匹兹堡医护前线（2025）

The Pitt S01E01

Part 6 March 11, 2025, 8:29 p.m.

Not really. - Well, what are you leaning towards?
我还不确定 - 好吧你还有时间
I'm not really sure yet. - OK, well, you have time.
我能问你一个私人问题吗
Uh, can I actually ask you a personal question?
我20岁了我有资格来这里
I'm 20, and I've earned the right to be here.
对我毫不怀疑这一点
Yeah, I don't--I don't doubt that for a minute.
我其实想知道外科的艾琳沙姆西医生
I--I was actually wondering if Dr. Eileen Shamsi from surgery
是不是你的朋友或亲戚
is a friend or relative of yours.
我看到你在大厅里跟她说话 - 她是我妈妈
I saw you talking to her in the hall and I thought-- - Yeah, she's my mother.
那很酷
Oh, that's cool.
你真的只有20岁 - 是的
You're really only 20? - Yeah.
还有我父亲也在这里工作
And for the record, my-- my father also works here.
他是内分泌学家 - 所以这就像家族企业
He's an endocrinologist. - Oh, so it's like a family business.
抱歉那只是个玩笑
I'm sorry. That was a joke. That was a joke.
我敢肯定这会带来很大的压力
And I'm sure that comes with a lot of pressure.
至于年龄问题我是个42岁的第二年住院医生
And as for the age thing, I'm a 42-year-old R2,
所以记恨我的人也不少相信我
so I have my own haters, trust me.
好的
OK.
有时忙起来了我们会帮护士把病人带进来
Um, sometimes when it gets busy, we'll help the nurses bring back patients.
好的
OK. - Um, OK.
下一位患者是弗雷德塞义塔摔倒后膝盖疼痛
Next to come back is Fred Saeta. Knee pain after a fall.
弗雷德... - 嘿医生你好我是道格德里斯科
Fred Sa-- - Doc. Hey, Doc. Hi. Hi. Doug Driscoll.
能给我看看吗我已经等了两小时
Any chance someone could see me now? I've been here for, like, two hours.
很遗憾你前面还有很多病人
Unfortunately, Mr. Driscoll, there's a lot of patients still ahead of you,
其中一些人病得很重
some of whom are severely ill.
是的我晚上胸痛会把我疼醒
Yeah, and I got chest pains that woke me up in the middle of the night.
胸痛 - 是的
Chest pain. - Yeah.
不我是想纠正一下你不能用复数
No, it's not plural. It's just chest pain, not chest pains.
如果我有不止一次胸痛那就是复数了吧
Yeah, and if I have more than one, it's chest pains.
你是真正的医生吗 - 她是医学生
Are you even a real doctor? - She's a student doctor.
好吧让她离我远点
Yeah, well, keep her the hell away from me.
我只是需要找个医生来
I just need to see someone,
好吗她不行胸痛不算紧急情况吗我不...
OK? Not her. Isn't chest pain an emergency? I don't--
这里写你来到这里五分钟后做了心电图
It looks here like you got an EKG five minutes after arrival,
所以不是心脏病发作
so it's not a heart attack.
对但我应该做胸部X光和血液检查
Yeah, but I'm supposed to get a chest X-ray and blood tests.
马上就轮到你了好吗注意听护士叫你的名字
Ah, and you are next in line for lab tech, OK? So listen for your name.
失陪了弗雷德...
Excuse me. Fred--
能帮我推个轮椅过来吗
Actually, can you get me a wheelchair, please?
嗨我是麦凯医生发生什么事了
Uh, hi. I'm--I'm Dr. McKay. What's going on?
我在浴室的地板上发现了她
I, uh, found her on the floor in the bathroom.
她一直呕吐 - 她叫什么名字
She can't stop puking. - What's her name?
特蕾莎她是我妈妈
Theresa. She's my mom.
特蕾莎特蕾莎你有吃药吗
Theresa? Theresa, are you taking any medication?
没有 - 之前得过胃病吗
No. - Any previous stomach problems?
没有 - 呕吐是什么时候开始的
No. - When did the vomiting begin?
昨晚
Um, last night. Last night.
你感到头晕或疲劳吗
Do you have any dizziness or fatigue?
谜团解开了
Mystery solved.
脚部脱套伤的女士是尼泊尔人
Our lady with the degloved foot is Nepali.
嘿恭喜你
Oh, hey, congratulations.
奥蒂斯的血压急剧下降高压70低压50 他还在等透析
Otis's BP is crashing. 70 over 50. Still waiting for dialysis.
你怎么样奥蒂斯 - 不好不太好
How you doing there, Otis? - Not so good.
50升非再吸入型面罩谢谢
50 liters. Non-rebreather, please.
糟了
Oh, crap.
右心房♥和右心室舒张性心脏衰竭
Diastolic collapse of the right atrium and right ventricle.
尿毒症积液引起的心包填塞
Tamponade from uremic effusion.
所以他的血压才这么低 - 是的
That's why his BP is low? - Yep.
心脏承受了太多液体和压力心室装不下了
Too much fluid and pressure around the heart, chambers can't fill.
奥蒂斯你的心脏周围有液体
Otis, you've got some fluid around your heart.
我们得把它吸出来 - 发生什么事了
We need to get it off. - What's happening?
注射25毫克异丙酚
25 of Propofol,
10毫升利多卡因和肾上腺素心包穿刺托盘
10 cc's of lidocaine with epi, pericardiocentesis tray.
我得去中心区取 - 不用打开一个中心静脉工具包就行
I have to get that from central. - No, no. Just open a central line kit.
桑托斯医生你待在床头如果他停止呼吸就给他换气
Dr. Santos, take the head of the bed and bag him if he stops breathing,
颈动脉没脉搏了就做心肺复苏
compressions if we lose the carotid.
备皮并消毒剑突下区域 10毫升1%麻醉剂
Prep and drape the subxiphoid, please. 10 cc's of 1% with.
这是氯己定 25号♥还是27号♥针头 - 25号♥长针头谢谢
Chlorhexidine here. 25 or 27-gauge? - Long 25, 25. Thank you.
注射利多卡因 - 血压下降高压60低压40
Injecting lidocaine. - Pressure down. 60 over 40.
好的
Right.
等等你不能仅凭超声就放置 - 我知道所以我带了探针
Wait, you can't ultrasound and place. - I know, that's why I'm taking the probe.
请给我18号♥薄壁取样针头和60毫升注射器柯林斯医生快点
18-gauge thin wall on a 60 cc syringe, please, Dr. Collins. Let's go.
你从我探针正上方中间穿过去
You're going in right over the center of my probe,
缓慢向前推进
advancing very slowly.
我们要寻找高回声点
We're looking for the hyperechoic tip.
非常缓慢不要用力
Very, very slowly. Do not hit that heart.
桑托斯医生看到那片黑色了吗那是积液
Dr. Santos, do you see that sea of black? That's the effusion.
我们在找一个小白点就是这个
We're looking for a little white dot. There it is.
明白正在抽取积液 - 三毫升应该够了
Got it. Aspirating. - 3 cc's should be enough.
很好接下来我们放导线然后放三腔导管
Good. Next, we'll place the guide wire, and then the triple lumen catheter.
血氧浓度99 - 血压升高了高压124低压78
Pulse ox is 99. - Pressure is up. 124 over 78.
看起来一切恢复正常了
Looks like things are back to normal.
太厉害了
That was cool.
注射了四毫克的枢复宁 - 那应该能止住恶心
Four Zofrans on board. - That should stop the nausea.
大卫你有呕吐吗 - 没有
David, have you had any vomiting? - No.
家里还有人生病吗
Anyone else sick at home?
家里只有我们俩
No, it's just us.
我丈夫几年前死于新冠肺炎
My husband passed away a few years ago, from COVID.
我很遗憾
Oh, I'm so sorry.
钾含量3.1
Potassium, 3.1.
有问题吗
Is that bad?
可能会导致心脏问题但我们会解决的
It can cause heart problems. But we're gonna correct it, OK?
10毫升加到输液袋另外再开20毫升
10 in the bag, 20 PO.
贾瓦迪有问题吗
Javadi, any questions?
大卫你们俩最近出过国吗
uh, David, have you two traveled out of the country recently?
我们哪儿都没去过
We never go anywhere.
她要待在这里吗
Is she gonna have to stay here?
如果其他检查结果良好她对治疗有反应的话就可以回家了
If the rest of the tests are good, and she responds to treatment, she can go home.
米尔顿先生我是丹尼斯维塔克
Mr. Milton, my name is Dennis Whitaker.
我是其中一个医学生我先给你看看
I'm one of the student doctors here. I'll be seeing you first.
很高兴认识你 - 高压150低压90
Nice to meet you. - BP's 150 over 90.
好的只是稍微有点高
That's just a touch high.
我今早忘记吃依那普利了
I forgot to take my damn enalapril this morning.
我们会帮你拿的 - 跟我说说腹痛的事
Oh, we'll get that for you. - Tell me about this belly pain.
是从这里开始的
Uh, it started about here.
凌晨2点把我痛醒了
Um, woke me up at, like, 2:00 AM.
很剧烈持续了大约一个小时
Pretty intense. Lasted about an hour.
现在不疼了
Now it's gone.
有发烧吗呕吐 - 没有我从来不生病
Any fever or vomiting? - Nah, I never get sick.
好的你昨晚吃了什么
OK. Uh, what did you eat last night?
昨晚我妻子过生日我带她去苏利文餐厅吃了牛排
Oh, it was my wife's birthday. I took her out to Sullivan's for a steak.
检查结果没什么问题我要查一下是否有胆结石
Well, the exam is pretty benign. I'm gonna test for gallstones.
如果有结石再加上你吃的比较油腻
If there is a stone and you eat fatty food,
胆囊收缩时可能会感到疼痛
there can be pain when the gallbladder contracts.
有了一颗结石在这儿
Uh, bingo. One stone. There it is.
我需要做手术吗
Do I need surgery?
你只要保持低脂饮食应该就没问题了
Uh, you should be able to manage with a low-fat diet.
但我们会化验一下肝脏和胰腺指标
But we'll send off labs for liver and pancreas.
如果还有疼痛的情况就告诉我们
Just let us know if you have any more pain.
好的谢谢
OK. Thanks.
不客气
Yeah, you bet.
好极了
Great.
你要给他做心电图吗 - 为什么
You want an EKG? - For?
心脏病发作可能表现为上腹痛
Heart attacks can present as upper abdominal pain.
对好主意谢谢
Um, yeah. No, yeah, that's a great idea. Thank you.
我已经尽量加快速度了
I'm going as fast as I can.
我还要接两个病人 - 我什么都没说
I'm picking up two more patients. - I didn't say anything.
我需要旁观者的意见 - 什么意见
I, uh--I need a fresh set of eyes. - On what?
54岁女性顽固性呕吐被她18岁的儿子送来医院
54-year-old woman brought in with intractable vomiting by her 18-year-old son.
我有种奇怪的感觉
I'm, um-- I'm getting a weird vibe.
怎么说
How so?
我说不好也许她被下药了虐待老人之类的