争分夺秒（2015）

Critical S01E03

Part 2 Jan. 6, 2021, 2:20 p.m.

Got an arterial pressure now. Good.
为什么你一开始不说
So why didn't you say anything earlier?
不想说
Didn't like to.
为什么你有时候会有点
Why? You can be a bit...
有点什么
Bit what?
凶
Fierce.
哈真会挑时间
Huh! You pick your moments.
老大
Bosh!
回去监测心室比利
Convert back to vent, Billy.
大动脉已横跨钳闭
Aorta cross-clamped.
远端血流已切断现在大家听着
Distal flow is down. Now listen, everybody,
刚才真是太不像话了
that was piss-poor.
但是你们需要精进起来知道为什么吗
But you will get better at this and do you want to know why?
因为当你们面对这个人的家属
So that when you look this man's family in the face
说你们已经尽了全力的时候
and you say you did everything you possibly could for him,
那他妈就不是一句谎话
it is not going to be a bloody lie!
现在已经横向钳闭远端血流切断
We're cross clamped. Distal flow is down.
好了请立刻通过锁骨下动脉快速滴注
OK, let's get the rapid infuser going into the subclavian, please.
是这就来现在问腿的事是不是时机不太好
Yeah, on it. Is this a bad time to ask about the legs?
是的好吧抱歉
Yeah. Yes. Right, sorry.
肝素帽
Bung.
(肝素帽: 用于各种体内留置导管的封堵装置
以向留置导管内注射肝素等抗凝药物防止发生凝血)
谢谢
Thank you.
好了快速滴注器已连接到锁骨下动脉
OK. That's the rapid infuser connected to the subclavian.
我感觉到收缩了
I'm feeling contractions.
停止按压
Stop compressions.
心脏自主收缩
Got spontaneous contractions.
太好了
Yes.
看起来有窦性心律了
Looks like sinus.
请继续给他输血三比二的比率
Keep filling him up with pink please, three to two.
还在用第二包好现在测得到血压了
Still on pack B. OK. Registering a proper BP now.
60/35 血氧饱和度缓慢上升中
60 over 35. Sats coming up sluggishly.
血压90/60 血氧继续上升
BP 90 over 60, sats climbing.
谢谢拉玛克里士纳
Thanks, Ramakrishna.
拉玛克里士纳他居然记对了
He gets Ramakrishna right.
好了请紧急呼叫手术室人员
OK, let's fast-bleep the theatre staff.
病人两分钟后到达
Patient ETA two minutes.
紧急呼叫心胸外科和普外科医生
Fast-bleep cardiothoracics and gen-surg.
我们现在就送他过去
We're taking him now.
叫放射科技师带着便携式仪器到手术室去
And we need the radiographer to do portables in theatre.
我是菲奥娜·罗马斯给腿部照一下X光
This is Fiona Lomas. X-ray the legs.
去洗手这就去
Get scrubbed up. Get in.
解开刹车走吧
Brakes off. Let's go.
解开刹车推
Brakes off. Rolling.
你放任那姑娘让你出丑啊小子
You're letting that girl make a fool of you, boy.
我又不是你儿子
I'm not your boy.
一整周都没见面然后因为创伤急救而手忙脚乱
Haven't seen each other all week, then the scramble of a trauma call.
都没机会打招呼
I never got to say hello.
你好
Hello.
还适应吗
How are you settling in?
不错有什么问题吗
Fine. What's the problem?
你自己都说了 "一整周都没见面"
Well, you said it, "Haven't seen each other all week."
你好你好
Hi. Hi.
他未婚妻来了
The fiancee's here.
能抽空和她谈谈吗好的
Does someone have a minute to talk to her? Yes.
当然好
Sure. OK.
劳伦这位是博伊尔先生他是创伤科主任医师
Lauren, this is Mr Boyle, the trauma consultant.
抱歉我只能简短说几句劳伦
I'm sorry this has to be quick, Lauren.
亚当受伤很严重
Adam is critically injured.
他的自行车撞上了一辆货车
His bike was involved in a collision with a lorry
导致他多处受重伤
resulting in multiple serious wounds.
他的心脏停跳了
His heart stopped beating
所以我们打开了他的胸腔让它重新跳了起来
and we opened his chest and got it pumping again.
心脏停跳是因为他有内出血
It stopped because he's bleeding internally.
现在我们得去找出出血点
And now we have to find out from where
然后去处理亚当两条腿的严重撞伤
and to operate on some serious crush injuries to both of Adam's legs.
但我们会尽力保住它们
But we're going to do everything we can to save them.
我们真的需要立刻赶回到他身边去
Right now, we really should get back to him.
谢谢
Thanks
我会让迪伦先生送你去我们的家属室
I'm going to ask Mr Dhillon to sit you in our relatives' room.
你要我打电♥话♥给谁吗
Is there anyone that you need me to call?
赶紧都动起来
You need to get on with it.
因为不管你们有没有准备好我五分钟后动刀
Because, ready or not, in five minutes, I'm cutting.
可以做准备了吗
OK to prep?
请做准备请动手吧
Please do. Yes, please.
请拿掉夹板
Splints off, please.
把剩余的裤子也脱掉
And whatever's left of his trousers.
鞋子也脱了
Trainers too.
我要把他抬起来我来数数一二三
I'm going to lift him. On my count. One, two, three.
好现在我们来搬腿都拿开
OK. Now we lift the leg. Clear out.
好一二三
OK. One, two, three.
血压现在稳定在100/80 血氧值维持在96
BP's now a very respectable 100 over 80. Sats sitting pretty at 96.
谢谢动脉夹已经夹了八分钟了
Thank you. Clamp's been on for eight minutes.
我们需要赶紧动手
We need to crack on.
请小心背后
Watch your backs, please.
数到三后放射
Rays coming up after three.
一二三放射
One, two, three, rays.
抬起来
And lift.
放下
Down.
自我介绍我是格伦·博伊尔创伤科主任医师
Let's who. I'm Glen Boyle, trauma consultant.
菲奥娜·罗马斯创伤科副主任医师
Fiona Lomas, trauma fellow.
拉玛克里士纳·钱德拉曼麻醉师
Ramakrishna Chandramohan, anaesthetics reg.
比利·芬利负责麻醉的手术部医生
Billy Finlay, anaesthetic ODP.
丽贝卡·奥斯古德矫形外科主治医师
Rebecca Osgood, orthopaedic registrar.
卡莉·奥斯曼洗手护士
Khaali Osman, scrub nurse.
露西·哈特维尔普通护士
Lucy Hartwell, staff nurse.
西塞尔·多利普通护士
Heather Dooley, staff nurse.
安德雷·科瓦克记录护士
Andrei Kovac, documentation nurse.
阿尔敏·库拉尔手术部医生
Armen Khular ODP.
丹尼尔·英萨拉科快速输液操作员
Daniel Insalaco, rapid-infuser operator.
雪莉·伊姆斯放射科技师
Shelley Imms, radiographer.
黛西·麦克多纳尔德巡回护士谢谢
Daisy MacDonald, circulating. Thank you.
数到三放射
Rays in three.
一二三放射
One, two, three, rays.
非常感谢可以进来了
Thanks very much. All clear.
请让一下
Excuse me.
确认病人
Let's confirm the patient.
病人姓名亚当·理查德斯生日1989年11月16日
Patient's name Adam Richards, date of birth 16-11-1989,
病号♥G893677498
Patient number G893677498.
骑自行车与重型货车相撞已确认
Cyclist crushed by HGV. Confirmed.
再检查一次动脉气血? 谢谢
Run off a new set of ABGs? Thank you.
我已签署四号♥同意书接下来要为了制止
I've signed a Consent Form 4, for a laparotomy
危及病人生命的腹膜内大出血而进行剖腹手术
to stop a life-threatening intraperitoneal haemorrhage.
我已签署四号♥同意书
I've signed a Consent Form 4,
接下来要整合下肢骨折并给撞伤清创
for fixation of lower-limb fractures and debridement of crush injuries.
(清创: 在无菌条件下彻底清理污染伤口使之变为清洁伤口
减少感染促进伤口一♥期♥愈合的手术)
请给我纱布
Swabs to me please.
一二三
One, two, three.
举高点
Nice and high.
现在把X光照片放到屏幕上
Radiographs coming up on screen now.
不现在别放手术刀
No, not now. Blade.
可以切吗是的
Am I OK to cut? Yep.
切开
Cutting.
给我剪刀
Scissors to me.
我还在等着呢
Still waiting.
抱歉创伤病人还夹着动脉钳
Sorry. Trauma patient, aortic clamp.
我们必须行动迅速我会试着跟上的
We're going to be moving fast. I'll try to keep up.
腹部有大量血液淤积
Massive blood pooling in abdomen.
好我来切开腹膜都准备好了吗
OK, I'm opening the peritoneum. Everybody ready?
准备好了准备好了
Ready. Ready.
开始了