- 9 hours ago
Emergency - Season 6 (AU) - Episode 02
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00:00John started dodging a coming car.
00:03It's then resulted in him actually hit another park car
00:06and landed about five metres away.
00:09When your motorbike stops and you don't stop,
00:11you can have any number of injuries.
00:15He cannot feel his legs.
00:18Usually when we see this,
00:19it means that they're going to be a paraplegic.
00:22It's a disaster.
00:23Alright, let's go.
00:30Look inside my eyes and help me try to ease the pain.
00:34You're my lifeline.
00:36It's gonna be right.
00:41You're my lifeline.
00:44Reach out your hand.
00:47Take mine.
00:50Very worried for you, my friend.
00:52The blinds drink smashed abuse.
00:55He's actually stopped breathing.
00:57Oh, it's serious.
00:59Without intervention, he's likely to die.
01:01That's better.
01:03I need you to save me now.
01:20Royal Melbourne's newest recruit emergency registrar,
01:23Dr. Ruth, is juggling two big life changes.
01:27In the six months that I've been at Royal Melbourne Emergency Department,
01:30I've also got married.
01:33My husband, Jordan,
01:35we've been together for over ten years
01:37and I wouldn't have been able to do any of it without him.
01:41So I don't like working completely without one of my rings on.
01:44So I've found a necklace that I can wear
01:47that will safely hold my wedding band or my engagement ring
01:51while I'm doing anything particularly messy.
01:54No matter how hard the shift is,
01:56knowing that I'll be able to go home to Jordan is invaluable.
02:01But today, in a non-stop ED, the honeymoon is over and the pressure is on.
02:08Royal Melbourne receiving.
02:10An ambulance is minutes away with Dr. Ruth's first case.
02:14I've got a 54-year-old male that's been on a motorbike
02:17and it is a witness to strike the bonnet of an oncoming car.
02:22He has no sensation or movement,
02:24sort of distally or probably his locker region.
02:28MBA, deformed wrist, lower limb reflex loss.
02:31When you hear no sensation, no movement in the legs after a motorbike crash,
02:35you're very worried about spinal cord injury.
02:38But there are other things we need to rule out
02:39that could be more immediately life-threatening.
02:4254-year-old John was only three minutes from home
02:45when a collision with a parked car
02:48catapulted him over the handlebars of his bike.
02:51We think maybe he's got a broken spine and a broken wrist.
02:55So who's doing what?
02:57With the countdown to the man's arrival on,
02:59it's all hands on deck with Dr. Jonathan taking the lead.
03:03Hi. Come on in.
03:05Hi, John.
03:06We're going to get you over to the bed next door
03:07and then we'll all do a lot of things around you at once.
03:10One, two, three.
03:13John started dodging a coming car.
03:15It's then resulted in him actually hitting another parked car.
03:21He's then flipped over the top of it
03:23and landed about five metres away.
03:25He had significant sternal pain.
03:27From there down, he cannot feel any sensation whatsoever.
03:31This is pretty bad.
03:32When your motorbike stops and you don't stop
03:34and then strikes something,
03:36you can have any number of injuries.
03:38He's got pain in his chest and pain in his back.
03:41John, can you feel me touching both sides?
03:43He can't feel anything from there down.
03:45I've got a really bad feeling that he's got a spinal cord injury.
03:48Can you try to wiggle your toes again for me?
03:51I'm trying.
03:52The team immediately check for any sensation in John's legs.
03:56I'm feeling it in here.
03:58I'm feeling it down here.
03:59I'm feeling it down here.
04:00I'm feeling it down here.
04:01I'm feeling it down here.
04:01I'm feeling it down here.
04:01It feels like ice.
04:03John's saying that it feels like ice when his lower legs are touched
04:06is suggestive that there is damage to his spinal cord.
04:10Ready for x-ray when you are.
04:13If he has a really serious spinal injury, he may never fully recover.
04:19He will be a paraplegic.
04:21John, who's your next of kin?
04:24Facing the grim prospect of never walking again, John urgently needs his family.
04:31Our sister.
04:32Who's that?
04:33Your sister.
04:34It's crucial.
04:35Nurse Eliza tracks them down.
04:37Oh, you just have to keep holding the light.
04:39Yeah.
04:42She's old school.
04:44He needs to have his best people by his side immediately.
04:49Because he's terrified.
04:51Because he cannot feel his legs.
04:52I need my brother.
04:54I'm not just a you, please.
04:56I'm straight away, please.
04:57John shares a close bond with his older brother, Patrick.
05:02John's a pretty amazing person.
05:04He is really kind and giving and patient.
05:10He's the type of person that would give the shirt off his back for someone else.
05:14John is very, very important to me.
05:16You think the worst in these types of situations.
05:20How's the ultrasound route?
05:21Lungs are good.
05:22So lungs are good.
05:23I think he's got a sternal fracture.
05:24First tests reveal John doesn't have a punctured lung.
05:28But Dr. Jonathan is worried his chest pain could be critical.
05:32That's a big problem.
05:33There's many reasons why he'd have pain in his chest.
05:36He could have broken ribs, broken breast bone.
05:38But he might have done something even worse.
05:40Are you happy with the chest x-ray or do you want me to do another one?
05:43Yeah, yeah.
05:45There's lots of important structures in your chest and it's never good when you've got chest pain in a trauma.
05:51Hmm.
05:52What's going on there?
05:53That's not normal.
05:54Like he's got a mass or a hematoma or an aorta or something.
05:58See that?
06:00That's not.
06:00That's bad.
06:01The x-ray reveals John's heart is in extreme danger.
06:05That's not good.
06:07Hello.
06:08I'm just going to look at your heart again.
06:10There's a widening around his thoracic spine.
06:13That might be there because he's got a fracture in that area.
06:16But his heart sitting there as well could be damaged.
06:19Your stomach feels sore?
06:21Under the chest.
06:22Under the chest.
06:22I'm looking for fluid or blood around the heart, which will cause him to have a cardiac arrest.
06:28In your chest, is it the middle part?
06:30Or under the chest plate.
06:32Oh yeah, yeah.
06:40OK.
06:41When Director of Emergency Training Dr Cheung is on shift...
06:45Check out some of the babies.
06:46Hello.
06:46..the nurses know a game of trivia could strike at any time.
06:51It's the talk of emergency.
06:53Really?
06:54I like to keep everyone on their toes.
06:57So I like to imagine the worst case scenario that could happen to the patient.
07:00And if it does, there'll be no surprises.
07:04And today's contestants are nurses Abby and Ruby.
07:09I've got a 60-year-old female who's fainted maybe seven times since last night.
07:13She's got a low blood pressure, but heart rate is pretty quick.
07:16What should we give her?
07:18What's your pain?
07:19Anything else?
07:21Starts with I.
07:23Isoproniline.
07:24See?
07:24They knew the answer.
07:30As Dr Cheung's next patient arrives, the questions turn to an injury rarely seen in the ED.
07:37So I've been told that there's a female patient coming who's been transferred from the Middle East with shrapnel wounds
07:46to her face.
07:47So she's relaxed.
07:49The patient, Ronim, is an Australian student who was studying dentistry in the West Bank when shrapnel from a bullet
07:56tore through her eye.
07:58To be honest, I'm still, you know, shocked by the event.
08:02I'm still trying to cope with it.
08:04I feel like I'm seeing, but I'm not.
08:06After unsuccessful eye surgery in Jerusalem, Ronim flew home to Melbourne for further treatment.
08:13How are you feeling?
08:14Are you okay?
08:16I'm sorry.
08:17I'm okay.
08:18Her mum, Rana, hasn't left her side.
08:25Hello.
08:27Hello.
08:29I'm sure nice to meet you.
08:30I'm one of the doctors here.
08:31How are you going?
08:32Yeah?
08:33It could be better.
08:34Yeah.
08:35I'll come around this way.
08:36Can you tell me what happened?
08:38Mm-hmm.
08:39So I was in my apartment in Abu Ghz, Jerusalem.
08:42Mm-hmm.
08:43The West Bank site.
08:44And out of the blue, we heard sound bombs.
08:48Yeah.
08:48My friend, she decided to take a look out the window, and we got shot at.
08:54The bullet hit the corner of the window, and her face was covered in blood, but it wasn't her injuries.
09:03It was actually, the blood was actually coming out of my eye.
09:05The shrapnel.
09:06Yeah, the shrapnel hit my face, my eye, and they did an operation on my eye.
09:10In Jerusalem?
09:12Yeah.
09:12To maintain the structure of the globe.
09:15Okay.
09:15Yep.
09:16I was in contact with the Australian embassy regarding moving to Australia to continue with my treatments.
09:22So they helped me cross the borders from Palestine to Jordan.
09:26Okay.
09:27You're falling back from there.
09:28So tell me, have you got vision out of the eye?
09:31The minute I got hit, I lost my...
09:33You've lost vision.
09:34No light, no light.
09:35Nothing.
09:35All right.
09:36So when I look at the eye, it is sunken.
09:38I'm very worried that she will not regain her vision.
09:41Any problem with the facial bones?
09:43No fracture?
09:44I do still have shrapnel in my face, so I don't know anything.
09:48That's all right.
09:48You lie back.
09:51Any pain on your cheekbones?
09:53Yeah, yeah, yeah.
09:53This side?
09:54Yeah.
09:54From the shrapnel?
09:55I think it's shrapnel.
09:56Yeah.
09:56A few other things up there.
09:58Up there too.
09:59Just that I don't feel the side of my head.
10:01Oh, okay.
10:02She tells me that she can't feel the side of her head.
10:04I'm worried that it's gonna be permanent nerve damage.
10:07Also, there's potential for the shrapnel to penetrate the skull.
10:11If there's shrapnel in the brain, operating on the shrapnel could potentially kill her.
10:15We'll do another scan.
10:17In particular, we want to see where these shrapnels are in relation to the skull.
10:22So, it must have locked the nerve.
10:24Anyway, the scan will tell us where they are.
10:27Any questions?
10:28Rana is fearful her daughter may lose her eye completely.
10:33The most important thing that, you know, she has hope to save her eye.
10:40Yeah.
10:41So, I'll speak to the eye surgeons.
10:44This is the most important thing that, you know, she has.
10:48Anyway, we'll go slow, all right?
10:52I don't want to give you false hope, okay?
11:02The most important thing that, you know, she has hope to save her eye.
11:09Yeah.
11:10Dentistry student Raneem has lost vision in her right eye after a bullet hit the window
11:16of her apartment in the Middle East, pelting her with shrapnel.
11:20So, I'll speak to the eye surgeons.
11:23After eye surgery in Jerusalem failed, she's desperate to know if Dr Cheung can save her eye.
11:31Not sure.
11:33Okay.
11:34All right.
11:34Okay.
11:40So, I have to speak to the eye surgeons.
11:42I don't think she'll be able to ever see out of that eye again.
11:45So, the next step now is whether she can preserve her eye.
11:50And then there is a patch of numbness to the right side of the scalp.
11:53It could be that one of the shrapnel's severed the nerve.
12:01Still in shock from her daughter's ordeal, Rana was at home in Melbourne when family broke the news.
12:10At first, we didn't know it's a bullet.
12:14It was really, really a very horrific moment to hear.
12:18I have never imagined that her injury was so severe.
12:25I think we should give a formal history handover.
12:27Neurosurgeon Dr Mohamed's expertise is needed.
12:31I'm assuming at the moment, can you see our type of eye or not?
12:34No.
12:35Nothing at all.
12:35Anywhere else?
12:36I think I got one in my ear, but it's really small.
12:39But it's just when I, you know, kind of like touch it, I feel sting.
12:43Yeah.
12:44Okay.
12:44All right.
12:45Well, we'll get you a CT scan.
12:46Let's see what's going on first and take a minute.
12:50The team act quickly to get Ranaim scanned.
12:53Oh, yeah.
12:54CT is fine.
12:55Oh, yeah.
12:55She will have a CT scan now which will identify all the metal fragments,
13:00how deep they are, how extensive they are,
13:02or whether there's any shrapnel inside her head
13:04or any neurological injuries that may be something that we need to deal with.
13:08See you soon, all right?
13:10She's a dental student.
13:11She may not be able to go back to studying dentistry.
13:15This is an extremely significant life-changing injury for her.
13:27As the day wears on in the emergency department, case numbers continue to climb.
13:33Royal Melbourne receiving.
13:35Good afternoon, Royal Melbourne.
13:37This is a patient with a left shoulder dislocation.
13:40We've had quite a delay in extricating this patient as he was under a house.
13:44He has a very altered sensation through his left hand with reduced sensation in fingertips.
13:51With the patient's arrival imminent, emergency doctor Manny springs into action.
13:57We know very little about the story at the moment other than he's been found underneath a house
14:02and the ambulance crew think that he has dislocated his shoulder.
14:06There can be potentially serious injuries and they're definitely extremely painful.
14:1129-year-old Radisson, an apprentice electrician, was working under a house
14:16when he reached back to grab a cable and felt his shoulder pop.
14:20He was trapped for an hour as Fiery's removed Briggs to get him out.
14:26Couldn't have happened in a worse place.
14:30Hey guys, Radisson?
14:32Hi man.
14:32Hi Radisson, my name is Manny, I'm one of the emergency doctors.
14:35I'll let my ambulance colleagues here get you across and then we'll hear the story.
14:38Every movement the young Sparky makes causes him excruciating pain.
14:44So this is Radisson, this is his fifth dislocation.
14:46Right, so are you happy considering this is already pretty much cut if I cut the rest of the shirt
14:50off?
14:50Yeah, it's a lot of work shit.
14:51He's also got some numbness and tingling in his fingers.
14:54Yeah, looking at his sort of left hand.
14:56His fifth and fifth blue.
14:57And he's had 7.5 of IV morphine.
15:01The ambulance is concerned not just with the altered sensation in the patient's hand
15:05but also the fact that it's changing colour.
15:07There may be damage on one of the major arteries in the armpit, which is a medical emergency.
15:11Can you feel me touching on the outside of that hand?
15:14Yep.
15:14And on the inside?
15:15Less so, yeah.
15:16Less so along the thumb.
15:17Yeah.
15:18How about just around the shoulder?
15:19Very dull.
15:19So it's very dull around there.
15:21You've clearly got an off-ended shoulder.
15:24The things that we're worried about sometimes when shoulders come out is not just the bony injury,
15:28but sometimes it can also stretch nerves around the shoulder joint,
15:31which is why you're still a little bit numb over there.
15:34So I think we should just crack ahead, get that shoulder back in in the next rate
15:37and see what we're dealing with.
15:38After five shoulder dislocations, this is a procedure the young Sparky knows well.
15:45I think given your past experience would probably just go straight to sedation.
15:49I agree.
15:49My priority in this situation is to get the shoulder joint back into its normal place as soon as possible.
15:55And certainly giving a sedative and aesthetic does help us make this experience a little bit better for him.
16:01I'm going to get one of my colleagues to assist me with that.
16:04Any questions about that at all?
16:05Nah.
16:06Oh, I do have pliers in my pocket.
16:08Pliers.
16:09Okay.
16:10I don't know if you guys need any.
16:11We're not going to need it to put the shoulder back in.
16:14Good on you.
16:14No worries.
16:16With Radisson on board with the plan, emergency nurses Georgia and Chris gather the proper tools for the job.
16:23Radisson, what I'm going to do is start giving you some oxygen before we put you off to sleep.
16:27Yep.
16:27Dr Scott arrives to help with sedation.
16:30Hey mate, I'm Scott.
16:32Hi mate.
16:33Have you had a general anaesthetic before?
16:35Yeah, first time in the hospital they gave me something, put me under.
16:38Yep.
16:38I don't remember it.
16:39That's okay.
16:40That's probably a good thing.
16:41They were surprised that so much.
16:43Okay.
16:43There are risks of any sort of anaesthetic.
16:46We want to find a sweet spot where they're asleep enough that they're not aware of the procedure and they're
16:51not suffering any discomfort.
16:53Giving more medications can increase the risk of side effects.
16:57In a lot of cases it will make them stop breathing.
16:59Alright, no objections to a starting.
17:02This is a high risk procedure and the team must follow a strict protocol.
17:07So we'll just run through the checklist, so departments, airway doctor, airway nurse, proceduralist, scribe.
17:15Alright, so I'm going to give 50 a propofol to start and we'll work up from there.
17:25Have you got feeling in your fingers or not?
17:27Yeah, you can move them?
17:28Yeah.
17:29I'm just going to look at your heart again.
17:31An horrific motorbike accident has left John paralysed from the waist down.
17:36Yeah, I've got a good view of his heart.
17:38But an x-ray has led Dr. Jonathan to a potentially bigger problem.
17:43A life-threatening injury to John's heart.
17:47With the ultrasound we're looking for fluid or blood around the heart, so that's really serious.
17:52That's perfect.
17:59That looks fine.
18:01I don't see a big aorta, so maybe that's something else.
18:05You're doing well, mate.
18:06So I do the ultrasound and there's no fluid around the heart, which is great.
18:10And just confirming still loss of sensation.
18:12But for Dr. Jonathan, the relief is short-lived.
18:16We don't have to turn to the real problem, which is why John can't move his legs.
18:20We're going to roll you on your side.
18:22Just want to have a feel down your back and see where it hurts.
18:25What I think I saw in that x-ray is a fracture.
18:27It's a bad one.
18:28If you hang on to your sore hand, because his spinal cord's going to be injured probably around that area.
18:35One, two, three.
18:38John, is there any pain where I'm pushing?
18:40No.
18:41No?
18:41Any pain down here?
18:43No.
18:44What about down here?
18:45Yeah.
18:46Yeah?
18:46Yeah.
18:47What is that?
18:48This is upper thoracic.
18:51Yeah.
18:54Where the x-ray looks funny.
18:56Yeah.
18:57Can you feel me touching down here?
18:58Near your bottom?
19:00Nothing.
19:01He's now tender in his spine, as well as not moving his legs.
19:04They are the classic signs of a spinal injury.
19:09Terrified, he still has no feeling in his lower back.
19:12John urgently needs the support of his family, who are on their way.
19:20Hello.
19:20How are you feeling?
19:21You're not moving your legs.
19:23Is that right?
19:23They don't move?
19:24Yeah.
19:25Yeah.
19:25So we're going to get a scan and have a look and see what's going on.
19:29All right?
19:29Yeah.
19:30Yeah.
19:31Well, we're going to try and work that out.
19:34Do you have any...
19:36Can you move them at all or not?
19:39Okay.
19:40Yeah.
19:41Yeah.
19:41All right.
19:41They've sort of all gone numb.
19:43Yeah.
19:43Okay.
19:48The main thing here is going to be that he can't move his legs properly, and that's
19:52the devastating injury.
19:53We can fix rib fractures and sternal fractures, but we can't fix spinal cord injuries.
19:57We've got high likelihood of a spinal fracture, but not everyone has a permanent injury.
20:03Some people have an incomplete injury, and some people actually recover.
20:06So we don't actually know what's going to happen.
20:09There's always hope.
20:10All right.
20:10Let's go.
20:39Let's go.
20:54Let's go.
21:04Let's go.
21:06Let's go.
21:06Is it going to hurt?
21:08Look, I don't think so.
21:10It's just the skin's sort of grown over them a little bit.
21:16she's a very brave yeah my biggest worry that the doctors will say yeah no we can't save her eye
21:26and how this will leave an impact on her life
21:38the final report on Renee CT paints a confronting picture I've been working in emergency for over
21:4620 years and no I've not seen an injury like this not in Australia you can see more shrapnel on
21:52the
21:52nose on the cheek and that's on the side of her scalp there is so much shrapnel everywhere in
21:59the eye in the face it's just catastrophic how much these weapons cause this sort of effects on
22:05on the body that one's pretty close to the skull but I don't think it's gone past the skull so
22:11she
22:11hasn't got a broken skull if the shrapnel had gone a couple of centimeters further into the brain you
22:17could have died this is the main concern there's a large piece of shrapnel lodged within the right
22:22eye itself that's that's that's the end of the eye might have to give her a prosthetic eye Dr Cheung
22:32must
22:33now deliver the shattering news now the thing with the eye I don't think we'll be able to preserve
22:41their sight well I'll speak to them about the eye itself but I think the vision itself could could
22:48be lost so it's a long journey for her from here she's going to go up to the ward and
23:05she's going to
23:06be seen by multiple surgical units so for her the immediate question is do we have to take the eye
23:12out and then shrapnel on the rest of the body it's almost impossible to remove every piece of
23:17shrapnel there'll be a piece of metal in her for the rest of her life a daily constant reminder of
23:23what
23:23happened to her I'll be honest with you but we'll see about the eye itself yeah she has a dream
23:31to
23:31become a dentist like a mother but unfortunately with the vision loss I doubt that she will be able
23:37to so this is a great tragedy Raneem's hopes of keeping her eye now lie in the hands of eye
23:46surgeons
23:46I'm thankful that I'm with my family but it still does break my heart that my eye my dreams my
23:56vision
23:59they they didn't come along the trips sadly you know how you doing there Addison we'll try and get on
24:21top of that as best we can but hopefully we'll have you nice and sleepy fairly soon
24:25Dr Manny and Dr Scott are about to sedate Addison so they can quickly relocate his shoulder
24:32uh it's always busy here it's amazing how you're thinking about us right now
24:38the young Sparky's hand is tingling and turning blue suggesting a bigger threat I'm going to give 50
24:45of propofol to start we're worried about a nerve injury or a vessel injury the safest and most
24:50appropriate thing is putting them to sleep and get the joint back into place as quick as possible to
24:54avoid that injury from progressing this one sometimes stings a little bit as it goes in
24:59Dr Scott gives the first dose of the powerful sedative just try and keep your eyes open for
25:07us as long as you can doesn't work instantly all the secrets come out now
25:22with the propofol we'd usually give it in small doses in this circumstance we still haven't quite got
25:28the effects that we want we often end up with a patient in what we call the twilight zone where
25:33they're not quite asleep we might need to think about reaching for a second vial
25:37I'm going to give another 50 of propofol this is going to ruin my dnd painting session
25:43or make it well we'll try not to keep you too long Radisson's worry about his dnd painting
25:49has left the doctors totally bamboozled what was the dnd plan do you know
25:55what's the first we're hearing of it 40k fans 40k what's that I don't know young people
26:04I don't know young people things anymore but Radisson's off the wall chat is nothing new to
26:16a nurse Chris you were not a nerd in school that's 50 in uh I was but in a different
26:21way
26:22different kind of nerd Warhammer 40k is a tabletop game with miniature figurines Dr Scott and Manny
26:27don't seem to have an idea of what we're talking about but Radisson and I I know that we're speaking
26:31the same language happy if we try to lifelight yeah go for it all right still with us there
26:39with the sedation kicking in the team make an attempt to get Radisson's shoulder back into place
26:46all right you need anything from me not at the moment
26:52I think I'm going to need more sedation from you in fact quite a lot
26:56you're okay man just trying to get that arm into a better spot okay with Radisson's shoulder still
27:03not in place I'll just get the traction on dr. Scott gives more sedation so dr. Manny can try
27:11again so George I'm gonna give you another 50 so the 250 so far he's still resisting me quite a
27:23bit
27:24this guy yeah Radisson has had a really high dose of sedative medication we do
27:33run the higher risk of causing problems with breathing I'm still getting a little bit of
27:38resistance but I'm desperately hoping that we're successful with this attempt
27:47there you go oh well done mate finally Radisson's shoulder is back in place so this is usually the
27:57risky part but now there's potentially an even bigger problem so once we've stopped giving him
28:03a painful stimulus all that anesthetic catches up to them so they often stop breathing now
28:08that's exactly what happened Radisson big breaths for us mate usually we can tolerate about 30 seconds
28:14of a patient not breathing anything beyond that the oxygen levels can drop very very quickly we might
28:19need to hook them up to a ventilator to support their breathing big breaths big breaths take some deep
28:25breaths for us 29 year old tradie Radisson is not breathing Radisson after he was heavily sedated
28:33so dr manny could pull his dislocated shoulder back into place
28:37I'm just gonna go bed down Chris yep Radisson big breaths mate come on all done if he doesn't start
28:44breathing within 30 seconds the team will need to take urgent action and put him on a ventilator
28:50hey Radisson open your eyes for us all done take some nice big breaths yeah
28:57big breaths for us well done back we go still got a pulse we can rotate yep once he's starting
29:03to show
29:04signs of breathing on his own it's usually a sign that the anesthetic's wearing off and that we're
29:08out of the danger zone hey Radisson open your eyes it's all finished you're slowly waking up it all went
29:14really really well we're just going to get an x-ray now and make sure that it's all good okay
29:18thanks
29:19managed we're gonna head around for x-ray now I hear if you get to 10 dislocations you get a
29:24superpower
29:25well the x-ray will show if Radisson's shoulder is in exactly the right spot and there's no nerve damage
29:34if you hold nice and still we'll take that first picture okay yep with Radisson all smiles
29:40dr manny can finally see if the procedure has worked we've got the shoulder successfully back in position
29:47very happy with that we'll get him home shortly hey Radisson how's the hand feeling better better
29:55basically it looks like everything's okay it's back in position what we'll do is we'll move you to our
29:59rapid stay area just to keep an eye on you for another half hour or so and I'll organize your
30:03discharge paperwork okay thanks man but before Radisson can leave dr manny is curious about Radisson's
30:10mysterious dnd plans what do you remember about what you may have told to us while you were under
30:16what did I say something do you know Dungeons and Dragons Dungeons and Dragons thank you very much
30:22at the end of the work today I was gonna meet up for like five friends of mine and paint
30:27our little
30:27miniatures luckily I paint with the right hand so hopefully I can keep a steady hand today should
30:32be fine pleasure see ya John we're gonna do the rolly thing again okay well you stay still and we
30:50move you okay just on to the CT scanner bed a motorbike accident has left 54 year old John with
30:57potentially devastating injuries we'll see from the scans so don't think about that now we don't know
31:04we need to get the scan and we'll find out okay John is starting to realize the gravity of the
31:11injuries
31:11he might have it's hard to know the best way to answer these questions when I don't have all the
31:15answers John I'm just about to start that injection warm feeling coming yeah it's got a big hematoma and a
31:33fracture hasn't it yeah yeah hmm what's impacted wow I don't know but it's probably t2 or something like
31:42that yeah so he's got a fracture it looks like where we saw it on the plane film so high
31:49up in
31:49his thoracic spine looks like the bones shattered and that would explain why he's not moving his legs
31:56down two three oh one three one two three ejection as John is taken back to the trauma bay dr.
32:08Jonathan
32:08stays behind waiting for the specialists to confirm just how badly John's spine is injured
32:17in my back break when I fell down yeah yeah it's not great it's not great but we'll know more
32:26what
32:26they can do about it when their specialists have had a look and they'll come soon okay
32:43yeah she's coming but as we get more and more of the results of the scans it's hard to work
32:48out
32:49what to tell John we can't know what the injuries are for certain so until that there is still hope
32:56that these injuries aren't as serious as they seem see what the rest of the film looks like
33:1654 year old John has survived an horrific motorbike accident that has left him with a fractured spine
33:23to find out if he'll ever walk again dr. Jonathan has called in specialists to review the CT scans is
33:31there a bit in the spine yes you just got a burst fracture there's a bit of bone it's just
33:35sticking
33:36into the canal into the canal the whole thing's disrupted yeah yeah usually when we see this it
33:42means that the person's not going to be walking again they're going to be a paraplegic this is
33:46something that we can't fix it's a devastating thing what else can I say John I've had a look
34:03that you do have a really bad fracture in your T4 vertebrae so about sort of this level in the
34:11back
34:11your legs they're not working now and that's probably because your spinal cord's been damaged
34:19I'm worried that you won't walk again from what I'm saying yeah it's bad that's why not moving your
34:25legs all right yeah yeah I'm sorry that that's that's what we worried about yeah all right
34:38oh it's awful I mean you know we have to get bad news very often unfortunately that's what happens
34:46in emergency John John's older brother Patrick Patrick yeah and sister Roselle finally arrive very good to
34:56see you there's a whole team now that will look after John he'll go to intensive care the surgeons
35:09will decide whether it is an operation or not and then he'll usually go to one of the spinal units
35:14to
35:14be looked after there I'm just going to take a little break as one of only five nurse practitioners
35:32in the ED nurse Meredith specialist skills are often in high demand oh hello how are we an emergency nurse
35:43practitioner is a nurse who has had a number of years experience in the emergency specialty and the
35:51master's degree that means we can actually independently diagnose illnesses and conditions do sometimes you
35:59know give give my little family a call nurse Meredith juggles her fast-paced job with being a mom
36:06yeah so this is Eleanor our daughter's six daddy and daughter she loves performing
36:17nurse Meredith is urgently called back to the ED
36:22oh you poor thing oh you literally just flew back in yeah 26 year old Brianna has rushed to the
36:29ED
36:29straight from the airport after cutting short an overseas holiday with mates sorry what's happened
36:36oh I got bitten by a dog oh dear okay Vietnam sure and where was the bite yeah okay yep
36:45not too sure sure
36:47but they yep they obviously got their teeth in we don't know that that was a rabid dog but we're
36:52gonna
36:52assume that it was this bite wound we would consider as a category three exposure which means it's the
36:58highest risk so even though this looks like such a small innocent wound if Brianna were to develop
37:05rabies unfortunately her chances of survival would be pretty much zero so did you sort of get attention
37:11immediately for the bite um no I went to sleep so I was a bit drunk yeah and then it
37:17was like bleeding
37:18but I just kind of covered it up had you had a rabies vaccine in the past knowing rabies can
37:24be
37:24fatal nurse Meredith needs to quickly understand how at risk Brianna is in 2019 but I don't know okay I
37:32don't think I had the full amount I'm gonna go and um do a bit of hunting around on the
37:36computer and
37:37see what I can find about your your vaccine record and sort of see what we need to do in
37:41terms of
37:42treatment to to stop you from getting rabies all right thank you thank you while nurse Meredith goes
37:49in search of her health records Brianna's own research has sent her into a spiral of anxiety
37:56I didn't know much about rabies at all I didn't get vaccinated for it before Vietnam my worst fear is
38:03I
38:04guess I could die from it it's deadly yes nurse Meredith is worried 26 year old Brianna could have
38:15contracted the fatal virus rabies after she was bitten by a dog while on the holiday in Vietnam
38:22Brianna's come back early um from her trip to make sure that she can get the right treatment and it's
38:27a
38:27category three it's a high risk um exposure nurse Meredith is urgently checking Brianna's vaccination
38:33record so she has her my health record activated to be fully protected against the virus Brianna needs
38:41to have had three rabies shots and I can see she's actually had one two three doses so she's actually
38:53had
38:53a full course which is great armed with all the information nurse Meredith updates a very anxious
39:00and sleep deprived Brianna oh poor thing hello sorry good news I've checked I managed to check your
39:07vaccination record so you did have the full course you had three rabies vaccines in 2019 so all you need
39:14is one more vaccine today and then you're actually good yeah so you'll be well protected so we'll grab that
39:20for you now and that's done yeah awesome yeah so I can really understand Brianna's anxiety today this
39:26is a really scary thing to have happen and we see a lot of people returning from their travels and
39:32even
39:32if they've sought the treatment that they should there's still that unknown and there's still that
39:36fear that something's gonna something bad's really gonna happen all right try and relax your arm as best
39:41as you can okay sharp scratch emergency nurse Rob gives Brianna the booster the one vaccine I didn't
39:52bother to do this time around and I got bitten by a dog but looks like the 2019 one got
39:58me saved me
39:59pulled me through very happy very relieved have a good night's sleep tonight
40:12apprentice Sparky Radisson was rushed to the ED after he became trapped under a house with a dislocated shoulder
40:20couldn't have happened in a worse place fearing the 29 year old's dislocation had caused nerve damage Dr
40:26Manny and Dr Scott sedated him to rapidly relocate his shoulder okay after a short stay in hospital
40:34Radisson was discharged in time to make it to his Dungeons and Dragons painting session
40:41Australian student Raneem was left with extensive shrapnel wounds after a bullet hit the window of her
40:47student accommodation in the West Bank have you got vision out of the eye the minute I got hit I
40:54lost
40:55vision CT scans confirmed the 20 year old would never regain vision to her right eye but questions remained
41:02about whether her eyeball could be saved I'd have to give her a prosthetic eye
41:10after multiple surgeries to remove shrapnel from Raneem's face neck and chest surgeons turned their
41:17attention to her attention to her eye eye before I used to be actually a lot faster but now because
41:22it's the vision thing sometimes I just poke it in and it just doesn't land or it's supposed to the
41:27most
41:27impactful surgery was the removal of my eye there was a piece of shrapnel 2.9 millimeters long
41:34it basically cut my eye in half so they just took out the whole thing
41:41here's the thing now they have got both offers one at Griffith University and one at Melbourne University
41:47it's not an easy decision now recovering at home with the support of her mum Rana Raneem is focused on
41:56her future
41:56my main objective which is to be a dentist that's not going to change if I'm going to be like
42:02this
42:03is too hard for me I've admitted that I have been defeated and I I'm not going to do that
42:07no matter
42:08what I'm not going to let it define me I'd like to thank everyone who has helped me throughout this
42:15journey 54 year old John was rushed to the ED after an horrific motorbike accident left him unable to move
42:23his legs you'll be touching down here nothing CT scans confirmed a fracture to John's spine had
42:31damaged his spinal cord leaving doctors doubting he would ever walk again I'm worried that you won't
42:37walk again from what I'm saying is that bad doctor yeah it's bad after spinal surgery doctors could
42:44finally confirm the true extent of John's injury hi John how are you Paulina how are you darling I'm
42:51good oh that's good I'm ready to get it in my chair all right lovely I remembered the doctor's
42:57face coming to tell me sorry John but you've got about three percent chance to walk again that's
43:04when I knew that I'll be in a wheelchair for the rest of my life how's that good yeah how
43:10are you
43:10feeling yeah good darling in one way I do think my lucky stars because I guess it could have been
43:16lights
43:18out despite the months of rehab ahead John is determined to live his life to the full I'm blessed
43:26really they have such a beautiful family they do love me I'm a paraplegic now more than ever it's
43:32important to have that support there's not too many bad days in rehab I'll be honest because the people in
43:38the front lines such as the nurses incredible they've given me the confidence and encouragement
43:44to be able to get out in the public on my own so I can do most things most able
43:50people can do hey
43:52Daryl hey John how's it going yeah good Daryl yourself yeah good I went with your beard anyway
43:57well I had to come off mate it's bloody hot yeah it was 10 years old now I feel 10
44:02years old
44:03but you missed a bit you have a whole life after an injury like this it's going to be okay
44:08and I'm going to make the mess of my new life I'm not going to let this get me down
44:13that's not me
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