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Everyone arriving at a hospital’s emergency room(ER)wishes to be seen quickl
Everyone arriving at a hospital’s emergency room(ER)wishes to be seen quickl
游客
2023-08-18
21
管理
问题
Everyone arriving at a hospital’s emergency room(ER)wishes to be seen quickly, but for stroke patients it can be a matter of life or death. The most common stroke involves a blood clot blocking vessels in the brain, killing brain cells nearby almost immediately. Luckily, an effective treatment exists. Thrombolytic(溶解血栓的)therapy uses drugs to dissolve the clot and restore the flow of blood. If started within a couple of hours of a stroke occurring, it can limit brain damage and reduce long-term disability. Neurologists even have a catchphrase for this: "time is brain".
Understandably, hospitals strive to identify stroke cases and administer such medication without delay. A key step is using a computed tomography(CT)scanner to ensure that there has been no bleeding in the brain, in which case thrombolytic drugs would make things worse. The last couple of decades have seen many innovations in reducing this "time to CT".
But in shaving seconds from medical procedures, researchers may have neglected something more important: the human element. Gal Ifergane, a neurologist at Soroka University Medical Centre in southern Israel, noticed that stroke patients who were accompanied to the ER by friends or family seemed to fare better than those who arrived alone. So for 15 months, ER staff at Soroka recorded the number of companions escorting each stroke sufferer, over 700 in all, and tracked their progress.
The results, recently published in Medicine, tell a striking story. Stroke victims arriving with someone were more than twice as likely to be correctly diagnosed by the triage nurse, and had their CT scans performed earlier. Patients eligible for clot-busting medication also received it much faster if accompanied, although their numbers were too few for the researchers to be sure it was because they had company. The differences were far from trivial. Patients with one companion had CT scans an average of 15 minutes sooner than those unaccompanied. A second companion shaved a further 20 minutes off the wait, although three or more companions did not confer any additional benefit.
Dr. Ifergane did not record who the companions were, however, or how they were able to reduce delays. He believes that it is probably a combination of focusing the attention of clinical staff on their loved ones, and providing basic care such as helping to move patients into bed.
Dr. Ifergane admits that his study has limitations. The sample size was rather small and his findings may reflect cultural norms in Israel that do not apply elsewhere. But he has already tried to make changes in the way the Soroka University Medical Centre operates. " We asked our security team to allow two people to come in with stroke patients rather than just one," he says. "And we now consider stroke patients who are coming alone as a group at risk. "
Dr. Ifergane also recommends that ERs provide a friendly "stroke liaison" to accompany lone patients during the diagnostic and treatment processes. Something other hospitals might think about, too. [br] What is Dr. Ifergane’s finding about the human element?
选项
A、Medical staff gave priority to accompanied patients.
B、Patients received clot-busting quicker because of company.
C、Two companies may maximally reduce the "time to CT".
D、Companies can partially replace the work of clinical staff.
答案
C
解析
推理判断题。第一个定位句首先明确了所谓人为因素对于伊孚格恩医生而言是指就医的陪同,而第二个定位句指出两名陪同比一名陪同能再缩短20分钟等待就医的时间,而更多的陪同就不会带来进一步的优势。可见,两名陪同的优势是最大的,故答案为C)。A)“医务人员给予有陪同的病人一些优先权”,在第五段中作者指出陪同可能帮助引起医务人员的注意,但这不能说明医务人员给予其优先权,故排除;B)“由于有人陪同,病人能更快地接受血栓崩解治疗”,第四段第三句虽提到有人陪同的病人能更快地接受治疗,但又补充说道,由于样本太少,不能确定提早治疗的原因是否在于有人陪同,故该项可以排除;D)“陪同人员可部分替代医务人员的工作”,第五段最后一句虽然提到陪同人员参与了一些基本的护理工作,但并没有说可以部分替代医务人员,故排除。
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