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good hand washing technique
could be a surgeon i don't know yet
oh
well calling for help is the right thing
that's the first thing you want to do in
these types of situations
is juggling been cut does anyone have a
clean cloth how does he know it's the
jugular vein that's pretty impressive
that's great
putting pressure on a wound like this is
the first thing you need to do outside
of obviously calling for help anything
you can do to stop the bleeding put
pressure on the site is important in
order to help that person survive you're
killing him
i'm saving his life he was bleeding out
now you have it in the wrong place i
think i remember enough of anatomy 101
to know where the jugular vein is you
would be in the right place if you were
an adult he's not an adult he is a boy
which means you're also putting pressure
on his trachea which means he's not
currently breathing
i can't really see where his hands are
but it's good advice
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don't take it out
some glass don't take it out you'll be
fine
yeah who are you
hello i'm dr sean murphy i'm a surgical
resident at san jose st bonaventure
hospital well hello dr sean nice to meet
you by the way just so you know if you
have an object inserted into you object
i know that sounds kind of weird if you
get stabbed with a knife if some glass
goes inside of you if a nail goes inside
of you never pull it out make sure you
call 9-1-1 let the paramedics decide
what to do let them take you to the
nearest hospital because a lot of times
what that object is doing is preventing
you from bleeding out because it's
putting pressure on the spot where the
artery or vein was cut a special meeting
of the board of directors as much as i
love you all
questioning one of my hiring decisions
did you bother to look up the definition
of president while you were skimming the
dictionary you're hiring him to be a
surgical resident my department over my
objection the bureaucracy that you're
seeing here is real there are board
members there's presidents there's
employees there's uh trust funds so
these things exist they put a lot of
pressure on doctors and presidents to
make certain decisions yes he has autism
but he also has savant syndrome genius
level skills in several areas he has
almost perfect recall he has spatial
intelligence and he sees things and
analyzes things in ways that that are
just remarkable in ways that we can't
even begin to understand those are
assets undeniable assets for any doctor
particularly a surgeon i'm not gonna lie
i agree with the president on that as a
surgeon it's more important to have very
good spatial ability to be able to have
perfect recall to understand the anatomy
perfectly than it probably is to explain
the complexity of
a specific case and be able to
communicate well with people most of the
time when you're a surgeon your patient
is not awake that being said i think it
is still important for surgeons to be
able to improve their communication
skills to be able to talk to patients
help them understand the risks and
benefits of operations and make sure
that they don't force patients to go
into the knife when they don't have to
you seen her no now go away and turn off
the light sure
resident beef
resin and beef
oh i need you to um
i heard it
and here i thought this was going to be
an all medical show no grey's anatomy
drama at least where i practice medicine
there's different on-call rooms for
males and females there are times where
one of their call rooms may be
unavailable and you do have to have a
male and a female sleeping in a room
together usually it's not a problem but
this is unprofessional folks it's gonna
lead to drama lots of drama we don't
have a relationship
we have sex
but
you have a sexual relationship
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i wish i had vision like that that's
impressive
venus distension is caused by increased
intrathoracic pressure inside the chest
cavity he's basically saying the veins
in the arms are swollen so he thinks
there's some extra pressure going on
inside the
the chest cavity can be because of uh
cardiac tamponade which means that
there's blood usually in a traumatic
sense like this inside the pericardial
tissue which is the lining of the heart
and there could be blood in there and it
makes the heart unable to beat properly
the veins in the boy's left arm are
popping is that bad i i don't see
inter-thoracic pressure no his chest is
rising he's breathing no the the chest
is
moving paradoxically paradoxical chest
movement is a consequence of something
known as flail chest if you get a trauma
where a section of your ribs break from
the rest of the ribs that part of the
rib cage doesn't move normally when you
take a deep breath in and deep breath
out so the the chest sort of moves
paradoxically that's what he's talking
about
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what happens during a pneumothorax one
of the lungs collapses or sometimes both
of the lungs collapse and you can't
oxygenate that area meaning that when
you breathe no oxygen goes to that area
it causes increased pressure the
life-saving treatment for this is to
literally insert a needle in order to
release some of that pressure who here
has a sharp knife oh played five inches
or longer
no body is he going to go into the
second or fourth
intercostal space can't be back here oh
i need a knife
he's going to tsa a knife
sure anything else
i do also need a
narrow six foot tube and high proof
alcohol and gloves and baggage handling
tape but i'm going to get the alcohol
from the duty free store and the tube
from the back of the soda machine he's
going to put a chest tube
for a traumatic pneumothorax
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looks like he's going to a party with
all that jim bean he reminds me of zac
efron a little bit i know it's a weird
thought to have in the middle of this
medical emergency but i don't know
i always found that blowing to the glove
thing really obnoxious how much bacteria
do you have in your mouth probably even
more than your fingers you're blowing it
inside the glove but you're getting some
of that bacteria on the outside of the
glove that you want clean or relatively
clean when you're gonna
go insert a chest tube into a young boy
he's gonna clean his hands with the gym
bean but that's not perfect
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incision should take place two ribs down
second intercostal space my man
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he's actually following proper technique
because you want to stay in the mid
axillary line meaning in the middle of
your armpit that way you have a lower
probability of hitting the heart when
you go in with the scalpel or whatever
you're going in with okay well why the
bottom the air will continue to leak and
accumulate until the damage can be
properly repaired the tube allows the
air to get out the water in the bottle
stops the air from coming back in
a homemade one-way valve
he's breathing
you saved his life
he saved his life
attention pneumothorax you can literally
put
a needle in that can release some air
and
that equilibrium does enough of a job
you didn't need all of this fancy
technology here i need to get to san
jose st bonaventure hospital that's
where we're going
good
one of the classic uh signs that someone
has autism or may have autism is they
don't make great eye contact they're not
great at picking up social cues if you
find out that your child has autism you
can start them in these early
intervention programs where they teach
them how to mimic some of these social
cues where they're not looking to make
eye contact with you like we do normally
because we have good physical
recognition and body language
recognition but they do so because
they're trained to do so to make
conversations seem more normal early
intervention has shown some very
promising results for those with autism
we'll find another school no we won't
because nothing's gonna change
they can't handle them i don't blame
them because obviously we can't handle
them either what the hell happened this
time what happened
what did you do
those who have autism and grow up with
pets actually have better results moving
forward in terms of communication in
terms of interpersonability so if your
child does have autism
getting them a pet early on definitely
serves a benefit
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it
changed
the boise cg changed
it's the same 86 bpm no it used to be
higher no usb86 is still 86. it used to
come up to here that's not the right way
to do it you have to be seated you have
to have calipers you have to be looking
at the strip and comparing the little
boxes on the screen maybe this guy he
has super human powers it's possible but
in reality you need to be a lot more
careful because this isn't just a game
it's people's lives at risk
eight-year-old healthy voice status post
encounter with a shattered glass sign
numerous lacerations echo get them set
up in trauma 3 with an ekg full blood
work in a pan scan so far very accurate
i'm very impressed the way that the
paramedic told the history very very
accurate adam needs an echo cardiography
no behave yourself or you'll be removed
from the building
i don't know what to make of this guy
i like him because he's super human and
knows everything but it's just so
unrealistic it's crazy
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is this the same security guard who
knows everywhere he's going to go maybe
this guy's a savant too
do an echo
sir the boys would open it's going to
take a while good that'll give me time
to figure out why the hell we're doing
an echo dr brown you're with me we're
gonna go find your weird guy keep him
stable surgeons just don't go and look
for another doctor or someone else on
the street that wanted to give them a
recommendation on how to treat this
patient i noticed that there was a
slight reduction in the intensity of the
electrocardiogram the electrical flow i
noticed that too
the heart rate was the same but the
amplitude dropped pericardial effusion
reduced cardiac output would stress
other organs causing them to shut down
yes just to break that down pericardial
effusion peri means surrounding the
heart the tissues surrounding the heart
sometimes there's fluid there and when
there's fluid there that makes it
difficult for the heart to beat and you
get cardiac tamponade that's what i was
talking about earlier
again
there
looks normal to me
it's not normal four doctors are looking
at a scan they don't believe there to be
an issue
this guy comes in sees an issue with the
skin that no one else sees and now all
of a sudden they're starting to believe
him that maybe it could be that if
you're looking at the scan it either is
or it isn't i don't know what they're
debating about the concavity that's open
to interpretation i've never seen a
situation like this the youtube clip
already has over 200 000 views that's
pretty good 200 000 views the more i
think about what he did there uh in the
airport the more i think it's
inappropriate there is a good samaritan
law that's in place to help with basic
emergencies pulling some out of someone
out of a burning car and in the process
you hurt their back but you were trying
to save them but performing an advanced
medical procedure like putting in a
chest tube especially a makeshift chest
tube like that man unless he saves the
boy and it's a hundred percent safe
there's gonna be malpractice and lawyers
involved in that case so
the good doctor strikes again you saved
that boy's life
oh good
his name is adam traumatic pneumothorax
i'm hungry
sean
dr melendez's team is going into surgery
i mean
if you're interested
i mean how about getting him to sign all
the paperwork and disclosures and hipaa
forms and making sure he has
identification put your mask on
put your mask on sean i saw a lot of
surgeons in medical school
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you're much better than them i have a
lot to learn from you
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you're very arrogant
matter of fact do you think that helps
you be a good surgeon
does it hurt you as a person
is it worth it
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and there you have it first episode of
the good doctor things i definitely
enjoyed about the show number one it's
fairly medically accurate the drama in
the show is interesting it kept my
attention and i wanted to see more what
would happen i really dig the fact that
it gave an inside look into how hard
living with autism can be you know you
can have abuse of family you you have
bullying that's happening dealing with
autism is a difficult situation and i
appreciate that the show highlights that
i will say however that
they almost make him look super human
and that's not realistic so that's
definitely a con in my book but i
understand that it needs to they need
that factor to make the show work there
wasn't that much medical stuff to
comment on it was a lot about developing
him as a character if you know a better
episode where there were more medical
situations that i can comment on let me
know in the comments if there's another
show you want me to watch please leave
it down below in the comments the best
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help me make more content to make better
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always stay happy and healthy
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