hello hello I'm James what's your name
你好你好我是詹姆斯你叫什么名字
j j what's happened tried to get into
j j发生了什么事试图进入
and I just fell backwards fine okay you
但我只是向后摔倒了好吧你
didn't lose Consciousness I'm I'm just
没有失去意识我只是
afraid you put your leg up and me stop
害怕你把你的腿抬起来而我停在
there so the most important thing for
那里所以最重要的 June 要做的一件事
June is to realign her foot and try to
就是重新调整她的脚，并尝试
restore some blood flow when treating
恢复一些血液流动，在治疗
elderly trauma patients they can be sent
老年创伤患者时，他们可以送去治疗，这是
is quite aeric and they want to put on a
相当危险的，他们想要表现出
brave face and it's important to break
勇敢的面孔，重要的是
down those barriers and make sure that
打破这些障碍，并确保
you're treating the patient as they need
你' 重新治疗患者，因为他们需要，
it okay so I've got access just going to
好的，所以我有权限
give us some morphine um and then the
给我们一些吗啡，然后
plan would be a bit of ketamine and a
计划是一点氯胺酮和
bit of MZ at okay pul are going in now
一点 MZ，好的，现在就进去，
Jean well done well done Jean's ankle
吉恩做得很好做得很好 Jean 的脚踝
facture is one of the worst I've seen it
骨折是我见过的最严重的骨折之一，它
has a significant vascular injury
伴有严重的血管损伤，
associated with it as well with some
还有一些
active bleeding and the bones protruding
活动性出血，骨头也
from the wound as well so it's quite a
从伤口突出，所以这是一个相当
complex factor to manage all the way up
复杂的因素，需要一直处理，
okay I think that's
好吧，我 认为
we take you to a specialist hospital
我们会带你去专科医院
that looks after trauma because that's
照顾创伤，因为那里
where all the experts are okay and
所有的专家都很好，
that's exactly where you need to be hang
那正是你需要坚持的地方，
in
there how long have we lived there for
我们在那里住了多久了，
56 years 56 years wow long time these
56年了，56年了，哇，很长时间了，这些
days they live in one place my neighbors
天他们住在一个地方，我的邻居
always have they was that your neighbor
一直都是这样 你的邻居
is that your neighbor with you oh she's
就是那个和你在一起的邻居哦她很
lovely it's awful you Mo anyone we're
可爱这太可怕了你莫任何人我们
here for you though June okay thank you
在这里为你虽然六月好的谢谢你
they always
他们总是在
here there's a real risk that the blood
这里有一个真正的风险,血液
flow to the foot has been lost and
流向脚已经失去,
that's a limb threatening
这是一个肢体威胁
injury this is June she's 87 years old
伤害 这是六月，她已经 87 岁了，
she went to get in a taxi she stumbled
她去打车时
backwards she's gone over on her right
向后跌倒了，她的右
ankle it was an open crature dissocation
脚踝摔倒了，这是一个开放性骨折，有一个角度，
that was angulated with a Venus bleed on
现场有静脉出血，
scene with a tibia protruding by about 2
胫骨突出了大约 2
or 3 cm it's been reduced on the scene
或 3 厘米，这是 现场已经减少了
and the wound has been packed with
，伤口已经用
hematic gwes but there's a continuous
血块填塞，但那里也有持续的
bleed as well there I had to repack it
出血，我不得不重新填塞，
cu the bleeding was so much she's got
因为出血太多了，她已经
good sensation which is exactly the same
好了 感觉完全一样，
it's just a lack of a ped pulse that I
只是缺少足部脉搏，我
couldn't obviously feel no Beed B no
明显感觉不到没有 Beed B 没有
obvious ped pulse pedal pulse is a pulse
明显的足部脉搏 足部脉搏是
point on the top of the foot that we use
脚背上的一个脉搏点，我们用它来
to assess the circulation coming down to
评估血液循环
the foot itself if it's absent it's an
脚本身，如果它不存在，这
indication the blood supply is not
表明血液供应
sufficient to the Foot Right lovely so
不足，对吧，可爱，所以
we're going to give you the good stuff
我们要给你好东西，
I'd
我
love okay let's do this first and then
喜欢，好吧，我们先做这个，然后
you can have something
你可以得到一些东西，
yes older patients they're much more
是的，老年患者，他们 更
susceptible to having accidents and
容易发生意外和
injuries they're less stable on their
受伤，他们的脚步不太稳定，
feet they may have balance problems I
他们可能有平衡问题。我
want to give every patient both young
希望给每一位患者，无论年轻
and old the best chance of getting back
还是年老，在受到严重伤害时，都有最好的机会重新
to living independently to walking
独立生活、独立行走
independently when it's really serious
injury it's not always
这并不总是
possible okay you still want that tea
可能的，好吧，你还是想喝茶，
yeah once you've woken up a little bit
是的，一旦你醒了一点，
more I'll get you a cup of tea we now
我会给你一杯茶，我们现在
need to get a CT scan really urgently if
需要紧急进行 CT 扫描，如果
there's an artery that's in there
那里有动脉
bleeding it could be a matter of her
出血，它可能
losing her foot if we don't get her to
如果我们不尽快送她去剧院，她可能会失去她的脚，是的
theater
rapidly yeah thank you sister all
，谢谢姐妹们
right we've debrided all the soft tissue
好的，我们已经清除了所有的软组织，
so taking away all the Mucky skin and
所以去除了所有暴露在外面的脏皮肤和
fat that was contaminated because it was
被污染的脂肪，
exposed to the outside well can I have
我可以用
the saw
锯子，
next we've just taken off the distal end
接下来我们刚刚取下了
of the tibia and the top end of the
胫骨的远端和顶部 裁缝的末端，
tailor so the ankle joint effectively
这样踝关节就可以有效地
we've so it off so that we can create
脱落，这样我们就可以创造
two nice flat surfaces and ensuring that
两个漂亮的平面，确保
the bones can actually fuse can
骨头可以真正融合，可以
heal can you show me more of the foot
愈合，你能给我看看脚的更多部分吗，
please I think we'll go for that that's
我想我们会去 那
nice
很好，
just have a quick look at the
只需快速看一下
knee yeah that's perfect there you can
膝盖，是的，那很好，你可以
save that so we know she's going to have
保存它，这样我们就知道她将进行
a knee replacement she's got enough
膝关节置换术，她有足够的
space for which is nice yeah all right
空间，这很好，是的，好的
guys so we're going to close now hi June
伙计们，我们现在要结束了 六月
how are you how's your leg yesterday I
你好吗你的腿怎么样昨天我
walked to the window and back that's
走到窗前又回来了
brilliant a it's very good surgery went
这很棒手术进行
really well we just need to give it a
得很顺利我们只需要给它
bit of time see how she responds with
一点时间看看她
regards to the physio rehab really good
对理疗康复的反应真的很好
unfortunately some elderly patients feel
不幸的是一些老人 病人
quite lonely and vulnerable going back
回家后感觉很孤独和脆弱，
home oh
perfect I didn't want to leave my home
太好了 我不想离开家，
but I've got to I realize it's I just
但我意识到我已经
can't cope anymore so I'm going to go
无法再忍受了，所以我
into insisted accommodation so you've
要去住所，这样你就会
always got someone
一直有人
there
在那里