芝加哥急救

Chicago Med S07E07

Part 3 Nov. 21, 2021, 4:34 p.m.

离手
Clear.
中轴桡骨骨折，轻度成角
Mid-shaft radial fracture with mild angulation.
EJ，你可能需要做手术，
EJ, you might need surgery, but, in the meantime,
但与此同时，我们能联♥系♥谁吗？
is there anyone we can call?
比如说你妈妈或者祖父母？
Like your mom or maybe a grandparent?
不，我爸是我唯一的亲人了
No, he--my dad's all I have left.
拜托了，一定要救活他
Please, you can't let him die.
拜托了，你…你得让我看看他。拜托了
Please, you--you have to let me see him. Please.
好吧。我现在就去看看他怎么样了
All right. Look, I'm gonna go check on him right now.
好吧?但南希要带你去做个CT扫描。
All right? But Nancy here has to take you for a CT scan.
我们得看看你是不是脑震荡了
We have to see if you have a concussion.
我知道。会没事的
I know. It'll be all right.
好吗?好
Okay? Okay.
父亲怎么样？
How's the dad?
不太好，四肢没活动
Not good. Not moving his extremities.
送他去做通体扫描和颈部血管造影
Sending him for a panscan and a neck CTA.
得叫神经外科来
Stat paged neurosurgery.
爸？等等
Dad? Wait!
爸？等等，等等
Dad? Hold on, hold on.
爸？爸…等等，等等EJ
Dad? Dad-- Whoa. Hold up. Hold up, EJ.
等等，等等。不，坚持住
wait, wait, no. Hold up.
他还好吗？过来
Is he gonna be okay? Come on.
他出了什么事？别激动，别激动
What's wrong with him? Come on, come on.
你不必看这些的。镇定
You don't need to see this. Come on.
你好，布雷克医生
Hey, Dr. Blake.
我看到我们找到了病人谢尔顿·韦斯特需要的肝脏
I saw we found a liver for our patient, Sheldon West.
看一眼
Take a look.
嗯，检查结果看起来不错
Oh, yeah. Labs look good.
没有异常。很好
No abnormalities. Very nice.
注意测量
Note the measurements.
捐赠的肝脏对谢尔顿的腹部来说太大了
The donor liver's too large for Sheldon's abdomen.
所以呢？你不准备接受吗？
So what? You're not going to accept?
好吧，作为规矩
Well, as a rule,
我不喜欢把方桩塞进圆孔里
I don't like forcing square pegs into round holes.
是啊，但谢尔顿的终末期肝病模型评分是38
Yeah, but Sheldon's got a MELD score of 38.
他快没时间了
He's running out of time.
在我们等待更好的匹配时
He'll tolerate another round of liver dialysis
他会再接受一轮肝脏透析
while we wait for a better match.
呃，布雷克医生。
Uh, Dr. Blake.
抱歉，如果你愿意的话，
Sorry, if you'd indulge me,
肝切除术怎么样？把这个肝尺寸减小
what about a hepatectomy? Trim the liver to size?
这就增加了谢尔顿
That adds time to the procedure
不需要的手术时间
that Sheldon won't have.
我在急诊室做过几十次手术，
Well, I've done dozens out of the ED.
如果你允许我帮忙，
If you'll allow me to assist,
我相信我能成功。
I'm confident I can pull it off.
等等，等一下，停下
Wait, wait, stop.
我爸还能走路吗？
Is my Dad gonna walk again?
你叫EJ是吧？
EJ, right?
现在下结论还为时尚早
It's too early to say.
但艾布拉姆斯医生会好好照顾他
But he's in good hands with Dr. Abrams.
你要去做手臂手术吗？
Are you off to surgery for your arm?
你觉得可以等吗?
You think it can wait?
我不希望我被麻醉的时候我爸出什么事
I--I don't want anything to happen to my Dad while I'm out.
不如我跟你做个交易?
How about I make you a deal?
你继续做你的手术，在有情况发生前
You stick to your surgery, and I'll keep you looped in
我会随时通知你
before anything happens.
怎么样？
Sound good?
成交。好
Okay. Okay.
谢谢你。不用谢
Thanks. Yeah.
谢谢你
Thank you.
所以情况怎么样？
So what's the word?
丹尼尔斯先生的大脑C5段严重损伤。十分严重
Mr. Daniels is an ASIA A at C5. Complete injury.
颈部以下没有运动和感觉功能
No motor or sensory functions below the neck.
这太糟糕了。他四肢瘫痪
That's catastrophic. He's tetraplegic.
这就是我的评估
That would be my assessment.
我猜你已经安排做CT扫描了？
I assume you ordered a CT scan?
结果刚刚出来
The results just came in.
C5段和C6段的双边跳跃面
Bilateral jumped facets at C5 and 6.
他的脊椎受到这么严重的损伤
Well, there's no chance his cord is getting perfused
他的颈椎不可能被灌注
when his spine's that maligned.
我们得马上给他做牵引
We need to get him in traction now.
我去推牵引推车
I'll grab the traction cart.
好，血氧饱和度为75。就快好了
Okay, sat's at 75. Almost got it.
70。你快没时间了，伊森
70. You've run out of time, Ethan.
快啊，快啊
Come on. Come on.
68。他正在昏迷
68. He's braying down.
我插♥进♥去了，插♥进♥去了
I'm in. I'm in.
啊，就这样吧。到此为止吧。你的病人昏迷了
Nah, that's it. That's it. Your patient's coding.
我猜我比我想象的还要生疏一点
I guess I'm a little rustier than I thought.
他被捕时你要站在那还是怎么的？
Are you gonna stand there while he arrests or what?
是，队长
Aye, Chief.
开始按压
Starting compressions.
泰勒医生
Dr. Taylor.
查尔斯医生
Dr. Charles,
呃，我没看到你在那
Uh...I didn't see you there.
我的过敏症发作了
My allergies were acting up.
我听说你让阿斯特丽德·梅多斯去做核磁共振
So, I heard that you sent Astrid Meadows for an MRI?
是的。但不是—但不是毫无原因的
I did. Yeah, but not-- but not without cause.
你和她父母在一起的时候，
When you were with her parents,
我抓住机会重新检查了她，
I took the opportunity to re-examine her,
然后我注意到她那只受伤的胳膊变得更紧了，
and I noticed increased tone in her injured arm,
这是意料之中的
which is to be expected.
但我也意识到那是在她的另一条手臂上
But then I also realized that it was in her other arm.
慢点说。对，当然，好的
Slow down a little bit. Right. Of course. Yes.
所以我决定注意
So I decided to take note of the reflexes
她身体两侧的反射
that are affected on both sides of her body.
然后我意识到这里可能出现了别的情况，
And then that's when I realized that something else
是一种潜在的状况
might be going on here, an underlying condition.
也许是神经系统或者肌肉骨骼之类的
Maybe something neurological or musculoskeletal or--
我确实给她用了氟哌啶醇。
Well, you know, I did give her some Haldol.
这就解释了反射减弱的原因
Which, you know, could explain the diminished reflexes.
也许。尽管如此，我还是觉得谨慎起见，还是安排做核磁共振检查
Perhaps. Nonetheless, I felt it prudent to order an MRI.
老实说，结果很有趣
And honestly, the results were interesting.
你想看一下吗？
You want to take a look?
如果你看这里和这里，你可以看到
You know, if you look here and here, you can see
T2白质发生了变化
the T2 white matter changes.
可能是多发性硬化症，对吧?
I mean, that could be MS, right?
这就能解释她手臂僵硬
And that could explain the rigidity in her arms,
甚至是幻觉的原因了
or maybe even the hallucinations.
你知道吗？
You know what?
解读核磁共振成像可能很棘手，对吧?
Interpreting MRIs can be tricky, all right?
例如，我的意思是，这些白质的变化，
For instance, I mean, these white matter changes,
也可能只是正常的衰老。
they could also just be normal aging.
我…我觉得我们还是要谨慎
I-I think we want to careful about getting too far ahead
别太超前了。
of ourselves here. You know?
泰勒医生？第三治疗室有病人入院
Dr. Taylor? You got an intake in T3.
我马上到
I'll be right there.
我只想勤奋
I just wanted to be diligent.
那太好了
That's great.
威尔·霍斯特德？我们在那边
Will Halstead? We're over here.
你好，杰莎
Hi, Jessa.
听着，我听说了埃莉诺·霍尔特的事
Listen, I heard about what happened to Eleanor Holt,
我只想表达我的哀悼
and I just wanted to extend my condolences.
谢谢你
Yeah, thank you.
今天上午有个研讨会
There was an M&M this morning.
他们确定了什么
What'd they determine?
这是绝密的，杰莎。我真的不知道
That's confidential, Jessa. I really can't get into it.
噢，天哪，当然
Oh, my gosh, of course.
只是—我只是刚刚开始上班
It's just--I'm just at the beginning of my career,