芝加哥急救

Chicago Med S07E04

Part 2 Oct. 25, 2021, 3:53 p.m.

我精力很旺盛经得起消耗
I have a lot of energy it needs to go somewhere.
听着，凡妮莎，我支持你的干劲
Okay, look, Vanessa, I'm all for the gung-ho spirit,
但你得控制好你的节奏
but it's important to pace yourself.
这些天，住院医生休息是件好事
These days, residents getting rest is a good thing
而且是被要求的
And required.
那只是他们说的，不代表是他们的意思
That's what they say, not what they mean.
好吧
All right, then.
这是什么
What's this?
你的处方
Your prescription.
时不时地，休息一会
Every now and then, take a break.
你注意到了吗？凡妮莎和克罗特？
Did you catch that? Vanessa and Crockett?
是
Yup.
第一年的住院医生爱上了他们的导师
First-year resident falling for their mentor?
这可不好
That's not good.
通常住院医生都不会有好的结果
Doesn't usually end well for the resident.
那当然
Nope.
救护车来了，我们去第四治疗室
Ambo's coming in. We're in Treatment 4.
来了
On it.
凡妮莎，有时间参加另一个病例吗？
Vanessa, got time for another case?
当然
Definitely.
Ashley Bardsley，48岁，癫痫发作时
Ashley Bardsley, 48, in line at Starbucks
她在星巴克排队
when she had a seizure.
目击者说她重重的摔倒
Witnesses said she fell pretty hard,
碰到了她的头
hit her head.
左臂严重变形
Gross deformity of the left arm.
我们到的时候她还昏昏沉沉，
She was groggy when we arrived,
但保护了她的呼吸道
but protecting her airway.
血压120 / 80，心率72，
BP 120 over 80, heart rate 72,
血氧饱和度100%。
sats 100% on oxygen.
无法进行静脉注射
Couldn't get an IV.
数到三换床
Okay, let's transfer on three.
1,2,3
One, two, three.
谢谢你，考特尼
Thank you, Courtney. Yep.
嘿。
Hey.
呼吸音正常。阿什利？
Good breath sounds. Ashley?
你能听到我说话吗
Can you hear me?
阿什利。还是无意识
Ashley. Still out of it.
发作后阶段是一个通配符
Post-ictal phase is a wildcard.
昏迷可能需要持续一段时间
Fuzziness could last a while.
做静脉注射，全血细胞计数，骨形态发生改变，胸部x光，头部CT。
Get a good IV, CBC, BMP, chest X-ray, and a head CT.
知道了
You got it.
那胳膊呢？
What about the arm?
生命胜过肢体
Life over limb.
做完CT我们再处理
We'll deal with it after the CT.
钱宁先生，我是霍斯特德医生
Mr. Channing, I'm Dr. Halstead.
叫我佩特就好
Oh, call me Pete.
在35岁之前我还不是钱宁先生
I'm not going to be Mr. Channing until at least 35.
你说对了
You got it.
告诉我，怎么回事
Tell me, what's going on?
我吐的一塌糊涂
I've been puking up a storm.
多么有趣
How fun.
生命体征正常。体温升高，38.3℃
Vitals are normal. Temp's elevated, 101.1.
佩特，你闻起来像一桶啤酒
Not for nothing, Pete, but you smell like a keg.
对不起
Yeah, sorry.
我上了一年半的网课后回到了校园
Back on campus after a year and a half online.
一直在弥补失去的派对时间
Been making up for lost time on the party front.
这样啊
Aha.
哪疼吗？
That hurt?
到处都疼
Everything kind of hurts.
我以为只是又一次的严重宿醉
I thought it was just another bad hangover,
而不是能让他们晕倒的灵丹妙药
but the elixir that usually knocks them out, isn't.
我能闻一下吗？
May I?
那个椰子水？
That coconut water?
里面加了一些电介质粉和冰
With some electrolyte powder and ice.
我一上午都在不停地喝
I've been drinking it nonstop all morning,
但我也没感觉好到哪去
but I'm not feeling any better.
好了，我们得做一些化验
Okay, all right, well, let's run some labs,
就从这开始，好吗？
and we'll go from there, okay?
做全血细胞计数，心率，淀粉酶，脂肪酶化验和胸透
CBC, BMP, amylase, lipase, and a chest X-ray.
我稍后就回来
I'll be back in a bit.
今天早上在咖啡馆看见你和设备代表在一起
Saw you in the caf¨| this morning with that device rep.
本来是想过去打个招呼的但我不想当电灯泡
Was gonna say hi, but I didn't want to be a third wheel.
只是业务，迪恩。嘿，我错了
Just business, Dean. Hey, my mistake.
一定是个很棒的设备
Must be one hell of a device.
没关系，来吧，没关系
It's all right, come on. It's okay.
麦基，哪个房♥间空着？第三治疗室
Maggie, what's open? Treatment 3.
好。你需要精神科医生吗？
Okay. You need a psych tech?
随时待命。查尔斯医生？
On standby. Dr. Charles?
他正往这来。好
On his way down. All right.
你需要什么吗？
Hey, you need anything?
水？吃的东西？不，不了，谢谢你
Water? Something to eat? No. No, thank you.
你呼叫了精神科医生？
Hey, you call for a psych tech?
是的，只需要呆在附近
Yeah, just stay close.
要约束带吗？不需要
Restraints? No.
没事的，没关系
It's okay. It's all right.
嘿，查尔斯医生
Hey, Dr. Charles.
罗兰22岁—被诊断患有精神分♥裂♥症
Roland is 22--he was diagnosed with schizophrenia,
差不多，三个月前
like, three months ago.
这是他的药
These are his meds.
氟奋乃静。第一代抗精神病药物。
Fluphenazine. First generation antipsychotic.
一天30毫克？真是大剂量
30 milligrams a day? Heavy dose.
他妈妈，帕姆·巴克斯特说他从来没少吃一次药
His mom, Pam Baxter, says he never misses a dose,
但今天他还是把药断了一下
yet today he still had a break.
你怎么样？
How you doing?
没有什么事我之前没处理过
Nothing I haven't dealt with before, man.
巴克斯特夫人？
Ms. Baxter?
你怎么样？我是查尔斯医生
How are you doing? I'm Dr. Charles.
见到你很高兴
It's great to meet you.
你会帮我儿子吗？这就是我来这的原因
You'll help my son? That's why I'm here.
你介意我向他问好吗？
Uh, you mind if I say hello to him?
罗兰，你好吗？我是查尔斯医生
Roland, how you doing? I'm Dr. Charles.
没事的。没关系
It's all right. It's okay.
帕姆，让我带你去休息室，好吗？
Pam, let me show you to the waiting room, okay?
心输出量和心脏指数
Cardiac output and index.
脉搏压力和每搏输出量
Pulse pressure and stroke volumes.
中心静脉压，平均动脉压
Central venous pressure, mean arterial pressure,
以及氧气输送等计算值
and calculated values like oxygen delivery.
瓦西监视仪是一种一体化的心脏检测设备
The 瓦西监视仪 is the all-in-one cardiac monitoring device.
它几乎让我们都变得不必要了。是几乎
It almost makes us unnecessary. Almost.
我喜欢
I love that.
库珀医生
Dr. Cooper.
所以在新冠病例中，量化肺水肿是有用的
So with Covid cases, it can be useful to quantify pulmonary edema.
瓦西监视仪能做到这一点吗？
Is that something the 瓦西监视仪 is capable of?
肺水量？绝对
Lung water volume? Absolutely.
哦，我很抱歉。我不是有意来打扰
Oh, I'm sorry. I didn't mean to interrupt.
我只是—我只是开完预算会议的时候把茶杯落在这了
Uh, I just--I left my water bottle there from the budget meeting.
要多喝水，对吧？
Gotta stay hydrated, right?
抱歉，就当我不在这
Sorry, just forget I'm not here.
噢，事实上说到水
Uh, actually, speaking of water,
你刚才说肺水量还是…
what were you saying about lung water volume or...
对，是的
Right. Yes.
它可以在几秒钟计算出肺水量
It can be calculated in seconds.
这是因为
The reason:
瓦西监视仪拥有复杂网络人工智能
the 瓦西监视仪's sophisticated neural network AI.
这个，与中心静脉线尖端的
This, in combination with a thermistor at the tip
热敏电阻和动脉侧的
of the central venous line and the waveform analysis
波形分♥析♥相结合，确保了设备提供了
from the arterial side ensures the device delivers
一致和准确的测量
consistent and accurate measurements.
而且这是微创的
And it's minimally invasive.
好吧，反正不是花你的钱
Well, not when it comes to your wallet.