急诊室的故事
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第二季
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急诊室的故事
ER S02E13
Part 3
March 14, 2020, 9:25 p.m.
Let's try and cardiovert.
除颤器 先来100焦
Paddles. Start him at 100.
-把手拿开 -离手
- Hands off. - Clear.
这就对了
There we go.
这样的心率才对
That's a nice rhythm.
他的头动了
He moved his head.
心率下降到160
Rate's down to 160.
180 又来一次
180. Whoops, here we go again.
利多卡因没有起作用
Lidocaine's not working.
试试静推500毫克臭苄铵
Let's try bretyllium, 500, I.V. push.
准备静脉起搏器
Prep transvenus pacemaker.
充电200焦
Charge to 200.
离手
Hands off.
你为什么觉得这是一个动脉瘤 卡特
What makes you think it's an aneurysm, Carter?
因为在降主动脉上有钙化斑
The calcium plaque on the descending aorta.
你刚刚救了这个人的性命
Well, you just saved this man's life
还让一群挪威的外科医生非常不高兴
and made a group of Norwegian surgeons very unhappy.
-干得漂亮 -谢谢
- Good work. - Thank you.
病人在哪
Where's the patient?
六号♥病房♥
Uh... Room Six.
去六号♥病房♥
To Room Six.
干得漂亮 卡特
Hey, way to go, Carter.
检测结果回来了 电解质正常
Labs are back. Lytes are normal.
未检测出毒物
Tox screen's negative.
我们俩都错了
We were both wrong.
这家伙到底出了什么毛病
What the hell's wrong with this guy?
心率上升至220
Rate's up to 220.
脉搏微弱
Faint pulse.
起搏器到位
Pacer's in.
我们给他加速到230吧
Let's overdrive him to 230.
最大量
Maximum gain.
看看我是否能控制住这心率
See if I can grab hold of this rhythm.
你已经有点控制住了
You've got capture.
太好了 我们慢慢把它降下来
Lovely. Let's take it down slowly.
210...
210...
200.
180.
它又上升了
It's jumping back up.
又失控了
Lost capture.
没有脉搏了 他出现心室颤动了
Lost the pulse. He's in v-fib.
开始做心脏复苏
Let's start C.P.R.
再加100毫克普鲁卡因胺 静推
Add pronestyl, 100 migs., I.V. push.
除颤器 充电360焦
Paddles. Set them at 360.
现在几点钟
What time is it?
8:45
0845.
记下时间
Mark that time.
-手拿开 离手 -离手
- Hands off. Clear. - Clear.
过于复杂的心搏过速
Wide complex tachycardia.
还是没有脉搏
Still no pulse.
几点了
Time?
9:05
0905.
没有脉搏多久了
How long's he been down?
20分钟
20 minutes.
用了起搏器
Tried the pacer.
他就出现了心室颤动
He went into v-fib.
电击了他将近二十次
Shocked him, 15, 20 times.
他一直出现这些非常诡异的心率
He keeps running these chaotic rhythms.
他有可能是低血钾吗
Could he be hypokalemic?
不是 电解质正常
No. Lytes are fine.
可♥卡♥因♥
Cocaine?
未检测出毒物
Tox screen's negative.
酸中毒呢
Acidotic?
好问题
Good question.
再做一个血气分♥析♥
Let's get another gas.
几点了
Time?
9:22
0922.
再加100毫克普鲁卡因胺
Another 100 of pronestyl.
你的血气分♥析♥报告出来了
Got your blood gases here.
PH值7.24 动脉血氧分压110
PH 7.24, PO2's 110.
还在室颤
Still in fib.
他快不行了
He's going down.
所有抗心律失常的药你都试过了吗
You gone through all the anti-arythmics?
还有几个没试
Still got a few more.
准备好胺碘酮
Stand by with the amiodarone.
-退后 离手 -离手
- Back off. Clear. - Clear.
几点了
Time?
9:32
0932.
还是没有脉搏
Still no pulse.
试试硫酸镁
Try magnesium sulfate.
-离手 -离手
- Clear. - Clear.
几点了
Time?
9:41
0941.
加大肾上腺素剂量 5毫克 离手
High dose EPI, five milligrams. Clear.
-时间 -9:45
- Time? - 9:45.
-离手 -离手
- Clear. - Clear.
-离手 -离手
- Clear. - Clear.
32岁
32 years old.
死亡时间...
Time of death...
9:55
0955.
为什么
Why?
在你的丈夫心脏中
There was an electrical disturbance
有一股异常的电活动
in your husband's heart
导致他的心脏异常地跳动
that caused it to beat in an irregular way.
我也希望我能告诉你为什么会这样
I wish I could tell you what caused it to happen.
但事实是我也不清楚原因
But the truth is, I don't know.
这算什么说法
That's not good enough.
我们刚到这的时候 他的心脏...还是好的
I mean... we came in here, and his heart was... okay.
你还说过没什么大问题
And you said it wasn't anything serious
-所以一定是有人搞砸了什么 -不是的
- So somebody must have screwed up. - No.
你怎么能让这种事发生
How did you let this happen?
威姆伯夫人...
Mrs. Wimbur...
你对他做了什么
What did you do to him?!
你好 艾文
Uh, hello, Alvin.
你有...你有他的新号♥码吗
Oh. Well, do you, uh... have his new number?
凯瑞...
So, Kerry...
稍微...等一下
One... second.
怎么了 苏珊
Yes, Susan?
我仔细考虑你们今早的提议了
I've been thinking about your invitation this morning,
我愿意争取一下总住院医师的职位
and I would like to throw my hat in for chief resident.
我很高兴 希望能为你提供帮助
I'm glad. I look forward to showing you the ropes.
我也很荣幸
Me too.
第二诊室有个胆囊患者还没人照看
Nobody signed up for the gallbladder in two yet.
交给我了
I've got it.
做CT要多久
How long does a cat scan take?
但愿不会超过一小时
Hopefully, not more than an hour,
可有的时候得多等等
but sometimes, there's a wait.
我有点担心我车里的蚯蚓
I'm a little concerned about my worms in the truck.
你还把蚯蚓也带上了
You brought your worms with you?
就一箱
Just one bin.
头晕发作的时候我正在送货
I was making a delivery when the dizziness hit.
你觉得会有人偷它们吗
You think someone will steal them?
不会 都上锁了
No. They're locked up.
五千块的蚯蚓没人看管可不行
You don't leave $5,000 worth of worms unsecured.
不过它们可能会冻僵
But they could freeze.
我要是把钥匙交给你
Listen, if I gave you my keys,
你能把它们拿进来取暖吗
could you bring them in out of the cold?
医院不能带动物进来
We can't have animals in the hospital.
又没危险
There's no danger.
蚯蚓是地球上仅有的无病生物
Worms are the only disease-free organisms on earth.
这是真的
It's a fact.
我真的不能拿进来
I really shouldn't.
拜托了 那可是我的蚯蚓啊
急诊室的故事
ER
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