匹兹堡医护前线（2025）

The Pitt S01E02

Part 1 March 11, 2025, 8:29 p.m.

匹兹堡医魂
第一季第二集

罗比
Robby.
(新冠肺炎隔离区-止步始终佩戴好口罩)
罗比那个呼吸窘迫的大学生来了
Robby. College kid in respiratory distress is here.
好的
All right.
你没事吧 - 没事
You OK? - Yep.
第二小时早8点至9点
我想跟中心区12号♥病房♥ 那个病人的儿子谈谈但他跑了
I wanted to talk to the patient in Central 12's son, but he took off.
有什么问题吗
Is there a problem?
据他妈妈说她找到了一份他想要消灭的
Uh, according to Mom, she found a list of high school girls
高中女生名单
that he'd like to eliminate.
现在的孩子都怎么了
What's wrong with kids these days?
你是说除了社交媒体和全球大瘟疫
Uh, you mean besides social media and the worldwide pandemic
和环境危机之外
and the environmental crisis?
是啊 - 还有枪♥支♥暴♥力♥
Yeah, yeah, yeah. - And gun violence?
你可真是今天的希望之泉啊
You're a fucking fountain of hope today, aren't you?
尼克布拉德利 19岁被父母发现失去意识
Nick Bradley, 19, found unresponsive by parents.
没有药物史没有过敏史
No meds, no allergies.
到达时他几乎没有呼吸瞳孔缩小心动过缓心率38
On arrival, he was barely breathing with pinpoint pupils, bradycardic at 38.
瞳孔对纳洛酮有反应
Pupils responded to Narcan,
但呼吸没有恢复我们给他做了插管
but we tubed him when his respirations didn't pick up.
现场有毒品或酒精吗 - 没有
Any drugs or alcohol on the scene? - No.
创伤迹象 - 没有
Signs of trauma? - Nothing.
好的睁开眼睛尼克
OK. Open your eyes, Nick.
数到三一二三
On three. One, two, three.
他在哪里被发现的 - 在床上他妈妈发现的
Where was he found? - In bed by his mom.
瞳孔六毫米无反应
Pupils are 6 millimeters, non-reactive.
心率6♥4♥ 循环血压
Heart rate's 6♥4♥. BP is cycling.
对疼痛没有反应昏迷指数3分
No response to pain. GCS 3.
符合任何毒理症候群吗 - 没有
Does that fit any toxidrome? - No.
如果只是鸦♥片♥过量注射纳洛酮后他应该能自主呼吸了
If it was just opiates with Narcan, he'd be breathing on his own.
乙型阻滞剂不应该出现针尖状瞳孔
Uh, beta blockers shouldn't get pinpoint pupils.
也许父母在卫生间放了一些处方药
Maybe parents had some prescription meds in their bathroom.
他们在路上了
They're on their way.
外伤病人一层预计五分钟后到达
Code trauma, tier 1, ETA five minutes.
有个站立踏板车骑手撞上了车门没戴头盔
That's a stand-up scooter rider versus car door. No helmet.
腹部没有血没有心包积液
No blood in the belly. No pericardial effusion,
肺叶张开
and lungs are up.
血红蛋白15 正常
Hemocue's good, 15.
高压84低压58 - 好的
BP 84 over 58. - OK.
你有什么计划柯林斯医生
What's your plan, Dr. Collins?
注射0.1毫克肾上腺素
Um, push dose epi, 0.1 milligram.
插入导尿管稳定体征准备做CT 广撒网排除病因
Foley for urine, stabilize for CT, and throw a wide net.
我们要去哪里 - 我们需要给别人腾出房♥间
Where-- where are we going now? - We need the room for someone else,
但在化验结果出来前你可以在大厅里休息
but you can rest in the hall till we get your labs back.
你父母一定很骄傲吧
Your parents must be proud.
有个当医生的儿子
Having a son for a doctor.
是啊我想是的
Yeah, I guess.
我是我们家第一个上大学的人
I was the first one in my family to go to college.
他们牺牲了很多才让我有了今天
You know, they sacrificed a lot to get me here.
你还疼吗米尔顿先生
How's your pain, Mr. Milton?
我没事了不过我需要喝杯拿铁
Uh, I'm fine. Could use a latte, though.
那可能会导致胆结石疼痛复发
That could bring back the gallstone pain.
来杯波旁威士忌
How about a bourbon?
现在才八点钟来点冰块如何
It's barely 8:00. Uh, how about some ice chips?
不用了谢谢我更喜欢纯的威士忌
No, thanks. I prefer my whiskey neat.
那不可能
Yeah, that's not happening.
收缩压降到90
Systolic back down to 90.
再注射0.1毫克肾上腺素
Another 0.1 of epi.
四肢驰缓性瘫痪
Flaccid paralysis of all four extremities.
冰水刺♥激♥没有眼动
No eye movement with ice water.
所以没有脑干功能 - 原因呢
So no brainstem function. - Due to?
缺氧损伤大出血
Hypoxic injury, massive hemorrhage.
萨米拉送他去做CT 把药盒带上
Samira, escort him to CT. Take the drug box with you.
有需要就找我
Call me if you need me.
嘿你还好吗
Hey, are you OK?
挺好的 - 你确定吗
Yep. - Are you sure?
我什么时候让你担心过
Have you ever had to worry about me?
没有但确认下总没坏处这是我工作的一部分
No, but it never hurts to check in. It's part of my job.
你已经确认过了
Consider yourself checked in.
好的
OK.
你拿的什么
Got something?
我有个病例要请示柯林斯医生
Oh, I had a case for Dr. Collins.
我能看看吗 - 好的
May I see? - Yeah.
68岁男性有高血压病史
A 68-year-old male, history of hypertension,
吃了一顿高脂肪餐后右上腹疼痛一小时现在痊愈了
one hour of right upper quadrant pain after eating a fatty meal, now resolved.
没有发烧无触痛床旁超声显示有一颗胆结石
Afebrile, non-tender. There was a gallstone present on POCUS.
心电图显示没有急性缺血性改变但我还在等肝功和脂肪酶的结果
EKG shows no acute ischemic changes, but I'm still waiting on LFTs and lipase.
你为什么给他做心电图
Why did you order the EKG?
护士建议排除任何心脏问题
The nurse suggested it to rule out any cardiac issues.
你们两个都做得不错
Well, good call on both your parts.
护士们的专业技术都很过硬听她们的话别犹豫
Nurses know what they're doing. Never hesitate to listen to them.
化验结果出来后来找我 - 好的
Come find me when those labs are back.
对了你的手指怎么样了 - 没事了
Hey, how's that finger? - Oh, it's nothing.
罗比医生 - 什么事
Dr. Robby? - Yep?
看护中心那位斯宾塞先生他儿子和女儿来了
The son and daughter of Mr. Spencer from assisted living, they're here.
好的我马上到
OK. I'll be right there.
你们的父亲得了肺炎和一种叫做脓毒症的病
Your father has pneumonia and a condition called sepsis.
那到底是什么
What is-- what is that exactly?
意思是细菌已经从他的肺部扩散到血液
It means that the bacteria has spread from his lung to his bloodstream.
到目前为止他对治疗的反应良好
So far, he's been responding well to treatment.
嘿爸爸
Hey, Pop.
我们是海伦和杰里米
It's Helen and Jereme.
杰里米...
Jereme...
希拉里...
Hillary...
鲍勃...该死的
Boob... Fud.
这是《黄色潜水艇》那部动画片里的人物
It's the "Nowhere Man" from "Yellow Submarine."
我以前不写作业的时候他就这么叫我
It's what he used to call me when I didn't do my homework.
这是他的正常状态吗
Is this his baseline?
他时好时坏
He has good days and bad days.
我们能借一步说话吗
Why don't we step out for one more second?
你们父亲入院时血压很低这一情况正在好转
So your father came in with low blood pressure, which is improving.
他能回去看护中心了吗 - 最终会的我们希望如此
Can he go back to assisted living? - Eventually, we hope so.
你们父亲签过一份事前指示书
Your dad has an advanced directive expressing his wishes,
上面说静脉注射和药物都没问题
which says that IV fluids and medications are OK,
但不能上体外呼吸机不能做心肺复苏
but no artificial life support, no CPR.
他不想靠一堆机器来维持生命
He doesn't want a bunch of machines keeping him alive.
好的那我们继续给他吸氧静脉注射和服用抗生素
OK. Then we will continue with oxygen and IV fluids and antibiotics,
但如果他的肺停止工作了我们不会在他气管上插管
but if his lungs stop working, we're not going to place a tube in his windpipe
连接呼吸机的
for a breathing machine.
但肺炎是可以治好的吧
But pneumonia is treatable?
大多数时候是的
Most of the time, it is.
但如果他能在一周内好转那就给他上呼吸机
But if he can get better in a week, then put him on a machine.
那不是他想要的
That's not what he wanted.
你们谁有医疗照护永久委托书吗
Do either of you have durable power of attorney for health care?
是的 - 我们两个都有
Yes. - We both do.
好吧你们不需要现在就做决定
OK. Well, this is a decision that does not need to be made right now.
回去好好想想商量一下
Why don't you think about it? Talk about it.
如果情况变得更糟
If things get worse,
有时让老人舒适地自然死去是最人道的方式
sometimes allowing for a comfortable natural death can be the most humane path.
我们评估完一层的病人前不接常规病例谢谢
No routine cases until we assess the tier 1. Thanks.
朗登医生
Dr. Langdon?
退伍军人管理局感觉怎么样
So, uh, how was the VA?
对挺好的很有挑战性我学到了很多
Yeah, it was, uh good, uh, you know, challenging. I learned a ton.
我只是觉得也许应该强制所有医生
I just think it-- maybe it should be mandatory
定期去那里
that all doctors spend time there, like, on a regular basis
毕竟他们为我们牺牲了那么多
because of all they've sacrificed for us.
这想法不错你为什么选匹兹堡
That's a nice thought. Why'd you choose the Pitt?
我有个有特殊需要的妹妹
Oh, I have a sister with special needs
她参加了匹兹堡这里一个很棒的项目
and she got into this really great facility here in Pittsburgh.
而且这里的二尖瓣整形术非常有名我觉得很适合我