芝加哥急救

Chicago Med S01E17

Part 4 Jan. 25, 2020, 11:24 a.m.

Uh, Frank McCormick is going into surgery.
将他的血管造影上传至系统
I need you to load his angio into the system.
你是罗德斯医生吗
You Doctor Rhodes?
是
Uh, yep.
现在应该能看到了
Should be up now.
布劳医生
大卫·唐尼射频消融术
好了谢谢
Yeah, thanks.
还没找到吗
No luck yet, huh?
还没但我们还没去翻垃圾箱
Not yet, but we haven't even gone through the trash.
你没事吧
Are you okay?
没事
Yeah, uh...
我有点头晕
My head is...spinning.
我感觉要吐了但天呐麦基
I feel like I'm gonna throw up, but--oh, Maggie.
娜塔莉我会找到你的戒指
Natalie, I'm gonna find your ring,
但与此同时
but in the meantime,
我要你进去
I want you to go in there,
喝杯水
have a drink of water,
躺下休息
and lie down.
好吗
Okay?
好
All right.
娜塔莉
Natalie?
不懂你们为什么让我做这些化验
I don't know why you guys are ordering all these tests.
我贫血没什么大不了
I'm anemic. It was nothing.
心电图可不这么显示
That's not what the EKG's saying.
心肌前端与侧导联的ST段抬高
I'm seeing elevated ST segments in the anterior and lateral leads.
哪里
Where?
跟超声心动室说我们这就带她上楼
Tell echo we're bringing her upstairs.
超声心动
Echo?
我没有心脏病史也没有风险因素
I have no cardiac history, no risk factors.
你们就因为是我所以谨慎过头了
You guys are just being overly cautious because it's me.
小娜你说得很对我们就是这样
Nat, that's darn right that's what we're doing.
别固执了这人怎么说你就怎么做行吗
Stop being stubborn and listen to the man, please?
我们走
Let's go.
每周三我会下楼去美容院
On Wednesdays, I go downstairs to the beauty shop.
我的头发都是我邻居希拉帮我做的
My neighbor Sheila always does my hair.
好的
Okay.
那棋牌室呢
How about the card room?
我经常玩凯钠斯特
I play a lot of canasta.
-在靠南的大厅吗 -不是亲爱的
- In the south lobby? - No, darling.
在北边
Uh, in the north.
怎么样啊女士们
How we doing, ladies?
有发现吗
Any luck?
这位旺达很可爱
Wanda here is lovely,
虽然我很感谢你说我们的情况
and though I appreciate your theory that our conditions
可能来自同一源头
may arise from the same source,
但恐怕我们唯一的共同点就是住西奈半岛花♥园♥
I'm afraid the only thing we have in common is Sinai Gardens.
里斯小姐我能...
Ms. Reese, could I, um...
我能跟你聊几句吗
could I talk to you for a moment?
你们继续
Keep at it.
她们的化验结果都是阴性
Their labs are all negative,
但又都是发热伴随白细胞增多
but both are febrile with leukocytosis,
而老年人感染
and infections in the elderly
表征可能跟一般人不一样
can present quite differently than normal.
我觉得我们得查查埃巴病毒
I think we need to start looking for zebras.
立克次氏体细螺旋体病...
Rickettsia, leptospirosis--
斯特恩小姐的左眼有点泛红
Ms. Stern had some redness in her left eye.
你注意到了吗
You notice that?
可能是由游泳池中的氯引起的
Probably from the chlorine in the pool.
她喜欢做水中有氧运动
She likes to do water aerobics.
但考虑一下这些症状
But consider the symptoms.
严重谵妄重度脱水
Acute delirium, severe dehydration,
下腹疼痛一只眼睛红痒
lower abdominal pain, one itchy red eye.
就像我刚才说的对一个85岁的老人来说
Like I said, in an 85-year-old,
什么都有可能
it could be anything.
如果这些人跟你的年龄更接近一点
If these women were closer to you in age,
你会怎么想
what might you suspect?
不会
No.
绝对不会
No, no, no, no, no.
为什么不会
Why not?
不会因为她们很老了
No. Because they're old ladies.
她们不可能会得淋病
They can't have gonorrhea.
你是想说因为她们老了
Are you trying to tell me that because they're old,
就不会有性冲动了吗
they can no longer be sexually active?
拜托她们连玩凯钠斯特的精力都没怎么有了
Well, come on, they barely have the energy to play canasta,
不管那是什么
whatever that is.
我觉得我们还要继续调查
I say we keep digging.
有位来自
There's a gentleman
别的养老院的先生
from the retirement home out there
在询问你们两位病人的情况
inquiring about the status of your two patients.
他说他叫克莱德
Says his name is Clyde.
她们可能还是有别的共同点的
Maybe they, um, have something in common after all.
我们需要一些棉签
We're gonna need some swabs.
霍斯特德医生
Dr. Halstead!
怎么了
What happened?
他突然开始吐♥血♥
He just started vomiting blood.
肯定是食管静脉曲张破裂
Must have ruptured an esophageal varix.
预备一根明尼苏达管准备输血
Prep a Minnesota tube and call for MTP.
我先插管
I need to intubate.
这是因为多年的酒精性肝硬化
It's from years of alcoholic cirrhosis.
血管扩张扭曲
The vessels get dilated and tortured.
但为什么现在会突然发作
But why's this all happening right now?
肯定是一直呕吐引发了破裂
Must have ruptured from all the vomiting.
好了导管
Right, tube.
导气管好了
Got an airway.
接气瓶
Bag him.
两边的呼吸听起来都很好
Good breath sounds bilaterally.
现在得开始止血
We need to stop this bleeding.
-明尼苏达管 -好的医生
- Minnesota tube. - Yes, Doctor.
-需要什么 -插入腹股沟输血管
- What do you need? - Start a groin line.
进行快速输血输入两个单位的血快
Get a rapid transfuser, and give him two of blood, stat.
继续抽吸
I need more suction.
收到
I got it.
找人快点去总台取注射器
Send a runner to Central for the infuser,
打电♥话♥给血库
and call the blood bank.
这就去
I'm on it.
我什么都看不到
I can't see a damn thing.
好吧我只能盲插了
All right, I'm gonna have to go in blind.
输血管就位
Line's in.
开始输血
Start the MTP.
血压降到了80/40
Pressure's down to 80 over 40.
快失血致死了
He's bleeding out.
快点
Come on.
快点
Come on.
好了
Got it!
-在输血了 -很好
- Blood's going. - Good.
准备好充气
Ready to inflate the internal balloons.
针筒
Syringe.
要X光片定位吗
Want an x-ray for placement?
没时间了
No time.
气球一充好
As soon as the balloons are inflated,
我们就能知道作用在血管上的压力
we'll know whether the pressure they're placing on the vessels
是否足以止血
is enough to staunch the bleeding.
血止住了
Bleeding's stopped.
暂时止住了
For now.
通知肠胃医生过来烧灼血管
Call GI to cauterize the vessels.
好的
Okay.
我在尽全力救他
I'm doing everything I can.
霍斯特德医生
Dr. Halstead?
超声心动室拿来了曼宁医生的检查结果
Dr. Manning's results from echo.
咚咚咚
Knock, knock.
你拿到我的超声心动图了吗