有外伤患者送来时需要调动所有人手
家长 我们会注射苯那君可能会让孩子犯困
Mom, Dad, we’re giving some Benadryl. Might get a little sleepy.
不用为此担心 我就在外面 好吗?
Don’t get concerned about that. I’ll be right outside the room.
我们几分钟后过去
We’ll be going over in a few minutes.
能够进入急诊室帮上忙这种感觉好极了
It’s a great feeling to come in and make a difference,
因为我的孩子就住在附近如果他们出了什么事
’cause I have children in the area, and if something were to happen,
会被送到这里
they’d end up here.
Transplants coming.
移植器官快到了
好的 稍等一下
Alright, hold on one second.
嗨 我是科恩医院的唐纳德可以帮我转接儿科急诊室吗?
Hi, it’s Donald from Cohen’s. Can I get the Peds ER, please?
这间办公室是我们的儿科呼叫中心
This office is our pediatric call center.
我们是该地区唯一的儿科危重护理转运队之一
We are one of the only pediatric critical care transport teams in the area.
转运队 唐纳德
Transport, Donald.
作为护士 我们的医生对我们进行更好水平的培训
And as nurses, our physicians train us to a higher level.
别的医院会像呼叫911一样呼叫我们
Outside facilities call us as if we’re 9-1-1,
常常需要将患者转运到我们医院
and frequently it requires actual transport into our facility.
转运队 唐纳德
Transport, Donald.
他是一名17岁男子入院时有两处射入伤口
He’s a 17-year-old male coming in with two entrance wounds.
也许是两处射出伤口
Probably two exit wounds.
穿透了横膈膜 肝脏撕裂
Pierced the diaphragm, lacerated the liver,
胃和脾脏同样有撕裂
as well as the stomach and spleen.
准备出发!
Ready to go!
仍在流血
Still actively bleeding.
我们刚刚接到任务抢救一名一级创伤患者
We just got activated for a level one trauma.
伤者17岁 昨晚中枪
A 17-year-old who was shot last night.
他被送到了我们的另一家医院的急诊科
He was brought to the emergency department at another hospital of ours.
半夜有三次差点死掉
In the middle of the night, he actually tried to die three times.
我们目前掌握的信息还不完整
We don’t really have all the information at this point,
这在创伤科很常见
which is really common in a trauma kind of world.
我们只能根据不完整的信息做出决定
We have to make decisions with imperfect information.
嗨 大家好 谁是我这个小组的?
Hi, guys, how are you? Who’s here from my team?
早上好 普林斯医生
Good morning, Dr. Prince.
大家需要知道
The key thing for the team
这孩子在重症监护病房♥躺了一晚上了
is this kid’s been in an ICU setting all night.
所以动作一定要快
So this needs to be efficient.
我们急需做CT/血管造影
We really just want the CT/Angio.
要安静高效 让他进入下一步
We want to be quiet, efficient, and get him to the next step.
-家属也来了 好-母亲来了
– Family is here too? – Mom is here.
Okay.
Good.
Okay, this is Joshua, a 17-year-old male.
好 这是约书亚 17岁男性
有多处枪伤
He has multiple gunshot wounds.
做了脾切除术
He had a splenectomy.
之前的医生修复了肝脏撕裂伤还做了胃大部切除术
They did repair lacerations of the liver, also gastrectomy times three.
One, two, three, ready.
约书亚 一切安好 你在医院
Joshua, everything’s okay. You’re in the hospital.
颈部有穿透伤吗?
Was there a penetrating injury to the neck?
-没有-他不是遇袭了吗?
– There was not. – Was there an assault as part of this?
之前的病史不清楚…
Unclear of the history prior to–
The injuries are the humerus and belly.
受伤部位在肱骨和小腹
好
Okay.
-如果你们有新鲜冷冻血浆-可以帮他拿一袋吗?
– If you happen to have an FFP. – Can we get him an FFP?
好的 去拿新鲜冷冻血浆 我来输血
Alright, so somebody get the FFP, I’ll give it.
Another. Get it.
再来一袋 去拿
可以再给我一袋血浆吗?
Can I have another FFP?
嗨 我是普林斯医生
Hi, I’m Dr. Prince.
很遗憾让你大上午在这种情形下见到我
Sorry you’re meeting someone like me in the middle of the morning like this.
Right now, they’re just calmly getting him from the stretcher
他们正在冷静地将他从担架和转运设备上抬下来
and all the transport stuff here,
同时搭设仪器 以便进行监护
and set up to our equipment so we can track everything.
接下来我们会去隔壁房♥间再做一次CAT扫描
And then we’re gonna go next door to get another CAT scan.
我们跟之前的手术医生谈过了
We spoke to the surgeons that did the surgery there.
我们很了解现在的状况
We’re very up to speed with where things stand.
只是想确保救护车转运途中没出什么意外
Just wanna make sure with the move in the ambulance,
途中发生了很多事
there’s a lot going on,
同时收集信息以便拟定下一步抢救方案
and get information so we can draw out the next step.
好
– Okay. – Um…
你现在有问题想问我吗?还是…
Do you have questions for me right off the bat? Or…
我很害怕
I’m just scared.
这是正常的
That’s appropriate, ma’am.
我很遗憾
I’m so sorry.
这很正常 害怕是正常的
And that’s appropriate, ma’am. You’re allowed to be scared.
Look, you are not here alone.
你在这里并不孤单
这里有这么多人
There’s everyone here.
我们都是来帮助你的
All of us are here to help you with this,
我听说你有很多家人也来了
and I know I was told there was a lot of family with you,
等时机适当时我们会让他们全都进来
so we’ll get them all in when the time is right.
And…
We’ll walk you through this. We’re here for you.
我们会为你详细解释的我们会陪着你
我很遗憾
I’m sorry.
I’m not sure how much of this is just New York City, COVID,
我不确定在多大程度上
纽约市的表现只是新冠疫情的个别现象
但世界已经改变了
but the world’s changed.
新冠疫情是一记响亮的警钟
COVID was like a real wake-up call,
但也让我们倍感压力至今仍未完全缓解
but also a stressor that we still haven’t fully recovered from.
早期之所以死了这么多人原因之一是医院不堪重负
One of the reasons we saw so many deaths early was hospitals were overwhelmed,
but people wouldn’t come in until they were really sick
但人们由于恐惧总是等到病情非常严重时才来医院
because they were afraid.
患有轻微甚至是严重疾病的人
People that had moderate problems, or even major ones,
之前一直不肯来医院突然之间全都来了
that were staying out of hospitals, suddenly reappeared,
之前的就医需求被新冠疫情抑制了
that had been hibernating under the cover of COVID.
我只是担心这个血块的大小
I’m just worried about the size of this clot.
她年轻又健康
She’s young and she’s healthy.
我不想等待观察 这个血块太大了
You know, I wouldn’t want to wait on this. This is too big.
她叫什么?
– What’s her first name? – Julian. She wants a family.
朱利安 她想组建一个家庭
早上好
Good morning.
– How you doing? – I’m doing well.
-你好吗?-我很好
很好
Good.
嗨 队友
Hi, team.
当时这个女孩在参加一场婚礼
So, this girl was at a wedding.
她感觉左侧面部无力 双臂变得无力
The left side of her face was weak, she’s getting weakness of her arm.
她中风了 来紧急就医
She literally was having a stroke, comes in emergently.
她的右脑有一个巨大的血块
She has a huge blood clot in the right hemisphere.
可以把口罩拉下来让我看看你的脸吗?
Can you lower your mask just to look at your face?
笑一笑
Smile for me.
这种症状符合所谓的海绵状血管瘤
It’s consistent with what’s called a cavernous malformation.
通过后续检查 我们确认
We confirmed that with follow-up study,
血块已经略微缩小了一些
which showed that the amount of clot shrunk a little bit,
不过你也知道 她才29岁还有大好人生等着她
but you know, a 29-year-old girl with all her life ahead of her?
我们绝对不想冒着再次出血的风险
The last thing we want to do is take the risk of it bleeding again
给她造成终身的缺憾
and giving her a big deficit the rest of her life.
所以见到她病情有所改善
After seeing her improve,
and the thing is shrinking, let’s get it out of her.
血块正在缩小我们决定将血块取出来
所以我们要尽快手术
That’s why we’re doing this quickly as we can.
大部分外科医生信奉“应做尽做”
Most of our surgeries are “should and must,”
意思是 为了防止患者死亡或瘫痪
and that means that you have to have the operation in order to prevent
该做的手术必须做
loss of life or limb.
已注射1%的利多卡因和十万分之一的肾上腺素
One percent lidocaine with epi 1:100,000 was injected.
我们在常规手术中心和手术室备有除颤器
We have defibrillator in regular surgery center and surgery floor.
马到成功
Let’s rock.
这位女士29岁
So, this lady’s 29.
发病时她跟丈夫在参加一场婚礼
She was at a wedding with her husband
她丈夫是北岸医院的整形外科住院医师
who’s an orthopedic surgery resident in North Shore.
她是个歌♥剧演员
She actually is an opera singer, of all things,
也是个非常可爱的女士
and a really sweet lady.
她丈夫也是个好人 所以大家好好干
And her husband is a good guy too. So let’s do a good job.
…在时代广场一名枪手在发生争执后开枪
…in Times Square, as a shooter fires after a fight,
路人慌忙找地方躲藏…
sending people scrambling for cover as–
这是我们的订婚派对四个月前我们结婚了
This is our engagement party. We got married four months ago.
她是受过正统训练的歌♥剧演员
She’s a classically trained opera singer.
她还经常参加百老汇的面试
She also auditions for Broadway.
这是她第一次演出
This was like her first show.
她一直在打电♥话♥跟差不多50个人聊了电♥话♥
She must have been on the phone with like 50 different people.
她说:“我不想睡觉
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