- New Amsterdam, season
three, episode one, let's go. (upbeat music) Shout out to everyone
who's gotten their vaccine #ThisIsOurShot is an amazing campaign
of our healthcare workers showing themselves getting their shots, talk about leading by example. And I hope that everyone talks
to their primary care doctors or other health professionals
about getting their vaccines. Linking my videos on vaccines down below, I did one with Mama Doctor
Jones in case you are pregnant or thinking about
getting pregnant as well. - I just wanna tell
everyone how proud I am of this whole hospital. - I don't know how I feel
about this beard on him. I think I liked him without the beard. You know, actually him and
I, before the pandemic, walked in "Blue Jacket
Fashion Show" to raise money for prostate cancer. He`s quite the model. - I am committed to fixing
the cracks around here. Okay the system abandoned
us when we needed it most. (clouds roaring) And I vow to fix the system
that left us overburdened. - Since when do hospitalists
have a conversation about something very important like hospital funding in
hallways around patients. There's conference rooms for a reason. (plane engine roaring) Okay. Is this a Sully moment? "US Airways 1549 landing on
the freezing cold Hudson River all because of heroic Captain Sully and his fabulous crew." (plane engine roaring)
- Whoa! this is a Sully moment (plane engine roaring) (water splashing) Whoa. That look like a fairly smooth landing. I mean, outside of some bumps and bruises and depending on how cold
it is, some hypothermia, I think everyone should
be pretty safe on board. (woman wheezes) But obviously, cause it's a medical trauma
(laughing) That's not gonna be the case. - Ma'am we're gonna take
good care of you okay? Let's go, a Trauma one. Hey, I need an EKG of portable chest and full blood panel, including co-op.
(woman crys) - Ordering blood tests
in a situation like this is important but the first
thing you wanna do is get big large bore IVs into both
arms to give fluids and blood in case the person's bleeding out. That kind of access is
the most important thing to someone's survival. Obviously airway and breathing
as well but I already saw that she is in fact airway
clear and breathing. - That's been suspended
with muffled heart cells - Tamponade from blunt force trauma. - That means, she's actually
bleeding in an enclosed space into the lung cavity,
into the cardiac cavity. And as a result, if you have
so much fluid around the heart it can't expand fully. 'Cause when a heart beats
It doesn't just contract. It actually has to relax. And if it doesn't have
room to relax and expand it actually doesn't get
enough blood flow to itself because it's a muscle. It needs its own level of circulation. (door slams) - Co-pilot with deep abdominal
blood lac and blood loss. Heart rate up to 118, BP down to 108. - So with the patient who
is bleeding from the abdomen has a laceration to the abdomen. A low blood pressure with
a high pulse can mean that that person is
bleeding out, losing blood. Because what's essentially happening is you're losing pressure
in this closed arterial and venous system in
the circulatory system, and your heart is trying to compensate by increasing the heart
rate to try and get more blood flow to the areas that aren't getting enough oxygenation. It's a compensatory mechanism. - We'll do our best to
stay out of your way. We just need to interview every
crew member and passenger, who may have pertinent information. - Well, Roger that. Oh, well sorry. As long as it doesn't
interfere with patient care I will help in any way I can. - Understood. We wanna start with the
pilots, Captain Starks - I'll find him for you. - Why are they going to the director of the hospital for this? Like if they just walked in,
went to the head triage person in the emergency room, they
can get all this information. They are law enforcement technically. They don't need to go to the
chairperson of the hospital. - It's your job to investigate
and it's our job to heal. So once we're done... - Doctor Goodwin, to clarify you're blocking access to a key witness. - I'm pretty sure if you
come with a federal subpoena or like a judge's order, you can get the hospital
to order some blood tests. But I think a patient
has the right to refuse unless it's like one of these very specific orders by the court. And I think as a pilot, you
sort of give up that right and allow them to test your blood. I could be wrong here though. Pilots weigh it. (machines beeping) - You smell that? - Someone chewing gum? candy anything? - It's the co-pilot. It smells like ethylene glycol. - Antifreeze. - When the plane crashed, maybe our host snapped
her open abdominal wound. - Absorbed it which is why we
can't get the blood to clot. - To clot, push Fomepizole. It should act as an antidote - That's a very advanced situation that a part of the antifreeze
of the plane stabbed him in the stomach and is
now pouring that poison into his stomach, Jesus, what a story? Oh, well he must have been stabbed with tubing that had ethylene glycol from the airplane and then it pumped into his stomach and
then hurt his bile duct cause the liver enzymes
were slightly inflamed, never happening in reality. - Liver enzymes are elevated' - How high? - Three and a half times normal. - That's so mild. Liver enzymes being elevated
three half times normal is not great, but it could be just shock because it's not getting
enough circulation. That's a good time to mention some stuff about liver enzymes. They're called oftentimes LFTs, which has liver function tests. But the reality is they do not represent whether or not your liver
is functioning well. They're actually signs of
liver inflammation that if you have damage to the liver, you actually leak these enzymes. And as a result if their elevated, your liver function tests are saying that there's
damage to your liver. (machines beeping) - Now what? - BP falling, temps dropping. - She`s septic. - Start on hand gentle pluzzer hang a bag of dopamine
at two mikes a minute. - How did they not start that already? The patient is open wound from a trauma. You should have started
them on antibiotics broad spectrum. - Enzymes are six times normal. Liver's not gonna last much longer. - I need to expose the entire organ. We'd need to extend the surgical field across the whole abdomen. - Not proud of me. - Scalpel. - Do you wanna call in Gastro? - No, there's no time. - You're not getting your hands dirty? - Of course not. But,
it's been a few years. - You have a steady hand? - Yes. - Clear field of vision? - Yes. - Still like that type of place on 17. - Yes. - Then what are you waiting for? - The last I remember
she was an Oncologist. Am I wrong? - [male] Yeah, she is an oncologist. - Why is she operating? Why is the oncologist operating? (door slams) - We've got a problem with Shanaz. (door slams) Dissecting aortic aneurysm. Couldn't see it till I
drained out the fluid. - That's a problem. So basically an aneurysm is a
ballooning of the main artery. That's usually coming off of the aorta, which is the main artery
that comes off of the heart. If you have this ballooning,
meaning that there's a weakness in the wall and a
dissecting aortic aneurysm means that there's a
tear inside this wall. These ballooning sections of the arteries these aneurysms are more likely to tear because there's less tissue there. It's thinner. - And what does that mean Dr. Wolch? - The aorta could rupture. - If it tears, it's basically rupturing. (laughs) A lot of times the classic
sign is that a patient comes in either with very bad chest
pain or very bad back pain. And sometimes dissecting
aortic aneurysms are missed because sometimes doctors
unfortunately misdiagnosis it as like back pain or some
kind of sciatic type pain. When the reality is they need to rule out this dissecting aortic aneurysm, which can be done with an x-ray, an EKG or a cheetah scan, an ultrasound. (machines beeping) - What are you doing? - We`re not sending another patient off into the great unknown
when I can help them right here, right now. - We just paged cardio she's
not your patient anymore. - They are all my patients. - How is she gonna perform an aortic aneurysm repair
in the, I don't understand (machines beeping) - The dancing catheter. Okay, I'm at the aorta. - Is she really performing
some kind of aortic repair as an ER physician? I don't know, like I've never
heard of this or seen this. someone, please tell me if I'm wrong here. I don't think this is appropriate - BP is dropping (machine beeps) dissection's extending. - It`s greater than 200
(door slams) - What the hell are you doing? - Trying to stop the dissection. - Well you didn't, you made it worse. - I'm trying to fix it. - Not fast enough. Thanks to you going rogue, I
gotta crack her chest here. - The way that they were trying to repair, was putting in a catheter
going through the blood vessel to go from the interior
portion and attack that problem the tear from the inside of the artery, without failing, now they have
to go out from the outside and open the chest. Which means a longer recovery time higher risk, et cetera, et cetera. - Ma'am, we are authorized to speak to any individual who
may have information. - Hey whoa, whoa, whoa enough. You don't have the right to come into this hospital and rip a
patient away from their doctor. violating HIPAA rules. - As a matter of fact, we do. (paper clatters) - Yeah that's what I was looking for. - What is this? - A federal order? - I'm kind of proud of myself. And I think LegalEagle will be proud too that I said a federal
judge has to order this. And he said, it's a federal lawyer. - Smart. - Smart. - So I'll ask one more
time, where's the pilot? - Now you could be in trouble
for obstructing justice. - All right, so on take off, if a pilot discovers that
his airspeed indicator is giving him an inaccurate reading and he's flying too slow,
what would that pilot do? - Why is the hospital staff
doing this investigation? - Get the nose down. You go into the dive
in order to gain speed and then you'd lift up at the very end - which is exactly what you did, right? - You think that Captain Starks jeopardized the lives of 150 people, We think he saved the lives of 150 people. - Oh yeah, with this
information that you just got five seconds ago. I've ranked all of the medical
dramas that I've watched including New Amsterdam. See where it falls on
my list by clicking here and as always stay happy and healthy. (upbeat music)
Great episode! What happened to it? It gone?