实习医生格蕾

Grey's Anatomy S07E15

Part 6 March 1, 2020, 11:20 a.m.

I gave him three rounds of epi, two of atropine.
我给他用了胺碘酮但他还是心动过速
I loaded him up with amiodarone, but he's tachycardic now.
我想他可能不行了
I mean, he's barely hanging on.
他需要手术预订一个手术室
He needs surgery. Book an O.R..
我去找一个手术室然后准备好
Okay. I'll get a room prepped and ready.
没时间了
No time.
我们说话这会儿他的主动脉正在撕裂
His aorta's dissecting as we speak.
他需要即刻进行手术
He needs surgery right now.
他们说所有的手术室都被预订了
They're saying all the O.R.s are booked.
告诉他们取消一个
Well, tell 'em to bump someone,
因为我们无论如何都要过去
'cause we're come up either way.
我有一个手术室
I have an O.R.
告诉他们取消我的然后准备心脏急诊手术
Tell 'em to bump mine and prep it for an emergency cardio.
-好了我们走 -好了走
- All right. Here we go. - Got it. Go.
请让一让
All right. Let clear it.
帮忙停住电梯
Let's hold that elevator!
快点快点快点
Come on. Come on. Come on.
电梯门一打开我们就送他去手术室
Once these doors open, we're gonna have to get him in the O.R..
-然后尽快开胸 -我知道
- And open him as soon as possible. - I know.
即便如此如果主动脉破裂了
Even then, if that aorta tears,
我们可能已经太迟了
we may already be too late.
并且我们没时间洗手了
And we're not gonna have time to scrub.
我知道
I know. I know.
谢谢
Thanks.
把优碘直接倒在他胸上
Just pour the Betadine straight on to the chest.
不用弄得太漂亮我们只需要快点开胸
It doesn't need to be pretty. We need to get in there.
好了插上电源
All right. Plug me in.
手术刀
Scalpel.
给
Here you go.
-电刀 -给
- Cautery. - Here.
-开始电凝 -快点格蕾
- Cauterizing now. - Get in there quickly, Grey.
心肌层最花时间了
Time is myocardium.
好了胸骨锯
All right. Saw.
准备好牵开器
Get that retractor ready.
这家伙以为他只是严重的心口疼
This guy thought he had a bad case of heartburn.
发展成现在这样还不到四十五分钟
He went from that to this in less than 45 minutes.
心脏病就是这样血压多少
That's how these work. How's his pressure?
七十并且还在下降
70s and dropping.
牵开器
Retractor.
每一次心跳都会把裂口撕的更大一点
Every beat of his heart rips this tear a little bit wider.
-好的 -有多少例这样的主动脉夹层
- All right. - How many of thesese ruptured dissections
破裂你及时赶上给他们手术的
have you caught in time to operate?
四十例也许五十
40. Maybe 50.
-有多少你救过来的 -三例
- How many have you been able to save? - Three.
好了我进胸腔了
All right. I'm in.
-不不糟糕 -他在大出血
- Oh, no. No, no, no, no, no, no. Damn it. - He's bleeding out.
他的主动脉完全断开了血管钳
His aorta is wide open. All right, clamp.
-快点快点 -给
- Come on! Come on! Come on! - Here.
格蕾我们试试做体外循环旁路
All right, Grey. Let's try sucker bypass.
套管
Cannulas.
这不管用出血太多了
It's not working. There's too much blood.
好吧只要我们给他接上体外循环
All right. Well, once we get him on bypass,
这就好控制了
it'll be easier to control.
心脏纤颤
Heart's fibrillating.
胸腔内心脏按♥摩♥
All right. Cardiac massage.
电极
Paddles.
我就快给他插上管了
I've almost got him cannulated.
充电十焦离手
Charge to 10. Clear.
该死他的鼻子耳朵都在流血
Damn it. He's bleeding out of his nose and ears.
我给他输了血血浆和VII因子
I've been loading him up with blood, F.F.P. and factor VII,
但这赶不上出血的速度
But I can't keep up with the losses.
导尿管里也全都是血
Foley's full of blood, too.
他已经弥散性血管内凝血了
He's DIC.
体外循环插管的地方在渗血
His cannula sites are oozing.
三个单位肾上腺素准备电击
Let's push 3 of epi. Set me up for another shock.
离手
Clear.
-糟糕 -要做什么告诉我做什么
- Damn it. -Well, what can we do? Just tell me what to do?
没有办法他的主动脉已经成碎片了
There's nothing. His aorta is in shreds.
那做那个
Well, what about-
没有任何办法了宣布吧
There is nothing left to do. Call it.
宣布吧格蕾
Call it, Grey.
不我说我们
No, I mean, we-
格蕾我们到得太迟了
Grey, we got here too late.
已是回天乏术
These are almost impossible to catch.
没有别的办法了我很遗憾
There is nothing that we can do. I'm sorry.
宣布死亡时间吧
We need to call it.
死亡时间十八点五十二分
Time of death-- 18:52.
听说你有个病人去世了
Hey. I heard you lost a patient.
不是我想独占着你
You know, it's not that I don't want to share you.
其实我确实想独占着你
I mean, I don't want to share you,
但我不是因为这原因而不想让你做
but that's not the reason I don't want you to be
凯丽的宝宝的教母的
Callie's baby's godmother.
好吧
Oh. Okay.
我只是觉得如果你同意
It just seems like, if you agree to be
做凯丽宝宝的教母
Callie's baby's godmother,
就等于暗示着我永远不会有自己的孩子了
you're saying that I'll never have a baby of my own.
梅瑞狄斯你了解的我
Meredith, you know, I--
我怎么可能会暗示那种那种事
I'm in no way saying anything that--that--
我明白可我就是有这种感觉
I know. It just feels that way.
好吧
Okay.
好
Okay.
那么我
Well, I, uh...
得去跟凯丽来一场
have to go have really uncomfortable conversation
极其尴尬的谈话了
with Callie now.
那你呢你要去做什么
How about you? What are you up to?
我得去跟奥利佛的家属联♥系♥下
Oh, I have to contact Oliver's family.
喂喂等等你这有点
Oh, hey, hey, hey, wait. You got, uh...
血迹还是什么的
blood or something.
谢谢
Thank you.
不客气
You're welcome.
主任
Hey, Chief.
-之前的事 -没事了
- About earlier-- - It's all taken care of.
我亲自检查了阿戴尔的脑部扫描
I checked Adele's head C.T. myself.
没有异样她的手腕也固定好了
It was clean. Her wrist is in a splint.
我要带她回家了
And I'm taking her home now.
我还是有些担心
Well, I still have some concerns.
如果她脑部扫描结果正常那我就更担心了
And if her C.T. was clean, then I have even more concerns.
梅瑞狄斯谢谢不过我保证阿戴尔没事
Thank you, Meredith, but I assure you, Adele is fine.
主任她的思维非常不清楚
Chief, she's been get things very confused.
梅瑞狄斯她没事的我要马上带她回家
Meredith, she is fine, and I'm taking her home right now.
这都二月份了她怎么还在做圣诞装扮
Why was she getting Christmas decorations down in February?
晚安梅瑞狄斯
Good night, Meredith.
而且她说她刚下班回到家
And she said she had just gotten home from work.
-她不是退休了吗 -梅瑞狄斯
- Didn't she retire? - Meredith--
-主任情况不对劲啊 -好了够了
- Chief, something isn't right. - Okay, that's enough.
我知道你想说什么
Now I know what you're implying.
我感谢你的关心但别再说了
And while I appreciate your concern, that's enough.
阿戴尔今天受到了惊吓她摔倒了
Adele had a scare today. She had a fall.
任何事都可能导致
Any number of things could account
她思维的混乱
for her mixing up a couple of details,
你这样一直拷问她或许也是原因之一
not the least of which is her being interrogated by you.
如果我妻子出了什么问题
Now if something bigger were wrong with my wife,
我会发现的
I would know it.
你满脑子都在想老年痴呆
You've got Alzheimer's on the brain.
就像你买♥♥了辆车
I mean, you--you buy a car
结果不管走到哪好像都能看到它的影子
and you start seeing it everywhere you look.
你夜以继日地进行老年痴呆的试验
Now you've been working on this Alzheimer's trial 24/7.
我能理解
I get it.
但阿戴尔不是你的母亲梅瑞狄斯
But Adele is not your mother, Meredith.
她是我的妻子
She's my wife.
晚安了