一名頭部外傷病人出現脈壓變寬和心搏過緩。護理師懷疑是什麼情況？

頭部外傷（head injury）病人出現脈壓變寬（widening pulse pressure）和心搏過緩（bradycardia）是顱內壓（intracranial pressure, ICP）增高的晚期且危險的徵象，這組症狀通常被稱為柯興氏三病徵（Cushing's triad），其第三個徵象是呼吸不規則（irregular respirations）。顱內壓增高會導致腦部血流灌注不足，進而引發一系列代償性生理反應。護理師應立即識別這些生命徵象的變化，因為它們提示腦部可能正在遭受嚴重壓迫和缺血，需緊急醫療介入以避免不可逆的腦損傷或死亡。

In a client with a head injury, a widening pulse pressure and bradycardia are late and dangerous signs of increased intracranial pressure (ICP); together with irregular respirations, they make up Cushing's triad. Increased ICP causes insufficient cerebral perfusion, which triggers a cascade of compensatory physiologic responses. The nurse must immediately recognize these vital sign changes, as they suggest that the brain is undergoing severe compression and ischemia and requires emergency medical intervention to avoid irreversible brain damage or death.

柯興氏三病徵（Cushing's triad）作為顱內壓增高的典型晚期徵象，其病理生理學和臨床意義在台灣和美國的醫療教育與臨床實踐中是普遍且一致的知識。護理師對頭部外傷病人生命徵象的監測和判讀標準並無顯著差異，皆視其為緊急且危及生命的狀況。