急腹症的鉴别诊断与处理医院急诊科.ppt

* * * * * * * * * * * * General appearance “Sick versus not sick” Mobile versus still Obvious pain or discomfort “Doorway” impression Vital signs “That’s why they’re called vital” General exam: Is the patient distressed or in pain? Signs of shock Jaundice Anaemia Weight loss Objective measures: Temp; pulse; BP; resp rate. 病人烦躁不安、面色苍白、出汗，或仰卧 屈膝、侧卧不动，明显脱水，黏膜干燥，眼窝凹陷，呼吸浅快等提示病情很重。 * 心率快伴低血压，说明容量不足。 * 皮肤黏膜黄染提示胆道梗阻或感染。 * 高热提示有感染发生。 * Inspection Distention, scars, bruises Auscultation Present, hyper, or absent Actually not that helpful! Palpation Often the most helpful part of exam Tenderness vers