实习医生格蕾

Grey's Anatomy S07E18

Part 6 March 1, 2020, 11:21 a.m.

胎儿血氧降低
The baby's having decels.
这样下去不行杨说的对
This is not working. Yang is right.
我们该撤掉肝素
We need to reverse the heparin
进行外周修复
and try the percutaneous repair.
什么不我能搞定
What? No. I can do this.
我只需该死
I just need-- damn it.
给我拿个内窥镜包
Get me a percutaneous catheter kit.
超声引导我从腹股沟处入手
Flip on the echo. I am going up through the groin.
不我说了我能搞定
No. I said I've got this.
艾弗里你能协助吗
Avery, can you assist?
阿尔特曼医生稳定好心脏然后退下
Dr. Altman, stabilize the heart and step back.
不我行的我只需该死
No, I can get it. I just need to--damn it.
阿尔特曼医生
Dr. Altman.
阿尔特曼医生退下
Dr. Altman, step away.
你做得到的
You can do this.
-一步一步来 -一步一步来
- One step at a time. - One step at a time.
?一开始你说我们需交谈?
Step one you say we need to talk
?他不予理睬?
He walks
?你说坐下交谈而已?
You say sit down it's just a talk
?他回眸微笑?
He smiles politely back at you
?你也礼貌回望?
You stare politely
去除导丝上的针头
Removing the needle over the guidewire.
?与之交睫?
Right on through
导管
Catheter.
?你右侧有窗?
Some sort of window to your right
镊子
Forceps.
帮格蕾医生抽吸
Suction to Dr. Grey.
?他向左你在右?
As he goes left and you stay right
?恐惧还是责难?
Between the lines of fear and blame
?你惘然不知何从?
You begin to wonder why you came
顺利进去了
It's going in easy.
接好三通管
Get the T.E.E. ready.
?我错于何处?
Where did I go wrong
?痛失挚友?
I lost a friend
?苦不堪言?
Somewhere along in the bitterness
?陪你整晚?
And I would have stayed up
?夜不入眠?
With you all night
?如果我知道如何拯救生命?
Had I known how to save a life
仍有某些局部出血
Still got some active bleeding coming from somewhere.
再检查次腹膜后腔
Well, then let's recheck the retroperitoneum.
进去了
I've got access.
?让他知晓你最清楚?
Let him know that you know best
?事实如此?
'cause after all you do know best
镊子吸引
Forceps. Give me some suction.
?跨越?
Try to slip past
组织钳打结
Clamp and give me a tie, please.
?他的防线?
His defense
-脑部正在减压 -球囊已经增大
- Brain is decompressing. - Balloon is advanced.
?但不予原谅?
Without granting innocence
请给我一根特硬导管
Extra-stiff guidewire, please.
脑出血得到控制
Brain bleed has been controlled.
?刨根问底错于何处?
Lay down a list of what is wrong
瓣膜阀已放入打开多普勒超声
Okay, the occluder's in. Turn on the doppler.
?念叨之事?
The things you told him all along
?祈愿他能聆听?
And pray to god he hears you
室间隔缺损流量降到最低
Minimal residual V.S.D. flow.
好的这边完事撤出
Good. Then we're done here. Pulling out.
?祈愿他能聆听?
And pray to god he hears you
腰部部分腔静脉有撕脱拿两个组织钳
I got a lumbar vein avulsed in the vena cava. Two allis clamps.
室性逸搏心率
Idioventricular rhythm.
?我错于何处?
Where did I go wrong
?痛失挚友苦不堪言?
I lost a friend Somewhere along in the bitterness
该死心率下降
Damn it. She's bradying down.
血压下降心脏收缩55次每分钟
Pressure's down. 55 systolic.
推一单位阿托品
Push one of atropine.
?陪你整晚夜不入眠?
And I would have stayed up with you all night
中心静脉压和肺动脉压上升
C.V.P. and pulmonary artery pressures just went up.
可能是气栓
It might be an air embolus.
?如果我知道如何拯救生命?
Had I known how to save a life
通过静脉导管吸出
Pull back on the P.A. catheter.
加氟替卡松和第七因子她要不行了
Hang more F.P. and factor VII. We're losing her.
已经差不多给她换血了
we've already replaced her entire blood volume.
开始心脏按♥摩♥
Starting cardiac massage.
-注射一单位肾上腺素 -找出血点并止住
- Push one of epi. - Find whatever's bleeding and shut it down.
一单位碳酸氨苄西林行吗
How about an amp of bicarb?
?他大声叱喝?
As he begins to raise his voice
?你低声细语给她最后选择?
You lower yours and grant him one last choice
推三单位肾上腺素一单位阿托品
push 3 of epi and another atropine.
理查德你有一分钟恢复她心跳
Richard, you have one minute to get her heart back,
?继续如此直至迷失?
Drive until you lose the road
否则我只能开腹接生
Or I'm taking the baby out.
?或是摒弃恪守的信条?
Or break with the ones you've followed
加油加油
Come on. Come on!
?他会二择其一?
He will do one of two things
?他会坦诚一切?
He will admit to everything
?也许他会放弃你?
Or he'll say he's just not the same
?你惘然不知何从?
And you'll begin to wonder why you came
?我错于何处痛失挚友?
Where did I go wrong? I lost a friend
有呼吸吗
Is she breathing?
胎儿呈紫色
Her color's bad.
?苦不堪言?
Somewhere along in the bitterness
刺♥激♥胎儿反应吸引仪器监控
Stimulate and suction and get some access.
?陪你整晚夜不入眠?
And I would have stayed up with you all night
?如果我知道如何拯救生命?
Had I known how to save a life
?我错于何处痛失挚友?
Where did I go wrong I lost a friend somewhere
还没听到心跳克莱夫医生
I'm not getting a heartbeat. Dr. Karev,
-协助我下好吗 -去吧
- I could use a hand. - Go.
?苦不堪言陪你整晚?
Along in the bitterness And I would have stayed up
连上监护仪吸氧
get those monitors on. Ventilate.
?夜不入眠?
With you all night had I known
阿普加评分还是零
Apgar still zero.
?如何救死扶伤?
How to save a life
加油宝宝
Come on, baby.
好了托瑞斯抢救回来了
There it is. Torres is coming back.
心脏收缩70次每分钟并持续增快
Systolic 70 and rising.
用了氧气球囊还是没呼吸
Getting no chest rise with to the bagging.
-我们应该插管 -好
- We should intubate.- Okay, do it.
?如何救死扶伤?
How to save a life
插管完毕开始上氧
Tube's in. Starting ventilation.
?如何救死扶伤?
How to save a life
?我错在何处痛失挚友?
Where did I go wrong I lost a friend
让开
Move.
?苦不堪言?
Somewhere along in the bitterness...
继续胸部按压从管内吸引
Continue compressions. Suction through the tube.
好出血受到控制
Got it. The bleeding's controlled.
颅内压暂时稳定推9单位1受体
I.C.P.'s stable for now. Push 9 cc's of l.R.,
注射0.5毫升肾上腺素和碳酸氢钠
Point 0.5 cc's of epi, and .5 of bicarb.
?如何救死扶伤?
How to save a life
我需要2.0可吸收线我这边马上就好了
I need another 2.0 vicryl. I'm almost done.
?如何救死扶伤?
How to save a life
?如何救死扶伤?
How to save a life
有心跳了
I have a heartbeat.
妈妈的心跳很有力
Mom's heart is strong.
?如何救死扶伤?
How to save a life
我们已经尽力了
We've done everything we can.
现在我们只有等着她自己醒来
Now we just have to wait for her to wake up.
但问题在于你上次叫醒她的时候
But the fact that she barely responded
她几乎没什么回应是吗
when you weaned her off the paralytics before?
也许说明她还没做好醒来的准备
Could mean she wasn't ready to wake up.
-或者呢 -或者说明她的大脑受损
- Or? - Or it could mean her brain has been compromised,