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创伤急救呼叫 速去急诊部 'Trauma call, attend emergency department.
创伤急救呼叫 速去急诊部 'Trauma call, attend emergency...'
哇 抱歉 比利 运气真差 Whoa! Sorry, Billy. Bad luck!
早 请来一份全套早餐 Morning. Full English, please.
创伤急救呼叫 速去急诊部 'Trauma call, attend emergency...'
是叫我们 贾斯汀 真够好的 That's us, Justin. Awesome!
创伤急救呼叫 速去急诊部 'Trauma call, attend emergency department.
创伤急救呼叫 速去急诊部 'Trauma call, attend emergency department.'
你没事的 我们会把你治好的 You're all right. We're going to take care of you.
冷静 Stay calm.
抱歉 来早了 Sorry, early.
请让一下 哦 抱歉 Sorry... Oh, sorry.
你好 早 早 Hi. Morning. Morning.
重大外伤 预计一分钟后到达 'Major trauma, ETA one minute.
重大外伤 预计一分钟后到达 Major trauma, ETA one minute.'
谢谢你 贾斯汀 Thanks, Justin.
谢谢你 我是哈莉 Thanks. Er, Harry.
我是菲奥娜 Fiona.
6还是6.5 6, 6.5?
有点残酷啊 是说导管 Bit harsh. Tube.
6.5 6.5.
大家早 早 Hi, everyone. Morning.
罗琳·拉帕波特夫人 血管外科主任医师
准备迎接 Here we go.
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六层 'Level six.
五层 'Level five.
四层 'Level four.'
哦 该死 Oh, shit!
该死 快 快 Shit! Let's go, let's go!
走吧 快走 Here we go. Let's go!
去开门 Get the door!
让一下 Coming through!
我们直接送你去复苏室 We're taking you straight through to our resus room.
这边 This way.
开始计时 被甩出的乘客 Starting the clock. Ejected passenger,
失去知觉 脉搏130 很弱 found unconscious, pulse 130 weak,
血压90/70 左肺呼吸音减弱 BP 90/70. Diminished breath sounds on the left.
搬开担架 你来数一二三 Let's move the scoop on your count.
好的 请解开上下搭扣 OK, unclip top and bottom, please.
都让开 Clear a space around him.
让开 一 二 三 抱歉 Clear a space. One, two, three. Oh, sorry.
大家准备好了吗 Everyone ready?
是的 一 二 三 Yeah. One, two, three.
谢谢 一 二 三 Thank you. One, two, three.
好极了 干得好 Great, well done.
伙计 给他做过胸廓造口术了吗 没 Mate, has he got thoracostomies? No.
(一种较为简单的外科手术 一般用于治疗各种胸腔积水 积液和气胸等)
大量咯血 猩红色的... 吸液... Massive haematemesis, scarlet... Suction...
一次一个人说话 One conversation at a time, please.
抱歉 抱歉 Sorry. Sorry.
好极了 别担心 伙计 OK, great. All right, mate, all right,
我们在帮你治疗 we're sorting you out.
伙计 你在城市综合医院的急诊部 Mate, you're in the emergency department at CGH.
我是麻醉师钱德拉曼医生 I'm Dr Chandramohan, an anaesthetist.
我需要看一下你的喉部 I need to look down your throat.
我现在会把这带子解开 I'm just going to take this strap off.
请拿下肢支撑架来 Leg support, please.
拿走固定块 谢谢 Blocks coming off. Thanks.
先生 我会扶着你的头 让它保持不动 Sir, I'm just going to hold your head to keep it still.
抱歉 我来迟了 Sorry I'm late.
骨科医师总算来了 Nice of orthopaedics to show up.
气管无异物 呼吸频率30 Airway clear. Resps 30.
先生 我叫菲奥娜·罗马斯 我是创伤科主治医师 Sir, my name is Fiona Lomas, I'm the trauma registrar.
我们会竭尽全力帮你康复 We're going to do our best to get you better.
呼吸急促 脉搏正常 好的 谢谢 Tachypneic, decent pulses. OK, thank you.
好了 交接的时候请各位保持安静 谢谢 OK, nice and quiet everyone while we listen to the handover, thanks.
早晨6点30分接到交通事故的报案后 Trauma Air Service arrived on the scene at 6:45am
空中医疗服务于6点45分到达现场 after an RTC called in at 6:30am.
金斯盖特地下通道多辆车辆相撞 Multiple vehicles involved in a collision on the Kingsgate underpass.
患者从一辆大巴中被甩出 Patient was found on the roadside
发现时他在路边 after having been an ejected passenger from a bus.
(被甩出的乘客 意识不清)
多处软组织受伤 Multiple soft tissue injuries,
从头到脚 撕裂伤 擦伤 血肿 lacs, grazes, haematomas, top to toe.
胸壁内侧有一道撕裂伤 There is a lac on the interior chest wall,
左腕骨折 左胫骨开放性骨折 left wrist is fractured, left tib is an open fracture.
左肺呼吸音减弱 Diminished breath sounds on the left.
左胫骨开放性骨折
在现场用面罩供给百分之百纯氧 100% oxygen given via mask at the scene.
在工作电梯和走廊内咯血 Haematemesis in the service lift and corridor.
谢谢 Thank you very much.
请跟耐莉丝去签文件好吗 Can you sign off some paperwork with Nerys?
来签名放弃权利 Come and sign your lives away.
如果可以 我可以来当...书记员 I could act as...scribe if you'd like.
需要用导管 菲奥娜 Need to tube him. Fiona.
左边叩诊有浊音 需要做胸廓造口术 Dullness to percussion on left side. He needs a thoracostomy.
左边叩诊有浊音
是的 Yeah.
先生 我们来帮你减轻呼吸困难 Sir, we're going to do something to help your breathing.
贾斯汀 胸廓造口术 Justin, thoracostomies.
哦 对 气管往右偏斜 Oh, right! Trachea deviated to right.
还有很多 显然这是第一个 Loads more on the way. First of many, apparently.
哦 好极了 哦 好极了 Oh, great! Oh, great!
好 给他插管 OK, let's get him intubated.
哦 又怎么了 室性心动过速 Oh, what now? VT.
颈动脉有输出 Carotid output.
股动脉有输出 除颤 Femoral output, defibbing.
请让开 贾斯汀 Off the chest, please, Justin,
有输出的室性心动过速 好吧 VT with output. All right.
可电击复律 不需要心肺复苏 Shockable rhythm, no CPR.
电击150焦耳 Sync shock 150 joules.
正在充电
已选择150焦耳 正在充电 '150 joules selected. Charging.'
好 大家站开 把氧气拿开 OK, everyone, clear. Oxygen away.
拿开了 数一二三电击 Away. Shocking on three.
一二三 One, two, three.
还是室性心动过速 Still in VT.
有输出 Output.
该死 Damn it!
充电 充电 Charging. 'Charging.'
数一二三电击 一二三 Shocking on three. One, two, three.
该死 Shit!
加油啊 Come on!
有输出 充电 Output. Charging.
充电 数一二三电击 一二三 'Charging.' Shocking on three. One, two, three.
窦性心律 输出正常 好 自主循环恢复 Sinus rhythm. Good output. OK. We have ROSC.
干得好 谢谢 Well done. Thank you.
干得好 Well done.
好 我来做胸廓造口术 帮助他呼吸 OK, I'll do the thoracostomies to help with his breathing.
用什么麻醉药 拉玛克里士纳 Give him, um, Ramakrishna?
30毫克开他敏 开他敏 30 of ket? Ketamine.
好的 如果他受不了的话 我会停下来再给他加点 OK, and I'll pause for a top-up if he protests too much.
他的断腿需要静脉注射安美汀(抗生素) There's an open tib that needs IV Augmentin?
谢谢提醒 这就来 Thank you, in a minute.
请把电话关掉 Phones off, please.
开他敏 30毫克 Ketamine. 30 milligrams.
伙计 给你打一针 让你好受一点 Mate, just going to give you something to take the edge off.
把手推车推过来好吗 Can you bring me the trolley please?
看看她大衣口袋里 Try looking in the pockets of her coat.
他没反抗 我觉得这样正好 是的 Well, he's not protesting, I think we're all right. Yep.
脉搏130 血压80/65 Pulse 130, BP 80/65.
我觉得不再让他失血会比较好 好的 I think he'd benefit from some more blood. OK.
谢谢你 康斯坦丝 来一下好吗 好 Thank you. Constance, could you, please? Yep.
请严密监视血压 Let's keep a close eye on the BP, please.
谢谢 对于拧捏没有反应 Thank you. No response to trap pinch.
一 昏迷等级? One. GCS?
四分 镇静状态下四分 Four. Four with sedation.
(GCS是格拉斯哥昏迷指数 四分属重度昏迷)
抱歉 Sorry.
双侧胸廓切开完成 引流时间? Bilateral thoracostomy patent. Time for drains?
数据是88 Sats 88.
最好先把他控制住 Prefer to get him under first.
好了 急救人员可以走了 OK. That's the lads off.
好的 谢谢两位 祝你们愉快 OK, thanks, guys, have a good one.
下次再见 伙计们 See you next time, lads.
不是给他打过镇静剂了么 I thought he was sedated?
是的 是的 He was. He was.
吸液 好的 Suction. OK.
需要快速诱导插管 比利 Need to RSI, Billy.
快速诱导插管是在应用一种强诱导剂后 立即用 速效神经肌肉阻滞剂使患者神志丧失和肌肉麻痹状态 以进行气管插管的方法 预防和维持病人呼吸道的畅通
这就来 这就来 Yeah, I'm on it, I'm on it.
请赶快 OK, do it fast, please.
血压下降 BP's dropping.
血压严重偏低 没有桡动脉脉搏 Severely hypotensive, no radial pulse.
我们需要插管 We need to get a tube in.
血压这么低我没办法插管 Yeah. I can't get a tube in with the BP down this low.
好吧 赶紧拿血来 直接挤进去 OK, blood straight away, just squeeze it in.
贾斯汀 快 Justin! Quickly.
我们得把他的血压弄上去 We need to get this blood pressure up.
先生 我们会清理你的喉咙 Sir, we're going to clear your throat.
请冷静下来 这样我们才能帮你 Please try to be calm so we can help you.
数据在下降 The sats are going down,
我们得赶紧把管子插进去 we really need to get the tube in.
天啊 我在试呢 ...sake, I'm trying.
测到桡动脉脉搏了 I've got a radial pulse.
好吧 血压够高了 OK, you've got enough pressure,
请尽快把管子插进去 好 来吧 you need to get the tube in, please. OK, here we go.
你是新来的住院医师? Are you the new SHO?
是的 大家都叫我哈莉 Er, yeah, everyone calls me Harry.
好 能请你在我们拿走固定块时 OK, can you give me inline C-spine immobilisation
帮他做颈椎中立位固定吗 while we take the blocks off, please?
不 把手放进来 No, get your hands in there!
好 扶紧 OK. Hold tight.
对了 That's it.
天啊 Jesus.
你扶好了吗 是的 You got him? Yeah.
谢谢 Ta.
扶紧了 是 Hold tight. Yeah.
250毫克硫喷妥钠(静脉麻醉药) 好的 Thiopentone, 250mg. OK.
250毫克硫喷妥钠 正在注射 Thio, 250. Going in.
正在注射 只是让你睡一觉 伙计 Going in. Just sending you off to sleep, mate.
推 嗯 Push. Yeah.
终于安静下来了 Finally, some peace and quiet.
100毫克司可林 正在注射 Sux 100, going in.
(司可林是筒箭毒碱合成代用品 肌肉松弛作用快 可使气管插管容易进行)
我们在处理创伤时使用司可林 因为起效快 We use sux in trauma cos it works fast.
但这里可不止这一种药 That's not the only thing around here.
让病人失去知觉得花上一阵子 Takes a while to paralyse the patient.
好了 Here we go.
哦 好了 吸液 OK, yeah. Suction.
别忘了做动脉血气检测和心电图 Make sure you do ABGs and an ECG.
(动脉血气检测是检测肺换气功能的重要项目 从而判断出 有无缺氧及其程度 有无酸碱失衡及其失衡的类型 程度等)
是 阿彻菲尔德医生 Yes, Dr Archerfield.
一个人就要那么多医护人员 All those staff to one patient.
不 那是创伤急救呼叫 是重伤病患 No, that's a trauma call, critical injuries.
真是疯了 It's madness.
这人有点冷 有没有量过体温 This guy feels cold. Did we get a temperature?
没有人告诉过我 Not that anyone's given me.
他们过了多久才把他放上铲式担架的 How long till they scooped him?
15分钟后到达现场 25分钟后放上担架 They were there in 15 minutes, scooped after 25.
颈动脉核心体温 36.1度 Carotid core, 36.1.
对于一个30分钟内被塞入担架的人来说 他体温偏低 Yeah, he's cold for someone they scooped inside 30 minutes.
15加25是40 那就算40分钟吧 15 and 25 is 40. 40 minutes then.
冰柜里还有多少血 只剩三包了 How much blood is left in the fridge? We're down to three bags.
胸内出血 请给我纱布 Intrathoracic haemorrhage, get me a swab, please.
好了 来了 病患出现突发症状 OK, here we go. I'm calling a code.
我们需要更多的血 再来一个静脉留置针? We need more blood. Another Venflon?
对 还要一根大号导管 Yes, and a trauma line.
我可以来插静脉留置针 I can do Venflon.
我是梅里克护士 复苏室 病患情况危急 Sister Merrick, resus, we're coding.
请给我氨甲环酸(缓解出血) 这就来 Tranexamic acid, please. Coming up.
先止血 大量输血方案 Let's stop this haemorrhage. Major transfusion protocol.
不 不 别给我接血库 No, no, don't put me through to blood bank.
哦 我知道你们不需要我提醒 各位 Oh, I know you don't need me to say this, everyone,
请利索点 but nice and fast, please.
复核 Crosscheck.
O+型 已记录并核查 已复核 O pos, dated and checked. Crosschecked.
不 我知道 我还在等 No, I know, I'm still holding.
还剩两单位的O+血 Two units of O pos remaining.
氨甲环酸 静脉注射一克 紧接着注射一克 TXA, 1g IV, 1g infusion to follow.
对 我是拉帕波特夫人 Yes, this is Mrs Rappaport,
我是重伤待命主任医师 I'm the consultant on call for major trauma
我们刚刚启用了大量输血方案 and we have just enacted the major transfusion protocol.
立刻给我们送12单位的O+型血来 You send us 12 units of O positive immediately.
8单位新鲜冰冻血浆和四单位血小板 Eight of FFP and four of platelets.
你有授权吗 什么 'Do you have authorisation?' What?
那应该是第三个单位的血包了吧 I make that the third unit of blood now.
一个单位的O+血 One unit of O pos.
那赶紧把我接过去啊 OK, then, please put me through.
不 谢谢了! No, thank you!
下个单位的O+血通过大号导管注射 Let's put the next unit of O pos through the trauma line
请按紧胸腔出血口 and pressure on the thoracostomy bleed.
哈莉 请按紧 Harry, pressure, please.
来 Here.
好 我插入大号导管时请去拿血 OK, let's take bloods as I do the trauma line.
你好 我是罗琳·拉帕波特 重伤待命主任医师 Oh, hi, yes, this is Lorraine Rappaport, consultant on call for trauma...
请从储藏室里再拿一袋O+血来 Let's have another bag of O pos from the store, please.
有名重伤病人昏迷了 没有你的认可 We have a major trauma patient in recess and blood bank
血库不肯启用大量输血方案 won't enact the major transfusion protocol without your say-so.
你们测量过他的血红蛋白吗 Did you ever have a haemoglobin measurement?
不 我们没有测量过病患的血红蛋白 No, we haven't measured the patient's Hb,
就算测了 也一定是正常的 and if we did, it would be normal because
因为他血液里的血红蛋白浓度不会变 the concentration of haemoglobin in his blood won't have changed.
但有改变的是在他体内循环的血 But what has changed is he has a lot less blood circulating
比半小时前少了很多 than he did half an hour ago.
如果我们不给他输血 他会死 And if we don't transfuse him, he will die.
打扰一下 谢谢 Excuse me... Thank you.
抱歉 Sorry...
抱歉! 怎么了 Sorry! Yes.
这个胸廓切口的血止不住 This thoracostomy's really bleeding.
他失血过多了 He's bleeding out.
我们需要更多的血 不然就救不了他了 We need more blood, we're losing him.
这家伙的胸腔里到底怎么了 What the hell's going on in this guy's chest?
请来一个人给他做胸腔引流 We need someone to do a chest drain, please.
我来 Me.
有人自荐了 贾斯汀 立刻去止血 We have a volunteer. Justin, get on that bleed now.
换掉手套 护目镜 罩袍 两分钟内全部换好 Swap gloves, eye guards, gown. I want you ready to go in two minutes.
比利 血气检测如何 Billy, where are those blood gases?
动脉血氧分压 5.3 动脉血二氧化碳分压 4.5 PaO2, 5.3. PaCO2, 4.5.
酸碱度 7.1 乳酸 8 PH, 7.1. Lactate, 8.
碱剩余 -6 Base excess, -6.
谢谢 Thank you.
气道安全 病患呼吸顺畅 Airway secure. Patient ventilated.
输O+血 把血拿开 O pos transfusing, bloods away,
病患保持数值和血压 patient maintaining sats and blood pressure.
有什么值得注意的吗 麻醉师满意吗 Anything outstanding? Anaesthetists, happy?
非常满意 很好 Over the moon. Good.
花费时间 11分30秒 Elapsed time, 11 minutes 30.
血压下降 BP's down.
请继续把血挤进去 Keep squeezing the blood in, please.
现在仅剩的都用完了 谢谢 That's it through now. Thank you.
请立刻开始做胸腔引流 You've got to start that chest drain now, please.
发生了车祸? 多人受伤 这是第一个 This an RTA? First of multiple casualties.
我是不是完事了 Is that me done?
创伤不都主要是车祸造成的吗 I thought trauma was mainly RTAs?
为什么是你来做引流 你是新来的住院医生 Why are you doing the drain? You're the new SHO.
对 大家都叫我哈莉 Yeah, everyone calls me Harry.
我是希克林夫人 大家都叫我希克林夫人 I'm Mrs Hicklin, everyone calls me Mrs Hicklin.
我是拉玛克里士纳 对 主要是车祸和刺伤 I'm Ramakrishna. Yeah, it's mainly car crashes and stabbings.
谢谢 Thanks.
有点阻碍 推 There's a bit of resistance. Push.
心脏烤肉串 上啊 Cardiac kebab, here we come.
别这么说 使劲推 Oh, don't. Just push.
喔 天啊 哦 好吧 Ooh, God! Oh, OK.
这样可以吗 Is that good?
对 对 这完全是预料之中的事 请缝合 Yes, yes, that's exactly what we expect. Suture it, please.
呃 好的 Er, yes.
谁先去打个电话给CT Can someone please phone ahead to CT,
让他们知道我们马上过去好吗 let them know we're on our way?
血库很快就会送血过来 And blood bank will be delivering some blood very soon.
如果两分钟之内没有送过来 去催一下 If they're not here in the next two minutes, we need to chase them.
我来打电话给CT和血库 I'll call CT and blood bank.
这巧克力棒有人要吗 Is this anyone's Twix?
我们是要给手腕和胫骨做X光扫描吗 Are we getting x-rays for the wrist and tibia?
等CT决定 Wait for the CT.
是的 抱歉 嗯 Yeah, sorry. Um...
我可以现在还原一下胫骨吗 I could reduce the tibia now?
当然 好的 Sure. OK.
要不要替换氨甲环酸注射 Shall we replace the TXA infusion?
哦 是的 当然 谢谢 Oh, yes, of course, yes, thank you.
贾斯汀 能把腿露出来吗 Justin, can you expose the leg, please?
稍等 Just a sec.
谢谢 猪头 Cheers. Prick.
拍得不错 Nice one.
牵引? Traction?
对 我是希克林夫人 Yes, this is Mrs Hicklin.
我们稍后就会带重伤病人麦克·阿尔法去做CT We'll be bringing major trauma, Mike Alpha, for CT, very shortly.
请准备一下好吗 Will you be ready for us?
很好 Good.
谢谢 Thank you.
麦克·阿尔法的O+血 新鲜冰冻血浆和血小板 O positive, FFP and platelets for Mike Alpha.
好极了 Great.
请立刻给他输两包O+血 let's get a couple of bags of this O pos up immediately, please.
病人是麦克·阿尔法 O+型血 Patient Mike Alpha. O positive.
有人看到我的开衫了吗 Has anyone seen my cardie?
还有我的巧克力棒呢 And a Twix?
打扰了 Sorry.
好 开始输血后立刻转去CT OK, soon as the blood's up, transfer to CT.
不用弄那个了 You can leave that.
耐莉丝 可以加大氨甲环酸剂量了 好的 Nerys, this TXA is ready to go up. Yep, course.
抱歉 花了这么久 I'm so sorry that's taken so long.
请立刻上传X光照片 Make sure those x-rays are uploaded straight away
因为这病人已经在这里呆了三小时了 because the patient's been here for three hours.
罗琳 一切都还顺利吗 Lorraine. How's it going?
创伤急救呼叫 有什么有趣的事吗 Trauma call. Anything juicy?
我们说好了大量输血方案是由创伤急救队长 We agreed that the major transfusion protocol was to be enacted
决定启用 没错 by the trauma team leader. Absolutely.
那为什么还要我去打电话给血液科主任医师 So why, then, yet again, am I talking to a haematology consultant
被他傲慢地质问病人的血红蛋白这种问题? who pompously asks me the patient's Hb?
同意创伤急救方案是一回事 Agreeing to the trauma protocol is one thing,
让各部门去实际照做 getting the departments actually put it into practice
完全是另一回事 is something completely different.
你说过各方已经同意了 You said it had been agreed.
他们各自为政 而我左右为难 They're territorial, and I'm stuck in the middle.
不 我才是 病人才是 No, I am, and the patient is.
我看得出你生气了 I can see you're upset...
这里以前是很普通的急诊部 This used to be a bog standard A&E.
现在成了重伤中心... 哦 等下 We are now a major trauma centre... Oh...Hold on,
我不喜欢这种说法 I resent that description.
我们以前是本地区最出色的单位 We USED to be the best-performing unit in the region.
现在接收的病人数量总体上升了 Now we take more patients overall,
来了更多危急病人 资源紧张啊 more critical patients, resources are stretched.
据此推测 我们就没以前那么好了 Supposedly, we're not doing as well.
那么我们中就有人得加把劲了 Well, then, some of us need to raise their game.
你到底想说什么 Where is this going exactly?
早上好 在大约一分半钟后 Good morning. I will be ready to start the scan
我就可以做扫描了 in approximately one and a half minutes.
谢谢你 布莱恩 他已经失了1000毫升的血 Thank you, Brian. He's already bled 1000mls.
他有凝血症状 因为他体温过低 体温过低 He's coagulopathic because he's cold. Cold.
所以如果他在路上的时间超过40分钟 So if he was on the road for longer than 40 minutes...
等下 先来解决凝血症的问题 Wait, let's deal with the coagulopathy.
立刻给他输新鲜冷冻血浆和血小板 I want FFP and platelets up now.
我们的队长去哪儿了 Where's our leader got to?
有谁去看一下罗琳是否快回来了好吗 Can someone just please go and check that Lorraine's on her way back?
把警报关掉 Kill the alarm.
耐莉丝 Nerys.
去叫拉帕波特夫人或者阿彻菲尔德医生好吗 Will you bring either Mrs Rappaport or Dr Archerfield?
请马上就去 Just right now, please.
是 希克林夫人 该死 他出现室性心动过速 Yes, Mrs Hicklin. Shit, he's in VF.
比利 Billy.
在 Yeah.
没有输出 No output.
失败 回到复苏室去 Fail. Back into resus.
边做心肺复苏边慢慢回去 Slowly with CPR.
快回去 回去做心肺复苏 Fast, and we'll do it there.
快 快走 Quickly, let's go.
小心 快开门 Careful. Get the door.
好 拿到了 拿到了 Yeah, got that, got that.
贾斯汀 你来按压 Justin, take over compressions.
连接电极 电极已连接 'Connect electrodes. Electrodes connected.
诊断心率 'Diagnosing rhythm.
心室纤颤 'Ventricular fibrillation.
调整到150焦耳 'Advising 150 joules.
已选择150焦耳 '150 joules selected.
正在充电 'Charging.'
贾斯汀 让开 Justin, off the chest.
准备电击 三二一 Shocking, three, two, one.
从31分钟开始做两分钟心肺复苏 Two minutes of CPR to come at 31 minutes.
请准备好肾上腺素和胺碘酮 Adrenaline and amiodarone on standby, please.
好 Yeah.
罗琳在哪里 找不到罗琳 Where's Lorraine? Lorraine wasn't there.
她去哪儿了 Well, where is she?
我不知道 那叫克莱夫来 I don't know. Fetch Clive, then.
他也不在 He wasn't there either.
做两分钟心肺复苏 CPR counting towards two minutes.
然后准备再做一次150焦双向除颤 Then get ready to give another 150 biphasic.
在那之后 准备好注射1毫克肾上腺素 After that, be ready with adrenaline 1mg,
300毫克胺碘酮 amiodarone, 300mg.
活下去 活下去 Staying alive, staying alive...
(Bee Gees乐队的歌"Staying Alive" 据说是最适合做心肺复苏数节奏的歌之一)
你好 我是罗琳·拉帕波特 请留言 'Hello, this is Lorraine Rappaport. Please leave a message.'
罗琳 我是菲奥娜 请立刻回电 Lorraine, it's Fiona. Please call me right back.
我需要你在这里 老大 I need you here, boss.
饿死了 Absolutely starving.
我因为这个错过了早餐 I missed breakfast because of this.
你不应该叫全套的 You shouldn't have a full breakfast...
还有一分钟 One minute to go.
点好餐 然后被呼叫了 然后就放那儿了? Ordered it, then the beeper went. It's just sat there then?
我不知道 我没付钱 所以应该不会吧 I don't know, I didn't pay for it, so I doubt it.
对内脏不好 Not good for your insides.
活下去 活下去 Staying alive, staying alive...
你来得有点早 是不是 You're in a bit earlier, aren't you?
车子今早发动不了 所以我迟到了一点 The Fiesta didn't start this morning so I was a bit late.
还有40秒钟 40 seconds to go.
快到两分钟了 Coming up to two minutes.
检查脉搏 停止按压 Check pulses, stop compressions.
没有脉搏 No pulse.
还有心室纤颤 贾斯汀 Still VF. Justin.
正在充电 'Charging.'
充电完成 都让开 'Charged.' Everybody clear.
贾斯汀 让开 Justin, off the chest.
准备电击 三 二 一 Shocking in three, two, one.
诊断心率 窦性心律 'Diagnosing rhythm.' Sinus rhythm.
请按照准则来 贾斯汀 Follow the guidelines, please, Justin.
抱歉 希克林夫人 Sorry, Mrs Hicklin.
我听到心跳声了 或许自主循环已恢复 I'm hearing heart sounds. We might have ROSC.
贾斯汀 停一下 停 Justin, stop for a second. Stop.
有输出 Output.
谢谢 干得好 Thank you. Good job.
自主循环恢复 We have ROSC.
请继续输血 Put the bloods up, please.
好了 现在干嘛 做CT All right, now what? CT.
你觉得病患足够稳定可以随意挪动了? You're happy the patient's stable enough to be moved?
罗琳说接下来要做CT 那是在他心脏停跳前 Lorraine wanted a CT next. That was before he arrested.
我们需要了解他胸腔里的情况 We need to know what's going on in the chest.
这得由创伤急救队长来决定 That's a decision for the trauma team leader.
罗琳不在这里 Lorraine isn't here.
所以得有人来指挥 So, someone needs to lead.
CT CT.
第二次尝试 我们来给他做好准备 Take two, let's get him ready to go.
我们把他送去四楼 Let's get him on the fourth floor.
你好 我是罗琳·拉帕波特 请留言 'Hello, this is Lorraine Rappaport. Please leave a message.'
罗琳 刚刚病患心室纤颤 心跳停止 我不知道原因 Lorraine, the patient just had a VF arrest. I've no idea why.
我很担心我忽视了什么 I'm really worried I'm missing something here.
我们要送他去做CT 那边见 We're going to take him to CT. I'll see you there.
你会处理他的手腕和胫骨吗 Are you doing anything about the wrist and tib?
先把胸腔搞定再说 好的 We need to fix the chest first. OK.
如果需要我 到病房找我 I'll be on the ward if you need me.
她的想法是对的 She's got the right idea.
什么 如果事态恶化 最好别在这里 What? Not being here if all this goes tits-up.
聪明 Smart.
再来一次? 抱歉 布莱恩 Shall we try again? Sorry, Brian.
病患计时已同步 数到三 一二三 Patient clock synchronised. On three. One, two, three.
干得好 Well done.
布莱恩·赵 CT技师及部门协调员副手 Brian Zhao, CT radiographer and deputy assistant department coordinator?
给你的 For you.
罗琳 Lorraine?
哦 稍等 ..Oh, just a second.
请告诉我所有的结果 All the results you've got please.
呃 不许碰任何按钮 Er...Nobody touch any buttons.
数到三 一 二 三 Three. One, two, three.
谢谢 再见 Thank you. Bye.
你知道吗 什么 D'you know what? What?
我觉得这个我们救不活 I think we're going to lose this one.
控制扫描 Control scan.
我错过什么了吗 刚开始 Have I missed anything? Just starting.
开始头部扫描 罗琳呢 Starting head scan. Where's Lorraine?
嗯? Hmm?
她没和你在一起吗 She's not with you?
头部扫描完成 不许碰任何按钮 Head scan complete. Nobody touch any buttons.
好 头部一切正常 Right, your head is NAD,
没有明显颅内损伤或流血 you've got no obvious intracranial lesions or bleeding.
你高兴吗 菲奥娜 Are you happy, Fiona?
给 Here.
好的 Right.
对比扫描 Contrast run.
导管位置正确 Tube's in the right place.
如果我把导管弄乱的话 他就会被送去病理门诊科 I'd messed up the tube, he'd be on his way to pathology outpatients.
我真希望我能够得到更多的锻炼 I really wish I'd had more practice at it.
我们可以这周找个时间 We could find some time this week.
如果你不觉得麻烦的话 Only if it's not too much trouble.
我会找方法把你安插进来的 I'll find a way to fit you in.
回急诊部去 Back to the ED.
你也是 我真的很想看完整个过程 And you. I really wanted to see this case through.
你在重伤急救这边 那边就忙不过来了 When we lose you to a major trauma, patients stack up.
好吧 Right.
反正最精彩的部分已经结束了 Best bit's over anyway.
左边又充血了 Left side's filled with blood again.
有个未控制的胸廓出血 We've got an uncontrolled intrathoracic haemorrhage.
罗琳去哪儿了 Where is Lorraine?
我说过了 我不知道 I told you, I don't know.
克莱夫·阿彻菲尔德 Clive Archerfield.
啊 谢谢你给我回电 Yeah, thanks for getting back to me.
如果有需要 去急诊部找我 If you need me, I'm in ED.
你好 啊 抱歉 Hello. Yes, sorry about that.
对 我们接到建议说... Yes, we're being advised...
异物! 金属! 谁往我的机器里放金属了 Streaks! Metal! Who put metal in my machine?
我这就进去 Going in.
呃 可以进入 Er, clear to enter.
那是什么 看起来像是一片刀刃 What's that? Manifestly, it is the blade of a knife.
是刺穿了心脏吗 Is it penetrating the heart?
好 OK.
转弯 好 Turn. Yeah.
可以了吗 开门 Got it? Open the door.
让开 Clear the bay!
把仪器都重新打开 准备好除颤 Get all the monitors back as they were. Defib on standby.
请你去看一下急诊部主治医师能帮忙吗 Can you see if the ED reg can help?
我马上就回来 把这些包都拿走 I will be right back. Let's get these bags up.
贾斯汀 回复苏室去 Justin, back to resus.
好极了 Excellent!
对 哈莉 你也是 太好了 Yes, Harry, and you. Yes! Um...
能让主治医师签一下这个吗 Can you get the reg to sign off on this?
谢谢 Thank you.
主治医师会来吗 只有我 The reg coming? Just me.
他们不可能放主治医师来的 They're never going to give you the reg.
忙着接收病人呢 Too busy keeping admissions moving.
看起来血压能够维持 He seems to be maintaining a blood pressure.
呼叫心胸外科时继续给他输血 Let's keep transfusing him while we chase cardiothoracics.
你好 调控 我是梅里克护士 Hello, switch, it's Sister Merrick.
请再帮我们紧急呼叫一次心胸外科好吗 谢谢 Please can you fast bleep cardiothoracic again for us? Thanks.
已经紧急呼叫心胸外科了 Cardiothoracic's fast bleeped.
我就说吧 车祸加刺伤 Told you, car crashes AND stabbings.
罗琳在哪里 我不知道 Where's Lorraine? I don't know.
我们在这里没事 去喝杯咖啡吧 你看起来累爆了 We're fine here. Grab a coffee or something, you look like shit.
钱德拉曼医生 在病人面前语出不雅? Dr Chandramohan, using strong language in front of a patient?
他昏迷着呢 He's unconscious.
警方已经在查交通监控 Police are already checking the traffic cams
寻找事故原因了 to establish the cause of the accident.
没有人被甩出巴士 No-one was ejected from the bus.
是路上有一个人 引起车辆避让 There was a body in the road which caused vehicles to swerve
然后才导致撞车的 and that's how the collisions happened.
他们现在认为我们的病患一定是 They now think our patient must have fallen
在被袭击后坠下 或被人扔下大桥 or been thrown from a bridge following an assault.
谢谢你 加尔斯 不用谢 Thanks, Giles. You're welcome.
心胸外科的人五分钟后到 Cardiothoracics will be here in five minutes.
很好 我说什么来着 Good. What did I say?
体温太低 不可能是车祸发生后才有的 Too cold just to have been there since the crash?
哦 真天才 Oh, genius!
他失血过多 He's bleeding out.
没有输出 No output.
无脉性电活动 不要按压 心脏里有刀刃呢 PEA. No compressions, there's a knife in the heart.
我们得止血 We need to stop this bleeding.
止血等心胸外科医生来吧 他们还没到 Cardiothoracics needs to stop this bleeding. They're not here.
没有血压 No BP.
开胸 好极了 Clamshell. Brilliant!
我去叫克莱夫 I'll find Clive.
请把他罩起来 好的 Bag him, please. Yeah.
穿上 Take this.
什么 我? 是的 What, me? Yes.
可以切了吗 OK to cut?
我决定不了 It's not my call.
我要切了 该死 该死 Cutting. Shit, shit...
哦 天啊 Oh, my God...
哈莉 快过来 Harry, get in here.
握住伤口 拉开 Grab the wound edges, and pull apart.
注意手指 Mind your fingers.
打开 Hold it open.
转动控制杆 Turn the lever.
往另一边 Other way.
对了 再开点 That's it. Wider.
吸液 Suction.
你来 Do this.
我可以摸到刀子 I can feel the knife.
换边 贾斯汀 请把无影灯移过来好吗 好的 Switching. Justin, bring the light over, will you? Yeah.
有收缩 没有输出 Contractions but no output.
刀刃在心室壁上开了个小洞 The blade has made a tiny hole in the ventricular wall.
再大一点点 他就早死了 是啊 运气真好 Any bigger, he'd be long dead. Yeah, he's got all the luck.
我需要剪刀 I need scissors.
听着 亲爱的 你不能在没有主任医师的情况下这么做 Listen, love, you can't do this without a consultant here.
最好等克莱夫来 或者心胸外科医生 Best wait for Clive. Or cardiothoracics.
他等不了 He can't wait.
心脏已暴露 Heart exposed.
继续吸液 尽量把血液都清理干净 Keep the suction going, clear as much blood as you can.
缝合 Suture.
贾斯汀 等下 Justin, wait.
我需要你为我做一件很重要的事 I need you to do something very important for me.
我需要你用手指堵住病人心脏上的洞 I need you to put your finger in this hole in the patient's heart.
请帮我这么做好吗 哈莉 Will you do that for me, please? Harry?
好的 OK.
哦 天啊 Oh, my God...
把手指拿掉 Finger out.
这样就好了 That's got it.
请再来一包血 Another bag of blood up, please.
还是没有输出 等一会儿 Still no output. Give it a minute.
有脉搏了 Got a pulse.
心胸外科医生来了 Cardiothoracics are here.
很好 是谁做的 Good. Who did this?
转移到手术室去 完成修复 Let's transfer to theatre and complete the repair job.
梅里克护士 手术尚未完成 Sister Merrick, TNP.
请紧急呼叫创伤手术室职员 We need trauma theatre staff fast bleeped.
谢谢 Thank you.
你刚刚帮忙救了他的命 谢谢你 You just helped save his life. Thank you.
骨科 我是复苏室的梅里克护士 Orthopaedics, Sister Merrick, resus.
你可以来接手麦克·阿尔法了 Mike Alpha is ready for you now.
谢谢 Thank you.
你不该那么做的 You shouldn't have done that.
你说得对 应该由克莱夫来做 You're right. Clive should have.
克莱夫得对这整个部门负责 Clive has a responsibility to this entire department.
不可能照顾到个案 两个问题 It supersedes the needs of individual cases. Two questions.
罗琳怎么了 不关你的事 What's happened to Lorraine? Not your concern.
另一个问题呢 谁来接手 And the other question? Who's covering?
你最好不要管这事 所以你别管了 It's in your best interest to stay out of this, so stay out of this.
喂 妈妈 你不会相信我刚刚做了什么的 Hi, Mum? You won't believe what I've just been doing.
不 不 我没事 No, no, I'm fine.
通知 多名伤患即将到来 'Colleague announcement. Multiple incoming casualties.
请创伤急救小组回到复苏室去 'Will trauma team please return to resus.'
通知 多名伤患即将到来 'Colleague announcement. Multiple incoming casualties.
请创伤急救小组回到复苏室去 'Will trauma team please return to resus.'
(菲奥娜·罗马斯来电)
早 长官 早 Morning, sir. Morning.
喂 我是格伦·博伊尔 'Hello, this is Glen Boyle.
现在我无法接电话 请留言 'I can't take your call, please leave a message.'
是我 我 It's me. I...
我最不愿意麻烦的就是你 但是 You're the last person I want to call, but...
你是唯一能帮我的 You're the only one who can help.
我觉得我的老大好像被停职了 I think my boss just got suspended.
你好 格伦 请进 Hi, Glen. Come in.
谢谢 Thanks.
很高兴再次见到你 Good to see you again.
J. R. 布莱恩特中校 皇家精神科医学院 及皇家陆军医疗队精神科主任医师
你好吗 How are you?
就不能问个简单点的问题么 You could have opened with an easier one.
不管大人们是怎么想的 都他妈是胡扯 Whatever the grown-ups think, that was the dog's bollocks.
这边 Right here.
谁来指挥 Who's leading?
好了 给他接上仪器 开始工作 OK, let's get him wired up, let's get to work.
(下集预告)
那个象人是怎么回事 是啊 What's with the whole Elephant Man thing? Right.
哦 天啊 Oh, my God.
重伤案例需要急救队长 A major trauma case needs a trauma team leader.
有人要来 他还没到吗 Somebody coming in, isn't he here yet?
很高兴见到你 It's good to see you.
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.
破烂熊字幕组 -==http://www.ragbear.com==- 欢迎加入