- 3 minutes ago
The.Pitt.S02E05.540p.X265.AAC [Full Movie] [Watch Free Online]Full EP - Full
Category
🎥
Short filmTranscript
00:14Robby yeah cellulitis on the dorsum of the foot now spreading up the leg
00:20hello I'm dr. Robby what if I take a look how long do you think this is gonna take I
00:25took an
00:26early lunch break I don't know that you're gonna make it back to work today erythema and warmth
00:32halfway up her knee when did you see you donnie he didn't I did when about four hours ago I
00:38gave
00:38her a dose of cat flex told her come back if things got worse things have definitely gotten worse
00:42data what's open trauma to Jessie can you get her starting trauma to with some banco and blood
00:47cultures got it boss I'm coming with suit yourself Santos you want in on trauma too uh too much
00:55starting to a little time 62 year old male presents with chief complaint of left lower back pain
01:02consider the diagnosis of Jesus Christ I'm charting sorry did I do something wrong besides interrupting
01:11me probably then I apologize I know that second year of residency can be stressful so there's
01:18anything I can do to help you like stop talking that's a great idea yeah consider the
01:25diagnosis of aortic aneurysm or dissection got a new one for you in 13. I'm 20 charts behind
01:32and the new attending is threatening to make me repeat a year if I can't catch up
01:35cry me a river old lady with fat abdominal pain somebody's got a stamp Dana please do me as holiday
01:40holiday weekend Westbridge is down in our waiting rooms on overdrive I'm sorry but your charting's
01:44going to have to wait until after you're shipped Uncle V that Santos needs you to pick up a new
01:50patient at 13. yes ma'am I'm on it draw it while you supervise best I can do
01:59I'm not going to pay for money
02:01and that's just trying to help setting up a GoFundMe that's what our generation does that's how they
02:06support each other doctor tell him your wife's right staying here is going to cost more than we
02:12can afford look I'm feeling better I'll just leave Mr. Diaz even if your blood sugar is back to normal
02:19we have to continue with the insulin drip until we clear the ketones from your bloodstream
02:23otherwise you could experience electrolyte disorders heart and kidney problems your health
02:29is what matters I'll make you a deal you agree to stay on the insulin drip and I'll go find
02:34our
02:34case manager to discuss cost-cutting options for your stay deal and I'm sitting here making sure he
02:40doesn't move you should go look for Anna I can find her BRB hang in Vanko what's Vanko a really
02:51strong antibiotic to kill skin germs need a hand uh no we got this I'll just observe pretend I'm not
02:58even here uh let's send off a CBC blood cultures and CMP and also a lactic acid CRP and calcitonin
03:05she's not febrile not tachycardic no evidence of SIRS yet what's SIRS systemic inflammatory response
03:12syndrome sorry an exaggerated defense response sorry a what sometimes the human body can have an
03:20overreaction to an infection so we're going to monitor you and make sure that this does not
03:24progress it's my boss sorry I have to take this or he's going to fire me hello uh no I'm
03:35still at the
03:35hospital I'm being seen right now oh no they just stuck me with a needle um I don't know you
03:46want to
03:46talk to them they're kind of busy right now I know you are second IV's in well I'm not overreacting
03:55my body's overreacting please please don't fire me I this is Dr. Michael Rabinovich I am the chief
04:03of emergency medicine at PTMC if you fire her she will sue you and I will testify on her behalf
04:11okay don't worry about it we got you
04:19do you know how long Jackson's going to be asleep so there's no exact timeline that the sedative sleep
04:23gave him but he should be awake soon have you spoken to your parents yet yeah they're on their
04:28way back from Columbus maybe you should take some time for yourself before they arrive um yeah a
04:33cafeteria is right down the hall decent grilled cheese stay away from the tuna thanks but I'm not
04:38hungry you know I just can't believe that a campus security guard tased my brother aren't they
04:43supposed to be helping students and protect them not shoot at them you have every right to be upset
04:48and you should absolutely pursue accountability but right now we are taking care of your brother
04:53and you should really take care of yourself I have your number um I'll text you as soon as
04:59Jackson's LP results get back or if he wakes up okay okay thank you of course
05:09uh hypoactive bowel sounds soft with moderate tenderness in the left lower quadrant
05:13uh mrs randolph do you take percocet every day no huh and what about your water intake
05:20pause mrs randolph you said you don't take percocet every day but when was the last time you took some
05:26maybe three or four times last week assisted living had a ballroom dance competition I tweaked
05:34my back any further questions Ogilvy uh when was your last bowel movement
05:43I don't know sometime last week I've been stopped up for at least five or six days
05:50painkillers can cause constipation I know that's why they put me on a stool softener and then they
05:56tried an enema and and no movement sip and then they gave me this horrible drink mag citrate yeah
06:06mag citrate made me puke all right what's next Ogilvy let's get you an x-ray and see how we
06:13can help
06:13you mrs randolph thank you differential uh probable stool impaction but with her history of
06:21cholecystectomy it could be small bowel obstruction or worse sigmoid volvulus but that's a surgical
06:29emergency wouldn't you have tons of pain not always especially when you're in your 80s
06:40I am getting concerned this is a millimeter past the line
06:44or my line was sloppy any increase in pain oh okay sorry let's try fluoromorphine white counts only
06:5010 000 it'd be over 12 for service there are other criteria she's still a febrile did you ask about
06:56past history of MRSA not specifically but she's never been hospitalized you have it in some of an
07:00immunocompromised state no she's also steroid use never maximum heart rate's only 89 is that okay
07:05that's good very good stay with her monitor her closely there's any change in her condition
07:12come find me I mean any change
07:17roxy hamler 42 home hospice patient with a history of lung cancer new onset tonic clonic seizure with
07:23right lower leg pain she hit it on the coffee table initially non-verbal now coming around
07:30that's normal after a seizure hi i'm dr al-hashini do you need a hand nope we got it she
07:34hit her hand
07:34no i was there i caught her no ivy couldn't get one in give her four of i and bursette
07:39for the
07:40seizure 25 offend for the pain okay dina where to drama one this way haven't seen you guys in a
07:46hot
07:46minute pick up messy uh john's forge supposed to go to westbridge we got diverting to you yeah you and
07:53everybody else princess i need you to pivot to central nine got it gus varney 54 victim of assault
07:58with diffuse blunt trauma it's got bruising to the face the right chest 10 centimeter lacerations
08:02to the left arm vp's 136 over 84 pulse 102 good stats 95 under america how you feeling there mr
08:09varney
08:09fucking hurts where everywhere i am dr robbie this is dr alashimi we'll get you something for the pain
08:15i've got a progressive cellulitis oh thank you gus do you know who hurt you one of the fine
08:22upstanding citizens of cell block six it's a deep whack in the through the muscle fascia and can we
08:27get the cuffs off once he settles not a chance orange jumpsuit he's cut for a reason let's go
08:43okay everyone on my count one two hold on
08:54go one two three e fast whitaker primary assessment on it
09:06oh weird bruise did he fall on something footprint got stomped jesus
09:13is it is that necessary afraid so
09:18airways patent good lung sliding on the left
09:24sorry good on the right too how are the lungs uh good breath sounds no crepitus no effusion
09:31pulse ox 97 bp 118 over 78 heart rate 112 tachycardic from the pain start with four of morphine
09:37repeat pr on it swollen mandible open your mouth for me gus a little wider can't whitaker you know the
09:46tongue blade exam yeah it's a great test for a mandible fracture gus bite down hard on this for
09:52me sorry gus positive test no free fluid in the belly any idea how long this will take too soon
10:02to tell whitaker here assessment fractured left mandible multiple rib fractures complex forearm
10:08lack okay log roll to the left then pan scan where were you when mr varney got assaulted i just
10:13move
10:13i don't get to know him ct's ready for us cycling the bp okay this redness is now a centimeter
10:19over
10:20that line and this might be a bullet forming thank you it takes a little time to work vital signs
10:24are
10:24still stable 122 over 78 i got it how are you feeling w i'm feeling a little warm that can
10:33happen with
10:33mr vanco thanks man lactic acid 4.2 uh okay what's wrong that can be a sign of a more
10:43serious
10:43infection but the good news is we know what to do jesse two liters of lr wide open this is
10:49severe
10:49substance i know but at 7 a.m it was a simple cellulitis anyone want to give her keflex we
10:54could
10:54add carbapenem or zosin and brought in our antibiotic cover it's okay i got it thanks jesse one
11:00grab marapenem 900 milligrams clinton page dr garcia please what's going on we're adding new
11:06antibiotics it's serious we want to get ahead of it and make sure it doesn't become serious
11:13what else can i do i think you've done enough you can go
11:20all good in there called sepsis stable for the moment how about you perfect vitals e fast negative
11:26off to ct good keep me posted ditto
11:35how's it going great if you ignore the hot mess and cheers any update on our little baby jane doe
11:40securities are going to cctv from last night and this morning
11:46you two kissing mic up yet i think someone needs to smoke a cigarette
11:49why don't you quit when i'm on my trip everyone's glad to have you back
11:53well not everyone
11:57hey you went in on this betting board look all you got to do is pick why westbridge went down
12:02how many of their pictures we're going to get and when they'll be back in action
12:06hey already up to 500 dollars
12:09i gotta pass still catching up on rehab bills respect
12:17all right what's the rules on me changing my bet only if you double down
12:25sinkhole
12:28you watch too many movies man
12:32considered the diagnosis of aortic aneurysm or dissection but the point of care ultrasound was
12:37done with that good luck granny
12:39uh ordered an acute abdominal series to rule out obstruction still waiting on the x-ray
12:44great then you're free to treat our latest and greatest in sas 16
12:46oh come on d it's like every time i get a moment to chart i barely get a sentence out
12:52before i get
12:52interrupted
12:54sucks to be you but trust me it sucks worse for the poor gal in 16
12:58i'm beginning to think you enjoy torturing me
13:00work to the job
13:02yeah movie let's go
13:07hold out your hand louis
13:11a little shaky
13:12i'm no surprised i've been here since 4 a.m
13:16we can get you something for that
13:17oh i can take care of myself if you cut me loose right now
13:21let's get louis 50 milligrams of librium
13:23i'll put in the order
13:27i will get it for lupidius
13:33i'm already assigned as louis treating physician just to make sense that i put it in
13:38yeah yeah yeah of course
13:45uh any changes with our septic waitress
13:48not yet
13:48but if you have a sept i don't
13:50the point of care ultrasound was negative for both
13:53i considered the diagnosis of cauda quina syndrome
13:56you've written a great american novel
13:59um charting and supervising
14:01stay in this idea
14:02who is the lucky patient
14:04a unhoused woman with a bad cough
14:06ogilvy's all over it
14:07okay
14:12okay deep breath in
14:14blow it out real hard
14:16you haven't heard enough already
14:17i need to check for wheezing with forced exhalation
14:25the cough is killing me
14:27you smoke mrs yardley
14:29yeah but i have been able to for a couple of days because of this cough
14:32you ever consider quitting
14:34you ever considered minding your own business
14:42well the good news is that your test from earlier came back negative for both covid and influenza
14:46but i'm gonna order a chest x-ray so that we can see what's really going on in those lungs
14:49you got time to let us do that
14:52where the fuck else you think i gotta be
14:56yeah we're in three grams of kepler for ten minutes that'll prevent another seizure
15:00thank you
15:01nobody can ever get an iv in her
15:03yeah midline cath is the way to go when your veins are shot
15:07tacitur 114 bp 94 over 70 sat 91 on two liters
15:13cold
15:13uh is it possible to get her a blanket and some socks
15:18can do
15:20when was she diagnosed
15:22seven years ago
15:24reset to the lobe
15:27four cycles of platinum chemo gave us a couple good years but
15:30then it spread to the bones
15:32has she had radiation therapy
15:33it shrunk down the mats but they're still there
15:36that's why you're at hospice at home
15:38yeah
15:39i'm sorry
15:41you too
15:43uh
15:45sorry
15:46you have kids
15:48two boys
15:5015 and 9
15:52my son's 12
15:53goes fast
15:56too fast
15:58swelling and bruising over the distal tibia
16:01uh
16:0250 fentanyl
16:04what's your stalax over 100
16:05what do you usually take for pain
16:10uh
16:11ms continent 30 milligrams
16:13twice a day
16:14oxycodone for breakthrough
16:15and sublingual lactic
16:17for um
16:17when it gets really bad
16:20that's a lot
16:21you handle pain meds
16:23sometimes
16:25all the time
16:26a hospice nurse comes by
16:28a few times a week
16:29but i was alone
16:30when she had the seizure
16:31they told us that
16:33it could happen
16:34but
16:34she couldn't breathe
16:35and
16:36i freaked out
16:38i called 9-1-1
16:39i'm so sorry
16:42i'm sorry
16:44i'm sorry
16:55due to your family income
16:57you make too much
16:59to be eligible
16:59for either penny
17:00or the hospital's charity care
17:02but we can't afford
17:04health care premiums
17:05it's unfortunately
17:06very common
17:07for people to fall
17:08between the cracks
17:09it's an imperfect system
17:11can ptmc help
17:12with the cost in any way
17:13we can offer
17:14financial assistance
17:15you pay the same
17:17that medicare
17:18or medicaid would pay
17:19how much is that
17:20you pay 60%
17:21we cover 40%
17:24thank you
17:25uh-huh
17:29where have you been
17:31how are you doing
17:32i'm sorry
17:33you're being thoughtful
17:34i just blew up
17:36well miss noel
17:38was just telling us
17:39that the hospital
17:39is gonna give us
17:40a big discount
17:41we can knock 40%
17:42off your final bill
17:44that's great
17:45i stay here for a few days
17:47my bill could be
17:48over 100,000
17:49right
17:51yes unfortunately
17:53it could end up
17:55being lower
17:55depending on your level
17:57of needed care
17:58or higher
18:00so we would still
18:01have to pay
18:0260,000
18:04which we don't have
18:05he has to stay here
18:06to get better
18:07right
18:07yes
18:08no
18:10excuse me
18:11i mean
18:12not necessarily
18:13couldn't we just
18:14admit him to med surge
18:15instead of icu
18:16wouldn't that be
18:17a lot cheaper
18:17med surge won't accept
18:19him with an insulin drip
18:20usually true
18:21but let me talk
18:22to the chargers upstairs
18:24and i'll
18:25i'll see what she says
18:26thank you
18:30food poisoning
18:31and holds asking
18:32to leave
18:32wants to take
18:33her kids to the water
18:33park
18:34those places
18:35are cesspools
18:37it's in the quiet
18:37if she's feeling
18:38fine on his offer
18:39and she's good to go
18:40all right
18:40uh louie's in
18:41south 15
18:42meds are coming down
18:43another couple hours
18:44to monitor
18:44and then he can brew
18:45straight to the liquor store
18:46don't pass it out
18:47what about that clamshell
18:49case that went up
18:49anything
18:50out of surgery
18:50and recovery
18:51still sedated
18:52good
18:52keep me posted
18:53on that
18:54we'll do
18:57three times
18:58in one day
18:59to what do we
18:59owe the pleasure
19:00i came down
19:01for a consult
19:02and to persuade
19:03him to start
19:03a new bedding board
19:04why is the westbridge
19:06board full already
19:07i was gonna ask
19:07him to start
19:08one about you
19:08and your midlife
19:09crisis trip
19:10i give it
19:11four weeks
19:13seven tops
19:15you have a little
19:16faith
19:16not faith
19:17just facts
19:19facts
19:19based on my experience
19:21you're a seven week
19:22edge kind of guy
19:23hey robbie
19:24a med student's
19:25got a pickleball player
19:26in the north hall
19:27a possible Achilles rupture
19:28asking for your opinion
19:29thank you perla
19:30at least somebody down
19:31here has a little
19:31faith in me
19:35you know what
19:36motorcycle mic
19:37sabbatical's really about
19:38i never try to guess
19:39what's going on
19:39and i had a hiss
19:40three months
19:42being on the open road
19:43by himself
19:43and they can't stand
19:45to be alone
19:45for more than a few hours
19:46he sleeps with the tv
19:47on in his bedroom
19:49i really don't think
19:50i needed to know that
19:54maybe he's looking
19:55for something new
19:56we're trying to
19:57outrun some old ghosts
19:59i hope he finds
20:01what he's looking for
20:03mantas are some peace
20:05amen
20:06i consider the diagnosis
20:07of cauda equina syndrome
20:09but the motor and sensory exam
20:11were both intact
20:12our own house coffer has pneumonia
20:14i'm cursed
20:15fucking cursed
20:17fuck
20:18that is a cavitary lesion
20:22in the right upper lobe
20:23active tv
20:24what's next
20:27uh afb stand to confirm
20:28move her to a negative airflow room
20:30start her own meds
20:31call infection control
20:33and public health
20:34and now you get to sign in
20:35as a patient
20:36and get your blood drawn
20:37for a quantifier in gold
20:38it's too soon to be positive
20:40yeah but you were exposed
20:41you need a baseline test
20:43and then again in eight weeks
20:44to see if you convert
20:46and if i do
20:48then meds every day
20:49for three or four months
20:50with regular blood tests
20:51to check for toxicity
20:53jesus
20:53all right
20:54let dana know what's up
20:55and for the love of god
20:56mask up when you move her
21:07dr langdon
21:08hey man
21:09alex
21:09let's take a look
21:15is it bad
21:16it's not good
21:18sorry your chart says
21:20you were burned with dry ice
21:21what happened
21:22my jack off brother
21:23does he not like you
21:24i asked him to do it
21:26just not like this exactly
21:28what why
21:29he was gonna brand me
21:30like i branded him
21:31brand like cattle
21:33instead of hot branding
21:35you stick the iron in
21:36dry ice
21:37let it get super cold
21:38and then you put it
21:39on your skin
21:39cool huh
21:42let's get some lead
21:43on this
21:44i'll get some
21:44sniffs to debride
21:48you good
21:49uh yeah
21:50yeah good
21:52you sure
21:53doesn't seem like
21:54robbie's all that
21:55happy i'm back
21:56well
21:57he's not going to be here
21:59and i'm happy you're back
22:02thanks
22:07head and neck ct is negative
22:09except for mandible fracture
22:12let's get him off the board
22:13roll him right side out
22:15hey we're gonna need
22:15the cuffs off
22:20ready
22:20and one
22:21two
22:22three
22:22ah
22:23gentle
22:23ah
22:25dr king how are the chest
22:26and belly
22:26uh we have
22:27three anterior rib fractures
22:29and a small pulmonary contusion
22:32not too bad
22:32when do pulmonary contusions peak
22:34after a few hours
22:35and do we always admit
22:36for a three rib fracture
22:37uh in the elderly yes
22:39but not if a patient
22:40can manage the pain
22:41and doesn't need
22:41supplemental oxygen
22:42good
22:44okay he's really hurting here
22:45you think you can set us up
22:46with a serratus anterior
22:47field block
22:48no problem
22:48oh uh
22:49as long as that's okay
22:50with dr al-hashimi
22:52if the patient consents
22:54mr varney
22:55we want to give you
22:56a shot to numb
22:57your broken ribs
22:58so you can breathe easier
23:00okay get mr varney prepped
23:01and draped
23:02dr mohan you're in charge
23:03let's identify the landmarks
23:05cuffs
23:07yeah you can just leave him off man
23:09he's clearly not moving on his own
23:12we follow protocol
23:13for his safety
23:15and yours
23:19do you need to get that
23:20uh
23:20nope
23:21it's my mom
23:23ignore it
23:24just ignore it
23:26amen sister
23:26form is numb
23:27we can irrigate
23:28if i ignore a problem
23:30for long enough
23:30it just goes away right
23:32i wish i could ignore
23:33my deposition
23:34that you can't ignore
23:36but you'll be fine
23:37what's up with you whitaker
23:39trouble in roomy land
23:40no not really
23:42i think i overstepped
23:44with dr langdon
23:45earlier
23:45oh
23:47he was
23:48trying to prescribe
23:49the patient benzos
23:49and i told langdon
23:51that it'd be better
23:52if i did it
23:52woof
23:53only because i was already
23:55the assigned position
23:55but yeah
23:57now i feel like an asshole
23:58langdon's fine
23:59he went to rehab
24:00he's working the steps
24:02and
24:02hopefully
24:03it's all behind him
24:06place the needle
24:07in plane
24:08superficial to the serratus
24:09anterior
24:10between it
24:11and the latissimus dorsi
24:13you can see the fluid
24:14dissect and diffuse
24:16dr mohan
24:16we need you
24:17we've got two more
24:18rigs from westbridge
24:19pulling up right now
24:21go
24:21we got this
24:22thanks
24:23how we doing in here
24:25uh spiked attempt
24:27to 102
24:27gave tylenol
24:29check out her leg
24:31that is a definite
24:32bullet
24:32did surgery come down yet
24:34not yet
24:35i need surgery
24:36page up again
24:37surgery would be
24:38a last resort
24:39we would like them
24:40to come down
24:41and check out your leg
24:42in case we need to
24:42remove this infected skin
24:44i thought it was just
24:45a little swelling
24:46because i'm on my feet
24:46all day
24:48the piece down
24:49to 85 over 40
24:50how much lr is it
24:51full bolus
24:52you know the leader
24:53let's start
24:53levofed titrate
24:54to a map of 65
24:56can someone please
24:57tell me what's going on
24:58pulse ox down to 89
24:59100% non-rebreather
25:01sometimes
25:02an infection
25:02can cause your blood
25:03pressure to drop
25:04and lower the amount
25:05of oxygen in your blood
25:06am i gonna be okay
25:07we're doing everything
25:08that we can to make
25:09sure that you are
25:10jesse
25:14what's up
25:15be ready to intubate
25:16if you need to
25:16you want me to call
25:17langdon
25:18no i will be right
25:19back and you can
25:19call surgery and tell
25:20them to get their
25:21heads out of their
25:21asses and get down
25:22here
25:32did you bring
25:32langdon back here
25:33no alishimi did
25:34you banished him
25:35to scott purgatory
25:36he did everything
25:37you would have done
25:37with that cellulitis
25:38patient if you think
25:39you missed something
25:40tell him
25:40well we're probably
25:41gonna need to intubate
25:42we're definitely
25:42gonna need an icu bed
25:43what happened
25:45she is in septic
25:46shock on pressers
25:47open shoulder
25:47dislocation is back
25:49westbridge shut down
25:50all their or so they
25:51told us to bring him
25:51back here
25:52you joking this ain't
25:53the radisson
25:53not my problem
25:54where should we park
25:55him grab a wall
25:56on the well call
25:57ortho call the or
25:58tell me we got a
25:58patient back that
25:59needs surgery and
26:00admission
26:00hey so sorry about
26:02this ambulance tour of
26:03allegheny county mr
26:04billings but we got you
26:05from here i promise
26:06yeah i'm starved and
26:07is there any way i can
26:08get something to eat
26:09sorry not before
26:10surgery can i have a
26:11visitor sure
26:13any word from glory
26:14about what's going on
26:15at westbridge radio
26:16silence from the ivory
26:17tower and the
26:17charge nurse over there
26:18isn't responded
26:19must be bad i wonder
26:20if it's something that
26:20security needs to know
26:21about i keep you
26:22buzzing hey uh you're
26:24kind of buzzed with
26:25gloria did she say
26:25anything to you about
26:26what's happening at
26:26westbridge no you
26:28nope how are your
26:30patients our prisoner gust
26:32has stable injuries and
26:33our law student in
26:34central 10 is awake
26:35normal lp and
26:36awaiting a psych
26:37consult good quicker
26:39we can treat them
26:40street them move them
26:40up the food chain the
26:41better question why are
26:44you treating me like
26:45one of your residents
26:48i'm not as the
26:50attending i'd like to
26:51know the status of all
26:51the patients and
26:52doctors in the ed in
26:53case i need to jump in
26:54quickly makes sense now
26:57your turn what as your
27:00fellow attending in our
27:01ed it only makes sense
27:03for me to know the
27:03status of all the
27:04patients and all the
27:05doctors in case i need
27:07to jump in on a moment's
27:08notice
27:10touche
27:10you have a non-displaced
27:15fracture distal tibia so
27:17if you look at the bone
27:17here it's pretty well
27:18aligned
27:18sorry hi hi i was in the
27:21shower and i came as
27:22soon as i got paul's
27:23message lena
27:25what happened i had a
27:27seizure you loaded with
27:29capra uh yeah yeah she's
27:32back to baseline mental
27:33status but i'm sorry i'm
27:34confused aren't you off
27:35duty i'm roxy's death
27:37doula
27:39her what i help advocate
27:42for people like roxy to
27:43make their transition to
27:44death a more peaceful
27:45process it's like a birth
27:47doula but for the end of
27:48life
27:48you should be a real
27:49lifesaver for our family
27:52my husband cracking jokes
27:53while i'm dying see why
27:55i married him whatever
27:57you have to say about my
27:58condition you can share
27:59with lena too
28:01um we were just explaining
28:02that roxy has pathological
28:03fracture through a
28:04metastatic lesion can you
28:06fix that the bones are
28:08well aligned so she won't
28:09need surgery the treatment
28:10is immobilization and a
28:12long way
28:12ah
28:14maybe we up her payments
28:16uh yeah sure we could do
28:18that
28:19the bones should heal in
28:20about six weeks
28:21if i live that long
28:25still know i'm here
28:26yeah bro
28:28great
28:30you think it's gonna
28:31leave a scar
28:32i don't think it i know
28:34it
28:36holy shit
28:38fuck are you doing here
28:39sorry who are you
28:41concerned brother
28:42that looks not too bad
28:44you good in me
28:45yeah it's nasty
28:47thanks to you
28:48wait you did this
28:50oh yeah you want to see
28:51the video
28:54yes
28:54definitely
28:56get you
28:57all right
28:59all right
29:00i'm getting close
29:00brothers unite
29:04dude
29:05why in the world would you ask
29:07to have that done to you
29:07he's trying to brand me with
29:09our family crest
29:13your family crest is the
29:15penguins logo
29:15we're gonna be bonded for life
29:17you already are
29:18with dna
29:19yeah
29:20i love you man
29:22i'm really sorry
29:23it's okay doc said it's
29:25gonna take some time but
29:26it'll heal okay
29:27awesome
29:29so maybe we can try again in a couple of months
29:31no
29:34okay
29:34thank you
29:37yellow on the end title
29:39sorry
29:39got backed up
29:40sounds a little wet
29:41someone asked for surgical counsel
29:42that's because of all the fluid
29:43here are the lines for now
29:44and settings 50%
29:45tidal volume 500
29:46ac 12
29:47yep that's perfect
29:48surgery here
29:49hello
29:49hey it's about time
29:50where's garcia
29:51stuck on the ur
29:52she sent me down
29:52what you got
29:53septic shock
29:54respiratory failure
29:54impossible necrotizing
29:55fasciitis
29:56she needs to go to the ur
29:57asap
29:57the infection was isolated
29:59at the door some of the foot
30:00five hours ago
30:01but now we're almost to the knee
30:02with bullet crevice and edema
30:03yeah
30:04you seen a neck fashion before
30:05in a textbook
30:06i was a med student two weeks ago
30:10gotta show this to dr garcia
30:11okay jesus christ
30:13go get anybody else from your service
30:14down here
30:14shamsie
30:15miller
30:15walsh
30:16i don't know any of those people
30:16don't take this personally
30:17i just need a fucking grown up down here
30:21nice job on the subcues
30:23really took the tension off the wound
30:25thanks
30:25i can help with the skin layer
30:28forehands are faster than two
30:32whoa
30:33uh that just tore right through the skin
30:35may need to take bigger bites
30:37farther away from the wound edges
30:41skin seems pretty fragile
30:49oh yeah this is not working
30:52he has the skin strength of an 80 year old
30:54put down stair strips with benzo in
30:56not across the wound but along each wound
30:58edge both sides
30:59it'll hold the sutures
31:00yeah
31:01what say you dr robbie
31:04great
31:05mcgyver move go for it
31:09does it
31:10dr mcgyver
31:11what care
31:13i don't know
31:15the patient's symptoms are consistent with lumbar radiculopathy at l4 l5 most likely due to disc
31:21herniation
31:22coughing patient admitted to isolation for verified medication administration and started on right
31:26therapy
31:26yeah why do i even bother just fail me now
31:28okay
31:30get in touch with a social worker
31:31they're gonna want to do contact tracing and help her figure out transitional housing for when she's discharged
31:36got it
31:36and make sure infection control responded the people in the waiting room could have been exposed they need to be
31:42notified and tested
31:44okay
31:48relax
31:48you can take the mask off
31:49you don't have tb
31:51at least not yet
31:54oh great
31:57this is fucked up
31:59how many of you sell calm
32:01expected job hazard
32:03you can get used to it
32:04yeah no thanks
32:05seventy percent of doctors in training at urban hospitals get exposed to tv and wind up on meds
32:11jesus
32:12mm-hmm
32:13they don't teach you that in med school
32:16mrs randolph's back
32:17pulled up her x-ray
32:20okay
32:20no volvulus
32:22no air fluid levels
32:23what do you think of this
32:26fecal material
32:28a shit ton
32:30sorry i had to be said
32:31so what she needs an enema
32:32no tried and failed remember
32:34yeah
32:35time to dig in
32:36how are we gonna do that
32:38oh there is no we in disimpaction
32:47i haven't done one before
32:50shouldn't i observe first
32:53i know just the guy to teach you
33:04i spoke to the charge nurse
33:06in med surg
33:07they can take orlando today
33:09yes
33:09that was wonderful
33:10they know he's on an insulin drip
33:12they know and they can change to a squid protocol
33:14squid
33:15sub-q insulin and dka
33:17so no ivy drip
33:18just shots of short-acting insulin every four hours prn
33:22the med surg nurses have time to check her glucose every hour
33:25they say so
33:26and five days on med surg
33:28is gonna cut your hospital bill down by two-thirds
33:32okay um
33:33so what's that gonna cost
33:35i can't give you an exact amount but roughly 35,000
33:39so after about 40 percent
33:41i'll start to pay what like 20 grand
33:44the hospital can work out a payment plan
33:46orlando
33:47we'll be okay
33:48we'll figure it out
33:50i'll take on extra shifts at the coffee shop
33:52we got you dad
33:55let's give you some private time with your family
33:58thanks
34:01sorry
34:02thank you
34:03was worried he might bail
34:04my pleasure
34:05the real thanks goes to the newbie here for thinking outside the box
34:11sorry i doubted your med surg pitch
34:13ah no sweat
34:15what'd you think of that
34:17uh my family had to think of a lot of creative ways to help manage her grandma
34:23leukemia
34:24system doesn't work for you you gotta work the system
34:28she survived
34:30for a while
34:31until she didn't
34:32she died before my freshman year of college
34:35sorry
34:37her death taught me a lot
34:40mainly that i don't want to be around people dying
34:44i got it
34:45i feel like coming out of here soon
34:47yeah
34:47oh i think so
34:48i think so
34:49okay
34:49hi
34:52uh morphine pca looks ready to go
34:55this should do the trick
34:57uh
34:57do you notice a difference
34:59better
34:59oh great
35:01great
35:02how does this thing work
35:04there's a
35:05a baseline rate of morphine
35:06and if you're having pain
35:08you can push this button
35:08you'll get some extra
35:09and you can push for another dose
35:11every ten minutes if needed
35:12your very own morphine butler
35:17amazing
35:18because she can go home with this
35:20uh yeah
35:21though you'll need more equipment for the house
35:24now that she can't bear weight on her leg
35:26okay
35:26like
35:26what
35:28uh
35:28a wheelchair to go to the bathroom
35:30a shower chair
35:31uh wall bars
35:33if you don't already have them
35:34and a hospital bed
35:35could be helpful too
35:37how do we get all that
35:38you don't
35:39i do
35:40i will get everything
35:41so that the two of you
35:42can get out of here
35:43and back to the kids
35:44at home
35:45thank you
35:54nice of you to join us huckleberry
35:55what do you need
35:56some help with a disimpaction
36:00that is a med student procedure
36:02you know the old adage
36:04see one
36:04do one
36:05teach one
36:06say hello to teaching young ogilvy here
36:10okay
36:10double glove ogilvy
36:12all right
36:13mrs randolph
36:14we're going to need to manually unblock your rectum
36:17so that you can get your bells moving again
36:19i know
36:19here we go
36:22mrs randolph
36:23i would like you to relax
36:26like you're having a bowel movement
36:28nice and deep
36:32okay
36:33curve the finger
36:35like an ice cream scoop
36:38and
36:39bring it out
36:42you're up ogilvy
36:48some more pressure mrs randolph
36:50ready
36:59and here
36:59i thought you weren't a quick study
37:03you're gone
37:05mrs randolph
37:06in order to prevent this from happening again
37:08i think you need a better stool softener
37:10you can try miralax
37:11just a tablespoon with a big glass of water every morning
37:14should do the trick
37:15okay
37:18oh
37:20sorry
37:21passing gas is good
37:22means we're making progress
37:24does that mean that i can
37:25i can stop
37:26no
37:26no
37:26keep going
37:32okay
37:32ogilvy
37:33you
37:33you might want to
37:36ah
37:38ah
37:40ah
37:41much better
37:44maps hold none
37:45leave a fed
37:46one mic per kg per minute
37:48give me a favor
37:49give me some 4x4s and some betadine
37:50sorry
37:51we're getting killed with transfers from westbridge
37:53wasn't your ischemia
37:54perforated bowel
37:55got a hot one here
37:56yeah
37:57possible magfash
37:59possible
38:00need ct with contrast to confirm
38:01this is spreading like wildfire
38:02by the time you get your ct
38:03it's gonna be up to her way
38:04she's gonna need a hemicorporectomy
38:05she needs a ct scan
38:06how about stainless steel scan
38:09for christ's sake
38:11rabinovich
38:12robbie
38:12what the fuck are you doing
38:15oh god i figured my
38:16that's called dirty dishwater exudate without purulence
38:19there's a great appearance to the fascia
38:21and in the or you'll see easy separation in the tissue planes
38:23when do you start your sabbatical
38:25tomorrow
38:25not a moment too soon
38:27thanks for coming down
38:32i'm catching up on my charting as fast as i can
38:35why don't you give my generative ai app a try
38:38it's 30 percent more efficient
38:40and providers report increased job satisfaction
38:42and you rarely have to stay over time to complete charts
38:45yeah
38:47okay
38:48yeah i'm usually here at least a couple hours after every shift trying to catch up
38:52so
38:52sure ai will make doctors more efficient
38:55but hospitals will expect us to treat more patients without any extra pay of course
38:59all the while eliminating staff positions for attending and residence
39:02oh dr robbie i am not an advocate for erasing my own profession
39:06but i am advocating for getting to spend more time with my son
39:10nothing can replace family
39:13what's the status of your septic patient
39:15neck fascia
39:16surgery's taking her out
39:17think they'll be able to save her leg
39:20right now i'm just hoping they can save her life
39:22hey uh
39:23how's ogilvy doing
39:24a little tb exposure
39:26a touch of asplosion
39:28all in all pretty good day so far
39:31hey you know what i was gonna let you miss peter
39:33operas at the fourth of july party
39:35come on now
39:36hey
39:38brats and bro
39:39you are the man
39:40appreciate the bromance over here
39:42but no food
39:43because you might go into surgery
39:44no beer
39:45because we're a goddamn hospital
39:51starting your sabbatical early
39:52i know somebody who could really use a drink right now
39:54in the hospital
39:56as a parting gift
40:03how's it looking
40:03good
40:05the stair strips did the trick
40:06ct is ready
40:08where'd you scan him
40:09a head and neck
40:10want thin cuts
40:11and a 3d reconstruction of the mandible
40:13before they decide if mr varney needs surgery
40:15have they even come down to examine him in person
40:17no they must be backed up
40:19or there's a july 4th sale at the bmw dealership
40:23labs are back
40:24albumin's low
40:25total protein's low
40:26he also has megaloblastic anemia
40:27malnutrition
40:28probably jail cuisine
40:30whittaker what labs should we add
40:31b12 folate
40:33iron levels
40:33good
40:35we're gonna run some more tests mr varney
40:37hang in there
40:42i have to pee
40:44oh
40:45there's no pure wick here
40:46but here you go hon
40:48i'll help you get on
40:49no no no bedpan
40:51i can walk to the bathroom
40:52i just need a little help
40:53are you sure
40:54i'm here babe
40:55oh we got this mr imble
40:56you'll have to bring your iv and portable oxygen
41:00please
41:02i'll grab a wheelchair
41:04let's try to suit you up and dangle your legs
41:06okay
41:11one two three
41:19this is not a good idea
41:21i don't think we're gonna need this
41:23hey paul paul um why don't you come grab a cup of coffee with me
41:27i'm still zunked for my all-nighter and i want to go over some delivery instructions with you
41:31uh sure
41:33um
41:34rox you okay
41:37mm-hmm
41:38yeah it's okay
41:46bedpan it is
41:56you lose your pulse ox again bud
42:04louie
42:05louie
42:07he kept pulling off his pulse ox
42:10it's on
42:10it's at 71
42:11louie wake up
42:14i'm gonna get the carotid
42:16i got the airway
42:16hey parla crash car intubation tray please
42:19let's go
42:20hey
42:21okay
42:33you
42:34okay
42:42okay
42:44okay
42:44go
42:46go
42:47go
42:47go
42:48go
42:48go
Comments