急诊室的故事
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急诊室的故事
ER S01E12
Part 5
Nov. 22, 2019, 11:57 a.m.
- Just don't push. Don't push! - Take short breaths.
-浅呼吸 -去你的
- Short breaths. - Screw you.
像要吹蜡烛一样短促呼吸 没错做得好
Short breaths like you're blowing out a candle. Good like that.
见鬼 胎儿有只脚已经出来了 而且是蓝色的
Oh dame! We got a foot coming out, and it's blue.
好的 推回去 然后将她推进这里
Okay! Let's back her up, and take her in here.
快一点 各位
Come on, people.
麻烦借过 把路让开
Excuse us! Make way!
呼叫产科 叫他们立刻下来这里
Call OB. Tell them to get down here right away.
没什么会比可♥卡♥因♥中毒且足式臀位生产更糟了
It can't get much worse than a cocaine-toxic footling breech.
有的 脐带已经脱垂了
Yes, it can. Umbilical cord's prolapsed.
把监护器推来 导管在哪里
Grab the monitors. Where're the leads?
在急救车里有 把生命监护仪接上
In the crash cart. Pull in a dynamap.
-他们会没事的吧 -你是谁
- Are they gonna be okay? - Who are you?
我住他们隔壁 他们的猫不断抓门想要进屋
I live next door. Their cat was scratching to get in the apartment
但我敲门 却没有人应门
But when I knocked, nobody answered.
她的皮肤呈樱桃红色 特别是指甲下面
Her skin is cherry red, especially under the nails.
吸氧量在15升 呼叫呼吸科 立刻
O-2 at 15 liters. Call Respiratory in here, stat.
他们两位都大概是一氧化碳中毒
It's probably carbon monoxide poisoning with both of them.
卡萝 做个氢氧化钠测试
Carol, do a sodium hydroxide test.
从架子上拿几个测试用试管来
Get a couple of test tubes from the rack.
他们有用室内暖气炉之类的吗
Did they use any kind of space heaters?
是的 他们有用那种小型的暖炉 不烧油的 但
Oh yeah. They got those little ones. It's not oil, but...
-烧煤油 -正是
- Kerosene. - That's it.
我们这里需要一台便携X光机
We need a portable x-ray in here now.
他们会好起来的吧 会吧
They are gonna be okay, aren't they?
他们一直住在我隔壁
They lived next door to me all of my life.
就像我的祖父母一样
They're like my grandparents.
两份样品都检测出了一氧化碳
CO's present, both samples.
检测出碳氧血红蛋白
Carboxyhemoglobin.
好的 将氧气接到这边来
All right! Let's get the oxygen hooked up here.
你要些做什么检查
What kind of lab test you want?
-去把暖气开了 -今天新生儿重症科是谁值班
- Turn the warmer on. - Who's on in N.I.C.U?
迪桑早些时候在
Dizon was here earlier.
你个混♥蛋♥ 这真疼
You son of a bitch, it hurts.
不 我不行了 帮帮我
No! Guys! I can't. Helps...
-把暖气打开 -很好 我抓到另一只脚了
- Turn the warmer on. - Okay! Good, I got the other leg.
另一只脚出来了
The other leg is out.
婴儿通常旋转到脊柱前位
The baby usually rotates to the spine anterior position.
肩胛骨出来了
Shoulder blades are free.
好的 现在将它向旁边转
Okay, now rotate it sideways.
将手臂折向胸口
Sweep the arms down over the chest.
-你在干些什么 -好的 孩子出来了
- What are you doing? - Okay, here we go.
他在颤抖 抽吸
He's tremulous. Suction.
呼吸 保持住呼吸
Breathe. Keep breathing.
我的宝贝
My baby.
我会交叉固定头皮静脉输液管
I'll stick a butterfly in the scalp vein.
给我从脚后跟测个血糖
Get me a heel-stick glucose.
血糖值25
Blood sugar's 25.
-有阴♥道♥撕裂吗 -没有很严重
- Any vaginal tears? - Not too bad.
让我采点脐带血
Let me get some cord blood.
三分钟内给他6毫克10%的葡萄糖
Give him six milligrams of 10 percent DW over three minutes.
苏珊 你刚才是不是让一个
Susan, didn't you just release a patient
叫维纳贝克的病人出院了
named Vennerbeck?
亲爱的 肯定不会有事的
Honey, everything will be okay. I just know it.
-怎么了 -我不知道
- What happened? - I don't understand.
严重的胸骨后胸痛 蔓延到左臂
Severe substernal chest pain radiating down the left arm.
已经打了五针吗♥啡♥...
He's had five morphine...
出现了全收缩期杂音并伴有震颤
He's got a new holosystolic murmur with a thrill.
给我7.5的气管导管
Give me an ET tube 7.5.
-你为什么让他离开 -400毫克的多巴胺滴注
- Why did you let him go? - Start a 400 milligram dopamine drip.
有人可以告诉我发生了什么吗
Will somebody please tell me what is going on?
38岁 因胸痛再次入院
38-year-old bounced back with chest pain.
全收缩期杂音
Holosystolic murmur.
低血压 可能有室间隔穿孔
Hypotensive with a possible ventricular septal rupture.
给我40毫克适泄锭静脉推注
Give me 40 milligrams Lasix IV push.
求求你 医生 谁能告诉我现在什么情况
Doctor, please. Someone tell me what is going on!
推他上楼
Let's get him upstairs.
呼叫导管室准备主动脉内球囊
Call the cath lab to prep for intra-aortic balloon.
走 快走
Go! Come on, go! All right.
刘易斯医生 你不用跟着来了
That'll be all, Dr. Lewis.
维纳贝克太太 我是凯森医生
All right. Mrs. Vennerbeck, I'm Dr. Kayson.
我们需要采取
We need to take certain
急救措施来稳定你丈夫的情况
emergency measures to stabilize your husband.
马力昂斯基女士...
Ms. Maryanski...
马力昂斯基女士 我很抱歉
Ms. Maryanski, I'm sorry
你大概不想听到这样的消息
it's not the news that you wanted to hear.
不 我想要这个孩子
No, I want this baby.
那是你丈夫吗
Is it your husband?
他不想要孩子吗
He doesn't want to have the baby?
马力昂斯基女士...
Ms. Maryanski...
你们两个人
...this is something that the two of you,
作为夫妇 该认真讨论的问题
as a couple, really should discuss.
他不育
He's infertile!
好吧...
Well...
这种情况的话
...in that case...
好吧 就该
...that, yeah, would be...
这些是上颌窦
These are the maxillary sinuses.
受影响的一侧出现混浊
Opacification on the affected side...
这就是微小的信♥号♥♥
...is a subtle clue that
意味着眶内壁骨折
the interior wall of the orbit is fractured.
如果现在不方便的话
If this isn't a good time...
抱歉 今天真是漫长的一天
Sorry, it's been a long day.
事实上 七分钟后我就要和
Actually, I'm scrubbing with Dr.Benton
本顿医生一起进行胆囊手术了
on a gallbladder in 7 minutes.
以我对本顿医生的了解 他肯定会早到
Well, if I know Dr. Benton, he'll be early.
你最好现在就过去
Better get out of here.
卡特 记住这三个部位:
Carter, Remember these three things:
胆囊管 总胆管 肝
Cystic duct, common duct, liver.
快走吧
Get out of here.
他们睡着了
They're asleep.
你吓到我了
You scared me.
抱歉
Sorry.
血气分♥析♥结果正常了 一氧化碳水平下降了
Their blood gases have normalized. Their CO levels are down.
他们会没事的 抢救非常及时
They're gonna be fine. They're on a 23:59 hold.
我只是想在下班前来看看他们
Well, I just wanted to check on them before I head out.
巴布科克先生有一家面包店
Mr. Babcock owned a bakery.
从他们结婚那年就开始经营
Started it the year they were married.
每年他们的纪念日 6月14日
He still makes a three-tiered cake...
他都会做三层的蛋糕
...every June 14th on their anniversary.
他们今天很幸运
They got lucky today.
我觉得也许他们每天都很幸运
I think maybe they've been lucky every day.
卡特...
Carter...
不需要用屁♥股♥开门倒着进来 你还没消毒
Don't butt in backwards. You're not sterile yet.
-好 -用膝盖打开水龙头 打开一个刷包
- Okay. - Turn on the faucet with your knee. Pop open a brush packet.
快点 打开
Come on, get it open.
很好
Good.
现在 将手打湿 从指甲开始
Now, get your hands wet, starting with your fingernails.
擦洗手指十次
Scrub your fingers 10 times.
前面 侧面...
Front, side...
背面 指缝儿
...back, webbing.
这样吗
Like this?
对 基本上就这样
Yeah, sort of.
然后擦洗手掌十次
Then scrub the palm 10 times.
手背...
Back of the hands...
小臂
...down the arm...
正面 侧面
...front, side...
背面 一直到手肘
...back, up to the elbows.
然后冲洗
Then rinse...
这样水流可以从你的手臂流下来
...so that the water runs down your arms...
...而不是从手上 明白了吗
...not your hands. You got it?
明白
急诊室的故事
ER
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