争分夺秒（2015）

Critical S01E05

Part 1 Jan. 6, 2021, 2:21 p.m.

(前情提要)
克莱夫人挺好的
Clive's all right.
小心你不知道他的真面目
Be careful, you don't know what he's like.
我看得出你生气了
I can see you're upset,
但是那么我们中就有人得加把劲了
but... Then some of us need to raise their game.
罗琳去哪了?
Where's Lorraine?
我说了我不知道
I've told you, I don't know.
你是在现役服完后直接来我们这里的吗?
Did you come straight to us from active service?
抱歉有个将死的人在等我
Sorry, dying man waiting for me.
事实上我现在要回家去
I'm actually heading back to my digs.
我看见你动手了
I saw you do it!
收到重伤病患FH
'Major trauma Foxtrot Hotel received.
收到重伤病患FH 如果你到隔间去
'Major trauma Foxtrot Hotel received.' If you go into the cubicle.
请把他也带去好吗?
Take him in there, will you, please?
冷静你们嚷嚷的话我们没法治疗
Calm down! We can't treat you if you're shouting.
耐莉丝护士科斯特洛护士!
Sister Nerys, Staff Nurse Costello!
派对挺热闹啊
Nice party?
其实有一种叫做"扩音器"的东西
Right, we have this invention called a Tannoy.
我们需要保安里面的人都疯了
We need more security. It's mental in there.
老天重伤病患FH 是枪伤
Oh, dear. Major trauma Foxtrot Hotel. Gunshot wound.
两分钟前下的车好
Started to unload two minutes ago. Right.
噢真好笑嗨鲍勃
Oh, funny! Hi, Bob.
亲爱的重伤FH交给你了是枪伤
Major Trauma Foxtrot Hotel for you, love. Gunshot wound.
请送到A诊室耐莉丝
Bay A, please, Nerys.
耐莉丝你不介意这次我来当记录员吧?
Nerys, you don't mind if I scribe on this one do you?
你请便亲爱的谢谢
Scribe away, love. Thank you.
弹孔在哪? 腰部左侧
Where's this bullet hole then? Left lumbar region.
没有射出伤? 子弹可能还在里面
No exit wound? Probably still in there.
我们下次会尽量给你找点更刺♥激♥的工作
We'll try and find you something more exciting next time.
克...
Cl...
克洛弗克洛弗
Clover. Clover.
我还以为他们把你栓在办公桌后了呢
I thought they had you chained to a desk.
我逃出来了
I broke loose.
准备转移一二三
Are we ready to transfer? One, two, three.
解开上下搭扣
Unclipping top and bottom.
一二三
One, two, three.
我是菲奥娜·罗马斯我们在城市综合医院
My name is Fiona Lomas. We're at City General Hospital.
你能听到我吗?
Can you hear me?
开始输氧是
Onto taxpayers' oxygen. Yep.
当务之急是什么? 血氧饱和度是82
Immediate needs? Sats were 82.
我们输了纯氧但她的情况没有好转
We bagged with 100% oxygen, but her numbers didn't improved.
血压? 110/95 稳定
BP? 110 over 95, and stable.
我看看是否有明显异物堵塞气道
I'll just check if there's anything obvious obstructing the airway.
没有发现
There's nothing to see.
现在血氧饱和度是多少?
What are the sats now?
呃 81 插管吧
Er, 81. Let's get a tube in.
好我来做昏迷等级评估
Yeah. I'll do a GCS.
初步诊断开始前还有什么要告诉我们的?
Any other points before we start primary?
急救队长要写谁的名?
Who do I put as Team Leader?
格伦马上就来有人看见他了吗?
Glen will be here shortly. Has anyone seen him?
抱歉来晚了有人吐我身上了你能相信吗?
Sorry I'm late. I got puked on. Can you believe it?
不错啊
Nice.
哈莉在右侧留出静脉注射区域
Harry, I need IV access, right side.
(HCG是人绒毛膜促♥性♥腺♥激♥素♥ 由由α和β两个不同亚基组成是检查是否怀孕的金指标
可用以诊断早孕宫外孕孕期的监护恶性葡萄胎的辅助诊断等)
通过静脉留置针采血做血常规及βHCG的检查
All the usual bloods through the Venflon plus Beta HCG.
好的耐莉丝
OK. And, Nerys,
请再给我准备一袋O型血
would you put up another bag of O neg for me, please?
好没问题颈椎已固定
Yes, of course. C spine is protected.
气管居中
The trachea is central.
瞳孔等大无反应
Pupils are equal and reactive.
O+型已记录并核查
O pos, dated and checked.
呼吸困难唇色发绀
Breathing laboured. Lips cyanosed.
我是钱德拉曼医生你能听见我吗?
My name is Dr Chandramohan. Can you hear me?
病人对声音刺♥激♥没有做出睁眼反应
Patient doesn't open eyes in response to verbal stimulus.
(E V M分别代表眼声音动作这三项的最高指数分别为4 5 6
病人反应越小指数越低这是格拉斯哥昏迷指数的评估指标)
这代表E1
That's E1.
她能发出无法辨析的声音代表V2
Making incomprehensible sounds. V2.
脉搏很强
Strong pulses.
对挤压有躲避反应代表M4
Withdraws from trap pinch. That's M4.
(昏迷指数由E V M的分数相加所得 13分到14分为轻度昏迷 9分到12分为中度昏迷
3分到8分为重度昏迷因插管或气切无法发声的重度昏迷者会有2E或2T 的评分)
昏迷指数7分(重度昏迷)
GCS, 7.
请把我的常规工具准备好比利
Round of my usual, please, Billy.
马上好头儿
Coming right up, boss.
加快点速度行不行贾斯汀?
Can we have a bit of speed there, please, Justin?
行
Yeah.
拿证物袋来贾斯汀好的
Forensic bag, Justin. OK.
为什么没有早脱下她的衣服?
Why isn't she already exposed?
当时周围有很多人啊
There were loads of people about.
老天爷啊鲍勃病人也有尊严
For God's sake, Bob. Patient dignity.
对做得对
Yeah, good call.
她要是死了就没尊严可提了
Not that dignified if she died.
好了翻个身把她的衣服挪开
OK. Let's do a log roll and get this coat out.
一二三
One, two, three.
谢谢鲍勃
Thank you, Bob.
我看看
Let me have a look.
好看一下另一侧哈莉?
OK. Let's have a look at the other side. Harry?
让一下鲍勃
Scooch down, Bob.
好一二三谢谢鲍勃
OK, one, two, three. Thank you, Bob.
我来看看
Let's have a look.
有一处小的穿透伤符合枪伤的形态
There's a small penetrating wound consistent with a gunshot.
一二三
One, two, three.
贾斯汀来扶着? 好
Justin, collar? Yeah.
(有小穿透伤)
快伙计扶好
Come on, mate, grab on.
我以为她还在休病假呢
I thought she was still off sick.
比利环状软骨
Billy, cricoid.
已注射250毫克硫喷妥纳
250 of thio going in.
100毫克司可林
And 100...of sux.
冲洗
Flush.
(叩诊音分为清音浊音鼓音实音过清音五种过清音介于鼓音与清音之间
是一种极易闻及的叩诊音临床上常见于肺组织含气量增多弹性减弱时如肺气肿)
呼吸音减弱右侧有过清音
Diminished breath sounds and a hyperresonance on the right side.
临床上来说她有肺炎症状
Clinically, there's a pneumo.
请准备胸腔引流套件耐莉丝好
Chest drain kit, please, Nerys. Yes.
已经过去了三分钟
Three minutes gone.
我要对她进行胸腔引流减轻气胸症状
I'm going to put in a chest drain to relieve the pneumothorax.
请给我探镜
Scope, please.
好探镜插入内部组织可见给我导管
OK, scope in, chords visualised. Tube?
现在...
And...
搞定不错嘛拉玛
...bull's-eye. Nice one, Rama.
冲管吧
Cuff up.
贾斯汀你去做血化验好吗? 好
Justin, can you do bloods, please? Yep.
病人呼吸顺畅
Patient is on vent.
那就交接吧行
Let's do the hand over. Yep.
病患为女性无身份证大约30岁不到
Patient is female. No ID. Appears to be late 20s.
我们在00:37到达她受伤时间是00:15
We arrived at 00.37. Time of the injury was 00.15.
据警♥察♥说一名目击者看到她中弹
According to police, a witness saw her being shot
并摔下了三♥级♥水泥台阶
and falling down three concrete steps.
左腰侧有小的穿透伤
Small penetrating injury to the left lumbar region,
伤口距腰椎三厘米
three centimetres from the lumbar spine.
现场警♥察♥认为它是枪伤
Police on scene believed that to be a gunshot wound.
子弹还留在体内
Suspect bullet still inside.
病人当时情况昏迷指数9分(中度昏迷)
Stats at scene - GCS 9,
氧饱和度82% 能自主呼吸但很困难
sats 82%. Resps spontaneous but laboured.
血压118/74 脉搏119
BP 118 over 74. Pulse 119.
我们用面罩给她供给了纯氧
We gave her 100% oxygen via mask.
在左臂进行了静脉注射
IV established on the left arm.
滴注了250毫升盐水
One 250ml bolus of saline given.
好的各位谢谢
OK, guys, thank you.
静脉血气检测结果
VBGs.
拉玛克里士纳需要我做完初步诊断吗?
Ramakrishna. Do you want me to finish the primary?
好的谢谢哈莉
Yes, thank you, Harry.