芝加哥急救

Chicago Med S04E11

Part 2 Jan. 21, 2020, 1:48 p.m.

预备一二三
Ready. One, two, three.
米尔顿米尔顿
Milty? Milty.
你跟这些人说让他们离我远点
Tell these people to get the hell away from me!
其实我是查尔斯医生
I'm actually Dr. Charles,
不过你能跟我聊聊米尔蒂吗
but--but could you tell me a little bit more about Milty?
米尔顿是她丈夫
Milton was her husband.
-你是谁啊 -肺部没有杂音
- Who the hell are you? - Lungs are clear.
妈妈是我阿兰娜
Mom, it's me. It's Alana.
别碰我
Don't touch me!
2.5克氟哌啶醇肌肉注射
2.5 haloperidol IM.
可以帮助她安静下来
Help calm her down a little bit.
我很抱歉
I'm so sorry,
这已经是这个月她第三次走丢了
this--this is the third time this month she's wandered.
我不明白她怎么老是溜出来
I-I don't know how she keeps getting out.
我一直是锁门的
I always lock the door.
你发现她还有什么别的变化...
You notice any other changes in her--
在她性情方面
her general disposition?
她比以往更容易激动
Uh, she's--she's more agitated than usual,
她体重也掉了一些
and she's--she's lost some weight too.
好的我们会做些化验
All right, well, we'll run some labs
来看看是不是有什么地方不正常
and see if there's anything out of the ordinary, okay?
好
Okay.
也许只需要调整一下用药
Might just have to adjust her meds a bit.
谢谢
Thank you.
漫长的一夜
Long night?
非比寻常得漫长
Exceptionally long.
要不你去我那吧
Why don't you head over to my place?
新的床垫今天早上刚送到
The new mattress just got delivered this morning.
难道这个东西不应该是
Ah. Don't you think that's something
我们两个一起磨合吗
we ought to break in together?
我喜欢你这想法
I like where your head's at.
听着我们还没有
So listen, we haven't really, um,
还没有谈论过宴会上发生的事
we haven't talked about what happened at the gala.
康纳
Connor...
科尼利厄斯跟别人说的...
What Cornelius told people...
这是我爸的经典招式
It was vintage my father.
他散播谣言利用你来激怒我
He's spreading lies and using you to get under my skin.
他是个混♥蛋♥
Look, he's a prick.
贝克太好了
Bekker. Good.
东慈爱医院附近的高速路发生严重的连环追尾
There was a huge pileup on the highway near East Mercy.
我不得不派两名外科医生过去帮忙
I had to send two surgeons over there to assist.
你能在急救室顶一下吗
Do you mind sticking around the ED?
我们真的需要人手帮忙
We could really use the extra hand.
别想睡觉了没问题
So much for sleep. Sure.
钥匙你拿好了
You hold onto those.
-你们俩有一腿 -跟你有什么关系
- You two a thing? - What's it to you?
她把你踹了的时候通知我一下
Well, give me a heads-up when she dumps you.
罗德斯汽车撞人创伤科3号♥
Rhodes, head vs. auto, trauma three.
交给我吧考特尼
You got it. Courtney?
莱斯莉·泰勒 37岁女性
Leslie Taylor, 37-year-old female.
在人行横道上被车撞了
Car struck her in the crosswalk.
昏迷指数12 心率130
GCS 12, heart rate 130.
血压86
BP 86 over palp.
莱斯莉我是罗德斯医生
Leslie, I'm Dr. Rhodes,
你知道自己在哪里吗
do you know where you're at?
发生了车祸吗
Uh, was there an accident?
你被车撞了现在你在医院里
You were hit by a car, but now you're in the hospital.
发生了什么我出车祸了吗
What happened? Was I in an accident?
她有过昏迷的情况吗
She lose consciousness at any point?
目击者说在车祸
Bystander said she was out
刚发生后她昏过去几分钟
for a few minutes after it happened.
在救护车里她无法提供连贯的信息
Couldn't get anything coherent from her in the ambo.
好的听我的口令转移她
All right. Let's get her over on my count.
一二三
One, two, three.
过来了
There we go.
呼吸音两侧都有且没有杂音
Breath sounds clear and present bilaterally.
-我出车祸了吗 -麦基跟我说了
- Was I in an accident? - Maggie filled me in.
我把颈托拿下来吗
I'll clear the C-spine?
不能她出现持续言语症
Can't. She's perseverating.
你得等她神志清醒时才行
You gotta wait until she's lucid.
我们做个快速扫描
Let's do a fast scan.
-她有黄疸 -对
- She's jaundiced. - Yeah.
-麦基 -什么事
- Maggie! - Yeah.
查一下患者是否在系统里
Check to see if the patient's in the system.
看看有什么能解释黄疸的吗
Look for anything that would account for the jaundice.
刚刚调出她的病历
Just pulled up her records.
她腹中有大量血液
She's got a lot of blood in her belly.
我们给她一升生理盐水
All right, let's give her a liter of fluid,
两个单位血浆两单位血
2 units of plasma, 2 units of blood.
一旦血压稳定我们把她送去做CT
Once her pressure stabilizes, we're gonna move her to CT.
好的医生
Yes, Doctor.
黄疸是她的肝病引起的
Jaundice is from liver disease.
她在等候移植名单里
She's on the list.
-我出车祸了吗 -如果她的肝被撞了
- Was I in an accident? - If her liver took the hit--
她的时间就不多了
She doesn't have much time.
对
Yeah.
霍斯特德医生
Dr. Halstead.
他们是内特和斯蒂芬妮·艾迪生
This is Nate and Stephanie Addison,
双胞胎的父母
the twins' parents.
-你好 -你好
- Hi. - Hi there.
你好
Hi.
恐怕我有些不好的消息
I'm afraid I have some difficult news.
出什么事了
What's wrong?
男性胎儿有个
The male fetus has something
被称之为先天性膈疝的问题
called a congenital diaphragmatic hernia.
他的腹部器官跑到了胸腔里
His abdominal organs have migrated into his chest
是通过横隔膜的洞过去的
through a hole in his diaphragm.
-我的天 -这个能治的对吗
- Oh, my God. - It's treatable, right?
出生以后可以手术修复但是...
There are surgical options post-birth, but...
由于问题棘手
due to the severity of his case,
他的预后并不好
his prognosis is poor.
很遗憾这还没完
And unfortunately, that is not all.
越来越多的液体挤压了女性胎儿
The increased fluid is compressing the female twin,
威胁到了她的生长
jeopardizing her growth.
你是说她也有麻烦了
So you're saying she's in trouble too?
你们一定能做点什么的
There has to be something you can do.
选择性地引产男性胎儿
Selectively reducing the male fetus
是她生存下去最好机会
would give her the best chance of survival.
-你是说... -放弃他
- You mean... - Lose him.
我非常抱歉
I am so sorry.
如果我们什么都不做是否有可能
Is there a chance things could stabilize
情况会自己稳定下来
on their own if we just wait?
有可能但极有可能
It's possible, but in all likelihood,
液体会越积越多
the fluid will continue to build,
妨碍到她的肺发育
hindering her lung development.
不
Oh! Oh, no.
但我们越早干预效果越好
But the earlier we intervene, the better.
查尔斯医生
Dr. Charles.
我拿到了弗兰·穆尼的化验报告
I got Fran Mooney's labs back.
她的促甲状腺激素真的很低
Her TSH is really low,
所以我做了些其他检查
so I ran some more tests.
这像是过度服用甲状腺药物造成的
It's likely due to an overdose of her thyroid medication.
是的所以我要给她用乙型阻滞药
Yeah, so I'm gonna put her on beta blockers
同时开始用炭给她戒瘾
and start detoxing her with charcoal.
我跟她女儿聊一下
Let me--let me talk to the daughter,
看看谁负责给她吃药
find out who's in charge of the meds.
好的
Okay.
你的心电图和化验结果都是阴性的
Your EKG and labs were negative.
你没有心脏病发
You didn't have a heart attack.
你以前有像那样胸口疼过吗
Have you ever had chest pain like that before?