急诊室的故事
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急诊室的故事
ER S01E15
Part 2
Nov. 22, 2019, 11:58 a.m.
And what precipitates these headaches?
死啊
Death.
这又是怎么了
What was that?
神经性抽搐 我有这毛病好多年了
Nervous tic. I've had it for years.
血气分♥析♥结果出来了 氧分压低
Blood gases are back. PO-2's low.
-胸片出来了吗 -出来了
- Where's the chest film? - Right here.
脉搏血氧饱和度降到51了
The pulse ox is down to 51.
-肺动脉出现扩张 -他快不行了
- Pulmonary artery's enlarged. - He's crashing.
-肺灌注扫描结果 -通气血流比异常
- Perfusion scan? - VQ mismatch.
你说对了 150万单位溶栓酶
You were right. 1.5 million units streptokinase.
不用了 推他到创伤科 做荧光镜
Forget that. Get him to Trauma. We need a fluoroscope down here.
把摩根斯坦找来
Somebody get Morgenstern.
罗兰多 创伤室有地方吗
Rolando, we got a Trauma room?
有 二室可以用
Yeah. Two's open.
-你要做栓子清除吗 -凡事都有第一次
- Gonna do an embolectomy? - First time for everything.
-怎么了 -马鞍栓塞 马克在处理
- What's going on? - Saddle embolus, Mark's going in.
他要在急诊室做清除术吗
He's doing an extraction in the ER?
斯米托维奇先生在四室
Mr. Smitrovich is in 4.
血常规 生化七项 血气分♥析♥和点滴
CBC, Chem-7, blood gases, IV started.
卢奇思在六室 腹痛 吐♥血♥
Luchesse's in 6. Abdominal pain, vomiting blood...
禁食 鼻胃管
NPO, a nasogastric tube...
-本顿医生 -怎么了
- Dr. Benton? - What is it?
听说格林医生在做栓子清除术
If Dr. Greene is doing an embolectomy,
我们 我想去观摩一下
we... I'd like to observe it.
没人拦着你 去吧
Who's stopping you? Go.
你也想去 去吧去吧
You wanna go too? Get out of here.
-你怎么了 -卢奇思什么情况
- What's the matter with you? - Luchesse?
吐♥血♥ 禁食 鼻胃管 洗胃
Vomiting blood, NPO, nasogastric tube, gastric lavage.
你安排的洗胃
You ordered a gastric lavage?
我只是写出来了 还需要你签字确认
No, I wrote it down. You still have to sign it.
-我自己会写医嘱 -护士
- I write my own orders. - Nurse?
如果你自己有事 不要把气撒我身上
If you're having a problem today, don't take it out on me.
我写医嘱你执行 明白
I write the orders, you carry them out, understood?
-护士 -干什么
- Nurse! - What?
肾上腺素注射
Isoproterenol's going.
慢慢放入导管
Ease the catheter in slowly...
穿入肺动脉
and thread it up to the pulmonary artery.
注意不要刺破下腔静脉
Be careful not to puncture the vena cava.
-情况如何 -呼吸频率升到45了
- How's Mr Weiss doing? - Resps are up to 45.
脉搏血氧饱和度降到63了
Pulse ox down to 63.
坚持一下 维斯先生 很快就好了
Hang in there. Mr Weiss, you'll be feeling better before you know it.
卡特 陈 你们俩过来看下
Carter, Chen, why don't you get over here so you can see.
看见了吗
See that?
现在是在右心室
I'm in the right ventricle.
很酷不是吗
Is that cool, or what?
-卡特 看见栓子了吗 -不小
- Carter, you see the embolus? - Yeah, it's huge.
把漏斗对准凝块
Position the cup against the clot.
好 开始注射器抽吸
Good. Start your syringe suction...
把栓子吸进漏斗里
and aspirate the embolus into the cup.
好了
Got it.
现在撤出吧
Now work back down.
就像清理下水道一样
Just like snaking a drain.
好了各位 我还有个胆管手术
Well, folks, I got a date with a bile duct.
你们继续
Carry on, one and all.
脉搏血氧饱和度升到85了
Pulse ox up to 85.
呼吸频率在下降
Resps are coming down.
维斯先生 现在感觉如何
How you feeling, Mr Weiss?
我能呼吸了
I can breathe.
我能呼吸了
I can breathe.
哈罗德 有什么东西咬了你是吗
Okay, Harold. So something bit you?
-宠物蛇 -是吗 我养过青蛙
- Pet snake. - Oh, yeah? I used to keep frogs.
青蛙是两栖动物 我的蛇能吃青蛙
Frogs are amphibians. My snake eats frogs.
-是哪种蛇 -金色的睫角响尾蛇
- What kind of snake? - Yellow eyelash pit viper.
-你把响尾蛇当宠物 它有毒吗 -很烈
- You have a pet pit viper? Is it poisonous? - Very.
我会安排中毒控制给你
I'll call poison control.
哈罗德你有没有感觉无力恶心或者打冷战
Are you feeling weak, Harold, nauseous, any chills?
没有 你能通过模样来判断蛇有没有毒吗
No. Can you tell if it's poisonous just by looking?
不能
I don't think so.
我把它放在袋子里带来了
Because I got him right here in the bag.
让它老老实实地待在袋子里吧
We're gonna keep him in the bag, okay?
他是冷血动物 所以我得把它放在保温灯上
No. He's cold-blooded and I had him on the El all day.
它会睡觉
He'll sleep.
刚才它还在这了
He was here a minute ago.
你不应该在护士面前否定我
You shouldn't contradict me in front of nurses.
我没否定你 我们只是诊断意见不一致
I wasn't contradicting you, we disagreed on a diagnosis.
你再稍微克制些的话我会非常感激的
I'd appreciate your showing little more restraint.
那人就要死了
The man was dying.
我希望你尊重我 你能不能做到
I'm asking you for respect. Are you going to give it to me or not.
我那会并不是不尊重
I wasn't being disrespectful...
能还是不能
Yes or no?
苏珊 我尊重你
I respect you, Susan.
谢谢 记得偶尔表现出来
Thank you. Now, try to show it once in a while.
我去找动物管理部门
I'll get animal control in here.
怎么了 道格 发生什么事了
What's going on? Doug, what's going on?
我是急诊室的罗斯医生 这丢了条眼镜蛇
This is Dr Ross in ER. Pit viper got loose.
-蛇 -一条大蛇
- A snake? - A big snake.
格林医生 36岁乳腺癌患者
Dr Greene? 36-year-old woman with breast cancer...
从临终关怀医院来的
brought in from Dignity House.
两次乳腺癌根治术 扩散到淋巴了
Two modified radical mastectomies, spread to her lymph nodes.
-你是 -安妮塔·里斯伯格 临终关怀护士
- Who are you? - Anita Risberg, a nurse at the hospice.
-我是马克·格林 她化疗吗 -三苯氧胺
- Mark Greene. She have chemo? - Tamoxifen.
但是癌细胞转移了
But it's metastasized.
-骨盆 脊柱都是 -给她用吗♥啡♥吗
- Pelvis. Spine. - You got her on morphine?
要睡觉的时候注射120毫克
120 mg just to sleep,
但是最近药效变弱了
but the last few days, it's just not enough.
如果加大用量
I got worried if I up the dose,
我担心会加深呼吸抑制
it'd cause further respiratory depression.
你的判断是对的 她叫什么名字
You're right. What's her name?
格蕾丝 格蕾丝·霍尔斯滕
Grace. Grace Holsten.
你好 格蕾丝 我是马克·格林
Hi, Grace. I'm Mark Greene.
我们将尽力减轻你的痛苦
We'll make you more comfortable.
医生 求你了
Doctor, please...
让我死吧
...let me die.
拜托
Please...
就让我死了吧
...let me die.
动物管理人员说那是条树蛇
Animal control guy believes it's a tree snake.
他说那蛇会爬到高处温暖的地方
He thinks it'll crawl up high where it's warm.
抱歉 医生
Sorry, doc.
我要跪趴着过完这一天了
I'll spend the rest of the day on my hands and knees.
莉迪亚 道格 过来
Lydia, Doug. Come over here.
花了大概六个月的时间
It took about 6 months and a couple
交了几千份申请表 我终于做到了
thousand requisition forms, but I finally did it.
猜猜床单下面是什么
Guess what's under the sheet?
-别这样 快猜猜 -我们不想猜
- Come on guys, guess. - We don't wanna guess.
别这样 猜猜吧
Oh, come on, please?
-休息室的新沙发床 -不是
- New day bed for the lounge? - Nope.
-新的售货机 -不是
- New vending machines? - Nope.
新急救车
New crash carts.
真不错
That's great.
你从哪弄来的
Where'd you get those?
心脏科那边想要 但是我比较无情
Cardiology wanted them, but I was relentless.
三号♥房♥腹部疼痛 还有个枪伤病人要送过来
An abdominal pain in 3 and a gunshot victim coming in.
不许乱拿新急救车上的东西
Now, no raiding off the new crash carts.
车上的东西都不许拿走
Everything on these carts stays on the carts.
谢谢大家
Thank you.
本顿医生 今天下午的创伤展示
Dr. Benton, about this afternoon's trauma presentation.
-我还没有完全准备好 -几周前就通知了
- I'm quite not fully prepared. - You've known for weeks.
-是的先生 我知道 -别叫我先生 陈小姐
- Yes, sir, I know that... - Don't call me sir, Ms. Chen.
好的先生 那个 医生
Yes, sir. I mean, doctor.
对不起
I'm sorry.
我大概只需要半个小时
急诊室的故事
ER
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