芝加哥急救

Chicago Med S05E14

Part 2 June 22, 2020, 10:17 a.m.

是新婚夫妇吗
Mmm. Newlyweds?
一个月前刚结婚
A month ago.
不过我们还在享受新婚的感觉
But we're still working our way through the cake.
特别甜
Oh, but it's delicious. Mmm.
你们今天过来是怎么了
So, what brings you in?
我身上起了湿疹
This awful rash.
一直到脖子
It goes all the way up my neck.
腿上也都是
It's all over my legs.
我的妇科医师上周给我开了氟康唑
My gynecologist prescribed me fluconazole last week
为了治疗酵母感染
for a yeast infection.
-跟那个有关系吗 -也许
- Could that be related? - Maybe.
会不会是我公♥寓♥里的东西
What about something in my apartment, maybe?
妮娜刚搬进来
Nina just moved in.
那公♥寓♥从2015年起就没打扫过了
Hadn't been cleaned since 2015.
别闹
Okay.
你肯定是对什么过敏了
Well, you're definitely allergic to something.
我们会做一些检查
We're gonna order some labs,
给你开抗组织胺
and get an antihistamine for you,
然后再告知你们过敏原的分♥析♥结果
then come back for a full allergen history.
我们会帮你控制住湿疹的
We'll get this rash under control.
可是我很喜欢你红红肿肿的样子
Aw, but I love you all red and puffy.
你过来
Come here, you.
不你过来
No, you come here.
今早的互助会你没来
Missed you at the meeting.
你现在是跟踪我了吗
So, you're stalking me now.
所有离开注射站的女人
Do you do this with all the women
你都会这样吗还是因为我特别呢
that leave the injection site, or am I special?
我只是有点担心
I'm just concerned.
好吧我要是知道去安全注射站
Yeah, okay, if I had known going to a safe injection site
会导致你阴魂不散
would result in you hounding me,
我从一开始就不会去的
I never would've gone in the first place.
我是拉尼克医生这是库里女士
Hi, I'm Dr. Lanik, this is Ms. Curry,
四年级医学生
fourth year medical student.
我是凡妮莎泽维尔的妈妈
Hi, I'm Vanessa, Xavier's mom.
这是我男朋友阿尔文
And this is my boyfriend, Alvin.
我看到泽维尔
So, I see Xavier was diagnosed
在遭遇自行车事故后被诺里斯纪念医院
as being in a persistent vegetative state
诊断为持续性植物人状态对吗
at Norris memorial after a bike accident?
是的大概五个月前他撞到了头
Yeah, about five months ago, he hit his head.
你们今天怎么过来了
So, what brings you in today?
我早上给泽维尔换衣服的时候
I was changing Xavier's clothes this morning,
发现他臀部长了疮
and I noticed a sore on his hip.
是我让他侧躺了太久吗
Maybe I left him on his side too long?
我很担心是不是感染了
I'm just worried it's infected.
-翻个身吧 -好
- Let's roll him. - Okay.
这是压疮
We call that a pressure ulcer.
看起来确实是感染了
Yeah, it does look infected.
你们是一直在家照顾泽维尔吗
Have you been managing Xavier's care at home?
他四个月前出院之后
Since he was discharged from the hospital
就一直在照顾
about four months ago.
看到中心的肉芽了吗
See the granulation in the center?
我们会清理伤口包扎伤口
We'll go ahead and clean and dress the wound.
好
Okay.
不应该发展到这个地步的
So, it should never get to this point.
我们经常给他翻身的
We try to turn him regularly.
其实用空气垫会很有帮助
There's actually an air mattress that can help with that.
我们会开一些抗生素药
We'll send you home today with some antibiotics,
不过你们还是跟我来
but why don't you come with me,
我可以和你们讲一下如何预防坏疮
and we can go over a handout about how to prevent bed sores?
防止下次类似情况发生
Keep this from happening again.
跟我说说情况马蒂
Talk to me, Marty.
血压好转输了很多血
BP's better. He's gotten a lot of blood.
我把肝脏裂痕缝合好了
Packed his liver crack pretty well.
出血应该不是问题了
Bleeding should no longer be an issue.
我有点担心
I'm worried.
导尿管里只有10cc的尿液
There's only 10 cc's of urine in his foley.
黑棕色我已经送样去检查了
Dark and brown. I sent a sample for labs.
可能是横纹肌溶解
Could mean he's in rhabdo.
把手术布摘一下
Let's remove the drape please.
轻点
Nice and easy.
腿部情况糟糕
Yeah. Leg's not looking good.
肌肉坏死毒物进入了血液里
Muscle is dying and dumping off into the bloodstream.
-检查结果呢 -肌酸磷酸激酶水平很高
- Lab report? - CPK levels are high.
高达25000
25,000.
绝对是横纹肌溶解
That does indicate rhabdo.
必须得截肢不然会害死他
Leg's gotta come off or it's gonna kill him.
得跟他妻子商量一下
Gotta talk to his wife.
根据你的扫描和神经测试结果
So, based on your scans and neuro exam,
我们可以排除创伤性大脑损伤
we can safely rule out a traumatic brain injury.
但我还是想再问你一次你的淤青
But I do want to ask you again about the bruising--
我告诉过你了我摔倒了
I told you. I fell.
泰勒太太
Hi, Mrs. Tyler?
我是马塞尔医生
I'm Dr. Marcel.
我是给你丈夫瑞克做手术的外科医生
I'm the surgeon who operated on your husband, Rick.
他怎么样
How is he?
他的肝部受损严重目前情况仍然很危险
He had a bad liver injury and he's still pretty sick.
他能活下来吗
So, is he going to live?
我们已经把失血控制住了
Well, we got the bleeding under control,
但我主要的担心是他的右腿
but my main concern is his right leg.
肌肉正在坏死毒物正在进入他的血液
The muscle is dying, and it's poisoning his blood,
反过来在损伤他的肾脏
which in turn is hurting his kidneys,
-让他肾功能衰竭 -这都是什么意思
- putting him in renal failure-- - W--what does all that mean?
瑞克的腿使他的情况很危险
Rick's leg is making him very sick.
会要他的命的
It will kill him.
我需要你同意给他截肢
And I need your consent to amputate.
他要失去一条腿吗
He has to lose a leg?
难道你们就没有什么别的办法吗
I--isn't there something else you can do?
很遗憾
I'm sorry.
他会非常痛苦的
He'll be so upset.
金我理解这是很大的事
Kim, I know this is a lot to deal with.
我...
I...
我不...
I'm not--
我不确定瑞克会想怎么做
I'm not sure what Rick would want.
也许他宁愿死掉也不想只有一条腿他...
He might rather be dead than have only one leg, he--
你确定你们没有别的办法吗
You sure there's nothing else you can do?
-别的办法我不推荐 -你告诉我吧
- Not that I'd advise. - Please, tell me.
我们可以把他转去重症监护室
We could move him to the ICU
尽力让他活着
and do the best we can to keep him alive.
那样也许能给我们一些时间等他醒过来
That might give us some time for him to wake up
自己来做决定
and make the decision himself.
好
Okay.
就这样吧
Let's do that.
我们等待的每一秒
Every second we wait increases the risk
都会增加他因为多器官衰竭而死亡的风险
of him dying of multi-organ failure.
我明白但...
I understand, but...
这应该由他决定
he should be the one to decide.
好吧
Okay.
我出去一下就回来
I'll be back in a moment.
-我说 -怎么了
- Hey. - Yeah?
这样做我觉得不太好
I am not comfortable with this.
那个女人被她丈夫虐待
That woman was abused by her husband.
-你确定吗 -对
- You sure about that? - Yes.
以我来看她不应该来做这个决定
And in my opinion, she should not be making this decision.
泰勒先生能自己醒过来
What are the chances Mr. Tyler
并做出决定的概率有多大
does wake up on his own to make this call?
很小
Slim.
瑞克需要被截肢
Rick needs to have his leg amputated.
如果他一直虐待她的话我觉得
And I don't think it's right to have Kim decide
让金去做决定是不对的
if he's been abusing her.
为什么
Why not?