急诊室的故事

ER S01E01

Part 11 Nov. 22, 2019, 11:56 a.m.

I know, but there's no one to do him.
好吧通知摩根斯坦
Okay, okay, call Morgenstern.
让他马上过来
Tell him to get over here right away.
我先开始做破裂的动脉瘤手术
I'm starting a ruptured aneurysm.
皮特不行你只是住院医师
Peter, you can't. You're just a resident.
你想干什么等下去吗
What do you want to do? You wanna wait?
我们讨论的时候这家伙可能会死
This guy could die while we are here discussing this.
-我知道但是 -听着
- I know that, but - Look!
我只是想让他活到
I'm just trying to keep him alive
摩根斯坦来就这么简单好吗
until Morgenstern shows up. That's all, ok?
马上通知手术室让他们准备开腹手术
Now call the O.R. and tell them to set up for a laparotomy.
拜托
Please.
是的我是刘易斯医生
Yes, this is Dr. Lewis.
让摩根斯坦听电♥话♥
Get me Morgenstern.
那就把他找来我们有个动脉瘤破裂的病人
Well find him! We have an blown aortic aneurysm,
本顿医生要开始做手术了
and Dr. Benton's starting.
他需要帮忙是的没错
He'd like some help. Yes, that's right.
本顿医生要做手术
Dr. Benton's starting.
-有什么情况 -腹部主动脉瘤破裂
- What's on? - Ruptured abdominal aneurysm.
-谁做手术 -本顿医生
- Who's doing it? - Dr. Benton.
本顿医生吗
Dr. Benton?
本顿动脉瘤
我来帮你做麻醉皮特
I'm doing anesthesia for you, Peter.
太好了到血库去
Great. Get down to the blood bank,
让他们给我们送20个单位来
make sure they send us 20 units.
让护士们都动起来患者在路上了
And get the nurses jumping. The patient's on his way.
你确定没问题吧
You sure you're okay about this?
我紧张得要命这家伙的腹部已经破裂了
I'm scared as hell. The guy's already ruptured his belly.
肿块就像个气球一样他会内出血致死的
His puff is like a ballon. He's bleeding to death internally.
我得救他我是他唯一的机会了
I gotta do him. I'm his only chance.
晚上好先生们我想跟你们说一声
Evening, gentlemen. I just wanted to let you know...
我准备在二号♥室
...I'll be starting
做主动脉瘤破裂的手术
a ruptured abdominal aortic aneurysm in Room 2.
等你们有空了希望你们能来搭把手
I'd appreciate a hand when you have a minute.
-他说什么 -他说他要做动脉瘤手术
- What did he say? - He said he's doing an aneurysm.
开玩笑的吧
That's a joke, isn't it?
谢丽尔去看看他是不是在开玩笑
Cheryl? Go make sure he's joking.
阿什利医生他确实要做这个手术
Dr. Ashley, he's doing it.
开什么玩笑吉姆快去给他帮忙
You're kidding! Jim, break and help him.
我这边完了之后尽快赶过去
I'll finish here and get there as soon as I can.
各位开始吧
Okay, boys and girls, let's go.
这可不是野餐是深夜秀
This isn't a picnic. It's the late, late show.
请做准备吧
Prep, please.
请做准备不要盯着我看好吗
Prep, please! Come on, quit staring at me.
我只是想让这可怜的家伙活下去好吗
Look, I'm just trying to keep the poor guy alive, okay?
好了塑料覆膜
All right, plastic.
-吉米会过来帮忙 -太好了
- Jimmy's coming in to help. - Oh, great!
医院里唯一的对血管手术
The only guy in the hospital that knows less
懂得比我还少的家伙
about vascular surgery than I do.
-好吧哈维先生有意见吗 -他没说什么
- Okay, is Mr. Harvey happy? - He isn't complaining.
好那我们就开始吧手术刀
All right, then let's do this. Knife, please.
谢谢
Thank you.
手术开始的时间是凌晨2:13
We start up this operation at 2:13 A.M.
我们看看还要多久
Let's see how long it's gonna take the Chief
主任才能放下妹子回来跟我们一起工作呢
to get off his girlfriend and into his work with us.
就这样慢慢来稳一点
Yes, nice and slow.
吉米我们没等你就开始了
Started without you, Jimmy.
给你先生
There you go, sir.
好听着
Okay, now listen up.
我们就沿着腹白线向下划
We're going straight down the linea alba.
不太好看这家伙反正也只有50%的生存机率了
Nothing fancy. The guy's got a 50% mortality anyway.
抽吸就这样
All right. Suction. Let's get that.
谢谢这样也算不错了
Thank you, for all the good it'll do.
拿起来拿起来吉米跟上我的节奏
Pick up, pick up. Come on, Jimmy, work with me.
里面有好多血
Lots of blood in there.
这正是他的问题所在
It's precisely his problem.
好的我们动手
Okay, here we go.
祝我好运吧手术刀
Wish me luck. Knife.
收缩压保持在100
Systolic's holding at 100.
妈呀
Mother!
就是现在
Now!
我找不到
Can't find it.
他妈的
Damn it!
那里不不是
There! No, no.
吉米把手伸进去
Jimmy, get your hand in there
把小肠拨到一边
and push away the small intestine.
小出血点你在哪儿呢他的血压有多糟糕
Come on, little leak where are you? How bad is his pressure?
-你不会喜欢的 -我不喜欢考虑一下他
- You won't like it. - I won't like it? Think about him.
卡萝再挂六个单位的红血球浓厚液
Carol, hang 6 more units packed cells
还有一个单位新鲜冷冻血浆和血小板
and a unit of fresh frozen plasma and platelets.
等等
Wait a minute.
希望太高了对不对
It's too much to hope, huh?
我找到了
I got it.
没错我找到了停止计时
Yeah, I got it. Time down.
过几分钟再开始
Call it out in minutes.
把这块地方抽吸干净
Let's suck this field clean
才能看清楚我们在做什么我找到了
so we can see what the hell we're doing. I got it.
本顿医生住院医生主任
Dr. Benton, the Chief Resident
已经回到医院正在赶过来
is in the hospital and on his way.
好把这块地方抽吸干净主任来了
Well, suck that field clean, we got the Chief coming!
别让他觉得
We don't want him to think
我们不知道自己在干什么
we don't know what we're doing here, huh?
-血压 -100/70 还在下降
- Pressure? - 100 over 70 and falling.
我不会紧张的我们继续输血
I won't sweat that. Let's just keep that blood going in.
吉米怎么啦你的手在抖
Jimmy, what's the matter? Your hands are trembling.
-我不知道为什么 -好吧我也不知道
- I can't imagine why. - Yeah, well, me neither.
但一切都很好
But everything's cool here.
我们只要坐着等就行了
All we have to do is sit and wait.
本顿医生阿什利医生会尽快赶过来帮你的
Dr. Benton, Dr. Ashley will be with you as soon as he can.
突然之间所有人都跑来帮我了呢
All of a sudden, I got all the help I want, huh?
开始硝酸甘油静脉滴注
Start a nitroglycerin drip.
50毫克配250毫升糖水 80毫克呋♥塞♥米♥
50 to 250 D5W, 80 of Lasix.
静脉推注
IV push.
检测一下血常规电解质心肌酶
Get a CBC, lytes, cardiac enzyme...
做个胸透十二导联心电图
...chest X-ray and a 12-lead EKG.
你吃洋地黄了吗亲爱的
You take digitalis, dear?
你今天吃过了吗今天早上
Have you taken any today? This morning?
再测一下洋地黄的指数
Add a digi level.
还有 3豪克吗♥啡♥ 静脉推注
Meanwhile, 3 milligrams of morphine. IV push.
我不能放弃
I can't give this up.
不不不是说你你没事
No, no, no. Not you, you're fine.
格林医生你太太在2204线
Dr. Greene, Your wife on 2204.
我回头再打给她
I'll have to call her back.
进来这里一定要花不少时间吧
Sure taking a long time getting in here, huh?
他们在外面刷手好像刷了一个月了
They've been out there scrubbing for the last month.
你知道吗有时候就是这样
You know, it's times like these
我会陷入一种思绪
when I get into a reflective mood...
我会停下来想怎么样
...and I pause and think of how-
早上好皮特赶紧介绍一下情况
Good morning, Peter. Give it to me quick.
57岁白人男性健康状况良好
57-year-old white male, in good health,
八周前来到我院
previously seen at this hospital 8 weeks ago...
照X光的时候发现他的腹部
...when he was found to have a pulsatile abdominal mass...
存在主动脉钙化以及搏动性肿块
...with aortic calcification on X-ray.
本来安排在下个月择期手术
Elective surgery was scheduled for next month.
但是今晚他诉称
But this evening, he was complaining of
中背部出现了严重的间歇性疼痛
severe intermittent pain in the mid-back.
等来到医院时
By the time he got to the hospital,
他已经腹部肿胀
he had a distended abdomen,
腹膜异常红细胞压积下降
peritoneal irritation and reduced hematocrit.
所以你决定给他开刀
So you decided to open him up.
这是我见过的最难看的切口
This one is the uglist incision I've seen in a long time.