事件记录
播音员: Is it bad enough to go to the emergency room or isn't it? 你正在听的是 "ER or Not" on 范围.
面试官: 好吧. 是时候合作了. Dr. 特洛伊马德森 is going to give us the answer to our scenario here today of whether or not you should go into the ER for this particular condition or situation. 今天,头晕. 所以再一次, 不是由其他原因引起的, 就好像不知道从哪里冒出来的, all of a sudden I feel pretty dizzy. 我得坐下来，不管是不是急诊室?
Dr. 马德森: So this one depends a lot on how high a risk you have for a stroke and this is what I think about with dizziness. So young person, otherwise healthy, they feel dizzy, probably not a big deal. 如果你65岁, you've got high blood pressure, 高胆固醇, maybe you've had a previous heart attack or a previous stroke, someone like that comes in and says to me, “我只是觉得头晕. I feel like the room is spinning. I can't walk in a straight line," I get really concerned about a stroke.
So there are some blood vessels that feed the brain, the back part of the brain. That's what controls your balance. 所以如果你中风了, people will often describe a feeling like the room is spinning, they say they can't walk in a straight line, 它们往一边掉. So that's when I get really concerned and I say, “嗯, let's get our neurologist down here right now. We may need to give you a clot busting medication to treat the stroke." So really it's a time dependent thing if you're in that category.
面试官: 好吧. And does that usually come with the other stroke symptoms, slurred speech, facial droop?
Dr. 马德森: 有时是，有时不是.
面试官: 它可以是孤立的?
Dr. 马德森: 这是最难的部分. I mean, typically, it will come with balance issues. 这是大发娱乐看到的大事, persons falling to one side or they just say they cannot walk in a straight line. But oftentimes with these types of strokes, they don't have a facial droop. They don't say, "My arm's weak." They don't say, "I'm having trouble speaking," because it's a different part of the brain. So that's why I get really concerned when I hear that, and that's why we kind of jump right on top of it in terms of getting them treatment if they're within that window where we can treat them.
面试官: If it's a younger healthier person that you don't believe that it's a stroke, 那你怎么跟他们说?
Dr. 马德森: So if someone comes in the ER and they say, “我觉得头晕。,“你知道吗？, we'll typically do some tests like an EKG to look at their heart. Certainly full physical exam, neurologic exam. Say, "Is anything else going on?" But quite often what this ends up being is what's called benign positional vertigo. So you've got like these canals in your ear that help you keep your balance and these little stones. And if one of these little stones gets out of place, it feels like the room is spinning and anyone who's been through this knows how miserable that feeling is.
You know, most cases it's going to go away after a week or so. We can give medication to kind of calm that sensation down and there are actually repositioning maneuvers you can do to try and get this little stone back in the right place. You know, it sounds kind of funny but it's . . . 是的, it's one of the more common things we see in younger people, 健康的人, 谁有这种症状.
面试官: And for that person, no immediate danger. Would they be able to just go to their regular physician to get some of these things that would offer them relief for that two-week period while they're recovering?
Dr. 马德森: 完全. 我认为大多数情况下, 你知道, if you're otherwise healthy you can probably wait, 去看医生吧. One medication that can help in the short term is meclizine. It's an anti seasickness, anti motion sickness medication. It's kind of the non drowsy form of Dramamine. You'll see it right there next to Dramamine. I recommend taking it if you have that. It can help out with some of those symptoms.
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