最后审阅: 3 十一月 2021
最后更新: 08 六月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 低血压
  • 心动过速
  • 皮肤改变
  • 少尿
  • 精神状态改变
  • 危险因素
  • 发热
  • 胸痛
  • 呼吸困难
  • 缺氧
  • 体温过低

其他诊断因素

  • 腹痛
  • 外周水肿
  • 颈静脉压(jugular venous pressure, JVP)升高
  • 心音低沉或微弱
  • 心律失常
  • 瘀点疹
  • 荨麻疹
  • 血管性水肿
  • 胸部一侧呼吸音减弱
  • 气管偏移
  • 膀胱充盈
  • 四肢驰缓性麻痹

危险因素

  • 年龄增长
  • 合并症
  • 心肌梗死
  • 心肌病
  • 心脏瓣膜疾病
  • 心律失常
  • 创伤
  • 胃肠道出血
  • 腹主动脉动脉瘤破裂
  • 烧伤/热射病
  • 胃肠道液体丢失:腹泻和呕吐
  • 胰腺炎
  • 脓毒症
  • 全身过敏反应/中毒
  • 脊髓或脑干损伤
  • 内分泌疾病
  • 肺栓塞
  • 心脏填塞
  • 新药(过敏性休克)

诊断性检查

首要检查

  • 乳酸(动脉血气分析结果)
  • 动脉血气(ABG)或静脉血气(VBG)
  • 葡萄糖
  • 全血细胞计数
  • 尿素和电解质
  • 凝血功能检查
  • C 反应蛋白
  • 心电图(ECG)

需考虑的检查

  • 胸部 X 线检查(CXR)
  • 尿液分析和尿妊娠试验
  • 感染筛查
  • 床旁超声
  • 胸部、腹部和盆腔 CT
  • 长骨 X 线检查
  • 脊柱 X 光

治疗流程

急症处理

撰稿人

专家顾问

Alexander Alexiou, MB, BS, BSc, DCH, FRCEM, Dip IMC RCSEd

Flight Doctor

Greater Sydney Area Helicopter Emergency Medical Service

Sydney

New South Wales

Australia

利益声明

AA declares that he has no competing interests.

Clovis Rau, MBBS, BSc, MRCEM

ST4 Emergency Medicine

Emergency Department

University College Hospital

University College London Hospitals NHS Foundation Trust

UK

利益声明

CR declares that he has no competing interests.

Acknowledgements,

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Samuel J. Stratton MD, MPH

Professor

Fielding School of Public Health

David Geffen School of Medicine at UCLA

Los Angeles

Deputy Health Officer

Orange County Health Care Agency

Health Disaster Management/Emergency Medical Services

Santa Ana

CA

利益声明

SJS declares that he has no competing interests.

同行评议者

Paul Frost,

Reader (clinical)

Centre for Medical Education

School of Medicine

Cardiff University

Honorary Consultant in Intensive Care Medicine

University Hospital of Wales

Cardiff

UK

利益声明

PF declares that he has no competing interests.

编辑

Annabel Sidwell,

Section Editor, BMJ Best Practice

利益声明

AS declares that she has no competing interests.

Tannaz Aliabadi-Oglesby,

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Luisa Dillner,

Head of Research and Development, BMJ

利益声明

Julie Costello,

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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