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Файл:Введение в биомедицинскую инженерию. Учебное пособие
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5. Dialysis e) It is a room within a hospital where
surgical operations are carried out
6. Cardiopulmonary
resuscitation
f) It is a hospital or primary care
department that provides initial
treatment to patients with a broad
spectrum of illnesses and injuries, some
of which may be life-threatening and
require immediate attention
7. Defibrillation g) It is a medical device used to provide
nutrition to patients who cannot obtain
nutrition by swallowing
8. Artificial pacemaker h) It is a specialized department used in
many countries' hospitals that provides
intensive care medicine
9. Emergency
Department
i) It allows the patient's urine to drain
freely from the bladder for collection, or
to inject liquids used for treatment or
diagnosis of bladder conditions
10. Intensive Care Unit j) It is a medical device which uses
electrical impulses, delivered by
electrodes contacting the heart muscles,
to regulate the beating of the heart
11. Operating Rooms k) It is a method to mechanically assist
or replace spontaneous breathing. This
may involve a machine called a
ventilator
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5. Read the text about defibrillation and mark the following
statements as true (T) or false (F). Prove your point of view.
1. A defibrillator is used to restore a normal heart rhythm
when the heartbeat is dangerously slow due to ventricular
tachycardia or ventricular fibrillation.
T/F
2. Manual defibrillators can be operated by lay people with
T/F
only basic training in an emergency.
3. Cardioversion is usually performed under emergency
T/F
circumstances.
4. Automatic external defibrillators (AEDs) are designed to
T/F
read the heart rhythm patterns of the patient and signal if
defibrillation is necessary.
5. An automatic external defibrillator (AED) is a device
T/F
that is implanted in a patient’s chest.
6. Some information such as number and types of
T/F
treatments given, success of each treatment, programmed
settings, etc. is stored in the ICD memory.
7. Pacemakers can deliver the high energy electrical shock
T/F
required for defibrillation.
8. An ICD is similar in many respects to a pacemaker. T/F
Defibrillator
About defibrillators
A defibrillator is used to restore a normal heart rhythm by
delivering an electrical shock to the heart when the heartbeat is
dangerously fast due to ventricular tachycardia or ventricular
fibrillation. Defibrillation consists of delivering a therapeutic dose of
electrical energy to the affected heart with a device called a defibrillator.
This depolarizes a critical mass of the heart muscle, terminates the
arrhythmia, and allows normal sinus rhythm to be reestablished by the
body's natural pacemaker, in the sinoatrial node of the heart. Some
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defibrillators are external (e.g., defibrillator paddles in an emergency
room), while some may be implanted in the patient’s chest (e.g., an
implantable defibrillator).
There are three basic types of defibrillators:
Manual defibrillators, or defibrillator paddles, which are used by
healthcare professionals in a clinical setting, such as a hospital.
Automatic external defibrillators (AEDs), which can be operated by lay
people with only basic training in an emergency. Implantable
cardioverter defibrillators (ICDs), which are implanted in the patient’s
chest to monitor for and, if necessary, correct an abnormal heart rhythm
(arrhythmia). These can sometimes be combined with a pacemaker in
the event of complex arrhythmias.
Manual defibrillators
A manual defibrillator, or defibrillator paddles, are used by
physicians to deliver high intensity electrical charges to patients in
ventricular fibrillation or cardiac arrest, restoring normal heart rhythm
and restarting the flow of blood. Manual defibrillators are also used in
non-emergency situations in a procedure called elective cardioversion.
In this procedure, lower levels of electricity are used to restore normal
heart patterns in patients with non-emergency arrhythmias (e.g., atrial
fibrillation). Cardioversion is the term doctors use to describe the
delivery of a shock that is carefully timed to the waveform of the
heartbeat, usually under controlled circumstances. This contrasts with
defibrillation, which can occur at any point in the cardiac cycle and is
usually performed under emergency circumstances.
Automatic external defibrillators (AEDs)
Automatic external defibrillators (AEDs) are external devices that
can be used by minimally trained laypersons in emergency situations.
They are designed to read the heart rhythm patterns of the patient, signal
if defibrillation is necessary, then deliver the appropriate electrical
shock. This significantly reduces the amount of training needed for their
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effective use and allows people with minimal training to perform
defibrillation in emergency situations with little risk of additional injury
to the patient. The AED reads the patient’s heart rhythms to determine if
a «treatable rhythm» exists. At the moment of collapse, most rhythms
are treatable – but this becomes less likely as more time passes. If the
patient does not have a «treatable rhythm,» the AED will not discharge
the electrical shock. Automatic defibrillation attempts should begin as
quickly as possible after the onset of cardiac arrest. Indeed, AEDs have
become more common in ambulances and fire rescue vehicles, as well
as public places, such as stadiums, airports, shopping malls, health clubs
and golf courses.
Implantable cardioverter defibrillators (ICDs)
An implantable cardioverter defibrillator (ICD) is a device that is
implanted in a patient’s chest and can be programmed to monitor
for and, if necessary, correct an abnormal heart rhythm (arrhythmia).
If the heartbeat gets too fast (ventricular tachycardia) the ICD will
stimulate the heart to restore a normal rhythm (anti-tachycardia pacing).
In potentially fatal cases where the heart no longer beats but merely
«quivers» or fibrillates (ventricular fibrillation) the ICD can deliver an
electric shock (defibrillation) to «reset» the heartbeat. The ICD has an
electronic memory that a physician can retrieve during follow up visits.
The memory stores information such as: number and types of treatments
given, success of each treatment, status of the heart during the most
recent episodes, state of the ICD’s batteries and programmed settings.
An ICD is similar in many respects to a pacemaker, which is another
type of device that corrects an abnormal heart rhythm. However,
pacemakers are usually chosen to correct a heart rhythm that is too slow
(bradycardia), whereas ICDs are commonly used to detect and correct a
heart rhythm that is too fast (ventricular tachycardia). Pacemakers
cannot deliver the high energy electrical shock required for
defibrillation. However, ICDs can be programmed to function as a
pacemaker, and combination devices are available to detect and treat
multiple heart rhythm problems in the same patient.
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6. Answer the following questions according to the text given
above:
1. In what cases are defibrillators used?
2. What types of defibrillators are there and what are their main
differences?
3. When else is a manual defibrillator used besides cardiac arrest?
4. What is a pacemaker? What are the main differences of a
pacemaker in comparison to a defibrillator?
7. Read the text about artificial pacemakers. Some words and
word combinations have been removed from the article. Choose
from the words the one which fits each gap. Translate the text.
http://www.medterms.com/script/main/art.asp?articlekey=7475
Artificial pacemaker
Artificial pacemaker is a device that uses 1 ______ to regulate the
heart 2 ______ or to reproduce that rhythm. An 3 ______ pacemaker
is one in which the electrodes into the heart, the electronic circuitry
and the power supply are implanted (internally) within the body.
The battery-powered device emits impulses that trigger heart-muscle
4 ______ at a rate that is preset or is determined by demand. Although
there are different types of pacemakers, all are designed to treat
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bradycardia, a 5 ______ that is too slow). Pacemakers may function
continuously and stimulate the heart at a fixed rate or at an increased
rate during exercise. A pacemaker can also be programmed to detect too
long a pause between 6 ______ and then stimulate the heart. The device
today may be as small as one inch (2.5 cm) in diameter and weigh as
little as 0.5 oz. (14 gm). It is implanted, using 7 ______ anesthetic,
under a flap of skin in the chest or 8 ______. One or more electrodes are
threaded through a vein from the device to the right side of the heart.
Modern versions can monitor the heart and activate only when
necessary; they are also less sensitive to 9 ______ sources of 10 ______
than earlier
а) – internal; b) – heart rate; c) – abdomen; d) – electrical
impulses; e) – outside; f) – heartbeats; g) – contraction; h) –
electromagnetic radiation; i) – local; j) – rhythm
Video
5. Skim the text about anaesthesia. Find an appropriate
heading for each section (1 – 8).
A. Is anaesthetic safe?
B. What is it like after the operation?
C. What is an anaesthetic?
D. How do people feel when they wake up?
E. What does the anaesthetist do?
F. How and where does the patient wake up?
G. Who is the anaesthetist?
H. Where and how does the patient go to sleep?
Written by Dr Gordon FN Smith, consultant anaesthetist
(1) An anaesthetic is used to temporarily reduce or take away
sensation, usually so that otherwise painful procedures or surgery can be
performed. Throughout the procedure, different types of medicines are
added or removed to relieve the pain and maintain the right level of
unconsciousness.
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(2) A consultant anaesthetist is a specialist doctor who, after
qualifying in medicine, spends about six years training in the specialty
of anaesthesia. Anaesthetists see patients while being trained, but a
consultant supervises them during all procedures.
(3) The anaesthetist takes a careful look at the history of the
patient's general health and uses this information to decide how best to
offer care. During the operation, the anaesthetist stays with the patient at
all times to make sure they are comfortable and safe. This includes
controlling pain, replacing body fluids and measuring and controlling all
the vital functions of the body such as the heart beat, blood pressure and
brain and kidney function.
(4) Anaesthetics are almost entirely safe, but every operation
carries a very slight risk. A recent survey in the UK showed that death
due to anaesthesia occurred in about five in every million anaesthetics
given.
(5) Patients are given a small injection in the hand to make them go
to sleep. This usually takes place in a room next to the operating theatre.
Some patients – especially children – have an anaesthetic cream rubbed
onto the skin beforehand so that they won't even feel the injection.
Others are given a mixture of gases to put them to sleep very quickly.
(6) After the operation, the anaesthetist stops giving the medicines
that were keeping the patient unconscious and he or she is taken to a
recovery room where there are specially trained staff. The longer the
operation, the longer it takes to wake up. When the patient has woken up
completely, they are taken back to the ward. Occasionally, people
recover consciousness in the operating theatre once their operation is
over. This is quite safe.
(7) Patients often feel cold and slightly confused. They may have
pain or feel a bit sick, but these symptoms can be treated when the
anaesthetist visits the patients to check that they are alright.
(8) How people feel after the operation depends on the kind of
surgery they have had. They will be encouraged to get out of bed as
soon as possible and will usually be allowed to eat and drink in the first
few hours after a minor operation.
http://www.netdoctor.co.uk/health_advice/facts/anaesthetic.htm
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6. Guess what definitions in column B corresponds to the term
in column A. Check that your ideas make sense in the context of the
text.
1) anaesthetic
a) the state of being without normal sensory
awareness; insensibility
2) sensation
b) any manipulation of the body or one of its
organs or parts to repair damage, arrest the
progress of a disease, remove foreign matter,
etc
3) unconsciousness c) essential to maintain life
4) operation d) causing or characterized by anaesthesia
5) safe
e) any sensation or change in bodily function
experienced by a patient that is associated with
a particular disease
6) vital f) a gaseous anaesthetic, such as nitrous oxide
7) gases g) affording security or protection from harm
8) symptom h) the power of perceiving through the senses
7. Read the text about anaesthetic agents. Some words and
word combinations have been removed from the article. Choose
from the words the one which fits each gap. Translate the text.
Anaesthetic agents
Volatile agents are specially formulated organic liquids that
evaporate readily into 1 ______, and are given by inhalation for
induction and/or maintenance of 2 ______ anesthesia. Nitrous oxide and
xenon are 3 ______ at room temperature rather than liquids, so they are
not considered volatile agents. The ideal anesthetic vapor or gas should
be non-flammable, 4 ______, lipid-soluble, and should possess low
blood gas solubility, have no end organ (heart, liver, kidney) toxicity or
side-effects, should not be metabolized, and should be 5 ______ when
inhaled by patients.
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Certain pharmacokinetic 6 ______ of volatile agents have become
another point of comparison. Most 7 _______ of those properties is
known as the blood: gas partition coefficient. This concept refers to the
relative solubility of a given agent in 8 ______. Those agents with a
lower blood solubility (i.e., a lower blood–gas partition coefficient;
e.g., desflurane) give the anesthesia provider greater rapidity in titrating
the depth of anesthesia, and permit a more rapid 9 ______ from the
anesthetic state upon discontinuing their administration. In fact, newer
10 ______ agents (e.g., sevoflurane, desflurane) have been popular due
to their versatility for a faster emergence from anesthesia, thanks to their
lower blood–gas partition coefficient.
а) – important; b) – non-explosive; c) – blood; d) – vapors;
e) – volatile; f) – gases; g) – non-irritant; h) – general; i) – properties;
j) – emergence.
8. Now scan the text about the anaesthetic machine and in
each passage find English equivalents of the following Russian
terms:
Anaesthetic machine
http://www.ganfyd.org/index.php?title=Anaesthetic_machine
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(1) Anaesthetic machine
The anaesthetic machine is used by anaesthetists to support the
administration of anaesthesia. The most common type of anaesthetic
machine in use in the developed world is the continuous-flow
anaesthetic machine, which is designed to provide an accurate and
continuous supply of medical gases (such as oxygen and nitrous oxide),
mixed with an accurate concentration of anaesthetic vapour (such as
isoflurane), and deliver this to the patient at a safe pressure and flow.
Modern machines incorporate a ventilator, suction unit, and patientmonitoring devices.
1) применение, введение
анестезии
2) наркозный аппарат
постоянного потока
3) медицинский газ
4) испарение наркозного
средства
5) аспиратор
6) устройства контроля за
пациентом
(2) Components of a typical machine
A modern machine typically includes the following components:
− connections to piped hospital oxygen, medical air, and nitrous
oxide. Pipeline pressure from the hospital medical gas system (wall
outlet) should be around 400 kPa (60 psi; 4 atmospheres).
− reserve gas cylinders of oxygen, air, and nitrous oxide attached
via a specific yoke with a Bodok seal. Many newer machines only have
oxygen reserve cylinders. The regulators for the cylinders are set at
300 kPa (45 psi; 3 atmospheres). If the cylinders are left on and the
machine is plugged into the wall outlet, gas from the wall supply will be
used preferentially, since it is at a higher pressure. In situations where
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