匹兹堡医护前线（2025）

The Pitt S01E15

Part 2 May 20, 2025, 4:18 p.m.

最后一个粉区病人也要上楼了
Last pink patient going upstairs.
你们俩还好吗 - 是的
You two hanging in? - Oh, yeah.
开始收尾工作吧剩下的交接给夜班的同事
OK, start wrapping it up, and then hand off what you have left to the night shift.
能聊聊吗 - 回家吧我不想再重复了
Can we talk? - Go home. I don't want to tell you again.
你需要我 - 你知道你惹了多大的麻烦吗
You needed me here. - Do you have any idea how much trouble you're in?
除非你举报我
Only if you report me.
我会假装... - 罗比
I'm gonna pretend that I didn't-- - Robby!
骨盆挤压伤
Pelvic crush injury.
想都别想创伤科不是暂停接诊了吗
Don't even think about it. Thought we were closed to trauma.
这是棕色代码的病人
This is the Code Tan.
被正在倒车的医疗物资运输车挤压到墙上了
He got pinned behind a truck backing up with replacement supplies.
脉搏微弱伴有室速...
Pulse is weak and thready, tachy at...
请给我拿一些心电监护电极片
Grab me some monitor leads please.
100%非再吸入型面罩
100% non-rebreather.
准备120毫克氯♥胺♥酮♥ 和100毫克罗库溴铵
Let's draw up 120 of ketamine, 100 of rock,
并呼叫创伤外科
and page trauma surgery please.
这家伙是从哪来的 - 我们的装卸区
The hell did this guy come from? - Our loading dock.
天哪
Oh, my God.
好的我拿到床旁超声了拿个加压骨盆带
OK, I got the EFAST. Grab a binder.
明显是盆腔骨折
Obvious pelvic fracture.
我好痛
I'm in a lot of pain!
你目前有服用什么药物吗 - 瑞舒伐他汀
You taking any medications? - Crestor.
有药物过敏吗 - 没有我不会有事吧
Any drug allergies? - No. Am I gonna be OK?
当然 - 我们会治好你的赫克托
Absolutely. - We got you, Hector.
高压68低压42 脉搏
130BP 68 over 42, pulse 130.
我在左肘前静脉置入了14G静脉导管
I got a 14 gauge in the left AC.
启动全血大量输血方案
Whole blood massive transfusion protocol.
伊利和扬斯敦的全血正在往这里运送
Uh, we got whole blood coming in from Erie and Youngstown.
我不确定是否已经到了
I'm not sure it's here yet.
那我们就自己配红细胞血小板和血浆
Let's go one-to-one-to-one, red cells,
这些都有插管完成后请准备颈内静脉穿刺
platelets, and plasma. We've got that. Let's place an IJ after the intubation please.
好的 - 床旁超声显示阴性
On it. - OK, EFAST negative.
出血集中于腹膜后间隙尿道外口无渗血
It's all retroperitoneal. No blood at the meatus.
给我一个导尿管 - 赫克托
Pass a Foley. - Hector,
你的骨盆遭受粉碎性骨折
you crushed all the bones in your pelvis,
并伴有内出血我们需要给你打镇静剂才能进行救治
and you've got some internal bleeding. We need to sedate you to treat you.
好疼
Hurts a lot!
你醒来时就不能说话了
When you wake up, you're not gonna be able to talk.
我们会给你插一个呼吸管
You're going to have a breathing tube in your throat.
能先让我和妻子说句话吗 - 没时间了赫克托
Can I speak to my wife first? - Afraid we have to move now, Hector.
第一袋红细胞已经开始输注
First unit of packed cells in the infuser.
这里是什么情况
What have we here?
看来是两个老白男偷了我们的病人
It looks like two old white guys poached our patient.
我知道你不是在说我们
Oh, I know you're not talking about us.
我知道他不是在说我
Well, I know he's not talking about me.
骨盆粉碎性骨折出血性休克
Crushed pelvis, hemorrhagic shock.
大量输血方案加压骨盆带我在做插管
MTP, pelvic binder. I'm doing an intubation,
马上做颈内静脉穿刺
about to place an IJ.
需要我们吗 - 暂时不用
You need us? - We got this for now.
你们坚守好阵地把白班剩下的匹兹堡音乐节患者处理完
Hold down the fort. Get caught up on the day shift's remaining PittFest patients,
我们负责稳住这个病人
and we'll get this guy stabilized.
你感觉怎么样麦克斯
How are you feeling, Max?
我还好
Yeah, I'm all right.
我们正在为你治疗高铁血红蛋白血症
So, we are treating you for methemoglobinemia.
你最近有服用过或吃过什么特殊的东西吗
Um, have you taken anything or eaten anything out of the ordinary lately?
没有只是一些不健康的路边摊
No, just some unhealthy food truck choices.
好的你的工作会接触到有毒化学品吗
OK. Do you work around toxic chemicals?
不会我是个平面设计师
No, I'm a graphic designer.
你最近看过牙医吗
Have you had dental work done lately?
用过局部止痛药吗 - 没有
Used topical pain relievers? - Nope.
你认识麻风病患者吗
Do you know anyone with leprosy?
麻风病
Leprosy?
我不认识有麻风病的人
Yeah, I don't know anyone with leprosy.
你摄入或接触到的某种东西
Well, something that you ingested
导致你病得很重
or came into contact with made you really sick,
你差点就死了
and you could have died.
我们得查明原因避免这种事再次发生
So we need to figure out what caused it so it doesn't happen again.
不会的
It won't.
你还有别的事想跟我们聊聊吗
Um, is there anything else going on in your life that you want to talk about?
让你感到过度紧张或担心的事
Anything causing you undue stress or worry?
没有
No.
我想我只是需要休息一下
I think I just need a little rest.
好的
All right.
我会回来的
Well, I will be back.
这一定是全世界最慢的电梯
This has to be the slowest elevator in the world.
你急着回去吗
Are you in a hurry to get back down there?
还有很多积压病例要处理
There's still a backlog of cases to check on.
我们的轮班几小时前就结束了
Our shift was over hours ago.
你不想回家睡觉吗
You don't want to go home and sleep?
希望这件事不会浇灭你做急诊的热情
I hope this didn't turn you off of practicing emergency medicine.
今天的事让我彻底不想干临床了
I'm pretty sure today turned me off of practicing all forms of medicine.
过了今天一切都会轻松起来的我保证
Everything will be a cakewalk after today. I promise.
来吧我们去找个好病例
Come on, let's go find a good case.
好我马上就来
Yeah. I'll be right there.
抱歉
Sorry.
中心静脉导管已置入
Central line is in.
把快速输液器连接到颈内静脉导管然后我们可以拍片确认
Let's hook up the rapid infuser over to the IJ, and then we can shoot the film.
清场拍X光
Clear for X-ray.
正在拍摄
Shooting.
可以了
Clear.
这可不妙
Oh, that ain't good.
你有什么发现
What have you got?
耻骨联合前部增宽
Widened symphysis pubis anteriorly.
骶髂关节后部变形
Distorted sacroiliac posteriorly.
这家伙像被宰的猪一样流血
Guy's bleeding like a stuck pig.
我接通了手术室的沃尔什医生电♥话♥开了免提
I got Dr. Walsh on speakerphone from the OR.
嘿伙计们怎么了
Hey, guys. What's up?
病人骨盆骨折情况不稳定
We've got an unstable pelvic ring fracture,
收缩压68 床旁超声阴性
systolic of 68, EFAST negative.
我以为创伤科不接诊了
I thought we were closed to trauma.
病人是医院工作人员被倒车的补给车挤伤
Hospital worker versus reversing supply truck.
已启动大量输血方案用了加压骨盆带
MTP and pelvic binder in place.
氨甲环酸 - 已经给药了
TXA? - Gave it.
能做CT血管造影吗
Stable for CT angiogram?
暂时还不行
Uh, not at the moment, no.
继续输血
Keep transfusing.
血库还在等送货
The blood bank is still waiting on a delivery,
除非你楼上有多余的
unless you have some upstairs.
他不需要手术
He doesn't need surgery.
他需要介入放射科栓塞血管止血
He needs interventional radiology to embolize the bleeders.
他们不喜欢不稳定的病人
They don't like unstable patients.
他们今晚会喜欢的
They will tonight.
我做完这个五级肝裂伤手术就下去
I'll be down as soon as I finish this grade 5 liver lac.
霍奇斯手腕弹片伤 - 没问题
Hodges, wrist shrapnel. - Check.
马洛伊腿部弹片伤 - 没问题
Malloy, leg shrapnel. - Yup.
蒙哥马利腹部弹片伤 - 不对
Montgomery, abdominal shrapnel. - Uh, no.
这里应该是头部撕裂伤的周女士
This is supposed to be Cheu, female with a head lac.
好极了她去哪了
Ugh, great. Where the hell did she go?
金医生维塔克
Dr. King, Whitaker!
这张床上应该是一名头部撕裂伤的亚洲女性患者
There's supposed to be a female Asian patient with a head lac in this bed!
对我觉得那不是她
Uh, yeah, I don't think that's her.
维塔克我需要你找到那个应该躺在这里的病人
Right. Whitaker, I need you to find the patient that's supposed to be here.
周女士有头部撕裂伤的老年女性 - 我吗
Cheu, elderly female with a head lac. - Me?
我见识过你抓老鼠的英姿
I saw you caught that rat.
你是我们最接近猎犬的人选我这么说是在夸你
You're the closest thing we got to a bloodhound. I mean that as a compliment.
嘿现在方便吗
Hey, is this a good time?
不方便我有个病人失踪了
No, I got a missing patient.
你见过一个姓周的头皮撕裂伤的女人吗
You've seen a woman with a scalp lac, last name Cheu?
没有但我需要和你谈谈 - 谈吧
Uh, no, but I need to talk to you. - So talk.
你治疗过一个姓周的头皮撕裂伤的女患者吗
You treat a woman with a scalp lac named Cheu?