病人對抗生素產生過敏性休克。護理師的優先處置為何？
A client is diagnosed with anaphylaxis after receiving an antibiotic. What is the nurse's priority action?
- AAdminister intramuscular (IM) epinephrine✓ 正解給予肌肉注射（IM）腎上腺素
- BStop the antibiotic infusion immediately立即停止抗生素輸注
- CAdminister intravenous antihistamines給予靜脈注射抗組織胺
- DMaintain a patent airway and administer oxygen維持呼吸道暢通並給予氧氣
依 AHA / Resuscitation Council 2024 急救指引，anaphylaxis 的第一線優先處置為立即「肌肉注射腎上腺素」（IM epinephrine 0.3-0.5 mg of 1:1000），通常注射於大腿外側 vastus lateralis；這是救命的藥物，可逆轉支氣管痙攣與血管擴張。停止過敏原（B）雖必須同步進行，但本身不能逆轉已發生的全身性反應，因此不是『最優先』動作。維持呼吸道（D）與抗組織胺（C）為輔助性處置，無法取代 IM epinephrine。注意皮下注射吸收太慢，已不再是 anaphylaxis 的建議路徑。
According to the AHA/Resuscitation Council 2024 emergency guidelines, the first-line priority intervention in anaphylaxis is immediate intramuscular epinephrine (IM epinephrine 0.3-0.5 mg of 1:1000), typically injected into the lateral thigh (vastus lateralis); this is the life-saving medication that reverses bronchospasm and vasodilation. Stopping the allergen (B) must occur simultaneously but, by itself, cannot reverse the systemic reaction already underway, so it is not the single most prioritized action. Maintaining the airway (D) and antihistamines (C) are adjunctive measures and cannot substitute for IM epinephrine. Note that subcutaneous administration absorbs too slowly and is no longer the recommended route for anaphylaxis.
在美國臨床指引中，過敏性休克時腎上腺素首選為大腿外側肌肉注射（IM），而台灣早期臨床較常使用皮下或靜脈注射，目前教學已逐步與國際接軌，強調 IM 給藥以確保穩定吸收。