(o.options.showBadgeAfter)}).then(function(){return o.options.prenotify&&!e&&b.default._isNewVisitor?o.message.enqueue(o.text["message.prenotify"]).then(function(){return o.badge.show()}):c.nothing()}).then(function(){return o.initialized=!0})];case 6:return r.sent(),[2]}})})},e.prototype.patchSafariSvgFilterBug=function(){if(!(s.default.safari&&Number(s.default.version)>=9.1)){var e="drop-shadow(0 2px 4px rgba(34,36,38,0.35));",t="drop-shadow(0 2px 4px rgba(34,36,38,0));",n="drop-shadow(0px 2px 2px rgba(34,36,38,.15));";this.graphic.setAttribute("style","filter: "+e+"; -webkit-filter: "+e+";"),this.badge.element.setAttribute("style","filter: "+t+"; -webkit-filter: "+t+";"),this.dialog.element.setAttribute("style","filter: "+n+"; -webkit-filter: "+n+";")}s.default.safari&&this.badge.element.setAttribute("style","display: none;")},e.prototype.applyOffsetIfSpecified=function(){var e=this.options.offset;e&&(this.launcher.element.style.cssText="",e.bottom&&(this.launcher.element.style.cssText+="bottom: "+e.bottom+";"),"bottom-right"===this.options.position?e.right&&(this.launcher.element.style.cssText+="right: "+e.right+";"):"bottom-left"===this.options.position&&e.left&&(this.launcher.element.style.cssText+="left: "+e.left+";"))},e.prototype.setCustomColorsIfSpecified=function(){var e=this.dialog.element.querySelector("button.action"),t=this.button.element.querySelector(".pulse-ring");this.graphic.querySelector(".background").style.cssText="";for(var n=this.graphic.querySelectorAll(".foreground"),i=0;i0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0))for(var n=0,i=t.buttons;n0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]OneSignal: This page cannot be directly opened, and must be opened as a result of a subscription call."),[2,Promise.resolve()]):((e=i({},this.options)).appId=e.appId,e.subdomainName=e.subdomain,e.origin=e.origin,OneSignal.config=e||{},[4,(new c.default).getAppConfig(e)]);case 1:return t=r.sent(),OneSignal.context=new u.default(t),OneSignal.context.workerMessenger.listen(!0),OneSignal.initialized=!0,this.loadPromise={},this.loadPromise.promise=new Promise(function(e,t){n.loadPromise.resolver=e,n.loadPromise.rejector=t}),this.establishCrossOriginMessaging(),[2,this.loadPromise.promise]}})})},e.prototype.establishCrossOriginMessaging=function(){},e.prototype.dispose=function(){this.messenger.destroy()},e.prototype.finishInitialization=function(){this.loadPromise.resolver()},e.prototype.subscribe=function(){return r(this,void 0,void 0,function(){var e,t;return o(this,function(n){switch(n.label){case 0:return[4,OneSignal.isPushNotificationsEnabled()];case 1:return e=n.sent(),t=opener||parent,e?t&&window.close():a.default.registerForPush(),[2]}})})},e}();t.default=l},function(e,t,n){"use strict";var i,r,o;Object.defineProperty(t,"__esModule",{value:!0}),(i=t.ConfigIntegrationKind||(t.ConfigIntegrationKind={})).TypicalSite="typical",i.WordPress="wordpress",i.Shopify="shopify",i.Blogger="blogger",i.Magento="magento",i.Drupal="drupal",i.SquareSpace="squarespace",i.Joomla="joomla",i.Weebly="weebly",i.Wix="wix",i.Custom="custom",(r=t.NotificationClickMatchBehavior||(t.NotificationClickMatchBehavior={})).Exact="exact",r.Origin="origin",(o=t.NotificationClickActionBehavior||(t.NotificationClickActionBehavior={})).Navigate="navigate",o.Focus="focus"},function(e,t,n){"use strict";var i=this&&this.__importDefault||function(e){return e&&e.__esModule?e:{default:e}};Object.defineProperty(t,"__esModule",{value:!0});var r=n(1),o=i(n(6)),s=i(n(2)),a=i(n(35)),u=function(){function e(e,t,n,i,r,o,s){void 0===i&&(i="shown"),void 0===r&&(r=["opacity","transform"]),void 0===s&&(s=500),this.selector=e,this.showClass=t,this.hideClass=n,this.state=i,this.targetTransitionEvents=r,this.nestedContentSelector=o,this.transitionCheckTimeout=s}return e.prototype.show=function(){var t=this;return this.hidden?new Promise(function(n){if(t.state="showing",o.default.trigger(e.EVENTS.SHOWING,t),t.hideClass&&r.removeCssClass(t.element,t.hideClass),t.showClass&&r.addCssClass(t.element,t.showClass),0==t.targetTransitionEvents.length)return n(t);var i=setTimeout(function(){s.default.debug("Element did not completely show (state: "+t.state+").")},t.transitionCheckTimeout);r.once(t.element,"transitionend",function(s,a){if(s.target===t.element&&r.contains(t.targetTransitionEvents,s.propertyName))return clearTimeout(i),a(),t.state="shown",o.default.trigger(e.EVENTS.SHOWN,t),n(t)},!0)}):Promise.resolve(this)},e.prototype.hide=function(){var t=this;return this.shown?new Promise(function(n){if(t.state="hiding",o.default.trigger(e.EVENTS.HIDING,t),t.showClass&&r.removeCssClass(t.element,t.showClass),t.hideClass&&r.addCssClass(t.element,t.hideClass),0==t.targetTransitionEvents.length)return n(t);r.once(t.element,"transitionend",function(i,a){var u=setTimeout(function(){s.default.debug("Element did not completely hide (state: "+t.state+").")},t.transitionCheckTimeout);if(i.target===t.element&&r.contains(t.targetTransitionEvents,i.propertyName))return clearTimeout(u),a(),t.state="hidden",o.default.trigger(e.EVENTS.HIDDEN,t),n(t)},!0)}):Promise.resolve(this)},e.prototype.waitUntilShown=function(){var t=this;return"shown"===this.state?Promise.resolve(this):new Promise(function(n){a.default.emitter.once(e.EVENTS.SHOWN,function(e){if(e===t)return n(t)})})},e.prototype.waitUntilHidden=function(){var t=this;return"hidden"===this.state?Promise.resolve(this):new Promise(function(n){a.default.emitter.once(e.EVENTS.HIDDEN,function(e){if(e===t)return n(t)})})},Object.defineProperty(e,"EVENTS",{get:function(){return{SHOWING:"animatedElementShowing",SHOWN:"animatedElementShown",HIDING:"animatedElementHiding",HIDDEN:"animatedElementHidden"}},enumerable:!0,configurable:!0}),Object.defineProperty(e.prototype,"content",{get:function(){return this.nestedContentSelector?this.element.querySelector(this.nestedContentSelector).innerHTML:this.element.innerHTML},set:function(e){this.nestedContentSelector?this.element.querySelector(this.nestedContentSelector).innerHTML=e:this.element.innerHTML=e},enumerable:!0,configurable:!0}),Object.defineProperty(e.prototype,"element",{get:function(){return 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Date).getTime()>=t.expirationTime||(new Date).getTime()>=o)]}})})},e.prototype.getSubscriptionState=function(){return i(this,void 0,void 0,function(){var t,n,i,o;return r(this,function(r){switch(r.label){case 0:if(e.isSafari())return[2,this.getSubscriptionStateForSecure()];switch(t=y.default.getWindowEnv(),t){case v.WindowEnvironmentKind.ServiceWorker:return[3,1]}return[3,4];case 1:return[4,self.registration.pushManager.getSubscription()];case 2:return n=r.sent(),[4,S.default.getSubscription()];case 3:return i=r.sent().optedOut,[2,{subscribed:!!n,optedOut:i}];case 4:return[4,y.default.getIntegration()];case 5:switch(o=r.sent(),o){case P.IntegrationKind.Secure:return[3,6];case P.IntegrationKind.SecureProxy:return[3,7];case P.IntegrationKind.InsecureProxy:return[3,11]}return[3,13];case 6:return[2,this.getSubscriptionStateForSecure()];case 7:switch(t){case v.WindowEnvironmentKind.OneSignalProxyFrame:case v.WindowEnvironmentKind.OneSignalSubscriptionPopup:case v.WindowEnvironmentKind.OneSignalSubscriptionModal:return[3,8]}return[3,9];case 8:return[2,this.getSubscriptionStateForSecure()];case 9:return[4,OneSignal.proxyFrameHost.runCommand(OneSignal.POSTMAM_COMMANDS.GET_SUBSCRIPTION_STATE)];case 10:return[2,r.sent()];case 11:return[4,this.getSubscriptionStateForInsecure()];case 12:return[2,r.sent()];case 13:throw new a.InvalidStateError(a.InvalidStateReason.UnsupportedEnvironment)}})})},e.prototype.getSubscriptionStateForSecure=function(){return i(this,void 0,void 0,function(){var t,n,i,o,s,a,u,c,l;return r(this,function(r){switch(r.label){case 0:return[4,S.default.getSubscription()];case 1:return t=r.sent(),n=t.deviceId,t.subscriptionToken,i=t.optedOut,e.isSafari()?(o=window.safari.pushNotification.permission(this.config.safariWebId),[2,{subscribed:!("granted"!==o.permission||!o.deviceToken||!n),optedOut:i}]):[4,this.context.serviceWorkerManager.getActiveState()];case 2:return s=r.sent(),[4,navigator.serviceWorker.getRegistration()];case 3:return a=r.sent(),[4,this.context.permissionManager.getNotificationPermission(this.context.appConfig.safariWebId)];case 4:return u=r.sent(),c=s===E.ServiceWorkerActiveState.WorkerA||s===E.ServiceWorkerActiveState.WorkerB,a?[4,a.pushManager.getSubscription()]:[2,{subscribed:!1,optedOut:i}];case 5:return l=r.sent(),[2,{subscribed:!!(l&&n&&u===h.NotificationPermission.Granted&&c),optedOut:i}]}})})},e.prototype.getSubscriptionStateForInsecure=function(){return i(this,void 0,void 0,function(){var e,t,n,i,o;return r(this,function(r){switch(r.label){case 0:return[4,S.default.getSubscription()];case 1:return e=r.sent(),t=e.deviceId,n=e.subscriptionToken,i=e.optedOut,[4,this.context.permissionManager.getNotificationPermission(this.context.appConfig.safariWebId)];case 2:return o=r.sent(),[2,{subscribed:!(!t||!n||o!==h.NotificationPermission.Granted),optedOut:i}]}})})},e.prototype.registerFailedSubscription=function(e,t){return i(this,void 0,void 0,function(){return r(this,function(n){return 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e>0?t.bell.badge.show():Promise.resolve(t)}).then(e(n)):(t.bell.badge.decrement(),e(n))})},t}(a.default);t.default=l},function(e,t,n){"use strict";var i=this&&this.__assign||Object.assign||function(e){for(var t,n=1,i=arguments.length;n0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]=63&&(a.default.tablet||a.default.mobile)?[4,OneSignal.privateShowHttpPrompt()]:[3,8];case 7:return n.sent(),[3,10];case 8:return[4,y.default.registerForPush()];case 9:n.sent(),n.label=10;case 10:return[3,12];case 11:OneSignal._sessionInitAlreadyRunning=!1,n.label=12;case 12:return[3,16];case 13:return!0!==OneSignal.config.userConfig.autoRegister&&A.default.debug("OneSignal: Not automatically showing popover because autoRegister is not specifically true."),S.default.isHttpPromptAlreadyShown()&&A.default.debug("OneSignal: Not automatically showing popover because it was previously shown in the same 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'+this.options.actionMessage+'
',l.addDomElement("body","beforeend",'
'),l.addDomElement(this.container,"beforeend",'
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this.notificationIcons?l.isChromeLikeBrowser()||a.default.firefox||a.default.msedge?this.notificationIcons.chrome?this.notificationIcons.chrome:this.notificationIcons.firefox?this.notificationIcons.firefox:"default-icon":a.default.safari?this.notificationIcons.safari?this.notificationIcons.safari:this.notificationIcons.chrome?this.notificationIcons.chrome:"default-icon":void 0:"default-icon"},Object.defineProperty(e.prototype,"container",{get:function(){return document.querySelector("#onesignal-popover-container")},enumerable:!0,configurable:!0}),Object.defineProperty(e.prototype,"dialog",{get:function(){return document.querySelector("#onesignal-popover-dialog")},enumerable:!0,configurable:!0}),Object.defineProperty(e.prototype,"allowButton",{get:function(){return document.querySelector("#onesignal-popover-allow-button")},enumerable:!0,configurable:!0}),Object.defineProperty(e.prototype,"cancelButton",{get:function(){return document.querySelector("#onesignal-popover-cancel-button")},enumerable:!0,configurable:!0}),e}();t.default=d},function(e,t,n){"use strict";var i=this&&this.__assign||Object.assign||function(e){for(var t,n=1,i=arguments.length;n0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1] Host) Getting event listener count for ",t),e.reply(OneSignal.emitter.numberOfListeners(t)),!1},e.prototype.isSubscribed=function(){var e=this;return new Promise(function(t){e.messenger.message(OneSignal.POSTMAM_COMMANDS.IS_SUBSCRIBED,null,function(e){t(e.data)})})},e.prototype.unsubscribeFromPush=function(){var e=this;return new Promise(function(t){e.messenger.message(OneSignal.POSTMAM_COMMANDS.UNSUBSCRIBE_PROXY_FRAME,null,function(e){t()})})},e.prototype.getProxyServiceWorkerActiveState=function(){var e=this;return new 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this.element.querySelector("#"+this.subscribeButtonSelectorId)},enumerable:!0,configurable:!0}),Object.defineProperty(t.prototype,"unsubscribeButton",{get:function(){return this.element.querySelector("#"+this.unsubscribeButtonSelectorId)},enumerable:!0,configurable:!0}),t.prototype.updateBellLauncherDialogBody=function(){var e=this;return OneSignal.getSubscription().then(function(t){c.clearDomElementChildren(document.querySelector(e.nestedContentSelector));var n="Nothing to show.",i="";if(e.bell.options.showCredit&&(i='
Powered by OneSignal
'),e.bell.state===d.default.STATES.SUBSCRIBED&&!0===t||e.bell.state===d.default.STATES.UNSUBSCRIBED&&!1===t){var r="";r=(l=e.getPlatformNotificationIcon())?'
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"+e.bell.text["dialog.main.title"]+'

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  1. Access Settings by tapping the three menu dots â‹®
  2. Click Site settings under Advanced.
  3. Click Notifications.
  4. Find and click this entry for this website.
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'),this.bell.setCustomColorsIfSpecified()},t}(u.default);t.default=p},function(e,t,n){"use strict";var i,r=this&&this.__extends||(i=Object.setPrototypeOf||{__proto__:[]}instanceof Array&&function(e,t){e.__proto__=t}||function(e,t){for(var n in t)t.hasOwnProperty(n)&&(e[n]=t[n])},function(e,t){function n(){this.constructor=e}i(e,t),e.prototype=null===t?Object.create(t):(n.prototype=t.prototype,new n)}),o=this&&this.__importDefault||function(e){return e&&e.__esModule?e:{default:e}};Object.defineProperty(t,"__esModule",{value:!0});var s=function(e){function t(){return e.call(this,".onesignal-bell-launcher-badge","onesignal-bell-launcher-badge-opened",null,"onesignal-bell-launcher-badge-active",null,"hidden")||this}return r(t,e),t.prototype.increment=function(){if(!isNaN(this.content)){var e=+this.content;e+=1,this.content=e.toString()}},t.prototype.show=function(){var t=e.prototype.show.call(this);return OneSignal.notifyButton.setCustomColorsIfSpecified(),t},t.prototype.decrement=function(){if(!isNaN(this.content)){var e=+this.content;e-=1,this.content=e>0?e.toString():""}},t}(o(n(51)).default);t.default=s},function(e,t,n){"use strict";var i=this&&this.__awaiter||function(e,t,n,i){return new(n||(n=Promise))(function(r,o){function s(e){try{u(i.next(e))}catch(e){o(e)}}function a(e){try{u(i.throw(e))}catch(e){o(e)}}function u(e){e.done?r(e.value):new n(function(t){t(e.value)}).then(s,a)}u((i=i.apply(e,t||[])).next())})},r=this&&this.__generator||function(e,t){var n,i,r,o,s={label:0,sent:function(){if(1&r[0])throw r[1];return r[1]},trys:[],ops:[]};return o={next:a(0),throw:a(1),return:a(2)},"function"==typeof Symbol&&(o[Symbol.iterator]=function(){return this}),o;function a(o){return function(a){return function(o){if(n)throw new TypeError("Generator is already executing.");for(;s;)try{if(n=1,i&&(r=i[2&o[0]?"return":o[0]?"throw":"next"])&&!(r=r.call(i,o[1])).done)return r;switch(i=0,r&&(o=[0,r.value]),o[0]){case 0:case 1:r=o;break;case 4:return s.label++,{value:o[1],done:!1};case 5:s.label++,i=o[1],o=[0];continue;case 7:o=s.ops.pop(),s.trys.pop();continue;default:if(!(r=(r=s.trys).length>0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1] Host) User unsubscribed but permission granted. Re-prompting the user for push."),n.label=1;case 1:return n.trys.push([1,3,,4]),[4,g.unsubscribeFromPush()];case 2:return n.sent(),e.reply(OneSignal.POSTMAM_COMMANDS.REMOTE_OPERATION_COMPLETE),[3,4];case 3:return t=n.sent(),v.default.debug("Failed to unsubscribe from push remotely:",t),[3,4];case 4:return[2]}})})},t.prototype.onMarkPromptDismissed=function(e){return s(this,void 0,void 0,function(){return a(this,function(t){switch(t.label){case 0:return v.default.debug("(Reposted from iFrame -> Host) Marking prompt as dismissed."),[4,d.default.markHttpsNativePromptDismissed()];case 1:return t.sent(),e.reply(OneSignal.POSTMAM_COMMANDS.REMOTE_OPERATION_COMPLETE),[2,!1]}})})},t.prototype.onIsSubscribed=function(e){return s(this,void 0,void 0,function(){var t;return a(this,function(n){switch(n.label){case 0:return[4,OneSignal.isPushNotificationsEnabled()];case 1:return t=n.sent(),e.reply(t),[2,!1]}})})},t.prototype.onUnsubscribeProxyFrame=function(e){return s(this,void 0,void 0,function(){return a(this,function(t){switch(t.label){case 0:return[4,OneSignal.isPushNotificationsEnabled()];case 1:return t.sent()?[4,OneSignal.setSubscription(!1)]:[3,4];case 2:return t.sent(),[4,OneSignal.database.rebuild()];case 3:t.sent(),t.label=4;case 4:return e.reply(OneSignal.POSTMAM_COMMANDS.REMOTE_OPERATION_COMPLETE),[2,!1]}})})},t.prototype.onServiceWorkerState=function(e){return s(this,void 0,void 0,function(){var t;return a(this,function(n){switch(n.label){case 0:return[4,OneSignal.context.serviceWorkerManager.getActiveState()];case 1:return t=n.sent(),e.reply(t),[2,!1]}})})},t.prototype.onWorkerVersion=function(e){return s(this,void 0,void 0,function(){var t;return a(this,function(n){switch(n.label){case 0:return[4,OneSignal.context.serviceWorkerManager.getWorkerVersion()];case 1:return t=n.sent(),e.reply(t),[2,!1]}})})},t.prototype.onSubscriptionExpirationState=function(e){return s(this,void 0,void 0,function(){var t;return a(this,function(n){switch(n.label){case 0:return[4,OneSignal.context.subscriptionManager.isSubscriptionExpiring()];case 1:return t=n.sent(),e.reply(t),[2,!1]}})})},t.prototype.onProcessExpiringSubscriptions=function(e){return s(this,void 0,void 0,function(){return a(this,function(t){switch(t.label){case 0:return OneSignal.context,[4,l.default.processExpiringSubscriptions()];case 1:return t.sent(),e.reply(OneSignal.POSTMAM_COMMANDS.REMOTE_OPERATION_COMPLETE),[2,!1]}})})},t.prototype.onGetSubscriptionState=function(e){return s(this,void 0,void 0,function(){var t;return a(this,function(n){switch(n.label){case 0:return[4,OneSignal.context.subscriptionManager.getSubscriptionState()];case 1:return t=n.sent(),e.reply(t),[2,!1]}})})},t}(b.default);t.default=m},function(e,t,n){"use strict";var i=this&&this.__awaiter||function(e,t,n,i){return new(n||(n=Promise))(function(r,o){function s(e){try{u(i.next(e))}catch(e){o(e)}}function a(e){try{u(i.throw(e))}catch(e){o(e)}}function u(e){e.done?r(e.value):new n(function(t){t(e.value)}).then(s,a)}u((i=i.apply(e,t||[])).next())})},r=this&&this.__generator||function(e,t){var n,i,r,o,s={label:0,sent:function(){if(1&r[0])throw r[1];return r[1]},trys:[],ops:[]};return o={next:a(0),throw:a(1),return:a(2)},"function"==typeof Symbol&&(o[Symbol.iterator]=function(){return this}),o;function a(o){return function(a){return function(o){if(n)throw new TypeError("Generator is already executing.");for(;s;)try{if(n=1,i&&(r=i[2&o[0]?"return":o[0]?"throw":"next"])&&!(r=r.call(i,o[1])).done)return r;switch(i=0,r&&(o=[0,r.value]),o[0]){case 0:case 1:r=o;break;case 4:return s.label++,{value:o[1],done:!1};case 5:s.label++,i=o[1],o=[0];continue;case 7:o=s.ops.pop(),s.trys.pop();continue;default:if(!(r=(r=s.trys).length>0&&r[r.length-1])&&(6===o[0]||2===o[0])){s=0;continue}if(3===o[0]&&(!r||o[1]>r[0]&&o[1]1)return o.default.warn("OneSignal: The web push SDK is included more than once. 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loading...

Sepsa – fakty, które trzeba znać


To nie choroba, a sieje śmierć. Może dopaść każdego. Ratunkiem jest świadomość istnienia sepsy i znajomość jej objawów, co daje szansę na szybkie podanie leków. Każda godzina zwłoki zmniejsza szanse pacjenta na zdrowie i życie.

Sepsa – fakty, które trzeba znać
zdjęcie ilustracyjne: pixabay

13 września obchodzimy Światowy Dzień Sepsy, który ma uwrażliwić zarówno pracowników służby zdrowia, jak i pacjentów, na ryzyko, jakie niesie sepsa oraz na istotne szczegóły, na które trzeba zwracać uwagę w sytuacji każdego zakażenia drobnoustrojami.

Co to jest sepsa?

Słowo sepsa pochodzi z greki i po raz pierwszy w medycznych pismach pojawiło się u Hipokratesa. Można powiedzieć, że oznacza proces niszczący życie. Nie jest to choroba, a zespół objawów, które towarzyszą silnemu zakażeniu organizmu drobnoustrojami. Mogą to być grzyby, wirusy, ale najczęściej sepsę powodują bakterie. 
– Bez zakażenia drobnoustrojami sepsy nie ma. Sepsa może być konsekwencją każdego zakażenia – podkreśla anestezjolog prof. Andrzej Kuebler.

Czy sepsa jest groźna?


Bardzo, ponieważ często doprowadza do śmierci, która na dodatek następuje dosłownie w ciągu kilkunastu godzin. Według WHO na świecie co 3-4 minuty ktoś umiera z powodu sepsy. Jak mówi prof. Kuebler, w Polsce przypadków sepsy jest co najmniej 50 tys. rocznie, a co drugi chory umiera. Współczynnik zgonów z powodu tego stanu to 65 na 100 tys. mieszkańców. Dla porównania współczynnik zgonów z powodu raka tchawicy, płuc i oskrzeli wynosi 59/100 tys., a zawałów serca – 49/100 tys.
Sepsa doprowadza do uszkodzenia tkanek i narządów wskutek niewłaściwej reakcji organizmu na zakażenie. Jej istotą jest zmiana reakcji organizmu na zagrożenie z prawidłowej na nieprawidłową. Jednak na początku zawsze musi nastąpić inwazja patogenów.
„Jeśli sepsę porówna się do wojny, to drobnoustroje można porównać do armii najeźdźcy, która istotnie wpływa na jej przebieg. Drobnoustroje charakteryzują się całą gamą czynników zjadliwości, ułatwiających atak na gospodarza” – czytamy w książce prof. Kueblera pt. „Sepsa”. 
W odpowiedzi na atak organizm w procesie septycznym zaczyna w pewnym momencie podejmować niewłaściwe działania. – W efekcie organizm zaczyna uszkadzać własne tkanki i narządy – podkreśla profesor.

Jakie są objawy sepsy

Eksperci wskazują na fakt, że do wysokiej śmiertelności z powodu sepsy dochodzi z powodu mało swoistych objawów na początku jej rozwoju. To:
  • Gorączka (ale nie zawsze występuje!)
  • Dreszcze
  • Poczucie zimna
  • Szybki oddech, duszność
  • Ból i złe samopoczucie
  • Spocona skóra 
  • Wysypka nieznikająca po ucisku
  • Przyspieszone bicie serca
  • Pogorszenie kontaktu z otoczeniem, dezorientacja.
Takie objawy mogą jednak sugerować wiele innych problemów (choć pojawienie się wysypki to już groźny symptom w sepsie, a na końcowym jej etapie ciało chorego pokrywają rozległe wybroczyny). 
- W odróżnieniu od np. zawału serca, sepsa nie ma swoistych markerów rozpoznania, w rodzaju EKG czy określenia poziomu odpowiednich enzymów. Dlatego diagnoza opiera się na obserwacji klinicznej i ocenie przebiegu zmian czynności w organizmie – mówi prof. Kuebler.
Dr Alicja Karney, dyrektor ds. medycznych Instytutu Matki i Dziecka, apeluje o szczególną uważność zarówno do lekarzy, jak i bliskich pacjenta, który zmaga się z jakimś zakażeniem. Wskazuje, że o rozwoju sepsy może świadczyć zmiana zachowania. 
– Dziecko w przebiegu dotychczasowych chorób było na przykład senne, a matka zauważa teraz, że jest pobudzone, lub na odwrót, albo jest senne. Matki mówią czasem: „Jest jakieś inne” – dodaje. 
Pacjent, u którego rozwija się sepsa, często ma zimne dłonie i obniżone ciśnienie tętnicze. To jednak także nie są przecież swoiste objawy.

Dlaczego w sepsie czas jest ważny?

Eksperci podają, że każda godzina zwłoki w podaniu antybiotyku w czasie rozwoju sepsy zwiększa śmiertelność z jej powodu o 8 proc. - pamiętajmy, że sepsa może zabić w ciągu 24 godzin. Według prof. Kueblera, lekarze, tak jak w razie zgłoszenia się pacjenta z bólem w klatce piersiowej muszą najpierw wykluczyć (lub potwierdzić) zawał, tak w razie zakażenia, muszą pamiętać o możliwości rozwoju sepsy. Dr Karney radzi, żeby rodzice dzieci, które „są jakieś inne” i czują silny niepokój, byli czujni i nie ustawali w szukaniu przyczyny takiego stanu. 
– Może nawet nie jest złym pomysłem pytać lekarza, czy podejrzewa rozwój sepsy – dywaguje. Po to, by uczulić lekarza pierwszego kontaktu, do którego najczęściej z pierwszymi objawami sepsy rodzice zabierają dziecko, że w przebiegu zakażenia wirusami, grzybami czy bakteriami może dojść do sepsy.

Jakie bakterie wywołują sepsę?

Wbrew pozorom najczęściej nie te szpitalne, choć pobyt w szpitalu jest czynnikiem rozwoju sepsy, choćby z tego powodu, że w szpitalu przebywają osoby bardziej narażone na zakażenie, ponieważ są osłabione chorobami.
Według CDC (Centres for Disease and Control – agendy rządowej USA mającej na celu monitorowanie chorobowości i sposobów zapobiegania chorobom) około 80 proc. przypadków sepsy jest wywoływanych przez bakterie pozaszpitalne. Wśród nich prym wiodą meningokoki, czyli dwoinki zapalenia opon mózgowych. Inne bakterie, które często prowadzą do sepsy to:
  • Paciorkowce (odpowiedzialne m.in. za wywołanie anginy, ale i zapalenia mieszków włosowych)
  • Pałeczki hemofilne typu B (wywołują m.in. zapalenie płuc).
Sepsa wywołana w przebiegu zakażenia meningokokami jest niezwykle groźna, ponieważ jest „piorunująca” – często w przypadku nierozpoznania od pierwszych objawów do śmierci mija doba.
- Sepsa wywołana meningokokami to około przypadków 200-300 rocznie – mówi dr Karney – Niby mało, ale każde zachorowanie jest niezwykle groźne.
Wielu chorych umiera z powodu sepsy meningokokowej, a u 30 proc. tych, którzy przeżyli, pozostają trwałe uszkodzenia (np. upośledzenie słuchu lub głuchota, utrata kończyny z powodu konieczności amputacji, cofnięcie w rozwoju – problemy intelektualne).

Co to są meningokoki

To bakterie – dwoinki zapalenia opon mózgowych. Wielu z nas jest ich bezobjawowymi nosicielami – kolonizują nosogardziel (badania wykazały ich obecność u 10 proc. zdrowej populacji). Przenoszą się drogą kropelkową. Mogą wywołać niegroźne zapalenie gardła, ale i niebezpieczne zapalenie opon mózgowych oraz inwazyjną chorobę meningokokową. Ok. 60-90 proc. zakażeń meningokokowych dotyczy dzieci i młodzieży.

Ile trwa leczenie sepsy i kto ją leczy

Może być długotrwałe i konieczne jest m.in. podawanie antybiotyków. Pacjenci leczeni są w szpitalu, najczęściej na oddziałach intensywnej terapii. Wyspecjalizowani w terapii sepsy są anestezjolodzy. Pacjent na Oddziale Intensywnej Terapii (OIT) z powodu sepsy może spędzić nawet 20 dni, przy czym na pobycie w OIT leczenie się nie kończy. W wielu przypadkach konieczna jest rehabilitacja wskutek uszkodzenia narządów podczas sepsy. „Większość [pacjentów wypisanych ze szpitala po sepsie – przyp. red] przejawia poważne zaburzenia czynności organizmu (…). Są to m.in.:
  • Zaburzenia snu
  • Halucynacje, napady paniki
  • Bóle mięśni i stawów
  • Krańcowe zmęczenie
  • Zaburzenia koncentracji
  • Upośledzenie czynności umysłowych
  • Utrata samooceny i wiary w siebie.

Czy sepsa jest zaraźliwa

Sepsa nie, nie jest to choroba, którą można się zarazić. Ale niektórymi chorobami zakaźnymi, w przebiegu których dochodzi do sepsy, już tak – np. zapaleniem gardła. Stąd, jeśli zostanie rozpoznany przypadek sepsy w przebiegu zakażenia meningokokami, wszyscy z otoczenia chorego otrzymują odpowiednią profilaktykę w postaci osłony antybiotykowej. Trzeba jednak pamiętać, że sepsa może wystąpić pod wpływem różnych czynników, zarówno zakaźnych, jak i niezakaźnych. 

Czy można się chronić przed sepsą?

Skuteczną ochroną przed sepsą wywołaną przez niektóre bakterie są szczepienia:
  • Przeciwko meningokokom (jest zalecane przez lekarzy, ale niefinansowane ze środków publicznych)
  • Przeciwko pałeczce hemofilnej typu B (szczepienie jest obowiązkowe i finansowane ze środków publicznych)
  • Przeciwko pneumokokom (od niedawna szczepienie jest finansowane ze środków publicznych).
Przed zakażeniami innymi drobnoustrojami chronią podstawowe zasady higieny – częste mycie rąk, skuteczne leczenie zakażeń, niedzielenie kubka czy sztućców z innymi osobami itp.

Komu przydarzyć się może sepsa

Praktycznie każdemu, choć częstość występowania sepsy rośnie wraz z wiekiem. Ponad połowa jej przypadków diagnozowana jest u osób po 65. roku życia. Zapadalność na sepsę jest też znacząco wyższa u niemowląt niż w pozostałej części populacji.
Jest jednak wyjątek. Dr Alicja Karney zwraca uwagę, że do sepsy w przebiegu zakażenia meningokokami dochodzi najczęściej u osób uprzednio zdrowych i młodych. Z uwagi na tryb życia nastolatków jest to – druga po małych dzieciach – grupa ryzyka takiego zakażenia. 
Justyna Wojteczek (zdrowie.pap.pl)
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