芝加哥急救

Chicago Med S01E11

Part 2 Jan. 25, 2020, 11:22 a.m.

背后扎一针
and one poke in your back
这样才能弄明白到底是怎么回事
so we can figure out what's going on
治好你的头痛
and get rid of this headache.
你觉得可以吗
Is that okay with you?
可以是吗那好
Yeah? Okay.
我们一会再来
All right, well, we'll be back in.
谢谢
Thank you.
教授说过儿科最难应付的往往不是孩子
Professor told me hardest part of pediatrics--never the kids.
真漂亮
Nice.
谁送你的
Who sent you those?
不是我的
Not mine.
古德温的结婚32周年纪念日
Goodwin's anniversary. 32 years.
崔医生有病人
Dr. Choi, incoming.
-收到 -六号♥急诊室
- Got it. - Treatment six.
肯·卡拉格 57岁男性装有左心辅助装置
Ken Gallagher. 57-year-old male with an LVAD.
因剧烈腹痛和上腹压痛
Called 911 with severe abdominal pain
打电♥话♥求救生命体征稳定
and epigastric tenderness. Vitals are stable.
卡拉格先生从一到十
Mr. Gallagher, on a scale of one to ten,
你觉得疼痛的程度是多少
how bad is your pain?
-一亿万 -好吧给他过床
- A zillion. - All right, let's move him.
听我指挥一二三
On my count. One, two, three.
准备高剂量抗生素谢谢
High dose antibiotics set up please.
你身上装了左心辅助装置是吗
That's a left ventricle assist device, right? An LVAD?
很不幸是的
Unfortunately, yes.
没有压痛和反跳痛
No guarding or rebound tenderness.
这种情况以前出现过吗
Has this happened before?
我胃上有个洞疼痛从来就没停止过
There's a hole in my stomach. It never stops.
你被诊断出有胃溃疡吗
You've been diagnosed with an ulcer?
确诊扩散输血再扩散
Diagnosed, scoped, transfused, scoped again.
听起来你过得挺不容易的
Doesn't sound like you've had an easy time.
你可能会感到有些...
Okay, you're gonna feel a little p--
有些压力我说过不是第一次了
Feel a little pressure. Like I said, not my first rodeo.
好吧你有服用治疗溃疡的药物吗
All right. You on any ulcer meds?
有三种这次是什么情况
Three of 'em. What is it this time?
化脓还是穿孔流血
Abscess? Breakthrough bleeding?
好像有点血丝
May be a trace of blood in there.
给我一根鼻胃管通知脾胃科做胃镜
Get me an NG tube, and call GI for an endoscopy.
我想再仔细看看
I want a better look.
别我给你看之前的胃镜结果行吗
No, no. Can't I just show you my last six endoscopies?
反正照的都是这个胃
It's still the same stomach.
我可以给你些药物止痛
Well, I'll give you something for the pain,
但我们必须弄明白
but we have to try and figure out
如何才能控制溃疡的程度
how to get this ulcer under better control.
我可以告诉你怎么做把这玩意弄掉
I'll tell you how. Get rid of this thing.
不是个好主意那玩意
Not a good idea. That thing,
左心辅助装置在帮你的身体泵血
the LVAD, is pumping your blood for you.
自从装了它以后各种问题全来了
Yeah, and all my problems started right after I got it.
我明白
I understand,
但这个问题你最好跟你的心脏医生谈
but it's better you follow up on that with your cardiologist.
我的心脏医生是个傲慢自大的混♥蛋♥
My cardiologist is an arrogant SOB.
-求你了 -好吧
- Come on. - Fine.
我让心胸科医生下来看看
I'll have cardiothoracic down to take a look.
谢谢你
Thank you.
我恨透这玩意了
Man, do I hate that stuff.
没有它你更麻烦
It's a lot worse without it.
好吧
Okay.
我估计你应该知道怎么做
I have a feeling you know the drill.
-罗恩 -丹
- Ron. - Hey, Dan.
好久没看见你了
I haven't seen you in a while.
如果你能偶尔来打个扑克
Oh, it'd be more often
估计就能经常见到我了
if you'd show up at poker now and again.
只要你别总赢我的钱
Maybe I'd show up more often
或许我会经常去玩玩
if you didn't keep taking my money.
只要你别每次虚张声势都摸下巴
Yeah, I'd stop taking your money
我就不会整天赢你的钱了
if you didn't touch your chin whenever you bluffed.
等等
Wait.
是我自己暴露了真的吗
I have a tell? Really?
真的吗
Really?
不管怎么说我试着尽量不来这里
Anyway, I try to stay out of here.
私人诊所医生来医院
Private practice doc in a hospital
向来不是什么好事
is never good news.
你有病人送来了这里
Patient of yours get admitted?
坏死性筋膜炎
Necrotizing fasciitis.
老天那病可不好办
Oh, man. That is a bear.
找我看病有十年了
Been seeing me for ten years.
人挺好的回见丹
Good guy. I'll see you, Dan.
你多保重
Take it easy.
小娜那个发烧的小女孩雪洛·凯恩
Nat, the little girl with the fever, Shiloh Kane.
她的化验结果出来了说很紧急
Her lab results. They said it was urgent.
艾普尔对二号♥急诊室的病人进行隔离
April, get the patient from two into isolation
并安排胸部X光和头部扫描
and order a chest X-ray and CT head,
然后把家人安排进另外一间房♥
and put the rest of the family in another room
并做三次细菌培养
for culture times three,
无论如何不准让任何人离开
and no matter what, do not let anyone leave.
-好的 -怎么了
- Okay. - What's going on?
帮我联♥系♥疾控中心
Get me on the phone with the CDC.
马上
Immediately.
有多危险
How dangerous is this?
要看情况
It depends.
乙型流感嗜血杆菌通常使用
Haemophilus influenza B can often be contained
我们现在给她的抗生素
with the antibiotics
就能得到控制但这并不是绝对的
we're giving her now, but not always.
万一没控制住呢
And if it's not contained?
可能会导致听力退化脑损伤
It can cause hearing loss, brain injury...
甚至致死
even death.
是吗我没听过这说法
Well, I've never even heard of it.
她怎么得的
How'd she get it?
这就是问题所在了
Well, that is the question.
这是标准疫苗接种机制的一部分
It's part of the standard vaccination regimen.
雪洛接种过疫苗吗
Is Shiloh vaccinated?
没有
No.
其他的孩子呢
Are any of them?
乙型通常通过唾液传播
Type B is transmitted by saliva,
也就是说我和霍斯特德医生这样非故意和她接触的
which makes incidental contacts like Dr. Halstead
没有危险
and I not at risk,
但任何和她有长♥期♥亲密接触的人都有危险
but any of her long-term close contacts are.
我们会通知学校
We'll notify the school,
但同时我们也需要确认你们未染病
but in the meantime, you'll each need to be immunized.
我不想这样
I'm not sure we want that.
凯恩先生我觉得这是
Mr. Kane, I think it's very--
你的孩子现在身患重病
Your children are at serious risk.
我们也觉得接种疫苗很危险
We feel vaccinations pose a serious risk as well.
不是这样的
That is not true.
医生不能干预病人决策我知道
Doctors are about intervention. I get it.
但别的不提人的身体本身就有很好的免疫机制
But left alone, the body has a perfectly good immune system,
一旦你向内注入了异种蛋白和异种预防剂
and once you start injecting it with foreign proteins
你的身体机制肯定会被改变
and preservatives, you can't help but change that.
现在我们所有的孩子
Right now, all our other children
都很好
seem to be fine,
而雪洛却一个人孤零零的在里面
and Shiloh's in there all alone.
我们能进去陪她吗
Can we just go be with her?
当然可以
Of course you can.
我们会派人去照顾你们其他的孩子的
We'll send someone in to watch your other children.
谢谢
Thank you.
然后呢
So what?
你就这样放过他们了吗
You're just gonna let them off the hook?
他们现在害怕得要死
They're scared to death right now.
现在不是时候
It is not the time to push.
我稍后会再和他们谈一次的好吗
I will talk to them again later, okay?
他的脸色和原本一样好
His coloring is pristine.