- Welcome to the new studio space. Really excited to film the first episode of 9-1-1 Medical Scenes. We've done this one before. These are hyper unrealistic but some good medical learnings to be had. Let's get started. - Your son seems to have
his head on his shoulders. Well now anyway. - Are they playing golf in the rain? It also feels like fake
rain like from a sprinkler. - You're some piece of work, Billy. - So I've been told.
(thunder rolls) - When thunder roars, go indoors. But lightning strikes do happen. Two dozen deaths a year in the US about. Actually one third of them happen indoors. So the recommendation from
the CDC to keep yourself safe from lightning strikes is
to like not do the dishes. To stay away from plumbing,
not to take showers not to use electrical equipment 'cause it can travel
through the electricity in your home and through plumbing. So just about like sitting,
being peaceful and meditating. And it goes without saying, being outdoors in a thunderstorm
is not generally safe. Standing in near tall object
is not generally safe. Like trees. That's a really bad idea. - Someone call 9-1-1! - Okay that's actually the
first thing you should do after a lighting strike. When it comes to first aid, call for help, and then it's about
trying to help the person in their time of need. Meaning if they're like vomiting, you wanna turn them on their side. If they're pulseless,
you know what you do. Chest compressions. Chest
compressions. Chest compressions. - I thought we could move on to... To... - Is she withdrawing from heroin? - So itchy. - Or maybe just acute
intoxication with a substance? - I'm sorry I- - He's wearing cross stripes on a shirt that has plaid on it. My man, pick one or the other. - Okay. This is some kind of psychosis. Psychosis-related excoriation where they start scratching themselves thinking that there's
insects on them or something. - I'm on the edge of my seat here. - Bro. She's stabbing herself with a fork! Can you show a little compassion? - Right, we were going to (audio fades) portfolio projections and first quarter profits,
which we hope will do. Liza? What are you doing? Liza! - These are officially
the least caring people, colleagues I've ever seen in my life. She's scratching herself with a fork, having some sort of
medical situation occur and they're just annoyed. - To your knowledge, was
Liza on any substances? - No. She was two years sober.
She knew better than that. - Just because someone says
they're two years sober doesn't mean that that's the case. And also as a police
officer, if someone says no, move on, there's no point
trying to push through in a situation like this. You test the blood and then
you find out the answer. - Several victims suffering seizures. Two people stabbed themselves. All symptoms came without warning. (indistinct) Special
response is on its way. In the meantime we rounded
up everybody still standing. - I've never seen anything like this stab. - We need to get these people transported. - We're not going anywhere until we know what we're dealing with. - I mean I would get everyone
out of the building instantly because first of all you don't know if this is an inhalation
situation or an oral ingestion. So something weird is happening here. - What'd you have for lunch? - Skipped it. Big breakfast. - Wait for it. - I know who did this? - What? - Mercury. - Did this police officer/paramedic, I can't tell who this is speaking, know that this is mercury poisoning before he even opened up the sandwich. No, never gonna happen. And first of all, that type
of mercury doesn't really get absorbed well in the digestive tract, only through respiratory and then it can actually
spread throughout the body. Be neurotoxic and hurt
the lungs, all that. The danger of that mercury
is if it gets aerosolized like with a vacuum or something or a fan. So the fact that they're all just like breathing it in and
chilling, that's like not ideal. - I'm too scared. It's bad. - Oh come on now little man. Lemme take a look at you. Just a toy. - Oh-kay. - Told you it's bad, huh? - We actually have tools for this in the ER to pull things out of noses. I just wouldn't do it on a
roof 'cause let's say you do it and it hurts the child
and they move weird. They could fall off the roof. So get into a safe environment first. Ideally an emergency room. - Okay Harry, showtime. On the count of three, I
want you to blow your nose like you have the biggest
booger in the world in there, okay?
- Okay. - Okay. - I mean for small things that could work but for larger things like
that I wouldn't start doing it 'cause you're drastically
increasing intracranial pressure. So like if you can just pull it out with tweezers like in in an
emergency room setting, do that. - Okay, don't worry. Just means we're gonna
have to go to plan B. Where I use my special
toy car removal device. - Promise won't hurt though, right? - Yup. - Or you could just be
honest with the child and not lie and say it's
gonna be very quick. Move the subject along. Say that it's gonna hurt
less than leaving that thing in there so you're
creating an honest answer, but still keeping the child calm. - Okay, buddy. - Why standing? Why in the forest? If he starts having a major nose bleed, what are you gonna do in the field? - No.
(child screams) Got it. - This is like a bunch
of dudes came together and said we're gonna be doctors in the field and they
started practicing medicine. - How? - After you left, I
kept wondering how Harry got it so far up there. - So you figured it out. Tweezers? - No. What the (indistinct)? Why is there lava in the pool? Was this house built
on an erupting volcano? - Chad. - No.
- Wait, wait, wait. Stop! - Why is this turning into a rave? They're putting rave music
on while someone's dying. - Chad. (indistinct) Give your hand, give me your hand. - Okay, so when you have
burns that are this bad you could actually start
tearing skin off just by applying the slightest
amount of pressure. In a situation like this,
obviously the risk of doing that is worth it because you
wanna save their life and one of the ways people
lose their lives here is from a lack of hydration. When you have such severe
burns, you actually release a huge amount of different
electrolytes into your bloodstream, which can
be toxic to certain cells of your body, especially
your cardiac cells. So hydrating people that
are going through really bad burns is of utmost importance. It's like the first step. And then also knowing
that when your skin is not intact you actually lose a lot more fluids throughout the day. - Thank you, guys. (shouts) - He's like iron man but not. - Oh my God. Is that the thing
that's keeping you alive? - It was. It is now an antique. - We have to extract it. Here. Yeah, that's impossible. - We don't, it cooks his heart - But if we take it out,
he'll bleed to death. - Not if the heat from the
rock cauterized everything around it. - What if it didn't? - We don't have a choice. Look, damn thing's sinking
into him. Clamp now. - The confidence level
these first responders have to make medical decisions is impressive. You know, as someone who's
worked in a hospital a decade I have no idea what to
do in that situation. I probably take it off but... (sighs) - What are you doing? No! - Oh, is this an MRI? Oh no. Just for people to know. There's few types of imaging
that we get in the hospital. Some are x-ray, CAT scans
are basically x-rays with many slices and then
you have MRIs which is magnetic resonance imaging
where we actually use spinning magnets in order to
visualize the body in a way that doesn't create radiation. So there's no harm from their imaging. There may be indirect harms
from finding out the results but the actual process itself
is not harmful to humans. With the exception of if
they have some metallic parts on their body or they walk into
a room with metallic items. - There should be a safety
button in there that'll overheat the magnet and kill it. The problem is we can't access the button. It's on the front of the machine. - Which I'm assuming is
somewhere behind that gurney. Okay, tell your staff to step away please. - What about the metal in our uniforms? - I was just getting to that. - Help me. Help me. - We're gonna get you
down but I need you to- - There are safety standards. It's called OSHA Occupational Safety and
Health Administration. I hope I said that right,
where you don't need to go in your frigging lingerie
to go and rescue someone. - Airways are clear, but
I'm hearing a strider, possible Pneumothorax. - What is the use in
talking about his lungs like he's an inpatient in a hospital when he's acutely jammed. - (groans) (gasps) - You guys can get dressed now. - Bilateral test raise. - What does that mean? - It means your lungs didn't collapse. - Why does it hurt so much? - Because you cracked some ribs. - Chest rise first of all and that means he doesn't have flail chest which means that his ribs aren't broken. I would not go ahead and venture to say that
his lungs aren't injured. I would like to hear
bilateral breath sounds in all lung fields in order to say that
there's no new pnuemothorax. - When I left my ex Julian,
he said that he would ruin my life. And ever since our
divorce I've been feeling I don't know, different. (straining) Liza are you all right? - Is she pregnant? - (sneezes) (screams) - She has some kind of
very aggressive parasite. - Need you to hold still for me, okay? And you should close
your eyes for this part. A little tug. - I don't know if this
is ideal for people to do in the field given the fact
that some of these worms can actually attach to the
intestines through like hooks and such. And then as a result, by ripping them out you
can actually cause trauma. - [Liza] What is that? - Round worm? By the looks of it. - There's different types of round worms. Almost all of them are treatable
by medications called like Albendazole or Mebendazole. These are just anti-parasitic, anti worming, deworming agents. Could be a hookworm, could be a pin worm. Hookworms are usually a little bit bigger and they can actually enter
your body through skin going through feces ridden soil
in underdeveloped nations. It can actually end up in your intestines as gross as that sounds. Sometimes the pinworms can
lay eggs surrounding the anus and then like a young
child can scratch that area and pass it on to others. That's why daycare centers
oftentimes have outbreaks and there's a test we do, it's
called the scotch tape test where overnight we actually put a piece of scotch tape on the
anus and then take it off bring it in, look at microscope,
see if there's eggs on it. - Liza, are you okay? - (gasping) Can't breathe. - She must have aspirated
some of the material. TK, track her O2 levels. - So that can happen
sometimes if you vomit from a laying down position, you
can get some of the vomit into your lungs and that can be
quite problematic 'cause, in vomit, there's acid. Acid going to the lungs
can create a pneumonitis and over time can even create a pneumonia. - She's satting a 90 cup. - If you're satting low,
that means that you're not oxygenating your blood. She also looks like she's
unconscious and not breathing and if you just check her
and she doesn't have a pulse, you should start chest compressions. - Nancy, start compressions. - Well, thank you. - (speaking Spanish) - Those are the worst chest compressions. She's pushing on her freaking throat. This is a 9-1-1 show, they
don't have a medical specialist on board say stop pushing on their throat? - By your great power, heal this woman. - (gasping) - We've got her back. - Oh well I'm just gonna have that lady be with all my patients
and saying nice things. Inhaler. By the way, for those who have asthma
that's triggered by colds, it usually happens as a
result of overreaction to the cold air and sometimes
even to the cold dry air and it causes a type
of bronchoconstriction. There are some people that, especially before exercise in what we call EIB, which is exercise induced
bronchospasm from cold weather like this can actually get relief by using an asthma inhaler before the sport and then they actually
don't need it afterwards. There's a huge amount of worry in parents in children who have
exercised induced bronchospasm to the point where they're like, oh, I'm not gonna have my child play sports. It's exact opposite. Playing sports is good for them and a lot of athletes
actually have some kind of exercise-induced asthma or just maybe regular asthma altogether and they still perform very high caliber. - (coughing and gasping) - Whoa. It's cold in that water. His heart rate's definitely slowing as a result of a dive reflex. That's so scary. Never let children play on ice. There is something to
be said about drowning in really cold water where it
actually slows the heart rate down through that dive
reflex and as a result, makes your body require
less metabolic demand means that you could survive a little bit longer without brain injury. Rewarming protocol is
really important here. - Does that mean he's dead? - No ma'am, you're not dead
until you're warm and dead. We're gonna do some rapid rewarming and hopefully we'll be
able to get him back. - When we say rapid rewarming we not only can put obviously heat packs around the body, et cetera,
but we could also give warmed up fluids throughout the
body as well through the IV. And those are the worst chest
compressions I've ever seen in my life. - Get the portable ECMO machine. - (indistinct)
- Got it. - What is this? - Yes, please tell me your heater works. - Look, what is she doing? What is this? She's literally going like this. I just broke my webcam. - Is that time y'all to
find out who's got the sheer audacity to Terri's 78 ounce (indistinct) which is about 78 ounces
more sirloin than any mortal should eat in one sit-. - 78 ounces of sirloin is a
huge load of fats and sodium. That's where my main concern comes from because like if you eat a lot
of protein, okay, whatever but sodium quite dangerous,
fat could be problematic. It can start forming gallbladder issues. Just nausea, vomiting, ugh. Oh. And that's a concussion. - (indistinct), We're
gonna get you outta here as soon as possible. Sonya. Is there any chance
that you're pregnant? - Pregnant with prime rib. - BPs 90 over 60.
- But her heart rate's 116. I don't think it's a heart attack. - You don't judge whether
or not someone's having a heart attack if they're
hypotensive and tachycardic. Hypotensive meaning low blood pressure, tachycardic meaning high heart rate. In fact, when someone becomes
hypotensive that means that they don't have enough fluid or something's going on
where they're losing blood. They're basically losing volume
in their circulatory system, in their plumbing system. When you don't have enough pressure there, you can't get the blood to
certain areas of the body like the brain and vital organs. Your heart can try and compensate
for this by pumping faster so your it becomes tachycardic, it becomes a faster heart rate. That's cardiac output. So the fact that this person says, oh she's not having a heart attack or she's having a fast
heart rate is complete BS. - Can you tell me what year it is? - Tuesday. - Concussion.
- Just doesn't make any sense. - Yeah, she hit her head. It makes total sense. - Her bladder's distended.
- (indistinct) Stomach. It's a eating contest. - Why are they diagnosing her? Stabilize and bring to the emergency room. - Is that her place there
with the empty pitchers? - Oh yeah, she was throwing 'em back. - This is hyponutremia.
- Water intoxication. - We need to reposition her. - No, no, no, no, no, no, no, no. You do not look at empty
glasses and say someone has water intoxication. You stabilize them so that
they're not dying in the field. You bring them to the hospital and you allow people to do
a blood test that will very quickly confirm or deny your
supposed diagnosis here. - Grab me a catheter and a Foley bag. We need to divert fluids now. - Divert fluid from where? - That's it, as soon as
we get her on the regular, the hospital handle this we give her a catheter now we'd be liable. - Her bladder's about to burst. It's my call. - How does she know her
bladder's about to burst? When someone becomes hyponatremic and their sodium level drops below 135. Usually that happens as
a result of medications or health conditions like kidney issues. But it could also happen
through something, process known as water psychosis
where people who are not in a well mental state chug a lot of water and that essentially
dilutes the amount of sodium that's in the bloodstream
'cause when you have low sodium, that could mean you have
excess fluid or actually low sodium that you're getting
rid of too much sodium. So in a person who
consumes a lot of water, they end up diluting the sodium level. As a result, tissues start to swell. And the reason tissues swell
is 'cause the water starts leaving in order to try and equalize, leaving the bloodstream
and goes into cells. And when they swell, that
could become problematic especially in areas of the
brain where there's limited space, swelling can
actually cause brain death. - Mateo?
- Yep. - Unplug the battery. Judd, Marjon. Make sure there isn't any fluid leaking. It's gonna ignite. - Face shield stuck. - Leave it alone. Don't force it. Let's just see what
we're dealing with first. TK, put him on the life pack. - Copy, Cap. - Hey sir, we are here to help. Can you tell me your name? - Looks like he has a sub-, not subdural, subconjunctival hemorrhage. - BP's spike, Cap. - We're looking at possible
orbital compartment syndrome. - No, you're not! Stop making up things. I'll give 15, right
now, different diagnoses that are more likely
than what she just said. This person is on drugs because they're wearing a knight costume out in the middle of the day. They have a concussion 'cause
they just got hit by a car. They have a brain bleed, which could be a subdural
or epidural hematoma. They could actually have an
aneurysm that's ruptured. They could just have cranial hemorrhage. They could also be having cardiac arrest because of chest trauma. Like the amount of things
that could be going on before she makes this
ridiculous diagnosis is insane. - BP's coming back down to earth, Cap. - Cap, look at his lips. And I do not like this rash. - It's erythema.
- Like that could be a raccoon sign 'cause he
fractured his basilar skull plate. - This isn't a regular head wound. This is carbon monoxide poisoning. - Must (indistinct). - Which explains the delirium. - How did she get to
carbon monoxide poisoning? - Well this could be something. About five blocks from you,
there's a novelty pizza place. Swords and Slices. - Come on man. Carbon monoxide poisoning
is very real and people die every year in the United States 'cause of carbon monoxide poisoning, it's usually the result of
a terrible accident going into a well-ventilated
space solves that issue. And the reason carbon
monoxide poisoning even happens is because the
carbon monoxide actually displaces the oxygen on the hemoglobin which is the oxygen carrying portion of the red blood cell that
now can't carry oxygen. As a result, you start having
really bad health effects. - It's a medieval mass casualty. - That's a good thing
they weren't open yet. - And what they don't have a CO2 detector? - Jud, why don't you find
the control and shut it down? - Oh, why don't you get the people outside and that'll help all of them. - We're gonna need more O2 off the truck. - No good. We used the last cylinder
O2 about five minutes ago. - Oh, so how about bringing
them into a medical center instead of treating them
right there on the street? - We should eat here sometime. Place seemed dope. - (laughs mockingly) Want to learn the secret to happiness? Click here for my interview
with the professor the Doctor of Happiness. Most viral Ted Talk on happiness, actually click here to check that out. And as always, stay happy and healthy. (upbeat energetic beat plays)
