急性心肌梗塞合併三度房室阻斷個案之急診照護經驗

An Emergency Nursing Experience in a Patient with Acute Myocardial Infarction Complicated with Third DegreeA-V Block

本文旨在探討一位急性心肌梗塞合併三度房室阻斷個案，歷經休克、呼吸困難而引起焦慮之急診照護過程。筆者藉由羅氏適應模式進行評估，經由觀察、會談、身體評估等方式，確立個案的健康問題有心肺組織灌流失效、氣體交換障礙及焦慮。護理期間為95年3月12日09:16-10:40，筆者運用羅氏適應模式為評估工具，於急診照護期間除了穩定個案生命徵象以儘快接受心導管治療，更運用傾聽、解釋、同理等人性化的身心照護，緩解內心焦慮。此急診照護經驗可提供臨床護理同仁對急性心肌梗塞個案照護之參考，藉由高度警覺及熟稔的急救處理，避免治療的延誤。

The purpose of this article is to describe a nursing experience in a patient having AMI and 3rddegree A-V block who had cardiogenic shock, dyspnea and anxiety in the emergency department.The authors assessed the patient's health condition by Roy's adaptation model at 09:16 to 10:40,March 12, 2006. Three nursing problems were identified as follows: Insufficiency of tissue perfusion-cardiac and pulmonary, disturbance of gas exchange and anxiety. During the nursing process,the authors stabilized the patient's vital signs to accept PCI as soon as possible.Mental support wasgiven to release anxiety by listening, explaining and empathy. From this experience, it can be seenthat emergency nursing care for a patient with AMI and 3rd degree A-V block can be effective inassisting emergency crisis and avoiding treatment delays.