At Death’s Door

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Situation

Sophie, an 18-year-old female, had to be airlifted by the emergency response team after sustaining multiple injuries from a car crash.  She was unconscious and had unstable vital signs. Doctors also suspect that she had several fractures from the accident.

Dialogue

Physician:         Can you identify the patient?

Nurse:              The EMT handed me her driver’s license and it identified her as Sophie Turner, 18 years of age, from 14 E Stonybrook, Connecticut.

Physician:         Please give her Lactated Ringer’s solution to be infused rapidly via two large-bore peripheral intravenous catheters.

Nurse:              Blood pressure is dropping, oxygen saturation is at 90%, and respiratory rate at 7 breaths per minute.

Physician:         Let’s start the endotracheal intubation and place ventilatory monitoring and ECG leads. This patient is at death’s door. We will also conduct a fast abdominal sonogram to determine the extent of her chest or abdominal injury.

Nurse:              I already called the sonography department, doc.

Physician:         Once the procedure is done, you may wheel the patient to the ICU department.

Nurse:              That has been noted, we will transfer the patient after my call to the ICU department about this admission.

Vocabulary

At death’s door A near death experience
Airlift Transportation by air
EMT Emergency Medical Technician
Sustain an injury To suffer or have an injury
Fracture Another term for broken bone
Unconscious Not awake or responding to external stimuli
Infuse To let a fluid substance into a person’s vein
Large-bore intravenous catheter An intravenous line that delivers large amount of fluid
Oxygen saturation The amount of red blood cells (hemoglobin) that has oxygen
Endotracheal intubation Placement of tube through the windpipe or the mouth
Ventilatory Pertaining to something that helps circulate air
Sonogram The image produced during a sonography
Wheel To carry someone through something that has wheels

Analysis

  • When someone is at death’s door, he or she is very ill and almost dying.

Example: He was at death’s door after getting involved in a car accident, but the doctor revived him.

  • When someone or something has to be airlifted, the means of transportation is by air.

Example: The food supply was airlifted to reach the troop.

  • An Emergency Medical Technician or an EMT is a member of the healthcare team trained to respond during emergency. They are also called ambulance technicians in some countries.

Example: The EMTs responded quickly following the car crash.

  • If you sustained an injury, it means you had or suffered an injury after an accident.

Example: She sustained right leg fracture due to fall.

  • A broken bones or fracture can be caused by accidents. It may be due to sports, falls, or vehicular accidents.

Example: Kirsten sustained a fracture on the right arm from a fall.

  • A person becomes unconscious, meaning not awake and responsive to tactile (touch), verbal, and other form of stimulation usually because of an injury.

Example: He became unconscious immediately after getting into a collision with another car.

  • When you infuse something, usually in fluid form, you introduce fluid through a patient’s vein.

Example: Maria received medications via intravenous infusion.

  • A large-bore IV catheter usually utilizes large cannula that delivers large amount of fluids into the patient’s vein in the fastest way. This is used especially during emergencies.

Example: She lost lots of blood and they had to deliver fluids via large-bore IV catheter to prevent shock.

  • Oxygen saturation refers to the amount or fraction of hemoglobin or red blood cells that carry oxygen versus the total amount.

Example: Healthy individuals have an oxygen saturation of 94-100%.

  • A tube is usually inserted through the mouth during endotracheal intubation especially during emergency situations. The tube may also be inserted via the windpipe (trachea) or the nose.

Example: They had to do endotracheal intubation because her ventilation was impaired following an injury to her lungs.

  • Ventilation refers to the movement of air from one space to another. Anything that refers or pertains to ventilation is called ventilator.

Example: She couldn’t really breathe so she has to be assisted by a ventilatory device.

  • Sonography is commonly known as ultrasound. The image produced following this imaging test is called the sonogram.

Example: The sonogram revealed a tumor.

  • When you are being wheeled, you are carried or transported to another place via something that has a wheel.

Example: She was wheeled into the operating room per stretcher.

esl-post-7-questions

Nurse Back to Health

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Situation:

Mr. Sanchez, a 55-year-old man of Hispanic descent, was admitted to the hospital due to angina pectoris. He also complained of dizziness, fatigue, and radiating pain from the jaw down to the neck and the arms. He was profusely sweating when he was brought to the hospital. After being confined at the hospital for 3 days, he is ready to be discharged by his physician.

Dialogue:

Physician:         Good morning, Mr. Sanchez! How are you feeling today?

Mr. Sanchez:     Oh, I felt so much better than when I was brought to the hospital!

Physician:         That’s really good to know. So, are you ready to go home?

Mr. Sanchez:     Yes, doc. You and your healthcare team really took care of me, and helped nurse me back to health.

Physician:         That’s really good to know! And I have good news for you. You can wear your street clothes now, pack up, and you may go home once I’m done with my discharge orders for you. The nurse on duty will discuss it with you in a bit.

(Nurse comes in a few minutes later)

Nurse:              Hello Mr. Sanchez! I am Nurse Beatrice and I’m here to discuss your discharge plan. First up, we will talk about your prescribed diet, which should include lots of fruits, veggies, whole grains, and saturated fats must be avoided.

Mr. Sanchez:     Uh oh. That means no more burritos for me.

Nurse:              Certainly. And, you also have maintenance medications which include aspirin, statins, beta blockers, and clot-preventing drugs. The dosage for each medication is on this sheet. (Hands a piece of paper) Do you have any questions, Mr. Sanchez?

Mr. Sanchez:     I believe there’s none. Thanks for taking care of me during my stay in this hospital.

Nurse:              You’re welcome! We are happy to serve you. Bye.

Mr. Sanchez:     Bye.

Vocabulary:

Nurse back to health To take care of an ill person
Angina pectoris (an-juh-nuh pek-to-ris) Medical term for chest pain
Hispanic descent A person whose ancestors come from a Spanish-speaking country
Dizziness A spinning or whirling sensation
Fatigue Being physically or mentally tired
Radiating pain Pain that spreads to different body parts
Profusely sweating To produce plentiful amount of sweat
Veggies Short term for vegetables
Whole grains A collective term for grains whose bran has not been removed
Saturated fats Unhealthy fat
Statins Medicines that help lower blood cholesterol levels
Beta blockers Medicines that help reduce blood pressure

Analysis:

  • When you nurse someone back to health you help take care of a sick person until he or she returns to the normal healthy state.

Example: My grandma had a stroke and I helped nurse her back to health.

  • Angina pectoris, sometimes just called angina, is the common symptom of coronary artery disease. Angina in layman’s term is chest pain that is usually described as heavy, squeezing chest pain.

Example: He experienced angina after a morning jog.

  • Hispanic and Latino are often interchangeably used. However, they mean entirely different. One is considered to have Hispanic descent if your ancestors or family comes from a Spanish-speaking country. For instance, if you come from Brazil, you are not Hispanic because Brazilians speak Portuguese. Latino, on the other hand, refers to people coming from Mexico.

Example: Jose’s family comes from Mexico. So, he is both Hispanic and Latino.

  • Dizziness is that spinning or whirling sensation even when you are not moving.

Example: High fever caused her dizziness so she had to stay in bed the whole time.

  • Fatigue is the feeling of physical or mental tiredness after a demanding activity.

Example: He experienced fatigue after working 7 days straight.

  • When pain radiates, this means it spreads to other areas of the body.

Example: Angina is often associated with radiating pain.

  • Anything profuse is excessive or plentiful in amount.

Example: There was profuse bleeding from his gunshot wound.

  • Whole grains include wheat, rice, and oats whose bran has not been removed or processed.

Example: White rice does not belong to whole grains because its bran has been processed.

  • Saturated fat is the type of fat usually contained in animal products. Saturated fats are found to raise cholesterol levels. Food that are known to have high saturated fat content include cheese, pizza, hamburger, and burrito.

Example: Saturated fats are linked to diabetes and hypertension, and must be avoided.

Comprehension:

esl-post-6-questions

 

Go Under the Knife

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Situation:

Sophie was rushed to the hospital due to lower right abdominal pain. The pain is aggravated upon coughing and other jarring movements. The doctor suspects that Sophie is suffering from appendicitis.

 

Surgeon:           Hello Sophie! I’m Crystal Jennings, one of the resident surgeons of Saint Therese Hospital and I’m here to assess your condition. Now, may I have the permission to check your abdomen. (Applies gentle pressure on the lower right side of the abdomen)

 

Sophie:             I’m afraid that hurts. (Does abdominal guarding when her abdomen was pressed)

 

Surgeon:           We will run further tests on you to confirm if it’s appendicitis you’re suffering from. I will have your blood drawn and you may have to undergo urine and imaging tests, but before that, I’ll have you sign this consent first. (Explains the procedure) Do you have any questions?

 

Sophie:             Is it possible that I’ll go under the knife if it’s confirmed that I have appendicitis?

 

Surgeon:           Yes. You will have to undergo appendectomy once appendicitis has been confirmed and other possible medical conditions have been ruled out. Meanwhile, I’ll have the nurse do a skin test on you for your antibiotic therapy. Is there anything else, Miss Sophie?

 

Sophie:             That would be all. Thanks!

 

Surgeon:           Thanks!

Vocabulary:

Go under the knife To have or undergo a surgery
Jarring Shaking, vibrating or sudden movement
Appendicitis Inflammation or swelling of the appendix
Abdominal guarding The act of tensing the abdominal muscles to guard a painful organ
Run tests Conduct a laboratory test
Appendectomy Removal of the appendix
Rule out Remove/eliminate from the possibility or consideration
Skin Test A test done to determine certain medications or chemical components that a person is allergic to
Informed consent A form signed by the patient or an immediate relative that the former allows himself/herself to undergo a treatment or a medical procedure

Analysis:

  • To go or to be under the knife means submitting oneself for surgery.

Example: She had to go under the knife for the removal of her appendix.

  • If something (or someone) jars, (he or she) it is shaking. It may also mean sudden movement.

Example: The jarring movement gave him a headache.

  • Appendicitis is the swelling of the finger-shaped pouch called the appendix, which is located on the lower right side of the abdomen.

Example: Pain located on the lower right side of the abdomen may be caused by appendicitis.

  • When the abdomen is pressed and the abdominal wall muscles get tensed, the tensing is referred to as abdominal guarding. This is usually seen in people suffering from appendicitis or diverticulitis.

Example: She had abdominal guarding when the doctor examined and pressed her abdomen.

  • When health professionals tell you that they will run tests on you, it means you have to undergo certain tests and submit urine, blood and other samples that will be sent to the laboratory to be tested. The results are then relayed to the physician, which will be later on explained to you.

Example: Before surgery is performed, they need to run some tests on her.

  • Appendectomy is a surgical procedure that involves removal of the appendix.  From the words appendix and –ectomy a suffix which means “out and to cut”.

Example: Her appendix was inflamed so she has to undergo an appendectomy.

  • Rule out is a term used in the medical practice, which means to exclude the possibility of or from consideration.

Example: The chest x-ray that was done helped rule out pneumonia.

  • A skin test is a test that helps determine certain substances that a person has an allergic reaction to. This can be done in two ways: through a prick or a puncture, and by injecting a diluted allergen just right below the surface of the skin.

Example: Her skin test result revealed negative allergy for penicillin.

  • An informed consent is a form that a patient signs, which serves as an agreement that he or she understands the benefits and risks of a certain medical intervention.

Example: The doctor made her sign an informed consent after explaining the benefits and risks of the surgery.

Comprehension:

  1. What surgical procedure does Sophie have to undergo?
  2. Have you tried being under the knife? What type of surgery?
  3. Differentiate appendicitis and appendectomy.
  4. What form did the doctor make Sophie sign?

 

 

 

 

 

 

Come Down with a Flu

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Situation:

Carice was under so much stress and she feels like she is coming down with a flu. She is experiencing malaise, joint pains, runny nose, and intermittent fever. Before she takes a turn for the worse, she decided to schedule an appointment with her physician over the phone.

Dialogue:

Secretary: (Phone rings) Hello! You have reached Dr. Anderson’s clinic and it’s her secretary speaking. How may I help you?

Carice: Good morning! This is Ms. Carice Williams and I’d like to set an appointment with Dr. Anderson tomorrow, September the 5th, 2016, at around 9 in the morning.

Secretary: That has been noted, Ms. Carice, but let me check Dr. Anderson’s schedule tomorrow first. Hmmm. It looks like she will not be around tomorrow, but a locum tenens will fill in for her. Would you still want to push through with your appointment?

Carice: Yes. I’m pushing through with it because I’m afraid if I cancel I would take a turn for the worse. I feel like I’m coming down with a flu judging by the symptoms I have. I’m experiencing runny nose, intermittent fever, and malaise.

Secretary: Alright, Ms. Carice. I’m finalizing your appointment. We’ll see you tomorrow then!

Carice: Thanks for the help!

Secretary: You’re very much, welcome!

Vocabulary:

Come down with (a flu) To get sick with a flu, cold, or any illness
Malaise (pronunciation: mah-layz) An overall bodily discomfort
Runny nose Sensation felt when there is excess fluid draining from the nose
Intermittent fever An on and off type of fever
Take a turn for the worse If something, like an illness or a situation, becomes severe
Locum tenens A person who is a temporary substitute, specifically a physician

 

Analysis

  • If you come down with something, it means you get sick with a certain illness like a flu or cold.

Example: My coworker is sick with the flu. I feel like I’m coming down with it, too.

  • Malaise is general body weakness or uncomfortable feeling.

Example: Lack of sleep caused me malaise the following day.

  • If you have allergies or sick with a cold or flu, your body will produce extra mucus and if excess fluid drains from your nasal cavity, you are said to have runny nose.

Example: It’s hard to focus at work with this runny nose.

  • When you have intermittent fever, there are periods that you run a fever and then it subsides.

Example: I already want to return to work, but I still have an intermittent fever.

  • A situation or an illness takes turn for the worse when it becomes severe.

Example: The fever has already subsided then she suddenly took turn for the worse when she started having seizures.

  • A locum tenens is a professional, specifically a physician, who temporarily substitutes another person of the same profession.

Example: Dr. Anderson is on a vacation so a locum tenens stands in for her.

 

Comprehension:

  1. What are the symptoms experienced by Carice?
  2. When is Carice’s appointment with Dr. Anderson?
  3. Who is going to fill in for Dr. Anderson in her absence?
  4. What does a locum tenens do?

In Bad Shape

Situation:

Robb Tully is a middle-aged man with an endomorphic body type.  He thinks he is in bad shape so he went out for a run one day, but experienced shortness of breath afterwards. He decided to visit his cardiologist, Dr. Frey.

Dialogue:

Dr. Frey: Good morning, Mr. Tully. I’ve noticed this is your second visit to my clinic this month. What seems to be the problem?

Robb Tully: I was just out for a run early this morning and I suddenly experienced chest pain and shortness of breath.

Dr. Frey: Let me check your blood pressure first. Hmm…It is quite elevated. I’ll have your ECG done to monitor your heart’s activity. If results are good, I’ll prescribe you medications and just send you home.

Robb Tully: Alright. Sounds good to me. Thanks Doc!

Dr. Frey: You’re most welcome, Mr. Tully.

 Vocabulary:

In bad shape In bad physical condition, not fit or healthy
Endomorphic A round body type; fat
Middle-aged Age period between young adulthood and old age
Shortness of breath Difficulty breathing
Cardiologist A doctor who specializes on treating disorders of the heart
ECG Stands for electrocardiogram/electrocardiography

Analysis:

  • Injury, pregnancy, and obesity are some of the reasons why someone is in bad shape.

Example: I’ve gained weight in the past couple of months. I need to diet and exercise because I’m in bad shape.

  • If a person has large amount of body fat, he or she is considered an endomorph. Endomorphic is used to describe a round body type.

Example: Overweight people usually are usually endomorphic.

  • A middle-aged person is someone who is roughly between 45 to 65 years old.

Example: My aunt just turned 45. She is already a middle-aged woman.

  • When you experience chest tightness, pain, and have to exert effort in breathing, you are most likely experiencing shortness of breath.

Example: I had the worst cough this month. They had to rush me to the hospital due to shortness of breath.

  • A cardiologist is a medical doctor who specializes on the diagnosis, treatment or management of the diseases of the heart.

Example: My grandpa is known to be hypertensive. He needs to see his cardiologist every month.

  • An electrocardiogram is a test that checks the electrical activity of the heart to determine whether or not it’s working normally.

Example: She complained about experiencing chest pains so the cardiologist made her undergo an ECG.

Comprehension:

  1. Are you an endomorph? Why? Why not?
  2. What test did Dr. Frey conduct on Robb Tully?
  3. How old a person should be to be considered middle-aged?
  4. What did Rob Tully do before experiencing shortness of breath?

Full of Beans

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Situation:

Catelyn Stark, a toddler, was rushed to the hospital by her mom because she has difficulty breathing. Her mother also noticed that she was wheezing, poorly feeding and lethargic. Mrs. Stark wants her daughter to be full of beans again.

Dialogue:

Nurse Arya: Good day! My name is Arya and I am your nurse on duty this shift. How is the patient doing now?

Mrs. Stark: She still feels sick, although I have seen some improvements in her symptoms.

Nurse Arya: Could you please tell me more about your observations?

Mrs. Stark: She is no longer wheezing and lethargic, but still poorly feeding.

Nurse Arya: Yes. I noticed the wheezing has already cleared up.

Mrs. Stark:  I am extremely worried about her lack of appetite though. I don’t want her to turn into a bag of bones.

Nurse Arya: This has been noted and we will notify your attending physician about your concern.

Mrs. Stark: Thank you! I can’t wait to see my daughter to be full of beans again.

Vocabulary:

Full of beans To have lots of energy and enthusiasm
Bag of bones Very thin
Lethargic Lacking energy
Wheezing Breathing with a whistling sound

Analysis:

  • If a person has a lot of energy and enthusiasm, he is said to be full of beans.

Example: It’s surprising how he manages to be full of beans after a busy day.

  • As someone becomes extremely thin, the bones will protrude from the skin and the skin is figuratively referred to as a bag. Hence, the term bag of bones.

Example: She hasn’t been eating well for months. She is turning into a bag of bones.

  • When you move slowly, feel drowsy or sleepy, and doesn’t have the energy, you are lethargic.

Example: We normally feel lethargic before breakfast.

  • Wheezing is the whistling sound that comes out as a result of breathing difficulty.

Example: A wheezing sound is usually heard among people with asthma.

 

Comprehension:

  1. Why was Catelyn rushed to the hospital?
  2. What are the usual reasons for you to feel lethargic?
  3. What was Catelyn’s mom worried about?
  4. How do you manage to stay full of beans?
  5. Give synonyms for the expression bag of beans. Think as many as you can.

 

 

Doctor’s Visit: Tummy Bug

Situation:

Mr. Smith, a 50-year-old male, is experiencing diarrhea accompanied by abdominal cramps, nausea, and low-grade fever. He went to visit Dr. Chen, an internist.

Dialogue:

Dr. Chen: Hello Mr. Smith. How are you feeling now?

Mr. Smith: I feel a bit under the weather.

Dr. Chen: Would you please tell me the symptoms that you are experiencing.

Mr. Smith: I’ve been passing loose stools since this morning.

Dr. Chen: Oh, you might have a tummy bug.

Mr. Smith: I’m having abdominal cramps. I also feel warm and nauseous.

Dr. Chen: Okay. Let me check your temperature first. You’re running a fever. We need to conduct a few tests on you to further identify the cause of your illness. I’ll get back to check and update you on the laboratory results once they are in.

Mr. Smith: Thanks Dr. Chen!

Dr. Chen: You’re welcome. Don’t worry. We’ve got you covered.

Vocabulary:

Under the weather Ill, sick , ailing
Got you covered Another way of saying “we’ll take care of your needs”
Tummy bug Stomach flu/virus
Run a fever To have a temperature higher than normal
Nauseous Sick to the stomach and you may feel like vomiting
Loose stool Diarrhea; loose, watery stool quickly discharged during bowel movement:

Notes/Analysis:

  • Aside from feeling sick, the phrase under the weather could also mean feeling down or depressed. It is also used as a euphemism for a hangover. This expression was said to have originated in the early 1800s suggesting that the weather affects someone’s health.

Example: She felt under the weather when her dog died. (This means she felt depressed.)

Andrew was drinking all night and now he feels under the weather. (This is another way to say that a person is suffering from a hangover.)

  • When you say you got something or someone covered, it means you will provide whatever is needed. It’s another way of saying you’ll take care of everything.

Example: When the attending physician is on a vacation, the locum tenens gets him or her covered. (Meaning: The temporary physician (locum tenens) will take care of everything while the attending physician is on a vacation.)

  • The tummy bug is medically known as the intestinal flu or gastroenteritis although it’s not caused by the influenza virus. A bug is an informal term for a virus.

Example: Mr. Smith suffers from nausea, abdominal cramps, and fever. The doctor suspects he is infected with the tummy bug.

  • When someone is running a fever, his or her temperature is higher than normal.

Example: The flu caused her to run a fever. (Meaning: The flu made her body temperature rise.)

  • Nausea is being sick to the stomach, giving you the urge to vomit (throw up/puke). When you are suffering from nausea, you are said to be nauseous.

Example: The smell of the dead rat made him nauseous. (Meaning: The smell of the dead rat is so disgusting. It made him want to throw up.

  • When you have loose stool, the matter that comes out during bowel movement is watery and it is discharged quickly. It is another term for diarrhea.

Example: The spoiled spaghetti made me pass loose stool.

 

Comprehension:

  1. Why does Mr. Smith feel under the weather?
  2. What could be the possible cause of Mr. Smith’s illness?
  3. At around what time did Mr. Smith start passing loose stools?
  4. Were Mr. Smith’s needs being attended to?