争分夺秒（2015）

Critical S01E02

Part 5 Jan. 6, 2021, 2:19 p.m.

Dominic Busby, Gas Reg.
比利·芬利负责麻醉的手术部医生
Billy Finlay, Anaesthetic ODP.
阿尔敏·库拉尔手术部医生
Armin Khular, ODP.
阿历克斯·巴吉尔普通护士
Alex Badger, Staff Nurse.
克拉拉·罗伊德普通护士
Clara Lloyd, Staff Nurse.
波莉·梅森记录护士
Polly Mason, Documentation Nurse.
菲奥娜·罗马斯创伤科副主任医师
Fiona Lomas, Trauma Fellow.
夏洛特·布莱斯巡回护士
Charlotte Brase, Circulating.
请确认病患身份
Can we confirm who the patient is, please?
重伤FB
Major Trauma Foxtrot Bravo.
出生日期不明
Date of Birth 1.1.1900.
谢谢
Thank you.
我已经签了四号♥同意书
OK, I've signed a consent form four.
(四号♥同意书: 针对无法对某项治疗方案作出同意的成年病患)
我要进行剖腹手术制止危及病人生命的大出血
I'm performing a laparotomy to arrest a life-threatening haemorrhage.
大家都同意吗
Everyone good with that?
是的
Yes.
准备好了吗
Are we ready?
准备好了博伊尔先生
Ready, Mr Boyle.
手术刀
Blade.
可以切了吗
OK to cut?
可以
OK.
切开
Cutting...
该死吸引器真空泵
Shit. Suction. Vacuum.
血压直线下降
Pressure's dropping like a stone.
纱布我什么都看不见
Packs. I can't see a thing.
我正在努力那再努点!
I'm trying. Then try harder!
给
Here.
腹部使用五条纱布用掉五条
Five packs in the abdomen. Five in.
钢圈
Ring.
你知道我要说什么
You know what I'm going to say...
那就别说我一定要说
So don't say it. I've got to say it.
血压下降氧饱和度下降
BP's dropping, sats are dropping.
(气道峰值压传感器未连接)
好了好了我需要主动脉钳
OK. OK. I need an aortic clamp.
我不呃我需要主动脉钳
I, don't er... I need an aortic clamp.
好的呃是
Right, er, yes...
我需要主动脉钳我们没有...
I need an aortic clamp. We don't have...
我需要主动脉钳
I need an aortic clamp.
楼上手术室快去
Upstairs theatres! Go!
啊小心
Ow! Careful!
血压是65/38 请给我更多纱布马上!
BP's 65 over 38. More packs, please! Now!
手
Hands.
把手伸进去按住流血口
Get your hands in there, press down on the bleed.
好的
OK.
血压... 我们看得到
BP... We can see.
腹部又塞入五条
Five more in the abdomen.
用掉十条
Ten in.
把那关掉
Turn that off!
该死抱歉
Shit, sorry.
没关系
It's OK.
血压下降纱布没用
Pressure's falling. Packs not working.
我们一个区一个区地拿掉
We unpack quadrant by quadrant,
然后一个个处理出血点
and we deal with the bleeds as we get to them.
从左上区开始好么
Starting with the left upper quadrant. OK?
脾脏在出血
Spleen's haemorrhaging.
腹膜后血肿正在变大
There's an expanding retroperitoneal haematoma.
该死! 重新包上
Shit! Repack.
血压又下降了
Pressure dropping again.
脾脏出血可以控制
The spleen is controllable.
肾脏出血会要她的命
It's the renal bleed that's killing her.
我真的需要动脉钳
I really need that clamp.
她正在下来对按住
She's going down. Yeah, pressure.
我们快失去她了
We're losing her!
好她需要更多的血给她输血
OK, she needs more blood - let's fill her up.
30分钟前呼叫过失血过多了
Code was called 30 minutes ago.
这里是创伤手术室病人是FB
This is Trauma Theatre, for patient Foxtrot Bravo.
我们还在等...
We are still waiting on...
12单位血 8单位新鲜冷冻血浆 4单位血小板
12 units, eight of FFP, four of platelets.
12单位交叉配血 8单位新鲜冷冻血浆
12 units of crossmatch, eight units of fresh frozen plasma
以及4单位血小板谢谢
and four units of platelets. Thank you.
我拿到主动脉钳了
I've got the aortic clamp.
给我快
To me! Quickly!
给我快
To me! Quickly!
好了
OK.
所以我们可以钳住大动脉止住下半身的出血
So we can clamp off the aorta and stop all bleeding in the lower body.
那表示我们需要把纱布拿掉才能夹
That means unpacking her to get the clamp on.
是的没错
Yes, it does.
看在上帝的份上! 是谁的手♥机♥
For Christ's sake! Whose phone is that?
一定是病人的
Must be the patient's.
上面有短♥信♥记录
There's a text trail here.
稍后再说你听听上面说的
Later. You ought to know what it says.
最后一条短♥信♥是发给一个叫蕾切尔的人的
The last text she sent was to someone called Rachel.
那是她女儿能稍后再来说这个吗
That's her daughter. Can we do this later?
不现在处理赶快
No, we do it now, quickly.
"对不起我很想见他
"I'm sorry. I miss him so much.
"我全心爱你但他曾经是我的宝贝
"I love you with all my heart, but he was my baby.
"我以为有一天我会释怀但我永远不会
"I thought one day I'd get over it, but I never will.
"对不起我爱你
"I'm sorry. I love you.
"妈妈"
"Mum."
她是自己跳下来的
She jumped.
我说"开始"以后拿掉所有的纱布
When I say "go" we rip out the packs
然后打开腹膜后隙
and we open up the retroperitoneal space.
明白了吗
You got it?
是的
Yes.
按住
Pressure.
该死开始
Shit. Go.
血压下降
Pressure dropping.
吸引器!
Suction!
赶紧吸液不然我看不清手底下
I need more suction if I'm going to see what I'm doing here.
还在下降
Still falling.
好了
OK.
我要做一个内旋来找到大动脉
I'm going to do a medial rotation to access the aorta.
该死在哪里
Shit! Where is it?
请把血弄出去把血清掉
Let's get the blood out of there, please. Clear the blood.
我找不到大动脉
I can't locate the aorta!
不我看不见就无法进行
No, I can't do this blind.
我要你用吸引器把里面清干净
I need you to clear the field with suction.
好了钳子
OK, clamp.
找到了吗
Have you got it?
是的找到了
Yes, I've got it.
好了钳子
OK, clamp.
夹住了夹住了吗
Clamp on. Is it on?
是的数据? 快
Yes. Numbers? Quickly.
还在下降 50/20
Still falling, 50 over 20.
等等等一下
Hold on, wait a minute.
血压上升了
BP climbing.
干得好
Good work.
血压70/45
BP 70 over 45.
好了来收尾吧吸引器和纱布
OK, let's mop up, suction and swabs, please.
好了血止住了
OK, We've got haemostasis.
血压100/70
BP now 100 over 70.
很好
Good.
我要结扎右肾动脉
I'm going to ligate the left renal artery.
止血钳
Dardic.
谢谢
Thank you.
肾动脉在断裂处上方被夹住
Renal artery clamped above the rupture.
握住那镊子
Hold that clamp.
握住了 2-0号♥缝合线
Got it. 2-0 tie, please.
(每种缝合线按线径可以分为4, 3, 2, 1, 0, 2-0, 3-0, 4-0/T,
4-0, 5-0, 6-0, 7-0, 8-0 从4号♥线到8-0 依次减小)
谢谢
Thank you.
抱歉有人正在实施手术