匹兹堡医护前线（2025）

The Pitt S01E04

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

Oh, good. That's a relief.
发生什么事了 -缺氧血氧饱和度78
What's going on? - Hypoxic to 78.
血压急剧下降收缩压82 -脉搏很微弱
BP's crashing. Systolic's 82. - Pulse is thready.
我应该插管他需要大量输血吗
I should intubate. Does he need a massive transfusion protocol?
不左边没有呼吸音右边气管偏移
No. Absent breath sounds on the left, tracheal deviation to the right.
给我一支14号♥套管针给他戴上非再吸入型面罩
14 gauge angiocath now. Put him on a non-rebreather.
你在干什么
What are you doing?
BiPAP正压引起的张力气胸
Tension pneumothorax from the BiPAP's positive pressure.
你听到了吗谁让用BiPAP的加西亚
You hear that? Who the hell ordered BiPAP? Garcia?
不是他的血氧饱和度下降了是我要求用的
No, his--his sats were down. I did.
是吗没有经过我审核
You did? Without running it by me?
我能插入胸管吗 -他不需要胸管
Can I put in a chest tube? - He doesn't need a chest tube.
他需要猪尾导管我会给他做
He needs a pigtail catheter. And I'll be doing it.
血氧饱和度和血压都上升了
Sats and pressure both coming up.
注射75单位氯♥胺♥酮♥
Draw up 75 of ketamine.
她为什么还在哭 -囟门柔软平坦
Why is she still crying? - Fontanelle soft and flat.
双眼瞳孔大小相等有反应跨越中线跟踪
Pupils equal and reactive, tracking across midline.
莫汉医生保持专注 -粘膜完整湿润
Dr. Mohan, keep it focused, please. - Mucous membranes nice and moist.
哭声导致难以听清但肺部无杂音
Hard to hear over the crying, but lungs are clear.
心率过速但正常
Heart rate's tachy but normal.
腹部柔软没有明显的触痛迹象
Soft abdomen, no obvious signs of tenderness.
所以基本上一切正常 -那问题到底出在哪
So basically a normal exam. - Then what's wrong?
给我们一点时间完成我们的检查 -好的我知道
Give us a little time to finish our exam. - Yeah, I know. I know.
要我找什么金医生
What am I looking for, Dr. King?
蜂窝组织炎肾病综合征导致的水肿
Uh, cellulitis? Edema from nephrotic syndrome?
确诊了 -是什么
Diagnosis made. - What is it?
头发导致血液不流通
Hair tourniquet.
妈妈的湿头发可能会多次缠绕脚趾
Mother's wet hair can wrap around the toe multiple times.
头发干了之后会收紧并切断血液循环
When it dries, it tightens and cuts off circulation.
我的头发我在喂她之前洗过澡
My hair? I--I showered before nursing her.
很容易疏忽孩子妈妈
Easy to miss, Mom.
但我们发现得早所以脚趾不会有永久性损伤
But we caught it early, so there won't be any permanent damage to the toe.
怎么治疗莫汉医生 -缠得太紧了没法用剪刀
Treatment, Dr. Mohan? - Uh, it's too tight for scissors.
我们有脱毛膏吗 -还真有
Do we have Nair? - We do indeed.
脱毛膏化妆品店卖♥♥的那种
Nair? Like from the drugstore?
十分钟后应该就能溶解掉孩子就不会再哭了
10 minutes, should dissolve it right off and stop the crying.
嘿你没事了
Hey, you're okay.
怎么了 -我们要给那个狂躁的病人打麻醉
What's up? - We're gonna give the wild one a shot.
接到指令了药在路上了但我们需要人手控制住他
Have the order, meds on the way, but we need bodies.
我负责按头我上次被踢了
I call the head. - I got kicked last time.
右臂 -左臂
Right arm. - Left arm.
右腿 -我还需要一个人
Right leg. - Need one more.
两个我只是来旁观的
Uh, two more. I'm just here to observe
等病人被控制住后再跟他说话
and speak with the patient once he's under control.
嘿罗比你能搭把手按一下克拉科齐亚先生吗
Hey, Robby! Can--can you help us with Mr. Krakozhia?
不行 -懦夫
No. - Coward!
维塔克正是我们需要的人
Whitaker-- just the man we need.
请过来
Come over here, please.
我错过了什么
Whoa, what did I miss?
张力性气胸的一个小插曲
A little drama from a tension pneumo.
你可以给我打电♥话♥的 -我们控制住了
You could have called me. - We got it under control.
很好
Good.
桑托斯医生学到了
And Dr. Santos learned what can happen
给一个轻微气胸病人戴上BiPAP面罩会发生什么
when you put a patient with a small pneumothorax on BiPAP.
拇指手术刀
Thumb scalpel.
他缺氧了我以为会有帮助
He was hypoxic. I thought it would help.
但你没跟我商量他差点因此死掉扩张器
But you didn't discuss it with me, and he almost died. Dilator.
你开的每一个单子都需要请示资深住院医师或主治医师
You need to run every order by a senior resident or attending.
所以这是四年的项目
That's why it's a four-year program.
现在当你做这个手术时
Now, when you do this procedure,
你要确保永远不要弄丢导线
you want to make sure to never, ever lose this guidewire.
如果它被吸进胸腔你就完蛋了
That gets sucked in the chest, you're screwed.
现在准备插入猪尾导管
Now, ready for the pigtail.
你在干什么
What the hell are you doing?
气胸很轻微它会自行消失的
Pneumo is tiny. It'll resolve spontaneously.
是的原本是很轻微直到病人用了BiPAP面罩
Yeah, it was tiny until the patient went on BiPAP.
你♥他♥妈♥在开玩笑吗 -导线取出来了
Are you fucking kidding me? - Guidewire out.
他的血氧饱和度下降了
His sats were down.
是我给他用的 -没跟我说
I--I gave the order. - Without clearing it with me.
新手难免出错我们都是这样学习的
Honest mistake from the rookie. That's how we learn.
如果她什么都知道那她会是你的主治医生而不是实习生
If she knew everything, she'd be your attending, not an intern.
这话倒是没错
That is very true.
而且就算没有BiPAP 这种事也可能会发生
Besides, it could have happened on its own without the BiPAP.
哇真是美妙的时刻房♥间里充满了爱
Wow. Beautiful moment. A lot of love in the room.
失陪了完美救场
If you'll excuse me. Nice save.
病人名字是维勒
It's Wheeler.
阿伯特医生说6点半来复诊他会在这里但我们睡过头了
Dr. Abbot said to come back at 6:30, and he'd still be here, but we overslept.
我忘了给手♥机♥充电我真的很抱歉
I forgot to charge my phone. I'm really sorry.
好吧让我们看看
Okay, let's see.
维勒克里斯汀吗 -是克里斯蒂我是她妈妈
Wheeler, Kristin? - It--it's Kristi, and-- and I'm her mom.
阿伯特医生7点就下班了但没关系
Dr. Abbot went off duty at 7:00, but that's no problem.
我们会叫你的你坐着等叫号♥就行了
We'll get you back. Have a seat until we call your name.
好的非常感谢 -谢谢
Okay. Thank you so much. - Thank you.
不客气下一个
You're welcome. Next.
你们还好吗 -很好谢谢
How you guys doing? - Good, thanks.
我们错过了预约但除此之外我们挺好的
We missed our appointment, but otherwise, we're fine.
天啊
Oh, no.
你在这里很久了吗 -我在这里待了四个小时
Have you been here long? - I've been here about four hours.
我们两个晚上前来过我们当时等了七个小时
We were here two nights ago. We waited seven hours.
太扯了
It's all bullshit.
真不敢相信没人死在这里
Can't believe somebody hasn't died out here.
情况如何 -没有变化
How we doing? - No change.
一直都是我在说
I--I've been doing all the talking.
你想…说点什么吗
Do you want to... say some things?
有什么好说的
What is there to say?
我很伤心很生气
I'm sad. I'm angry.
我不想让他走
I don't want him to go.
我希望很多事情都能有所不同
There's so much that I wish were different.
这不公平
It's not fair.
告诉他
Tell him.
我就是在告诉他我在告诉你们俩
I am telling him. I'm telling both of you.
这不公平
It's not fair.
我想要你拥有过的一切
I wanted what you had.
我爱你爸爸
I love you, Dad.
我很感激你为养育我们所做的一切
And I'm thankful for everything you did to provide for us.
但你不是我想要的爸爸
But you weren't the dad I wanted,
因为我不打棒球不做模型也不钓鱼
because I didn't-- I didn't play baseball or build models or fish.
我朋友们的爸爸都有成年人的工作
My friends' dads all had grown-up jobs.
他们不会讲愚蠢的笑话
They didn't tell silly jokes
也不会模仿角色说话或编故事
or talk in character voices or make up stories.
我觉得很丢脸
I was embarrassed, and I--
我不想我的朋友们见到你
I didn't want my friends to meet you.
海伦 -是真的
Helen. - It's true.
我很羞于承认但这是真的
I'm ashamed to admit it, but it's true.
我离家上大学我躲得远远的
I left for college, and I-- I stayed away.
我本可以去钓鱼的
I could have gone fishing.
我本应该去钓鱼的
I should have gone fishing.
我现在很好奇
And I'm--I'm curious now.
我原谅你爸爸
And I forgive you, Dad,
原谅你没有成为我希望你成为的那个人
for not being the man that I wanted you to be.
但我很感激你没有
But I am-- I am so grateful that you weren't.
这个世界需要你保持原样
The world needed you to be exactly as you are.
这个世界已经病入膏肓丑陋不堪
It got--it got serious, and-- and it turned ugly.
但你和你的朋友们创造了一个虚构的社区
And you and your friends built the Neighborhood of Make-Believe.
这是不可思议的天赋
What an incredible gift.
爸爸我很抱歉
Oh, Daddy. I am so sorry.
请原谅我
Please, please forgive me.
完事后来找我
Come find me when it's time.
没有直升机的新闻报道没有天眼
No news chopper coverage. No eye in the sky.
连一架该死的无人机都没有
Not even a damn drone.
这里没有未解之谜警♥察♥说在376街东边