急诊先锋：纽约（2023）

好的 我帮你转接肝脏移植科
Alright, let me get Liver Transplant on the line for you.
你好 医生 说说患者的情况吧
Hello, doctor. Why don't you tell us about the patient?
她因为疲倦和黄疸来就诊
She comes for fatigue and jaundice.
她皮肤发黄 所以来到医院
She turned yellow, and she came into the hospital.
你觉得是自身免疫性疾病?
You're thinking autoimmune here?
是的 我觉得是自身免疫性疾病 现在病情正在恶化
Yeah, I think it's autoimmune. And now she's doing worse.
各位 这是移植名单小组的紧急会议
Guys, this is an emergency meeting of the transplant listing group
因为这位年轻女士的病情急剧恶化
because this young lady is getting much sicker.
她出现了急性肝功能衰竭 是自身免疫性疾病
She has acute liver failure, autoimmune.
大家都赞成将这名患者 列为一类状态吗?
Is everyone in favor of making this patient a status one?
当然
Absolutely.
患者现在是一类状态 这是美国的最高状态
So the patient is now status one, that's the highest status in the country.
我们将即刻开始寻找一个肝脏
Starting from right now, we're going to be looking for a liver.
肝脏突然受损的人
And what happens to someone who suddenly gets a hit to the liver,
肝功能无法得到代偿
there's no means of compensating.
患者会开始变得意识模糊
They begin to get confused.
她最终会不记得自己的名字
She will eventually not know her name.
她是一名四年级老师 有两个年幼的孩子
She's a fourth grade teacher, and she has two young kids.
-你的孩子叫什么名字?-米娅和泰勒
- What are your kids' names? - Mia and Taylor.
他们几岁了?
How old are they?
Uh... seven and...
七岁和...
好的 没关系
Okay. That's okay.
她很快就会说不出话 然后需要插管
Soon she won't be able to speak, and then she'll need to get intubated.
这是肝功能衰竭的自然进程
This is the natural course of liver failure.
这是跟时间赛跑
It's a rush, it's a race.
如果无法在48至72小时内找到器官
If there's no organ available in the next 48-72 hours,
她将输掉 去见上帝
she will lose and she'll go to God.
-我们会帮你找到健康的肝脏的 -谢谢
- We're going to find you a good liver. - Thank you.
-一旦有肝脏 就是她的 -我们一定要找到器官
- First one to pop up will be hers. - Let's just find an organ.
片名:急救先锋:纽约
剧名:压力之下
(莱诺克斯山医院)
扣好白大褂 把衣领弄好
Button your jacket. Fix your collar.
Okay.
- Thank you. - Alright, you're fine. Let's go.
-谢谢 -好 行了 走吧
美好的一天
Beautiful day.
地铁人流如织 餐厅宾客满座
Subway's packed, restaurants are busy.
形势正在好转
Things are looking up.
终于
Finally.
- Oh, there he is. - How are you?
-他在那里 -你好吗?
-太谢谢你了 -不客气 很高兴见到你们
- Thank you so much. - My pleasure, good to see both of you.
路上还顺利吧?
And how was the drive up?
不错 很顺利 他们不让我开车
It was good, very nice. They wouldn't let me drive.
我开车太快
- I drive too fast.
We're really blessed to be back here. I'm really lucky.
我们很幸运能回到这里 我真的很幸运
-好的 我想让你看几张片子 -好
- I want to show you some pictures. - Okay.
显然 当我从侧面看你的时候
So, obviously, when I'm looking at you from the side here.
患者的父亲 你可以看到 这是侧面
Dad, you can see that this is the side view.
Mm-hmm.
- And this is the growth. - Wow.
-这是肿瘤 -哇
- Can I touch? - Of course.
-我能摸摸吗?-当然了
就是这里
It's this right here.
你看到中间的红色磨损部位了吗?已经开始感染了
You see in the middle here where it's red, worn down, and starting to get infected?
问题就出在这里
That's the issue.
现在情况变得非常紧急
This became really an emergency.
肿块的生长速度非常快 已经开始穿透头皮了
The mass is growing so quickly, it's starting to erode through his scalp,
所以我让他趁周末从肯塔基开车过来
so I made him drive up from Kentucky over the weekend.
这是癌症
This is all cancer.
他的病情有一个有趣又棘手的地方
What's fascinating and difficult about his case
就是癌症已经转移到肺部了
is that it's actually metastasized to the lung.
这种状况值得报告
That is a reportable event,
因为这种癌症 很少转移到大脑以外的地方
meaning that it happens so infrequently where it leaves the brain.
所以我们要切除整个肿瘤
So, we're going to take all this,
and then we're going to go in and take out the tumor in the brain.
然后继续深入 拿掉大脑中的肿瘤
Awesome.
我知道你会问 肺部转移怎么办?
I know you're going to ask, what about the lung?
我们会在做完PET扫描后 着手解决这个问题
We're going to deal with that after we get a PET scan.
-我们讨论过PET扫描 记得吗?-记得
- Remember we talked about that? - Yeah.
跟你们在一起 让我很有信心
I feel really confident to be here with you guys.
我很高兴我们做了这个决定
I'm so glad we made this decision.
感谢你的信任 我们像对待自己一样对待病人
We appreciate your trust, and we treat 'em like our own.
没错 我们不会让他受到伤害的
- Exactly. - We'll keep him out of harm's way.
精神感人 他全家人如此乐观
What a spirit. His whole family, to have that kind of optimism.
我叫他来 他们立马就上路了
I told him to come, he's like, "We're on our way."
I mean, incredible courage, and hopefully he's got a life in front of him.
勇气令人感佩 希望他能好好地活下去
你还真是紧张
And you're really nervous.
多谢你来陪我
Thank you so much for being here.
我当然会陪你
I wouldn't have it any other way.
- What are you doing this weekend? - Sleeping.
-这个周末你打算怎么过?-睡觉
我说过了
I told you.
-我要好好维护心理健康 -因为打了疫苗吗?
- I'm taking a mental health day. - Because of the vaccine?
-是的 我的身体需要恢复 -搞不懂你
- Yeah, my body needs to recuperate. - I can't with you.
我的当务之急是睡觉 我缺觉
My biggest thing is sleep. I don't sleep enough.
我要做的是 不管发生什么事
What I try to do is no matter what, no matter what,
我都要回家洗个澡 换上睡衣 上♥床♥躺着
I'm going home, take a shower, and get in my pajamas, and get in bed.
Mm-hmm.
如果你想聊天 就来我的床上跟我聊
If you wanna talk, come talk to me in my bed.
如果你想找个借口出门...听着...
If you want an excuse to be out-- and look...
-你们可以处理一个紧急状况吗... -头部受伤
- Can you respond to emergency-- - Head injury.
要走几条街 对吧?
A couple of blocks down, right?
那边
Over there.
那孩子在哪儿?我去
Where's the kid? Damn.
-他在哭 -糟糕 还有一个孩子 克里斯蒂娜
- Oh, he's crying. - Oh no, there's another kid, Kristina.
他的头上有个大大的血肿
He has a big hematoma on his head.
准备好了吗?下车时小心点 戴上口罩 好吗?
Are you good? Be careful getting out. Put your mask on, okay?
Yeah.
不 别动 坐下 看看我
No, you don't move. I want you to sit. Look at me.
我要你坐着别动 好吗?很好
I want you to sit and don't move, okay? You're doing a great job.
好 你在哪所学校读书?
Okay, what school do you go to?
他们有症状吗?那就再叫一辆救护车
They're having symptoms? Call another bus then.
我们需要三辆救护车
We need three busses.
请求增派两辆救护车 现场提供 基础生命支持 增加了两名患者
Requesting two additional busses, BLS to location. Two additional patients.
- They're here, Kris. They're here. - Alright, sit down.
他们到了 克里斯 他们到了
冷静 好吗?
Try to calm down, okay?
-别担心 -我们会照顾你的
Don't worry, we got you.
Can you call the parent?
-麻烦你给家长打电♥话♥ -我会照顾你的
I got you.
薇琪 我需要血压值
Vicky, I need the blood pressure.
-好 -我们得走了
- Okay. - We gotta go.
得马上送他去创伤中心 快点 我们得离开现场
He has to go to the trauma center now. Now. We gotta get off the scene.
好 我们可以走了吗?
Yeah, can we check out right away?
Squeeze my hand, sweetie, can you squeeze?
握住我的手 亲爱的 能握住吗?
你还好吧?这里疼吗?
You okay? Does this hurt right here? Does this hurt down here?
(科恩儿童医疗中心 诺斯韦尔健康)
(布鲁门菲尔家族大楼)
我每天早上5点半起床 这样差不多有20年了
Every day, I've started my life before 5:30 in the morning for 20 years almost.
我接受培训时 早上4点就要起床
And when I was in training, it was 4:00 in the morning.
但我会喝古巴咖啡
But I drink my, uh, Cuban coffee,
然后就有精神了
and I get going.
I can't remember. What name did you give her?
你们给她取的什么名字?
-你们给她取名了吗?-艾莉安娜
- Did you guys pick a name for her? - Elliana.
艾莉安娜?好
Elliana? Okay.
我去跟团队谈谈
So, I'm going to talk to the team,
我们要看看她的病历
and we are going to look over her medical information,
然后我们去手术室 好吗?
and then we will be heading out to the OR, okay?
我们将做出最终决定
So, we're gonna make a final decision,
但我想我们会采用 右侧胸廓切开术 然后...
but I think we're gonna go with the right thoracotomy, and then...
我们大概率会使用补片 具体取决于缺损的大小
There's a good chance we'll use a patch, depending on the size of the defect.
而且我们不用内窥镜
And we're not gonna use the scope.
根据婴儿的体型大小 我们直接打开胸腔做
We're gonna do it straight open, based on the size of the baby.
好
Okay.
我们要修补一处膈疝
We're gonna fix a diaphragmatic hernia
患者是一个体重1.8公斤的早产儿
in a tiny preemie baby that weighs four pounds,
出生还不到一周
who is less than a week old.
当时发现膈疝时 并不确定胎儿能否活下来
It was not clear it was going to survive, uh, when this was found.
婴儿出生前 在一次超声波检查中发现