医院革命

New Amsterdam S03E01

Part 3 March 15, 2021, 12:51 p.m.

创伤是头猛兽
And trauma is a beast.
看不到
It's invisible.
做断层扫描是看不出的但是真实存在
It's not gonna show up on your CT, but it's real.
跟癌症一样真实
It's as real as cancer.
就像癌症如果不接受治疗
And just like cancer, if it goes untreated,
只会越来越严重
it'll get worse.
事实如此
That is a fact.
但你要知道戴恩
But you know, Dane,
你的一切感受
all of these things that you're feeling,
我都可以帮助你摆脱
I can help them go away,
前提是你跟我沟通
but you have to start talking to me.
这样才能开始
That's where we start.
我不
I don't--
我什么都不记得了
I don't remember any of it.
好的
Yeah, okay. Yeah.
这很正常
That's perfectly normal, actually.
不是
No, I was--
我狂躁发作了
I was having a manic episode.
没人知道
Nobody knows.
我有双相障碍
I'm bipolar.
血压将至90收缩压
BP's down to 90 systolic.
得控制住出血
We've got to get this bleeding under control.
纱布垫
Lap pad.
推一安培葡萄糖酸钙
Push an amp of calcium gluconate.
我看看
Let me see.
闻到了吗
Do you smell that?
有人嚼口香糖吗薄荷糖之类的
Is someone chewing gum? Mints, candy, anything?
是副驾驶身上的味道
It's the copilot.
- 闻着好像乙二醇 - 是防冻剂
- It smells like ethylene glycol. - Antifreeze.
飞机坠毁的时候可能管道断开了
When the plane crashed, maybe a hose snapped.
- 她开放性的腹部创伤 - 吸收了防冻剂
- Her open abdominal wound... - Absorbed it.
怪不得止不住
Which is why we can't get the blood...
- 血 - 推甲吡唑
- both: To clot. - So push Fomepizole.
应该可以补救
It should act as an antidote.
血红蛋白8 酸碱值7.6
HB level 8 pH 7.6.
凝血了很棒
It's clotting. Good save.
先别急紧急化验结果出来了
Not so fast. Emergent lab is back.
- 肝酶升高 - 多高了
- Liver enzymes are elevated. - How high?
比正常的高3.5倍
3 1/2 times normal.
- 这不是因为防冻剂了 - 漏了什么
- That's not the antifreeze. - We're missing something.
怎么办
- - Now what?
- 血压下降 - 体温下降
- BP falling. - Temp's dropping.
她要败血症了
She's septic.
推入一磷酸腺苷利泻药还有甲硝哒唑
Start her on amp, gent, and Flagyl.
每分钟挂一个2微克的多巴胺
Hang a bag of dopamine at 2 mcg a minute.
备注15毫升
Coding 15 mils.
布拉德·温顿
Brad Winton.
送去神经科观察了
Sent up to neuro for observation.
我们这里不能观察吗
Because we couldn't do that here?
布伦达·尼尔森
Brenda Nelson.
妇产科观察收治
Admitted to OB for spotting.
- 然后呢 - 妇产科接手了
- And? - OB took over.
- 伊芙·谢弗 - 副驾驶还在手术中
- Eva Schafer. - Copilot's in surgery.
预断下病情
Prognosis.
卡西安还没给出目前进展
Cassian doesn't exactly give updates.
那你追着他问啊
Yeah, well then, go force one out of him.
我跟你们说
You know what?
怎么会没人知道我们病人的具体情况
How does no one know what happened to our patients?
因为一旦交出去就不是我们的病人了
'Cause once we pass them on, they're no longer our patients.
错
Wrong.
这里是急诊室不是等待室
This is an emergency room, not a waiting room.
所有人今天下班之前
You know what? I want a full report
都要交一份完整的报告
by end of shift of everyone who came through here today.
动起来
Go.
去啊
Go.
干嘛
What?
我这个要求合情合理
It's a perfectly reasonable request.
席纳兹出问题了
We've got a problem with Shenaz.
夹层主动脉瘤
Dissecting aortic aneurysm.
不把液体排干净看不到里面
Couldn't see it till I drained out the fluid.
但你看到这里了吗
Yeah, but look. See here?
撕裂导致血液在
The tear's causing the blood to pool
动脉壁各层之间累积
in between the layers of the arterial wall.
这是什么意思沃尔什医生
And what does that mean, Dr. Walsh?
主动脉可能会破裂
The aorta could rupture.
呼叫心脏科
Page cardio.
你干嘛
What are you doing?
我明明此时此刻
We're not sending another patient
就可以帮助这位病人
off into the great unknown
不要再送到其他科室了
when I can help them right here, right now.
刚刚已经叫了心脏科
We just paged cardio.
她已经不是你的病人了
She's not your patient anymore.
这些都是我的病人
They're all my patients.
碘伏
Iodine.
比尔我是马克斯·古德温大学医院那边都还好吗
Bill, Max Goodwin here. How's everything at University?
我们一个月亏损4千万呢
Well, we're losing over $40 million a month,
我把清洁工都开了
and I'm laying off my janitors
就为了筹到足够的钱
just so I can find enough cash to pay
让工作人员和物资重启选择性手术
for the staff and supplies to restart the elective procedures
这样才能赚到足够的钱
that will allow us to generate enough cash
再把清洁工聘回来
to hire back those janitors.
- 你要什么 - 异丙酚
- What do you want? - Propofol.
- 你在开玩笑吗 - 你感觉我像开玩笑嘛
- Are you serious? - Do I sound like I'm kidding?
我们完全空了很着急用
We're completely out, and we need it.
大家都是这样啊
Everyone's out and needs it.
而且就算我们有
So even if we did have it,
我也不会给你的
there's no way I'd give any of it to you.
你这等于帮助了病人啊
But you'd be helping patients.
我帮助我的病人不好吗
Ugh, it wouldn't be helping my patients.
我们现在
Look, we're in the middle
各种药物缺口也很大
of a massive drug shortage of our own.
甲硝哒唑干扰素β-1a粉针剂来那度胺
Metronidazole, Avonex, Revlimid--
我15岁的儿子找药都比我有手段
my 15-year-old son has more access to drugs than I do.
欢迎来到新常态
Welcome to the new normal.
我不知道你们有什么权限
I don't know what authority you have.
但我不会告诉你任何一个病人的下落
I am not telling you where any of our patients are.
女士我们有权乔去跟了解内情的病人
Ma'am, we are authorized to speak to any individual
进行谈话
who may have information.
好了好了
Hey--whoa. Whoa, whoa, whoa, enough.
你们没有权利跑到医院来
You don't have the right to come into this hospital
把医生从病人身旁带走
and rip a patient away from their doctor,
这样违反了健康保险流通与责任法案
violating HIPAA rules and--
事实上我们有这个权利
As a matter of fact, we do.
- 这什么 - 联邦调令
- What is this? - A federal order.
美国司法部发布的
Issued by the United States Department of Justice,
甩健康保险流通与责任法案N条街
which supersedes HIPAA by 120 years.
所以我再问一次
So I'll ask one more time.
机长在哪里
Where's the pilot?
所以在我看来
So it's my understanding that
有双相情感障碍的飞行员
pilots with bipolar can still fly
只要正常吃着药还是可以飞行的
as long as they're on the proper medication.
是的
They can.
他们也可能会相安无事然而凌晨三点的航♥班♥
They can also end up with nothing but 3:00 a.m. flights,
没有加薪只是为了上班
no raises, and a nudge out the door.
法规的存在是为了保护你不受报复
Regulations exist to protect you against retaliation.
你有孩子吗
You have kids?
我有孩子吗
Do I have kids?
我有
Yeah. I do.
有好几个
Like, a lot.
好的如果你家老大
All right, so your oldest