急诊室的故事

ER S03E01

Part 3 July 17, 2020, 11:33 a.m.

我病了
I'm sick.
哪里不舒服
What's wrong?
我胃疼
My stomach hurts.
你没告诉他吗
Didn't you tell him?
什么时候开始疼的
When did this pain start?
我不知道
I don't know.
也许是今天早上
Early this morning maybe?
我说了我不知道这货是蠢货吗
I said I don't know. What is he, an idiot?
-你多大了 -足够大了
- How old are you? - Old enough.
如果疼了你就告诉我
I want you to tell me if this hurts you.
-很明显腹部有疼痛症状 -没错
- The abdomen is apparently tender. - I get it.
给她做血常规
Let's order a C.B.C.
生化七项和腹部检查
chem seven and an abdominal series.
都做完了
They're done.
我要先看看你的检查结果布凯西夫人
I'm going to check your tests, Mrs. Bucasy,
不过恐怕你可能需要做手术
but I'm afraid that you're going to require surgery.
你不想再多检查一下吗医生
You don't want to examine her a little bit more, doctor?
她之前做过腹部的手术
She's had a previous abdominal surgery.
所以她很可能有黏连
She probably has adhesions.
你确定他是医生吗
You sure he's a doctor?
你也许可以考虑做一个肛检
You might consider, uh, doing a rectal.
绝不能让小肠梗阻过夜
Never let the sun set on a small bowel obstruction.
卡特医生我能借一步说话吗
Dr. Carter, may I see you for a moment, please?
失陪一下女士
Excuse us, ma'am.
怎么搞了这么长时间
What the hell is taking so long?
我来这本来挺开心的结果突然之间
I come down here and happy, and all of a sudden
白板上你就有四名病人候诊了
you have four patients on the board.
你难道没去查看吗
Didn't you check it?
我被呼叫来去检查一名病人
I got beeped to examine a patient.
永远要先查看白板
Always check the board first.
你怎么能判断这个病人的病情危急呢
How could you possibly tell that this patient was emergent?
小肠梗阻
Small bowel obstruction.
她会需要做手术的
She's gonna need surgery.
我希望能参与这名病人的手术本顿医生
I'd like to scrub in on this one, Dr. Benton.
卡特所有外科急腹症都需要做肛检
Carter, all surgical abdomens require a rectal.
即使是一年级实习生都知道
Even first-years know that.
她是便秘了
She's impacted.
好了去检查其余的病人
Look, go check on the rest of your patients
然后再回来让她排宿便
and come back here and disimpact this one.
这不应该是护士的工作吗
Isn't that a nurse's job?
今天不是
Not today, it isn't.
88岁男性意识模糊低血压
88-year-old male, altered l.O.C., hypotensive.
血压60 窦性心动过速128
B/p 60 palp, sinus tach at 128.
呼吸很浅频率30 皮肤温暖干燥
Resps shallow at 30. Skin's warm and dry.
毛细血管再充盈情况糟糕无法静脉注射
Poor cap refill. Couldn't get an I.V.
氧流量4 插了输氧鼻管
O2 four liters, nasal canula.
我们走去创伤一室
All right, let's go. Trauma one.
白板是怎么回事
What's the matter with the board?
这些字母和数字是什么意思
What are all these letters and numbers?
病患隐私系统
Patient confidentiality system.
那我要怎么猜出
How am I supposed to figure out
谁是外科的谁是内科的
who's surgical and who's medical?
我可没时间玩解谜游戏
I don't have time for this crap.
谁想出这么蠢的主意
Whose stupid idea is this?
是我第一天在外科上班吗卡特医生
Mine. First day on the surgical service, Dr. Carter?
真高兴能有你在
Nice to have you with us.
一号♥病房♥需要外科医生本顿在吗
Need a surgeon in one. Is Benton in?
是你对吧走吧
It's you, right? Let's go.
凡事总有第一次医生
There's always a first time, doctor.
最好赶紧去
Might as well get it over with.
天哪
Oh, god.
需要外科医生吗
Somebody call for a surgeon?
扎一个深静脉
Drop a central line.
等你准备好了我再插管
I'll intubate after you get it in.
血氧饱和度85%
Pulse ox is 85.
麻烦摆成垂头仰卧位护士
Trendelenburg, please, nurse.
深静脉包
Central line kit.
1%利多卡因和肾上腺素
One percent lidocaine with epi.
谢谢护士
Thank you, nurse.
插管托盘
Intubation tray.
-冲着胸骨凹口 -我知道
- Angle toward the sternal notch. - I know.
尿管插入了
Foley's in.
快点
Come on.
快点
Come on.
-你那边还顺利吗卡特医生 -快好了
- How you doing over there Dr. Carter? - Almost.
快好了
Almost.
我找不到
I can't find it.
准备右侧锁骨下开静脉通路
Prep for a right subclavian approach.
拜托了
Please.
别扎到肺
Try not to hit the lung.
好吧什么情况
All right, what do we got?
88岁男性患者需要开深静脉
88-year-old male needs a central line.
我找不到颈内静脉
I couldn't get the internal jugular.
我试着开锁骨下的静脉
I tried for a subclavian approach.
-还有什么 -我想我扎到他的肺了
- Set me off. - I think I nicked his lung.
-该死 -右侧呼吸减弱
- Damn! - Decreased breathing on the right side.
他脸色不妙我必须插管了
He's getting dusky. I need to intubate.
他的静脉一定已经完了
His veins must have collapsed.
插♥进♥去了听诊器
I'm in. Stethoscope.
把呼吸科的叫来准备好呼吸机
Get respiratory down here to set up a vent.
恭喜卡特医生
Congratulations, Dr. Carter.
你的病人需要做插胸管了
Your patient now needs a chest tube.
胸管包 28号♥法式
Chest tube tray. 28 French.
十号♥手术刀
Ten blade.
好了来吧把管子接上
All right. Let's go. Hook me up.
拿好持针器
Hold still for the driver.
准备好凡士林纱布四乘四
Vaseline gauze will be the next. Four-by-fours.
-患者血压如何 -收缩压90
- How's his pressure? - 90 systolic.
-2升盐水全速 -体温39.5摄氏度
- Two liters, wide open. - Temp's 103.
头孢呋辛 1.5克 8小时一次
Cefuroxime, 1.5 grams Q8.
我替他检查是否感染绿脓杆菌
I'd check him for pseudomonas.
头孢他啶 2克
Ceftazidime, two grams.
庆大霉素也8小时一次
Q8 plus gent.
好了各位
All right, people.
通知一下放射科...
Somebody call up Radiology...
听听这个 "洁白的沙滩
Listen to this. "Pearl-white beaches...
七月四日下午5:45
"与蔚蓝的热带天空相得益彰
"Set against an azure blue tropical sky.
"凉爽的微风将半独♥立♥式住房♥
"Cool breezes that make your semidetached bungalow
打造成您的专属天堂"
your own little piece of paradise."
这是哪里
Where is that?
密克罗尼西亚
Micronesia.
这又是哪里
Where is that?
管它呢反正跟这里远隔重洋
Who cares? It's a long, long ways from here.
"与莱尼和弗朗西斯
"Dive with Lenny and Francis and the boys
"还有帕劳最古老经验最丰富的
"at Fish 'n' Fins, palau's oldest
潜水中心的小伙子们一同潜游"
and most experienced charter operators."
那是条鲨鱼吗
Is that a shark?
有五六条呢好酷吧
Ooh, five or six of them. Cool, huh?
快看夏威夷
Oh, look! Hawaii.
你去过夏威夷吗
Have you ever been to Hawaii?
夏威夷南太平洋
Hawaii, South Pacific.
去这些地方不都得坐上飞机
Don't all these places require that you get on a plane
飞越重洋飞上很高很高的地方吗
and fly over water like, at great heights?
无所谓这些地方看起来真美
I don't care. They look beautiful.
我可以克制住我自己全程睡过去
I'll just self-medicate and sleep through the whole thing.
我一个字都看不懂
I can't understand a damn thing out there.
OT是什么职业疗法吗
What the hell is O.T., occupational therapy?
白板上有一半病人需要这个东西
Half the patients on the board need it.
是"其它疗法"
"Other."
当你不知道病人怎么了