芝加哥急救

Chicago Med S01E11

Part 3 Jan. 25, 2020, 11:22 a.m.

左心室辅助装置也运行无误
The LVAD is working perfectly.
我不懂我们这次能做什么
I just don't see what else we can do at this time.
-这根本不是我原本的 -我明白
- This is not pristine. - I understand.
不幸的是用这些装置很容易导致胃肠道溃疡
Unfortunately, GI ulcers are not uncommon with these devices.
好得好像这两种病都不疼不痒一样
Yeah, apparently neither is torture.
我受不了了
I can't live like this.
幸运的是这种左心室辅助装置并非永久的
Well, fortunately, the LVAD is temporary.
只不过是你接受心脏移植之前的过度用品
Just a bridge until you can get a heart transplant.
得了吧你知道我还得排多久吗
Come on, do you know where I am on the list?
等到你快死了我都排不到
Your heart will fail before I get one.
这话可不对有很多因素影响的
That's not true. There are a lot of factors.
你是外科医生对吧
You're a surgeon, right?
把它拿掉
Take it out.
-你说什么 -把那个鬼东西给我拿掉
- Excuse me? - Take the damn thing out.
卡拉格先生您肯定很清楚
Mr. Gallagher, I'm--I'm-- I'm--I'm sure you understand.
您的心脏太虚弱了无法自己搏动
Your heart is too weak to pump on its own.
而这个装置就是帮您的心脏搏动的
The device is doing it for you.
我不管
I don't care,
我没有家人
and I don't have a family.
我的心脏我做主我不想要它
It's my heart. I want it out.
这不可能
That's not possible,
因为我们一旦拿掉它你就会死
because if we take it out, you will die.
我很抱歉
I'm sorry.
安格医生回来了吗
Is Dr. Unger coming back?
安格医生吗我不知道他...
Dr. Unger? I don't know. Was he--
他正准备解释病情
He was starting to explain things,
但有人一直找他他没法只得先离开
but his office kept paging him, so he had to go.
但听起来似乎情况不妙
But it sounded bad.
坏死性筋膜炎
Necrotizing fasciitis
就是人们常说的"吃肉的病菌"
is what people call "flesh-eating bacteria,"
但这种说法是不对的
but that's a misnomer.
它并不会吃它只是传播得很快
It doesn't actually eat. It just spreads very quickly.
就算动用手术和抗生素
Even with surgery and antibiotics,
一旦它开始传播我们根本无法跟上它的速度
once it starts moving, we hardly ever catch up.
安格医生就是要说这个
That's what Dr. Unger was saying.
他是伊莱亚斯的私人医生吗
Is he Elias's regular doctor?
是啊
Yeah.
不是私人医生
I mean, not regular.
他几乎不怎么去看医生
He hardly ever went.
周一是他大概两年以来
Monday was the first time he'd been in, like...
第一次去
two years.
他两天前见过安格医生吗
He saw Dr. Unger two days ago?
是啊
Yeah.
他手臂上有个疹子让他很不舒服
He had a pimple on his arm that was bugging him.
安格医生做了什么
And what did Dr. Unger do?
他觉得这没什么好担心的
He didn't think it was anything to worry about.
不就是个疹子吗
I mean, it was just a pimple.
结果他昨天更难受了我们就给他打电♥话♥
It hurt him more yesterday, so we called,
但他没回我们
but we never heard back.
我猜那大概不止是个疹子
I-I guess it wasn't just a pimple.
是啊
No.
珍妮弗的护士说她这段时间适应得很好
Jennifer's nurses say she's tolerating the trial really well.
不恶心不呕吐没有肌肉酸痛
No nausea or vomiting. No muscle pain.
也没有认知混乱
No cognitive dysfunction.
她真的恢复得很好
It's as good as a report as you could ask for.
谢谢你
Thank you.
真的很感谢你告诉我
I really appreciate this.
亲爱的你老公可真贴心
Hey. Sweet, sweet man, your husband.
你要是需要的话我会找人送去你办公室
If you want, I'll have someone take them to your office.
不用了暂时放在这里吧
No. Keep 'em here for now.
它们把整家医院都点亮了
They brighten up the place.
我也觉得你们今晚要干什么
Works for me. What are you guys doing tonight?
跟每年一样啊去吉布森牛排店
Same as every year. Gibson's.
伯特点T骨牛排我点黑鲈
Bert orders the T-bone, and I get the sea bass.
你去芝加哥最好的牛排店点鱼吗
Best steak house in Chicago and you get the fish?
好吃嘛
It's delicious.
你认识一个叫安格的私人诊所医生吗
Do you know a doctor in private practice named Unger?
我知道啊
Yeah.
他名声好吗
Is he reputable?
怎么了
Why?
他漏诊了现在那位病人
He missed a diagnosis, and now that patient's
可能会死
probably going to die.
老实说这几个月来他漏诊好几次了
Truthfully, he's missed a few in the last few months.
你能拉出一张
Can you pull up a list of his patients
他最近的病人清单吗
who've been here recently?
艾普尔
April.
好吧别说是我给的
Okay. Just keep my name out of it.
你不是从我这拿到的
You didn't get this from me.
蓝色警报
Code blue.
他呼吸窘迫怎么回事
He's in respiratory distress. What happened?
推急救车来
Get the crash cart.
先让他躺平
Let's get him flat.
他毫无意识
He's unresponsive.
准备手术盘
Prep a tray.
血压监测不到
BP's not registering.
他浑身都是汗我们要插管
He's wet as a sponge. We're gonna intubate.
-我摸不到脉搏 -他不会有的
- I can't find the pulse. - He won't have one.
左心室辅助装置绕过了心脏
LVAD's the pump. It bypasses the heart.
一定是他的装置坏了
His device must have failed.
他的心脏衰弱到无法自行输送血液
His heart's too weak to pump blood on its own.
所以他才会肺水肿
That's why his lungs are soaked.
准备中
Prepping now.
我这有14和16号♥电池
I got a 14 and a 16 standing by.
不
No.
左心室辅助装置的电池他自己做的
The LVAD battery. He did this to himself.
-什么情况 -呼吸窘迫
- What do we got? - Respiratory distress
急性心力衰竭
and acute heart failure.
我来锁骨下注射
I'll start a subclavian.
他自己拿出来的吗
He take that out himself?
看来是的
Looks that way.
自杀举动今天不让你如愿伙计
Suicide mission. Not today, buddy.
插♥进♥去了
And I'm in.
设置供气16次每分钟一次换气量500
Vent setting's AC 16, tidal volume 500,
呼气末正压通气为5 吸氧分数为100%
peep of 5, and O2 at 100%.
-电池装好了 -注射增压剂
- Battery's back in. - Pushing pressors.
他的血液开始流动了
He's pinking up.
血压是100/65 正在回升
BP is 100 over 65 and climbing.
-稳定下来了 -救得好
- He's stable. - Nice save.
我去给楼上打电♥话♥
I'll call upstairs.
他要转到那里去
He's gonna need to be admitted.
霍斯特德医生我要和你谈谈
Dr. Halstead, I need a word with you.
你为什么要在临床试验区闲逛
Why were you poking around the clinical trial wing?
-我没和她说话 -我说明过
- I didn't talk to her. - I instructed you
你不能以任何形式靠近詹妮弗·贝克
not to go anywhere near Jennifer Baker.
但我听说有好消息
But I heard good news.
珍妮弗没有经受任何常见的副作用
Jennifer hasn't had any of the usual side effects.
她的治疗非常理想
She's doing great in her treatment.
那不是重点
That's beside the point.
你嚣张地漠视了
You blatantly disregard the one thing
我要求你不能做的事
I asked you not to do.
这可能意味着她正在好转
This could mean she's on the road to remission,
那我肯定他们会撤掉诉讼
and then I'm sure they'll drop the lawsuit.
你怎么知道呢
You don't know that.
我很努力想支持你
You know, I have tried to be supportive of you,
但你要再错一步我就让你停工
but one more misstep and I will suspend you.
你会被禁止踏入这家医院
You will be barred from this hospital
直到诉讼出结果
until the lawsuit is settled,
到那时候我会建议董事会
and when it is, I will recommend to the board
停止雇用你
that you be terminated.
我说完了
I'm done.