芝加哥急救

Chicago Med S01E04

Part 2 Jan. 25, 2020, 11:20 a.m.

100/78 心率120
100 over 78, heart rate 120.
她心脏停跳了多久
How long was she down?
23分钟
23 minutes.
我上一个停跳这么久的病人结局很糟糕
Last patient I had down that long--it didn't end well.
给她插胸管然后送她去做CT扫描
Let's get a chest tube in her and then get her up to CT.
到时再看情况
We'll take it from there.
能深呼吸一下吗
Can you take a deep breath for me?
再来一次好吗
How about another one?
你是车祸伤者吗
Were you part of the crush?
你是不是被撞岔了气
Did you get the wind knocked out of you?
所以才昏迷了
Is that why you passed out?
不在那之前我就觉得头晕了
No, I got dizzy before anything happened.
那呕吐症状呢
What about the vomiting?
我不知道原因
I don't know why.
你买♥♥糖吃了吗
Did you buy candy?
或是那些可怕的奶油爆米花
Or that horrible buttered popcorn?
知道吗那根本不是奶油
You know, that's not even butter.
不我什么都没吃
No, I didn't eat anything.
如今走到哪都是垃圾食物
Everywhere you go, junk food.
年轻时我以为可以想吃什么就吃什么
When I was a teenager, I thought I could eat whatever I wanted.
当然结果我变胖了
Of course, I got fat.
好了你的心率正常
All right, well your heart's regular,
肺也没有杂音
your lungs are clear.
还觉得恶心吗
How's the nausea now?
好点了吧我想
A little better. Maybe.
我也不知道我总是觉得没什么力气
I don't know, I just always feel kind of blah.
我给你准备的便当呢
What about that meal I packed you?
你吃了吗
Did you eat that?
我给她准备了健康食物她却不肯吃
I make her healthy options, she won't eat them.
那恶心死了
They're gross.
再说我吃了也不舒服
Besides, they make me feel bad too.
好吧
Okay.
我们先做点检查看看结果如何
Let's run some tests and see what comes back.
食物过敏感染
Food allergies, infections--
这些都有可能导致长时间的恶心
these could lead to extended periods of nausea.
一会就有护士来给你抽血
Nurse will be in to draw your blood.
帮我安排些基础检查
Get me some baseline labs.
血常规血液生化前清蛋白
CBC, CMP, prealbumin,
尿MAG 尿酸血HCG 尿毒检查
mag, UA, HCG, a urine tox,
再帮我找查尔斯医生过来谢谢
and I need Dr. Charles. Thanks.
-什么情况 -17岁男性
- What do we got? - 17-year-old male.
昏迷指数6 腹部多处枪伤
GCS six, multiple GSWs to the abdomen.
两条静脉补液
Two large bore IVs.
心率曾高至160 血压过低
Tachy's at 160. Pressure's marginal.
-是开枪嫌犯吗 -没错归你了
- Baghdad turned over? - Yeah, it's all yours.
里斯留下来
Reese! Stay with us.
好了听我指挥
All right. On my count.
一二三
One, two, three.
好了检查呼吸音
All right, check for breath sounds.
这是枪手吗
This the shooter?
别太尽力抢救了
Don't knock yourself out over this one.
好了交给我们谢谢
Yeah, we got it from here, thanks.
两边都有呼吸音
Breath sounds bilaterally.
这年头连电影院都没法去了
Can't even go to the movies anymore.
医生
Doctor.
-没有脉搏里斯 -来了
- No pulse. Reese? - On it.
他的腹腔内正大量积血
He's bleeding into his belly.
我们必须夹住主动脉
We need to clamp the aorta to keep
确保他体内为数不多的血液
whatever blood he has left
能供应到心脏和脑部
going into his heart and brain.
你要在这里做开胸手术吗
You're gonna crack the chest here?
-没错 -没用的
- Yeah. - It's futile.
还是你只打算练习一下胸廓切开术
What, are you just practicing your thoracotomy?
事实上我打算救活他
Actually, trying to save his life.
心脏已经没血了
Aw, the heart's empty.
立刻用仪器泵血
Pump the blood with the level one now.
把管给我我从腹股沟插♥进♥去
Give me the tubing, I'll run it through the groin here.
好了主动脉用十字钳夹住了
All right. Aorta's cross-clamped.
开始计时
Clock starts now.
我们有30分钟时间找到出血点
We have 30 minutes to find out where he is bleeding from.
通知手术室告诉他们我们马上会带着
Call the OR, tell them that we're on our way up
腹部中枪的开胸伤者上去
with an open chest and a gunshot to the belly.
祝你好运
Good luck.
如果他活下来我让你在美国医学会杂♥志♥上发表
I'll let you write it up in JAMA when he pulls through.
走吧
Let's go.
没错正带着中枪开胸伤者上去
Yeah, headed up with an open chest, gunshot wound.
谢谢
Thanks.
她对痛感没有反应
She's not responding to pain.
瞳孔仍然无反应
Pupils still non-responsive.
没有角膜反射和呕反射
No corneal reflex, no gag reflex.
呼吸极度微弱
Not over-breathing the vent,
没用通过第一次呼吸暂停试验
failed the first apnea test.
有奇迹吗
We get a miracle?
今天没有
Not today.
大规模颅内出血
Catastrophic intracranial hemorrhage.
情况太严重了
Too many kicks.
老天这本不该发生的
God, this shouldn't have happened.
怎么你想知道为什么
What, you want a why?
人性丑恶这就是为什么
People suck. That's why.
-麦基 -什么事
- Maggie? - Yup?
露西·西姆斯是注册器官捐献者
Lucy Simms was a registered organ donor.
她丈夫已经同意
Her husband has given permission
摘除她的呼吸机
for her to be taken off the ventilator
并捐献出器官
and her organs harvested.
希望之馈器官运送车马上就会到
The Gift of Hope transport vehicles will be here soon.
我来通知手术室
I'll alert the OR.
谢谢
Thank you.
是你里克·米勒
Hey, it's you, Rick Miller.
就是你制♥服♥了枪手
You're the guy that took out the gunman.
谢谢你哥们
Thanks, man.
太谢谢你了我永远不会忘记你的
Thank you so much. I will never forget you.
我永远不会忘记你的谢谢你
I'll never forget you. Thank you.
谢谢你米勒先生
Thank you, Mr. Miller.
我们需要更多那样的人
We need more guys like that.
是啊
Right.
米勒先生
Mr. Miller?
能麻烦你跟我来吗
If you would follow me, please.
-谢谢你 -你救了我们大家
- Thank you! - You're a lifesaver.
反应挺快知道给他开胸
Quick thinking, cracking open his chest.
不过是我就用主动脉球囊阻断了
I would've used the REBOA, though.
我还以为萨内蒂医生
And for a second, I thought Dr. Zanetti
要夸奖我了呢
was about to give me a compliment.
那小子还活着就是对你的夸奖
The kid's alive, that's your compliment.
好了给他包扎一下看看是哪里出血
Okay, let's pack him up, see where he's bleeding from.
好的医生
Yes, Doctor.
开腹开胸
Open belly, open chest.
这小子可得有不少伤疤了
Kid's gonna have a hell of a set of scars.
是他活该
Huh. Serves him right.
这种话别说出来行吗
Keep the commentary to yourself, okay?
抱歉
Sorry.
我还不知道你这么悲天悯人
Didn't peg you for a bleeding heart.
我不知道你还想指点我
Didn't know you were trying to peg me.
出血来自肝部上方的
Bleeding's coming from the portal vessel
门脉血管
high up in the liver.
在芝拉克待了一年我都数不清
A year at Chiraq and I've already lost count
做了几起连续肝门阻断了
of how many Pringle Maneuvers I've done.
芝加哥和手♥枪♥ 绝佳组合
Chicago and guns. Winning combination.
让我们都成为了很棒的外科医生
And making us all very good surgeons.
该死
Damn it.
子弹摧毁了门脉血管
The bullet decimated the portal vein