匹兹堡医护前线（2025）

The Pitt S01E12

Part 2 May 20, 2025, 4:18 p.m.

LMAs. - We got plenty of that stuff.
蝴蝶超声仪可以在手♥机♥上使用
Butterfly ultrasound works off a cell phone.
这个不错我们会把情况不稳定的胸部和腹部伤病人
That's cool. But we're gonna send all the
直接送到手术室好了大家听好了
unstable chest and belly straight up to the OR. OK, everybody listen up.
我们这么办救护车停靠点将作为我们的临时分诊处
This is how it's going to work. Our ambulance bay is now our Triage.
急救人员会不知所措
EMS will be overwhelmed.
大多数人可能乘车到达每辆车有几名受害者
Most will probably arrive by car, several victims per vehicle.
有些新人可能不认识沈医生是我们的夜班主治医生
For all you newbies that don't know, Dr. Shen is our night shift attending.
约翰我给你安排到分诊处 - 好的
John, I'm gonna put you on Point Triage. - Cool.
分诊处会根据伤势分配患者
Triage will decide who goes where depending on their injury.
每个科室都会指定一个负责人
Every department will have a designated primary
负责监督他们的员工
who will oversee their staff.
如果你们需要人帮忙找穿背心的
If you need someone, look for the vest.
我们都有对讲机有什么需求我们都会满足你
We're all gonna have walkies. We can get you whatever you need.
除非需要外伤急救否则患者不能进创伤室
No patient goes into a room unless it's a trauma bay,
每个房♥间最多容纳四名患者
and they will have four patients each.
我们得让所有人待在开阔的地方以便我们能随时关注一切
We need to keep everybody out in the open so we can keep an eye on everything, OK?
好吗分诊处会评估每个患者并用彩色的啪啪手环标记
Triage is gonna assess and assign every patient
把他们分配到特定区域
to a specific zone with a colored slap band.
带红色手环的患者去红区
Patient who comes in with a red slap band goes to the Red Zone,
红区是创伤抢救室外溢的部分在这里
which is the trauma rooms, with overflow out here.
这些是最危重的患者如果不立即救治就会死亡
These are the most critical patients who will die without immediate attention.
萨米拉你在哪
Samira, where are you?
你跟我和阿伯特医生一起杰克要负责运送患者
You are here with Dr. Abbot and me. Jack's gonna run traffic.
我们有五分钟的时间稳定红区的患者
We have five minutes to try and stabilize the reds.
在那之后患者会被送到手术室重症监护室或太平间
After that, it's OR, ICU, or morgue.
南区和中♥央♥的公共区域是粉区
The south and central common area over there will be the Pink Zone.
用于一小时内未经治疗会死亡的患者
That is for patients who will die in under an hour without treatment.
麦凯和贾瓦迪
McKay and Javadi, you are over there,
你们负责那里夜班医生和外科人员会协助你们
with help from incoming night shift and surgical staff.
北走廊是黄区
Yellow Zone is the North Corridor.
大部分是四肢伤生命体征良好能说话的患者
Those are gonna be mostly extremity wounds--good vitals, talking.
梅尔你和桑托斯和维塔克一起负责
Mel, you're gonna run point there with Santos and Whitaker.
如果有无脉搏的四肢伤呢
What if there's a pulseless extremity?
如果你感觉不到脉搏
If you can't feel a pulse,
用这个做多普勒血流检测这是迷你超声仪
check for Doppler flow with this. It's a mini-ultrasound.
跟着屏幕提示操作就行
Follow the screen prompts.
但黄区患者也可能变成红区患者如果情况恶化要持续跟进
But a yellow can change to a red if they go south. You got to stay on top of them,
即使他们看上去很平稳 - 好的
even if they seem stable. - OK, yeah.
你没问题的金医生
You got this, Dr. King.
绿区轻微伤和扭伤他们去家庭医院
Green--minor lacs and sprains. They go to Family Medicine.
黑白条手环是来院时已死亡患者
Black and white bands are DOA, imminent death.
儿科现在是我们的太平间了希望人数不会太多
Pedes is now our morgue. Let's hope we don't get too many of these.
我们现在相当于是一个移♥动♥军事医疗单位
We're a MASH unit now.
没有图表没有电子病历没有信息板
There's no charting, no electronic medical records, no board.
我们如何记录治疗
How do we document treatment?
你们每个人都会拿到一支记号♥笔每个患者都有一个腕带记录表
You'll all get Sharpies, and every patient has a wrist chart
记录治疗和手术过程
to document treatment and procedures.
如果没地方写了就写到患者的额头上
You run out of room, write on the patient's forehead.
认真的吗 - 是的
Really? - Yeah, really.
每张腕带记录表都有独一无二
Each wrist chart has
大规模伤亡事故条形码和患者编号♥
a unique mass-casualty-incident barcode and patient number.
以帮助识别
That's how the patients are gonna get identified.
这是朴实无华的战地医疗
This is no-frills combat-zone medicine.
没有超声波没有X光没有CT 没有实验室
No ultrasound, no X-rays, no CT, no labs.
根据意识状态和脉搏强度评估情况
Assess based on mental status and pulse strength.
我们为每个危重患者提供一次骨内输注插管
Every critical patient gets an IO, intubation,
一单位血浆和胸管如果有需要的话
a unit of blood, and chest tube if needed.
你需要的一切血液药物绷带
Everything you need-- blood, drugs, bandages--
都储存在行为健康科室那是我们的补给站
everything will be in the Behavioral Health rooms. That's our supply depot.
在口袋里放几把11号♥刀目标是尽快救活患者
Keep a couple of 11 blades in your pocket. Goal is to resuscitate ASAP
这样他们就能去楼上得到更精准的治疗
so they'll make it upstairs for definitive care.
创伤外科和神经外科将决定谁去手术室
Trauma surgery and neurosurgery will decide who goes up to the OR immediately
谁去重症监护室做进一步的治疗和评估
and who goes to the ICU for further treatment and evaluation.
保持沟通如果需要就寻求帮助
Communicate. Ask for help if you need it.
相信你的主治医生
Trust your attendings.
我们会一起度过难关的 - 没错我们会的
We will get through this together. - Damn right we will.
你们三个我想跟你们谈谈
OK, you three, I want to talk to you.
我需要你们三个去后勤中心把所有胸腔引流管气管插管
I need you three to raid Central Supply and bring back all the chest tubes,
胸腔密封贴和生理盐水都拿回来 - 我以为那是...
ET tubes, thora-seals, normal saline-- - I thought that
我们可能在最初的一小时内就把那些都用完了
was all in Behavioral Health. We can burn through all that in the first hour.
西地下室核医学科过去一点就是
West basement, just past nuclear medicine.
西地下室知道了 - 等等
West basement. Got it. - Wait, wait, wait, wait, wait.
带一个空的灾难箱把能拿的都拿来
Take one of these empty disaster bins so you can grab everything you get your hands on.
灾难箱 - 那边的空塑料箱你不会错过的
What's a disaster bin? - Empty plastic boxes right there. You can't miss them.
柯林斯在哪里
Where's Collins?
她回家了但达娜正在给她打电♥话♥
She went home, but Dana is calling her now.
别担心我们有很多人来帮忙
Don't worry. It's OK. We got plenty of people coming in.
听阿伯特医生的指挥就行了
Just follow Dr. Abbot's lead.
约翰我来帮你做分诊的初始工作
John, I'm gonna help you get started in Triage.
听起来不错
Sounds good.
达娜你需要什么
Dana. What do you need?
为收治四肢伤的黄区做准备
Prep the Yellow Zone for extremity wounds.
我们需要很多绷带
We need a shitload of bandages, tourniquets,
止血带分叉吊带和静脉注射抗生素
splint slings, and IV antibiotics.
我这就去
I'm on it.
莫娜
Myrna.
莫娜去哪了安东尼你解开了莫娜的手铐吗
Where the hell did Mryna go? Antoine, did you take the cuffs off Myrna?
没有那女人让我毛骨悚然
Hell, no. That woman scares the shit out of me.
她一直想咬我
She keeps trying to bite me.
王八蛋
Son of a bitch.
好多腕带记录表啊 - 三百张
That's a lot of wrist charts. - 300.
希望我们不需要全部
Let's hope we don't need them all.
你参加了上一次大规模伤亡员工会议了吗
Were you at the last mass-casualty faculty meeting?
没有我三个月前还是住院医生
No. I was still a resident three months ago.
也对
Right.
一次一个病人对吗
Well, one patient at a time, right?
目标是在10秒内对每个患者进行分类
The goal is to triage each patient in ten seconds.
十秒钟明白了
Ten seconds, got it.
患者的意识状态用AVPU来评估
Mental status is AVPU.
清醒对语言有反应对疼痛有反应和无反应
Alert, response to verbal, response to pain, unresponsive.
好的
Yep.
接下来看他们有没有脉搏
Next, do they have a pulse?
桡动脉颈动脉或股动脉告诉你该把他们送到哪里
Radial, carotid, or femoral tells you where to send them.
差不多就这些 - 好的
That's it. - OK.
好极了
Cool.
我听说今天会下雨
Oh, I heard it might rain today.
约翰 - 是的伙计
John? - Yeah, man.
意识状态和脉搏你只需要检查这两项
Mental status and pulse gives you everything you need.
好的
Cool.
无反应无脉搏
Unresponsive with no pulses, slap a black and white band on them,
给他们戴一个黑白条手环送去太平间
send them to the morgue.
对疼痛有反应且伴随微弱呻♥吟♥ 股动脉脉搏微弱无桡动脉脉搏呢
Responds to pain with a faint groan, weak femoral pulse, no radial?
红色手环 - 没错
Red. - Right.
给他们戴上红色手环送到后面
Slap a red band on them, send them back.
醒着意识清醒桡动脉脉搏有力
Awake, alert with strong radial?
这个挺难的
Trick question.
可能是绿色手环擦伤或扭伤送去家庭医院
Could be green, Family Medicine for scrapes or sprains,
但如果情况稳定有穿透性四肢伤要送去黄区
but stable, penetrating extremity wounds go to yellow.
很好 - 伙计别紧张
Perfect. - Dude, relax.
前门交给我吧你负责后面就行了
I got the front door. You worry about the back.
保罗各位把轮床的头抬高30度
Hey, Paolo, everybody, let's put the heads of these gurneys up 30 degrees
好让它们都以正确的方式移♥动♥
so they all roll in the right way.
罗比医生
Dr. Robby.
你跟你儿子谈过了 - 没有但我拿到了表格
Did you talk to your son? - No, but I have the form
可以把他送进精神病院
to put him on a psychiatric hold.
社工签了名现在就差你的签名了
A social worker signed it. I just need you.
好了你该回家了特蕾莎这家医院关闭了
OK. You should probably go home, Theresa. This hospital is essentially closed.
大卫不会这么做的
David wouldn't do this.
我真心希望你是对的
I really hope you're right.
我有四个枪击受害者