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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
27
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 does the author think of Dr. Ifergane’s study?
选项
A、It has some significant implications.
B、It will start the key reform of clinics.
C、It means little to clinics outside Israel.
D、Its validity should be questioned.
答案
A
解析
观点态度题。第四段第一句提到,伊孚格恩医生的研究揭示了一个惊人的事实,而最后一段第一句提到,伊孚格恩医生推荐急诊室为单独就诊的病人在其诊断和治疗期间提供一名友好的“中风联系人”,接下来作者建议其他医院考虑推行此项研究带来的一些改变。可见,在作者看来,这个研究具有重要的启示性,故答案为A)。B)“它会开启医疗机构的重要改革”,作者只是建议其他医疗机构参考试行,并没有说会开启重要改革,故可排除;C)“他对以色列以外的医院没有什么意义”,尽管在第六段提到这个研究可能存在地域局限性,但全文最后一句指出其研究发现的某些启示还是可以作为其他医院的参考的,故可排除;D)“它的可信度应受到质疑”,尽管研究有局限性,但作者并没有质疑研究可信度的意思,故可排除。
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