Abstract：
ABSTRACTEffective communication between patients and providers is critically important, particularly in the setting of acute illness. In time-sensitive medical emergencies, language barriers may be seen as burdensome, but should be addressed attentively to gather accurate information and to form a trusting relationship with patients and their families. Such is the case with a 79-year-old man who was brought to the emergency department (ED) with symptoms concerning for acute stroke. His Russian-speaking wife was the only source of the patient\'s history, and information was initially gathered without the aid of a medical interpreter. Based on this information, which was provided in broken English, the patient was determined to be out of the time window to receive intravenous tissue plasminogen activator (IV tPA). Subsequent history taken by the admitting medicine team with the help of a medical interpreter revealed that the patient\'s symptoms began much more recently than previously understood. Based on the time he was last seen normal, the patient could have been a candidate for IV tPA when he first presented, but the information was clarified after he was outside this time window. Subsequent head imaging confirmed the presence of acute infarct in the left middle cerebral artery territory.This communication failure serves to highlight the importance of thorough and detailed communication between healthcare providers and their patients. As evidenced by the case presented, the outcomes of this underutilization can lead to catastrophic decision-making and, in turn, hinder the ability of providers to provide quality care for their patients.
摘要：
患者和提供者之间的有效沟通至关重要，特别是在急性疾病的背景下。在时间敏感的医疗紧急情况下，语言障碍可能被认为是繁重的，但应该注意收集准确的信息，并与患者及其家人建立信任关系。对于一名79岁的男子来说就是这种情况，他被带到急诊科（ED），症状涉及急性中风。他说俄语的妻子是病人病史的唯一来源,信息最初是在没有医疗翻译的帮助下收集的。根据这些信息,它是用残破的英语提供的，患者被确定超出接受静脉内组织纤溶酶原激活剂(IVtPA)的时间窗.在医学翻译的帮助下，入院医学小组随后取得的病史表明，患者的症状比以前理解的要早得多。根据他最后一次正常的时间，该患者在首次就诊时可能是IVtPA的候选人，但是在他离开这个时间窗口后，信息得到了澄清。随后的头部成像证实左大脑中动脉区域存在急性梗塞。这种沟通失败有助于强调医疗保健提供者与患者之间进行彻底和详细沟通的重要性。正如所提出的案例所证明的那样，这种未充分利用的结果可能导致灾难性的决策，反过来,阻碍提供者为患者提供优质护理的能力。
