芝加哥急救

Chicago Med S02E21

Part 2 Jan. 23, 2020, 12:13 p.m.

How come?
我不知道
I don't know.
我家有精神病史
I mean, there is a history of psychiatric issues in my family.
我知道了
I see.
你能告诉我
You want to tell me about
过去几周发生了什么吗
what's been happening in the last few weeks?
我开始听到我公♥寓♥的墙里有老鼠
I started hearing rats in the walls of my apartment.
帕克斯夫人
Mrs. Parks. Hi.
呼吸好点了吗
You breathing any better?
-好点了 -很好
- A little. - Good.
你还好吗
Are you okay?
还好
Yeah.
莉亚刚刚做了一轮化疗
Leah just finished a round of chemo.
还有点恶心
She's been a little nauseous.
知道了
Got it.
你和萨姆去透透气吧
Why don't you and Sam go get a little fresh air, huh?
-我和你一起去 -好
- I'll go with you. - Okay.
谢谢桃瑞丝
Thanks, Doris.
你的检查结果显示
So your tests show
你的肺部没有塌陷
that you do not have a collapsed lung,
但是我看到了更令人担心的情况
but I'm seeing something more concerning.
你现在心脏衰竭
You're in heart failure.
她上次怀孕的时候
Uh, she had a peripartum cardiomyopathy
有围生期心肌病
during her last pregnancy.
那么你知道你面临的危险
So you understand the danger you're in?
我别无选择
I had no choice.
我们的儿子萨姆
Our son, Sam...
和莉亚不匹配不能做她的捐赠者
wasn't a donor match for Leah.
这是我能救她的唯一的办法了
This is the only way that I can save her.
我们很清楚风险
We're well aware of the risks,
但是我们充分讨论过了我们...
but we discussed this at length and we, uh--
我们愿意冒这个险
we're willing to take the risks.
我知道这很难接受
I realize that this is difficult to hear,
但是在这种情况下最安全的办法是...
but the safest choice in cases like this is to...
给你减负并终止妊娠
take the load off of your system and terminate the pregnancy.
如果明年我女儿
My daughter can't make it
没有得到骨髓移植的话
without getting a marrow transplant
她就撑不过去了
in the next year.
如果我流掉这个孩子就太晚了
If I lose this pregnancy, it'll be too late.
三个星期罗德斯医生我们只需要三个星期
Three weeks, Dr. Rhodes. That's all we need.
你能帮我们吗
Can you help us do that?
好
Yes. Okay.
我会给你开些药
I'm gonna put you on some medicine
来帮助强化你的心脏
that will help to strengthen your heart.
让你的血压回升
We will get your pressure back up,
但愿你很快就能呼吸得轻松一些
and hopefully, you'll be breathing easier again soon.
-谢谢你 -谢谢
- Oh, thank you. - Thank you.
不用谢
Of course.
查尔斯医生
Dr. Charles.
罗宾的事谢谢你的帮忙
Thanks for the help with Robin.
应该的
Of course.
丹尼尔
Hey, Daniel?
我知道里斯医生是评估罗宾的住院医生
I understand Dr. Reese is the resident evaluating Robin.
是啊这很正常啊
Yeah, well, it makes sense.
她很擅长处理和她同龄的病人
She's very good with patients in her own peer group.
是的但她也是你的学生
Yes, she is, but she's also your student.
我最好的学生之一我...
One of my very best, and I, uh--
我百分之百信任她
I have the utmost confidence in her.
我知道你相信她丹尼尔
Well, I'm sure you do, Daniel.
我知道这很复杂
I know this is complicated,
但是我真心希望你不是利用里斯医生
but I sincerely hope you're not using Dr. Reese
做你的代理人
as your surrogate.
莎伦听我说
Sharon, look.
我当然很喜欢很信任莎拉
Of course I'm a big fan of Sarah's,
但是权医生具体负责这件事
but Dr. Kwon's running the show on this one.
我唯一要做的就是做个好爸爸
My only job is to be a good dad,
不要碍事
and stay out of the way.
室性心动过速
He's in unstable V-tach.
脉搏很微弱
Barely got a pulse.
来人帮下忙
A little help in here!
他心搏快停止了一定是又犯心脏病了
He's peri-arrest-- must be another heart attack.
威尔上气袋
Will, start bagging.
艾普尔充电至100
April, charge the paddles to 100.
-好的 -他的血管造影怎么样
- On it. - What did his angio look like?
在导管室给两处小病灶搭了支架
Stented two small lesions in the cath lab.
充电至100
Charged to 100.
离手
Clear.
没有脉搏我要开始按压了
No pulse. I'm starting compressions.
注射一毫克肾上腺素
Have a milligram of epi.
充电至200
Charge to 200.
他的生命体征怎么样
How were his vitals?
他刚刚还没事完全稳定
He was fine. He was totally stable.
-充电到200 -离手
- 200. - Clear!
离手
Clear.
室颤
He's gone into V-fib!
再注射一毫克肾上腺素
Another milligram of epi.
300单位胺碘酮
300 amiodarone.
继续按压充电至200
Keep up compressions and charge to 200.
那他一定有我们不知道的更严重的疾病
Then he must have had a worse disease than we thought.
-充电至200 -离手
- Charge to 200. - Clear!
离手
Clear.
心搏停止
Asystolic.
死亡时间 10点32分
Time of death--10:32.
怎么会这样
How did this happen?
现在我们最后一位患者
And now, for our final case...
今天早上达恩先生
Mr. Dayne passed out this morning
因心律不齐晕厥了
from a cardiac arrhythmia.
现在体征稳定但还是有心房♥纤颤
He's stable now, though still in A-fib.
达恩先生你是否知道你的心律不齐
Mr. Dayne, do you have any idea how long ago
是什么时候开始的
your irregular heartbeat began?
不知道
Nope.
谢谢我们稍后回来
Thank you. We'll be back.
如果心房♥纤颤是之前48小时内开始的那就...
So, if the A-fib started less than 48 hours ago, we--
直接电击调整心率
Uh, shock him back into rhythm?
正确
Correct.
但如果开始时间早于48小时
But if it's been longer than 48 hours,
使用电击可能会导致他出现严重脑血栓
that same shock could throw a dangerous embolus to his brain.
各位有智慧的年轻人
So, my bright, young minds,
你们需要找出答案
one of you needs to come up with the answer.
斯托尔医生
Uh, Dr. Stohl?
我们要怎么找出答案
How are we supposed to do that?
拭目以待
Impress me.
里斯医生你好啊
Dr. Reese, what's up?
罗宾在做静脉切开
Robin is down in phlebotomy now.
好的
Great.
看来你非常胸有成竹
Well, sounds like you're on top of it.
那么...
How's it, um--
顺利吗
how's it going?
我已经在整理临床表现了
I'm starting to put together a clinical picture.
好的
Good stuff.
我再说一次如果你需要家族病史
Once again, you know, if you need any family history,
或其他背景知识
any background--
比如她经常会提到她的公♥寓♥
for instance, she's been talking about her apartment a lot.
她有提到过吗
Has that come up at all?
我不能跟你说这个
I really can't discuss this.
我明白很抱歉
Of course you can't. I'm sorry.
我的意思是
I just meant
单纯从临床角度出发
purely from a clinical standpoint, you know,
家能反映一个人的思想什么的
the home is a reflection of the mind and all that.
了解一下也没坏处不过你说得对
It couldn't hurt exploring, but you're absolutely right.
继续加油吧