夜班医生（2014）

The Night Shift S04E04

Part 3 March 5, 2021, 3:50 p.m.

急救车准备气管插管
Crash cart. Prepare for intubation.
你都做了什么蒂娜
What have you done, Tina?
米尔斯先生为了大家安全你得在外面等候
Mr. Mills, for everyone's safety, I need you wait outside.
救救她不不救救她
Help her. No, no, help her!
蒂娜蒂娜
Tina! Tina!
我需要你在外面等
I need you to wait outside.
插♥进♥去了生命体征好转
I'm in. Sats are going up.
失血太多了
This bleeding's out of control.
这是富血供肿瘤我们得找到病灶
The tumor is hyper-vascular. We gotta get to the source.
-血压68/35 -手术室已经准备好了
- BP is 68 over 35. - The O.R. is ready.
她撑不到手术室的我们得在这做手术
She'll never make it up to the O.R. We gotta do this here.
去创伤二室现在走
Trauma 2. Now. Let's go!
晚上好威尔逊先生
Good evening, Mr., uh, Wilson.
我是阿利斯特医生
I'm Dr. Alister.
叫我亚瑟
Call me Arthur.
我肚子很疼
This cramping in my stomach hurts really bad.
疼多久了
How long have you felt it?
从我两天前吃了阿♥拉♥莫辣椒开始
Since I had some Alamo Peppers two days ago.
-你吃药了吗 -没有没有
- You take anything for it? - No, no.
这比消化不良难受多了
This hurts much worse than indigestion.
这可能是胆结石或是溃疡
This could be gallstones or an ulcer.
也有可能是心脏病发作
Maybe even a heart attack.
好了我们先不要过早下结论
All right, let's not jump to extremes quite yet.
能麻烦你躺下吗
Can you sit back for me, please?
很难不那么想
It's hard not to.
我的医疗病史可以追溯到1993年
I have a long medical history dating back to 1993
我第一次做手术的时候
when I had my first surgery.
做什么手术
Uh, which was for what?
隐睾手术
Ah! An undescended testicle.
我很确定那和你现在的不舒服无关
I'm pretty sure your current discomfort is unrelated.
现在是谁过早下结论了
Now who's jumping to extremes?
难以置信你竟然自♥由♥攀岩了光明之路
I cannot believe you free soloed El Sendero Luminoso, man.
我连碰都不敢碰
Even I wouldn't touch that.
很抱歉打扰你们了
Hey, sorry to interrupt.
马丁你感觉怎么样
Martin, how you feeling?
有点困但没那么疼了
A little sleepy, but less pain.
好很好很高兴你感觉好些了
Okay, good. I'm glad that you're feeling more comfortable.
好...
Okay, um...
胸部CT显示你有肺部瘀伤的迹象
so your chest C.T. shows signs of a bruised lung.
你的X光片显示腿部有多处骨折
And your X-rays found multiple leg fractures,
整形外科会在会诊后给你治疗
which Orthopedics will resplint after their consult.
但在这之前我想问你一下
But before we get to all of this, I wanted to ask you
关于之前发生的事
about the incident that happened earlier.
什么事
What incident?
在手术盘掉到地板上后
After the surgical tray crashed to the floor,
你开始尖叫
you started screaming.
我不记得了
I don't remember that.
你朝着我们大吼让我们停下
Well, you were yelling and screaming at us to stop.
你太激动了我们不得不给你打镇静剂
You got so agitated that we had to sedate you.
-跟你说过了我不记得了 -好吧
- Told you, I don't remember. - Okay.
你的睡眠怎么样
How's your sleep?
不错
Fine.
你记得你有做过关于服役期间的噩梦吗
Any, um, memories or nightmares of your time in service?
-没有 -总是生气易怒
- No. - Lingering anger, irritability?
-麻烦你停下 -停下什么
- Stop, please. - Stop what?
你问我的问题和几年前
You're asking me the same PTSD questions
海军心理专家问的创伤后应激障碍问题是一样的
those Navy shrinks asked me years ago.
我来猜猜你接下来要问什么
Let me guess what's next.
心理麻木吗对吗
Any psychological numbing, too? Right?
我告诉你的和我告诉他们的一样
Look, I'm gonna tell you the same thing that I told them.
我没有创伤后应激障碍症我真的受够了
I don't have PTSD and I'm really tired of people telling me
-别人说我有 -我没说你有创伤后应激障碍症
- that I do. - Well, I didn't say that you did.
但是你在这么想
But you're thinking it.
我喜欢自己一个人攀岩就这样
Look, I like to climb alone. That's it.
-好好我们知道了 -你们并不知道
- Okay, okay. We get it. - You don't get it.
你们不知道
You don't get it.
所以给我接好断掉的骨头
So just fix my broken bones
别管我的脑子怎么想了好吗
and leave my head out of this, okay?
有什么想法吗
Any ideas?
我去联♥系♥一下我觉得能帮忙的人
I'm gonna contact someone who I think can help.
好
Okay.
杜克的信♥号♥♥在100米范围内
Duke's signal is within a hundred meter perimeter.
准备出发
Get ready to move.
-我们去哪... -你别说了灰姑娘
- Hey, where are we go-- -You don't speak, Cinderella.
你悄悄地待在这里等你的水晶鞋
You stay shush in here and wait for your glass slipper.
我们叫你你再过来
You come when we call you.
扔烟雾弹
Smoke out!
这里是斯巴达六号♥ 有很多敌人
This is Spartan 6. We're under heavy contact.
敌人在前面行动行动
Contact, front! Move, move!
格雷格斯中枪了格雷格斯中枪了
Greggs is hit! Greggs is hit!
我告诉你让你待在后面了
I told you to stay back.
闭嘴如果你想活命的话就按我说的做
Shut up and do what I say if you wanna live.
发现杜克需要更多火力支援他被困住了
Spotted Duke. Need more fire power. He's pinned down.
你的股动脉被射中了
You're hit in the femoral artery.
你以为我不知道吗
Think I don't know?
再偏一寸我就蛋碎了
Another inch, and my nards would've been ribbons.
没了蛋蛋你也能活
You lose your balls, you'd still be alive.
但失血会让你丢了性命
This bleed may kill you.
好了我得止血
Okay, look, I gotta stop the bleeding.
-会很疼好吗 -做你需要做的
- This is gonna hurt, okay? - Just do what you gotta do.
你确定吗
You sure?
准备好了吗
Ready?
别动我的膝盖在帮你止血
Don't move. My knee's keeping you from bleeding out.
把头低下你死了对我可没有什么好处
Keep your head down. You're no good to me dead.
即使用凝血剂夹紧
Even with the clotting agent and clamping,
我也控制不了出血如果我们能栓塞了动脉
I can't control the bleeding. If we can embolize the artery,
-就不会流血了 -血压又下降了
- the bleeding will stop. - BP is down again.
血红蛋白指数降低五点
Hemoglobin is down 5 points.
准备推一支肾上腺素拿一级输液器
Draw up push dose epi, get a level one infuser
开始大量输血
and start the massive transfusion protocol.
我就提个醒她是耶♥和♥华♥...
Just throwing it out there, she's Jehovah's...
不她不是她祖父才是
No, she isn't. Her grandfather is.
法律规定父母可以以身殉道
The law says parents may be able to martyr themselves,
但无权决定他们孩子的性命蒂娜割伤自己
but not their children. When Tina cut herself,
是为了把生命掌握在自己手中
she was trying to take control of her life.
我希望让她重新把握自己的生命
I intend to give it back to her.
她的心率在下降脉搏56
She's bradying down. Pulse is 56.
好的反常心动过缓
All right, paradoxical bradycardia.
给她注射0.5毫克阿托品
Give her 0.5 milligrams of atropine.
静脉安全准备栓塞导管
Line secure. Ready for embolization catheter.
-医生她心跳骤停 -去紧急呼叫
- Doctor, she lost her pulses. - Call a code blue!
-她室颤了 -开始做心肺复苏
- She's in v-fib. - Starting CPR.
准备好除颤器充电到200焦耳
Put the pads on. Charge it to 200 joules.
推一毫克肾上腺素开始
Give 1 milligram of epi. Let's go!
-充电完毕 -离手
- Charged. - Clear!
离手
Clear.
再推一毫克肾上腺素
Another milligram of epi.
推300毫克胺碘酮充电到200
Start amiodarone 300 milligrams, charge it to 200.
-充电完毕 -离手
- Charged. - Clear!
离手
Clear.
她已经昏迷15分钟了
She's been down for 15 minutes.
别看时间肯尼继续按压
Don't watch the clock, Kenny. Just keep pumping.
我们所有血液都输完了
All of our blood products have been transfused.
-这是最后一单位的红细胞 -换位置
- We're on our last unit of RBCs. - Switch out.
我止不住血
I can't embolize the bleeder.
心肺复苏让她动得太厉害了
She's moving too much from the CPR.
我们心脏按压坚持不了那么久
We can't hold a compression for that long.
我们可以坚持到体外膜肺氧合就好
We can and we will once she's on ECMO.
到底到哪了乔斯林
Where the hell is it, Jocelyn?
他们说快运过来了电梯太慢
They said it's on the way. The elevators are slow.