急诊先锋：纽约（2023）第一季 第七集

I’ll see you guys. Any questions, I’m right out here.
(科恩儿童医疗中心)
两岁男性哮喘患者 病情危重
Asthmatic 2-year-old male in severe distress,
呼吸困难
having a hard time breathing.
需要转运到科恩儿童医院
Needs transport to Cohen Children’s.
氧气接通
The tank is on.
血压为95和190
His BP was 95 over 190.
可以把氧气调低点吗?格雷舒服吗?
You want to try dropping the O2 a little bit? Make Grace happy?
– Yeah. – Her thresh– He said yes. Okay!
-是的 -她的阈值…他说是的 好!
血压125和70
Blood pressure at 111 over 73.
很好 看来他想睡觉
Good. Looks like he wants to go to sleep.
没错 对吧?
I know, right?
他有严重的哮喘病
He’s a severe asthmatic.
所以他需要肾上腺素、特布他林
So he’s required epi, terbutaline,
吸几口舒喘灵 还有镁和类固醇
several puffs of albuterol, and magnesium, and steroids,
他仍然喘得厉害
and he’s still having a lot of wheezing.
他很好 对
He’s good. Yep.
嗨!
Hi!?
严重哮喘 三月份插管 过去一天 出现了各种上呼吸道感染症状
So, severe asthmatic,
intubated in March, all the URI symptoms for the last day.
没有发烧 跟妈妈住在家里 没上托儿所
No fever. Lives at home with Mom, doesn’t go to daycare.
接到时病情危重 妈妈在家让他吸了喷雾
He came in severe distress. Mom gave him some puffs at home,
急救人员给他用了肾上腺素 我为他做了快速补液 就是这样
EMS gave him epi, and I gave him a fluid bolus, so here we are.
呼吸 宝贝 吸气和呼气
Breathe, baby, in and out.
对 吸气和呼气
Yeah, in and out.
我很难过 看见五名医生围着他
It’s traumatizing seeing five doctors surrounding him.
那些护士…这里扎一下 那里扎一下 宝宝在哭喊 他才两岁
The nurses… Jabs here, jabs there. Babies screaming.
He’s only two.
这让人…
So it’s…
那是我最好的朋友
That’s my best friend.
想要你的鲸鱼吗?
You want your whales?
-嗯? -果汁
– Huh? – Juice.
你的果汁?我现在没有果汁!
Your juice? Oh, I don’t have any juice right now!
一会儿给你果汁 行吗?
How about we’ll give you some in a little bit, okay?
– Ooh. All right.
那是果汁怪物
That’s the juice monster.
现在我和他相依为命
It’s just me and him right now,
我们一起经历了很多事 要是没有他 我不知道我会怎么样
and we went through so much together. I don’t know what I would do without him.
-嘿 一会儿见 -好
– Hey. See you in a little bit. – Yup.
有时候你回到这里 拯救一条生命
Some days you come back and save a life,
有时候你走进来 宣布某人死亡
and other days you walk in and pronounce someone dead,
然后一个人走出去 但这就是我们的工作
and you walk out without him, but it’s what we do.
但最终还是会影响你
But it has a toll, eventually.
急救队前往长岛犹太医疗中心 成人急诊室 9号♥诊室
Rapid response team to LIJ, Adult Emergency Room. Room 9.
外科急救队前往长岛犹太医疗中心 成人急诊科 9号♥诊室
Surgical rapid response team to LIJ, Adult Emergency Department, Room 9.
还有一个人!
One more!
-奥伦 快点! -你怎么满头大汗?
– Oren, hurry up! – Why are you sweating?
-等等 那谁来开车? -因为我刚处理完一起灰色代码事件…
– Wait, who’s on wheels, then? – Because I was in a Code Gray.
– Sorry!
门诊中心的W代码事件 可能需要快速响应
So Code W in an outpatient center can be a rapid response,
小到有人不舒服 大到心跳骤停
someone’s not feeling well, everything to a cardiac arrest.
Um, the ER response and transport, I think they should also be there.
急诊室人员和转运队 我想他们应该也到了
急诊医生跟我们在一起
ER physician’s here with us.
So everyone goes to see what’s going on and we figure it out.
大家都去了解具体情况 然后想办法解决
-就在这里 伙计 -奥伦 干劲不错
– Right here, buddy. – Oren, some driving you got.
-你叫什么? -唐纳德
– What’s your name? – Donald.
Nice to meet you. Transport.
很高兴认识你 我是转运队的
很高兴认识你 唐纳德
Nice to meet you, Donald.
我们要走了 因为我猜他是住院病人
We’re gonna go, because I guess he’s inpatient.
对 他是住院病人
Yeah, he’s inpatient.
他在停药
He’s on mid-break.
-嘿 宝拉 -嗨 最近怎么样?
– Hey, Paula! – Hi, how’s it going?
很忙
It’s busy.
好
Okay.
-你明晚上班吗? -上
– Do you work tomorrow night? – I do.
食物来了吗?
Did the food come?
来了 刚才我正在吃 我打算来找你的
It did. I was eating. I was gonna come get you.
回归正常生活
Back to regular life.
– Yeah. So that was uneventful. – For the most part.
-对 刚才虚惊一场 我是说… -没什么大事
没什么大事 每次来这里 都不知道会遇到什么事
For the most part. We never know what we get when we come here.
直到下一次
Until the next one.
Was it real?
刚才真的有事吗?
Uh, inpatient seized on an MRI table.
住院病人做核磁共振时癫痫发作
-好吧 -所以对 还好吧
– Oh, okay. – So pretty decent.
-我来接吧 -给
– I’ll take that. – Over here.
No, that’s a wrong number.
不 打错了
转运队 好的 我还没起床呢 再见
Transport. Okay, good. I didn’t get up yet. Bye.
– She wants her food. – Her food?
-她想要吃的 -吃的?
她说她会过来
She said she’s coming.
-嗨 -嗨
– Hi. – Hi.
我为你准备了吃的 你想把它锁起来 然后回来吃吗?
I have food for you. You wanna lock that up, come back and eat?
-不行 特别受害科来人了 我得走了 -好吧
– No, SV is here, so I have to go. – Alright.
好的
Alright. Yeah.
刚才进来的是我的另一半 她碰巧是我的上司
That was my significant other that came in, who happens to be my boss.
(唐)
Yeah, sounds good. Yeah. So, what I’ll do–
对 听起来不错 对 所以我会这样做…
– It hasn’t been accepted yet. – Go so I can burn some fuel.
-还没被接受 -走吧 我想消耗点燃料
No problem.
没问题
是的 我们可以把这个留在这里
Yeah, we can leave this over here.
Do you have any questions?
I’m MacKenzie, I’m the flight nurse.
我是空中护士麦肯齐
很遗憾 我们以这种方式相识
I’m so sorry that we have to meet this way.
你昏倒的时候 你失去意识了吗?
Now, when you passed out, did you lose consciousness?
我想是的
I believe I did.
还可能会进行提取 所以不清楚他们是否…
There also might be a retrieval, so it’s unclear if they–
他们是否会做IR之类的?好的
If they were going to go to IR or something? Okay.
IR的意思是介入放射学检查
IR just means Interventional Radiology,
那是一个特别区域 他们在那里提取凝血块
and that’s just a special area where they can retrieve a blood clot.
这是什么时候的事?
When did that happen?
大约三周前 我想一切都是它造成的
Oh, about three weeks ago. I think that’s the reason for everything.
我也这么觉得
I think so too.
大约三周前 这个病人在滑旱冰时
This patient was actually involved in a roller skating incident
出了事故
about three weeks ago,
造成胫腓骨折
which caused her to have a tib-fib fracture.
当你四肢发生骨折 不得不打石膏
When you break an extremity and it has to be casted
或者绑夹板时
or it has to be splinted
它会长时间保持特定的姿势
and remain in a certain position for a long period of time,
有时会造成血液淤积 可能形成血栓
sometimes the blood can pool, and it can form a blood clot.
她的左腿有一处明显的血栓
She has a significant blood clot in that left leg,
同时拥有双侧血栓 一个大血栓已经形成骑跨
and she also has bilateral blood clots and a large blood clot that’s saddled,
所以必须确保他们不会用力过度
so it’s very important to make sure that they’re not overexerting,
因为她会出现呼吸急促
because she is going to be short of breath.
有时她的心脏需要额外用力地泵血
Her heart is going to be working extra hard at times to pump.
血栓有时很恐怖
Blood clots can be scary.
她可能会呼吸骤停 意思是停止呼吸
She could go into respiratory arrest, meaning she’d stop breathing.
她可能会心跳骤停 那就严重了
She could go into cardiac arrest. I mean, they’re pretty serious.
最糟糕的情况是死亡
Like, the worst-case scenario is death.
我们得把注意力放在神经上 肿瘤会脱落的
We gotta focus on the nerves, and the tumor will fall down.
肌腱剪 先冲洗一下
Tenotomy. With an irrigation first.
剪子
Scissor.
视神经受到压♥迫♥ 肿瘤压着它
The optic nerve, it’s under pressure. The tumor is pressing on it,
我们要在这块骨头上钻孔 让它出来 不再受到压♥迫♥
and now we’re loosening it by drilling it out of the bone here.
You do everything you can to prevent damage just by manipulating the nerve.
你要尽一切努力 操控神经 避免造成损伤
我要切开 让它从这处管道出来
I’m just cutting it out of its canal here.
主任!
Chiefy!
-没错 伙计 这是脑膜瘤 -怎么样了?
– Yeah, buddy. – How’s it going?
It’s a meningioma.
– A big-ass– – Oh. What’s the consistency like?
-很大一个… -质地怎么样?
不妙 很硬
It’s bad. It’s hard.
脑膜瘤 可以给我几个杯子吗?
Meningioma. Can I get some glasses?
我在把肿瘤推离神经
And I’m pushing down the tumor away from the nerve.
看起来不错 就大小而言
It looks pretty good, size-wise.
-朗格回来了!鼓掌! -对!
– Langer’s back! Clap it up! – Yeah!
Here we go, David, here we go!
加油 大卫 加油!
你看到右视神经了吗?