匹兹堡医护前线（2025）

The Pitt S02E05

Part 2 Feb. 14, 2026, 6:09 p.m.

我便秘至少有五六天了
I've been stopped up for at least five or six days.
止疼药有可能导致便秘 - 我知道
Mm-hmm, painkillers can cause constipation. - I know.
所以他们给我用了软便药
That's why they put me on a stool softener,
后来还尝试了灌肠
and then they tried an enema.
但还是不行 - 一点用都没有
And--and no movements? - Yep.
然后他们给我喝了一种巨难喝的药
And then they gave me this horrible drink.
柠檬酸镁
Mag citrate.
对柠檬酸镁
Yeah. Mag citrate.
把我都弄吐了
Made me puke.
好了接下来呢奥吉尔维
All right, what's next, Ogilvie?
我们给你拍个X光片再确定治疗方案吧兰道夫太太
Let's get you an X-ray and see how we can help you, Mrs. Randolph.
谢谢
Thank you.
鉴别诊断
Differential?
高度怀疑是粪便嵌塞但考虑到患者切除了胆囊
Probable stool impaction. But with her history of cholecystectomy,
也可能是小肠梗阻 - 甚至更糟
it could be small bowel obstruction. - Or worse.
乙状结肠扭转
Sigmoid volvulus?
但这是外科急症她应该会剧痛难忍♥才对吧
But that's a surgical emergency. Wouldn't she have tons of pain?
不一定尤其是当你是八十多岁的老年人
Not always, especially when you're in your 80s.
我开始担心了越界了一毫米
I am getting concerned. This is a millimeter past the line.
可能是我的边界画得不够准确
Or my line was sloppy.
疼痛加重了吗
Any increase in pain?
好吧抱歉
OK, sorry.
先打四毫克吗♥啡♥试试
Let's try four morphine.
白细胞只有一万 SIRS的标准要超过一万二
White count's only 10,000. It'd be over 12,000 for SIRS.
还有其他指标
There are other criteria.
还是无发热
Still afebrile.
你问过MRSA的感染史吗
Did you ask about past history of MRSA?
没特意问过但她从没住过院
Not specifically, but she's never been hospitalized.
有免疫功能低下的迹象吗
Any evidence of an immunocompromised state?
没有她很健康 - 用过类固醇吗
No, she's healthy. - Steroid use?
从来没有
Never.
最大心率只有89 - 这正常吗
Maximum heart rate's only 89. - Is that OK?
正常非常正常
That's good, very good.
守着她密切监测
Stay with her. Monitor her closely.
如果她情况有变立刻来找我
If there's any change in her condition, come find me.
我是说任何变化
I mean any change.
罗克茜·亨勒 42岁
Roxie Hamler, 42,
家庭临终关怀患者有肺癌史
home hospice patient with a history of lung cancer.
新发强直阵挛性癫痫伴右小腿疼痛
New-onset tonic-clonic seizure with right lower leg pain.
她撞到咖啡桌了
She hit it on the coffee table.
最初无法说话现在意识逐渐恢复
Initially nonverbal, now coming around.
这是癫痫发作后的正常现象你好我是阿尔-哈希米医生
That's normal after a seizure. Hi, I'm Dr. Al-Hashimi.
需要帮忙吗 - 不用我们能行
Do you need a hand? - Nope, we got it.
她撞到头了吗 - 没有我当时在场接住了她
She hit her head? - No. I was there. I caught her.
没有静脉注射 - 扎不进去
No IV? - Couldn't get one in.
给她肌注了4毫克咪♥达♥唑♥仑♥控制癫痫
Gave her four of IM versed for the seizure,
25微克芬太尼用于止痛
25 of fent for the pain.
好的达娜送去哪里 - 创伤一室
OK. Dana, where to? - Trauma One.
这边
This way.
好久没见你们了
Haven't seen you guys in a hot minute.
从琼斯锻造州立监狱接来的
Pickup from SCI Jones Forge.
原本应该送去西桥纪念医院的但被转到了你们这儿
Was supposed to go to Westbridge but got diverted to you.
是啊全往这儿送了
Yeah, you and everybody else.
普林塞斯你去中♥央♥区9号♥病房♥吧
Princess, I need you pivot to Central 9.
知道了
Got it.
格斯·瓦尼 54岁被袭击全身多处钝挫伤
Gus Varney, 54, victim of assault with diffuse blunt trauma.
他脸有淤青右胸受伤
He's got bruising to the face, the right chest,
左臂一道十厘米的伤口
10-centimeter laceration to the left arm.
高压136 低压84
BP's 136 over 84, pulse 102,
脉搏102 血氧饱和度良好室内空气下95
good sats, 95 on room air.
你感觉怎么样瓦尼先生
How you feeling there, Mr. Varney?
疼死了 - 哪里疼
Fucking hurts. - Where?
浑身都疼 - 我是罗比医生这位是哈希米医生
Everywhere. - I am Dr. Robby. This is Dr. Al-Hashimi.
我们可以给你用点止痛药
We'll get you something for the pain.
创伤二室有个进行性蜂窝织炎患者在等我
I've got a progressing cellulitis in Trauma Two.
去吧我自己可以的 - 谢谢
Go. I'm good. - Thank you.
格斯你知道是谁弄伤了你吗
Gus, do you know who hurt you?
来自6号♥监区的一位“模范”市民
One of the fine, upstanding citizens of cell block 6.
伤口很深穿透了肌筋膜
It's a deep lac through the muscle fascia.
等他稳定下来能把手铐解开吗 - 不可能
Can we get the cuffs off once he settles? - Not a chance.
他穿橙色囚服被铐着是有原因的
Orange jumpsuit. He's cuffed for a reason.
我们走吧
Let's go.
好了各位听我指令
OK, everyone, on my count.
一二…
1, 2--
等一下
Hold on.
好了 - 一二三
Go. - 1, 2, 3.
梅尔床旁超声检查
Mel, E-FAST.
维塔克做初步评估 - 好的
Whitaker, primary assessment. - On it.
奇怪的淤青
Oh, weird bruise.
他摔到什么东西上了吗 - 那是脚印
Did he fall on something? - Footprint,
被人踩的 - 天哪
got stomped. - Jesus.
有这个必要吗 - 恐怕是的
Is it--is that necessary? - Afraid so.
气道通畅
Airway's patent.
左边肺滑动正常
Good lung sliding on the left.
抱歉右边也没问题
Sorry. Good on the right, too.
肺部如何
How are the lungs?
呼吸音清晰无摩擦音
Good breath sounds. No crepitus.
无胸腔积液
No effusion.
血氧饱和度97 高压118 低压78 心率112
Pulse ox 97, BP 118 over 78, heart rate 112.
疼痛导致了心动过速
Tachycardic from the pain.
先打四毫克吗♥啡♥ 不够再加 - 明白
Start with four of morphine. Repeat prn. - On it.
好的下颌肿大
OK. Swollen mandible.
请张开嘴格斯
Open your mouth for me, Gus.
再张大点 - 大不了了
Little wider. - Can't.
维塔克你知道压舌板检查吧
Whitaker, you know the tongue blade exam?
知道
Yeah.
这是检查下颌骨骨折的好方法
It's a great test for mandible fracture.
格斯用力咬住
Gus, bite down hard on this for me.
抱歉格斯检查结果阳性
Sorry, Gus. Positive test.
腹部未见游离液体
No free fluid in the belly.
你们需要多久 - 现在还确定不了
Any idea how long this will take? - Too soon to tell.
维塔克你的判断是什么 - 左侧下颌骨骨折
Whitaker, your assessment? - Fractured left mandible,
多处肋骨骨折
multiple rib fractures.
前臂复合型裂伤
Complex forearm lac.
好的左轴向翻身然后做全身扫描
OK, log roll to the left, then pan scan.
瓦尼先生被袭击时你在哪
Where were you when Mr. Varney got assaulted?
我只负责把人送来具体情况不太清楚
I just move 'em. I don't get to know 'em.
可以做CT了
CT's ready for us.
自动血压监测中
Cycling the BP.
好的红肿部分现已超出标记线一厘米了
OK, this redness is now a centimeter over that line,
这看起来像是个正在形成的水疱
and this might be a bulla forming.
万古霉素需要一点时间才能起效
The vanco takes a little time to work.
生命体征依然稳定
Vital signs are still stable,
高压122 低压78
122 over 78.
我去接
I got it.
你感觉怎么样黛比
How are you feeling, Debbie?
我感觉有点热
I'm feeling a little warm.
这可能是万古霉素引起的
That can happen with vanco.
谢谢
Thanks, man.
乳酸4.2
Lactic acid 4.2.
好的 - 怎么了
OK. - What's wrong?
你的感染可能比预期更严重
That can be a sign of a more serious infection,
但好消息是我们知道怎么办
but the good news is, we know what to do.
杰西两升林格氏液输注流速开到最大
Jesse, 2 liters of LR wide open.
这是严重的脓毒症
This is severe sepsis.
我知道但早上七点时还只是普通的蜂窝织炎
I know, but at 7:00 AM, it was a simple cellulitis.
换成任何人都会给她用先锋霉素
Anyone would have given her Keflex.
我们可以加上碳青霉烯类或他唑巴坦扩大抗菌覆盖范围
We could add carbapenem or Zosyn to broaden our antibiotic coverage.
好的我知道了谢谢
OK, I got it. Thanks.
杰西加美罗培南1克克林霉素900毫克
Jesse, 1 gram meropenem, 900 milligrams clinda,