醫學筆記匯整 ED Notes

1. 輕聲安撫病人情緒

2. 教病人腹式呼吸, 不要用胸部呼吸

3. 教病人數節拍 : 吸氣四秒鐘, 吐氣四秒鐘, 慢慢呼吸

握住病人的手, 真的有幫助
但不一定是醫師來握, 叫病人信任的友人或家人來握就好
醫師只要教病人腹式呼吸, 4秒進4秒出
差不多5分鐘, 病人就能恢復平穩了

- Rule out the serious conditions that can cause the presenting symptoms.
  A low pulse oximetry reading in a patient who is hyperventilating should never be attributed to HVS. 

- 第一次的 Hyperventilation Syndrome, 老人
   可能是需要做 Survey 排除其他問題 ( ACS, PE )
   CXR, EKG, ABG, Lab
   Drug toxicology screening is often indicated. 

- Rebreathing into a paper bag is not recommended.
  Deaths have occurred in patients with AMI, pneumothorax, and PE 
  who were initially misdiagnosed with HVS
  and treated with paper bag rebreathing.

- 似乎常有人用 O2 mask 1 L/min
  缺氧的還是必須按照缺氧處理
  不缺氧氣的, 如果1L/min可以提供安慰效果, 可以用
  如果病人覺得吸不到氣, 掙扎想拿掉1L/min的mask, 就拿掉吧

  由於過度換氣的鑒別診斷很多, 因此EMT應該仔細的理學評估, 病史詢問與血氧監控
  切勿快速認定病人一定就是過度換氣