一位病人主訴突發性胸痛、呼吸困難和焦慮。病人有深層靜脈栓塞病史。應優先排除哪個潛在診斷？
A nurse is assessing a client who reports sudden onset of chest pain, shortness of breath, and anxiety. The client has a history of deep vein thrombosis. Which potential diagnosis is the highest priority to rule out?
- APulmonary embolism✓ 正解肺栓塞
- BMyocardial infarction心肌梗塞
- CAortic dissection主動脈剝離
- DPneumonia肺炎
病人有 DVT 病史，並出現胸痛、呼吸困難等症狀，這些都是肺栓塞的典型表現。肺栓塞可能危及生命，需立即評估與處理，因此為最高優先診斷。心肌梗塞、肺炎、主動脈剝離也可能出現類似症狀，但 DVT 病史使得 PE 更為可疑且緊急。
The client has a history of DVT and presents with chest pain and dyspnea—classic features of pulmonary embolism (PE). PE can be rapidly life-threatening and must be assessed and treated immediately, making it the highest-priority diagnosis to rule out. Myocardial infarction, pneumonia, and aortic dissection can also present with similar symptoms, but the history of DVT makes PE more suspicious and more urgent.
美國急診醫學訓練強調辨別危及生命症候的優先順序，強調跨科合作；台灣急診醫師經驗豐富，但團隊協作和標準化流程有發展空間。