拯救希望（2012）

Saving Hope S01E05

Part 4 Aug. 20, 2021, 8:13 p.m.

"John Doe." That's not a name.
我该叫你什么呢
What should I call you?
Darcy先生你如此神秘莫测
Mr. Darcy? You're mysterious, aloof.
名字就是
First name...
Fitzwilliam
Fitzwilliam.
这个名字不常见但是
Not common knowledge, but...
是我的幻觉还是他的腹部有肿胀
Am I seeing things, or is his abdomen distended?
是确实有点
Yeah, a bit.
他的排尿量如何很少吗
How's his urine output? Low?
过了临界线吗
Borderline?
要低一些膀胱压力呢
It's low. And his bladder pressure?
升高了吗
Is it elevated?
没有 15 正常
Nope. 15. He's normal.
这样啊
Huh.
好吧
Okay.
谢谢
Thanks.
我们的无名先生正在苦苦挣扎
Our John Doe is struggling in there.
抗生素要过几天才能起作用
Antibiotics take a few days.
如果是肺炎呢
What if it's pneumonia?
我不是在质疑你的诊断
I'm not questioning your judgment...
洗耳恭听
Glad to hear it.
但是他呼吸非常困难
But he's had a lot of difficulty breathing.
他的腹部受了重伤
He suffered trauma to his abdomen,
输了很多液现在他的腹部膨胀
received a lot of fluids,and now it's distended,
所以如果是急性冠脉综合症呢腹部的...
so what if it's A.C.S., abdominal...
筋膜室综合症吗
Compartment syndrome?
你检查过他的膀胱压力吗
Have you checked his bladder pressure?
最后一次查他的尿中免疫抑制酸性蛋白含量是多少
And what was his latest I.A.P.?
15.
15吗如果是筋膜室综合症就会达到25或者更高
15? If it was a.C.S., it'd be more like 25 or higher.
Maggie
Maggie.
听着我懂
Look, I get it.
你希望别人注意到你
You're trying to get noticed,
但我不是叫你来这儿对我的病人指手画脚的
but I didn't call you down here to diagnose my patient.
我把你叫来是给病人消肿的
I called you down here to drain an abscess.
不要把简单问题复杂化
Think horses, not zebras.
好吧
Okay.
用肝素化盐水冲洗
Heparinized saline.
Ron 请把这里切断
Ron, can you cut this here, please?
Victor 再来一根8-0缝线
One more 8-0, Victor.
在尾部打结
Rounding the finish line.
再来一次
One more throw.
差不多了
Here we go.
然后呢我的活儿完了
And... I'm done.
干得好好了该测测他的血管功能了
Good work. All right. Time to test his pipes.
放松止血带恢复血液供给
Deflate the tourniquet and restore the blood flow.
好的 Kinney医生 Macara呢
Yes, Dr. Kinney. Macara?
希望两个手都好起来
One hand good. Two hands better.
这可是马拉松不是冲刺跑
It's a marathon, not a sprint.
医生你的那个手没有变粉红色
Doctor, your hand isn't pinking up.
是止血带...
Is the tourniquet...
完全松开了
Completely deflated.
血流应该进去了但是没有哪里出问题了
Blood should be getting in. It's not. What's wrong?
也许有血块或者动脉阻塞
Maybe there's a clot or arterial spasm.
好了 Victor 血流量恢复了
Done. Reestablish blood flow, Victor.
你要明白与其想着创什么缝合记录
You know, instead of trying to go for some suturing record,
你应该好好锻炼你的耐心
you might want to think about your patient.
你说什么
Excuse me?
左手呈完美的粉红色 Reid医生这是你的新纪录
Left hand pinking up nicely, Dr. Reid. Patency confirmed.
好啊是的我们做到了
Yes. Yeah. All right. All right!
创口肯定太大了
The zone of the injury must be too big.
所以血液不能灌注进去
That-that's why it's not perfusing.
好吧我们时间不多了
Okay, we don't have enough time.
Alex 你来看看这个吧拜托了
Alex, take a look at this, please.
我刚跟你说过的...
I just told you it's...
好的
Okay.
让她来看看
Let her in.
让我用全新的另一只眼睛来看看
Just a fresh set of eyes.
你来吧
You're up.
好的
Okay.
什么情况 Reid
Talk to me, Reid.
你看到了什么
What do you see?
你好像缝合到了背面
Looks like you picked up the back wall,
所以主动脉被阻断了因此没有血液流入
so the artery is constricted and there's no blood flow.
所以你勾住主动脉然后把它缝合了吗
So you hooked up the artery, and you sewed it shut?
Joel 这很正常退后
It happens, Joel. Back off.
你只要把里面的缝线剪断就可以了
You just need to get in, cut the sutures,
重新缝合我们还有时间拯救这只手
redo the anastomosis. There's still time to save it.
你别碰这只手了 Reid 你来
You're not touching that hand. Reid, patient's yours.
Kinney医生听着我可不在乎你的什么感受
Dr. Kinney. Listen, I don't care about feelings.
我只在乎我们能不能拯救这双手你明白了吗
I care about saving those hands. You hear me?
非常清楚
Loud and clear.
我有个病人他快死了
I have a patient who is going to die,
但Tolliver医生不听我的
but Dr. Tolliver won't listen to me,
因为我这么一个食物链底层的外科住院医生
because how could I, a lowly surgical resident,
怎么可能意识到我在胡说些什么
possibly know what I'm talking about?
哇哦 Maggie 慢慢说
Whoa, whoa. Maggie, slow down.
好吧事情是这样的
Okay. Here's the situation.
我的病人看上去跟教科书上的肺炎症状完全一样
My patient looks like he has textbook pneumonia.
但我认为实际要糟糕的多
But I think it's something way worse.
怎么个糟糕法
Way worse how?
好吧你还记得多少普外的知识
Well, how much general surgery do you remember?
嗯什么都不记得
Uh, none.
这些可是Reycraft的东西
Those are Reycraft's.
他直接生吃的他还管这些叫"自然能量饮料"
He eats them raw, calls them "nature's energy drink."
Reycraft是个怪胎
Reycraft is a weirdo.
所以情况是这样的
So here's the dealio.
如果我的病人真是我想象的那种情况
If my patient has what I think he has,
他的腹部有大得惊人的内压
there's this crazy pressure building up in his abdomen.
这样会阻塞血液流入他的肠啊肾啊
It's blocking off blood flow to the bowel, to the kidneys.
我们很难帮他把压力排放出来
We're having trouble ventilating him,
但这不是因为肺炎
but it's not because of the pneumonia.
这是因为病人内部病人就像个压力锅
it's because, inside, he's a pressure cooker,
如果内部的压力不能及时放出
and if the pressure isn't released in time...
天啊
Whoa.
他会爆♥炸♥吗
He'll explode?
不会但他会因此患上多器官系统衰竭
No, but he'll suffer multiorgan system failure
然后死掉
and then die.
问问Reid医生
Ask Dr. Reid.
她正在做手术
She's in surgery.
那就再回去找Tolliver医生
Then go back to Dr. Tolliver again.
我的病人快死了
My patient is dying!
你确定吗?
Are you sure about that?
动脉成功分离
Artery successfully detached.
重头开始计时 8-0号♥线 Victor
Time to start all over again. 8-0, Victor.
好的应该能成功
Okay. That should do the trick.
放开止血带
Tourniquet down.
-快一点快一点呈粉红色吧 -快一点
- Come on. Come on. Pink up. - Come on.
-快点止住血吧 -快点 —发生什么了?
- Come on. Pink up. - Come on. - What's happening?
还是没有血液流动
Blood's still not flowing.
我告诉过你肯定还有其他的东西在里面
I told you, there has to be something else.
我们来看看重力会不会帮助我们 Victor
Let's see if gravity will help us. Victor?
-好了? -好了
- Good? - Yeah, and...
-好了漂亮 Reid -是的
- Yes. Nice one, Reid. - Yes!
-谢谢你 -做得好
- Thank you. - Well done.
好的让我们重新接上静脉来恢复静脉的回流
Okay. Let's reattach some veins to establish venus return.
然后我们再来接桡骨动脉
Then we'll do the radial arteries,
然后进行外科修补
and then on to plastics.
对 Reycraft 快点真正的工作开始了
All right. Reycraft, come on.Let the real work begin!
这在任何人身上都会发生的不要对自己太严厉
It could've happened to anyone.Don't be so hard on yourself.
-好 -明白
- Yeah. - Sure.