匹兹堡医护前线（2025）

我找不到出血点
Can't locate the source.
肺门近端位于胸骨下方
Proximal hilum is under the sternum.
连同右心室大部分
Along with most of the right ventricle.
你需要更好的术野暴露
You need better exposure.
转为蛤壳切口
Convert to a clamshell.
没错 - 创伤剪
Exactly. - Trauma shears.
让他们自己想到那个计划比较好
Would've been nice to let them come up with that plan.
心脏需要进行双重按压 就像这样
Heart's going to need double compressions just like this.
从心尖向主动脉挤压
Squeeze from the apex to the aorta.
右心室状态良好
Right ventricle looks good.
肺门大出血
Massive hemorrhage from the hilum.
开始输第二袋血 追加四单位
Second MTP pack is going, additional four units.
肺门损伤位置非常靠近中心 可能累及肺动脉和肺静脉
Hilar injury looks very proximal-- may be pulmonary artery and vein.
钳闭完成
Clamp's on. Nope, no good.
不行 还在大量出血
Still bleeding like a stuck pig.
我来试试吧
I can give it a try.
加西亚医生技艺高超 如果她都没辙
Dr. Garcia is a very skilled surgeon. If she can't get it,
那我们就得另想办法了 - 比如呢
we need to think of something else. - Like what?
肺门翻转术
Hilar flip.
我们把肺部旋转180度 就像扭花♥园♥水管一样
We're going to rotate the lung 180 degrees, like putting a kink in the garden hose.
应该可以止血
It'll stop the bleeding.
这个办法或许可行
That could possibly work.
或者 当你把整片肺从肺门撕脱时 他就会死
Or he'll die when you rip the entire lung off the hilum.
动作轻一点 非常轻柔 非常缓慢
Gently, very, very gently, very, very slowly.
出血减慢了 - 这是个好兆头
Blood loss is slowing down. - That's a good sign.
肺门没渗血了 - 是啊 但心脏是空的
Hilum looks dry. - Yeah, but the heart feels empty.
好了 漏点修好了 现在把油箱加满吧
Okay, we fixed the leak. Now let's fill the tank.
你今天可真受欢迎啊
You are very popular today.
抱歉 我腾出手来会立刻关掉
Sorry, I'll turn it off when I can.
9岁的凯莉·康纳斯 她父亲的女友吉娜送来的
Nine-year-old Kylie Connors-- brought in by her dad's girlfriend, Gina.
凯莉今早从楼梯上摔下来了
Kylie took a tumble on the stairs this morning.
下巴有三厘米裂伤 门牙缺损
3-centimeter chin lac and a chipped front incisor.
已进行麻醉包扎 到院时有活动性出血
She's got LET on a pressure dressing. Bleeding pretty good on arrival.
用皮肤胶应该能搞定
Dermabond should do the trick.
有什么问题吗
Any questions?
金医生
Dr. King?
梅尔
Mel?
我什么都没说
Oh, um, I didn't say anything.
你感觉怎么样 凯莉
Uh, how you feeling, Kylie?
很累 - 我们从早上5点半一直待到现在
Tired. - We've been here since 5:30.
我也是
Oh, that makes two of us.
但是别担心 我们会把你修复得完好如初
But don't worry. We'll patch you up good as new.
让你尽快出院
And we will get you out of here as soon as we can.
有什么问题吗 - 你能抬起下巴吗
Any questions? - Can you raise your chin?
没有 我只是她父亲的女友 我对这种事没经验
No, I'm just her dad's girlfriend, so I'm new to all this.
没关系 交给我们就好 下一个
No worries. We got you. Next.
26岁的利亚姆·桑德斯 从自行车上摔下来了
26-year-old Liam Sanders-- took a fall from his bicycle.
意识清醒 神经系统检查 无局灶性体征 小腿裂伤 无骨性压痛
No LOC, nonfocal neuro, lower-leg lac with no bony tenderness.
你戴头盔了吗 利亚姆
Were you wearing a helmet, Liam?
没有 我只是在家门口骑骑
No, I was just riding in my neighborhood.
任何时候都应该戴头盔
You should always wear a helmet.
嘿 很高兴你能加入我们 - 嘿
Hey, nice of you to join us. - Hey.
朗登医生
Dr. Langdon!
朗登医生拍得
Sold to Dr. Langdon.
坎迪斯·奥格雷迪 82岁
Candace O'Grady, 82...
她儿子理查德送来医院的 顽固性呕吐
Brought in by her son Richard for intractable vomiting.
右侧几乎没有出血 - 看来翻转术起作用了
Hardly any hemorrhage on the right. - Looks like the flip worked.
心脏怎么样 - 里面充满血了
How's the heart, Whitaker? - Feels full of blood.
手术开始以来第一次 - 停止按压
First time since we started. - Hold compressions.
像一袋颤动的蠕虫
Quivering bag of worms.
恢复按压
Resume compressions.
心脏这样颤动 明显是室颤了
When the heart quivers like that, it's obvious V-fib.
好的 体内电极板准备好了吗
Okay, internal paddles ready.
充电到多少
Charge to...?
25焦耳 - 50焦耳
25 joules. - 50 joules.
50焦 一步到位
50 gets it right the first time.
充电完毕 - 你准备好就开始吧
Charged. - Okay, Whitaker, when you're ready.
清场
Clear.
这才是正常窦性心律的样子
That's what normal sinus looks like.
颈动脉搏动有力 - 准备生理盐水腹腔垫 送手术室
Strong carotid. - Saline lap pads and up to the OR.
一大早就这么惊心动魄
That's a hell of a way to start the day.
方法虽不常规 但结果是好的
Unconventional, but a decent outcome.
我们还是分开行动吧 这样能提升效率
Why don't we split up for efficiency?
住院医生找我们其中一个就行 不需要都在场
Residents present to either one of us but not both.
这事可以商量
We can certainly discuss that.
你当时感觉到虚弱或是头晕吗 - 没有
Were you feeling weak or dizzy? - No.
我起来撒尿
I-I got up to pee,
在黑暗中被脏衣篮绊倒了
and I tripped over a laundry basket that I couldn't see in the dark.
你撞到头了吗
Did you hit your head?
病历上说我撞到头了
Does my chart say that I hit my head?
没有 我们只是想细致些 确保没有遗漏
No, we just want to be thorough to make sure you don't miss anything.
能先专注于处理伤口吗
How about we focus on patching me up?
好的 威廉先生 我们会给你的手腕拍个X光片
All right, Mr. Williams, we're going to check an X-ray of your wrist
然后尽快安排你出院
and try to get you out of here as quickly as possible.
好极了
Great.
尽量把那些乱七八糟的额外收费 控制到最低 好吗
And let's keep the bullshit extra charges to a minimum, huh?
我的自付额已经够坑了
My deductible is already a bitch.
没问题
Sure.
（我一有空就打给你）
（我只能做到这一步了）
（是的）
（好）
再见
Bye.
我妈妈要毁了我的人生
My mother is trying to destroy my life.
是啊 而且她们似乎乐在其中
Yeah, they seem to take pleasure in that.
为了离她近一点 更好地照顾她
I committed to a partnership-track position
我还答应了明年回新泽西一家医院 担任合伙人职位
next year at a hospital back in Jersey so I could be close and support her.
但现在她居然要结婚了 还要卖♥♥掉我们的房♥子
But now she's getting married and selling our house
去搞什么为期一年的环球邮轮之旅
to go on a year-long cruise around the world.
哇 我是说 这也太…
Wow. I mean, that's a--
要我说 这主意简直蠢透了
Pretty fucking stupid idea, if you ask me.
她和那男人认识还不到一年
She's known this guy less than a year.
万一他是个骗子呢
What if he's a player?
万一她在大海上消失了呢
What if she disappears at sea?
万一他们真的相爱了呢
I mean, what if they're in love?
是欲望还差不多
Lust is more like it.
那样更好
That is even better.
天啊 我好久没做♥爱♥了
Man, it has been a while,
这周末又是孤身一人
and I'm solo this weekend.
我得发泄一下
I need to get laid.
没到8点就聊这个话题 有点早了 是吧
It's a little much before 8:00 a.m., right?
是啊
Yeah.
以后也免了吧
Or ever.
还好吗 埃斯梅 - 又是天堂里的一天
How's it going, Esme? - Oh, just another day in paradise.
听说你要去旅行了
Heard you're going on a trip.
我要休假了 今晚就走
Taking a sabbatical. Leave tonight.
你要去哪
Where you going?
野牛跳崖处
Um, Head-Smashed-In Buffalo Jump.
麦片船长飞松鼠袜
Captain Crunch flying squirrel socks.
我们在对什么暗语吗 还是你中风了
What, are we talking in code, or are you having a stroke?
那是艾伯塔省的一处 原住民♥联♥♥合♥国♥教科文组织文化遗产
It's an Aboriginal UNESCO Heritage Site in Alberta.
我还没去过恶地呢
I've never seen the Badlands.
这是什么心灵探索之旅吗
What is this, like, uh, some sort of spirit quest?
是啊 差不多
Uh, yeah, something like that.
听着 我觉得我们应该谈谈
Look, I, uh-- I guess we should talk.
我有很多事要… - 以后再说吧 现在不行
Got a lot of things I need to-- - At some point, not right now.
现在 我要去趟卫生间
Right now I got to hit the head,
你去分诊处帮唐尼吧
and I would like you to go help Donnie out in Triage.
分诊
Triage?
不 我已经接手了一个北区2号♥的病人 自行车摔伤 腿部…
N-no. No, I already picked up a patient in North 2, a bicycle fall leg lac, so maybe--
我确信没你也行 我们已经这样做了几个月
Pretty sure we can cover for you. We've been doing it for months.
好吧
Right.