ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Emergency Australia - S02E09
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1
Is that the patient?
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I was not expecting that. Was found unconscious.
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Ambos came, shocked him, gave him three further shocks.
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He's at risk of re -arresting any second.
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Second, darling.
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We're not able to get his oxygen any higher.
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His prognosis is even more dire than we thought.
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Would you rescue me when I'm by myself, when I need your love?
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If I need your help, would you rescue me?
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Would you rescue me?
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But I start to wonder,
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wonder If I'm sipping under,
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under Would you rescue me?
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Would you give my back?
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We're going to staple your head back together.
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There is a possibility he might die.
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Would you rescue me?
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Would you rescue me?
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Would you rescue me?
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Would you rescue me?
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Senora, your daughter is here.
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At the Royal Melbourne Hospital, emergency doctor Michelle Thornhill is displaying one of her many talents.
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Well, I grew up in a country just off the coast of South America, so there were a lot of Spanish -speaking people around,
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and I really enjoyed studying Spanish at school.
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Patients feel more at ease when somebody could just say a simple Hola, como estas?
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Okay, we've closed the curtain up.
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You definitely need to know a bit about everything in emergency because any and everything can come through the door.
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How are you going?
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Yeah, pretty good.
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Yeah?
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Under control?
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All under control.
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All right.
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Well, it is Friday, so it's midday, so it's about to go out of control.
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Just putting it out there.
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OK, I'm ready for it.
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Yeah.
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You don't ever really, truly relax, and you're always ready for the next big thing to whirl through the door.
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Ah!
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Ah!
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In the ambulance bay, paramedics are rushing in Dr. Michelle's next patient, 55 -year -old Matthew, who was found unconscious outside a local library.
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Ah!
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Matthew, a DJ, has been revived several times by the paramedics after going into cardiac arrest.
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We've got an adrenaline we need while we're getting all that sorted.
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Definitely make sure we accept our defibrillator.
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Yeah.
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Our priorities are making sure that his heart continues to beat
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and we're also at the same time really concerned about his breathing.
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Do you want to manage airway?
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Yeah.
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OK.
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Because if we can't get the oxygen in, then it's useless getting the heart to pump.
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Are you going to help me with airway?
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Yep.
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Dr. Luke De La Rue will take charge of Matthew's breathing and oxygen levels.
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Almost as life -threatening as you can get if your heart's recurrently stopping. Is that the patient?
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I was not expecting that.
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Just relax, arms down for me.
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My name's Luke.
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I'm one of the doctors.
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I'm going to take good care of you.
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You just need to stay nice and still and in the bed.
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Matthew's agitated.
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He is screaming and yelling and he's confused, which could be a reflection of the lack of oxygen that's gone to his brain.
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Unknown downtime was found unconscious.
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Okay.
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Then ambos came, shocked him, gave him three further shocks that broke him.
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You're okay, mate breaths i think we need to secure his airway
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because we can't have him like this let's go pads
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then monitoring with all cardiac rests what we worry about the most is the brain
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when the heart is stopped if not enough blood
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or oxygen has reached the brain for a sufficient time then that can cause irreversible brain damage Sarah,
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I'll scribe an airway.
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Scribe an airway, please?
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Yes.
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Precedure.
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Good, good.
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Across the corridor, emergency nurses Sarah Thomas and Jess Chapman.. are setting up another trauma bay for an injured mum -to -be.
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There's been a car accident involving a young female and she's 29 or 30 weeks pregnant.
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We've been told that her heart rate's quite elevated.
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Primary concern is that they've got to bleed somewhere.
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They're bleeding internally.
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34 -year -old Larissa was on her way to her doctor for a pregnancy check -up when the car crash happened.
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Hey, my name's Jess.
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I'm one of the nurses.
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I'm going to be holding your head, OK?
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And then we're going to slide across, OK?
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You're just staying nice and still.
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One, two, three.
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A car accident is just so violent to the body.
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And when there is damage to the placenta, it can release hormones that can induce labour.
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Just copy a blood pressure cup on your arm.
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We're going to be coming at you from all angles.
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Straight away, the trauma team examine Larissa and her unborn baby.
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We can do things concurrently.
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So with the ultrasound, we can check the heart rate of the baby
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and make sure that the heart rate is at an acceptable level and that there's no signs of fetal distress.
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Larissa's heart is beating faster than normal, which could be a sign of shock or internal bleeding.
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Hello.
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I'm Sarah, one of the other nurses.
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Having a bit of a shitty day, huh?
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Yeah.
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It's always really good if we can kind of find some common ground that we can use to build a rapport.
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Definitely being a mum helps with that.
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First baby?
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Yeah.
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Boy or girl?
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Little boy.
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Oh, I've got a little boy.
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But little boys are great.
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I'm just worried about them.
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And you just let us do all the work, hey?
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As Larissa waits for the results of her ultrasound, news comes through about a seriously injured patient being treated next door.
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He's a driver in the same accident.
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The rear...
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The rear ender.
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Yeah, the partner.
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As in husband?
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Yes.
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Yeah, he was driving.
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Oh, no. Oh, you poor thing.
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Is he OK?
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You're OK, mate.
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Just relax.
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Arms down.
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In Royal Melbourne Emergency, Doctors Michelle Thornhill and Luke Delarue are trying to save 55 -year -old Matthew, whose heart keeps stopping.
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Just relax.
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Big breaths.
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It's critical to know, as best we can, how long somebody was in an arrest for.
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If they were down for just five minutes or less, we could continue this resuscitation and still hope for a positive outcome.
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If they've been down for more than half an hour, we know the chances are very slim to none.
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When you're ready, go ahead.
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Matthew is struggling to breathe.
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His prognosis is even more dire than we thought.
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If we can't get his oxygen levels up, he's not gonna get the oxygen he needs for his brain.
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I think that you could have a look at his heart while they're preparing for intubation.
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Thank you.
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Senior emergency doctor
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Martin Dutch joins the team to help with Matthew's intubation.
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Some really getting great views through there.
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There might be blood outside his heart compressing it.
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It might be dilated because there's a big blood clot travelling to his lung.
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No matter what the cause, your heart stopping is almost always fatal.
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We have oxygen sats 87.
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It'd be great to optimise that oxygenation if we can.
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We're going to get set up the tube now.
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OK, yep.
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All right, he has the drugs for intubation.
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Matthew's sedated, so a tube can be put down his throat to take over his breathing.
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So we're not able to really get his oxygen any higher.
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Okay.
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The most worrying thing is the lack of oxygen circulating in his body.
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Muscles are dying and his brain is suffering.
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So it really decreases his chances of survival.
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Okay, so where are we at with Aoi?
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We're good to go.
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Yep, good blood pressure.
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Happy for you guys to proceed when you are.
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But Matthew's oxygen level is dropping.
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We immediately start thinking about what we can do to get.. those oxygen levels back up as best we can.
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SATs are 87 percent.
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SATs are 86.
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SATs are 80 percent.
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SATs are still dropping.
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What have we got this time?
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Allergic reaction.
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Senior emergency doctor Jonathan Papson has known his next patient for more than 20 years.
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In general, doctors and nurses make pretty good patients because they know what's going on, they know what to expect.
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How long did you get there?
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45 minutes ago.
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In the treatment bay, senior nurse Randall Britton has come to emergency after being stung by a swarm of bees.
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So you're covered in an urticaral rash.
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That's what made you think of the preventative.
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Randall knows the symptoms of an allergic reaction.
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He's worked at the Royal Melbourne for 25 years.
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So Randall's a friend.
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He's one of the top nurses at RMH.
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He's been here even longer than me, which is a really long time goes way back to like last century and beyond.
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Randall's having an allergic reaction, but when you get abdominal pain and nausea or tingling lips, it starts to put it in a more serious category.
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It's got a whole body reaction.
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It's got an anaphylactic reaction going on, which is much more dangerous.
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Have you got any other health problems just ordinarily?
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Do you have any medicines or anything?
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No. No. Thank you.
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Nurse Randall's inaugural honey harvest has landed him an emergency as a patient.
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I've got a home beehive and my wife and I were doing our first harvest.
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We were going to steal some honey and I got stung.
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Somehow or another some bees managed to get in my in my veil
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and I got stung in the ear and stung all over my face.
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My wife got stung too.
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They were Once they start stinging, they're just stinging everything.
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It isn't the first time Randall's been stung by his own bees, but it is the most severe.
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I got stung last week.
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Yeah, yeah.
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It's the same beehive.
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Yeah.
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It may just be the load of bees.
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Sometimes you get many stings.
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People die every year from anaphylactic reactions to bee stings.
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Randall's been stung by multiple bees, so he's had a much higher dose.
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If the reaction continues to get worse, your lips swell up, your tongue swells up, you can't breathe.
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And that can be fatal.
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So it can go either way.
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So you've got the cutaneous menstrual station continually around your lips.
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You're like, I am adrenaline that I'll talk about.
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Let's do that.
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We'll give you some adrenaline.
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An injection of adrenaline can have some serious side effects.
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Well, I had adrenaline once about 30 years ago.
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I didn't like it then, so I'm not looking forward to it now.
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Back in trauma bay one anxious mum to be Larissa is
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having an ultrasound to look for her baby's heartbeat is he okay
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34 year old Larissa was in a car crash
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which may have injured her unborn baby
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or brought on early labor what's showing us
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that the baby's heart rate is is within the normal ranges which is very reassuring for Larissa.
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It's just, it brings a sense of relief, not only to the mum, but also to us in the room.
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This is the other person in the vehicle.
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Next door, Larissa's husband
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Jake has suffered head injuries and is being treated by Dr Miriam Yasser.
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He's a partner with a depressed skull fracture, so we'll see what it is.
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Jake was driving and hit his head on the steering wheel when the car crash happened.
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Head injuries are often very common, especially if there's no airbags or, you know, if their head hits the window or the steering wheel.
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Open your eyes for me.
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Look to the left.
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Is that sore?
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Not really.
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It hurts when I go to the right.
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OK, look over here.
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That's sore?
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Yeah, more like a...
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Ah, yeah.
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Yeah.
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Look over here.
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That's sore to do.
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Yeah, yeah.
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Open your mouth as wide as you can.
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It's sore to open your mouth?
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Yeah.
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Okay.
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Sorry.
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Got some very nasty fractures which involve his eye and around his eye and so his vision becomes a hugely important concern.
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The first time parents were on their way for a.. pregnancy checkup when the crash happened.
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Given the mechanism of your accident and the injuries that we can see, we're going to be doing a scan of most of you,
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so your head, your neck, the facial bones.
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Yeah, here's a white baby, okay, just fearing the worst.
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Apart from him having his own injuries to deal with, the one thing that I really am aware of is,
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you know, the shock of being in a high -speed accident, the shock of having your own injuries
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and then not knowing what's going on to a loved one or your baby is you know it's it's terrifying
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andrea that's his partner in there yes can i just give him an update is she she's all right
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when her baby's fine yeah thank you
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hey jake i've just had a chat to your to the doctor who's looking after your partner next Yeah.
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Baby's fine and your partner's okay. Are you okay?
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Aw.
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Just a relief?
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Everything's fine.
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Just take a minute to process it, okay?
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You're alright.
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You're okay.
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The relief was there for me as well.
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I think to be able to break some good news.
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I mean, it is not always the case
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that we have good news to break in an emergency department
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and it is just lovely it is just the nicest thing to be able to tell him that things are okay.
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But Jake faces some serious issues with his injured eye.
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Your job is just to stay pain -free and lying flat on your back until the results of your scans come through.
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I'm worried.
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Has he caused so much damage to the eye that it's going to be irreversible?
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I mean, with eyes, you just don't want to mess around with them.
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I'm going to see you have a fraction, OK?
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Thank you.
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In Royal Melbourne Emergency, first -time parents Larissa and Jake are waiting to be reunited after a car crash.
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We're going to change that collar to a bit more comfortable one, yeah, I reckon.
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27 -week pregnant Larissa is in danger of going into premature labour.
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Her husband Jake has a serious eye injury and possible head injuries.
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Sarah, I've already updated him on his partner so he knows.
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How's he doing so I can update her?
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So he's just going to have a scan?
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Just a CT brain or a pool?
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No, he's going to have a pool.
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I'll let her know.
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Thank you.
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I've just spoken to the doctor.
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They're going to do a bunch of scans
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and then see what the actual damage is and then see if it needs surgery or not.
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But I'll keep you updated and if I can, wheel you in there if you wanted to see him.
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Oh, well.
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OK.
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All right.
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He does know the baby's OK.
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Thank you.
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As soon as we can get her in there and let her see her husband, we most definitely will do that.
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Love your ring.
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Thank you.
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It is a gorgeous ring, isn't it?
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It's beautiful.
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Good job, hubby.
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Very lucky.
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Larissa is going to the CT scanner ahead of Jake because of their unborn baby.
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Before we can let Larissa move around and get out of bed, we need to make sure that her spine's clear.
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All we need to do is stay still as you can and see what's going on.
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Thank you.
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It tugs at my heartstrings a little bit more because I just know how vulnerable I was when I was pregnant.
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And then for something like a major trauma to happen, it's quite scary.
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And then when you've got your husband in the bed next to you, it's scary.
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You all right?
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Yeah.
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All done?
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Is that a bit better?
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Yeah.
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The CT results have come in for Larissa.
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Her scan results came back and everything looks really good.
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We're still monitoring the baby with the CTG monitoring on her tummy.
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But the doctor is organising a bed for her over at the women's, which is just next door.
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I'm OK because we've been in good hands.
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So, yeah, still feeling OK.
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I'm probably just more worried about Jake at this point.
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Jake's injured eye is very worrying for Dr Miriam Yasser.
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We need to get him to the scanner to assess the extent of the injuries that he has.
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Any damage to the eye itself.
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And then any potential injuries to his brain and to his neck.
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Dr Miriam has an update for Jake, who's resting to protect his eyes.
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The result of that scan came back, and it does look like you've got some fractures around that left, the bone that surrounds the eye.
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And one of them is pressing on one of the muscles that moves the eye, which is why you're getting that pain.
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So we've got specialists that have a look at fractures of the face.
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So we will have a chat to them and see what they reckon.
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I recommend, OK?
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I think given the extent of his fractures, there's a very strong likelihood that
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Jake is unfortunately going to have to have an operation.
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It is too early to appreciate if there's going to be any long -term limitation in his vision.
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Your spine's fine, so I'm happy if you want to sit up.
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Oh, yeah, that's a good one.
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We'll take this one off here.
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I think your partner's still in the bed next door, so have a chat to her, that's OK.
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I just need to.
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Hey, Meg, is it okay if she just...
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Oh, awesome.
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You're always so worried about me.
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Yes, I am.
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We're going to take you to the normal nurse, to my turn.
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Yeah.
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It's not being so hard.
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Yeah.
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Senior doctor Jonathan Pabson is prescribing a shot of adrenaline for workmate Randall,
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who's come in on his day off after being stung by his own honeybees.
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He's having an anaphylactic reaction, a serious reaction to the multiple bee stings.
347
He fits the criteria for adrenaline, he's getting it to turn off the reaction, otherwise the reaction's going to get worse.
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Adrenaline will give you a bit of a rush
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but it'll sort it out you'll be otherwise you'll be like this all day.
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So Randall would be worried and the adrenaline will make him jittery
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and his heart rate go fast and there'll be side effects
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but he's given adrenaline many many times so Randall has seen all the side effects from adrenaline that can happen.
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Randy I've got your doors in here.
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Here is okay.
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Yeah.
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Yeah.
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I'll get you some water.
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Right here.
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It seems to have turned off the allergic reaction he was having, so that's good.
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A for adrenaline, and that does the trick.
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We'll watch him for a while.
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While Randall recovers from his stings, he has other bee problems on his mind.
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We've got, like, 20 kilos of honey to clean up when we get home.
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There's going to be honey everywhere.
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So it's going to be a bit of a mess. So that's 80%.
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In Trauma Bay 2, heart attack patient Matthew has dangerously low oxygen levels.
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OK, so, Martin, you're going to take over?
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Yeah.
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The emergency team needs to take over the 55 -year -old's breathing, but it's a very risky procedure.
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Can I have the stool to my end, Gina?
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Senior emergency doctor
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Martin Dutch has just seconds to put a breathing tube down Matthew's throat.
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Ideally, we'd have oxygen levels at 100%.
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We actually stop people breathing for a period of time while we're actually placing the tube.
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If you've got low oxygen levels and you stop breathing, they're only going to go lower and there's only so low
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that the body can cope with before Matthew's heart may stop again.
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We've got a plateau to 84.
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He's been planning.
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It's just on the turn.
380
All right, we have CO2.
381
Saks are slowly recovering.
382
Having said that, his blood pressure was in the 200.
383
It's now 129, so we need to keep an eye on C.
384
Matthew's heart can rest again at any time
385
and worst case scenario is we can't actually get it back
386
and he doesn't get the circulation he needs to give his brain oxygen and he could die.
387
Do you need your drugs topped off or you have enough?
388
Yeah.
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Matthew, a disc jockey, had just left his local library when he collapsed from the first of many heart attacks.
390
The laryngoscope, whenever you're ready.
391
We use a device called a laryngoscope, which essentially looks like a claw on a hammer, and it has a light at the end of it.
392
And we can lift the tongue and the jaw out of the way and put the tube in.
393
OK, tube over the top, please.
394
Placing a breathing tube into a patient's lungs is a complex procedure that has a number of different stages,
395
all of which can go life -threateningly poorly.
396
And now, two seconds.
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Just push the tube down so I can grab it.
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Yes, grab the bougie.
399
Yep.
400
The hole that's really hard to put the breathing tube in, that's the hole that we need to aim for.
401
It's around the corner and it's in a dark place.
402
And hopefully put the tube in that hole and do all of that while Matthew's holding his breath. And now two seconds.
403
Yep, grab the bougie.
404
Senior emergency doctor
405
Martin Dutch has just seconds to put a breathing tube into Matthew, who's clinging to life after multiple cardiac arrests.
406
Matthew literally stops breathing while Dr Martin works the tube down his throat.
407
The video laryngoscope allows us to make sure that our tube is tracking through Matthew's vocal cords into his windpipe.
408
Once we've done that, we can increase the amount of oxygen that Matthew is getting.
409
Okay.
410
Fouji out.
411
It's all right.
412
Cup up, please.
413
Get the bag ready to bag patient, please.
414
Bag patient, please.
415
Cup's up.
416
Ready to bag.
417
It's out to lady six.
418
All right.
419
Good.
420
Let's secure the tube.
421
I'm happy.
422
Now that we've placed the breathing tube, his oxygen levels have begun to increase.
423
He's no longer distressed, and we can really begin to rest his heart
424
and take the strain off that heart that's having its worst day of its life.
425
Still have good blood pressure, maintaining sex.
426
Even though we've treated the immediate life threats for Matthew, there's still a lot of challenges that he faces.
427
The fact that potentially there's an area of his heart that's still not being supplied with oxygen
428
because he may have had a heart attack need to be addressed.
429
So, UT tube looks great.
430
His lungs are inflated.
431
OK, I'm happy.
432
Thank you.
433
I think we've done what we can for him here.
434
Airways secure.
435
I think we just got him straight up.
436
OK.
437
Dr. Michelle decides Matthew is stable enough to be sent to a special heart unit.
438
The lab's ready for you.
439
The lab's ready.
440
Excellent.
441
Can we page for Gina, one of the EDAs?
442
Thanks.
443
But the move can be very dangerous.
444
Anything can happen in transport, and it's your worst nightmare, because you're out of your familiar environment.
445
He could rearrest at any point in time.
446
So we basically all hold our breaths until we get him onto the table and walk away.
447
We have a rest dose if we need to in a syringe.
448
HEM's coming in shortly.
449
Five o 'clock.
450
Five o 'clock, I'll team lead and Kin is around.
451
Okay.
452
Hailing from Sheffield in the UK, Dr Andrew Trezise joined
453
Royal Melbourne Emergency a year ago.
454
Being in a big, busy tertiary centre is, you know, it's pretty exciting.
455
We get some interesting cases.
456
Signpost came up through the floor of his car.
457
He'd like literally kebabbed himself.
458
We see everything really, patients from all walks of life.
459
It always brings its own interesting unique challenges every time you see a new patient.
460
Paramedics are bringing in a young tradie with a large gash in his upper arm from an accident at work.
461
He's been trying to go around a colleague who was using an angle grinder with a sander attachment.
462
Hit Stephen in the back of the arm, shoulder to elbow just on the back.
463
So I'm in the hospital.
464
Thank you.
465
Cheers.
466
All right, Stephen, yeah, so my name's Andrew.
467
I'm one of the doctors here.
468
Bit of a day for you, eh?
469
Yeah.
470
Yeah, a little bit.
471
Arm at the moment feeling OK down here?
472
Yeah.
473
Can you give me a big thumbs up and try and do an OK for me?
474
Good stuff.
475
All right, let's take a quick look.
476
It's always worth having a thought of what might I find.
477
Any kind of limb wound, we'd always think, do we need a tourniquet just in case we take this bandage down and it starts bleeding everywhere?
478
There's always the chance the angle grinder has actually got into the bone itself.
479
Am I going to sort of find something that's really significant that's going to cause serious impact to this patient?
480
All right, so let's have a good look.
481
It looks like the cutter has gone most of the way down his upper arm, which is a big wound.
482
It's gone down probably just about to the muscle there.
483
Stephen's right -handed, so the wound is likely to force him out of work for a while.
484
As I walked past it caught my arm.
485
So it kicked back?
486
Yeah, it kicked back.
487
It just got about that.
488
Straightened into my arm.
489
If you have a deep enough injury, you could get a fracture in that bone.
490
And obviously we know that the average angle grinder is not particularly clean, so there's always the chance of introducing infection as well.
491
What I might do is I might...
492
Just put a bit of local anesthetic in the whole thing so that you won't be too sore.
493
Unfortunately for Steven, it's going to require him to have quite a few injections.
494
It does sting a little bit when it first goes in.
495
Ow.
496
Once the anesthetic starts working, it shouldn't hurt anymore.
497
We want to make sure the wound is nice and numb
498
and that he's not getting any pain from it so that we can give it a good wash.
499
Ah.
500
Just a couple more.
501
Almost there.
502
This side should be nice and feel a bit numb now.
503
Yeah, that's right.
504
I feel it.
505
Yeah, it's got to put me like.
506
All righty.
507
Doing OK?
508
Yep.
509
Good bye.
510
Give this a good wash.
511
Definitely infections is going to be the big thing that we would worry about, particularly if the infection gets into the bone and it spreads.
512
That can be really, really difficult to treat, and there is a small possibility that they would have to amputate the arm.
513
So I'll try and sort of shove this under your arm.
514
Yeah, that's good.
515
In Royal Melbourne Emergency, labourer Stephen is having a large gash in his arm numbed, so it can be cleaned to stop infection.
516
So try and sort of give it a bit of a scrub as I go, so tell me if it's very sore.
517
Yep.
518
What we would be particularly concerned about would be fragments of things left in there, so whether it's fragments of the angle grinder,
519
the disc itself, whatever was being cut, whether it was wood or metal, or plastic or something, you know,
520
you can get those fragments into these kind of wounds.
521
Yeah, give us five minutes and then mum's been funny and we'll just cover it up.
522
Yeah, how's your mum with blood?
523
She's not too bad with it, but she probably doesn't want to see it.
524
Don't want to run the roads.
525
It's different when it's your own son as well, I'm sure.
526
Stephen's mum, Caroline, has been waiting outside for news of her son's injury.
527
I'll just take a picture to put on the medical notes as well.
528
I'll take a photo for you too.
529
Yeah, you need a picture of yours.
530
You've got to show the mains down the path, haven't you?
531
I still want to put this on.
532
Here you go, it's gross.
533
Yeah.
534
A little bit gross, yeah.
535
I've seen better though.
536
It's all right.
537
We're probably all a bit weird in the emergency department.
538
I think we probably all quite like wounds like this.
539
I, yeah, it's difficult to think why anybody would like that, but I suppose it's probably just that little bit of,
540
a bit of sort of adrenaline rush you get from it.
541
You know, it's not something that you get to see every day.
542
Wonderful.
543
All right.
544
Good man.
545
So, yeah, we'll get some antibiotics into you just to cover for any infection, and then get you home.
546
Hi, Caroline.
547
Coming in.
548
Stephen's mum is finally able to see him.
549
I've just been giving it a good clean -out and washing it up.
550
We thought we'd bandage it before you came in.
551
I thought you might not appreciate it.
552
Look, it looks very dramatic, but actually it's quite a superficial injury.
553
I think he'll need to stay in at least tonight.
554
I'd like the plastic surgeons to probably, they'll need to do an operation to just stitch it up.
555
Just because of the depth of the wound and the size of the wound,
556
this is probably something that's going to need an operation to fix up.
557
Good stuff.
558
I'll let you sit with him for now and I'll come back and let you know when we've got an update.
559
Caroline arrived on the scene shortly after Stephen's accident.
560
Washed round to his workplace, to be told yeah he'd been hit with an angle grinder I think it was
561
but there was quite a few people there
562
so I just stayed a little bit out of the way is it's like
563
if I start crying he'll start crying or
564
if he starts crying I'll start crying
565
so it's like I'll just think we'll just
566
I'm just gonna stay out the way she's worried about a 21 year old son's future job prospects is
567
that a permanently damaging injury you know like the nerve damage
568
or you know so that sort of thing especially with sort of trade work, you know, you need your arms.
569
Yeah, the artery or anything.
570
Yeah.
571
Or the muscle.
572
Very lucky.
573
Just missed.
574
Yeah, thank his lucky stars that he's all right, and I think his arm will be fine.
575
Just with.. left with a bit of a scar and a good story at the end of it.
576
In an emergency, you have to switch gears very quickly from one to the next because the patients just keep on coming.
577
It's down by one of the nurses in ED.
578
Can I get a MEP pack for a traumatic arrest please?
579
A big emergency team headed by senior doctor Jonathan Papson is gathering quickly to treat a man with life -threatening stab wounds.
580
Stab two neck that's arrested.
581
Yeah, yeah.
582
We're about to receive a man who's been stabbed.
583
He is in traumatic arrest and it usually means someone has bled
584
so much that there's not enough blood in their system for the heart to pump now.
585
Can you page an EDA?
586
Nurse Gemma Hodson has worked in Royal Melbourne Emergency for nine years
587
and she's coordinating the trauma team, well aware of the pressures.
588
I've ordered it, I need an EDA.
589
I know straight away that I need to organise some urgent blood from our blood bank.
590
We need to make sure that we've got blood to replace what he has lost.
591
Can you run upstairs, get that, take it to T2.
592
So yeah, just the EDA is just bringing some blood back because obviously he'll need lots.
593
He'll possibly even need a second met pack but we'll just see how things go at the moment.
594
It definitely can be stressful when we are anticipating someone who's critically unwell.
595
So our training just kicks in and we know the processes, we know what to do.
596
Come in now.
597
Yep.
598
I'll do procedures.
599
I'll do airway.
600
This is as urgent as it gets.
601
We need to stop the bleeding and replace the blood that's been lost.
602
We have to act straight away to reverse what we can and we need to get it done within two minutes.
603
So we don't know the time the injury occurred, but it wouldn't have been long.
604
On our arrival, he was in cardiac arrest with a penetrating neck injury.
605
A significant amount of lives surrounding his body.
606
So we've essentially rated him, assessed and treated on route.
607
So this is our punctual injury?
608
Yeah.
609
This gentleman has a penetrating neck injury.
610
It's gone into all the deep structures.
611
It's gone in deep and it's hit something.
612
It's not one centimetre.
613
On the neck?
614
On the neck.
615
There may be other you do here having a seagull.
616
Necks full of blood vessels.
617
So the first thing we need to do is to stop any obvious bleeding, put pressure on it.
618
It's only small.
619
It's very, very deep.
620
While the patient gets oxygen, Dr Papson needs to make a small incision into his chest to release any built -up pressure.
621
Potentially the cause of his arrest arrest is air in the wrong place around the lungs, compressing the lungs, making the lungs unable to expand.
622
That can kill you.
623
So we need to reverse that by cutting the chest open to let the air out at the wrong spot.
624
Left side is compressed.
625
We don't know anything about this gentleman.
626
We don't know his name.
627
I'm ASAP, I'm sorry.
628
Police attended and is fed unconscious.
629
They commit CPR and call.
630
Assets over a video, asystolic.
631
That's the heart sync moment, because when you're asystolic after a penetrating injury, it means your heart's actually stopped. And they took their...
632
It's got no pulse.
633
Senior Dr Jonathan Papson and his team are desperately trying to revive a man who's been stabbed in the neck.
634
It looks like he's bled out.
635
We have only minutes to save this man if we can.
636
We got access or not?
637
I'll just drill him.
638
I'll just put an eye out in.
639
When people bleed a lot, their veins collapse and it's harder to get access.
640
So I need to drill into the hollow part in the middle of the bone and we can pump blood into there.
641
I only do it in the most extreme emergencies.
642
I understand.
643
We got some blood?
644
Please?
645
It's still the last story.
646
The team is running out of options.
647
We use our ultrasound to show us, as a last resort, is there anything else we can do?
648
So is there a surgical option we can take?
649
What are you seeing, Adam?
650
Nothing.
651
No heart.
652
The ultrasound has shown us that he's acetyl, his heart's not beating.
653
We've got no breathing, we've got no pulses, we've got cardiac spans.
654
And it's been how long?
655
20 minutes.
656
So it's the worst outcome.
657
It's an awful tragedy that this has happened.
658
We tried everything.
659
There's nothing further we can do that will help bring this guy back.
660
I'll just tell that side to sort of keep their curtains closed and get...
661
Gemma Hodson and her fellow nurses will watch over
662
and care for the patient until he is transferred out of the emergency department.
663
Uh, 12 by 5.
664
Thank you.
665
That's alright.
666
I think in any circumstance where someone has passed away,
667
especially in tragic circumstances, your thoughts are always with their family and friends and loved ones.
668
Are you all good?
669
Yeah.
670
It never really gets any easier, but we sort of, we get better at managing sort of how we feel about it.
671
That's not to say that some days we sort of, we might have a cry.
672
We do see death on a, say, regular basis but we're never shamed if we show emotion.
673
First baby?
674
Yeah.
675
I was worried about you.
676
Expectant parents Larissa and Jake were in a car crash and rushed to the emergency department.
677
The result of that scan came back
678
and it does look like you've got some fractures around that bone that surrounds the eye.
679
Jake had surgery to repair the damage to his eye.
680
And after a night in hospital, Larissa and baby were sent home with a clean bill of health.
681
All right, let's take a quick look.
682
Laborist Stephen's gash from an ankle grinder needed dozens of stitches.
683
He was discharged two days after his operation and soon after was given the all -clear to return to work.
684
Senior nurse Randall came to emergency on his day off with multiple stings from his honeybees.
685
Randall recovered and thanked his friend and colleague, Dr Jonathan, with a special gift.
686
I actually got a tub of honey from Randall when he came back to work.
687
So that was good.
688
The honey was good.
689
Doing a good job there.
690
Although we would advise against keeping bees if you've got an allergy to bees.
691
But the honey was good.
692
You're OK, mate.
693
Just relax.
694
Arms down.
695
DJ Matthew was found unconscious in the street and his heart stopped multiple times on the way to emergency.
696
Tim, how's the drugs for intubation?
697
Doctors battled to keep him alive with a breathing tube so he could be sent for surgery.
698
To find all the odds, Matthew survived and is grateful to everyone who helped him.
699
I am very lucky.
700
I had these wonderful angels around me like the nurses and the doctors.
701
So many people were involved.
702
So thankful for all the work that the Royal Melbourne staff put into there keeping me alive.
703
And I really appreciate it.
704
For Dr Michelle, Matthew's recovery is the greatest reward.
705
It feels really satisfying to know that he came in on what was the brink of death.
706
And we were able to literally save his life.
707
Surgeons put a stent in Matthew's heart and with regular medication he has a new lace on life.
708
I feel alive, I'm happy.
709
I feel that I can do anything but slowly.
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คำศัพท์และข้อสังเกตด้านการพูดสำหรับบทเรียนนี้
บทเรียนฝึกพูดนี้ใช้วิดีโอ “Emergency Australia - S02E09” เป็นสื่อ วิดีโอนี้มี 709 ประโยค และ 6361 คำ สำหรับฝึกพูดตาม ช่วงที่มีเสียงพูดยาว 43:42 ผู้พูดพูดด้วยความเร็วสม่ำเสมอ ประมาณ 146 คำต่อนาที เหมาะกับการฝึกพูดตาม 82% ของคำอยู่ใน 3,000 คำที่ใช้บ่อยที่สุดในภาษาอังกฤษ ส่วนที่เหลือควรดูไว้ก่อนเริ่มฝึก
คำศัพท์สำคัญในวิดีโอนี้
คำที่ควรเรียนรู้ 15 คำจากวิดีโอ พร้อมคำอ่านและความหมาย:
| คำศัพท์ | คำอ่าน | ความหมาย |
|---|---|---|
| oxygen คำนาม | /ˈɑksɪd͡ʒən/ | ออกซิเจน |
| tube คำนาม | /tuːb/ | หลอด |
| breathe คำกริยา | /bɹiːð/ | หายใจ |
| sting คำกริยา | /ˈstɪŋ/ | กัด, ต่อย |
| nurse คำนาม | /nɝs/ | พยาบาล |
| adrenaline คำนาม | /əˈdɹɛnəlɪn/ | ฮอร์โมนเนื้อในต่อมหมวกไต |
| bleed คำกริยา | /ˈbliːd/ | ตกเลือด |
| rescue คำกริยา | /ˈɹɛs.kjuː/ | ช่วยเหลือ, กู้ภัย |
| bone คำนาม | /boʊn/ | กระดูก |
| honey คำนาม | /ˈhʌni/ | น้ำผึ้ง |
| bee คำนาม | /ˈbiː/ | ผึ้ง, ภมร |
| fracture คำนาม | /ˈfɹæk.t͡ʃʰəː/ | กระดูกหัก |
| trauma คำนาม | /ˈtɹɔm.ə/ | การบาดเจ็บ |
| lung คำนาม | /ˈlʌŋ/ | ปอด |
| sore คำคุณศัพท์ | /soɹ/ | เจ็บ |
กริยาวลีที่คุณจะได้ยิน
| คำศัพท์ | ความหมาย |
|---|---|
| come back คำกริยา | กลับมา |
| turn off คำกริยา | ปิด, ดับ |
| pass away คำกริยา | เสียชีวิต |
ประโยคที่ควรฝึกพูดซ้ำ
ประโยคสั้น ๆ ที่สมบูรณ์จากวิดีโอ ซึ่งนำไปใช้ในบทสนทนาประจำวันได้:
- If I need your help, would you rescue me?
- Would you give my back?
- Do you want to manage airway?
- It's sore to open your mouth?
- How's he doing so I can update her?
ไวยากรณ์ในวิดีโอนี้
โครงสร้างที่ผู้พูดใช้บ่อยที่สุด พร้อมคำพูดจริงจากวิดีโอ:
| โครงสร้าง | ในวิดีโอ |
|---|---|
| Present perfect continuous have/has been + -ing — การกระทำที่เริ่มก่อนหน้านี้และยังดำเนินอยู่ | He's been planning · He's been trying · has been waiting |
| ประโยคเงื่อนไข if + อนุประโยค, will/would + กริยา — เงื่อนไขและผลลัพธ์ | If I need your help, would you · if I start crying he'll start · if he starts crying I'll start |
| Present perfect have/has + กริยาช่อง 3 — เหตุการณ์ในอดีตที่ยังเกี่ยวข้องกับปัจจุบัน | we've closed · has been revived · has reached |
| Passive voice be + กริยาช่อง 3 — เน้นสิ่งที่เกิดขึ้น ไม่ใช่ผู้กระทำ | Was found · has been revived · is stopped |
การออกเสียงที่ควรระวัง
ผู้พูดใช้รูปย่อและรูปลดเสียง 161 ครั้ง เช่น I'm, I'll, we're ให้พูดแบบสั้นตามที่ได้ยิน
- เสียง “th”: breathe /bɹiːð/, throat /ˈθɹoʊt/, threaten /ˈθɹɛt.n̩/, gather /ˈɡæðɚ/, anesthetic /ˌænəsˈθɛtɪk/
- เสียง “sh” และ “zh”: shock /ʃɔk/, unconscious /ˌʌnˈkɑnʃəs/, infection /ɪnˈfɛkʃən/, rush /ɹʌʃ/, shortly /ˈʃɔɹtli/
- คำยาว — ลงเสียงหนักให้ถูกพยางค์: adrenaline /əˈdɹɛnəlɪn/, essentially /ɪˈsɛnʃəli/, establishment /ɪˈstæb.lɪʃ.mənt/, potentially /pəˈtɛnʃ(ə)li/, acceptable /əkˈsɛp.tə.bəl/
เสียงที่คนไทยมักออกเสียงยาก:
- เสียงท้ายคำ — ออกเสียงให้ครบ ไม่เปลี่ยนเป็นตัวสะกดแบบไทย: nurse /nɝs/, angle /ˈæŋ.ɡəl/, relax /ɹɪˈlæks/, unconscious /ˌʌnˈkɑnʃəs/, muscle /ˈmʌs.əl/
- /v/ — ไม่ใช่ /w/ ให้ฟันบนแตะริมฝีปากล่าง: reverse /ɹɪˈvɝs/, involve /ɪnˈvɑlv/, harvest /ˈhɑɹ.vəst/, violent /ˈvaɪ.ə.lənt/, arrival /əˈɹaɪ.vl̩/
- /z/ — เสียงก้อง ไม่ใช่ /s/: confused /kənˈfjuːzd/, resort /ɹɪˈzɔɹt/, ease /iz/, mechanism /ˈmɛk.ə.nɪ.zəm/, examine /ɪɡˈzæmɪn/
วิธีฝึกกับวิดีโอนี้
- ฟังวิดีโอให้จบหนึ่งรอบโดยยังไม่ต้องพูด แล้วจดคำที่ยังไม่รู้จัก
- พูดตามทีละประโยคด้วยความเร็วปกติ ทำซ้ำแต่ละประโยคจนจังหวะของคุณตรงกับผู้พูด
- อัดเสียงตัวเองแล้วเทียบกับต้นฉบับ โดยสังเกตคำอย่าง oxygen, tube, breathe เป็นพิเศษ
เทคนิค Shadowing คืออะไร?
Shadowing เป็นเทคนิคการเรียนรู้ภาษาที่ได้รับการรับรองทางวิทยาศาสตร์ พัฒนาขึ้นสำหรับการฝึกนักแปลมืออาชีพ วิธีการนี้เรียบง่ายแต่ทรงพลัง: คุณฟังเสียงภาษาอังกฤษจากเจ้าของภาษาและพูดตามทันที — เหมือนเงาที่ตามผู้พูดด้วยช่วงเวลาห่าง 1-2 วินาที การวิจัยแสดงว่าเทคนิคนี้ปรับปรุงความแม่นยำในการออกเสียง ทำนองเสียง จังหวะ การเชื่อมเสียง การฟังเข้าใจ และความคล่องแคล่วในการพูดได้อย่างมีนัยสำคัญ