匹兹堡医护前线（2025）

按压两分钟 不行就上利多卡因加肾上腺素
Uh, pressure for two minutes. Lidocaine and epi if that doesn't work.
外科重症监护室入院医嘱下了吗 - 该死
Are the admit orders in for Surgical ICU? - Fuck!
怎么了 - 这个
What? - This.
生理盐水冲洗 - 只是个小伤口
Irrigation saline. - It's just a small cut.
这是工作相关的血液暴露
It is a work-related blood exposure,
这意味着你现在是病人了 - 你是认真的吗
which means you're a patient now. - Are you serious?
被针♥刺♥伤的吗 - 是一块玻璃
Needle stick? - Piece of glass.
给你 - 谢谢
Here you go. - Thanks.
没有这人的过往记录 我们不了解他是否有艾滋或肝炎
No past records on this guy. We don't know HIV or hepatitis status.
我这就开单子 查艾滋抗体 乙肝表面抗原和丙肝
I'll put the orders in, HIV antibody, Hep B surface, and Hep C.
她需要用暴露后阻断药 - 也许不用
She needs post-exposure medication. - Maybe not.
对于职业暴露 快速艾滋病毒检测只需要一两个小时
For occupational exposure, the rapid HIV test takes an hour or two.
皮下刺伤
Subcutaneous puncture wound.
没伤到关节和肌腱
No risk of joint or tendon involvement.
抬高患处 压住 然后贴个创可贴
Elevate, pressure, and then a Band-Aid.
等结果期间 如果你愿意 可以自己服用一剂阻断药
Give yourself a dose of PEP if you want while you're waiting for results.
建个档案 我另找护士给你抽血
Start a chart, and I'll find another nurse for your blood draw.
好极了
Great.
看来又有西桥纪念医院转来的病人了
Looks like we've got a couple more diverted from Westbridge.
他们预计要停摆多久 - 不清楚
Any estimate on their downtime? - Not yet.
是时候把朗登医生 从分诊调过来了吧
Time to pull Dr. Langdon from triage?
不
No, no.
他第一天回来 我想让他慢慢适应
First day back. I want to let him kind of ease into things.
明白 我会盯着点的
Understood. I'll keep an eye on it.
感谢
Thank you very much.
你要改赌注吗
Thinking about changing your bet?
我只是在评估胜率
I am just weighing my odds.
别担心 我会用赢来的钱请你喝酒的
Don't worry. I'll buy you a drink with my winnings.
你哥哥应该很快就回来了
Your brother should be back shortly.
排队做CT的人有点多
There was a little holdup at CT.
我应该担心吗
Um, should I be worried?
我们先等等看他的报告结果如何
Let's wait and see what his test results say.
这真是...
This is just, um...
这完全说不通啊
this just doesn't make any sense.
我哥哥不是能做出那种事的人
It doesn't sound like my brother at all.
他是我认识的最友善的人
He's the--the friendliest guy I know.
他甚至从没生过气 他很少吼人
He never even gets angry, barely yells.
他以前没发作过吗
He's never had an episode like this in the past?
据我所知没有
No, or not that I know of.
他和女友感情很好
He's in a great relationship.
他念法学院是为了帮助别人
And he's in law school 'cause he wants to help people.
他总跟我说要勇敢追寻自己的梦想
He always tells me that I should, um... follow my dreams,
尽管那意味着会被父母扫地出门
even if it means my parents may disown me.
我应该打给他们吗
Should I call them?
我觉得这是个好主意
I think that's a good idea.
他的情况可能很严重
This--this could be pretty serious.
谢谢
Thanks.
新来的放射科医生是个大帅哥 - 好的
The new radiologist is a hottie. - Okay.
他的头部CT正常 血检和尿检也正常
his head CT is normal, as are his blood and urine tests.
那他是怎么了
Then--then what's wrong with him?
我们暂时还不能确定
We're not, um, sure yet.
还有另一个检查 腰椎穿刺
There is another test-- a-a spinal tap.
这可能是脑脊液感染
This could be, um, an infection
引起的病毒性脑炎
in the fluid that surrounds the brain--viral encephalitis.
也能导致人神志不清和意识混乱
Um, it can also cause... altered mental status and confusion.
如果是的话能治吗
Can you treat it, if it is?
能
Yes.
好的
Okay.
好的
Okay.
我去找阿尔-哈希米医生 我们会一起操作
I'll go find Dr. Al-Hashimi, and--and we'll do it together.
谢谢 - 不客气
Thank you. - Of course.
跟我们预想的一样
Just what we thought--
你是尾椎骨折
it's a fracture of your coccyx.
是你的尾骨
It's your tailbone.
你看 这里的这些碎片 本应该和那边对齐
Yeah, see, these pieces here should be lined up with that part here.
我需要做手术吗 - 不用
Do I need surgery? - No.
这类骨折会自己愈合 但大概需要六周
No, no, these heal pretty well, but it'll take about six weeks.
六周
"Six weeks"?
我每周末都有晚餐约会
I have dinner dates every weekend.
你可以...你仍然可以如期赴约
You can keep your-- still keep your dinner plans.
晚餐定在皮诺餐厅 城里最好的意大利馆子
Dinner starts at Pino's, the best Italian in town.
之后通常去我家喝杯睡前酒
A nightcap at my place usually follows,
然后第二天享用床上早餐
and then breakfast in bed.
好的
Ah, okay.
这样的话 你可能需要休息一阵子了
Well, in that case, you might-- you might need to take a little break.
我生活中最大的乐趣 就是我的社交日程
My greatest joy in life is my social calendar.
你还有别的办法吗
Is there something else you can do?
确实有一种复位手术 能把碎骨推回原位
W-well, there-- there is a procedure to push the fragments back in place.
有助于加速愈合 - 终于说到点子上了
It could help it heal faster. - Now we're talking.
但会很疼的
Yeah, but it'll hurt pretty bad
但只会疼一下子 - 我能忍♥受
but only for a second. - I can take it.
好吧 过来 穿回病号♥服
Okay. Come here. Back in the gown.
你感觉怎么样
How's it going over here?
好多了
Better now.
你脚部的X光片结果出来了
Oh, the X-ray is back on your foot,
没有骨折
and no fracture.
所以用弹力绷带加压包扎 冰敷 休息并抬高患处即可
So, um, ACE wrap, ice, rest, and elevate,
如果疼可以吃布洛芬
and you can take ibuprofen if you need it.
就这样
So that's it?
如果你实在疼到走不了路
Well, if it's--if it's too painful to bear weight,
我们可以给你配个拐杖撑一两天
we can give you crutches to use for a day or two.
所以 我们不会再见面了
So I won't be seeing you again.
作为患者是见不到了 但很高兴认识你 布莱恩
as a patient, no, but... it was nice meeting you, Brian.
我也很高兴认识你 麦凯医生
It was nice meeting you, too, Dr. McKay.
其实 我今晚打算
You know, I was-- I was going to go check out
去劳伦斯维尔逛几家美术馆的
a few of the art galleries in Lawrenceville tonight.
你去过40街和巴特勒路口的那家吗
Have you been to that one on 40th and Butler?
没有 我是有这个打算 可能9点左右
No, I was, um, gonna go by. Maybe around 9:00?
好的
Okay.
好的 - 好的
Cool. - Cool.
伙计 我救活了那个跑酷的小子 还给一个心梗病人插了管
Dude, I resuscitated that parkour guy and--and intubated a STEMI.
我想我可以的
I think I can handle this.
第一次最好在旁观察
It's best if you watch the first one.
你的牙齿怎么样了
How's that tooth feeling?
我这半边脸都麻了
The whole side of my face is numb.
要的就是这个效果
That's how we like it.
好的
Okay,
23号♥牙 侧切牙...
we've got a... a fluctuant gumline at--
牙龈有波动性肿胀
Tooth number 23, lateral incisor.
并已扩展为...
With an extension to an--
根尖脓肿
Apical abscess.
又答对了 - 这孩子真聪明
Right again. - Ah, the kid's smart.
接上杨克吸引器 准备好牵开牙龈
Hook up the Yankauer. Get ready to retract the gum.
路易 这只是个权宜之计 好吗
Hey, Louie, this is a temporary fix, okay?
你得去看牙医 把那颗牙拔掉
You're going to need to get that tooth pulled by a dentist.
你能给我介绍一位吗
Hey, you going to find me one?
我们可以让你跟迪伦聊聊
We can have you talk to Dylan.
柯林斯医生在吗
Is Dr. Collins around?
那个姐们一直很照顾我
Sister always helps me out.
柯林斯医生结束了规培
Uh, Dr. Collins finished her residency,
去波特兰当主治医生了
took up a job in Portland as an attending physician.
波特兰 - 是的
"Portland"?
我想那是她的家乡
Yeah, I think that's where she's from.
她要领养一个孩子 想离家人更近
She's adopting a baby. Wanted to be closer to her family.
真美好
Well, that's a beautiful thing.
准备就绪 - 好的 你准备好了吗
We're set. - Okay. Ready?
3毫升注射器
Okay, 3-cc syringe,
20号♥针头 从最饱满处进针
20-gauge needle entering at the juiciest part,
对准根尖方向
aiming for the apex.
要送去培养吗
Send that for culture?