匹兹堡医护前线（2025）

The Pitt S01E07

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

Charged. - Pause compressions.
动脉置管检测不到脉搏准备清场电击
No pulse on the A-line. Clear for the one-two punch.
清场 - 清场
Clear. - Clear.
恢复按压我们最后这根救命稻草起效了吗
Resuming compressions. That was our Hail Mary.
还有一个办法
We got one more.
启动体外膜肺氧合装置
Activate ECMO.
好的做个动脉血气分♥析♥ 准备股静脉康蒂思导入器
OK, draw up an ABG. Prep the fems. Cordis introducer.
让体外膜肺氧合装置小组过来
Get the ECMO team down here.
感觉好点了吗
Feeling any better?
好像没那么...
Maybe. Um, less...
我们可以联♥系♥谁吗
Is there anybody we can call?
你的朋友必须离开但我们会通知她最新消息
Your friend had to leave, but we can give her an update.
凯莉丝她其实不是我的朋友
Charis. She's not really a friend.
我没有朋友只有粉丝
I don't have friends, just followers.
所以你玩抖音
So you're on TikTok?
当然了我是个美妆网红
Of course. I'm a beauty influencer.
教别人化妆那种吗
Like makeup tutorials?
化妆护肤发型
Makeup, skincare, hair.
你最火的视频有多少浏览量
What's the most amount of views you've ever gotten on one of your videos?
两百万 - 两百万
2 million. - 2 million?
好吧我得关注你
OK, I need to follow you.
南迪你今天为何会在车流中徘徊
Nandi, why did you wander into traffic today?
我害怕有人来追我
Um, I was afraid of people coming after me.
我在家感觉不安全
I don't feel safe at home.
谁会追你 - 我不知道
Who's coming after you? - I don't know.
有些事情改变了 - 什么时候
Something changed. - When?
也许一个月前
Maybe a month ago.
什么改变了
What changed?
我不记得了
I can't remember.
我一直很焦虑睡不着觉
I was worried all the time, trouble sleeping.
有身体症状吗疼痛之类的
What about physical symptoms? Pain? Aches?
我的手会颤抖
My hands shake.
我甚至无法化妆
I can't even put on makeup.
我的脚会麻木
My feet get numb.
还有什么
What else?
我有时认不出镜子里的自己
I don't recognize myself in the mirror sometimes.
我觉得自己在梦里什么都不是真的
I feel like I'm in a dream, and nothing is real.
我这是怎么了
What's happening to me?
我们还不知道但我们会做更多的检查
We don't know yet, but we're gonna do more tests.
有什么想法吗 - 让精神科会诊
Any ideas? - Call for a psych consult.
我们先做个增强脑CT吧
Let's ask for a head CT with contrast first.
查什么 - 震颤协调问题
Looking for what? - Tremors, coordination problems.
额叶病变会导致行为改变
Frontal lobe lesions can cause behavioral changes.
我们不能假设这就是精神问题
We can't assume this is all psych.
明白了
Got it.
我已经放好了7毫米的康蒂思导入器
I've got a seven French cordis in place.
罗比 - 你们来了
Robby. - Here we go.
动脉血气分♥析♥ - 看起来没问题我们开始吧
ABG? - Looks good. Let's do this.
我已经预先插好了右侧股静脉 - 谢谢你
I accessed the right femoral vein. - Thanks for that.
维塔克我们要按无菌手术流程操作
So, Whittaker, we treat this like a sterile surgical procedure.
不能让细菌进入循环系统
We can't introduce bacteria into the circuit.
他会从右腿静脉中
He'll get a garden hose
取出一根软管连接到体外膜肺氧合机器获取氧气
coming out of the vein at the right leg. That flows into the ECMO machine for oxygen
然后通过第二根软管注入到左股动脉
and gets pumped back through a second hose into the left femoral artery.
这些家伙真厉害
These guys are impressive.
体外膜肺氧合装置能代替所有心肺功能
The ECMO does all the work of the heart and lungs.
在颈部放置一个颈内静脉插管他们会用得上的
Place an IJ at the neck. They'll want that.
好的
Got it.
这里已经够拥挤了
OK, I think there's enough warm bodies in here.
我去看看科室的其他病人
I'm gonna go check the rest of the department.
你不要耽误太久... - 这些人很专业的
You don't want to hang out until-- - These guys know what they're doing.
罗比医生 - 什么事
Dr. Robby? - Yep.
我们能谈谈创伤一室的病人吗
Can we talk about the patient in Trauma 1, Silas,
塞拉斯从梯子上摔下来的那个
the fixer upper who fell off the ladder?
他的化验结果出来了吗
Are his labs back yet?
没有但他的妻子苏珊告诉我
No. But his wife, Susan, told me
她一直在往他的咖啡里放黄体酮 - 黄体酮为什么
that she's been putting progesterone in his coffee. - Progesterone? Why?
她想遏制他的性冲动
She wanted to kill his sex drive.
他在性侵他们的女儿
He's been sexually assaulting their daughter.
该死
Shit.
这都是一面之词 - 他妻子原话是怎么说的
Well, we don't know that. - What exactly did the wife say?
他会在孩子洗澡时进到浴室里强行给她按♥摩♥
He goes into the kid's bathroom when she's showering, gives her unwanted massages.
她的行为因此改变影响了学业
Her behavior's changed. She's struggling in school.
她妈妈很担心
The mom is really worried.
她还没和女儿谈过这件事
But she hasn't talked to her daughter about any of this,
不想给她灌输这些想法
doesn't want to put ideas in her head.
这是性诱导我们宾州有强制举报虐待儿童条例
It's grooming. And we are mandated reporters of child abuse in Pennsylvania.
除非有证据否则没什么可举报的
There's nothing to report unless we have proof.
现在这都是推测
Right now, it's all speculative.
我们有义务举报妈妈毒害丈夫吗
Are we obligated to report Mom for poisoning the husband?
很不幸是的
Unfortunately, yes.
她不是想杀他只是担心她的女儿
She's not trying to kill him. She's just worried about her daughter.
他摔下梯子摔断了肋骨
He fell off a ladder. He broke a bunch of ribs.
你在治疗他如果下次情况更糟呢
You're the one who's treating him. What if next time, it's worse?
我们就让她回家等她作为乱♥伦♥的受害者再次回来
So we're just gonna send her home and wait till she comes back as a victim of incest?
除非女儿出面否则我们也无能为力
We can't do anything unless the daughter comes forward.
我们可以试着和她谈谈但如果妈妈不愿意...
We can try to talk to her. But if Mom doesn't want us to--
我会和妈妈谈好吗
I will talk to the mom, OK?
然后再看情况
Then we'll just take it from there.
继续扩张直到能放下最大的导管
They keep dilating until it takes the largest catheter.
我们为什么没给米尔顿先生上这种机器我那个胆囊病人
Why didn't we try ECMO on Mr. Milton, my gallbladder guy?
要使用体外膜肺氧合装置需要五分钟内做心肺复苏
For ECMO, you need CPR within five minutes
且初始心律为室颤心动过速或无脉搏性电活动
and an initial rhythm of V-fib, V-tach, or PEA.
他都没有 - 是的
Which he had none of. - No.
第一根软管已经插入并夹紧
First line's in and clamped.
你需要什么吗北岛太太 - 我要上厕所
Do you need anything, Mrs. Kitajima? - I need to use the bathroom.
我可能需要帮助
I'm afraid I may need some help.
没问题附近就有一个
Oh, no problem. There's one nearby.
要我拿口译器吗
Should I grab the interpreter device?
先看看他们交流得怎么样
Let's see how they do first.
嘿
Hey.
我是山姆
I'm Sam.
我是米努
Minu.
疼吗
Does it hurt?
一个陌生人走向你
A stranger walked up to you
然后推了你
and pushed you.
我看到了
I saw it.
我会帮警♥察♥找到对你做这件事的人
I'm gonna help cops find person who did this to you.
他们逃不掉的
They won't get away with this.
这是毗湿奴宇宙的保卫者和守护神
It's Vishnu, protector and guardian of the universe.
好了米努是时候带你去手术室了
OK, Minu, time to take you up to the OR.
祝你好运
Good luck.
两个导管必须连到体外膜肺氧合装置不能有气泡
The two catheters have to get attached to the ECMO lines with no air bubbles.
你看到发生了什么吗
You see what's happening?
可以了
Good to go.
开启循环松开钳子
Circuit on and clamping.
好的这是右股静脉的血
OK, it's venous blood out the right femoral,
流入装置进行氧合后然后通过左股动脉返回体内
into ECMO for oxygen, and then pump back into the left femoral artery.
停止LUCAS心肺按压系统
Stop the LUCAS.
数值多少 - 74
What's the MAP? - 74.
很好
Excellent.
现在体外膜肺氧合装置已经接管了心脏和肺
So the ECMO has taken over for the heart and lungs.
一旦他们疏通了阻塞的动脉就能重新启动心脏
Once they open up the blocked artery, they can restart the heart,
他就能完全恢复健康 - 太神奇了
and he's basically good as new. - Incredible.
抱歉麻烦你了 - 没关系
I'm sorry you have to do this. - It's OK.
本来应该是我女儿帮我的我不知道她在哪里
My daughter would have helped me. I don't know where she is.
她可能很快就会回来
She--she's probably gonna be back soon.
孩子真的很难带
The kids are such a handful.
你的孙辈吗
Your grandchildren?
有时候我都快受不了了但我丈夫忙着工作
Sometimes it's just too much. But my husband's busy with work.
你丈夫...