急诊室的故事

ER S01E12

Part 4 Nov. 22, 2019, 11:57 a.m.

Carter, it's 34 degrees out. You might want to get your coat.
我的外套
My coat.
卡特有什么紧急情况吗
Carter, is there some kind of emergency?
好的走吧
All right, come on.
这边是什么情况
All right. What've we got?
车祸伤者
MVA.
校车和双门轿车相撞
School bus versus two-door.
腹部钝挫伤
Blunt abdominal trauma.
伤者25岁脉搏150 很微弱
Twenty-five years old. Pulse 150 and thready.
血压50
BP 50 palp.
-快快 -无法插管
- Go! Go! - Couldn't intubate.
扶好走吧
Scooped and flew.
好的
All right.
我们接手了
We'll take it.
毛细血管再充盈指数很低
Cap refill's slow.
-窦性心动过速心率150 -需要清理血块
- Sinus tach at 150. - Run a strip.
什么情况
What've we got?
车祸伤者腹部钝挫伤
MVA. Blunt trauma to the abdomen.
各位准备插管
Okay, people. Let's intubate.
我来
I got it.
你协助插管我去把X光机推过来
You help intubate. I'll get X-ray down here.
好的卡特先生他就交给你了
Okay, Mr. Carter, he's all yours.
康妮可以给我一支7.5口径插管吗
Connie, can I get a 7.5?
吉姆急诊室的莉莉创伤二室要便携式X光机
Jim, it's Lily in the ER. We need portable X-rays in Trauma 2.
颈椎腹部全面检查
C-spine abdominal series to start.
-好的谢谢 -这里需要一些毛巾
- Okay, thanks. - Got some towels over here.
他这里有太多分泌物我需要抽吸
He's got a lot of secretions in here. I need some suction.
O型血还没到吗
Where's the O-neg?
快到了
On its way.
伸入插管
Advance the blade.
看清声带
Visualize the vocal cords.
穿过管子
Pass through the tube.
他已经输多少液了
How much fluid has he had?
现场时挂了2升这加一起会有4升
2 liters in the field. This'll make 4.
-我好了 -我需要一根抽吸导管
- I got it. - Give me a suction cath.
-需要呼吸器吗 -不用我们手动给他通气
- Respirator? - No, we'll bag him.
他的腹部很硬要腹腔灌洗
His abdomen's rigid. Peritoneal lavage?
还是你来做吗卡特先生
Would you like to do that also, Mr. Carter?
-不你来吧 -那就谢谢你了
- No, you can do that one. - Why, thank you.
不用了皮特有一组人准备术前消毒了
Don't bother, Peter. I got a team scrubbing up.
把他挪上楼吧告诉我重点
Move him upstairs. Give me the bullet.
患者二十五岁恶性心率失常
MVA, 25 years old.
入院时脸色苍白大量出汗
Brought in pale and diaphoretic.
脉搏150 血压50
Pulse is 150, BP is 50 palp.
呼吸频率25次每分钟已插管
Resp's 25. Intubated.
腹部钝器性外伤脾脏可能破裂
Blunt abdominal trauma, probable ruptured spleen.
感谢各位剩下由我们接手了
Thank one and all. We'll take it from here.
-留意仪器线 -我们走
- Watch the line. - Let's go!
-留心那个饰条 -顺利通过
- Watch that strap. - We're clear.
各位借过
Excuse us, people.
摩根斯坦和我晚上八点要做个胆囊切除术
Morgenstern and I have a gallbladder at 8 p.m.
你七点半之前来洗手准备上台
Scrub in by 7:30.
我们碰头了重复我们已碰头了
We have made contact. I repeat, we have made contact.
-是你在找他是吗 -没错
- It was you who was looking for him, right? - Yeah.
凯森医生
Dr. Kayson.
-我正要去导管室刘易斯医生 -那我想请你
- I'm on my way to the cath lab. Dr. Lewis. - Then I will ask you to
现在就签字批准维纳贝克先生出院
sign out Mr. Vennerbeck now.
38岁患者已排除心肌梗塞的可能
A 38-year-old, ruled out MI,
收治时左胸非放射性疼痛
admitted with non-radiating left chest pain.
会随着活动而加剧
reproducible with movement.
左胸骨边缘有压♥迫♥性疼痛已自行好转
Tenderness left sternal border. Resolved without treatment.
-心电图正常吗 -是的
- EKG's normal? - Yes.
-心肌酶检测正常吗胸片呢 -都正常
- Enzymes, chest x-ray? - Normal.
-他头晕吗有没有心悸 -没有
- Dizzy? Palpitations? - No.
-大量出汗吗 -没有
- Diaphoretic? - No.
-有出现高血脂症状吗 -没有
- Hyperlipidemia? - No.
-有胸痛的病史吗 -没有但是
- History of chest pain? - No, but...
有风险因素吗
Risk factors?
没有但他血压有点微高
None, but slightly elevated blood pressure.
听起来不像是心脏科的问题
Doesn't sound cardiac.
让他约自己的医生做个压力测试吧
Have him see his doctor for a stress test.
-谢谢你刘易斯医生 -谢谢你凯森医生
- Thank you, Dr. Lewis. - Thank you, Dr. Kayson.
维纳贝克先生你一切正常可以走了
You're free and clear. Mr. Vennerbeck
你需要跟你的私人医生约个压力测试
You need to see your own doctor and get a stress test.
这下可好我错过了两个约会
Oh, Great! Missed two appointments,
而你花了三小时来通知我去见我的私人医生
and you take three hours to tell me to see my own doctor.
我对这花了你那么长时间深感抱歉
Well, I'am sorry that it took so long.
但我们想要为你检查全面一点
But we wanted to give you a thorough check-out.
好的没事谢了好吧
Sure, sure. Thanks, okay?
-我去叫个护士进来帮你 -再好不过
- I'll send a nurse in. - Great.
刘易斯医生
Dr. Lewis.
在我还是住院医师的时候
When I was a resident,
我总是忙于得到人们的认可
I was always worried about getting people's approval.
主治医师的认可病人的认可
The attending, the patients.
也许这是因为我是个女性
Maybe because I was a woman.
一个黑人女性
A black woman.
但生活在我不再纠结这个之后容易多了
Life was a lot easier once I got over it.
别让这些病人影响你刘易斯医生
Don't let the patients get to you, Dr. Lewis.
我们尽可能快地给他们治疗
We treat them as soon as we can.
并且不需要为花了长时间而道歉
And there's no need to apologize for how long it takes.
我们是个繁忙的医院不是餐馆
We're a busy hospital, not a restaurant.
-是盖比先吵起来的 -不是我
- Gaby started it. - I did not!
-你也有份 -我没有
- You did too! - Did not.
女士们拜托你们是姐妹问题能解决的
Ladies, come on! You're sisters. We can work this out.
萨丽之前不想选艾米莉这个名字所以我选了
Sally didn't want the name Emily. It's why I choose it.
艾米莉是我们祖母的名字我一直都想选
Oh! Oh! Emily is Grandma's name. I've always wanted it.
你看还有很多其他名字可供你选择
You know, there are plenty of other names you can use.
-你可以用个别的名字 -你都不确定是女孩
- You can find an other name. - You don't even know if it's a girl!
-再说我比你早一周生 -如果我催产就不一定
- Besides, I deliver a week earlier. - Not if I have it induced!
病床要过了
Coming through.
康妮让开
Connie... Get out of the way!
康妮给病人做个血常规和生化7项
Connie, get a CBC and a Chem-7.
用多普勒仪听个胎心呼叫产科
Get FHTs with a Doppler, and call OB.
苏珊你闲吗想找点事干吗
Hey! Susan, are you bored? Looking for something to do?
跟我来她叫特芮塔她十九岁
Come on. Her name's Tarita. She's 19 years old.
她主诉腹痛
She's complaining of abdominal pains.
她需要注射纳洛酮和一剂糖水
She needs Narcan and an amp of glucose.
接根吸管来做抽吸
Hook up the suction to a Yankauer.
我们需要来一剂糖水
We need an amp of glucose.
纳洛酮已经注入
Narcan given.
多普勒仪来了吗
Where's that Doppler?
血压70/30 呼吸微弱频率在每分钟8次
BP's 70 over 30. Resp's shallow at 8.
把静注滴速调快她意识朦胧
Crank up the IV. She's somnolent.
瞳孔针缩她磕了什么药
Pupils pinpoint. What's she on?
她男朋友说她吃了摇♥头♥丸♥和可♥卡♥因♥
Boyfriend says pills and cocaine.
-我们做个毒理检查 -她还需要一剂糖水
- Let's get a tox screen. - She needs an amp of D-50 too.
我们会帮你的特芮塔
We are gonna help you, Tarita.
你能告诉我你的预产期是什么时候吗
Can you tell me when your due date is ?
不我不知道
No! I don't know!
躺下来一切都会好的
Lie back, it's gonna be fine.
我不知道要生了要生了
I don't know. It's coming. It's coming.
她的宫口全开了
She's fully dilated.
宫颈管完全消失
A 100% effaced.
胎膜已经破了带她去产科
Membrane's ruptured. Let's get her to OB.
我去通知重症科准备个病房♥
I'll notify an ICU unit.
有对老年夫妇在路上双双昏迷
Elderly couple's coming in. Both comatose.
预计到达时间两分钟
ETA's 2 minutes.
本顿在手术中希克斯医生正下来
Benton's in surgery. Dr.Hicks is on her way down.
快一点要生了
Please hurry, it's coming!
要生了
It's coming.
-先别用力推先别推 -浅呼吸