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In almost every TV show about an emergency room you probably see an ambulance screeching to a stop with its lights flashing , a gurney being rushed through the corridors and emergency staff racing against time to save a person's kife with only seconds to spare. This scene is possible and occasionally happends , but most of he cases that a typical emergency department sees aren't so dramatic. Let's look at how an ordinary case goes through the normal flow of an emergency room. When patients arrive at the Emergency Department , they go to triage first. In triage , each patient's condition is prioritized , typically by a nurse. She puts the patient into one of three general categories. The categories are: ・Immediately life-threatening ・Urgent , but not immediately life-threatening ・Less urgent Categorizing patients is necessary so that someone with a life-threatening condition doesn't have to wait to get care. The triage nurse records the vital sugns (temperature , pulse , respiratory rate , and blood pressure). She also takes a brief history of the patient's current medical complaints , past medical problems , medications and allergies. From this information , the nurse can decide which triage category is suitable. Registration is the next stage in the ER process. A TV show rarely lets us see this part. It's not exciting , but it is very important. This is where the hospital collexts the patient's personal details and insurance information. Registration is needed to create a clear medical record so that the patient's medical history , lab tests , X-rays , etc. , will all be put on his or her medical chart. That chart can then be checked by doctors , nurses and other medical staff when necessary. Also , this information will be important for creating the hospital bill. If the patient has a life-threatening situation or arrives by ambulance , the registration stage might be done later at the beside. Finally , the patient comes to the exam room. The nurse has the person put on a patient gown so that an examination can be done properly. She might also collect a urine specimen at this time. After the nurse's tasks are fished , the emergency-medicine physician meets with the patient. The physician asks questions t create a more detailed medical history about the present illness , past medical problems , family history , social history , and also takes a close look at all the patient's physical systems. The physician then formulates a list of possible causes of the patient's symptoms. This is called a differential diagnosis. The most likely diagnosis is then determined by th patient's symptoms and the physical examination. If this stage is not enough to create a clear diagnosis , then further diagnostic testa are done.

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ER(緊急医療室)についてのTV番組ではほとんどの場合、救急車が緊急ランプを点滅させながら飛び込んできて、ストレッチャーが廊下を駆け抜け、秒単位で生命の危機にある患者の生命を救おうと救急医療スタッフたちが急ぎ集まってくるというような状況を映す。このような場面は、事実時折発生することではあるものの、実際のERの現場で起こっていることは、このようなTV番組の場面のようなことばかりではない。ERでのごく一般的なケースでの処置の流れを見てみよう。 患者がERに搬送されると、先ず最初にトリアージ判定が行われる。患者は搬送されてきたときの状態によって看護師により優先付けされる。看護師は3つのカテゴリーのどれかに患者を分けるのだが、ここでのカテゴリーは、 ・生命に危機に関わり緊急対応が必要な状態 ・緊急対応は必要であるが、生命の危機にはならない状態 ・緊急対応が不要なもの となる。 患者のカテゴリー分けは、瀕死の状態にある患者が処置を待たされてはならないという理由のためである。トリアージを行う看護師は、体温、心拍数、呼吸数、血圧などの必要データをまず記録する。同時に、適切なトリアージでのカテゴリー分けを行うために、患者の現在の疾患記録、過去の病歴、処方記録、アレルギー記録等を取得する。これらの情報から看護師は、適切なトリアージカテゴリーを選択するのである。 ERで次に行われることは受付登録である。TV番組ではこの部分を往々にして省いている。あまり見栄えのしないことだからであるがとても重要なことである。病院側では、患者の個人の詳細な個人データ、保険情報などを取得する。この受付登録により患者のこれまでの健康情報、様々な検査結果、X線撮影等々の医療記録が作られ、以降様々な医療統計情報などもこれに加えていくのである。医療統計情報は、医師、看護師その他の医療スタッフにより必要に応じて活用される。さらに、この情報に従って病院からの請求書も作成されるのだ。 患者が瀕死の状態にある場合や救急車で搬送されてきたような場合、登録受付は後から行われることになる。 最後に、患者は検査室へ移される。看護師は、患者を患者用ガウンに着替えさせ適切な検査が受けられるようにする。検尿採取もこの段階で行われる。これら看護師の仕事を経て、患者は緊急医療医師による処置を受ける。医師は、現在の疾病状況、過去の病歴、家族や親戚の病歴など、さらに詳しい医療関係の記録を作るために問診し、同時に、患者の現在の状態について詳しく診察するのである。医師は、患者の症状について原因を特定してゆく。これは鑑別診断と呼ばれる。ほとんどの場合、診断は患者の症状や診察から行われる。もしもこの段階で十分な診断結果を行うことが出来ない場合は、さらなる検査が行われることになる。

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    In almost every TV show about an emergency room you probably see an ambulance screeching to a stop with its lights flashing , a gurney being rushed through the corridors and emergency staff racing against time to save a person's kife with only seconds to spare. This scene is possible and occasionally happends , but most of he cases that a typical emergency department sees aren't so dramatic. Let's look at how an ordinary case goes through the normal flow of an emergency room. When patients arrive at the Emergency Department , they go to triage first. In triage , each patient's condition is prioritized , typically by a nurse. She puts the patient into one of three general categories. The categories are: ・Immediately life-threatening ・Urgent , but not immediately life-threatening ・Less urgent Categorizing patients is necessary so that someone with a life-threatening condition doesn't have to wait to get care. The triage nurse records the vital sugns (temperature , pulse , respiratory rate , and blood pressure). She also takes a brief history of the patient's current medical complaints , past medical problems , medications and allergies. From this information , the nurse can decide which triage category is suitable. Registration is the next stage in the ER process. A TV show rarely lets us see this part. It's not exciting , but it is very important. This is where the hospital collexts the patient's personal details and insurance information. Registration is needed to create a clear medical record so that the patient's medical history , lab tests , X-rays , etc. , will all be put on his or her medical chart. That chart can then be checked by doctors , nurses and other medical staff when necessary. Also , this information will be important for creating the hospital bill. If the patient has a life-threatening situation or arrives by ambulance , the registration stage might be done later at the beside. Finally , the patient comes to the exam room. The nurse has the person put on a patient gown so that an examination can be done properly. She might also collect a urine specimen at this time. After the nurse's tasks are fished , the emergency-medicine physician meets with the patient. The physician asks questions t create a more detailed medical history about the present illness , past medical problems , family history , social history , and also takes a close look at all the patient's physical systems. The physician then formulates a list of possible causes of the patient's symptoms. This is called a differential diagnosis. The most likely diagnosis is then determined by th patient's symptoms and the physical examination. If this stage is not enough to create a clear diagnosis , then further diagnostic testa are done.

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