匹兹堡医护前线（2025）

The Pitt S01E03

Part 4 March 11, 2025, 8:29 p.m.

这他妈太酷了
This is so fucking cool.
桑托斯医生你和这个病人有一个共同的词汇
Dr. Santos, you and this patient share a common vocabulary.
是的我经常说脏话我知道抱歉
Yeah, I swear a lot. I know. I'm sorry.
他们说这是智慧的象征
They say it's a sign of intelligence.
我认为这是缺乏自♥制♥力的表现
I think it shows a lack of self-control.
但我他妈的知道什么
But what the fuck do I know?
左心室只有一处穿刺伤
Single puncture wound to the left ventricle.
我们有一根手指压住了
We've got a finger on it.
输血一个单位血压上升
First unit is in. Pressure's up.
心脏充盈良好
Heart is filling well.
做一个褥式缝合我们就可以撤了
Throw in a horizontal mattress, and we're out of here.
我缝针的时候给伤口止血
Stop the bleed while I sew.
那个心梗病人到了
STEMI's arrived.
你能行吗 - 给他打包送到手术室就行了
You got this? - Just wrapping him up for OR delivery.
2-0缝合线圆针
2-0 Prolene on a tapered needle.
埃德格林先生 52岁
Mr. Ed Gellin is 52 years young
有高血压和高血脂病史
with a history of hypertension and hyperlipidemia.
二十分钟胸骨后疼痛
20 minutes of substernal chest pain.
百分百有呼吸困难和脱水症状
10 out of 10 with dyspnea and diaphoresis.
高压152低压95 目前在嚼服324毫克婴儿用阿司匹林
BP is 152 over 95. Currently chewing 324 mgs of baby aspirin.
好的
OK.
已抽血并进行第二次静脉注射血压稳定
Blood's drawn. Second IV started. BP stable.
前方导联ST段抬高7毫米
Seven millimeters ST elevation... One nitro spray, sublingual. In the anterior leads.
这些有时被称为墓碑 - 张嘴先生
Those are sometimes called tombstones. - Open up, sir.
“墓碑” - 抬起舌头
Tombstones? - Lift your tongue.
盖林先生你在经历严重的心脏病发作
Mr. Gellin, you're having a very big heart attack right now.
输送氧气到心脏的主要动脉几乎完全堵塞了
Major artery that carries oxygen to your heart is almost totally blocked.
听起来不太妙
That doesn't sound too good.
是的非常不妙我们会送你去心导管室
No, it's not very good. We're gonna send you up to the cath lab.
一位心脏科医生会用球囊疏通
A cardiologist is gonna unblock that with a balloon
然后用支架撑起血管
and leave it open with a stent.
但我还在心脏病发作
But I'm still having a heart attack?
如果一切按计划进行你会像从未心脏病发作一样
If everything goes as planned, it'll be like you never had a heart attack.
我们要在这根动脉里插一根导管
We're gonna put a catheter in this artery right here.
我们要用推剪剃掉毛发
We're gonna shave the hair with a clipper.
除非你们的巴西脱毛膏用完了
Long as you stop short of a Brazilian.
这是我们的新升级产品价格略高一点
It's an option we offer. Costs a little bit more.
很多人的保险不能报销
A lot of people's insurance won't cover it.
别逗我笑了好痛的 - 成交
Don't make me laugh. It hurts. - Deal.
我们可以打给谁吗 - 我妻子
Anybody we can call? - My wife.
已经有她的号♥码了
Already have her number.
好的我们会打给她你坚持住我马上回来
OK, we'll call her. You hang in there. I'll be right back.
我想他们完成了尼克的呼吸暂停测试
I think they finished the apnea test on Nick.
你能问下结果出来了吗
Can you check the results?
暂时还不行血样得送到实验室
Not just yet. The blood test needs to go to the lab.
检测需要几分钟时间
It takes a few minutes to run the test.
一旦出来我就去病房♥找你们 - 好的
I'll come find you in the room as soon as it's done.
褥式缝合完毕止血效果很好在这里剪一下
Horizontal mattress in place with excellent hemostasis. Cut here.
湿润的无菌毛巾手术完成
Moist, sterile towel. And away we go.
我跟心外科打过招呼了他们在手术室等你
I spoke to cardiothoracic. They can meet you in the OR.
干得好
Good job.
借过
Coming through.
干得好
Well done. Well done.
祝你好运盖林先生 - 非常感谢
Good luck, Mr. Gellin. - Thank you so much.
不客气
You're very welcome.
挽救了两个病人实在是太帅了
Two saves. Totally awesome.
我刚刚手里握着一颗跳动的人类心脏
I just held a beating human heart in my hands.
我们应该庆祝一下
We should celebrate.
我们应该打扫这些房♥间带更多的病人回来
We should clean these rooms and bring some more patients back.
听起来是个好计划 - 恶人不得闲
Sounds like a plan. - No rest for the wicked.
心梗病人的手术做得好快 - 时间就是心肌
Code STEMI was fast. - Time is myocardium.
我们的入院至球囊扩张时间数据
And our statistics for door to balloon time
会被审核评论并发表到网上
get reviewed, critiqued, and published online.
入院至球囊扩张时间
Door to balloon time?
就是从病人踏进我们医院
That's the time from when they hit our door
到心导管室里血管成形术的气球被充气的时间
to when the angioplasty balloon gets inflated in the cath lab.
我们把它控制在51分钟以内
We keep it to under 51 minutes,
就能逆转心脏病发作并拯救生命
we can reverse a heart attack and save a life.
我都有点希望米尔顿得的是心梗了
Kind of wish Mr. Milton had a STEMI.
谢谢你让我远离他
Thank you for letting me go the distance on him.
我真的以为我们能救回他
I really thought we'd get him back, you know?
是啊即使你把一切都做对了也未必就能得到你所希望的结果
Yeah, well, you know, even though you do everything right, you don't always get what you hope for.
我的父母都有镰状细胞的特征
My parents both had sickle cell trait,
我刚出生时就被筛查出有FS型血红蛋白
and I was screened as a newborn with the hemoglobin FS pattern.
你注射过青霉素吗 - 一直到我五岁
Did you take penicillin? - Mm-hmm, until I was five.
然后疫苗开始发挥了作用
Then the vaccines kicked in.
她的整个病史都在手♥机♥上
She has her entire medical history on her phone.
非常长
It's extremely long.
莫汉医生能聊一下吗 - 好的抱歉失陪一下
Dr. Mohan, do you have a minute? - Yep. Excuse me.
那边有什么问题吗 - 没有她的疼痛控制得很好
Is there a problem over there? - No, her pain is well controlled.
你知道这是我在委婉地问你
You understand that's my polite way of asking
为什么要在一个病人身上花费这么多时间吧
why are you spending so much time with one patient?
你是三♥级♥住院医生
You're an R3.
作为三♥级♥住院医生你每小时至少应该看两个病人
As an R3, you should be seeing at least two patients an hour.
我有两个病人乔伊斯和那位好心的华♥莱♥士♥先生
I have two, Joyce and Mr. Wallace, our Good Samaritan.
他正处于昏迷状态情况稳定你这个时候应该有四个病人
Who's comatose and stable. You should have four by now.
我的病人满意度是最高的
I have the highest patient satisfaction of anyone.
这一点我不怀疑但我们几个小时前才谈过
I don't doubt it, but we just had this conversation a couple of hours ago.
我知道人们叫我“慢动作医生”
I know people call me Slow-Mo.
你不必确认或否认
You don't have to confirm or deny.
以前这让我很伤心但我没办法
It used to hurt my feelings a lot, but I can't help it.
我必须以我舒适的速度工作
I work at the speed I'm comfortable at.
因为你害怕犯错
Because you're afraid of making a mistake?
我一直都害怕犯错你不是吗
I'm always afraid of making a mistake. Aren't you?
我当然是但你明白我的意思
Yeah, of course I am. But you know what I mean.
你犯了一次错有病人死了
You make a mistake once, and somebody dies,
你因此非常内疚并决心永远不再重蹈覆辙
and you feel so badly about it, you'll never let it happen again--
这有什么错 - 因为你在不必要的检查上
How is that wrong? - Because you waste time and money
浪费了时间和金钱
on unnecessary tests.
你让病人等得太久
You keep sick patients waiting too long.
你错过了可以从中学习的病例
You miss out on cases you could be learning from.
你没有充分利用你的专业知识
You shortchange your own education.
我跟你说这些不是因为我苛刻
I'm not saying this to be a hard-ass.
而是因为我知道你可以做好你的工作
I'm saying this because I know you could do this,
但你必须达到一个更高的水平我知道你有这个能力
but you need to do it at a level I also know you're capable of.
万一我没有呢
And what if I'm not?
那你应该找一个更适合你的科室
Then you should look into a specialty that better suits you.
你考虑过精神科吗
Have you thought about psychiatry?
我不想去精神科
I don't want to go into psychiatry.
我想待在这里 - 待在这里...
I want to be here. - Being here
意味着无论你有多优秀无论你有多努力
means no matter how good you are or how hard you try,
你都会再次犯错还有人可能会死
you're gonna make another mistake, and someone else might even die.
这就是急诊医生要付出的代价
That's called being an emergency medicine doctor.
如果你接受不了那也许这不是适合你的地方
And if you can't accept that, then maybe this isn't the place for you.
我可以接受 - 你确定吗
I can accept that. - You sure?
确定 - 好的
Yes. - OK, good.
很好去拯救生命吧
Go save some lives.
顺便清理一些床位
Clear some beds while you're at it.
要是有人能给我递杯茶水就好了
I would fancy a spot of tea at some point.
你想喝茶吗亲爱的我去给你倒
You want some tea, darling? I'll get you some tea.
谢谢你亲爱的
Oh, thank you, sweetheart.
罗比医生有空吗
Is Dr. Robby available?
他在看一个病人我能帮上忙吗
He's with a patient. Can I help?
我父亲开始动了
My father's starting to move.
好的我会告诉他的 - 谢谢
OK, I'll let him know. - Thanks. Yeah.
这是好事还是坏事
Is it good or bad?
如果没有自主呼吸那二氧化碳浓度会超过60
If there's no spontaneous breathing, then carbon dioxide levels rise above 60.
所以82...
So 82
绝对意味着尼克的脑干没有触发呼吸
definitely means that Nick's brainstem is not triggering him to breathe.
你能解决这个问题吗
Well, how can you fix that?