急诊室的故事

ER S01E14

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

是关于将视作普通人的
on relating to patients as people.
叫做"患者全面解读"
It's called "The Whole Patient."
别影响工作
Just don't let it interfere with your work.
他是认真的吗不是吧
He didn't mean that. Did he?
我没有把他摔得很重
I didn't throw him that hard.
我只是在给他演示抱摔
I was showing him a take-down move.
这个动作我都做过几百次了
I've done the same move over 100 times.
这里疼吗扎克
Does this hurt, Zack?
有点疼
Yeah, it hurts a little.
肯定很疼我在九岁的时候摔断过胳膊
I bet it hurts a lot. I broke my arm when I was nine.
康妮静脉注射2毫克吗♥啡♥
Connie, two migs of morphine, IV.
这边疼吗
Does this hurt?
我教了13年体育了
Thirteen years of teaching physical,
从来没发生过这样的事
this has never happened to me.
奥尔曼先生只是腿部骨折而已别紧张
Mr. Allman, it's a broken leg. Relax.
胫后脉搏很弱
Posterior tibial pulse is weak.
扎克踩我的手就像踩油门一样
Zack, push down on my hand, like a gas pedal.
好的扭一下脚趾
Okay, wiggle your toes.
拍个胫部的片子吗
Femur films?
竖直加水平
AP and lateral.
扎克我们起来一下
Zack, we're gonna get you up,
给你拍个X光片看看什么情况
get you some x-rays and see what's going on.
会更疼吗
Is it gonna hurt more?
会有一点疼但是想象一下
It'll hurt a bit, but think of the fun
大家都来你的石膏上签字多有趣
you'll have getting your cast signed.
她一直在吐是不是应该催产
She's been throwing up, maybe you should induce labor.
现在催产还太早
That's a little extreme right now.
张太太有没有宫缩出血的症状
Mrs. Chang, have you had any cramps, bleeding?
她只是胃不舒服
It's just her stomach.
你可能得了一种叫作先兆子痫的病
You could have a condition called preeclampsia.
你的血压有点偏高
Your blood pressure's a little elevated.
但等检查结果出来就能知道的详细多了
But we'll know a lot more when we get your test back.
可能是胎儿状况不好
Maybe the baby's in trouble.
为什么不引产呢还有两个礼拜就该生了
I mean, why not induce? It's only two weeks away.
我们会照顾你太太的
We're gonna take care of your wife.
你不妨冷静下来
Why don't you try to stay calm?
骨科谁值班
Who's on for Ortho?
泰格拉里
Taglieri.
还有谁有空尼尔森医生呢
Who else is available? What about Dr. Nelson?
他还在不是吗
He's still up there, isn't he?
通知尼尔森医生 10岁患者股骨骨折
Tell Dr. Nelson, 10-year-old, broken femur.
我需要有人每周替我代几天班
I need somebody a few days a week.
你妈妈病情恶化了是吗
Your mom's got worse, huh?
你知道有谁能代班吗
You know anybody?
八楼有个女的在理疗中心兼♥职♥ 叫珍妮·布雷
A woman on 8, part-time in physical therapy, Jeanie Boulet.
你会喜欢她的就像你喜欢其他所有人一样
You'll like her. As much as you like anyone.
哈蕾
Haleh.
能帮2号♥诊疗室的孕妇做个血液检查吗
Can you get a blood workup on the pregnant woman in 2?
恐怕不行实验室早关了开玩笑的
I don't think so. The lab's completely shut down. Just kidding.
马克自杀未遂
Mark, suicide attempt.
哈里斯·弗兰 32岁看样子是服药过量
Harris Fran, 32, looks like an OD.
她留了张字条他们找到一个丙咪嗪的空瓶
She wrote a note. They found an empty bottle of imipramine.
生命体征如何
Vitals?
收缩压50 舒张压无脉搏120
BP 50 palp, pulse 120.
我从七点就开始呼救了
I started calling at 7.
应该再早点来的
I should have gotten there sooner.
把她放到床上
Put her on the bed.
-听口令一二三 -注射0.8毫克纳洛酮
- On my count: One, two, three. - Point eight narcan.
哈蕾拿葡萄糖来
Haleh, get a glucose.
-透析还是灌流 -不用含三环素的药物
- Dialysis or hemoperfusion? - Not with tricyclics.
我们得把她的胃清理干净
We gotta pump her stomach.
需要一个艾伐特式胃管和炭
Let's get an Ewald tube and a charcoal.
做个毒理检查
Draw a tox screen...
-查鲁德氏综合征 -她用过其它抗郁药物吗
- ...and a Rud's. - Was she on any other anti-depressants?
不知道
I don't know.
她一直说她没那么抑郁
She kept saying she wasn't that depressed.
女士还是把你的孩子带到外面去吧
Ma'am, maybe you should take your baby outside.
他不是我的孩子是她的
He's not mine. He's hers.
把他带出去麻烦哪位来帮帮她
Take him outside. Somebody help her, please.
米利特看看药瓶
Millette, see the bottle of pills...
找到她心理医生的名字查查她还用了什么药
...get the shrink's name, find out what else she was on.
艾伐特式胃管
Ewald tube.
毛细血管回流缓慢
Capillary refill's poor.
准备三升生理盐水灌洗干净
Three liters saline. Lavage till clear.
血压还在降收缩压40 舒张压无
BP's falling, 40 palp.
窦性心动过速 140每分
Sinus tach 140.
痉挛了马克
Seizures, Mark.
糟糕
Ah, crap!
输安定 10毫克静脉注射
Valium, 10 milligrams IV push.
1克苯妥英钠每分钟注射50毫克
Dilantin 1 gram at 50 migs a minute.
-扶住她 -心动过速
- Hold her! - Tachycardic.
静脉注射一支碳酸氢钠再往生理盐水兑两支
Give her an amp bicarb IV push, then put 2 amps into that liter.
看着像尖端扭转型室速
Looks like torsade.
硫酸镁 2克
Magnesium sulfate, two grams.
脉搏血氧还在降
Pulse ox is falling here.
静脉注射中
IV's infiltrated.
慢点
Slow down.
慢点
Slow down.
在体育课上发生的他们在摔跤
Happened in gym class, wrestling.
-好了这项检查用不上你 -没问题
- Okay, I won't need you for the exam. - No problem.
还有道格
And, Doug...
听好我是值班的主治医生
Listen, I'm the attending on call.
我值班时叫我就好不用叫别人
When I'm on, you call me, not somebody else.
无关私人恩怨这是专业起见
It's not personal, it's professional.
-明白了吗 -是约翰明白了
- Got that clear? - Yes, John, that's clear.
小伙你好吗
Hey, tiger, how you doing?
女士您要不要去坐下
Ma'am, would you like to sit down?
不我得守在这
No, I should stay.
等她醒了她肯定想见孩子
When she wakes up she'll wanna see her baby.
我们联络不上她的心理医生
We can't get in touch with her therapist.
她还有可能用了什么药
Is there anything else she might have taken?
我得给她男友卡尔打电♥话♥ 他得来这
I should call Carl, her boyfriend, he should be here.
她用了什么其他处方药吗
Was she taking any other prescriptions?
她怎么能这样做
How could she do this?
她明明很幸福
She was happy.
她都回去上课了一切都好好的
She'd gone back to school. Everything was fine.
您还是让我来
If you'd just let me...
-不用我来照顾他 -没事的
- No, I'll take care of him. - It's okay.
她还在吃其他药吗
Was she taking any other drugs?
我应该给卡尔打个电♥话♥
I should call Carl.
你们这有电♥话♥吗电♥话♥在哪
Do you have a phone? Where's the phone?
脉搏血氧60
Pulse ox is 60.
-不见效 -还是心脏停搏
- This isn't working. - Still PEA.
无脉搏
No pulse.
加大肾上腺素剂量 7毫克
High-dose epi, seven milligrams...
再来1毫克阿托品
...another mig of atropine.
她发绀好厉害
She's really cyanotic.
多长时间了
Time down?
至少25分钟了
25 minutes at least.
心跳听不到
I don't hear a thing.
她心脏停搏了
She's in asystole.
她一定吃了三环素
She had to take tricyclics.
吃止痛药不就得了
Why the hell didn't she take painkillers?
异常娃娃眼征瞳孔固定散大
Abnormal doll's eyes. Pupils fixed and dilated.
脑干损坏
Brain stem's shot.
她不行了
She's gone.
没事的小家伙
It's okay, buddy.
你会没事的
You'll be okay.
骨头附近的这大♥片♥区域可能是骨肉瘤
This big mass around the bone may represent an osteosarcoma.
不敢相信这是我♥干♥的
I can't believe I did this.