急诊室的故事

ER S03E21

Part 4 July 17, 2020, 11:43 a.m.

I'll go check on him as soon as I get you settled.
放心吧
Just take it easy.
还有几分钟就好
Just be a couple of more minutes.
房♥间还没整理出来
Housekeeping hasn't finished.
好
Okay.
一二三
One, two, three.
-碰到肋骨了 -是
- Rib? - Yeah.
-我们要赶你出去了 -我没事
- We're gonna kick you out of here. - I'm fine.
生命体征正常供氧5升昏迷指数11
Normal vital signs, oxygen at five liters. GCS 11.
介意我拿点生理盐水走吗
You guys mind if I steal some saline?
可以自己拿
Go ahead. Help yourself.
瞳孔等大反应良好
Pupils are equal and reactive.
没有出现鼓室积血
No hemotympanum.
肺音清晰腹部平软
Chest is clear, abdomen, soft and flat.
脉搏80 血压120/75
Pulse is 80, B.P. 120/75.
他叫什么名字
What's his name?
哈里·史密斯
Harry Smith.
哈里能听见我说话吗
Harry, can you hear me?
你知道你在哪里吗
Do you know where you are?
下医嘱吧卡特
Let's order something, Carter.
查血常规生化七项血型与抗体筛检
C.B.C., Chem-7, type and screen.
要检尿吗
Want to dip a urine?
要还要做颈椎胸腔骨盆X光片
Yeah, let's get a C-spine chest and pelvis.
警♥察♥说患者是酒驾吗
Police said it was a D.U.I.?
不清楚
I don't know.
这个人在州际公路来回变道
The guy was swerving in and out of lanes on the Eisenhower
时速不到六十公里
only going about 35.
结果撞上了电线杆
Then he hit a light pole.
查查血液酒精浓度
Let's get a blood alcohol level.
呼吸里没酒味
There's no alcohol in his breath.
谢谢你们给的补给
Thanks for the supplies.
不用谢
Any time.
他癫痫了
He's seizing!
准备劳拉西泮 2毫克
Okay. Get some ativan, 2 mgs!
塔巴施在哪
Where's Tabash?
他在照看其他病人
Well, he's with another patient.
他安排了什么检查
What's he ordered?
全部
Everything.
血常规电解质血培养是吗
C.B.C., lytes, blood cultures, what?
对都安排了
Yes. All that.
血气胸片呢
A.B.G., chest X-ray?
也有
Yes.
本顿医生
Dr. Benton.
你的儿子现在情况稳定了
Your son is stable at the moment.
给他做了什么检查
What labs have you ordered?
我们做了全套败血症检查
We've done a complete septic workup.
不我需要确切地知道你的医嘱
No, I need to know exactly what you've ordered.
做了哪些检查用了什么抗生素
What, uh, labs, what antibiotics.
本顿医生你儿子心率170
Dr. Benton, your son's heart rate is 170
在吸纯氧的情况下血氧91
and his pulse ox is 91 on 100% oxygen.
我们给他拍了胸片
We've taken a chest X-ray
抽血查了血常规电解质血气
drawn blood for C.B.C., lytes and A.B.G.,
还做了血培养尿培养
and sent off a blood culture, a urine culture,
气管内吸出物培养
an endotracheal aspirate culture,
脊髓液培养
a spinal fluid culture,
给他用了100毫克氨苄西林
and started him on 100 milligrams of ampicillin
6毫克庆大霉素
and six milligrams of gentamicin.
他血压低
He was hypotensive
只有30/18
with a blood pressure of 30/18,
所以还给他用了5%白蛋白
so he's received five percent albumin
每公斤体重10毫升
10cc's per kilo,
还用了多巴胺
and we've started dopamine
每分钟每公斤体重5毫克
five mics per kilo per minute.
我们会滴定至平均动脉压40
And we'll titrate to a M.A.P. of 40.
现在你只需要知道
Now, what you need to know--
只需要告诉孩子母亲
what you need to share with this child's mother--
目前孩子情况稳定
is that, at the moment, the baby is stable,
但仍是重症
but critically ill.
他的血液很可能有严重感染
Probably has a serious infection in his blood
我们不能确定他的肺部
and we don't know if his lungs
是否能充分供氧以维持生命
can provide enough oxygen to sustain life.
不幸的是我们除了
Unfortunately, we have no choice
等待观察他对现在的治疗作何反应以外
but to wait and see how he responds
别无选择
to the present therapy.
一小时后再来看看他情况如何
Let's see how he's doing in an hour.
到时候我们再谈
That's when we should talk again.
你儿子叫什么名字本顿医生
What's your son's name, Dr. Benton?
他还没有名字
He doesn't have one.
卡萝我有个好消息还有个坏消息
Carol? Hi. I've got some good news and bad news.
反正你两个都得告诉我说吧
You'll tell me both. So go ahead.
坏消息是你的兄弟姐♥妹♥们♥
The bad news is, your brothers and sisters-in-arms
今晚要给你办个生日惊喜派对
are planning a surprise birthday party for you tonight.
道格这个玩笑你今早开过了
Doug, you did this joke this morning.
不我说真的
No, this is real.
我收到邀请了
'Cause I got invited.
我不想听了
I'm not listening.
好消息是我知道你讨厌过生日
The good news is, I know you hate your birthday
所以我帮你脱身了
so I got you out of it.
我不讨厌过生日
I do not hate my birthday.
你一直讨厌啊我告诉他们你去不了派对
You always have. I told them you cannot possibly make it
因为你要跟我共进晚餐
because you're having dinner with me.
我一个字都不信
I do not believe a word of this.
今天有多少人祝你生日快乐了
How many people wished you a happy birthday today?
只有凯瑞今早祝了
Just Kerry, this morning.
那有几个人知道
And how many people know
你今天过生日呢
that it is your birthday?
你知道他们的生日对吧
You know theirs, right?
知道啊我们都共事好多年了
Well, yeah. We've worked together for years.
当你明知道
What is the one reason
某人过生日却不祝对方生日快乐
why you don't wish someone happy birthday
唯一的可能是什么
when it is their birthday?
天啊因为大家在密谋惊喜派对
Oh, god. 'Cause they're planning a surprise party.
我要说的就是这个意思
That's all I'm saying.
为什么我感觉被你带到沟里了
Why is it that I somehow feel you've trapped me into this.
带到沟里了
Trapped you?
我救了你
I saved you.
你应该请我吃晚饭
You should be buying me dinner.
我随时来接你
I'll pick you up any time.
饭店随你挑还有
You name the place, and...
你纱布掉地上了
Got some gauze out here.
好了我一小时前就该走了
OK. I'm out of here as of an hour ago.
兰迪能拜托你把卡拉·里斯的病历
Randi, can you send that Carla Reese chart
送到妇产科吗
up to O.B., please?
好交给我
Sure, I got it.
你刚才说卡拉·里斯吗
Did you say Carla Reese?
对她大概一小时前把孩子生下来了
Yeah. She just delivered a baby about an hour ago.
卡拉
Carla?
你认识她吗
You know her?
不算认识我记得她
Not really. I remember her.
她一个月前来过急诊室
She came through the E.R. a month ago.
她离预产期还早
She wasn't near being due.
我知道孩子才32周大是个男孩
I know. The baby's only 32 weeks, the little boy.
他还好吗
Is he okay?
我不知道
I don't know.
他在新生儿重症监护室
He's in the NICU.
阿普加评分很低只能插管
Apgar was poor, had to intubate.
能不能脱险不好说
It's touch and go.
孩子妈妈还好吗
Is she doing all right?
除了孩子的事别无大碍了
She didn't have other complications
你问的应该是这个意思吧
if that's what you mean.
我都不知道救活过多少个早产儿了