NATIONAL UNIVERSITY OF CHIMBORAZO

HEALTH SCIENCES FACULTY

MEDICAL CAREER

Topic:
WORKBOOK UNIT 5 – READING AND GRAMMAR

SUBJECT: MEDICAL ENGLISH

Made by:

Chamba Lissette
Castillo Delfa
Hidalgo Nicole
Tixi Grace
Reyes Angie
Riera Valeria

Parallel: “8A”
Period: May - September 2021
Date: Thursday 29 of June 2021
Riobamba- Ecuador
2021

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SKIMMING AND SCANNING ACTIVITIES

Read the passage carefully. Then answer these questions:

1. What is the general purpose of this article?

Emergency rooms are one of the most important parts of a hospital. Hospitals have many
different departments, one of them being the emergency room. The emergency room is used for
the purpose of treating patients that arrive to the hospital in critical condition or in urgent need
of medical attention. Many times, patients arrive to the emergency room through an ambulance
following an accident. There are countless reasons as to why an individual may need to go to the
hospital with emergency room. From an accident to unexpected injuries, emergency rooms serve
a vital role for hospitals. Every hospital has an emergency room in order to treat patients and
ensure the safety of their community. Hospitals do not turn down anyone who is seeking
emergency room services.

2. What makes Emergency Rooms or Departments so special?

Hospital emergency departments play a growing role in the U.S. health care system, accounting
for a rising proportion of hospital admissions and serving increasingly as an advanced diagnostic
center for primary care physicians.

The emergency department is the most stressful and critical area of a hospital to work in. Despite
this, the area creates the most significant impact on saving lives and hospital success. Getting
management right requires the right resources, processes, and consistency. Using a combination
of technology, strategy, and improvement, hospitals can improve satisfaction, decrease leaving
rates, and improve profitability.

3. What is triage?

The process of sorting people based on their need for immediate medical treatment as compared
to their chance of benefiting from such care. Triage is done in emergency rooms, disasters, and
wars, when limited medical resources must be allocated to maximize the number of survivors.

When you arrive at the Emergency Department, your first stop is triage. This is the place where
each patient's condition is prioritized, typically by a nurse, into three general categories. The
categories are:

• Immediately life threatening

• Urgent, but not immediately life threatening
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• Less urgent
This categorization is necessary so that someone with a life-threatening condition is not kept
waiting because they arrive a few minutes later than someone with a more routine problem. The
triage nurse records your vital signs (temperature, pulse, respiratory rate and blood pressure). She
also gets a brief history of your current medical complaints, past medical problems, medications
and allergies so that she can determine the appropriate triage category

4. How is a medical record developed in the ER?

Medical Record greatly improve hospital and clinic efficiency and provide more timely service
for patients. Furthermore, the Medical Record system gives the health-care provider instant
access to other clinicians' evaluations, as well as all diagnostic tests. From an academic point of
view, the Medical Record is an excellent tool for big data research through the huge amount of
clinical information that is stored in the database. Overall, the Medical Record is efficient, secure,
and readily accessible to staff and to patients.

Emergency physicians should play a lead role in the selection of all medical record
documentation aspects for the health care system.

An effective ED medical record assists with:

• Documentation of clinically relevant aspects of the patient encounter including

laboratory, radiologic, and other testing results
• Efficiency in the patient encounter continuum
• Legibility
• Communication with other providers
• Coordination of follow-up care
• Identification of who entered data into the record
• Discharge instruction communication
• Ease of data collection and data reporting
When implemented successfully, a high-quality ED medical record should accurately capture the
process of evaluation, management, medical decision making and disposition related to a patient
encounter. It should facilitate quality assessment, quality improvement, meaningful use, and risk
management activities and not interfere with physician productivity. The ED medical record
should be promptly available after the patient encounter.

5. How many separate specialized areas are there in some ERs?

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A full fledged emergency department has the following areas of care:

• EMS (Ambulance) Coordination Center

• Triage
• Resuscitation Area
• Major Trauma / Medical Areas
• Consultation Rooms
• Patient Waiting Area
• Minor Procedure Rooms
• Major Operating Room
• Observation Units
• Injection Room
• 24 hour Pharmacy
• Prayer Room
• Library and Reading Rooms
• Doctors Restroom
• Cafeteria
• 24 hour internet access to online journals and medical information
EMS (Ambulance) Coordination Center

The Emergency Medical Services (Ambulance services) of the hospital is the community's main
access to the hospital in an emergency and is also the most visible part of the emergency
department to the public eye.

The EMS consists of:

• Fleet of well equipped ambulances
• Emergency medical technicians (EMTs)
• Ambulance drivers
• EMS Administrator
• Biomedical technicians
• Radio and telephone operators manning the central call & coordination center
• And the emergency department itself
The EMS administrator must be a qualified emergency medicine physician himself or atleast be
well trained in EM. Most often the the head of the EM department will be the EMS administrator.
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EMS systems administered by non medical personnel are known to be highly inefficient.

Resuscitation Area

This area is dedicated to the immediate care of patients and victims in cardiac arrest, airway,
breathing and circulation compromise. The 'Resus' area consists of two or more resuscitation
beds (sometimes upto 12) with all resuscitative equipment (monitors, defibrillators, airway,
intubation & surgical equipment) available at an arm's distance including pediatric resuscitation
kits.

A patient maybe shifted to the Resus area from outside or from an area within the hospital or
emergency department itself.

All priority I patients are managed here.

Major Trauma / Medical Area

All priority II patients are managed here. This area will have dedicated EM physicians (along
with EM nursing staff) looking after the patients directed here. Majority of the ED admitted
patients are assessed and managed here.

Consultation Rooms

Since majority of the patients coming to an ED do not have an emergent problem, they are
assessed and treated on outpatient basis in the consultation rooms.

Minor Procedure Room

Procedures like washing, dressing & suturing of wounds, reduction & splinting of fractures &
dislocations, and other minor surgical procedures are done here.

Major Operating Rooms

Any major emergency surgery can be conducted here by the operating team.

Emergency physicians are usually not involved in any major surgery, even though they maybe
qualified in that field.

Observation Units

Patients who need to be admitted and observed for less than 24 hours are placed here. Such
patients are those with non cardiac chest pain, acute asthma, vague abdominal pain, minor head
injury, acute depression, febrile convulsions, dehydration, etc. Dedicated staff from emergency

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medicine look after these patients.

6. Why is this useful for medical attention?

Medical care has several important functions other than restoring or maintaining health. These
other functions are assessment and certification of health status, prognostication, segregation of
the ill to limit communication of illness, and helping to cope with the problems of illness--the
caring function. Medical care serving these "paracurative" functions may legitimately be given
indepedently, without associated curing or preventive intent of the provider of care. Although
such services do not result in benefits to health, such as extension of life or reduction of disability,
they do have other valued outcomes, outcomes not measurable as a gain in personal health status.
For example, caring activities may result in satisfaction, comfort, or desirable affective states,
even while the patient's health status deteriorates during an incurable illness.

7. What is an emergency nurse’s job?

The emergency nurse comes to the team in a number of ways. One way is completing a four-year
degree in college to obtain a BSN. (bachelor of science in nursing). Alternately, a nurse may
complete a three-year diploma program (usually at a hospital) or a two-year associates degree
program (usually at a community college). After completing any of these academic endeavors,
the nursing graduate is eligible to take a licensing exam. After passing this exam, the nursing
graduate becomes an RN (registered nurse) and can practice nursing. Many emergency nurses
take an additional exam to become a CEN (Certified Emergency Nurse

8. What is an emergency-medicine physician’s job?

Many emergency departments utilize physician assistants (PA). PAs work under the supervision
of an emergency physician. They can examine, diagnose and treat patients (usually the less
complicated ones) and review their findings with the physician. In most states, they can prescribe
medications. Typically, a PA has at least two years of college (most have a four-year degree) and
some health-care experience before completing a two-year program to become a physician
assistant. An exam is required to become licensed.

9. How are different test tubes recognized in the ER?

The patient's blood is put into different colored tubes, each with its own additive

depending on the test being performed:

• A purple-top tube is used for a complete blood count (CBC). A CBC measures:

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1) The adequacy of your red blood cells, to see if you are anemic.

2) The number and type of white blood cells (WBCs), to determine the presence of infection.

3) A platelet count (platelets are a blood component necessary for clotting)

• A red-top tube is used to test the serum (the liquid or non-cellular half of your blood).

• A blue-top tube is used to test your blood's clotting.

10. What is the patient’s consent?

Informed consent consists of getting patients to sign the written form in which they authorize the

performance of an intervention. Informed consent is basically a verbal process during care.

11. What is a physician assistant?

Many emergency departments utilize physician assistants (PA). PAs work under the supervision
of an emergency physician. They can examine, diagnose and treat patients (usually the less
complicated ones) and review their findings with the physician. In most states, they can prescribe
medications. Typically, a PA has at least two years of college (most have a four-year degree) and
some health-care experience before completing a two-year program to become a physician
assistant. An exam is required to become licensed

12. What is an emergency department technician’s job?

Emergency Department Technician perform a variety of tasks depending on the institution and
state laws. Some of these tasks may include taking your vital signs, drawing your blood, starting
your IV, performing EKGs, transporting you to and from various tests, and providing aid and
comfort to family and friends.

13. What equipment is necessary in the ER?

Emergency Departments are stocked with a huge array of equips :

• Stethoscope

• Cardiac monitor

• Suture tray

• Orthopedic equipment

• Crash cart
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• Transport Incubators.

• Portable Anesthesia Machines.

• Vital Signs Monitors Port

• Central vein catheters

• Endotracheal intubation equipment

14. What are lethal arrhythmias?

Lethal arrhythmias is a sudden cardiac rhythm disorder that compromises life, they are classified
as reversible and irreversible, the most frequent symptoms to be found are papitations and
tachycardias

15. What drug is used in ventricular fibrillation and in ventricular tachycardia but not in
PEA?

Lidocaine: used in ventricular fibrillation and ventricular tachycardia and not in PEA

16. After medical attention in the ER, where is the patient sent and why?

Depending on a patient's specific medical condition, physicians will either admit the patient to
the hospital, discharge the patient, or transfer the patient to a more appropriate medical facility.
If you are discharged, you will receive discharge instructions (either written specifically for you
or pre-printed) that explain your medications and other treatments. If medications are prescribed,
you may receive a beginning dose if there are no pharmacies open in your area at that particular
time. You will also be referred for follow-up care should your condition continue or worsen.You
may need to be transferred if your condition is better treated at another institution. You may have
to sign a consent form if your condition or mental state allows.

GRAMMAR EXERCISES

INSTRUCTIONS

Read the previous passage carefully.

Find structures that may be changed to commands (imperative); find active voices structures and
change them to passive voices or vice verse (appendix 1).

GRAMMAR EXERCISES
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A. Read the previous passage carefully.

B. Find structures that may be changed to commands (imperative); find active voices
structures and change them to passive voices or vice verse

IMPERATIVE

ORIGINAL STRUCTURE STRUCTURES CHANGED TO

COMMANDS

He tells you to go to your local hospital's Go to your local hospital's emergency

emergency department department

You call your regular doctor Call your regular doctor

Your first stop is triage. First stop is triage

You need to register. Register

You may also provide them with your Provide them with your insurance
insurance information, Medicare, Medicaid information, Medicare, Medicaid or HMO
or HMO card. card.

At this point, the emergency physician may Do not eat or drink anything.
request that you not eat or drink anything.

You then sign a consent form to document Sign the consent form to document this and
this and permit her to operate on you permit her to operate on you

You may have to sign a consent form if your Sign a consent form if your condition or
condition or mental state allows mental state allows

ACTIVE TO PASSIVE VOICE

ACTIVE VOICE PASSIVE VOICE

Millions of Americans visit an emergency An emergency room is visited by millions

room each year of Americans each year

Millions more have seen the hit TV show The hit TV show "ER" have been seen by
"ER." millions more

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The triage nurse records your vital signs Your vital signs are recorded by the triage
nurses

She also gets a brief history of your current A brief history of your current medical
medical complaints, past medical problems, complaints, past medical problems,
medications and allergies medications and allergies is gotten by her.

She can determine the appropriate triage The appropriate triage category is
category. determined by her.

Here they obtain your vital statistics. Here your vital statistics are obtained by
them.

Once the nurse has finished her tasks Once task has been finished by the nurse

He gets a more detailed medical history about A more detailed medical history about your
your present illness, past medical problems, present illness, past medical problems,
family history, social history, and a complete family history, social history, and a
review of all your body systems. complete review of all your body systems is
gotten by him.

He then formulates a list of possible causes of A list of possible causes of your symptoms
your symptoms is formulated by him

A CBC measures the adequacy of your red The adequacy of your red blood cells, the
blood cells, the number and type of white number and type of white blood cells, a
blood cells, a platelet count platelet count is measured by a CBC

PASSIVE TO ACTIVE VOICE

PASSIVE VOICE ACTIVE VOICE

This is the place where each patient's This is the place where typically, a nurse
condition is prioritized, typically by a nurse, prioritize each patient's condition into three
into three general categories. general categories.

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this step may be completed later at the At the bedside may complete this step.
bedside.

You are seen by an emergency-department An emergency-department nurse sees you,

nurse who obtains more detailed information who obtains more detailed information
about you. about you.

Some emergency departments have been Into separate areas have subdivided some
subdivided into separate areas emergency departments

The most likely diagnosis is then determined The patient's symptoms and physical
by the patient's symptoms and physical examination determinates the most likely
examination diagnosis

A purple-top tube is used for a complete For a complete blood count use a purple-top
blood count tube.

The patient's blood is put into different Into different colored tubes put the patient's
colored tubes. blood

A red-top tube is used to test the serum To test the serum, use a red-top tube

A blue-top tube is used to test your blood's To test your blood's clotting use a blue-top
clotting tube

bacterial infections are commonly associated Aappendicitis associates commony with

with appendicitis. bacterial infections

• ACTIVE-PASSIVE VOICE

1. Active: Millions of Americans visit an Passive: Emergency room is visited by

emergency room each year. millions of Americans each year

2. Active: The triage nurse records your vital Passive: The vital signs (temperature, pulse,

signs (temperature, pulse, respiratory rate respiratory rate and blood pressure) are

and blood pressure). recorded by the triage nurse

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3. Active: She also gets a brief history of your Passive: Your brief history, current medical

current medical complaints, past medical complaints, paste medical problems,

problems, medications and allergies medications and allergies are gotten by nurse

4. Active: He gets a more detailed medical Passive: The medical history about your

history about your present illness, past present illness, past medical problems,

medical problems, family history, social family history, social history, and a complete

history, and a complete review of all your review of all your body systems are gotten

body systems. by doctor

5. Active: He formulates a list of possible Passive: A list of possible causes of your

causes of your symptoms. symptoms is formulated by doctor

Active: He makes a determination of the Passive: The determination of the most

6.
most likely diagnosis from his differential

likely diagnosis from his differential diagnosis is made by doctor

diagnosis

Active: She examines your symptoms: Your symptoms: Pain and tenderness in the
7.
pain and tenderness in the right, lower right, lower abdomen, vomiting, low-grade

abdomen, vomiting, low-grade fever and fever and elevated WBC count are examined

elevated WBC count. by nurse

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PASSIVE-ACTIVE VOICE

1. Passive: This is the place where each Active: This is the place where a nurse

patient's condition is prioritized, typically prioritizes each patient's condition

by a nurse into three general categories into three general categories.

2. Passive: The most likely diagnosis is then Active: The patient's symptoms and

determined by the patient's symptoms and physical examination determine the

physical examination. diagnosis.

3. Passive: You may be examined by an intern Active: An intern or resident will

or a resident examine you.

4. Passive: Atropine used in asystole, Active: In asystole, bradycardia and

bradycardia and sometime PEA sometimes PEA use Atropine

5. Passive: Lidocaine used in asystole, Active: In ventricular fibrillation and

bradycardia and sometimes PEA ventricular tachycardia use Lidocaine.

6. Passive: There a many other pieces of Active: The chest-tube tray, which holds

equipment that are used in a emergencies the equipment needed to put in a chest

department, including the chest-tube tray, tube (tube placed between the ribs and

which holds, the equipment needed to put in the lung to re-expand a collapsed lung) is

a chest tube (a tube placed between the ribs used in an emergency department.

and the lung to re-expand a collapsed lung)

7. Passive: Specialized equipment used most Active: For nosebleeds and to remove

commonly for nosebleeds and to remove foreing bodies from the ear, nose, throat,

foreing bodies from the ear, nose or throat. use specialized equipment.

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BIBLIOGRAPHY

• De la Calle, L. (2011-2012). MedicalEnglish. En L. De la Calle, English for Specific

Purposes for Medical Students (págs. 28-29). Riobamba

• De Koning, G. H. J., Veldkamp, A., & Fresco, L. O. (2018). Land use in Ecuador: a
statistical analysis at different aggregation levels. Agriculture, ecosystems &
environment, 70(2-3), 231-247.

• Kelsh, M. A., Morimoto, L., & Lau, E. (2009). Cancer mortality and oil production in the
Amazon Region of Ecuador, 1990–2005. International archives of occupational and
environmental health, 82(3), 381-395.

• Hentschel, J., Lanjouw, J. O., Lanjouw, P., & Poggi, J. (2019). Combining census and
survey data to trace the spatial dimensions of poverty: A case study of Ecuador. The
World Bank Economic Review, 14(1), 147-165.

• Mite-León, M., & Barzola-Monteses, J. (2018). Statistical model for the forecast of
hydropower production in Ecuador. Int. J. Renew. Energy Res, 10(2), 1130-1137.

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