芝加哥急救

Chicago Med S09E05

Part 3 March 2, 2024, 11:21 p.m.

不过我不太确定原因
Though I'm not quite sure why.
毒物检验结果是阴性，没有头部创伤的迹象
Tox screen's negative, no sign of head trauma.
像小孩一样的情感表现
The childlike affect,
不是阿兹海默病，或血管性认知障碍症常见的表现
it's not what you normally see with Alzheimer's or vascular dementia.
但还是不能排除可能性
But you can't rule it out.
我想也许是某种智能缺陷
I'm thinking some kind of intellectual deficit.
所以我想我们应该，安排头部电脑断层扫描
So, I'm thinking we should get a head "C.T."
当然
Definitely.
我们对他没有更多资讯了吗？
We have no more information on the guy?
你联络芝加哥警署了吗？
Your each out to "C.P.D."?
有，但没有失踪人口符合他的描述
Yeah. There're no missing persons matching his description.
也没有人来找他
And no one's come looking for him.
他一直提到他妹妹贝蒂，对吗？
Keeps on talking about his sister Betty, right?
说他非常担心她
How, he's very concerned about her.
她生病了，她需要我们的帮忙
She's sick, she needs our help.
对，但有监于他的心智状态，你觉得真的有这号♥人物吗？
Yeah, but given his mental state, is that even a real person?
我是想，也许是他小时候认识的人
You know, maybe it's someone from his childhood
或是他在电视上看到的剧集
or a show he saw on "T.V."
是啊
Yeah.
我又拨了一次他身上那支电♥话♥号♥码，还是无人接听
I tried the number he had again, still no answer.
我又留了一条信息
I left another message.
好
Okay.
先假设那真的是贝蒂的电♥话♥，好吗？
Let's say that is actually Betty's number, right?
也许她没有接听是因为她没办法
Maybe she's not answering because she can't.
因为她事实上丧失行为能力
Because she is in fact, incapacitated.
不然我们请芝加哥警署做个反查？
How about we ask "C.P.D." to run a reverse trace?
那样的话至少我们可以找到住址
That way at least we'll get an address.
好
Okay.
艾卓亚医生，有病人送达
Doctor Archer, incoming.
麻烦你去四号♥创伤室
You're going to trauma four.
迪文亚当斯，28岁，呼吸短促，发汗
Damon Adams, twenty-eight, shortness of breath, diaphoretic.
收缩压130，舒张压90，心率125
"B.P." one-thirty over ninety, heart rate one-twenty-five.
氧饱和度89
Sats eighty-nine.
我需要帮忙
Need help
过去那边
Right there.
辛？
Sean?
他住在我工作的康复中心
He lives at the Center where I work.
是我咨♥询♥辅♥导♥的个案
I've been counseling him.
好，在这里等
All right, wait here.
好，听我数
All right, on my count.
各就各位，好了吗？一、二、三
Ready, you good? One, two, three
好的，迪文，我是艾卓亚医生，你怎么了？
All right, Damon, I'm Doctor Archer, what's going on?
很不舒服
Real sick.
是吗？什么时候开始的？
Yeah? When did this start?
几天前
Couple days ago.
我喘不过气
I can't catch my breath.
我们可以帮你，过来这里，帮他坐起来
We can help you. Come on, let's get him up here.
让他坐起来，给他吸百分之百的氧气
Let's lift him up, start him on a hundred percent "O" two.
立即照前后位胸腔X光
"A.P." chest STAT.
我需要全套血液检查、基本代谢指数，和动脉血液气体分♥析♥
I need a "C.B.C.", "B.M.P." and an "A.B.G."
-X光照射 -远离
-X-ray! -Clear!
肺水肿
Pulmonary edema.
肺部有液体
Fluid in the lungs.
呼叫心脏科，立即进行超声波检查
Call Cardiology for a STAT echo.
好，马上去
Yeah. Got it.
好的
Okay.
有比较好吗？
Better?
我可以告诉辛你的病况吗？
Is it okay if I share some things with Sean?
好，我等一下就回来
All right, I'll check back soon.
你朋友的状况很严重
So, your friend's in pretty bad shape.
肺水肿意味着他心衰竭了
Pulmonary edema suggests that he's in heart failure.
像他那么年轻的人不应该出现这种问题
We shouldn't be seeing that in somebody so young.
天啊
Oh, man.
你说他住在康复中心
You said he's living at the rehab center.
他是成瘾者吗？
Is he an addict?
正在戒毒中
Recovering.
但我很肯定他现在没有毒瘾
But I'm pretty sure he's clean.
我们聊了很多
We talk a lot.
他真的很努力要戒毒
He's really been working the program.
有可能是有东西流入他的心脏
It's possible whatever's going on with his heart
也许跟点滴输注的药物有关
might have something to do with "I.V." drug use.
好，你可以帮助他，对吗？
Well, you'll be able to help him, right?
我会努力试试看
I'll do what I can,
但你得明白，辛，他的情况真的很严重
but you need to understand, Sean, his condition is serious.
如果有谁可以帮他的话，就是你了，爸
If anybody can help him, you can, Dad.
我知道你可以的
I know you can.
亚力士还好吗？
Is Alex all right?
他很好
Yes.
手术非常顺利
He handled the surgery like a champ.
还好你们有带他来医院
And it's a good thing you brought him in.
他的阑尾真的需要切除
His appendix really needed to come out.
是啊，病理学报告显示未扩散的阑尾癌
Yeah, the pathology report showed a contained appendiceal cancer.
癌症？
Cancer?
癌症？等等，他才15岁
Cancer? Wait, wait. He's only fifteen.
不用担心
No need to worry.
肿瘤很小，才一厘米，我们已经全部切除了
It was small, just one centimeter, and we got it all.
幸好他有戴手表
Good thing he was wearing that watch.
哇
Wow.
我们不需要跟肿瘤科医生谈吗？
And we don't need to talk to an oncologist?
你们之后回诊的时候，我们可以再讨论这个
When you come back for a follow-up, we can talk about that.
但是治疗方式就是切除阑尾，而我们已经切除了
But the treatment is to remove the appendix, and we did that.
好的
Okay.
我们什么时候可以看亚力士？
When can we see Alex?
现在
Now.
亚曼医生会带你们去恢复室
Uh, Doctor Ahmad will take you to recovery.
-谢谢 -谢谢
-Thank you. -Thank you.
不客气
You got it.
不…
No, no, no, no.
我只是来这里检查我的膝盖
I'm...I'm just here to have my knee looked at.
伯特，你上次身体♥检♥查是什么时候？
When was the last time you had a physical, Bert?
我不知道，我在医院的时候，他们有带我去扫描
I don't know. They did some scans when I was here.
那不是身体♥检♥查
That is not a physical.
你人都在这里了，医生检查很快
You're already here, the doctor'll make it quick.
丹尼尔会进来跟你打个招呼
Daniel will come in and say hello.
这是你欠你孩子和孙子的，你答应会好好注意自己的健康
You owe it to your children and your grandson to look after your health.
好吧
All right.
好啦
All right.
谢谢你
Thank you.
我看到心包膜积水
I'm seeing pericardial effusion.
代表心脏周围的囊袋有体液堆积
That means that there's a building of fluid in the sac around the heart,
压♥迫♥心脏，所以心脏无法有效跳动
and that puts pressure on the heart, so that it doesn't pump effectively.
主治医生来看的时候，可以跟我说一声吗？
Uh, would you please let me know when the attending's looked at this?
没问题
You got it.
好
Okay.
我不确定到底怎么了，好吗？
So, I'm not sure what's going on, okay?
我会先开始让你服用抗生素
So, I'm gonna start you on antibiotics
以防是细菌感染
in case it's a bacterial infection.
我们可以处理心包膜积水
And we can treat the pericardial effusion
用类固醇和抗发炎药物
with steroids and anti-inflammatories.
他的氧饱和度是83
His sats are at eighty-three.
血压正在下降
And blood pressure's dropping.
爸？
Dad?
好，我想我们需要帮你接上呼吸器，让机器替你呼吸
Okay, I think we need to put you on a machine that breathes for you.
-好 -好的
-Okay. -All right.
为了要这么做，我们需要让你睡着
In order to do that, we need to put you to sleep.
可以吗？
Is that all right?
好
All right.
呼叫呼吸系统科
Call respiratory.
好的，20毫克依托咪酯，100毫克琥珀胆碱
All right, twenty of etomidate, a hundred of sux.
马上来
On its way.