急诊室的故事

ER S03E04

Part 2 July 17, 2020, 11:35 a.m.

Morning, folks,
什么情况
what's the word?
有个无名氏
We've got a Jane Doe in status.
我们让她昏迷了
We're putting her in a coma.
给她注射苯妥英钠
Load her up with dilantin?
喝得酩酊大醉
Maxed out on the benzos.
病史
History?
30分钟前来的
Came in 30 minutes ago.
癫痫病史未知
Seizure history unknown.
药物未知
Meds unknown.
可能是脑膜炎吗
Could have been meningitis?
道格认为她喝酒了
Doug thinks she's been drinking.
以为你中午才上班
Thought you weren't on till noon.
是啊她是我送来的
I'm not. She's with me.
体温41.2摄氏度
Temp's 106.2.
她有高温危象
She's hyperthermic.
道尔呼叫神经科和麻醉科
Doyle, alert Neuro and Anesthesiology
带一台双通道脑电图仪
and bring in a two-channel E.E.G.
好的
Done.
两分钟内我们需要负荷剂量
We need a loading dose of phenobarbital
100毫克苯♥巴♥比♥妥♥
100 milligrams over two minutes
还有一个插管托盘
and an intubation tray.
是不是有点过了
Jumping the gun, aren't you?
她癫痫半个小时了道格
She's been seizing for half an hour, Doug.
还有更好的建议吗
Have a better suggestion?
-马克 -她的血气结果来了
- Mark... - Her blood gas is back.
Ph值是7.1
Ph is 7.1.
酸中毒
She's acidotic.
所以才昏迷
That put her in a coma.
凯瑞你想帮我插管吗
Kerry, you want to help me intubate?
好的
Okay.
7.5号♥气管内插管
7.5 E.T. tube.
我去车上找找车辆信息
I'll go to the car, find the registration
看能不能找到身份证什么的
see if I can get some kind of an I.D. or something.
对该系统的另一个修改
Another modification to the system will be
将是回归专业性
a return to professionalism.
我们是外科医生我们要看起来像
We're surgeons. Let's look like it.
从现在开始我制定了一个政策
From here on out, I'm instituting
手术室之外的所有医生都要
a jacket-and-tie policy for all surgeons
穿白大褂打领带
outside the O.R.
当然女性员工除外
Except, of course, for the ladies on staff
我相信她们会穿的很合体
who I trust will dress appropriately.
说曹操曹操到
As I was saying...
该做的和不该做的就说到这里
Well, so much for the dos and don'ts.
我想提醒大家
Oh, I would like to remind everybody
我们的外科志愿者
that we're still woefully short on
还是很少
surgical volunteers...
胰脏对比局部的手术
Pancreatic versus local procedures...
卡特
Carter,
你迟到了是我调的投影仪
You're late. I had to set up the projector.
我知道但我想跟你说一下
I know, but I want to talk to you.
你能控制投影仪对吧
You can run a projector, can't you?
我可以但是
Yeah, I can, but...
该死到我了
Damn, I'm starting.
要来介绍一篇关于胰腺切除术的
...will be presenting a fascinating paper
很好的文章
on total pancreatectomy
对比胰腺癌姑息疗法中的
versus the whipple procedure in the palliative treatment
十二指肠切除术
of pancreatic carcinoma.
本顿医生
Dr. Benton.
谢谢安斯弗医生
Thank you, Dr. Anspaugh.
我今天要来讲
I'm going to be talking today about, uh...
十二指肠切除术
the use of the whipple procedure
来代替完全胰腺切除术
in lieu of total pancreatectomy
这应该是
which is, I guess
安斯弗医生刚刚讲的
what Dr. Anspaugh just said.
拜托关一下灯
Lights, please?
胰腺切除术移除了
Pancreatectomy removes...
多源性疾病复发的可能
The potential for recurrence due to multifocal disease
而且避免了胰管空肠吻合术
and avoids pancreatico-jejunostomy.
现在麻烦开一下投影
Now, uh, slide, please?
如果你看这里渗漏的附属性风险
If you observe here, the attendant risk of leakage is...
请打开第一张
Path slide one please.
这是我刚刚想跟你说的
That's... that's what I was trying to tell you.
你刚刚想跟我说什么
What were you trying to tell me?
可能我们要单独谈一下
Maybe I could speak to you alone for a moment.
有什么问题吗本顿医生
Is there a problem, Dr. Benton?
没有安斯弗医生完全没有
No, Dr. Anspaugh. No, not at all.
卡特赶紧把幻灯片放进去
Carter, put in the damn slide.
我做不到
I can't.
我公♥寓♥被烧毁了
My apartment burned down.
病理学幻灯片没有了
I lost the pathology slides.
表格呢
The tables?
手术照片呢
And the operative photographs?
也没了
Those too.
她好像稳定下来了
Looks like she's stabilizing.
没有发烧
No spikes.
这才像话
That's more like it.
我去看看神经外科
I'm going to see what's keeping neuro.
看他们在忙什么
See what's keeping them.
我能跟你讲几句话吗
Uh, could I have a minute?
当然
Sure.
怎么了
What's up?
事情太多太乱了
In all the commotion
我不确定你记不记得
I wasn't sure if you remembered
今天我们的初步研究开始了
that today, we start our pilot study--
医学和外科医生职责的划分
the medical-surgical division of duties?
是一个主治医生去处理所有的
That's where one attending
真正的紧急情况
gets all the real emergencies
另一个去发阿司匹林和胃药吗
and the other hands out aspirin and antacid?
其实是一个处理医学病例
Actually, one takes the medical cases,
一个处理外科的
one takes the surgical.
我们之前讨论的时候你想要外科的
You wanted surgical when we discussed it before.
不我们之前讨论的时候我哪个都不想要
No, I wanted neither when we discussed it before
因为我觉得这是馊主意
'cause I think it's a bad idea.
安斯弗医生同意了
Dr. Anspaugh approved it
而你刚刚一进来就接管了
and since you just walked in and effectively took over
这个癫痫病人
this seizure patient...
好吧
OK, fine.
那要么你去管外科我去管医学
Why don't you take surgical, I'll take medical.
她癫痫发作了
She's seizing!
她归你了跟他说吧
She's all yours. Report to him.
好吧
All right.
你和我今天
Looks like you and I
要处理所有的医学病例了
are handling all the medical cases today.
只有医学吗
Only medical?
计划是这样的
That's the grand plan.
以为她稳定下来了
Thought she was stabilized.
好吧 6单位泮库溴铵
Okay. Uh, six of pavulon.
要麻醉她吗
We going to paralyze her?
是的你知道为什么吗
Yes. And do you know why?
这是她唯一的机会
'Cause it's her only chance?
是的
That's right.
-姑娘 -你好
- Hey, girl. - Hey.
你错过了好戏
You missed all the drama.
罗斯医生带了个不认识的女的来忙死我们了
Dr. Ross brought a lady in and he stack us.
是吗
Oh, yeah?
你没事吧
You okay?
没事只是秋天了
Yeah. It's just autumn.
我过敏很严重
My allergies go crazy.
本顿医生
Dr. Benton,
我只想关于幻灯片的事