芝加哥急救

Chicago Med S01E02

Part 4 Jan. 25, 2020, 11:19 a.m.

得了吧她才14岁
Come on. She's 14 years old.
不管是不是她主动的那都是强♥奸♥
Solicitation or not, that's rape.
这也不能使她脱罪
Doesn't absolve her.
她有可能被指控好几项重罪
She's facing several potential felonies.
弃子谋杀未遂
Abandonment, attempted murder.
这得由州检察官和法官判定但在库克郡
It's up to the State's Attorney and the judge, but Cook County?
一切皆有可能
Anything could happen.
我以为我可以的
I thought I got it all.
强制排除胎盘是产科手术
Forcing the delivery of the placenta is an OB procedure,
你到底在想什么啊
so what the hell were you thinking?
当时情况紧急我做出了决定
It was an emergency situation. I made a decision.
一个错误的决定
A bad one.
你越界了然后惹了大♥麻♥烦
You overstepped your bounds, and you botched it.
那个女孩差点得切除子♥宫♥
That girl almost needed a hysterectomy.
她才14岁啊
A 14-year-old!
我问你崔医生
Now, let me ask you something, Dr. Choi.
你不喜欢这个病人你不赞成她的举措
You didn't like this patient. You disapproved of her.
你觉得这会影响我的判断力和能力吗
You think that affected my judgment and my performance?
你说呢
You tell me.
霍斯特德医生请到急诊科
Dr. Halstead to the E.D.
霍斯特德医生请到急诊科
Dr. Halstead to the E.D.
蓝色警报
Code blue.
霍斯特德医生心搏停止五号♥治疗室
Dr. Halstead, cardiac arrest, treatment 5.
-你的病人 -蓝色警报
- Your patient. - Code blue.
你不是说他会没事的吗
I thought you said he was gonna be okay.
放上体外起搏器垫
Get the pads on him.
他之前来过医院
He was in earlier.
病例上还有需要我们了解的信息吗
Is there anything we need to know from his charts?
没有给他做了全身检查没查出毛病
No. We did a full workup, and everything checked out.
我当时开车回家我转头看他
I was driving home, and he--I looked over
他面如白纸
and he was just white as a sheet.
然后我就赶紧开回医院
And then I turned around and drove back as fast as I could.
我觉得他当时没有呼吸了
I don't think he was breathing.
女士抱歉你得到外面等候
Ma'am, I'm sorry. You need to wait outside.
好
Okay.
暂停按压
Hold compressions.
室颤充电到200
V-fib, charge to 200 joules.
-离手 -离手
- Everyone clear. - Clear.
有脉搏了
I got a pulse.
窦性心律心跳50
He's in sinus rhythm, brady at 50.
血压
BP?
90/45
90 over 45.
慢着慢着 72/35
Wait, wait, wait. 72 over 35.
静脉滴定10单位多巴胺使收缩压升至90
Start dopamine at 10 and titrate to a systolic of 90.
-好的 -安排12导联心电图
- Yes, sir. - Get a 12 lead EKG.
马上安排霍斯德特医生
Right away, Dr. Halstead.
我们要将他的血压升上来
We gotta get his BP up.
呼叫曼宁医生
呼叫曼宁医生
你呼我了吗
You paged me?
是格兰特医生
Dr. Grant.
气胸右肺萎陷
Pneumothorax. Right lung collapsed.
开始给他插管
Tubing him now.
血氧饱和度78 低于75就会...
O2 sats at 78. We get below 75 and--
不会低于75的...
We're not getting below 75.
坎贝尔
Campbell.
你需要什么
What do you need?
一氧化氮吸入治疗需要提高供氧量
Inhaled nitric oxide. We need to improve oxygenation.
我去拿气罐
I'll get a tank.
他心律过缓
He's really bradycardic.
打开多巴胺滴定
Turn up the dopamine.
会帮助改善血压和心率
It should help the pressure and heart rate.
霍斯德特医生已经15分钟了做决定吧
Dr. Halstead, it's been 15 minutes--make a decision.
我还没打算放弃
I'm not giving up yet.
右心室不动了
RV's not moving.
右心室爆裂严重失动
You have a blown-out RV and severe akinesis.
我想你应该考虑多输入液体
I think you might want to consider giving more fluids
而不是不停给他升血压
instead of escalating the pressers.
联♥系♥放射科拿一罐一氧化氮来
Call RT for a tank of nitric oxide.
一氧化氮
Nitric oxide?
这会减少右心室后负荷从而减少心脏负荷
It'll reduce the afterload so that the heart works less
在他去导管室之前为他争取一些时间
and buy some time till the cath lab is ready.
我从没见过这样的疗法
I've never seen it used for this.
我知道不是正规疗法
It's unorthodox, I know,
但我没有气囊泵我们别无他选了
but I don't have a balloon pump, and we're out of options.
放射科的人说曼宁医生拿走了最后一瓶气罐
RT says Dr. Manning is signing out the last tank.
十分钟后才能拿到下一罐
They'll have another ready in ten minutes.
他那时早死了
He'll be dead by then.
小娜你去哪
Nat, where are you going?
新生儿重症监护室无名宝宝的血氧量在70左右
NICU. Baby Doe's sats are in the 70s.
-让他接受体外膜肺氧合 -万不得已时才这么做
- Put him on ECMO. - That's a last resort.
抱歉我需要这瓶气罐
I'm sorry, but I need this tank.
你干什么啊
What the hell are you doing?
我没有其他选择了你有
I have no other option. You do.
把气罐还给我
Give me that tank!
小娜没有它我的病人会死
Nat, my patient will die without it.
宝宝会因此有生命危险
You're putting the baby at risk.
我不会让这个人死
I'm not gonna lose this guy.
-威尔 -他有三个孩子
- Will -He's got three kids.
用医生的思维思考别因为怀孕就感情用事
Try thinking like a doctor and not a pregnant woman.
他出现室颤又没有脉搏了
He's in v-fib. Lost his pulse again.
充电到200 离手
Charge to 200. Everyone clear.
-离手 -离手
- Clear. - Clear.
再注射一次肾上腺素快
One more round of Epi. Let's go.
重新按压
Restart compressions.
-没反应 -拜托
- Nothing. - Come on!
道格道格求你了
Doug? Doug, please?
听我说好吗
Please listen to me, okay?
我们需要你我需要你明白吗
We need you, all right? I need you, okay?
-护士 -求你醒来求你...住手
- Nurse. - Please? Please--stop.
暂停按压
Hold compressions.
有脉搏了又是窦性心动过缓
I got a pulse. Sinus brady again.
开始穿刺带他到导管室
Start amnio drip. Let's get him to the cath lab.
松开
Let's unclamp.
打开循环
Turn on the circuit.
体外膜肺氧合的作用是心肺分流
ECMO acts as a heart-lung bypass,
在婴儿体外通过血液为婴儿输氧
oxygenating the infant's blood outside its body.
-血氧量上升了 -谢天谢地
- Sats are rising. - Thank God.
曼宁医生
Dr. Manning?
楼下有位叫卡拉·多尔蒂的女士找你
There's a Kara Dougherty downstairs to see you.
好
Okay.
老样子迪诺
The usual, Dino.
查尔斯医生
Dr. Charles.
崔医生
Dr. Choi.
你以前是海军吧
You were in the-what, the Navy, right?
现在也在海军后备队
Still am. Naval Reserves.
有个跟我一起做住院医师的医生当时正要离开海军
Doc I did my residency with was on away leave from the Navy.
跟你们一起当精神科医生太艰难了
It was tough as hell practicing psychiatry with you guys.
不能让任何人敞开心扉
Couldn't get anybody to open up.
可能是软弱的表现
Could be a sign of weakness.
炸猪皮
Pork rind?
不吃谢谢
No, thanks.
我不该吃太多这种垃圾食品
I shouldn't eat this stuff so much.
我想军队那一套很严格吧
Guess that military culture's tough, right?
不能随便说话之类的
Loose lips and all?
最后一次机会了兄弟
Last chance, man.
我确定是有机食品
Pretty sure they're organic.
-不用了 -不要吗
- I'm good. - No?
卡拉我是娜塔莉我们在电♥话♥里聊过
Kara, I'm Natalie. We spoke on the phone.
我给艾瑞卡带了些衣服来
I brought Erika some clothes.
谢谢你
Thank you.