急诊室的故事

ER S01E13

Part 2 Nov. 22, 2019, 11:57 a.m.

Eight days? Sounds like one for the Guinness Book of Records.
你不要怪他做这种尝试这要坐二十年牢
You can't blame him for trying. He's facing 20 years.
没有明显的毒性迹象
No obvious signs of toxicity.
避孕套肯定还完好无损
The condoms must still be intact.
如果你能给他开点泻药我的工作会容易很多
If you can give him a laxative, it'd make my job easier.
没经过他的允许我们不能给他药物治疗
I can't give him any medication without his consent.
笔借我一下我们会劝说他给他做X光
Borrow a pen? We'll work him up, x-ray him...
希望在避孕套破裂前他能拉出来
...hope that nature takes its course before a condom breaks.
你在哪学的西班牙语
Where'd you learn Spanish?
这儿
Here.
我们的工作时间和本顿一样他睡觉我们睡觉
We work Benton's hours, sleep when he sleeps,
也就是说基本不睡觉
which is practically never.
我们从昨天早上开始值班到现在
We've been on call since yesterday morning.
这是静注车
This is IV cart.
大多数病人一进门就需要输上液
Most patients get an IV the second they come through the door.
如果他们在流血就用16号♥静脉留置针
Angiocath 16 needle if they're bleeding.
你知道该怎么静脉注射吧
You know how to start an IV, right?
-是不知道 -你不是都大三了吗
- Yeah. Actually, no. - I thought you were third year.
卡特四号♥房♥有个人体运毒的
Carter, we got a body packer in four.
你来负责做下腹部平片药物筛选和尿检
Work him up. KUB, drug screen, urinalysis.
做过尿检吗
Ever do a urinalysis?
卡特再做个肛检
Carter, do a rectal.
今天你走运了
This is your lucky day.
-情况如何 -他呼吸困难
- What do we got? - Respiratory distress.
我们在检查体征时他晕过去了
We are taking vitals when he crashed.
从心跳35次到无心跳
From bradycardic at 35 to flatline.
体温40摄氏度血培养已经送过去了
Temp's 104. Blood cultures sent.
败血性休克给他一剂肾上腺素一毫克阿托品
Septic shock. Give him an amp of epi, a mig of atropine...
红霉素和头孢霉素各1.5毫克
...1.5 of each Erythro and cefotaxime.
-发生了什么 -你是他的父亲
- What's going on? - You his father?
-是的 -我们要给他注射药物刺♥激♥他的心脏
- Yes. - We're giving him drugs, stimulating his heart.
肾上腺素和阿托品就位
Epi and atropine on board.
-有心跳声吗 -没有
- Any heart sounds? - Negative.
携带异丙肾上腺素滴剂他以前有过这种情况吗
Piggyback an Isuprel drip. This ever happen before?
有过一次他当时得了肺炎
Once, when he had pneumonia.
-大脑性麻痹 -脑损伤
- Cerebral palsy? - Brain damage.
-有脉搏了 -好了心跳恢复了
- Got a pulse. - All right, heart's back.
-他室颤了 -什么情况
- He's in V-tach. - What the hell?
现在暂停异丙肾上腺素再注射利多卡因
Hold the Isuprel now, and give him lidocaine.
50毫克静脉注射
Fifty milligrams, IV push.
-怎么回事 -他的心跳速度过快
- What's happening? - His heart is racing.
-怎么会这样 -我不知道
- Why? - I don't know.
用十二导联心电图看看是怎么回事
Let's get the 12-lead in there and see what's going on.
移♥动♥
Move that.
移♥动♥
Move it. Draw petrillian.
我试图劝服凯森这类责怪的话
I tried to convinc Kayson that this kind of finger-pointing...
与教学医院的精神背道而驰
...runs contrary to the spirit of a teaching hospital.
-来杯果汁吗 -不用了谢谢
- Juice? - No, thank you.
但是他听不进去
He failed to see my point.
他要对你提出纪律处分
He's bringing disciplinary charges against you.
这到底是什么意思
What does that mean, exactly?
你下周要来委员会为自己辩护
You'll come before the committee next week, defend yourself.
我们会通过你的辩护作出相应的决定和措施
We'll make a determination and steps will be taken accordingly.
摩根斯坦医生我希望你能知道
Dr. Morgenstern, I want you to know that
我试图介绍维纳贝克先生的历史记录
I tried to present Mr. Vennerbeck's history.
是凯森医生打断了我并让他出院
Dr. Kayson cut me off and ordered him release.
苏珊我不关心细节
Susan the specifics don't concern me...
但我在意你没法坚持自己
...nearly as much as your inability to assert yourself.
什么意思
Excuse me?
你让凯森威胁到你了
You allowed Kayson to intimidate you.
这不是第一次
Not the first time.
我记得你和本顿也有一次类似关于阑尾的经历
I recall a similar incident with Benton about an appendix.
我当时是对的
I was right about that.
但是你同意了本顿的判断这就是我想说的
But you deferred to Benton's judgment, that's my point.
你似乎缺乏提出自己意见的魄力
You seem to lack the authority to put forward your own opinions.
无法做一个维护自己病人的积极倡导者
To act as an aggressive advocate for your patients.
我得改进这一点
I guess I have to work on that.
是的没错
Yes, you do.
自信
Confidence.
面对压力也能保持冷静有魄力
Composure under pressure. Assertiveness.
这些是急诊室专家必需的品质
These are the requisite qualities of a good ER specialist.
我很乐意给你机会培养这些品质
I'm willing to give you the chance to develop them.
但如果你做不到我们以后就要讨论一下
If you don't, we'll have a future discussion...
你自身的气质最适合转去哪个专业了
...about which specialty might best match your temperament.
高峰T波不稳定的心率一定是因为钾含量吧
Peaked T waves, unstable rhythm. Gotta be potassium, right?
-电解质报告有了吗了 -还没有
- His lytes back? - Not yet.
来不及了给他注射15毫升的葡萄糖酸钙
Can't wait. Give him calcium gluconate 15 mils.
-这有可能会杀了他的 -照做
- It could kill him. - Just do it.
-心搏停止了 -再注射一次肾上腺素和阿托品
- Asystole. - All right, repeat epi and atropine.
医生
Doctor?
先生看起来你儿子的钾含量太高了
Sir, it looks like that your son's potassium is too high.
可能是因为肾衰竭
Probably from renal failure.
我们会尽可能地降低钾含量
We'll do anything we can to bring it down.
我摸到脉搏了虽然很虚弱但是是有的
I think got a pulse. Weak, but it's there.
-收缩压35 无舒张压 -我来吧
- BP 35 palp. - I'll take it.
血电解质恢复了钾含量高 7.5
Lytes are back. Potassium's high, 7.5.
我们的方法是对的准备血糖和胰岛素
We're on the right track. Stand by with glucose and insulin.
他能活下来吗
Is he gonna live?
看样子他能挺过来
Looks like he'll make it.
卡萝尔听说你又被扎了第四次了吧
Carol, I heard you got stuck again. What is it, number four?
-数一下 -五次我才三次
- Count them. - Five. Wow! I've only got three.
杰米清理利器盒的时候
Jamie once put me down for emptying
超过了我我得赶上来
the sharps containers. I need to catch up.
不要挑战命运
Don't tempt the Fates.
-你和塔格确定好日子了吗 -还没有
- You and Tag set a date yet? - Not yet.
怎么样了
How'd it go?
怎么样一言难尽
How'd it go? Well, it's hard to describe.
提米佩特罗夫斯基的病历在哪
Timmy, where's Petrofsky's chart?
怎么了发生什么了
Why? What happened?
让我现在说的话我觉得我输了
You know if I told you right now, I think I'd lose it.
下去到2号♥检查室
Go down to Exam Two.
你住在玛丽蒙之家
You live at the Marymount Home?
为情绪障碍人士而设的地方
For the emotionally disabled.
这就是社会给我定义的标签
That's what society has labeled me.
提米那间屋子空着
Timmy, what's open?
创伤室其他的都满了
Trauma room. Everything else is full.
呼吸急促是什么时候开始的
When did the shortness of breath start?
大概一个月前但是这周情况恶化了
About a month ago. But this week it got worse.
你在服用什么药物吗
Are you on medication?
是的这是我的医疗活页本我从14岁开始收集
Yes. This is my medical binder. I've kept it since I was 14.
药物是橙色的其实更像是南瓜色
Medications are in orange. Actually, it'd be more pumpkin.
你有在服用锂剂丙戊酸钠和甲状腺素
And you take lithium, Depakote and Synthroid.
是的我在服用这些
Yes. I've taken these.
关于我过敏的部分是淡紫色的
My allergy section. These pages are mauve.
接种疫苗是灰色的
Vaccinations are gray.
医生的名字和号♥码是紫红色
Doctors' names and numbers are plum...
过去的医疗记录是不同的红色
...and past medical records are in various shades of red...
从朱红色到深褐色
...from vermillion to puce.
色彩缤纷啊
Very colorful.
谢谢夸奖
Thank you.
-而且你穿的一身蓝色 -对因为是周一
- And you're dressed all in blue. - Yes. It's Monday.
进来吧阿兰
Come on in, Alan.
不行
I can't.
-为什么 -房♥间是绿色的
- Why not? - It's green.
这样不好吗
Is that bad?
很糟糕
Very.
他睡着了
He asleep?
是的我回去取了一些他的东西
Yeah. I went and got a few of his things.
本病得很重先生他得过肺炎
Ben's pretty sick. Mr. He's got pneumonia...
导致了他今天的心脏问题
...which caused his heart problems earlier the day.
希望抗生素能让他的情况好转