急诊室的故事

ER S01E15

Part 4 Nov. 22, 2019, 11:58 a.m.

of a depressed fracture of the left frontal bone
和眼眶边缘破裂的例子
with disruption to the orbital rim.
由于病人的脸部受卸胎棒打击
Both the result of blunt-force trauma
导致了钝器所致的外伤
when the patient's face intercepted a tire iron.
约翰帮忙开一下投影仪
John, if you would, please? The projector.
谢谢
Thank you.
眼眶边缘和额窦骨折
Orbital rim and frontal sinus fractures
还有其他面部骨折
along with other fractures to these facial bones
经常导致伴随性中枢神经损伤
often result in concomitant CNS injury.
通过X光片和CT
Diagnosis is established with radiographic studies
做出诊断
and computerized tomography,
最好使用患者颅骨的三位影像
preferably using a three-dimensional image of the patient's skull.
不难看出额窦
As you can see, the frontal sinus
和眼眶边缘的骨折可以轻易被发现
and orbital rim fractures here are easily appreciated.
她呼吸得怎么样
How's she breathing?
有退步但没事她终于睡着了
Depressed but okay. She's finally out.
或许我们调的量正好她可以睡一会了
Maybe we got the balance right, and she can get some sleep.
卡西
Kathy.
-谁是卡西 -她女儿
- Who's Kathy? - Her little girl.
她知道她在这吗
Does she know she's here?
她和格蕾丝的前夫住在西边的某处
She lives out West somewhere with Grace's ex-husband.
我觉得住在西雅图
Seattle, I think.
格蕾丝进入临终关怀医院时放弃了监护权
Grace gave up custody when she entered the hospice.
她失去孩子了吗
She lost her child?
她来临终关怀医院等死
She entered the hospice to die.
生活总会继续
Life goes on.
然而有时继续不了
Then again, sometimes it doesn't.
-临终关怀医院的老梗了 -天啊
- Old hospice joke. - Oh, God!
我的天
Oh, God!
-天啊太疼了 -芬太尼的药效在逐渐消失
- God, it hurts. - The fentanyl's wearing off.
-躺下躺下 -好疼啊
- Lie down. Lie down. - It hurts.
她呼吸频率太低了我不能再给她更多吗♥啡♥了
Her resps are too low, I can't give her any more morphine.
-我受不了了我忍♥受不了 -抱歉很抱歉
- I can't stand it. I can't stand it. - I'm sorry. I'm so sorry.
-太疼了医生 -我该做的都已经做了
- It hurts so much, doctor. - There's nothing else I can do.
请你杀了我吧求你求求你拜托了
Please kill me. Please. Please. Please!
-放松放松点 -杀了我吧
- Relax. Just relax. - Please kill me.
求你了求求你
Please, please!
苏珊
Susan!
-患者情况 -一名52岁男性昏倒了
- What have we got? - A 52-year-old male collapsed.
血压过低 80/60 心动过速心率120
Hypotensive, 80 over 60, tachycardic at 120.
高血压服用雷米普利和天诺敏治疗
Hypertension treated with Altace and Tenormin.
那些冰鞋是怎么回事
What are those skates?
他是冰球裁判在一场比赛中昏倒
He's a hockey ref, collapsed during a game.
有些小孩跟着我们
Some of the kids followed us.
15升氧气和8毫克吗♥啡♥
15 liters of O-2 and he's had 8 migs morphine.
他在发汗呼叫心脏科我需要心电图和心肌酶
He's diaphoretic. Call Cardiology. I need an EKG and enzymes.
到此为止你们得在候诊室等候
End of the line, you gotta wait in the waiting room.
-他会没事吗 -我们还不清楚马利克
- Will he be okay? - We don't know yet. Malik!
-你能带他们去候诊室吗 -好的等我一分钟
- Can you take them to Waiting? - Yeah, I'll be there in a minute.
我们会竭尽所能好吗
We're gonna do everything we can, okay?
拿一下急救包
Okay, get the ambu-bag.
-没有脉搏了 -他出现室颤了急救车
- Lost his pulse. - He's in fib. Crash cart.
关掉氧气
Turn off the O-2.
-急救车呢 -在这
- Where's the cart? - Right here.
不新的那辆呢
No. Where's the new cart?
小心那条线
Watch that line.
电极板
Paddles!
不一小时前我就放了辆新车在这
I put one in here less than an hour ago.
卡萝 200焦
Carol, 200.
-不敢相信有人偷我的新急救车 -离手
- I can't believe somebody already stole my new cart! - Clear!
杰克在吗
Hey, is Jake around?
他去买♥♥苏打水了
He went to get a soda.
办公室不错管理者都这样吗
Nice digs. So this is how the other half lives?
说实话如果玻璃再少点就更好了
I could do with a little less glass, actually.
地毯上没有血和急诊室相比好多了
There's no blood on the carpet, so it's a step up from the ER.
介意我坐下吗我尽力了
Do you mind if I sit? I've had my shots.
辛迪说得对你有点魅力
Cindy was right. You are kind of charming.
那不好吗
Is that bad?
分情况了
Depends.
-杰克是个好孩子 -那当然
- Jake's a great kid. - He is a great kid.
希望你别介意我们偶尔一起投篮
I hope you don't mind if we shoot hoops now and then.
我保证不会通过篮球技巧传播厌女情结
I promise not to pass along any misogyny with the basketball tips.
我才不担心如果厌女情结可以遗传
I don't worry. If misogyny's genetic,
他早就从他父亲那里继承许多了
he's inherited plenty from his father.
他经常见他父亲吗
Does he see his dad much?
以支票的方式
They communicate by check when it comes.
如果你不喜欢我你不必隐藏
You know, if you don't like me, you don't have to hide it.
你可以出去直接向我展示你不喜欢我
You can just come whereout and show it.
我有这么敏感吗
I didn't know I was being subtle.
你来了
Hey, yourself!
罗斯医生来问你想不想打篮球
Dr. Ross came to see if you wanna play basketball.
我们就打半小时
We'll be about a half an hour.
-把外套穿上 -我会监督他的
- And put the jacket on. - I'll make sure he wears it.
糖水盐水
D5 ns...
每小时100毫升
...100cc's per hour.
鼻胃管洗胃...
NG tube, gastric lavage...
血常规生化七项酶化验
...CBC, Chem-7, amylase.
打电♥话♥预定手术室
Call the O.R., book a room.
本顿医生
Dr. Benton.
这上面写的什么
What does this say?
-鼻胃管 -就是指鼻饲管吗
- NG tube. - By that you mean a nasogastric tube?
-是的 -还有这个是什么
- Yes. - And this?
-5%葡萄糖注射液盐水 -静脉注射吗
- Dextrose 5, normal saline. - An IV?
没错静脉注射
Yes, an IV.
话说我刚检查过病人
Well, I've examined the patient.
说实话我觉得只有你这样优秀的外科医生
Frankly I believe she needs a fine, surgical hand like yours...
才能对她正确进行静脉注射
...to get an IV going properly.
我叫卡特来做
I'll have Carter do it.
那鼻饲管呢
And the nasogastric tube?
你会发现她有鼻中隔移位
You'll notice she has a deviated septum...
我觉得插♥进♥去有点困难
...and I don't feel comfortable putting one in.
我自己来
I'll do it myself.
告诉化验室他的凝血检查正在做
Tell the lab his coag panel's cooking.
这是他的胸片
Here are his chest films.
如果你能找到那些打冰球的孩子
If you can find those hockey kids,
告诉他们他会好的
tell them he's gonna be okay.
苏珊苏珊
Susan? Susan.
苏珊过来一下
Susan, come on.
-我很忙马克 -我要跟你咨♥询♥一个病人
- I'm busy, Mark. - I need to talk to you about a patient.
乳腺癌末期已经骨转移到后背和腿上
End-stage breast cancer, bone-Mets to her back and legs.
吗♥啡♥和芬太尼都不起作用
Morphine's not working. Neither's the fentanyl.
她非常痛苦我却无能为力
She's in agony. There's nothing I can do to help her.
把吗♥啡♥作用于脊髓呢用脊髓索切开术
Spinal morphine therapy, cordotomy?
她都拒绝了她一心求死
She refused both of them. She just wants to die.
听起来她就快死了
Well, it sounds like she's going to, soon.
她想让我帮她
She wants me to help her.
她的呼吸频率已经降到12了
Her resps are down to 12.
我只要再多打一点点吗♥啡♥ 她就停止呼吸了
If I give her a little more morphine, her breathing will stop.
你会怎么办
What would you do?
我不知道我要走了
I don't know. I gotta go.
你还要这样多久
How long are you gonna keep this up?
-你当时不支持我 -这是公事不是私事
- You weren't there for me. - It was professional, not personal.
我们不是夫妻只是同事公事就是私事
We're not married, we work together. Professional is personal.
我想你
I miss you.
你应该告诉我你在做面部骨折手术
You could have told me you were doing facial fractures.
还有电脑的事我感觉自己就像个白♥痴♥
And that thing with the computer. I mean I looked like an idiot.
别停下继续冲洗
No, no. Keep irrigating that.
我可以给你那个制图程序很容易上手
I can give you the graphics program. It's easy to use.
我不是这个意思
That's not the point.
我得让本顿给我写封很好的推荐信
I need a good recommendation from Benton
才能做外科住院医师