急诊室的故事

ER S02E20

Part 3 March 14, 2020, 9:28 p.m.

I think Kerry's right. Let's not try to solve this today.
先让这件事开始运作吧
Let's just start the ball rolling.
卡特找到你真好
Carter. Glad I caught you.
我马上要第一次在乳♥房♥♥重建手术中做助手了
I was about to assist on my first breast reconstruction.
恐怕你做不了了
I'm afraid you aren't.
为什么
Why?
你是不是给教务室打了电♥话♥
Did you call the Registrar's office
要求看你的成绩单
requesting a review of your transcript?
我想要确认我能以优异成绩毕业
I wanted to verify that I'm graduating with honors.
他们在调取你的档案是发现
They discovered when they pulled your records
你的问诊坐诊次数不够
that you're deficient in ambulatory medicine.
什么
What?
如果你看诊的儿科患者数量
You can't graduate without seeing
没有达到要求就毕不了业
the required number of Pedes patients.
什么
What?!
幸运的是道格·罗斯愿意
Luckily, Doug Ross is willing to take you on
在接下来的四周带你
for the next four weeks.
我本来想选修整形科的
I was hoping for an elective in plastics.
如果你今早就开始
If you start this morning
你还有时间补救
you have time to complete this remedial work
争取和班上其他同学一起毕业
and graduate with the rest of your class.
罗斯医生在等你
Dr. Ross is expecting you.
我想立刻在这儿开始咨♥询♥
I want that consult here stat.
你刚刚说了"立刻"吗
Did you just say "stat"?
是的我是认真的
Yeah, and I mean it.
看看这是谁呀多可爱啊
Look who's here! Isn't she precious?
和她妈妈一模一样
She looks just like her mommy.
她会让我抱她吗
Will she let me hold her?
希望如此
Oh, I hope so.
我的胳膊快要断了
My arm's about to fall off.
你好你好小不点儿
Hello! Hello! So tiny!
你好小宝宝你好
Hello, baby. Hello.
衣服真漂亮
Nice outfit.
这可是兰迪定制
Hey, it's Randi-wear.
苏珊
Susan!
什么情况
What have you got?
这个女人在人行横道上昏倒了
A woman passed out in a crosswalk.
现场昏迷指数为10 正在醒转
GCS 10 in the field. She's coming around.
好送创伤一室
Okay. Trauma one.
女士女士你知道你在哪里吗
Ma'am? Ma'am? Do you know where you are?
数到三我们把她移到床上
All right. Let's move her on a count of three.
一...
One...
二...
Two...
三...
Three.
拿一瓶葡萄糖
Get a glucose.
她高血压 170/120
She's hypertensive. 170/120.
注射硝普钠点滴直至舒张压为100
Titrate a nipride drip to a diastolic of 100.
女士你有高血压病史吗
Ma'am, do you have a history of high blood pressure?
不不要再来一次
Oh, no! Not again.
好了试着放松
Okay, try and relax.
她叫乔安·拜罗斯
Her name is Joanne Bairos.
乔安我们要给你降压
Joanne, we're going to try and lower your blood pressure.
这种情况以前出现过吗
Did this happen before?
我不想失去宝宝不要再一次失去
I don't want to lose this baby! Not again.
-你怀孕了 -是的
- You're pregnant? - Yeah.
怀孕多久了
How far along?
20... 不 21周
20... no, 21 weeks.
不用硝普钠了
Cancel the nipride.
给她10个单位氢丙嗪
Give her ten of hydralazine.
呼叫妇产科
Call OB.
你之前流产过吗
You lost an earlier baby?
去年怀孕六个月的时候流产了
Last year in the sixth month.
天呐我不能再承受一次这样的事情了
God, I can't live through this again!
上胎儿监护器和心电仪
Hook her up to the fetal monitor and an EKG.
你以前得过子痫前期吗
Did you have preeclampsia before?
你有印象吗
Do you remember?
他们说那是高血压
They said it was high blood pressure.
高血压使我的胎盘撕裂
It made my placenta tear,
如果不把胎儿取出我就会死
and if they didn't take the baby out, I'd die.
我的孩子太小了
My baby was too little.
她没活下来
She couldn't live.
血压升高 180/130
BP is rising. 180/130.
加普♥萘♥洛♥尔♥
Add propranolol.
妇产科谁值班
Who's on call for OB?
克鲁瓦医生
Dr. Croix.
不是宝宝的错
It's not the baby's fault!
你的高血压可能与怀孕有关
Your hypertension is probably related to the pregnancy.
不在两次怀孕期之间我也头晕
No. I've been dizzy sometime in between the pregnancies.
真的吗
You have?
是的
Yes.
胎心率是多少
What's the fetal heart rate?
145 变异性良好
145. Good variability.
求你不要让他们拿掉孩子
Please, don't let them take her.
苏珊我们难道不该送她上楼吗
Susan, shouldn't we be moving her up?
不我先做个超声波检查
No. I'm going to do an ultrasound first.
她的血压已经190/140了
Her BP's 190/140.
胎儿还算稳定
The fetus isn't in distress.
我要先做个超声检查
I want an ultrasound first.
你要干嘛ttt
What are you doing?
尽力救你的孩子
Trying to save your baby.
不清楚我去查一下
I don't know. I'll check it out.
听见了我会去查的
Yeah, I heard you. I'll check it out.
跟你说了他们生气了
Told you they were mad.
哈蕾这个超声仪就是给那个
Haleh, is that ultrasound for the hypertensive patient
让产科对我嘶吼的高血压病人的
O.B.'s been screaming at me about?
谁要用它
Who the hell ordered that?
我来处理
I'll take care of it.
跟我说下最新情况
Bring me up to speed.
高血压女性孕周第21周
Hypertensive woman in her 21st week.
胎心正常
Fetal heart tones normal.
她对血管扩张剂和普潘奈有反应
She responded to hydralazine and propranolol.
血压如何
What's the B.P.?
130/100.
情况稳定可以转移
She's stable for transfer.
有宫缩吗
Any contractions?
有些痉挛但显示器未显示任何症状
Some cramping, nothing on the monitor.
是前兆子痫
It's preeclampsia.
送她去产科
Get her up to O.B.
凯莉这是苏珊的病人
It's Susan's patient, Carrie.
病人去年因前兆子痫失去了22周大的胎儿
Patient lost a 22-week fetus last year to preeclampsia.
看在上帝的份上
For goodness sake...
病人说在两次怀孕之间
Complains of dizzy spells
也有眩晕和高血压症状
and possible hypertension between pregnancies.
有蛋白尿吗
Any protein in the urine?
苏珊如果我们已知任何关于...
Susan, if we've learned anything...
对对在那
Yes, yes, there.
就在那右肾上腺的肿块
Right there, mass in the right adrenal gland.
通知手术室安排房♥间
Call the O.R. to schedule a room.
你说得对看上去像康氏症
You're right. Looks like Conn's syndrome.
什么意思
What's that mean?
你的肾上腺有个肿块
You have a tumor in your adrenal gland
产生一种激素导致你的血压升高
producing a hormone, which is making your blood pressure rise.
非常严重
It's very serious.
需要通过手术摘除这个肿块
You'll need a surgery to remove the mass.
那胎儿呢
But the baby?
应该没事
It should be okay.
取消产科我们直接去手术室
Cancel O.B., We're going straight to surgery.
做得对不然我们都会疏忽那个肿块
Good call, Susan. I think all of us would have missed that.
也可以在产科做超声检查
They could have done the ultrasound up in O.B.
上次产科给她做了流产
They aborted her last time.
通知手术室我们马上就到
Let surgery know we're on the way.