they're chicago pd their chicago fire
but i'm most concerned with you guessed
it chicago med let's get started
it doesn't look too bad all right you're
gonna be all right
good triage 45 year old male left leg
amputation treatment two
tree motorman gcs3 vp of 90 by pal gcs3
is the glasgow coma scale
three is very bad you need to be
intubated
you're basically in a life or death
situation at that moment and he keeps
biting down i can't get the blade in
look you bag him i'll do cpr
if you can't um insert a tube to help
someone breathe
one thing you can do is you can continue
bagging them that
still oxygenates their airway it's
obviously not as ideal as putting an
endotracheal tube in but the most
important thing is cpr
chest compressions chest compressions
chest compressions
almost there it's not time yet
never ideal to do chest compressions
with one arm like that
but i can understand if he's been doing
chest compressions for 15 minutes it's
really tough it's tiring to do chest
compressions i've done chest
compressions for a while
and generally after each round you have
a student or a resident standing behind
you ready to jump in and start doing the
chest compressions
because it's all about at least getting
two inches of compression to the chest
which can sometimes break ribs but it's
all about getting them
enough time to get to the hospital uh to
hopefully save their life i got it from
here man
nope he's mine okay who the hell is this
guy says he's a docs
get off the gurney doc i'm a senior
resident in this er yeah well i'm your
new trauma fellow
it doesn't happen like that trauma
fellows don't just run in
this guy could be anybody you need to
see some id i'm all for
the show trying to set up the stage for
this character but
people don't just run into the hospital
and say i'm the doctor now
get a bp and keep giving him blood send
a rainbow of tubes into type and cross
get his blood gas and get him to the or
type and cross again you're trying to
find out the correct blood type for now
giving o negative is fine
but you don't want to keep wasting the o
negative blood so you want to do a
typing cross when he says
the rainbow of tubes that's basically
tubes that
are sent off for a wide variety of tests
wide array of tests like
cbc which is a complete bud count bmp or
cmp which is a metabolic panel
a pt inr which shows clotting
abilities and clotting times
no gag reflex didn't even need sedation
not good
we got another problem this woman's
pregnant
what he's doing there with the
ultrasound is called a fast scan it
basically allows you to see if there's
any internal bleeding going on
especially in the abdomen
because you can lose a lot of blood in
the abdomen without even knowing that
you're bleeding into the abdomen
but obviously the situation he's found
that this patient is
pregnant which complicates the situation
even more 20 year old male cystic
fibrosis complaining of chilled labored
breathing temps 98.
jamie that you hi maggie
back so soon i missed you guys cystic
fibrosis
is a it's a deadly illness unfortunately
and
basically you build up so much mucus
in your airway because uh you cannot
clear the mucus out of your airway as
efficiently as someone who's healthy and
doesn't have cystic fibrosis
so you get uh very often uh lung
infections
obstruction in your airway and most
people
live somewhere into their 40s or 50s
with the illness and
that's pretty much a life expectancy
with someone who has cystic fibrosis
mr dilson i see that you're using
inhaled antibiotics tobramycin
albuterol you wear a vibration jacket at
night and use a humidifier
the vibration jacket actually helps
break up some of that mucus and allows
it to
naturally come out when a patient coughs
very commonly we use something known as
chest physical therapy
which is almost like clapping on the
chest to help clear some of the mucus
parents of young children who have
cystic fibrosis are trained in giving
their children this procedure
baby checks out fine healthy heartbeat
amniotic sac and placenta are intact
gina though i'm afraid suffered a
traumatic head injury
and so far she's unresponsive
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we need to contact her family if you
have any information
my husband and i are pretty much her
family she
she's been living with us since before
the embryo was implanted
that's such a difficult situation i mean
to have
someone be a surrogate to carry your
baby and then
they're living with you and they're
involved in this horrible accident they
have a traumatic brain injury
where they're being kept alive by
machines that's going to be a tough
decision whether or not to keep her
alive
using machines so that the baby can
continue growing and get to at least to
a stage where
the baby can survive on its own
following a c-section
man jamie i've got your test results
back
i wish they were a little more
encouraging your you're pan-cytopenic
which means that your cell counts are
low
you've got a blood ph of 7.14 when your
blood ph
is that low that means you're trapping
carbon dioxide within your body
uh and you're having obstruction which
comes from the cystic fibrosis
that's very dangerous because when you
go into an acidotic state like that your
enzymes within your body can't function
and you can
you can die i'd like to innovate you put
you to sleep
get you on a ventilator you're getting
fatigued this would just allow you to
rest so that the antibiotics can do
their job
i've been individed eight times
i think i'll skip it
the purpose of intubating someone who
has such a strong acidosis
is when you put the tube in it allows
the per
the person to not work to breathe so
heavy to expel all that carbon dioxide
the machine basically does it for them
and again it allows them to rest and
allows the antibiotics to do their
job and it improves the ph quicker than
the person can do themselves
very uncomfortable not a lot of patients
like it
i've never seen and again i'm not a
trauma surgeon i'm not an er doctor but
i haven't seen
options given that frankly to patients
if
a ph was that low in my hospital
generally we would strongly advise the
patient
uh to intubate them but again i'm not as
super specialized in this field so i'm
just going off
based off my own experiences
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sherry dr halstead i need to blow down
her co2 take her off the vent and bag
her give her a dose man at all and
increase her dopamine trip to 12. right
away
doctor gina's intracranial pressure is
rising what happens after an injury
to the brain is just like any part of
the body there exists inflammation
swelling edema and the problem with
having swelling
inside the cranium is that the cranium
is a skull it's meant to keep things
from coming in and protect you
but it also crams the brain when there's
edema and swelling and it actually
damages the brain further and
can be fatal so you try and control it
with medications you try and give the
patient
uh something to reduce the swelling in
the brain there's also some physical
things you can do
like elevating the head to hopefully get
some of the fluid to come down
but in reality if the condition gets
worse you need to do the surgery
to open a piece of the cranium to allow
the brain to swell
and not cause increased pressure within
the brain intubating jamie
is the only hope we have of keeping him
alive what's that gonna give him a week
ten days it could be six months a year
more this goes to the heart of the issue
of patient autonomy
that they have the right to choose what
happens to their body
i don't know how old jamie is once
you're at the age of 18 or older
you have the right to turn down medical
treatments you have to write
and say that as long as you understand
the consequences of what you're doing
you can undergo or um skip any treatment
that you want nobody can
force treatments upon you i understand
what the er doctor's doing i also
understand what a psychiatrist is doing
as soon as we hear something i'll let
you know
rachel rachel can you hear me what is
wrong
what's happening i can't find a pulse
oh my god
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well the medical student is doing the
exact right thing call the alert
start doing chest compressions right
away you're not compressing the heart
sir you got to go harder
but she's so small i don't want to
harder do it let's go
come on sarah harder
hold there we go back inside it's
getting bp
what happened she arrested we got her
back
i can't get an id hey mr girl get an i o
line an i o
line is an interosseous line in children
sometimes it's difficult to put an iv
line
sometimes they need extra fluids uh what
we can do is we can drill
a little needle right it sounds brutal
but it's really not that bad
uh drill a little needle directly into
the shin bone and what that allows us to
do is to give
extra fluids and medications uh to that
area i just broke a little girl's ribs
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reese you saved the girl's life breaking
someone's ribs while doing proper cpr
is part of the course and the cpr
actually saved lives the ribs
are an unintended consequence but
they're a side effect of trying to keep
the young girl alive this is jorge's
yes inside
i found this
why would you give that to her in this
moment that's so unnecessary i promise
this will not happen in the hospital
what happened with a little girl
she had a cardiac contusion bruising
caused her to arrest she's good now
but it was a real scare sometimes when
you have a direct injury to the heart
that can cause a contusion which is just
a bruise
and sometimes that can mess with
electrical activity of your heart
and cause it to cause you to have a
cardiac arrest which means that it just
stops the cardiac rhythm
actually this is a common scenario
during baseball games if someone hits a
line drive
and it hits someone in the infield
directly on the chest
if it hits in a specific time of the
electrical rhythm you can actually stop
the heart
jorge's brain was without oxygen for too
long
paso mucho tiempo
we have translators in the hospital for
moments like this
if you're gonna have a conversation
that's about life or death you need a
translator there your broken spanish
isn't the right way to communicate with
the patient he's 20 years old
without new lungs he will die
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your fiancee
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a little unethical here they're talking
about the patient's condition
to a non-family member it's technically
breaking information protocol
i don't think they're gonna get in
trouble for this i think they're doing
the right thing
and that's why a lot of rules are open
to interpretation
and i think here they're looking out for
the best interest of the patient and
maybe telling his patient information to
somebody else but
in hopes to save his life so i think
legally this isn't right but i think
morally and ethically it's the right
move
going back to the hospital yeah
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wouldn't mind being there when he wakes
up
can i come
sure i appreciate that the doctors
want to spend their off time with the
patient but
you know you got to recharge your own
batteries you got to get the seven to
nine hours of sleep so you can make the
best decisions for your patients the
following day
again you want to be empathetic but you
don't want to burn out either because
then your future patients will suffer
also so
it's a fine line between being a good
empathetic doctor and
burning yourself out
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this is a good show quality actors
quality script
good medical info showed some very
unique situations that have
inherent drama built into them but they
were realistic
based off this pilot episode i'm
definitely a fan so thank you for
recommending this there's another
medical show you want to do
drop it down below in the comment
section and don't forget to subscribe
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to make sure you know every time i'm
publishing a new video as always stay
happy and healthy
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you