匹兹堡医护前线（2025）

谢谢 - 不客气
Thank you. - Yeah.
帕梅拉·佩里 48岁
Pamela Perry, 48, abdominal pain
在食用辣酱墨西哥玉米饼配煎蛋后 出现腹痛呕吐
with vomiting after eating chilaquiles with fried eggs.
高压108 低压6♥4♥ 脉搏98
BP 108 over 6♥4♥, pulse 98,
血氧饱和度良好 - 好的
good sats. - Okay,
给她用点枢复宁 快速补一升液 看是否有好转
let's see how she feels with some Zofran and a liter wide open.
明白 - 喂 维塔克
Got it. - Yo, Whitaker.
你感觉如何 佩里女士
How are you feeling? OK?
不太好
Not so good.
这一位是什么情况
Who do we have here?
吉恩·桑巴 54岁 左侧胸痛持续半小时
Jean Samba-- 54, half an hour of left-sided chest pain.
有高血压病史 在服用赖诺普利和瑞舒伐他汀
History of hypertension, on lisinopril and Crestor.
服用两剂硝酸甘油后有所缓解
Some relief with two nitro.
生命体征良好 心电图未见 ST段抬高型心肌梗死
Decent vitals, no STEMI on 12-lead.
给他服了324毫克阿司匹林咀嚼片
Gave him 324 of chewable aspirin.
好的 我们会给你做个全面评估 先生
Okay, we're going to give you a full evaluation, sir.
如果我要死了 蒙主保佑 我将看到主的珍珠大门
Oh, if I am to die, God willing, I will see His pearly gates.
有什么想法 - 再做一次心电图
What's the plan? - Repeat 12-lead,
查肌钙蛋白 按新发心绞痛入院
check a troponin, admit for new onset angina.
排查肺栓塞 主动脉夹层 - 这还用说
Evaluate for PE, aortic dissection. - That goes without saying.
就这么办吧 我随后就到
Sounds good. I'm a minute behind you.
(匹兹堡救护车)
这一位是什么情况 - 文斯·科尔 23岁
And who do we have here? - Vince Cole, 23,
砸穿了花店的天窗
fell through the skylight of a florist shop,
从三米高的地方掉进一片蕨丛中
10 feet down to a bunch of ferns.
主诉头痛 反复提问相同问题
Complained of headache, asking repetitive questions,
仅对疼痛有反应 - 多处玻璃割伤
and only responds to pain. - Multiple lacs from the glass.
高压118 低压72 脉搏98
BP 118 over 72, pulse 98,
5升氧流量下血氧饱和度99
sats 99 on 5 liters.
没有服用药物 没有过敏史
No meds, no allergies.
嘿 文斯 你怎么会从天窗摔下来
Hey, Vince, how'd you fall through a skylight?
文斯
Vince?
你当时跟他在一起吗
Were you with him?
是的 我们在跑酷 他做金刚跳时冲太猛了
Yeah, we were parkouring, and he overshot a kong vault.
从楼上往下跳的那种吗 现在还流行呢
What, like, jumping off of buildings? - People still do that?
这项运动差点成了奥♥运♥项目
It was almost an Olympic sport.
现在我们知道为什么没成了
Now we know why it isn't.
瞳孔等大且有反应 - 病人什么情况
Pupils are equal and reactive. - What do you got?
从三米高处落下 意识改变 - 那挺高的了
A 10-foot fall, altered. - That's a long way down.
三米是启动创伤中心的门槛
10 feet is the threshold for trauma center activation--
三米 10%的死亡率
10 feet, 10% mortality.
是0% 超过0%都需要警惕
0%, anything over 0% is a concern.
有人讨人嫌了 但不是我
Somebody's annoying, and it's not me.
嘿 你说有两个 少了一个
Hey, you said two. You missed one.
我不是派人支援你了吗
Sent you backup, didn't I?
一 二 三
One, two, three.
好的 谢谢各位 很高兴与你们共事
Okay. Thanks, guys. Good to see you.
把床旁超声拿来
Get the EFAST.
奥吉尔维 乔伊 格拉斯哥昏迷评分
Ogilvie, Joy, GCS, please.
请睁开眼睛 先生
Uh, open your eyes, sir.
睁眼项2分 言语项2分
Two for eyes, two for verbal.
双侧肺滑动良好 - 乔伊 完成格拉斯哥昏迷评分
Uh, good lung sliding bilaterally. - Joy, finish GCS.
握紧我的手
Squeeze my hand.
运动项4分
He gets a 4 for motor.
血氧饱和度99 心率102 高压1♥1♥4♥ 低压78
Pulse ox 99, heart rate 102, blood pressure 1♥1♥4♥ over 78.
床旁超声阴性 - 这是个好消息
And EFAST is negative. - Music to my ears.
有人在拍纪录片吗
Somebody shooting a documentary here?
这里禁止拍摄
Whoa, whoa, whoa, you can't film in here.
我们要保护病人隐私 你的手怎么了
We've got patient-privacy laws. What happened to your hand?
割伤了
Cut it.
谁能带这位大导演去候诊室
Can somebody show Spielberg here out to the waiting room
到分诊那儿登个记吗
and get her registered at triage, please?
他是我的创意搭档
He's my creative partner--
我有他的书面授权 可以为我们的抖音账号♥拍下全部过程
I have his written consent to film everything for our TikTok page.
把相机放下
Put the camera down.
我们要在国♥庆♥日发布这条视频
We have to drop this video for the Fourth tonight.
我完全不关心
That literally means nothing to me.
说真的 肖恩 你能带她出去吗
Seriously, Sean, can you escort her out, please?
他一旦情况稳定 会有人通知你的 谢谢
Somebody will come and find you once he's stabilized. Thank you.
如果她态度好点 我可能真会让她留下来
I would have let her stay if she'd asked nicely.
外科那边情况如何
What is the, uh, story with surgery?
你们收到西桥纪念医院 转来的患者了吗
You guys getting any Westbridge transfers yet?
还没有 但该来的总会来
Not yet, but I'm sure it's coming.
全身扫描 从头到骨盆 尽快送他去检查
Pan scan, head through pelvis. Let's get him to CT ASAP.
无咽反射 做CT前得先插管
Absent gag. We need to intubate before CT.
能让我做吗
C-can I do it?
我在写操作日志
Uh, I'm keeping a procedure log,
这次轮岗我还需要多做几次插管
and I need more intubations on this rotation.
如果麦凯医生想教你的话
If Dr. McKay wants to teach?
当然
Sure.
好的 我需要吸引器
Okay, uh, I need suction.
8号♥管 依托咪酯加琥珀胆碱 监测呼气末二氧化碳
8-oh tube, etomidate and sux, end tidal CO2.
很有野心
Ambitious.
他让我想起一个我很熟悉的人
He reminds me of someone I know very well.
你能保持点距离吗
Can you not?
好的 抱歉 - 新鲜出炉的
Yeah, sorry. - Hot off the press.
好的
Okay.
没有ST段抬高型心肌梗死 暂不需要送去心脏导管室
No STEMI, doesn't need to go right to the cath lab.
单子下好了
And orders are in.
维塔克 再用一次硝酸甘油 肌钙蛋白结果出来告诉我
Whitaker, try another nitro and let me know when the troponin's back.
好的 嘿 杰西
Yeah. Hey, hey, Jesse?
你可以重做一次吗 这次把胸前电极贴到后背
Do you think you could repeat this but with the chest leads on his back?
为什么
Why?
T波偏高 前壁ST段压低
T Waves are kind of high with ST depression anterior.
前壁ST段压低的情况很常见
We see ST depression all the time.
对 但这可能是后壁心梗
Yeah, but it could be a posterior MI.
好吧 去请示一下主治医生 如果他们同意 我们就做
All right, run it by the attending. If they agree, we'll do it.
谢谢
Thank you.
维多利亚 如果他的CT正常 就需要做腰椎穿刺
Uh, Victoria, if his CT's normal, he'll need an LP.
好的
Got it.
阿尔-哈希米医生
Dr. Al-Hashimi.
这是洁达·戴维斯 杰克的妹妹
This is Jada Davis, Jackson's sister.
谢谢 你好
Oh, thank you. Hi.
他没事吧 他为什么睡着了
Is he okay? And why is he asleep?
他刚来时不配合 我们给他用了镇定剂
Well, he was uncooperative when he first arrived and needed to be sedated.
“不配合”
"Uncooperative"?
这没道理啊 发生什么事了
That doesn't make any sense. What happened?
我们还在尝试搞清楚来龙去脉
We're still trying to piece the story together.
他是被一名学校保安送来的
He was brought in by a campus security guard
保安电击了他 据说他此前... - “电击他”
who Tased him after he was allegedly... - "Tased him"?
...有攻击和暴♥力♥行为 - 什么意思
Combative and violent. - Wait, what do you mean, Tased him?
我们给他处理了伤口
We've treated his injury,
现在我们正设法弄清 他如此躁动的原因
and now we're trying to understand why he was so agitated.
好吧 这完全不像我哥哥的作风
Okay, this doesn't sound like my brother.
他的毒理结果是阴性
Well, his drug screen came back negative,
我们要带杰克逊去做个脑部CT
so now we're taking Jackson to get a CT scan of his brain
看是否有异常
to look for any abnormalities.
我能一起去吗
Can I go with him?
你不能进CT室 但你可以等他回来
You can't go into the CT, but you can wait for him to come back.
然后我们可以讨论接下来的步骤
And then we can discuss next steps.
好的
Okay.
我刚做了我人生中第一次急诊插管
Just did my first ER intubation.
恭喜你啊 伙计 - 真是个混♥蛋♥
That's great, man. - Such a prick.
有时间吗 - 什么事
You got a second? - What's up?
我的一个胸痛病人 12导联心电图没有显示心梗
12-lead on my chest-pain patient shows no STEMI,
但胸前导联的图形提示 可能是后壁心梗
but the anterior leads might be suspicious for a posterior MI?
同意 - 我打算重做一次
Uh... agreed. - Yeah, I was going to repeat,
但要把胸前电极贴到后背
but with the chest leads on the back.
加做V7到V9 好主意 - 谢谢
V7 through V9. Good idea. - Thank you.
嘿 罗比医生同意做后背导联了
Hey, Dr. Robby gave the go-ahead for the back leads.
抱歉 伙计 我刚接到电♥话♥ 说有个脓毒症患者要送往重症监护室