2015年7月31日 星期五

Present patient with chest pain

This is my patient  checking with ECG , so I'm research somethings in Taiwan doing ECG test  from google(Chinese).
心電圖
心電圖檢查有什麼意義嗎?
1.診斷心房及心室肥大。
2. 診斷心肌缺血及梗塞。
3. 診斷心律不整。
4.診斷心包炎。
5.全身性的疾病所引起的心臟變化。
6.心臟藥物或非心臟藥物的影響如毛第黃及奎尼丁。
7.電解質代謝方面的不正常如鉀離子的不正常。
8.可以對電子心律器的功能做有效的評估。
心電圖是檢查哪個部位?
心電圖是檢查胸腔內心臟之部位。為連接儀器開始檢查前請病人脫下鞋子、外套、鐵衣或脊椎架,上床平躺後,將上衣掀開至前胸,褲管拉高至膝蓋,袖子拉高至手肘。並閉上眼睛,身體放輕鬆,不要出力不要動即可。
檢查時手機是否需要關機? 眼鏡、項鍊或手錶等物品是否也需要脫掉?
檢查前請事先將手機關機,以免干擾儀器。其餘配件一般皆不需移除。
檢查時會不會痛?
檢查時並不會有任何不適的感覺。
吃完飯後可以做檢查嗎?
此項檢查並不需要禁食。
請問心電圖檢查時間需要多久?
檢查時間一般約為3~5分鐘。
請問檢查後何時可以看報告?
1.速件檢查門診病人,回當天原門診主治醫師作報告解釋。
2.非速件檢查之門診病人,於下次回門診時主治醫師會解說檢查結果。
3.住院病人,主治醫師於巡房時作檢查結果解說。
若逾期檢查需要再約檢查時間嗎?
請直接持檢查單及健保卡,於下次門診前或檢查單上日期六個月內前來作檢查,不須重約檢查時間。

Translation:

ECG
EKG what sense?
1. Diagnosis of atrial and ventricular hypertrophy.
2. The diagnosis of myocardial ischemia and infarction.
3. Diagnosis of arrhythmia.
4. Diagnosis of pericarditis.
5. Heart disease caused by systemic changes.
6. Drugs that affect the heart or heart drugs such as hair first yellow and quinidine.
7. Electrolyte metabolism is not normal, such as potassium ions is not normal.
8. Electronic rhythm can make the function effective assessment.
ECG is to check which part?
Check the chest electrocardiogram within the heart of the site. Before connecting the instrument to start checking your patients take off their shoes, coats, iron clothes or spinal frame, after lying in bed, the shirt open to the chest, his pants pulled up to the knee, sleeves pulled up to the elbow. And close your eyes, relax the body, do not move can not contribute.
Check whether the need to shut down the phone? Are glasses, necklaces or watches and other items also need to take off?
Check in advance before the phone off, so as not to interfere with the instrument. Generally are not required to remove the remaining parts.
Does it hurt check?
Does not have any discomfort check.
After dinner you can do to check it?
This check does not require fasting.
Will the ECG time how long?
Check in time is generally about 3 to 5 minutes.
When Will the inspection report can be seen?
1. Speed ​​parts inspection outpatient, outpatient physician back the same day as the original report explains.
2. Non-member inspection of outpatient speed, back to the clinic at the time of the next physician will explain the results.
3. Patient, physician for the test results to explain at the time of rounds.
If you need to check about overdue examination of time?
Please direct support checklists and insurance card, to date six months before the next clinic within the checklist or come for inspection shall check the weight is not about time.


And Follow my patient up (-7/31)

Like use ECG test and looked Measurement diagram between he walks and do some exercise 15-20mins (before/after ECG pic).Also give some medications to slow his pain. He himself also believed to be effective before, but I can not go to see their own pictures, what kind of change can not be available to everyone.Please also capable of teaching how to properly interpret ECG. I only know what the position of each part of the location and the measurement is to it.

Furthermore, there is the patient's case to shoot down, please also share their own experiences to talk to see if they have similar symptoms. Initially suspected cardiac vascular blockage, resulting in paralysis of his chest and hands.(From Chinese)

後續追蹤7/31
每天一樣持去給這位45歲先生測試運動前/後之間ECG的測量圖。目前也給些藥物治療減緩他的疼痛。他本身也是認為是有效過的,但因我本身無法去看出圖片有什麼樣的變化無法提供給大家。

也請大家能夠教學如何正確的判讀ECG。我只知道各部位的位置以及測量的位置是什麼而已。

再者有把病人的病例給拍攝下來,請大家也可以分享自己的經驗談看是不是有類似相關症狀。初步懷疑是心臟的血管有堵塞,造成他的胸痛以及雙手麻痹。

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