驻院医生

The Resident S04E11

Part 4 May 30, 2021, 8:01 a.m.

对找出你能用的手术工具
Yes. Find any type of surgical equipment that you can use.
病人状况怎么样
What's the status on the patient?
对疼痛刺♥激♥没有反应
He's unresponsive to painful stimuli.
还有什么设备吗
What else have you got, equipment-wise?
缝线和手套手术刀和其他用品
Sutures and gloves. Scalpels and surgical equipment
在柜子里但我们拿不到
are in the cabinet but we can't get to it.
听我说没有正确的设备
Okay, listen to me, you cannot do this
- 你们做不了这个 - 这里有床单
-without the right tools. -We do have sheets
- 和枕套 - 很好
and pillowcases. -Okay, great.
很好放到病人旁边
Great, great. Lay those around the patient.
消毒的呢
How about sterilization?
- 有手部消毒剂 - 行
Hand sanitizer. -Okay.
仔细听我说如果你们把棍子拔掉
So here's the deal. If you remove that rod,
他可能会失血而死
he could die of exsanguination.
如果你们不拔他会因脑疝而死
If you don't, he can die of herniation.
我会尽我所能帮他活下来
I want to do whatever gives him the best shot at survival.
告诉我们该怎么做凯因医生
Just tell us what to do, Dr. Cain.
快点说我怕断线
And speak fast before we lose you.
把杆子拔掉但之后你们需要移除
Okay, remove that rod. But then you'll need to remove
伤处附近的头盖骨房♥间里有没有
a section of the skull around the impalement. Do you have
别的能用的东西
anything else in that room that you can use?
有个工具箱
We have a toolbox.
电钻
-Power drill.
钳子
Pliers.
刀片
X-Acto.
这不够理想但必须得用
Okay, that's not ideal, but it's gonna have to work.
一旦你们把棍子抽出来
Once you take out that rod,
就需要止住颅内出血
you have to stop the bleeding inside the cranial vault.
希望他的动脉无损
Fingers crossed that that artery's still intact.
然后要取走
Then you're gonna remove
所有的骨头碎片
all of those bone fragments.
你们得
: You have to be very...
凯因医生
-Dr. Cain.
完了断线了
Damn it. We lost him.
就靠我们了
We're on our own.
不如你先去刷手
Hi. Hey, uh, why don't you go
我之后跟上
scrub and I'll catch up.
好
Okay.
好了
Okay.
一定得是你来动手
It has to be you.
我医学院毕业之后就没进过手术室了
I haven't been in surgery since med school.
能听到我说话吗
Hey, can you hear me?
整面墙倒了
WORKER: Whole wall's collapsed.
至少得一个小时可能更长
At least an hour, maybe more.
我的天
Oh, God.
听着我知道你害怕
Listen, I know you're scared,
但你现在必须得做
but you have to do this now.
我不是害怕
I'm not scared of anything.
但催我没有任何用处
But rushing me won't help.
莉拉怎么回事
Leela, what's happening?
告诉我我该怎么做拜托
Tell me what to do, come on.
我的大脑需要时间来接受新事物
My brain needs more time to process one new thing
这信息量太大了
and this is... many.
好
Okay.
想象棍子周边有个象限
Visualize a quadrant around the rod.
想象在四角上都钻洞
Imagine drilling a hole in all four corners.
然后我们切开骨头
And then we cut open the bone.
到下面
We get underneath it.
然后
And...
把棍子抽出来止血
Extract the rod and stop the bleeding.
夹好血管了
AUSTIN: Vascular clamping complete.
好摘器官吧
BELL: Yeah, let's remove the organs.
我知道作为外科医生我们要保持冷静
I know as a surgeon, we're supposed to play it cool.
但这太疯狂了
But this is insane.
时间不多了到旁边桌上
Yeah, the clock is ticking. Let's resect
切除肿瘤吧然后
the tumors on the back table, then...
把器官放回她身体里
get the organs back inside her body.
我开始重建门静脉
I'll begin the portal vein reconstruction.
奥斯汀医生你没事吧
Dr. Austin, are you okay?
你为什么觉得我有事杰西卡
What about me suggests that I'm not okay, Jessica?
难道我没有在打开她的腹腔
Am I not elbow deep in a child's abdominal cavity
像神一般做手术吗
doing the work of gods?
我伤心吗对
Am I sad? Yes.
我和这可怜的孩子感觉一样空虚吗
Do I feel as empty as this poor child?
对
Yes.
我需要别人一直提醒我
Do I need people constantly reminding me
因为失去所爱而受伤吗
that I've been mortally wounded by the loss of love?
不需要
No!
是我不好杰西卡
my bad, Jessica.
我没事
I'm fine.
- 好 - 电刀
Okay. Bovie?
- 谢谢你 - 不谢
Thank you. -You're welcome.
派珀的血压急剧下降
Piper's blood pressure's failing.
- 我好像看到出血点了 - 我会继续输血
I think I see the source. -I'll keep transfusing,
但是她的身体快不行了
but her body's starting to shut down.
她不能再失血了
She can't afford to lose any more blood.
又有一处出血
There goes another one.
我们给派珀截肢
We didn't amputate Piper's leg
不是为了让她死在手术台上的
just to let her die on the table.
她要室颤了
She's going into V tach. -
我们得加快速度
We need to speed this up.
好了把棍子取出来吧
Okay, let's get the bar out of his head.
手稳一点
Steady hands.
就算是有1毫米误差
You move it even one millimeter in the wrong direction,
可能都是毁灭性的
it could be catastrophic.
你可以的
Look, you got this.
我来稳住他的头
I'll hold his head.
没有大出血
No major bleeding.
现在我们需要把
Okay, now we have to remove
剩余的骨碎片取出来
the remaining bone fragments.
肿瘤切除了
BELL: The tumors are resected.
我们要没时间了
JAKE: Yeah, we're running out of time.
现在就得把器官重新放回去
She needs these organs re-implanted now.
坏消息是肿瘤入侵了
The bad news is the tumors eviscerated
她的胰腺脾脏和胃
her pancreas, spleen and stomach.
好消息是肝脏和肠道
The good news is we still have enough healthy
还有足够的健康部分
liver and intestine.
你准备好重新植入了吗
You ready for re-implantation?
没有我刚发现她
AUSTIN: No. I just came across
腹腔壁上有一处
a smattering of malignant growth
恶性肿瘤
in her abdominal wall.
肯定是拍片子的时候没发现
They must've been undetected on imaging.
这让我们没法缝合
These are going to prevent us from closing.
我们需要快速给她
Okay, we are gonna have to rebuild her
由内向外重建
quickly from the inside out, starting with
从重建消化道开始然后是腹腔
the GI reconstruction, then the abdominal reconstruction.
有整形外科的医生在真好
It's a good thing we have a plastic surgeon in our midst.
慢慢来
Nice and slow.
好
Okay.
动手吧
Let's do this.
好了我觉得这是最后一个碎片
All right, I think that's the last fragment.
应该没有了
I don't see any more.
是动脉血他要失血过多了
Oh, it's the artery-- he's bleeding out.
加压
Apply pressure.
没用得要东西给他缝上
It's not working. We need something to seal it off.
我来找莉拉你继续压着
All right, I'll look. Leela, keep applying pressure.
好
Okay.
病人状态不稳定
The patient is becoming unstable.
不稳定是因为血管出血
The instability is related to a bleeding vessel.
我们需要保证体內稳态
We need to achieve homeostasis.