- 4 minutes ago
Category
📺
TVTranscript
00:00John started dodging a coming car.
00:03It's then resulted in him actually hit another parker
00:06and landed about five metres away.
00:09When your motorbike stops and you don't stop,
00:11you can have any number of injuries.
00:13Do you want to get something else?
00:14I don't hear.
00:15He cannot feel his legs.
00:17He's going to be out there.
00:18Usually when we see this,
00:19it means that they're going to be a paraplegic.
00:22It's a disaster.
00:23All right, let's go.
00:30Look inside my eyes and help me try to ease the pain.
00:34Do my life, life, time, it's going to be right.
00:41Do my life, life, reach out your hand, take mine.
00:50Very worried for you, my friend.
00:52The Brown's dream smashed to bits.
00:55He's actually stopped breathing.
00:57See ya.
00:59With our intervention, he's likely to die.
01:01That's better.
01:20Royal Melbourne's newest recruit emergency registrar,
01:23Dr. Ruth, is juggling two big life changes.
01:27In the six months that I've been at Royal Melbourne Emergency
01:30Department, I've also got married.
01:33My husband, Jordan, we've been together for over 10 years,
01:37and I wouldn't have been able to do any of it without him.
01:41So I don't like working completely without one of my rings on.
01:44So I've found a necklace that I can wear that will safely hold my wedding band
01:50or my engagement ring while I'm doing anything particularly messy.
01:54No matter how hard the shift is, knowing that I'll be able to go home to Jordan is invaluable.
02:01But today, in a non-stop ED, the honeymoon is over, and the pressure is on.
02:08Royal Melbourne receiving.
02:10An ambulance is minutes away with Dr. Ruth's first case.
02:14I've got a 54-year-old male that's been on a motorbike and it is a witness to strike the
02:20bonnet of an oncoming car.
02:22He has no sensation or movement, sort of distally, or probably his lumbar region.
02:28MBA, deformed wrist, lower limb reflex loss.
02:31When you hear no sensation, no movement in the legs after a motorbike crash, you're very worried about spinal cord
02:37injury.
02:37But there are other things we need to rule out that can be more immediately life-threatening.
02:4254-year-old John was only three minutes from home when a collision with a parked car
02:48catapulted him over the handlebars of his bike.
02:51We think maybe he's got a broken spine and a broken wrist, so who's doing what?
02:57With the countdown to the man's arrival on, it's all hands on deck with Dr. Jonathan taking the lead.
03:03Hi. Come on in.
03:04Hi, John. I'm going to get you over to the bed next door and then we'll all do a lot
03:09of things around you at once.
03:10One, two, three.
03:13John started dodging a coming car. It's then resulted in him actually hitting another parked car.
03:19John, are you ready for that at the moment?
03:21He's then flipped over the top of it and landed about five metres away.
03:25He had significant sternal pain.
03:27From there down, he cannot feel any sensation whatsoever.
03:31This is pretty bad. When your motorbike stops and you don't stop and then strike something,
03:36you can have any number of injuries.
03:38He's got pain in his chest and pain in his back.
03:41John, can you feel me touching both sides?
03:43He can't feel anything from there down.
03:45I've got a really bad feeling that he's got a spinal cord injury.
03:48Can you try to wiggle your toes again for me?
03:51I'm trying.
03:51The team immediately check for any sensation in John's legs.
03:56Do you feel anything here?
03:58Do you feel anything down here?
04:00Do you feel anything down here?
04:01It feels like ice.
04:03John's saying that it feels like ice when his lower legs are touched is suggestive that there is damage to
04:09his spinal cord.
04:10Ready for x-ray when you are.
04:13If he has a really serious spinal injury, he may never fully recover.
04:19He will be a paraplegic.
04:21John, who's your next of kin?
04:24Facing the grim prospect of never walking again, John urgently needs his family.
04:31Our sister, who's that?
04:32Your sister.
04:34It's crucial.
04:35Nurse Eliza tracks them down.
04:43He needs to have his best people by his side immediately because he's terrified because he cannot feel his legs.
04:53I need my brother.
04:54I'm not just the you, please.
04:56You straight away, please.
04:57John shares a close bond with his older brother, Patrick.
05:02John's a pretty amazing person.
05:04He is really kind and giving and patient.
05:10He's the type of person that would give the shirt off his back for someone else.
05:14John is very, very important to me.
05:16You think the worst in these types of situations.
05:20How's the ultrasound, Ruth?
05:21Lungs are good.
05:22The lungs are good.
05:23I think he's got a sternal fracture.
05:24First tests reveal John doesn't have a punctured lung.
05:27But Dr Jonathan is worried his chest pain could be critical.
05:32That's a big problem.
05:33There's many reasons why he'd have pain in his chest.
05:36He could have broken ribs, broken breastbone, but he might have done something even worse.
05:40Are you happy with the chest X-ray or do you want me to do another one?
05:43Powerless as well?
05:44Yeah, yeah.
05:45There's lots of important structures in your chest and it's never good when you've got chest pain in a trauma.
05:51Hmm, what's going on there?
05:53That's not normal.
05:54Like he's got a mass or a hematoma or an aorta or something.
05:58See that?
06:00That's not, that's bad.
06:01The X-ray reveals John's heart is in extreme danger.
06:05That's not good.
06:07Hello.
06:08I'm just going to look at your heart again.
06:10There's a widening around his thoracic spine.
06:12That might be there because he's got a fracture in that area.
06:16But his heart sitting there as well could be damaged.
06:19Your stomach feels sore?
06:21Under the chest?
06:22Under the chest.
06:22I'm looking for fluid or blood around the heart, which will cause him to have a cardiac arrest.
06:28In your chest, is it the middle part?
06:30Or over the chest plate?
06:32Oh yeah, yeah.
06:40Okay.
06:41When Director of Emergency Training Dr Cheung is on shift...
06:45Check out some of the babies.
06:46Hello.
06:46...the nurses know a game of trivia could strike at any time.
06:51It's the talk of emergency.
06:53Really?
06:54I like to keep everyone on their toes.
06:57So I like to imagine the worst case scenario that could happen to the patient.
07:00And if it does, there'll be no surprises.
07:04And today's contestants are nurses Abby and Ruby.
07:09I've got a 60-year-old female who's fainted maybe seven times since last night.
07:13She's got a low blood pressure, but heart rate is pretty quick.
07:16What should we give her?
07:18What's your pain?
07:19Anything else?
07:21Starts with eye.
07:22I think it's a friend of mine.
07:24They knew the answer.
07:30As Dr Cheung's next patient arrives, the questions turn to an injury rarely seen in the ED.
07:38So I've been told that there's a female patient coming who's been transferred from the Middle East
07:45with shrapnel wounds to her face.
07:47So she's relaxed.
07:48The patient, Raneem, is an Australian student who was studying dentistry in the West Bank
07:54when shrapnel from a bullet tore through her eye.
07:58To be honest, I'm still, you know, shocked by the event.
08:02I'm still trying to cope with it.
08:04I feel like I'm seeing, but I'm not.
08:06After unsuccessful eye surgery in Jerusalem, Raneem flew home to Melbourne for further treatment.
08:13How are you feeling?
08:14Are you okay?
08:16I'm still around.
08:17Her mum, Rana, hasn't left her side.
08:26Hello.
08:27Hello.
08:29I'm sure nice to meet you.
08:30I'm one of the doctors here.
08:31How are you going?
08:32Yeah?
08:33It could be better.
08:34Yeah.
08:35I'll come around this way.
08:36Can you tell me what happened?
08:38So I was in my apartment in Abu Dhabi, Jerusalem.
08:42The West Bank site.
08:43Part of the West Bank.
08:44And out of the blue, we heard sound bombs.
08:47Yeah.
08:48My friend, she decided to take a look out the window.
08:52And we got shot at.
08:54The bullet hit the corner of the window.
08:57Mm-hmm.
08:58And her face was covered in blood.
09:01But it wasn't for injuries.
09:03It was actually, the blood was actually coming out of my eye.
09:05The shrapnel.
09:06Yeah, the shrapnel hit my face, my eye, and they did an operation on my eye.
09:10In Jerusalem?
09:12Yeah, to maintain the structure of the globe.
09:15Okay, yep.
09:16I was in contact with the Australian embassy regarding moving to Australia to continue with my treatments.
09:22So they helped me cross the borders from Palestine to Jordan.
09:26Okay, you're falling back from there.
09:28So tell me, have you got vision out of the eye?
09:31The minute I got hit, I lost my...
09:33You've lost vision.
09:34No light, no light.
09:35Nothing.
09:35All right.
09:36So when I look at the eye, it is sunken.
09:38I'm very worried that she will not regain her vision.
09:41Any problem with the facial bones?
09:43No, no fracture?
09:44I do still have shrapnel in my face, so I don't know anything.
09:48That's all right.
09:48You lie back.
09:51Any pain on your cheekbones?
09:53Yeah, yeah, yeah.
09:53This side?
09:54Yeah.
09:54From the shrapnel?
09:55I think it's shrapnel.
09:56Yeah.
09:56A few other things on up there.
09:58Up there too.
09:59Just that I don't feel the side of my head.
10:01Okay.
10:01She tells me that she can't feel the side of her head.
10:04I'm worried that it's going to be permanent nerve damage.
10:07Also, there's potential for the shrapnel to penetrate the skull.
10:11If there's shrapnel in the brain, operating on the shrapnel could potentially kill her.
10:15We'll do another scan.
10:17In particular, we want to see where these shrapnels are in relation to the skull.
10:22So it must have knocked the nerve.
10:24Anyway, the scan will tell us where they are.
10:27Any questions?
10:28Rana is fearful her daughter may lose her eye completely.
10:33The most important thing is that, you know, she has hope to save her eye.
10:40Yeah.
10:41So I'll speak to the eye surgeons.
10:44This is the most important thing that, you know, she has.
10:48Anyway, we'll go slow, all right?
10:52I don't want to give you false hope, okay?
11:02The most important thing that, you know, she has hope to save her eye.
11:09Yeah.
11:09Dentistry student Raneem has lost vision in her right eye after a bullet hit the window of
11:16her apartment in the Middle East, pelting her with shrapnel.
11:20So I'll speak to the eye surgeons.
11:23After eye surgery in Jerusalem failed, she's desperate to know if Dr. Cheung can save her eye.
11:31Not sure.
11:33Okay.
11:34All right.
11:34Okay.
11:40So I have to speak to the eye surgeons.
11:42I don't think she'll be able to ever see out of that eye again.
11:44So the next step now is whether she can preserve her eye.
11:49And then there is a patch of numbness to the right side of the skull.
11:53Could be that one of the shrapnels severed the nerve.
12:01Still in shock from her daughter's ordeal, Rana was at home in Melbourne when family broke the news.
12:10At first we didn't know it's a bullet.
12:14It was really, really a very horrific moment to hear.
12:19I have never imagined that her injury was so severe.
12:25I think we should give a formal history handover.
12:27Neurosurgeon Dr. Mohammed's expertise is needed.
12:31I'm assuming at the moment, can you see our type of eye or not?
12:34No.
12:35Nothing at all.
12:35Anywhere else?
12:36You have a shrapnel?
12:36I think I've got one in my ear, but it's really small.
12:39But it's just when I, you know, kind of like touch it, I feel it's dead.
12:43Yeah.
12:44Okay.
12:44All right.
12:45Well, we'll get you a CT scan.
12:46Let's see what's going on first.
12:47You can take a minute.
12:50The team act quickly to get Ranaim scanned.
12:53Oh, yeah.
12:54CT is fine.
12:55Oh, yeah.
12:55She will have a CT scan now, which will identify all the metal fragments,
13:00how deep they are, how extensive they are,
13:02or whether there's any shrapnel inside her head
13:04or any neurological injuries,
13:06that may be something that we need to deal with.
13:08See you soon, all right?
13:10She's a dental student.
13:11She may not be able to go back to studying dentistry.
13:15This is an extremely significant, life-changing injury for her.
13:27As the day wears on in the emergency department,
13:31case numbers continue to climb.
13:33Royal Melbourne receiving.
13:35Good afternoon, Royal Melbourne.
13:37This is a patient with a left shoulder dislocation.
13:40We've had quite a delay in extricating this patient
13:43as he was under a house.
13:44He has a very altered sensation through his left hand
13:47with reduced sensation in fingertips.
13:51With the patient's arrival imminent,
13:54emergency doctor Manny springs into action.
13:58We know very little about the story at the moment
14:00other than he's been found underneath a house
14:02and the ambulance crew think that he has dislocated his shoulder.
14:06There can be potentially serious injuries
14:08and they're definitely extremely painful.
14:1129-year-old Radisson, an apprentice electrician,
14:14was working under a house when he reached back to grab a cable
14:18and felt his shoulder pop.
14:21He was trapped for an hour
14:23as fireys removed bricks to get him out.
14:26Couldn't have happened in a worse place.
14:30Hey, guys. Radisson?
14:31Hi, Radisson. My name's Manny.
14:33I'm one of the emergency doctors.
14:35I'll let my ambulance colleagues here get you across
14:37and then we'll hear the story.
14:38Every movement the young Sparky makes
14:41causes him excruciating pain.
14:44So this is Radisson.
14:45This is his fifth dislocation.
14:47Right, so are you happy considering this is already pretty much cut
14:49if I cut the rest of the shirt off?
14:50Yeah, it's a lot of work shit.
14:51He's also got some numbness and tingling in his fingers.
14:54Yeah, looking at his sort of left hand.
14:56Fifth and fifth blue.
14:57And he's had 7.5 of IV morphine.
15:00And the ambulance is concerned
15:02not just with the altered sensation in the patient's hand
15:05but also the fact that it's changing colour.
15:07There may be damage on one of the major arteries in the armpit,
15:09which is a medical emergency.
15:11Can you feel me touching on the outside of that hand?
15:14Yeah.
15:14And on the inside?
15:15Less so, yeah.
15:16Less so along the thumb.
15:17Yeah.
15:18How about just around the shoulder?
15:19Very dull.
15:19So it's very dull around there.
15:22You've clearly got an off-ended shoulder.
15:24The things that we're worried about sometimes when shoulders come out
15:27is not just the bony injury,
15:28but sometimes it can also stretch nerves around the shoulder joint,
15:31which is why you're still a little bit numb over there.
15:34So I think we should just crack ahead,
15:35get that shoulder back in in the next row
15:37and see what we're dealing with.
15:38After five shoulder dislocations,
15:41this is a procedure the young Sparky knows well.
15:45I think given your past experience,
15:47probably just go straight to sedation.
15:49My priority in this situation
15:51is to get the shoulder joint back into its normal place
15:53as soon as possible.
15:55And certainly giving a sedative anaesthetic
15:57does help us make this experience a little bit better for him.
16:01I'm going to get one of my colleagues to assist me with that.
16:04Any questions about that at all?
16:05No. Oh, I do have...
16:07Oh, here we go.
16:07It's in my pocket.
16:08Pliers, OK.
16:10I don't know if you guys need any.
16:11We're not going to need it to put the shoulder back in.
16:14Good on you, no worries.
16:15With Radisson on board with the plan,
16:18emergency nurses Georgia and Chris
16:20gather the proper tools for the job.
16:23Radisson, what are you going to do?
16:24Start giving you some oxygen before we put you off to sleep.
16:27Yep.
16:27Dr Scott arrives to help with sedation.
16:30Hi, mate, I'm Scott.
16:32Hi, mate.
16:33Have you had a general anaesthetic before?
16:35Yeah, first time we were in the hospital,
16:36they gave me something.
16:37Mm-hmm.
16:37Put me under.
16:38Yep.
16:38I don't remember it.
16:39That's OK.
16:40That's probably a good thing.
16:41They were surprised at so much.
16:43OK.
16:43There are risks of any sort of anaesthetic.
16:46We want to find a sweet spot where they're asleep enough
16:49that they're not aware of the procedure
16:51and they're not suffering any discomfort.
16:53They're giving more medication.
16:54It can increase the risk of side effects.
16:57In a lot of cases, it'll make them stop breathing.
16:59All right, no objections to a starting.
17:02This is a high-risk procedure
17:04and the team must follow a strict protocol.
17:08So we'll just run through the checklist.
17:09So departments, airway doctor, airway nurse, proceduralist, scribe.
17:15All right, so I'm going to give 50 of propofol to start
17:18and we'll work up from there.
17:25Have you got feeling in your fingers or not?
17:27Yeah, you can move them.
17:28Yeah.
17:29I'm just going to look at your heart again.
17:30An horrific motorbike accident has left John paralysed from the waist down.
17:37Yeah, I've got a good view of his heart.
17:38But an X-ray has led Dr. Jonathan to a potentially bigger problem,
17:43a life-threatening injury to John's heart.
17:46With the ultrasound, we're looking for fluid or blood around the heart.
17:50So that's really serious.
17:52Just take the blood to see.
17:58That's perfect.
17:59That looks fine.
18:00So I don't see a big aorta.
18:03So maybe that's something else.
18:04Yeah.
18:05You're doing well, Nick.
18:06So I do the ultrasound and there's no fluid around the heart, which is great.
18:10And just confirming still loss of sensation.
18:12But for Dr. Jonathan, the relief is short-lived.
18:16We're going to have to turn to the real problem, which is why John can't move his legs.
18:20We're going to roll you on your side.
18:22Just want to have a feel down your back and see where it hurts.
18:25What I think I saw in that X-ray is a fracture.
18:27It's a bad one.
18:28If you hang on to your sore hand, all right?
18:31Oh, wow.
18:32Because his spinal cord's going to be injured probably around that area.
18:35One, two, three.
18:38John, is there any pain where I'm pushing?
18:40No.
18:41No?
18:41Any pain down here?
18:43No.
18:44What about down here?
18:45Yeah.
18:46Yeah?
18:46Yeah.
18:47Yeah.
18:48What is that?
18:48This is upper thoracic.
18:51Yeah.
18:52Oh, fuck.
18:53Fuck.
18:54Where the X-ray looks funny.
18:56Yeah.
18:56Can you feel me touching down here?
18:58Near your bottom?
19:00Oh.
19:00Nothing?
19:01He's now tender in his spine as well as not moving his legs.
19:04They are the classic signs of a spinal injury.
19:06Three, two, one.
19:09Terrified, he still has no feeling in his lower back.
19:12Well, I need my brother or my sister, you please.
19:15John urgently needs the support of his family, who are on their way.
19:20Hello.
19:20How are you feeling?
19:21You're not moving your legs.
19:23Is that right?
19:23They don't move?
19:24Yeah.
19:24Yeah.
19:25So we're going to get a scan and have a look and see what's going on, all right?
19:29Yeah.
19:30I'm going to go to the door.
19:31Well, we're going to try and work that out.
19:33Um, do you have any, can you move them at all or not?
19:39I'm trying.
19:40Yeah.
19:41Yeah.
19:41All right.
19:41They've sort of all gone numb.
19:43Yeah.
19:43Okay.
19:48The main thing here is going to be that he can't move his legs properly, and that's
19:52the devastating injury.
19:53We can fix rib fractures and sternal fractures, but we can't fix spinal cord injuries.
19:57We've got high likelihood of a spinal fracture, but not everyone has a permanent injury.
20:02Some people have an incomplete injury, and some people actually recover, so we don't
20:07actually know what's going to happen.
20:09There's always hope.
20:10All right.
20:11Let's go.
20:2120-year-old Ranim has just been scanned to see if shrapnel from a bullet is dangerously
20:28close to her brain.
20:30If there's shrapnel in the skull, there's also a potential risk of the shrapnel breaking
20:34through the skull into the brain, so I'm hoping that there is no permanent brain injury.
20:39And also, the CT will show me whether she's going to lose vision in her eye completely.
20:44When the shooting happened, Ranim was studying in the West Bank.
20:48Unable to get the treatment she urgently needed, Ranim was evacuated to Melbourne in a desperate
20:54bid to save her eye.
20:57Oh.
20:58As radiologists review her scans, emergency nurse Emma tackles Ranim's other injuries.
21:05I'll just get the sutures out.
21:06Is it going to hurt?
21:08Look, I don't think so.
21:10It's just the skin's sort of grown over them a little bit.
21:16Ranim, she's a very brave girl.
21:20My biggest worry that the doctors will say, yeah, no, we can't save her eye, and how this
21:29will leave an impact on her life.
21:32I'll pop a little dress in here.
21:38The final report on Ranim's CT paints a confronting picture.
21:43I've been working in emergency for over 20 years, and no, I've not seen an injury like
21:49this, not in Australia.
21:51You can see more shrapnel on the nose, on the cheek, and that's on the side of her scalp.
21:57There is so much shrapnel everywhere, in the eye, in the face.
22:00It's just catastrophic how much this weapon has caused these sort of effects on the body.
22:06That one's pretty close to the skull, but I don't think it's gone past the skull, so she
22:11hasn't got a broken skull.
22:12If the shrapnel had gone a couple of centimetres further into the brain, you could have died.
22:18This is the main concern.
22:20There's a large piece of shrapnel lodged within the right eye itself.
22:24That's the end of the eye.
22:27Might have to give her a prosthetic eye.
22:31Dr Chung must now deliver the shattering news.
22:35Now, the thing with the eye, I don't think we'll be able to preserve their sight.
22:43Well, I'll speak to them about the eye itself, but I think the vision itself could be lost.
22:49There goes my life.
23:01So it's a long journey for her from here.
23:03She's going to go up to the ward, and she's going to be seen by multiple surgical units.
23:08So for her, the immediate question is, do we have to take the eye out?
23:13And then shrapnel on the rest of the body, it's almost impossible to remove every piece
23:17of shrapnel.
23:18There'll be a piece of metal in her for the rest of her life.
23:21A daily constant reminder of what happened to her.
23:24I thought I'd be honest with you.
23:26But we'll see about the eye itself.
23:29She has a dream to become a dentist, like her mother.
23:33But unfortunately, with the vision loss, I doubt that she will be able to.
23:37So this is a great tragedy.
23:41Raneem's hopes of keeping her eye now lie in the hands of eye surgeons.
23:47I'm thankful that I'm with my family.
23:51But it still does break my heart that my eye, my dreams, my vision,
23:59they didn't come along with the trips, sadly, you know.
24:03You know, yeah.
24:18How are you doing there, Addison?
24:21We'll try and get on top of that as best we can,
24:22but hopefully we'll have you nice and sleepy fairly soon.
24:25Hopefully.
24:25Dr. Manny and Dr. Scott are about to sedate Addison
24:29so they can quickly relocate his shoulder.
24:32What are you doing?
24:33It's always busy here.
24:35It's amazing how you're thinking about us right now.
24:37Yeah, I'm thinking about that.
24:39The young Sparky's hand is tingling and turning blue,
24:43suggesting a bigger threat.
24:45I'm going to give 50 of propofol to start.
24:47We're worried about a nerve injury or a vessel injury.
24:49The safest and most appropriate thing is putting them to sleep
24:51and get the joint back into place as quick as possible
24:54to avoid that injury from progressing.
24:56This one sometimes stings a little bit as it goes in.
24:59Dr. Scott gives the first dose of the powerful sedative.
25:05Just try and keep your eyes open for us as long as you can.
25:08It doesn't work instantly.
25:15All the secrets come out now.
25:19Mate, there's nothing left to give, mate.
25:23With the propofol, we'd usually give it in small doses.
25:26In this circumstance,
25:27we still haven't quite got the effect that we want.
25:29We often end up with a patient in what we call the twilight zone
25:32where they're not quite asleep.
25:34We might need to think about reaching for a second vial.
25:37I'm going to give another 50 of propofol.
25:39This is going to ruin my D&D painting session.
25:43Or make it.
25:45Well, we'll try not to keep you here too long.
25:47But Radisson's worry about his D&D painting
25:49has left the doctors totally bamboozled.
25:53What was the D&D plan, do you know?
25:56It was the first we're hearing of it.
25:5840K plans.
25:5940K?
26:00What's that?
26:01I don't know.
26:03Young people.
26:04Oh, Warhammer.
26:06I don't know young people things anymore.
26:08Warhammer's been around for years.
26:12But Radisson's off-the-wall chat
26:14is nothing new to Nurse Kreese.
26:17You were not a nerd in school?
26:18That's 50 in.
26:20I was, but in a different way.
26:22Different kind of nerd.
26:23Warhammer 40K is a tabletop game with miniature figurines.
26:26Dr Scott and Manny don't seem to have an idea
26:28of what we're talking about,
26:29but Radisson and I,
26:30I know that we're speaking the same language.
26:33Happy if we try to lifelight?
26:35Yeah, go for it.
26:38Still with us there?
26:40With the sedation kicking in,
26:41the team make an attempt
26:43to get Radisson's shoulder back into place.
26:46Do you need anything from me?
26:48Not at the moment.
26:52I think I'm going to need more sedation from you.
26:55In fact, quite a lot.
26:56You're OK, man.
26:58Just trying to get that arm into a better spot, OK?
27:01With Radisson's shoulder still not in place...
27:04I'll just get the traction on.
27:06Oh, no.
27:07Dr Scott gives more sedation
27:09so Dr Manny can try again.
27:11So, George, I'm going to give you another 50.
27:14So it'll be 250 so far.
27:17Oh, no.
27:19Oh.
27:20You're OK, man.
27:22He's still resisting me quite a bit here, Scott.
27:24Yeah.
27:27Oh.
27:29Radisson has had a really high dose
27:31of sedative medication.
27:32We do run the higher risk
27:34of causing problems with breathing
27:36and still getting a little bit of resistance.
27:38But I'm desperately hoping
27:40that we're successful with this attempt.
27:42Oh.
27:47There you go.
27:50Oh.
27:51All done, mate.
27:52Finally, Radisson's shoulder is back in place.
27:56So this is usually the risky part.
27:58But now there's potentially an even bigger problem.
28:02So once we've stopped giving him a painful stimulus,
28:04all that anaesthetic catches up to them,
28:07so they often stop breathing now.
28:09This is exactly what happened.
28:10Radisson, big breaths for us, mate.
28:12Usually we can tolerate about 30 seconds
28:14of a patient not breathing.
28:15Anything beyond that,
28:16the oxygen levels can drop very, very quickly.
28:18We might need to hook them up to a ventilator
28:20to support their breathing.
28:22Big breaths.
28:23Big breaths.
28:24Take some deep breaths for us.
28:2629-year-old tradie Radisson is not breathing.
28:30Radisson.
28:31After he was heavily sedated,
28:33so Dr. Manny could pull his dislocated shoulder
28:36back into place.
28:38I'm just going to go bed down, Chris.
28:39Yep.
28:40Radisson, big breaths, mate.
28:42Come on.
28:42All done.
28:43If he doesn't start breathing within 30 seconds,
28:46the team will need to take urgent action
28:48and put him on a ventilator.
28:51Hey, Radisson.
28:52Open your eyes for us.
28:53All done.
28:54Take some nice, big breaths, yeah?
28:57There you go.
28:57Big breaths for us.
28:58Well done.
28:59Back we go.
29:00Still got a pulse.
29:01We can rotate.
29:02Yep.
29:03Once he's starting to show signs of breathing on his own,
29:05it's usually a sign that the anaesthetic's wearing off
29:07and that we're out of the danger zone.
29:09Hey, Radisson, open your eyes.
29:11It's all finished.
29:12You're slowly waking up.
29:13It all went really, really well.
29:15We're just going to get an X-ray now
29:16and make sure that it's all good.
29:18OK.
29:19Thanks, Manny.
29:19We're going to head around for X-ray now.
29:22I hear if you get to 10 dislocations, you get a superpower.
29:26Well...
29:27The X-ray will show if Radisson's shoulder
29:30is in exactly the right spot and there's no nerve damage.
29:34If you hold nice and still, we'll take that first picture, OK?
29:37Yep.
29:37With Radisson all smiles,
29:40Dr Manny can finally see if the procedure has worked.
29:44We've got the shoulder successfully back in position.
29:47Very happy with that.
29:48We'll get him home shortly.
29:51Hey, Radisson.
29:52Hey, mate.
29:52How's the hand feeling?
29:54Better.
29:55Better?
29:55Basically, it looks like everything's OK.
29:57It's back in position.
29:58What we'll do is we'll move you to our rapid-stay area
30:00just to keep an eye on you for another half hour or so
30:02and I'll organise your discharge paperwork, OK?
30:05Thanks, Manny.
30:05But before Radisson can leave,
30:07Dr Manny is curious about Radisson's mysterious D&D plans.
30:12What do you remember about what you may have told to us
30:14while you were under?
30:16What did I say?
30:17Something D.
30:18Oh, you know, Dungeons & Dragons.
30:20Dungeons & Dragons.
30:21Thank you very much.
30:22At the end of the work today,
30:23I was going to meet up with, like, five friends of mine
30:26and paint our little miniatures.
30:28Luckily, I paint with the right hand,
30:30so hopefully I can keep a steady hand today.
30:32It should be fine.
30:34Pleasure. See you.
30:45John, we're going to do the rolly thing again, OK?
30:48Where you stay still and we move you, OK?
30:51Just on to the CT scan event.
30:53A motorbike accident has left 54-year-old John
30:56with potentially devastating injuries.
30:59Will I be able to walk again?
31:01We'll see from the scans.
31:03Don't think about that now.
31:04We don't know.
31:04We need to get the scan and we'll find out, OK?
31:07John is starting to realise the gravity
31:10of the injuries he might have.
31:12It's hard to know the best way to answer these questions
31:14when I don't have all the answers.
31:17John, I'm just about to start that injection.
31:19Warm feeling coming.
31:31It's got a big hematoma and a fracture, hasn't it?
31:34Yeah.
31:35Yeah.
31:37What's impacted?
31:39Well, I don't know what memory it is,
31:40but it's probably T2 or something like that.
31:43Yeah.
31:43Let's see.
31:45So he's got a fracture.
31:46It looks like where we saw it on the plane film.
31:48So high up in his thoracic spine.
31:50Looks like the bone's shattered.
31:52And that would explain why he's not moving his legs.
31:55One, two, three.
31:57Down, two, three.
31:59Oh.
32:00On three.
32:00One, two, three.
32:01Exactly.
32:02Oh.
32:02Good job, John.
32:04As John is taken back to the trauma bay,
32:07Dr. Jonathan stays behind,
32:09waiting for the specialists
32:10to confirm just how badly John's spine is injured.
32:17Did my back break when I fell down?
32:20Yeah.
32:20Yeah.
32:21Yeah.
32:22It's been bad news.
32:23It's not great.
32:25It's not great.
32:25But we'll know more what they can do about it
32:27when their specialists have had a look,
32:28and they'll come soon, OK?
32:33Not necessarily.
32:35Don't think about it now.
32:36We'll know more in a bit, OK?
32:40I'm going to see my face back, buddy.
32:42Yeah.
32:43She's coming.
32:44As we get more and more of the results of the scans,
32:47it's hard to work out what to tell John.
32:51We can't know what the injuries are for certain.
32:54So until that, there is still hope
32:56that these injuries aren't as serious as they seem.
33:10We'll see what the rest of the film looks like.
33:1654-year-old John has survived an horrific motorbike accident
33:20that has left him with a fractured spine.
33:23To find out if he'll ever walk again,
33:26Dr Jonathan has called in specialists to review the CT scans.
33:30Is there a bit in the spine?
33:32Yeah, so he's just got a burst fracture,
33:34this bit of bone that's just sticking into the canal.
33:36Into the canal.
33:37The whole thing's disrupted.
33:39Yeah.
33:39Yeah.
33:40Usually when we see this,
33:41it means that the person's not going to be walking again,
33:44they're going to be a paraplegic.
33:45This is something that we can't fix.
33:48It's a devastating thing.
33:49What else can I say?
34:01John, I've had a look.
34:03You do have a really bad fracture in your T4 vertebrae,
34:09so about sort of this level in the back.
34:11Your legs, they're not working now,
34:13and that's probably because your spinal cord's been damaged.
34:17Living in your leg.
34:19I'm worried that you won't walk again, from what I'm seeing.
34:22Is that bad, Dr Jonathan?
34:23Yeah, it's bad.
34:24That's why you're not moving your legs.
34:27All right?
34:28Yeah.
34:29Yeah, I'm sorry.
34:30That's what we're worried about.
34:32Yeah.
34:33All right.
34:38Oh, it's awful.
34:39I mean, you know,
34:40we have to give bad news very often,
34:43and unfortunately,
34:45that's what happens in emergency.
34:47John?
34:48John's older brother, Patrick...
34:50Patrick here!
34:52..and sister, Roselle, finally arrive.
34:55Very good to see you.
34:57Well, hopefully God will be able to see me here.
35:00You know, we're praying for you to storm in heaven.
35:03There's a whole team now that will look after John.
35:06He'll go to intensive care.
35:08The surgeons will decide whether he needs an operation or not,
35:11and then he'll usually go to one of the spinal units
35:14to be looked after there.
35:28I'm just going to take a little break.
35:30As one of only five nurse practitioners in the ED,
35:34Nurse Meredith's specialist skills are often in high demand.
35:37Oh, hello.
35:40How are we?
35:42An emergency nurse practitioner is a nurse
35:45who has had a number of years' experience
35:48in the emergency specialty and a master's degree.
35:52That means we can actually independently
35:54diagnose illnesses and conditions.
35:58I do sometimes, you know, give my little family a call.
36:02Nurse Meredith juggles her fast-paced job with being a mum.
36:06Yeah, so this is Eleanor, our daughter's six,
36:10daddy and daughter.
36:12She loves performing.
36:17Nurse Meredith is urgently called back to the ED.
36:21Two hours of sleep.
36:23Oh, you poor thing.
36:24Oh, you literally just flew back in.
36:25Yeah.
36:2626-year-old Brianna has rushed to the ED
36:29straight from the airport
36:31after cutting short an overseas holiday with mates.
36:34So, what's happened?
36:36Oh, I got bitten by a dog.
36:39Oh, dear.
36:40OK, Vietnam, sure.
36:42And where was the bite?
36:43Yeah, OK.
36:45It's not too bad.
36:47Sure, sure.
36:48But they obviously got their teeth in.
36:50We don't know that that was a rabid dog,
36:52but we're going to assume that it was.
36:53This bite wound we would consider as a Category 3 exposure,
36:57which means it's the highest risk.
36:59So, even though this looks like such a small, innocent wound,
37:02if Brianna were to develop rabies,
37:06unfortunately, her chances of survival would be pretty much zero.
37:09So, did you sort of get attention immediately for the bite?
37:14No, I went to sleep, so I was a bit drunk.
37:16Yeah.
37:17And then it was, like, bleeding, but I just kind of covered it up.
37:19Had you had a rabies vaccine in the past?
37:23Knowing rabies can be fatal,
37:25Nurse Meredith needs to quickly understand
37:27how at risk Brianna is.
37:30In 2019, but I don't know.
37:32OK.
37:32I don't think I had the full amount.
37:34I'm going to go and do a bit of hunting around on the computer
37:37and see what I can find about your vaccine record
37:39and sort of see what we need to do in terms of treatment
37:42to stop you from getting rabies.
37:44All right.
37:47While Nurse Meredith goes in search of her health records,
37:51Brianna's own research has sent her into a spiral of anxiety.
37:56I didn't know much about rabies at all.
37:59I didn't get vaccinated for it before Vietnam.
38:02My worst fear is, I guess, I could die from it.
38:09It's deadly, yes.
38:11Nurse Meredith is worried 26-year-old Brianna
38:14could have contracted the fatal virus rabies
38:17after she was bitten by a dog while on holiday in Vietnam.
38:22Brianna's come back early from her trip
38:24to make sure that she can get the right treatment
38:26and it's a Category 3, it's a high-risk exposure.
38:30Nurse Meredith is urgently checking Brianna's vaccination record.
38:34So she has her My Health record activated.
38:38To be fully protected against the virus,
38:41Brianna needs to have had three rabies shots.
38:43And I can see she's actually had one...
38:48..two...
38:51..three doses.
38:53So she's actually had a full course, which is great.
38:55Armed with all the information,
38:57Nurse Meredith updates a very anxious and sleep-deprived Brianna.
39:02Oh, poor thing.
39:03Hello. Sorry.
39:05It's good news.
39:06I've checked...
39:06I managed to check your vaccination record.
39:08So you did have the full course.
39:10You had three rabies vaccines in 2019.
39:13So all you need is one more vaccine today...
39:16Wow.
39:16..and then you're actually good.
39:18Yeah.
39:18So you'll be well-protected.
39:19So we'll grab that for you now.
39:21And that's done.
39:22Yeah.
39:22Awesome.
39:23Yeah.
39:23So I can really understand Brianna's anxiety today.
39:26This is a really scary thing to have happen
39:28and we see a lot of people returning from their travels.
39:32And even if they've sought the treatment that they should,
39:34there's still that unknown
39:35and there's still that fear
39:37that something bad's really going to happen.
39:39All right.
39:40Try and relax your arm as best as you can.
39:43Okay.
39:44Sharp scratch.
39:45Emergency nurse Rob gives Brianna the booster.
39:49The one vaccine I didn't bother to do this time round
39:53and I got bitten by a dog,
39:55but it looks like the 2019 one got me, saved me,
40:00pulled me through.
40:01Very happy.
40:02Very relieved.
40:03Have a good night's sleep tonight.
40:13Apprentice Sparky Radisson was rushed to the ED
40:16after he became trapped under a house
40:18with a dislocated shoulder.
40:20Couldn't have happened in a worse place.
40:22Fearing the 29-year-old's dislocation
40:24had caused nerve damage,
40:26Dr. Manny and Dr. Scott sedated him
40:29to rapidly relocate his shoulder.
40:32Okay.
40:33After a short stay in hospital,
40:34Radisson was discharged in time to make it
40:37to his Dungeons & Dragons painting session.
40:41Australian student Raneem
40:42was left with extensive shrapnel wounds
40:45after a bullet hit the window
40:47of her student accommodation in the West Bank.
40:50Have you got vision out of the eye?
40:52The minute I got hit, I...
40:54You've lost vision.
40:55CT scans confirmed the 20-year-old
40:58would never regain vision to her right eye.
41:01But questions remained about whether her eyeball
41:04could be saved.
41:05I'd have to give her a prosthetic eye.
41:10After multiple surgeries to remove shrapnel
41:13from Raneem's face, neck and chest,
41:15surgeons turned their attention to her eye.
41:19Before, I used to be actually a lot faster,
41:21but now, because of the vision thing,
41:24sometimes I just poke it in,
41:25and it just doesn't land where it's supposed to.
41:27The most impactful surgery was the removal of my eye.
41:30There was a piece of shrapnel 2.9 millimetres long.
41:35It basically cut my eye in half.
41:37So they just took out the whole thing.
41:41Here's the thing.
41:42Now they have got both offers,
41:45one at Griffith University and one at Melbourne University.
41:48It's not an easy decision.
41:50Now recovering at home with the support of her mum, Rana,
41:54Raneem, is focused on her future.
41:57My main objective, which is to be a dentist,
41:59that's not going to change.
42:01If I'm going to be like, this is too hard for me,
42:04I've admitted that I have been defeated,
42:06and I'm not going to do that, no matter what.
42:09I'm not going to let it define me.
42:11I'd like to thank everyone
42:13who has helped me throughout this journey.
42:1654-year-old John was rushed to the ED
42:19after an horrific motorbike accident
42:21left him unable to move his legs.
42:24You still me touching the opening up?
42:26Nothing.
42:27CT scans confirmed a fracture to John's spine
42:30had damaged his spinal cord,
42:33leaving doctors doubting he would ever walk again.
42:36I'm worried that you won't walk again, from what I'm seeing.
42:39Is that bad, Dr. Is it?
42:40Yeah, it's bad.
42:42After spinal surgery,
42:43doctors could finally confirm
42:45the true extent of John's injury.
42:48Hi, John. How are you?
42:49Hi, Paulina. How are you, darling?
42:51I'm good.
42:52Oh, that's good.
42:52I'm ready to get it in my chair.
42:54All right, lovely.
42:55I remember the doctor's face
42:58coming to tell me,
42:59sorry, John,
43:00but you've got about a 3% chance to walk again.
43:04That's when I knew that I'd be in the wheelchair
43:05for the rest of my life.
43:08How's that?
43:08Good?
43:09Yeah, how are you feeling?
43:10Yeah, good, darling.
43:11In one way,
43:13I do thank my lucky stars
43:15because I guess it could have been lights out.
43:19Despite the months of rehab ahead,
43:22John is determined to live his life to the full.
43:25I'm blessed, really.
43:26They have such a beautiful family.
43:28They do love me.
43:29I'm a paraplegic now.
43:31More than ever,
43:32it's important to have that support.
43:34There's not too many bad days in rehab,
43:36I'll be honest,
43:37because the people in the front line,
43:39such as the nurses,
43:40incredible.
43:41They've given me the confidence
43:44and the encouragement
43:44to be able to get out in the public
43:46on my own
43:47so I can do most things
43:49most able people can do.
43:51Hey, Daryl.
43:52Hey, John, how's it going?
43:53Yeah, good, Daryl.
43:54Yourself?
43:55Yeah, good.
43:56I won't be dead anyway.
43:58I had to come off, mate.
43:59It's bloody hot.
44:00Yeah, you look 10 years old now.
44:01I feel 10 years old.
44:03But you missed a bit.
44:04You have a whole life
44:05after an injury like this.
44:06It's going to be OK.
44:08And I want to make the most of my new life.
44:10I'm not going to let this get me down.
44:13That's not me.
Comments