匹兹堡医护前线（2025）

The Pitt S01E13

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

我闭着眼睛都能操作
I can do these with my eyes closed.
给你的好的
For you. Okay.
刀会留下一个气管钩所以你不可能错过对吧只要…
The knife leaves a trach hook behind, so you can't miss, right? Just...
很好
good.
把引导器放进去
You slide in the introducer.
好的摸到气管钩很好
Okay. Feel the tracheal rings. Good.
大功告成
Bob's your uncle.
好快啊
That was incredibly fast.
气球鼓起来了 -我们为什么不储备这种工具包
Balloon is up. - Why don't we stock these?
没有那么多预算
No room in the budget.
呼气末二氧化碳黄色
Yellow on end-tidal.
现在没事了 -对
It's okay now? - Yeah.
谢谢你阿伯特医生
Thank you, Dr. Abbot.
太棒了
好的我们用Kerlix填塞口腔
Okay, let's pack the oral cavity with Kerlix
看看头颈外科能多快把他送到手术室
and see how fast Head and Neck can take him up to the OR.
干得好各位
Great job, everybody.
你的包里还有什么
What else do you got in your go bag?
等着瞧吧
Oh, just wait and see.
贾瓦迪这位是莎莉
Javadi, this is Sally.
她需要什么 -后背第11胸椎中枪
What does she need? - Gunshot wound to the back at T11.
脉搏正常但可能有脊髓损伤
Good pulse, but probable spinal cord injury.
你的腿能动吗 -我在努力
Can you move your legs? - I'm trying.
我瘫痪了吗 -恢复还是有希望的
Am I paralyzed? - There's some hope for recovery.
让她躺在背板上监测腹腔出血情况
Keep her on the backboard and monitor for intra-abdominal hemorrhage,
神经科重症监护室会安排她去做CT 好吗
and neuro-ICU will triage to CT, okay?
莎莉这里会有针♥刺♥感
Sally, pinprick right here, okay?
沃尔什知道这个病例他们正在准备手术室
Walsh knows about the case. They're holding an OR.
而病人还在不断涌来
And the hits keep coming.
我们走
Let's go.
你这边是什么情况
Who do you have?
半昏迷只对疼痛有反应
Semiconscious, only responds to pain.
颈动脉脉搏有力
Decent carotid.
把他衣服脱掉
Strip him. Let's go.
左上腹入口伤
Ah, left upper-quadrant entrance.
按住他
Hold him down.
抓住他的脚
Grab his foot! Grab his foot!
枪他要去拿他的枪 -别让他…
Whoa, gun! Gun! He's going for his gun!
趴下
Get down, get down.
趴下
Stay down. Stay down.
天哪
SIG P365 9毫米口径手♥枪♥
Sig P365 9 mil.
驾照 -他才刚到
Driver's license? - He just got here.
现在对疼痛没反应了
Not responding to pain now.
安全了
All clear.
你确定 -他失去意识了
You sure? - He's unconscious.
所有人都回去工作
Everybody back to work.
濒死呼吸他需要建立气道
Agonal breathing. He needs an airway.
正在做骨内输液 -正在抽取氯♥胺♥酮♥和琥珀胆碱
Working on an IO. - Drawing up ketamine and sux.
好了开始吧
Here, have at it.
隐蔽持枪许可证我们会查他的身份信息
Concealed carry permit. We'll run his ID.
这些伤口太大了不能用9号♥针头
These wounds are too big for a 9.
骨内输液失败这家伙太壮了针头够不到骨头
Failed IO. Guy's huge. Needle won't reach the bone.
他需要诱导药和输血
He needs induction meds and blood.
我这边也一样没看到任何可用于静脉注射的地方
I'm having the same problem here. I don't see anything usable for an IV.
罗比 -什么
Robby. - What?
这家伙需要给药但骨内输液针头够不到肱骨
Guy needs access, but the IO won't reach the humerus.
胫骨近端
Proximal tibia?
行吗
Yes?
行 -胫骨近端不是个好选择
Yeah. - Tibia's not great access.
那里每小时只能输进去一升
You can only get a liter an hour down there.
这时候就别挑三拣四了
You get what you get.
该死的
God damn it!
不管那是什么能把它关掉吗
Whatever that is, can you please turn it off?
我都没办法思考了
I can't hear myself think!
病人稳定了可以送去重症监护室送她过去我马上回来
Stable for the ICU. Get her up. I'll be right fucking back.
收到
Copy that.
我已经有一个了别让那玩意靠近我
I already have one. Keep that away from me.
这不是给你的
It's not for you.
这里是监控中心
This is the monitoring center.
关于你的系统你有权…
We see that you're not in your inclusion zone. Do you have permission--
表演结束了
Show's over.
你会惹上麻烦吗
are you gonna get in trouble for that?
可能吧
Probably.
嘿
Hey.
外面怎么了
What's going on out there?
音乐节上有很多人受伤了
A lot of people were hurt at the festival.
我要上厕所
I need to use the bathroom.
我叫他用水槽了
I told him to use the sink.
你怎么回事 -你宁愿我带他去外面吗
What is wrong with you? - Would you rather I take him out there?
坚持一下我马上回来好吗
Hang on. I'll be right back, okay?
给你
Here.
这是什么
What's that?
这是尿壶你可以尿到这里面
It's a urinal. You pee in it.
我还是憋着吧
I think I'll just hold it in.
拉出来我找到了一把4号♥刀
Pull out. I found a 4 blade.
这样好多了
This is better.
环境服务请到北区走廊
该死
Shit.
灯灭了肯定是电池没电了
I lost the light. The battery must be dead.
这个也没电了
This one's dead, too.
谁有能用的带光源的喉镜
Anybody have a laryngoscope with a light that still works?
我们会查查看 -快点查
We will check. - Check quick.
这家伙的麻♥醉♥药♥快失效了
This guy's paralytics are wearing off.
继续给他吸氧给我一根7毫米的气管插管
Keep bagging. Give me a 7.0 ET tube.
他是个大块头得用8毫米的
He's a big guy. He needs an 8.
这次不用 -7毫米
Not for this. - Number 7.
你要干什么 -触觉插管
What are you doing? - Tactile intubation.
我的食指进入了会厌谷
My index finger goes into the vallecula.
我的中指会引导插管穿过会厌
And my middle finger will guide the tube past the epiglottis.
如果你插到食道他就完了
But if you hit the esophagus, he's toast.
你说过除非能看到声带否则不要插管
You told us never to pass a tube unless we see the vocal cords.
没错但今天不适用
Correct. Not today.
如果我保持在正中线我应该能让它绕过声带
If I stay in the midline, I should be able to get it past the cords.
好吧给气球充气给他吸氧
Okay. Balloon up. Bag him.
呼气末二氧化碳看起来不错 -干得漂亮
Looks good on the end-tidal. - Slick move, boss.
没有脉搏开始按压 -把他抬起来
No pulse. Start compressions. - OK. Get him up.
试着用两升生理盐水把他救回来
Try to get him back with two liters.
这是我们能为每个患者提供的最大量了
That is as much as we can afford per patient.
从腿部输液太慢了上臂的速度是五倍
Leg is too slow; upper arm is five times as fast.
我们只能这样不要停我们能救活他
Best that we can do. Keep at it. We'll get him back.
罗比这里需要帮助
Robby, need help here!
朗登 -继续挤压
Langdon! - Keep squeezing.
你怎么样
How are you making out?
家属发来了很多邮件和照片
Lots of emails and photos coming in from concerned families.
等他们输入大规模伤亡事件受害人编码后就容易多了
It'll be easier once they've entered every patient's MCI number.
好了看起来眼熟吗
Here we go. Look familiar?
7号♥ 他叫文森特里维拉
MCI-7. His name is Vincent Rivera.
他一定有朋友和家人在食堂是他们发了照片
He must have had friends or family in the cafeteria who sent in the photo.
我会给他们发信息说我们马上到
I'll text them we're coming.
你在干什么 -给他一个机会
What are you doing? - Giving this guy a chance.
他需要一根大的中心静脉导管以便快速输液
He needs a big central line for fast transfusion.
没有超声辅助你不能做颈内静脉穿刺尤其是对这么壮的人
You can't do an IJ without an ultrasound, especially on a guy this big.
如果导致肺塌陷或刺中颈动脉你会害死他的
You'll kill him if you collapse a lung or hit the carotid.
我不是要做颈内静脉穿刺拔掉输血管把它拿过来
I'm not doing an IJ. Unhook that blood line. Bring it up here.
这是锁骨上入路锁骨下静脉穿刺
This is a supraclavicular subclavian.
如果你要盲目操作
If you have to go in blind,
这是进入大静脉的唯一安全方法
this is the only safe way to access a giant vein.
暂停按压
And hold compressions.
距离胸锁乳突肌外侧头一厘米
A centimeter from the lateral head of the sternocleidomastoid,
距离锁骨一厘米
a centimeter off the clavicle,
瞄准对侧乳♥头♥