去年最火的医疗剧，莫过于《急诊科医生》，有关急诊科医生的工作与生活日常受到了大众的关注。
旅美的中国医生宋瑞医生将和美国哈佛大学医学院附属布列根和妇女医院急诊科美国华裔医生侯全益医生一起，在「中美医生话急诊」栏目中与你用地道的专业英语，聊聊美国急诊制度。
中美医生介绍
美国医生：侯全益医生，哈佛医学院急诊科讲师, 布列根和妇女医院急诊科医生，外科 ICU 重症监护专家。
U.S. doctor: Dr. Peter Hou is an Instructor in Emergency Medicine at Harvard Medical School, an Emergency Physician at Brigham and Women’s Hospital, and a critical care specialist in the Surgical ICU.
中国医生：宋瑞医生，曾在中国和新加坡担任内科住院医师，现为自由作家，同时在波士顿进行自闭症相关临床研究。
Chinese doctor: Dr. Rui Song, former resident physician of internal medicine in China and Singapore, freelancer and she is doing clinical research on Autism in Boston.
第一期
Episode 1
急诊科医生是「全能手」吗？
Are Emergency physicians「 omnipotent」?
以下为录音中英文字版本：
Dr. 宋：侯医生您好，请问您看过美剧《急诊室的故事》、《豪斯医生》或《实习医生格蕾》吗？
Hi Dr. Hou, have you seen the TV series of ER, House, or Grey’s anatomy in America?
Dr. 侯：当然。
Of course.
Dr. 宋：我还知道有一部在美国波士顿拍摄的电视纪录片名叫《波士顿医务组》。
I also know that there was a TV documentary called Boston Med that was filmed in Boston.
Dr. 侯：是的，我想那是在 2010 年播出的。有趣的是，在 2000 年至 2001 年，我在南加州进行急诊科住院医培训的时候，也出现在了一部叫做《创伤：急诊室里看人生》的电视纪录片里。
Yes, I think it was in 2010. And interestingly during my emergency residency training back in 2000 to 2001, I was in another TV documentary called Trauma: Life in the ER, which came to film in South Los Angeles.
Dr. 宋：哇，真的是太巧了！最近，中国有一部非常受欢迎的医疗电视剧《急诊科医生》刚刚结束播映。大众觉得急诊科医生是「全能手」，因为他们总能从死亡线抢救回患者的生命。他们是从电视剧中得到了这样的感受。那么您怎么看待这个观点呢？
Wow, what a coincidence! Recently in China, there was a very popular TV drama called Emergency Physician that just finished broadcasting. People think emergency physicians are「omnipotent」because they often bring a patient back to life from death. They got the feeling from the TV series. What do you think about this opinion?
Dr. 侯：所有我认识的急诊科医生可能都会说急诊科医生并不是全能的。我们知道我们有自己的局限性，因为我们工作的环境非常繁忙并充满了不确定性。
All emergency physicians that I know will mostly likely say that they are not omnipotent.
We have and know our limitations since we work in busy environment with many uncertainties.
Dr. 宋：那么急诊科医生值班时都做些什么呢？
So what does emergency physicians do during their shift?
Dr. 侯：我们被培训去诊治生命或肢体已受到威胁或即将受到威胁的医疗情况。
我们在值班时会同时照顾很多患者。他们中有非急症如感冒、脚踝扭伤等，也有需要与时间赛跑的急症如心脏病发作、中风、外伤、败血症等。
我们的轮岗一般是 9 小时制，其中有约 1 个小时用来将患者的情况交班给接班的急诊科医生。
We are trained to take care of life or limb threatening, impending life or limb threatening conditions, and their expected course.
In terms of what we do actually during a shift, we take care of patients, many patients simultaneously varying from less acute conditions such as common cold or ankle sprain to acute more time sensitive conditions such as heart attack, stroke, trauma, or sepsis.
Most of our shifts are around 9 hours, which allows some 1 hour for handoff or pass-off of patients to the next emergency physician’s shift.
Dr. 宋：好的了解。那么您通常在急诊科都会遇见怎样的患者呢？
I see. So what kind of patients do you usually see in ED?
Dr. 侯：在我们医院的急诊科，我们会接诊自行前来就诊的患者和救护车送来的患者。他们可能是由他们的家庭医生转诊来急诊科进行进一步的检查和评估。通常情况下，我们为患者所做的就是排除疾病，确保他们没有任何紧急情况需要及时诊断和治疗。
就美国整体人口统计而言，急诊科患者的住院率约为 10-15%。然而，在我们医院，由于这是一家学术和转诊医院，我们急诊科患者的住院率高达 30-35%。因此，医院患者有较高的危急程度，与社区医院急诊室有明显不同。
我认为这很大程度上归因于我们与丹娜法伯癌症研究所的紧密联系以及其中大量的癌症人群。肿瘤患者往往免疫力低下，并有许多复杂的医疗状况，往往需要紧急诊断、稳定病情，并收入医院病房或重症监护病房。
同时我们也有一大群心血管病患者，他们也进一步提升了我们急诊科患者人群的危急程度。
In our hospital ED, we have patients who are called walk-in’s or others get transported by ambulance. They may be referred by their doctors to the ED for further testing and evaluation. Often, what we do for our patients are called rule-outs to make sure they don’t have any emergent conditions which need to be diagnosed and treated in a timely manner.
Just as background in terms of the overall demographics in the US, the hospital admission rate of ED patients is about 10-15%. However, in our hospital, which is an academic and referral hospital, our admission rate of ED patients is more like 30-35%. Hence, our patient population here has a higher acuity and is definitely different from the community ED’s.
Much of this I think is attributed to our close affiliation with Dana Farber Cancer Institute and with its large cohort of cancer population of course. The oncology patients often are immunocompromised and have a lot of complex medical conditions, which often require emergent diagnosis, stabilization, and admission to the hospital ward or ICU. We also have a large cohort of cardiovascular patients which further contributes to the higher acuity of our ED cohort.
Dr. 宋：非常感谢您的分享。下期节目，我想请您谈谈您所在的急诊科医疗团队是怎样的好吗？
Thank you for sharing this and for the next time, could you describe your medical team in the ED?
Dr. 侯：没问题！
Absolutely!
下一期讲什么？
What shall we talk about next?
急诊科医疗团队组成－医护以外的健康守护者。
The medical team in E.D.－healthcare providers in addition to doctors and nurses.
欢迎留言来说说「你所知的中国急诊科工作是一种什么样状态？急诊医疗团队由哪些人组成？」
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