芝加哥急救

Chicago Med S03E05

Part 3 Jan. 23, 2020, 11:09 a.m.

我们正在努力
We are working on it.
搞定了你非常勇敢
All done. You were so brave.
妈妈大概一两小时内会出结果
Mom, we should have the results back within an hour or two.
我不明白你说她检查结果正常
I don't understand. You said her tests were normal.
-确实但是... -但她情况恶化了
- They were, but-- - But she's getting worse.
她现在双腿完全动不了了
She can't move her legs at all anymore.
等我们收到丹妮丝脑脊液的检查结果
We'll have a much clearer picture once we receive
应该能有更清晰的判断
the results back on Denise's cerebrospinal fluid.
我们会让实验室尽快出结果好吗
And we'll ask the lab to put a rush on these, okay?
-谢谢 -不必应该的
- Thank you. - Yeah. Of course.
威尔那女孩的脑脊液你看到了非常干净
Will, you saw that girl's CSF. It was crystal clear.
实验室不会有什么新发现
The lab's not gonna tell us anything we don't already know.
很明显不是脑炎脑膜炎
And it's obviously not encephalitis, meningitis,
-或者格林巴利综合征 -等等
- Guillain-Barre syndrome, - Hold on then.
格林巴利综合征先待定
Let's not rule out GBS.
她目前的症状非常符合GBS
It fits her clinical presentation almost to a T.
血液运作正常
I mean, normal blood work,
进行性对称瘫痪反射缺失
ascending symmetrical paralysis, absent reflexes.
先再做一次检测吧
Let's just do one more round of labs first.
好检查重金属中毒境外感染
Alright, test for heavy metal poisoning, exotic infection,
如果这些结果还是没线索
and if we don't get anything from those,
那我也支持按GBS治疗好吗
I'm all for treating it as GBS, okay?
好的
Alright.
应该慢慢掌控方向
You're supposed to steer into the skid.
好了请弯曲膝盖
Okay, can you flex your knee for me?
不应该猛踩刹车我怎么就记不住呢
Never slam on the brakes. Why couldn't I remember that?
慢慢抬到胸前
Now bring it to your chest for me.
好的
There we go.
塞克斯顿先生这位是斯潘塞的妈妈坎迪丝
Dr. Sexton, this is Spencer's mother, Candace,
还有他哥哥特伦斯
and his brother, Terrance.
天哪
Goodness.
他没事吧
Is he gonna be okay?
臀部脱臼不过除此之外
Dislocated his hip, but other than that,
都是擦伤和淤青
just scrapes and bruises.
我们给他做了头部腹部和骨盆的CT
We did a CT of his abdomen, pelvis, and head.
没有检查到任何内出血或骨折情况
All negative for internal bleeds and fractures.
谢谢你塞克斯顿医生
Thank you. Doctor Sexton.
就不该让你一个人开车
Shouldn't have let you drive by yourself.
他上周才刚拿到驾照
He just got his license last week.
是啊考了五次
Yeah. Took him five tries.
妈我撞到人了
Mom, I hit someone.
行人吗
A pedestrian?
不是个司机刚送来医院
No, the driver, they just brought her in here.
她刚才就在那里出血非常严重
She was right over there. She was bleeding real bad.
-正在做手术 -她还好吗
- She's in surgery. - Is she gonna be alright?
斯潘塞知道芝加哥最强创伤科医生在努力
I told Spencer the best trauma surgeon in Chicago is working on her.
万一她挺不过来呢
What if she doesn't make it?
别担心她会没事的
Don't worry, she-She'll make it.
肝脏轻微撕裂
Small liver lac.
脾部粉碎伤
Spleen is shattered.
应该是四级伤害
Looks like a Grade 4.
肺门正在大量出血
Actively bleeding from the hilum.
胃短动脉也发生了撕裂
Short gastrics are avulsed, as well.
罗德斯医生我是诺亚
Hey, Dr. Rhodes, it's Noah.
我很忙诺亚有什么事
I'm a little busy here, Noah. What do you need?
好我就是想问问
Yeah, I just wanted to check in
患者情况如何
on the status of the patient.
现在还不知道
I don't know yet.
好好吧
Okay, yeah, sure.
只是...
It's just, um,
撞到她的那个孩子很害怕
the kid who hit her is really freaking out.
那我也爱莫能助诺亚
Yeah, I can't help that, Noah.
如果我能告诉他们她会没事的...
Well, if I could just tell them that she's gonna be okay--
不行
No.
永远别那么做
Don't ever do that.
等等她不答应做检测
Wait a minute, she won't consent to being tested
因为她情愿死也不愿让家人发现
because she'd rather die than have her family find out
她患上了艾滋病
that she has AIDS.
你还跟我说她有能力做出合理决定吗
And you're saying she's capable of making rational decisions?
你不赞成她做出的决定
Just because you don't like the decision she's making,
不代表她无法做决定
doesn't mean she's incapable of making it.
她在非洲长大 HIV带来的污名和歧视
Growing up in Africa, HIV-related stigma and discrimination
可能是她天天能见到的事
was probably something she witnessed on a daily basis.
-那是她阿姨吗 -薇拉
- Is that her aunt? - Vera.
阿贝纳跟她住一起
Abena lives with her.
家里其他人都在加纳
Rest of the family is back in Ghana.
她知道她不是非得把这事
Well, she knows she's not being forced
告诉阿姨的对吗
to tell her aunt, right?
她知道我们有严格的医患保密条例
She understands we have strict privacy rules here.
没用
Doesn't matter.
她相信如果接受测试
She's convinced that if she takes the test,
开始用抗逆转录药物他们就会发现
starts the antiretrovirals, that they'll figure it out.
但手术就不会暴露了
But the lesions won't give her away.
拜托她们可是住在同一屋檐下的
Come on, she's living under the same roof, for chrissakes.
如果她还想瞒得住
If she wants to continue concealing this,
-就得接受治疗 -那你得说服她
- she needs to start treating it. - Well, you gotta convince her.
你们得说服她
You have to convince her.
抱歉我不能就这么同意
I'm sorry I can't just rubberstamp this.
崔医生阿贝纳说觉得恶心
Dr. Choi, Abena is complaining of nausea.
真棒现在她又需要胃肠医生了
Great, now she'll need a GI consult.
加在她的账单上吧
Just add it to her tab.
她的账单吗
Her tab?
莎伦我知道你压力很大但是...
Sharon, I know you're under a lot of pressure, but--
丹尼尔我们在努力救她一命
Daniel, we're trying to save her life.
我说说我的看法
Look, just for argument's sake,
假设我们说弓形虫在损伤她身体
let's say the toxo is causing impairment,
逼着她做检测
and we force the test.
然后呢
Then what?
有谁能后半辈子都陪着她
Somebody shoves pills down her throat
天天强制她吃药吗
for the rest of her life?
就是法♥院♥也不可能命令...
I mean, no court is ever going to mandate--
谁快来帮帮忙救命
Please someone help! Please!
我女儿喘不过气来了
My daughter, she can't breathe.
好
Okay.
丹妮丝看着我
Hey, Denise. Look at me.
深呼吸好吗吸气吐气
Deep breaths for me, okay? In and out.
你能捏住我的手吗
Can you squeeze my hand?
你能把胳膊抬起来吗
Can you lift your arms for me?
怎么回事
What's happening?
麻痹开始向她脊柱上方蔓延了
The paralysis is moving up her spine.
注射10毫克依托咪酯 50毫克琥珀胆碱
10 of etomidate and 50 of sux.
准备插管
We're intubating.
你要把那个插♥进♥她嗓子里吗
You're gonna put that down her throat?
不如我们腾出点地方给医生操作吧
Okay, why don't we give the doctors some room to work?
不求你了我想陪着我女儿
No, please, please, I wanna stay with my daughter.
没事的我们就站在这里
It's okay, we'll stay right here.
好了
Okay.
她现在打了安定又插着管
Couldn't do much of a neuro exam
没法做太详细的神经检查
with her sedated and intubated,
但要我猜的话她瘫痪了
but if I had to guess, I'd say she's paralyzed.
谢谢你萨姆
Thanks, Sam.
在跳踢踏舞吗霍斯特德
Doing the hokey pokey there, Halstead?
-什么 -你的脚
- Huh? - Your foot.
是有点麻而已
Oh. Yeah, it just fell asleep.
-撞到了... -行了当我没问
- Kinda banged it at this-- - No, never mind.
你说得对
You were right.
我们早该开始静注免疫球蛋白和血浆置换的
We should have started IVIG and plasma exchange way earlier.
等下去是错误
It was a mistake to wait.
不你做了决定
No, you called it--
我觉得这已经不是链球菌感染了
I don't think it is GBS anymore.