— 照護管理 · HARD · MCQ —
急診檢傷護理師評估同時湧入的不穩定病人。下列哪位需最高優先級檢傷分類（Level 1）？
An ER triage nurse evaluates an influx of unstable clients. Which client requires the highest level of triage prioritization (Level 1)?
- AA 24-year-old male asthmatic whose breath sounds have suddenly disappeared (silent chest).✓ 正解一位 24 歲男性氣喘患者，其呼吸音突然消失（無聲胸）。
- BAn adult presenting with shivering, generalized weakness, and fatigue.一位呈現畏寒、全身虛弱和疲勞的成人。
- CA client with a closed jaw fracture and severe pain.一位患有閉合性下顎骨折且疼痛嚴重的病人。
- DA 55-year-old with persistent vomiting and right upper quadrant pain.一位 55 歲，有持續嘔吐和右上腹痛的患者。
— Explanation · 中文詳解 —
ER 檢傷依 ABC 排序，氣道阻塞最優先。 選項 A 正確：氣喘 silent chest 表示支氣管完全阻塞、即將呼吸停止，需立即插管或腎上腺素。 選項 D：嘔吐穩定，非數分鐘致命。 選項 B：泛發無力需評估，非 Level 1。 選項 C：下顎骨折緊急但呼吸道未受脅。
ER triage prioritizes by ABC; airway obstruction is highest priority. C correct: Silent chest in asthma means complete bronchial obstruction—imminent respiratory arrest requiring immediate intubation or epinephrine. A: Vomiting is not minute-fatal. B: Generalized weakness needs assessment but not Level 1. D: Jaw fracture urgent but airway intact.
✦ 台美臨床差異
世界急診共通考點。看到氣喘從 wheezing 變成 silent chest，代表立刻瀕死。