匹兹堡医护前线（2025）

The Pitt S01E13

Part 6 May 20, 2025, 4:18 p.m.

瞳孔正常脉搏正常
Normal pupils, normal pulse.
脑损伤
Brain injury?
不是她走路步态很稳 -还是需要做头部CT
No, she was walking with a steady gait. - Still needs a head CT.
那得等上几小时 -我可以在两侧颅骨钻孔
Well, that's not gonna be for hours. - I could drill EZ-IOs on both sides.
对上一个人有效
It worked on the last guy.
也许是因为目睹了一切导致了创伤后应激障碍
Maybe it's PTSD from all she's seen.
这里有心理医生吗
Is Psych even here?
没有但她也许只是需要一个安静的地方
No, but maybe she just needs a quiet place.
随便你
Well, knock yourself out.
怎么样了维塔克
What's up, Whitaker?
交界处止血带似乎起作用了
Junctional tourniquet appears to be working.
纱布上没有新的血迹
No new blood on the gauze.
你看起来不错卡门
You're looking good, Carmen.
她…卡门
Is she--Carmen? Carmen?
脉搏微弱她这样多久了
Pulse is thready. How long has she been like this?
她一分钟前还是清醒的
She was awake and alert a minute ago.
这是失血过多的影响
All that blood loss is catching up with her.
注射一升补液滴速开到最大
Run in a liter wide open.
膀胱附近有大量积血
Uh, huge collection of blood near the bladder.
子弹一定是向上移♥动♥ 并击中了髂外动脉
The bullet must have tracked north and hit the external iliac.
我们止住了腿部的出血
We stopped the bleeding near the leg,
但她的体内仍在出血我们需要梅尔
but she's still bleeding internally--we need Mel.
不我们需要给她输血并把她送到红区
No, we need to give a unit of blood and move her to the red zone.
好的他们有空位了通知我
Okay, let me see if they have space. Coming through.
罗比在哪
Where's Robby?
在行为健康科室2号♥病房♥ 跟枪手在一起
In BH-2 with the possible shooter.
你们能接个新病人吗
Can you guys take a new patient?
现在不行病人什么情况
Not right now. What do you got?
低血压性盆腔出血
Hypotensive pelvic bleed.
输两单位血我们一会过去
Transfuse two units. We'll get to it.
阿伯特我有一个颈动脉损伤病人血栓脱落
Abbot! I got a carotid injury, popped a clot.
我马上来帮我一下
I'll be right there! Help me out.
那是罗比和大卫吗
Is that Robby with David?
是的我看到警♥察♥把他抓进来的
Yeah. I saw the cops bring him in.
大卫是谁
Who's David?
一个威胁伤人的高中生
High school kid who was making threats.
你觉得是他干的
You think he did this?
伙计们专注于病人
Guys, focus on the patients.
你这边什么情况
What do you got?
好吧无菌静脉输液管脐带扎带
Ooh, okay, sterile IV tubing, umbilical tape,
红色橡胶导尿管和无菌手套
and red rubber Robinson, and sterile gloves.
来了一个粉区病人
We got a Pink coming in.
我们绕个路吧
Let's take the long way around.
我可以把杰克安置到家庭病房♥
I can put Jake in the family room.
不用我来吧
No, it's okay. I'll do it.
使用静脉输液管进行缺损旁路
Defect bypass with IV tubing.
你做过Rummel止血带吗 -什么
You ever done a Rummel tourniquet?
罗比你能帮我做一个Rummel吗
Robby, can you help me with a Rummel?
最困难的部分是将脐带扎带穿过导管
Toughest part is getting the umbilical tape through the tubing.
夹住
And clamps.
很厉害 -你们能行吗
Very cool. - You guys got this?
没问题
Oh, we're good.
罗比医生我有个腹膜后出血病人
Dr. Robby, I have a retroperitoneal bleed.
找阿伯特 -他很忙
Get Abbot. - He's busy.
好的稳定住病人然后找个外科医生坐上来
Okay, stabilize and find a surgeon. Get in the chair.
嘿怎么了
Hey, what's going on?
莉亚的伤势非常严重
Leah's injuries were really serious.
她停止呼吸了
She stopped breathing.
我们给她喉咙插管以输送氧气
We put a tube down her throat to deliver oxygen.
我们成功排出了压♥迫♥她肺部的血液
We were able to drain the blood that was collapsing her lungs.
我们尽最大努力给她输血
We gave her as much blood as we could.
我们甚至把她胸腔里自己的血也输了一些回去
We even transfused some of her own blood that was in her chest.
但我们还是没办法…
But we were unable to...
逆转大量失血造成的后果
get ahead of the massive blood loss.
她的心脏停跳了
Her heart stopped.
你看到我做心肺复苏了
You saw me doing CPR.
我们尽力了
We did everything that we could.
她死了
She's dead?
是的
不对啊她中枪后我和她说话了她当时还能说话
No, no, but I-- 'cause I was talk-- I was talking to her after she got shot, and she was talking.
她的心脏损伤无法修复
Her heart was damaged beyond repair.
我们无力回天了
There was nothing that we could do to save her.
我想见她
I want to-- I want to see her.
我很抱歉但你不能见她 -为什么
I'm really sorry, man, but you can't. - Why not?
因为警方和联邦调查局正在联合调查这起案件
Because this is an active police and FBI investigation.
她死了 -我知道
She's--she's dead. - I know.
几天后他们会把她的尸体交给她父母
They're gonna release her to her parents in a couple days.
不拜托你得让我见她
No, please, you-- you have to let me see her.
求你了
Please, please, please.
送信的来了她还好吗
Bringing in mail. How's she doing?
还有脉搏
Still has a pulse.
你在干什么
What are you doing?
准备做主动脉复苏性血管内球囊闭合术
Prepping for REBOA.
你疯了吗阿伯特批准了吗
Are you crazy? Did Abbot approve this?
他说了做你该做的事
He said, do what you have to do.
主治医生都腾不出手来
Attendings are all tied up.
如果我能将气球在主动脉内充气就能止住出血
If I can blow up a balloon in the aorta, it'll stop the bleeding.
这会切断她半身的血液供应
It'll cut off the blood supply to half her body.
我只进入几英寸肾脏下方的主动脉第三区
I'll only go in a few inches, zone three, below the kidneys,
直到她被送进手术室戴上手套哈克贝利
until she gets up to the OR. Glove up, Huckleberry.
好吧你需要超声和X光的辅助
Okay, you're gonna need an ultrasound, X-ray.
今天不行
Not today.
你以前做过吗
Have you done this before?
这是中心静脉导管
It's a central line.
我只需要穿刺股动脉…像这样
I just need to hit the femoral artery... like that.
小菜一碟
Piece of cake.
好的导丝和导引鞘管呢
All right, guidewire, then introducer sheath.
桑托斯在做主动脉复苏性血管内球囊闭合术
Santos is doing a REBOA.
不是吧
Oh, no, no, no way.
是的
Yes way.
不行我们需要主治医生或资深住院医生在场
Um, no, we need an attending or a senior resident for that.
对我有点信心吧
Oh, ye of little faith.
受害者确认身份
Victim identification.
你确定吗 -确定
Are you sure? - Yes.
这些人都死了
All these people are dead?
是的
Yeah.
哪一个是莉亚
Which one is Leah?
你手腕上的编码是多少
What number do you have on--on your wrist?
91号♥
91.
目前我已经推进了15厘米注入了5毫升生理盐水
I'm at 15 centimeters with 5 cc's of saline so far.
球囊闭合术你在逗我吗 -我劝过她了
A REBOA? Are you shitting me? - I told her to stop.
盆腔动脉无法控制的出血没有别的选择
Uncontrollable bleeding from a pelvic artery-- no other options.
我们需要动脉导管来监测血压是否上升
We need an art line to know if the BP's up.
我们可以通过脉搏强度和意识状态来判断
We'll go with pulse strength and mentation.
颈动脉很微弱桡动脉几乎没有
Carotid's weak. Radial's barely there.
气球里再注入3毫升 -注射中
Another 3 cc's in the balloon. - Injecting.
我试试触诊收缩压 -好的开始吧
I'll try for palpable systolic. - Yes, go for it.
桡动脉强多了
Uh, radial's much stronger now.
锁好球囊检查伤口开始
Lock the balloon. Check the wound. Go.
触诊血压110 -可以了
BP's 110 by palp. - That'll do.
是的伤口干燥了几乎没有出血
Yeah, wound's dry. Barely a trickle.
那是因为没有血液流经她的腿了
That's because there's no blood going to her legs.
好了时间不多了球囊最多能撑一小时
Okay, the clock is ticking. Balloon can stay up for one hour, tops.
让介入放射科和血管外科来处理
Get IR and Vascular on the case.
这就去
On it.
嘿坚持住卡门
Hey, hey, hang in there, Carmen.
你没事的好吗
You're good, okay? You're good.
你不该自己做那种手术下不为例明白吗
Okay, you never should have done that on your own, ever. Do you understand?
但你做的很棒你救了她的命干得好
But that was pretty badass. You saved her life. Good job.
你给她父母打电♥话♥了吗
Did you-- did you call her parents?
他们会把电♥话♥号♥码给我们的社工