匹兹堡医护前线（2025）

匹兹堡医魂
第二季第二集

阿尔医生
Dr. Al?
阿尔医生
Dr. Al.
后门有外伤病人
Trauma's at the back door.
等她其余的化验结果出来了通知我
Let me know when the rest of her labs are back.
那个女友并没有多大帮助
The girlfriend hasn't been much help.
她不配合吗 - 不是的
Is she being uncooperative? - No, not really.
显然 她跟那个小女孩凯莉的父亲
Apparently, she's only been going out
只约会了几个月
with the little girl Kylie's father for a few months.
（早上8点）
他现在在哪 - 他在纽卡斯尔出差
Where is he now? - He's in New Castle for work.
我给他留言了 让他来医院
I left him a message to come in.
好吧 等他到了来找我
Okay, come find me when he gets here.
你这周跟心理创伤咨♥询♥师聊过了吗
You talk to the trauma counselor this week?
我正打算去
I'm going to.
我保证 - 很好
Promise. - Okay, good.
救护车刚到 - 我马上过去
Medics are rolling in. - I'll be right there.
从楼梯摔下来的小女孩怎么样了
How's our little girl who took a stair tumble?
我要给她做个超声 看是否有内出血
I'm going to check for internal hemorrhage
你的直觉呢
with an ultrasound.
她的直觉 - 对
What is your gut telling you? - Her gut?
这是人工智能永远不会有的东西
Yeah, it's this thing that AI will never have.
我现在不想去思考我的直觉
I don't want to think about what my gut is saying right now.
有后续情况记得来找我 - 找我们 如果你不介意的话
Come find me when you know more. - Us, if you don't mind.
我不介意 有后续情况来找我们
I don't mind. Us--come find us when you know more.
这台外科手术你要上吗 - 我实在抽不开身
Do you want to jump on this trauma? - I've got my hands full.
我必须查清楚这件事
I don't want this one getting away from me.
我们还没了解全貌呢 别急着下结论
We don't know what this is yet. Don't go jumping to conclusions.
我没有下任何结论 我只是为了我的病人着想
I'm not jumping to anything. I'm just looking out for my patient.
关于桑托斯 有什么我该知道的吗
Uh, something I should know about Santos?
非常自信 不害怕趟浑水
Very confident, not afraid to get her hands dirty,
坚定维护患者的权益 无所畏惧
strong patient advocate, fearless.
你刚才好像在暗示她妄下结论
Seems like you were suggesting she jumps to conclusions.
不 我只是建议或者说提醒她 别那么做 什么事
No, no, no, no. I was merely suggesting or reminding her not to. Yeah.
58岁男性 跌倒致舟骨骨折
Uh, 58-year-old guy. Tripped with a scaphoid fracture.
鼻出血 神经系统检查 无局灶性体征
Epistaxis, non-focal neuro,
但否认有撞到头部
but denies head trauma.
但每次我给他检查 他的情绪状态都在恶化
But every time I check on him, his affect has drastically changed.
我的直觉告诉我有哪里不对劲
My gut is telling me something's not right.
怎么了 - 没什么
What? - Nothing.
你有什么计划
Your play.
先做个头部CT 如果正常的话 再做腰椎穿刺 排除脑炎
Start with a head CT. If normal, LP, rule out encephalitis.
就这么办吧
Put in your orders.
他以前来过吗 - 没有
Has he been here before? - No.
你联♥系♥过家属
Have you called the family to rule out
排除心理疾病史了吗 - 没有 但我会的
any psychiatric history? - No, but I will.
与此同时 你要参与这个外伤病例吗
Do you want to jump on this trauma in the meantime?
是什么情况 - 是个惊喜
What is it? - It's a surprise.
好极了
Wonderful.
梅尔 你要来吗 - 什么情况
Mel, you want to jump on this? - What is it?
是个惊喜
It's a surprise.
给我们介绍一下情况 安博伊
What do you got for us, Amboy?
艾伦·比林斯 一托盘屋顶瓦片 从两米高处坠落
Allen Billings-- Pallet of roofing tiles
击中其上臂 造成开放式脱位
fell eight feet, hit his upper arm with an open dislocation.
好痛
Ouch.
两轮芬太尼 第一轮每公斤1微克 第二轮每公斤0.5微克
Two rounds of fent, 1 then 0.5 per kilo.
意识清醒 定向良好 生命体征良好
A and O, with good vitals.
梅尔 扶稳他的胳膊 - 好的
Mel, hold the arm steady. - Sure.
比林斯先生 我是麦凯医生
Mr. Billings, I'm Dr. McKay.
我是外科的加西亚医生
And I'm Dr. Garcia from surgery.
这位是金医生 - 嗨
And this is Dr. King. - Hi.
真的好痛
Oh, it really hurts.
给我们一分钟 我们会处理你的伤口 好吗
Give us a minute. And we're gonna take care of that, okay?
有头痛 胸痛或腹痛吗 - 没有 只有胳膊
Any headache, chest or belly pain? - No, just the arm.
血氧饱和度99 脉搏104 高压116 低压78
Sats 99. Pulse 104. BP 116 78.
你怎么看 金医生
What do you think, Dr. King?
这是开放性脱位
Oh, um, it is an open dislocation.
能再具体一点吗
Can you be more specific?
我觉得是骨头向下脱出关节
I think it's inferior, yeah?
你记得专业术语叫什么吗
Do you remember the name for that?
听上去很像《哈利·波特》里的咒语
Sounds like a Harry Potter spell.
直举性脱位
Luxatio erecta.
正确 检查神经血管循环状况
Correct. Check the neuro-circ.
先生 你能感觉到我的触碰吗
Sir, can you feel me touching you?
好的 你可以动一下手指吗 - 可以
Okay. Can you wiggle your fingers? - Yeah.
桡动脉搏动良好 - 床旁超声检查阴性
Good radial pulse. - E-FAST is negative.
好的 接下来做什么 麦凯医生
Okay, what's next, Dr. McKay?
注射头孢唑林与庆大霉素 镇静后进行牵引和反牵引复位
Ancef and gentamicin. Sedate for traction, countertraction.
他需要做个CT血管造影 排除血管损伤
And he needs a CT angiogram to rule out vascular injury.
听上去很合理
That sounds like a plan.
但因为有关节开放性损伤 他需要去手术室由骨科医生灌洗清创
But with an open joint, he needs a washout in the OR with ortho.
同意 - 而不是在这里浪费时间
Agreed. - Instead of wasting time down here,
在全身麻醉下复位应该会更容易 风险也更低
it should be easier to reduce under general anesthesia with fewer risks.
有可能
Possibly.
我们问一下骨科的意见吧
Let's get an opinion from ortho.
一看你就是新来的 医生 想法太乐观了
You're definitely new, Doctor--wishful thinking.
骨科不喜欢管闲事
Ortho like to take their sweet time.
好了 给他镇静吧 麦凯医生
Okay, sedation orders, Dr. McKay.
100毫克丙泊酚 滴注至起效
100 of propofol. Titrate to effect.
我去备药
Be back with that.
让一下
Excuse me.
今天过得怎么样 医生
How's your day going, Doc?
挺好的
Yeah, pretty good.
看来你的白蛋白已经输上了
Looks like your albumin's infusing.
医学生奥吉尔维和乔伊
Oh, uh, medical students Ogilvie and Kwon
会来协助我 - 你好
are gonna be working with me. - Hello.
我们是实习医生 - 你想让他们试试吗
Student doctors. - You want them to try it?
他们早晚都得上手
They got to learn sometime.
他们第一次还是观摩比较好
Uh, it's best if they watch the first one.
我可以做术前消毒和铺单 - 好的
I can prep and drape. - Yeah.
在你的白蛋白输完之后 - 没错
After your albumin's in. - That's correct.
为预防低血压
Uh, to prevent hypotension,
如果我们预计失血量超过五升 会给予白蛋白
we introduce albumin if we anticipate more than five liters.
上一次是六升
Last time it was six.
那相当于是一加仑半
That's, like, a gallon and a half.
高标号♥优质汽油
Of high-octane premium.
好的 你还需要什么吗 路易先生
Okay, you need anything else, Mr. Louie?
不用了 女士 - 好的
No, ma'am. - Okay.
你准备好了叫我 - 好的
Grab me when you're ready? - Yeah.
维塔克 你今早那个放弃抢救的病人 家属在中♥央♥区8号♥
Whitaker, wife of your DNR this morning is in Central 8.
她知道她丈夫死了吗
Does she know her husband died?
等你告诉她就知道了
Not till you tell her.
我马上过去
I'll be right there.
好的 务必要先找到积液区 再确认进针点
Uh, yeah, uh, always make sure your entry point is safe
这样才能保证安全
by identifying the pocket of fluid.
这哪是积液区 这简直是个湖
That's not a pocket. That's a lake.
是的 但你不想进针时 扎到静脉或动脉
Yeah, but you do not want to hit a vein or artery
所以一定要用彩色多普勒确认下
on the way in, so make sure you check with color Doppler.
乔伊
Joy?
我看不到了 我什么都看不到
I can't see. I can't see anything.
因为你的眼睛是闭着的 - 我睁不开
That's 'cause your eye is shut. - I can't open it.
我贴假睫毛的时候被胶水粘住了
It's glued shut. I was trying to put on lashes.
我的天啊 我会瞎吗
Oh, my God. Am I gonna go blind?
不会 我相信我们能解决这个问题
No, no, I'm pretty sure this is something we can fix.
深吸一口气
Just take a deep breath.
好的
Okay,
你用什么把眼皮粘住了
so you, uh, glued your eye shut with what exactly?
超级胶水
Super glue.
好吧 你平时贴假睫毛 都是用这个胶水吗
Okay. Well, is it something you typically use to apply your lashes?
不是 这东西通常是用来
No, it's typically something you use