ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: KCU CSR Patient Encounter Abdominal Pain in the ED

Come in.

Hi, Ms. Layman?

Yes.

Hi, my name is Alexis.

I'm a medical student working with the physicians here in the ED.

Is it okay if I come in and ask you a few questions before you see them?

Yeah, that's fine.

It's nice to meet you.

Nice to meet you.

So I hear you're having some abdominal pain.

Yeah, it's pretty bad.

Okay, I'm sorry.

When did this start for you?

It just started last night.

Last night?

Mm-hmm.

And kind of show me, point to it with your finger.

Well, it started like right here, like right at my belly button and now it's kind of over here.

More on the lower right side now?

Yeah.

Okay.

And is this intermittent pain or is it kind of constant?

It's kind of constant now.

Okay.

And then how would you describe the pain?

Well, last night it was kind of, I don't know, achy or something.

Yeah, and then, but today it's kind of got sharp, like almost like a stabbing pain.

Oh my, that's hurt.

Okay, I'm sorry.

What would you say your pain is on a scale of zero to ten?

Zero being no pain at all, ten being so bad you would pass out.

It's probably about a seven right now.

Okay.

Well, we will be sure to get you some pain medicine very shortly.

Have you noticed that there's anything that makes that pain worse?

It really hurt whenever we were coming over here

and there would be bumps in the road or speed bumps and that would really hurt.

That made it worse.

Okay.

Anything that you've tried that's made it better?

Not really.

I tried taking ibuprofen last night, but that didn't seem to help at all.

How much ibuprofen did you take?

I think it was just like 400 milligrams.

400, okay.

And then have you noticed any other symptoms like fever?

Yeah, I feel like I have a fever.

Okay, did you take your temperature?

No, I didn't.

Okay, just felt like feverish, okay.

How about nausea, vomiting?

Yes, I feel very nauseous.

I haven't actually vomited though.

Okay.

And then, do you use any tobacco products?

No. Okay.

Any illicit drugs?

No. Do you drink alcohol?

Occasionally on the weekends.

Okay.

Are you a student or do you work?

I'm an undergraduate student right now.

Okay.

And then do you have a partner?

I'm engaged, yes.

Okay, alright.

And how many, I know this is kind of hard to talk about, but I'm just trying to get a better idea of everything that's going on so that we can rule out some things.

How many sexual partners have you had?

Just two.

Two?

Have you ever had an STD such as chlamydia, gonorrhea, trichomonas, syphilis, HIV, hepatitis, anything like that?

No. Okay.

And when was your last menstrual period?

Just a week ago.

Okay, great.

And then do you have any medical history, anything that you've ever been diagnosed for, even as a child, anything you've seen a doctor for?

I had some eczema, but that's really it.

I've been pretty healthy.

Okay.

Any allergies?

No. Okay.

Not allergic to any medications?

None that I know of.

Okay.

Have you ever had a surgery before?

No. No. Have you ever been in the hospital before?

Mm-mm.

And then what is your, the health of your parents like?

My dad has some high blood pressure and then my mom has I guess a hypothyroid.

Oh okay.

Yeah.

Okay and then are you taking any medications right now?

No. Yes I get my birth control.

Okay and you take that that's a pill?

Yes.

Okay.

Okay is there anything about what's going on that I forgot to ask?

I think I got most of the information from on you?

I can't think of anything okay well real quick I know you're hurting

100

but I am gonna just do a brief exam okay first I'll listen to your heart

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just gonna slide this under your gown a little bit

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So yeah, your heart is beating just a little bit fast, I would say.

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Now I'm going to listen to your lungs.

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I just want you to take a deep breath in and out through your mouth.

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Good.

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Last one.

107

Good.

108

Your lungs sound great.

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I'm going to get a towel to cover you.

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So I'm just going to have you lean back.

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Okay.

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This for you.

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I'm going to lift this up so I can see your abdomen.

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And now point to me where you're feeling the pain right now.

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It hurts a lot right here.

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Down there.

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Okay.

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I'm just going to listen first.

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Now I'm just going to tap.

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When I push down on this side, does that hurt anywhere?

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It kind of hurts a little bit over here.

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Okay.

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No tenderness over here.

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Mm-mm. And then, how's that? That hurts. That hurts.

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Yeah.

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And I just want you to take a deep breath in and out.

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Good.

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I'm going to have you bend this.

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Have you bend your right knee.

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And I just want you to try and push your knee up against me.

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Mmm, that hurts.

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That hurts a little bit.

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Okay, I'm going to take your leg now.

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Oh, yeah.

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That's a little tender too.

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Mmm-hmm.

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And then, would you say, does it hurt more when I push in or when I let go?

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When you let go.

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When I let go?

140

Yeah.

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Okay, and how's about this?

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Oh, that one kind of hurts too.

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That was tender too?

144

Yeah.

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I'm going to help you up.

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There you go.

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So I think what's going on is, what it sounds like at least, is appendicitis, which just means your appendix,

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this little organ kind of down here in the right side of your abdomen, is infected.

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I think the best thing for us to do would be referred to general surgery

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and get a surgeon to come see you and talk to you.

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they might want to do antibiotics they might want to do

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some IV fluids you know they might end up taking you to the operating room

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but in the meantime I think what we need to do is get a CAT scan

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so that we can image that appendix and actually see how big it is

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and make sure it's not ruptured

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but it definitely what you're describing sounds an awful lot like appendicitis that's kind of scary it is

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but you know we're going to take really good care of you here we can answer all your questions

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and then is there anyone

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that you would like for me to bring back to sit with you

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while you're waiting my fiance is out in the waiting room yeah would you like the nurses

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or myself to go get him sure okay is

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that do you have I know there's a lot going on

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but do you have any other questions right now no I'm gonna go talk to the doctors is it okay

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if I come back with them to sure yeah okay it was really nice to meet you thank you

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ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: KCU CSR Patient Encounter Abdominal Pain in the ED

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