芝加哥急救

Chicago Med S01E10

Part 4 Jan. 25, 2020, 11:22 a.m.

- No pulse. - Rhodes, on his chest.
艾伦他注射了多少肾上腺素
Allen, how much epi has he gotten?
20毫克
20 mics.
脉搏回来了
Got a pulse back.
跳动很稳定
Good waveform on the A Line.
他出现窦性心律
He's in sinus rhythm.
做食道超声心动图
Let's TEE.
好的
All right.
-给医生 -谢谢护士
- Here you go, Doctor. - Thank you, Nurse.
进去了
Get in there.
让我看看情况
Show me what I need to see.
看看主动脉瓣膜
Look at the aortic valve.
瓣膜面♥积♥0.6
Valve area's .6.
心脏病医生说只是轻度到中度狭窄
Cardiologist said it was only mild to moderately stenotic.
我知道但这是重度
I know, but this is critical.
他需要新的瓣膜
He needs a new valve.
肺部灌注多久了
How long have the lungs been perfusing?
包括移植的时间至少有六小时了
Including transport, at least six hours.
还能再撑五六个小时
They're good for another five to six,
但是不修复好瓣膜就没法移植
but we can't transplant until we fix that valve.
继续深度麻醉他的肺部和血栓这个情况
Keep him deep--between his lungs and the blockage,
没办法在承受一次手术
he won't tolerate going under again.
你跟我得迅速想出解决办法
You and I need to figure out a plan quickly.
蓝色警报一号♥治疗室
Code blue, treatment 1.
蓝色警报一号♥治疗室
Code blue, treatment 1.
怎么回事
What happened?
一秒前他还很稳定
A second ago, he was perfectly stable.
-我们还在说话 -停止按压
- We were talking. - Hold compressions.
没有脉搏
No pulse.
-怎么回事 -我不知道
- What's going on? - I don't know.
没有呼吸声了
No breath sounds.
室颤
V-Fib!
急救车
Crash cart!
-充电200 -充电中
- Charge to 200 joules. - Charging.
-充电完成 -所有人离手
- Charged. - Everyone clear.
小娜让开
Nat, back away.
不再给我一秒
No, just give me one more second.
我看到索线了
I see the cords.
差不多进去了
I'm almost in.
好了管道插好了开始
All right, tube's in. Let's go.
所有人离手
Everyone clear!
没反应收到手术室准备好了
Nothing. Copy. O.R. on standby.
-推注肾上腺素 -好的
- Round of epi. - Got it.
-充电 -充电完成
- Charging. - Charged.
-离手 -离手
- Clear! - Clear.
还在室颤
Still in fib.
小娜你来按压
Nat, you take over compressions.
别为任何事停下艾普尔肾上腺素在哪儿
Don't stop for anything. April, where's that epi?
已注射肾上腺素
Epi's in.
离手离手
Clear. Clear!
继续心肺复苏注射肾上腺素
CPR. Epi again.
加注碳酸氢盐
Follow it with an amp of bicarb.
好的医生
Yes, Doctor.
心脏停播他没有脉搏了
Asystole--he's got no pulse.
我来
I got it.
威尔
Will.
威尔他死了
Will, he's gone.
死亡时间 14点21分
Time of death--14:21.
瓣球囊成形术能稳定瓣膜
Balloon valvuloplasty will stabilize the valve
让我们完成移植
and allow us to do the transplant.
这只是应急措施
It's only a stopgap.
过一个月我们就又回到了原点
In a month we're back at square one
还是得替换瓣膜
needing to replace the valve,
只不过现在病人急需进行移植
only now the patient's fresh off a transplant.
那我们打开他的胸腔
Then we open him up,
换掉瓣膜
replace the aortic valve,
然后再进行移植
and do the transplant afterwards.
我不想把他胸腔开这么久
I don't want him open that long.
情况会变得很复杂
Invites a whole host of complications.
好吧
Okay.
那这样呢
How about this?
我们同时做瓣膜替换
We do the valve replacement and the lung transplant
和肺部移植
at the same time.
我们要先做瓣膜替换手术...
We'll do a trans-aortic valve replacement first--
损伤更小
less invasive.
心脏科医生可以通过腹股沟导管
Cardiologist can go in through the groin via catheter
修复瓣膜
to fix the valve.
他们做好我们就进行移植手术
Once they're done, we'll move on with the transplant.
好的
Yes, sir.
颅内感染你是说脑膜炎吗
A brain infection-- like meningitis?
但这是可以用抗生素治疗的对吧
You can treat this with antibiotics, can't you?
可以我们之前的确掌握了这项技术
Possibly. We did catch this one early.
这是大脑炎而非脑膜炎
This is cerebritis, not meningitis,
这个不止很严重
which is not only serious
而且是由某些潜在因素引起的
but stems from some underlying condition,
而这个因素我们还未查明
one we have yet to find.
那要做更多检查吗
So...more tests?
恐怕必须如此
Afraid so.
第三场儿子我们没问题的
Third period, son. We got this.
库伯先生
Mr. Cooper...
能借一步说话吗
mind if I talk to you for a second?
没问题
Yeah, sure.
稍等
Hang tight.
我们要好好聊聊
We're gonna get to the bottom of this.
听着我之前无意中发现的
Look, I couldn't help but notice earlier--
慢性创伤性脑病
The CTE.
-是啊 -我知道
- Yeah. - Yeah, I know.
我知道我已经把它控制住了
I know. I got it under control.
库伯先生病症是不断发展的
Mr. Cooper, the disease is progressive.
你以为我不知道吗
You think I don't know that?
我可是有私人医生的
I have a private physician,
是我队里的队医
a team doctor from when I played,
他说没事
and he says it's not too bad.
那布莱特呢
And Bret?
布莱特没事对吧
Bret is fine. All right?
现在比赛变了更安全了
The game's changed, huh? Safer.
更好的器械奖罚制度更完善了
Better equipment, better penalty regulations--
他知道吗
Does he know?
我不明白
Well, I don't really see
这关你什么事
how that's any of your damn business.
布莱特理应知道真♥相♥
Bret deserves the truth. What kind of father
什么样的爸爸会一直蒙骗自己儿子啊
keeps his kid in the dark?
你说话给我小心点
Hey, you watch what you say to me!
崔医生
Dr. Choi!
我为我的同事向您诚挚地道歉
I apologize for my colleague, sincerely.
不如你
Why don't you, um,
不如你去看看你的妻儿吧
why don't you go check on your wife and son?
我非常抱歉
I'm very sorry about that.
好的谢谢
Okay. Thanks.
他一直瞒着布莱特
He's keeping it from Bret.
所以你就觉得
And so you thought threatening him
威胁他就能让他更坦率吗
would make him more forthcoming?
这应该是我跟他聊的你怎么不叫我
That's my conversation anyway. Why didn't you page me?
没用的那人一心不承认
Wouldn't have helped-- guy's in total denial.
是吗
Oh, he is?
正因如此你才要接受治疗
This is why you go to therapy
而且还得一直接受治疗
and why you stick with it.
快点啊
Come on.
维他命K 10毫克
什么鬼
What the hell?
我能和你聊聊吗
Can I talk to you for a minute?