争分夺秒（2015）

Critical S01E05

Part 4 Jan. 6, 2021, 2:21 p.m.

现在? 拜托
Now? Please.
菲奥娜你来接手好的
Fiona, please. Yes.
听着你不是非得要做这事的
Listen, you don't have to do this.
谁都可能失手
That could have happened to anyone.
我同意我说的不是这个意思
Oh, I agree, that's not what I meant.
是克莱夫
It's Clive.
他想加害于你这可能会一发不可收拾
He's gunning for you and this could turn into a shitstorm...
所以我们别给他把柄好吗
...so let's not give him the ammunition. Yes?
菲奥娜你可以接替我吗
Fiona, are you OK to take over?
当然如果你没意见的话
Of course. If that's all right with you?
那这样我就交给你了
In which case, I shall leave you to it.
请继续
Let's go, please.
拔出眼镜蛇导管
Cobra catheter coming out.
球囊
Berenstein balloon, please.
检查球囊
Check the balloon.
正常
Yeah.
喂你做得到的
Hey...You're fine.
扩张球囊
Inflating the balloon.
不收缩它和动脉不相合
No, deflate it. It's not conforming to the artery.
血压下降 105/84
BP dropping. It's 105 over 84.
请增加输血 90/76
Let's increase the blood, please. 90 over 76.
撕裂口比我想象的更高
The tear extends higher than I thought.
我要在更近心端阻断
I'm going to occlude it more proximally.
好的但这解决不了后背流血
OK. But that's not going to take care of the back-bleed.
我不能冒扩大撕裂口的风险
I can't risk enlarging the tear.
血压还在下降
BP still dropping.
左髂总动脉在撕裂口上方被阻断
The left common iliac artery is occluded above the tear.
请停止透视
Stop screening, please.
子♥宫♥变得绷紧而坚硬你能让它放松吗
The uterus is becoming tense and woody. Can you relax it?
(连续静滴间羟叔丁肾上腺素可激动子♥宫♥平滑肌β2受体
抑制自发性子♥宫♥收缩和催产素引起的子♥宫♥收缩预防早产同样原理亦可用于胎儿窒息)
250毫克间羟叔丁肾上腺素
250 micrograms of terbutaline, please.
好的比利我们有吗在那里面
Yeah, Billy, have we got that? It's in there.
正在注射250毫克
250 mics going in now.
再来250毫克加油
Another 250, please. Come on.
再次注射250毫克
Another 250 going in.
能让我看一下血压吗好的抱歉
Can I see the BP, please? Yep, sorry.
你不把孩子拿出来血压不会上去的
It's not going to go up until you get that baby out.
放松了一点但是不稳定
It's relaxing a bit, but it's unstable.
我需要立刻取出胎儿
I need to get the foetus out immediately.
胎儿存活几率是多少
What are its chances of survival?
得看体重最多百分之三十到四十吧
Depending on weight, between 30 and 40%, max.
如果存活的话长♥期♥预后呢
And the long-term prognosis if it does survive?
有百分之六十的可能会有某种损伤
There's about 60% risk of some impairment -
如果供氧不足的话还会更危险
more if there's been significant hypoxia.
不我想在不取出胎儿的情况下控制背部出血
No, I want to control the back-bleed with the foetus in place.
子♥宫♥很敏感
The uterus is irritable.
有可能收缩或者胎盘有可能剥离
It could contract or the placenta could abrupt.
立刻做剖腹产不然母子都可能有危险
Caesarean now, or we could lose mother and the foetus.
好吧好的
OK. Right.
请让一下
Excuse me.
12单位的O-血 8单位鲜冻血浆
12 units of O neg, 8 FFP,
4单位血小板 2单位冷凝蛋白质
4 platelets and 2 cryo, please.
好的
Yep.
我需要立刻把我的小队叫进来
I need my team here now.
我们要做紧急剖腹产
We're doing an emergency C-section.
比利立刻去叫新生儿科医生
Billy, we need neonatal here, right now.
你好我是创伤手术室的手术部医生比利·芬利
Hello, yeah, it's Billy Finlay ODP, in trauma theatre.
我们叫一队新生儿科医生待命
We have a neonatal team on standby,
现在需要他们立刻进来
we need them here right away.
谢谢这就来
Thanks. On their way.
好我们得等着
OK, we have to wait.
所以你为什么洗手不干了
So, what made you hang up your boots?
谁说我不干了
Who said I have?
12单位的O-血 8单位鲜冻血浆
12 units of O neg, 8 FFP,
4单位血小板 2单位冷凝蛋白质齐了
4 platelets, 2 cryo. Bosh!
给布鲁斯那你呢
There you go, Bruce. What about you?
哦我只是觉得是时候该安定下来了
Oh, I just thought it was time to settle down.
好了我们要准备做传统的剖腹产
All right, we are prepping for a classical C-section.
准备的时候请签到
Sign in as you set up, please.
菲·欧文登新生儿科主任医师
Fay Ovenden, Consultant Neonatologist.
斯蒂文·肯尼亚助产士接生婆!
Stephen Canja, Midwife. Midwife!
汉娜·西蒙森新生儿科住院医师
Hannah Simonson, Neonatal SHO.
佐尔顿·法卡斯新生儿科护士
Zoltan Farkas, Neonatal Nurse.
准备好了吗菲准备好了
Ready, Fay? Ready.
嗯数据稳定下来了
Yeah, numbers stabilising.
好那开始吧
Right, let's get cracking then, shall we?
稍等
Excuse me.
子♥宫♥放松下来了
The uterus has relaxed.
也就是说现在不需要马上做剖腹产了对不对
Means there's no immediate need to do a C-section now, is there?
菲奥娜如果我做开腹手术你能帮我夹住动脉吗
Fiona, if I did a laparotomy, can you clamp the artery?
或许
Maybe.
不动胎儿? 是的
With the foetus still in place? Yes.
但你可以移一下子♥宫♥吗动不了多少
But could you move the uterus? Not much.
有可能引起胎盘早剥
It could trigger placental abruption.
如果剥离的话她就会死
If she abrupts, she dies.
各位准备做开腹手术
Let's prep for a laparotomy, everyone.
这对你来说不容易吧
This can't be easy for you.
这个病例很难
It's a tough case.
我们回家去再说
We'll talk about it at home.
48分钟了请给我手术刀
48 minutes. I'll take a blade, please.
可以切开吗是的
Am I OK to cut? Yeah.
切开
Cutting.
梅奥剪
Mayo, please.
皇家陆军医疗队的手法啊
RAMC finesse.
你随时可以加入进来
You can join in any time you want.
很乐意旁观学习
Happy to watch and learn.
小S拉钩
Deaver retractor, please.
你准备好了吗
Are you ready?
是的交给你了
Yeah. Over to you.
汤姆
Tom?
移♥动♥子♥宫♥
Moving the uterus.
只能动这么多了
That's as far as it will go.
血压维持
BP's holding.
解剖剪
Dissecting scissors, please.
我要把手伸到腹膜后腔里去
I'm going to enter the retroperitoneum.
吸引器
Suction.
止血钳
Dardik clamp, please.
好了
OK.
再拿开一点
A bit further.
只能这样了我需要更多的空间
That's it. I need more room.
血压下降 94/78
BP dropping. 94 over 78.
我有刺♥激♥到子♥宫♥的危险我得伸进去
I'm in danger of stimulating the uterus. I have to get in.
73/61 不稳定
73 over 61. Unstable.
布鲁斯增加供血
Bruce, increase the blood, please.
汤姆给我30秒钟就好拜托
Tom, just give me 30 more seconds. Please.
30秒
30 seconds.
摸到了
I've got it.
再拿出来一点拜托不行
A bit further, please. I can't.
我得止住背部出血
I have to stop the back-bleed.
血压下降 79/68
BP dropping. 79 over 68.
我夹不到
I can't get it.
已经30秒钟了再多几秒就好
That's 30 seconds. A few more seconds.
75/6♥4♥
75 over 6♥4♥.
好了髂总动脉夹住了是金属碎片的远心端
OK. Common iliac artery clamped, distal to the metal fragment.
很好继续
Good. Keep going.
你控制住背部流血了我得把这个放回去
You've controlled the back-bleed. I need to put this back now.
我们需要夹住金属碎片的近心端止血钳
We need to clamp, proximal to the metal. Dardik, please.
被球囊控制着呢还不够
It's controlled by the balloon. It's not enough.
就10秒好的
Ten seconds. OK.
子♥宫♥在收缩
The uterus is contracting.