芝加哥急救

Chicago Med S04E08

Part 1 Jan. 21, 2020, 1:48 p.m.

加夫尼芝加哥医院
医院大门
我就让你放一个窃听器后就别管了
I asked you to plant one bug then walk away.
但你都做不到
But no, you couldn't do that.
你怎么就不明白呢
Hell, you don't seem to get it.
作为医生我的职责是...
As a physician, I have a responsibility--
这话我听腻了
I'm so tired of hearing that.
在核磁共振的闹剧之后雷·伯克
After the MRI fiasco, Ray Burke said
让你别再找他但你还是给他打电♥话♥了
he was done with you and still you called him.
我得和他谈谈他的核磁共振结果
Well, I need to speak to him about his MRI results.
我很担心
I'm concerned.
担心什么
Concerned how?
他的两侧颈动脉都有些
There are some subdural hematomas
硬膜下血肿和血小板
and plaques in both his carotids.
说明他有可能中风
It could mean he's at risk for a stroke.
可能
Could?
没有更细致的检查我无法下结论
I can't make a diagnosis without more of a work-up.
这样的话你无需向雷交代什么
That case, there's nothing to report to Ray about.
如果不是因为你搞砸了我们一周前
We could have nailed that scumbag a week ago
就能逮捕这个人♥渣♥
if you hadn't screwed things up.
别再打电♥话♥了
No more calls.
我不能袖手旁观
I can't just walk away.
你可以你也会这么做
You can and you will.
结束了霍斯特德医生
It's over, Dr. Halstead.
你拿雷的回扣时就铸成了大错
Hey, you made this mess when you took Ray's kickback.
都怪你
This is on you.
威尔那个女人是谁
Will, who was that woman?
一个医药代表
Oh, just a drug rep.
他们不停地来烦我
They just won't leave me alone.
是吗我从没见过她
Really? I've never seen her before.
听着 DJ给我发信息了
So, listen, the DJ texted me.
三周后就要举♥行♥婚礼了
The wedding's only three weeks away.
我们还没把歌♥单给他
We haven't given him a song list.
她在推荐什么
What was she pushing?
那个医药代表
The drug rep.
就是些钙通道阻滞剂
Oh, just some calcium channel blocker.
关于DJ的事
So about the DJ...
-是麦基 -我也收到了
- It's Maggie. - Yeah, me too.
父女二人是肇事逃逸的受害者
Father and daughter hit and run victims.
这是阿比盖尔·琼斯两岁
This is Abigail Jones, two years old.
昏迷指数9 钝器头外伤并有撕裂
GCS nine, blunt head trauma with lacerations.
输液管在左腿上
IO line in the left leg.
阿比盖尔一切都会好的
Abigail, it's gonna be okay.
-父亲在哪 -在路上
- Where's the father? - En route.
我们离开现场时
Other ambo was trying to get an airway
其他救护人员正在为他插管
when we rolled away from the scene.
父女俩在人行道上绿灯亮着
They were in crosswalk. They had the signal.
车径直冲向他们
Car plowed right through them.
听我的口令把她抬上去一二三
Let's transfer on my count: One, two, three.
阿比盖尔阿比盖尔
Abigail? Abigail?
没有反应我得插管
She's unresponsive. I need to intubate.
给我儿童急救尺
Broselow tape.
和胸片仪
And a chest X-ray.
大约十二到十四千克
Just about 12 to 14 kilos.
黄色抽屉
Yellow drawer.
四单位麻醉剂二十单位司可林
Four etomidate. 20 of sux.
血压100/70
BP 100 over 70.
脉搏每分钟136
Heart rate 136.
氧饱和88
Sats 88.
X光就位小娜好了告诉我们
X-rays in place. Nat, tell us when.
插♥进♥去了
All right, I'm in.
照吧
Go.
离手
Clear.
右侧胸腔全是血
Right side's whited out.
胸管
Chest tube.
超声仪
Ultrasound.
氧饱和下降到80
Sats down to 80.
快速扫描呈阴性没有内出血
Fastscan's negative. No blood in the belly.
胸管进去了
Tubes in.
氧饱和回升到100了
Sats coming back up. 100%.
血压和脉搏也稳定了
BP and heart rate's stabilizing, as well.
瞳孔有反应但移♥动♥缓慢
Pupils are reactive but sluggish.
注意急救人员现在带着父亲来了
Heads up, paramedics are coming in with the father right now.
你去照顾他这里我来
You go take him. I'll finish this.
马克·琼斯 32岁
Marc Jones, 32.
昏迷指数3 当场插管
GCS 3, intubated in the field.
怀疑是颈椎受伤
Suspect a C-spine injury.
他脖子后部有处错位
There's a step off on the back of his neck.
好我们把他抬上去
All right. Let's transfer him.
一二三
One...two...three.
-谢谢塞萨尔 -不客气
- Thank you, Cesar. - Yep.
双边呼吸音正常
Good breath sounds bilaterally.
血压88/58 脉搏每分钟120
BP 88 over 58. Heart rate 120.
给他再挂一包吗
Should we start a neo bag?
没错滴注到血压恢复110
Yes, titrate to a pressure of 110.
还需做胸片和超声波
Need a chest X-ray and an ultrasound.
收到
Yep.
我的天
Oh, my God.
霍斯特德医生
Dr. Halstead.
等等
Hold on.
不要抢救
芝加哥医院
第四季第八集
小女孩怎么样了
How's the little girl?
她的体征正常没有长骨骨折
Her vitals are stable and no long bone fractures.
但头部CT显示有慢性脑实质出血
But CT Head shows diffuse intraparenchymal bleeding.
神经科怎么说
And what did neuro say?
刚和他们通完电♥话♥
I just got off the phone with them.
他们放置了一个血压检测仪
They put in a pressure monitor,
也同意我
and they agreed with me to treat
用过度通气与甘露醇进行治疗
with hyperventilation and mannitol
以减轻颅内压的方案
to reduce the intracranial pressure.
那父亲呢
And what about the father?
已插管但无镇静反应
Intubated but unresponsive without sedation.
-脑损伤吗 -我不确定
- So, a brain injury? - I'm not sure.
瞳孔对称且有反应这是个好迹象
Pupils are equal and reactive, so that's a good sign.
我们在等扫描结果
We're just waiting on scan results to see
看看伤势有多严重
how bad the injuries are.
听着马克现在稳定但如果他情况恶化了呢
Look, Marc's stable now, but what if he goes downhill?
他身上有很多纹身
He's wearing a lot of ink.
这个"不要抢救"能当作合法的病人要求吗
Is this "Do No Resuscitate" a legit advanced directive?
医院的律师团正在讨论这个问题
The hospital's got a team of lawyers trying to figure that out.
他的家人呢
What about his family?
他们知不知道这纹身是否他的本意
Do they know if he meant it or not?
我们还在寻找他的家人
We're looking for them too.
但现在看来只有
It seems it's just Mr. Jones
琼斯先生和他女儿阿比盖尔
and his daughter, Abigail, in the world.
他戴着婚戒没找到妻子吗
He had on a wedding ring. There's no wife?
以前有叫梅琳达律师找到了讣告
There was, Melinda. Legal found an obituary.
她去年因卵巢癌去世了
She died last year. Ovarian cancer.
如果他妻子的最后时光
If his wife had to be intubated
只能在呼吸机上度过
and wasn't able to get off the vent,
看到她痛苦的样子可能是他纹身的原因
seeing her like that could be why he got that tattoo.
也许当时他是那么想的
Yeah, maybe that's what he was feeling then,
但现在呢
but what about now?
阿比盖尔只剩下他了
He's all Abigail has.
我觉得为了阿比盖尔
I can't see him not wanting us to do everything
他会让我们尽全力救他
in our power to keep him alive for her.
事实上我们并不知道
Well, the truth is, we don't know
琼斯先生纹身的目的和他现在的想法
why Mr. Jones got the tattoo or how he feels about it now.
我们先别忙着下结论除非我们有真凭实据
So, let's not jump to conclusions until we have real facts.
那同时呢
And in the meantime?
同时医院在做他们的背景调查