yping88 发表于 15-8-2013 14:29:07

Be paralyzed from neck down 从脖子以下的部位全无知觉

Be proportionally related to 与。。。成正比

yping88 发表于 15-8-2013 14:48:58

Michael:

Medically paralyzing (利用药物使病人处于肌松状态) ventilated patients still remains attractive to hospital system, it is still considered the standard practice to prevent patients accidentally to extubate (拔出气管插管) themselves.

Well, please turn to (求助于) the medically induced-coma (药物辅助的知觉丧失) as your last resort after patients failed in all other options.

You should definitely explore first why patient is fighting against the ventilating model you put them on. Question yourself if there are any other better options that can address their breathing troubles better.

yping88 发表于 15-8-2013 15:16:39

Michael:

Now, please think about whether or not the anxiety patients show when they develop trouble breathing is due to hypoxemia (低氧血症)?

Well, no matter how tempting the YES answer seems, please be aware that it's not.

Surprisingly enough, hypoxemia leads to Euphoria (欣快感), which means if patients are deprived of (缺乏氧气供应) oxygen long enough to cause hypoxemia, they become paradoxically (令人费解地/讲不通地) excited.

No matter how hard you try to put them back on the ventilator, they would push it away and take on the attitude that suggests "I don't care!"

Well, hopefully you care enough to stick around trying your best to pull them out of the trouble. But please don't say this anymore: "xxx, please don't take it off, the ventilator needs to stay on to help you through your trouble breathing".

Why this doesn't make sense to them anymore? Because they don't care what's gonna happen when they are in the euphoric state due to hypoxemia. So, start modifying your patronizing nursing model now, and trying to explore what is really behind patients' destructive behaviours!

So, what makes patients anxious and lose control?---The fear of not being able to breathe!

yping88 发表于 15-8-2013 15:37:24

Sorry for abusing your eyes with all these medical stuff, guys!

Now, I'd like to tell you something different to relax your sight.

Before the lecture started, I was strolling around the hallway with my shoe-lace dangling around. But I just marching through the crowds without noticing anything different.

Kim pointed out to me in private: Ping, your shoe-lace came undone (松开了).

Me: Oh, did you notice since when it came undone? OMG, I remember I almost cut across (从人群中穿过) every single group!

And then, during the afternoon tea, I noticed my shoe-lace go loose again. I blamed Kim: Hey, look at my shoe-lace, nobody is minding that any more.

Kim: Oh, sorry, Ping. I was too hungry to mind anything else just now. Now, I am back on duty!

蓝色热带鱼 发表于 15-8-2013 19:45:17

mark, thanks a bunch!

MICHELLE07 发表于 15-8-2013 23:30:29

本帖最后由 MICHELLE07 于 16-8-2013 22:03 编辑

I'm totally lost....are all these slangs?
都不明白有什么特定的含义,除了最后一个,没有去google :'(:'(
Once in a blue moon

I'm a kissing frog

He is a Chili bush

A walk in the park: 有别的意思吗?

My mood hits the record low : 就这个看起来不tricky

Upclose and personal 搜索了一下,是一部电影《因为你爱过我》

MICHELLE07 发表于 15-8-2013 23:46:45

for every single individual 真正的人性化
病人的需求是最好的标准,这个理念和方法必将make a significant difference

why patient is fighting against the ventilating model?
是本能的抗拒吗? 呼吸困难的人会拒绝帮助?

看了664楼似乎明白了,有似乎更糊涂了。

第一句不懂:
Now, please think about whether or not the anxiety patients show when they develop trouble breathing is due to hypoxemia (低氧血症)?
Well, no matter how tempting the YES answer seems, please be aware that it's not.
就是说, 答案是NO, 病人呼吸困难时表现出来的焦躁不是因为低氧血症,不是吗?后面不是说因为缺氧会失控,也能解释663楼,但,为什么说:焦躁不是因为低氧血症?

不好意思,有点小白痴的感觉。。。



Dux 发表于 16-8-2013 00:22:09

好帖。学习了!:zan

yping88 发表于 16-8-2013 07:58:20

本帖最后由 yping88 于 18-8-2013 00:57 编辑

Dux 路垄卤铆脫脷 16-8-2013 00:22 static/image/common/back.gif
潞脙脤没隆拢脩搂脧掳脕脣拢隆

Hey, Dux, thanks for being here, hopefully you will frequent this column for discussion, argument and agreement!

Please stay tuned and weigh in your opinions every so often!

yping88 发表于 16-8-2013 08:18:22

why patient is fighting against the ventilating model?
是本能的抗拒吗? 呼吸困难的人会拒绝帮助?

Yeah, Michelle!

If patient was put on the mechanical ventilator that's not synchronized (与。。。保持同步) their usual model of breathing or not their need-oriented (以病人的需求为目的的), they would instinctively (本能地) fight against it.

For instance, if the ventilator delivers the breath when patient is expirating, or ventilator delivers the breath in a higher speed/pressure/volume than he can tolerate, then, he wouldn't care about what your intention is to put him on the ventilator, all he would try is to push away the potential risk (as patient himself would think, it's his reality).

That's why Michael gave us two examples on what happens in a shopping center's car park, to illustrate when the breath should be delivered and how!

yping88 发表于 16-8-2013 08:39:16

Now, please think about whether or not the anxiety patients show when they develop trouble breathing is due to hypoxemia (低氧血症)?
Well, no matter how tempting the YES answer seems, please be aware that it's not.
就是说, 答案是NO, 病人呼吸困难时表现出来的焦躁不是因为低氧血症,不是吗?后面不是说因为缺氧会失控,也能解释663楼,但,为什么说:焦躁不是因为低氧血症?

Traditionally, it has been believed that the anxiety in patient with breathing trouble is due to hypoxemia. That's why the answer YES seems so tempting () for everybody to let out.

But it's the FEAR (恐惧) to not being able to breath that makes patient to lose their control, not hypoxemia. Michael pointed out this fact to make clear that we shouldn't force the ventilator on to the patient before we explore why the patient is fighting against it.

According to the nature, helping somebody to breathe to pull him out of his hypoxic ordeal (缺氧的困境) should be theoretically easy to be accepted by the receiver.

But, if patient is hypoxic (缺氧) enough to go into hypoxemia (低血氧症), he would be in a state of euphoria, too disorientated (神志恍惚不清) to care what's happening to him any more.

That's why nursing staff's persuading him to not push the ventilator away makes no sense to him anymore.

yping88 发表于 16-8-2013 08:45:22

MICHELLE07 发表于 15-8-2013 23:30 static/image/common/back.gif
I'm totally lost....are all these slangs?
都不明白有什么特定的含义,除了最后一个,没有去google...

Sorry, I should've put them all in the context when I posted them here. I'll repost them one by one differently and explain them.

I was in a rush when I initially brought them up, because I had to finish off my recollection (回忆) of the lecture before it fades away from my age-related poor memory.

Please bear with me!

Heeeheeee

yping88 发表于 16-8-2013 12:44:04

MICHELLE07 发表于 15-8-2013 23:30 static/image/common/back.gif
I'm totally lost....are all these slangs?
都不明白有什么特定的含义,除了最后一个,没有去google...

Once in a blue moon It's almost impossible for something to happen! 可能性微乎其微


I'm totally lost....are all these slangs?
都不明白有什么特定的含义,除了最后一个,没有去google
Once in a blue moon

I'm a kissing frog

A lady and I had a casual chat about relationships and marriage, she asked me about mine. After giving her the answers, I threw the same questions over to her. She said:

No, I am not married yet, I have been just a kissing frog.

She explained that in a loving fairy-tale, a knight fell in love with a beautiful talking frog. One day, the knight kissed the frog, who turned into a pretty girl, and ended up being his lovely princess. And they shared a happy, joyful life thereafter.

She said she has been in different relationships, on and off, nothing has turned into something serious yet. So, she is just a kissing frog, but not anybody's princess yet.

MICHELLE07 发表于 16-8-2013 12:45:42

yping88 发表于 16-8-2013 12:44 static/image/common/back.gif
Once in a blue moon It's almost impossible for something to happen! 可能性微乎其微




Beautiful story!
I love it
It's nice to be a kissing frog

yping88 发表于 16-8-2013 12:54:36

He is a Chili bush

A gentleman was in a critical situation and admitted under my care. He got a very supportive and caring daughter. When he became a bit stable, the daughter hugged her father and kept telling him:

"Hey, dad, please hang in there, I know you are a chili bush".

I prompted her for answer afterwards, she said: The chili bush is a toughest kind in the desert. You can beat it, break it, deprive it of water, you can do every damage to it, but can never kill it due to its toughest surviving capability.

yping88 发表于 16-8-2013 13:03:22

A walk in the park 轻松而愉快的任务

Upclose ane personal 请走近某人,倾听他的故事,理解他,接受他 please don't keep distance, get upclose and personal

@MICHELLE07 You are right, there is an american movie call UPCLOSE AND PERSONAL, starred by Michelle Pfeiffer, one of my favorites.

yping88 发表于 16-8-2013 13:14:19

本帖最后由 yping88 于 16-8-2013 14:12 编辑

After discussing with Zoe, I would like to make a bit alteration to an expression in #633

FOB==Fresh Off Boat

Also means someone newly arrives at a country, doesn't speak the adopt country's language perfectly. There is a negative component in it in this context.

Teenagers often mock each other for their inappropriate language, writing, or doing things not in a so-called cool way, etc...

yping88 发表于 16-8-2013 18:38:57

@BlackUmatta

A very well-done on you for sticking around, it has been such a pleasure to see you turn up regularly!

MICHELLE07 发表于 16-8-2013 22:07:47

yping88 发表于 16-8-2013 12:54 static/image/common/back.gif
He is a Chili bush

A gentleman was in a critical situation and admitted under my care. He got a v ...

恩,有点类似于打不死的小强。
对了,Zoe 很可爱。

yping88 发表于 17-8-2013 11:15:02

Fit as a fiddle非常健康,精神非常好 Why FIDDLe? Anybody cares to weigh in?

Good as gold 非常好,伤好/病愈好完好如初

MICHELLE07 发表于 17-8-2013 15:48:11

yping88 发表于 17-8-2013 11:15 static/image/common/back.gif
Fit as a fiddle非常健康,精神非常好 Why FIDDLe? Anybody cares to weigh in?

Good as gold 非常好 ...

谢谢分享。
why fiddle?我的理解是小提琴调节好了,音色漂亮,形容人健康。
还有,under the weather,in the pink ,down with the bug

你都听说过吗?

yping88 发表于 17-8-2013 17:26:36

本帖最后由 yping88 于 17-8-2013 18:27 编辑

MICHELLE07 发表于 17-8-2013 15:48 static/image/common/back.gif
谢谢分享。
why fiddle?我的理解是小提琴调节好了,音色漂亮,形容人健康。
还有,under the weather,i ...

Michelle, it's a wonder how everything makes more sense after you analyze it. And it sounds like a beautiful poem as well.

Now, I am carious what the telephone numbers might turn out to be if you give them an explanation!

yping88 发表于 17-8-2013 17:36:28

MICHELLE07 发表于 17-8-2013 15:48 static/image/common/back.gif
谢谢分享。
why fiddle?我的理解是小提琴调节好了,音色漂亮,形容人健康。
还有,under the weather,i ...

Thank you for bringing these ones up here now, perfect place and perfect timing to discuss them.

I have never heard of "In the pink", yeah, the other two ring the very bell:

Come down with something 感染上。。。

Feel under the weather感觉不舒服

I am aware you know both of them, but you don't mind me putting them in chinese, do you?

Please advise what "in the pink" means and analyze it!

Could I be more demanding? Haaahaaa

fenzuan 发表于 17-8-2013 21:49:15

想问一下大家,有时听到有些人说same same,为啥要说两遍呢?听着有点怪,是地道的英语吗?

yping88 发表于 17-8-2013 22:58:12

fenzuan 发表于 17-8-2013 21:49 static/image/common/back.gif
想问一下大家,有时听到有些人说same same,为啥要说两遍呢?听着有点怪,是地道的英语吗?

To be honest, I am not sure about this one!

But, I often hear someone say "Here, Here" to tell the group that they agree with what has been just said. It has to be brought up in a timely manner though, otherwise, nobody knows what you agree to!

MICHELLE07 发表于 18-8-2013 00:05:56

本帖最后由 MICHELLE07 于 19-8-2013 12:08 编辑

yping88 发表于 17-8-2013 17:36 static/image/common/back.gif
Thank you for bringing these ones up here now, perfect place and perfect timing to discuss them.
...

记得一个笑话,有个人打开广播,听到主持人说“如果毛色发亮,皮肤粉红,说明很健康。。”
他照了一下镜子,很得意地想 “恩,看来我很健康”,然后就听到主持人继续说:“好了,养猪讲座到此结束了”

还有,判断人是否健康,可以看指甲,如果光亮呈粉红色,说明健康。

所以,in the pink 就是指健康了!

yping88 发表于 18-8-2013 20:16:55

Play safe从安全的角度出发

Play fool/play dumb 装傻卖呆

Play dead装死

Hold grudge towards somebody 抱着对某人的怨气

The likewise to you! 还你同样的问候 Usually say it in return to someone's greetings, nice words, good wishes and such.

fenzuan 发表于 18-8-2013 21:44:06

yping88 发表于 16-8-2013 08:18 static/image/common/back.gif
why patient is fighting against the ventilating model?
是本能的抗拒吗? 呼吸困难的人会拒绝帮助?
...

Wow, difficult! So what should a nurse do if the patient push away the ventilator because of hypoxemia?
BTW, yping, what did you study for your post graduate course?

yping88 发表于 18-8-2013 21:56:13

fenzuan 发表于 18-8-2013 21:44 static/image/common/back.gif
Wow, difficult! So what should a nurse do if the patient push away the ventilator because of hypox ...

To your first question, @fenzuan

All other options have to be tried out first to address the potential factors that lead to patients' resistance: Is the ventilation mode suitable? Is the volume too high for patient's lung capacity? Is the ventilator works with patient in synchronized pace? Is the gas delivered too fast for patient to tolerate?

Only after the above issues were explored thoroughly and options were exhausted, could patient be put on sedation passively to make the ventilator actually help patients in need.

To your second question: I did the post-grad course in cardiac nursing!

Hope I answered your questions!

fenzuan 发表于 18-8-2013 22:17:42

yping88 发表于 18-8-2013 21:56 static/image/common/back.gif
To your first question, @fenzuan

All other options have to be tried out first to address the ...

The second answer is easy haha. Thanks. For the first answer,I used a dictionary. :L Sorry, still 晕。If the patient push away the ventilator. After all the possible causes have been checked, if the reason is hypoxemia, so, the nurse can put the patient on sedation in order to let the ventilator work. Can I understand like this?
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