急诊室的故事

ER S02E13

Part 2 March 14, 2020, 9:25 p.m.

I need a TB test too.
听说摩根斯坦在你当
So I hear Morgenstern has really turned up
住院总医师的事上给你加压了
the pressure on you becoming Chief Resident.
是个好机会
Yeah. It's a good opportunity
但没有办法摆脱加班
but can I do it and not work killer hours?
你知道我在工作和家庭的平衡上做得有多好吧
You know how well I managed to balance work and family.
懂了
Guess that answers that.
你会想出解决办法的
You'll be able to work it out.
把文书工作带回家做
Take your paper work home,
时间就不会过得那么慢了
hours won't be that bad.
你得让韦弗喘口气
You have to give Kerry Weaver slack.
什么意思
What do you mean?
你现在这么躲着她
You go out of your way to avoid her.
一旦她开始培训你了
If she is going to train you,
那你就得和她肩并肩地工作了
you'll have to work together hand-in-hand.
光是想象就受不了了
Oh, there's an image.
你干嘛休息日还来上班
What are you doing here on your day off?
我跑着跑着就到这儿了
I went for a jog, ended up here.
想着算了吧说不定还能拯救几条人命呢
And figured what the hell, might as well save some lives.
又是个不想锻炼的好理由
Another good reason not to exercise.
32岁男性后发作期
32-year-old male, post-ictal,
癫痫发作五分钟
five-minute grand mal seizure.
我来开始填病历
All right. I'll take it. Start a chart.
休息日这么拼
On his day off?
那些静脉营养药一小时前就该来了
Those TPN orders should have been called in an hour ago.
对不起我忘了
Sorry. I forgot.
我以为你想在这儿当住院医师
I thought you wanted a residency here.
再忘下去你就滚到北达科他州去
Keep forgetting, you'll end up in North Dakota.
我们已经收到300份申请了
We've got six slots, 300 applications.
面试什么时候开始
When do interviews start?
已经开始了我这就上去
They already have. I'm on my way to
乌泽里奇还需要一例动脉瘤来完成他的研究
Vucelich needs one more aneurysm for his study.
遇到腹痛胸痛外伤就叫我
Abdominal pains, chest pains, traumas, call me.
你多久晕一次亨利夫人
How often do you get dizzy spells, Mrs. Henry?
一天三四次
I get three or four a day.
一般是我在花棚里干活时
Usually when I'm working in the shed.
这个时候搞园艺
You garden this time of year?
我是个蠕虫养殖者
I'm a vermiculturist.
我养蚯蚓
I raise earthworms.
真的
Really?
比利时的大蚯蚓
Big ones from Belgium.
世界上最好的
Finest castings in the world.
您指的是
And by castings, you mean..?
蠕虫的粪便
Worm dung.
黑色黄金
Black gold.
这是用钱能买♥♥到的最好的肥料
It's the best fertilizer money can buy.
还能为土地补充氮元素
It fixes the nitrogen in the soil.
你卖♥♥虫屎
And you sell the stuff?
我卖♥♥的是虫子
I sell the worms.
你的血压有点高
Your blood pressure's a little high.
赚得多吗
So it pays well?
不少六位数
Yeah. Six figures.
他以前癫痫发作过吗
Has he had a seizure before?
不他很健康每天都跑步
No. He's a health nut. He runs every day.
我们要给他做个头部CT
We're gonna have to get a CAT scan
来查明这次癫痫的起因
To pinpoint the cause of the seizure.
艾伦
Alan.
艾伦
Alan?
他什么时候才能醒过来
When's he going to come back?
从癫痫发作中恢复需要些时间
It takes time to recover from a seizure.
要多久
How long?
通常需要三十分钟
Usually about 30 minutes.
频发多源性早搏
Multi-focal PVCs.
什么
What?
他的心率有点不对劲
His heart rhythm's a little off.
可能是癫痫导致的缺氧造成的
Probably oxygen deprivation from the seizure.
他以前胸部也有杂音吗
Has he had a murmur before?
不会
No.
大概没有什么严重的问题
Probably nothing serious.
CT之后给他做一个超声心动图
Let's get an echo of his heart after the C.T.
安全起见
Just to be safe.
推100毫克的利多卡因然后挂点滴
Lidocaine bolus 100 milligrams then start a drip.
不对卡特约翰·卡特
No. Carter, John Carter.
我打来是因为
I was calling because
我以为你们之前想联♥系♥上我
I thought you were trying to get in touch with me
来面试住院医师的职位
to set up an interview for the residency.
不是
No, huh?
不过我还是很愿意去工作的...
Well, I am available any...
好吧对再见
Okay. Right. Bye.
我听说乌泽里奇悬赏找到一个动脉瘤的钱
I hear Vucelich doubled his finder's fee
翻了一番
for an aneurysm.
可能吧
Could be.
那我刚刚赚了一千元
Aha. I think I made 1,000 bucks.
病人有溃疡的病史
Patient presented with a history of ulcers.
但他说这次的疼痛感和以往不同
But he says the pain's different this time.
腹部硬吗
Rigid belly?
很难判断他很胖但是...
Hard to tell, he's so fat, but...
看到他的降主动脉上的钙化了吗
See the calcifications on the descending aorta?
-没有在哪 -这里
- No. Where? - Here.
不是这个太侧面了
No, it's too lateral.
很可能只是他肺上的脏东西
Probably just schmutz on his lungs.
所以我不应该告诉乌泽里奇
So I shouldn't call Vucelich?
别说除非你想被他吼
Yeah, if you want to get yelled at.
哈珀你带他去做CT
Harper, need you to get this guy to C.T.
来了
Coming.
帮我个忙把这张X光送回他房♥间
Do me a favor. Return this x-ray to his room?
-好的哪间病房♥ -六号♥
- Yeah. Which room? - Six.
你看完了吗
Are you done with that?
这可真是动脉瘤的孕育沃土啊
Wow. That's a mother of an aneurysm.
你为什么这么觉得
How can you tell?
降主动脉上有钙化出现
Calcification on the descending aorta.
没错
Yeah.
是的
Yeah.
我们会做一个CT来确认
We're going to run a CAT scan to rule out lesions
是哪部分脑区导致的癫痫
that could have caused a seizure.
怎么了
What's wrong?
他室颤了送他去创伤室
He's in v-tach. Let's get him to trauma.
-哈蕾 -我在这有脉搏
- Haleh. - I'm here. I got a pulse.
他怎么了
What's wrong with him?
他的心率变得更糟糕了
His heart rhythm's gotten worse.
你确定他没有服用过任何药物吗
Are you sure he hasn't taken medication?
-没有 -非处方药呢
- No. - Non-prescription drugs?
没有从没有他...
No, never. He...
好的我们会把情况控制好的
Okay. We're going to get this under control.
麻烦来个人送威姆伯夫人去休息室
Can someone take Mrs. Wimbur to the waiting room?
-我只是想... -没事的谢谢
- I just want to... - It's okay. Thank you.
再给他静推50毫克利多卡因
Let's get another 50 of lidocaine, I.V. push.
心跳加快 200
Heart's racing. 200.
心率乱到一塌糊涂
Rhythm is all over the place.
看起来像是尖端扭转性室速
Looks like torsade de pointes.
哈珀做一个电解质和毒物检测
Harper, get lytes and a tox screen.
看看我们是否有这家伙的记录
See if we've got records on this guy.
任何能帮助我们查出原因的资料都去看看
Anything that will give us a clue as to what's going on.
利多卡因已静推
Lido's on board.
你感觉像什么哈蕾
What's your gut say, Haleh?
钾偏低
Low potassium?
-莉迪亚 -可♥卡♥因♥
- Lydia? - Cocaine.
他妻子说他从不吸毒
His wife says he's tox-free.
我们马上就能清楚了
We'll know soon enough.
心率上升到210
Heart rate's up to 210.
我们来试着让他心率恢复正常