争分夺秒（2015）

Critical S01E04

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

血压还是很低各种指标都很糟手术刀
BP's still very low, his numbers are crap. Blade.
切开
Cutting.
梅奥剪
Mayo.
腹部自动拉钩套件
Balfour, please.
谢谢
Thank you.
腹腔拉钩
Morris retractors, please.
吸引器
Suction, please.
没有好转
It's no better.
我看到骨盆血肿了
OK, I can see the pelvic haematoma.
接收器
Receptor, please.
这里
Here.
吸引器
Suction.
我需要纱布一块一块给给我
I'm going to need swabs, one at a time. Hit me.
给我
Hit me.
给我
Hit me.
给我
Hit me.
啊该...
Agh, sh...!
格伦手套破了
Glen, the glove is torn.
只是钩破了
It's just a nick.
小心为妙
See to it.
手套
Gloves.
可以继续了吗
OK to proceed?
给我
Hit me.
给我
Hit me.
用掉五块有好转吗
5-packs in. Any improvement?
没有我再给他一剂氨甲环酸
No. I've given him a second dose of tranexamic acid.
情况依旧危急
And he's still crashing.
塞了纱布血还是没有止住
Bleeding is continuing through the packs.
髂内动脉分支有活动性出血
We've got an active arterial bleed in a branch of the internal iliac.
CT扫描上没显示出来
It didn't show on the CT scan.
一定是冲掉了血块血管破裂了
It must've blown off a clot. It's a rupture.
再推一下加温快速输注器我要做结扎
Push the Belmont. I'm going to need to ligate.
请吸液新的血栓弹力图
Get some suction in here, please. New teg.
应该已经在系统里了
Should be on the system.
来看一下
Let's see it.
这是旧的新的... 弯血管钳
That's the previous one. The new one... Lahey.
旧的新的
Old, new.
旧的新的
Old, new.
他真是太棒了
He's doing really well.
越来越疯狂了
So much more deranged.
2-0薇乔缝线血压还在下降
2-0 Vicryl, please. BP still falling.
我们得改善一下这人的凝血症状
We need to reverse this man's coagulopathy,
不然他会很快失血过多而死
otherwise he's going to bleed out very, very quickly.
他需要冷凝蛋白质血小板和新鲜冰冻血浆
He needs cryo, platelets and FFP.
都在C组合血包里
They're in Pack C.
还没到
It's not here yet.
C组合血包死到哪里去了
Where the hell is Pack C?!
请接血库
Blood Bank, please.
对还是创伤手术室的手术部医生
Yes, this is the ODP in the trauma theatre again.
我们还在等C组合血包呢
We're still waiting for Pack C!
他们不肯送过来
They're refusing to bring it.
他们在等他们的直线经理指示
They're waiting for advice from their line manager
是否要接近感染区域
on whether to go near an infection area.
开什么玩笑
You're joking.
告诉他们你去传染隔离线上去接他们
Tell them you'll meet them at the infection barrier.
创伤部门是传染控制区
The trauma department is an infection control area.
闲人免进
Strictly authorised personnel only.
创伤部门是传染控制区
The trauma department is an infection control area.
闲人免进
Strictly authorised personnel only.
你要我签收吗
Do you want me to sign for it?
白♥痴♥
Knobhead.
请吸液还有纱布
Suction, please, and packs.
拿到了干得好
Got it. Well done.
给我
Hit me.
我是矫外科主治医师约瑟夫·维特内尔
I'm your orthopod consultant, Joseph Whitnell.
是那个不情愿的奥斯古德夫人的代班医生
Substitute for the reluctant Mrs Osgood.
现在我们暂时暂停了固定外支撑架
We've abandoned the ex-fix at the moment.
我们正在处理髂内动脉出血和其他一些事
We've got an internal iliac bleed and some other issues.
我这就进来哦不听着约瑟夫
I'll come through. Oh, no, listen, Joseph.
这里有个传染源呢
We've got a pathogen in here
没必要再让更多的人冒感染的危险
and there's no point in exposing anyone else to it.
我们需要处理骨折我会全面小心的
We'll need to fix the fracture. I'll take full precautions.
微生物学结果出来了
Microbiology results.
进来
Come on through.
结果如何维斯
What can you tell us, Wes?
我找到病因了
OK, so I found the bugs.
好消息不是出血热病毒
Good news, ruled out a haemorrhagic virus.
只是脑膜炎双球菌性脓毒病
It's only meningococcal sepsis.
(脑膜炎双球菌: 又名脑膜炎奈瑟菌或脑脊髓膜炎双球菌
简称为脑膜炎球菌是一种革兰氏阴性菌可通过飞沫传播
因其所导致的脑膜炎而闻名只感染人类)
太好了但我们需要谨慎处理
Great news. But we should treat this seriously.
继续滴注头孢曲松两克针筒注射
Continue ceftriaxone, two grams BD.
并确保有人已经去安排预防措施了
And make sure that someone is getting those prophylaxis sorted.
你们好了以后
Once you're done,
把他送到重症监护室去我会尽快过去
get him up to ITU and I'll be there as soon as I can.
好吗好的
OK? OK.
见到
Scissors.
结扎完成
Ligation is completed.
看起来已经控制住出血了
Seems as if the bleeding is under control.
脉搏110
Pulse rate 110.
大块纱布
Large swabs, please.
谢谢你维斯没事
Thank you, Wes. Yep.
谢谢你的付出没问题
Thanks for doing that. No problem.
给我Robinson导管
Give me the Robinson tube.
(Robinson导管有2~6个开口的直形导管以利引流
对有血块的引流特别有用因为血块可能会堵塞一个或几个开口)
各项指标在缓慢好转
Numbers are improving slowly.
请给我止血钳
Give me a Spencer, please.
收缩压上100了加油
Systolic up to 100. Come on.
这就对了我的朋友
That's it, my friend.
我觉得凝血症被血液制品纠正了
I think the coagulopathy is being corrected by the blood products.
拿出腹腔拉钩
Morris out.
他正在稳定下来
He's stabilising.
这次还真是小菜一碟
Piece of piss, this game.
真是好消息
That's terrific news.
我来帮你完成外支撑架
I'll finish the ex-fix for you.
嗯我去安排一个重症监护室
Yeah, I'll just go and organise a side room in ITU.
谢谢
Thank you.
大家听着
Listen, everyone.
我觉得我们做到了
I think we got there.
我们救了他然后
We saved him and...
我想谢谢各位
...I just wanted to say thank you.
你好我是创伤手术室的拉玛克里士纳
Hi, it's Ramakrishna in trauma theatre.
能安排一间重症监护病房♥给MO吗
Can I have a side room for Mike Oscar, please?
能把CT片子放到屏幕上去吗
Can I have the CT image on screen, please?
那是血
That's blood.
是你的还是病人的
Is it yours or the patient's?
你手划破了吗
Is it cut?
不是我的血
Not my blood.
有结果了吗
We get a result?
是的他挺过来了
Yes, he's come through it.
在诊断结果出来前我们得把普外科医生
Pre the diagnosis, we had to take both the general
和心胸外科医生暂时撤下岗位
and cardiothoracic consultants temporarily off duty,
因为怕可能的感染
down to possible exposure.
他们都错过了门诊
They both missed their clinics.
那是因为不必要的参与创伤急救
That's down to unnecessary trauma attendance.
不是理想状况对吧
It's not ideal, is it?
对的确不是
No, I suppose not.
但你知道么如果是在日常基础上这会...
But, you know, on a case-by-case basis, this is going...
你让我在面对日程管理人时非常难堪
You've put me right in the middle of the schedule managers.
但最重要的是病人没有死
But the most important thing is that the patient didn't die.
是因为你的干预措施和小队的努力