急诊室的故事

ER S01E18

Part 2 Nov. 22, 2019, 11:58 a.m.

从没见过星形的暖气旋钮
Never seen a star-shaped radiator knob.
我会联♥系♥其他医院
I'm gonna call other hospitals.
看她是否去过其他医院看病
See if she's been seen anywhere else.
打扰一下
Excuse me!
来人
Excuse me!
马利克推一个轮床来
Malik, get a gurney!
怎么回事
What happened?
他在一个餐馆里
He was sitting in a restaurant.
才吃完早饭突然倒下
He just finished breakfast when he keels over...
全身发抖
...starts shaking and shivering,
翻白眼
his eyes roll back in his head...
-什么情况 -癫痫大发作
- What is it? - A seizure, grand mal type.
-二床空着 -没有伤到舌头
- Curtain 2 is open. - No tongue abrasions.
没有失禁你是亲属吗
No signs of incontinence. So are you related?
不我是餐厅经理
No, no, I manage the restaurant.
谢谢你送他来这里我接手了
Thank you for bringing him in. I'll take it from here.
等一下
Just a sec.
如果他没事了让他打给我好吗
Look. If he's okay, have him call me, okay?
说起来有点丢人但他饭钱还没付
I know this sounds bad, but he didn't pay the check.
他吃了带香槟的早午饭牛排和鸡蛋
He had the champagne brunch, steak and eggs.
三十五美元呢
It was a $35 meal!
邻居听见一声巨响在楼梯底下找到了他
Neighbor heard a crash. Found him at the bottom of the stairs.
-体征 -血压80/60 心率128
- Vitals? - 80 over 60, heart's racing at 128.
-输液没 -没找不到静脉
- Get him...um...IV in? - No. Couldn't find a vein.
哈蕾准备中♥央♥静脉导管
Haleh, prep for a central line.
把他推进来我数到三把他抬过来
Ok, people, let's get him in. Let's get him across on my count.
把插管托盘拿来
Get a cordis tray.
我们动作会很轻并且迅速你听见了吗
We're gonna do this nice and gentle. Do you hear me?
一二三起小心点来了
One, two, three. Go. Here we go. Here we go.
注意导管
Watch the line.
毛细血管回充很差
Capillary refill's poor.
这个老头有胃管
All right. The old guy's got a G-tube.
-他叫什么 -约瑟夫·克莱恩
- Do you know his name? - Joseph Klein.
-低血压血压50 -脚部水肿
- Hypotensive. BP's 50 palp. - Pedal edema.
充血性心力衰竭
Congestive heart failures.
听不到呼吸声肺萎陷了
No breath sounds. Lung's collapsed.
-肋骨肯定断了 -这老头一团糟
- Must have broken a rib. - This guy's a train wreck.
把胸管托盘拿来快
Just get a chest tube tray. Now.
听得懂我说话吗回答我
Also, can you understand me? Talk to me.
卡特他说不了看脖子没有喉头
Carter, he can't. Look at his neck. No voice box.
他很痛苦我们能给他点止痛药吗
He is in pain. Can we give him something?
-准备吗♥啡♥ 2毫克 -谁有钥匙
- Stand by with morphine, 2 mg. - Who's got keys?
好了卡特 28号♥法式快
All right, Carter. 28 French. Move.
呋♥塞♥米♥ 80毫克静脉推注
Lasix. 80 mg, IV push.
拿些束带来
Get some restraints in here.
他现在就需要吗♥啡♥ 快点
He wants the morphine now. Come on.
-在这让开 -导管插♥进♥去了
- Over here, now. Move! - Line's in.
加多巴胺 400毫克 250毫升糖水
Load the dopamine, 400 mg. 250 D5W.
我们会照顾好你没事了
We'll take care of you. It's gonna be okay.
血压120/80 不错啊
Pressure's 120 over 80. No bad.
神经反射正常
Reflexes are normal.
-我看不到癫痫的症状你呢 -我也是
- I don't see any signs of a seizure, do you? - No.
心跳规律
Has an irregular heartbeat.
-他刚刚睁眼了 -真的吗
- Hey. He just opened his eye. - Really?
是啊
Yeah.
你好啊我知道你忙着昏迷
Hello in there. I know you're busy having a coma.
能告诉我们原因吗先生
Do you wanna tell us why, Mr?
我们知道他的名字吗
Do we have a name?
有好几个名字
Actually, we have several.
亚特·莫斯萨姆·哈特和金·芬奇
Art Moss, Sam Hart and Gene Finch.
嗨又是我
Hello. Me again.
我想告诉你你身体的确有问题
I wanna let you know that you actually do have a medical problem.
我们要开刀了胸骨撑开器
We're going to have to go in. Rib spreader!
为了吃霸王餐够拼的
Helluva way to get a free meal.
-你能拿一下血样吗 -血压
- Can you get bloods? - BP?
还是低 60
Still low. 60 palp.
加多巴胺 10单位
Increase the dopamine. 10 mics permitted.
-有十号♥刀片吗 -在托盘里
- Got a number 10 blade? - On the tray.
坚持住克莱恩先生
Hang in there, Mr. Klein.
来吧
Let's have it.
入院时充血性心力衰竭气胸
Came in with congestive heart failure, tension pneumo.
他注射了高剂量的多巴胺皮特在插胸管
He's on high-dose dopamine. Peter's putting in a chest tube.
好这里由我接手
Yeah, I'll take it from here.
我能对付
I got it.
我来接手
I'll take it from here.
要么去睡会儿要么回家这是最后一遍
Either get some sleep or go home. I won't tell you again.
克莱恩先生的病历来了
Mr. Klein's old chart came up.
我能看看吗
Can I see it?
看一下他在吃哪些药
Check to see what meds he's on.
胸管插♥进♥去了
Chest tube's in.
听到呼吸声了
We got breath sounds.
血氧含量从82上升到了90
Pulse ox up to 90 from 82.
老头救回来了
Train is back on the tracks.
大家干得漂亮
Nice job, everybody.
克莱恩先生是癌症晚期
Mr. Klein has terminal cancer.
他上次在这时签了一个协议
And the last time he was here, he signed a paper...
要求不采取急救措施来延长生命
...requesting no heroic measures be taken to prolong his life.
你和珍要继续分居一年
You and Jen are going another year like this?
我想没别的方法了
I guess we're gonna have to.
格林医生恭喜你升了主治医师
Dr. Greene, congrats on the new attending gig.
谢谢
Thanks.
珍坚持留在密尔沃基吗
Jen is adamant about keeping her job in Milwaukee?
她想让我搬过去
She wants me to move there.
我不能放弃做主治医师
I can't give up this job as attending.
-有事吗 -你是格林医生吧
- Can I help you? - Dr. Greene, right?
是啊
Yes.
约翰·科赫
John Koch.
麻省理工学院斯隆管理学院
MIT, Sloan School of Management.
-找我有什么事 -他们没给你打电♥话♥
- What can I do for you? - They didn't call you?
没打
No.
我是来观察你的部门的
I made arrangements to observe your department.
我在为安多弗项目做调查
I'm doing research for the Andover Project,
你也许听过
which you may heard of,
白宫新闻发布会 CNN报道过
White House press conference, profile on CNN?
-我肯定错过了 -我们在为二十一世纪
- Must've missed it. - We're building a new hospital...
建一栋新的医院打破陈旧的模式
...for the 21 st century, scrapping the old model...
紧跟潮流
...for these competing fashions
创造新型合作典范
in favor of a more collaborative paradigm.
像团队管理那样
Like a team approach?
是但是更加综合
Yes, but on a comprehensive scale.
我们从建筑
We're reconceptualizing the hospital architecturally,
组织人体工程学角度
organizationally
重构医院的概念我们希望建立
...ergonomically. We hope to build the model...
未来所有医院参照的模式
...on which all future hospitals will be based.
所以你想观察我们看看错误示范
So you'd like to watch us to see how it shouldn't be done?
相反这里拥有卓越的口碑
On the contrary. This place has a superior reputation.
我想取其精华去其糟粕
I want to keep what works and change what doesn't.
-请自便吧 -很好
- Feel free to look around. - Great.
我无意中听到了
Oh, I couldn't help overhearing.
我有个办法解决你们夫妻相隔两地的僵局
I may have a solution to you and your wife's geographic impasse.
-什么 -基诺沙在芝加哥
- Excuse me? - Kenosha. Midway between...
和密尔沃基中间通勤时间不到一小时
...Chicago and Milwaukee. Commute's less than an hour.
这样你们能一起住也可以继续自己的工作
Each way you can live under one roof and both keep your jobs.
克莱恩先生
Mr. Klein.
克莱恩先生我是约翰·卡特
Mr. Klein, I'm John Carter.
你也许记得我
You might remember me from earlier.
我带了纸和笔方便你和我沟通
I brought a pad and a pen, in case you want to say something.
我放桌子这边了
I'll just put them here on the end of the table here.
克莱恩先生我为刚才的事道歉
Mr. Klein, I'm sorry about what happened earlier.
你的血压还是很低
Your blood pressure's still pretty low,