争分夺秒（2015）

Critical S01E07

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

It's been a crazy week, sorry. Shifts all over the place.
气道通畅好
Airway secure. Good.
不好意思你是?
Excuse me, you are...?
罗拉
Lola.
可以做下交接吗? 好的
You OK to do the hand-over now? Yep.
女性二十到三十岁凌晨2:45
OK, female, twenties - involved in an RTC at 2.45am,
遭遇两车相撞事故
involving two vehicles.
她当时坐在小型出租车的前座
She was the front-seat passenger in a minicab,
前额和脸部左侧有撞伤
and sustained contusions to the front and left of face,
左肱骨可能有骨折
possible fracture to the left humerus.
当时昏迷指数9到12 在路上情况恶化
GCS 9 to 12 on scene, deteriorated en route.
当时心率120 在来的路上逐渐升高
Heart rate on scene was 120, and it was creeping up on the way in.
当时血压90/65
BP on scene was 90 over 65.
在下降
It's going down.
我们在她右臂插入了静脉针被她拔了出来
We inserted IV access to the right arm, which she pulled out.
给她进行了输氧输液没注射药物
Have given oxygen, fluids, no meds.
谢谢
Thank you.
好的把她的衣服脱掉先脱上半身
OK. Let's get her out of her clothes. Top half first, please.
抽血做常规化验全血细胞计数尿素与电解质
Let's take blood, usual suspects. FBC, U and E.
血栓弹力图交叉配血血液酒精浓度
TEG and cross match, EtOH,
静脉血气检测 βHCG
VBGs and Beta-HCG, please.
骨折部位非常不稳定
This fracture's highly unstable.
安全带留下的印子酷啊
Seatbelt sign. Cool.
气管居中
Trachea central.
没有明显连枷胸
No obvious flail chest.
(连枷胸: 严重的闭合性胸部损伤导致多根肋骨骨折
使局部胸壁失去肋骨支撑而软化吸气时软化区胸壁内陷呼气时外突)
她有随身物品吗?
Any belongings?
是的有几个包还在车上
Yeah, there's a couple of bags in the truck.
我们去拿
We'll go and get them.
好运
Good luck.
呼吸均匀胸腔无异常
Equal air entry. Chest clear.
左侧肋骨有几处骨折
Couple of left-sided rib fractures.
需要帮忙吗坎贝尔护士?
Need a hand there, Sister Campbell?
我就是想提供帮助嘛
Just offering my services.
请便好的
Be my guest. OK.
瞳孔情况
Pupils, please.
谢谢
Thank you.
腹部膨胀僵硬
Abdomen is distended, rigid.
瞳孔...
Pupils are...
有反应但不等大
reactive, but unequal.
左侧3毫米右侧5毫米
Left three mil, right five mil.
有颅内出血?
Intracranial bleed?
这就能解释她为何有意识波动
Fits with the fluctuating consciousness.
骨盆稳定
Pelvis is stable.
血压还是低
BP remains low.
我还是想给她做脑CT
I still want to get a CT of the head.
请通知CT室和神经外科
Can we call CT and neuro, please.
哇塞神经外科!
Whoopee - neuro!
我是复苏室的希克林夫人
This is Mrs Hicklin, resus.
请快速呼叫待命的神经外科医师
Can you fast-bleep the on-call neurosurgeon, please?
谢谢
Thank you.
真是太美味了
Ah, that was lovely, that.
如果现在还不需要我处理她的胳膊
If you don't need me for the arm just yet,
我要去急诊室处理一个桡骨近端骨折病人
they've got a proximal radius fracture in the ED.
去吧谢谢
Go. Thank you.
我是希克林夫人
This is Mrs Hicklin.
我们要带重伤病患FE
We need to bring Major Trauma Foxtrot Echo
在15分钟后去CT室
down to CT in the next 15 minutes.
抱歉
Sorry.
她的手刚才动了吗?
Did her hand just move?
给她打了那么多镇定剂不可能动的
With the amount of sedation she's had, she's not moving anywhere.
看得出你很厉害
I can see you've got the touch.
好的 CT室会为我们准备好
Great. ..CT will be ready for us.
谢谢
Thank you.
她皮肤绷得太紧我扎不进去
She's peripherally shut down. I can't get access here.
继续尝试她的血管真的很不清晰
Keep trying. She's got really crap veins.
心跳在加速 159 160
Heart's racing, 159, 160.
她要把插管拔♥出♥来♥了
She's going to self-extubate.
行了行了
OK, OK...
我需要纱布和止血带快点
I need swabs and a tourniquet, please, now!
来人去叫丽贝卡
Someone grab Rebecca!
好了安娜好了
It's OK, Ana. It's OK.
再拿两个要已经打开能直接用的
I need two more, open and ready to go.
好了安娜好了
It's OK, Ana. It's OK.
好了你拿着这个
OK. You take this, please?
比利压住这里
Billy, pressure there.
好谢谢
Got it. Thank you.
没事的安娜没事的
You're OK, Ana. You're OK.
好了注射异丙酚(麻醉剂)
OK, propofol going in.
抬起来慢点继续压住
OK, lift. Easy. Keep the pressure on.
在必须把这个摘下来以前我们有大概60分钟
We've got about 60 minutes before this needs to come off.
请给我拿支笔
Someone get me a pen, please.
现在的意识水平... 躁动
Altered conscious level... Agitation.
(这里应该是对患者进行了镇静-躁动评分这是ICU的常用评估项目
焦虑代表躁动有拉扯导管的行为代表危险躁动)
好了立刻送她去CT室
Right, I wanna get her to CT right now.
我们得知道这是不是脑损伤
We need to know if this is a head injury.
时间凌晨3:43
Time, 3.43am.
要命该死的
Oh, come on! Shit!
静脉注射
VT.
没有心搏了可以进行除颤
There's no output. It's a shockable rhythm.
贾斯汀胸部按压好的
Justin, compressions Yeah.
充电到150
Charge to 150.
正在充电
'Charging.
充电完成
'Charged.'
倒计时三二一
Shocking in 3, 2, 1.
大家都让开
Everybody clear.
除颤
Shocking.
气道再次通畅
Airway secured. Again.
好了接近两分钟了充电到150
OK. Coming up on two minutes. Let's charge to 150.
除颤前先检查一下她的脉搏
And let's pause before shocking to check the pulse.
哈莉去把自己清理一下
Harry, go and get yourself cleaned up.
帮我拿一件手术服上衣好吗好的
And can you get me a scrub top, please? Sure.
充电完成警告请远离警告请远离
'Charged. Warning - stand clear. Warning - stand clear.'
检查脉搏
Pulse check.
(窦性心律就是心脏的正常跳动)
等一下窦性心律很好
Hold the shock. Sinus rhythm. Nice.
但速度在140
Albeit tachy at 140.
* 活下去活下去 *
* Stayin' alive, stayin' alive... *
你真得找首新歌♥了
You've so got to find a new tune.
输入高渗盐水治疗脑损伤
Let's put up an infusion of hypertonic for the head injury,
帮助减轻颅内压
help reduce any intracranial pressure.
好的
OK.
血压还在下降
BP is still dropping.
她肯定某个部位有大出血
She's got to be losing volume somewhere.
同意
I agree.
我要启动红色警报
I'm calling a code red.
去拿A组合血包
Let's grab pack A and
通过静脉留置针输入一单位O-型血
run one unit of O-neg through the Venflon, please.
耐莉丝请准备大号♥导管全套工具
Nerys, trauma line kit, please.
五分钟后去CT室
We're gonna be in CT in five.
你先插上大号♥导管
But can you run a trauma line, please?
好的耐莉丝准备全套工具
OK. Nerys, trauma line kit, please.
马上办
I'm on it.
正在通知血库谢谢
Calling through to blood bank. Thank you.
箱式夹板准备好了
Box splint to go.
别问
Don't ask.
我是坎贝尔护士复苏室启动红色警报
It's Sister Campbell. We have a code red in resus.
对病人编号♥FE
Yep. Patient reference, Foxtrot Echo.
B组合血包里需要六单位O-型血
From Pack B, we need six units of O-neg,
四单位新鲜冷冻血浆两单位血小板
four of FFP and two of platelets.
你们知道她血液不流通吗? 手臂骨折
You know there's no circulation? Brachial rupture.