匹兹堡医护前线（2025）

The Pitt S01E07

Part 3 March 11, 2025, 8:29 p.m.

传染性脑炎 - 这些都有可能
infectious encephalitis. - These are all possibilities.
我们给她做个彻底检查看看能不能找到病因
OK, let's work her up medically and see if we can clear her.
查一下全血细胞计数促甲状腺激素甲状腺素药检和绒促性素
Chem panel, CBC, TSH and T4, drug screen, and hCG.
好的有消息通知我
Yep. Keep me posted.
如果都是阴性的那就让她去精神科
If it's all negative, then admit her to psych.
你还觉得恶心吗 - 没有
Still feeling nauseous? - Not really.
很好
Good.
所以...你妈妈在找你
So your mom is looking for you.
我没想到我妈妈会发现
I didn't think my mom would find out.
如果我和她一起回家我的人生就完了
If I go home with her, my life is over.
也许她会改变主意的
Mm. Maybe she'll change her mind.
有时候这个肌腱叫做腓短肌
Sometimes this tendon called peroneus brevis
可以扯下一块骨头
can pull off a piece of this bone,
第五跖骨 - 那是舞者骨折对吗
the fifth metatarsal. - That's the dancer's fracture, right?
没错你很可能有二级脚踝扭伤
Exactly. You most likely have a second-degree ankle sprain.
X光片会告诉我们一切
The X-ray will tell us everything.
技术人员会来接你然后我会回来给你看影像
Tech will come get you, and then I'll come back and show you the images.
太好了 - 好的
Great. - OK.
我来下订单 - 你怎么做到的
I'll put the orders in. - How'd you do that?
做什么 - 跟他交流
Do what? - Talk to him.
我只是认真倾听了他的话 - 真好笑
I listened? - Funny.
不你解锁了什么东西我跟他一点进展都没有
No, you-- you unlocked something. I wasn't getting anywhere with him.
我妹妹是自闭症患者
Oh, my sister is on the spectrum.
嘈杂的急诊室对自闭症患者来说非常难以承受
And the ER can be a very, very overwhelming place for autistic people, so I--
所以需要用另一种方法
I don't know. It just takes a different approach.
你和你妹妹很亲近吗 - 我们是最好的朋友
Are you and your sister close? - Yeah, we're best friends.
有一次... - 我得去趟卫生间
There was this one time we were on the swing-- - I got to hit the head.
X光片出来后告诉我一声
Let me know when the X-rays are back.
她在哪
Where is she?
她没事只是需要点时间
She's OK. She just needs a minute.
我给了她足够的时间
I have given her enough time.
她可以在回家的路上消化这件事
She can process this on the car ride home.
我们能聊一会吗
Can we talk for a moment?
拜托了
Please.
我知道你想帮忙但这是我和我女儿之间的事
I know you're trying to help, but this is really between me and my daughter.
所以如果你能让她出来我们就出发了
So if you could just bring her out, we will be on our way.
她真的很难过
She's really upset.
她会好起来的
She'll get over it.
你怀她的时候也是跟她差不多的年纪吧
Weren't you about the same age when you got pregnant with her?
是的
Yes.
所以你知道这有多难
So you know how hard it can be.
当时确实很难
It was very hard at the time.
但她是上天给我的最好礼物
But she turned out to be the best thing that has ever happened to me.
我希望在她准备好的时候也有同感
And I hope she feels the same way when she's ready.
但现在她没有对她来说天都要塌了
But right now, she's not. For her, the world is ending.
如果你把她推开她可能再也不会回来了
If you push her away, she might never come back.
柯林斯医生
Dr. Collins?
失陪了
Excuse me.
代码ST段抬高型心肌梗死已经在创伤二室了
Code STEMI, Trauma 2 now.
需要帮忙吗 - 我们人手够了
Hey, need a hand with the STEMI? -We're all set.
维塔克你跟我来
Whitaker, you're with me.
创伤二室胸骨后疼痛伴出汗十分钟后被同事送来的
Trauma 2. Brought in by a coworker after 10 minutes of substernal chest pain with diaphoresis,
分诊处判断为前壁急性心梗
anterior STEMI and triage.
桑托斯医生你有时间吗
Dr. Santos, do you have a minute?
当然
Yeah, sure.
我是朗登医生这位是罗比医生
I'm Dr. Langdon. This is Dr. Robby.
我叫张哈维 - 你心脏病发作了先生
Harvey Chang. - You're having a heart attack, sir.
我知道 - 你以前发作过吗
I figured. - You ever had one before?
没有
No.
有多痛
How much pain?
就像我胸口上坐了只大象
Like an elephant's on my chest.
你在吃药吗
Are you taking any medications?
二甲双胍和罗苏伐他汀
Metformin and rosuvastatin.
分诊处高压170低压92
170 over 92 at triage.
324毫克阿司匹林咀嚼片舌下硝酸甘油五分钟一次共三次
324 chewable aspirin, sublingual nitro q five times three.
心导管室准备好了
Cath lab is standing by and ready.
如果你去心脏科他们可以切开堵塞的动脉
Harvey, if we get you up to cardiology, they can open your blocked artery.
我们就能阻止这次心脏病发作
We can stop this heart attack.
有人知道匹兹堡海盗队比分多少吗
Anyone got a score for the Pirates game?
他们在第一节结束时领先两分
They're up by 2 at the bottom of the first.
麦卡钦打了一个反向本垒打
McCutchen hit an oppo taco.
天啊
Clutch, clutch.
我们能打电♥话♥给谁吗
Is there anybody we can call?
我妻子一年前去世了
No. My wife died a year ago.
今天就是我跟她团聚的日子
I guess today is the day I'll be joining her.
我能理解你的心情但这不是我们的计划
I appreciate that sentiment, but that is not part of our plan.
没有杂音桡动脉搏动对称
No murmurs. Radio pulses are symmetric.
出现室颤维塔克胸部按压充电到200
V-fib. Whittaker, chest compressions. Charge to 200.
好的
面对恐惧的最好方法 - 我能想到更好的方法
Best way to face your fears. - Yeah, I can think of better ways.
100%浓度吸氧准备插管
Let's bag him on 100%, set up for intubation.
已充电清场
Charged and clear.
还是室颤继续按压给他上LUCAS心肺按压系统
Still V-fib. Resume compressions. Let's get him on the LUCAS.
一旦有最新消息我会来找你的
As soon as we know anything, I'll come and get you.
这都是我的错
This is all my fault.
你指什么
What is?
你有什么事没告诉我们吗
Is there something you haven't told us?
邓恩太太为了有效治疗你的丈夫
Mrs. Dunn, in order to effectively treat your husband,
我们需要知道任何...
we need to know anything that--
激素水平异常...可能是因为黄体酮
The hormone levels-- it could be the progesterone.
他在服用黄体酮
He's taking progesterone?
我一直在给他服用我每天早上放进他的咖啡里
I've been giving it to him. I put it in his coffee every morning.
我以为如果我能遏制他的性♥欲♥ 他就会停下来
I thought if I could kill his libido, he'd stop.
停下什么
Stop what?
我觉得他在猥亵我们的女儿
I think he's molesting our daughter.
关于Lifepak除颤仪你得学会这个 - 好的
Whitaker, on LifePak. You need to learn this. - Yeah.
设置200焦耳异步按充电键
Set 200 joules asynchronous. Press charge.
暂停按压
Pause compressions.
还是室颤
Still V-fib.
没有脉搏 - 清场
No pulse. Clear. - Clear. Clear.
该你了维塔克 - 该死
That's your cue, Whitaker. - Shit.
没有变化
No change.
注射肾上腺素和胺碘酮
Epi and amio, please.
他救不回来了是吧 - 我们还有很多方法可以尝试
He's not coming back, is he? - We still got a ways to go.
已注射一单位肾上腺素 - 接下来是双重连续电击
One of epi is in. - Double sequential defibrillation next.
值得一试我放个动脉导管
Worth a shot. I'll put it in an art line.
右胸骨缘顶部
Right sternal border, apex.
理论是利用第一次电击
The theory is that the first shock lowers
降低除颤阈值使得第二次电击
the defib threshold so that the second shock
成功逆转任何颤动的几率更大
has a better chance of converting any fibrillating myocytes.
华♥莱♥士♥先生你感觉如何
Mr. Wallace, how are you feeling?
我挺好的
I'm OK.
你已经在这里七个小时了
You've been here about seven hours,
你撞到头后陷入昏迷摔得很惨
hit your head and came in unconscious, took a pretty nasty fall.
铁轨
The T?
对摔到了铁轨上
Yeah, on the T tracks.
那个亚洲女人呢她怎么样了
What about the Asian lady? How's she doing?
米努她好多了
Minu? She's doing a lot better.
警♥察♥抓到推她的人了吗
Did the cops catch the guy who pushed her?
她是被推下去的
She was pushed?
是的我看到了
Yeah. I saw it.
警♥察♥之前来过这里他们想和你谈谈
The cops were here earlier. They wanted to talk to you.
我可以给他们做笔录
I can give them a statement.
好的我们可以联♥系♥他们
OK. We can reach out.
我能见见她吗
Can I see her?
我想我们能安排
I think we can make that happen.
维塔克如果他没脉搏我们就清场然后电击两次
All right, Whitaker, if he's pulseless, we clear it and then shock-shock.
我先来然后你用最快的速度接上
I go first. You hit it as fast as you can.
我明白
I got it.
我现在把两个都充到200
Charging both to 200.
已充电 - 停止按压