匹兹堡医护前线（2025）

The Pitt S01E02

Part 2 March 11, 2025, 8:29 p.m.

And PTMC has such a great reputation, I thought, you know, it'd be a good fit.
能帮我处理一个疑难病例吗 - 好的什么情况
Can I present my headache to you? - Uh, yeah, what do you got?
36岁女性子♥宫♥颈触发点导致严重头痛
A 36-year-old woman with severe headache due to paracervical trigger point.
在注射2毫升麻佳因之后疼痛值从11降到零
Her pain went from 11 to zero after 2 ccs of IM Marcaine to the--
等等你在请示前就做了触发点注射
Wait, wait, wait. You did a trigger point injection before presenting the case?
是的我... - 实习生必须先请示
Yeah. I-- - Interns always present first.
我在霍普金斯的疼痛诊所待过一个月
I spent a month at the pain clinic at Hopkins.
这样是不行的 - 患者来了
No, it's not OK. - Incoming!
我很熟悉... - 这样绝对不行
I'm very comfortable with-- - It's definitely not OK.
23岁的本肯珀没戴头盔骑电动滑板车时撞上了汽车车门
23-year-old Ben Kemper, no helmet, got doored riding an e-scooter.
脖子撞到了把手上之后脸栽到了人行道上
Neck versus handlebar then face-planted to the pavement.
明显的面部骨折但有意识和方向感生命体征良好
Obvious facial fractures, but alert and oriented with good vitals.
准备
Here we go.
一二三
One, two, three.
你怎么样本
How are we doing, Ben?
我喉咙里有血
Blood, back in my throat.
可能是因为流鼻血的缘故
That's probably from the nosebleed.
请给我一个短的快鼻
Short Rapid Rhino, please.
心动过速心率120 脉搏血氧饱和度接近90
Tachy at 120, pulse ox borderline at 90.
给他“漏气”吸氧15升
Blow by at 15 liters for now.
颈部挫伤 - 高压138低压84
Neck contusion. - BP 138 over 84.
喉部向右偏移没有声响
Larynx shifted to the right, no crepitance.
四毫升吗♥啡♥
4 of morphine.
我要在你鼻子里塞点东西止血
I'm going to stick something in your nose to stop the bleeding.
没有血鼓室 - 给气球充气
No hemotympanum. - Inflate the balloon.
现在感觉如何本
How about now, Ben?
好多了
Better.
情况如何
What's up?
生命体征良好有意识和方向感我们来看看
Good vitals, A and O, let's have a look.
天啊 - 脸部浮肿
Ouch. - Floating face.
勒福特三型骨折
Le Fort III fracture.
这种病例可不是每天都有
You don't see that every day.
好吧准备插管做两手准备以防万一
OK, let's prep for airway. Double setup just in case.
干得好
Nice work.
谢谢
Thanks.
好了塔加里先生你可以走了
All right, Mr. Tagari, you are good to go.
谢谢
Oh, thank you.
记住医生和护士打九折
Remember, 10% off for doctors and nurses.
我是医学生
I'm a student doctor.
抱歉我撞到头了记得吗
Oh, right. Sorry. I hit my head, remember?
我儿子喜欢披萨所以我肯定会去店里光临的
Well, my son loves pizza, so I will take you up on it for sure, OK?
谢谢你 - 谢谢等护士来
Thank you. Thank you. - Thank you. Wait for a nurse.
好的谢谢 - 再见
OK, thanks. - Hi.
我刚意识到听起来我总是给我孩子吃垃圾食品
I just realized it sounds like I always feed my kid junk food.
披萨啦烤棉花糖啦
You know? Pizza, s'mores.
没有别这么说我喜欢披萨和烤棉花糖人人都喜欢
No, no, please. I--I like pizza and s'mores.
谢谢
Who doesn't?
你有几个孩子
How many kids do you have?
只有一个他叫哈里森今年11岁了
Just one, Harrison. He's 11 now.
你丈夫做什么的
What does your husband do?
没有丈夫只有我和我儿子
No husband, just me and my son.
我猜你没有孩子吧我不是指你的年纪
I take it you don't have kids? I--I don't mean on account of your age.
或许是吧
Or maybe I do.
大多数医学生都没有孩子
I mean, most medical students don't have kids.
是啊我没孩子
Oh, yeah, no, no. Um, no kids.
连男朋友都没有目前只是上学
Just not even a boyfriend. Uh, it's just school for now.
是啊那会让你非常忙碌我一点都不怀念
Yeah. That'll keep you pretty busy. I do not miss it.
作为一个年轻的母亲一定很难吧
Must have been difficult as a young mother.
确实有过难的时候但我的生活一直都充满挑战
It had its moments, but my life has been full of challenges,
到目前为止医学院并不是最难的一个
and med school was not one of the hardest, by far.
但却是最有收获的一个除了我儿子之外
It was one of the most rewarding, though. Other than having my son.
嘿面部割伤眼睛里可能有异物
Hey. Facial lash with possible foreign object in the eye,
WMMV指数绝对能上七分
which is always a solid 7 on the WMMV Scale.
全称是“马提奥呕吐指数”
What Makes Mateo Vomit.
你还好吗
You OK?
挺好的他真幽默...
Yeah. Yeah. Um, he's funny, the...
那个护士 - 马提奥你可以说他的名字
the nurse. - Oh, Mateo. You can say his name.
是的...眼睛里有异物可能会很严重
Um, yeah, uh... a foreign object in the eye could be really serious.
嘿水果蛋糕
Hey, Fruitcake.
嘿我跟你说话呢水果蛋糕
Hey, I'm talking to you, Fruitcake.
莫娜我跟你说过无数次了我叫罗比医生
Myrna, I told you a hundred times my name is Dr. Robby.
你想看我的阴♥道♥吗
You want to see my vagina?
我已经看过了一次就够了谢谢
I have already seen it. And once was enough, thank you.
罗比尼克布拉德利那个吸毒过量的青少年他父母来了
Robby, parents of Nick Bradley, the OD teen, are here.
好的带他们去创伤一室他去做CT还没回来
OK, park them in Trauma 1. He's not back from CT yet.
我马上就过去 - 你有乖乖听话吗莫娜
I'll be right there in a minute. - Got it. Behaving yourself, Myrna?
是的女士
Oh, yes, ma'am.
情况如何 - 已经注射氯♥胺♥酮♥和司匹林
How we doing? - Ketamine and sux on board.
脉搏血氧饱和度保持在94
Pulse ox holding at 94.
准备颈部手术以防万一
Prepping the neck just in case.
我们来看看
Let's have a look.
再深一点
A little deeper.
肿得很厉害我看不到声带 - 右边左边
Lots of swelling. I can't see the cords. - To the right. The left.
是啊因为外伤严重变形了而水肿只会变得更糟
Yeah, it really distorted from the trauma, and the edema's only going to get worse.
所以我们应该做甲膜切开术
Which is why we should crike.
喉部骨折不能做切开术
You don't crike a laryngeal fracture.
别听埃德温娜剪刀手的
Don't listen to Edwina Scissorhands here.
如果他们不能切开那外伤科就不知道怎么修复它
If they can't cut it, surgery doesn't know how to fix it.
甲状腺软骨的挫伤很严重
The contusion is high at the thyroid cartilage,
所以你就站在那里负责美丽急诊室肯娃娃让我来处理
so you just stand there looking pretty, ER Ken, and let me fix this.
降到85了
We're down to 85.
好了抽出来 i-gel麻醉吸氧准备做切开术
All right, pull out. I-gel, bag and crike.
i-gel麻醉谢谢 - 关掉警报
I-gel, please. - Turn off the alarm.
我以前没做过切开术 - 不梅尔来做
I've never done a crike before. - No. Mel will do the crike.
你已经忙了一早上了手套戴上梅尔
You've already had a busy morning. Glove up, Mel.
不我来做切开术医生
No, I'm doing the crike, doctor.
如果今天不是单日当然可以由你来做医生
You would be doing it, doctor, if it wasn't an odd day.
双日归外科单日归急诊你知道的看在上帝的份上
Surgery gets even days, ED gets odd days. You know this. For crikes' sake.
那是因为你们急诊的人都是怪咖
That's because you're all fucking odd down here.
好吧有点团队精神我们专注于病人吧
OK, team work, please. Let's focus on the patient.
我非常感谢你的理解
I so appreciate your gracious understanding.
我来协助以防她搞砸了
I'll assist in case she screws up.
约兰达友善点
Yolanda, play nice.
麻醉后血氧饱和度上升了
Sats are up with the I-gel.
准备好了吗听到了吗
You ready? Hello?
听到了
Oh, uh, hello.
你做过吗 - 是的在尸体实验室做过
You've done this? - Yes, in the cadaver lab.
希望这可怜的家伙不会沦落到那里
Let's hope that's not where this poor soul ends up.
还有点时间我们做个切开教学
We'll do an open technique since we have a minute.
好的
OK.
你要做一个垂直切口
OK, you're going to be making a vertical incision
避开颈静脉和颈动脉
to avoid the jugulars in the carotids.
很好如果这个切开术需要在几秒钟内完成
Mm-hmm, good. If this was a crike that needed to happen in seconds,
你可以用十号♥刀你的手指和探针
you could use a 10 blade, your finger, and a bougie.
这是威特兰纳牵引器这是气管拉勾
This is called a Weitlaner. And this is your trake hook.
脊椎头部CT 口腔颌面手术异丙酚静脉点滴
C-spine, head CT, OMF. Start a propofol drip.
好现在我们要横切
OK, now we're going to make a horizontal incision
切开环腺膜
across the cricothyroid membrane.
对
Yeah.
四毫米导管准备给氧
4.0 Shiley next. Get ready to bag the crike.
好很好
Yeah, yeah, yeah, good.
不好意思 - 没关系
Oh, excuse me. - No worries.
呼气末二氧化碳数值显示黄色
End tidal CO2 is yellow.
黄色是对的做得好缝合吧好了我就在隔壁
Yellow is yes. Nicely done. Sew it in. OK, I will be next-door.
你的住院医生会缝合吗还是需要我教
Does your resident know how to suture, or do I need to teach?
你真是极品小约 - 我知道谢谢
You're all class, Yoyo. - I know, thanks.
从你嘴里说出来都算是夸奖
That means a lot of nothing coming from you.
梅尔你没事吧
Mel, you OK?
如果你们吵完的话
If you're done fighting.
我们没有吵架我们闹着玩的朗登太弱了吵不了架
We're not fighting. This is playing. Langdon's too soft to fight.
是啊我对加西亚医生只有尊重