匹兹堡医护前线（2025）

从而引起严重脱水 心脏和肾功能障碍
leading to severe dehydration, cardiac and renal dysfunction.
胰岛素滴注 含钾补液 每小时测一次指尖血糖
Insulin drip, fluids with KCL, capillary glucose every hour,
每四小时查一次生化七项
chem-7 every four hours.
重症监护室那边 会要求放一根双腔中线导管
ICU is gonna want a double lumen midline, too.
我可以 - 我可以
I can do it.
6号♥半手套 - 7号♥半手套
6 1 2 gloves. - 7 1 2 gloves.
我想说一下 我们评价学生 不仅基于他们的知识储备
Can I just say, we evaluate our students not only on their fund of knowledge
和操作技能
and on their procedural mastery,
但更重要的是 我们会考察他们的团队协作能力
but, also, maybe more importantly, on their skills as team players?
他可以 - 她可以
He can do it. - She--she can do it.
奥特罗 你能给大家介绍一下情况吗
Otero, will you update everyone?
巴瑞·米歇尔 在帕梅拉餐厅吃早饭
Barry Mitchell. Eating breakfast at Pamela's.
突发呼吸窘迫
Sudden onset respiratory distress.
有喘鸣音 血氧饱和度尚可 但说话困难
Some stridor. Decent pulse ox but trouble speaking.
他们试过海姆立克急救法吗 - 三次
And they tried the Heimlich? - Three times.
有哮喘病史吗
Any history of asthma?
准备插管 - 同意
Set up for intubation. - Agreed.
好的 先生 请挪过来
Okay, sir, scoot across.
他们能自己挪到床上 就是个好兆头
Always a good sign when they slide over on their own.
他从餐厅来的 上气道梗阻
Came from a diner with an upper-airway obstruction.
海姆立克法没起效 我们得检查下
Didn't clear with abdominal thrusts. We got to take a look.
心率118 血氧饱和度96
Heart rate's 118. Pulse ox 96.
米歇尔先生 我们要给你镇静 然后看一下你喉咙里面 好吗
Mr. Mitchell, we're gonna sedate you to look down your throat, okay?
抽取氯♥胺♥酮♥和罗库溴铵
Draw up ketamine and rocuronium.
只用氯♥胺♥酮♥怎么样
What about ketamine only?
不行 我们需要肌肉完全松弛 来确保首次插管成功
No, we need full paralysis for a successful first-pass intubation.
如果只是个异物 可能根本不用插管
Might not need an intubation if it's just a foreign body.
我们不能做这个假设
We can't assume that.
有可能是声门下狭窄 或者会厌炎
It could be subglottic stenosis, epiglottitis.
氯♥胺♥酮♥和罗库溴铵都准备好了
I got ketamine and roc.
只用氯♥胺♥酮♥ 80毫克
Ketamine only, 80 milligrams.
既然如此 就交给你这位大能人全权处理了
In that case, I'll leave this in your capable hands.
西他卡因喷雾和杨克氏吸痰管 谢谢
Cetacaine spray and a Yankauer, please.
半小时前 我告诉过你我从没被投诉过
30 minutes ago, I told you I'd never been sued.
我希望能继续保持下去
I'd like to keep it that way.
八小时屹立不倒
Instead of showing up here,
还以为他会好好利用一下 没想到跑这儿来了
you'd think he'd put an eight-hour hard-on to good use.
这确实是医疗紧急情况
Well, it is a medical emergency.
如果放任不管 异常勃起可能会导致
If left untreated, priapism can cause
永久性阴♥茎♥损伤和终生勃起功能障碍
permanent damage to the penis and erectile dysfunction forever.
感谢你插播的公益广♥告♥
Thanks for the PSA.
药剂师配好了去氧肾上腺素 每毫升100微克 共10毫升
Pharmacist mixed up phenylephrine. 10 cc's of 100 mikes per cc.
好极了 这是最大剂量
Great. That's the maximum dose.
单剂量无菌生理盐水
Sterile bolus saline.
你可能需要多备点 因为她们会反复冲洗
You might need to refill since they'll be flushing over and over again.
拿一个空盆 接住他吐出来的任何东西
Hold out the empty basin to catch whatever they pull out.
听明白了吗 - 我想是的
Got it? - I think so.
如果有需要就喊我
Holler if you need me.
这边情况如何 - 他注射了咪♥达♥唑♥仑♥ 已经没意识了
How we doing? - Oh, he's out from Versed.
在10点和2点钟方向 给阴♥茎♥背神经做了利多卡因阻滞
Did a lidocaine block to the dorsal penile nerves at 10 and 2.
是的 他准备好了 - 很好
Yeah, he's ready. - Excellent.
从背面进针 刺入海绵体
Enter the dorsal side to hit the corpus cavernosum.
我来固定龟♥头♥
I'll hold the glans.
扎多深 - 两公分
How deep? - 2 centimeters.
可以抽了
Ah, now aspirate.
你们每天都干这种事吗
You guys do this, like, every day?
如果走运的话
If we're lucky.
好了 我们让他平躺 看一下到底是什么东西
Okay, let's lay him down and take a look.
好的
Okay.
会厌视野清晰
Good view of the epiglottis.
谜团解开了
And mystery solved.
这就是早饭吃西兰花的后果
This is what you get for eating broccoli for breakfast.
把它夹出来
Get a good grip on it.
好的
Okay.
好的
Okay.
我知道为什么海姆立克法没用了
I can see why the Heimlich didn't work.
转一转
Rotate a little bit.
成功
Voilà!
这就是为何仅用氯♥胺♥酮♥即可
That is why you give ketamine alone,
因为如果用了肌肉松弛药
because if we gave a paralytic,
就必须给他插管 并且上一小时的呼吸机
we would have to intubate and ventilate for an hour.
好了 这位病人要转院至西桥做手术
All right, this guy is going to Westbridge for surgery.
创伤一室很快就空出来了
Trauma 1 will move out shortly.
阿尔茨海默症遗孀艾芙琳·博斯蒂克 可以去观察室看她丈夫了
And our Alzheimer's widow, Evelyn Bostick, can see her husband in the viewing room.
上帝保佑她
God bless her.
迈克尔·威廉的CT结果出来了吗
My CT results back on Michael Williams?
还没 凯莉的化验结果也没有
Not yet--neither are the labs on our little girl, Kylie.
那不是我的病人
That's not me.
不过被遗弃的无名氏宝宝 倒是出了一些结果
I did, however, get a few things back on our abandoned baby Jane Doe.
这也不是我的病人
Still not me.
给我吧
I'll take those.
一有消息我们会通知你
Just keeping you informed.
好的
Yep.
好吧
Okay.
我们只是想把她转移到楼上
We're just trying to get her upstairs.
好吧 知道了
Okay. All right, got it.
超级宝宝的尿检结果出来了 白细胞阴性
Superbaby's urine dipped negative 0 WBCs.
呼吸道病原体♥检♥测显示鼻病毒阳性
Respiratory panel is positive for rhinovirus,
说明是良性诱因 降钙素原和C反应蛋白结果还没出来
giving us a benign source. Procalcitonin and CRP are pending.
儿科说他们需要先做尿液毒物筛查
Now peds is saying they want a urine tox screen
和HIV抗原检测 才愿意接收她
and an HIV antigen before they'll take her.
有点多余了吧
That sounds excessive.
我感觉他们只是想把她留在急诊
I feel like they're just trying to keep her down here.
这能怪他们吗
Can you blame them?
我就没见过正常的儿科护士
Never met a peds nurse yet that wasn't a little wacky.
你知道连续12小时听婴儿哭 会对一个人造成多大精神伤害吗
You know what 12 hours of crying babies does to a person's psyche?
我差点去了儿科 - 万幸你没有 相信我
I almost went into peds. - Good thing you didn't, trust me.
在那儿待久了 你都能得失心疯
Too long up there, you're cuckoo for Cocoa Puffs.
你今天很犀利啊
You are very punchy today.
犀利是我的新基线
Punchy's my new baseline.
谁敢不怀好意地看我 我就把他揍趴下
Anyone even looks at me funny, I'm taking them out,
直插双眼
going right for the eyes.
我会戳瞎你眼睛
I'll eye-gouge you.
你肯定不知道我有这一面吧 - 不知道
Bet you never knew that about me. - I did not.
阿尔-哈希米医生哪去了
Where is Dr. Al-Hashimi?
去北区5号♥看异常勃起的患者了 - 她比我合适
In North 5 with the priapism. - Ha! Better her than me.
我没有任何性暗示的意思
I did not intend for that to come off as sexual in any way.
好了 我要去看看路易
And on that note, I'm gonna go check on Louie,
然后去救护车停靠区透透气
and then I'm gonna get some air in the ambulance bay.
所以有人需要我 去那儿找我
So if anybody needs me, that's where I'll be.
明白 船长
Got it, Cap.
看起来侧切牙根部有脓肿
It looks like some pus at the base of the lateral incisor.
我们可以切开 把脓引出来
We can drain that for you.
感觉挺疼的 - 不会 我们给你上麻药
Sounds like it's gonna hurt. - No, we'll numb you up.
要用好麻药
Make sure you-- you use the good stuff.
我会给你用最好的 路易 我保证
It'll be top shelf, Louie, I promise.
这边怎么样
How we doing in here?
挺好的 快引出来四升了
Good. Almost 4 liters out.
我已经感觉好多了
I already feel like a million bucks.
我只是需要换个机油
I just needed an oil change.
我马上就要切开引流一个根尖脓肿了
And I'm just about to drain an apical abscess.
这就对了嘛
That's what I'm talking about.
我感觉像在做水疗
I feel like I'm having a spa day.
继续加油 维塔克
Keep it up, Whitaker.
这要多久
How long does this take?
一小时 有时要两小时
Up to an hour, sometimes two.
梅尔 有什么建议吗
Mel, any suggestions?
（评估你的疼痛等级）
梅尔 你在退伍军人医疗中心 做过这些
Mel, you did these at the VA.
我们要如何让勃起消退
How can we facilitate detumescence?
有时按♥摩♥阴♥茎♥体可能会有帮助