芝加哥急救

Chicago Med S04E08

Part 4 Jan. 21, 2020, 1:48 p.m.

All right. Thank you.
艾普尔手术室需要我
April, I'm getting pulled into surgery.
好的这里交给我
Okay, I'll hold it down out here.
一会还有鼻胃管肝素阀
Oh, and I've got a delivery of NG Tubes, Hep Locks,
和腹部垫的送货
and ABD Pads coming in.
我昨晚订的
I called it in late last night.
我会对比检查订单和货单
I'll double check the order against the invoice,
确保东西齐全
make sure it's all there.
好的
All right. Oh.
这周要发工资所以你要...
And it's payroll week, so it means that you have--
需要所有护士签字确认她们的考勤卡
All the nurses need to sign off on their timecards.
麦基你要把我逼疯了
Maggie, you're driving me crazy.
发生什么事我都能处理
If anything happens, I'll handle it.
好而且你有我写的
Okay, and you've got the reference guide
参考手册所以没问题
that I wrote, so we're all good.
没问题没问题
All good. Good, good, good.
你想要人陪吗
You want some company?
如果你想自己待着我也能理解
I get it if you'd rather be alone.
不见到你我很高兴
No, I'm glad to see you.
马克怎么样
How's Marc?
没有变化仍在昏迷中
No change. Still unconscious.
阿比盖尔才两岁
Abigail was only two.
现在她不在了
And now she's gone.
就因为有个家伙盯着手♥机♥
All because some guy couldn't look away from his phone.
但也许这一切也能有些好处
But maybe something good could come from all of this.
这么多孩子等着移植
I mean, all these kids waiting for transplants.
儿科捐献者太少了
There are so few pediatric donors
而需要移植的孩子成千上万
in comparison to the thousands of children in need.
阿比盖尔可以捐献器官
Abigail could be an organ donor.
她是未成年人你知道得有
As a minor, you know, she's gotta get
一名家长或监护人签字同意才能捐献
a parent or guardian to sign off before she can donate.
我知道
Yeah, I know that.
如果古德温找不到她的其他家人
And if Goodwin can't track down any of her other family,
就只剩下她的父亲了
then all that's left is her father.
你觉得马克会醒过来吗
Do you think Marc will wake up?
我见过状况更糟的病人好转
I've seen patients in worse shape turn around.
这还是头一次见
Well, that's a new one.
一般来说我得亲自开颅才能看到大脑
Usually I have to cut them open myself to get to the brain.
你怎么想
So, what do you think?
不管因为什么原因
Well, for whatever reason,
她头皮那块区域的皮神经失控了
the cutaneous nerves in that part of her scalp went haywire.
导致一直感到瘙痒所以她忍♥不住挠
Makes them always feel itchy, so she keep scratching.
有治疗办法吗
There a fix?
有手术
Yeah, surgery.
切断神经
Sever the nerve.
没有感觉没有瘙痒
No more feeling, no more itching.
不会挠了
And no more scratching.
还有可能出现的严重不可逆转的副作用
Yeah, and possible serious, irreversible side effects.
面部瘫痪视力模糊
Facial paralysis, blurred vision.
最坏的情况她可能会坐上轮椅
Worst case, she ends up in a wheelchair.
我又不是在巷子里给她开刀丹尼尔
I'm not cutting her open in an alley, Daniel.
你说的风险比起回报完全可以忽略
The risks you're describing are dwarfed by the reward.
-但愿如此 -你有什么建议
- Yeah, we hope. - What do you suggest?
每周两次心理咨♥询♥吗
Twice a week counseling sessions?
当然了我们还得在她脖子上套个套
Of course, we'd have to put a cone around her neck
免得她挠
to keep her from scratching.
萨姆挠了那么多年神经已经麻痹了
Sam, all those years of scratching, those nerves are shot.
不可能还有什么失控
There's nothing left to go haywire.
查尔斯医生如果是这样
Dr. Charles, if that were the case,
基根应该什么感觉也没有
Keegan shouldn't feel anything.
更不要提瘙痒了
Let alone an itch.
如果神经没断
If those nerves were active,
那么麻醉剂应该能缓解瘙痒几个小时
that anesthetic would have provided relief for hours.
-但是没有 -你只用了五毫克
- It didn't. - You only used 5 mil.
-量不够 -我同意
- It wasn't enough. - I agree.
麻醉剂有效时间不长但是有效
The anesthetic didn't work for long, but it did work.
证明与神经有关
Proves the nerves are involved.
好极了多数赞同虽然我不在乎
Great, we have a majority. Not that I care.
-说完了吗 -萨姆
- We done? - Sam?
我只是想说我认为手术完全没用
All I'm saying, I don't think operating is gonna do a damn thing.
谢谢你的意见
Thanks for you input.
但据我所知我才是神经外科医生
But the last time I checked, I was the neurosurgeon.
给她安排手术
Put her on the schedule.
手术不应该是最后的选择吗
Isn't surgery supposed to be the last option?
查尔斯医生她挠到了颅骨了
Dr. Charles, she scratched into her skull.
怎么回事
What happened?
他突然就室颤了
He suddenly went into v-fib.
电击了数次然后心脏停搏了
Shocked him multiple times and then he went asystolic.
再来一针肾上腺素
Another round of epi.
推进去了
It's in.
检查脉搏
Check for a pulse.
没有脉搏
Nothing.
加油马克
Come on, Marc.
不许放弃
Don't you give up.
脉搏恢复窦性心跳过速
Pulse is back. Sinus tach.
他活过来了
He's back.
好了
All right.
准备转移
Prep him to move.
我去告诉重症监护室我们要送他上去
I'll call ICU, tell them we're sending him up for cooling.
他心脏停搏了多久
How long was he asystole?
将近十分钟
Almost ten minutes.
你男友在想什么
What's your boyfriend thinking?
他醒不过来了
This guy's not waking up.
你的溃疡加重了吗
Hey, is your ulcer getting worse?
今天很难熬
Today's not helping.
是啊
Yeah.
我看了急救人员的事故现场报告
So, I looked at the Paramedic's report from the accident scene.
在救助到达前马克至少心脏停搏了五分钟
Marc was down at least five minutes before help arrived.
刚刚这次将近十分钟
And after this last code it was almost ten.
加起来是将近十五分钟的缺氧
I mean, that's almost 15 minutes with no oxygen.
我知道
I know.
加大了
Increases the chances
他脑功能受损的几率
the brain function he has is now compromised.
但直到他醒来前我们都不能确定
But we won't know if that's the case until he wakes up.
你真的认为他会醒来
You think he really will?
这次抢救后还会醒来
After he coded?
我不知道
I don't know.
也许是时候开始考虑
Maybe it's time to start thinking about
履行他的预嘱
honoring his advanced directive.
预嘱
Advanced directive?
小娜那是个纹身不是法律文件
Nat, it is a tattoo, not a legal document.
可能是代替品
It might be a proxy to one.
而且如果马克真的有文件支持呢
And what if Marc does have the paperwork to back it up?
文件可能在家里可能在保管箱
I mean, it could be at home in a file or in a safety deposit box.
如果真的有具有法律效应的东西
If something binding exists,
医院的律师会找到的
the hospital's lawyers will find it,
我肯定会履行
and I'll obey whatever it says.
但在那之前这只是一个纹身
But until then, it's just a tattoo,
他有不止一个纹身
and one of many.
威尔阿比盖尔的器官仍然健康
Will, Abigail's organs are still healthy.
但活力保持不了多久了
But they won't be viable for long.
没有马克或家人的同意
Without Marc or any family to consent,
我们不能捐献它们
we can't donate them.
但如果我们履行他纹身的指示放弃救治
But if we honor his tattoo and we let him go,
然后医院可以申请
then the hospital can petition
成为阿比盖尔的法定监护人
to become Abigail's legal guardian,
这样我们就有权决定
and we can make the decision
在浪费之前捐献出她的器官
to donate her organs before they go to waste.
娜塔莉你的意思是让马克死
Natalie, you are asking me to let Marc die.
我做不到
I can't do that.
就算有奇迹发生他醒过来了