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Everyone arriving at a hospital’s emergency room (ER) wishes to be seen quic
Everyone arriving at a hospital’s emergency room (ER) wishes to be seen quic
游客
2023-08-21
37
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] Dr. Ifergane has made a suggestion that________.
选项
A、clinical staff should record identities of the companies
B、companies should be encouraged to provide basic care
C、changes should be made to operations of medical institutions
D、clinics should ensure stroke patients have appropriate company
答案
D
解析
事实细节题。定位句指出,伊孚格恩医生建议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”,再结合前文他对中风病人陪同人员重要性的强调可知,他建议一定要确保中风病人得到适当的陪同,故答案为D)。A)“医务人员应该记录陪同人员的身份”,第五段第一句提到伊孚格恩医生的研究没有记录陪同人员的身份,也没有提到他建议记录其身份,故可排除;B)“应该鼓励陪同人员提供基本的护理”,文章虽提到陪同人员参与了基本的护理,但并没有说伊孚格恩医生建议这样做,故排除;C)“应该改变医疗机构的运作模式”,第六段提到伊孚格恩医生改变自己所在医院的部分运作方式,但由于他承认自己的研究可能存在地域局限性,故并未建议所有医疗机构都这样做,故可排除.
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