TRANSCRIPT

Unit 3 Rooms and Equipment - Hospital Facilities

Shopping

There is a gift shop on the ground floor of the Plaza Building that sells magazines
and newspapers, as well as sweets, soft drinks, greeting cards and other gift
products. We are sorry but we do not sell flowers.

Food

There is a canteen which serves a variety of hot and cold food. It is open 24 hours a
day. There is also a coffee shop near the entrance of the Plaza Building, which
serves a variety of sandwiches, snacks and coffee.

Opening hours: Monday to Sunday, 9:00 a.m. to 5:00 p.m.

Pharmacy

There is a pharmacy on the ground floor of the Outpatients Building, in Churchill

Street.

Opening hours: Monday to Friday, 9:30 a.m. to 5:15 p.m.

Banking

There is a cash point in the shop on the ground floor of the Plaza Building.

Vending Machines

You can find vending machines selling hot and cold drinks, crisps and chocolates
near the entrance of the Plaza Building.

Unit 6 Hygiene Listening 1

Nurse Carter: Do you need help getting ready today, David?

David: Thank you, Nurse Carter. Could you give me a hand shaving, please? I can’t
hold the razor without shaking. It’s very difficult.
Nurse Carter: No problem. I am going to get a washbowl and shaving cream and we
can start.

David: Before that, can you help me to the toilet, please? I hate using the urinal
bottle.

Nurse Carter: Yes, of course.

David: Thank you. I’m so embarrassed.

Nurse Carter: There is no need to feel ashamed, David. Most patients find the
situation difficult.

David: I am going to find my stick. Okay, here it is.

Nurse Carter: Do you need any help getting onto the toilet seat?

Unit 6 Hygiene Listening 2

Nurse Johnson: Good morning, Sarah. How are you feeling today?

Sarah: Hi Nurse Johnson. I'm doing okay, but I need some help with my hygiene
routine.

Nurse Johnson: Of course, I'm here to assist you. What specific help do you need?

Sarah: Well, I'm having trouble reaching my feet to wash them in the shower. Could
you help me with that?

Nurse Johnson: Absolutely, Sarah. I'll make sure to provide you with a sturdy chair
to sit on in the shower and help you wash your feet properly.

Sarah: Thank you, that would be really helpful. And also, I'm having difficulty
brushing my hair. My arms get tired quickly.

Nurse Johnson: I understand. How about using a hairbrush with a longer handle
that might be easier for you to grip and maneuver?

Sarah: That sounds like a good idea. And, I've been having trouble putting on my
socks and shoes. Would you be able to assist with that too?

Nurse Johnson: Of course. I can help you put on your socks and shoes.

Sarah: I appreciate your help and suggestions. It's just frustrating not being able to
do these simple things.
Nurse Johnson: No problem. Don't worry.

Unit 7 Preventing Infection

Speaker A: I've noticed there has been a recent outbreak of C. diff on the ward.

Speaker B: Yes, that's right. We have all the infected patients in isolation now.

Speaker A: Have those patients received any visitors recently?

Speaker B: Yes, we are making sure they wash their hands when they arrive and
leave to avoid contamination.
Speaker A: Good. Make sure they don't use those alcohol-based sanitizers. You
know they need to use soap and water.

Speaker B: Yes, we've made sure of that.

Speaker A: Excellent. Has any of the visitors reported any symptoms?

Speaker B: No, they haven't.

Speaker A: Okay, but make sure you stay on top of that. What about the nurses?

Speaker B: One nurse who was treating those patients has come down with
something.
Speaker A: The same infection?

Speaker B: We are not sure. They're doing some diagnostic tests at the moment. It
might be E. coli.

Speaker A: It's crucial that we act swiftly to prevent the spread of any potential
infections. I'll review the protocols for isolating patients and ensure the nurses are
using proper protective equipment.

Unit 9 Taking Vital Signs Listening 2

Checking the pulse is one of the routine procedures in physical examination. The
pulse rate is a measure of the heartbeat and reflects the healthy or ill condition of the
patient's heart and blood circulation. Every time the heart beats, the blood is pumped
through the arteries into the body.

The most common site for taking the pulse is the radial artery at the wrist. It is done
by placing the index finger and middle finger over the artery. Other sites for taking
the pulse are superficial arteries, such as the carotid artery in the neck, the temporal
artery at the temples, the femoral artery in the groin and the popliteal artery behind
the knee. The apical pulse can be heard by placing the stethoscope over the apex of
the heart, just below the patient's nipple.

Pulse rate is the number of beats per minute. The normal pulse rate is between 50 to
100 beats per minute. It is slightly higher in females (65 to 85 beats per minute) than
in males (60 to 80 beats per minute). It is slower when the person is relaxed and
faster during exercise, excitement, anger or fear. Age and body build also affect the
pulse rate.

In a newborn infant, the normal pulse rate is 120 to 140 beats per minute and it
decreases with age. Short, overweight persons have a slower pulse rate than tall
and thin persons. A normal pulse beat should correspond with the person's age,
should be strong and have a regular rhythm.
A disease may change the pulse rate and rhythm. Increased body temperature,
certain heart diseases, shock, and major injury with excessive blood loss
(hemorrhage) cause a faster pulse rate, called tachycardia. An abnormally slow
pulse rate is called bradycardia. Irregular pulse rhythm is called arrhythmia. If the
pulse is weak, it can be a sign of heart failure, shock, and obstructed blood
circulation or peripheral circulatory disease. Any changes in the pulse rate below 50
and above 100 indicate a serious problem.

Unit 12 Accidents Emergencies and First Aid

Medic: Hello sir. Don't worry, everything's going to be okay. What happened?

Patient: There was an accident at work. A machine caught fire behind me.

Medic: Okay. Where are you injured?

Patient: My back hurts pretty badly. I think it's burned.

Medic: I can see that. But I don't think it's too serious, though.

Patient: Really? How can you tell?

Medic: Well, it's blistering, and that's a good sign. It means it's probably not a third-
degree burn.

Patient: That's good. It still hurts though.

Medic: Of course. I'll get an ice pack to put on it. That should make it feel a bit better.

Patient: Thanks. I also cut my hand as we were trying to put the fire out.

Medic: Okay, we just need to sterilize it and get a bandage over it.

Patient: All right. Thank you so much.

Unit 19 Signs and Symptoms Listening 1

Doctor: How are you today, Jason?

Jason: I have a sore throat.

Doctor: Do you have a cough?

Jason: Yes, and... and spots.

Doctor: Spots? Really? Can you show me?

Jason: Yes. I've got them here and here.

Doctor: Ms. Corrigan, does Jason have any other symptoms?

Ms. Corrigan: He has a slight fever and a running nose.

Unit 19 Signs and Symptoms Listening 2

Signs and symptoms are the tools for making a diagnosis, but what is the difference
between the two? The signs of an illness are the things that a doctor or nurse can
see and measure. Signs are things like spots and bleeding. Temperature, heart rate,
blood pressure and respiration rate are all signs because you can measure them.

Symptoms are the things which a patient experiences, but others can't always see.
Dizziness and nausea are examples of symptoms. The symptoms which make a
patient seek medical help in the first place are called the presenting symptoms.
Medics describe them in terms of being either strong, mild or weak.

Sometimes the symptoms of serious illnesses like cancer and diabetes are weak.
They stay weak for a long time and the illness remains undiagnosed. Many illnesses
have the same symptoms. These symptoms are called non-specific. Fatigue is an
example of this. It's a symptom of many kinds of illness, both chronic and acute, and
of both physical and mental disorders.

Doctors ask patients about the onset of the symptoms, what they feel like, what
relieves them and what makes them worse. The more detail they have, the faster
they can make a diagnosis.

Unit 19 Signs and Symptoms Listening 3

Doctor: How can I help you?

Patient: I'm having some stomach aches lately.

Doctor: What kind of stomach aches?

Patient: They come and go. Sometimes they feel like I ate something that disagreed
with me. Other times I just feel nauseous.

Doctor: Do you have any other symptoms?

Patient: Yes, I feel really tired. I'm always exhausted.

Doctor: It sounds like you might be experiencing some gastritis. I'd like to prescribe
you some pain medication to help with the discomfort.

Patient: Thank you, Doctor.

Doctor: You're welcome.

Unit 30 In the radiology department Listening 1

A mammogram is a special type of X-ray of the breasts. Mammograms can show
tumors long before they are big enough for you or your health care provider to feel.
They are recommended for women who have symptoms of breast cancer or who
have a high risk of the disease. You and your health care provider should discuss
when to start having mammograms and how often to get one.

Mammograms are quick and easy. You stand in front of an X-ray machine. The
person who takes the X-rays places your breast between two plastic plates. The
plates press your breast and make it flat. This may be uncomfortable, but it helps get
a clear picture. You will have an X-ray of each breast. A mammogram takes only a
few seconds and it can help save your life.

Unit 30 In the radiology department Listening 2

X-rays are a type of radiation called electromagnetic waves. X-ray imaging creates
pictures of the inside of your body. The images show the parts of your body in
different shades of black and white. This is because different tissues absorb different
amounts of radiation. Calcium in bones absorbs X-rays the most, so bones look
white. Fat and other soft tissues absorb less and look gray. Air absorbs the least, so
lungs look black.

The most familiar use of X-rays is checking for fractures (broken bones), but X-rays
are also used in other ways. For example, chest X-rays can spot pneumonia.
Mammograms use X-rays to look for breast cancer.

When you have an X-ray, you may wear a lead apron to protect certain parts of your
body. The amount of radiation you get from an X-ray is small. For example, a chest
X-ray gives out a radiation dose similar to the amount of radiation you're naturally
exposed to from the environment over 10 days.

Unit 31 X-ray and CT Listening 1

Machines called CT scanners beam X-rays at multiple angles through a section of a
patient's body. The absorption of all these X-rays, after they pass through the body,
is detected and used in a computer to create a cross-sectional picture of the body
section examined.

The ability of sensitivity CT scanners to detect abnormalities is increased by the use

of iodine containing contrast agents, which outline blood vessels and enhance soft
tissues. The CT scanners are highly sensitive in detecting disease in bony structures
and can actually provide images of internal organs that are impossible to visualize
with ordinary X-ray technique.
Unit 31 X-ray and CT Listening 2

The chest X-ray is the commonest diagnostic X-ray examination. Normally a frontal
anteroposterior view is obtained. The patient stands facing the photographic plate
with the chest pressed to the plate, with hands on hips and elbows pushed out in
front. The radiographer, the technician who takes the X-ray, asks the patient not to
move, then to breathe in deeply and not to breathe out.

This makes a blurred, unclear X-ray image less likely and improves the quality of the
image, as it is easier to see abnormalities in air-filled, inflated lungs than in deflated
lungs. For a side, or lateral view, the patient is asked to stand sideways to the
photographic plate with arms raised.
A chest X-ray may be repeated at intervals to track for any changes. These repeated
examinations are called serial chest X-rays.

Unit 32 MRI and Ultrasound Listening 1

The technology of ultrasound is attractive because it does not use ionizing radiation,
and the machines are relatively inexpensive. For these reasons, ultrasound has
found widespread use in obstetrics. The use of so-called real-time ultrasound allows
the images to be seen in sequential frames just as in a movie. This capability has
proved popular for imaging rapidly moving structures, such as the heart.

Unfortunately, ultrasound images can be quite dependent on operator set

parameters, and the field of view within the patient is limited. Thus unless clear
labels are placed relative to orientation, the images can be difficult or impossible for
the novice to interpret.
Ultrasound images are usually presented as white echoes on a black background
but occasionally as black echoes on a white background. In addition to using echoes
to generate images, you can analyze the returning echo frequencies. This Doppler
analysis allows identification of moving blood as well as its direction and magnitude.
One example of its use is to identify and quantitate stenoses of the carotid arteries.

Unit 32 MRI and Ultrasound Listening 2

Magnetic resonance imaging or MRI generates images by applying a varying

magnetic field to the body. The magnetic field aligns atoms. When the field is
released, radio waves are generated. The frequency of the emitted radio waves is
related to the chemical environment of the atoms as well as to their location.

With computer analysis of these data, MR images, which are essentially hydrogen
maps, can be generated. Although many MRI techniques exist, the two basic types
of images are T1 and T2.
T1 images show fat as a white or bright signal, whereas water or cerebrospinal fluid
is dark. On a T2 image, fat is dark, and blood, edema, and CSF appear white.
Unfortunately, calcium and bone are difficult to see on MR images. What people
think are the "white bones" is really visualization of fat in the marrow.

Computer manipulation of MR images allows slices similar to those of CT orientation

to be used. An intravenous contrast agent, Gadolinium, is often used in conjunction
with MRI. Not many significant patient reactions occur with this agent.

Unit 36 Surgery

Doctor: Sam, could we go over tomorrow's surgery schedule?

Sam: Sure thing, Doctor. First up is a bowel resection for Paul Jackson at 7:00
o'clock.

Doctor: Yes. Is there anything else scheduled for the rest of morning?

Sam: You are supposed to perform a gallbladder excision on Amanda Burns at 10:00
o'clock.

Doctor: Right, the cholecystectomy. That could be a problem. I think Mr. Jackson's
resection could take a while.

Sam: Why's that, Doctor?

Doctor: I remember the abdominal CT scan showing the tumor to be quite large and
advanced. I need to allow time for complications.

Sam: I see. What should we do, then?

Doctor: Well, we may need to push back that procedure by a couple of hours.

Sam: Okay. Let's see here. There's an operating room open at noon.
Doctor: That would be perfect. Who's the anesthesiologist for the operation?
Sam: Dr. Gibbins is slated to work with you on that.

Doctor: Good. Please let Dr. Gibbins, Ms. Burns, and the nursing staff know about
the change.

Sam: Will do. See you tomorrow, Doctor.