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The.Pitt.S02E01.540p.X265.AAC [Full Movie] [Full Version]Full EP - Full
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00:23You are close to me
00:30And I'm thinking of the time we spent together
00:34Now it's in my backyard
00:40Sometimes I sit and wonder
00:45If I'll ever tell your number
00:51Cause I'm having fun
00:53Looking out when I'm on
00:56Doing all the things I like to do
01:02I'm having fun
01:04Cause I knew it all along
01:07Would be better off without you
01:11I used my cast off
01:16As soon as you parked that outside
01:18Morning doc
01:18Olsen
01:19Happy 4th
01:20See you guys
01:21Sorry
01:50Hey how's it going dad
01:52I'm so sleep deprived
01:53My house is starting to feel like a CIA black site
01:55If you consider hiring a night nurse
01:57You're looking at him
01:58You got a ripe one coming in
01:59You're going to have to deal with
02:00Before everybody out there starts puking
02:01Lovely
02:02Your replacement came in early
02:04She brought in a full bagel spread
02:05I'm just saying
02:06She's not my replacement
02:07She's just covering his chief
02:08While I go on my little sabbatical
02:09Three months
02:10I'll be back before your daughter
02:11Sips in the night
02:12Hey dude
02:12That's cold
02:13Morning
02:14Morning
02:30Morning
02:30Morning John
02:30I could have sworn it was still around 4am
02:33Did you guys have an easy night last night?
02:35The waiting room actually looks manageable
02:36I wouldn't call it easy
02:38But not too bad
02:39I figured we'd have hands and burns down here a bunch
02:41But so far nobody's blown off any fingers
02:43Oh you know you just jinxed
02:45You guys and your jinxes
02:46Please Jesus please
02:47Hail Mary again
02:49In the sanctified flesh
02:50Don't let me die alone
02:51Just try to relax Margaret
02:52I need a priest
02:54Hey hey Dr. Robbie
02:55What's the good word Perla?
02:57All your results came back normal Mrs. Walker
02:59I'm dying
03:00You're not dying Mrs. Walker I promise
03:01Jesus is coming for me
03:03If he is he hasn't checked the net registration yet
03:05Please don't let me die a sinner
03:06Don't worry Margaret
03:07We're going to have the hospital chaplain
03:09Come and see you in a moment
03:10I'm not going to last that long
03:11Yes you will
03:12Because we're going to give you a shot
03:13To keep you alive until they get here
03:15What are you thinking Dr. Abinovich?
03:17500 mics of cyanocobalamin?
03:18In her condition I push a full thousand
03:20Woo
03:21You heard the man Perla
03:23God bless you
03:24God bless all of you
03:26Amen to that
03:29Nothing like the miracle healing powers
03:31Of a good old B12 shot
03:32She hold down a job
03:34She doesn't
03:35She's wearing a waitress uniform
03:37Yeah from a diner that closed 20 years ago
03:41And so it begins
03:43My husband is still waiting to see a doctor
03:46I apologize for the wait
03:47But here are two doctors just for you
03:49Mr. Burgess has been complaining of leg cramps for a day
03:52Slightly tacky at 110
03:54BP 128 over 75
03:56Afebrile
03:57Good stats
03:57I'm Dr. Shen
03:59But I'm going off shift
04:00Dr. Abinovich will be one of the doctors looking after you
04:02What other medications are you currently taking Mr. Burgess?
04:05I brought his meds
04:08Thank you
04:09These are his supplements
04:11Mostly all natural and organic where possible
04:13And these are his homeopathic prescriptions
04:15I also have a list of his refrigerated probiotics
04:19Thank you
04:23Where the hell is everybody?
04:25Our new attending is torturing our intern and med students in trauma one
04:29She came in early to meet the night shift and took things over
04:33Okay
04:33That takes giant balls of disrespect
04:35Giant balls of disrespect was the name of my band in high school
04:38And my nickname for my ex-husband
04:41Hey
04:42Hey, uh
04:42Is this your last shift?
04:43For a while, yeah
04:44Oh, I'm so jealous
04:47Hey, I'll pay you a grand if you take my second husband
04:50Tempting
04:51So
04:52Tell me about this new attending
04:53Uh, she's pretty
04:55Divorced
04:56One kid can already tell she is a strict rule follower
04:59I'm probably going to grow to hate her
05:01What's her name again?
05:02Dr. Buran Al-Hashimi
05:04Al-Hashimi?
05:06What is that?
05:08Irish
05:10She's some sort of clinical informatics expert
05:12When she started talking about AI
05:14I started thinking about robots
05:16And kind of stopped listening
05:18Clear
05:19Off the chest, Ogilvy
05:21Get ready to step up here, Joy
05:22Ogilvy, off the chest
05:24Clear
05:26Still VTAC, but it looks weird
05:28Agreed
05:28No pulse
05:29No effusion
05:30Good lung sliding
05:31Hey, start compressions, Joy
05:32We haven't considered all of the T's
05:34I checked for tamponade and tension pneumo
05:36What if it's thrombosis?
05:36If it's a pulmonary or a cardiac clock
05:38T and K could save it
05:39We are sticking with the algorithm for now
05:41Algorithm's not working
05:42Faster and deeper, please
05:43Uh, you need a break, Joy?
05:45No, I need an attending
05:46I'm right here
05:49Stop compressions
05:50We're calling it
05:52Sorry
05:52The patient's dead
05:57All right
05:58Who can tell me what went well?
05:59We followed the VTAC algorithm
06:01We checked for reversible causes
06:02We limited our rhythm in pulse checks
06:04To ten seconds
06:05Excellent
06:05Should we have given thrombolytics?
06:07No
06:07You should have recognized
06:08That the cardiac rhythm on the monitor
06:09Was polymorphic
06:11Not just VTAC
06:12It was torsade de point
06:14That's French
06:15Twisting up the points
06:16From prolonged QT
06:17Anti-arrhythmic electrolyte disorders
06:19Your patient would have lived
06:21If you pushed magnesium sulfate
06:22Good news is
06:23He's an organ donor
06:24Parts of him we're gonna get used
06:26To make frisbees
06:27Water bottles
06:27End up as microplastics
06:29In our brains
06:29And reproductive organs
06:30Thank you for the words of encouragement boss
06:32Dr. Alashimi
06:32Dr. Michael Rabinovich
06:33Everybody calls me Rami
06:34Pardon please
06:35Welcome to the pit
06:37Yeah
06:37Tom is a minute up
06:38Ooh
06:39Who wants to treat a real patient?
06:40Yes please
06:41Things gonna give me nightmares
06:45I hope you don't mind me
06:46Jumping right into things
06:47I find that a mock code
06:49Is a great way to assess
06:50The students capabilities
06:51Well
06:52It might have been nice
06:53If we'd had a little time
06:54To go over how we do things
06:55Did you not get a packet
06:56From Dr. Underwood
06:57Gloria
06:58It outlined the quality improvement changes
07:01I instituted at the VA
07:02We're adopting the program
07:03At all of the university hospitals
07:05You didn't read it?
07:06No I did
07:07I mean I will
07:08I'm going to
07:08I want to
07:09I thought I had a little bit more time
07:11Before you came in today
07:12We've already distributed
07:13Patient passports
07:14To everyone at registration
07:16What is a patient passport?
07:18So glad you asked
07:21Samira
07:21Dr. Al
07:22We worked together at the VA
07:24A few years ago
07:25And now you're in R4
07:26Yes
07:27And I'm so excited
07:28You're joining us
07:29Dr. Mel King is here too
07:30I think you worked with her as well
07:32I did indeed
07:33John Doe
07:34Dishwasher penetrating trauma
07:36From a kitchen knife
07:36To the right chest
07:37Salter accident?
07:38Unclear
07:39Initially had a pulse
07:40Lost it two blocks away
07:44What do we got party people?
07:46Dr. Yolanda Garcia
07:48Trauma surgery fellow
07:49Meet Dr. Baran Alashimi
07:51New ED attending
07:52She's going to be covering for me
07:53While I'm gone
07:54So nice to meet you
07:55That time they replaced you
07:56Rabbit bitch
07:57I'm going to miss you too
07:58YOLO
07:59Dr. Garcia has a hard time
08:00Expressing your feelings
08:01Not all of them
08:02One
08:03Two
08:04Three
08:06Prefer a laparocotomy
08:07I'm on it
08:09What's up boy chocolate?
08:11Did you know
08:12Our farm boy here
08:14Is a vintage funk freak?
08:16Unfortunately
08:16He also likes to use
08:18Other people's toothbrushes
08:19There's one time
08:19They were the same color
08:21What's your plan Samira
08:24Chest tube to the right
08:25Standby with master
08:26Transfusion protocol
08:27I put two units on the infuser
08:28Stare web six and a half
08:29Here we let the fellows
08:30And the residents
08:31Kind of take charge
08:32I'll hold on to them
08:33Just in case
08:34Is the VA even a trauma stand?
08:37Not for medic runs
08:39But they walk in
08:41Falls
08:41Major MBCs
08:43GSWs
08:45Stab wounds on the right
08:46Why are we opening
08:47The left chest?
08:48Better access if it's tamponade
08:49And you can cross clamp
08:51The aorta
08:52Giovanni, Whitaker
08:53Stare gloves
08:54Can I glove that?
08:54That's best if you
08:55Watch the first one
08:57This guy's dead anyway
09:01Sunblade
09:0228 French on a long pillie
09:05Giovanni, you're on section
09:06Whitaker, get ready
09:07For internal compressions
09:11Sorry, that's my phone
09:15Finished out of a tractor?
09:16Whitaker, give me a little room
09:18I need to get to his heart
09:19I'm in
09:19Hook up the thoracic seal
09:22Tommy, you get that for you?
09:23Not right now
09:34Good tamponade
09:35Pretty dry in here
09:38Heart's empty
09:39Somebody start cardiac massage
09:40I'll cross clamp
09:41Yeah, I got it
09:41You do these one-handed
09:43Pushing up against the breastbone
09:44Four fingers
09:45Very good
09:46Not much blood to suction
09:47Okay, team
09:48I can really
09:48Next steps
09:50Keep transfusing
09:51Open the right chest
09:51That is correct
09:52Booties on kids
09:53There will be blood
09:56Frank
10:00Landis
10:03Frank
10:12You should be good
10:13You should be good to go now, hon
10:14Thanks, Lupe
10:15Of course
10:16Hey, go get them
10:21Hey, dog
10:23It's been a while
10:27I got a bad toothache today
10:31We'll take care of that, Lord
10:33All right
11:00Yeah, I see
11:01You got a couple fingers
11:07There's too much blood to suction
11:10Uh, we're tracking the lung
11:12Try to identify the source
11:13Could be the right ventricle
11:15Or more likely the hilum
11:16Fresh lop pads
11:19Siri, turn on silent mode
11:22Siri, turn on silent mode
11:26Siri, turn on silent mode
11:28Siri, turn on silent mode
11:30Siri, turn on silent mode
11:30Siri, turn on silent mode
11:31Siri, turn on silent mode
11:33Siri, turn on silent mode
11:33Siri, turn on silent mode
11:33Siri, turn on silent mode
11:34Siri, turn on silent mode
11:35Siri, turn on silent mode
11:35Siri, turn on silent mode
11:35Siri, turn on silent mode
11:35Siri, turn on silent mode
11:37Siri, turn on silent mode
11:38Siri, turn on silent mode
12:14Good morning.
12:15It was a good morning and I'd still be in bed.
12:17So what are you doing here?
12:18Ventry's mom is visiting for the holiday.
12:20She's still alive.
12:21It was to me to die.
12:23Plus who else is going to get this place to the 4th of July weekend?
12:25Sure as hell ain't going to be me.
12:27I rest my case.
12:28What am I walking into?
12:30Nothing too bad yet.
12:31These are the ones I keep an eye on.
12:36The prodigal son returns.
12:38Too soon?
12:40No, I guess not.
12:42You're back.
12:43It took some time.
12:45Like an old trail horse, always follow the way back out.
12:48You look good, kid.
12:49How are you feeling?
12:50Oh, yeah.
12:50Great.
12:51You know, it's been a journey.
12:56I bet.
12:57Thanks.
12:57Robbie, you're on?
12:59He's in with the trauma, but if you hurry back, you can catch some of the pass-ons there in
13:03North.
13:04Thanks.
13:07I'll keep an eye on him.
13:11I think we have a lost little lamb.
13:13Excuse me, hon.
13:14Can we help you?
13:16I'm looking for the charge nurse.
13:18Oh, well, you found two of them.
13:20I'm Lena.
13:21This is Dana.
13:21I'm night shift going home, but Dana is queen of the day shift.
13:25Emma Nolan.
13:26Nice to meet you both.
13:27I'm a new grad RN here to shadow.
13:29Welcome to the pit, Emma Nolan.
13:31Here, let me put some of your stuff behind the desk, and I'll give you a quick tour.
13:34Okay.
13:36Where you from, sweetheart?
13:37To St. Marie.
13:38It's in Upper Michigan.
13:40Practically Canada.
13:42My great-grandmother was from up that way.
13:45Nice area.
13:46A lot of bugs.
13:48How about a cup of coffee?
13:51Can't locate the source.
13:53Proximal high-olum is under the sternum, along with most of the right ventricle.
13:56You need better exposure.
13:58Convert to a clamshell.
14:00Exactly.
14:00Trauma shears.
14:02It would have been nice to let them come up with that clam.
14:04Heart's going to need double compressions, just like this.
14:07Squeeze from the apex to the aorta.
14:12Right ventricle looks good.
14:13Massive hemorrhage from the highland.
14:15Second MTP packs going.
14:17Additional four units.
14:19High laryngeal looks very proximal.
14:21Maybe pulmonary artery and vein.
14:23Clamp's on.
14:24Nope, no good.
14:26Still bleeding like a stuck pig.
14:28I can give it a check.
14:28Dr. Gersick is a very skilled surgeon.
14:30If she can't get it, we need to think of something else.
14:31Like what?
14:36Highlar flip.
14:37You're going to rotate the lung 180 degrees, like putting a keg in the garden hose.
14:41It'll stop the bleeding.
14:42That could possibly work.
14:43Or he'll die when you rip the entire lung off the hilum.
14:47Gently.
14:49Very, very gently.
14:49Very, very slowly.
15:06Blood loss is slowing down.
15:07That's a good sign.
15:08Highland looks dry.
15:09The heart feels empty.
15:10Okay, we fixed the leak.
15:12Now, let's fill the tank.
15:15You are very popular today.
15:18Sorry, I'll turn it off when I can.
15:24Nine-year-old Kylie Connors, riding by her dad's girlfriend, Gina.
15:28Kylie took a tumble on the stairs this morning.
15:31We submitted a chin-lack and a chipped front incisor.
15:34Just got lead on a pressure dressing.
15:36Bleamed pretty good on a rival.
15:38Dermabond should do the trick.
15:40Any questions?
15:42Dr. King?
15:44Mel?
15:45Oh, um, I didn't say anything.
15:51How you feeling, Kylie?
15:53Tired.
15:54I've been here since 5.30.
15:55Oh, that makes two of us.
15:57But don't worry, we'll patch you up good as new,
15:59and we will get you out of here as soon as we can.
16:02Any questions?
16:03No, I'm just her dad's girlfriend, so I'm new to all this.
16:06No worries.
16:07We got you.
16:07Next.
16:1026-year-old Liam Sanders.
16:12Took a fall from his bicycle.
16:14No LLC, non-focal neural.
16:16Lower leg lack with no bony tenderness.
16:18Were you wearing a helmet, Liam?
16:20No, I was just writing in my neighborhood.
16:22You should always wear a helmet.
16:24Hey, nice of you to join us.
16:25Hey.
16:26Dr. Langdon!
16:30Sold.
16:30It's Dr. Langdon.
16:33Candace O'Grady, 82.
16:35Brought a virus on Richard for intractable vomiting.
16:41Heart lean and hemorrhage on the right.
16:42Looks like the flip worked.
16:43As a heart worker.
16:44Feels full of blood.
16:45First time since we started.
16:46Hold compressions.
16:50Quivering bag of worms.
16:52Resume compressions.
16:53When the heart quivers like that, it's obvious if you fit.
16:56Okay.
16:56Internal paddles ready?
16:58Charge tilt.
16:5925 joules.
17:0050 gets it right the first time.
17:04Charge.
17:04Okay, Whitaker, when you're ready.
17:05Clear.
17:10That's what normal sinus looks like.
17:14Strong carotid.
17:15Saline lap pads and up to the OR.
17:19How the way to start the day?
17:21Unconventional, but a decent outcome.
17:25Why don't we split up for efficiency?
17:27Residents present to either one of us, but not both.
17:31We can certainly discuss that.
17:37Were you feeling weak or dizzy?
17:40No.
17:41I got up to pee and I tripped over a laundry basket that I couldn't see in the dark.
17:44Did you hit your head?
17:46Does my chart say that I hit my head?
17:48No.
17:48We just want to be thorough to make sure you don't miss anything.
17:52Yeah, how about we focus on patching me up?
17:55Ah.
17:56All right.
17:57Mr. Williams, we're going to check an x-ray of your wrist.
18:00and try to get you out of here as quickly as possible.
18:02Great.
18:03And let's keep the bullshit extra charges to a minimum, huh?
18:06My deductible is already a bitch.
18:11Sure.
18:36My mother is trying to destroy my life.
18:38Well, yeah, they seem to take pleasure in that.
18:41I committed to a partnership track position next year at a hospital back in Jersey so I could be close
18:45and support her.
18:46But now she's getting married and selling our house to go on a year-long cruise around the world.
18:52Wow.
18:53I mean, that's a...
18:54That's a pretty fucking stupid idea if you ask me.
18:57She's known this guy less than a year.
18:58What if he's a player?
19:00What if she disappears at sea?
19:02I mean, what if they're in love?
19:04Lust is more like it.
19:05That is even better.
19:08Man.
19:09It has been a while.
19:12And I'm solo this weekend.
19:15I need to get laid.
19:21It's a little much before 8 a.m., right?
19:24Yeah.
19:27Forever.
19:34How's it going, Esby?
19:35Oh, just another day in paradise.
19:55Who's you going on a trip?
19:57Take a sabbatical.
19:59Leave tonight.
20:00Where are you going?
20:02Um, head smashed in buffalo jump.
20:06Captain Crunch flying squirrel socks.
20:08Are we talking in code or are you having a stroke?
20:12It's an aboriginal UNESCO heritage site in Alberta.
20:15I've never seen the Badlands.
20:17What is this, like, uh, some sort of spirit quest?
20:20Uh, yeah.
20:22Something like that.
20:24Look, I, uh, I guess we should talk.
20:26I've got a lot of things I need to...
20:28At some point, not right now.
20:29Right now, I've got to hit the head.
20:30And I would like you to go help Donny out in triage.
20:32Triage?
20:34No.
20:35No, I already picked up a patient in North, too.
20:37A bicycle.
20:38Pretty sure we can cover for you.
20:39We've been doing it for months.
20:43Right.
20:44No, and I am, I am very, uh,
20:47both very sorry and appreciative of that.
20:49I just would hate to think this is some kind of a punishment for...
20:53Uh, yeah.
20:54Yeah, no, for sure.
20:55We'll, we'll talk later.
20:56Before you go.
20:59Like I said, not right now.
21:01Donny just passed his DMP certification.
21:03He can help you if you get in over your head.
21:09Hey, Mel.
21:11Can you take over a bike fall leg-lack in North 2 from Langdon
21:14while he's out in triage?
21:15Um, you know, I, I can work in triage.
21:17No, I want to keep Langdon out in triage,
21:19and I want to keep you back here.
21:21You okay with that?
21:22Sure.
21:23Great.
21:24Absolutely.
21:33So, who should I pick up?
21:35We're about to get the morning rush.
21:37What do you mean?
21:38Every morning around this time,
21:40the nursing homes and assisted living facilities
21:42do their morning bed checks.
21:44Uh-huh.
21:48It looks pretty quiet to me.
21:54Uh-huh.
21:56Incoming.
21:57Oh, like I said, come on.
22:01Ethan Bostic, 79.
22:02Found altered this morning at assisted living.
22:04No history of dementia.
22:06Has a pulse.
22:07What's a pulse?
22:08Position orders for life-sustaining treatment.
22:10No CPR, no intubation.
22:13Then there's, there's nothing for us to do.
22:15South 15 is open.
22:16Uh, well, do not resuscitate does not mean do not treat.
22:20He may perk up with fluids, IV antibiotics.
22:28What's the good word, Crash?
22:30You save that ventriloquist dummy?
22:32Yeah.
22:33Really?
22:34No.
22:36Wait, tell me you're not actually charging about losing a mannequin.
22:39It's part of the exercise, Dr. Lashimi asked us to do it.
22:42Who's his next of kin, Barbie?
22:44Okay.
22:44Bye.
22:46What's your, uh, take on the new attending?
22:50Not too soon to tell.
22:53You?
22:54She's already bugging me about being behind on my charting.
22:57Now I know why everyone says being a second-year resident sucks.
23:00Because it does.
23:01I must have sat through the part of med school where they tell you 90% of your time will
23:05be spent typing.
23:06Which is just one more reason surgery is a better lifestyle choice.
23:10Hey, Dr. Shamsi.
23:11Dr. Trinity Santos.
23:13Ah, yes.
23:14The ER intern who's interested in my surgery program.
23:16Well, it's me.
23:17But I'm an R2 now.
23:18And thinking of double boarding in surgery and emergency medicine.
23:22Which I know would sound ridiculously ambitious if I didn't have the talent to back it up.
23:26And a required attitude.
23:29Are you here to see a patient?
23:31I was.
23:32I did.
23:33And now I'm here to learn why you aren't returning my calls or texts.
23:38Okay, I'm out.
23:39Nice seeing you again, Dr. Shamsi.
23:41As soon as I get a little free time, I will make plans for all of us to do something
23:44together.
23:45What about Tuesday?
23:46I'm working.
23:46On your birthday?
23:48I will call you and Dad tomorrow, and we will come out this night to do together.
23:51I promise, right now.
23:52I just, like, have a bunch of night shift handoffs.
24:03We have schedules.
24:04You have chaos.
24:07You know she's wasting her talents down there.
24:09Victoria is a big girl.
24:10She can make her own decisions.
24:12She's also a young girl who's still very impressionable.
24:15And you can be very...
24:17Impressionable?
24:21Yes.
24:22Who?
24:24Who?
24:25Oh, for God's sake.
24:27I'll be right there.
24:28We need to talk.
24:31About the same time tomorrow.
24:36Next Tuesday is your birthday?
24:38No.
24:40Yes.
24:41Your 21st birthday.
24:42Please don't say anything.
24:43Okay, I get a little anxious about...
24:45Dr. Shamsi, this little girl with her chin legs getting to a gown.
24:47Don't mind, but you don't want.
24:50Nothing.
24:53Have a good day.
24:54You too.
24:55Mele gayonka arawan.
24:59Hey, Duke.
25:00I'm just calling to remind you that this is my last shift for a while.
25:04So I need you to come in before three o'clock in case we need to run some tests.
25:11Okay?
25:12We had a deal, brother.
25:15Oh.
25:16Hello.
25:17Hi.
25:18Hi.
25:18I know you're crazy busy.
25:19Always.
25:20But I figured we should really go over a few things before you're gone.
25:23Sure.
25:24Where would you like to start?
25:26Well, one little thing that I think would have a big impact with staff and patients alike
25:30is if we launched a campaign to eradicate referring to this wonderful department as the pit.
25:37Really?
25:37I know you think it's silly and petty.
25:40No, I think it's just kind of endearing.
25:41Pretty damn accurate.
25:43I would argue the opposite.
25:45I think subconsciously it affects those who work here.
25:48It also lowers expectations, which in turn lowers patient satisfaction.
25:52Well, you've been talking to Gloria.
25:53Yes.
25:54And she agrees with me.
25:55Don't doubt that for a moment.
25:57You have to see the middle of a director.
25:59We see people in order of severity, ma'am.
26:02I don't know what you're saying.
26:07I can't taste the shit in the back of my throat.
26:09Actually, the ladies' rights are going to make all of us sick.
26:11Yes, please.
26:20All right.
26:21We'll get him back.
26:23Tell Dana we're bringing the funk.
26:28Lisa, when did your eyes start bothering you, Miss Matthews?
26:31Sister Grace, please.
26:33I'm only married to God.
26:34Of course.
26:35I'm sorry.
26:36A few days ago, I thought it was pink eye.
26:40Or maybe I scratched it while gardening.
26:42It's a very bad case of conjunctivitis.
26:44We should send a sample to the lab to direct her treatment.
26:47Look up for me.
26:54I'll put a numbing drop in your eye and check for a scratch with a special lamp.
27:01And I'll get you to look up for me again.
27:05Have you ever considered serving God?
27:08Which one?
27:09Excuse me?
27:12My family's Hindu, so we have, like, 33 different kinds of deities.
27:16We have the one.
27:18Some people only need one, right?
27:21Okay.
27:25Most important rule around here, be smart, be safe.
27:28Can't warn you enough about protecting yourself and your fellow nurses.
27:31We use the STAMP acronym to assess patients.
27:34You know it?
27:35Uh, S is for staring or refusal to make eye contact.
27:38If they're staring, they're scaring.
27:39T?
27:40Tone of voice.
27:41Often the threat level rises with their voice.
27:43A is for anxiety.
27:45You can also think aggression.
27:47M is mumbling.
27:48If you're listening closely enough, it's often the same.
27:50What they're thinking of doing is to talk themselves up to it.
27:52And P?
27:53Pacing.
27:54Good.
27:54We also have a safe word.
27:56Hula hoop.
27:57I guess technically it's two words, but whatever.
27:59If there's a threat, say hula hoop, and we'll all respond.
28:04Yeah?
28:06Lovely.
28:07Okay.
28:08I'll be right there.
28:09With Ram fourth mouse.
28:11Duty calls.
28:13We're headed for triage.
28:20I'm gonna get your cash off.
28:41The antibiotics should clear everything up, but you should try to stay off it for a few days.
28:47Uh, I have to work.
28:49I'm late as it is.
28:50Well, um, take breaks and elevate when you can.
28:54Tie it on Advil for the pain.
28:56If the pain persists or feel like it's getting worse, come on back.
29:00We'll get you fixed up.
29:01Thanks.
29:02Listen, give this to the doctor.
29:06What the hell is it?
29:07What the hell is it?
29:08Patient passport.
29:09Let's patients know what they're waiting for and how long it'll take.
29:11You check off if he needs labs, x-rays, CT.
29:14No, and the above.
29:15When do we start this?
29:16Today.
29:17The new attending.
29:20What's up with your tooth, Louie?
29:23It's been going on for a while, but it got bad last night.
29:28Lower left side.
29:30Okay.
29:32Ah.
29:33Oh.
29:33Ah.
29:34Ah.
29:35It could be an infection at the root.
29:37Oh.
29:37We can drain it, but then you're, uh, you're breathing kind of fast.
29:44Yeah, I mean, well, I've been, uh, walking more, trying to get in shape.
29:50Sometimes, like, I get a little short of breath.
29:52Yeah, you need to walk past the liquor store, not into it.
29:56The shape you're getting is for a liver transplant.
29:58I don't need a new liver.
29:59Just get rid of this toothache.
30:01Deep breath.
30:03Ah.
30:06One more.
30:08Is my heart still ticking?
30:09Like a jackrabbit.
30:11How long you been sitting down?
30:12Oh, just for a few minutes.
30:14Not that long.
30:15Um, Louie.
30:19There's something I need to tell you.
30:23Last time I saw you, about ten months ago, I treated you, and I took some of your medicine.
30:32I'm not sure I follow.
30:34I have an addiction to benzos.
30:36And I helped myself to some of the librium I prescribed you for your withdrawal.
30:42You stole my pills?
30:46Yeah.
30:47Yeah.
30:48Yes.
30:48Um, I'm sorry.
30:51It was, uh, it was not only wrong and utterly unprofessional, but it was a betrayal of my
30:58Hippocratic oath, and it was a fucking crime.
31:02That's where I've been rehabbing and counseling.
31:08Huh.
31:09I'm sorry.
31:10I, I understand if you prefer a different doctor.
31:13Hey doc, we have a situation.
31:17Excuse me.
31:19What kind of situation?
31:21Someone left the little baby in the restroom.
31:32Okay, let's think about reversible causes of confusion in the elderly.
31:37Uh, hypo or hypernatremia.
31:39Infection, but he's afebrile, good or two sats, and urine dip was negative.
31:42Yeah, great.
31:43Joy, anything to add?
31:46Nah.
31:49VTAC, can I?
31:50Yeah.
31:53No pulse, should we call for a code blue?
31:55No CPR, no shock.
31:57We honor his pulse and his wishes.
32:00So, what does that leave us?
32:02Making sure he's comfortable.
32:05Palsuction.
32:07Altered mental in the elderly can also be toxicity from anticholinergic, sedative hypnotics, opioids.
32:15Am I missing something?
32:17Social skills?
32:23You look so peaceful.
32:25Should we maybe go find a new patient?
32:26No, stay here.
32:31A systole.
32:42Quick and painless.
32:44We should all be so lucky.
32:45I'll try to contact some family.
32:50Yeah, one of the things we like to do here...
32:56...when we have the time...
32:57...is to take a moment of silence when we lose a patient to respect their humanity.
33:02He was someone's son, perhaps a father himself, a brother, a friend.
33:13Oh, uh, just make sure your phones are on silent.
33:20Great, great, great, great.
33:21Okay.
33:23Is anyone missing a baby?
33:26Did anyone leave their child in the restroom?
33:31You, uh, remember seeing a woman enter with a baby, believe, without one?
33:36No.
33:37Sorry.
33:38Might be on the security tapes.
33:40I'll have them all check it out.
33:42Please.
33:42Yeah.
33:43Harlow Graham to window one.
33:46Harlow Graham to window one.
33:50Harlow Graham to window one, please.
33:58Donnie, Donnie, you're a nurse practitioner, and this is Emma, new grad nurse.
34:01Hey.
34:02Nice to meet you.
34:02What's going on?
34:03Somebody dumped their kid.
34:05Well, maybe Mom just stepped out for a smoke or something.
34:07What?
34:08I'm being hopeful.
34:09Sometimes I just need a little break, and then they come back.
34:13At least I didn't leave her in a suitcase at the bus station.
34:16Does that happen?
34:17If that's a true story, I don't want to know about it.
34:19Get the worst of seeing.
34:20Please, please, don't tell me.
34:21I'm a new dad, remember?
34:23Okay.
34:31I'll get Robbie.
34:33Should I come with?
34:33No, stay here.
34:34Donnie, Jesse, teach her something.
34:39You know how to check a rectal temp on an infant?
34:42Uh, theoretically.
34:52Mr. Williams, how's the pain?
34:55Nothing I can't manage with some Vicodin and a little scotch.
34:59Well, it's best not to mix the two.
35:01James here is going to take you to get an x-ray of your wrist.
35:04I'm going to be fine.
35:06Well, it'll tell us if you need a cast.
35:08I doubt it.
35:09I should probably go home, keep some ice on it.
35:11I know you guys always need the beds.
35:15Well, it'll only take a minute, and then we'll know for sure.
35:19Yeah, I really don't think it's necessary, and I have a busy day,
35:21but I appreciate your concern.
35:27I'd really like to observe you for a little bit,
35:29in case you did hit your head.
35:31My head?
35:33I have my schnoz on my arm, I think.
35:35Nothing more.
35:36You think you don't remember?
35:38No.
35:39Yes.
35:41I'm going to be fine, really.
35:44Thank you for your concern.
35:54How about we take that x-ray, just to be safe?
35:58Yeah.
36:00Yeah, okay.
36:01Okay, good idea.
36:04Somebody found a baby?
36:06Yeah.
36:07Not the first time it's happened.
36:09So, about those pills I took.
36:12Don't worry about it, Doc.
36:13Look, if the pills helped you, great.
36:17I never really liked taking them.
36:21I appreciate that, Louie.
36:23That's not really the point, but...
36:25I need to lift up your shirt for a second.
36:34How long has your belly been hard like that?
36:36I don't know.
36:37I figured I could wait another week.
36:39You need, uh, some lab tests and a procedure to drain off some of this fluid.
36:44Yeah, I know the drill.
36:46I've been tapped a few times before.
36:49Three times in the last six months.
36:52You need to give your liver a break, Louie.
36:55Yeah, I know.
37:01Just heard somebody dumped a baby in the waiting room bathroom.
37:04How sad is that?
37:05Huh?
37:07What's up with you today, Mel?
37:09Lynn, Galia?
37:11What makes you think there's something up with me?
37:13I mean, you're moping around here all day like somebody gunned down your favorite K-pop band.
37:17I don't really have a favorite K-pop band.
37:19Not that I don't like the genre.
37:21Hey, forget K-pop.
37:22What's going on with you?
37:24You usually ride in here on your unicorn tossing wildflowers.
37:28Unicorn?
37:28Never mind.
37:30Is everything okay with your sister?
37:33Oh, yeah, she's great.
37:35It's just this...
37:38Spill, girl.
37:40Um, well, a couple of months ago I got named in a malpractice lawsuit.
37:47And so today is the deposition.
37:52That's it?
37:53Every emergency medicine doc gets sued sooner or later.
37:56Seriously.
37:57Don't sweat it.
37:58I mean, you're still a resident.
37:59We're protected by the hospital.
38:01You could cut somebody's head off and get away with it.
38:04But, you know, like, don't...
38:07You won't want to become known as the one who put Mel in malpractice.
38:12Hey, Santos.
38:13Our little girl Kylie has been in the West Bend Emergency Department a couple times.
38:18Now, I'm not saying this isn't necessarily the case here, but recent studies have linked
38:22bullying behavior to different personality disorders.
38:26On the other hand, though, I am known to be a bit overly sensitive sometimes.
38:31Yes?
38:32You talk to yourself again.
38:33You need something?
38:34Uh, yeah.
38:34I'm a lawyer.
38:35I don't know.
38:36I'm kidding.
38:37I'm not...
38:40Yo, Rabinovich.
38:41Somebody ditched a bundle of joy in chairs.
38:43How old?
38:44A couple months.
38:44Maybe Donahue's got her in peds.
38:46No one saw who left her?
38:47Apparently not.
38:48It's so sad.
38:50Tell me about it.
38:50Who throws away a perfectly good baby?
38:53Make a leg.
38:54Ah!
38:55Sweet baby Jesus, Antoine!
38:57Right to the outdoor shower!
38:58I'll just drive him.
38:59I'm not a wash and detail service.
39:00Yeah, yeah.
39:01God forbid you prove useful.
39:03Ah, good time in the summer.
39:04Time for you and me to do the Lord's work this way.
39:07Oh, God.
39:08What is that?
39:09Okay.
39:10Big breath.
39:13All right.
39:13Lungs sound great.
39:14Can you lean forward for me?
39:22Uh, did you hit your back when you fell down the stairs?
39:26No.
39:27Okay, there's a pretty good bruise here.
39:29I got knocked down in soccer.
39:33Oh, no.
39:34You broke your wrist last year, too, huh?
39:36Fell with my skateboard.
39:37Got a purple cast.
39:39Cool color.
39:40And you were treated at West Penn.
39:42Is that your closest hospital?
39:44Uh, I guess that would make sense.
39:46I've only been dating your dad a few months.
39:49Uh, he lived in Garfield before the divorce.
39:51And, uh, what about these?
39:53Soccer.
39:54Do you wear shin guards?
39:55My dad ordered them.
39:58What does your dad do for work?
40:00He draws buildings, but he's not an architect.
40:03He's, uh, draftsman for a firm in Newcastle.
40:07Um, Kylie, any chance you can pee?
40:11Mm, maybe.
40:12Okay.
40:13Well, uh, with the bruise on your back, we need to check your urine.
40:16Okay.
40:17Okay.
40:21Did you eat anything out of the ordinary recently?
40:23No.
40:24Sorry, but we went through this a bunch.
40:27Don't you people communicate?
40:29You're the third nurse we've told her story to.
40:30I'm a doctor.
40:32Richard.
40:33Would you go to the cafeteria and get me a large chamomile tea?
40:37What can we get you, my dear?
40:39I'm fine.
40:44Yeah, I'll be right back.
40:49Please excuse my son.
40:52Ever since my husband died, he's been a little overprotective.
40:56I think it's sweet.
40:58You're very lucky to have him.
41:00I am.
41:02Are you still taking your loperamide and cholestyramide?
41:07Um, not so much.
41:10No?
41:11That may be why you're experiencing the abdominal pain and vomiting.
41:15When did you stop taking your meds?
41:17Last winter or so.
41:21My neighbor Helen and I bingo in Wintersville.
41:25There's a dispensary next door.
41:28And we got some marijuana.
41:30And I swear, it cleared everything up.
41:34A few cookies.
41:35Every few hours.
41:37And no more pain.
41:40A few cookies?
41:43How many are you eating in a day?
41:45Oh, uh...
41:47I don't know.
41:50Probably a dozen or so.
41:52But they're not very big.
41:55There have been some studies that show an added dementia risk with marijuana use in older adults.
42:03No, that sucks for old people.
42:07Kylie, there are some questions that we ask every kid who comes in with an injury.
42:13Like what?
42:14Like, sometimes the people that you live with can get so mad that they hit you or hurt you, maybe
42:24without even meaning to.
42:26Does that ever happen?
42:27No, not to me.
42:29Or sometimes kids can get punished for doing something wrong with maybe a spanking or a belt.
42:37I get timeouts.
42:40How about at school, Kylie?
42:42You know, is anybody being, you know, mean or bullying you?
42:45No, I have lots of friends.
42:47No, I have lots of friends.
43:17Many times.
43:18Good morning, Mr. Cloverfield.
43:19What's up, Doc?
43:20Where's your new resident badge buddy, buddy?
43:23Oh, uh, yeah, they didn't give me a new one yet.
43:26Bummer.
43:28You and your ducklings got time to tap a six-pack off our friend here?
43:31Louie needs a paracentesis.
43:32Yeah, sure.
43:34It's good to see you again, Louie.
43:36Not in this condition, of course.
43:37How are you feeling?
43:38Feeling like I need a drink pretty soon.
43:42Okay, well, first things first,
43:43we are going to make you more comfortable by draining some fluid.
43:47You're going to take off a big volume.
43:49Start with 60 grams of 25% albumin IV.
43:52You tapped him before?
43:54No.
43:55That's okay, Doc.
43:56I'll talk him through it.
43:58Okay.
44:01Sats, 99 on room air, normal BP, normal pulse.
44:07Oh, well hydrated.
44:09No obvious source of infection.
44:10Could be a benign virus, but can't assume that.
44:13Is this the abandoned baby?
44:15Mm-hmm.
44:16How old?
44:17How old do you think she is?
44:19A month?
44:19A month and a half?
44:20It's tricky.
44:22Under 28 days is a safe haven drop-off, no questions asked.
44:25But over 28 days is a crime, child abandonment.
44:29How should we assess?
44:31Under 28 days gets everything, including an LP.
44:34But over 28 days, you can follow PCARN
44:38or step-by-step determine risk of invasive bacterial infection.
44:41This baby looks great.
44:42We know nothing about the birth history.
44:45Did mom have group B strep, active HSV lesions?
44:48We should assume the worst.
44:50Put in your orders, Dr. Mohan.
44:54CBC, blood culture, chem panel, chest x-ray, UAN culture,
45:00respiratory virus panel, check inflammatory markers,
45:04procalcitonin, and CRP.
45:07Then take it from there.
45:09That sounds like a plan.
45:11Dr. Robbie, Santos needs you, North One.
45:13Okay, I'll be right there.
45:15Feel excuse.
45:16Feel excuse.
45:19Mind if I join with?
45:20Uh, no.
45:22I got this.
45:23It will help me get a better sense of how you like to do things
45:26by seeing you in action with the residents.
45:29Be my guest.
45:33I will be right back.
45:41Um, nine-year-old Kylie Connors took a tumble running up the stairs this morning,
45:45chin-lack and fractured tooth brought in by her dad's girlfriend, Gina.
45:50Supposedly, the dad had to leave early for work.
45:53Kylie has a lot of bruising on her body.
45:56Some old, some new.
45:57Are you concerned about non-accidental trauma?
46:00Or worse, her urine sample shows gross hematuria,
46:05which could be renal injury or vaginal bleeding from trauma could have contaminated the specimen.
46:10Lots to consider.
46:12What's your plan?
46:13Labs, ultrasound, social work consult, then decide if this is reportable.
46:18Mm-hmm.
46:22Let me know if you can feel this.
46:24No.
46:25Am I supposed to?
46:26No.
46:31Your hair's such a pretty color.
46:35Reminds me of my mom.
46:37She died when I was nine.
46:39Oh, I'm sorry about that.
46:41She wore glasses like you, too.
46:43Weird.
46:45And what do you like to do when you're not working?
46:49Um, spend some time with my sister.
46:51Read.
46:53Do you drink coffee?
46:55Uh, no, I avoid caffeine.
46:58Me, too.
47:01What about boba?
47:04I love boba.
47:10It'll be some gum, but it's laced with nicotine, trying to quit smoking.
47:16That's good.
47:17Birdie's still out.
47:19Getting all those nooks and crannies, Mr. Digby.
47:21Your skin will thank you.
47:23We all will.
47:25I could stay in here all day.
47:29A miracle what a little soap, water, and human decency can do sometimes.
47:33Don't forget the ears, pal.
47:35Don't want anything growing in there, either.
47:37Okay.
47:38Okay.
47:39What's your story, Emma?
47:40What do your parents do?
47:41Got siblings?
47:42Boyfriend?
47:43Have a killer man in a bar fight?
47:48Uh...
47:57So, Mr. Williams, sometimes a fracture of the scaphoid bone doesn't show up on day one.
48:03So, my advice to be safe is we're split for two weeks and then come back for a repeat x
48:09-ray and we'll see if it's really there.
48:13My knee hurts.
48:15Oh, did you hurt your knee?
48:19I must have.
48:27What is this?
48:30That's, um, for your wrist.
48:33And I need this?
48:36Well, um, if it's a, uh...
48:39John, can you...
48:40Yeah.
48:41If it's a fracture and we don't immobilize, the bone might not heal properly.
48:48How long is this going to take?
48:51Just a few minutes to fit you.
48:56Is this place new?
49:02Mr. Williams, do you know what day it is?
49:09It's Taco Tuesday.
49:12Do you know where you are?
49:15Yeah, I'm in the slowest medical clinic in the West.
49:19Do you know what year it is?
49:21How about you just fix my wrist and you stop with all the questions?
49:27I am not here to be profiled.
49:34Yeah, of course.
49:38I'll be back, okay?
49:51All right, Mr. Digby, looking better already.
49:53Certainly smell a little better.
49:55Do you have any conditioner?
49:56Let's get you dried off and back inside.
49:59Get him downed up and put him in South 21 and cross from the old nun.
50:02Maybe some have heard the fine gray, so we're off on him.
50:05Who do we have here?
50:06Sir, Evelyn Bostick, 81, with Alzheimer's.
50:09We brought her husband in about 30 minutes ago.
50:12She was supposed to get a ride in, but they found her wandering in traffic.
50:14Where are we?
50:15You're at the hospital, dear.
50:17I'm not sick.
50:18We brought you to see your husband.
50:20Oh, no.
50:21Is he isn't okay?
50:22Be in to chat with you, Mrs. Bostick.
50:25He died.
50:27What you got, Aunt Boy?
50:29Alan Billings had a palate fall into his outstretched arm.
50:32Looks like an open dislocation.
50:34Yeah, that's gotta hurt.
50:35Don't worry, sir.
50:36We got you.
50:43What's she doing?
50:44Seems happy enough.
50:46Yeah.
50:47I just got a quick point of care, CBC.
50:51Oh.
50:57Is there a problem?
51:02Did I miss something?
51:04Dr. Al?
51:06Dr. Al?
51:14I'm in hurt
51:17But I refuse to cry
51:29It's so true
51:30You know, you know, you know, you know I cannot
51:33Stop.
51:35And I said, yeah, yeah, yeah
51:38Yeah, yeah
51:57Yeah, yeah, yeah
52:03You know, you know I won't cry, baby.
52:07I'm telling you, I won't cry.
52:10Oh, I don't like, oh, but I refuse to cry.
52:17And I say, sometimes, darling, your friends, they treat you so cold.
52:24But, baby, you know they act better, yeah, yeah, when you have that cold.
52:32But, I won't lie, y'all know, y'all know, y'all know.
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