匹兹堡医护前线（2025）

The Pitt S01E06

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

This isn't your fault.
随着婴儿潮一代逐渐老去这种情况越来越多了
We're seeing more cases like this as Baby Boomers age.
这对他们的家庭来说很艰难
It's really tough on their families.
谢谢
Thanks.
罗比医生尼克布拉德利的脑灌注研究结果出来了
Dr. Robby, Nick Riley's cerebral perfusion study is back.
脑干没有血流过
No blood flow past the brain stem.
好的
OK.
器♥官♥移♥植♥中心的人到了告诉我一声
Let me know when the transplant people from CORE arrive.
好的
Will do.
有消息吗 - 有我们到外面说吧
Any news? - There is. Why don't we step outside?
我们走这边
Let's go this way.
我拿到了尼克的脑灌注扫描结果
So I have the results of Nick's cerebral perfusion scan.
不幸的是这上面显示尼克的大脑没有血流
Unfortunately, it shows that there's no blood flow to Nick's brain.
这个是什么
Uh, what am I looking at?
给你们看这个可能会更好理解这是一个健康的大脑
It might help you if I showed you. This is a healthy brain.
看到黑色♥区♥域了吗这代表血液流向大脑
See the black? That's blood flowing to the cerebrum.
当没有血流时...
When there's no blood flow...
是白色的
It's white.
是的
Yes.
他脑死亡了 - 我非常抱歉
He's brain-dead. - I am so very sorry.
我祈祷过我本来抱着希望...
I prayed. I had hoped...
我们都是
We all did.
所以他不会醒过来了
So he's not-- he's not coming back?
不会
No.
呼吸暂停测试和灌注扫描都证明了这一点
The apnea test and now the perfusion scan prove that.
现在怎么办他连着那些机器...
What happens now? He's hooked up to all those machines...
给自己点时间试着消化一下这件事
Take some time. Try to process this news.
家庭支持专家很快会过来
A family support specialist will come in very soon
帮助你们完成接下来的步骤
and help you through the next steps.
谢谢
Thank you.
你还好吗
Are you OK?
是的我只是要给服药过量的青少年的父母看灌注扫描结果
Yeah. I just had to show the parents of the OD'd teen the perfusion scan results.
怎么样 - 从来都不容易
How'd it go? - Oh, it never gets easier.
那是罗比医生吗你欠我一支舞
Is that Dr. Robby? You owe me a dance.
看来这是个提高病人满意度的好机会
Looks like an opportunity to boost your patient satisfaction.
我有点生疏了但我们试试看好吗
Well, I am a little rusty, but let's give it a go, shall we?
准备好了吗
Ready?
先涂些塞洛仿然后用四乘四的消毒纱布
Xeroform first, then two cut 4x4s.
金会教你怎么做的
Kim will show you how to do it right.
包在我身上 - 谢谢
I absolutely will. - Thanks.
只有500毫升他不需要待在手术室
Only 500 out. He won't need the OR.
你跟我来
You, follow me.
我彻底搞砸了 - 说点我不知道的
I totally fucked up. - Tell me something I don't know.
你很有自信这是好事
You're confident. That's good.
但自信和自大只有一线之隔
But there's a fine line between confidence and cockiness.
我该给你抽血吗 - 你已经抽了
Should I draw your blood? - You already did.
是啊我是说艾滋病和肝炎检查
Yeah, I-I mean for the HIV and hepatitis panels.
我也可以给赛拉斯做检查
I can do Silas', too.
不伤口修复后我会让达娜做
No, I'll have Dana do it after the wound repair.
我能帮你缝合吗
C-can I suture for you?
不要我自己缝你可以帮忙
Hell, no. I'll do it myself. You can assist.
给我一次性尿片还有缝合托盘
Set me up a chux, suture tray, betadine,
碘伏灌注盐水防溅注射器以及5-0普利灵缝线
irrigation saline, syringe on splash guard, and 5-0 prolene.
1%的利多卡因加肾上腺素五毫升注射器 27号♥针
1% lido with epi, 5 CC syringe, 27-gauge needle.
克里斯蒂和她妈妈还在谈吗
Mom and Kristi still talking in there?
我会尽量给她们时间 - 在合理范围内
I'm giving them as much time as I can. - Within reason.
你觉得妈妈会同意克里斯蒂终止妊娠吗
Do you think Mom will consent to Kristi terminating the pregnancy?
女人只有想生孩子时才该生孩子
A woman should only have a child if she wants to.
如果你没有较真阿伯特的测量值
Well, if you'd just gone with Abbot's measurements,
她们一小时前就已经出院了
they would have been discharged an hour ago.
你是认真的吗
Are you serious?
我需要一个医生去分诊处越快越好 - 怎么了
I need a doctor in triage ASAP. - What's up?
我有一个严重阴囊疼痛的患者我需要排除睪丸扭转
I have a teen with severe scrotal pain. I need to rule out torsion.
四单位咪♥达♥唑♥仑♥ 鼻腔给药我来处理
Pull four of intranasal Versed. I got this.
请便吧
Be my guest.
嗨
Hi.
看看这个漂亮的黑美人你是我们的医生吗
Look at this beautiful Black queen. Are you our doctor?
谢谢是的我是希瑟柯林斯医生这位想必就是迪伦吧
Thank you. Uh, yes, I'm Dr. Heather Collins. And I take it this is Dillon?
我是他妈妈蒂娜 - 很高兴认识你们
And I'm his mother, Tina. - It's nice to meet you both.
迪伦你什么时候开始痛的 - 大概一小时前
Dillon, when did the pain start? - It started, like, an hour ago.
你被踢了还是被球打了
Did you get kicked or hit with a ball or anything?
没有突然就疼起来了
No, it--it just came out of nowhere.
天啊
Oh, God.
你可以的 - 好的
OK.
我需要做一个超声检查
I need to do an ultrasound to make sure
确保你的睾丸没有扭转并切断了血液供应
your testicle didn't twist on itself and cut off the blood supply.
可以吗 - 我能换个男医生吗
Is that all right with you? - Can I get, like, a dude doctor?
拜托迪伦这就是你需要的医生我向你保证
Come on, Dillon. This is the doctor you want. I promise you.
好吧真♥他♥妈♥疼啊 - 别说脏话宝贝
OK, fine. It really fucking hurts. - Language, baby.
谢谢 - 对不起真的好疼
Thanks. - I'm sorry. It really does.
我们要往你鼻子里喷点药
We're going to squirt some medicine up your nose.
它能帮助你放松并缓解疼痛
It'll help you relax and help take away some of the pain.
让他们做吧好吗柯林斯医生说会有帮助
Then do it. OK, Dr. Collins says it'll help.
我知道妈我听到了我耳朵没毛病
I know, Mom. I heard her. My ears are fine.
我的蛋蛋疼得要死拜托了
It's my junk that's killing me. Please.
好的抱歉宝贝 - 来吧老兄
OK, sorry, baby. - Come on, bro.
别动
Hold still.
一切都好吗贝托 - 一切都好医生
All good, Beto? - All good, Doctor.
总有一天我们也会变成那样
That'll be us one day.
你肯定比我早 - 谢谢
You sooner than me, of course. - Shit. Thanks.
我差一点就赢了
I was one crack pipe away from winning the whole thing.
所以柯林斯赢了
So Collins won, huh?
你们知道他们为什么偷车吗
You guys ever find out why those kids stole the rig?
前额叶皮质发育不全
Uh, undeveloped prefrontal cortex.
那群白♥痴♥现在要坐牢了
Idiots gonna do prison time now.
朗登医生约瑟夫马里诺的CT结果出来了
Dr. Langdon, I have Joseph Marino's CT results.
我们的那位癫痫患者
Our seizure patient.
加西亚怎么样了
How's Garcia?
她没事她正在给自己抽血化验
Uh, she's fine. She's getting her labs drawn.
我一会去找她填工伤表
I'll go visit her in a minute, start a chart on her.
你的老伙计怎么样了 - 说来话长我们来看看
What happened to your old bud? - Oh, long story. Let's take a look.
你看到我看到的了吗 - 神经囊肿
You see what I'm seeing? - Neurocysticercosis.
跟他好好说
Be gentle with this one.
病人通常不愿意接受这样的诊断
Patients don't usually handle this diagnosis very well.
明白
Got it.
这里完全没有血流 - 很危险吗
There is no blood flow here at all. - Is that dangerous?
如果超过六小时没有治疗他可能会失去睾丸
If it goes untreated for more than six hours, he could lose a testicle.
我可能会失去蛋蛋
I could-- I could lose my balls?
失去一个睾丸我们会尽量避免出现这种情况
One testicle. And we're going to try and prevent that.
你到底干了什么迪伦我要把你门上的锁取下来
What the hell were you doing, Dillon? I'm taking that lock off your door.
不幸的是睾丸扭转的发病原因很难确定
It's difficult to know what causes a torsion, unfortunately.
迪伦嘿我必须马上为你治疗
Dillon, hey, it's really important that I try and fix this now.
好的
OK.
我们要开一个新处方...
And I see we're gonna have a new prescription sent to--
传给药房♥ 每天早上吃一粒
To the pharmacy. And, uh, it's just one pill every morning.
好接下来是北区4号♥病房♥的恶心呕吐患者
OK, up next, nausea and vomiting in North 4.
南区走廊奥福里先生的前臂X光片结果出来了
Forearm X-rays are back on Mr. Ofori in the south corridor.
给他上脊椎夹板就可以出院了通知骨科预设医疗指示
You can discharge with a volar splint. Notify ortho. ADF.
永远先办出院明白
Always discharge first. Got it.
四岁是发烧小孩
Four-year-old with a fever.
你的医疗诊断写的是中耳炎
Your medical decision-making says otitis media.
是的她耳朵感染了
Yeah, she had an ear infection.
你有没有考虑过并排除了脑膜炎乳突炎
Did you also consider and rule out meningitis, mastoiditis,
恶性外耳道炎 - 有
malignant otitis externa? - I did.
那你应该记录下你的推断过程
Then you should document your cognitive work in the MDM.
你要我填写病历吗
You want me to pad my chart?
不我想让你展示你的工作收费只是附带的
No, I want you to show your work. Billing is a side effect of that.
有人认真听我刚才说的话了吗
Did anyone listen to what I said earlier?
大多数情况下睾丸是往内侧的方向扭转
Most of the time, the torsion is to the inside,
所以我们要像打开书本一样向外旋转
so we rotate outward by opening the book.
睾丸可能扭转到了另一边