芝加哥急救

Chicago Med S08E02

Part 4 April 5, 2023, 10:17 a.m.

Let's get him up on monitors.
下肢脉搏变弱了
Okay, DP and PT pulse has diminished.
剪开下身衣物翻身检查有没有其他枪伤
Let's strip and flip him, make sure there's no other holes.
好，预备
Okay, here we go.
一，二，三
One, two, three.
小心一点
Easy, easy.
大腿上有两个洞，没有大量出血
Just two in the thigh. No active bleeding.
好，替胸部和骨盆拍X光片，好吗？
Okay, let's have x-ray get us a quick chest and pelvis, okay?
为什么要做胸部X光检查？他只是腿部中枪
Why do we need a chest X-ray? He was only shot in the leg.
一颗子弹进去出来
One whole bullet in, one whole bullet out.
确保伤口有贯通，他中了两枪
Make sure they connect. He was shot twice.
子弹的途径让人难以预料，对吧？
Bullets travel in unexpected ways, right?
要是他胸口有颗子弹，你会做何感想？
How would you feel if you left a bullet in his chest?
-X光准备好了 -不如这样吧
-x-ray is ready. -Okay, you know what?
你何不去跟玛姬说我们需要做血管造影
Why don't you go tell Maggie that we're gonna need an angio
找到动脉的伤处
to find where the injury to the artery is.
我来处理这里的事
I'll finish up here.
珍怡？
Jenny?
你好吗？
How are you doing?
我是查理斯医生
I'm Dr. Charles.
他们派你来取得我的同意，是吗？
They sent you in here to get my consent, didn't they?
“他们”是谁？
Who's "they"?
另外两个假装是医生的家伙
The other ones pretending to be doctors.
那个红头发的人想骗我说
That redheaded one tried to convince me
我儿子的手断了
my son had a broken arm.
霍士迪医生真的是医生
You know, Dr. Halstead is, in fact, a doctor.
你知道的，珍怡，他没有撒谎
And you know, Jenny, he wasn't lying.
我可以给你看X光片
I mean, I can show you the x-ray.
你以为我看不出骗子吗？
You think I can't tell a fake?
我要见你的主管，不然我发誓我会…
I want to see your supervisor, or I swear, I...
珍怡？
Jenny?
你还好吗？怎么了？
You all right? What's going on?
再说一次你是谁
Who are you again?
我是查理斯医生
I'm Dr. Charles,
我们刚在谈亨利，你儿子的事
and we were just talking about Henry, about your son.
我已经跟你说过了
I already told you.
我不允许任何人治疗我儿子
I'm not giving anyone permission to treat my son.
你知道吗？其实我…
Well, you know what? I...I'm actually um,
我希望你同意我们治疗你
I'd like to get your permission to treat you,
如果可以的话
if that's okay.
我？
Me?
我一点事也没有
There's nothing wrong with me.
但不幸的是，在排除车祸造成的创伤之前
But unfortunately, we can't release you or Henry
我们不能让你和亨利离开
before we rule out any trauma from the car crash.
如果可以的话
So if it's okay,
我想让你上楼做个快速扫描
I'd just like to send you upstairs for a quick scan.
结束之后，我就可以离开了吗？
And as soon as that's done, I'm free to go?
这样吧，我们先去做扫描
I tell you what, how about we do the scan
看看结果如何，再讨论下一步？
and see what it tells us and then go from there?
你觉得可以吗？
Does that sound like a plan?
好吧
Okay.
你有取得她同意了吗？
Did you get her consent?
不算是
Not exactly.
我想让她上楼拍头部电脑断层扫描
I want to send her upstairs for a head CT with contrast.
还有，你能跟森说我想让他看一下这位病患吗？
And also, can you tell Sam I want his eyes on this too?
-知道了 -怎么回事？
-Roger. -So what's going on?
这看起来不像是
You know, it just doesn't seem like
普通的精神病，你知道吗？
a garden-variety psychosis, you know?
她有个奇怪的节奏
There's this odd rhythm to it.
她刚才突然失去意识
And she had this temporary loss of mentation.
我真的认为有可能是
And I really think we could be looking
神经外科方面的问题
at something neurosurgical.
让我猜猜，我还不能治疗亨利的断臂吧
Let me guess. Henry's broken arm has to wait?
听我说，兄弟
Well, just bear with me, buddy.
让我们先看看扫描结果，我想
Let's take a look at this scan, and I think
我们会搞清楚状况的
we're gonna get some clarity.
我们可以继续用拍痰背心跟雾化吸入器
We can continue riding out the percussion vest and nebs.
再花点时间也许就会好转
With a little more time, there's a chance it could work.
这样不够好
But not a good enough chance.
清除堵塞并恢复呼吸的
The only way to clear the plugging for sure
唯一方法就是使用支气管镜
and restore your breathing is with a bronchoscope.
我不要插管
No intubation.
我想我们都很清楚，欧拔
I think we've established by now, Al,
我不是在危言耸听
that I'm no alarmist,
请你相信我说的话
so believe me when I say this.
这个状况今天就会让你致命
This thing will kill you today,
你会死在这个房♥间
right here in this room.
就算是这样也没关系
If it does, I'm okay.
我准备好了
I'm ready.
真的吗？
Really?
就这样？真的吗？
Just like that? Really?
你能诚实地告诉我
You can honestly tell me
你已经没有活下去的意义了吗？
that you've got nothing left to live for?
你儿子过得好吗？
Your son, how's he doing?
太太又怀孕了
Wife's pregnant again.
我的第二个孙子
My second grandchild.
看吧？
See?
这值得期待，不是吗？
That's something to look forward to, isn't it?
迪恩，我最害怕的事
It's my biggest fear, Dean,
就是被困在呼吸器上
being stuck helpless on a vent.
我跟你保证，欧拔
I promise you, Al.
我不会让这种事发生的
I will not let that happen.
嘿，这是怎么回事？
Hey, what's going on here?
为什么病患不准备血管造影？
Why isn't my patient prepped for angio?
说了你也不信
You're not gonna believe this.
看来他们找不到显影剂
Apparently, they can't find any contrast dye.
你在开玩笑吗？
Are you kidding me?
我们得检查一下股动脉
We need to look at the femoral artery.
他的指数只有0.7
His AVIs are at 0.7.
嘿，老兄，又不是我的错要讲就跟这个人讲
Hey, man, it's not my fault. Talk to this guy.
好吧，盯好他的生命征象
All right, keep an eye on his vitals.
我去看看放射科有没有
I'll see if radiology has any.
你运气真好
You lucked out.
这是我们的最后一滴显影剂
This is literally the last drop of contrast we got.
不会吧
You're kidding.
都怪冠状病毒跟乌克兰战争
Blame COVID or the war in Ukraine.
我也不知道
I don't know.
她对氟哌啶醇没反应吗？
She had no response to the Haldol?
没有，她还有奇怪的意识错置
Nada, and these weird lapses in awareness.
嗯
Hmm.
如你所知，抗精神病药物的抗药性
And as you know, resistance to antipsychotics
有时候代表…
can sometimes mean...
她的神经递质有问题
Something's going on with her neurotransmitters.
没错
Yeah.
-嘿，基恩？-怎么了？
-Hey, Gene? -Yeah?
听说你可能还有剩一些显影剂
I was told you might have some contrast dye left.
这个扫描完成之后就没有了
Not after the scan, I don't.
不行，你先不要动…
Oh, no, no, no, no. Stop, stop.
我需要显影剂
I need that dye.
说实话，我根本不知道我们为什么要开会
I honestly don't even know why we're having this conversation.
这是最基础的检伤分类，头比脚重要
This is triage 101, head over leg.
恕我直言，森
With all due respect, Sam,
也许这件事没那么简单
perhaps it's not so cut and dry in this case.
马素医生，如果你不能做血管造影
What happens, Dr. Marcel,
会发生什么？
if you're not able to perform your angiogram?
我可能得把这可怜家伙的大腿切开
Well, I'll probably have to filet the poor guy's thigh open
才能找到伤口进行修复
in order to find and fix the damage.
这样会变成更大型的手术
It'll be a much bigger surgery
失血更多，风险更大
with more blood loss and a greater risk.
查理斯医生，那你呢？
Dr. Charles?
说实话，我不太愿意说