匹兹堡医护前线（2025）

The Pitt S01E01

Part 2 March 11, 2025, 8:29 p.m.

Actually, this is the most important person that you're gonna meet today.
这是达娜她是我们的护士长
This is Dana. She's our charge nurse.
她是我们马戏团的大管事
She is the ringleader of our circus.
照她说的做
Do what she says when she says it.
你们也看到了我们这个急诊室总是人满为患
As you can see, our house is always packed,
科室里大部分区域都被寄宿生占据了
and our department is mostly clogged up with boarders.
他们是在等楼上♥床♥位的住院病人有时要等上好几天
Those are admitted patients waiting for a room upstairs, sometimes for days.
这里的床位可是稀缺商品
Beds are a very precious commodity around here,
所以请你们快速高效地进行检查
so please be quick and efficient with your workups.
还有什么我们在这里治疗病情较重的病人
What else? We treat the sicker patients back here,
但请随时关注候诊室
but please keep your eye on that waiting room.
确保没人会死在那里
Make sure nobody's gonna die out there.
你们的高级住院医生是柯林斯医生和朗登医生
Your senior residents are Dr. Collins and Dr. Langdon.
你们向他们汇报他们向我汇报
You report to them, and they report to me.
明白了吗很好
OK? Great.
高级住院医生你们登出系统了吗 - 是的
Senior residents, you got your sign-outs? - Yep.
好了 - 好吧让我们开始吧
Yep. - OK. Let's do this.
维吉尔斯崔克左肩9毫米口径枪伤
Virgil Straker. 9mm GSW to the left shoulder.
CT血管造影阴性
CT angiogram negative,
外科医生想让他今晚留院观察
surgery wants to admit for overnight observation.
生命体征良好
Good vitals.
血球比复查了吗 - 血球比稳定每两小时一次共三次
They repeat a crit? - Stable crits every two hours times three.
开点西福辛出院吧明天来复查他在家里能休息得更好
Discharge on Ceftin, recheck tomorrow. He'll get way more rest at home.
早上好斯崔克先生你想回家吗
Good morning, Mr. Straker. You want to go home?
当然了 - 好的
Hell yeah. - OK.
嘿罗我终于要离开这里了
Hey. Hey, Ro. Hey, Ro, I'm finally getting out of here!
好吧墨菲罗滕斯坦
All right, Murphy Rottenstein.
48岁女性患有肝硬化和上消化道出血
48-year-old woman with cirrhosis and upper GI bleed.
插管及输血一个单位后情况稳定正在等待重症监护室床位
Intubated and stable after one unit. Awaiting ICU bed.
嘿医生
Hey, Doc.
我们都认识路易克洛弗菲尔德
And we all know Louie Cloverfield.
晚上11点的血液酒精浓度达到了420
Blood alcohol of .420 at 11:00 PM.
我一直在努力戒酒 - 他怎么还活着
I've been cutting back. - How is he still breathing?
对你我来说那是致死剂量但对路易却是欢乐时光
That's a lethal dose for you and me. That's happy hour for Louie.
完全清醒了注射了两轮劳西拉泮
Sobered up. Had two rounds of lorazepam.
把手伸出来好吗
Hold out your hands for me, Louie.
再来两剂劳西拉泮 - 好的
Another two of lorazepam. - On it.
再开一盒利眠宁
And a script for Librium.
很高兴见到你路易 - 是我的荣幸医生
It's good to see you, Louie. - It's always a pleasure, Doc.
酒吧斗殴导致八号♥牙完全脱落
Bar fight with complete avulsion of tooth number eight.
笑一笑查理
Smile, Charlie.
你的牙齿呢查理
Where's your tooth, Charlie?
我怎么知道 - 取消出院
Fuck if I know. - Cancel the discharge.
安排胸部X光片必须排除穿刺可能
Order a chest X-ray. Got to rule out aspiration.
有患者
Incoming!
42岁男性山姆华♥莱♥士♥
42-year-old male, Sam Wallace.
头部钝伤濒死呼吸掉在了火车铁轨上
Blunt head with agonal respirations. Dropped down on the T tracks.
没法给他插管已置入喉罩 - 自杀未遂
Couldn't tube him. LMA in place. - Suicide attempt?
他是救人的见义勇为
Rescue. He's a good Samaritan.
营救一位掉下轨道的女性时摔倒了
Took a spill helping a woman who fell off the track.
她就在我们后面 - 创伤一室推他过去吧
She's right behind us. - OK. Trauma one. Go ahead.
收到 - 来吧
Copy. - Come on.
一位女性从火车站台摔下去了生命体征良好没有头部伤
Woman fell from T platform. Good vitals and no head injuries.
脱套伤右下肢有开放性骨折
Degloving injury, right lower leg with open fracture dislocation
脚踝脱臼 - 好的
to the ankle. - OK.
创伤二室我们走
Trauma two. Trauma two. Let's go!
怎么样准备好了吗
How are we doing? We ready?
好的准备好了吗一二三
OK, here we go. Ready? One, two, three.
呼吸良好双侧都有呼吸音但我们需要保护...
Good breath sounds bilaterally, but we need to protect...
显然他跳下去就是为了救这位女士
Apparently he jumped down to save the lady.
但爬上来时脚滑摔倒了撞到了头
When he climbed back up, he slipped, fell back, and hit his head.
好的谢谢 - 梅尔对吧
OK, thanks. - Uh, Mel, right?
我需要你做一个E-FAST超声评估
I need you on the E-FAST.
瞳孔扩张四毫米有反应
Pupils 4 millimeters and reactive.
这是好消息 - 你想给什么药
OK, that's encouraging. - What do you want for meds?
120毫升氯♥胺♥酮♥和80毫升罗库溴铵 - 显示器有房♥颤
120 ketamine, 80 of rock. - A-fib on a monitor.
气道通畅 - 出血量比预期的要多
Courses clear. - That's a lot more blood than expected.
他可能房♥颤抗凝血了查下他的病历
Um, he's probably anticoagulated for A-fib.
看看他是否口服了抗凝血剂
Check his medical records, see if he's on a DOAC.
如果有脑出血的话随时准备使用四因子PCC
Stand by with four-factor PCC if there's a brain bleed.
PCC里面有什么梅尔
What's in the PCC, Mel?
凝血因子II VII IX和X
Uh, clotting factors two, seven, nine, and ten.
好的马上回来 - 太好了
OK. Be right back.
50微克芬太尼对她无效
50 of fent didn't touch her.
她是晕倒了还是跌下站台的
Did she faint or did she trip off the platform?
没人知道另一个人跳下去把她从铁轨拉了上来
Nobody knows. The other guy jumped down, pulled her off the tracks
正好赶在火车开进来之前
just as the train was rolling in.
只有脚部受伤 - 火车碾过了她的脚
Isolated injury to the foot. - The train ran over her foot?
夹在站台和迎面而来的火车之间
Got caught between the platform and the incoming train.
女士你叫什么名字 - 好的三型开放性骨折
Ma'am? Ma'am, what's your name? - All right, type 3 open fracture.
两克头孢唑林 400毫克庆大霉素 - 你会说英语吗
Two grams Cefazolin, 400 of gent. - Do you speak any English?
气道和呼吸无异常 - 血液循环也是高压140低压85
Airway and breathing are perfect. - As is circulation. BP 140 over 85.
学生们有哪些原因可能导致她晕倒在站台上
Students, what might have made her faint on the platform?
短暂性脑缺血发作脑血管事件 - 可能是心律失常心脏病
Uh, TIA, CVA. - Could be an arrhythmia, cardiac event.
所以她需要...
So she needs...
头部CT - 心电图和肌钙蛋白检测
Hed CT. - EKG and troponin.
很好 - 什么情况派对狂人们
OK, good. - What do we got, party people?
地铁列车碾压造成的脚部脱套伤外加开放性骨折脱位
Subway train degloved her foot with an open fracture dislocation.
我还以为我的脚后跟很痛呢
Ooh, and I thought my heels were painful.
血液动力学指标稳定 - E-FAST阴性
Hemodynamically stable. - E-FAST negative.
女士我是约兰达加西亚医生你感到胸部或腹部有疼痛吗
Ma'am, I'm Dr. Yolanda Garcia. Any pain in your chest or belly?
我们能注射吗♥啡♥吗 - 不行这会影响她的精神状态
Can we please push the morphine? - No, it could cloud her mental status.
她这样我做不了检查注射一下该死的吗♥啡♥
I can't do an exam like this. Push the damn morphine.
我们正在做腘窝阻断术让下肢麻木
We're doing a popliteal block. Numbs the lower leg,
没有副作用 - 太棒了
no side effects. - Wonderful.
另一个人怎么样了 - 他在隔壁情况更糟
Where's the other guy? - Next door. He's a bit worse.
给她做个水平扫描她停止尖叫时告诉我
Pan scan her. Let me know when she stops screaming.
声带很靠前
The cords are very anterior.
是的因为我们不能弯曲颈部让曲棍球棒形探头保持直立
Yeah, that's because we can't flex the neck. Keep the hockey stick straight up.
我进去了 - 很好干得好
I'm in. - Good. Well done.
告诉我最新情况 - 插管缓解濒死呼吸
Bring me up to speed. - Intubated for agonal respirations.
昏迷指数5分可能有抗凝血问题
GCS 5. Probably anticoagulated.
因为什么 - 第一次来我们院
With what? - First time here.
没有医疗记录 - 需要使用新鲜冷冻血浆吗
There's no medical records. - Call for FFP?
不用我们有四因子PCC
No, we got four-factor PCC.
注射80毫升甘露醇减少脑部肿胀然后直接去做CT
80 of mannitol to reduce brain swelling, then right up to CT.
帮我个忙你去和杰茜换一下好吗
Do me a favor. Swap out with Jesse for me, would you?
好的 - 谢谢
Of course.
罗宾纳维奇医生你有空吗 - 现在有点忙格洛丽亚
Dr. Robinavitch, do you have a moment? - I'm just a little busy right now, Gloria.
稍等一下
One sec.
神经阻断完成 - 好像开始起作用了
Nerve block complete. - Seems like it's starting to work.
我们换一下杰茜
Swapping out, Jesse.
完全起效需要十分钟麻佳因麻醉时间能持续整整四小时
Takes ten minutes for the full effect, and the Marcaine lasts a good four hours.
接下来安排她做CT
She's next for CT.
知道那是什么语言吗 - 绝对不是他加禄语
You have any idea what language that is? - Definitely not Tagalog.
可能是印地语或乌尔都语 - 我去叫语言服务
Maybe Hindi or Urdu. - I'm gonna go get language services.
你不是会说五种语言吗 - 六种但这个我不会
Don't you speak, like, five languages? - Six, but that's not one of them.
六种我还以为柯林斯很聪明呢
Six? And I thought Collins was smart.
现在就开始做混♥蛋♥事还为时过早朗登
Oh, it's way too early for you to start being an ass, Langdon.
在病人面前公开表现敌意 - 她不会说英语
Open hostility in front of the patient? - She doesn't speak English.
刻薄又轻蔑
Judgmental and dismissive.
情况如何 - 生命体征稳定
How are we doing? - Vitals stable.
不像这两个 - 真不错普林塞斯开了个玩笑
Unlike these two. - Ooh, good for you. Princess made a joke.
你为什么总这么混♥蛋♥
Why are you always an asshole?
感谢你给我的美好祝福合十礼
And I thank you for that beautiful blessing. Namaste.
好了我们有手♥机♥或任何有亲戚名字的东西吗
OK, do we have a phone or anything with a relative's name on it?
急救人员说地铁碾过时钱包被毁了
EMT said the purse got obliterated when the subway ran over it.
我能和她谈谈吗
Any way I can speak with her?
非常怀疑我们不知道她说的是哪种语言
Highly doubt it. We don't know what language she speaks.
她有可能是自己跳下去的吗 - 她可能是被推下去的
Hey, um, any chance she jumped? - She may have been pushed.
天啊 - 是啊