芝加哥急救

Chicago Med S07E18

Part 2 April 16, 2022, 9:21 p.m.

好, 去重伤治疗室. -停搏时间未知
Okay, let's go to Baghdad. - Unknown downtime
我们一到现场就开始做
in the field. CPR initiated
心肺复苏了. 在救护车上心肺复苏
when we got there. ROSC obtained in the ambo.
血压100/77, 心率120, 血氧饱和度100%
BP 100/77, heart rate 120, sats 100%.
怎么回事? -入室抢劫的受害者,
How'd this happen? - Victim of a home invasion--
被闯入者打中. 邻居报的警
shot by an intruder. Neighbor called it in.
好, 我们到了
Okay, here we go, guys.
轻轻地, 听我口令
Nice and easy on my count, okay?
一、二、三
Here we go. One, two, three.
好了, 伙计们, 帮我推他
All right guys, help me roll him.
好
All right.
子弹穿透了
Bullet went through and through.
把他放下
Put him down.
脉搏良好
Got good pulses.
左侧呼吸音良好.
Good breath sounds on the left.
右侧无呼吸音
Nothing on the right.
用快速输血器输一单位全血
Let's get a unit of whole blood on the rapid transfuser.
好了, 我们做个胸部x光检查
All right, let's just get chest x-ray goin'.
穿上警服了, 老妹? 你负责这个案子?
Sup with the clown suit, sis? You workin' this case?
布拉斯让我在休息日执行减暴案
Brass has me workin' VRS on my days off.
那是什么?
What's that?
减少暴♥力♥计划. -哦
Violence reduction strategy. - Oh.
离手
Clear.
血气胸. -他需要插胸管
Right hemopneumothorax. - He needs a chest tube.
我来. 科利, 准备好
I got it. Curly, set me up.
你还知道些什么?
What else do you know?
强行入室, 现场有打斗痕迹
Forced entry, signs of a struggle at the scene.
好消息是, 袭击者真是个”天才”
Good news--the assailant was a real genius.
他把武器留下了
Left the weapon behind.
一把半自动步♥枪♥ -加文是唯一的受害人吗?
Semi-automatic rifle. - Was Gavin the only one?
是, 他老婆孩子出城过周末去了
Yeah. His wife and kid were out of town for the weekend.
他们正在赶来的路上
They're on their way here now.
好了, 开始吧
Okay, here we go.
粘膜下肌瘤看起来正在退化
Submucosal fibroid looks like it's degenerating.
而且正在坏死
And becoming necrotic.
这会让塔拉面临早产和败血症的高风险情况
Putting Tara at high risk for pre-term labor and sepsis.
好了, 给她注射100毫克吲哚美辛
All right, let's load her up with 100 of indomethacin
然后开始注射三倍剂量
and we'll start triples, yeah?
但自从塔拉上次
But the fibroid has also grown
做超声检查后肌瘤又长了
since Tara's last ultrasound.
如果这种趋势继续下去
If this trend continues,
就会导致胎儿生长受限
it'll lead to fetal growth restriction.
是啊, 很有可能,
Well, yeah, there's a good chance of that,
但那是以后才需要谈的事
but that's a conversation for another day.
好吧, 我认为这件事
Well, I think that's a conversation
我们现在就得和塔拉谈谈
we need to have with Tara right now.
为什么?
Well, why?
我们对胎儿无能为力
We can't do anything for the fetus
只能观望和等待
except watch and wait.
那试试子♥宫♥肌瘤切除术怎么样?
Hey, what about a myomectomy?
给一个孕妇做手术? 你疯了吗?
For a pregnant person? Are you out of your mind?
出血的可能性太大了
The possibilities of hemorrhaging are too great.
我们可以在手术期间给塔拉注射血栓素
We can give Tara TXA during surgery,
帮助减少出血
help minimize with blood loss.
好吧, 所以你是在建议我们拿母亲的生命冒险
All right, so you're suggesting that we risk
去救那个胎儿? -不是这样的
Mom's life to save the fetus? - That is not true.
子♥宫♥肌瘤切除术也有助于
A myomectomy will also help
防止母亲败血症和器官损伤
prevent against sepsis and organ damage in Mom.
听着, 我知道这不是一个正统的方法
Look, I know it's an unorthodox approach.
我明白 -这是一个保守的说法
I get that. - That's an understatement.
你一定要跟塔拉分享你的保留意见
By all means, share your reservations with Tara.
但她应该知道她所有的选择
But she deserves to know all her options.
我说了不要！不去医院
I said no! No, no hospital!
女士, 请躺下
Ma'am, lie back, please.
35岁女性行人被一辆机动车撞倒,
35-year-old female pedestrian struck by a motor vehicle,
当场失去知觉
loss of consciousness at the scene.
昏迷评分15, 血压118/70
GCS of 15, BP 118/70,
心率112, 血氧饱和度100%
Heart rate 112, sats are 100%.
麦基, 过来帮一把 -哇噢
Maggie, another set of hands. - Hey, hey, whoa!
让我走！-淡定, 淡定
Let me go! - Whoa, easy, easy.
我们得给你做检查
We have to check you out.
好了, 听我口令
All right, let's transfer on my count.
准备好了吗?
Everybody ready?
一、二、三
One, two, three.
不, 我得离开, 让我走
No, I have to leave. Let me go.
哦, 不 -女士, 拜托
Oh, no, I--- Ma'am, please.
深呼吸 -不
Take a deep breath. - No.
好吗? -我不能在这
Okay? - I can't--I can't be here.
两侧呼吸音清晰
Clear breath sounds bilaterally.
瞳孔平衡, 反应活跃 -跟我们说说什么情况
Pupils equal and reactive. - Okay, talk to us.
怎么回事?
What's going on?
我保证我们会照顾好你的
I promise we'll take care of you.
我, 我不是公民. 我没有证件
I--I'm not a citizen. I don't have papers.
喂, 这里没人会把你报上去
Hey, no one here's gonna report you.
你很安全
Okay? You're safe.
你能告诉我你叫什么吗? -不, 不
Can you tell us your name? - No, no.
我不能进系统. -我们会让你
I don't want it in computer. - We'll keep you anonymous
在系统里匿名. 但我们应该怎么称呼你?
in the system. But what should we call you?
莉娅
Lia.
好. -莉娅, 我要检查一下
Okay. - Okay, Lia, I'm gonna check
你肚子上的触痛部位
your belly for areas of tenderness.
哎呀
- Ah, ah.
噢, 哎呀
Ow! Aah!
好了, 给她做个腹部CT
All right, need a CT of the belly.
还有胸部和骨盆x光片, 头部和颈椎CT
Also chest and pelvis x-rays, CT head and c-spine.
莉娅, 好好休息一下, 好吗?
Hey, Lia, just try to get some rest, okay?
我们马上回来
We'll be back shortly.
克罗克特 -什么事?
Crockett. - Yeah?
威尔斯夫人, 我是斯科特医生, 这位是马塞尔医生
Mrs. Wells, I'm Dr. Scott. This is Dr. Marcel.
我是达琳. 这是我妹妹克里斯托
It's Darlene. My sister Krystal.
加文怎么样了? 他
How's Gavin? Is he...
我们有一个儿童日托所
We have a daycare for the children.
有很多玩具和好吃的
Yeah, lots of toys and snacks.
我带他们去. -好
I can take them. - Okay.
跟这位善良的女士去吧, 我们马上去找你
Go with the nice lady, kids. We'll be by soon.
跟我们走吧
You guys wanna follow us?
不幸的是, 虽然加文的状态暂时稳定,
Unfortunately, though Gavin's pseudo-stable at the moment,
但他的胸管仍在抽血
his chest tube is still putting out blood.
天哪
Oh, my God.
如果出血不停止的话, 我们就得打开胸腔
If it doesn't stop, we're gonna have to open up his chest
找到出血点
to see where the bleeding's coming from.
达琳, 我很抱歉
Darlene, I'm so sorry.
我应该让他跟你和孩子们一起去的
I should've let him come along with you and the kids.
如果我… -克里斯托, 别说了
If I had--- Krystal, stop.
如果他做了手术, 就会没事吗?
If he has to have surgery, will he be okay?
呃, 你丈夫在现场被发现
Um...your husband arrested in the field.
急救人员不清楚他的大脑缺氧多长时间
Paramedics don't know how long his brain went without oxygen.
等到加文醒来才能确定
We won't know until Gavin wakes up
他是否有认知障碍
whether he suffered any cognitive impairments.
你的意思是他可能说不了话了?
You mean like he might not be able to talk?
或者不能自己吃饭?
Or feed himself?
是的, 这是有可能的
That is a possibility, yes.
不…不, 加文不会想那样生活的
No...no, Gavin wouldn't want to live like that.
我们谈过这种事
We've talked about this type of thing.
不是这件事, 但…
Well, not this, but...
你知道的, 如果我们有谁出了什么事…
you know, if something were to happen to either of us...
你是说如果加文的心脏
You're saying if Gavin's heart
再次停止跳动,
would've stopped beating again,
你不相信他会想要再活过来
you don't believe he'd wanna be resuscitated?
他写了这些东西吗?
Did he put that in writing somewhere?