Shadowing Practice: Escharotomy - Burn Care Series - Learn English Speaking with Video
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Escarotomy The
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skin of a deep bone can become thickened, dry and tight.
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there is often swelling underneath the burn that worsens over time.
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If the burn encircles a limb or the torso or neck,
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it can act like a tourniquet and reduce circulation or restrict breathing.
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In these cases, an escharotomy needs to be done.
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This procedure cuts through the tight skin to release the constriction.
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This will restore circulation in the limbs or improve breathing in the chest.
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This video shows how to recognize the need for escarotomy and how to do it.
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There are two signs that indicate the need for escarotomy.
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First, the burn extends all the way around a limb, the torso, or the neck.
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In this patient, the white appearing skin is a full thickness burn encircling both arms.
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Second, circulation is reduced.
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This patient's hands are cold,
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his pulse is weak, Capillary refill is delayed,
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taking longer than three seconds for a fingernail to regain its pink colour, and he has pain in his arms.
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If the burn is on the torso, check for difficulty breathing.
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This man has burns encircling his arms and signs of reduced circulation.
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He needs an emergency escharotomy.
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Escharotomy is often done at the bedside with sedation, local anesthesia and simple instruments.
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Or if you have the facilities and the escharotomy will be extensive, it can be done under general anesthesia.
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Create a sterile field, clean the limbs with antiseptic, and spread sterile drapes beneath them.
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Next, mark where you will make the incisions.
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Refer to accurate escarotomy guidelines for where to cut to avoid underlying nerves and blood vessels.
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Mark a line on the inside of the arm and a notch to avoid the ulnar nerve.
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Mark a line on the outside of the arm.
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To avoid cutting into the median nerve, keep the arm straight.
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If the arm is flexed, it's easy to cut in the wrong place.
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If the medial or innermost line is drawn down the side of the bent arm, when the arm is straightened,
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the line is now in the middle of the arm, you will risk cutting the median nerve.
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The patient's limbs must be in the anatomical position with the arms straight and palms facing forward.
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Now the lines are drawn correctly down the lateral part of the arm, avoiding the median nerve.
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On the leg, mark an inside line and an outside line.
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To avoid the common perineal nerve of the lateral lower leg, mark in front of the knob of the fibula.
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The chest will need excisions to allow expansion in all directions.
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On the hand, mark lines for three incisions between the metacarpal bones from the knuckles to the wrist.
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If you are giving local anesthesia, inject along the marks you have drawn on the skin.
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Here's how to do an escarotomy.
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Use a scalpel or an electric coterie tool.
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Start and end your incision within an area of normal skin or superficial burn.
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Make your cuts right through the depth of the burned tissue into the fat layer below
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so that the constricting tissue springs apart.
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Once you have cut deep enough, the sides will spring apart.
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This can be a few centimeters wide.
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The limb should immediately feel softer and the pulse should become stronger.
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Expect some bleeding with the incisions.
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Use direct pressure and pack some gauze in the incision.
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Put sterile Vaseline gauze over the burn.
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Follow with an absorbent layer of cotton dressing and a stretchy wrap.
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Elevate the limbs above the level of the heart and continue to monitor for signs that further escarotomy may be needed.
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Remember, an escharotomy is needed if a burn encircles the limb, the torso, or the neck,
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and there is reduced circulation.
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Cut through to the fat layer along the lines that avoid major nerves and vessels.
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Thank you.
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Vocabulario y notas de pronunciación para esta lección
Esta lección de conversación se basa en el vídeo “Escharotomy - Burn Care Series”. Las palabras que más se repiten: arm, burn, limb, nerve, mark. Este vídeo tiene 54 frases y 644 palabras para practicar shadowing. La parte hablada dura 7:19. El hablante habla despacio, unas 88 palabras por minuto, así que hay tiempo para imitar cada sonido. Solo el 76 % de las palabras está entre las 3.000 más comunes del inglés, por lo que el vocabulario es exigente.
Vocabulario clave de este vídeo
15 palabras del vídeo que vale la pena aprender, con su pronunciación y significado:
| Palabra | Pronunciación | Significado |
|---|---|---|
| limb sustantivo | /lɪm/ | miembro, extremidad |
| nerve sustantivo | /nɝv/ | nervio |
| circulation sustantivo | /ˌsɝkjʊˈleɪʃən/ | circulación |
| layer sustantivo | /ˈleɪ̯ɚ/ | capa, tongada |
| breathe verbo | /bɹiːð/ | respirar |
| median sustantivo | /ˈmiː.di.ən/ | mediana |
| bone sustantivo | /boʊn/ | hueso |
| tissue sustantivo | /ˈtɪʃ.(j)u/ | tejido |
| vessel sustantivo | /ˈvɛsəl/ | embarcación, barco |
| pulse sustantivo | /pʌls/ | pulso |
| lateral adjetivo | /ˈlætəɹəl/ | lateral |
| refer verbo | /ɹɪˈfɜː/ | referir, remitir |
| procedure sustantivo | /pɹəˈsiː.d͡ʒə/ | procedimiento |
| delay sustantivo | /dɪˈleɪ̯/ | retraso, demora |
| monitor sustantivo | /ˈmɑ.nɪ.tɚ/ | monitor |
Gramática en este vídeo
Las estructuras que más usa el hablante, con las palabras exactas del vídeo:
| Estructura | En el vídeo |
|---|---|
| Voz pasiva be + participio pasado — importa lo que ocurre, no quién lo hace | be done · is reduced · is delayed |
| Present perfect have/has + participio pasado — una acción pasada que sigue importando ahora | have drawn · have cut |
Pronunciación a tener en cuenta
- Los sonidos de “th”: breathe /bɹiːð/, beneath /bɪˈniːθ/, underneath /ˌʌndɚˈniθ/, thickness /ˈθɪknəs/, anesthesia /ˌæn.əsˈθi.ʒə/
- Los sonidos de “sh” y “zh”: circulation /ˌsɝkjʊˈleɪʃən/, tissue /ˈtɪʃ.(j)u/, superficial /ˌsupɚˈfɪʃəl/, incision /ɪnˈsɪʒən/, anesthesia /ˌæn.əsˈθi.ʒə/
- Palabras largas — cuida el acento: circulation /ˌsɝkjʊˈleɪʃən/, difficulty /ˈdɪfɪkəlti/, superficial /ˌsupɚˈfɪʃəl/, anesthesia /ˌæn.əsˈθi.ʒə/, anatomical /æ.nəˈtɑ.mɪ.kəl/
Sonidos difíciles para hispanohablantes:
- s + consonante al inicio — sin añadir una “e” delante: swell /swɛl/, sterile /ˈstɛɹəl/, scalpel /ˈskælpəl/, straighten /ˈstɹeɪtn̩/, stretchy /ˈstɹɛt͡ʃi/
- /v/ — no es /b/: los dientes tocan el labio inferior: nerve /nɝv/, vessel /ˈvɛsəl/, elevate /ˈɛləveɪt/
- /dʒ/ — no es la “y” ni la “ch”: procedure /pɹəˈsiː.d͡ʒə/, inject /ɪnˈd͡ʒɛkt/
Cómo practicar con este vídeo
- Escucha el vídeo entero una vez sin hablar y anota las palabras que no conoces.
- Haz shadowing frase por frase a velocidad normal, repitiendo cada una hasta que tu ritmo coincida con el del hablante.
- Grábate y compara con el original, prestando atención a palabras como limb, nerve, circulation.
¿Qué es la Técnica de Shadowing?
Shadowing es una técnica de aprendizaje de idiomas respaldada por la ciencia, desarrollada originalmente para la formación de intérpretes profesionales y popularizada por el políglota Dr. Alexander Arguelles. El método es simple pero poderoso: escuchas audio en inglés nativo y lo repites en voz alta de inmediato, como una sombra que sigue al hablante con solo 1-2 segundos de retraso. A diferencia de la escucha pasiva o los ejercicios de gramática, el shadowing obliga a tu cerebro y músculos de la boca a procesar y reproducir simultáneamente patrones de habla reales. Las investigaciones muestran que mejora significativamente la precisión de la pronunciación, la entonación, el ritmo, el habla conectada, la comprensión auditiva y la fluidez al hablar, convirtiéndola en una de las metodologías más efectivas para la preparación del IELTS Speaking y la comunicación en inglés en el mundo real.