- [Surgeon] Scalpel.
(cheering)
(laughing)
(beep)
(upbeat music)
(beep)
- We've dabbled in medical dramas recently on this channel,
but I've yet to review the sort of trailblazer
of all medical dramas, Grey's Anatomy.
You've been sending me tons of comments
asking me to react to it.
And I feel like it's some type of rite of passage
for doctors on YouTube to react to Grey's Anatomy, right?
But, before we get into it, if you're new to my channel,
welcome, my name is Dr. Jordan Wagner. I'm an ER doctor.
If you enjoy the educational reaction videos
and other stuff that you see here on this channel,
please smash that subscribe button
and turn your bell notifications on.
That way you learn when I post a new video.
All right, let's dive right in.
- [Dr. Webber] Look around you,
say hello to your competition.
Eight of you will switch to an easier specialty.
Five of you will crack under the pressure,
two of you will be asked to leave.
This is your starting line.
- Wow. What a good start.
Thanks for joining us
and working your butt off in med school,
going through all your interviews,
taking all your exams to try to be the top of your class
and you get into our residency program,
and now we're going to beat you down.
That's kind of how it feels like actually sometimes.
- Hi, I'm Isobel Stevens but everyone calls me Izzie.
- I have five rules, memorize them.
Rule number one, don't bother to suck up.
I already hate you, that's not going to change.
Trauma protocol, phone lists, pagers.
- Pagers are the worst thing on the planet.
We actually still use them in the hospital.
Sometimes you can use your phone, text messaging now,
but pagers, man, if you hear that go off it's like.
(whimpers)
- Nurses will page you,
you answer every page at a run, a run!
That's rule number two.
- So that's the chief resident.
I was a chief resident during my residency
in charge with another co-chief resident.
So we actually ended up just being liaison
for the other doctors to the residents,
as well as helping making the schedule
and setting up lectures.
- On call room's. Attendings hog them,
sleep when you can, where you can,
which brings me to rule number three.
If I'm sleeping, don't wake me
unless your patient is actually dying.
- Surgical residents probably have one of the worst
schedules when it comes to a resident because they are
Q3 or Q2, so they're on call every other day.
Like this is crazy!
- Rule number four,
the dying patient better not be dead when I get there.
I don't know if you have killed someone,
you would have woke me for no good reason. We clear?
- You definitely are even scared to call your attending.
If you have a question you're like,
you really want to look it up before because
you don't want to get yelled at or made to feel stupid.
But when it comes to someone's life, you just call
if you have questions.
- (pager beeps) Rule number five, when I moved you move.
- The threat,
we always have like medical students or residents
like either follow us, even now as an attending,
it's really funny.
Everybody's like basically chasing the one person in charge
and you always have to tell him like, 'wait,
I'm going to the bathroom, you don't need to follow me.'
- [Doctor] 15 year old female, new onset seizures.
Intermittent for the past week.
- We don't typically go to the helipad,
maybe a nurse or EMT or a tech in the ER goes,
but we're there waiting in the emergency department for,
you know, everything's set up ready to go.
- [Doctor] ID lost in route.
Started grand mal seizing as we descended.
- Grand mal seizures are tonic clonic, okay?
They're very fixed movements.
And as you can see, they're not trying to stop it.
They are just letting it run its course.
When somebody has continuous seizures
over a certain period of time,
that person in called with status epilepticus,
which typically requires intubation
if you can't get them to stop seizing.
And if you actually have to intubate and sedate them,
they actually need to be on an EEG monitor
because you don't know if they're continuing to seize
because you have them sedated.
- Izzie, 10 milligrams diazepam IM.
- 10 milligrams diazepam, which is Valium.
IM meaning intramuscular, so if they don't have an IV line,
you can give it intramuscular.
Sometimes you can give it intranasally,
and they even have up the butt
if you really have to for kit.
- No, no, the white lead is on the right.
Righty whitey. Smoke over fire,
- She's talking about smoke over fire.
What the heck does that mean?
They're trying to put the leads on the patient
so they can monitor the cardiac activity.
White is right, so white goes right shoulder
and then left as smoke over fire,
so you put the black on the left shoulder
and then the red on the left lower quadrant.
- Dr. Bailey, lets shotgun.
- That means every test in the book. CT, CBC,
chem seven, tox screen. Christina, you're labs,
George patient workups, Meredith get Katie for a CT.
- We don't necessarily use the word "shotgun".
You're basically you're doing like an altered mental status
work up, which could be CT scans, EKG, chest x-ray.
Like one of the first things you need to check is just
a glucose level, which is just a finger prick to check,
to make sure that they're not hypoglycemic
or crazy high hyperglycemia.
And you're not checking everything under the sun
because those are usually send out labs to a lab
outside of your hospital. It won't come back in a day.
(surgeon resident mumbling to himself)
- Oh, he's scrubbed in.
(laughing)
- [Surgeon] He's a fainter.
- He's a fainter, oh my gosh
- He's gonna sweat himself unsterile.
- 10 bucks as he messes up the McBride
- Jay he says he cries
- I'll put 20 on a total meltdown.
- Oh my gosh. I love it.
Teaching hospitals have the viewing room so they can learn
in different surgical situations
without having to be in the room.
Ooh, nice.
He's using probably either 10 blade
or a 15 blade to open up the skin,
and then once you actually get through the skin,
you don't just keep cutting. You actually use a Bovie,
which is basically a cutting electrical kind of knife
that also cauterizes blood vessels at the same time.
There's always tricks to shaking hands.
You just got to anchor them.
Cause if you're free flowing, anybody's going to shake.
But if you anchor it down on say like with a pinky,
then you won't shake.
- Convert the stump into the cecum,
but be careful not to-
- Rip it. Oops
- He ripped the cecum?
- And now he ripped the cecum
which is basically the first part of the large intestine,
which the large intestine happens to store our poop.
And now you have poop leaking into the abdomen
and now you've increased risk of infection.
So you've got to get in there and got to wash it out.
- BP's dropping.
- He's choking.
- Come on, George.
- Sometimes people are like deer headlights
and they don't know what to do,
but they also may be thinking to work in a fashion
that it's purposeful versus just reacting.
- Today.
Pull your balls out of your back pocket, let's go.
What do you do?
(monitor rapidly beeping)
(head surgeon sighs)
- Getting too low, folks.
- So what do they mean? BP dropping?
So blood pressure dropping.
Blood pressure dropping is a sign of shock,
which typically in this situation
could be due to blood loss.
Typically it's gotta be a lot of blood loss
to start that fast.
Go, go, go, come on!
Oh, he froze.
Oh no. That's stinks.
That's why I have the attending with you,
to help in those situations.
And they're also teaching and guiding.
- Diazepams not working.
- That is not a grand mal tonic clonic seizure.
That is just abnormal movements.
- Phenobarbital. Load her with phenobarbital.
(monitor beeping)
- There you go, phenobarb.
Jumped a couple steps.
- Well, page him again, stat.
- What do you want to do?
(echoing) Doctor, you need to tell us what you want to do.
(monitor flat lining)
- You got to get the seizures to stop, intubate.
- [Nurse] Call blue! Call blue!
- Well, now you're in cardiac arrest.
They call it code blue to get other resources down
to that room because the doctor's already there, right?
But you need respiratory therapists.
You need the ventilator, you need other tools,
that sort of thing.
(monitor flat lining)
- So she's putting gel on the, charging,
- [Meredith] Clear.
the gel on the pad.
We now have like stick-on pads now
versus these old school machines in the United States.
So you do it basically right-sided chest, left flank.
Then, you charge and then you want to say
'Clear. Everybody clear.' So it's all clear.
And then you shocked. And then once you're shocked,
this is an older show, so the current protocols is,
you continue CPR, you do not look to see
if you shock them back into a rhythm.
- [Nurse] 200.
300.
Anything?
27 seconds.
- Charge to 360.
- 300, that must be a monophasic, so get it up there.
Just max it out. There's no harm to that.
And so they're just stacking shocks is what this is called,
it's not done anymore,
because it has been proven not to work well.
- Anything?
- I see sinus rhythm.
- Blood pressures coming up.
- Oh, it's a miracle.
(children cheering yay)
It's got her back.
- [Nurse] It's coming back.
- What the hell happened?
- You wouldn't do it over a gown either.
It needs to be on the tissue.
- You're supposed to be monitoring her.
- I checked on her and-
- I got her, just, just go.
- Well saying you're supposed to be monitoring. 'Yeah, I was
And then she had a seizure and she had a heart stopped.
Like, what am I supposed to do?'
And then you act in that situation.
- I've got this kid, Katie Bryce.
Right now, she's a mystery.
She doesn't respond to our meds.
Labs are clean, scans are pure,
but she's having seizures.
Grand mal seizures with no visible cause.
I can't do it alone.
I need your extra minds, extra eyes.
I need you to play detective.
I need you to find out why Katie is having seizures.
- They're kind of rounding.
So sometimes you can round on a patient
where you're going around to each room.
So that's what they're doing, they're discussing the case.
And basically more brains are better than one.
- Okay she has no headaches, no neck pain, her CT is clean.
There's no medical proof of an aneurysm.
- [Dr. Shepherd] Right?
- But what if she has an aneurysm anyway.
- Look, I appreciate you trying to help-
- She fell when she twisted her ankle, she fell.
It was no big deal, not even a bump on the head.
You know, she got right back up iced her ankle
and everything was fine. It was a fall so minor
her doctor didn't even think to mention it
when I was taking her history. But she did.
She did fall.
- Well, you know what the chances that a minor fall
could burst the aneurysm? One in a million, literally.
- But if you're looking for burst aneurysm,
you should have lateralizing signs. What does that mean?
You burst an aneurysm in your brain
on one side of the brain or the other.
So you, it should affect, basically, the opposite side.
That's why it's like kind of weird,
but it could be in a certain area of the brain
that doesn't actually show up on, say like a physical exam
and you're having these seizures.
Oh, we're doing a vascular study
an aneurysm study.
- There it is.
- It's minor, but it's there.
- They found an aneurism.
It could have just had an LP too,
but they're not showing that here.
So if you have a ruptured aneurysm,
you'd have like a leakage of the blood around
in your angiography that you're doing.
Cool, good job intern. Yes.
- All right everybody,
it's a beautiful night to save lives,
lets have some fun.
- What he just said there like
"it's a beautiful day to save lives."
Every day I go into work and it's like,
we're going to help people,
we're going to save people's lives today.
That's what we're there for.
And that's why we went into this.
I like statements like that because we are there to help.
If you guys liked this video,
check out this one over here
and as always like in subscribe
and thank you so much for watching
and stay healthy my friends.
(beep)
(upbeat music)