急诊室的故事

ER S01E03

Part 2 Nov. 22, 2019, 11:56 a.m.

Your first name?
或者你的
Or your...
没关系不知道名字也没事
It's okay, actually. I don't need your name.
好吧
Hey now...
你想喝点什么吗
Would you like a drink?
我倒是想来一杯
I know I would like a drink.
-有个枪伤患者 -到哪了
- Gunshot wound's on its way. - When?
已经到了
Now!
马利克去找本顿
Malik, find Benton,
空出创伤一室通知手术室
clear Trauma 1 and notify the O.R.
莉迪亚做血常规
Lydia, draw CBC,
让验血室交叉配型6单位全血
get the lab to cross and type 6 units whole blood.
找找还有多少O型阴性血他失血很多
Find how much O-neg's around. He's got a major bleeder.
又来一个 79岁男性可能是心脏病发作
Got another one. 79-year-old male, probable heart attack.
急救车两分钟后到
EMTs are here in two minutes.
通知苏珊·刘易斯和值班心脏病医生
Call Susan Lewis and the cardiologist on call.
-生病的孩子周末玩疯的人 -欢迎回来
- Sick kids? Weekend partiers? - Welcome home.
他休克了保持静脉输液
He's in shock. Keep those IVs wide open.
好了该上场了来吧
All right, people. Showtime! Let's move.
他没有呼吸把插管盘拿来
He's not breathing. Get the intubation tray.
无呼吸声左侧扣音增强
All right, no breath sounds, hyperresonant on the left side.
他有张力性气胸
He's got a tension pneumo.
把胸管包拿来现在插管
Let's get a chest tube tray and let's get in now.
七号♥半
Seven and a half.
-X光片呢 -我去拿
- Where the hell is X-ray? - I'll find it.
去苏珊那看看心脏病患者要不要帮忙
Check with Susan. See if she needs help with that heart guy.
创伤一室要X光片
They need X-ray, Trauma 1.
他马上到欢迎回到贝鲁特战区
He's on his way. Hey! Welcome back to Beirut.
-我需要你搭把手 -提米去找潘
- I could use some company. - Timmy, find Pam.
-什么情况 -心脏病发症状
- What've you got? - Heart attack symptoms.
胸骨下胸痛
Substernal chest pain
延伸至左臂伴随发汗
radiating down left arm with diaphoresis.
喷了两次硝酸甘油没好转
Had nitro spray times two without relief
打了5毫克吗♥啡♥
and 5 mg morphine.
卡萝你好啊
Hey, Carol. Hi.
-体征呢 -血压90/50 呼吸率24
- Vitals? - BP's down 90 over 50. Respiration 24.
他本来是窦性心律然后我们停车时变这样了
He was in sinus rhythm then went into this as we pulled off.
数到三一二三
Okay, on three. One, two, three.
弗莱尼根先生我是刘易斯医生
Mr. Flannigan, I'm Doctor Lewis.
你现在还痛吗
How's your pain now?
好多了凯森是我的心脏病医生
Much better. Dr. Kayson's my cardiologist.
有人说要联♥系♥他
Someone was going to call him.
好我们联♥系♥一下凯森医生
Okay, let's check on Dr. Kayson.
心电图胸透血常规生化七项
Get an EKG, chest, CBC, Chem-7,
心肌酶检测血凝率
enzyme and coag panel.
血压90/55 脉搏高达180
BP's 90 over 55, pulse is racing at 180.
他的心率看起来像什么
What does his rhythm look like to you?
很难说如果是室性心动过速我们得电击
It's hard to say. If it's V-tach, we need to shock him.
-你想这样做吗 -不他看着还行
- You wanna do it? - No, he seems relatively stable.
试试腺甘酸静脉注射6毫克
Let's try adenosine. 6 mg IV push.
心率在降低
Heart rate's dropping.
血压降低到50了
BP's down. Down to 50 palp.
该死把体外起搏器拿来
Damn! Get the external pacemaker.
-起搏器呢 -抽屉里
- Where's the pacer? - In the drawer.
卡萝呆在这我们需要你
Carol, stay put. We need you in here.
把这个带去4号♥房♥给苏珊
Take this to Susan in 4.
-肚子怎么样 -很硬
- How's his belly? - Abdomen's rigid.
-要灌洗 -没错
- Lavage time? - You got it.
要麻醉吗
Anesthesia?
我觉得他的"朋友"已经帮我们搞定了
I'd say his buddies already took care of it for us.
心率很低再给他1毫克阿托品
Heart rate's low. Give him another milligram of atropine.
-起搏器重获心率 -很好多巴胺注射了吗
- Pacemaker's capturing. - Good. Is the dopamine running?
注射了你确定不给他插管
Yes. Sure you don't wanna intubate him?
他咬着牙我得给他麻醉考虑到他血压低
He's biting down, I'd have to paralyze him, which I'd rather not...
我决定先不插管继续鼓气
...considering his low BP. Keep bagging.
刘易斯医生
Doctor Lewis?
他的血气很糟糕你联♥系♥上凯森了吗
This guy's blood gas stinks. Did you reach Kayson?
正在呼叫
He's being paged.
等不及了拿肌肉松弛剂咪♥达♥唑♥仑♥
Can't wait. Get the Pavulon, Versed and sux,
溶血栓剂来以防万一
and a dose of TPA. Just in case.
-体征怎么样 -血压50/30 呼吸率36
- Vitals? - BP's 50 over 30. Respiration 36.
-脉搏140 -我们去看看导管
- Pulse 140. - Let's take a look. Catheter.
ST波太高了急性心肌梗塞糟了
His ST wave is way up. Acute MI. We're in trouble.
你想注射溶血栓剂吗
You wanna inject TPA?
他的病历给我
Hand me his old chart.
没有不能用溶血栓剂的体征
He has no contraindications to TPA,
但我不想让他大出血
but I don't want to start him bleeding.
-血压多少 -90/60
- How's his pressure? - 90 over 60.
行吧只能这样了
Oh man. Okay, we gotta go with it.
5000单位的肝素推10毫克抗血栓剂
5000 units heparin and TPA, 10 mg push.
一小时60毫克再做一次心电图全程监控
60 over one hour. Let's get another EKG. Keep him on the monitor.
-血压 -还是90/60
- BP? - Still 90 over 60.
他在室颤急救车
He's in v-fib. Crash cart!
-200 -是的
- Two hundred? - Yes.
离手
Clear.
再来
Clear again.
我是凯森医生什么情况
I'm Dr. Kayson. What have we got?
急性下壁心肌梗塞我刚开始推溶血栓剂
He's having an acute inferior wall MI. I just started TPA.
不先问我
Without consulting me?
你该去导管室做血管成形术
You should go to the cath lab for angioplasty.
他有药物治疗的指征
I felt drug therapy was indicated.
你觉得不该做血管成形术吗
Did you think angioplasty wasn't?
-行但是 -我认为要激进一点
- No. But since... - I favor a more aggressive approach.
那是你的观点我选择药物治疗这更保险
That's one opinion. I chose drugs. It's less invasive.
刘易斯医生弗莱尼根先生是我的病人
Dr. Lewis, Mr. Flannigan is my patient.
你只是住院医师
You're a resident.
我才能为他的治疗做决定
All decision concerning his care will be made by me.
打给心脏手术室告诉他们我们马上到体征
Call the cath lab. Tell them we're coming. Vitals?
血压110/70 脉搏90
Blood pressure is 110 over 70. Pulse is 90.
好的起搏器奏效好的开始
Okay. Pacemaker captured, that's a start.
再准备1毫克阿托品继续鼓气
Prep another milligram atropine. Keep bagging.
快快快走了
All right. Come on, let's go, let's go. Move.
我去血库
I'll get up to the blood bank.
心梗病人怎么样了
How's that MI?
凯森好像控制住局面了
Kayson seems to have it under control.
想喝杯咖啡吗
You wanna grab some coffee?
刚刚做的很好卡萝
That was good work in there, Carol.
你可能对回归还有些疑虑但我们都没有
You may have doubts about being back, but none of us do.
谢谢
Thanks.
-你看见摩根斯坦了吗 -没
- Have you seen Morgenstern? - No.
-道格你看见苏珊了吗 -没有我又不是监控
- Doug. Have you seen Susan? - Am I the hall monitor? No.
4号♥诊室需要你
I need you in Exam 4.
张太太三十出头眼睛和脸颊肿胀
Mrs. Cheung, early 30s, eye and cheek swollen.
面部有伤肋部淤青不知道原因
Facial lacerations. Bruised ribs. Don't know how it happened.
不会英语但是她儿子会
Doesn't speak English, but her son does.
*走我推荐的路*
*Travel my way*
*走高速公路*
*Take the highway*
*最棒了*
*That's the best*
无名氏女士
Madame X?
她不会回你但她的确是
She doesn't answer to that, but yes.
*在66号♥公路上找点乐子*
*Get your kicks on Route 66*
至少她唱得挺好
At least she's good.
*从芝加哥一路蜿蜒到洛杉矶*
*It winds from Chicago to L.A*
你肯定错了
You are absolutely wrong.
-我没错 -那是个错误的决定承认吧大卫
- I'm not wrong. - It was a bad call. Admit it, Div.
谁都有可能会这么做
Anybody could've made it.
你在逗我吗
Are you kidding?
三垒有人不应该再牵制一垒啊
You don't pick a guy off first with the winning run on third.
已经两人出局了
There were two outs.
麦克道尔本来已经控制住局面了
McDowell had it all sewed up right there.
是啊直到他把球扔到了休息区