(weapon slices)
- Oh!
(character yells)
This is in a video game?
Fiery arrows, viking wrestling moves,
and big old pointy things you should avoid.
Today we're headed back in time to the British Isles,
breaking down and reacting
to all of the unpleasant medical scenes
and colorful injuries from Assassin's Creed Valhalla.
Let's dive right it.
(characters groan) Oh.
Huge punch to the face right at the beginning.
I just see blood splatter everywhere.
I mean, blood will splatter but not like that.
Lands on his head,
could you potentially have a cervical fracture?
Maybe has to do with a hyper flexion injury.
Typically, when we see fractures
relating to that type of injury,
it's because of either the vertebral body
smashing on top of each other
or you have a ligament that's attached so tight
that it pulls off of the bone.
(characters groan, fists slam)
Oh!
Oh, look at that elbow!
A nasty dislocation, maybe fracture.
Hard to know obviously in that moment.
That's gotta hurt.
- That's gotta hurt.
- You have your nerves that are running
straight through that area.
Typically, most fractures of the elbow
either occur on the olecranon process,
which is the big elbow bone.
Very rarely is it the radial head.
(weapon slashes)
Oh!
Slow mo.
(Ace groans)
Cool blade injury right underneath the mandible
to the soft tissue going straight up.
That type of injury could be just soft tissue,
could cause some fractures of the front part for your face
but if it's missing, your brain is more just nasty injury
to the face versus anything deeper.
(characters groan, weapon slashes)
Whoa, decapitation being that strong to be able to do that.
Hard to know if that's actually possible.
I don't see these injuries.
They don't come to the emergency department.
Obviously if you're decapitated, you're not going to live.
(characters groan, weapon slashes)
Oh.
Does it cause that type of injury?
Does it stick inside?
Most of the time it's probably gonna bounce right off.
Injuries that we see that people get to their face
are usually blunt from using your fists
or kicking or knees and then obviously mechanical falls
where people fall on their face.
Some car accidents, obviously those are the big ones
that we see in the emergency department.
(bones crunch)
We do see a lot of cross injuries
and fractures to the skull.
Fractures to the skull typically will heal on their own.
You don't obviously like put somebody in a cast
on their head unless there's a massive deformity
but even then, do you use a plate to help support it?
(characters groan, weapon slashes)
Okay.
Using a hatchet.
- You know what a hatchet is, don't you bug?
- Because the fulcrum is short,
the strength of the individual actually plays
a bigger component than the weapon itself.
'Cause you have to be able to swing it hard enough
and fast enough to be able to penetrate through a skull.
Whoa, whoa, chokin' him out.
(bones crunch, character groans)
Okay, I saw blood pop out.
I don't know what that was.
You can cause somebody to choke
for multiple different reasons.
Pushing on the airway itself, collapsing the vessels
of the neck, and then somebody could actually die
typically due to the fact of lack of oxygen
and lack of blood flow to the brain.
(characters groan, weapon slashes)
Oh, stab wound to the lower abdomen
and inner aspect of the left leg.
If you get it into the right place and deep enough,
you might be able to hit the femoral vein.
Femoral artery, but they're pretty protected.
They're deep in there,
and that's the way our bodies are made.
They're actually more superficial in the groin
and like right behind the knee.
Low in the abdomen in the pelvis area,
you're worried about the bladder.
You're worried about your intestines.
Those are pretty much the main structures
there in the midline.
(weapon slashes)
Oh!
(character groans)
This is in a video game?
(broadcast signal beeps)
Stabbing to the lateral aspect of the neck, left side.
You have your sternal cleido mastoid muscle,
your platysma muscle, and you have some scalene muscles
that also are on that side.
All have to do with protection of the neck,
rotation of the neck, all these different aspects
of movement, but they're also protecting vital structures.
(characters groan, weapon slashes)
Okay.
- Okay?
- I don't think normal people will be
walking around with a weapon that large.
You have to use your full body to wield that.
Using that momentum and the weight of the object
is what's probably causing the amputations to occur.
Looked like it was a below the knee amputation
which actually occurs at the hospital.
If somebody has horrible peripheral vascular disease
or if there's significant trauma
to a large extremity and you can't save it.
(characters groan, weapon slashes)
Oh man, a huge ax just getting stuck in the upper back.
It'll probably be hitting right into the spine.
The spine and the spinal cord
in the back is actually deeper than you think.
When we have to do a spinal tap
we're using a needle that's like
three and a half inches long
and we're getting most of that bad boy in there.
Usually we do go in at an angle.
We're not going directly in, but it gets far in there
because you have just multiple different layers of tissue.
(characters groan, weapon slashes)
(doctor laughs)
That ax is so big.
Obviously that's not realistic.
But we do see people that get penetrating traumas
to their head, either by bullet, very unlikely, a knife.
A lot of times I've seen nails.
Just depends on the area of the brain that it hits,
but you're always worried about swelling
as well as bleeding in the brain.
(weapon slashes) Oh!
Whoa, big sword
straight through the chest cavity.
If it goes through the heart, obviously done for.
Maybe you won't bleed out very quickly
but even if you try to take it out slowly
and you got a medieval doctor there around,
probably not going to be able to be survivable.
And then if it misses to the right,
you're still hitting the lung itself,
and it could be a big cavity, big hole in that area.
(characters groan, weapon slashes)
Oh, clavicle fracture, possibly.
If you got a lot of muscles there
of your trapezius muscle, it could protect you.
And then you're always worried about the upper airway,
but underneath the clavicle here
you have your subclavian vein.
That's major blood vessels in that area.
Sometimes if somebody needs a central line
we'll actually stick a needle
right where it kind of curves in.
(characters groan, weapon slashes)
- Oh, a hammer, well my gosh.
- Pick up the hammer.
- Just causing significant amount of blood trauma.
The biggest thing we worry about after fractures,
dislocations, are you going into like rhabdomyolysis
which is muscle breakdown
which then could lead into kidney failure.
Or the other component is so much trauma to an extremity
you do increase the risk of having compartment syndrome,
which if that occurs, you need to filet the tissue open
'cause the compartment syndrome causes compression down
on the blood vessels, not allowing blood flow to go through.
(characters groan, weapon slashes)
Oh!
Crushing the neck itself.
It's cartilage here, right?
It's not bone.
You have a hyoid bone that sits above here,
but all this is cartilage.
It takes a lot of force to fracture cartilage.
Cause cartilage actually gives, right?
It's soft, it's movable, you know,
and these don't go all the way around.
They're not like a distinct ring.
There's only one that goes all the way around
and that's your cricoid.
(characters groan, weapon slashes)
Head trauma, people hit other people with their own head.
Here there's a pretty thick part of your bone.
- Pretty thick. - Even if you hit somebody
you can actually cause a concussion to yourself.
Your brain sloshes back and forth,
and you can cause a contusion to your brain.
You can have post-concussive syndrome
where you have dizziness, lightheadedness,
visual changes, nausea, vomiting.
That could be prolonged for, you know,
weeks to months even a year.
And headaches as well.
(characters groan, weapon slashes)
Oh, you gonna burn him?
(doctor gasps)
Oh my gosh.
The individual's wearing fur.
If it's super dry,
looks like you put some alcohol on to burn.
The things you worry about burn injuries
are one, the soft tissue issues.
Fire requires oxygen
so potentially taking away the oxygen surrounding you.
And then are you inhaling those hot flames
which then can burn the mucus membranes?
This was actually really cool
the way that they portrayed the graphics and the injuries.
Very interesting and allowed, again, me to discuss
what I see on a daily basis in the emergency department.
Let me know what your favorite Assassin's Creed is.
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Thank you so much for watching and stay healthy my friends.