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When the tricky diagnosis of appendicitis is considered, blood tests and a urinalysis are required. 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: 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. The tests in your case indicate that you have an elevated WBC count. This is a sign of a bacterial infection, and bacterial infections are commonly associated with appendicitis. At this point, the emergency physician may request that you not eat or drink anything. The reason is that appendicitis is treated by surgery, and an empty stomach is desirable to prevent some complications of anesthesia. When the emergency physician has all the information he can obtain, he makes a determination of the most likely diagnosis from his differential diagnosis. Alternately, he may decide that he does not have enough information to make a decision and may require more tests. At this point, he speaks to a general surgeon -- the appropriate consultant in this case. The surgeon comes to see you and performs a thorough history, physical exam, and review of your lab data. She examines your symptoms: pain and tenderness in the right, lower abdomen, vomiting, low-grade fever and elevated WBC count. These symptoms all point to appendicitis. The treatment of appendicitis is removal of the appendix, or an appendectomy. The surgeon explains the procedure, including the risks and benefits. You then sign a consent form to document this and permit her to operate on you. The vast array of people caring for patients in an emergency department can be quite confusing to the average health care consumer -- as confusing as if you were watching your first baseball game ever and no one was around to explain all those players. Additionally, most people are uncertain of the training and background necessary to become a member of the emergency-department team. Well, here's the scorecard. The emergency physician comes to the team after spending four years in college studying hard to get as high a GPA (grade point average) as possible in order to get accepted into medical school. Medical school is a four-year course of study covering all the essentials of becoming a physician. It generally includes two years of classroom time, followed by two years rotating through all the different specialties of medicine. Toward the end of medical school, each medical student must select a particular specialty (emergency medicine, family practice, internal medicine, surgery, pediatrics, etc.). The medical student then completes an internship (one year) and residency (two to three additional years) in order to be a specialist in emergency medicine. Physicians must pass an all-day written exam and an all-day oral exam to become board certified in emergency medicine. As of 2001, there were approximately 32,000 emergency physicians practicing in the United States, of which 17,000 were certified by the American Board of Emergency Medicine.

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以下のとおりお答えします。 虫垂炎の疑いのある診断が考えられる時には、血液検査と尿検査が必要になります。 患者の血液は、それぞれ実行されるテストに応じて添加剤が加えられ、種々の色つきの試験管に入れられます: ・頂点部が紫色の試験管は、完全な血球数測定(CBC)のために使われます。CBCでは次のような測定がなされます。1) 貧血であるか否かを見るための、赤血球の個人別適正量。2) 感染の有無を決定する白血球(WBCs)の数と型。3) 血小板計算(血小板は凝固に必要な血液組成です)。 ・頂点部が赤色の試験管は、血清をテストするために使用されます(血液の液性部分または無細胞部分)。 ・頂点部が青色の試験管は、血液の凝固をテストするために使用されます。 あなたの場合のテストでは、WBC数値の高いことが示されています。これは細菌感染の兆候であり、細菌の感染は一般的に虫垂炎と関連します。 この時点で、救急医はあなたに飲食を控えるように要請するかも知れません。理由は、虫垂炎は外科によって扱われるので、空の胃は麻酔による合併症を防止するのに望ましいのです。 救急医は、入手できるすべての情報を持っている時には、自分の鑑別診断から最もありそうな診断を確定します。 代って、彼が自分で決定するための情報を十分持ち合わせないので、さらなるテストが必要であるとの判断を下すこともあります。この時彼は、一般外科医-このケースに適する相談役-と話し合いをします。外科医があなたに会いに来て、あなたの完全な病歴や身体の検査、実験データの閲覧などを行います。 彼女(外科医)は、あなたの徴候を調査します。すなわち、右下腹部の痛みや柔らかさ、嘔吐、熱、およびWBC計算での数値高の状況です。これらの徴候すべてが虫垂炎を示唆します。虫垂炎の取り扱い(手術)は、虫垂または虫垂炎部位の切除です。 外科医は手続を説明しますが、それにはリスクと利点が含まれます。あなたがこの文書に署名すると、彼女があなたに手術することへの同意の表示となります。 救急部門の患者を世話する人々の膨大な陣営は、平均的な医療受診者にとっては実に紛らわしい-まるで、選手の説明をしてくれる者もないまま、初めて野球の試合を観戦するように紛らわしいものかも知れません。 さらに、ほとんどの人は、救急部門チームの成員となるのに必要な訓練や背景については不案内です。それではここで、選手一覧表を見てみましょう。 救急医師は、医学校に入るためにできる限り高いGPA(平均成績評価点)を得るべく、熱心に4年間大学での研究に費やした後、チームに参加します。 医学校は、医師になるための全必須事項をカバーしている4年間の学習課程です。それは一般に2年の教室時間を含み、それに医学の全専門分野を巡回経験する2年が続きます。 医学校の終わり頃に、個々の医学生は特定の専門(救急医療、開業医、内科医学、外科、小児科学など)を選ばなければなりません。医学生が救急医療の専門家になるためには、それからインターンシップ(1年)、および研修(さらに2, 3年)を満たすことになります。 医師が救急医療の認定部局員になるためには、丸1日の筆記試験と丸1日の口頭試験を通らなければなりません。2001年現在、米国では約32,000人の救急医師が実習中であり、そのうち17,000人が米国救急医療の部局員に認定されています。 以上、ご回答まで。

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  • 次の英文の和訳をお願いしたいです。

    Million­s of Americans visit an emergency room each year. Millions more have seen the hit TV show "ER." This­ has sparked an almost insatiable interest in the fascinating, 24-hour-a-day, non-stop world of emergency medicine.A visit to the emergency room can be a stressful, scary event. Why is it so scary? First of all, there is the fear of not knowing what is wrong with you. There is the fear of having to visit an unfamiliar place filled with people you have never met. Also, you may have to undergo tests that you do not understand at a pace that discourages questions and comprehension. In this article, Dr. Carl Bianco leads you through a complete behind-the-scenes tour of a typical emergency room. You will learn about the normal flow of traffic in an emergency room, the people involved and the special techniques used to respond to life-or-death situations. If you yourself find the need to visit an emergency room, this article will make it less stressful by revealing what will happen and why things happen the way they do in an emergency. One of the most amazing aspects of emergency medicine is the huge range of conditions that arrive on a daily basis. No other speciality in medicine sees the variety of conditions that an emergency room physician sees in a typical week. Some of the conditions that bring people to the emergency room include: •Car accidents •Sports injuries •Broken bones and cuts from accidents and falls •Burns •Uncontrolled bleeding •Heart attacks, chest pain •Difficulty breathing, asthma attacks, pneumonia •Strokes, loss of function and/or numbness in arms or legs •Loss of vision, hearing •Unconsciousness •Confusion, altered level of consciousness, fainting •Suicidal or homicidal thoughts •Overdoses •Severe abdominal pain, persistent vomiting •Food poisoning •Blood when vomiting, coughing, urinating, or in bowel movements •Severe allergic reactions from insect bites, foods or medications •Complications from diseases, high fevers The classic emergency room scene involves an ambulance screeching to a halt, a gurney hurtling through the hallway and five people frantically working to save a person's life with only seconds to spare. This does happen and is not uncommon, but the majority of cases seen in a typical emergency department aren't quite this dramatic. Let's look at a typical case to see how the normal flow of an emergency room works. Imagine that it's 2 a.m., and you're dreaming about whatever it is that you dream about. Suddenly you wake up because your abdomen hurts -- a lot. This seems like something out of the ordinary, so you call your regular doctor. He tells you to go to your local hospital's emergency department: He is concerned about appendicitis because your pain is located in the right, lower abdomen. 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 •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. Here you find out that your temperature is 101 degrees F.

  • 次の英文の和訳をお願いします。

    Millions of Americans visit an emergency room each year. Millions more have seen the hit TV show "ER." This has sparked an almost insatiable interest in the fascinating, 24-hour-a-day, non-stop world of emergency medicine.A visit to the emergency room can be a stressful, scary event. Why is it so scary? First of all, there is the fear of not knowing what is wrong with you. There is the fear of having to visit an unfamiliar place filled with people you have never met. Also, you may have to undergo tests that you do not understand at a pace that discourages questions and comprehension. In this article, Dr. Carl Bianco leads you through a complete behind-the-scenes tour of a typical emergency room. You will learn about the normal flow of traffic in an emergency room, the people involved and the special techniques used to respond to life-or-death situations. If you yourself find the need to visit an emergency room, this article will make it less stressful by revealing what will happen and why things happen the way they do in an emergency. One of the most amazing aspects of emergency medicine is the huge range of conditions that arrive on a daily basis. No other speciality in medicine sees the variety of conditions that an emergency room physician sees in a typical week. Some of the conditions that bring people to the emergency room include: •Car accidents •Sports injuries •Broken bones and cuts from accidents and falls •Burns •Uncontrolled bleeding •Heart attacks, chest pain •Difficulty breathing, asthma attacks, pneumonia •Strokes, loss of function and/or numbness in arms or legs •Loss of vision, hearing •Unconsciousness •Confusion, altered level of consciousness, fainting •Suicidal or homicidal thoughts •Overdoses •Severe abdominal pain, persistent vomiting •Food poisoning •Blood when vomiting, coughing, urinating, or in bowel movements •Severe allergic reactions from insect bites, foods or medications •Complications from diseases, high fevers The classic emergency room scene involves an ambulance screeching to a halt, a gurney hurtling through the hallway and five people frantically working to save a person's life with only seconds to spare. This does happen and is not uncommon, but the majority of cases seen in a typical emergency department aren't quite this dramatic. Let's look at a typical case to see how the normal flow of an emergency room works. Imagine that it's 2 a.m., and you're dreaming about whatever it is that you dream about. Suddenly you wake up because your abdomen hurts -- a lot. This seems like something out of the ordinary, so you call your regular doctor. He tells you to go to your local hospital's emergency department: He is concerned about appendicitis because your pain is located in the right, lower abdomen. 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 •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. Here you find out that your temperature is 101 degrees F.

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