匹兹堡医护前线（2025）

我们可以提供经济援助
We can offer financial assistance.
你们只需支付 与医保和医疗补助相同的费用
You'd pay the same that Medicare and Medicaid would pay.
那是多少
How much is that?
你们付60% 剩下的40%我们出
You pay 60%, we cover 40%.
谢谢
Thank you.
你去哪了
Where have you been?
你还好吗 - 对不起 亲爱的
How are you doing? - I'm sorry, mijita.
你是一片好心 我却对你发脾气
You were being thoughtful, and I just blew up.
诺艾儿小姐刚刚告诉我们
Well, Ms. Noelle was just telling us that the hospital
医院愿意给我们减免一大笔费用
is gonna give us a big discount.
我们可以减免最终账单四成的费用
We can knock 40% off your final bill.
太好了
That's great.
我如果住上几天 账单可能超过十万美元 对吧
I stay here for a few days, my bill could be over $100,000, right?
很遗憾 是的
Yes, unfortunately.
也可能不用那么多
It could end up being lower,
这取决于你需要的护理级别
depending on your level of needed care.
也可能更高
Or higher?
所以我们至少得付六万美元
So we would still have to pay $60,000?
但我们拿不出这么多钱
Which we don't have.
他必须留在这儿才能好起来 是吗
He has to stay here to get better, right?
是的 - 不是
Yes. - No.
你说什么
Excuse me?
我是说 不一定
I mean, not necessarily.
我们不能把他收进普通病房♥ 而非重症监护室吗
Couldn't we just admit him to med-surg instead of ICU?
那样不是便宜多了吗
Wouldn't that be a lot cheaper?
他打着胰岛素呢 普通病房♥不会收他的
Med-surg won't accept him with an insulin drip.
通常来说不会
Usually true.
但我可以跟楼上的护士长谈谈
But let me talk to the charge nurse upstairs, and I'll--
看看她怎么说
I'll see what she says.
谢谢
Thank you.
G厅食物中毒患者要求出院
Food poisoning in the hall's asking to leave,
说要带孩子去水上公园玩
wants to take her kids to the water park.
那种地方是细菌的温床
Those places are cesspools.
英雄所见略同
Preaching to the choir.
如果她服用昂丹司琼后感觉良好 那可以出院
If she's feeling fine on Zofran, she's good to go.
好的 路易在南区15号♥病房♥ 药马上送下来
All right. Louie's in South 15. Meds are coming down.
再观察几小时 没问题就能出院了
Another couple hours of monitoring, and he can broom.
然后一头扎进酒水店 - 直奔主题
Straight to the liquor store. - Don't pass "go."
那个送到楼上做开胸术的患者 怎么样了 有最新进展吗
What about that clamshell case that went up--anything?
刚做完手术 在恢复中 麻药还没过
Out of surgery, in recovery, still sedated.
很好 有后续情况通知我 - 好的
Good. Keep me posted on that. - Will do.
一天三次 什么风把你吹来了
Three times in one day. To what do we owe the pleasure?
我来会诊
I came down for a consult
并说服艾哈迈德开个新的赌局
and to persuade Ahmad to start a new betting board.
为什么 西桥纪念医院的赌局满员了
Why, is the Westbridge board full already?
我想让他开一个关于 你和你的中年危机之旅的赌局
Mm-hmm, was gonna ask him to start one about you and your midlife crisis trip.
我赌四周 最多七周
I give it four weeks. Seven, tops.
你对我也太没信心了
Ye of little faith.
这与信心无关 这是事实
Not about faith, just facts.
事实
Facts?
根据我的经验 你是那种能撑个七周左右的男人
Based on my experience, you're a seven-week-itch
嘿 罗比
kind of guy.
医学生在北区接诊了 一个匹克球运动员
Hey, Robby, med student's got a pickleball player in the North Hall with possible
可能跟腱断裂 想听听你的意见
Achilles rupture, asking for your opinion.
谢谢 波拉
Thank you, Perlah.
至少还有人对我有几分信心
At least somebody down here has a little faith in me.
你知道摩托车迈克 休假的真正原因吗
You know what Motorcycle Mike's sabbatical is really about?
我从不去猜他那脑袋里究竟在想什么
I never try to guess what's going on in that head of his.
独自在旷野公路上骑行三个月
Three months being on the open road by himself.
那家伙独处几个小时都受不了
Man can't stand to be alone for more than a few hours.
他睡觉时卧室电视得一直开着
He sleeps with the TV on in his bedroom.
我觉得我不需要知道这些
I really don't think I needed to know that.
也许他是想追寻新的东西
Look, maybe he's looking for something new
或是甩掉过去的包袱
or trying to outrun some old ghosts.
那我希望他能得偿所愿
Well, I hope he finds what he's looking for.
他值得拥有一些平静
Man deserves some peace.
阿门
Amen.
我考虑诊断为马尾神经综合征
I considered the diagnosis of cauda equina syndrome,
但骶部的运动和感觉检查都正常…
but the motor and sensory exam were both intact in the sacral nerve root--
那位无家可归的咳嗽患者得了肺炎
Our unhoused cougher has pneumonia.
我他妈一定是被诅咒了
I'm cursed, fucking cursed.
该死 - 怎么了
Fuck. - What?
右上肺有个空洞性病变
That is a cavitary lesion in the right upper lobe.
活动性肺结核
Active TB.
接下来怎么办
What's next?
做抗酸染色确诊
AFB stain to confirm,
把她转到负压病房♥ 开始用药
move her to a negative airflow room, start her on meds.
上报给感染控制和公共卫♥生♥部♥门
Call infection control and public health.
现在你要以患者身份挂号♥
And now you get to sign in as a patient
抽血做个QuantiFERON 结核干扰素释放试验
and get your blood drawn for a QuantiFERON Gold.
这么快查不出阳性吧 - 对 但你暴露了
It's too soon to be positive. - Yeah, but you were exposed.
你需要做一次基线检测
You need a baseline test
八周后再测一次 看是否转阳
and then again in eight weeks to see if you convert.
如果我转阳了呢
And if I do?
那就得每天吃药 吃上三四个月
Then meds every day for three or four months
定期验血监测毒性
with regular blood tests to check for toxicity.
老天啊 - 好了 跟达娜说一声吧
Jesus. - All right. Let Dana know what's up.
切记切记 转移她的时候要戴好口罩
And for the love of God, mask up when you move her.
朗登医生
Dr. Langdon.
嘿 伙计 艾利克斯 - 我们来看看
Hey, man. Alex. - Let's take a look.
很严重吗 - 不太好
Is it bad? - It's not good.
抱歉 你的病历上说 你被♥干♥冰烧伤了
Sorry, your chart says you were burned with dry ice?
怎么回事 - 都怪我那个混♥蛋♥哥哥
What happened? - My jack-off brother.
他不喜欢你吗
Does he not like you?
其实是我让他那么做的 但不是以这种方式
I asked him to do it, just not like this exactly.
什么 为什么
What? Why?
他想给我烙个印 就像我给他烙的那样
He was gonna brand me like I branded him.
烙印 像是给牛烙印那种吗
Branded? Like cattle?
不用热烙 把烙铁放干冰里
Instead of hot branding, you stick the iron in dry ice,
冷冻到极低温度 然后贴到皮肤上
let it get super cold, and then you put it on your skin.
很酷吧
Cool, huh?
你真是个蠢蛋
Let's get some LET on this.
你再了解下情况 我去拿剪刀清创
I'll get some snips to debride.
你没事吧
You good?
嗯 没事
Yeah. Yeah, good.
你确定吗
You sure?
罗比似乎不太高兴我回来
Doesn't seem like Robby's all that happy I'm back.
他马上就不在这儿了
Well, he's not going to be here,
我很高兴你能回来
and I'm happy you're back.
谢谢
Thanks.
头颈部CT除了下颌骨骨折外未见异常
Head and neck CT is negative, except for mandible fracture.
好吧 把他抬下来 - 给他翻身 右侧朝上
OK, let's get him off the board. - Roll him, right side up.
嘿 得把手铐解开
Hey, we're gonna need the cuffs off.
准备好了吗 一 二 三
Ready. And 1, 2, 3.
轻点
Ah, gentle.
金医生 胸部和腹部情况如何
Dr. King, how are the chest and belly?
有三处前肋骨折和轻度肺挫伤
We have three anterior rib fractures and a small pulmonary contusion.
还不算太糟
Not too bad.
肺挫伤什么时候达到高峰 - 几小时后
When do pulmonary contusions peak? - After a few hours.
三处肋骨骨折的病人 通常都要收治吗
And do we always admit for three-rib fractures?
对老年患者是的
In the elderly, yes,
但如果患者能耐受疼痛且不需要吸氧 那就不必住院
but not if a patient can manage the pain and doesn't need supplemental oxygen.
很好
好吧 他真的很疼
OK, he's really hurting here.
你能给我们做个 前锯肌区域神经阻滞吗
You think you could set us up with a serratus anterior field block?
没问题
No problem.
只要阿尔-哈希米医生同意就行
Oh, as long as that's OK with Dr. Al-Hashimi.
只要病人同意就行
If the patient consents.
瓦尼先生 我们要给你打一针 来麻醉断裂的肋骨
Mr. Varney, we wanna give you a shot to numb your broken ribs
让你的呼吸更顺畅
so you can breathe easier.
好的 给瓦尼先生做术前准备和铺巾