- 4 hours ago
The Pitt
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00:16What's up, Ghost Rider?
00:17You good?
00:18Never better.
00:19Okay, kids, bye-bye time.
00:21Thanks for the trip down memory lane.
00:23Um, where's Evans?
00:24Uh, I think she's by the family room.
00:27She is.
00:28Hey, hey, hey, where are you going?
00:30I'm not going to scan all this by myself.
00:31Cruz has a question on my cellulitis.
00:33I'll be right back.
00:34You better.
00:34Two minutes, tops.
00:35Where's Mel?
00:36Where's Donnie?
00:37They should be helping you.
00:38I don't know.
00:39Okay, day shift.
00:40Listen up.
00:40We're doing really well, but we still got a ways to go,
00:42and nobody's going home until all these paper charts are digitized, including me.
00:46And then we're free to celebrate our freedom?
00:48Exactly.
00:49Well, can you kick some ass and get the staff to hurry up on the EHR homepages?
00:53Where are Larry and Antoine?
00:55Uh, Antoine's fighting on the phone with his girlfriend outside,
00:57and Larry's on a cafeteria run.
01:00Yeah, that tracks.
01:02We've got five patients in beds waiting to be seen.
01:05How do you want to play this?
01:06Man-to-man or zone?
01:07Zone.
01:08Have Cruz and Ellis split up the new five.
01:10You take north and central, I'll take south and from.
01:12Cool.
01:13Want to switch to 1 a.m.?
01:14Why?
01:15Variety's the spice of life.
01:16I thought that was garlic.
01:18Oh.
01:19Sorry.
01:21I told you I'd be fast.
01:23Okay, let's do this and get out of here.
01:25What's the hurry?
01:26Got some hay to pitch?
01:27Uh.
01:29Oh.
01:30Oh, shoot.
01:31What?
01:32Uh, my ID badge is missing.
01:35I don't know.
01:35The one you just got?
01:36How'd you lose it?
01:37I don't know.
01:37It must have come off.
01:38Classic.
01:39Hope you remember your login and password.
01:41Okay, uh, retrace your steps.
01:42What'd you have at last?
01:43Uh, I was with Ogilvy in the ambulance bay.
01:46Out with Colonel Mustard in the library?
01:49Who's...
01:49Yeah, I'm just...
01:50What?
01:50No.
01:52The boy has no clue.
02:00Please don't do that.
02:02Oh, ma'am, I gotta go.
02:03I don't sit here any longer, I'm gonna get bed sores.
02:08I'm supposed to get some, uh, CT results.
02:11Any idea how much longer that's gonna be?
02:14Shouldn't be much longer.
02:16What is that, Nurse Vivi?
02:18You don't want any of that.
02:20No?
02:21No, she's out of your league.
02:22What league do you think I play in?
02:25Uh, old-timers night.
02:27Yeah, you're probably right.
02:29But some teams still appreciate a veteran presence.
02:32Well, don't say I didn't warn you.
02:34You are here for your heart, after all.
02:36My heart's been broken before.
02:38What's one more time?
02:39Uh, she's engaged to a jiu-jitsu instructor.
02:41With a bang, not a whimper, baby.
02:44And it's a cool bath a couple times a day for two days,
02:47followed by aloe vera to your skin.
02:48Okay, that's it?
02:50And, uh, sunscreen in your future.
02:52No, I'm never going outside ever again.
02:55I wouldn't swear off the sun entirely.
02:58You know, but like most things, moderation.
03:01Hey, we're getting kind of short-handed
03:03to get any charts out of here.
03:04When you finish, can you come lend a hand?
03:06Yeah, happy to.
03:09I'm happy to.
03:10I mean, there's nothing I would rather do less.
03:13They keep you pretty busy.
03:16Yeah, and today has brought some new challenges.
03:19Which is really putting a crimp
03:21in my 4th of July evening plans.
03:23You're going to see the fireworks?
03:26Uh, no.
03:27I was going to maybe meet up with this guy.
03:29Though that's sounding less appealing
03:30than the three Bs at this point.
03:33The three Bs?
03:36Look, bath and bed.
03:38College kid with mono and hemorrhagic tonsils.
03:41Submit med surge or observation?
03:43Observation.
03:44Bleeding stop with TXA.
03:45She's had steroids,
03:46so should be ready for discharge in the morning.
03:48Cool.
03:49How was your first shift back?
03:51Uh, slow start.
03:53Finding my rhythm.
03:55You're a little rusty, rusty James.
03:57Now you won't have motorcycle boy
03:59to big brother you.
03:59Is that a Rumblefish reference?
04:01Sure is.
04:02And Robbie is my big brother in this analogy?
04:05Bingo.
04:06Yeah, I wouldn't say he's been
04:07looking out for me exactly.
04:10I can probably prefer not to see me
04:11at all today, actually.
04:13Now you think that's because he's mad at you?
04:17I think he feels like I let him down.
04:20Because I did.
04:21Jesus, with all the martyrs around here.
04:23You think this was a passion play?
04:24That's your take.
04:28I worked with that man for 10 months
04:29while you were gone.
04:30He's not mad at you.
04:32He's mad at himself for failing you,
04:34Rusty James.
04:36Really?
04:38It's just more white night, white noise.
04:40That's how it is.
04:44Let's share with me with your friends if you can.
04:46Thank you so much.
04:47Be kind, be safe, be brave.
04:49What you doing?
04:50That's Robbie.
04:52Sorry, I was just, um...
04:53One of your TikToks?
04:54Yeah, about those.
04:55Listen, I'm not so sure...
04:56I was just, um, sharing that.
04:57No, I get it.
04:58I just, you know, we do have HIPAA laws here.
05:00We don't let anybody fill in the hospital.
05:00I would never violate any HIPAA laws, Dr. Robbie.
05:02I understand.
05:03Even still, we're getting behind on scanning patient charts,
05:05so how about no TikTok on the company clock, Dr. J?
05:09Dr. Robbie, I think you're...
05:11Out of touch?
05:12Probably.
05:13You would be the first to accuse me of it.
05:14However, when I was in medical school...
05:16You didn't have cell phones or TikTok or Internet
05:18or ICE agents coming in here
05:20and taking away patients and staff.
05:24I get it.
05:30We did have cell phones.
05:31Maybe not in the beginning.
05:38Where do you think you're going?
05:39Ah, home.
05:41I kind of need you to hang out a little longer
05:43to help digitize some of these analog patient records.
05:45Normally, I would, truly,
05:47but I got to get home.
05:48Wife, baby, bed.
05:51Okay.
05:51Go get some rest.
05:53You sure you're okay to drive home?
05:54Absolutely.
05:55Just enough in the tank.
05:57Don't tell anybody I let you go.
05:59Deal.
06:00Safe travels.
06:02Be sure to send some pictures from the road.
06:21Fight over at Zazu's sports bar.
06:23The two combatants are pulling up soon.
06:24One's a stabbing.
06:25Ellis, double trauma coming in.
06:26Grab the easy one.
06:27Bring the stabbing to trauma, too.
06:28We will get the room set up.
06:30All right.
06:30Roger.
06:32Okay, darling.
06:34Time for this dinosaur to head to extinction.
06:37You guys are real jammed today.
06:38Can't take you enough, Monica.
06:40A nice place to visit.
06:42Wouldn't want to live here anymore.
06:43Oh, we need this some days.
06:45But hey, Virginia Slim,
06:46you've come a long way.
06:48Glad I was wrong about you.
06:50Keep training them up right.
06:52I'll try.
06:53Okay, that's enough mush.
06:54Back to my life of mahjong and margaritas.
06:57Bye, Evans.
06:57Good help save.
06:58I will.
06:59See ya.
06:59Bye.
07:05She's right.
07:06You are the mama bear glue
07:07that holds this place together.
07:13Hey.
07:15Is you okay?
07:16No.
07:18Sad or scared
07:20or some fucking thing.
07:24I'm worried.
07:25What's going on?
07:28Robbie.
07:28I've got a bad feeling.
07:31It's like I'm never going to see him again after tonight.
07:34He say something?
07:35Yeah, he said a lot of things.
07:36You should talk to him.
07:36He listens to you.
07:37He's a grown-up.
07:38He just needs to go on a vacation.
07:41Can't you at least try?
07:43They get him to promise to come back in one piece.
07:47He doesn't like to listen.
07:49I need him.
07:50I need him.
07:56Fuck it.
07:57Check my DM.
07:58She hit me up.
08:00Sure, baby.
08:00I didn't even respond.
08:02Scavenger hunt?
08:03Yeah.
08:03Something like that.
08:04You need a hand?
08:05Nope.
08:05You do you.
08:08What do we got?
08:10Barrett Dunkle, 34.
08:11Decent vitals given he has old glory jammed in his chest.
08:14Batting 91 on 15 liters.
08:16BP, 132 over 87.
08:18Taki at 112.
08:20I got that.
08:20Respect him on strong.
08:21No, no, no, no, man.
08:23What the fuck?
08:24I'll call you back, babe.
08:28Shit.
08:29I thought I cleared it.
08:30Was it sticking out?
08:31Sticking out my ass.
08:33Man, this is on you.
08:34You went wide and you clipped the city.
08:36Bike shouldn't be parked there.
08:37It was sticking out.
08:39Had to be.
08:39There's no fucking way.
08:41Oh, no.
08:42You're paying for this.
08:43It's you or the city, but you're paying for this.
08:45Seriously, we don't need this hassle.
08:47I know.
08:47I know.
08:47Fuck.
08:48How bad is it?
08:49Not really good.
08:51Bobby Schneider, 32.
08:53Took a beer bottle to the face.
08:5412 centimeter locked.
08:55I'm going to take this thing out of my chest and shove it up your fucking ass.
08:57You hit me with a fucking rolling rock, man.
08:59So you got Iwo Jima.
09:01You fucking cheated, man.
09:02Every detail must be covered.
09:04Sit here, everybody.
09:05Gentlemen, you're on different health journeys now.
09:07I'm going to go see Iman.
09:09It's all going to be on a security video.
09:12This is going to shit.
09:16Okay.
09:18Hey, a little help?
09:19All right, he's going straight to trauma, too.
09:21What is his story?
09:22Vitals to the face.
09:23Strong vitals.
09:2412 centimeter facial act.
09:25Hey, where do you want us?
09:26North 4 just got clean.
09:28Abbott, single MVA on roof.
09:30Five away.
09:31Olive, can you find Robbie and Alashimi?
09:33We may need a couple more hands until we get caught up with these two.
09:36Sir, we are going to get you more pain meds, but you need to shut your fucking mouth.
09:39The acronym is SMART, Single Maintenance and Reliever Therapy.
09:43It's one inhaler that combines an inhaled corticosteroid with a fast-acting, long-lasting beta agonist.
09:49That's fancy talk for an anti-inflammatory and a lung muscle relaxer, all rolled into one.
09:54But it's $400, and without Medicaid.
09:57We can help you look into coverage options.
10:00Of course.
10:01Grady should feel worlds better in a few hours.
10:05So, what are my chances of getting off of the table alive?
10:09Once you're cleared by the heart and lung specialists next week, chances of death are low, like 102%.
10:15And how long would I be in surgery for?
10:18Between three and five hours.
10:21Jeez.
10:22It's long, because they have to stop your heart.
10:27You will be on a heart-lung bypass machine, which will be circulating your blood while they repair the aneurysm
10:34with a graft.
10:35Well, what's the graft made on?
10:38Synthetic fabric called Dacra.
10:40Super strong.
10:42Okay.
10:43New hoses, new gaskets.
10:45Then what happens after surgery?
10:47You will be in the hospital for about a week.
10:49No work for eight weeks after that.
10:51No strenuous activity.
10:53No lifting anything over five pounds.
10:56How am I supposed to take a piss?
11:00Nice.
11:04And how long till I'm back up to full speed?
11:07Three months.
11:08Maybe more like six, given your age.
11:13And if I don't get surgery?
11:1750% chance of death within 12 months if the aneurysm ruptures.
11:22What would I feel if it ruptured?
11:27Some chest pain.
11:29Maybe some shortness of breath for about a minute before you pass down from blood loss.
11:33And then the baby fade out.
11:35Roll the credits.
11:44Quite the coin flip.
11:46No coin flip.
11:47This has to happen.
11:48But I do worry that you are not going to make your appointments or follow your aftercare instructions if I'm
11:53not here.
11:54Sorry, Robbie.
11:55I've had asked for me to grab you for an NBA on route.
12:00Do what you got to do, man.
12:01I got to sit with this for a minute.
12:05You can go ahead and get dressed.
12:08I'll come back.
12:08I'll come back.
12:15I'm coming back.
12:17I'll come back.
12:19I'm coming back.
12:22I'll come back.
12:24See?
12:37Mom, you've got an ICU bed upstairs,
12:39we can take Orlando up now.
12:41The prep room for transfer.
12:43Thanks, huh?
12:44We need this room again in a minute.
12:56all good uh totally ah totally look once more i feel compelled to offer some unasked for and
13:07probably unwanted advice javadi wasn't making a tiktok video she's been posting about jesse
13:14trying to find someone who knows where he is ah and even if she were making one of her videos
13:22you ever watched one no no my account was suspended for erotically seditious content
13:29well they're not what you think they're actually kind of cool it's like this badass self-care
13:36huh okay that is it i'm going to bury myself in charting and try to dig my way out edith
13:41lynch
13:4146 right side of chest pain for an hour no cardiac history minimal relief from sublingual nitro
13:46no stemmy on the 12 leaf dana so that's his team hi edith i'm dr al-hashimi will be taking
13:52care of
13:53me today absent lung sliding on the right i could have told you that from here god bless america
13:59hemo dynamically stable i'll put in a 20 french and then right up to the or wait hold on i
14:04need
14:05surgery sir you have a collapsed lung we need to put a tube in your chest to see how much
14:08internal
14:08bleeding there is oh come on man just pull it out okay everyone knows what to do here right we're
14:15going to take this at a nice slow pace moving together if anyone has an issue speak up there
14:19are a lot of moving parts here well i need going up to icu finally yes great how you doing
14:24is that a
14:26trick question or not intended to be no then not great this one got past me well listen you tried
14:34to find a viable payment plan you tried to keep him here you even tried to give him a goodie
14:37bag
14:38when he left i'm not sure what else you could have done been more persuasive this was the patient's
14:42call his life his mistake what mistake getting diabetes not picking a higher spot to jump from
14:59history of hyperlipidemia an hour of substernal chest pain minimal relief with nitro and four of ms
15:07ekg is negative for stemmy heart score is four gave 324 milligrams of chewable aspirin admit for
15:13new onset angina don't mind me i'm just passing through seems like you wanted an update well as
15:18long as you feel like you got it covered i do go ahead and repeat the 12 lead since i'm
15:23here i did
15:23want to ask you about something i observed early oh you gotta be fucking kidding what look where these
15:28anterior leads are placed they're way too low holy shit what's happening mrs lynch b-tag no pulse
15:36charged to 200 charged and clear
15:44okay normal size strong pulse cycle at bp
15:48let's repeat that ekg please put the leads in the right fucking place
15:52who are the medics on this bosco notaro bosco notaro okay bosco notaro
15:59see you all monday may your night go smoother than my day happy fourth
16:04heard it's been crazy they shut down when ice came separate events get someone else to explain
16:09i'm going home damn what is that that smells good food from home i can't do the cafeteria
16:15oh you got to give me that recipe i'm going home get home safe
16:19mm-hmm
16:23hey hey i'm starving of course i will give you $20 for whatever that smell is
16:29i'll give you some i made too much anyway thank you just give me a sec yeah how can i
16:33help you
16:34my granddad just about cut his hand off with the tug of war well
16:37hi i i remember you from earlier you're having the family reunion right yeah is your hand actively
16:43bleeding oh not so bad here take a look mateo want to come straight back oh my god cover that
16:49up please i'll need to get his demographics from you you got him already handsome he's been in
16:54out of here all day long how did this happen he had the rope wrapped around his hand cut through
16:58it like he was shedding have a six sir take you right back and how would you rate your pain
17:03on a scale from one to ten oh it's not too bad count on my sugars with his diabetes his
17:09sensation's a little off yeah after you thanks ow what the fuck
17:15trigeminal nervous good six you're gonna fix me or torture me
17:21ouch yeah i need to call plastics i called the kiss off the tube off the rail
17:27fucker said i didn't call it but yes it was a bit noisy the fourth of sticks night
17:32but i called it i have witnesses sticks the band yeah love sticks i never heard of them
17:38you never heard of sticks mr ravato nice spotify ages and 62
17:44come sail away lady babe i don't know yeah maybe best if you don't talk
17:51looks like there's some sort of foreign body in there
17:55are you okay yeah it's just an awkward position go home rest heat ice yeah no no i know i'm
18:02just
18:02waiting for things to slow down oh express trains don't stop at your station
18:07you just gotta jump what is that heineken you want to say
18:13what from the glass line tanks of old la trobe ah rolling rock nice
18:25she's had four morphing how's the pain
18:28got into an eight there it is lateral stemmy okay called in
18:32the leads were too low to catch this yes not the first time it's happened you get a male
18:36medic who's more concerned about getting sued or a complaint for undoing a bra to see
18:39these anterior rates here you're having a heart attack from a blockage in the artery that brings
18:44oxygen to your heart so if we get you to the lateral stemmy v-tech arrest got her back after
18:49one shock she has cat left serious heart damage oh my god you're going to be okay hello i'm dr
18:54clues and i'm dr shen how are you feeling i'm really scared hey we've got you anything else
19:00like i got kicked in the chest normal after a shock to the heart family yeah husband's in
19:04root now leave the defib pads on and take her up in a minute i'm gonna check her on a
19:07neural block
19:07real quick go where's dr ellis human she was just here
19:24hello everyone i'm dr shen heard a rumor someone needed a nerve block i'm guessing that's you
19:29probably so although you know i don't have much pain i guess it's my diabetes oh we still need to
19:36numb you up to do proper deep clean you guys do whatever you gotta do yeah three shots menion ulnar
19:43and radial two grams of ansif hundred milligrams of gent for gram negative coverage how do you do this
19:48oh family reunion tug of war i wrapped the rope around my hand for better grip and
19:53when we fell down those bastards just kept pulling dirty that's just just the way we play
20:03michael you got a sec uh not really no well how about showing me a little respect and finding one
20:10sorry caleb are you feeling disrespected uh given that you've been actively blowing me off
20:14all day yeah maybe a little bit but i have a thick skin what can i do for you should
20:21have found
20:21a higher place to jump from it's an interesting diagnosis doctor
20:29no pithy retort yeah i didn't think so uh i just came to say goodbye i'm leaving soon
20:37i know you are too yes keep my number handy just in case huh yes i promise i will thank
20:48you
20:51we're gonna give you one diflucan pill to take home take it in three days if your symptoms persist
20:56how do i get there where's that home do you know where you live of course i do it's not
21:04far but
21:05i don't have a way to get there how'd you get here my my neighbor gwen dropped me off but
21:12she can't drive at night we could call you an uber or a taxi i don't have any money excuse
21:20me
21:21can i help mrs climber has been discharged but has no way home i'm so sorry i don't mean to
21:27be a
21:27burden no burden at all why don't we call you a lift what is that it's like a taxi service
21:34if you put your address in here a car will arrive in a few minutes to bring you home
21:39oh my treat
21:41that's very kind of you truly
21:45okay perfect okay olive could you take mrs climber out to the ambulance bay where florian
21:51will be arriving in six minutes in a white toyota camry you bet thank you
21:56good karma okay oh uh hey relax buddy it's advil no i didn't think you would headache
22:16uh i uh tweaked my back a little lifting that overheated kid i guess i should get used to
22:23playing through the pain again huh you look like you got into shape since i saw you last
22:28didn't peg you as a gym guy oh no i'm more maybe more of a barn guy i'm helping out
22:35a friend on the
22:36farm so nice i'm picturing babe except instead of farmer hoggett it's you and instead of a pig
22:45can you cut the shit
22:48excuse me the sarcasm thing the the the little buddy routine like like like you're what you're
22:54the skipper i'm gilligan dude you're not the skipper i know i'm not the skipper robbie is the
22:59skipper no robbie is the professor dane is the skipper okay somebody's watched a lot of nick at night
23:03so who am i play whatever part you like just don't pick mine for me
23:13okay okay that's fair you got it thank you you had it home
23:22uh no i'm waiting on robbie he asked me to house sit while he's gone so i'm waiting for the
23:27keys the
23:28alarm code nice nice yeah i've uh i've seen this place you're in for a sweet setup cool
23:38i'm sorry if i came across a little strong don't apologize for standing up for yourself
23:43it's a healthy habit
23:48you know i really don't need to see this again that is my favorite part
23:51uh my hand's starting to cramp we got to be done soon
23:55oh you can be done now but if you want the hospital to cover you last one
24:06hey robbie it was an accident man what are you talking about your bike
24:20son of a bitch oh motherfucker
24:27robbie gsw to the head somebody hit my bike dude that sucks
24:31is it still rideable it better be
24:37elbridge jerry 25 stable with good vitals
24:40shooting a 22 caliber pistol in the air with an aluminum pot on his head for protection
24:43didn't work
24:45about a quarter seagram 7 would probably light up a tox screen like a roman candle
24:52real wordsmith
24:53entry one on the frontal scalp seems to have tracked down the forehead
24:56as alert and oriented as you can be after multiple bong hits got vital setting 98 on room air
25:00all right robbie i can't leave i will be right back what's this low velocity dsw the head seems to
25:07remain extracranial lucky guy gloria gloria here's a dollar
25:13after a fireworks explosion resulting in the loss of two fingers
25:19that sounds nasty yeah that was a sad one parents were deported big sister works a full-time job and
25:27is
25:28the sole caregiver been there done that your parents were deported oh no i thought she said
25:33departed did either of you guys work on the uh revolutionary war reenactors earlier why do you
25:41think you could pull off a tricorn hat maybe i've always lived history and uh colonial williamsburg is
25:49my favorite school trip and you know there's always the ren fair but that's that's just once a year
25:55how often do you think the reenactors get together
26:01you should definitely look into that
26:16deep-throated husky with a touch of bits that's her tune that's what i thought but you're the expert i
26:21just need to make sure i was going through billings once cops saw my colors jacked me up
26:29kept me overnight and threw my sweetheart in the impound yard they claimed someone backed into it but
26:36you could see where they took a hammer to it man you gotta be careful out there this is all
26:41pretty
26:41minor though right yeah this is just cosmetic bring it in tomorrow and we'll get bonnie right well this
26:47will bend back this will tighten up i can do all that oh jesus let me do it there's no
26:51charge what
26:51you don't owe me anything except take care of yourself while i'm gone boy this record never stops
26:57huh no it's dance till you drop then what teach the kids the steps before you do and then what
27:04hope
27:05they make it farther than you are you rubbing you coming or going i'm going pretty soon what do you
27:12got
27:17intoxicated no etoh on his breath either syncope seizure or he just fell asleep at the wheel airbag
27:24deployed unconscious at the scene but he's waking up bp 140 over 80 pulse 120 pulse ox 98 no obvious
27:31injuries why don't you guys head on in i'll meet you in a minute
27:38well hey buddy i guess this is it make those appointments next week you know i'll call you
27:43from the road to make sure you do don't do that man what don't shine me on i'm not jesus
27:52i get it hard place to leave harder place to stay
27:59yeah
28:03look i'm not ready to say goodbye yet so go do what you gotta do and i'll get some tools
28:08from
28:09the truck and see if i can't make bonnie smile again for you
28:18okay okay then
28:26robbie man i'm so sorry we've been off for 14 straight i thought i cleared it all right
28:31honestly i feel terrible no real harm done i was bound to naked up on the road anyway first blood
28:36drawn it's a good omen really i thought i'd be more pissed i thought i might get punched
28:42justin belly look good let me drag neurosurgery down here to deal with the c-spline before i go
28:46you off yep an hour ago can you tell how you doing sir actually not too good
28:53uh the singling's getting worse it's in both my arms now i feel like something's wrong hey man what
28:59are we looking at ran into a telephone pole airbag deployed seizure stroke not sure possible c-spine
29:07ct showed unit for set dislocation oh i'm trying not to freak out i'm having trouble breathing squeeze
29:13my hand real hard three out of five strengths okay uh 10 milligrams dexamethasone dexamethasone
29:21for spinal injury it's compression from a jump for set and maybe some ischemia from kink vessel
29:26what's what's happening sir you have a partial dislocation of two vertebra in your neck it's
29:31putting pressure on your spinal cord how do you fix it we need a neurosurgery to screw a clamp
29:37into both sides of your skull and then use traction under x-ray guidance to get everything
29:43realigned like a chiropractic adjustment it's a bit more complicated than that i think i'm having
29:50a panic attack because i can't even get a shallow breath or he's losing c-3-4-5 uh page
29:58neurosurgery
29:58gracie i went to go get them no page overhead find robbie he's still here any available neurosurgeon
30:05to ed trauma one stat any available neurosurgeon to ed trauma one
30:11dr robbie uh yeah you're needed in trauma one okay patient dr langdon's neck injury
30:27i got the fellow they could be down in 15 minutes he's progressing too fast tonight what's going on
30:32you need to set dislocation c4 c5 paresthesia and decreased tidal body that's 85. we need to prepare
30:39for intubation any delay in reduction almost guarantees complete spinal cord injury what are
30:45the options do you have uh i saw neurosurgery do a close reduction once in icu blind that's crazy
30:51risky you gotta do something what's that procedure dr langdon it's just it's traction on the neck you
30:57flex the dislocated side and into slight extension quadriplegia if done wrong i'm sorry what did you
31:01say quadriplegia it is a possibility sir it's also the same possibility if we do nothing you want to try
31:07i've never seen it done you have i can't feel my feet sat 79 100 on our breathing is progressing
31:12dr langdon what is your plan uh neuro this is right here right now this guy's gonna be a living
31:18head
31:18if we do nothing i could paralyze doctor the fuck up sir the partial dislocation of the two vertebrae
31:29in your neck is putting pressure on your spinal cord i can try to move the neck bones back into
31:34place
31:34that could help there's no guarantees if we do nothing the weakness is definitely going to get worse
31:38but either way there's still a chance of paralysis do it please please 50 of fentanyl iv you need to
31:46let us know if the weakness gets worse or if there's any sudden pain and we'll stop immediately
31:50uh dr cruz robbie pull down his shoulders for counter traction okay i'm gonna pull on your head
31:56your job is to try to relax breathe so we can overcome the muscle spasm
32:05flexing to the right
32:09uh any change my legs are starting to tickle last step
32:18i felt something click oh oh talk to us what's going on i think i think
32:28i'm starting to breathe easier any change in your hand or feet oh
32:33how does this baby a little less numb Philadelphia collar is ready talk to me
32:37Langdon just reduced the unifacet cervical dislocation what without neurosurgery don't try this at home
32:43kids he was deteriorating quickly your exam is improving oh my god it's definitely better oh my god
32:51nice job all right repeat ct then neurosurge can take him over a halo brass walls buddy see you haven't
32:58lost it
32:59i'm not excuse me i'm just gonna step outside for a second
33:18Langdon honey i just got a call from upstairs were you supposed to get a urine screen and turn it
33:22in by
33:22tonight fuck um oh no uh uh yeah yes can you can you just can you tell them that i
33:29was under trauma i'm going right now
33:34where's he off to no idea did you find your id badge yet no i've looked everywhere must have
33:43been thrown out on accident they'll issue you a new one you just have to fill out a bunch of
33:46forms oh great
33:53what cow and labor no i i ordered a patient a lift now i have a 250 dollar surcharge and
34:01a complaint
34:02on my account what what would they do it was a sweet old lady who apparently had some racist and
34:08abusive things to say right before puking in the back you never know with some people
34:14who was my first paycheck saint huckleberry no good deed
34:22i can see why you liked restoring this bike you're a fixer i fix bikes but you fix people
34:29that's pretty damn impressive man some people can't be fixed look i'm i've done plenty of things i'm not
34:39proud of yeah me too no bad things hurt people on purpose hurt myself and i did my time but
34:49that
34:49doesn't wash away the regret i wish i'd done things differently i think about it every day
34:58you know they say that it's never too late to change
35:01some things can't be changed like death death can't be changed hey i know the surgery is scary
35:08i'm not talking about me
35:25yeah i don't know if i want to be here anymore
35:30i don't know how you stand 12 minutes in there let alone 12 hours 20 years
35:38no that's the only place i can be i have purpose in there i can be distracted in there
35:46i don't know that i want to be anywhere anymore
35:58so what's the plan
36:03right toward what i don't know away from what everything well that's that's not riding that's
36:10your honor that's your final lesson for these kids
36:20what's up robbie well if it isn't minix bosco notaro
36:28you still on not for much longer i was looking for you two
36:32rita wolcott 22 she was using a dumpster to climb the fire escape to get to a roof party slipped
36:38about
36:38six feet onto concrete possible tim fib fracture can i please tell it you're making me sound like
36:43an idiot my friends and i were just trying to watch the fireworks from the roof of our building but
36:47the roof access door and the stairwell's stuck so we decided to climb the fire escape they were
36:52supposed to hold the dumpster still but they didn't then i fell like i said six feet on the concrete
36:59yeah because they didn't hold it still well it's a good thing she didn't need a 12 lead
37:03why's that because you guys put one on about a half hour to go wrong and mr stemmy oh
37:07shit 46 year old woman minute after you left vtac vpdkg showed a massive lateral stemmy no way
37:14these were so inferior you might as well not put them on at all what were you afraid of her
37:19bra
37:19what have we got got a 22 year old probable tip fib fracture from a six foot fall why don't
37:24you take
37:24her to central 13. got it right this way saying bad data is data maybe she was diaphoretic and they
37:30slid down on root yeah she was moving a lot diaphragm my ass she had big breasts you didn't
37:35want to move them out of the way to get under her bra line come on robbie women are misdiagnosed
37:38for
37:38heart attacks all the time this is a big reason why shall we put it to a vote hey ladies
37:42in the room
37:43show of hands death with modesty or life with brief nudity death or life look at that turns out women
37:50want to live got it ekg is an amazing tool if you use it right you could have told us
37:54in private i think
37:55this was more instructive agreed hey hell of a save your boy made on the fly reduction of a unifacent
38:04cervical dislocation that's some cowboy shit yeah it was where is he ran out for a drug test
38:09got your wish you don't have to say goodbye
38:18hey thank you for saying all that i may have taken a slightly different approach
38:22i seem to have lost my filter i'm glad i could use an honest second opinion on a case
38:28do you have five minutes to spare
38:33sure why not what's the case i have the chart pulled up in eight
38:51i have some experience with this but i'd appreciate a fresh perspective
38:56after 14 hours i don't know how fresh my perspective is but i will give you what i got
39:00well after working with you dr rubinovich i've come to respect your opinion
39:09thank you dr ellis shimi
39:13likewise
39:15okay patient is a 40 year old female with a history of seizure disorder for the past 35 years she
39:20had no
39:20perineal complications and was in excellent health until age five when she had the onset seizure
39:24activity following prolonged illness with viral meningitis her ulcer mental status from the infection
39:29her
39:30i
39:31i
39:31i
39:31i
39:31i
39:39i
39:40i
39:45i
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