Prática de Shadowing: Escharotomy - Burn Care Series - Aprenda a falar inglês com vídeo
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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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Vocabulário e dicas de fala para esta lição
Esta aula de conversação usa o vídeo “Escharotomy - Burn Care Series”. As palavras que mais se repetem: arm, burn, limb, nerve, mark. Este vídeo tem 54 frases e 644 palavras para praticar shadowing. A fala dura 7:19. O falante fala devagar, cerca de 88 palavras por minuto, o que dá tempo para imitar cada som. Apenas 76% das palavras estão entre as 3.000 mais comuns do inglês, por isso o vocabulário é exigente.
Vocabulário principal deste vídeo
15 palavras do vídeo que vale a pena aprender, com pronúncia e significado:
| Palavra | Pronúncia | Significado |
|---|---|---|
| limb substantivo | /lɪm/ | membro |
| nerve substantivo | /nɝv/ | nervo |
| circulation substantivo | /ˌsɝkjʊˈleɪʃən/ | circulação, circundação |
| layer substantivo | /ˈleɪ̯ɚ/ | camada |
| breathe verbo | /bɹiːð/ | respirar |
| median substantivo | /ˈmiː.di.ən/ | mediano, mediana |
| bone substantivo | /boʊn/ | osso |
| tissue substantivo | /ˈtɪʃ.(j)u/ | tecido |
| vessel substantivo | /ˈvɛsəl/ | barco, navio |
| pulse substantivo | /pʌls/ | pulso |
| lateral adjetivo | /ˈlætəɹəl/ | lateral |
| refer verbo | /ɹɪˈfɜː/ | encaminhar |
| procedure substantivo | /pɹəˈsiː.d͡ʒə/ | procedimento |
| delay substantivo | /dɪˈleɪ̯/ | atraso, demora |
| monitor substantivo | /ˈmɑ.nɪ.tɚ/ | monitor, observador |
Gramática neste vídeo
As estruturas que o falante mais usa, com as palavras exatas do vídeo:
| Estrutura | No vídeo |
|---|---|
| Voz passiva be + particípio passado — o foco está no que acontece, não em quem faz | be done · is reduced · is delayed |
| Present perfect have/has + particípio passado — uma ação passada que ainda importa agora | have drawn · have cut |
Pronúncia para ficar de olho
- Os sons de “th”: breathe /bɹiːð/, beneath /bɪˈniːθ/, underneath /ˌʌndɚˈniθ/, thickness /ˈθɪknəs/, anesthesia /ˌæn.əsˈθi.ʒə/
- Os sons de “sh” e “zh”: circulation /ˌsɝkjʊˈleɪʃən/, tissue /ˈtɪʃ.(j)u/, superficial /ˌsupɚˈfɪʃəl/, incision /ɪnˈsɪʒən/, anesthesia /ˌæn.əsˈθi.ʒə/
- Palavras longas — acerte a sílaba tônica: circulation /ˌsɝkjʊˈleɪʃən/, difficulty /ˈdɪfɪkəlti/, superficial /ˌsupɚˈfɪʃəl/, anesthesia /ˌæn.əsˈθi.ʒə/, anatomical /æ.nəˈtɑ.mɪ.kəl/
Sons difíceis para falantes de português:
- Consoante final — sem acrescentar um “i” depois: indicate /ˈɪndɪˌkeɪt/, extend /ɛkˈstɛnd/, instrument /ˈɪnstɹəmənt/, wrap /ɹæp/, bend /bɛnd/
- /l/ final — a língua toca o céu da boca, não vira “u”: vessel /ˈvɛsəl/, lateral /ˈlætəɹəl/, swell /swɛl/, superficial /ˌsupɚˈfɪʃəl/, sterile /ˈstɛɹəl/
- s + consoante no início — sem um “i” antes: swell /swɛl/, sterile /ˈstɛɹəl/, scalpel /ˈskælpəl/, straighten /ˈstɹeɪtn̩/, stretchy /ˈstɹɛt͡ʃi/
Como praticar com este vídeo
- Ouça o vídeo inteiro uma vez sem falar e anote as palavras que você não conhece.
- Faça shadowing frase por frase na velocidade normal, repetindo cada uma até o seu ritmo ficar igual ao do falante.
- Grave a sua voz e compare com o original, prestando atenção a palavras como limb, nerve, circulation.
O que é a Técnica de Shadowing?
Shadowing é uma técnica de aprendizado de idiomas com base científica, originalmente desenvolvida para o treinamento de intérpretes profissionais. O método é simples, mas poderoso: você ouve áudio em inglês nativo e repete imediatamente em voz alta — como uma sombra seguindo o falante com 1-2 segundos de atraso. Pesquisas mostram melhora significativa na precisão da pronúncia, entonação, ritmo, sons conectados, compreensão auditiva e fluência na fala.