病人在靜脈輸注萬古黴素（Vancomycin）時出現臉部與頸部潮紅。護理師應採取何種優先行動？
A patient receiving IV Vancomycin develops flushing of the face and neck. Which action is the nurse’s priority?
- AStop the infusion immediately立即停止輸注
- BAdminister an antihistamine給予抗組織胺
- CNotify the physician通知醫師
- DSlow the rate of the infusion✓ 正解減緩輸注速率
萬古黴素輸注時出現的臉部與頸部潮紅，是典型的「紅人症候群（Red Man Syndrome）」。這是由藥物輸注速度過快引起的組胺（Histamine）非過敏性釋放反應。處理原則是先減緩速度，而非立即停止給藥，除非出現嚴重的低血壓或呼吸窘迫。減緩速度後通常症狀會緩解，此時可觀察評估。若立即停止會中斷治療，且若非嚴重過敏，並不一定需要給予抗組織胺。
Flushing of the face and neck during vancomycin infusion is a typical presentation of 'red man syndrome.' This is a non-allergic histamine release reaction caused by an overly rapid infusion rate. The management principle is to first slow the rate rather than stop the medication immediately, unless severe hypotension or respiratory distress occurs. After slowing the rate, the symptoms usually improve and the client can be observed and assessed. Stopping immediately would interrupt therapy, and if the reaction is not severe, antihistamines are not necessarily required.
在美國臨床，護理師通常有 Protocol 權限在輕微紅人症候群時自動減緩輸注速度並監測，不需要每次都先通知醫師。台灣臨床環境較為保守，常傾向於先停止並通知醫師。