急诊室的故事

ER S03E21

Part 5 July 17, 2020, 11:43 a.m.

I don't know how many preemies I've resuscitated.
但不知怎么我还是习惯不了
but I somehow still haven't gotten used to it.
我们明天见
I'll see you all tomorrow.
再见
See you.
珍妮那个眼痛的女人
Jeanie, were you taking that woman
被你收治了吗还是要派给玛姬
with the eye pain, or was'll send Maggie?
不我来收治我正准备去
No. I'm taking her. I'm just about to head in.
别让患者一直等
Don't keep the patients waiting.
他们可能会气得痛打你一顿
They might get angry and beat you up.
格林医生正为这事暴跳如雷呢
Dr. Greene's on a rampage about that.
他会调整回来的
He'll settle back in.
还需要几天
Takes a couple more days.
马克
Hey, Mark?
道格
Hey, Doug.
今天一整天没见到你
I've been missing you all day today.
你还好吗
How you doing?
我挺好能回来感觉很好
I'm fine. Feels good to be back.
是不是回太早了
Not too soon?
没能陪瑞秋感觉很好
No. It was nice having time with Rachel,
但我超过一个礼拜我就待不下去了
but a week at home is about all I could take.
警方有消息吗
Any word from the police?
他们今天下午会过来
They're going to come by this afternoon.
我给了他们一份名单上面是有理由如此动怒的
I gave them a list of names of patients and family members
病人及其家属
who might have had reason to be that angry--
我能想到的
at least, the ones I can remember.
所以这件事你就这么接受了
So you okay with this?
是也不是
Yes and no.
这不算是什么愉快的经历
Hasn't been the most pleasant experience
但也算给我敲了记警钟
but it's kind of a wake-up call.
提醒了我自己也会跟人结仇
A reminder that I can be abrupt with people
而这必将造成恶果
And it will sure backfire.
-道格 -我不知道是否有必要...
- Hey, Doug! - Well, I don't know if that's necessary...
四室有个腕部骨折的五岁孩子
You've got a five-year-old with a wrist fracture in four.
受伤的孩子给我提神
Child in pain. Music to my ears.
我晚点再跟你聊要一块吃午饭吗
I'll catch up with you later. Get some lunch?
-好的 -好
- Okay. - Okay.
太遗憾了皮特
I'm so sorry, Peter.
胸片显示局部弥漫性肺浸润病变
The chest X-ray showed a diffuse, patchy infiltrate
而气管内吸取物...
and the endotracheal aspirate...
检测出了革兰氏阴性菌
showed Gram negative bacteria.
他得了肺炎败血症
He's got pneumonia, sepsis,
早产婴肺和呼吸窘迫综合征
premature lungs and respiratory distress syndrome.
他们刚给他用了表面活性剂
They just gave him surfactant
帮他扩张肺部
to, uh, try to open up his lungs.
卡拉现在怎么样
How's Carla doing?
她让我在走廊里等着
She asked me to wait outside in the hall.
估计你还没对任何人说对吧
Probably haven't shared this with anyone, have you?
你的家人和同事
Your family, the people you work with?
你有朋友的皮特
You do have friends, Peter.
一个集体
A community.
希望一切顺利
I hope everything will be all right.
还有你不要一直站在走廊了
And you need to stop standing in the hall.
把手放到身体两侧兰斯基先生
Keep your hands on your sides, mr. Lensky.
我做不到疼
I can't. It hurts.
知道我们看得出来
Yes, I think we know that.
脉搏130 血压180/95
Pulse is 130, B.P. is 180/95.
做术前化验吗
Pre-op labs?
对
Yeah.
你最近有服用
Have you been taking
大量布洛芬吗
a lot of ibuprofen lately?
有的
Uh, yeah.
大约每天八片
About eight tablets a day.
那是因为我扭伤了膝盖
That's 'cause I twisted my knee
不是因为胃痛
not because of this stomachache.
卡特医生...
Dr. Carter...
有时间吗
Got a minute?
当然康妮给他拍正位胸片
Sure. Connie, let's get an upright chest X-ray
然后用10个单位吗♥啡♥ 静脉缓推注射
and give ten of morphine, slow I.V. push.
这会缓解你的疼痛兰斯基先生
That'll help with your pain, Mr. Lensky.
我马上就回来
I'll be right back.
我只想二次确认
I'm just double-checking.
这个人就是格林医生关心的
This guy's the "writhing and groaning in exam two"
"二室哼哼又打滚的家伙"吗
Dr. Greene was concerned about?
对我不知道他关心这个病人
Yeah. I didn't know he was concerned.
他担心这人等待外科会诊的时间太长
He was worried the guy was waiting too long for a surgical consult.
兰斯基先生的腹肌紧张
Ah. Well, Mr. Lensky's got a board-like abdomen,
无肠鸣音
absent bowel sounds,
四象限均有反跳痛和压痛
and rebound and guarding in all four quadrants.
胃穿孔吗
A perfed ulcer?
听着像我让他拍片了
Sounds like it. I ordered a film.
让安斯弗检查一下
Have Anspaugh check it out.
好的
Okay.
克雷氏骨折
Colles fracture.
要做闭合复位术吗
Going to have to do a closed reduction?
对他爸崩溃得不敢看了吗
Yep. His dad too flipped out to watch?
他爸自己吃了十片安定后
His dad's sacked out in curtain three
在三床睡过去了
having self-medicated with ten of valium.
真是有用
That's helpful.
我们或许得给拉塞尔买♥♥根棒棒糖
Maybe we should get a lollipop for Russell over here.
强效麻醉性镇痛药
果茶味芬太尼吗
Fentanyl oralet?
可以让他放松
Mellow him out.
我得从中心药房♥订可能需要点时间
And I'll have to order it from central pharmacy. It may take a while.
好我们也可以试试不用糖果
Okay. Or we can try it without.
好
All right.
拉塞尔我们现在打算...
Russel see what we're going to do here, buddy...
我去买♥♥棒棒糖
I'll just get that lollipop.
对去吧
Yeah, get right on it.
我想多等一会
I want to give it a little longer
但表面活性剂的作用不大
but basically, the surfactant didn't do much.
他仍需要用呼吸机
He's still requiring 100% oxygen
高压输送纯氧
with high pressures on the ventilator.
好吧他母亲想知道
Okay, well, his mother's going to want to know
所有可能的结果
everything that might happen.
本顿医生这里的每位父母
Dr. Benton, every parent in here
都希望知道可能发生什么
wants to know what might happen.
但我们无法确定
We just can't know for sure.
其实我...
You know, I, uh...
今年早些时候参加了小儿外科选修课
did a pedes surgery elective earlier this year
但我不了解全部后遗症
but I'm not up to speed on all the, uh, sequelae.
你是说视网膜病变之类的吗
You mean like retinopathy?
对没错虽然他目前有
Yeah, exactly, although his eyesight
很多比视力更让人担心的问题
should be the least of our worries right now.
我们需要更担心
We need to be more concerned about
脑室出血脑室周围白质软化
intraventricular hemorrhage, periventricular leukomalacia,
坏死性小肠结肠炎
necrotizing enterocolitis,
然后几周后是
and in a few weeks
支气管肺发育不良
bronchopulmonary dysplasia.
好吧我们该怎么办
All right, what do we do?
我担心高气压
Well, I'm concerned about the high vent pressures
会导致肺损伤
causing lung damage
所以我想给他换上
so I want to switch him over
振荡呼吸机
to an oscillating ventilator
然后...就是等了
And... we wait.
格林医生你有空吗
Hey, Dr. Greene, you got a second?
有什么事
Yeah. What is it?
哈利·史密斯的头部CT结果出来了
I got the head C.T. Back on Harry Smith--
哈利·史密斯
Harry Smith.
今早那个低速交通事故伤者
The slow-moving M.V.A. from this morning.
是阴性的没有出血
It's negative, no bleed.
但我刚才跟他母亲聊了一下
But I was talking to his mother who is over there