急诊观察医学observationmedicine

急诊观察医学observationmedicine内容摘要：

ncreased bowel sounds→obstruction • Rebound tenderness or rigidity→peritonitis • 上腹部烧灼样疼痛伴有恶心、呕吐，抑酸剂有效 → 胃部疾病 • 腹痛症状（重）和体征（相对轻）分离，恶心呕吐，血便，休克 → 血管疾病 Sex • 女性腹痛更复杂，涉及异位妊娠和盆腔器官疾病 • 很多女患者并未意识到她已经怀孕 • 除了月经推迟，早孕并无确切的可靠表现 • 异位妊娠在破裂前很难诊断 • 检测 HCG很有必要 Disease pattern • 持续性 or阵发性 • 放散部位 • 加重或缓解因素 Location of pain • 右下腹 • 右上腹 • 不固定 • 侧腹部 Atrial Fibrillation • Serious acute medical conditions associated with atrial firillation Acute myocardial infarction Unstable angina pectoris Acute pulmonary edema Pericardial tamponade Pneumonia Acute pulmonary embolus Thyrotoxicosis Hypertensive emergency Marked hypokalemia Atrial Fibrillation • 基本措施 控制心率（地高辛、 β受体阻滞剂、非二氢吡啶类钙通道阻滞剂如地尔硫卓等） • 选择性措施 纠正心律紊乱（药物转复或电击转复） • 必要措施 预防血栓栓塞 Chest Pain • Potentially lifethreatening Myocardial infarction Unstable angina Dissecting thoracic aneurysm Pericarditis with tamponade Tension pneumothorax or effusion Pulmonary embolism Esophageal rupture Chest Pain • Generally nonlifethreatening Stable angina Congestive heart failure Pericarditis without tamponade Mitral valve prolapse Pleurisy Pneumonia Stable pneumothorax or effusion Esophageal spasm Esophagitis Peptic ulcer Cholelithiasis with biliary spasm Pancreatitis Costochondritis Intercostal muscle strain Herpes zoster Confusion • Findings suggestive of a confusional state Poor judgment Poor orientation Worsening memory(recent) Worsening intellect。