芝加哥急救
Chicago Med S04E01
Part 2
Jan. 21, 2020, 1:46 p.m.
死亡时间 8点23分
Time of death, 8:23.
芝加哥医院
第四季 第一集
我们本可以不失去那个病人的
We shouldn't have lost the patient.
他的主动脉破了 你还能怎么办
His aorta burst. What could you have done?
我们在急诊室的时候
When we were in the E.D.,
他的主动脉还没有完全破裂
he hadn't yet suffered the fatal rupture.
如果我们能当场就修补好他的伤口
If we'd been able to repair his injury there,
他就能活下来
he'd still be alive.
问题在于将他转移到楼上的时间
The problem was the time it took transferring him upstairs.
但急诊室没有你说的
But the E.D. Isn't equipped to perform
那种手术设备
the kind of procedure you're talking about.
那就是罗德斯医生想说的
That's Dr. Rhodes's point.
急诊室应该也设立一个混合手术室
There needs to be a hybrid operating room in the E.D.
需要设备完全 能够进行紧急胸外科手术
Fully equipped to perform emergency cardiac surgery.
在急诊室设立手术室
An O.R. In the E.D.
我们转移病人到手术室的过程中
We have lost far too many patients
已经失去太多条命了
on the way to the O.R.
其实 我赞成这个想法
Actually, I like the idea,
但将创伤室改造成手术室
but converting a trauma room into a surgical suite--
这可不便宜啊
it's not an inexpensive proposition.
你这样 写一封提议
I'll tell you what. Write up a proposal.
一小时后就放到你桌上
I'll have it on your desk in an hour.
罗德斯医生 你有创伤科和心胸科两方面经验
Dr. Rhodes, with your background in both trauma and CT,
你应该是牵头这类项目的理想人选
you'd be the ideal person to head a program like this.
如果董事会同意这项提议 我希望你留下
If the board okays it, I'd like you to stay.
抱歉 古德温女士
I'm sorry, Ms. Goodwin,
但我下周一就会到梅约医学中心上班了
but I start at the Mayo Clinic on Monday.
-这戒指太适合你了 -我同意
- That looks so good on you. - I agree.
我们应该对约会认真一点
You know, we should get serious about a date.
-定个场地 -场地
- Book a venue. - A venue?
我还以为场地都是指市政厅什么的
I was thinking more of like a city hall-type thing.
约上三五好友 之后一起吃个饭就行
I don't know, a few friends. Maybe dinner after.
不是 我已经和布雷迪神父说过了
What, no, I already talked to Father Brady.
他答应我们周六在圣厄苏拉教堂等我们
He promised us a Saturday at St. Ursula's.
天哪 我把七大姑八大姨全叫上了
Man, I got a whole neighborhood to invite.
我们需要个礼堂
We need a hall.
曼宁医生 霍斯特德医生 跟我来
Dr. Manning, Dr. Halstead, with me.
好
Okay.
德斯蒙德
Desmond?
25岁失聪男性 名字叫彼得·拉什
25-year-old deaf male Peter Rush.
顽固性头痛 语无伦次
Intractable headache, disoriented.
对光敏感 昏迷指数15
Sensitivity to light. GCS 15.
在救护车上呕吐两次
Vomited times two in the ambo.
麦基 你能帮我们吗
Maggie, will you help us?
好
Yep.
你需要手语翻译吗
Would you like an interpreter?
-要 -她有执照
- Yes. - She's certified.
我们来转移 一 二 三
Let's sheet transfer. One, two, three.
心率112 血压122/76
Heart rate 112, BP 122/76.
-正常窦性节律 -他们俩会给你治疗
- Normal sinus rhythm. - These two take care of you.
这位是他的未婚妻 邦妮
This is his fiancée, Bonnie.
你是先天性耳聋吗
Have you been deaf since birth?
不 是14岁时得了腮腺炎
No, 14. Mumps.
她说他一个月前做了人工耳蜗植入手术
She says he had cochlear implant surgery a month ago.
就要激活了
It's due to be activated.
胸腔无杂音 第一和第二心音规律
Chest is clear, regular rate rhythm S1 and 2.
呕
Sick!
给他四毫克昂丹司琼
And let's give him four milligrams of ondansetron.
好的
Got it.
她说这是由植入引起的脑膜炎
She says it's meningitis from the implant.
她提醒过他不要植入
She warned him not to get it.
我们还不知道他是不是得了脑膜炎
We don't know that he has meningitis.
他的颈部检查一切正常
His neck exam is normal.
脑膜炎的确可能在手术后发生
And meningitis can occur after surgery,
但并不普遍
but it's not common.
给他做血常规 血液生化
Let's get a CBC, BMP,
-还有两种细菌培养 -好
- and cultures times two. - Right.
还有送他去照头部CT
And let's send him up for a head CT.
好 我会照顺序来
Okay, I'll put in the order.
-谢谢 -没事
- Thank you. - Yeah.
艾普尔
April.
艾普尔 可以给我点时间吗
Hey, April, can I get a second?
艾米莉已经洗心革面了
Emily's really turned her life around.
她不吸毒了 也在戒酒会
She's clean, going to AA.
她找了份工作 化妆品导购
She's got a job, sells cosmetics.
你为什么要告诉我
And you're telling me this why?
我要带艾米莉去参加康纳的聚会
I'm bringing Emily to Connor's party,
她想和你谈谈
and she'd like to talk to you.
-为什么 -她很抱歉
- Why? - She feels bad.
她是该
She should.
艾米莉想弥补 这也是她项目的一部分
Emily wants to make amends. It's a part of the program.
艾米莉嗑药 赌博
Emily has a drug problem and a gambling problem.
她偷医院的阿片类药物
She stole opioids from the hospital,
-我知道 -她该去戒毒中心
- I know. - She needs to be in rehab.
-我...-她需要心理治疗
- I-- - She needs psychotherapy--
我知道 但是她真的在努力
I know. But she's really trying.
总要慢慢来嘛
One step at a time.
杰克逊先生
Mr. Jackson,
他们是学生医生库里和麦克尼尔
these are student doctors, Curry and McNeal.
他们会协助我为你缝合
They're going to help me sew you up.
-好 -麦克尼尔 去戴手套
- Okay. - McNeal, glove up.
库里 不如你帮他输液
Curry, why don't you get him an IV
给他挂一包生理盐水
and hang a bag of normal saline?
-那是护士的工作 -什么
- That's a nurse's job. - I'm sorry?
我说 那是护士的工作
I said, that's a nurse's job.
每个医生都该知道怎么输液
Every doctor should know how to put in an IV.
我知道怎么做 但我觉得没意义
I do know how, but I don't see the point.
那不是我要干的事
That's not something I'm ever going to be doing.
我又没打算做病人护理
I'm not going into patient care.
-有什么问题吗 -没有 先生
- Is there a problem? - No, sir.
库里小姐 你在我手下做事的时候
Ms. Curry, when you are on my service,
就照我要求的做
you will do exactly what's expected of you.
你明白了吗
Do you understand?
杰克逊是名机械工
Mr. Jackson is a machinist,
他在车间割伤了前臂
and he cut his forearm in the shop.
-你对伤口有什么看法 -很干净
- What do you make of the wound? - Mm, pretty clean.
边缘很平滑 用尼龙缝线吗
Edges are smooth. Nylon suture?
你还是再仔细瞧瞧
You'd better take another look.
原来伤口这么深
That's actually a pretty deep cut.
那你要怎么去除死腔
So how do you obliterate the dead space?
可吸收缝线
Absorbable stitch.
对 对
Right, right.
-你是医生 -医学生
- You're a doctor? - Medical student.
你个子很高大
You're a big guy.
怎么不去打橄榄球
What's the matter, couldn't play football?
我们先给手臂打麻药
Let's numb that arm.
你没有得脑膜炎
You don't have meningitis.
另一方面 我们还不知道
On the other hand, we don't know why
为什么你会有这些症状
you're having these symptoms.
你的光敏感度令我们担忧
Your sensitivity to light concerns us,
所以我们要再做些血液检查
so we'd like to do some more blood work,
包括基因测试 只是为了万无一失
including a genetic test, just to cover our basis.
你们需要在医院过夜
You'll have to stay here overnight.
我们会为你在楼上安排张床
We'll try to find you a bed upstairs.
另外 我们会让你
Otherwise, we will make you
在这里待得尽可能舒服
as comfortable as possible down here.
好消息是我们已经和你的听力矫正医师谈过了
The good news is we've talked to your audiologist,
我们可以给你启动助听器了
and we can turn on your cochlear implant.
好 我想要 谢谢
Yes, I want it. Thank you.
对 我要戴
Yes, I'm doing it.
芝加哥急救
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