急诊室的故事

ER S02E02

Part 8 March 14, 2020, 9:20 p.m.

他也不会写病历
he won't write anything in the chart.
更不会做什么后续治疗
He's not going to be responsible for any follow-up.
这对孩子又有什么好处
Where does that leave the kid?
那现在就对孩子有好处了吗
Where's that kid left now?
他妈妈直接把他带走了
His mother took him out of here A.M.A.
这又该怪谁
And whose fault is that?
他不是精神科医生的病人
The psych resident was not managing this case, doug.
是你的病人
You were.
我要离开这里
I'm out of here.
道格
Doug...
我说了我下班了
I said... that I'm off!
道格你先等等好吗
Doug, come on. Wait a minute, okay?
我今天错过了什么吗
Did I miss something here today?
前往密尔沃基的最后一班火车
Let's just say that the last train
四十八分钟后就要出发了
to Milwaukee is in 48 minutes
我一定要赶上
and I plan to be on it.
所以现在不应该告诉你
So now's not a good time to tell you
你有一个胸部钝伤的病人
you got a blunt trauma to the chest
马上就到
pulling up to the back door?
明天见
See you tomorrow.
你还好吗
You okay?
我不敢动
I'm afraid to move.
我只要一动她就开始哭
Every time I do, she starts to cry.
但是这真是一种奇妙的声音
It's an amazing sound, really.
可不是嘛
Tell me about it.
我家里有两个孩子
I got two of them at home.
还有一个在肚子里
And a new one on the way.
恭喜你了
Congratulations.
我都不知道
I didn't even know.
没人知道
No one does.
你是第一个知道这个消息的人
I guess I just announced it.
但是该动的时候
But when you got to move them...
还是要动一下的
you got to move them.
只要大胆一点
Just... take your chances.
康妮抱歉我今天在创伤室
Oh, Connie, I'm sorry about my attitude today
态度那么差
in that trauma.
你当时确实够讨厌的
You were pretty pissy, all right.
但是看见你被喷了一脸绿色液体
But it was worth it just to see you
再怎么样都值了
take that green splash.
你要不要来抱抱她
Here. You want to try a hand-off?
好的
Yeah.
开拍
Shooting.
给他做一个十二导联心电图
We need a 12-lead E.K.G.
当做是一个教训吧丹尼尔
Let this be a lesson to you, Daniel.
千万不要用胸去拦截跑卫了
Never try to catch a running back with your chest.
我喘不过气了
I can't breathe too well.
放轻松
Well, take it easy.
你会没事的
You're going to be okay.
我只是撞出了淤青对吧
It's just a bruise, right?
他在过度呼吸
He's hyperventilating.
如果你的心口
Yeah, you would be too
被头盔撞了一下你肯定也这样
if you took a helmet to your solar plexus.
检测血氧含量
Get a pulse ox.
血压下降血压70/40
BP's falling, 70/40.
血氧含量92
Pulse OX is 92.
很好给他戴上氧气面罩
Great. Put him on a mask.
流速六升
Six liters.
有什么问题吗
Is something wrong?
有问题你下次应该重心再低一些
Yeah, you should've tackled lower.
血气分♥析♥结果出来了
Blood gas is back.
动脉血氧分压65
PO2 65.
二氧化碳分压28
PCO2 28.
酸碱度7.48
Ph 7.48.
好吧他确实是呼吸过度
Okay, he's hyperventilating.
但是他的氧分压也太低了
But his PO2's way too low.
呼吸短促
Shortness of breath.
严重缺氧除此之外就是一个健康的十五岁少年
Acute hypoxia in an otherwise healthy 15-year-old.
颈静脉扩张心音低沉
J.V.D., muffled heart sounds
血压骤降
crashing B.P.
钝伤引起的心包填塞
Pericardial tamponade with blunt trauma?
也有可能
It happens.
心包填塞是什么
What's a pericarpal tempernard?
很严重吗
Is that something bad?
我不能呼吸了
I can't breathe too well.
喘不上气了
I can't breathe.
心电图做吗
12-lead?
没时间了
No time.
准备心包穿刺术托盘
Pericardiocentesis tray.
这个病很少见丹尼尔
It's a bizarre thing, Daniel,
所以你是一个不同寻常的任务
which makes you a very bizarre guy.
但是我们喜欢这样的你
But we like that about you.
你的心脏外面的心包出血了
There's bleeding in the sac around your heart
所以不能正常地跳动
so it's not beating right.
我们先局部麻醉
We're going to numb the area
然后我们再插针进去
and then, we're going to insert a needle
把血抽出来
and drain the blood.
你要在我的心脏上扎针
You'll stick a needle in my heart?
别担心丹
Don't worry, Dan.
这种手术我已经做过无数次了
I've done it a thousand times.
约翰过来一点看清楚
John, move in for a better look.
好的
Sure.
从剑突下进路
I'm using a sub-xiphoid approach
45度角插入
45-degree angle.
朝着左肩的方向插入
We're aiming
插入的同时
at the left shoulder, drawing back...
进行抽液
as you advance the needle.
太厉害了
Cool.
看到了吧丹没什么好害怕的
See, Dan, there's nothing to it.
血压上升了 100/60
B.P's coming up. 100/60.
马克你不是说要去赶火车吗
Mark, didn't you say something about catching a train?
妈呀
Oh, no.
我的天谢谢
Oh, oh god, please... um, thanks.
大家晚安
Good night.
晚安
Night.
你打算什么时候告诉我
When were you going to tell me?
我尽力了苏西我真的尽力了
I tried... Susie, I... really did.
我找了一份工作
Hey, I got another job
干了几天服务员了
for a couple days, waitressing.
赚了一百一十块
Made 110 bucks.
上学太难了
School was too hard.
各种各样的软件
They had all these different programs.
你要把一个文件移到
You had to move
另一个文件
this file into this file.
这让我觉得自己很笨
It just... it made me feel so stupid.
班上的其他女生
All the other girls in the class,
她们都会打字了
they already knew how to type
还会起草商业信件
and how to write business letters.
而我以前总是觉得
I always thought a letter was, like
信就随便写写就好了
a letter, you know.
她们都穿着合适的衣服
They had all the right clothes.
我又没有那些衣服
I didn't have any of that stuff
就只能跟你借衣服穿
except for what I borrow from you.
就算这样
And even then
我穿着那些衣服也不合身
it doesn't look right on me.
我真的想好好学
I really wanted this.
为了苏西
For Susie.
并且向你证明我可以做到
And to show you... that I could do it.
我没有告诉你
I didn't tell you...
因为
because...
我知道会让你失望
I knew that I would disappoint you.