芝加哥急救

Chicago Med S03E19

Part 4 Jan. 23, 2020, 11:14 a.m.

If I only had, like, two more minutes in that apartment.
-丹尼尔 -怎么了
- Daniel... - What?
小心
Be careful.
-血氧浓度在下降 -怎么回事
- Sats are dropping. - What's happening?
-呼吸衰竭 -给氧
- Respiratory failure. - Bag him.
20单位依托咪酯 100单位斯可林
20 of etomidate, 100 of sux.
需要立刻插管
We need to intubate now.
血氧降到87
Sats are down to 87.
-小娜 -我快好了
- Nat... - I'm almost there.
-天哪 -82
- Oh, God... - 82.
插好了
I'm in.
现在给他十万分之一的
Now, let's get 10 parts per million
一氧化氮吸入治疗
of inhaled nitric oxide.
给插管做个胸透
Let's get a chest X-ray for tube placement.
爸爸
Dad?
莎拉
Oh, Sarah.
她比你描述得还可爱
She's even lovelier than you said.
谢谢
Thank you.
我得先走了
I should probably get going,
不过...
but, um...
谢谢罗伯特
thank you, Robert.
这对我而言意义重大
This has meant so much to me.
对我也一样
As to me.
这是怎么回事
What was that all about?
那是我的
That...was the widow
心脏捐赠者的遗孀
of my heart donor.
她想见见我
She had asked to meet me.
我得说其实我是保留意见的
I admit I was reticent about the whole thing,
不过很意外
but, surprisingly...
感觉还不错
it felt good.
-血氧浓度还是很低 -一氧化氮不起作用
- Sats are still in the tank. - Nitric oxide didn't work.
少量通气也是
Neither did low volume ventilation.
他妈妈呢
Where's the mom?
她去喝咖啡了
She went to grab a cup of coffee.
我们要送他去儿童重症监护室
We should get him up to the PICU.
我已经联♥系♥过了
I called already.
他们现在没有可用的隔离病房♥
They don't have an isolation room available.
流感病毒的传播会一发不可收拾
This flu epidemic is wreaking havoc.
该考虑用体外膜肺氧合了
It's time to consider ECMO.
没错
Yeah.
你怎么看这个
Hey, uh, what do you think of this?
红疹
A rash?
也不算罕见
It's not abnormal.
我会联♥系♥重症监护病房♥看还没有隔离病房♥
I'll call the ICU, see if they have an extra iso room.
谢谢
Thanks.
崔医生我们需要你
Dr. Choi, we need you.
-他在抽搐 -二毫克安定
- He's having a seizure. - Push 2 of Ativan.
放轻松放轻松
All right, take it easy, take it easy.
他的眼睛出现黄疸症状
His eyes are icteric.
他的肝脏有问题
There's something wrong with his liver.
海♥洛♥因♥造成的吗
From the heroin?
不太可能他的检查结果出来了吗
Not likely. Did we get his labs back?
好像几分钟前拿过来了
I think they came in a few minutes ago.
好
Okay.
阿片药
对乙酰氨基酚
检查出对乙酰氨基酚那是镇痛药的成分
Positive for acetaminophen. That's in Percocet.
我们也开始用乙酰半胱氨酸吧
Uh, let's also start a NAC,
每公斤140毫克
140 milligrams per kilogram.
好
Okay.
艾普尔你说的药物丢失的事
April, what you said about the missing drugs...
忘了吧我不该想那么多
Oh, forget it, I shouldn't have gone there.
其实你是对的
Actually, you should've.
我以为这个孩子嗑过量的是海♥洛♥因♥
I thought this kid OD'd on heroin,
但他的检查结果
but his labs came back positive
同时检测出了阿片药和对乙酰氨基酚
for both opioids and acetaminophen.
我不敢说他吃的就是但...
I can't tell it's exactly what he took, but...
最可能的来源就是我们丢失的镇痛药
the most likely source is Percocet, our missing drug.
你一开始就认为有这种可能
You thought from the beginning this could be a possibility.
-为什么 -我不知道
- Why? - I don't know.
也许是因为你告诉了我她的历史
Maybe what you've told me about her history.
艾普尔你有什么瞒着我
April, what aren't you telling me?
你还记得艾米莉第一天搬来的时候吗
Remember that first day Emily came to stay with you?
记得
Yeah.
她打扫了房♥间做了晚餐
She cleaned up and cooked dinner.
她还带了几个人过来
She also had some people over.
我在卫生间里
I found an ash tray
发现了装满烟蒂的烟灰缸
full of cigarette butts in the bathroom.
你就没想着告诉我吗
You didn't think I should know?
我只是希望你们两个能好好相处
I just--I wanted you two to get off on the right foot.
她求我不要告诉你
She begged me not to say anything.
抱歉我应该告诉你的
I'm sorry. I should've told you.
是啊
Yeah.
我去和她谈谈也许她会对我说实话
I'm gonna go talk to her. Maybe she'll come clean to me.
不
No.
她是我妹妹我来
She's my sister. I'll do it.
查尔斯医生真是想不到啊
Dr. Charles, what a pleasant surprise.
海伍德博士我就是来
Dr. Haywood, just wanted to--
来看看你怎么样了
to stop by, see how you're doing.
我最近是跑不了马拉松了
Well, I won't be running a marathon any time soon,
但我确实是好多了
but I'm getting along much better.
莎拉告诉我你在麦迪逊待过一阵子
You know, Sarah told me you spent some time up in Madison.
-我完全不知道呢 -是啊
- I had no idea. - Yeah.
我在那待过几个学期
I spent a few semesters.
他们一个劲地找我想让我过去
You know, they keep on bugging me to come up there
做个什么司法精神病学讲座
and do a forensic psychiatry seminar.
我不知道该不该花时间去跑一趟
I don't know, worth my time? Worth the trip?
我个人觉得麦迪逊那边
I found Madison to be
有点太拥挤了
a bit, uh, claustrophobic.
这样啊多谢提醒
Good to know. Good to know.
-能帮我个忙吗 -当然
- Could you do me a favor? - Course.
能不能帮我从那个箱子里
Would you mind... getting me a book
拿本书出来
from that box?
是
Yeah.
格里森姆的书
Ha, Grisham.
莎拉也没那么了解我
Well, Sarah doesn't know me very well.
好了海伍德博士
All right, Dr. Haywood,
你该去锻炼了
time for your exercises.
抱歉不能多聊了查尔斯医生
Sorry to cut this short, Dr. Charles.
希望你多来
I hope you'll stop by again soon.
那是自然
You can count on it.
手术很成功
The surgery was a success.
我们成功替换了瓣膜
We managed to replace your valve
避免了任何出血
and stave off any bleeding.
孩子呢
And the baby?
孩子没问题
The baby pulled through just fine.
谢谢你罗德斯医生
Thank you, Dr. Rhodes.
谢谢
Thank you.
我待会儿再回来看看你
I'll be back to check in on you soon,
看你的情况如何好吗
see how you're doing, okay?
罗德斯医生干得漂亮
Dr. Rhodes, good work.
这次我们总算走运了
Things broke our way this time.
不管怎么说干得漂亮
Nonetheless, well done.
话说我想问下连体双胞胎的模拟手术
Hey, I was wondering, uh, has there been any progress
有什么进展吗
on the conjoined twins simulation?
贝克医生和我都怀疑
Uh, Dr. Bekker and I suspect
可能组织钳的替换
it was the placement of the clamps
才是问题的诱因但我们已经证实
that caused the problem, but we've already confirmed
冠状血管和迷走神经并没有受到影响
that the coronary vessels and vagus nerve were not affected.
那窦房♥结呢
What about the sinoatrial node?
那我们还没考虑过毕竟位置太远
We hadn't considered that, given its location.
这两颗心脏的解剖结构都非常不寻常