匹兹堡医护前线（2025）

OK, get Mr. Varney prepped and draped.
莫汉医生 这里交给你了
Dr. Mohan, you're in charge.
我们先找到标记点
Let's identify the landmarks.
解开手铐
Cuffs.
你就一直让它开着得了 伙计 他这样子根本动不了
Yeah, you can just leave them off, man. He's clearly not moving on his own.
我们要遵守流程 这是为了保障你们双方的安全
We follow protocol, for his safety and yours.
你要接吗
Do you need to get that?
不用 我妈打来的
Nope. It's my mom.
别管它就行了
Ignore it. Just ignore it.
阿门 姐妹
Amen, sister.
前臂麻醉完成 可以冲洗了
Forearm is numb. We can irrigate.
如果我无视一个问题足够久 它就会自行消失 对吗
If I ignore a problem for long enough, it just goes away, right?
真希望我也能无视我的庭外质询
I wish I could ignore my deposition.
这种事儿你无视不了 不过你会顺利过关的
That, you can't ignore. But you'll be fine.
你又是什么情况 维塔克 跟室友闹别扭了
What's up with you, Whitaker? Trouble in roomie land?
不是
No, not really.
我想我之前冒犯到了朗登医生
I think I overstepped with Dr. Langdon earlier.
他想给一名患者开安定类药物
He was trying to prescribe a patient benzos,
我跟朗登医生说还是我来开为好
and I told Langdon that it'd be better if I did it.
我那么说只是因为 我是那名患者的主治医生
Only because I was already the assigned physician.
但我现在感觉自己很混♥蛋♥
But yeah, now I feel like an asshole.
朗登没事的
Langdon's fine.
他去过康复中心 那些步骤他都经历过了
He went to rehab, he's working the steps,
希望他已经彻底翻篇了吧
and hopefully it's all behind him.
进针与探头平面平行 置于前锯肌浅层
Place the needle in-plane, superficial to the serratus anterior,
前锯肌与背阔肌之间
between it and the latissimus dorsi.
你能看到液体在分离扩散…
You can see the fluid dissect and diffuse--
莫汉医生 我们需要你
Dr. Mohan, we need you.
又有两辆西桥纪念医院的救护车 马上就到了
We've got two more rigs from Westbridge pulling up right now.
去吧 这里有我们就行 - 谢谢
Go. We got this. - Thanks.
这边情况如何
How we doing in here?
体温飙到38.8度 给她吃了泰诺
Spiked a temp to 102, gave Tylenol.
看她的腿
Check out her leg.
这绝对是个大水疱 外科来看过了吗
That is a definite bulla. Did surgery come down yet?
还没有 - 我需要做手术吗
Not yet. - I need surgery?
再呼叫一次 手术是最后的方案
Page them again. Surgery would be a last resort.
我们想让他们来看一下你的腿
We would like them to come down and check out your leg
以防我们需要切掉部分感染的皮肤
in case we need to remove this infected skin.
我原以为只是有点浮肿 因为我整天站着工作
I thought it was just a little swelling 'cause I'm on my feet all day.
血压降到高压85低压40了
BP's down to 85 over 40.
补了多少液 - 全速输了快一整袋
How much LR is in? - Full bolus.
再输一升 然后加去甲肾上腺素 滴定至平均动脉压65
Do another liter and then start Levophed. Titrate to a MAP of 65.
谁能告诉我到底是怎么回事吗
Can someone please tell me what's going on?
血氧降到89了 - 上百分之百非再吸入式面罩
Pulse ox down to 89. - 100% non-rebreather.
有时感染会导致血压下降
Sometimes an infection can cause your blood pressure
降低血氧含量
to drop and lower the amount of oxygen in your blood.
我不会有事吧 - 我们在尽一切所能
Am I gonna be OK? - We're doing everything that we can
确保你不会有事 杰西 过来下
to make sure that you are. Jesse.
怎么了
What's up?
必要时立即插管
Be ready to intubate if you need to.
需要我叫朗登吗 - 不用 我马上回来
You want me to call Langdon? - No. I will be right back,
顺便打给外科的人 让他们别磨磨蹭蹭的了
and you can call surgery and tell them to get their heads out of their asses
赶紧下来
and get down here.
你把朗登调回来的 - 不是 是阿尔-哈希米医生
Did you bring Langdon back here? - No, Al-Hashimi did.
你把他贬到了杂活地狱
You banished him to scut purgatory.
他对那个蜂窝织炎病人的处置方式 和你完全一致
He did everything you would've done with that cellulitis patient.
如果你觉得他有疏忽就告诉他 - 我们可能需要插管了
If you think he missed something, tell him. - Well, we're probably gonna need to intubate.
我们肯定得再要一张重症监护室病床
We're definitely gonna need an ICU bed.
出什么事了 - 她感染性休克了 正在用升压药
What happened? - She is in septic shock, on pressors.
天啊 - 开放性肩脱位病人回来了
Open shoulder dislocation is back.
西桥纪念医院关停了所有手术室 让我们把他再送回来
Westbridge shut down all their ORs, so they told us to bring them back here.
开什么玩笑 这又不是丽笙酒店 - 不关我的事
You joking? This ain't the Radisson. - Not my problem.
把他推到哪儿 - 找个墙边的位置
Where should we park him? - Grab a wall.
呼叫诺艾儿 骨科和手术室 告诉他们有个病人回来了
Call Noelle. Call ortho. Call the OR and tell them we got a patient back
需要做手术并办理住院
that needs surgery and admission.
比林斯先生 很抱歉让你坐着救护车 在阿勒格尼县兜了一圈
Hey, so sorry about this ambulance tour of Allegheny County, Mr. Billings,
但从现在开始 我们会负责 我保证
but we got you from here, I promise.
好吧 我快饿死了 能给我拿点吃的吗
Yeah, I'm starving. Is there any way I can get something to eat?
抱歉 术前不能进食
Sorry, not before surgery.
我能有人探视吗 - 当然
Can I have a visitor? - Sure.
格洛丽亚那边有消息吗 西桥纪念医院到底出什么事了
Any word from Gloria about what's going on at Westbridge?
高层一点动静没有 护士长也没回应
Radio silence from the ivory tower. And the charge nurse over there isn't responding.
肯定是大事 我在考虑是否要通知安保部门
Must be bad. I wonder if it's something that security needs to know about.
我随时跟你通报情况
I'll keep you posted.
嘿 你跟格洛丽亚好像挺熟的
Hey, you're kind of buds with Gloria.
她有没有跟你说过 西桥纪念医院出什么事了
Did she say anything to you about what's happening at Westbridge?
没有 你呢 - 没有
No. You? - Nope. H
你负责的病人怎么样了
ow are your patients?
囚犯格斯伤情稳定
Our prisoner, Gus, has stable injuries,
中♥央♥区10号♥的法学生醒了
and our law student in Central 10 is awake,
腰椎穿刺结果正常 正在等精神科会诊
normal LP, and awaiting a psych consult.
很好 我们越快治疗 让他们出院
Good. Quicker we can treat 'em, street 'em, move 'em
送去楼上科室越好
up the food chain, the better.
我有个问题
Question.
你为什么把我当你的住院医生对待
Why are you treating me like one of your residents?
我没有
I'm not.
作为主治医生 我得掌握
As the attending, I like to know the status
急诊室里每位病人和医生的状况
of all the patients and doctors in the ED
以便需要时能快速介入
in case I need to jump in quickly.
有道理
Makes sense.
现在轮到你了
Now your turn.
什么
What?
作为急诊科与你同级的主治医生
As your fellow attending in our ED,
我也理应了解
it only makes sense for me to know the status
所有病人和医生的状况
of all the patients and all the doctors
以便必要时迅速介入
in case I need to jump in on a moment's notice.
有道理
Touché.
你有胫骨远端非移位性骨折
You have a non-displaced fracture, distal tibia.
你看一下这里的骨头 都是对齐的
So if you look at the bone here, it's pretty well aligned.
抱歉 嗨
Sorry. Hi.
嗨 我刚在洗澡 我一收到保罗的消息就尽快赶来了
Hi, I was in the shower, and I came as soon as I got Paul's message.
莱娜
Lena?
发生什么事了
What happened?
我癫痫发作了
I had a seizure.
你给她用了开浦兰吗
You load her with Keppra?
是的 她的神志已经恢复到正常水平
Yeah. Yeah, she's back to baseline mental status.
抱歉 我有点糊涂了 你不是下班了吗
I'm sorry, I'm confused. Aren't you off duty?
我是罗克茜的死亡助产士
I'm Roxie's death doula.
她的什么
Her--her what?
我帮助像罗克茜这样的病人
I help advocate for people like Roxie
让他们更平静地迈向死亡
to make their transition to death a more peaceful process.
有点像是…分娩助产士 但服务的是临终病人
It's like a birth doula but for the end of life.
她是我们一家的大救星
She's been a real lifesaver for our family.
我都快死了我丈夫还能开玩笑呢
My husband cracking jokes while I'm dying.
知道我为什么嫁给他了吧
See why I married him?
关于我的病情 你想说什么
Whatever you have to say about my condition,
都可以当着莱娜的面说
you can share with Lena too.
我们刚刚在解释罗克茜的骨折
We were just explaining that Roxie has a pathological
是因转移灶导致的病理性骨折
fracture through a metastatic lesion.
能治好吗
Can you fix that?
骨头全都是对齐的 所以不需要手术
The bones are well aligned, so she won't need surgery.
要治疗的话就是固定加佩戴长腿支具
The treatment is immobilization and a long leg boot.
或者加大止痛药的剂量
Maybe we up her pain meds.
没问题 这个可以
Yeah, sure. We can do that.
骨折大概六周后会愈合
The bones should heal in about six weeks.
如果我能活那么久的话
If I live that long.
这里还是麻的
Still numb here?
是的 老兄 - 好极了
Yeah, bro. - Great.
你觉得会留疤吗
You think it's gonna leave a scar?
我不是觉得 而是确定会留疤
I don't think it. I know it.
天啊