In this unit you will learn how to deal with accidents and emergencies.

You will
apply vocabulary and grammar structures to help you describe emergency
situations using the English language. You will also understand the difference
between the expressions “supposed to” vs. “have to”.

This unit is important because it gives you a deeper understanding of independent

and dependent clauses, and will introduce you to noun clauses and adverbial
clauses. Moreover, you will get to improve your English speaking skills with tips
about intonation.

8.1. Grammar
8.1.1. Clauses
8.1.1.1. Noun Clauses
8.1.1.2. Adverbial Clauses
8.1.2. Supposed to vs. Have to
8.2. Vocabulary
8.2.1. Accidents and Emergencies
8.2.2. Hospital Services
8.3. Pronunciation
8.3.1. Intonation: questions, answers and surprise
 Hi! My name is Linda. This is the story of how I broke my arm.

I got on the school bus to go to

school. The bus was very late so,
the bus driver was driving
extremely fast. He is not
supposed to go over the speed
limit. Then, he took a corner too
sharp and the bus rolled off the
road and crashed into a house.

What the bus driver did was very

wrong. All of us could have died
in that accident. However, only I
got hurt because when the bus
crashed, I had my arm out of the
window.

When I arrived to the hospital, I

was in so much pain. The doctor
asked me: “Can you tell me what
your name is?” But, I could not
hear what he said.

It's funny how before my arm got broken, I used to wish I'd break something so I could
have a cast and collect autographs. It’s not funny anymore. Now, I have to use a cast on
my arm for the next two months. Moreover, my mother has to pay the hospital bills. I hope
we have medical insurance.

I’m alone in the emergency room. I want my mommy. I wonder why she is not here. She
is supposed to be here with me. I feel homesick because I miss my mother.
Do you remember what a clause is?
Just remember that if you have a sentence with a subject and a verb, then you have
a clause. A clause is a group of words containing a subject and a verb. A clause can
be sophisticated or simple, but it’s still a clause.

An independent clause can function on its own and looks much like a regular
sentence.
Example:
 I had my arm out of the bus window.

A dependent clause cannot function on its own because it leaves an idea or

thought unfinished. Dependent clauses are also known as subordinate
clauses. They are not complete sentences.
Example:
 When the bus crashed

This is a dependent clause because the word “when” leaves us wondering. It’s
perfectly fine to have a dependent clause, but it should always keep company with
other clauses that complete the idea, like this:

 When the bus crashed, I had my arm out of the window.

Note that “I had my arm out of the windows.” is not a dependent clause
because it could exist on its own as a sentence.

A noun clause is a subordinate, or dependent clause that functions as a

noun. In other words, a noun clause has the same uses in a sentence as a noun. A
noun clause can act as the subject or object of a sentence. Remember that
the subject goes before the verb and the object goes after the verb
(subject-verb-object order).

Some words that may introduce noun clauses are:

How, if, that, what, whatever, when, where, whether, which, who,
whoever, whom, whomever, whose, and why. Here are some examples
of noun clauses:
Examples:
Subject Verb Object (Noun Clause)
1
I don't remember how I was taken to the hospital.

Note: In this sentence the noun clause “how I was taken to the hospital” is the
object of the verb “remember”.

Subject (Noun Clause) Verb

2
What the driver did was wrong.

Note: In this sentence the noun clause “What the driver did” is the subject of
the verb “was”.

Subject Verb Object (Noun Clause)

3
I could not hear what the doctor said.

Note: In this sentence the noun clause “what the doctor said” is the object of the
verb “hear”.

Subject Verb Object (Noun Clause)

4

I wonder why my mother is not here.

Note: In this sentence the noun clause “why my mother is not here” is the object
of the verb “wonder”.

Adverbial clauses are not complete sentences. They must be connected to an

independent clause (a complete sentence). When the adverbial clause comes
before an independent clause, a comma (,) is used to separate the two
clauses. Adverbial clauses modify verbs, adverbs or adjectives. They tell us
how, when, where, why, to what extent, or under what condition something
happened.
Some words that may introduce adverbial clauses are:
Because, before, after, as soon as, and when. Here are some examples
of adverbial clauses:

Subject Verb Adverbial Clause

1 I feel homesick because I missed my mother.

Adverbial Clause Subject Verb

Because I missed my mother, I feel homesick.

Note: An adverbial clause with “because” shows cause and effect.

Subject Verb Adverbial Clause

2 I lived with some friends before I came to Panama.

Adverbial Clause Subject Verb

Before I came to Panama, I lived with some friends.

Note: Adverbial clauses with “before, after, as soon as, and when” show time
relationships. “As soon as” means “at the time that.”
Subject Verb Adverbial Clause
3
Did you learn English when you were in school?

Adverbial Clause Subject Verb

When you were in school, did you learn English?

Note: “When” means “at the time that something happened or happens.”

The expression “supposed to” is a common phrase that functions the same way
a modal verb does. Remember that modal verbs such as “must, can, should, and
may” modify the meaning of the main verb in a sentence by expressing possibility,
ability, permission, or obligation. “Supposed to”, and “have to”, fall into the
“obligation” category. “Supposed to” can also be used to indicate what a
person (or thing) is likely to do. Use the verb “be” in front of supposed to.

Examples:

 You are supposed to rest after a surgery.

 My mother is supposed to be here with me.
 You are supposed to signal when you turn left or right.
 Where’s the ambulance? It’s supposed to be here by now.
 The bleeding is supposed to stop after you get stiches.

The expression “have to” has the same meaning as the modal verb “must.” It
indicates that the subject has no choice about performing the verb’s
action. In other words, when you must do something, it means that
you have to do it. “Have to” is used for a situation that has no choice. We
can say:
“You have to call to the police if you have been in a serious car accident.” Or
“You must call the police if you have been in a serious car accident.”

Examples:

 I have to use a cast on my

arm for the next two
months.
  People in England have to drive on the left.

If you are in an emergency situation in a foreign country, you’ll need to know how
to contact the police, an ambulance, or the fire department. Not every county uses
“911” as its emergency contact number, as we do in Panama and the United
States. For instance, the official emergency number for the United Kingdom is
“999”, but the European Union's emergency number is “112”.

 Have you ever had to deal with an emergency situation?

 Have you ever had to call 911? What was the emergency?
 Was it any of these accidents or emergencies?

Table 1. Accidents and emergencies (Bryan, 2018)

1. I got my arm/leg
broken. I got a
broken arm/leg.
I broke my arm/leg.

2. I fell down stairs and

hurt my back.
3. I had an allergic
reaction.

4. I sprained my ankle.

5. I burnt my
face/arm/leg.

6. I crashed into another

car/a tree/a house.

7. I had a heart attack.

 8. There was a fire in my
house.

 What are hospital services and fees?

 Have you ever visited an emergency room (ER)?

It’s important that you know where to go for medical care when you have a medical
emergency. There are some big differences between going to your primary care
provider and going to the emergency room (ER). Such differences vary between
fees, location, and medical specialists.

Usually when you seek medical care, primary care providers (PCP) work with you
to ensure that you get the right preventive services, manage your chronic
conditions, or improve your health. A primary care provider is a person you may
see first for checkups and health problems. Some primary care providers are:
medical doctors, nurses, dieticians, therapists, pediatricians, gynecologists, or
obstetricians.

Hospital services and fees are also known as

hospital charges. They typically include the
services that hospitals provide to their patients
and expenses related to the care of a physician
or nurse, medicines, etc. Hospital services and
fees may include things like medical tests,
anesthesia, physical therapy, or the use of
facilities. Some of the facilities or places in a
hospital are: consulting room, emergency room,
operating room, delivery room, intensive care maternity ward, and private or
standard rooms.

Before you go to a private doctor’s office, clinic, or health center you have to check
with you insurance health company (insurer) to see if they accept your health plan.
In case of an emergency, you should get healthcare (medical services) from the
closest hospital that can help you. However, it’s important to check if the hospital,
as well as, the doctor in the emergency room is inside the plan’s network of your
insurance company. Your insurance company can charge you more for getting
emergency room services at a hospital that is out of the network.

Sometimes a speaker says something that you can’t understand or

something that sounds strange or unbelievable. In this case,
you might ask another question to get the speaker to clarify or
repeat what he/she has said. Like expressions of surprise, these
questions usually have rising intonation. This is true even if they are
WH-questions, which normally have falling intonation. The question
word also receives more emphasis than it normally would.
Example:
Conversation:

Linda: Where did you go on your vacation?

Gabe: I went to Bermuda. It was so beautiful!

Linda: Where did you go?

Gabe: To Bermuda. Do you know where it is?

Rising intonation can be a sign of surprise or disbelief. It can also change a

statement into a question:
Examples:

What? You had an accident?

The meeting is today? I thought it was next week.

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Using the wrong intonation can result How to Improve Your Intonation in
in misunderstandings. Let’s continue English - Top 3 Ideas
learning how to use intonation to
improve sentence stress and be clearly Format: Video
understood with this video.
Link:

https://www.youtube.com/watch?v=k
WrDsFXbNNg

T. [Teacher Prix]. (2017, March 23).

How To Improve Your Intonation In
English - Top 3 Ideas. [YouTube].
Retrieved June 9, 2018, from
https://www.youtube.com/watch?v=k
WrDsFXbNNg
 Adverbial clause: it is a dependent clause that modifies a verb, adverb or
adjective.

 Emergency room: It’s the area in a hospital that is equipped and staffed for
the quick treatment of acute illness, trauma, or other medical emergencies.

 Fee: a payment made to a professional person or to company in exchange for

advice or services.

 Health insurance: it is a sort of insurance coverage that covers the cost of an

insured individual's medical and surgical expenses.

 Health plan: a plan that provides, or pays the cost of medical care in return for
a negotiated fee.

 Healthcare: the act of taking preventative or necessary medical procedures to

improve a person's well-being.

 Medical test: a medical procedure performed to detect, diagnose, or monitor

diseases, and determine a course of treatment.

 Noun clause: it is a dependent clause that functions as a noun.

 Primary care providers: a medical doctor, nurse, or physician assistant who

provides, coordinates or helps patients access a series of health care services.

 Ward: it is a large room in a hospital with beds for people to stay in.
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