匹兹堡医护前线（2025）

The Pitt S01E05

Part 5 March 11, 2025, 8:29 p.m.

Any medical problems?
没有只是咽喉发炎所以我才做了手术
No, just a ton of strep. That's why I had the surgery.
你服用阿司匹林吗其他药物呢
You take aspirin? Any other medications?
双侧呼吸音清晰没有喘鸣
Lungs are clear bilaterally, no stridor.
好的你想呕吐吗肚子疼吗
Okay, sure. You feel like throwing up? Any pain in your belly?
没有
No.
化验项目
Labs?
血气分♥析♥ 全套代谢功能或者再加个凝血分♥析♥
CBC, BMP, maybe coags?
还有血型测定和毒物筛查以防万一 -好的
Add a type and screen, just in case. - Yeah.
血氧饱和度98 高压115低压80
Good sats at 98%. BP is 115 over 80.
很好敷料钳夹取四乘四敷料我们来看看
Okay, good. Four by four on a ring forceps. Let's take a look.
好的头后仰张大嘴巴
Okay. Head back, open wide for me.
你看到什么 -没有活动性出血
What do you see? - No active bleeding,
但扁桃体区域有一些白色和深棕色的东西
but there's some white and dark brown stuff where the tonsils used to be.
很好那是纤维状凝块这意味着氨甲环酸起作用了
Oh, that's good. That's a fibrinous clot. That means the TXA is working.
你父母在路上吗
Your parents on the way?
他们在巴尔的摩参加婚礼我不想麻烦他们
They're in Baltimore for a wedding. I didn't want to bother them.
相信我他们是你的父母而你现在在急诊室
Trust me. They're your parents, and you are in an emergency room.
这从来都不是麻烦
It is never a bother.
把他们的号♥码写下来我会打给他们
Write their numbers down, and I will call them.
打给头颈外科在他们到之前陪着他好吗
Call Head and Neck. Stay with him until they get here, okay?
很好笔
Good. Pen.
我可以…
Can I get the...
山姆华♥莱♥士♥ 那个救了一位尼泊尔女士的好心人
Sam Wallace, our Good Samaritan who saved a Nepali lady,
正在排队等待复查头部CT
is in line for a repeat head CT
确保脑内出血没有扩大
to be sure there's no extension of the intraparenchymal bleed.
好的我们可以减少镇静剂如果他清醒过来…
Okay, so we can dial down the sedation, and, if he's alert,
检查插管参数 -好的
check extubation parameters. - Copy.
你拿到了乔伊斯签的插管同意书了吗
Did you get the consent form signed by Joyce the sickler for the intubation?
还没有 -天啊…
Not yet. - Jesus fucking--
她很害怕我只是想给她点时间
She's scared. I just wanted to give her some time to talk to her...
做什么安排葬礼吗乔伊斯严重缺氧血氧饱和度只有84
To do what, make funeral arrangements? Joyce is hypoxic at 84.
84意味着如果再这样下去
84. This goes on much longer,
她会面临永久性肺损伤心脏病发作
she runs the risk of permanent lung damage, heart attack...
我知道 -…中风和死亡的风险
I know. - Stroke, death.
我知道 -那就动起来快点
I know. - Then move! Now.
请坐我们马上就来
Just have a seat, and we'll be with you shortly.
这种废话我听得太多了
Oh, I've heard that load of bullshit before.
我的天啊
My fucking God.
他们大老远把我带过去
Took me all the way back there
就是为了把温度计塞进我嘴里
just to stick a goddamn thermometer in my mouth, you know.
“每四小时重复检查生命体征”
Repeat vitals every four hours.
妈呀你看到它急转弯差点撞上出租车了吗
Oh, dang! Saw how it swerved and almost hit the taxi?
我得走了
I gotta get out of here;
这东西肯定会毁了去匹兹堡音乐节的交通
I mean, this thing is totally gonna screw up the traffic to Pittfest.
不错你和罗比一起去吗 -原定是这样
Nice score. You going with Robby? - Well, I was supposed to.
但我有个新女友她对出场的明星阵容非常期待所以…
But I have this new girlfriend, and she's super excited about the lineup, so...
所以你为了一个姑娘甩了你老爸
So you ditched the old man for a hot piece of ass.
我也经历过
Been there, done that.
大四时我在洛拉帕鲁扎音乐节遇到了一个男人
Senior year, Lollapalooza, I met this guy.
他的名字是里奇还是瑞克来着无所谓了
Think his name was Rich-- or was it Rick? Doesn't matter.
但他长得很像戴夫纳瓦罗
But he looked like Dave Navarro.
温暖的微风凉爽的草地夜空中有无数颗星星
Warm breeze, cool grass, a million stars in the sky.
我一生中最棒的性♥爱♥
Best sex of my life.
你在公共场合做♥爱♥
You had sex in public?
我们盖着毯子
We were under a blanket.
它掉头了宝贝
It's turning around. It's turning around, baby.
回家找爸爸吧 -该死
Come home to Papa. - Shit.
我赌的是它在比弗县撞车
I had money on it crashing in Beaver County.
有备无患 -好的
Better safe than sorry. - Okay.
谢谢 -嘿你怎么样
Jake, what's up? - Hey, how are you?
丽塔在哪里
Where's Rita?
她去停车了应该不会超过五分钟
She went to park the car. Shouldn't have been more than five minutes.
你能输一下她的号♥码吗
Why don't you dial her number for me?
她接电♥话♥了吗 -直接转到了语♥音♥信箱
Did she pick up? - Straight to voicemail.
太奇怪了 -来一下
That's weird.
唯一的看护人不堪重负精疲力尽
Sole caretaker, overwhelmed, exhausted.
我劝她休息一下
I told her to take a break,
但你不会认为她抛弃了她妈妈吧
but you don't think she ditched her mom, do you?
我是说这种事经常发生
I mean, it happens.
你需要每天使用两次抗生素药膏
You're gonna need to use the antibiotic ointment twice a day
两天后再来检查伤口好吗
and come in for a wound check in two days, okay?
马提奥你能给我一些足够维持几周的样品吗
Mateo, can you grab me enough samples to last a couple weeks?
好的我这就去 -谢谢
Yeah, I'm on it. - Thank you.
谢谢我真的很感激
Thanks. I really appreciate it.
不客气
Yeah. No problem.
琪拉雅来过这里吗
Has Kiara been here yet?
没有琪拉雅是谁 -琪拉雅
No, who's Kiara?
她是医院的社工
Oh, she's the hospital social worker.
她可以帮你解决住房♥ 儿童保育食物…
She can help you out with, like, housing and childcare and food and security...
你告诉她了 -没有我…
You told her? - No, I..
都是免费的如果你愿意这个体系能帮到你
No, no, it's all free. The system works if you use it. You just have to...
够了
Enough!
我不需要你帮忙
I don't need your help.
你那番演讲很不错但下次别多管闲事了
Nice speech. Next time, mind your own business.
你听说过影响大于意图吗
You ever heard of impact over intent?
我绝不会故意让任何人难堪
I would never intentionally embarrass anybody.
但你那么做了
But you did.
你没有和雪莉对话也没有问她需要什么
You didn't have a conversation with Sherry or ask her what she needed.
相反你走进来告诉她该怎么做
Instead, you walked in here and told her what to do.
你得放慢节奏
You gotta slow down,
好好倾听而不是评判别人
take a beat, and listen instead of judging people.
我不评判别人 -拜托
I don't judge. - Please.
你一整天都在斜着眼睛看我
You've been eyeing me sideways all day.
听着也许我因为两边都经历过所以更容易理解
Look, maybe I have a better perspective because I've been on both sides,
但我们至少要尝试站在他们的立场上
but we gotta try to at least put ourselves in their shoes.
倾听和建立信任会让我们成为更好的医生
Listening and building trust will make us better doctors...
和更好的人
and better people.
对不起
I'm sorry.
我说这些不是要训斥你
I'm not telling you this to reprimand you.
我是想教你帮助你
I'm trying to teach you to help you.
等等那雪莉怎么办
Wait, what about Sherry?
她应该不会回来了
I doubt she'll be back.
但令人难过的是会有很多像她一样的人
But sadly, there will be many, many more just like her.
不他在圣迈克尔医院做了手术但他现在在这里
No. No, no, no. He had the surgery at St. Michael's, but he's here now.
不他没有车他的父母出城了
No, he doesn't have a car. His parents are out of town.
好吧那我怎么把他送回圣迈克尔给他叫辆网约车吗
Okay, okay, well, how am I to send him back to St. Michael's, call him an Uber?
你不能…那不行…
You can't--that doesn't make...
喂
Hey, hello. Hello!
出什么事了
What's wrong?
他们说解决其他医院的问题不是他们的工作
They said it is not their job to fix another hospital's problem.
不过别担心我会跟我的主治医生…
Don't worry about it, though. I'll talk to my attending--
该死
Oh, shit!
我需要一点帮助
I need a little help here!
好吧张嘴
Okay, come on, open up.
扁桃体切除术后出血
It's a post-tonsillectomy hemorrhage.
一次性抽吸头和海绵棒
Yankauer and sponge stick.
他本来很稳定的然后突然就喷血了
He was stable. Then it just opened.
打给血库两个单位全血准备第二条线
Call the blood bank. Two units, whole blood. Get a second line.
头颈外科不肯下来见他
Head and Neck wouldn't come down to see him.
那群混♥蛋♥ -心动过度137次血氧饱和度降到90
Assholes. - Tachy to 120. His sats are down to 90%.
好的取个高流量输氧鼻管 100毫升氯♥胺♥酮♥
Okay, get a high-flow nasal cannula, 100 of ketamine.
准备做可视喉镜检查
Set up the GlideScope.
保持抽吸我要试试直接施压
Hold suction. I'm gonna try for direct pressure.
如果头颈外科还是不肯下来就打给加西亚
If Head and Neck still won't come down, call Garcia.
你不会有事的
You're good. You're good.
好吧在我们开始之前我们暂停一下
Okay, before we begin, let's take a time-out.
这是乔伊斯圣克莱尔
This is Joyce St. Claire.
手术是气管内插管治疗急性胸腔综合征缺氧
Procedure is endotracheal intubation for hypoxia due to acute chest syndrome.
我们会使用可视喉镜和8毫米的管子 7.5毫米备用
We'll be using video laryngoscopy and an 8-0 ET tube with a 7.5 on standby.
用75单位异丙酚和100单位罗库溴铵诱导