- 7 hours ago
Critical Condition Season 6 Episode 1
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00:04We've got a cold red, we've got a stubble.
00:07Please don't help me!
00:11Hello, QE alert phone.
00:15Somebody's been impaled.
00:20You can see the pole sticking out.
00:23Even just a small movement of the pole could mean that you start bleeding catastrophically.
00:40It's a very big artery and has a high blood supply.
00:43You transect it, you bleed out in a couple of minutes.
00:51There's the potential that it's caused damage to the spinal cord.
00:54That's obviously really serious.
00:56So you could be left with permanent disability.
00:58Well done, well done.
01:05Breathe in and hold your breath.
01:10Breathe normally.
01:15Hello, QE alert, please.
01:2033-year-old Neil, coming to recess. ETA 30 minutes, coming by air.
01:25Yeah.
01:26All right, thank you, babe.
01:29He's fallen seven metres onto a flagpole, onto the floor.
01:32It's gone through his scrotum and his right hip.
01:34And it's a retained foreign body that's still through.
01:37I think we should add vascular.
01:39You do, yeah?
01:40Yeah.
01:42Hi, can I put a trauma call out?
01:44Yeah.
01:45Can I also add on neurology and vascular?
01:47Can you have some more hands?
01:49Can you guys need more hands?
01:55Guys, somebody's been impaled.
01:58Are you OK?
01:58What's your plan?
01:59Are you going to still lead it?
02:01I'm just going to lead it.
02:01OK.
02:05One of the challenges to recess is that things can happen very quickly.
02:09So you need to always be prepared for whatever's coming through the door.
02:13Any bleeding from your pelvis?
02:15Yeah.
02:16Pelvic injury.
02:20As trauma team leader, I'm someone who finds it very easy to remain calm amidst chaos.
02:32Yeah, the trauma call's gone out.
02:38Urology and vascular have been added on.
02:42Team leader.
02:50Andy, can you check if we've got blood in the fridge if we need it?
03:03Hi, guys.
03:04You're going into recess one.
03:08Sometimes it's quite difficult to judge just how critical the patient's going to be.
03:13We've got no idea what organs the flagpole has gone through.
03:18They've gone through a number of critical structures.
03:20It could be life-ending.
03:22And this is Chris.
03:25Chris is 33.
03:26At 12.45, he's fallen seven metres from the scaffolding onto the top of the flagpole, onto the floor.
03:34OK.
03:36The rest of the flagpole is still impaled.
03:38So, in terms of your seat, you've got an impalement through the scrotum region, out to the right hip.
03:43Mm-hmm.
03:44Which has been cut.
03:45And there's also the left side, that's why you're digging the seat from the foot at the bend.
03:48Cool.
03:48Shall we get him moved over, then, on our monitoring?
03:51Is that OK?
03:52It's really all gentle, guys, because, as you can see, there it is there.
03:55It's just a button that's scooped, so we don't want any pressure on it.
03:59Chris, what I want you to do is cross your arm across your chest when I've got your seatbelts off.
04:03OK.
04:03And I want you to lean to your left-hand side.
04:05OK.
04:06You can see the pole sticking out.
04:18OK, nice.
04:19OK, great.
04:21Now, you're there.
04:23We'll pull that scoop out, guys.
04:24Stay where you are, Chris.
04:25Put a shoulder on him.
04:26And then we'll get some wedging.
04:30So, put them under his butt, guys.
04:33Just coming out this side.
04:34And then we'll have one the other side of the spike, as well.
04:36So we can roll back onto it without it touching the bed.
04:41Do you want to roll back there, Chris?
04:42See how that is?
04:43Is that all right?
04:44Is that enough?
04:44OK.
04:47Make sure you've pitched it soon.
04:48Mm-hmm.
04:48We can have a couple of hands down this side, guys.
04:51Thank you anyway.
04:52I'll fit in.
04:53That's all right.
04:54Yeah.
04:54So that is the arch, the top of the arch.
04:56OK.
04:57They are, that's the other.
04:58Oh, yeah.
04:59The other flagpole that's not here.
05:00We've taken this flagpole all the way down.
05:03Yeah.
05:03Uh, that is the, as found.
05:07Good.
05:07Watch out.
05:08So there's the bit that's been removed.
05:09The warm section's still in.
05:12Yeah.
05:15You OK to start your primary survey?
05:18No airway concerns.
05:20Can you just lie back for me?
05:21Can you get me a two more seconds?
05:23I'm sorry.
05:23Okay.
05:24Looking at the pelvis.
05:27Any active bleeding from it that you can...
05:29There's slight drip, there was slight dripping from the wound on the right hip.
05:35From the penis.
05:39Sorry, it's from the scrotum, not the penis.
05:42OK.
05:45No guarding in the abdomen.
05:46Abdomen soft.
05:52One more compression.
05:54And then we'll just check his long bones and GCS.
05:59It looks like he's stable and he's awake, but obviously that can change at the top of a hat.
06:05You know, even just a small movement of the pole could mean that he starts bleeding catastrophically.
06:12So we need to make sure that we try and keep the pole as still as possible.
06:16We'll try and get him through the CT scanner and then to theatre as soon as possible.
06:23What's worrying me is the internal injuries potentially could be life-threatening.
06:28We don't know until we get the scan and we see the full extent of what's going on inside.
06:36Guys, CT's ready, so can we get him packaged and ready to go, please?
06:50Are we, are we, are we good to go?
06:54Let's go.
06:57The worst case scenario is that he could die or be left with long-term disability.
07:06The CT should show us exactly what organs have been damaged and exactly what path the flagpole has taken through
07:12the body.
07:13If the flagpole has damaged one of Chris's major arteries, it could lead to catastrophic bleeding.
07:20My right hip is, my right leg is in agony.
07:26It just feels like tense.
07:28It will be all your muscles going into spasms.
07:30Yeah, I can't, I can't really get it.
07:32So we're going to move you onto the scanner.
07:35It's not going to be very nice.
07:36It's okay.
07:38Okay.
07:39Ready, steady, tilt.
07:41Back, back, back.
07:43Well done, well done.
07:45Ready, steady, slide.
07:51The best case scenario for Chris is that the flagpole has passed through soft tissue and muscles and has missed
07:57any vital organs.
08:01Starting now, 75 seconds.
08:07I'm just keen to see where exactly the pole has gone, you know, is it perforated his bladder or bowel
08:12or is it sitting near any major blood vessels.
08:25It looks like it's missed his penis, isn't it, and it's gone.
08:28It's, well, it's...
08:29Into the scrotum.
08:31Wow.
08:35Are we happy?
08:36Yeah.
08:37Should we try to?
08:38Yeah, they've all finished.
08:39Should we get back on?
08:46Right, so, Chris, we'll go back to A&E now, okay?
08:50And we'll have a little look at your scan and then come have a chat to you about exactly what's
08:53what.
09:00We'll just see what the CT scan shows, but I imagine he's going to be going fairly promptly to theatre.
09:07We need to get the flagpole out as soon as possible.
09:11Infection can set in in a number of hours, which can lead to death.
09:15PHONE RINGS
09:22PHONE RINGS
09:23PHONE RINGS
09:25You really?
09:2773-year-old male.
09:29Trauma-alive by AI.
09:33ETA, 20 minutes.
09:36Yeah, yeah.
09:39I've got a trauma loop by my ear.
09:41He's falling three metres from a ladder.
09:43He's got thoracic spanky, deformed right wrist,
09:46pelvic pain and a head injury.
09:48So I've put the trauma loop at it, OK?
09:5073-year-old brother can't use a girl from a ladder.
09:54Do we have space?
09:55Er, bed one.
09:59To fall off a ladder at 73 is a significant mechanism of injury.
10:04You know, they could turn up and be really, really critically unwell.
10:09The fact that it's required an air ambulance with a doctor on board
10:12to go to them suggests that it's going to be a more severe injury,
10:16more time critical.
10:18So we're kind of prepared for the worst.
10:38I've got no idea.
10:40I don't think this one has been...
10:42No, this one's not been.
10:43...ravaged this morning.
10:45No.
10:49We have had quite the day today in here.
10:52Yes.
10:56We have a 73-year-old male coming by air,
10:59so he's fallen three metres from a ladder.
11:01He's got multiple injuries, wrist, spine, pelvis, head.
11:05The main issues are fluctuating consciousness
11:08with a bradycardia in the 30s.
11:22What's worrying me is the fact that he's fallen from a fair height
11:25for someone of his age.
11:27So he could have a number of injuries that aren't initially apparent
11:30when we examine him.
11:34Are you happy your patient's stable enough for transfer
11:37and then a handover?
11:38Yes, absolutely.
11:39Dennis, we're just going to move you over onto the hospital bed now.
11:43That'll be the last little bit of movement, OK?
11:45Just right sometimes.
11:47Happy?
11:48Yep.
11:49We're going to go on move, so ready, brace, move.
11:54So this is 73-year-old Dennis.
11:58He's fallen approximately three metres from the top of the ladder
12:01onto a concrete floor.
12:02He's got a deformed right wrist
12:04and a dislocated right middle finger
12:06and his most significant pain is coming from thoracic and lumbar spine.
12:11Obst-wise, he's been having runs of bradycardia going down to 38,
12:15sitting at a baseline of around 50.
12:17Cool. Lovely. OK.
12:18In that case, if you wouldn't mind starting your primary survey
12:21and get the monitoring on, thank you.
12:23Sir, do you know where you are at the moment?
12:25Yes.
12:26Patient is alert.
12:27Knows where he is right now.
12:30Chest is rising, relatively symmetrical.
12:36Can we do the abdo, pelvis, long bones?
12:40Can you lift your right leg up in the air for me, please, sir?
12:42Say again.
12:43That's your left one, but that's fine.
12:45I can do the same with your right one.
12:48He looks like he's moving all four limbs that I've witnessed,
12:51but I just want to know whether that fracture of the wrist is open
12:54and whether it's neurovascularly intact as well.
12:58I'm suspecting a copy of frozen.
12:59No.
13:00Copy of frozen because there's no bleeding anywhere.
13:02That's fine. There's no obvious bleeding from that area.
13:04There's no obvious bleeding anywhere.
13:05OK.
13:10The main thing that's concerning at the moment is that they've got a very low heart rate.
13:16Worst case scenario, they can go into cardiac arrest.
13:20We obviously need to figure out what's going on so we can stop that from happening.
13:26My name's Rachel. I'm the doctor in charge. OK.
13:29We're just giving you some more pain relief to get you a bit more comfortable.
13:33Oh, thank you.
13:33All right, and then we're going to get you through the CT scanner
13:35to have a look and see what injuries you've got.
13:37Do you remember what caused you to fall?
13:40The girlfriend pushed the ladder from underneath me.
13:43Oh, that hurts. No.
13:45I just... the ladder just slipped off the...
13:48OK.
13:48...and saw the ground and it went to the right and I went to the left.
13:54OK.
13:54And just landed on me... like on me wrist back.
13:58Yeah.
13:58Wrister and sent me back.
14:00That's fine.
14:01It's just that I've noticed on your ECG that you're having a slightly abnormal heart rhythm.
14:08And some...
14:08So would you.
14:09But that can be... sometimes that can cause people to black out.
14:12So I just wondered whether that had happened.
14:14But you seem quite confident that it slipped.
14:17No, I didn't.
14:17I didn't black out.
14:18OK.
14:19That's fine.
14:20Let's get you all wrapped up and round to CT.
14:22Yeah.
14:27Sometimes it can be difficult to tell the full extent of the injuries.
14:30Just because of what you're finding on the examination.
14:33Dennis has got quite a badly broken wrist and dislocated fingers.
14:36So that could be distracting him from the other injuries that he has.
14:42That's fine.
14:43You take the first scan.
14:45Mm-hm.
14:47It's on to you.
14:48It's on to you.
14:49It's on to you.
14:49It's on to you.
14:50It's on to you.
14:53Although he's 74, he is a very fit and active 74.
14:58So that's definitely going in his favour.
15:02But there's always that risk with these kind of injuries that he's going to deteriorate or get a complication.
15:07And that it could end with a bad outcome.
15:26So I'm worried about a potential chest injury and also you could have a spinal injury or pelvic injury as
15:32well.
15:39When I'm in the scan room waiting for the images to pop up and thinking about all the potential injuries
15:44that he could have.
15:45I'm trying to think one step ahead about what I'm going to need to do about them and who I'm
15:48going to need to call.
15:55Are you guys all right to get him back round?
15:57And I'm going to go sit and have a look at the CT.
16:00Yep.
16:01One, two, three.
16:01One, two, three.
16:04Thanks, guys.
16:08I didn't know anything about that.
16:28You alright?
16:29Yeah.
16:30Wow.
16:32Sam, you may want to kiss him.
16:34Do you want to kiss his daughter?
16:36You don't want to kiss his daughter who's run around like an endless chicken?
16:43You don't get up another ladder, aren't you?
16:46Where to go?
16:48I'm going to get up another ladder.
16:50No, you're not. No, you're not. You're grounded.
16:52Yeah.
16:53You're staying on the ground from now on.
16:55Not me.
16:56Yeah.
17:00I will never understand why you went up the ladder in the first place.
17:04There was no need to do them windows, Dad.
17:06No.
17:07I've just heard Sandy scream. I've run out there, and I've seen him.
17:12Sandy's trying to hold him up. I've just gone,
17:14Sam, move!
17:15And I've just grabbed him.
17:17This is one of them things, isn't it?
17:18They don't have things at all.
17:20Oh, yeah, Barry.
17:49Hello, Recess.
17:51All right, lovely. Thank you. Bye.
17:56We've had the final report back on his scan.
18:02So we can see that the pole, this black area coming into view,
18:06goes in through the scrotum.
18:08And then it heads straight towards the iliac bone and shatters through it
18:12and comes out the other side.
18:15We can see that the pole goes through all the muscles.
18:18And this little white bit here is one of the big blood vessels
18:21that it literally just skims past.
18:24If it had gone through that, he could have potentially bled to death in minutes,
18:28so he is very lucky.
18:32They think maybe part of his abdomen has been breached.
18:37Even on a CT scan, sometimes you can miss kind of subtle injuries to the bowel.
18:42If the bowel has been perforated, it can rapidly lead to infection,
18:45which can cause sepsis and multi-organ failure.
18:49So when they open them up, they'll, you know, have a bit of an explore
18:52and see exactly what damage has been done.
19:01I was in a church changing some high lighting of the scaffold tower.
19:07I'm not entirely sure what happened.
19:09I believe the scaffold tower gave way on me and I fell.
19:15Work up upon the floor and I'm just being told not to move.
19:20And you just think, oh, Christ, what have I done?
19:24Why did I do that?
19:25Every thought and everything crosses through your mind.
19:29You hear sirens and air ambulances and you end up in Birmingham hospital.
19:36So, yeah, it's a lot.
19:42You just sit there and hope that, hope it's all going to be okay.
19:49Hello.
19:49Hello.
19:50We've just been looking at your scans.
19:52Okay.
19:52Um, so the pole goes into your scrotum.
19:55Um, it's kind of skimmed the side of your penis, but the penis itself doesn't look particularly
20:00damaged on the scan.
20:01Okay.
20:02Um, it's then gone through all the muscles on the front of your pelvic wall and then
20:05it's shattered through your pelvic bone.
20:08So the big hip bone kind of gone straight through that and out the other side.
20:12Right.
20:12The good news is it doesn't look like it's gone through your bladder or like any of the
20:16big blood vessels or anything like that.
20:18Yeah.
20:18So walking as a part, obviously it's good.
20:21I'm not going to be able to, I will be able to walk again or.
20:23I see no reason why you wouldn't be able to.
20:25Yeah.
20:25You're obviously going to have to have an operation and have it all fixed.
20:27So you're going to have a, you know, a fairly long recovery ahead of you.
20:34Any questions at all?
20:35No, no.
20:37Cool.
20:37All right.
20:37I'll be back shortly.
20:52So it's going to be orthopedics and gen surge and urology.
20:57Yeah.
20:58We need to get a consensus from them on what they're going to do.
21:01Yeah.
21:02Um, so would you be able to chat to them all and get them to make a decision?
21:05And then we can let theatres know.
21:09Go on then.
21:10Ready? Let's go.
21:13Just hold the lid over.
21:15OK.
21:16Good.
21:18Thank you very much.
21:19See you later.
21:21Chris is going for a very risky operation.
21:27There's the potential that it's more difficult than anticipated to get the flagpole out.
21:31And this could lead to a large amount of blood loss.
21:34Only when he gets to theatre will they know the full extent of the damage.
21:39It's going to need a multi-team approach.
21:41Former orthopedics will be dealing with his broken pelvic bone.
21:45Urology will be dealing with his urinary system.
21:47And if any major blood vessels are damaged, the vascular surgeons will be needed.
22:10There you go.
22:15Put the pad slide underneath as far as possible.
22:18Yeah.
22:20Yeah.
22:31The procedure is unpredictable.
22:34The injuries can be from minor to major, so we're going to put a camera in Mr. Lord's belly and
22:43have a look at any injuries that might have happened.
22:46Based on that, hopefully we'll remove the impaled item.
22:59Because the impaled item puts pressure on vessels, you can't see it on the scan.
23:05The big worry could be vascular injury that causes a major bleed.
23:10And that's what worries us the most.
23:22The first thing is, we're going to divide the inequality of the two NPCs to move to five countries on
23:25질문.
23:25People are digital to a car impact, so people have an amplitude to investigate and understand what a train of
23:28Rush upside down.
23:28It absolutely does.
23:40We'll have the limitations of joining this program, as we just hear what happens.
23:42so we have Christopher anything between two hours to six hours blood loss could
23:52be significant if there's a vascular injury
23:59and aesthetic colleagues can we start and have a ten port please
24:14that's it put the camera that's for Ian yeah we're in okay gas on please
24:27that's okay that's enough thank you
24:34liver is fine this is the liver that's okay show me the cycle this
24:44this appendix there's no blood in the pelvis I don't think there's any injury to the bowel
24:49it's not breaching whatsoever so that's good news for him no major damage
24:56I'm happy for you guys to try and mobilize now
25:01the crucial bit for this operation removing the impaled object all the surgeons have to
25:07be very very attentive and make sure no nearby structures are being damaged as we come out
25:12we're just gonna remove the item as safely as possible
25:23show us the um build thing just here yeah so we're moving the impaled item through the way it came
25:35it's all out wow wow it was very unlucky to fall and have this happen to him but extremely lucky
25:48to not injure anything major and that's just a miracle
25:53that's a happy ending oh man I'm lucky aren't I now leave our urology colleagues to take a look at
26:03his testicle
26:08sorry let me give you a hand
26:14yeah that's fine
26:19there's been no damage to the scrotum or testicle so you'll have full function
26:27we are reassured and satisfied there are no major catastrophes so we're just closing now
26:36so we're closing the scrotal wound the abdominal wound and the wound where the impaled item was removed from
26:46perfect that looks good mate I wouldn't do much more that's fine okay
26:53hopefully go back to the ward resume full complete recovery maybe see the physios for a couple of days
27:00and just have some rehabilitation for the hip wound so he's very lucky indeed
27:06good good fantastic look at your feet to cover it
27:08I'm going to stay to play
27:19yes no one is empty
27:22one is empty
27:23yep
27:23it's fine
27:39so he's had x-rays of his wrist which shows that it's broken which we already suspected
27:47and also his middle finger is dislocated as well
27:51so his finger is going to need pulling back into position
27:55but you scroll down his back you can see one of the vertebrae in his spine is broken
28:01which explains why he was getting quite severe back pain
28:06the main worry with that is that the spinal cord can be affected
28:11so he's going to be going and having an MRI scan just to have a look at the spinal cord
28:16in more detail
28:16and check there's no kind of damage to the spinal cord
28:26the spinal cord is obviously really important because it controls all your movement and all your sensations your body
28:32so if it's damaged then potentially Dennis could be left with long-term disability as a result
28:44hello hi I'm Fernando one of the MRI radiographers
28:48you're here for an MRI of your spine
28:51I just need to ask you a few questions before we go in the tunnel
28:59it was just cleaning some windows I was putting the ladder and trying to hold it in straight but
29:06unfortunately he went one way and the ladder and the other
29:12came down with a crash
29:16I screamed his daughter came out and he wasn't able to breathe
29:24I was terrified that he was going to go unconscious
29:35he didn't appreciate and he'd keep slapping his face to keep him awake
29:40you just don't know whether there's any internal injuries or whatever
29:46and it's just literally terrifying
29:51he's gone in there for an MRI scan to see exactly what's happened to his back
29:57but his sense of humour has come back
30:01to my cost because he will tell you I pushed the ladder
30:07I promise you I didn't
30:15how much does Dennis mean to you hell of a lot
30:22I don't think I realized until today
30:38the next step for him is going to be having a few specialists come to assess him
30:43so the trauma and orthopaedic team will manage his wrist and the plastic surgery team will manage his finger
30:50Dr. Shan is going to be taking over his care so that we can move forward
30:54with what we need to do for him
31:00the patient's MRI is back
31:03the MRI essentially confirms what we know already
31:07the patient has a fracture as kind of one of the thoracic levels on the spine
31:13fortunately this type of fracture isn't too serious
31:15so it should heal with rest and hopefully he makes a full recovery
31:22what we need to do now
31:24is treat the injuries to his finger and wrist
31:29so this will just be a little moment
31:31is if we could actually just step outside
31:33is that alright
31:34yeah there we are
31:39little numbing injection coming through
31:41my lovely okay
31:42don't need a scratch
31:43little bee sting
31:44little bee sting
31:45okay good man
31:46but it's going to help
31:47brilliant
31:48oh
31:51yes
31:51good
31:52well done
32:06well done
32:08well done
32:09well done
32:10well done
32:13well done Dennis
32:14yes
32:14yes
32:14yes
32:16yes
32:16yes
32:18yes
32:18yes
32:20that's enough
32:22you're doing really well
32:23is it the wrist that's hurting you or is it the finger
32:26yes
32:26yes
32:26so in a little moment the bone doctors are going to fix the wrist for you my lovely okay
32:30I'm going to come back with some breathing medicine
32:34can you come back with a couple of cans of John Smith
32:36oh
32:36oh
32:37yeah
32:39well done sir
32:40I'll be back in a little further
32:41okay darling
32:42oh
32:43hi
32:44hi
32:45I'm going to take this hand you just come away okay
32:47trust me
32:48take that out first
32:50can you take some deep breaths sir
32:53nice deep breaths
32:54nice and slow
32:58nice and slow
32:58so you've got a little bit of pulling now
33:01nice deep breaths
33:02breathe out
33:03it's a pain killer
33:07you're doing really well
33:09take some nice deep breaths
33:11well done well done
33:13deep breaths
33:13take deep breaths
33:14breathe in
33:15like brewing out a candle
33:16nice deep breaths
33:17let's have the one
33:18go first
33:20take
33:20take
33:21take
33:22take
33:22take
33:22take
33:25take
33:26take
33:26take
33:27take
33:27take
33:27take
33:29take
33:30take
33:30alert phone
33:32a 28 year old male
33:34by land
33:36ETA seven minutes Teresa's
33:42you've got a stabbing
33:44left neck wound
33:46deep
33:46the same query the depth of it
33:47he's intoxicated but all of his other numbers are fine
33:50alright
33:51cool
33:51alright
33:57so this patient has suffered a neck injury from a stabbing
34:07can be quite serious injury because you have lots of major vessels going through there if you have nicked a
34:13major vessel the person can bleed out and die
34:19okay
34:19then you also have your breathing pipe and your feeding pipe going through the neck
34:23if you have injured that as well the risk of death or complications from that is quite high
34:29so it's something that we have to be very careful about
34:56what's going on please
34:57so this is David we believe he's been involved in the orientation
35:01he's got a large laceration to the anterior triangle of his left neck
35:05significant blood loss on the scene
35:09alright
35:09so
35:11we're going to open the wound and let ENT have a look yeah
35:18hello
35:19we're going to just have a quick look at your neck alright
35:23no
35:23what was it
35:25hey
35:26who's on the phone
35:26you want to speak to them
35:28my wife
35:28how is that
35:29tell my wife
35:29how is that please
35:33patients who come in intoxicated
35:36are agitated
35:37and quite difficult to manage
35:41especially in patients that have serious injuries like this one
35:45who has an injury to his neck
35:46that could have caused injuries to major blood vessels
35:50let's have a CT neck yeah
35:54no
35:54it's too sorry
35:55it's too sorry
35:56it's too sorry
35:56if it's alright sir what I want to do is put a camera down your nose
36:00and have a look
36:00no
36:00no
36:01no
36:02no
36:03that's not
36:03alright we don't have to do it
36:05we don't have to do your right test
36:07alright let's do this
36:07no let's do this
36:08right now assist me up
36:09don't move your arm please don't move your arm
36:11no there's cameras that would do all things on toes
36:13that's not happening to me
36:15assist me up and let's get me the fuck out
36:17OK, that's all.
36:18We're here to fight the Irish.
36:20All right.
36:21Go on.
36:22Get that in, son.
36:23You don't dust it, don't you, boy?
36:25Hi, sir.
36:26We're going for your scan.
36:28Oh, one, two, one.
36:29Two, one.
36:31Good.
36:33You'd like that.
36:34Please push.
36:37Yeah.
36:38We're here to fight the Irish.
36:42You fucking crazy Irish bastard.
36:45You want to stop?
36:47Yeah.
36:48What is going on?
36:51I'm going to scan it on the way.
36:53Two, twenty-one.
36:54I'm going to scan it on your phone.
36:56Yep.
36:57Oh, snap, snap.
37:01That's it.
37:01Well done.
37:02Right there.
37:03OK.
37:08He has a nine to ten centimeter wound on the left side of his neck.
37:15The question now is, has he transected any major blood vessels?
37:19I doubt it because he's not actively bleeding.
37:23However, it's possible that he might have hit a vessel and it's cluttered off, and that's why he's not bleeding
37:29currently.
37:30So we're looking to see the amount of damage he's done to guide us on what we should do next.
37:41If there is an internal bleeding, it could cut off his air supply in the neck.
37:46So he's at risk of having a cardiac arrest, especially if we cannot see the bleed and we don't know
37:51how much blood is bleeding into the neck.
37:55OK, cool. Let's take him back.
38:00The most important thing when we come to the CT scan is CT scan back to resource.
38:06Because, God forbid, you don't want a situation whereby the patient goes into cardiac arrest.
38:17So, God forbid, you can use that arm if you want in a minute.
38:27Sorry, it's a bit few wares.
38:46So, do you see these two white dots?
38:49So those are the big arteries called the carotid arteries that supply blood to the brain.
38:54Now, this is the left side. This is the right side. The R is the guide.
38:59So we know the injuries on the left side.
39:01So you can see that is the slash that he has in the neck.
39:05You see it's different from there.
39:08And it barely just missed the carotid artery.
39:13It's a very big artery and has a high blood supply.
39:16So you transect it, you bleed out in a couple of minutes.
39:20So he's very lucky he missed the artery.
39:26When it comes to delicate structures underneath, like the neck, you just can't suture it closed.
39:33You know, as the suture is, it's a sharp needle and it's close to that big artery.
39:38And, God forbid, you're trying to suture that and you just go into the big artery.
39:43As I said before, you just bleed out.
39:45So that has to be done in theatre by a specialist team.
39:50Right, just be careful with this one, alright?
39:52There you go.
39:54Oh, thank you.
39:56There you go.
40:01There you go.
40:07There you go.
40:11You're stuck.
40:14There you go.
40:16There you go.
40:23Yeah, a few people have asked about it.
40:27I said, do you want to see the spike?
40:30A picture of the spike. She was like, yes.
40:33She didn't want to see my testicle?
40:34No, she didn't want to see a testicle.
40:39The surgeons all told me the surgery went really well.
40:42They were amazed at how clean the spike came out.
40:46My father-in-law was going to put it in a little plaque for me
40:49and put it on the mountain beach somewhere
40:51to brag about three years ago.
40:54I do realise how lucky I am.
40:55It could have been far worse.
40:57It could have...
40:58I was speaking to a couple of nurses today and I said,
41:00what would have happened if it had caught my artery?
41:03She said, well, the one that it was closest to was my groin artery.
41:07If you nick that, you've got a pretty good chance
41:11of bleeding out pretty quickly.
41:12It makes you realise how precious life is.
41:17I've been up, I've had a bit of a walk now today, so...
41:22Yeah, I'm starting to get on the mend, I think, hopefully.
41:25Slowly but surely.
41:27I think I'll continue to moan at him about being safe.
41:31Making sure that he's doing things properly and carefully.
41:35I still probably won't listen, Willow, but...
41:36No, but I can keep trying.
41:39Keep nagging.
41:40Yeah.
41:41And I've got a reason to.
41:42Looking forward to getting home, having some cuddles with my little boy.
41:46We're going to have another little boy in the new year and...
41:48I should be right as rain to hop out as much as I can and...
41:53and do my bit.
42:11Do you remember being in the helicopter?
42:15Yeah, yeah.
42:16Yeah?
42:16Yeah.
42:17I remember being put in there, and when they shoved me into the helicopter,
42:22I broke, he put the earphones on me.
42:25And I could hear him, he could hear me, and I said,
42:27when's the cocktail tray coming round?
42:33We did worry that whether we would see him again,
42:35because I think in the height of the phone calls we were getting,
42:39we were like, we don't know what we're walking into.
42:41We don't know what kind of state he's going to be in.
42:46When I hit the ground, I felt, oh, that was it.
42:49It was game over type of thing, like, you know.
42:53And I just thought, well, if I survive it,
42:56I thought I'm never going to be able to move again.
42:58I'm going to be, you know, in a wheelchair.
43:02But at the moment, I'm on the mend.
43:06You're like a cat with nine lives.
43:08Yeah, yeah.
43:10But...
43:10Oh, don't worry, I'll still be up the ladder.
43:13No, you won't be.
43:14I'll still be up the ladder, don't worry.
43:16It won't stop me from working, put it that way.
43:19I'll still be working.
43:20I know, but you have got to start taking it easy.
43:24Oh.
43:25I'm only coming up to 74,
43:26I've got at least another five years of hard work left in me
43:29before I finish at 80.
43:31It was cheap.
43:33I'm retired at 80, I think.
43:44Yeah.
43:49That's fine.
43:51All right, guys.
43:52We have the cardiores coming in, and they are still pumping.
44:02We've got a cold red, we've got a stab wound.
44:05We've got self-inflicted knife wounds times two to her upper middle abdomen.
44:11We've been alerted that we have an acute heart attack.
44:15Heart rate is dropping.
44:17Okay, sir, you just stay with us.
44:20He's been on a quad bike.
44:22He's been found lying on a track with a lot of blood.
44:26I'm very concerned about the injuries.
44:29This can potentially be life-changing.
44:33See you!
44:34Fatch and olha for fun.
44:47He's2015.
44:48See you three weeks up in 72 years.
44:48I'm just Ariana Grabistic.
44:48If you get I'm actually missing a � Bana.
44:52Keep in your eyes.
44:52Fated in my head.
44:54A lasting love.
44:56Your equity truly came out.
44:57I'm very excited for you.
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