急診觀察醫(yī)學observationmedicine(編輯修改稿)
2024-11-16 17:54 本頁面
【文章內(nèi)容簡介】 ncreased bowel sounds→obstruction ? Rebound tenderness or rigidity→peritonitis ? 上腹部燒灼樣疼痛伴有惡心、嘔吐，抑酸劑有效 → 胃部疾病 ? 腹痛癥狀（重）和體征（相對輕）分離，惡心嘔吐，血便，休克 → 血管疾病 Sex ? 女性腹痛更復(fù)雜，涉及異位妊娠和盆腔器官疾病 ? 很多女患者并未意識到她已經(jīng)懷孕 ? 除了月經(jīng)推遲，早孕并無確切的可靠表現(xiàn) ? 異位妊娠在破裂前很難診斷 ? 檢測 HCG很有必要 Disease pattern ? 持續(xù)性 or陣發(fā)性 ? 放散部位 ? 加重或緩解因素 Location of pain ? 右下腹 ? 右上腹 ? 不固定 ? 側(cè)腹部 Atrial Fibrillation ? Serious acute medical conditions associated with atrial firillation Acute myocardial infarction Unstable angina pectoris Acute pulmonary edema Pericardial tamponade Pneumonia Acute pulmonary embolus Thyrotoxicosis Hypertensive emergency Marked hypokalemia Atrial Fibrillation ? 基本措施 控制心率（地高辛、 β受體阻滯劑、非二氫吡啶類鈣通道阻滯劑如地爾硫卓等） ? 選擇性措施 糾正心律紊亂（藥物轉(zhuǎn)復(fù)或電擊轉(zhuǎn)復(fù)） ? 必要措施 預(yù)防血栓栓塞 Chest Pain ? Potentially lifethreatening Myocardial infarction Unstable angina Dissecting thoracic aneurysm Pericarditis with tamponade Tension pneumothorax or effusion Pulmonary embolism Esophageal rupture Chest Pain ? Generally nonlifethreatening Stable angina Congestive heart failure Pericarditis without tamponade Mitral valve prolapse Pleurisy Pneumonia Stable pneumothorax or effusion Esophageal spasm Esophagitis Peptic ulcer Cholelithiasis with biliary spasm Pancreatitis Costochondritis Intercostal muscle strain Herpes zoster Confusion ? Findings suggestive of a confusional state Poor judgment Poor orientation Worsening memory(recent) Worsening intellect
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