POCUS—急診專科護理師臨床照護、評估與輔助鑑別診斷的新利器

急診專科護理師透過病史詢問、身體理學檢查收集病人的臨床主訴及異常生理評估資料，以提供主治醫師做為診斷及治療的依據。重點式照護超音波（POCUS）可協助鑑別診斷及臨床處置照護，即時提供影像並直接判讀，讓急診醫護人員能迅速掌握病況並做出相對應的處置。專科護理師使用超音波協助急診臨床照護及輔助診斷的效益在國外已有多篇研究佐證，專科護理師的可訓練性、專業能力及角色，在醫療照護團隊中有互補及彈性運用的功能。有鑑於專科護理師的臨床照護內容日趨複雜，涉及多項侵入性處置，如何提供安全有效的處置對專科護理師及病患來說是重要的議題。本文提出四個臨床案例說明急診專科護理師如何運用超音波執行病患評估、輔助主治醫師確立病患診斷並提供病患安全的照護行為。

關鍵字

重點式照護超音波； POCUS ；專科護理師；超音波；急診

並列摘要

Emergency nurse practitioners play a critical role in collecting clinical data which support attending physicians for further medical care and treatments. Point-of-care ultrasound (POCUS) is a valuable tool that facilitate differential diagnosis and clinical care in emergency medicine. The benefits of applying ultrasound by nurse practitioners on the assistance of emergency clinical care and diagnosis have been proven in many studies abroad. This article presents four clinical cases to illustrate how emergency nurse practitioners use POCUS to perform patient assessments and assist attending physicians in differential diagnoses. The cases highlight the importance of incorporating ultrasound into emergency clinical care and the role of emergency nurse practitioners in providing safe and effective care for patients. The applications of POCUS and the role of nurse practitioners in emergency medicine are important aspects of clinical care that should be further explored and developed.

並列關鍵字

point-of-care ultrasound ； POCUS ； nurse practitioner ； ultrasound ； emergency department

參考文獻

吳佩珊、李癸汌（2017）．膽囊炎之臨床治療．臨床醫學月刊，80（5），667－672。https://doi.org/10.6666/ClinMed.2017.80.5.122

郭嘉琪、吳貞鋆、馮已榕、李維鈞（2016）．超音波導引周邊靜脈注射之效應—系統性文獻回顧暨統合分析．護理雜誌，63（6），89－101。https://doi.org/10.6224/JN.63.6.89

Atkinson, P., Madan, R., Kendall, R., Fraser, J., & Lewis, D. (2014). Detection of soft tissue foreign bodies by nurse practitioner-performed ultrasound. Critical Ultrasound Journal, 6(1), 1-5. https://doi.org/10.1186/2036-7902-6-2

Carroll, A. G., Kavanagh, R. G., Ni Leidhin, C., Cullinan, N. M., Lavelle, L. P., & Malone, D. E. (2017). Comparative Effectiveness of Imaging Modalities for the Diagnosis and Treatment of Intussusception: A Critically Appraised Topic. Academic Radiology, 24(5), 521-529. https://doi.org/10.1016/j.acra.2017.01.002

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