芝加哥急救

Chicago Med S01E13

Part 4 Jan. 25, 2020, 11:23 a.m.

面对军人求我
who begged me,
"救救我的腿救救我的胳膊"
"Save my leg, save my arm."
你觉得我们不该收治他吗
You don't think you should commit this guy?
这会儿我唯一的选择就是对他进行
At this point, my only option is to put him
72小时防自杀看护
on a 72-hour suicide hold.
再之后就只能让他回家了
And then I got to let him go home.
然后呢
And then what?
他不会再动手吗
He'll try it again?
除非我能想办法治好他
Unless I can find a way to treat him.
威尔
Will.
你决定好了吗
What'd you decide?
我要不要打给布雷迪神父
Should I call Father Brady?
不我要说的是别的事
No, it's, uh, it's something else.
珍妮弗·贝克
Jennifer Baker.
我听一个负责临床实验的护士说的
I heard from a trial nurse.
怎么了
What?
她病情恶化了
She's going downhill.
恶化得很快
Fast.
很遗憾
I'm sorry.
我知道这是早晚的事
I know it was coming.
不过
But still...
如果我当初不去救她
If I'd just left her alone,
她就不会受这么多苦了
she would've been spared all of this.
曼宁医生
Dr. Manning.
那小男孩艾瑞克·詹金斯的X光片出来了
The little boy, Eric Jenkins, his x-rays are up.
你最好看一下
Better take a look.
麻烦你呼叫一下罗德斯医生
Page Dr. Rhodes, please.
好的
Will do.
我待会儿再和你谈
I'll talk to you later.
举起胳膊
And arms up.
你们有休假的时候吗
So they ever give you guys breaks?
就是州里法定的那些节假日
Only as often as the state requires.
等艾瑞克都好了之后
Maybe after Eric gets the all-clear,
不知道我们能不能一起喝杯咖啡
we could go out for coffee sometime?
我会尽量不泼你一身
I'll try not to spill it on you.
谢谢邀请但是医院
That's really sweet, but we're discouraged
不鼓励我们跟患者或患者家属出去
from going out with our patients or their families.
你不说的话我也不会说
I won't tell if you won't.
天抱歉艾瑞克
Um-oh, gosh, I'm sorry, Eric.
我...有种东西叫移情
I--there is this thing called transference.
大家会对照顾自己的人产生感情
Um, people develop feelings for their caregivers.
可那不是真的
It's not real.
詹金斯先生我是罗德斯医生
Hi, Mr. Jenkins, I'm Dr. Rhodes.
曼宁医生让我来一起咨♥询♥
Dr. Manning's asked me to consult.
介意出来一下吗
Would you mind stepping out for a minute?
-好的 -谢谢
- Sure. - Thanks.
艾瑞克你给我看看你刚才拼出来的
Eric, can you show me what you just made?
怎么了
What is that?
这是艾瑞克的X光结果这两个点
These are Eric's x-rays, and these two dots
就是磁铁
are the magnets.
两块磁铁相互吸引
They're attracted to one another,
如果吸到一起磁铁可能把
and if they meet, they could pin separate parts
他消化道内的几部分堆到一起然后引起
of his digestive tract together and erode through
很薄的小肠壁溃烂
the thin intestinal walls.
这可能导致全身感染
Which could cause systemic infection,
梗阻出血
obstruction, bleeding.
任何一样都可能危及生命
And any of those things could be life-threatening.
这样那我们该怎么办
All right, so--okay, so, um, so what should we do?
依我看我们该马上手术取出磁铁
In my opinion, we should remove them surgically. Now.
做手术不也有风险吗
But isn't surgery kind of risky, too?
是的有可能引起粘连
Uh, yes, there is the possibility of adhesions,
胃肠动力问题
motility issues.
什么意思
What does that mean?
他的消化能力会减弱
His digestive tract wouldn't work as well.
与磁铁的可能风险相比手术的风险不算什么
The argument for surgery outweighs the possible risks.
我们每多等一分钟
Every minute that we wait
出现严重后果的可能性就越大
increases the chance of a bad outcome.
我还是联♥系♥不到我前妻
I still can't reach my ex-wife.
我应该先跟她谈谈
I should talk to her first.
你先考虑一下吧
Why don't you think about it?
我会密切观察艾瑞克我们再做一次X光
I'll monitor Eric closely, we'll get another set of x-rays,
然后我们等一下再过来好吗
and then we'll check back in a little bit, okay?
-谢谢 -不客气
- Thank you. - Yeah.
娜塔莉
Natalie.
那孩子需要做手术
The kid needs surgery.
做手术可能让他终生有并发症
Surgery could leave him with a lifetime of complications.
这种决定不好做
It's not an easy decision to make,
那位父亲需要自己做出决定
and that dad has to make it all on his own.
你根本不知道那有多难
You have no idea how difficult that is.
沃茨先生
Mr. Wirtz?
沃茨先生
Mr. Wirtz!
血压刚飙升到190
His pressure just shot up over 190.
目前没有呼吸瞳孔放大
He's not breathing and his pupils are blown.
通知神经外科
Call neurosurgery.
我需要给他插管
I need to intubate.
他刚做了头部CT 你看
He just got a head CT. Look.
那是富士山现象[颅内积气]
That's a Mount Fuji sign.
他的头颅内空气越来越多
Air building up in his skull,
也就是说他鼻子里出来的不是鼻涕粘液
which means this is not mucous coming out of his nose.
而是大脑出来的脑脊液
It's cerebrospinal fluid from his brain.
他几天前一定摔倒过
He must've fallen a few days ago.
他不是鼻窦炎
This isn't a sinus infection.
而是前颅骨骨折
This is an anterior skull fracture.
如果不马上释放压力
And if we don't release the pressure immediately,
他会死的
he's gonna die.
我来麦基拿电钻
I'm in. Maggie, get the drill.
-好的 -蓝色警报队伍去急救室
- Got you. - Code blue team to the ED.
崔医生我需要你来钻个孔
Dr. Choi, I need you to drill a burr hole.
不行刚来了枪伤患者
Can't. Gunshot just came in.
-但是这个人就快... -你看过操作过程
- But this man's got about- - You've seen it done.
你做
Do it.
-谁来钻 -我来
- Who's gonna do this? - I am.
但你还是学生
But you're a med student.
你不能在人头上钻孔
You can't drill a hole into a man's head.
总得有人钻
Somebody has to.
给你
Here.
搞砸了我们俩都死定了
We're both gonna catch hell for this.
对
Yeah.
你确定钻对地方了吗
Are you sure you're in the right spot?
中线处三厘米
Three centimeters from the midline.
应该刚好在积气上方
Should be right above the pocket of air.
"应该"
"Should be"?
钻进了
I'm through.
血压降到130/74
BP back down 130 over 74.
里斯你做到了
Damn, Reese, you did it.
看看为什么神经科医生还没过来
See what's taking neuro so long to get down here.
好
Got you.
我认为最好的办法就是
So I'm thinking our best approach would be
既用药物治疗即血清素再摄取抑制物
a course of both medication-a serotonin reuptake inhibitor--
又进行心理治疗
and psychotherapy.
不会起作用的
It's not gonna work.
我们都还没试你怎么知道
How do you know until we've tried?
你看到外面那个人了吗
You see that guy out there?
他们给他做了什么神经传导阻滞
They gave him something called a nerve block.
那到底是什么
What, exactly, is that?
那是在神经附近进行区域麻醉
It's a regional anesthetic injected near a nerve
以阻滞某个特定区域
to block a specific site.
或许那个对我有用
Maybe that could work for me?
那样我就不会意识到这条胳膊存在了
You know, so I wouldn't be so aware of the arm.
那样治标不治本
Well, it wouldn't be a permanent fix.