匹兹堡医护前线（2025）

尿常规 血酒精浓度和毒理筛查 - 全做
UA, blood alcohol, and tox screen. - All of the above.
队长 如果这个年轻人情况稳定了 能尽快把他送去中♥央♥区10号♥病房♥吗
Cap, if this young man's stable, can he go to Central 10 pronto?
后门来了两个外伤病人 - 好的
Double trauma at the back door. - Okay,
你们听到老大说的了 加快速度
you heard the boss. Let's get going.
今天要开始忙碌起来了
Today is starting to heat up.
马克·易 32岁 系安全带的司机 汽车和摩托车相撞
Mark Yee, 32-year-old restrained driver, auto versus motorcycle.
意识改变 血压正常 吸氧每分钟2升情况下血氧饱和度99
Altered with normal BP, satting 99 on 2 liters.
我们现在到医院了 马克
We're at the hospital now, Mark.
他怎么了 他怎么不说话
What's wrong with him? Why isn't he talking?
这位是他妻子南希 坐在副驾 拒绝治疗
His wife, Nancy, front-seat passenger, declined transport.
我没事 我们的车速没那么快
I'm fine. We weren't going all that fast.
是摩托车闯了红灯
The motorcycle ran the light.
我是罗比医生 这是哈希米医生 - 很高兴认识你
I'm Dr. Robby. This is Dr. Al-Hashimi. - Nice to meet you.
这是护士达娜 她是我们的护士长
And this is Nurse Dana. She's our charge nurse.
我们要给你丈夫做检查
We need to look over your husband.
你好 我们暂时让开一下吧 亲爱的 让医生们做他们的工作 好吗
Hello. Let's step over here for a minute, hon. Let them get to work, okay?
安东尼 拉瑞 轮床推过来 创伤一室马上就空出来了
Antoine, Larry, transfer out here. T-1 will be open in a sec.
遵命 船长
Aye, aye, Cap.
一 二 三
One, two, three.
有病人来了
Incoming.
好的 乔伊 你跟着我
Okay, Joy, you stay with me.
萨米拉 你跟着阿尔-哈希米医生
Samira, you stay with Dr. Al-Hashimi.
开放性颅骨骨折 因濒死呼吸已进行气管插管
Open skull fracture. Tubed him for agonal respirations.
初始触诊血压60
BP 60 palp initially.
已开始一升生理盐水输液 但在途中脉搏消失
Started a liter of NS, but lost his pulse en route.
天哪 这看上去不太妙
Oh, boy, this doesn't look good.
一 二 三
One, two, three.
乔伊 检查他的瞳孔 谁递我一把剪刀
Joy, check his pupils. Somebody hand me a pair of scissors.
8毫米 无收缩反应
8 millimeters. Nonreactive.
即瞳孔散大 固定并扩张
AKA blown pupils, fixed and dilated.
颅骨粉碎性骨折伴大量脑组织外溢
Crushed skull with tons of gray matter extravasation.
至少他走得很快
At least it was quick.
没戴头盔吗
No helmet?
没有 因为他上过宾州交通部的 摩托车安全课程
Nope, 'cause he took the PennDOT Motorcycle Safety Course.
你不是也上过那个课吗 罗比 - 停止按压
Isn't that what you took, Robby?
是 但我仍然会戴头盔
Hold compressions. Yes, but I still wear a helmet.
他是器官捐赠者吗 - 不是
Is he a donor? - Also nope.
这太糟了 心搏停止
That is too bad. Asystole.
我想我们已经无能为力了 - 隔壁是什么病人
I think we are done here. - What's next door?
撞他的人 乔伊 你跟着我
The guy who hit him. Joy, you're with me.
不是要默哀吗 我以为…
What about a moment of reflection? I thought--
等我们回来他也一样是死的
He'll still be dead when we get back.
血氧饱和度99 高压108 低压72 - 床旁超声阴性
Pulse ox 99. BP 108 over 72. - EFAST negative.
比隔壁那家伙好多了
Hell of a lot better than the guy next door.
气道如何 - 通气量充足 血氧饱和度良好
How's the airway? - Good volume. Good sats. Gag reflex...
咽反射…
Present.
存在 - 要插管吗
Intubate? - Maybe.
或许要 或许不要 - 易先生
Maybe not. - Mr. Yee?
乔伊 像这样用指关节刮他的胸骨 请一定要用力
Joy, sternal rub on his chest, like this. Really hard, please.
易先生
Mr. Yee?
自发眼球运动 对疼痛刺♥激♥有反应
Spontaneous eye movement. Responds to pain.
格拉斯哥昏迷评分10分 处于插管的临界值
GCS is 10. Borderline for intubation.
没有肌张力 左臂弛缓性瘫痪
No muscle tone--flaccid paralysis in the left arm.
右臂也是 - 双腿也是
Same on the right. - And both legs.
在颈托两侧加垫毛巾 提高稳定性
Add towels to both sides of the collar for more stability.
不要让情况变得更糟
Let's not make this worse.
做全身CT平扫 对脊柱进行三维重建
Pan scan with 3D reconstruction of the spine.
他四肢瘫痪了 - 如果是这样 那是颈髓下段损伤
He's quadriplegic? - If so, it's a low cervical injury.
为什么 乔伊
Why is that, Joy?
第3 4 5节颈椎帮助你呼吸 让你活下去
C3, 4, and 5 helps you breathe to stay alive.
蒙特罗斯先生 你不能就这样随意走动 和病人交谈
Mr. Montrose... you can't just be wandering around, talking to patients.
那就是我的工作
Well, that's-- that's what I do.
我是沃尔玛的迎宾员
I'm a greeter at Walmart.
他们雇我就是为了让我四处走动 和人们交谈
I get paid to wander and to talk to folks.
那就当是帮我个人的忙
Well, as a-- as a personal favor to me,
你能至少待在你病房♥附近的区域吗
can you at least stay in your general vicinity?
我们等X光片的这段期间 我可以给你找个轮椅
I can get you a wheelchair while we wait for your X-rays,
但可能需要一点时间
but it might take a minute.
亲爱的 我不能坐下
My dear, I cannot sit.
我摔到屁♥股♥了 疼得要命
My backside is killing me from where I fell on it,
向你这样一位优雅的女士承认这件事 实在是尴尬
which is an embarrassing admission to make to such a lovely woman.
谢谢你的夸奖 但你没必要尴尬
Well, thank you for the compliment, but there's no need to be embarrassed.
你那一跤摔得可不轻
You took a very nasty fall.
那恕我直言
Well, then may I say
凝视着你美丽的眼睛 我好像又要再次摔倒了
that one look in your beautiful eyes and I think I'm falling again.
你可真是个妙人
What a charmer.
冲你这句话 我要去给你拿个甜甜圈坐垫
Just for that, I'm gonna get you a foam donut.
这是世界第八大奇迹
It's the eighth wonder of the world.
你的笑声真动听 医生
Pretty great laugh you got there, Doc.
天啊 我那女巫般的咯咯笑吗
Oh, God. My witch's cackle?
威廉先生的CT结果出来了
Got CT results for Mr. Williams.
哇
Oh, wow.
好吧
Okay.
时间刚好
Right on time.
马上就满了
Just--just getting full.
是的 我准备好灌第五瓶了
Yeah, I'm ready for number five.
太惊人了
That's impressive.
是啊 还有呢
Yeah, there's more where that came from.
不过我的库存快见底了
Although, uh, my intake is running low.
再来两瓶应该就够了
Yeah, well, two more bottles ought to do it.
然后把你那颗牙引流了
Then we'll drain your tooth,
赶在今晚放烟花前让你出院
and we'll get you out of here before the fireworks tonight.
好的 夹住了 奥吉尔维 换个瓶子
Okay. Clamped. Ogilvie, make the change.
好的
Okay.
好了 开始吧
All right. Let her rip.
像小河一样流淌
Flowing like a river.
我喜欢看烟花
I love me some fireworks.
是吗
Oh, yeah?
我在现场见过赞贝利先生…
Shit, I-I met Mr. Zambelli...
身体前倾
Lean forward.
…很多次
Many times on the field.
赞贝利是谁
Who's Mr. Zambelli?
孩子 如果你没听过赞贝利的名字 那就不能说你懂烟花
Son, you don't know fireworks if you don't know the name Zambelli.
他帮匹兹堡成了美国的烟花之都
He helped Pittsburgh become the firework capital of America.
这你总该知道吧 - 不知道
You did know that, didn't you? - No.
你们对焰火工艺简直一无所知啊
Y'all don't know nothing about pyrotechnics.
好好干医生的老本行吧
Stick to doctoring.
我们会的
Yes, will do.
我相信你一定有很多问题
I'm sure you have some questions.
我知道这个消息一时难以接受
I know it's a lot to take in.
是肿瘤
It's a tumor.
脑瘤 - 是个肿块
It's a brain tumor. - Well, it's a mass,
大概4公分 位于额叶
about 4 centimeters, in the frontal lobe.
是癌症吗
Is it cancer?
我们现在还不能确定
We can't say for sure right now.
有很多种可能性
It could be many things--
感染 发炎
uh, infection, inflammation,
良性囊肿
a benign cyst.
我是因为这东西摔倒的吗
Is it what made me fall?
是的 有可能
Yeah, possibly.
我们建议你留院 使用地♥塞♥米♥松♥治疗
We'd like to keep you here and treat with dexamethasone,
这是一种能消肿的类固醇药
which is a steroid to take down the swelling.
然后需要做个脑组织活检 确定那到底是什么
And then we'll need a brain biopsy to know exactly what it is.
什么 你们要切开我的脑袋
What, you're--you're gonna cut open my head?
只是钻个小洞
It's just a small hole.
我们将做一次CT引导的 立体定向穿刺活检
We'll do a-a CT-guided stereotactical biopsy
用一根钝头的细针取出脑组织
with a-a blunt, thin needle...
虽然听着吓人 但实际上非常精准
Which sounds crazy, but it's actually pretty amazing.
大部分病人第二天就能回家
I mean, most patients go home the next day.
我不知道
I don't know.