急診筆記

ideally within 24 hours. JAMA: 2018 PCI Update Timing to PCI: ■ NSTEMI / UA：within 24-48h (< 24h if severe) ■ STEMI：within 90-120min (ideally < 60min) early PCI 通常是在 24 小時內作. Killip class   2018年台灣心臟學會指引:   NSTEMI 除非是血行動力學不穩（SHOCK）, pulmonary edema, tachy-bradycardia, refractory angina with ECG dynamic change建議及早（<24小時)PCI外，72小時內做不影響預後（mortality）  In high-risk patients with GRACE risk score >140, an early invasive strategy lowered the risk of death, MI or stroke (HR 0.65, 95% CI 0.48–0.89). In a post hoc analysis of the ACUITY trial, a delay to PCI > 24 h was an independent predictor of 30-day and 1-year mortality. The excess of ischemic events associated with the PCI >24 h strategy was most apparent among moderate- and high-risk patients. In the NSTE-ACS patients undergoing PCI from the Taiwan ACS Full Spectrum Registry, early PCI within 24 h could not improve the primary outcome (cardiac death and recurrent MI) compared w...

空腹需多久? 憩室炎建議先空腹兩三天. 經治療後, 當發燒疼痛改善. 可開始嘗試 clear liquid diet. 一步一步增加.  Within 2-3 days of hospitalization, the patient's fever, pain, and leukocytosis should begin to resolve. The patient can then be started on a clear liquid diet and advanced as tolerated. If tolerating oral intake and clinically stable, the patient can be discharged to complete a 7- to 10-day course of oral antibiotic therapy. (From medscape)