争分夺秒（2015）

Critical S01E12

Part 5 Jan. 6, 2021, 2:22 p.m.

Come on, come on. Sats are dropping.
我什么都看不见
I can't see anything.
外科性气肿内管
Surgical emphysema...Tube.
好我觉得我可以...
OK, I think I can...
加油
Come on.
哦该死插不进去
Oh, shit...I can't.
哦该死我把他捅出血来了
Oh, shit! I've made him bleed.
康斯坦丝快速气管切开套件
Constance, Quicktrach.
等下稳住
Hang on a sec! Easy.
先试着给他插管
Let's try and get this tube in him.
来让我来
Here, let me.
你看他的血氧只有61 他需要做环甲膜切开术
Look, his sats are 61! He needs a cric.
稍等需要给他建立气道多米尼克
One sec. He needs an airway, Dominic!
等下手术麻醉师马上就来
Hang on! Surgical anaesthetist is on the way.
不他的血氧在下降
No! His sats are still falling!
如果你不停手他会死该死
If you don't stop, he's going to die! Damn it!
停! 无法插管无法通气
Stop! He's can't intubate, can't ventilate.
让开我们得立刻动手手术刀
Move. We do this now. Blade.
加油
Come on.
插♥进♥去了冲洗并通气冲洗并固定
We're in. Cuff up and ventilate. Cuff up and tie.
请握住这个
Hold this, please.
通气
Ventilating.
血氧度上升
Sats rising.
取出大弯止血钳剪刀
Roberts out. Scissors.
脾脏切除术完成纱布
Splenectomy is complete. Packs.
用掉两块用掉两块一共用掉八块
Two in. Two in, eight in total.
血压还在下降收缩压70
BP still dropping, systolic is 70.
好下面处理腹膜后出血嗯等下
OK, moving on to the retroperitoneal bleed. Um, hang on.
怎么了我们不应该先检查剩余的腹部吗
Yes? Shouldn't we examine the rest of the abdomen first?
我们得先处理流血但是规矩是...
We have to address this bleed. But the protocol is...
拉玛克里士纳这里没有主任医师
Ramakrishna, we don't have a consultant present.
所以得有人来主刀对不对
Someone has to lead. Yes?
谢谢
Thank you.
腹膜后出血正在扩张
Evidence of an expanding retroperitoneal haematoma.
血压还在下降现在收缩压是67
BP still dropping, systolic now 67.
让我看一下骨盆X光好的
Let me see the pelvic x-rays. Yup.
拿出四块拿出四块还有四块在里面
Four out. Four out, four in.
好骨盆没有明显骨折
OK. No pelvic fractures in evidence.
所以大出血很可能是由静脉引起的
So the haematoma is...probably venous in origin.
同意吗同意
Agreed? Agreed.
镊子麦金杜剪
Forceps, McIndoes.
菲奥娜在开始之前
Fiona, before we do it,
我能说句话吗快说
can I just say something? Quickly!
既然现在没有主任医师在场
Given there's no consultant present,
我们不应该采取保守一点的治疗方式吗
shouldn't we be treating this a bit more conservatively?
他的血压还在下降他等不了
His BP is still falling. He can't wait.
是啊我只是说如果是静脉出血
Yeah, I'm just saying if the bleed is venous,
为什么你还要冒险再扩大他的伤口呢
why would you wanna risk opening him up further?
好吧那我给他做一些腹膜外包裹
OK, I'll do some extraperitoneal packing
这样可以稳住他直到斯特里特来为止
That should stabilise him until Street gets here.
止血钳
Forceps.
纱布
Pack.
用掉六块用掉六块一共十块
Six in. Six in, ten in total.
好
OK.
血压? 维持住了
BP? It's holding.
维持
Holding.
维持
Holding.
哦拜托
Oh! Come on!
立刻给我镊子和麦金杜剪
Forceps, McIndoes - now!
血压下降收缩压6♥4♥
Dropping. Systolic is 6♥4♥.
动脉大出血吸引器
Massive arterial bleed. Suction.
比利赶紧输血是的
Billy, whack it in! Yes!
好吧我什么都看不到再来一个吸引器
OK. I can't see a thing here. I need another suction.
吸引器快
Suction, quickly!
我什么都看不见快点
I can't see anything here! Quickly!
找不到出血点一定是在盆骨里
I can't locate the bleed. It's got to be in the pelvis.
但没有骨折
But there's no fracture!
该死大出血
Shit! Hosing!
血压下降比利赶快输血
BP's dropping! Billy, whack it in!
是是已经在输了
Yes, yes, we're on it!
纱布再来
Packs! And again.
斯特里特在哪里我去找他
Where's Street? I'll get him.
收缩压60
Systolic is 60!
比利输血再快点
Billy, faster with the blood!
快越快越好收缩压57
Go! Must go with full pelt! Systolic is 57.
还在下降 53 该死他快不行了
It's dropping. 53. Shit, he's crashing.
菲奥娜
Fiona?
格伦我需要你的帮助
Glen, I need your help.
我控制不了他的腹膜后出血
I can't control this retroperitoneal bleed.
斯特里特呢他不在这里
Where's Street? He's not here.
我控制不住我需要你立刻到手术室
I can't controlt this. I need you in theatre now.
去B号♥病位
Bay B, please.
我这里有七个病人其中三人不稳定
I've got seven patients here, three of them are unstable.
我绝不可能离开的抱歉
There's absolutely no way I can leave. Sorry.
格伦我快救不回他了
Glen, I'm losing him.
告诉我具体怎么回事
Tell me exactly what's happening.
好吧我给他用了骨盆包裹法但血压还在下降
OK, I've packed him, but his BP is still falling.
收缩压50左右
Systolic's around 50.
他的腹膜后腔大量出血但这说不通
He's hosing into the retroperitoneum, but it doesn't make any sense -
没有破损的血管骨盆也是完整的
there are no torn vessels and the pelvis is intact.
而且确定没有骨折?
And we're absolutely sure it's not a fracture?
我现在正在看着X光片呢
I'm looking at the x-ray right now.
等下等下格伦
Hold on, hold on. Glen...
停送去哪里
Stop. Where are we taking him?
那里现在只能双床位了
OK, in there. We're double bedding.
X光片骨盆包扎带在上面吗
The x-ray, is the pelvic binder on?
是的好的听着
Yes. OK, listen...
开免提你听到他说的了
Put me on speaker. You heard him.
好说吧好所有人听我说
OK, go ahead. OK, everybody listen to me.
如果真是如我所想那样
If this is what I think it is,
那我们在巴斯申营地遇到过
then we had this at Bation.
很有可能骨盆的确骨折了
the chances are the pelvis is fractured.
只是包扎带捆住了
The binder has reduced it,
所以我们看不到裂纹但的确有
so we can't see the break, but it is there.
X光分辨率太低看不出来
X-rays are too low-res to reveal it.
该死我们没做CT 是啊
Shit. We skipped CT. Yeah.
止痛剂? 呃吗♥啡♥
Analgesic? Er, morphine.
10毫克? 是的一次2.5毫克好么
10mg? Yeah. 2.5 at a time, yes?
去吧你们需要这么做
Go. This is what you need to do.
你们需要拿掉纱布
You need to unpack,
进去钳闭其中一根髂内动脉
get in there and clamp off one of the internal iliac arteries.
如果无法判断是哪根那就得两根都钳住
If you can't determine which one, well, you'll have to do both.
两根都钳闭?
Both of them?
我知道这样很胡闹但必须得这样
Yeah, I know. It's crap, but yes.
好知道了很好请把免提关了停
OK, got it. Good. Take me off speaker, please. ..Stop.
去吧免提已经关了
Go. You're off speaker.
对我来说你比军队重要懂吗
You're more important to me than the army. OK?
所以我才要留下来
That's why I'm staying.
我得挂了
I have to go.
稍后再谈祝你好运
I'll speak to you later. Good luck.
谢谢
Thank you.
好
Right.
我们要拿掉纱布动作得快
We're unpacking. And this is going to be fast.
大家都准备好了吗
Is everybody ready?
是的罗马斯女士准备好了
Yes, Miss Lomas. Ready.
拉玛克里士纳好了上吧
Ramakrishna? Yeah, let's do this.
解开纱布
Unpacking.
拿出四块
Four out.
拿出四块还有十块该死
Four out, ten in. Shit.
好赶紧吸液
OK, get in there with suction.
我找不到