夜班医生（2014）

The Night Shift S02E08

Part 5 March 5, 2021, 4:23 p.m.

We got to move him now.
好现在减少骨筋膜间室压力
Okay. And now to reduce the compartment pressure.
给实习生10号♥手术刀
10 blade to our intern.
你认真的
Seriously?
不动手做就学不会
Never do it, never learn.
轮到你上了保罗
You're up, Paul.
你是说11号♥手术刀吧克莱门斯医生
You mean an 11 blade, right, Dr. Clemens?
我说的10号♥ 我指的就是10号♥
Well, I said 10. I meant 10.
我们都有自己的偏好
We all have our preferences.
这可不是偏好
Well, it's not a preference.
这是正与误的问题
There's a right way and a wrong way.
11号♥刀切得更精准对组织创伤也更少
11 gives you a more precise cut and less tissue trauma.
我知道11号♥手术刀的好处
I know what an 11 blade does,
但我们没工夫考虑美观精致
but we don't have time to be cute or fancy.
这是减少骨筋膜间室压力的筋膜切开术
This is a fasciotomy to reduce the compartment pressure.
不是神经外科手术
This isn't neurosurgery.
哦是吗
That's for sure.
请递给实习生10号♥手术刀
10 blade to our intern, please.
保罗用11号♥手术刀
Paul, use the 11 blade.
卡明斯医生我理解
Dr. Cummings, I understand
你习惯做手术时什么都由你说了算
that you are used to running the show,
但此时你在我的手术室
but you are in my O.R.,
我不能让你危害到我的队伍
and I cannot have you compromising my team.
你要么让我们做好工作要么就出去
You will either have to let us do our work or step out.
好吧我出去
Fine. I'll step out.
你们做的完全不对看得我闹心
Just drives me crazy to see things done the wrong way.
你一辈子都在受这个气
You've had to put up with that your whole life, huh?
我到这里就是为了逃出他的阴影
I came out here to get out from under his shadow.
我猜得克萨斯还是不够远
I guess - Texas wasn't far enough.
詹姆斯·班尼特 23岁
James Bennett, 23.
建筑物倒塌导致上臂断掉
Building collapse caused transhumeral amputation to the left arm.
血压过低伴有心跳过速
Hypotensive and tachycardic.
莫莉清理一下断臂准备再植
Mollie, prep this arm for re-attachment.
我的手在发烫
My hand's burning.
给我点什么对付一下我会好起来的
Just give me something for it. I'll be okay.
放松放松班尼特
Take it easy, there, Bennett.
给我两毫克镇静剂再打十毫克吗♥啡♥
Give me two migs of ativan and push another 10 of morphine.
乔斯林再给我拿两个单位O型阴性血
And, uh, Jocelyn, get me two units of O-neg
然后开一条中心静脉
and set up for a central line.
别激动
Take it easy.
我要回去
I'm going back out there!
要是想让我待在这不如拿枪打我
He can shoot me if he wants me to stay!
没人会开枪打你的好吗
No one's gonna shoot you, okay?
我们现在给你治疗
We're gonna take care of you.
你会没事的
You're gonna be okay.
好了
All right.
开始吧
There we go.
乔斯林你能给手术室打个电♥话♥吗
Jocelyn, can you call up to surgery
确保有手术室能进行断臂再植
and make sure there's an O.R. free for arm re-attachment?
-现在就去 -马上
- Do it now. - Right away.
好的你怎么样你狠挨了几下
Okay. You okay? You took quite a shot.
我很好比这个重的我也挨过
I'm good. I've been hit harder than that before.
数到三一二三
On three. One, two, three.
他已经心力衰竭了肺里都是渗出液
He's in heart failure. There's fluid in his lungs.
我们是不是漏诊了心梗
Did we miss a heart attack?
不是他的肌钙蛋白二正常
No, his second troponin is normal.
这还不够充分明确诊断
It's not complicated enough.
他需要做个心电图
He needs an echocardiogram.
-没错 -艾丽克斯的磁共振结果出来了
- Yeah. - Alex's MRI is back.
看看这个
Look at this.
艾丽克斯的病情更复杂了
Things just got more complicated for Alex.
是啊情况不妙
Yeah. It's not good.
克丽丝塔你留在这看着布恩
Krista, stay here and watch Boone.
我上楼去找人来会诊
I'll be upstairs - getting a surgical consult.
-我先走了 -好
- Excuse me. - Okay.
艾丽克斯出现了颈动脉剥离
Alex has a carotid dissection
导致血栓进入了脑血管
that has sent blood clots to her brain.
难怪她什么都看不见
Well, that would explain the loss of vision
-然后出现了中风 -没错
- and then the stroke. - Exactly.
再过几小时中风所导致的伤害就不可逆了
In a few hours, the damage from the stroke will be permanent,
而且她的大部分大脑都会死亡
and a large section of her brain will die.
但有个孤注一掷的办法
But there is a Hail Mary.
机械取栓术
A mechanical embolectomy.
我们用导管从她的大脑里导出血栓
We retrieve the clots from her brain using a catheter.
但这个时间找介入专家来院协助
But we'll be hard-pressed getting an interventionalist
难度很大
to the hospital at this hour.
是但问题是我们手上就有一个
Yeah, well, the thing is, we already have one.
保罗的爸爸
Paul's dad.
我已经给医院打电♥话♥申请了
I've already called the hospital for privileges,
他们现在正在发程序授权书过来
and they're sending over authorization for the procedure now.
我想麻烦你去请他
I-I'd like you to ask him.
我觉得他会更尊敬你一些
I figure he'd respect you more, you know?
就外科医生之间来说
Surgeon to surgeon.
-行 -太好了谢谢十分感谢
- Yeah. - Awesome. Thank you. I appreciate it.
在急诊室进行断臂再植我不知道
Limb re-attachment in the E.R.? I don't know.
谁在用心血管手术
What's the wait - on surgery and vascular?
再等几个小时
Backed up for hours.
班尼特没有几个小时可以等懂吗
Bennett doesn't have hours, okay?
再等他的断臂就用不了了
He'll lose the arm.
我不知道他到底经历了什么
I don't know his full story,
但退伍后他就一直不好过
but he's not had it easy since post-deployment.
你得让我们试试
So you got to let us try.
他是军人是我们的一员
Okay, he's a soldier. He's one of us.
他当时在外面救人然后受了伤
He was out there saving people and got hurt.
我知道情况很紧急我希望你们能手术
I-I get what's at stake. I want you guys to do it.
但如果又变得忙起来
But if we get swamped again,
我不想剩下的当班时间里
I can't have you two siphoned off
别人都快死了你们俩却脱不开身
for the rest of the night while other people die.
-莫莉 -什么事
- Mollie. - Yes?
大型事故的伤者入院情况怎么样
How we looking on mass casualty admits?
很久没人送来了据说现场已经没有伤者了
I haven't had one in a while. They say the area's all clear.
-怎么样 -好吧好吧你们去吧
- There you go. - Okay, okay. Do it.
但一旦忙起来我会把你俩叫回来
But we get busy, I'm gonna pull you off.
不能因为一条手臂放弃一条生命
We can't trade a life for an arm.
好谢谢
Okay, thanks.
-不是心梗 -的确不是
- It wasn't a heart attack. - No.
他的心脏怎么扩张这么多
How did his heart get so dilated?
他提到说今天晚上早些时候
He mentioned that he was under a lot of pressure
压力很大
earlier this evening.
可能是由于高度紧张
It could be the severe stressor
导致心脏虚弱才发生了心脏扩张
that weakened his heart, causing dilation.
应激性心肌病
Takotsubo cardiomyopathy.
破碎之心综合征
Broken-heart syndrome?
看起来是
That's what it looks like.
他需要心脏移植
He's gonna need a heart transplant --
或者至少要装个左心室辅助器
or, at the very least, an LVAD.
等他醒了我们再跟他谈治疗方案
We'll let him know what his options are when he wakes up.
但现在我们注意下艾丽克斯的手术
But for now, we should keep an eye on Alex's surgery.
他会想知道艾丽克斯病情究竟怎么样
He'll want to know how she's doing.
好的
Okay.
好谢谢
Okay. Thanks.
没事的兄弟
It's all right, bud.
我们刚刚收到了医院的回复
And we've just received hospital privileges
同意你来做手术
for you to perform the surgery.
你们当然收到了
Of course you did.
所以克莱门斯医生
So, um, Dr. Clemmens,
你允许我使用你的手术室
You'll allow me to use your O.R.?
或许还能用一下11号♥手术刀吗
And perhaps an 11 blade?
我很抱歉如果让你感到我...
Look, I'm sorry if you felt that I was...
半吊子没礼貌粗鲁
Tactless. Disrespectful. Rude --
爸