匹兹堡医护前线（2025）

The Pitt S01E01

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

Last interpreter thought she might be from Pakistan.
巴基斯坦有77种语言
There are 77 languages in Pakistan.
好吧弄清楚的人我请他吃午饭
OK, well, I will buy lunch for whoever figures it out.
祝你们好运如果需要我的话我正在拯救生命
Good luck. If you need me, I'll be saving lives.
太惨烈了
That was wicked.
太恶心了
That was gross.
是啊对那位出了大糗的宕机小姐来说过于残酷了
Yeah. Too much for Little Miss Crash and Burn.
你对她做了什么 - 没什么我想她会没事的
What'd you do with her? - Nothing. I think she'll be fine.
你在开玩笑吗
Are you kidding?
这点小场面都能晕过去她能撑过这次轮岗都算幸运了
If that took her out, she'll be lucky to make it through this rotation.
我赌50块她撑不过这次轮岗
I got 50 bucks says she doesn't last through this shift.
来吧敢说就要敢赌
Come on. Put your money where your mouth is.
不我什么都没说好吗
Uh, no. I didn't say anything, OK?
我也没有50块
And I sure as hell don't have 50 bucks.
等我还清学生贷款的时候我就和这位女士一样大了
I'll be this lady's age by the time I pay off my student loans.
我不是说你...
Not that you're--
嘿
Hey.
你想卖♥♥肾吗
You want to sell a kidney?
我这个周末就能给你三万
I could get you 30K as soon as this weekend.
这事只有咱俩知道
That's just between you and me.
考虑一下吧
Think about it.
你还好吗
How you doing?
是啊
Yeah.
QRS波变窄了他好转了
QRS has narrowed. Much better.
钾含量是7.7 肌酸5.6 - 高钾和肾衰竭
Potassium is 7.7. Creatinine, 5.6. - High potassium and renal failure.
跟你想的一样 - 今天一定是我的幸运日
Just what you thought. - It must be my lucky day.
给他注射10单位常规胰岛素和25克葡萄糖
Ordering 10 units of regular insulin and 25 grams of glucose.
为什么是胰岛素和葡萄糖 - 转移细胞内的钾
Why insulin and glucose? - Shift the potassium intracellularly.
没错但最终的治疗方案应该是... - 血液透析
Exactly, but the definitive treatment is... - Hemodialysis.
我会打给肾病科让技术人员准备好机器
I'll call renal and get a tech down with the machine.
你见过插入透析导管吗
Have you ever seen a dialysis catheter inserted?
柯林斯医生会在超声指导下放入一根股骨昆顿导管
Dr. Collins is gonna place a femoral Quinton under ultrasound guidance.
是绝佳的学习机会
It's an excellent way to learn.
我的胸口好疼 - 是的我们得电击你
Oh, my chest. - Yeah, we had to shock you.
你会疼上一阵子 - 你们电击了我的心脏
You're gonna be sore for a while. - You shocked my heart?
说来话长柯林斯医生会跟你解释的
Long story. Dr. Collins will fill you in.
你有时间吗
You got a sec?
你还好吗
You OK?
我为什么不好你还好吗 - 我为什么不好
Why wouldn't I be? Are you OK? - Why wouldn't I be?
你好像已经生我的气了可我才刚到
You seem annoyed with me already, and I just got here.
不是所有事都与你有关罗比
It's not always about you, Robby.
我会没事的吗
Am I gonna be OK?
是的你只需要多善待自己的身体
Yeah. You just need to take it easy on yourself.
肌肉分解和肌血球素损伤了你的肾脏
Muscle breakdown and myoglobin damaged your kidneys.
为什么要电击我的心脏
Why'd you shock my heart?
当你的肾脏罢♥工♥时钾就会积聚
When your kidneys don't work, potassium builds up
影响你心脏的电流活动
and messes with the electrical activity in your heart.
这种情况会再次发生吗
Can it happen again?
我们给你用了降低钾含量的药
We gave you medicine to lower your potassium,
你需要透析清除掉剩余的钾
and you'll need dialysis to clear it all out.
然后我就没事了
Then I'll be OK?
是的你的肾脏可能需要一两个星期才能恢复但会好起来的
Yeah. You might need a week or two for your kidneys to recover, but yeah.
在铁人三项之前和之后你都需要大量补充水分
You really need to hydrate like crazy before and after a triathlon.
相信我我不会让这种事再次发生
Trust me, I won't let this happen again.
很好
Good.
对自己好一点好吗
Be kind to yourself, OK?
嘿阿伯特告诉我他有个怀孕少女
Oh, hey. Abbot's told me that he's got a pregnant teen
今天要来吃口服堕胎药
coming back today for mifepristone.
她到的时候告诉我一声 - 好的
Let me know when she gets here. - Yep.
肠梗阻还在等手术会诊
Bowel obstruction, still waiting on a surgery consult.
加西亚呢她刚才还在这里处理外伤呢
What about Garcia? She was just here for the traumas.
我想她在等主治医生签字
I think she was waiting for her attending to sign off.
好吧
OK.
有个医学院的学生在手术室晕倒了
Oh, one of the med students took a header.
我打着报工伤的幌子让她去休息室了
I parked her in the lounge under the guise of a work comp report.
你能进去看一眼确保她没事吗
Will you just go in there, eyeball her, and make sure she's all right?
她会错过今早的活死人♥大♥军的
She's gonna miss the morning arrival of the living dead.
预计会有多少人
How many are we expecting?
有三个但有一个死在了途中
We were getting three, but one died en route.
不知道谁更幸运是我们还是他们
Don't know who's luckier, us or them.
抢救了多久
What's open?
14分钟 - 89岁女性来自一家护理机构
14. - 8♥9♥-♥year-old woman from a SNF.
有肺气肿慢性心衰和多发性硬化症病史
History of emphysema, CHF, MS.
室颤三次电击无反应已注射两轮肾上腺素
V-fib, unresponsive to three shocks. Two rounds of epi.
那是什么
What is that?
LUCAS心肺按压系统 - 机器人心肺复苏仪
LUCAS chest compression system - Robotic CPR.
大家都抓住了一二三
Everybody get a hold. One, two, three.
学生们像苍蝇一样纷纷阵亡 - 休息一下冰一下手指
Students are dropping like flies. - Take a break. Ice the finger.
你可以指望每天7点半左右
You can count on getting a couple elderly patients
在养老院和看护中心做完清晨查房♥后
every day around 7:30, after the nursing homes
都会来几个老年病人
and assisted living facilities do their morning bed checks.
你都可以设个闹钟了 - 有事前指示书吗
You can practically set your watch. - Was there an advanced directive?
没有养老院说要全力抢救 - 认真的吗
No, full code, per the nursing home. - Seriously?
LUCAS关闭 - 还是室颤
LUCAS off. - Still V-fib.
LUCAS开启再来一轮肾上腺素和电击
LUCAS on. One more round of epi, one more shock,
然后就停止抢救
and then we call it?
约瑟夫斯宾塞 79岁发烧和咳嗽从看护中心来的
Joseph Spencer, 79. Fever and cough. From assisted living.
他有轻度阿尔茨海默氏症病史
He has a history of mild Alzheimer's.
一二三
One, two, three.
脉搏130 高压90低压60 给他注射500毫升生理盐水
Heart rate 130. BP 90 over 60. Gave him 500 cc's normal saline.
嗨斯宾塞先生我是金医生这位是柯林斯医生
Hi, Mr. Spencer. I'm Dr. King. This is Dr. Collins.
你今天感觉如何
How are you feeling today?
晚餐时间到了吗我不饿
Is it dinnertime? I--I'm not really hungry.
我们这里有看护中心的文件吗
Do we have any paperwork from the facility?
他有急救医疗嘱讬
He has a POLST.
静脉注射液和药物都没问题但不能插管和心肺复苏
IV fluids and medications are fine, but no intubation and no chest compressions.
这很有帮助
That's helpful.
肺部粗糙 - 右中叶浸润
Coarse rhonchi here. - Right middle lobe infiltrate.
体温38.8摄氏度代号♥脓毒症
Temp 102. Call a code sepsis.
代号♥ - 确保我们完成了所有步骤
Code? - To make sure we check all of our boxes.
联邦政♥府♥会审核我们脓毒症的整体表现
The federal government audits our sepsis bundle performance
并在网上公布数据
and publishes the data online.
今天最好一切都做到完美
Today, it better be perfect.
提取两份血液培养物测乳酸水平按每公斤体重30毫升注射生理盐水
Two sets of blood cultures, lactic acid, 30 cc's per kilo NS,
一克头孢曲松
a gram of ceftriaxone,
500毫升阿奇霉素三小时后重复测乳酸水平
500 of azithromycin, repeat lactic in three hours.
很好
Nice.
正在充电...
Charging, and...
停下吧不用抢救了
Stop. Call it.
养老院刚传真给我们一份放弃急救同意书
Nursing home just faxed us a DNR.
开什么玩笑 - 电击器和LUCAS全部关闭
Are you kidding me? - Power off the defibrillator and the LUCAS.
浪费时间和金钱在那工作的都是什么人
Complete waste of time and money. Who the hell works at that place?
一个照顾60个病人找不到表格的护士
A nurse taking care of 60 patients who couldn't find the form.
她打了911 好让她可以照顾其他人
She called 911 so she could take care of the others.
好吧我们把她转移到安息室并通知家属
OK, let's move her to the viewing room and notify the family. Yep.
我们在这里要做的一件事是
One of the things we do here is
每当失去一个病人时都要默哀一会
to take a moment of silence when we lose a patient,
尊重他们的人性同时记住这个人也有父母
to respect their humanity and also to remember that this was somebody's child
或是兄弟姐妹子女和朋友
or sibling or parent, friend.
我很抱歉
I am so sorry.
或许可以在工作时把手♥机♥调成振动
Maybe leave it on vibrate while you're working.
再见医生 - 你要乖乖听话
Later, Doc. - You behave yourself now.
我一直都很乖
Always.
你那个医学生恢复过来了
Your med student's back on her feet.
那孩子多大了 - 我不知道我没问
How old's that kid? - I don't know. I didn't ask.
她是什么神童吗 - 我不知道也许吧
What is she, some sort of savant? - I don't know. Maybe.
罗宾纳维奇医生
Dr. Robinavitch.
我只是想为我的笨拙造成的麻烦道歉
I just wanted to apologize for any trouble my clumsiness might have caused.
我觉得很丢脸
I feel ridiculous.
我都不记得我的头撞上了多少次手术照明灯
Oh, I can't tell how many times I've hit my head on an overhead lamp.
其中有两次还缝了针