芝加哥急救

Chicago Med S07E06

Part 2 Nov. 13, 2021, 1:10 p.m.

Those her parents?
是，凯特和布兰登。那人看起来很眼熟
Yeah, Kate and Brandon. That guy looks familiar.
墨菲先生和墨菲夫人，我是斯科特医生
Mr. and Mrs. Murphy. I'm Dr. Scott.
这是我们的护士长，麦基
This is our charge nurse, Maggie,
你一定是西沃恩
and you must be Siobhan.
哦哦，我知道这表情
Uh-oh, I know that look.
我们非常确定西沃恩的胳膊骨折了
We're pretty sure Siobhan broke her arm.
她从我们公♥寓♥的楼梯上摔了下来
She fell down the stairs of our apartment complex.
我认识你吗？
Do I know you?
哦，我想咱俩没见过
Oh, I don't think so.
好吧，西沃恩，发生什么了？
All right, Siobhan, what happened?
我想我摔倒了
I guess I tripped.
她从来都不是世界上最协调的人
She's never been the world's most coordinated person.
所以只是一次很普通的摔倒
So just a normal run-of-the-mill trip?
除了你的脚外没有任何东西？
Nothing in front of you but you're own two feet?
我记不清了。当我摔倒时，我磕到了头
I don't really remember much. When I fell, I hit my head.
那之后，一切都有点模糊了
Since then, it's all been a little foggy.
我们需要做个脑部CT来检查一下脑部导致的模糊
So we need to get a head CT to check on that brain fog, yeah?
好，我检查一下你的胳膊
Okay. May I look at your arm?
让我看看
Let me see.
给胳膊做个X光
Get an X-ray on the arm.
好
Uh-huh.
好了，西沃恩，我们要给你的手臂
Okay, Siobhan, so we are gonna take a few pictures
和脑袋里拍几张照片
of your arm and the inside of your head.
听起来不错
Sound like a plan?
好
Okay.
我马上叫一个X光技师过来
I will be right back with an X-ray technician.
嘿，你和那个父亲之间是怎么回事
Hey, what was that between you and the dad?
我想起来我为什么知道他了
I realized how I know him.
我十年前以殴打罪逮捕过他
I arrested him for assault and battery 10 years ago.
真的吗？
Really?
你确定你还要负责这个病人吗？
Are you sure you should be on this case?
我可以再叫个别的人过来
I can call peds and get somebody else.
不，不，不。没关系，我很好
Oh, no, no, no. It's fine. I'm good.
抱歉，你漏掉了一整列
I'm sorry, you're missing a whole column over here.
你需要重新做一遍。好吧,我很抱歉
You need to re-do this. Okay, I'm sorry.
马塞尔医生，你到了。对不起，我迟到了
Dr. Marcel, you made it. Hey, sorry I'm late.
我在重症监护室碰到一个病人
I got caught up with a patient in the ICU.
记住，叫急诊科是有原因的
Remember, there's a reason why it's called the Emergency Department, yeah?
阿彻医生，马塞尔医生，有病人入院
Dr. Archer, Dr. Marcel, we have trauma incoming.
南茜，你有空吗？莱西，跟我说说情况
Nancy, you're good? Lacey, talk to me.
无名男子，未知年龄
John Doe, age unknown,
可能是一个长距离的游泳运动员
most likely a long-distance swimmer.
船员发现他漂浮在密歇根湖上，
Crew team found him floating in Lake Michigan,
把他捞了出来并进行了心肺复苏
fished him out and performed CPR.
芝加哥消防局给他做过一次除颤器，
CFD defibrillated him once,
有了心律，在现场给他插管
got a rhythm, and intubated in the field.
你为什么还在压着他
Why are you still doing compressing him?
30秒前我感觉不到脉搏
I lost pulse about 30 secs ago.
给他注射了一毫克肾上腺素
Gave him a milligram of epi.
好了，开始吧。慢慢来，好吗
Okay, here we go. Nice and easy, okay?
好了，听我口令转移
All right, we're gonna transfer on my count.
一、二、三
One, two, three.
继续按压
Continuing compressions.
有脉搏么？
Pulse?
没有，继续心肺复苏
No pulse. Continue CPR.
他室颤了
He's in V-fib.
给我电极板，充电到200
Give me the paddles, charge to 200.
充电
Charging.
好了，离手
Okay, clear.
有脉搏了，窦性心律
We got a pulse. Sinus rhythm.
好了
All right, he's hypothermic.
能给我们一些暖和的毯子吗？
Can we get some warm blankets, please?
瞳孔固定并放大了
All right, pupils are fixed and dilated.
脑部缺氧已经有一段时间了
That brain's been without oxygen for a while.
南茜，快速做个CT扫描
Nancy, CT for a panscan, please.
还有，给警署打电♥话♥
And also, let's call CPD up in here.
他们可以测测他的指纹，说不定能查出他的身份
They can run his prints. Maybe they can identify him.
嘿
Hey.
我只想说我对你母亲的事感到遗憾
I just wanted to say I'm sorry about your mom.
你很惊讶。惊讶？
You're surprised. Surprised?
她看起来就像个流浪汉，不是吗？
She looks like a street person, right?
你没想到是这种情况
You weren't expecting that.
如果你需要任何帮助
If you need any help...
谢谢你
Thank you.
你真好
It's nice of you,
但我已经处理这摊子事好长时间了
but I've been dealing with this a long time.
你妈妈的检查结果已经发给你了
Just forwarded your mom's labs.
是，和我想的差不多
Yeah, it's about what I expected.
你确定你不需要再找个主治医生代替我吗？
Are you sure you don't want an attending instead of me?
现在这样我能跟进她的病例
This way I can stay on top of her case.
好吧，你准备怎么处理？
Okay, well, how do you wanna handle this?
你打头阵
You take the lead.
没准她会听你的
She's more likely to listen to you anyway.
特丽，你手臂上的感染
Terri, you definitely have an infection in your arm
已经扩散到血液里了
that has spread to your bloodstream.
我们得像对待耐甲氧西林金黄色葡萄球菌一样对待它直到你的培养结果出来
We have to treat it like MRSA until your cultures come back.
我们已经知道它被感染了
We already knew it was infected.
是的，妈妈，但这种特殊的感染
Yes, Mom, but this particular type
对大多数抗生素都有抗药性
of infection is resistant to most forms of antibiotics.
我以为她才是我的医生
I thought she was my doctor.
我们仍然可以治疗，特丽
We can still treat it, Terri.
我们打算放个经外周静脉穿刺中心静脉置管
We'd like to put in a PICC line
那是我们要留在你手臂上的导管。
It's a catheter we'll leave in your arm.
因为如果你真的有耐甲葡萄球菌
Because if you do have MRSA--
静脉注射抗生素至少需要6周时间
It's a minimum of six weeks of intravenous antibiotics.
门都没有。这不是个选择题
Out of the question. It's not really optional.
你不能强迫我吃我不想吃的药
You can't force me to take some medicine I don't want.
我们没有任何要强迫的意思
We have no intention of forcing anything.
但如果感染得不到治疗，它可能会扩散到心脏瓣膜，
But if the infection goes untreated, then it could spread
变成心内膜炎
to your heart valves and turn into endocarditis.
这可能会杀了你
Which could kill you.
这六周内我得不停地来医院吗？
Six weeks I have to keep coming back to the hospital?
没门
No.
我们还可以安排一个
We could also make arrangements
家庭健康护士到你家来
for a home health nurse to come to your house.
或者任何你呆的地方
Or wherever you're staying.
她为我感到羞耻就因为我住在面包车里
She's ashamed of me because I live in a van.
一旦感染被清除，我们就可以…
Once the infection is cleared, then we can--
不，我不会让你在我的胳膊里放东西的
No, no, I'm not letting you put some thing in my arm
这样你就随时让我回到这
so you can reel me back like a fish whenever you want.
戈登，这已经多长时间了
How long has this been going on, Gordon?
几天吧…是一周
Just a few days-- A week.
玛丽埃尔一直催我去看一下，
Marielle's been nagging me to get this looked at,
但这肯定只是个感冒
but sure it's just a cold.
什么感冒能让你呼吸困难？
What kind of cold makes it hard to breathe?
亲爱的，这叫支气管炎
It's called a chest cold, hon.
新冠检测是阴性的
COVID PCR test came back negative.
做个全血细胞计数，血常规，血气分♥析♥，
Let's get a CBC, BMP, ABG,
血和痰培养，胸部x光
blood and sputum cultures and chest X-ray.
知道了
You got it.
戈登，我们会查清楚的
We're gonna get to the bottom of this, Gordon.
你就安心呆在这
You sit tight.
别担心，我不会让他乱跑的
Don't worry. I won't let him go anywhere.
她是个暴君，医生
She's a tyrant, doc.
连摩托车都不让我买♥♥
Wouldn't even let me get a motorcycle.
30年了，他还在说这个
30 years, he still talks about that.
这只是我个人的意见
Just my two cents.
但你应该继续听她的
But you should keep listening to her.
谢谢
Thank you.
查尔斯医生，你的大杯加蜂蜜的绿茶