芝加哥急救

Chicago Med S04E02

Part 5 Jan. 21, 2020, 1:46 p.m.

我们什么都做不了吗
There's nothing we can do?
原来你在这里
There you are.
我听说你♥爸♥的事了
I just heard about your dad.
你还好吗
Are you okay?
只是很难相信
Just hard to believe.
他生前是个硬汉
He was such a force.
杰怎么样了
How's Jay taking it?
不太好
Not good.
他们俩很像
They're a lot alike.
都很固执
Stubborn.
格温也没帮上什么忙
Gwen didn't help.
她说过她可以用医院的资源
I mean, she said she would use the hospital's resources
来让爸爸活下去的
to keep Dad alive.
是吗这可不像是她会说的话
Really? That doesn't sound like her.
没错我也很惊讶
Yeah, it surprised me too.
我爱你
I love you.
如果有需要帮忙的就告诉我好吗
Let me know if there's anything I can do, okay?
这是布莱恩·斯冯纳切克的动脉血气检查结果
Here are the ABG results for Brian Zvonecek.
-谢谢 -不客气
- Thank you. - You're welcome.
-查尔斯医生 -斯冯纳切克先生
- Doc Charles. - Mr. Zvonecek.
我什么时候能离开这儿
When can I get out of here?
现在情况是这样
See, here's the thing.
你的血液中二氧化碳含量较低
Your blood gas shows low CO2,
碳氧血红蛋白含量较低含氧量正常
low carboxyhemoglobin, and normal oxygen.
这很好对吗
That's good, right?
这说明你没有吸入性损伤
Well, what it means is that you didn't have an inhalation injury.
你更可能是由于
More than likely, you passed out
换气过度而昏倒
because you were hyperventilating.
所以我还是没生病
All the same, I'm not sick.
没错但是
Okay, but...
你为什么会换气过度
why were you hyperventilating?
我们找不到身体方面的原因
You know, when we can't find a physical reason,
这种情况多半是因为
more often than not, it's...
某些事情引起了感情波动
you know, due to an emotional reaction to some sort of...
等等等等
Wait, wait, wait, wait.
你想说什么
Where you going?
你的意思是我得了创伤后应激障碍吗
What, PTSD?
我没那么说
I didn't use that label.
我只是说这样就可以解释
I'm just saying it would explain...
你为什么会心跳过速血压上升
the tachycardia, the elevated blood pressure...
不这不可能
No. No way.
此外我今早也注意到了你有手抖的症状
Full disclosure, I noticed a little hand tremor earlier today.
但我跟你说过了这是我的血糖问题
But I told you, that was my blood sugar.
奥蒂斯你今年早些时候才中过枪
Otis. You were shot earlier this year.
就光那件事
I mean, that alone,
就已经能够引起一些创伤后压力了
it's gonna precipitate a little post-traumatic stress.
我自己也有过类似经验
And that I can tell you from personal experience.
再加上你今天遭遇的事情
And after what you went through today, I mean,
你为什么不让我带你上楼做一个快速评估呢
why don't you let me take you upstairs for a quick evaluation?
不我明白了
No. I get it.
就因为你是个心理医生所以你看见的每个人
You're a shrink, so everybody you see
都得有点心理问题是吧
has got to have some sort of mental problem, right?
但我不这样
But not me.
我很好
I feel great.
我在尽力帮你们
I'm trying to help you.
只是...
There's just been--
罗德斯医生
Dr. Rhodes.
抱歉各位我需要去擦洗
Sorry, guys, I gotta get scrubbed.
我们只是想聊聊斯黛拉的情况
We just want to talk to you about Stella.
是吗艾普尔
Really, April?
你还是听听他们要说些什么吧
Just hear them out.
我们不想让你摘除她的肺部
We don't want you to remove her lung.
肯定还有别的办法的
There has to be another option.
各位我明白你们的担忧
Look, guys, i understand your concerns.
但作为她的医生
But as her doctors,
我们已经决定了她的最佳治疗方案
we've decided on the best course of treatment,
只有斯黛拉的家人可以推♥翻♥这个决定
and only Stella's family can override that decision.
罗德斯医生
Dr. Rhodes.
我们就是她的家人
We are her family.
这是真的
That's true.
她也会跟你这么说的医生
She'd tell you the same thing, Doc.
又一个漠不关心的医生
Another walk-away.
还有一个办法
There's another way.
你什么意思
What do you mean?
肺部出血主要是来自下肺叶是吗
The majority of lung bleeds originate in the lower lobes, right?
所以呢
So?
如果我夹住肺动脉底部呢
So what if I clamp at the base of the pulmonary artery?
康纳之前的决定很正确
Connor, you made the right call.
外科手术方案那边也很好执行
We have a good surgical plan.
但如果我们先切除下肺叶呢
But what if we resect the lower lobe first?
如果血止住了我么也不必摘除整个肺部了
If the bleeding stops, we won't have to remove the entire lung.
不这太冒险了
No, it's too risky.
如果没起作用的话我们还是可以摘除全肺
If it doesn't work, we can still remove the lung.
那你也浪费了宝贵的时间
After wasting precious time.
你忘了我们是在尽力救她的命了吗
Have you forgotten we're trying to save her life?
我们可以在救人命的同时给她想要的生活
I think we can do that and give her the life that she wants.
她还年轻
She's a young woman.
她还可以另谋高就
She can find another career.
我必须试试
I have to try.
我欠她
I owe it to her.
也欠他们
I owe it to them.
康纳如果斯黛拉死在了手术台上
Connor, being a firefighter isn't gonna mean a damn thing
能不能当消防员就没有意义
if Stella dies on the table.
我能做到的
I can do it.
不要康纳
Don't--Connor!
注意时间罗德斯医生我们进行到哪了
Time, Dr. Rhodes. Where are we?
我就快成功了
I'm almost there,
但每次肺一膨胀就会阻碍我的视线
but every time the lung inflates, it obstructs my view.
马蒂你还能再减小肺的膨胀程度吗
Marty, can we deflate the lung any further?
没办法了现在输氧量已经减到最低了
No way. I'm barely keeping her oxygenated as it is.
再减少两成
Take it down another 20%.
那太冒险了
It's too risky.
我只需要够到下肺叶
I only need to reach the lower lobe.
就可以很快找到出血点并且把血止住
I'll find the bleed and make my resection before you know it.
那你快点
Make it fast.
你今天还真为患者发声啊
You're quite the patient advocate today.
你这么做究竟是为了斯黛拉还是凯利
Did you do it for Stella or for Kelly?
我从孩提时代就认识他了
I've known him since we were kids.
你没回答我的问题
You didn't answer the question.
我做这些是因为这是正确的事
I did it because it was the right thing to do.
马蒂
Marty?
血压降到了88
BP's down to 88 systolic.
我快了
I'm close.
希望如此吧
Let's hope so.
你没法完成的
You are not going to make it.
我们需要马上开胸并取出肺
We have to open her up and remove the lung.
血压降到82
BP's at 82.
增加升压剂
Up her pressers.
做不到已经是最大剂量了
Can't, I'm already maxed out.
康纳求你了
Connor, please.
再给我一点时间
Just give me a second.
血氧饱和量是78
Sats are at 78.
这是她承受的极限了
That's all she can tolerate.
我重新给肺部充气
I'm reinflating the lung.
不等等那里
No, wait. There.
就是这里这是出血点
That's it. That's the bleed.
你找到了但你有时间修复吗
You found it, but do you have time to fix it?
发生了什么
What happened?
她的手冰冷没有脉搏
Her hand's ice-cold. I can't get a pulse.
前臂紧绷她得了筋膜间隔区综合征
The forearm's tight. She's got compartment syndrome.