争分夺秒（2015）

Critical S01E06

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

What is the material in her stomach? God knows.
叫放射学家到手术室去向我报告
Get the Radiologist to report to me in theatre, please.
我去说
I'll go ahead.
好吧
Right.
不用谢
You're welcome.
这种情况不是罗琳造成的也不是我造成的
Lorraine didn't create this situation. Neither did I.
她是名好医生
She's a good surgeon.
但现在我们需要的不止是好而已
But maybe we need better than good right now.
是啊你好得令人难以置信
You're incredible.
手术室见
I'll see you in there.
病人是重伤病患FC
Patient is Major Trauma Foxtrot Charlie,
也叫努拉·巴林顿
AKA Nuala Barrington.
同意书
Consent, please.
我们需要准备做剖腹手术和开颅术
We need to prep for a laparotomy and a craniotomy, please.
或许会有神经外科医生来也或许不会来
Someone from neurosurgery may or may not be on his way.
谢谢
Thank you.
你看到菲奥娜了吗
Have you seen Fiona?
在换衣服
Changing.
数据如何
What's the numbers?
156/78 脉搏61
156 over 78, pulse is 61.
高渗溶液给我们争取了些时间是的但不多
Hypertonic's bought us some time. Yeah, not long.
请继续检查她的瞳孔好的
Keep checking her pupils, please. Yep.
菲奥娜我能和你私下说一句吗
Fiona, can I have a word?
尽快吧
If you're quick.
我昨天在急诊部见到过她谁
I saw her in the ED yesterday. Who?
努拉
Nuala.
她跟我抱怨说肚子疼
She came in complaining of stomach pains.
我以前也见过她大家都认识她她常来
I've seen her before, everyone knows her, she's a regular...
你有没有给她做检查
Did you examine her?
做了我给她触诊了腹部查了血压心跳
Yes. I palpated her abdomen, BP, heart rate -
为了哄她高兴我甚至给她查了血常规
I even did bloods just to keep her happy.
你有没有评估她的精神状态
Did you assess her mental state?
她一开始挺正常的以努拉来说是正常的
She seemed normal at first. Normal for Nuala.
但是她的确比平时更反常而我的确...
But she did kick up more than usual, and I did...
嗯?
Yeah?
我的确认为她需要做心理评估
I did think she needed a psych assessment.
你和谁说过这事吗
Did you discuss this with anyone?
值班主任医师阿彻菲尔德医生
The duty consultant. Doctor Archerfield.
克莱夫
Clive.
我把她的病史告诉他了
I told him her history,
(联络护士: 在病人出院后与病人联络确保病人继续受到适当治疗的护士)
我觉得她有必要去见精神卫生联络护士
and that I thought she should see a psych liaison nurse.
但是他说她就快破坏四小时法则了
But he said she was about to breach the four hour rule
(四小时法则: 英国卫♥生♥部♥为国民医疗服务综合医院设立的法则
95%的急症病人必须要在四小时之内就诊治疗入院或者出院)
叫我放她出院
and to discharge her.
你有没有写在病程录里面
Does it say this in your notes?
只写了我和他讨论过
Just says I discussed it with him.
好的
OK.
别担心
Don't worry.
我来解决
I've got this.
放射专家刚才上传了报告
Radiologist has just uploaded her report.
腹部因活动性出血而有游离液体
There's free fluid in the abdomen with active bleeding.
她肚子里的东西查出来了吗
Any news on the material in her gut?
你看这个
Take a look.
"胃部和小肠中有密集异物
"Dense foreign bodies within the stomach and
"表明是近期所吞食
"the small bowel suggesting recent ingestion.
"最大异物为1.9乘2.4厘米"
"The largest measures 1.9 by 2.4cm."
所以不愿意冒险诊断异物到底是什么吗
So, not prepared to risk an opinion about what it actually could be?
腹部有活动性出血
There's an active bleed in the abdomen.
我们得立刻给她开膛马上就来
We need to unzip her now. Right behind you.
我来主刀除非...
I'll do this unless...
好请告知数据
OK. Numbers, please.
158/80 脉搏60 血氧不算高
158 over 80, pulse 60. SATS could be better.
自我介绍
Let's do a WHO.
我是格伦·博伊尔我是创伤科主任医师
I'm Glen Boyle, I'm the trauma consultant.
罗琳·拉帕波特血管外科主任医师
Lorraine Rappaport, consultant vascular surgeon.
卡莉·奥斯曼洗手护士
Khaali Osman, scrub nurse.
西塞尔·多利普通护士
Heather Dooley, support nurse.
拉玛克里士纳·钱德拉曼麻醉师
Ramakrishna Chandramohan, gas reg.
比利·芬利负责麻醉的手术部医生
Billy Finlay, anaesthetic ODP.
贾森·马歇尔普通护士
Jason Marshall, support nurse.
菲奥娜·罗马斯创伤科副主任医师
Fiona Lomas, trauma fellow.
阿尔敏·库拉尔手术部医生
Armeh Khalor, ODP.
丹尼尔·英萨拉科快速输液操作员
Daniel Insalaco, rapid infuser operator.
病人是重伤病患FC 生日1988年4月17日
Patient is Major Trauma Foxtrot Charlie. Date of birth 17/4/1988.
从高处跌落有右侧硬膜下血肿
She fell from a height, there's a right-sided extradural haematoma,
腹腔内出血以及异物
intra-abdominal bleeding plus foreign bodies.
我已签署四号♥同意书进行剖腹手术
I've signed a consent form four for laparotomy plus proceed.
神经外科那边有消息吗
Any word from neurosurgery?
没有
No.
请给我纱布
Packs to me, please.
好请给我手术刀
OK, let's have the blade.
可以切开了吗可以
Am I OK to cut? OK.
切开
Cutting.
请准备吸引器
Standby Suction, please.
请给我两把钳子
Give me two clips, please.
给我梅奥剪
Let's have the mayo.
另一边你来
You do the other side.
好吧里面血很多
OK, there's plenty of blood there.
请准备用温盐水冲洗都准备好了吗
Let's get ready to flush with warm saline, please. Everybody ready?
好了好了
Yeah. Yeah.
好了
Yeah.
切开
Cutting.
哦天啊
Oh! Jesus Christ.
真是太谢谢了啊
Thank you very much
是你吗比利不是
Was that you, Billy? No.
请拿走这个
Take this, please.
弥漫性腹膜炎到处都有多房♥性脓液
There's generalised peritonitis with loculated pus just everywhere -
(腹膜炎是腹腔壁层腹膜和脏层腹膜的炎症可由细菌化学物理损伤等引起
按发病机制可分为原发性腹膜炎和继发性腹膜炎
急性化脓性腹膜炎累及整个腹腔称为急性弥漫性腹膜炎)
骨盆
the pelvis...
双侧结肠旁沟
...paracolic gutters...
这是异物造成的吗
Is it caused by the foreign bodies?
我不知道里面一团糟
I don't know. Just a mess in here.
我们应该叫普外科医生来看看
We should get Gen Surg to have a look at it.
是啊这主意不错
Yeah, that's not a bad idea.
好请紧急呼叫普外医生
OK. Fast bleep Gen Surg, please.
腹部自动拉钩套件和腹腔拉钩
Balfour and Morris retractor, please.
出血点大多数都在左上区
The bleeding's mostly in the left upper quadrant.
我们来看看
Let's have a look.
好
Ok.
对脾脏撕裂
Yep, ruptured spleen.
我们得处理一下请给我纱布
We're gonna have to have that. Packs, please.
好
Yeah.
给我
Hit me.
再来
Again.
再塞进去
Let's move down, again.
给我别停
Hit me. Keep 'em coming.
给我
Hit me.
再来
Again.
放进去多少块了八块
How many's that in? Eight.
给我
Hit me.
好
Yep.
腹部塞进十条用掉十条
Ten in the abdomen. Ten packs in.
情况如何
How we doing?
好点了但是在继续之前可以再加点血
Better, but let me catch up with some volume before you go any further.
两单位血两单位鲜冻血浆好的
Two units of blood, two FFP. Yep.
左眼反应相当迟缓
Left eye looking very sluggish.
两把血管钳
Two dardik, please.
谢谢
Thank you.
梅奥剪
Mayo.
托盘