— 照護管理 · EASY · MCQ —
護理師在急診進行檢傷分類。下列哪位病人需要醫師立即評估？
A nurse is triaging clients in the emergency department. Which client requires immediate assessment by the provider?
- AA client reporting severe abdominal pain for three days主訴嚴重腹痛已三天的病人
- BA client with a fever of 101.5°F and a cough體溫101.5°F並伴隨咳嗽的病人
- CA client with a closed fracture of the ankle閉合性腳踝骨折的病人
- DA client with an acute asthma attack and silent chest✓ 正解急性氣喘發作且聽不到呼吸音的病人
— Explanation · 中文詳解 —
氣喘發作時出現「安靜胸」（silent chest）表示氣道嚴重阻塞、呼吸肌衰竭，是呼吸衰竭的前兆，危及生命，必須列為第一優先處理。其餘選項雖有不適，但在循環呼吸上相對穩定，不具立即致命性，可安排在後續進行診療。
A client with an acute asthma attack presenting with a 'silent chest' requires immediate assessment because this finding indicates severe airway obstruction and impending respiratory failure. This is a life-threatening emergency, whereas the other clients described have stable vital signs or non-life-threatening conditions that allow for prioritized but less urgent care.
✦ 台美臨床差異
台美急診皆使用五級檢傷制度，對氣道受阻的判斷準則一致，無顯著差別。