争分夺秒（2015）

Critical S01E03

Part 4 Jan. 6, 2021, 2:20 p.m.

梅奥剪
Mayo, please.
(梅奥剪: 一种组织剪用来解剖剪断或分离剪开组织
由梅奥医院开♥发♥而得名)
斯特里特先生普外科主任医师
Mr Street, gen-surg consultant.
主刀医生是谁
Who's consulting here?
我们见过了格伦·博伊尔创伤科的
We met before. Glen Boyle, I'm trauma.
抱歉格伦又见面了
Sorry, Glen. Hello, again.
正在做脾脏切除术
Splenectomy in progress.
你们把腿切了? 别无选择
You took the legs? Had to.
这个决定肯定是对的
I'm sure it was the right decision.
但是出于医疗纠纷的考虑
But for medico-legal reasons
我会叫两位矫形外科主任医师审查一下笔记
I'll be requesting two orthopaedic consultants review the notes.
完全没问题我去洗手
Absolutely fine. Scrubbing in.
梅奥剪
Mayo.
剪吧
Cut.
你一定是来替代罗琳·拉帕波特的吧
So you must be Lorraine Rappaport's stand-in?
罗琳到底要离开多久啊
How long's Lorraine going to be off for?
我听说是不稳定的心绞痛据说是这样
Unstable angina, I heard. That's what's being said
但是不确定可怜的家伙
but we don't know yet for sure. Poor thing.
克莱夫那晚一定把详细情况告诉你了
I'm sure Clive filled you in the other night.
我听说那晚非常欢乐
I hear it was very convivial.
我们已经在这里等得够久了
We've waited here long enough.
我需要你现在就上台
I need you now, please.
剪吧
Cut.
缝线
Ties.
如果腿已经处理好了的话
if we're all done with the legs...
我... 嗯
I should... Yep.
不我是说已经处理好了你去吧
No, I mean we are done with them. You should go.
干得好
And well done.
谢谢
Cheers.
剪吧
Cut.
好了
Yes.
斯特里特先生叫我罗勃就行
Mr Street? Rob.
我们需要处理肝脏你动手吧我这就来
We need to tackle the liver. Go for it. Be right with you.
剪吧
Cut.
组织剪
Mac.
手术盘
Dish, please.
脾脏已摘除
Spleen out.
谢谢
Thank you.
打开动脉钳这边我来
Let's unclamp. I've got this.
打开一半
Half off.
下降
Dropping.
维持
Holding.
好了
Yeah.
打开四分之三
Three-quarters off.
下降
Dropping.
维持
Holding.
继续
Go on.
上吧
Let's go.
全部松开
Unclamped.
下降
Dropping.
肝脏在大出血不用夹了拿开右上区的纱布
Liver's haemorrhaging. Leave the clamp off and unpack the RU.
我来做Pringle阻断好的
I'll do the Pringle. OK.
(Pringle阻断法: 又称全肝入肝血流阻断法
为肝切除控制肝出血最常用的方法)
右肝叶破裂肠系膜有一些撕裂
Fractured right lobe, some torn mesenterics.
Pringle法不起作用重新夹上
Pringle's not working. Reclamp.
血压依旧很低
BP remains very low.
每次一打开动脉夹他失血速度就会快于输血速度
Every time you unclamp, he loses more than we can put back in.
我们可以结扎肠系膜
We can ligate the mesenterics.
我也这么想已重新夹上
I reckon so. Reclamped.
老大创伤手术室需要资深人员的支援
Boss, I need some senior support in trauma theatre.
我会下手结扎这些血管
I'll get on and ligate these vessels.
两个钳子 2-0薇乔缝线穿在针上给我
Two clips, 2-0 vicryl. Mounted ties.
(薇乔缝线: 一般为带针缝合线其中针的材料是不锈钢
线是由90%的乙交酯和10%的左旋丙交酯合成的可吸收聚合物)
我来把肝脏包起来好主意
I'll pack the liver. Good idea.
请给纱布
Packs, please.
请给我剪刀
Scissors, please.
肝脏已包起来
Liver packed.
好剪吧
OK, cut.
剪
Cut.
他又在流血了动脉钳松了吗
He's bleeding again. Has the clamp come loose?
大动脉是夹住的
Aorta's clamped.
该死
Shit!
钳子以下都系住了到底是哪里出血
Everything below the clamp is tied off. Where's it coming from?
哦天啊
Oh, God!
血压下降上压30 下压无法读数
BP dropping. 30 over unreadable.
钳子还夹着
Clamp's on.
我刚刚告诉你是夹好的
I just told you it was on.
那他就是钳子上方在流血
Then he's bleeding above the clamp.
横膈膜破裂了血流进腹部里来了
Diaphragm's ruptured, it's getting into the abdomen.
(横隔膜是将腹腔和胸腔分隔开的膜状肌肉)
胸腔里的血块被冲掉了
He's blown off clots in the chest.
听起来像是弥散性血管内凝血(DIC)
This is sounding like DIC.
(弥散性血管内凝血: 由于血液内凝血机制被弥散性激活
促发小血管内广泛纤维蛋白沉着导致组织和器官损伤
另一方面由于凝血因子的消耗引起全身性出血倾向)
死神来了(缩写亦是DIC)
Death Is Coming.
请立刻给我止血纱布
Haemostatic gauze. Now, please.
你来拿开纱布我把止血纱布放进去
You unpack, I'm going to get the haemostatic in.
谢谢
Thank you.
剪剪刀快
Cut. Scissors, quickly.
我们需要压塞出血处
We need to tamponade the bleed.
给我
Hit me.
剪
Cut.
纱布
Pack, please.
给我
Hit me.
哦天啊心脏停跳了
Oh, come on! He's down.
继续给他快速输液一直没有停过
Keep the rapid infuser going. It never stopped.
已经71分钟30秒了心脏里没有血
Coming up to 71 minutes, 30 seconds. The heart's empty.
新的手术刀和Foley导管 Foley导管
Fresh blade and a Foley, please. Foley.
(Foley导管: 一种软导管通常用于导尿)
手术刀
Blade.
我要把导管放进去
I'm going to put the Foley...
直接塞进右心房♥中去
Get it going right into the right atrium,
直接把血输进去你来用盐水冲管
fill him up from there and you're going to inflate the cuff.
格伦
Glen...
照我的话去做
Just do as you're told.
听着老兄你很努力但是他已经死了
Listen, mate, you gave it a good go, but he's down.
如果你想有发言权
If you want a say,
他妈一听到呼叫就给我过来啊
you're going to have to show up when you're bloody called!
72分钟又过去30秒
72 minutes, now been down 30 seconds.
可以灌注了
Cuff prime.
好了接到快速输液器上去赶快比利
Yes. Get that connected to the rapid infuser. Now. Billy.
对已经接上了对准备好了
Yeah, it's going. Yep. Ready.
好按压
OK. Compressions.
颈动脉? 谢谢
Carotid? Thank you.
输出非常少
Very weak output.
我需要缝合导管 2-0薇乔缝线
I need to secure the Foley. 2-0 Vicryl, please.
停止按压他的心脏已经停跳快一分半钟了
Stop compressions. He's been down for almost a minute and a half.
剪刀快
Scissors, quickly.
没有脉搏
Pulse absent.
剪
Cut.
再次按压
Start compressions again.
让我看看情况
Let me see what we've got.
谢谢
Thank you.
你可以停了
You can stop now.
谢谢你
Thank you.
病人在74分钟时死亡
Patient pronounced dead at 74 minutes.
我想要谢谢在场的所有人
I want to thank everyone.
抱歉伙计
Sorry, mate.
嗯我稍后把我的笔记发给你
Yeah. I'll email you my notes later.
所有人不要碰一切
Everybody leave anything
和尸体有关的东西
that's connected to the body exactly as it is for now.
抱歉