实习医生格蕾

Grey's Anatomy S09E13

Part 4 Feb. 28, 2020, 9:19 a.m.

No, she was in the right place at the right time.
她救了病人
She probably saved his life.
运气好罢了
I got lucky.
这被锯子伤到自己的哥们才幸运啊
Lucky for this guy his chain saw slipped today.
不然他明天就会死了
Tomorrow he'd be dead already.
什么情况
What do you got?
滑板的孩子撞上了汽车
Skateboarder versus car.
二十岁左右没有身份证
Late teens. Didn't have I.D.
这孩子和他朋友一起玩障碍滑雪
The kid was slaloming hills with a buddy.
急救现场没有反应
Was nonresponsive in the field.
心脏收缩70
His last systolic was 70.
心律在130左右
Heart rate tacking along in the 130s.
心电图显示有变化怀疑是心脏创伤
E.K.G. Shows some changes, so I suspect cardiac trauma.
马上拿个便携式X光过来
Okay, I need a portable x-ray up here, stat.
还有十二导联心电图在床边放台经食管超声心动图仪
I need a 12-lead, and, uh, let's get a T.E.E. bedside.
-马上 -数到三声就抬一二三
- Right away. - Ready on three. One, two, three.
-墨菲去弄经食管超声心动图 -好的
- Murphy, set up the T.E.E. - Got it.
需要六单元的血
Type and cross for six units.
尽快给两单元的O型阴性血
Hang two units of O-neg as soon as possible.
你的朋友叫什么名字
Hey, what's your buddy's name?
瑞奇瑞奇·坎皮恩
Um, Rich. Rich Campion.
他有药物过敏史么
Does he have any allergies that you know of?
现在有没有服什么药
Is he on any medications?
我不知道
I-I-I don't know.
他会好起来吗
Look, is he going to be okay?
我们会尽力帮他的
We're doing everything we can.
右肺没有呼吸声马上插个胸管
No breath sounds on the right. Someone set up a chest tube.
马上
On it.
好像是纵隔血肿
It looks like a Mediastinal Hematoma.
可能是大动脉破裂
Could be an aortic transection.
我们得抓紧时间
Uh, we need to move fast, people.
血压还在下降剪刀
B.P.'s still dropping. Scissor.
他快不行了血来了么
Yeah, he's crashing. Where is that blood?
马上输血医生
Right here, doctor.
他有医疗卡不过肯定坏了
Oh, he has a medical I.D. It must have broken off.
上面写什么他对什么过敏
Okay. What's it say? What's he allergic to?
天啊
Oh, god.
他对什么过敏
What is he allergic to?
耶♥和♥华♥见证人基♥督♥教的一个分支教派
好的停下来
Okay, stop.
他是耶♥和♥华♥见证人我们不能给他输血
He's a Jehovah's Witness. We can't give him blood.
耶♥和♥华♥见证人信徒禁戒血不献血也不接受输血
他们在准备手术室要做无血手术
They're prepping the O.R. for a bloodless surgery
我们要给他做血液再循环
So we'll need to recirculate his blood.
我们要用血液回收机
So we'll put him on a cell saver machine,
继续给他输高渗盐水
and then continue the hypertonic saline,
胶体还有凝血因子来增强血管内容积
colloids, and factor vii to pump up his intravascular volume.
我们真的要做无血手术
We're seriously repairing an aortic transection
修复动脉破裂吗
without blood?
-我们没有选择 -我们可以输血
- Yeah, we have no choice. - We could use blood.
我们会因人身攻击被逮捕
Oh, we could also be arrested for assault and battery.
真有趣
Very funny.
这可不是玩笑
I'm not joking.
对于不愿意或不能接受输血的病人
There are protocols in place for people who won't
我们是有固定规章的
or can't accept supplemental blood.
无血手术不是什么稀奇事
We do bloodless surgeries here all the time.
那你做过这种吗无血动脉修复手术
Have you ever done this-- a bloodless aortic transection?
没有
No.
拉德诺医生请到产房♥
Dr. Radnor to labor and delivery...
我听到你说什么了真的
I-I hear you. I did.
然后
And...
阿历克斯
Alex.
你还没让她下床走路吗
You don't have her walking yet?
根本没法和那女孩交流
Oh, there's no talking to that girl.
里面前景一片黑暗啊
It's dark in there.
相当黑暗
Really dark.
-克莱夫 -我说真的
- Karev- - I'm serious.
那女娃让我都想自杀了
That girl turned me into a suicide risk.
还是让老娘来劝她吧
I'm gonna move her myself then.
武力征服坏人登场
Mm. Excessive force-- bad cop's go-to move.
知道坏人为何坏
You know what makes a bad cop bad?
因为好人的温柔好方法解决不了问题
When the good cop's namby-pamby approach gets us nowhere.
坏人就不得不出格一点
Then bad cop has to set a limit
所以坏人就坏了
and ends up looking like a big meanie.
好人的方法需要时间
A good cop's approach takes time
还有耐心
and patience.
坏人就是横冲直撞
Bad cop is a notorious hothead.
如果她哭闹着要穿裙子
If she's going to insist on wearing dresses,
她就得穿连体袜
she has to wear tights.
我还是去躺躺吧
I'm gonna go lie down.
他的生命体征在下降
His vitals are worse.
-血液回输装置准备好了吗 -马上好
- How's the cell saver coming? - Almost ready.
-我们有外科胶水吗 -有
- Do we have surgical glue? - Yes.
-微纤维胶原呢 -有
- Avitene? - Yes.
给我准备好两把电刀
Okay, I want two bovies set up.
-我去做 -乔伊把头灯给我准备好
- I'm on it. - Joy, get my headlamp ready.
-在这呢 -等一下等一下
- Here it is. - Wait a minute. Wait a minute.
我的泡沫胶和凝血酶呢
Where is my gel foam and thrombin?
我们要把失血量降到最低
We're trying to keep blood loss to a minimum.
这点还不够用
We need a whole bunch more.
高渗生理盐水搞定
Okay, hypertonic saline? Check.
第七凝血因子搞定
Factor vii? Check.
-血液回输装置 -搞定
- Cell saver ready? - Check.
好得赶在他血流殆尽前开始
Okay, let's go before he bleeds out.
我不能下手这样他会失去更多的血
I can't cut. He'll lose too much blood.
那我们怎么办
What do we do?
我们采用经皮切割手术
We'll go in percutaneously.
重新做好腔内修复术准备
Get the O.R. ready for an endovascular repair.
开始吧
Let's move.
很不错格蕾医生
Excellent, Dr. Grey.
还有19个
19 more to go.
你会失败的格蕾
You're gonna choke, Grey.
你会败得惨兮兮我会赢得漂漂亮
You'll choke and die, and I will dance and sing.
见鬼见鬼
Damn it. Damn it!
网眼都堆积在耻骨结节处
The mesh is bunching up at the pubic tubercle.
我还是觉得你不知道
You know, I still feel that you do not--
我知道一开始可能会有点棘手
I understand this can be tricky at first,
但你一旦掌握好要领
but once you get the hang of it,
你就明白为什么整个国家的数十所医院
you'll see why a dozen hospitals around the country
都采用这种方法
have already adopted this approach,
而且我还接到了另外十二个医院的咨♥询♥
and I've already had inquiries from a dozen more.
-搞定 -先失陪一下
- Check! - Excuse me.
好吧思路是对的
Okay. All right. That's the right idea.
-但是 -但是什么
- But, um-- - but--but what?
-但是 -完成
- Well-- - check.
-完成 -完成
- Check! - Check!
有话就直说
Hey, don't beat around the bush.
告诉我你有哪个地方不满意
Tell me what you don't like,
因为我觉得挺不错的
'cause it looks perfect to me.
好吧
O-okay.
你可以看一下旁边格蕾医生的做法
Take a look at what Dr. Grey is doing over here.
你看她并不着急
You see how she doesn't rush,
正确的将网眼剪断
cut the mesh just right?
如果完成的不错网眼就契合的很好
See, now when done properly, the mesh will fit perfectly
完全不需要多余的缝合
and not require extra sutures to hold it,
因此也就减少了未来发生并发症的风险
thereby reducing the risk of future complications.
所以再做一遍注意细节
So do this over, pay attention to the details,
别着急
and take your time.
我很愿意
I would be happy
给你一些指点如果你愿意的话
to give you some pointers if you'd like.
你那鼓鼓的小肚子也许能保证你的工作
That bun in the oven may give you job security,
梅瑞狄斯·格蕾但是它不能阻止你