(前情提要)
我是拉帕波特夫人 我是重伤待命主任医师 This is Mrs Rappaport, I'm the consultant on call for major trauma.
罗琳去哪儿了 谁来接手 What's happened to Lorraine? Who's covering?
你最好不要管这事 所以你别管了 It's in your best interests to stay out of this, so stay out of this.
我最不愿意麻烦的就是你 You're the last person I want to call but...
但你是唯一能帮我的 ...you're the only one who can help.
我在全世界行过医 I've practised all over the world,
在军队里干过 也去过平民医院 in the Forces and civilian hospitals.
我的专长就是危重伤患 I specialise in critical injuries.
我还以为你需要我 这里需要你 I thought you needed me. This unit needs you.
你觉得我能改变罗琳改变不了的事 You think I can change things when Lorraine couldn't.
来吧 Bring it on.
-==破烂熊乐园倾情奉献==- 本字幕仅供学习交流，严禁用于商业用途
-==http://www.ragbear.com==- 争分夺秒 第一季第3集
-=破烂熊字幕组=- 翻译：翻到内伤 校对：校到吐血 时间轴：轴到晕血
* 你可以从我走路的姿势看出 * * Well, you can tell by the way I use my walk *
* 我深受女士们欢迎 没空闲聊 * * I'm a woman's man, no time to talk *
* 音乐震耳 姑娘们热情 * * Music loud and women warm *
* 我从小就被粗暴对待 * * I've been kicked around since I was born *
* 没关系 我不在乎 * * And now it's all right, it's OK, *
* 你可以视而不见 * * you may look the other way *
* 我们可以试着去理解 * * We can try to understand *
* 纽约时报对人的影响 * * The New York Times' effect on man *
* 无论你是兄弟还是个母亲 * * Whether you're a brother or whether you're a mother *
* 你都要活下去 活下去 * * You're stayin' alive, stayin' alive *
* 感受城市崩塌 众人颤抖 * * Feel the city breakin' and everybody shakin' *
* 我们会活下去 活下去 * * And we're stayin' alive, stayin' alive *
* 啊 哈 哈 哈 活下去 * * Ah-ha-ha-ha, stayin' alive *
已经到31分钟了 * 活下去 * That's 31 minutes. * Stayin' alive *
通过按压有任何输出吗 有一些 What output are we getting from compressions now? Some.
但是血氧饱和度还是很低 But SATS are still very low.
已经做了一分钟的按压 One minute of compressions given.
还有一分钟 贾森 你继续按压 One minute to go. Jason, you'll continue compressions
实在没办法了再叫耐莉丝进行电击 until the last possible moment before Nerys shocks.
在电击前检查一下脉搏 There will be a pulse check before the shock.
这是第三次电击 This will be the third shock.
准备好注射用的肾上腺素和胺碘酮了吗 是的 Do we have adrenaline and amiodarone ready to go in? We do.
(胺碘酮: 抗心律失常药)
肾上腺素1克 胺碘酮300毫克 Adrenaline one milligram, amiodarone 300 milligrams.
谢谢 Thank you.
除颤之后贾森再立刻恢复按压 Jason will restart compressions immediately after defibrillation.
是贾斯汀 然后注射药物 Justin! Then the drugs will be given
除非有突然而明显的自主循环 都听清楚了吗 unless we observe sudden obvious ROSC. Everyone clear?
* 你可以从 * * You can tell by the way *
* 我走路的姿势看出 我深受女士欢迎 没空闲聊 * * I use my walk, I'm a woman's man, no time to talk *
* 音乐震耳 姑娘们热情 我从小就被粗暴对待 * * Music loud and women warm, I've been kicked around since I was born
* 没关系 我不在乎 你可以视而不见 * * And now it's all right, it's OK, you may look the other way
* 我们可以试着去理解纽约时报对人的影响 * * We can try to understand The New York Times' effect on man
停止按压 检查脉搏 Pause compressions. Pulse check.
动脉血压为零 Flat line on arterial pressure.
(心脏的房室和动静脉各部都有高低不同的血压 我们通常所说的血压就是指大型动脉的血压)
请开始按压 Compressions, go, please.
十秒钟后电击 充电 150焦双向 Shock in ten, please. Charging, 150 biphasic.
已选择150焦 双向除颤电击 充电中 "150 joules selected. Biphasic shock. Charging."
这样吧 我觉得我还是先... Do you know what? I think I'll just...
已充满 大家都让开 "Charged." Everyone clear.
警告 "Warning."
贾斯汀 让开 请让开 警告 Justin, off the chest. "Stand clear. Warning."
准备电击 三 二 一 Shocking after three, two, one.
注射药物并按压 快 快 Drugs and compressions, go, go.
* 没关系 我不在乎 * * And now it's all right, it's OK, *
* 你可以视而不见* 已注射肾上腺素 * you may look the other way * Adrenaline given.
* 我们可以试着去理解纽约时报对人的影响 * * We can try to understand The New York Times' effect on man *
* 不管你是兄弟 * 贾森 你没事吧 * Whether you're a brother...* Jason, you OK?
* 你都要活下去 活下去 * 断了一根肋骨 * You're stayin' alive, stayin' alive * That'll be a rib.
该死 抱歉 悠着点 小伙子 Shit! Sorry. Easy, tiger.
在他把病人按成连枷胸之前 Someone take over from Jason
(连枷胸: 多发性肋骨骨折引起呼吸时胸壁运动反常的胸廓)
请谁来接替一下贾森 before he gives him a flail chest, please.
一 二 三 已注射胺碘酮 One, two, three... Amiodarone given.
八 九 十 十一 ...eight, nine, ten, eleven...
人渣! Arsehole!
输入血液 肾上腺素 现在多少单位了 Blood going in, adrenaline. How many units is that now?
12个单位 12个单位的O+血 12 units...12 units of O pos,
8单位新鲜冷冻血浆 4单位血小板 eight FFP, four platelets.
没错 That is correct.
做得真不错 人...渣 That's impressive. Arse...hole.
姑娘 好好做你的工作 Girl, do your business.
对不起 护士 这应该是放上担架就送来的 Sorry, Sister. This was supposed to be a scoop and run.
结果他们花了半小时才把他从路边移开 It takes them half an hour to get him off the roadside.
光靠按压几乎没用 Barely getting anything with compressions.
老大? 嗯 嗯 我听到了 Boss? Yeah, yeah. I hear you.
我要尝试其他干预措施 I want to move on to other interventions.
这一轮的心肺复苏还没完成 We haven't completed this CPR cycle yet.
我们只是在浪费时间 We're pissing in the wind here.
所以请准备开胸 马上去准备 So let's prep for a clam-shell, please. Right now.
太好了 没说你 哈莉 Yes! Not you, Harry.
继续做心肺复苏 一直到我们准备好手术为止 Keep CPR going until we're ready to cut.
赶快 动起来 抱歉 Get on it, move! Sorry.
抱歉 你们都傻愣着干嘛 Sorry, what the hell are you all doing?
需要在极短时间内把用品都拿出来 The kit needs to be out,
打开 随时供我们使用 opened and ready to go in seconds.
非常抱歉 博伊尔先生 贾斯汀 Very sorry, Mr Boyle. Justin!
这次最好给我准备好动脉钳 And there better be an aortic clamp this time,
不然我会发飙的 otherwise I am going to flip my lid.
立刻去创伤手术室拿动脉钳 Aortic clamp in trauma theatre now.
我? 别惹我 小子 Me? Don't test me, boy!
接收入复苏室以后已经接近34分钟 Approaching 34 minutes since admission to resus.
病人心脏已经停跳... 七分钟 Patient has been down... Seven minutes.
谢谢 耐莉丝 再电击一次 Thank you. Nerys, we'll shock again.
哈莉 坚持到最后一刻 Harry, continue until the last possible moment.
这次不要注射药物 No drugs on this cycle.
明白吗 是的 Understood? Yes.
请再来一把剪刀 Another set of shears, please.
十秒钟 Ten seconds.
充电 150焦双向 请拿近一点 Charging, 150 biphasic. Bring that closer, please.
已选择150焦 双向电击 "150 joules selected. Biphasic shock."
正在充电 "Charging."
你别停 哈莉 Not you, Harry.
充电完成 "Charged.
所有人都站开 警告 Everyone clear. Warning."
哈莉请站开 请让开 Harry off the chest. "Stand clear."
准备电击 三 二 一 请让开 Shocking after three, two, one. "Stand clear."
动脉血压为零 心室纤颤 颈动脉无输出 Flatlining arterial pressure. VF. Carotid absent.
停止按压 不 不 继续 Stop compressions. No, no. Keep going.
我们在你周围动刀 我们要切开了 We'll work round you. And we're cutting.
引流 注意手指 Drains. Mind your fingers.
我说注意 不是拿开 抱歉 博伊尔先生 I said mind, not move! Sorry, Mr Boyle.
好了 贾森 你来继续按压 贾斯汀 OK, Jason, get back on compressions please. Justin.
什么 他叫贾斯汀 What? His name's Justin.
是吗 是的 Is it? Yeah.
停 Stop.
抱歉 紧急血清钾检测结果 Sorry, urgent potassium result.
不用在意我 Don't mind me.
请进行胸内心脏按压术 Internal compressions, please.
心包膜已剪开 Pericardium open.
动脉钳呢 Where's the clamp?
真的假的 Really?
没有动脉钳 There's no clamp.
好极了 Excellent.
好 给我让个位置出来 OK. I'm going to need to get some access here.
好了 我已经手动控制大动脉 OK, I have manual control of the aorta.
在我们等动脉钳的时候 我会切断 I've shut off circulation to the lower part of the body
下半身的血液循环 马上就来 博伊尔先生 while we wait for the clamp. On its way, Mr Boyle.
现在有动脉血压了 很好 Got an arterial pressure now. Good.
为什么你一开始不说 So why didn't you say anything earlier?
不想说 Didn't like to.
为什么 你有时候会有点 Why? You can be a bit...
有点什么 Bit what?
凶 Fierce.
哈 真会挑时间 Huh! You pick your moments.
老大 Bosh!
回去监测心室 比利 Convert back to vent, Billy.
大动脉已横跨钳闭 Aorta cross-clamped.
远端血流已切断 现在大家听着 Distal flow is down. Now listen, everybody,
刚才真是太不像话了 that was piss-poor.
但是你们需要精进起来 知道为什么吗 But you will get better at this and do you want to know why?
因为当你们面对这个人的家属 So that when you look this man's family in the face
说你们已经尽了全力的时候 and you say you did everything you possibly could for him,
那他妈就不是一句谎话 it is not going to be a bloody lie!
现在已经横向钳闭 远端血流切断 We're cross clamped. Distal flow is down.
好了 请立刻通过锁骨下动脉快速滴注 OK, let's get the rapid infuser going into the subclavian, please.
是 这就来 现在问腿的事是不是时机不太好 Yeah, on it. Is this a bad time to ask about the legs?
是的 好吧 抱歉 Yeah. Yes. Right, sorry.
肝素帽 Bung.
(肝素帽: 用于各种体内留置导管的封堵装置 以向留置导管内注射肝素等抗凝药物防止发生凝血)
谢谢 Thank you.
好了 快速滴注器已连接到锁骨下动脉 OK. That's the rapid infuser connected to the subclavian.
我感觉到收缩了 I'm feeling contractions.
停止按压 Stop compressions.
心脏自主收缩 Got spontaneous contractions.
太好了 Yes.
看起来有窦性心律了 Looks like sinus.
请继续给他输血 三比二的比率 Keep filling him up with pink please, three to two.
还在用第二包 好 现在测得到血压了 Still on pack B. OK. Registering a proper BP now.
60/35 血氧饱和度缓慢上升中 60 over 35. Sats coming up sluggishly.
血压90/60 血氧继续上升 BP 90 over 60, sats climbing.
谢谢 拉玛克里士纳 Thanks, Ramakrishna.
拉玛克里士纳他居然记对了 He gets Ramakrishna right.
好了 请紧急呼叫手术室人员 OK, let's fast-bleep the theatre staff.
病人两分钟后到达 Patient ETA two minutes.
紧急呼叫心胸外科和普外科医生 Fast-bleep cardiothoracics and gen-surg.
我们现在就送他过去 We're taking him now.
叫放射科技师带着便携式仪器到手术室去 And we need the radiographer to do portables in theatre.
我是菲奥娜·罗马斯 给腿部照一下X光 This is Fiona Lomas. X-ray the legs.
去洗手 这就去 Get scrubbed up. Get in.
解开刹车 走吧 Brakes off. Let's go.
解开刹车 推 Brakes off. Rolling.
你放任那姑娘让你出丑啊 小子 You're letting that girl make a fool of you, boy.
我又不是你儿子 I'm not your boy.
一整周都没见面 然后因为创伤急救而手忙脚乱 Haven't seen each other all week, then the scramble of a trauma call.
都没机会打招呼 I never got to say hello.
你好 Hello.
还适应吗 How are you settling in?
不错 有什么问题吗 Fine. What's the problem?
你自己都说了 "一整周都没见面" Well, you said it, "Haven't seen each other all week."
你好 你好 Hi. Hi.
他未婚妻来了 The fiancee's here.
能抽空和她谈谈吗 好的 Does someone have a minute to talk to her? Yes.
当然 好 Sure. OK.
劳伦 这位是博伊尔先生 他是创伤科主任医师 Lauren, this is Mr Boyle, the trauma consultant.
抱歉我只能简短说几句 劳伦 I'm sorry this has to be quick, Lauren.
亚当受伤很严重 Adam is critically injured.
他的自行车撞上了一辆货车 His bike was involved in a collision with a lorry
导致他多处受重伤 resulting in multiple serious wounds.
他的心脏停跳了 His heart stopped beating
所以我们打开了他的胸腔 让它重新跳了起来 and we opened his chest and got it pumping again.
心脏停跳是因为他有内出血 It stopped because he's bleeding internally.
现在我们得去找出出血点 And now we have to find out from where
然后去处理亚当两条腿的严重撞伤 and to operate on some serious crush injuries to both of Adam's legs.
但我们会尽力保住它们 But we're going to do everything we can to save them.
我们真的需要立刻赶回到他身边去 Right now, we really should get back to him.
谢谢 Thanks
我会让迪伦先生送你去我们的家属室 I'm going to ask Mr Dhillon to sit you in our relatives' room.
你要我打电话给谁吗 Is there anyone that you need me to call?
赶紧都动起来 You need to get on with it.
因为不管你们有没有准备好 我五分钟后动刀 Because, ready or not, in five minutes, I'm cutting.
可以做准备了吗 OK to prep?
请做准备 请动手吧 Please do. Yes, please.
请拿掉夹板 Splints off, please.
把剩余的裤子也脱掉 And whatever's left of his trousers.
鞋子也脱了 Trainers too.
我要把他抬起来 我来数数 一 二 三 I'm going to lift him. On my count. One, two, three.
好 现在我们来搬腿 都拿开 OK. Now we lift the leg. Clear out.
好 一 二 三 OK. One, two, three.
血压现在稳定在100/80 血氧值维持在96 BP's now a very respectable 100 over 80. Sats sitting pretty at 96.
谢谢 动脉夹已经夹了八分钟了 Thank you. Clamp's been on for eight minutes.
我们需要赶紧动手 We need to crack on.
请小心背后 Watch your backs, please.
数到三后放射 Rays coming up after three.
一 二 三 放射 One, two, three, rays.
抬起来 And lift.
放下 Down.
自我介绍 我是格伦·博伊尔 创伤科主任医师 Let's who. I'm Glen Boyle, trauma consultant.
菲奥娜·罗马斯 创伤科副主任医师 Fiona Lomas, trauma fellow.
拉玛克里士纳·钱德拉曼 麻醉师 Ramakrishna Chandramohan, anaesthetics reg.
比利·芬利 负责麻醉的手术部医生 Billy Finlay, anaesthetic ODP.
丽贝卡·奥斯古德 矫形外科主治医师 Rebecca Osgood, orthopaedic registrar.
卡莉·奥斯曼 洗手护士 Khaali Osman, scrub nurse.
露西·哈特维尔 普通护士 Lucy Hartwell, staff nurse.
西塞尔·多利 普通护士 Heather Dooley, staff nurse.
安德雷·科瓦克 记录护士 Andrei Kovac, documentation nurse.
阿尔敏·库拉尔 手术部医生 Armen Khular ODP.
丹尼尔·英萨拉科 快速输液操作员 Daniel Insalaco, rapid-infuser operator.
雪莉·伊姆斯 放射科技师 Shelley Imms, radiographer.
黛西·麦克多纳尔德 巡回护士 谢谢 Daisy MacDonald, circulating. Thank you.
数到三放射 Rays in three.
一 二 三 放射 One, two, three, rays.
非常感谢 可以进来了 Thanks very much. All clear.
请让一下 Excuse me.
确认病人 Let's confirm the patient.
病人姓名亚当·理查德斯 生日1989年11月16日 Patient's name Adam Richards, date of birth 16-11-1989,
病号G893677498 Patient number G893677498.
骑自行车与重型货车相撞 已确认 Cyclist crushed by HGV. Confirmed.
再检查一次动脉气血? 谢谢 Run off a new set of ABGs? Thank you.
我已签署四号同意书 接下来要为了制止 I've signed a Consent Form 4, for a laparotomy
危及病人生命的腹膜内大出血而进行剖腹手术 to stop a life-threatening intraperitoneal haemorrhage.
我已签署四号同意书 I've signed a Consent Form 4,
接下来要整合下肢骨折 并给撞伤清创 for fixation of lower-limb fractures and debridement of crush injuries.
(清创: 在无菌条件下彻底清理污染伤口使之变为清洁伤口 减少感染 促进伤口一期愈合的手术)
请给我纱布 Swabs to me please.
一 二 三 One, two, three.
举高点 Nice and high.
现在把X光照片放到屏幕上 Radiographs coming up on screen now.
不 现在别放 手术刀 No, not now. Blade.
可以切吗 是的 Am I OK to cut? Yep.
切开 Cutting.
给我剪刀 Scissors to me.
我还在等着呢 Still waiting.
抱歉 创伤病人 还夹着动脉钳 Sorry. Trauma patient, aortic clamp.
我们必须行动迅速 我会试着跟上的 We're going to be moving fast. I'll try to keep up.
腹部有大量血液淤积 Massive blood pooling in abdomen.
好 我来切开腹膜 都准备好了吗 OK, I'm opening the peritoneum. Everybody ready?
准备好了 准备好了 Ready. Ready.
开始了 Then here we go.
吸引器 纱布 Suction. Packs.
拉钩 Morris.
(拉钩: 又称牵开器 用以牵开组织 显露手术野 便于探查和操作)
给我 Hit me.
给我 To me.
三 Three.
一 One.
二 腹部塞入十条纱布 Two. Ten in the abdomen.
已用15条 15 in.
可以打开钳子了吗 Am I OK to unclamp?
是的 准备好了吗 Yeah. Ready?
准备好了 可以了 老大 Ready. OK, boss.
我要松开一半 好 I'm going to unclamp by a half. Fine.
可以吗 可以 OK? OK.
一半 好了 Half. There.
血压下降 Pressure dropping.
维持 Holding.
好 OK.
可以试一下打开四分之三吗 好 Am I OK to risk three-quarters? Fine.
可以吗 可以 Yeah? Yep.
四分之三 Three-quarters.
好了 There.
下降 Dropping.
维持 Holding.
好 好 OK. OK.
可以全部松开吗 做吧 Can I go all the way? Do it.
全部松开了 That's all the way.
下降 Dropping.
下降 加油 Dropping. Come on.
加油啊 Come on!
下降 Dropping.
维持 Holding.
病人稳定 看起来不错 Patient is stable. Looking good.
喔 有点上升 Ooh! Bit of a rise.
哈 好极了 Ha! Nice.
或许我们现在可以看一下腿了? Maybe we could look at the legs now?
好的 很快看一下 请放图像 Yeah, quickly. Images, please.
下一张 Image.
该死 好吧 Shit! OK.
非常感谢 没问题 Thank you very much. No problem.
为什么还穿着鞋子 没人敢脱 Why's the shoe still on? No-one dared take it off.
请给丽贝卡戴两层手套 Can we double glove Rebecca, please.
请给我七号 手套 Seven's please. Gloves.
钳子松开了 Clamps off.
所以在寻找出血点前先把胸部重新包起来 Let's re-pack the chest before we hunt down the bleeds.
请给我纱布 Packs, please.
再来 And again.
胸部塞入两条 已用两条 Two in the chest. Two in.
格伦 Glen?
你没事吧 没事 You OK? Yes.
交给我吧 I'll take it.
去脱手套 Get the gloves.
博伊尔先生 怎么了 Mr Boyle? Yeah?
事实上我不太好 我可以先歇一歇吗 Actually, I'm not OK. Can I have a minute, please?
当然 Absolutely.
请给她一杯水 Someone bring her a cup of water, please.
我去拿 I'll go.
你需要听一下他的血气检查结果 说吧 You need to hear his gases. Go on.
他筋疲力竭了 当你恢复体循环的时候 Well, he's knackered. When you restore his circulation,
他的双腿会大出血的 a whole pile of shit is going to come out of those legs.
保住腿的话病人就会死吗 Save the legs but the patient dies?
不 不会让他在我手底下出这种事 Oh, no. Not on my watch.
告诉我他现在的血压情况 Tell me his haemodynamics.
没有动脉钳血压依旧维持 很好 Pressure's holding off-clamp. Good.
锯掉他的腿 We're taking his legs.
我要开始止血了 I'm going to proceed with haemostasis.
比利 请你再呼叫一次血库 Billy, can you put in another call to blood bank, please.
第三包 12-8-4-2 请给我钢圈好吗 Pack C. 12-8-4-2. Can I have the ring-plates?
12单位的交叉配血 8单位新鲜冰冻血浆 12 units of crossmatch, eight units of FFP,...
谢谢 4单位血小板和2单位冷凝蛋白质 Thank you. four of platelets and two of cryo.
(冷凝蛋白质: 病患纤维蛋白原偏低时输入可帮助凝血)
现在我要结扎两边的髂动脉 结扎线 I'm going to sloop the iliacs while I'm here. Sloops.
你还好吗 谢谢 You good? Thank you.
好 把腿锯掉 OK. Take the legs.
按照你自己的速度来 大面积清创 好吗 Crack on in your own time, wide debridement, yes?
我们一个区一个区的打开 止住出血点 OK, we're going to unpack quadrant by quadrant, lock down the bleeds.
我需要在膝盖弯曲处将腿支撑45度 楔子 I need the legs supported in knee flexion 45 degrees. Wedge.
手术刀 Blade.
拿出来一条 One out.
两条 Two.
锯子 Saw.
你没事吧 是的 谢谢 You OK? Yep. Thank you.
下部两个区已经打开 手术刀 Lower quadrants are unpacked. Blade.
下部两个区没有明显的出血点 There are no obvious sources of bleeding in the lower quadrants.
也没有明显腹膜后出血 血压维持 And no obvious retroperitoneal bleed. BP is holding.
我现在要结扎髂动脉了 能拿一下吗 I'll go for the iliacs now. Can you hold that?
谢谢 Thank you.
另一边能请你来吗 Can you do the other side, please?
钳子 Clips.
好了 我们控制住髂动脉了 你可以松开止血带了 OK, we have control of the iliacs. You can release the tourniquets.
拿出四条 拿出四条纱布 Four out. Four packs out.
直接送去楼下食堂吧 Those are going straight down the canteen.
用不着花时间弄得很漂亮 Don't waste time making them look pretty.
心胸外科和普外科真的一个人都来不了吗 Have we seriously still not got anyone from cardiothoracics or gen-surg?
请谁去催一下 Someone chase them, please.
就不应该让我们催... We shouldn't have to be chasing...
就不应该让我们催的 We shouldn't have to be chasing them.
你好 这里是创伤手术室 请告诉我们 Hello, this is trauma theatre. Can you please advise us when
心胸外科和普外科医生何时才能到场好吗 we will be able to welcome the cardiothoracic and general-surgeons?
是的 非常感谢 Yes. Thank you very much.
他们会再次紧急呼叫 They're fast-bleeping them again.
那接下来呢 Well? What's next?
打开左上区 继续止血 Unpack the left upper quadrant and continue the haemostasis, please.
拿出一条 两条 One out. Two.
该死 Shit!
脾脏大出血 Haemorrhaging around the spleen.
血压在下降 BP is dropping.
在直线下降! It's crashing!
该死 该死 他快流血致死了 Shit! Shit! He's bleeding out!
吸引器 Suction!
请再次夹上动脉钳 钳子 快 Get him reclamped, please. Clamp. Quickly!
血包呢 快 快 快 比利 赶快输进去 Where's that blood? Quick, quick, quick, Billy. Just bang it in.
对 正在输进去 加油 血压还在下降 Yeah, banging it in. Come on, it's still dropping.
已经重新夹上 Reclamped.
血库送来的血 Delivery from blood bank.
快 快 Quick. Quickly.
现在钳子在控制着腹腔流血 The clamp's controlling the abdominal bleeding for now
但我们要摘除脾脏 but we're taking the spleen.
血压还是很低 他快不行了 BP's still very low. He's shutting down.
赶紧输血 Well, let's fill him up.
我们可以继续用快速滴液输血 Well, we can keep going with the rapid infuser...
那就这么做吧 Then let's do that.
继续输交叉配血 Keep the crossmatch,
新鲜冷冻血浆和血小板不要停 血管夹 FFP and platelets going. Dardik, please.
纱布和绷带 两份纱布与绷带 Gauze and bandages. Gauze and bandages times two.
手术镊 弯血管钳 缝线 Forceps, Lahey, ties.
梅奥剪 Mayo, please.
(梅奥剪: 一种组织剪 用来解剖 剪断或分离剪开组织 由梅奥医院开发而得名)
斯特里特先生 普外科主任医师 Mr Street, gen-surg consultant.
主刀医生是谁 Who's consulting here?
我们见过了 格伦·博伊尔 创伤科的 We met before. Glen Boyle, I'm trauma.
抱歉 格伦 又见面了 Sorry, Glen. Hello, again.
正在做脾脏切除术 Splenectomy in progress.
你们把腿切了? 别无选择 You took the legs? Had to.
这个决定肯定是对的 I'm sure it was the right decision.
但是出于医疗纠纷的考虑 But for medico-legal reasons
我会叫两位矫形外科主任医师审查一下笔记 I'll be requesting two orthopaedic consultants review the notes.
完全没问题 我去洗手 Absolutely fine. Scrubbing in.
梅奥剪 Mayo.
剪吧 Cut.
你一定是来替代罗琳·拉帕波特的吧 So you must be Lorraine Rappaport's stand-in?
罗琳到底要离开多久啊 How long's Lorraine going to be off for?
我听说是不稳定的心绞痛 据说是这样 Unstable angina, I heard. That's what's being said
但是不确定 可怜的家伙 but we don't know yet for sure. Poor thing.
克莱夫那晚一定把详细情况告诉你了 I'm sure Clive filled you in the other night.
我听说那晚非常欢乐 I hear it was very convivial.
我们已经在这里等得够久了 We've waited here long enough.
我需要你现在就上台 I need you now, please.
剪吧 Cut.
缝线 Ties.
如果腿已经处理好了的话 if we're all done with the legs...
我... 嗯 I should... Yep.
不 我是说 已经处理好了 你去吧 No, I mean we are done with them. You should go.
干得好 And well done.
谢谢 Cheers.
剪吧 Cut.
好了 Yes.
斯特里特先生 叫我罗勃就行 Mr Street? Rob.
我们需要处理肝脏 你动手吧 我这就来 We need to tackle the liver. Go for it. Be right with you.
剪吧 Cut.
组织剪 Mac.
手术盘 Dish, please.
脾脏已摘除 Spleen out.
谢谢 Thank you.
打开动脉钳 这边我来 Let's unclamp. I've got this.
打开一半 Half off.
下降 Dropping.
维持 Holding.
好了 Yeah.
打开四分之三 Three-quarters off.
下降 Dropping.
维持 Holding.
继续 Go on.
上吧 Let's go.
全部松开 Unclamped.
下降 Dropping.
肝脏在大出血 不用夹了 拿开右上区的纱布 Liver's haemorrhaging. Leave the clamp off and unpack the RU.
我来做Pringle阻断 好的 I'll do the Pringle. OK.
(Pringle阻断法: 又称全肝入肝血流阻断法 为肝切除控制肝出血最常用的方法)
右肝叶破裂 肠系膜有一些撕裂 Fractured right lobe, some torn mesenterics.
Pringle法不起作用 重新夹上 Pringle's not working. Reclamp.
血压依旧很低 BP remains very low.
每次一打开动脉夹 他失血速度就会快于输血速度 Every time you unclamp, he loses more than we can put back in.
我们可以结扎肠系膜 We can ligate the mesenterics.
我也这么想 已重新夹上 I reckon so. Reclamped.
老大 创伤手术室需要资深人员的支援 Boss, I need some senior support in trauma theatre.
我会下手结扎这些血管 I'll get on and ligate these vessels.
两个钳子 2-0薇乔缝线 穿在针上给我 Two clips, 2-0 vicryl. Mounted ties.
(薇乔缝线: 一般为带针缝合线 其中针的材料是不锈钢 线是由90%的乙交酯和10%的左旋丙交酯合成的可吸收聚合物)
我来把肝脏包起来 好主意 I'll pack the liver. Good idea.
请给纱布 Packs, please.
请给我剪刀 Scissors, please.
肝脏已包起来 Liver packed.
好 剪吧 OK, cut.
剪 Cut.
他又在流血了 动脉钳松了吗 He's bleeding again. Has the clamp come loose?
大动脉是夹住的 Aorta's clamped.
该死 Shit!
钳子以下都系住了 到底是哪里出血 Everything below the clamp is tied off. Where's it coming from?
哦 天啊 Oh, God!
血压下降 上压30 下压无法读数 BP dropping. 30 over unreadable.
钳子还夹着 Clamp's on.
我刚刚告诉你是夹好的 I just told you it was on.
那他就是钳子上方在流血 Then he's bleeding above the clamp.
横膈膜破裂了 血流进腹部里来了 Diaphragm's ruptured, it's getting into the abdomen.
(横隔膜是将腹腔和胸腔分隔开的膜状肌肉)
胸腔里的血块被冲掉了 He's blown off clots in the chest.
听起来像是弥散性血管内凝血(DIC) This is sounding like DIC.
(弥散性血管内凝血: 由于血液内凝血机制被弥散性激活 促发小血管内广泛纤维蛋白沉着 导致组织和器官损伤 另一方面 由于凝血因子的消耗引起全身性出血倾向)
死神来了(缩写亦是DIC) Death Is Coming.
请立刻给我止血纱布 Haemostatic gauze. Now, please.
你来拿开纱布 我把止血纱布放进去 You unpack, I'm going to get the haemostatic in.
谢谢 Thank you.
剪 剪刀 快 Cut. Scissors, quickly.
我们需要压塞出血处 We need to tamponade the bleed.
给我 Hit me.
剪 Cut.
纱布 Pack, please.
给我 Hit me.
哦 天啊 心脏停跳了 Oh, come on! He's down.
继续给他快速输液 一直没有停过 Keep the rapid infuser going. It never stopped.
已经71分钟30秒了 心脏里没有血 Coming up to 71 minutes, 30 seconds. The heart's empty.
新的手术刀和Foley导管 Foley导管 Fresh blade and a Foley, please. Foley.
(Foley导管: 一种软导管 通常用于导尿)
手术刀 Blade.
我要把导管放进去 I'm going to put the Foley...
直接塞进右心房中去 Get it going right into the right atrium,
直接把血输进去 你来用盐水冲管 fill him up from there and you're going to inflate the cuff.
格伦 Glen...
照我的话去做 Just do as you're told.
听着 老兄 你很努力 但是他已经死了 Listen, mate, you gave it a good go, but he's down.
如果你想有发言权 If you want a say,
他妈一听到呼叫就给我过来啊 you're going to have to show up when you're bloody called!
72分钟 又过去30秒 72 minutes, now been down 30 seconds.
可以灌注了 Cuff prime.
好了 接到快速输液器上去 赶快 比利 Yes. Get that connected to the rapid infuser. Now. Billy.
对 已经接上了 对 准备好了 Yeah, it's going. Yep. Ready.
好 按压 OK. Compressions.
颈动脉? 谢谢 Carotid? Thank you.
输出非常少 Very weak output.
我需要缝合导管 2-0薇乔缝线 I need to secure the Foley. 2-0 Vicryl, please.
停止按压 他的心脏已经停跳快一分半钟了 Stop compressions. He's been down for almost a minute and a half.
剪刀 快 Scissors, quickly.
没有脉搏 Pulse absent.
剪 Cut.
再次按压 Start compressions again.
让我看看情况 Let me see what we've got.
谢谢 Thank you.
你可以停了 You can stop now.
谢谢你 Thank you.
病人在74分钟时死亡 Patient pronounced dead at 74 minutes.
我想要谢谢在场的所有人 I want to thank everyone.
抱歉 伙计 Sorry, mate.
嗯 我稍后把我的笔记发给你 Yeah. I'll email you my notes later.
所有人不要碰一切 Everybody leave anything
和尸体有关的东西 that's connected to the body exactly as it is for now.
抱歉 I'm sorry.
希克林夫人在吗 Is Mrs Hicklin there?
我是菲奥娜 It's Fiona.
病人死了 He went down.
一分钟前宣布的 Pronounced a minute ago.
我感到非常可惜 向各位表示哀悼 I'm very sorry. You all have my sympathy.
在这个阶段 我看到你们已经照程序做了 At this stage, and I can see you're already following the protocol,
任何人不得碰与逝者有关的 nobody should touch anything connected to
或者放入逝者体内的东西 or entering the deceased.
有什么需要我做的吗 Can I do anything for anyone?
没有 没有 No. No.
好的 OK.
伤口还开着吗 是的 The wounds are still open? Yes.
拍过照以后 你是自己来 Once the photos have been taken, would you be able to
缝合伤口 还是你要我叫别人来 close the wounds or would you like me to ask someone else?
不 我可以做 谢谢 No, I'll do it. Thank you.
你提到了罗琳的病 You mentioned Lorraine's illness.
我就想问问你听谁说的 嗯 I was just wondering where you got that from? Hmm.
克莱夫吗 是的 From Clive? Yes.
我听到的说法不同 Well, I heard different.
你当然没关系了 你又没有三个孩子 It's all right for you, you don't have three kids.
请问他的女友在哪里 Where's the girlfriend, please?
是未婚妻 我带你去 谢谢 Fiancee. I'll take you. Thank you.
我也去 I'll come.
我为你们感到惋惜 谢谢 I'm very sorry. Thank you.
劳伦 Lauren?
如果有任何我能做的事 谢谢 If there's anything I can do... Thank you.
家属室
人...渣 Arse...hole.
那位重伤病人死了 The major trauma died.
哦 是么 Oh, right.
我不知道 我一直在看轻伤 I didn't know, I've been on minors.
但你还是个混账 Still, doesn't make you any less of a cock.
我只是不知道我哪里做错了 不知道吗 I just don't know what I'm meant to have done wrong. No?
那为什么你的一个哥儿们问我要不要上插管辅导课? Then why did one of your mates ask if I wanted an intubation tutorial?
哥儿们 什么哥儿们 多米尼克·巴斯比 Mate? What mate? Dominic Busby.
该死 哼 Shit! Hmm!
你怎么跟他说的? "急救部有个绿茶婊" What did you tell him? "There's a slapper down in the ED."
"教她几招 她就帮你吹箫" "Give her a bit of teaching and she'll feel your tube."
哈莉 听着 我不想工作时发飙 Harry, listen... I'm not going to have this out at work.
那我打电话给你 算了 So I'll call you. Don't bother.
你瞎了吗 是舟状骨 You blind? Scaphoid.
舟状骨 Scaphoid.
可怜的家伙 Poor bloke.
我们失去了宝贵的时间 因为普外医生 We lost valuable time because gen-surg
和心胸外科医生没有准时到场 and cardiothoracics were not on scene.
他们分身乏术 They can't be in two places at once.
所以需要同步待命医生值班表 So on-call rotas need to be synchronised.
对 我已经提出过这个问题了 Yep. I've raised the issue.
遭到了一些抵抗 There's some resistance.
希望他们能够改变主意吧 Hopefully, they'll change their minds.
我们需要适合的专家来回应创伤急救呼叫 We need the right specialities coming to the trauma calls now,
所以不应该只是希望而已 so it should be more than just a hope.
收到你的申请 我还挺惊讶的 You know, I was quite surprised to receive your application.
是吗 是啊 Really? Yeah.
我不是一定要把你和你的小队安排到一起 I wouldn't have necessarily put you together, you and this unit.
我需要用我的经验让其受益 I want to give it the benefit of my experience.
是啊 当然 Yeah, of course.
抱歉 抱歉 我们可不可以 Sorry, sorry. Can we just...?
没关系 我保证一下就好 That's fine. Promise we'll just be a sec.
能给我一杯中杯卡布奇诺吗 Can I get a medium cappuccino. please?
双份浓缩咖啡 我来吧 Double espresso. Don't be silly.
谢谢 Thank you.
或许我能去和普外科和心胸外科谈谈? Maybe I could talk to gen-surg and cardiothoracics?
听着 我这么说或许有点傲慢 Look, this is going to sound very patronising
但你只是临时医生 而且才来了一周 but you're a locum and you've been here a week.
我在巴斯申营地(位于阿富汗)带领过创伤急救队 I led a trauma unit in Bastion.
你可以被炸掉一半的身体 You could've had half your body blown off,
只要你来巴斯申时还有脉搏 you came into Bastion with a pulse,
你就有98%的几率活下去 you've got a 98% chance of survival.
那里是全世界最好的 这里情况不同 That's the best in the world. Well, things are different here.
听着 今晚你过得很糟 我知道 Look, you've had a terrible night. I know.
交给我来处理好吗 Why don't you leave this lot with me?
和这帮人打交道有点像赶猫群 This lot, it can be a bit like herding cats.
(hearding cats: 喻意不可能完成的任务)
你们的咖啡 谢谢 Here's your coffees. Thanks.
给 谢谢 Eh! Thank you.
哦 抱歉 不 没关系 Oh, sorry. No, not at all.
他未婚妻怎样了 How's the fiancee?
丧亲顾问去见她了吗 Has the bereavement counsellor been able to see her?
都在掌握中 It's all in hand.
谢谢 Thank you.
我要你去说清楚 这起死亡事故是创伤科造成的 I want it made clear that this death occurred on the trauma service.
和急救部没有关系 It is not an emergency department death.
好吧 Right.
你好 我说过吗 Hey! Did I say?
我们的一名护士去年去过巴斯申营地 One of our nurses was at Camp Bastion last year.
哦 是么 Oh, yeah?
你是什么时候在那里的 When were you there?
就只是你的名字听起来很陌生 Only, your name didn't seem to ring a bell.
那地方很大 人们来来去去的 It's a big place, people came and went.
我不会放在心上的 I'll try not to take it personally.
谢谢你收尾 Thanks for closing.
有创伤急救呼叫 There's a trauma call.
我听到了 I heard.
你相信那什么罗琳病了的屁话吗 Do you believe that crap about Lorraine being on sick leave?
谢谢各位 不用担心 Thank you, everybody. No worries.
那是胡说 特别是你还和克莱夫去喝酒了 It's a lie. And to cap it all, you're on the town with Clive.
所以呢 兄弟出去喝一杯得出解决方法 So what? Big boys get it sorted out over a pint
这样我就不用担心了是不是 so I can stop worrying my little head.
你打电话来说你需要我 所以我立刻赶来了 You called, told me you needed me and I came running.
现在你生气了 为什么 Now you're pissed off. Why?
因为一个素不相识的人可以费心思请我出去 Because a complete stranger could be arsed to take me out
来欢迎我接受这份工作吗 to welcome me to the job?
你我出去喝一杯就这么难吗 Was it really too much to ask for me and you just to go for a drink?
我没有给你回信是有原因的 而你知道原因 I didn't return your messages for a reason. You know exactly why.
老大 创伤急救呼叫 Boss? Trauma call.
知道了 Yeah.
创伤急救呼叫 一分钟后到达 "Trauma call, ETA one minute."
请创伤急救队回到复苏室去 "Will trauma teams please return to resus."
创伤急救呼叫 一分钟后到达 又是交通事故 "Trauma call, ETA one minute." Another RTC.
真的? 我以前从没见过 Really? Not seen one of those before.
我们还是可以共同工作的 对 工作 We can still work together. Yeah. Work.
那我可以做到 That I can do.
来吧 Here we go.
这次请做得更好 And let's do better this time, please.
破烂熊字幕组 -==http://www.ragbear.com==- 欢迎加入