ER Doctor Answers Injury Questions From Twitter | Tech Support | WIRED

in the emergency department all the time i'm like i'm sorry your bone is fractured and they're like i'm just glad it's not broken and i'm like no that's actually the exact same thing hey i'm dr j max slaughter and i'll be answering your questions from twitter today this is injury support [Music] this is from sid 1998 how many concussions is too many concussions asking for a friend i'm thinking by the way that you delivered that you're actually asking for yourself a concussion is the state that you are in mentally temporarily after a mild traumatic brain injury the symptoms range from decreased attention span lethargy or feeling really tired feeling a little confused severe headaches light sensitivity and nausea the feeling that you're going to throw up so there's a very wide range of symptoms that you can have with this condition it depends on the type of concussion how big was the concussion and also how severe were your symptoms afterwards i'd say the most feared outcome of multiple concussions is something called cte or chronic traumatic encephalopathy people with chronic traumatic encephalopathy a lot of them are boxers or football players who get repetitive head traumas end up with very severe issues long term like dementia really bad headaches behavioral changes aggressiveness and suicidality there was one study that showed that about 17 concussions was the average of a lot of people who had chronic traumatic encephalopathy but the answer is avoid concussions at all costs from holohona what happens when you break a bone and don't set it back correctly it depends on where the fracture is how severe the fracture is and how well aligned the bones are i hear about people you know really hurting themselves a bonus you know facing in the wrong direction they're like i'm gonna be a man and just fix it on the spot don't do that you have no idea what injury that looks like under the surface of your skin it may not need any realignment at all so do not try to set your bones back do not try to put your dislocations back in place please don't do this at home also is it going into a joint a joint is basically where two bones meet we have joints all over our body and if a fracture goes into that joint it's more important for that fracture to heal very very well and for everything to be aligned because you can imagine if there are well like bone fragments inside the joint and then you try to move your extremity and it can be very painful and it can lead to a significant amount of arthritis long term so go see an orthopedic doctor don't try to fix your own brakes at home that's my answer from this isn't fabia i think i've dislocated my shoulder help how do i know if i've dislocated it first of all you'll know if you have a dislocation or a fracture because it'll be one of the most painful things that you've ever experienced in your life and these are things that need to be seen by doctors so don't try to diagnose yourself at home using dr google and try to pop things back in place but i will say in the emergency department before i get x-rays if somebody thinks that there's a shoulder dislocation i will have them take the arm that's affected and try to touch the other shoulder so if somebody has a shoulder dislocation they're not gonna be able to do it so that's one of the things i do after i pop a shoulder back in place which is awesomely satisfying i must say we check to see if it's back in place before x-rays by seeing if that arm goes up to the contralateral shoulder that is the opposite shoulder this question is from amseries how does one know when stitches are needed asking for a friend it's a difficult answer there are certain stitches that we put in place because it's just gonna have a better cosmetic outcome that is it's gonna look better long-term but there are other stitches real real deep lacerations that we absolutely need to stitch up for instance if it gets deep enough to go to this layer called the fascia now fascia is like really dense tissue and that kind of holds certain structures in place think of it as like layering like layering of a cake or something like that so that particular layer called the fascial plane that separates those two areas a lot of times needs to be repaired and so we'll put stitches in there to bring that back together and if you don't the muscles or structures that are under that fascial plane can kind of herniate through and they'll cause you some issues also i should mention there are absorbable sutures and there are non-absorbable sutures there are certain stitches that we don't want your body to absorb for instance if there's a tendon that's been cut and we're repairing that a lot of times we're going to use a non-absorbable suture we want that stitch to stay in place because it takes a long time for tendons to heal fully okay there are other areas of the body or certain situations where we want the stitches to dissolve and those dissolvable stitches or absorbable stitches are made out of either synthetic polymers or they're made out of animal intestines so come to the emergency department and we might stitch you up with animal intestines all right this next question is from justin wolfson i broke my femur in a car wreck and i have some cues by the way this is a terribly painful experience so justin wolf said my heart goes out to you brother how much force does it take to break a friggin femur how do they get that rod in there don't i need that missing bone marrow and how do these heal before this surgery existed it's a lot of force the answer is about 4 000 newtons of force 4000 newtons is about equivalent to 900 pounds here on on earth's gravity so you can think of like a sea lion or a really big moose that is the amount of force that it takes you think about surgeries in general is being a very like gentle precise operation orthopedic surgeries are not gentle they're putting force in there they're using muscles because it genuinely requires a significant amount of force to get these surgeries done and to put bones back in place to get that rod into your femur they basically have to align it where the cavity is where your bone marrow is okay and it's called an intra medullary rod they align it and they take a big ol hammer and they go until it's all the way in there so it is violent and it takes a lot of force and it's impressive to see don't i need that missing bone mirror nah you really don't i mean you have bone marrow throughout the rest of your bones you'll be fine last question how did these heal before the surgery existed and the answer is very very poorly they probably didn't heal very well at all that person maybe never walked again if you were in a car accident in the 1500s all right the next question is from kieran kalan why are shin splints so painful so shin splints are known as median tibial stress syndrome and that's basically where there's inflammation of a lot of the structures that are there around your tibia your tibia is this long bone here in your lower extremity right next to your fibula which is the skinnier bone that runs along the side runners always get these shin splints a lot of cheerleaders get shin splints and these can be very very painful now here's the thing though that pain should resolve with rest definitely get seen if that pain doesn't resolve with cessation of that activity this is from london hearts one what is a defibrillator do i have to be trained to use one so a defibrillator is basically a device that administers electricity to the heart the bottom part of your heart are the ventricles all right and when the heart naturally does its thing the top part squeezes first the atria squeeze the bottom part squeezes afterwards boom boom boom boom so if the bottom part of the heart isn't given a good a hearty squeeze there see what i did there with hardy that was a total accident you're not going to get blood flow to your brain or to your extremities and you're going to start dying when you go into these dangerous heart rhythms you get electricity of the heart as soon as possible ask for an aed or automatic external defibrillator don't be worried you can do this you can save someone's life call for 9-1-1 as well because they're trained they're going to know what to do especially in the field but if you can get an aed it'll tell you to put these pads on the chest and and on the back and you're going to basically sandwich the heart and that's going to make it to where the electricity runs between the two pads if you don't have access to an aed and or you're a professional this is what you're gonna need this is called a life pack so this bad boy is over fifty thousand dollars worth of machine what we do is we hook this up to somebody's chest when it's hooked up you'll be able to see the rhythm that the heart is in you'll be able to tell is that person in ventricular fibrillation or ventricular tachycardia and then we can determine do they need defibrillation or do they need something called synchronized cardioversion this will basically take someone who is inevitably going to die and bring them back to life very rapidly this is one of the best inventions that modern medicine has to be honest so this thing's pretty amazing the next question is from pt works and the question is what is the most serious or painful injury you've ever encountered i mean the most serious injuries are the ones where the patient comes in dead when you classify traumas based on like what hit what so you'll say like motor vehicle versus like bicyclist or train versus pedestrian you can imagine that train versus pedestrian was the most serious thing that i've seen in the emergency department the guy not to gross you out but had a traumatic amputation that is his arm was ripped off from the force and he was already dead by the time he came in and so that is the most serious injury that i've seen some of the most painful injuries that i see actually are ones that cause ischemia now ischemia is lack of blood flow to tissue or lack of oxygen so if there is an injury that either like rips the blood vessel apart or causes a certain abnormality that would decrease the blood flow to a certain area that is exquisitely painful hopefully you never have to experience something like that in your lifetime and this is from mediocentro is an achilles tendon terror the worst injury an athlete can get so i should tell you what an achilles tendon is your achilles tendon is this tendon back here that attaches your calf basically to your foot and allows you to flex your foot and so when this pops you can't do this anymore and that's pretty important for running walking jumping etc this is a shocking morbid injury but i would argue this is not the worst injury that an athlete can sustain because think about a spinal cord injury man you get a cervical spine injury that is you essentially like fracture the bones here in the neck and it ends up pushing on your spinal cord and you may never be able to walk use your arms or legs i think paralysis that's the worst injury that an athlete can get all right this next question is from let's do med legal is it okay to treat my dog bite injury at home absolutely not these are at very very high risk for infection you need antibiotics also when was the last time you got a tetanus shot also rabies that's a problem chances are pretty low right but if you get it guess how fatal it is a hundred percent now if they can catch the animal and it's a stray animal that's different what they do is they watch the dog for multiple days make sure they don't exhibit any signs of rabies if they don't then it's fine you don't have to get all your rabies shots and stuff like that but if it's some rando dog that you ran away and you're never going to see it again you need to get your rabies shot you also want to get x-rays to make sure there isn't a big old chunk of bone under the surface there because again very very high risk for infection from 41 sheisty what is tommy john surgery let me get my little arm model right here this is your humerus all right this is your alma right here and this is your radius and what happens in people that require tommy john surgery is they end up having a rupture of this tendon called the ulnar collateral ligament the older collateral ligament connects um the humerus which is this bone here right down to the ulna and if you are throwing overhead all day every day for years and years and years you put yourself a risk especially if you're putting a ton of force behind it you're throwing fastballs and once that thing pops you're going to have a lot of pain when you're throwing it's going to be really tender over that area where the ligament naturally is so what do they do during a tommy john surgery they end up taking a tendon to fix your ligament they'll either take a tendon from your forearm your hamstrings or your foot and they will reconnect those bones to kind of stabilize that area on the medial aspect of your elbow and you wonder do you not need the tendon that they're taking out from the other area of your body and the answer is no not really you're gonna do fine without it p1p31150 i have no idea what that stands for but how do you know if you have a broken rib asking for a friend it's always asking for a friend it's going to be very painful if it hurts a lot or you're having any difficulty breathing you absolutely need to be seen because you can have pain on one side and you think oh it's just a broken rib whatever they don't do surgery on that which is true but what can happen is that rib if that fractures and pokes your lung you can pop a lung you can have a collapsed lung if you get air in your thoracic cavity that's outside of your lung it can compress your lung to the point where one you have difficulty breathing and two you can put so much pressure in the thoracic cavity that you can cut off blood supply to the heart you can squeeze the blood vessels clothes that are responsible for getting blood back to the heart you can imagine it's only a matter of time before you die if you're not getting blood flow to your heart because if you don't get blood flow to your heart you don't get blood flow to the rest of your body so if you think you have a rib fracture get seen it might be more serious than you think next question is how to treat cooking oil burn i think i hate scars that was a quote that was a quote i didn't the answer is you treat a cooking oil burn by getting seen in person unfortunately you do need to get seen this isn't something you should be treating at home you have multiple different depths of injuries with burns they pretty much all need some sort of antibiotic cream to put on there now neosporin does work really well for a burn especially if it just looks like it's a sunburn and there's no bubbling or anything that's probably gonna be a superficial thickness burner first degree burn but when you start getting into those deeper burns when it's bubbling up on the surface go see a doctor to determine what depth of injury it is and then long term depending on where the burn is you may end up needing the skin graft which is where they take skin somewhere else in the body and then we attach it to the area where the burn is because our skin provides a very important role it one makes sure that we don't lose a lot of water to our environment but the skin also protects you against infection so they're very very high risk for infections also if the burn is over a joint you can get scarring to kind of resist your normal movement of the elbow and and you may develop contractures and they may need to get essentially released surgically so go see a doctor especially if it is bubbling or turning a whitish color from straw hat ruby what's the difference between a sprain and a strain a sprain is when you have an injury to your ligaments ligaments directly connect bone to bone tendons are affected when you have a strain i said it wrong and tendons connect muscle to bone and how do you kind of know the difference between the two it's difficult to say because both of them are very painful but one of the big differences is that muscle strains can end up having a lot of like cramping associated with the muscles now that technically can happen with sprains as well just a little less likely and you can have limited movement around that joint that's affected now that's with the strain with a sprain you won't have as much muscle spasm and you may have more movement at that joint because the ligament that was there kind of stabilizing and holding it in place is injured stretched maybe totally torn and so you may be able to move it more than you could before you could have instability of that joint so that's the difference between a sprain and a string from luxon can you break your funny bone not a rhetorical question i really slam that on a changing room locker the funny bone can be a very painful injury and it's usually very temporary but what happens is you have an ulnar nerve you have this big old nerve right on the medial aspect the middle side of your elbow and that nerve is responsible for your ability to feel there and so that's why when you hit it your fingers might kind of like tense up and you get this really weird tingling sensation all the way down your hand so no you can't break your funny bone but it can hurt a lot all right that's all for now hope you guys learned something today i'm dr j maxx signing off

Channel: WIRED

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Keywords: doctor, doctor expert, doctor explains injuries, doctor wired, dr slaughter, dr. j. mack slaughter, emergency doctor, emergency injuries, emergency room doctor, emergency room doctor injuries, er doctor, er injuries, expert doctor, injuries, injuries wired, injury, injury support, innovation, ott tech support, science & technology, sports injuries, sports injury explained, wired, wired doctor explains, wired injuries

Id: XTRzqw5MNZY

Length: 16min 53sec (1013 seconds)

Published: Fri Jul 01 2022