芝加哥急救

Chicago Med S07E16

Part 2 April 15, 2022, 2:42 p.m.

是。实际上，我的腿
Yes. Actually, my legs
过去一个月感觉一直很重。
have been feeling heavy this past month.
什么？
What?
你说真的吗？-我是个老婆子
Are you serious? - I'm an old lady.
事情就是这样
This is what happens.
你会变的弱
You get weaker.
基兰，你能闭上眼吗？
Kiran, can you close your eyes for me?
我接触的是哪只脚？
Which foot am I touching?
我不知道
I don't know.
你觉得是怎么回事？
What do you think's going on?
暂时还不确定
Not sure yet.
可能是腰椎或胸椎的问题。
Could be a lumbar or thoracic spine issue.
也可能是自身免疫性疾病。
Or it could be autoimmune.
我只是猜测，但格林-巴利综合症和
I'm just speculating, but Guillain-Barrè Syndrome
多发性硬化症确实会这样
and MS do come to mind.
哦
Oh.
妈妈？
Mom?
我有个表亲得了多发性硬化症
I have a cousin with MS.
真的吗？
For real?
很明显，我完全不了解你
Apparently, I don't know anything about you.
接下来呢？
What's next here?
给你做个脊椎扫描，然后去会诊。
A scan of your spine and a neuro consult.
医生，我很抱歉浪费了你这么长时间
I'm sorry to take up so much of your time, Doctor.
拜托，帕特尔夫人，你没什么可道歉的
Please, Ms. Patel, you have nothing to be sorry about.
所以凯拉得了坏死性小肠结肠炎。
So Kayla has what's called a necrotizing enterocolitis.
这种情况会导致肠道组织发炎
The condition inflames the intestinal tissue
然后导致它坏死
and causes it to die.
在凯拉的病例中，我们怀疑
In Kayla's case, we suspect
这是一种先天缺陷，
it's the result of a birth defect
它阻止了她的肠道
that prevented her intestines from developing
在怀孕期间的正常发育。
the way they should have during pregnancy.
我已经切除了她的大部分小肠
I've removed most of her small intestine,
但她的病情还是很重
but she's very sick.
这些机器和管子，
These machines and tubes,
它们能治好她吗？
they'll fix her?
不
No.
这只是暂时的，不能解决问题
They're temporary, not a solution.
有什么方法？
What is?
移植
A transplant.
没有新的肠道，凯拉无法活下来。
Kayla cannot survive without new intestines.
不幸的是，婴儿器官需要
Unfortunately, infant organs need to come
来自于婴儿捐赠者，而且…
from infant donors, and, uh...
它们非常短缺
They're in very short supply.
哦，天哪
Oh, God.
我的孩子会死吗？
My baby could die?
杰克·贝克，32岁男性
Jack Baker, 32-year-old male.
未系安全带，高速车祸
Unrestrained driver, high speed MVC.
昏迷评分8，血压100/60，心率124
GCS 8, BP 100/60, heart rate 124.
救护车上已经插管。-玻璃也太多了
Intubated in the ambo. - That's a lot of glass.
他穿过挡风玻璃了?-是的。
He go through the windshield? - Yeah.
艾森豪威尔高速上有大雾
Fog on the Eisenhower.
汽车开始猛踩刹车。
Cars start slamming their brakes.
等他发现的时候已经太晚了。
He doesn't see until it's too late.
突然转向，失去控制，冲出了道路。
Swerved, lost control, launched off the road.
好，听我口令
All right, transfer on my count.
一，二，三
One, two, three.
好了，看看这里有什么。
All right, let's see what we got here.
多处撕裂伤，面部，颈部，手臂，腿部。
Multiple lacerations, face, neck, arms, legs.
好吧，可能是闭合性骨折。
All right, likely closed fractures.
大腿骨，前臂，天知道还有哪里。
Femur, forearm, God knows where else.
车里不止他一个人
He wasn't alone in the car.
他的妻子罗斯坐在副驾驶座位上。
His wife, Rose, was in the passenger seat.
消防队员正在努力营救她
Truck company is still trying to extricate her.
好吧，故事越来越精彩了。
All right, the story just keeps getting better.
左侧呼吸音清晰
Breath sounds left clear,
右呼吸音减弱
right diminished.
嘿，迈克，能照张X光片吗？
Hey, Mike, can you please set up for a chest X-ray?
知道了
Got it.
腹部肿胀而结实，这是个不好的迹象。
Belly is distended and firm, that's a bad sign.
报告情况
Quick fast.
血压降低，90/55
BP is dropping, 90/55.
心率136
Heart rate's at 136.
好
All right.
好吧，因为腹腔里全是血
Well, that's because there's a belly full of blood.
好吧，启动大量输血方案
All right, trigger the MTP.
开始输血。
Start transfusing.
X光就位
X-ray up.
离手？-离手
Clear? - Clear.
好的，右边消掉了。
All right, right side is whited out.
血胸
Hemothorax.
多瑞丝！胸管
Doris! - Chest tube.
准备好了
Already on it.
好
Okay.
为我们争取了一些时间，但不多。
Bought us some time, but not a lot.
先去混合手术室，然后再做CT
Go to the hybrid OR and then CT afterwards, all right?
好，我们走吧
All right, let's go.
出发
Here we go.
体温38.9，血氧饱和度90%，每分钟4升。
Temp's 102, sats 90% at 4 liters per minute.
好，身子朝我这边倾
Okay, lean forward for me, would you?
深呼吸，埃尔南德斯先生
Deep breaths, Mr. Hernandez.
肺听起来像垃圾，不是吗？
Lungs sound junky, don't they?
嗯
Mm-hmm.
这是肺病科的库克医生
That's how Dr. Cook in pulmonology
上次描述的。
described them last time.
你不是第一次来医院了哈
Not your first time here at Med, huh?
硬结柔软
Nodes feel supple.
第一次来是去年来看新冠
First visit was with COVID last year.
我在重症监护室待了3周
I spent three weeks in the ICU.
康复后，我得了支气管炎、
Since recovering, I've had bronchitis,
鼻窦感染、肺炎，什么都有。
sinus infections, pneumonia, you name it.
我很抱歉
I'm sorry.
对很多人来说，新冠肺炎的道路是漫长的。
The COVID road's been a long one for a lot of people.
我戴口罩，保持社交距离，工作距离远，
I mask up, social distance, work remote,
几乎不出门，但不知怎么的，
barely leave the house, and somehow,
我总是在抗争。
I'm always fighting something.
也许是我太谨慎了
Maybe I'm being too cautious.
不，不，你做的很对
No, no, I like what you're doing.
不幸的是,没有什么是万无一失的。
Unfortunately, nothing's foolproof.
好了，做些检查去吧
All right, let's run some tests,
看看我们应该怎么治疗。
see what we're dealing with.
检查血常规，血生化，血液和痰培养再拍个胸片
CBC, CMP, blood and sputum cultures and chest X-ray.
收到
Got it.
好好呆着
Hang in there.
所以塔拉怀孕了？
So Tara's pregnant?
你在开玩笑
You're kidding.
你要当姥姥了？-我知道
You're gonna be a grandma? - I know, right?
我孩子就要当妈了
My baby's gonna be a mother.
怀孕多久了？-24周
How far along is she? - 24 weeks.
为什么我现在才听说
How am I just hearing about this now?
塔拉已经同意了。
Well, Tara just gave me the okay.
我一直想告诉你。
I've been dying to tell you.
怀的是男孩还是女孩？
So, boy, girl?
她还不知道
Oh, she doesn't know.
但她已经装饰好育儿室了
But she's already finished decorating the nursery,
她在计划自己的婴儿派对。
she's planning her own baby shower.
基本上，我是个旁观者。
Basically, I'm a spectator.
你知道的，她一直都是
Well, you know, she has always been
那种有主见的女孩。
a take charge kind of gal.
我想知道她从哪学来的。
I wonder where she gets that from.
嗯
Yeah.