TEDxMidAtlantic
Erica Frenkel: The universal anesthesia machine
艾丽卡･弗兰凯尔：万能麻醉器
Filmed:
Readability: 4.1
399,268 views
如果手术中停电了怎么办？没有灯，没有氧气－麻醉也停止供给。全世界的手术室里经常有这样的事，把日常程序弄成了悲剧。艾丽卡･弗兰凯尔展示了一个解决方案：万能麻醉器
Erica Frenkel - Medical technologist
At Gradian Health Systems, Erica Frenkel works to bring safe anesthesia to hospitals all over the world. Full bio
At Gradian Health Systems, Erica Frenkel works to bring safe anesthesia to hospitals all over the world. Full bio
Double-click the English transcript below to play the video.
00:15
I'm going to talk to you today
0
0
2000
今天我要谈的
00:17
about the design of medical technology for low resource settings.
1
2000
3000
是关于在低能源供给下的医疗技术设计
00:20
I study health systems in these countries.
2
5000
2000
我在这些国家学习医疗系统
00:22
And one of the major gaps in care,
3
7000
2000
一个重大的医疗缺口
00:24
almost across the board,
4
9000
2000
在很多国家都存在的
00:26
is access to safe surgery.
5
11000
2000
是安全手术通道
00:28
Now one of the major bottlenecks that we've found
6
13000
3000
我们发现的一个影响手术进行
00:31
that's sort of preventing both the access in the first place
7
16000
3000
和手术安全
00:34
and the safety of those surgeries that do happen
8
19000
2000
的重要医疗瓶颈
00:36
is anesthesia.
9
21000
2000
就是麻醉
00:38
And actually, it's the model that we expect to work
10
23000
2000
事实上，这个方案正是我
00:40
for delivering anesthesia
11
25000
2000
为手术能在如此环境下顺利进行
00:42
in these environments.
12
27000
2000
而致力开发的麻醉方式
00:44
Here we have a scene that you would find
13
29000
2000
这个场景是一个
00:46
in any operating room across the U.S. or any other developed country.
14
31000
3000
在美国和其他发达国家的手术室里常见的景象
00:49
In the background there
15
34000
2000
背景是
00:51
is a very sophisticated anesthesia machine.
16
36000
2000
一台非常精密的麻醉器
00:53
And this machine is able
17
38000
2000
这个机器能让
00:55
to enable surgery and save lives
18
40000
2000
手术顺利进行并挽救生命
00:57
because it was designed
19
42000
2000
因为它是按照此要求
00:59
with this environment in mind.
20
44000
2000
设计出来的
01:01
In order to operate, this machine needs a number of things
21
46000
3000
要操作这台机器
01:04
that this hospital has to offer.
22
49000
2000
医院需要具备一系列条件
01:06
It needs an extremely well-trained anesthesiologist
23
51000
3000
需要一个接受过良好训练的麻醉师
01:09
with years of training with complex machines
24
54000
2000
有数年操作复杂机械的经历
01:11
to help her monitor the flows of the gas
25
56000
3000
来监控气体进出
01:14
and keep her patients safe and anesthetized
26
59000
2000
保证病人的安全和
01:16
throughout the surgery.
27
61000
2000
手术中的麻醉状态
01:18
It's a delicate machine running on computer algorithms,
28
63000
3000
这台精巧的机器会进行精密运算
01:21
and it needs special care, TLC, to keep it up and running,
29
66000
3000
需要特别护理，TLC，以保证其正常运行
01:24
and it's going to break pretty easily.
30
69000
2000
而且它很容易出故障
01:26
And when it does, it needs a team of biomedical engineers
31
71000
3000
出故障的时候，需要一队能解决复杂问题的
01:29
who understand its complexities,
32
74000
2000
生物医学工程师的小组
01:31
can fix it, can source the parts
33
76000
2000
来修理，替换零件
01:33
and keep it saving lives.
34
78000
2000
让其继续挽救生命
01:35
It's a pretty expensive machine.
35
80000
2000
这是台很昂贵的机器
01:37
It needs a hospital
36
82000
2000
医院需要有
01:39
whose budget can allow it to support one machine
37
84000
2000
五万到十万美元的预算
01:41
costing upwards of 50 or $100,000.
38
86000
3000
来购置和维持运营一台机器
01:44
And perhaps most obviously,
39
89000
2000
也许最明显的就是
01:46
and perhaps most importantly --
40
91000
2000
或者说最重要的－
01:48
and the path to concepts that we've heard about
41
93000
2000
我们所知的那些概念
01:50
kind of illustrate this --
42
95000
2000
也说明了这个问题－
01:52
it needs infrastructure
43
97000
2000
这个机器需要
01:54
that can supply an uninterrupted source
44
99000
2000
能提供不间断电源
01:56
of electricity, of compressed oxygen
45
101000
3000
不间断供氧
01:59
and other medical supplies
46
104000
2000
还有其他医疗设备的基础设施
02:01
that are so critical to the functioning
47
106000
2000
这些都对这个机器的运转
02:03
of this machine.
48
108000
2000
至关重要
02:05
In other words, this machine requires a lot of stuff
49
110000
3000
也就是说，这台机器需要的许多东西
02:08
that this hospital cannot offer.
50
113000
2000
是这个医院所不能提供的
02:10
This is the electrical supply
51
115000
2000
这是马拉威一个乡下医院的
02:12
for a hospital in rural Malawi.
52
117000
2000
供电情况
02:14
In this hospital,
53
119000
2000
这个医院里
02:16
there is one person qualified to deliver anesthesia,
54
121000
2000
有一个人有实施麻醉的资质
02:18
and she's qualified
55
123000
2000
她具备资质的原因是
02:20
because she has 12, maybe 18 months
56
125000
2000
她接受过12或许18个月的
02:22
of training in anesthesia.
57
127000
2000
麻醉训练
02:24
In the hospital and in the entire region
58
129000
2000
在这个医院和这整个区域
02:26
there's not a single biomedical engineer.
59
131000
2000
没有一个生物医学工程师
02:28
So when this machine breaks,
60
133000
2000
所以机器一旦出故障
02:30
the machines they have to work with break,
61
135000
2000
就得带着故障运行
02:32
they've got to try and figure it out, but most of the time, that's the end of the road.
62
137000
3000
他们得自己试着修理，但大多时候，故障就意味着没戏了
02:35
Those machines go the proverbial junkyard.
63
140000
3000
这些机器就进了垃圾堆
02:38
And the price tag of the machine that I mentioned
64
143000
3000
而我提到过这台机器的价钱
02:41
could represent maybe a quarter or a third
65
146000
2000
这可能是这个医院
02:43
of the annual operating budget
66
148000
2000
一年预算的四分之一
02:45
for this hospital.
67
150000
2000
或三分之一
02:47
And finally, I think you can see that infrastructure is not very strong.
68
152000
3000
最后我想你们了解了它的基础设施不佳
02:50
This hospital is connected to a very weak power grid,
69
155000
3000
这家医院接入的电网非常弱
02:53
one that goes down frequently.
70
158000
2000
经常停电
02:55
So it runs frequently, the entire hospital,
71
160000
2000
这整个医院常常就是靠
02:57
just on a generator.
72
162000
2000
一台发电机运作
02:59
And you can imagine, the generator breaks down
73
164000
2000
可以想象 发电机若是出了故障
03:01
or runs out of fuel.
74
166000
2000
或者燃料耗尽会如何
03:03
And the World Bank sees this
75
168000
2000
世界银行借此估计
03:05
and estimates that a hospital in this setting in a low-income country
76
170000
3000
在一个低收入国家的此类条件下的医院
03:08
can expect up to 18 power outages
77
173000
3000
每个月大约有高达
03:11
per month.
78
176000
2000
18次断电
03:13
Similarly compressed oxygen and other medical supplies
79
178000
2000
同样，压缩氧气和其他医疗设备
03:15
are really a luxury
80
180000
2000
可以算是奢侈品了
03:17
and can often be out of stock
81
182000
2000
常常数月甚至一年
03:19
for months or even a year.
82
184000
2000
都没有任何储备
03:21
So it seems crazy, but the model that we have right now
83
186000
3000
这个看上去挺疯狂，但我们现在做的事
03:24
is taking those machines
84
189000
2000
就是把针对我最开始展示给你们的环境
03:26
that were designed for that first environment that I showed you
85
191000
2000
设计出来的机器
03:28
and donating or selling them
86
193000
2000
捐赠或出售给
03:30
to hospitals in this environment.
87
195000
3000
只有这样条件医院
03:33
It's not just inappropriate,
88
198000
2000
这不仅是不合适的
03:35
it becomes really unsafe.
89
200000
3000
而且不安全
03:38
One of our partners at Johns Hopkins
90
203000
2000
我们一位在約翰·霍普金斯大学的合作者
03:40
was observing surgeries in Sierra Leone
91
205000
3000
一年前在塞拉利昂观察了
03:43
about a year ago.
92
208000
2000
那里的手术
03:45
And the first surgery of the day happened to be an obstetrical case.
93
210000
3000
第一例手术正好是产科手术
03:48
A woman came in, she needed an emergency C-section
94
213000
3000
一个妇女需要进行紧急剖腹产
03:51
to save her life and the life of her baby.
95
216000
3000
来挽救她的孩子和自己的生命
03:54
And everything began pretty auspiciously.
96
219000
2000
开始一切顺利
03:56
The surgeon was on call and scrubbed in.
97
221000
2000
外科医生准备好了动手
03:58
The nurse was there.
98
223000
2000
护士也在
04:00
She was able to anesthetize her quickly,
99
225000
2000
能马上实施麻醉
04:02
and it was important because of the emergency nature of the situation.
100
227000
3000
因为是紧急情况所以这一切很重要
04:05
And everything began well
101
230000
2000
一切都很顺利
04:07
until the power went out.
102
232000
3000
后来停电了
04:10
And now in the middle of this surgery,
103
235000
2000
在手术进行过程中
04:12
the surgeon is racing against the clock to finish his case,
104
237000
3000
外科医生正和争分夺秒完成手术
04:15
which he can do -- he's got a headlamp.
105
240000
2000
他能做到，有个头灯
04:17
But the nurse is literally
106
242000
2000
但是护士就得
04:19
running around a darkened operating theater
107
244000
3000
在黑漆漆的的手术室里四处搜寻
04:22
trying to find anything she can use to anesthetize her patient,
108
247000
2000
能麻醉她的病人的东西
04:24
to keep her patient asleep.
109
249000
2000
让病人处于睡眠中
04:26
Because her machine doesn't work when there's no power.
110
251000
3000
因为没有电机器就不能运转
04:30
And now this routine surgery that many of you have probably experienced,
111
255000
3000
这样一个诸位都可能经历过
04:33
and others are probably the product of,
112
258000
2000
或者由此出生寻常手术
04:35
has now become a tragedy.
113
260000
3000
演变成了悲剧
04:38
And what's so frustrating is this is not a singular event;
114
263000
3000
更让人难过的是这并不是个案
04:41
this happens across the developing world.
115
266000
2000
在整个发展中的世界都是这样
04:43
35 million surgeries are attempted every year
116
268000
3000
每年有三千五百万例手术
04:46
without safe anesthesia.
117
271000
2000
是在没有安全麻醉的情况下实施
04:48
My colleague, Dr. Paul Fenton,
118
273000
2000
我的同事，鲍尔･芬东医生
04:50
was living this reality.
119
275000
2000
就处在这样的情况下
04:52
He was the chief of anesthesiology
120
277000
2000
他是马拉威一家医院的
04:54
in a hospital in Malawi, a teaching hospital.
121
279000
2000
首席麻醉师，那是个教学医院
04:56
He went to work every day
122
281000
2000
他每天就得
04:58
in an operating theater like this one,
123
283000
2000
去这样的医院上班
05:00
trying to deliver anesthesia and teach others how to do so
124
285000
3000
在医院里教导别人怎样实施麻醉
05:03
using that same equipment
125
288000
2000
怎么使用这个器材
05:05
that became so unreliable, and frankly unsafe,
126
290000
2000
十分不可靠
05:07
in his hospital.
127
292000
2000
不安全的设备
05:09
And after umpteen surgeries
128
294000
2000
在无数手术之后
05:11
and, you can imagine, really unspeakable tragedy,
129
296000
3000
你可以想象，无数悲剧之后
05:14
he just said, "That's it. I'm done. That's enough.
130
299000
2000
他说：“我不干了，我受够了
05:16
There has to be something better."
131
301000
2000
我得做点有用的东西。”
05:18
So he took a walk down the hall
132
303000
2000
他去了一趟
05:20
to where they threw all those machines that had just crapped out on them --
133
305000
2000
堆着扔掉的那些他抱怨过的机器的房间
05:22
I think that's the scientific term --
134
307000
2000
我想这就这些机器的名称
05:24
and he just started tinkering.
135
309000
2000
他开始修补
05:26
He took one part from here and another from there,
136
311000
2000
他从每个上面取一些
05:28
and he tried to come up with a machine
137
313000
2000
然后作出一个机器
05:30
that would work in the reality that he was facing.
138
315000
3000
能在他所处的环境里实用的
05:33
And what he came up with was this guy,
139
318000
3000
他就得到了这个东西
05:36
the prototype for the Universal Anesthesia Machine --
140
321000
3000
这就是万能麻醉器的原型
05:39
a machine that would work
141
324000
2000
这个机器能在
05:41
and anesthetize his patients
142
326000
2000
任何条件下
05:43
no matter the circumstances that his hospital had to offer.
143
328000
4000
工作，麻醉病人
05:47
Here it is back at home
144
332000
2000
这还是在那家医院
05:49
at that same hospital, developed a little further, 12 years later,
145
334000
3000
12年后 有了改进
05:52
working on patients from pediatrics to geriatrics.
146
337000
3000
适用于各个年龄的病人
05:55
Now let me show you a little bit about how this machine works.
147
340000
3000
现在我来解释一下它的运作原理
05:58
Voila!
148
343000
2000
哇！
06:00
Here she is.
149
345000
2000
这就是了
06:02
When you have electricity,
150
347000
2000
有电力供给时
06:04
everything in this machine begins in the base.
151
349000
2000
一切是从基座开始工作
06:06
There's a built-in oxygen concentrator down there.
152
351000
3000
下面有一个内置的氧气集中器
06:09
Now you've heard me mention oxygen a few times at this point.
153
354000
3000
你已经听我提到过几次氧气了
06:12
Essentially, to deliver anesthesia,
154
357000
2000
基本上，要实施麻醉
06:14
you want as pure oxygen as possible,
155
359000
2000
就得尽可能地使用纯氧
06:16
because eventually you're going to dilute it essentially
156
361000
2000
因为你最终会用气体
06:18
with the gas.
157
363000
2000
来稀释
06:20
And the mixture that the patient inhales
158
365000
2000
最后患者吸入的混合气体
06:22
needs to be at least a certain percentage oxygen
159
367000
2000
必须有一定比例的氧气
06:24
or else it can become dangerous.
160
369000
2000
不然就会很危险
06:26
But so in here when there's electricity,
161
371000
2000
但是当有电的时候
06:28
the oxygen concentrator takes in room air.
162
373000
3000
氧气集中器就采入室内空气
06:31
Now we know room air is gloriously free,
163
376000
3000
室内空气反正是免费的
06:34
it is abundant,
164
379000
2000
而起取之不尽
06:36
and it's already 21 percent oxygen.
165
381000
2000
并且含有21％的氧气
06:38
So all this concentrator does is take that room air in, filter it
166
383000
3000
集中器采入室内空气，过滤
06:41
and send 95 percent pure oxygen
167
386000
2000
输入95％的纯氧
06:43
up and across here
168
388000
2000
经过这里
06:45
where it mixes with the anesthetic agent.
169
390000
3000
混合麻醉成分
06:48
Now before that mixture
170
393000
2000
在混合气体
06:50
hits the patient's lungs,
171
395000
2000
进入病人肺部之前
06:52
it's going to pass by here --
172
397000
2000
会先经过这里
06:54
you can't see it, but there's an oxygen sensor here --
173
399000
2000
你看不到，这是个氧气传感器－
06:56
that's going to read out on this screen
174
401000
2000
能读出氧气含量
06:58
the percentage of oxygen being delivered.
175
403000
3000
显示在屏幕上
07:01
Now if you don't have power,
176
406000
2000
没有电的时候
07:03
or, God forbid, the power cuts out in the middle of surgery,
177
408000
3000
或者上帝不帮忙，手术中间断电了
07:06
this machine transitions automatically,
178
411000
2000
这个机器不需要人工操作
07:08
without even having to touch it,
179
413000
2000
就能自动切换模式
07:10
to drawing in room air from this inlet.
180
415000
3000
开始从这个口采入室内空气
07:13
Everything else is the same.
181
418000
2000
其他的都是一样的
07:15
The only difference is that now
182
420000
2000
唯一的区别是
07:17
you're only working with 21 percent oxygen.
183
422000
3000
你用的只是21％氧气
07:20
Now that used to be a dangerous guessing game,
184
425000
3000
这曾是个比较危险拼运气的手术部分
07:23
because you only knew if you had given too little oxygen once something bad happened.
185
428000
3000
因为通常是出事了你才知道供氧不足
07:26
But we've put a long-life battery backup on here.
186
431000
3000
但我们有一个超常寿命的电池
07:29
This is the only part that's battery backed up.
187
434000
2000
这是唯一一部分依靠电池的
07:31
But this gives control to the provider,
188
436000
2000
但这能让麻醉师能
07:33
whether there's power or not,
189
438000
2000
应对无论有电没电的情况
07:35
because they can adjust the flow
190
440000
2000
因为他们能按照屏幕上读取的
07:37
based on the percentage of oxygen they see that they're giving their patient.
191
442000
3000
氧气比例来调节气流
07:40
In both cases,
192
445000
2000
不论
07:42
whether you have power or not,
193
447000
2000
是否有电
07:44
sometimes the patient needs help breathing.
194
449000
2000
有时候病人需要协助呼吸
07:46
It's just a reality of anesthesia. The lungs can be paralyzed.
195
451000
3000
这是麻醉的现实情况 肺部有可能麻痹
07:49
And so we've just added this manual bellows.
196
454000
2000
所以我们加入了手动风箱
07:51
We've seen surgeries for three or four hours
197
456000
3000
我们见过三到四小时的手术
07:54
to ventilate the patient on this.
198
459000
3000
用这个来保持病人呼吸
07:57
So it's a straightforward machine.
199
462000
3000
所以这是个操作简明的机器
08:00
I shudder to say simple;
200
465000
2000
我不想说它简单
08:02
it's straightforward.
201
467000
2000
而是操作简明
08:04
And it's by design.
202
469000
2000
从设计层面上
08:06
And you do not need to be
203
471000
2000
而且你不必是一名
08:08
a highly trained, specialized anesthesiologist to use this machine,
204
473000
3000
经过优秀训练的，具备专门技能的麻醉医师才能来操作
08:11
which is good because, in these rural district hospitals,
205
476000
3000
这一点很重要，因为位于乡下的医院
08:14
you're not going to get that level of training.
206
479000
3000
不可能具备这个训练水平人员
08:17
It's also designed for the environment that it will be used in.
207
482000
3000
而且它也是按其使用环境来设计的
08:20
This is an incredibly rugged machine.
208
485000
2000
这是个不可思议地很粗糙的机器
08:22
It has to stand up
209
487000
2000
它能承受
08:24
to the heat and the wear and tear that happens
210
489000
2000
在乡下医院里
08:26
in hospitals in these rural districts.
211
491000
3000
会出现的过热和磨损
08:29
And so it's not going to break very easily,
212
494000
2000
也不容易出故障
08:31
but if it does, virtually every piece in this machine
213
496000
3000
但是如果出了故障，几乎每一个零件
08:34
can be swapped out and replaced
214
499000
3000
都可以用个六角扳手和螺丝刀
08:37
with a hex wrench and a screwdriver.
215
502000
3000
卸下来换个新的
08:40
And finally, it's affordable.
216
505000
2000
最后，它价钱不贵
08:42
This machine comes in
217
507000
2000
这个机器只有
08:44
at an eighth of the cost
218
509000
2000
之前展示的那个传统机器的
08:46
of the conventional machine that I showed you earlier.
219
511000
3000
八分之一的价格
08:49
So in other words, what we have here
220
514000
3000
也就是说，这个机器
08:52
is a machine that can enable surgery and save lives
221
517000
3000
能保证手术进行挽救生命
08:55
because it was designed for its environment,
222
520000
3000
因为它贴合环境实际的设计
08:58
just like the first machine I showed you.
223
523000
2000
用途就和我一开始展示的机器一样
09:00
But we're not content to stop there.
224
525000
2000
但是我们并不于此止步
09:02
Is it working?
225
527000
2000
这个机器能用吗？
09:04
Is this the design that's going to work in place?
226
529000
2000
这个设计能管用吗？
09:06
Well we've seen good results so far.
227
531000
2000
目前为止结果还是很好的
09:08
This is in 13 hospitals in four countries,
228
533000
3000
这个装备已经在4个国家13个医院应用
09:11
and since 2010,
229
536000
2000
从2010起
09:13
we've done well over 2,000 surgeries
230
538000
2000
我们已经用它做了超过两千例手术
09:15
with no clinically adverse events.
231
540000
2000
没有一起医疗事故
09:17
So we're thrilled.
232
542000
2000
我们乐坏了
09:19
This really seems like a cost-effective, scalable solution
233
544000
4000
这似乎是个经济又可推广的方案
09:23
to a problem that's really pervasive.
234
548000
3000
来应对目前广泛存在的问题
09:26
But we still want to be sure
235
551000
2000
但是我们仍需要确定这是
09:28
that this is the most effective and safe device
236
553000
2000
最有效和安全的设备
09:30
that we can be putting into hospitals.
237
555000
2000
能在医院里使用
09:32
So to do that we've launched a number of partnerships
238
557000
2000
所以我们为此和一些非政府组织及大学
09:34
with NGOs and universities
239
559000
2000
合作
09:36
to gather data on the user interface,
240
561000
3000
来收集使用者方面的资料
09:39
on the types of surgeries it's appropriate for
241
564000
2000
机器适宜操作的手术
09:41
and ways we can enhance the device itself.
242
566000
2000
以及增强设备的数据
09:43
One of those partnerships
243
568000
2000
我们的其中一个合作者
09:45
is with Johns Hopkins just here in Baltimore.
244
570000
3000
来自约翰･霍普金斯大学，正好也在巴尔的摩
09:48
They have a really cool anesthesia simulation lab out in Baltimore.
245
573000
4000
他们在巴尔的摩有一个非常棒的麻醉实验室
09:52
So we're taking this machine
246
577000
2000
我们带着机器
09:54
and recreating some of the operating theater crises
247
579000
3000
在一个受控的安全环境下
09:57
that this machine might face
248
582000
2000
重现机器
09:59
in one of the hospitals that it's intended for,
249
584000
2000
在其原本设计环境下
10:01
and in a contained, safe environment,
250
586000
3000
可能遇到的紧急情况
10:04
evaluating its effectiveness.
251
589000
2000
来评估其有效性
10:06
We're then able to compare the results from that study
252
591000
3000
这样我们就能把研究结果
10:09
with real world experience,
253
594000
2000
和实际经验进行比较
10:11
because we're putting two of these in hospitals
254
596000
2000
因为我们把两台机器投放到
10:13
that Johns Hopkins works with in Sierra Leone,
255
598000
2000
约翰･霍普金斯大学在塞拉利昂的合作医院
10:15
including the hospital where that emergency C-section happened.
256
600000
3000
包括紧急剖腹产的那家
10:20
So I've talked a lot about anesthesia, and I tend to do that.
257
605000
3000
我谈了很多关于麻醉的内容，我总是这么做
10:23
I think it is incredibly fascinating
258
608000
2000
我认为麻醉是医疗中
10:25
and an important component of health.
259
610000
2000
非常重要的一部分也是非常有意思的
10:27
And it really seems peripheral, we never think about it,
260
612000
3000
麻醉看上去是次要的，我们几乎想不到它
10:30
until we don't have access to it,
261
615000
2000
只要我们需要而得不到的时候
10:32
and then it becomes a gatekeeper.
262
617000
2000
那时候麻醉就变成守门人了
10:34
Who gets surgery and who doesn't?
263
619000
2000
能不能有手术机会？
10:36
Who gets safe surgery and who doesn't?
264
621000
3000
能不能施行安全的手术？
10:39
But you know, it's just one of so many ways
265
624000
3000
你知道 这只是无数设计中的一个
10:42
that design, appropriate design,
266
627000
3000
无数合适的设计中的一个
10:45
can have an impact on health outcomes.
267
630000
3000
会对医疗结果产生影响
10:48
If more people in the health delivery space
268
633000
2000
如果更多工作在医疗现场的人
10:50
really working on some of these challenges in low-income countries
269
635000
3000
能面对低收入国家的这些挑战
10:53
could start their design process,
270
638000
2000
开始设计
10:55
their solution search,
271
640000
2000
寻找方案
10:57
from outside of that proverbial box
272
642000
2000
跳出惯性思维
10:59
and inside of the hospital --
273
644000
2000
面对实际状况
11:01
in other words, if we could design
274
646000
2000
也就是说，如果我们
11:03
for the environment that exists in so many parts of the world,
275
648000
3000
能够按照世界各地不同的环境
11:06
rather than the one that we wished existed --
276
651000
2000
而不是我们希望的理想环境来设计的话
11:08
we might just save a lot of lives.
277
653000
3000
我们可以拯救很多生命
11:11
Thank you very much.
278
656000
2000
非常感谢
11:13
(Applause)
279
658000
4000
（掌声）
ABOUT THE SPEAKER
Erica Frenkel - Medical technologistAt Gradian Health Systems, Erica Frenkel works to bring safe anesthesia to hospitals all over the world.
Why you should listen
Erica Frenkel helps lead Gradian Health Systems, a social enterprise enabling safe surgery through innovative anesthesia technology. She has been a Peace Corps volunteer, managed the Global Media AIDS Initiative for the Kaiser Family Foundation and helped shape public health initiatives as a consultant for the Clinton Foundation, the Liberian Ministry of Health, Merck Vaccines, and the Wellcome Trust.
Erica Frenkel | Speaker | TED.com