匹兹堡医护前线（2025）

The Pitt S01E11

Part 3 May 20, 2025, 4:18 p.m.

Do you think--
我的天 -嘿宝贝
Oh, my God! - Hey, babe.
哈里森在哪里 -员工休息室
Where's Harrison? - Staff lounge.
他没事吧 -他没事
Is he okay? - He's fine.
我去看看哈里森
I-I'm going to go check on Harrison.
我很确定和她在同一个房♥间里
I'm pretty sure being in the same room
违反了人身限制令所以…
with her violates the restraining order, so...
我去吧我可以带他回家
I'll go. I can take him home.
事实上克洛伊因为我手术后不方便走动
Uh, actually, Chloe, since it'll be hard for me to get around after my surgery,
哈里森要和凯西住一阵子
um, Harrison is going to stay with Cassie for a little while.
是的 -不行
Right. - No.
我在这里
I'm here.
在你康复期间我可以帮你照顾他
I can help take care of him while you're recovering.
绝对不行 -宝贝我不介意
Absolutely not. - Babe, I don't mind.
我介意
I do.
当然如果你不介意的话在我恢复正常前就拜托你了
Um, yeah, sure, if you don't mind-- just till I'm back on my feet.
等一下
Wait--hold--hold on! I--
我们要把中心区6号♥的病人转移到创伤一室我们需要你
We're moving Central 6 to Trauma One. We need you.
这事还没说完
We are not done here.
重症监护室带来了一个48岁的肝硬化患者来这里治疗呕血
ICU boarder, 48-year-old cirrhotic, here for hematemesis.
插管过夜在输了一单位浓缩红细胞和新鲜冷冻血浆后应该是稳定的
Intubated overnight and after one unit pBRCs and FFP was supposedly stable.
现在不是了颈动脉微弱贾瓦迪我需要你来抽吸
Not anymore. Weak carotid. Javadi? I need you on suction.
她怎么突然出血了
W-why is she bleeding all of a sudden?
很可能是食道静脉曲张导致的
Most likely, bleeding is from the esophageal varices.
患有肝硬化的病人
With cirrhosis, you get enlarged veins under pressure
胃入口处的静脉会在压力下增大
at the entry of the stomach.
静脉曲张可能会破裂 -那是什么意思
Varicose veins, and they can burst. - What does that mean?
乙型肝炎导致你妈妈得了肝硬化
The cirrhosis from hepatitis B
进而引发了食道和胃之间的某处静脉破裂
caused a vein to burst where the esophagus meets the stomach,
血液就是从那里来的
and that's where the blood is coming from.
鼻子吸气嘴巴吐气
In through the nose--
帮助产妇用曲大腿法
Mel, I'll have you help with the McRoberts maneuver.
好的 -好的
Of course.
娜塔莉我们现在要把你的膝盖抬到胸前
Hey, Natalie... we're going to lift your knees up to your chest now.
你做得很好
Doing great.
贾斯汀这是你见过的最糟糕的我吗
Justin, is this the worst you've ever seen me?
这是我见过最多的你
This is the most I've ever seen of you.
你很美
You're beautiful.
我们在这里施压 -我们会一直陪着你
All right, a little suprapubic pressure here. - We got you.
你会感觉到我压在你的膀胱
You're going to feel me pressing on your bladder.
距离头部娩出已经过了两分钟
Two minutes since head delivery.
胎儿心率正常在正常波动范围内
Fetal heart rate looks good-- normal variability.
你做得很好小娜 -你来试试就知道了
You're doing great, Nat. - Feel free to step in and take over.
又宫缩了
Ah, another one's coming!
用力 -好的娜塔莉来吧你可以的
Give me a big push! - Okay, Natalie. Here we go. You got this.
就快出来了
You're almost there.
继续用力我们爱你 -加油娜塔莉
Keep going. We love you. - Go, Team Natalie.
晚期减速
Late decel.
好吧你能打给英格拉姆医生让他从新生儿重症监护室过来吗
Okay, can you call Dr. Ingram and tell him to come down here, please, from the NICU?
发生什么事了
What's--what's happening?
宝宝的心率变慢了这可能是胎儿窘迫的征兆
The baby's heart rate has slowed, which could be a sign of distress.
我们该怎么办 -接生宝宝
So what do we do? - We deliver this baby.
我们能行的
We got this. We got this.
尤塞比奥你能呼叫手术室让他们为可能的剖腹产做准备吗
Eusebio, can you page the OR and tell them to prep for a possible crash C-section?
高压82低压46 -嘿妈妈你会没事的
BP's only 82 over 46. - Hey, Mom, you're going to be okay.
快速输液大量输血方案特利加压素滴注
Rapid infuser, massive transfusion protocol, octreotide bolus and drip,
泮托拉唑和头孢曲松静脉输液
80 pantoprazole and ceftriaxone.
波拉把罗比叫过来
Perlah, get Robby in here.
嘿佩吉罗比在哪谢谢
Hey, Peggy. Where's Robby? Thank you.
罗比创伤一室静脉曲张破裂出血的患者需要启动大量输血方案
Robby, MTP from bleeding varices in Trauma One.
局部会有轻微的灼烧感
A little burning from the local.
该死好疼
Oh, fuck! That hurts.
如果我能把手伸进去放在宝宝的头下面…
If I can get my hand inside, under the baby's head,
释放下面那只卡住的胳膊
I can release that lower arm.
距离头部娩出已经过去三分钟
Three minutes since head delivery.
罗比医生 -什么事
Dr. Robby. - Yeah.
我现在脱不开身
My hands are a little tied up at the moment.
我需要一个明尼苏达盒谁在里面
I'll need the Minnesota box. Who's in there?
麦凯医生 -让她准备好
Dr. McKay. - Tell her to go ahead
她知道怎么做我一有空马上过去
and get set up-- she knows what to do. I'll be there as soon as I can.
好的 -我是产科的迈尔斯医生
Yeah. - I'm Dr. Myers with Obstetrics.
幸会 -谁是孩子的父亲
Nice to meet you. - And who's the father?
我们是 -谁是孩子的母亲
We are. - And who's the mother?
我们是
We are.
收到手术室已经准备好了我们需要上去吗
Roger that. OR is prepped and ready. Do we need to go up?
如果我可以旋转这个后肩就不用了
Uh, not if I can rotate this posterior shoulder.
好的我摸到肘部了 -确保是弯曲的
All right, there's the elbow. - Make sure it's flexed.
是弯曲的多谢提醒
It--it's flexed. Good call.
快好了坚持住好吗
We're getting closer. Just stay with me, okay?
我在努力 -好了我控制住胎儿的手了
I'm trying. - Okay. I've got control of the hand
前臂 -好痛
and forearm. - Oh, that hurts!
后肩向上旋转出来了
Rotating posterior shoulder up and out!
该死
Fuck!
很好 -很快了
Perfect. - You're right there.
再用力一次
Give me one good push.
很好
Good! Hey!
是个男孩
We got a baby boy!
我楼上的产后病房♥ 有一对难搞的双胞胎
Uh, I've got a stubborn set of twins upstairs. Admit her to postpartum.
恭喜各位
Congratulations, everyone.
做得好
Good job.
他好安静啊 -有时候他们需要点时间
He's pretty quiet. - Sometimes it takes them a minute.
给宝宝连上脉搏血氧仪和心脏监视器
Put the baby on a pulse ox and a heart monitor.
嘿艾米跟我换一下
Hey, Amy, swap out with me.
擦干并刺♥激♥婴儿大力刺♥激♥
Mel, dry and stimulate vigorously.
好的 -非常大力
On it. - Very vigorously.
他现在不是该哭了吗 -心率95
Shouldn't he be crying by now? - Heart rate is 95.
太慢了 -柯林斯医生心率
Too slow. - Dr. Collins, BVM.
低流量每秒一次这孩子需要氧气
Tiny volumes, once per second. This kid needs oxygen.
来吧宝宝呼吸
Come on, baby. Come on, let's breathe.
准备好抽吸了吗 -准备好了英格拉姆医生
Suction ready? - Ready. Dr. Ingram?
马上加入插管托盘 -是的
I'm opening the intubation tray. - Yep.
婴儿出生后一分钟阿普加评分为3分
One minute apgar is three.
阿普加评分不应该是9分或10分吗
Isn't apgar supposed to be nine or ten?
什么意思 -拜托宝贝快呼吸
What does that mean? - Come on, baby. Breath, baby, breathe.
好了
There we go!
这是好事对吧 -非常好
That's good, right? - That is very good,
非常好你能行吗 -嗯你去吧
very good. Okay, you got this? - Yeah, go.
好多了
Looking much better.
静脉曲张引起的出血性休克药物治疗失败
Hemorrhagic shock from varices. Failed medical therapy.
抽吸停止工作了
Suction stopped working.
因为你的罐子装满了 -我来换
Because your canister is full. - I'm on it.
天啊 -有人能带她出去吗
Oh, my God. - Someone please take her out.
妈妈 -非常感谢
Mom! - Thank you very much.
顺便说一句这样是不能提高病人满意度的
By the way, that is not how you raise patient-satisfaction scores.
麦凯医生你想跟贾瓦迪解释一下明尼苏达盒吗
Okay, Dr. McKay, do you want to explain to Javadi here all about the Minnesota?
好的止血的最佳方法是直接按压
Yeah. So best way to stop the bleeding is direct pressure.
第一个气球进入胃部作为锚点
First balloon goes in the stomach as an anchor.
第二个气球沿着食道的长度放置直接对静脉曲张施加压力
Second runs the length of the esophagus for direct pressure on the varices.
首先我们要在水下给气球充气
First, we want to inflate the balloon
就像自行车内胎一样检查是否漏气
under water like a bicycle inner tube to check for any air leaks.
贾瓦迪先安个阀门
Yeah. Javadi, stopcock in the ports.
注射器能用吗 -抽吸机正常运转了
Use the 50-cc syringe. - Suction's good and running.
我来了
I got it.
你给我用了什么药我感觉更糟了
What did you give me? Because I feel worse.
我说了我上次用吗♥啡♥后好转了
I told you that I got better last time with morphine.
我有一种类吗♥啡♥药物叫丁丙诺啡
I have a morphine-like drug called BUPE.
效果一样而且更快舌下含服
Works the same way and faster, goes right under your tongue.
如果没用我们就换吗♥啡♥
If this doesn't work, we'll switch to morphine.
但我们先试试这个好吗 -我只想让疼痛停止
But let's try this first, okay? - I just want the pain to stop.
张开嘴把舌头抬起来
Open up. Lift your tongue.
放在那里让它溶解我们十分钟后回来