匹兹堡医护前线（2025）

The Pitt S01E13

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

What about Bridget? - She's stuck in yellow.
梅尔需要一位主治医生
Mel needs an attending.
找个有空的我们给她输血吧
Find somebody who's free. Let's get blood.
阿伯特医生你能来… -我得等一会
Dr. Abbot, can you come-- - Gonna be a minute.
沃尔什医生 -我要送这个病人去手术室
Dr. Walsh. - Taking one up to the OR.
好吧
Okay.
我需要一个便携式脉搏血氧仪给格雷森先生
Hey, I need a portable pulse ox for Mr. Grayson.
给你
Here you go.
轮椅上那个右腿鲜血淋漓的孩子
Hey, what happened to the kid in the wheelchair
是怎么回事
with the bloody right leg?
不知道
No idea.
针尖样瞳孔可能是吸毒过量
Pinpoint pupils-- probable OD.
他衣服上的血不是他的
Blood on his clothes wasn't his.
我去拿点纳洛酮 -舌下注射
I'll grab some Narcan. - Sublingual injection.
这边还好吗 -看起来是阿片类药物过量
Okay here? - Uh, looks like a opioid overdose.
罗比和莉亚怎么样了
How's Robby with Leah?
如果病人仍未苏醒我们要进一步排查隐匿性创伤
If this guy doesn't wake up, we'll check for occult trauma.
胸腔引流出1400毫升血液第一单位输血完毕
1,400 of blood out the chest. First unit's in.
快速输注第二单位血然后我们再检查一次脉搏
Squeeze in a second unit fast, and then we'll do another pulse check.
需要再加一条静脉输液
She's needs a second line?
输新鲜冷冻血浆和血小板
For FFP and platelets.
你确定吗罗比
You sure, Robby?
苏菲去拿血浆
Sophie, get the plasma.
我来按压
I'm gonna take over compressions.
然后换你 -去吧
And swap.
社工请到南区走廊
Social worker to the south corridor. Social worker to the south corridor.
洁米轮椅
Jamie, wheelchair.
你不能到这里来
You can't be in here.
但他们在抢救我女友我得知道目前是什么情况
They're working on my girlfriend. I need to see what's going on.
目前的情况是你正在大量失血
What's going on is, you're losing a lot of blood.
如果不及时止住你会晕倒的
You're gonna pass out if we don't stop it.
不我不走别烦我
No, I'm not moving, man! Leave me alone!
杰克坐到轮椅上
Jake, get in the damn wheelchair.
不要 -现在快去
No! - Now! Go!
拜托
欢迎回来先生你在匹兹堡创伤医疗中心的急诊室
Welcome back, sir. You're in the ER at PTMC.
你叫什么名字 -马丁
What's your name? - Martin.
你吃了什么马丁你在匹兹堡音乐节上服药过量了
What'd you take, Martin? You overdosed at Pitt Fest.
我吃了一颗止痛药为了跳舞我的膝盖不好
I took one Percocet so I could dance. I've got a bad knee.
你从哪弄来的药 -一个朋友
Where'd you get the pill? - From a friend.
你因为服用伪装成止痛药的芬太尼药物过量时
Okay, while you were overdosing from the fentanyl in a fake pill,
匹兹堡音乐节上发生了大规模枪击
there was a mass shooting at Pitt Fest.
什么
What?
萨米拉你去黄区帮一下梅尔吧
Hey, Samira, see if you can go help Mel in the yellow zone.
带上我的新朋友马丁
Take my new friend Martin with you.
贾瓦迪帮我推一下
Javadi, roll with me.
我们走
两单位浓缩红细胞输注完毕新鲜冷冻血浆输完了吗
Two units packed cells in. FFP still going? Almost there.
快了好了暂停按压
Okay, holding compressions.
感觉不到颈动脉脉搏
Can't feel carotid.
股动脉脉搏也没有 -恢复按压
No femoral. - Resuming compressions.
你接下来打算怎么办老大
What's your next move, boss?
再输一单位血小板
Platelets, another unit.
然后我们可以通过胸腔引流装置
And then we can transfuse her with her own blood
将她的自体血回输准备好细胞回收装置
from the Pleur-evac to get ahead. Hang the cell saver.
全部输进去吗 -不
Squeeze all this in? - No.
60毫升注射器装上三通阀
Three-way stopcock on a 60-cc syringe.
我来抽取和注入 -好的
I'll push-pull. - Okay.
这不符合我们的大规模伤亡计划
Not exactly in our mass casualty game plan.
我问过了主治医生都没空 -好的
I tried. No attendings available. - Okay.
好的
All right.
看起来是浅表伤
Okay, those look pretty superficial.
可能是子弹击中地面后反弹的碎片
Might've been fragments from a ricochet off the ground.
虽然失了很多血但你不会有事的
Lost a lot of blood, but you're gonna be okay, bro.
问题不大把我放回轮椅上吧
It's not bad. Just put me back in the wheelchair.
不行你得躺在床上把腿抬高我们不希望你流血致死
No, no, stay in bed with your leg up. We don't want you oozing to death.
萨米拉你那边什么情况
Samira, what you got?
阿片剂服药过量注射纳洛酮后需要观察
Opiate OD needs observation after Narcan.
真无聊不用了谢谢梅尔大♥麻♥格雷森怎么样了
Ugh, boring. No, thank you. Mel, how's Ganja Grayson?
我们可以暂时把他送到粉区等重症监护室的床位
Um, we can put him in pink while he waits for ICU.
好的稍等一下
Okay, one second.
你在干什么 -我在检查视网膜
What are you doing? - I'm checking the retina.
检查有没有脱落 -颅内压
For detachment? - For intracranial pressure
可以通过测量视神经鞘直径来评估
by measuring the optic nerve sheath, which is--
结果是天啊十毫米
holy shit--10 millimeters.
正常是多少五毫米 -对五毫米
What's normal? 5? - Yeah, 5.
是颅内出血
It's an intracranial bleed.
压力在增加瞳孔没有发散
The pressure's been building up. There's no blown pupil.
对暂时还没有但如果他持续出血他会死的
Yeah, not yet. But if he keeps bleeding in his skull, he's gonna die.
是的他需要钻个一英寸的孔… 我去找颅骨钻
Yeah, he needs a one-inch, uh, burr hole in his-- with a cranial drill.
我去看看神经外科医生在不在
I'm just gonna see if Neurosurgery's here.
我们没时间等神经外科了
We don't have time to wait for Neuro.
我有碘伏和10毫升注射器
I got Betadine and a 10-cc syringe.
我们要插管吗呼吸过度 -甘露醇能降低颅内压
Should we intubate, hyperventilate? - Mannitol decreases ICP.
天啊 -搞什么
Holy shit! - What the hell?
释放颅内压这样他才不会死
Relieving intracranial pressure so he doesn't die.
用骨内输液的钻头
With an IO drill?
太帅了下一个让我来
That's sick. I get the next one.
只要别用在我身上就行
Long as it's not on me.
达娜神经外科医生在这里吗 -问普林塞斯
Dana, is Neurosurgery down here? - Ask Princess.
普林塞斯… -心胸重症监护室
Princess... - Cardiothoracic ICU.
我需要一个神经外科医生 -都在手术室呢
I need a neurosurgeon. - They're all in the OR.
沃尔什医生
Dr. Walsh,
北区走廊有一个颅内压增高的硬膜外血肿患者
I have an epidural in the north corridor with an elevated ICP.
瞳孔有发散吗 -没有
Is there a blown pupil? - No,
但超声显示有十毫米的视神经鞘
but a 10-millimeter optic sheath on the ultrasound.
我们需要颅骨钻孔
We need a burr hole.
搞什么
What the fuck?
在用骨内输液装置引流颅内出血
Draining the ICH with an EZ-IO.
目前已引流40毫升
40 cc's out so far.
就像她说的 “搞什么”
Like she said, what the fuck?
2022年《急诊医学》杂♥志♥上有一份病例报告
There was a case report in the 2022 "Journal of Emergency Medicine."
病人活下来了
Patient survive?
神经系统完好无损地回家了
Went home neurologically intact.
视神经鞘恢复正常了
The optic sheath is back to normal.
开始有目的的运动
Starting purposeful movements.
准备好插管了
Ready to intubate.
异丙酚罗库溴胺和甘露醇
Propofol, rock, and mannitol.
我会通知神经外科尽快送他上来
I'll let Neurosurgery know. We'll get him up ASAP.
救得好 -如果他活下来的话
Incredible save. - If he lives.
第三单位输注完毕 -好的检查脉搏
Third unit's in. - Okay, pulse check.
我好像感觉到股动脉脉搏了 -我摸到颈动脉脉搏了
I think I'm feeling a femoral. - I got a carotid.
艾默里我有一名胸部创伤患者需要进手术室
Emery, I got a chest case, needs to go to the OR.
我看到你给她做心肺复苏了
I saw you doing CPR on this girl.
左胸引流两升
Two liters out of the left chest.
输三单位浓缩红细胞自体血600毫升两单位新鲜冷冻血浆后脉搏恢复
Got a pulse back after three packed cells. 600 out of the cell saver, 2 of FFP.
我没摸到 -摸一下颈动脉
I'm not feeling it. - Check the carotid.
没有抱歉
Nothing. Sorry.
恢复按压我们应该带她上去她刚才有脉搏了
Resume compressions. No, no, we should take her up. She just had a pulse.
现在没有需要有脉搏才能进手术室如果有变化打给我
Not now. We need a pulse to go to the OR. Call me if anything changes.
有更多病人来了
Got a Pink coming in.
我们还有捐献者的全血吗
Do we have any more whole blood from the donors?
有 -再拿一个单位
Think so. - Okay, get another unit
里面有血小板和血浆能帮她凝血
that's got platelets and plasma. It'll help her clot.
好的
Got it.
四个单位了血是给那些还有得救的人准备的
Four units. Blood is for the ones we can save.
她就在生死边缘再来一个单位就能救活她
She is right on the edge. One more can make the difference.
我进去了
I'm in.
呼气末二氧化碳看起来正常
Uh, end-tidal looks good.
接下来就交给手术室团队吧
Okay, OR team can take it from here.
我们需要检查其他人
We need to check on the others.
我该回去粉区了 -坚强点宕机女孩