芝加哥急救

Chicago Med S05E08

Part 5 Nov. 18, 2019, 10:06 a.m.

对不起麦基但我不能让他出院
And I'm sorry, Maggie, but I can't discharge him.
麦基我...
Maggie, I...
刚拿到洛丽最新的检查结果
Just got Lori's latest set of labs back.
她的肌酐急剧上升
Her creatinine has risen dramatically.
这是什么意思
What does that mean?
肝素没有效果
The heparin isn't working.
洛丽很抱歉
Lori, I'm sorry.
你的肾脏严重受损
Your kidney is in serious distress.
不
No.
因为我们不能做CT
Since we're unable to get the CT
不能注射抗凝血药
needed to inject the tPA,
恐怕我们没有办法
I'm afraid there's not much more we can do
救你的肾脏
to save your kidney.
天啊
Oh, God.
还是可以透析
There's still dialysis,
你继续在移植名单上等着
and you can go back on the transplant list.
不我不要再经历一次
No, I can't go through that again.
求你了一定有别的办法
Please, there has to be another way.
我也希望有但是
I wish there was, but--
那你们之前说的
What about the thing you were saying earlier
抑制我的过敏呢
about suppressing my allergy?
有可能
Well, there is a chance
我们可以通过给你注射
we could prevent an allergic reaction
足够剂量的类固醇
to the CT contrast by loading you up
来抑制你对CT的过敏反应
with a high enough dose of steroids--
但极其危险
That would be extremely risky.
就这么做
I wanna do it.
你可能你可能会过敏性休克
You could--you could go into anaphylactic shock.
我在移植名单上等了太长时间
I spent too much time on the transplant list.
疼痛发烧失眠
The pain and the fever and the sleepless nights.
我不要再经历一次
I can't go through that again.
-但是亲爱的 -我不要再做透析了
- But, honey-- - I can't go back on dialysis.
洛丽我需要你父母的同意
Lori, I would need your parents' consent.
求你了我不能失去这个肾
Please. I can't lose this kidney.
洛丽
Oh, Lori.
好吧
Okay.
爸爸
Dad?
我们同意
You have our consent.
好的
All right.
你不能这么做
Hey, you can't do this.
她她可能会死在扫描仪里
She--she could die in the scanner.
艾尔莎我知道风险但我们必须试一试
Elsa, I understand the risk, but we have to try.
为什么
Why?
即使她没有了肾
I mean, even if she loses her kidney,
还是可以靠透析活下去
she can still survive on dialysis
一直等到新的器官出现
until a new organ is available.
她可能还要忍♥受透析的痛苦好几年
She could also spend years suffering on dialysis,
还可能在接受下一次移植前死掉
and still die before getting another transplant.
这是洛丽想要的我们得到了父母的同意
This is what Lori wants. We have parental consent.
心率升到了140
Heart rate's up to 140.
他最后一次吃止痛药是什么时候
When was the last time he had pain meds?
两到三分钟前
Two, maybe three minutes ago.
我们得马上带他去手术室
We need to get him to the OR now.
他快不行了
He's gonna crash.
你在说什么
What are you talking about?
-他的生命体征稳定 -不会持续很久
- His vitals are stable. - Not for long.
他的脉搏收缩心率上升
Pulse pressure's narrowing, heart rate's climbing,
嘴唇开始变得青白
and his lips are turning blue.
我以前见过这意味着他快不行了
I've seen this before. It means a crash is coming.
不我们差不多控制了出血
No, we almost have control over the bleed.
等他的血压下降就太晚了
If we wait until his pressure drops, it'll be too late.
拉尼克医生说了算
It's Dr. Lanik's call.
马塞尔医生
Dr. Marcel.
-停止手术 -我快好了
- We gotta stop this. - I'm almost there.
马塞尔医生你退后
Dr. Marcel, you need to back off.
他需要去手术室
He needs the OR!
离我弟弟远一点
Stay away from my brother.
-血压在下降 -现在我们可以转移他了吗
- Pressure's falling. - Now can we move him?
准备送他去手术室
Let's get him ready for the OR!
桃瑞丝诺亚那边有消息吗
Doris, what's the word on Noah?
他刚刚被紧急送去手术室
They just rushed him to the OR.
情况还不清楚
It's touch and go.
崔医生我这边需要你帮忙
Dr. Choi, I need some help.
他这是怎么了
What's happening to him?
准备超声检查
Ultrasound.
给他让点地方阿维娃
Give him some room, Aviva.
深呼吸小伙
Breathe in and out, buddy.
鼻子吸气嘴呼出来
In through the nose, out through the mouth.
你的阑尾已经快要穿孔了
All right, your appendix has nearly perforated.
我们现在要把你送去手术
We need to get you into surgery now.
-亲爱的 -如果不做处理阑尾很快就会破裂
- Babe... - It won't take long until your appendix bursts.
如果破裂可能就来不及救你了
When that happens, it may be too late to save you.
房♥间里的聊天信息说
Chat room's saying you should put him
你该让他服用西力士
on a medicine called Cialis.
西力士即他达拉非
与伟哥作用类似但并不能治疗阑尾炎
他们根本就是胡说八道
They have no idea what they're talking about!
丹尼斯你就让我们试试手术处理
Dennis, what do you say we give the surgery a shot,
让你再多活多拼一天吧
live to fight another day?
亲爱的我们粉丝刚刚破百万了
Babe, we just hit a million followers!
我们火了
We're going viral!
天哪我们真的做到了
Oh, my God! We did it!
丹尼斯你得想清楚了
Dennis, think this through.
亲爱的我们广♥告♥收益要翻倍了
Babe, our ad revenue is going to double.
抗生素还可能有效对吧
The antibiotics could still work, right?
-可能性很小 -但还是有可能吧
- It's highly unlikely. - But is it possible?
理论上说有可能
Technically, yes,
但可能性很小
but the odds are highly against it.
那我们就继续听在线投票的
Then we're still going with the vote.
各位让我看看你们的爱
Show me some love, people.
买♥♥我们的商品还要点右上角订阅按钮
Buy our merch and smash that subscribe button below!
给他打2克的头孢曲松钠
Get him up to 2 grams of ceftriaxone.
你还觉得他神智正常
Still think this guy's sane?
洛丽我们要给你注射糖皮质激素
All right, Lori, we're gonna give you the injection of steroids
然后就给你注射CT造影剂行吗
before we administer the CT contrast, okay?
我准备好了
I'm ready.
好的
All right.
现在打造影剂
And now the contrast.
你还好吧
All good?
很好让她过扫描仪吧
Great. Let's get her into the scanner.
-麦基 -艾迪
- Hey, Mags. - Oh, hey, Eddy.
曼宁医生的指示没有说让患者转院
Dr. Manning's order didn't mention this was a transfer.
不是转院我们要送他回家
Oh, it's not. We're taking him home.
临终关怀
Hospice care.
这是出院文件
Uh, here's the discharge.
曼宁医生签了字
Dr. Manning's signature.
好嘞来把他送上车
All right. Let's load him up.
你确定要这么做
Are you sure about this?
该送你回家了
It's time to get you home.
我们走
Here we go.
血氧饱和度在降
Sats are dropping.
扫描快完了吗
We close?
已经尽力在做了
Doing the best I can.
我们得让她中止检查
We have to get her out of there!
不用她能撑住的
No, she can tolerate it.
血氧下降到87%
Sats are down to 87.
-还要多久 -我需要再多一分钟
- How much longer? - I just need another minute.
她撑不住一分钟的
She doesn't have another minute.
我们得进去处理了
All right, we need to get in there.
好了洛丽放松
All right, Lori, just relax.
我要插管了 20单位依托咪酯 100单位司可林
I've got to intubate. 20 etomidate, 100 of sux.