黑色警报（2015）

Code Black S01E02

Part 2 Feb. 8, 2021, 12:04 p.m.

搞不好真是这样所有人听我数
It might be. On my count, everybody.
一二三
One, two, three.
放松放松
Easy. Easy.
抬稳了是的
You got it? Yeah. Got --
-小心小心 -走慢点慢点
- Whoa, whoa. Whoa, whoa. - Let's go. Slowly. Slowly.
谢谢
Thank you.
脊椎没问题
Spine's good.
好的放下来
Okay. Down we go.
沙维提医生下一步是什么
Dr. Savetti, what's your next move?
腹部超声波检查是否有积液
Ultrasound the abdomen, see if there's any fluid.
很好
Very good.
劳伦森医生我们要找到动脉
Dr. Lorenson, we're gonna find the artery up here
进行缝合
and tie it off.
取弯血管钳镊子 3-0缝合线
Grab a kelly, forceps, and some 3-0 prolene.
你知道我在说什么吧知道还是不知道
You know what I asked for? Yes or no?
知道我只是
Yes. Yes, I just --
弯血管钳就在托盘上
The kelly. It's on the tray,
-右数第二个 -是我知道
- second from the right. - Yes. Yes. I -- yes.
绝对不能犹豫
Can't hesitate. Not ever.
-腹部无积液 -很好
- Abdomen's clear. No fluid. - Very good.
隔壁床的洛里斯医生也需要检查积液
Dr. Rorish will need that at the next table.
抽吸把这部分清理干净
Suction, please. Let's clear the field.
插管好了
And...I'm in.
-好的 -好用气囊辅助呼吸
- All right. - Okay, bag it up.
皮内达医生交给雷顿医生
Dr. Pineda, hand off to Dr. Leighton.
你到这里来
I need you down here, please.
他醒了
He's awake.
他没醒看他的生命体征
He's not awake. Look at his vitals.
这只是反射行为
It's just a reflex.
我们在这儿杰克
We got you, Jake.
能听到我吗挺住
You hear me now? Stay with us.
杰西要确保他进入全麻状态
Hey, uh, Jesse, let's make sure he's down.
再推10毫克依托咪酯
Push another 10 of etomidate, please.
他不太可能醒来胸部几乎无起伏
He's not coming up over 80%. His chest is hardly rising.
好吧
All right.
心包有积液
Positive for pericardial fluid.
很多
Plenty of it.
雷顿医生停下
Dr. Leighton, stop.
把呼吸气囊放下
Put the bag down. Okay?
你使他换气过度导致颅内压下降
You're decreasing his ICP by hyperventilating him.
他只需要一分钟呼吸六次
Six breaths a minute, that's all he needs.
别慌先停一下
It's okay. Just hold it there.
没事的慢一点就好
It's okay. Just slow down.
我们要把他送到楼上去
Uh, we need to get him upstairs.
-杰西通知手术室 -好的
- Jesse, notify the O.R. - Okay.
看到了吗
See that?
动脉
The artery.
具体说是上颌动脉
The maxillary artery, to be precise.
它是颈外动脉的分支
It branches out from the external carotid.
很难搞定但在这几秒钟之内
It's a real bitch. But in a couple of seconds...
-我们必须搞定它 -没错
- It's our bitch. - Precisely.
肺部发现更多积液
More dependant fluid in the lungs,
左肺情况比右肺严重
left worse than right.
估计他进了电梯就得断气了
He's gonna die on the elevator.
很有可能
Likely, yes.
我需要开胸托盘
I need a thoracotomy tray.
你要给他开胸
You're gonna open up his chest?
你有更好的办法吗过来帮忙
You got a better idea? I could use the assist.
沙维提医生回来
Dr. Savetti, get back here.
你和劳伦森医生缝合
You and Dr. Lorenson close.
谁能说一下目前我们要做的是什么
Who can tell me what we're doing?
皮内达医生
Dr. Pineda?
开胸术就像掰贝壳打开左右胸腔
A thoracotomy -- a clamshell, right and left chest open.
对
That's right.
为什么这么做雷顿医生
Why? Dr. Leighton?
这个时候开胸是控制内出血的唯一办法
Uh, only way to stop the internal bleeding is to go in now.
没错
That's right.
大家听着开胸术是所有急诊手术的基础
Guys, the thoracotomy is the mother of all E.R. procedures.
在全国急诊室中成功率只有5%
Only 5% success rate in E.R.s nationwide.
现在不是通报数据的时候马拉娅
Don't need all the facts, Malaya.
我们的成功率更高
We are the statistical anomaly.
杰西我需要六个单位O型阴性血
Jesse, I need, uh, six units of O-Neg, please,
-用输血加温器 -已经准备好了
- through the Level-One. - Already here.
好的从用双头18G的留置针
All right. Push it through both 18s, please.
手术刀
All right. Scalpel.
好的
Okay.
好了
All right.
杰西
Jesse.
好了
Okay.
现在我们要撑开肋骨
We're gonna spread the ribs now.
然后将肺部推向两侧
Then...then push the lungs aside.
雷顿医生到另一边去
Dr. Leighton, take the other side, please.
十号♥刀
10 blade, please.
现在仔细看哈德森医生
Okay. Now, watch Dr. Hudson.
他要使心包露出来
He's about to reveal the pericardium,
就是心脏外的一层囊样结构包裹
the sac around the heart.
这个手术你做过很多次吗
You've done a lot of these?
不第一次
No. First one.
真欣慰啊
That's comforting.
这个手术哈德森医生做得比谁都多
Dr. Hudson has done more than most.
在来急诊之前他是外科住院医师
He did a surgical residency before he moved to E.R.
现在打开心包
Opening the pericardium now.
现在等等就是它就在这儿
Now, the -- wait, there it is. There it is.
你们能看得见的话
For those of you who can see,
看到那处撕裂伤了吗
Look, see that laceration right there
就在主动脉近端上方
above the proximal aorta?
-阻断钳 -现在要阻断主动脉
- Cross clamp, please. - Okay, we're cross-clamping it.
这样血液便向上引流至大脑
It'll divert the blood above the opening to the brain,
大脑是现在最需要血液的部位
which needs perfusion the most right now.
没有心脏活动
No cardiac activity.
雷顿医生注射心脏内肾上腺素
Dr. Leighton, can you inject with intracardiac epinephrine, please?
注射
Go ahead.
皮内达医生把手放到这里面
Dr. Pineda, get your hands in here.
-真的吗 -是的把手放进来
- Really? - Yeah, get your hands in.
轻轻用手包裹心脏
Put them around the heart really gently,
进行按♥摩♥
And you're gonna massage it.
天哪我感受到了
Oh, my God. I feel it.
它跳了
It's beating now.
它自主跳动了
It's beating without me.
感受到节奏了吧
Okay, you got a rhythm there.
车祸致头部创伤伤患的检查结果
Lab results for your MVA head injury.
谢了
Thanks.
奇怪
That's odd.
等等她说这是劳拉·哈洛伦的检查结果
Wait, did she say those are Laura Halloran's labs?
-对 -怎么了
- Yeah. - What's wrong?
她的乳酸浓度是4mmol/L
She has a lactate of 4.
可能她昨晚喝多了
Maybe she had too much wine last night.
或者是器官衰竭的早期症状
Or it's an early sign of organ death.
问题是哪个器官
But, uh, question is which organ?
不好意思这个患者怎么还在创伤一室
Excuse me, why is this patient still in Trauma One?
晚上好泰勒医生
Evening, Dr. Taylor.
抱歉忘了跟你寒暄了
Oh, sorry, I forgot my salutation.
你怎么样啊
How you doing?
她怎么还没登记入院
Now, why hasn't she been admitted yet?
因为有点问题我想不通
'Cause, uh, something's bothering me.
我还烦着呢
Well, something's bothering me, too.
痔疮屁♥股♥都快疼死了
Hemorrhoids. My ass is on fire.
能给我在创伤一室留个床位吗
Do I get a bed in Trauma One for that?
我不能把这名患者送到楼上去
I can't send the patient upstairs
直到我查清病因
till I know what's wrong.