急诊室的故事

ER S01E19

Part 3 Nov. 22, 2019, 11:58 a.m.

拿一个牙垫来硫酸镁挂上了吗
Grab a bite block! Is the mag in?
-明白 -按住她
- Got it. - Restrain her.
想想办法你们快帮帮她
Do something! Somebody help her!
救救她
Help her.
再注射4克硫酸镁
Push another four mag sulfate.
你会没事的
You'll be okay.
4克硫酸镁
Another four mag.
静脉注射针头滑出
IV's out!
另一个针头也掉了
The other one's blown.
我来进行颈外注射
I'll throw in an external jugular.
2毫克劳拉西泮
Two migs of Ativan.
-酒精棉片在哪里 -按住她
- Where's the prep pad? - Restrain her.
劳拉西泮准备好了
Ativan's ready.
按住她
Restrain her.
插♥进♥去了
It's in.
供氧量提到15升
O-2 to 15 liters.
好了癫痫停止了
Okay, seizure's stopping.
强换气做个多普勒
Alright. Let's hyperventilate her. Get doptones.
让我做个快速的盆腔检查
Let me do a quick pelvic.
做个血气分♥析♥
Let's get a blood gas.
宝宝心跳强劲心率140
Fetal heart tones, strong at 140.
-那是个好消息 -输入30毫升盐水
- That's good news. - Running 30cc's of saline.
宫口扩张2厘米子♥宫♥颈消失80%
2 cm dilated. Eighty percent effaced.
胎膜完整
Membrane's intact.
给楼上打电♥话♥ 看看妇产科是谁值班
Call upstairs, see who's on call for OB.
医生到底怎么回事
Doctor, What the hell is going on?
你妻子患了一种叫子痫的妊娠晚期障碍症
Your wife has a disorder of late pregnancy known as eclampsia.
血管痉挛
The blood vessels go into spasm,
导致大脑缺氧引起了癫痫
causing lack of oxygen to the brain which leads to the seizures.
我们正用药物缓解症状
We're relaxing them with medicine.
-宝宝怎么样 -我们要为她接生了
- What about the baby? - We'll need to deliver.
-什么时候 -很快
- When? - Soon.
非常快
Very soon.
谁在创伤一室
Who's in Trauma 1?
一个子痫发作的三十岁孕妇
A 30 year-old pregnant woman with an eclamptic seizure.
她发作过了但是已经醒了
She's postidictal but she's coming around.
血压稳定吗
BP's stabilized?
硫酸镁注射了我来接手你回家吧
Mag sulfate going? Okay, I'll take over. Go home.
没关系我想看她顺利转交给妇产科
That's alright. I'd like to see her through the OB.
-我应付得来 -跟你没关系是因为我
- I can handle it. - It's not about you, it's me.
我之前给她看的病诊断为尿路感染
I saw her earlier and I diagnosed UTI.
让她出院而她在停车场就发作了癫痫
Sent her out and she seized in the parking lot.
我以为她尿液中的蛋白质是因为膀胱炎
I thought the protein in her urine was due to cystitis...
我还忽略了临界性高血压
and I blew off one borderline BP.
我跟到底会放心一些
I'd feel better if I saw her through.
子♥宫♥底胎盘看起来不错
Fundal placenta. Looks okay.
血压120/70 非常好
BP 120 over 70. That's very nice.
-见见小亨特 -德蒙特
- Look at little Hunter. - Dermot.
-杰森. -帕特里克
- Jason. - Patrick.
B超查看胎儿性别主要是找三条平行线或圆拱
-到底是不是男孩 -四处特征加圆拱形
- Is that a boy or what? - Four plus turtle sign.
什么意思
What's that?
那里看起来像个小鸡鸡
Looks like a little head peeking out right there.
给每个类别打零分或者两分
You give a score of zero or two for each category.
-胎动呢 -看起来非常活跃
- Movement? - He seems very active.
每晚差不多这个时候都是这样
Every night, around the same time.
两分
Score two.
以上四项属于胎儿生理评估
以及呼吸张力羊水量
Also breathing, tone, amount of fluid.
他有八分低于六分才需要担心
He's an eight. Anything less than a six, then you worry.
你来测定羊水指数
You do the AFI.
你将腹部分成四部分
You divide the abdomen into four.
找到没有宝宝器官或脐带的
Find the deepest pockets of fluid...
羊水池最深处
without fetal parts or umbilical cord.
你标记好
You mark...
每一个部分的拐角
each corner of the quadrant.
测量好再加起来
Measure and then add up.
加起来就是这个数吗
Is that what this number is over here?
那是宝宝的心率应该处于120到160之间
That's the baby's heart rate. That should be between 120 and 160.
所以140是最好的
So 140's perfect.
宝宝状态很好
The baby's in great shape.
宝宝生理评估八分羊水指数14厘米
Biophysical profile's 8. AFI's 14.
子♥宫♥颈良好非压力试验也开始了
Cervix is favorable. I've got a non-stress test started.
我很自在我接生过一两百个婴儿
I feel very comfortable. I've delivered a couple hundred babies.
现在九点那我们一个小时后见
It's nine o'clock, so we'll see you in about an hour?
柯博恩怎么说
What did Coburn say?
她还在圣卢克她说她
She's at St. Luke's, and she says she'll be here...
剖腹产一完事就回来
as soon as she's finished with her repeat C-section.
她想让我开始引产
She wants me to start an induction.
当然前提是我觉得自在的话
That is, of course, if I feel comfortable.
她这么说的吗
She said that?
真是个贱♥人♥
What a bitch!
德雷克
Hey, Drake?
-情况怎么样 -很好
- How do things look? - Looks Great.
血压一直都很正常
BP's been perfectly normal.
老天我能不能
Oh, boy. How can l...?
失陪一下
Excuse me.
他绝对没超过十二岁
He can't be more than 12 years old.
他是妇产科的值班住院医生
He's the OB resident on call.
我刚和我们妇产科主治医生柯博恩医生谈过
I just spoke with Dr. Coburn, our OB attending.
她同意我们要尽快为你接生
And she agrees that we need to deliver you soon.
你是要做剖腹产手术吗
Does that mean you have to do a C-section?
我想自然分娩
I want to deliver naturally.
你的子痫已得到控制宝宝状况很好
Your eclampsia's under control, the baby's in good shape...
子♥宫♥颈良好我们就做个尝试分娩
and the cervix is favorable. I'd say we do a trial of labor.
如果不成功呢
And if it doesn't work?
我觉得会成功的
I think it will work.
我想试试
I want to give it a try.
那我们就试试
Let's do it!
失陪一下
Excuse me.
马克你可以一个人在楼下处理这件事吗
Mark, Do you feel competent to handle this down here without me?
楼上要忙死了
We are getting slammed upstairs.
我想我能应付过去
I think I can muddle through.
我十一点来看看你好吗
I'll check back with you at 2300?
收到
Roger.
卡萝你能给奥布莱恩夫人注射0.5%浓度的催产素吗
Carol, could you give Mrs. O'Brian .5 Pitocin IV?
你要在这里引产吗
You're inducing down here?
我们现在这里开始再送她上妇产科
We're gonna start here and then get her up to OB.
-宫缩有多频繁 -大概十分钟一次
- How frequent are the contractions? - Every 10 minutes or so.
-好吧让格林医生决定 -你在开玩笑吧
- Okay, let's have Dr. Greene decide. - You're kidding!
我们给家人打电♥话♥时不能叫他X宝宝吧
We can't call him Baby X when we call our parents.
好吧让我们看看
All right. Let's take a quick look.
宫口扩张5厘米
It's five centimeters dilated.
子♥宫♥颈消失了90%
Ninety percent effaced.
胎头位置负2 胎膜完整
Station, minus two. Membrane's intact.
-你也想试试吗 -我可以吗
- You wanna look too? - May I?
有何不可所有人都在下面乱摸
Why not? Everybody else has been poking around in there.
给
Here.
伊安帕特里克德蒙特
Ian, Patrick, Dermot...
听起来像彩虹仙子的演员名
Sounds like the cast of Finian's Rainbow.
-对不起 -亨特
- Sorry. - Hunter?
亨特·奥布莱恩
Hunter O'Brian?
你同意我的评估吗
You agree with my assessment?
你的分娩进行得很好很快
Your labor's progressing along nicely and quickly.
宝宝很好
The baby is doing great.
宝宝的心率这样下降正常吗
Is it normal for the baby's heart rate to be going down like that?
只要是短暂的并高于120就正常
As long as it's only briefly, and it stays over 120.
两张表上都有杰罗德
Jared's on both lists.
不是我最喜欢的
It's not my favorite.
妥协是婚姻的灵魂就叫杰罗德
Compromise is the soul of marriage. Jared, it is.
杰罗德
Jared.