急诊室的故事

ER S03E06

Part 7 July 17, 2020, 11:36 a.m.

Zach's condition has stabilized.
他应该很快就能醒来
He should wake up soon.
扎克
Zach?
没事的
It's okay.
梅根呢
What about Megan?
本顿医生正在为她缝合
Dr. Benton's closing right now.
真是个好消息
That's wonderful news.
是...是不是有辆卡车来着
Was... was there a truck?
是的
Yeah.
是的有一辆卡车
Yeah, there was a truck.
你到底是怎么想的
What on earth were you thinking?
我和你说了有碎片
I told you, there was debris.
我还和你说了什么都别多做只管缝合
And I told you not to do anything but close.
听我说我的判断是...
Look, in my judgment, I felt...
我不需要你的判断
I didn't ask for your judgment.
佩里丹尼斯准备呼吸装置
Perry, Dennis, set up a vent.
通知呼吸科马上准备血气分♥析♥
Call respiratory and get a blood gas right away.
100%纯氧准备多巴胺
F-I O-2 at 100%. Stand by with dopamine...
这写的是"鸡皮带"吗
Does that say "chicken belt"?
结膜炎
Conjunctivitis.
我讨厌病例审查
I hate Chart Q.A.
怎么了
What?
没事
Nothing.
谢谢你在直升机上帮我
Thanks for helping me in the chopper.
不用谢
No problem.
这里的压力还是挺大的
Things can get really pressured in here.
容不下一个没有经验的人
It just isn't a place for someone who isn't experienced.
我不能再让你在这里工作了
I can't have you work here again.
扎克
Zach?
天哪
Oh, God.
我能碰他吗
Can I touch him?
当然
Sure.
扎克亲爱的是妈妈
Zach, honey, it's mommy.
我就待在这里
I'm going to stay right here
直到你醒过来
until you wake up.
梅根怎么样了
What about Megan?
手术室那边没有人跟你说吗
No one from surgery's talked to you?
没有
No.
好吧我去看看是怎么回事
Okay, I'll go find out what's going on.
谢谢
Thank you.
卡特
Carter...
为什么还没人过来跟她说
why hasn't anyone been down to talk to her?
我不知道
I don't know.
本顿一小时前就缝合了
Benton was closing her an hour ago.
血气分♥析♥有好转吗
Blood gas is improved.
不多
Not by much.
可以让我们单独谈话吗吉特丹尼斯谢谢
Um, could you excuse us, Kit, Dennis? Thank you.
对不起我不应该让你独自处理
I'm sorry. I should never have left you unsupervised.
新生儿手术是有细微差别的
There are nuances in neonatal surgery.
新生儿肝脏更脆弱
The liver's more friable in newborns.
我只是想在缝合前清理干净创面
I wanted a clean field before I closed.
是的你说过
Yeah, you said that.
我的行为似乎合情合理
It seemed appropriate.
但问题是你忽略了
What's at issue here is that you ignored
我的具体指示
my specific instructions.
不我没有忽视什么东西
No, I didn't ignore anything.
我遵循了标准的手术程序
I followed standard operative procedures.
我已经给其他病人
Look, I've done it a dozen times
做过很多次这样的手术了
in other patients.
但这不是普通病人
This is not another patient.
这是个婴儿
This is an infant.
去外面说现在
Outside. Now.
你对儿科手术一无所知
You don't know anything about pediatric surgery.
我觉得有必要
Look, I felt it was necessary...
你是不愿意从错误中吸取教训吗
Are you unwilling to learn from your mistakes?
教材里也没说不要缝合肝脏
It doesn't say in the text not to stitch a liver!
但这是实战不是教材
It isn't in the text.
你根本不知道自己到底在干什么
You didn't know what the hell you were doing.
你发现自己搞砸了的时候
The second when you realized you screwed up
就应该立刻叫我的
you should have called me.
为什么我发现肝脏缝了三针
Why did I find three stitches in there?
-因为我当时正全力以赴 -我告诉你原因
- Becasue I was striving to - I will tell you why.
因为你盲目自信地以为你无所不能
Because you arrogantly and blindly think you have all the answers.
如果那孩子死了那是我的责任
If that baby dies, it'll be my responsibility
但追根究底还是你的错
but it will be your fault.
基顿医生她快不行了
Dr. Keaton, she's crashing.
脉搏血氧86 心率降至45
Pulse ox is 86, heart rate's down to 45.
右侧呼吸音减弱
Decreased breath sounds on the right.
0.04单位阿托品
Atropine 0.04.
听起来像气胸
Sounds like a pneumothorax.
做胸片
Chest X ray.
不需要
Don't need it.
右边胸部比较透亮
Increased transillumination on the right side.
是气胸
It's a pneumo.
胸管托盘
Chest tube tray.
这不再是教学案例了 12法式软管
This is no longer a teaching case. 12 french.
她需要再做血气分♥析♥
She'll need a repeat A.B.G.
脉搏升至72
Pulse is up to 72
但还是很微弱
but it's thready.
监护仪没有监测到血压
Dynamap's not registering a B.P.
准备胸腔引流器
Get ready with that thoraseal.
她心脏骤停心率降至20
She's arresting! Heart rate's down to 20.
该死
Damn.
开始做心肺复苏
Start C.P.R.
肾上腺素万分之一浓度 0.4
Epi, 1 to 10,00, 0.4
0.08毫克阿托品
Atropine, 0.08 milligrams.
血气分♥析♥结果怎么样
How's the blood gas?
PH值7.3 动脉血氧分压45
PH 7.3, PO2 45
二氧化碳30 纯氧情况下
PCO2 30 and 100% oxygen.
我们给她上人工肺了
We'll have to put her on ECMO bypass.
吉特准备两单位O型阴性血来启动系统
Kit, call and get two units O-neg to prime the system.
我直接开颈内静脉
I'll cut down to the internal jugular.
那我们要再把她送回手术室吗
So do we bring her back up to the O.R.?
不我们要把手术室给她搬到这里
No, we're going to bring the O.R. to her.
格林医生
Dr. Greene?
赫利希医生
Dr. Herlihy.
现在几点了
What time is it?
八点
8:00.
晚上吗
P.M.?
我的家人呢
Where's my family?
你妻子在楼上
Your wife's upstairs
两个孩子都做了开腹手术
and both the kids had laparotomies.
在重症监护室给你备了张床
A bed opened up for you in I.C.U.
他们怎么样了
How'd they do?
你儿子做完手术候送去在重症监护室了
Well, your son's out of surgery in I.C.U.
我不太清楚你女儿的情况
I don't know about your daughter.
我怎么才能知道我女儿的情况
How do I find out about my daughter?
我帮你问一下
I'll check for you.
谢谢格林医生
Thank you, Dr. Greene.
马克
Mark.
马克
Mark.
儿科手术室打来电♥话♥
Pedes O.R. called.
他的女儿在手术中心力衰竭
His daughter decompensated in surgery.
在新生儿重症监护室快不行了
She's crashing in N.I.C.U.
心电图还是平线
She's still flatline.
再注射0.04肾上腺素
Repeat 0.04 of epi.
来吧吉特
Go ahead, Kit.
没有脉搏多久了
How long has she been down?
22分钟了
22 minutes.
人工肺启动了吗
Is the ECMO circuit primed?
是的