匹兹堡医护前线（2025）

The Pitt S01E02

Part 6 March 11, 2025, 8:29 p.m.

So Beto said he's working here?
是啊他开始到处游荡所幸他每次都能回到这里
Yeah, he just started wandering. Fortunately, he always winds up back here.
他以为自己还在急诊室工作呢我给他家人打电♥话♥了
He thinks he still works in the ED. I called his family.
他们通常几个小时后会来接他
They usually pick him up after a few hours.
是吗 - 是的这能让他们休息一下
Really? - Yeah. It gives them a break.
看看他他在和别人说话感觉自己很有用还能锻炼下身体
And look at him. He's talking to people, feeling useful, getting some exercise.
真希望我也能那么开心
Hell, I wish I was that happy.
你觉得他擅长抓老鼠吗
You think he's any good at catching rats?
别闹 - 厄尔想要个三明治
Stop. - Oh, Earl wants a sandwich.
他总是想要三明治
He always wants a sandwich.
嘿看看这个我给孩子们买♥♥了只小狗
Hey, check it out. I got my kids a puppy.
真可爱希望那不是你的主意
Cute. Hope that wasn't your idea.
为什么这么说 - 你是认真的吗
Why? - Seriously?
你觉得你妻子照顾一家老小还不够累吗
You really think your wife needs anything else to take care of?
艾比喜欢狗
Abby loves dogs.
我还喜欢企鹅呢但不代表我想照顾一只企鹅
I love penguins. It doesn't mean I want to take care of one.
我很确定养企鹅是违法的
I'm pretty sure it's illegal to own a penguin.
我很确定你没抓住重点
Pretty sure you're missing the point.
重点是坦纳答应过他会照顾狗狗
The point is Tanner promised he would take care of it.
一个四岁孩子照顾狗好吧
A four-year-old? Yeah, OK.
她怎么样
How's she doing?
注射了20毫克吗♥啡♥后还活着呢
Still breathing after 20 of morphine.
疼痛有缓解吗乔伊斯
How's the pain, Joyce?
好一点了
A little better.
我们给你约了交换输血
We've ordered an exchange transfusion.
我想我需要那个
Mm. Figured I needed that.
你在家里的常规治疗是什么
What's your normal regimen at home?
每12小时注射一次90毫克缓释吗♥啡♥
90 of extended-release morphine every 12 hours
突发性疼痛吃羟考酮
and oxycodone for breakthrough pain,
但不管用
but it wasn't working.
我给你每小时滴注4毫克镇痛剂
Starting IV Dilaudid of four an hour.
如果不够的话按这个按钮
You can press this button if you need a little extra.
不过那东西每小时只能按一次所以悠着点
That only works once an hour, though, so don't go crazy.
我能跟你聊一下吗 - 可以
Could I confer with you? - Yeah.
你似乎对阿片类药物的剂量感到惊讶
You seem surprised by the opioid dosage.
似乎有点高了 - 她的痛苦也是
It seemed a little high. - So was her pain.
你怎么知道她不是药物成瘾 - 只有六的血红蛋白值是装不出来的
How do you know she's not drug-seeking? - You can't fake a hemoglobin of 6.
你知道镰状细胞病对身体的影响吗
Do you know what sickle cell crisis does to the body?
血细胞会堵住毛细血管
Blood cells get caught and plug up your capillaries
并夺走所有细胞的氧气
and deprive all your cells of oxygen.
它会导致一种“电击刺痛”
It's been described as an electrical stabbing pain
感觉就像打断了你的骨头再把玻璃冲进你的身体
that feels like it's breaking your bones and flushing glass through your body.
我从来没这么想过
I never thought of it like that.
对那些遭受真正痛苦的人抱有一点同理心会大有帮助
Little empathy goes a long way with those suffering in real pain.
好的 - 别担心
Yeah. - Don't worry.
你会学会分辨那些假冒者的
You'll get good at spotting the fakers,
而且半数情况下那些人需要的也只是一个愿意倾听的人
and half the time, all those people need is someone to really
听他们的故事
listen to them and hear their story.
内室压力49
Interior compartment pressure is 49.
灼伤导致大面♥积♥肿胀
Burn caused massive swelling.
他需要什么桑托斯医生
What does he need, Dr. Santos?
筋膜切开术但他还有桡动脉脉搏
Fasciotomy, but he still has a radial pulse.
压力要超过100才会失去脉搏
Pressure would have to be over 100 to lose the pulse,
但到了那时他的胳膊就保不住了
and at that point, he'd lose the arm.
49足以在几个小时内摧毁所有的神经和肌肉
49 is enough to destroy all the nerves and muscles in a matter of hours.
室压49
Compartment pressure's 49?
是的我要在这里做一个初始切口
Yeah. I'm going to make the initial incision down here.
骨科整形可以在手术室完成 - 好计划我去通知他们
Ortho can finish it up in the OR. - Good plan. I'll let them know.
嘿罗比 - 很高兴见到你弗雷德
Hey, Robby. - Always good to see you, Fred.
你觉得我的摇滚明星怎么样 - 她很不错
How do you like my rock star? - She's pretty good.
她有个很棒的老师
She has a great teacher.
给桑托斯医生无菌手套
Sterile gloves for Dr. Santos.
我们不教住院医生做前臂筋膜切开术
Oh, we don't teach forearm fasciotomies to our residents.
万一哪天需要她独自操刀没有任何后援怎么办
What if she's all alone somewhere someday with no backup?
这个路径能避开所有中位神经和主要血管
This is the path to avoid the median nerve and all major vessels.
或许第一次就旁观吧 - 她拿着刀片我来切
Maybe just watch the first time. - She'll hold the blade, I'll cut.
10号♥刀给桑托斯医生
10 blade to Dr. Santos.
我们从近端开始
We'll start proximal.
切多深
How much pressure?
差不多这样就行了
Just about this much.
穿透表皮和皮下组织
Through the skin and sub-Q.
很好
Good.
他们进行得怎么样了
How they making out?
他们还在聊呢
They're still talking.
你还好吗
You OK?
当然我只是讨厌看到家庭被拆散
Yeah, for sure. I just--I hate seeing families torn apart.
他们不会有事的
Oh, they'll be fine.
你怎么能确定 - 他们是白人
How can you be sure? - They're white.
可能就是手腕被打一巴掌以示惩戒
Probably get off with a slap on the wrist.
如果不是这样她可能会失去她的孩子
If they weren't, she'd probably lose her child
而他最终会进监狱但是...
and he'd end up going to jail, but...
抱歉我搞过犬儒主义研究
Sorry, I did a fellowship in cynicism.
你确定你没事吗
You sure you're OK?
非常确定我去透透气
100%. I'm just going to get some air.
我需要帮助
I need help!
我中枪了 - 你们能帮忙吗
I got shot. - Can you guys help?
你叫什么名字
What's your name?
亚历克斯 - 好的亚历克斯让我看看
Alex. - OK, Alex, let me take a look.
好痛
It fucking hurts.
我知道
Oh, I know.
好的我们会好好照顾你的
All right. We're going to take good care of you.
你们能行吗 - 我扶你上来亚历克斯
You guys got it? - Let me get you up here, Alex.
我扶你
I got you.
救护车停靠处有一个腹部中枪患者伤势严重
I have an abdominal GSW in the ambulance bay, code trauma now.
刚刚有辆车丢下了一个枪伤患者
GSW just got dumped by a homeboy ambulance.
你这边可以吗 - 可以你去吧
You got this? - Yeah, go.
给他两克头孢唑林骨科的人在来的路上了
2 grams of Ancef. Ortho's on their way.
收缩压只有80了左侧AC关节 14号♥针头
Systolic's only 80. 14 gauge left AC.
快速灌注器里有两个单位的全血
We got two units of whole blood going on the rapid infuser.
打给手术室我们马上就到肺叶张开
Call the OR. We'll be right up. Lungs up.
你每天都吃药吗
Do you take medications every day?
有过敏吗 - 没有
Any allergies? - No.
莫里森显示里面都是血你看到了吗
Morrison's is full of blood. You see that?
看到了 - 撕裂了他的肝脏
Yeah. - Tore up his liver.
他叫什么名字
What's his name?
亚历克斯 - 亚历克斯你失了很多血
Alex. - Alex, you've lost a lot of blood.
你得马上做手术
You need to go to surgery right away.
我会死吗 - 有我在死不了
Am I going to die? - Not now that I'm here.
外科医生能谦虚点吗
Spoken with the humility of a surgeon.
手术室准备好了他怎么样 - 血压升高了一点
OR's ready. How's he doing? - BP is coming up a bit.
我们走 - 你能打给我妈妈吗
Let's go. - Can you call my mom?
她是我手♥机♥上的备注是“移♥民♥局” - 当然
She's the "ICE" on my cell. - Of course, of course.
所以他不用等手术室吗 - 不用
So he didn't have to wait for an OR? - No,
我们是创伤中心我们总会预留一个手术室
we're a trauma center. We always keep one OR stocked
以备不时之需
and ready to go.
太棒了
Well, that's awesome!
如果有多个创伤患者需要做手术怎么办
What--what happens if there are multiple traumas needing OR?
那只能手脚更麻利些了
We get a lot busier.
米尔顿先生抱歉我们不得不把你搬进大厅
Mr. Milton, I'm sorry. We had to move you into the hall.
我知道这里很乱很吵
I know it gets pretty chaotic and noisy out here.
米尔顿先生嘿班内特醒醒
Mr. Milton? Hey, hey, Bennet, wake up for me.
该死我这边需要一点帮助
Oh, shit, shit, shit. Um, I need a little help here!
来人啊 - 你上次检查他是什么时候
Help! - When did you check on him last?
不知道最多半个小时前我在等化验结果
I don't know, around half an hour ago at most. I was waiting on labs.
发生什么事了 - 我的胆结石病人你看过他的心电图
What's going on? - It's my gallstone guy. You saw his EKGs.
昏迷时间未知他之前在大厅里睡觉
Unknown downtime. He was sleeping in the hall.
急救车快走
Crash cart, let's go!
我来吧
I got it.
暂停按压
Hold compressions.
心搏停止
Asystole.
恢复按压注射肾上腺素