芝加哥急救

Chicago Med S02E17

Part 1 Jan. 23, 2020, 12:12 p.m.

-一点吃午饭吗 -十二点半
- Lunch, one o'clock? - 12:30.
好
Oh, yeah, right.
-早上好 -早
- Morning. - Hey.
-早上好霍斯特德医生 -早上好
- Morning, Dr. Halstead. - Good morning.
好好好等等
Yeah, yeah, yeah. Wait.
惠勒医生第三治疗室有个病人
Dr. Wheeler, you got one in 3.
-马上过去 -好的
- Be there in a minute. - Okay.
-早上好杰夫 -早
- Morning, Jeff. - Hey, man.
这肯定是令人震惊的事件
This is obviously a tremendous shock.
惠勒医生是我们当中的一员
Dr. Wheeler was one of us.
处理这个事件的过程
And the burden of processing all that has happened
肯定很漫长也很艰难
will be a long and...and difficult one,
如果今天有人不想待在这里
so there would be no judgment on anyone
那没有任何问题
who would prefer not to be here today.
这种时候谈论任何话题
At times like this, talking about anything,
甚至是天气都无伤大雅
even the weather, never hurt anyone,
我的同事理查德森医生
so my colleague Dr. Richardson
今天随时待命
has made herself available all day.
有需要都可以去她办公室找她
She'll be up in her office if anybody wants to stop by.
好的谢谢大家
Okay? All right, thank you.
古德温女士据我经验来看
Ms. Goodwin, in my experience,
在这种时候保持士气的关键
the key to maintaining morale in times like this is
就是让一切都顺利进行
to keep things running smoothly.
-当然 -如果我让里斯医生
- Of course. - Okay if I take Dr. Reese
今天暂代一下可以吗
to fill in for the day?
查尔斯医生
Dr. Charles?
-当然 -谢谢
- Sure. - Thank you.
麦基候诊室都是病人开始工作吧
Maggie, waiting room's full. Let's keep 'em moving.
-有麻烦崔医生 -什么情况
- Trying, Dr. Choi. - What have we got?
五分钟后有掉进了河里的孩子来
Kid who fell in the river about five minutes out,
救人的也随后送过来
Good Samaritan right behind.
还有几个流鼻涕和耳朵痛的
Bunch of runny noses and earaches,
第六治疗室还有个肚子痛的
and abdominal pain in 6.
曼宁医生你去处理孩子
Dr. Manning, you're on the kid.
克拉克和塞克斯顿去帮忙
Clarke and Sexton, stand by to assist.
里斯你也准备好其他人都动起来
Reese, you're on deck. Everyone else, take a room.
别担心我们会顺利度过的
Let's go. Don't worry. We'll get through this.
我是崔医生听说你肚子疼
Hi. I'm Dr. Choi. Heard you're having some belly pain.
-对没什么大不了的 -他摔下了楼梯
- Yeah. It's not a big deal. - He fell down the stairs.
真的吗怎么回事
Really? How'd that happen?
没什么
Aah! It was nothing.
他当时抱着一个装着书的很重的箱子
He was carrying a pretty heavy box of books.
我们下周要搬家在打包
We're packing up to move next week.
大家都觉得看书很重要
And everyone thinks reading's good for you.
可能肋骨骨折了我要做一些检查
Might have a broken rib. I'd like to get some scans
确保没有别的问题
and make sure there's nothing else going on,
但看起来不是很严重
but it doesn't look too serious.
我过会儿再来看你
I'll be back to check on you in a little bit.
-还有什么问题吗 -没有是...
- Is there anything else? - No. It's--
就是他最近有点笨手笨脚的
it's just--he's been a little clumsy lately.
但这很正常对吗被自己的脚绊倒什么的
But that's normal, right? Tripping over his feet?
就是正在长身体吧
He's just growing into his body.
应该没事但我们有时间
It's probably nothing, but since we got some time,
我会做点血液检测看看有没有感染或者中毒
I'll run some blood to rule out any infections or toxicities
以防万一
just to be sure.
谢谢
Thank you.
-需要帮忙吗 -我们来
- Need any help? - We got it.
-麦基安排进创伤科了吗 -是的崔医生
- Mags, put him in Baghdad? - Already on it, Dr. Choi.
达斯汀·班克斯八岁
Dustin Banks, eight years old.
掉进冰窟窿里了
Fell through the ice into the river.
15分钟后被救出
15 minutes before he was pulled out.
心跳缓慢核心温度27摄氏度
Heart's in brady-arrest. Core temp 27 degrees Celsius.
冻死吗塞克斯顿你看呢
Cold and dead, Sexton? What do you think?
要先暖和过来才知道吧
Uh, that he's not dead until he's warm and dead?
你赢得了第一轮胸部按压
You just won the first shift of compressions.
好听我口令
All right. On my count.
一二三
One, two, three.
艾普尔插管 50毫克司可林10毫克麻醉剂
April, I need to intubate. 50 of sux, 10 of etomidate.
-马上 -能听到我说话吗达斯汀
- On it. - Can he hear me? Dustin!
医生很快就出来好吗
The doctor will be with you as soon as she can, okay?
吉姆·凯斯勒 58岁跳进河里
Jim Kessler, 58. Had a STEMI
救小孩之后出现急性心肌梗塞
after jumping in the river to save the kid.
现场用了阿司匹林和硝基
Aspirin and nitro in the field.
窦性心律现在120/80
Sinus rhythm now 120/80.
凯斯勒先生我是里斯医生能听到吗
Mr. Kessler, I'm Dr. Reese. Can you hear me?
-当然能 -好极了
- Sure can. - Great.
听我数三下把他抬上去
On the count of three, let's move him.
一二三
One, two, three.
-药物进去了 -麦基准备一个体外膜肺
- Meds are in. - Maggie, get an ECMO unit.
肺炎多发期
Pneumonia season.
全被楼上拿去用了
Every single one's in use upstairs.
没到95华氏度他不会醒的
He's not gonna wake up till he's 95 degrees.
搭桥呢
What about bypass?
都在手术中
They're both in surgery.
90分钟后可以调一个过来
We can get one down here in about 90 minutes.
那么到手之前我们就要保证
Then we're gonna have to keep his heart beating
-他心脏持续跳动 -按压90分钟
- until we get it. - Compressions for 90 minutes?
五分钟一换我们还要尽量
In five-minute shifts. And we'll warm him
给他保暖左肺先洗
the best we can with a left lung lavage.
杰夫我们需要两个32毫米胸管
Jeff, we need two 32-french chest tubes.
艾普尔拿取暖器和医院里所有的生理盐水来
April, get a warmer and all the saline in the hospital.
动起来
Let's go.
清洗左肺你确定可行吗
Left lung lavage? Sure it'll work?
我们要试试
We're gonna try.
曼宁医生这是大卫·班克斯达斯汀的父亲
Dr. Manning, this is David Banks, Dustin's father.
-他会没事吗 -现在还不好说
- Is he gonna be okay? - It's too soon to tell.
低温的好处是保存了大脑功能
The benefit of hypothermia is it preserves brain function.
但如果我们不能尽快让他暖起来
But if we don't warm him fast enough,
寒冷会最终侵蚀他的身体
the cold will eventually overwhelm his body,
所以我们会用温的生理盐水在他胸腔循环
so we're gonna circulate warm saline through his chest cavity
直到给他接搭桥机明白吗
until we can put him on bypass, okay?
好取暖器马上来不过这么多生理盐水
Okay, the warmer's on its way, but for this amount of saline,
中心供给得有医生的指令
Central Supply needs a doctor's order.
好的我保证我们会尽全力的
Okay. I promise you we are gonna do everything that we can.
你的心电图ST段异常显然是心脏病发了
Your EKG shows ST elevations. Definitely a heart attack.
之前有过心脏问题吗
Ever had any heart problems before?
时不时胸部有点疼
Little chest pain here and there.
我的医生有给我开些药
My doc's got me on some pills.
好吧他本应该叮嘱你
Okay, well, he should've told you
不要跳进结冰的河里
not to jump in a frozen river.
心脏病发差点要了你的命
The shock is probably what tipped you over the edge.
每个人都是礼拜一早上的四分卫[马后炮]
Everybody's a Monday morning quarterback.
我不知道那是什么意思
I don't know what that means,
但我知道我们需要评估
but I do know that we need to assess
你冠状动脉病情严重的程度
the extent of your coronary artery disease,
所以我想送你去疏导室
so I want to send you up to the cath lab.
你给我拿杯热可可我就答应你
Long as there's some hot cocoa in it for me, you got a deal.
好的我很快回来
All right. I'll check back in with you soon.
是心肌梗塞
Activate the STEMI protocol.
叫罗德斯医生来咨♥询♥下
And uh, call Dr. Rhodes for a consult.
好的
You got it.
他走运
He got off lucky.
他本可能会出现冷休克室颤凝血功能障碍
He could've gone into cold shock, v-fib, coagulopathy.
简直是太疯狂了
What a great but crazy thing to do.
他估计都没想过后果
He probably didn't even think about it.
只是看到那个孩子生命有危险的本能反应
Just saw a kid in trouble and reacted.
谢谢
Thank you.
小娜
Hey, Nat.
杰
Hey, Jay.
今天不怎么好过吧
It's a tough day, huh?