匹兹堡医护前线（2025）

The Pitt S01E11

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

Leave it there, and let it dissolve. We'll be back in ten minutes.
我没理解错的话我们的计划是对病人撒谎
Just so I'm clear... our plan is lying to patients?
我没有撒谎
I didn't lie.
丁丙诺啡确实是一种类吗♥啡♥药物与相同的受体结合
BUPE is a morphine-like drug, binds to the same receptor.
他说他不是瘾君子
He said he isn't an addict,
那为什么要用阿片受体激动剂来治疗他的戒断症状
so why give him an opiate agonist to treat his withdrawal symptoms?
因为我不相信他而且我知道这会奏效
Because I don't believe him. And I know this will work.
然后一旦他感觉好些了
Then once he feels better,
我们就可以让他承认他的毒瘾并制定一个长♥期♥治疗方案
we can get him to admit to his addiction and treat him long-term.
你说是就是吧
If you say so.
医生誓言第一条不要伤害然后是做对病人最好的事
First do no harm. Then do what's best for the patient.
给你亲爱的
Here you go, hon.
朗登打到总机了 -你开玩笑吧
Langdon called the main line. - You got to be kidding me.
我跟他说你很忙就是告诉你一声
Princess answered. Told him you were busy. Just wanted you to know.
好的知道了谢谢
Okay, noted. Thank you.
你能看到什么吗 -我不需要看
Can you see anything? - I don't have to.
只要把舌头推开让管子通过就行
You just have to push the tongue out of the way in order to pass the tube.
好的
Okay.
可以了
Here we go.
心率124 血压没变化高压84低压42
Heart rate's 124. BP's still only 84 over 42.
还在出血
Bleeding is still brisk.
能再输一单位血吗
Get another unit on that infuser, please.
你进入多少了 -50厘米
How far did you go? - 50 centimeters.
罗比医生
Dr. Robby?
你是说50厘米吗好的足够了
Did you say 50 centimeters? Yes, that's plenty.
给胃部的气球充气
Inflate the gastric balloon.
从50开始然后我们用X光检查支架的位置
Start with 50, and then we'll check the placement in the stomach with an X-ray.
阿普加现在是10分
Apgar is now ten.
来吧
Go on.
真的吗 -真的
Yeah? - Yeah.
好吧小家伙
Okay, little one.
好的
Okay.
托住他的头
All right, support his head right over here.
好吗好了给你
All right, come here. Right there. There you go.
你很有带孩子的天分
You're a natural.
等你准备好了
Whenever you're ready.
好的
Okay.
我知道你想你♥爸♥爸
Already miss your dad.
我马上就来 -好的
I'll be up soon. - Okay.
我现在可以把腿放下了吗
Can I put my legs down now?
等胎盘出来就可以了
As soon as your placenta's out.
呼吸很好
Breathe. Good, good.
出来了
Here it comes.
哇
Oh, wow.
怎么了
What?
很多血 -开始第二条静脉输液
That is a lot of blood. - Starting a second line.
一升生理盐水 -好的
Spike a liter of saline. - On it.
这是怎么回事 -有时会这样
What's going on? - This happens sometimes.
我们必须将子♥宫♥重新夹紧固定
We have to help the uterus clamp back down.
开始子♥宫♥按♥摩♥ 臀部注射40单位催产素
Starting uterine massage. 40 of oxytocin in the back.
800微克舌下含服的米索前列醇和1000毫克氨甲环酸
800 mikes of sublingual misoprostol and 1,000 of TXA.
去血库取两个单位全血以防万一
2 units from the blood bank, just in case.
打电♥话♥给妇产科找罗比过来
Call OB and get Robby!
达娜怎么还在这里 -她拒绝离开
Why is Dana still here? - She refuses to leave.
放置得很完美她想完成她的轮班
That's perfect placement. She wants to finish her shift.
当然了
Of course she does.
我就没见过不固执的护士长
I've never met a charge nurse who wasn't a stubborn bitch.
嘿
McKay.
当然是以可爱的方式 -我不知道没有她我们该怎么办
In an adorable way, of course. - I honestly don't know what we'd do without her.
她的嘴又被血填满了就像喷泉一样
The mouth is filling up again. It's like a fountain.
罗比医生请来一趟创伤二室 -好的我马上过去
Dr. Robby, we need you in Trauma Two. - Yeah, okay, I'll be right there.
她的食管上部仍在出血
She's still bleeding higher up in the esophagus.
娜塔莉
Natalie.
注意观察 -好的
Keep your eyes open. - We got it.
波拉 -是的
Perlah? - Yeah.
她的胃没有出血
She's not bleeding in her stomach.
我们得在食管靠上的地方充气
We have to inflate the second balloon up in the esophagus.
罗比医生
Dr. Robby,
我们需要你 -知道了该死的我来了
we need you! - Yes! Fuck! I'm coming, I'm coming!
该死的朗登
Fucking Langdon.
这个端口在食管内
This port is in the esophagus.
她流了好多血啊
With a ton of blood.
谜团解开了
Mystery solved.
将食管球囊充气至30毫米汞柱
Pump up the esophageal balloon to 30 millimeters mercury.
那是充气泵和压力计吗 -对就像高档的自行车打气泵
That's an insufflator and a manometer? - Yep, just like a fancy bike pump.
到30了关掉阀门
We are at 30, and shut the stopcock.
食道口几乎没有血流出来
Barely any blood coming from the esophageal port.
球囊应该能在我们把她送上手术台之前止住血
The balloon stopped the bleeding. Tomorrow GI can cauterize the veins.
太棒了
That was awesome.
我是从最优秀的人那里学来的
I learned from the best.
她会没事吗 -我们正在尽力
Is she going to be okay? - We are doing everything that we can.
产后大出血正在使用大量输血方案和所有子♥宫♥收缩药物
Massive PPH on MTP and all uterotonics.
子♥宫♥内翻伴有破裂是否有残留组织
Any rupture? Any inversion? Any retained products?
全部检查了没有 -这都是我的错
Checked for all. None present. - This is all my fault.
第二单位输上了 -仍是室速心率130 收缩压只有84
Second unit's going up. - Still tachy at 130. Systolic's only 84.
我们试试肌肉注射0.25毫克卡前列素并从中心区取一个Bakri球囊
Let's try carboprost, 0.25 milligrams IM. And get a Bakri balloon from Central.
跟她说话快去
You could talk to her. Get in there.
跟她说一些你们最美好的回忆会有帮助的
Tell her some of your favorite memories with her. That'll help.
谢谢你过来 -你说有披萨
Thanks for coming down. - You said there was pizza.
你还记得我担心的那件事吗
Uh, do you remember that thing I was worried about?
我的脚没事但我会让你请我喝鸡尾酒作为补偿
My foot is fine, but I'll let you make it up to me with a cocktail.
不是关于朗登的那件事
No, about Langdon.
他怎么了 -不幸的是我是对的
What about him? - Uh, unfortunately, I was right,
他被遣散了 -遣散是什么意思
and he's been dismissed. - What do you mean "dismissed"?
罗比医生让他回家了
Dr. Robby sent him home.
为什么
Why?
我们最好别再谈这个了
You know, it's prob--best if we don't talk about it anymore.
但如果你能对我之前提到的事情保密
But if you could just keep a lid on what I mentioned earlier,
那就太好了
that would be really great.
你叫我来谈这件事但你又不想谈
You called me down to talk about it, but you don't want to talk about it?
这是怎么回事 -他一直在偷药
What is going on? - He's been stealing meds.
打住我不想谈这件事
Stop. I don't want to talk about this.
你刚才还说… -我说了打住
You just said-- - I said stop.
我不想掺和进来
I don't want any part of this.
你是个麻烦
You're trouble.
需要一袋新的生理盐水 -好的
Need a fresh saline bag. - On it.
第三和第四单位全血来了也注入了新鲜冷冻血浆
Third and fourth units are coming up. FFP is also infusing.
继续说多说些回忆会有帮助的
Keep going. Keep talking to her. More memories. It'll help.
有一次我们从分类广♥告♥网上买♥♥了张玻璃桌
There was the time that we got that, um, glass table off of Craigslist,
我们去提货结果被抢劫了桌子也被偷了回去
and we went to go pick it up, and they mugged us, and they stole it back from us?
预计失血量 -大约两升也许三升
Estimated blood loss? - About two liters, maybe three.
给她用了什么药
What's she had?
催产素滴注氨甲环酸卡前列素
Oxytocin drip, TXA, carboprost,
大量输血方案
massive transfusion protocol.
一袋生理盐水 -气球过了子♥宫♥颈
Spike the saline. - Balloon is past the cervix.
我们该放多少进去 -最多五百
How much should we put in? - Up to 500.
如果没用她需要做子♥宫♥切除术
If that doesn't work, she'll need a hysterectomy.
子♥宫♥切除 -会有用的
"Hysterectomy"? - This is going to work.
继续说更多的回忆对她好对我们大家都好
Come on, keep talking. More memories. It's good for her. It's good for all of us.
还有那次因为害怕错过
Uh, and the time
我们在《权力的游戏》大结局前两个月一口气追完了整部剧
we binged "Game of Thrones" two months before the finale because of, uh, FOMO?
娜塔莉嘿娜塔莉坚持住
Natalie! Hey, Natalie! Natalie! Stay with us!
你感觉如何普格利西先生 -好多了
How are you feeling, Mr. Pugliesi? - Oh, I'm feeling a lot better.
恶心消失了
Nausea's gone.
你的胃疼和肌肉痉挛呢
What about your stomachaches? Muscle cramps?
我是说我好了75%了
I mean, I'd say I'm 75% better.
血压和心率恢复正常
Blood pressure and heart rate are back to normal.
难以置信 -你听起来很惊讶
Incredible. - You sound surprised.
不我只是替你松了一口气所以…
Oh, no, I'm just relieved for you, so...
好消息是你可以再服用一剂
Good news is you can have another dose.
这应该能让你恢复到100% 舌头抬起来