芝加哥急救

Chicago Med S07E05

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

See if she's a good candidate?
- Yeah, yeah, sure.
- 埃莉诺，罗恩，这是霍尔斯特德医生。
- Eleanor, Ron, this is Dr. Halstead.
- 嗨。
- Hi.
- 他只是要问你几个问题。
- He's just going to ask you a few questions.
- 很高兴见到你。
- 你必须帮助她。
- Nice to meet you.
- You have to help her.
埃莉，告诉他，
Ellie, tell him,
你一生中从未生病过一天。
you've never been sick a day in your life.
- 罗恩...
- 不，不，很高兴听到你这么说。
- Ron...
- No, no, that's good to hear.
你介意我？
You mind if I?
- 握紧拳头。
- Make a fist.
然后放松。
And release.
- 好。
- Good.
她有任何敏感或过敏吗？
Does she have any sensitivities or allergies?
最近的受伤，可能会干扰动脉
Recent injuries, meds that would interfere
的药物吗？
- 只有季节性过敏。
with an arterial line?
- Just seasonal allergies.
- 好的。埃莉诺，你在抽血的时候
- Okay. Eleanor, do you ever have any trouble
有过什么问题吗？
- 我认为没有。
when you get your blood drawn?
- I don't think so.
- 腿部肿胀呢？在长途乘车、旅行的时候会吗？
- What about leg swelling? Long car rides, trips?
- 不，我记得没有。
- No, not that I can remember.
- 好的。
- That's good.
好的，很高兴认识你。
All right, it was nice to meet you.
我要和哈默医生谈谈。
I'll have a chat with Dr. Hammer.
我们会马上回来。
We'll be right back.
- 你觉得怎么样？她适合用Vas-COM吗？
- What do you think? She look good for the Vas-COM?
也许。
Maybe.
她的回答有些含糊。
She was a little vague in her answers.
- 但她绝对应该上
- But she definitely should have
心输出量监测？
her cardiac output monitored?
- 哈默医生，如果你有兴趣，
- Dr. Hammer, if you're interested,
我可以给你Vas-COM的
I could give you copies
的FDA批准的使用标准。
of the Vas-COM's FDA-approved usage criteria?
- 你知道的，那...没那个必要。
- You know, that... that won't be necessary.
我认为埃莉诺会是一个很好的候选人。
I think Eleanor would be a great candidate.
- 好的，很好。我会把她安排好。
- Okay, good. I'll get it set up.
- 斯科特医生。
- 亚历克斯？
- Dr. Scott.
- Alex?
- 泰勒医生。
- 老弟？怎么了？
- Dr. Taylor.
- Buddy? What?
亚历克斯。
- 巴德...
Alex.
- Bud...
- 让开一下。
- 亲爱的，亲爱的？
- Excuse me.
- Honey, honey?
怎么...怎么回事？
- 他癫痫发作了。
What... what's happening?
- He's having a seizure.
给他12升氧气和0.5mg劳拉西泮。
Give him 12 liters of O2 and .five of Ativan.
- 等等，癫痫发作？他为什么会有癫痫？
- Wait, seizure? Why is he having a seizure?
- 我还不确定。
- I'm not sure yet.
来吧。
Come on.
来吧，来吧，来吧，来吧。
Come on, come on, come on, come on.
嘿，亚历克斯，你和我在一起吗？
Hey, Alex, you with me?
好的。
Okay.
我们会尽快解决这个问题。
We're gonna figure this out as soon as we can.
泰勒医生。
Dr. Taylor.
- 嗨，嗨，好了。没事了。
- Hi, hi, okay. It's okay.
- 那个伤口一直都在流血吗？
- Has that cut been bleeding like that the whole time?
- 我试着保持压力，但不起作用。
- I tried holding pressure, but it didn't work.
如果我试图太早缝合的话，
And if I would've tried to stitch too soon,
他会得血肿的。
he would've got a hematoma.
- 他可能患有出血性疾病。
- He could have a bleeding disorder.
你安排了凝血测试了吗？
Did you order coags?
- 嗯...不，我...
- 安排一套凝血测试，麦基。
- Um, well, no. I...
- Get a coag panel, Maggie.
还有告诉CT我们要过去。
And let CT know we're on our way.
- 等等，你认为他会不会有硬膜下血肿？
- Wait, do you think he could have a subdural hematoma?
- 是的，如果他确实患有出血性疾病，
- Yes, and if he does have a bleeding disorder,
然后伴有被击中造成的头部创伤
then the trauma from getting hit in the head
可能会导致颅骨出血，
could've caused a bleed in the skull,
这意味着他随时都可能出现脑疝。
which means he could herniate at any moment.
好了。我们走吧。
All right, now. Let's go.
天啊。
My God.
- 好的，准备释放肝血流阻断。
- Okay, ready to release the pringle.
- 等等，我还没仔细看十二指肠。
- Hold on, I didn't get a good look at the duodenum.
- 很清楚。
- 好的。
- It's clear.
- Okay.
- 好了，腹腔镜拉回来。
- All right, pulling back on the lap.
看起来挺好的。
Looks good.
- 她的血液酸碱度和体温是多少？
- What's her pH and temp?
- 7.34和36.9。
- 7.34 and 36.9.
- 好吧，看来你可以缝合了。
- All right, looks like you're good to close.
实际上，我们只是要塞好并让她保持开放。
Actually, we're just gonna pack and leave her open.
- 不，她的出血已经控制住了。
- No, her bleeding's under control.
没必要塞住她。
- 我不同意。
Packing her isn't necessary.
- I disagree.
她有四级肝裂伤。
She's got a grade four liver laceration.
再次出血的风险太高了。
The risk of re-bleeding is too high.
- 她是一个28岁的健康人。
- She's a healthy 28-year-old.
让她保持开放会使她面临感染、凝血功能障碍、
Leaving her open puts her at increased risk
低体温症和酸毒症等更大的风险。
for infection, coagulopathy, hypothermia, and acidosis.
- 布莱克医生，我...
- 缝合她，医生。
- Dr. Blake, I...
- Close her up, doctor.
- 我理解你的担忧。
- 不，不，你说得对。
- I understand your concerns.
- No, no, point well taken.
我在布莱克医生所说的话中看到了优点。
I see the merit in what Dr. Blake is saying.
- 阿彻医生...
- 好了，腹腔镜等一下。
- Dr. Archer...
- All right, hold off on the lap.
我需要止血材料，明胶海绵
I need Celox, Gelfoam,
并为马塞尔医生拿O Max和缝合线。
and get an O Max and suture for Dr. Marcel.
- 阿彻医生，你...
- 马塞尔医生。
- Dr. Archer, you...
- Dr. Marcel.
- 米勒先生和夫人，我是查尔斯医生。
- Mr. and Mrs. Miller, I'm Dr. Charles.
我在和斯科特医生
I had been consulting
一起讨论亚历克斯的病情。
with... with Dr. Scott on Alex's case.
- 精神病学？
- 头部受伤。
- Psychiatry?
- Head injury.
你知道的，再小心也不为过。
You know, can't be too careful.
不管怎样，斯科特医生想让我告诉你们
Anyway, Dr. Scott wanted me to let you know that
亚历克斯的扫描就快准备好了。与此同时，
Alex's scans are almost ready. And in the meantime,
有什么我可以帮你的吗？
is there anything I can get you?
一瓶水？
- 谢谢，但我们很好。
A bottle of water?
- Thank you, but we're fine.
是的。
Yeah.
抱歉。这是工作电♥话♥。
Sorry. This is work.
嗯，别忘了给我父母发短♥信♥。
Um, don't forget to text my parents.
- 抱歉。
- 好的。是的。
- Excuse me.
- Okay. Yep.
- 瑞安？是瑞安吗？你呢，伙计？
- Ryan? Is it Ryan? How about you, buddy?
需要我给你拿什么吗？
- 你介意我...
Can I get you something?
- Do you mind if I...
- 不介意。
- 好的，我马上回来。
- No, not at all.
- Okay, I'll be right back.
- 完全不介意。
- Not at all.
你要三明治什么的吗？
Would you, like a sandwich or something?
不？一袋薯片？
No? Bag of chips?
苏打？或者其他什么别的？
Soda? Anything at all?
- 不！你打断了我。
- No! You interrupted me.
- 抱歉。
- 我，我...我不是故意的。