問題詳情

B.When Lygia Dunsworth was sedated, intubated and strapped down in the intensive care unit at a hospital in FortWorth, Texas, she was racked by hallucinations: Outside her window, she saw helicopters evacuating patients from animpending tornado, leaving her behind. Nurses plotted to toss her into rough lake waters. She hallucinated an escape andducked into a freezer, surrounded by body parts. For years after recovering physically from abdominal infections and surgeries, Mrs. Dunsworth was tormented by herstay in intensive care. She had short-term memory loss and difficulty sleeping. She would not go into the ocean or a lakeand was terrified to fly or even travel alone. In fact, she was having symptoms associated with post-traumatic stressdisorder (PTSD). Annually, about five million patients stay in an intensive care unit in the United States. Studies show that up to 35percent may have symptoms of PTSD for as long as two years after that experience, particularly if they had a prolongedstay due to a critical illness with severe infection or respiratory failure. Those persistent symptoms include intrusivethoughts, avoidant behaviors, mood swings, emotional numbness and reckless behavior. What is unsettling for post-I.C.U.patients is that no one can verify their seemingly real horrors. Yet when patients leave the I.C.U., it’s the exception for them to be screened for psychiatric symptoms likepost-traumatic stress or low mood. Now critical care specialists are trying to prevent or shorten the duration of thedisorders. With the eerie, sleep-indifferent lights and the cacophony of machines and alarms, the I.C.U. setting itself can feelsinister to patients. Women may be more at risk to PTSD than men, as are patients with a history of depression or otheremotional difficulties. But researchers have begun to identify the treatment that has led to the most harrowing flashbacks:sedation, which is crucial in the I.C.U. to manage pain and compel patients to lie still. They now believe that a class ofsedatives known as benzodiazepines, which includes the drug Valium, may intensify the hallucinations that are sodisturbing to I.C.U. patients and can return for years. A British doctor, Sarah Wake, was intubated and sedated following a severe reaction to a medication in 2011. Shedescribed her hallucinations: “Blood seeping through holes and cracks in my skin, forming a puddle of red around me.”The fragmented delusional memories made it difficult for her to understand what had happened. “This prevented mypsychological recovery and led to the development of post-traumatic stress disorder,” she said. For months she could notwork in a hospital.The Society of Critical Care Medicine released new sedation guidelines, urging I.C.U. doctors to treat pain first andonly then to weigh using benzodiazepines for anxiety. Lighter sedation seems tied to better cognitive and physicalrehabilitative recovery, as well as fewer and less shattering hallucinations. Besides, in Britain, Germany and some Scandinavian countries, nurses in many critical care units keep a diary of thecare they give a patient, with additions from the family, which they give to the patient upon discharge. The diaries functionas a counterpoint to patients’ hallucinations or amnesia.
41. According to the passage, which of the following is not mentioned as the cause of PTSD?
(A) The unpleasant I.C.U. setting.
(B) Reckless behavior of nurses.
(C) A patient’s emotional problems.
(D) The use of a certain class of sedatives.

參考答案

答案：B
難度：適中0.5
統計：A(0),B(4),C(3),D(0),E(0)

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