How accurate is ER? Real life DOCTOR reaction

hello and welcome to sick notes my name is ed hope i'm a junior doctor from the uk and i asked you guys which medical tv show you'd like me to look at next and it was a resounding vote for er the classic hospital drama from the 90s now i never saw this first time around i was only 12 years old when the first episode came out i was probably too busy watching jim carrey film so i'm not expecting the medicine to be sort of super accurate it may be accurate for the time i don't really know much about medicine back then you know with advancements in medical practice things are probably different anyway but as with all these tv shows it's just a fun way for us to revisit the episodes for me to explain maybe a little bit more about what's going on screen and to share some of my experiences so let's crack on with the first episode of er dr green we tend to do a lot more work than sleep than is often depicted in these type of shows but in some specialties getting time to sleep is actually really accurate so when i worked in obstetrics and gynecology i'd frequently get a few hours every night but never in the emergency department what time is it five o'clock all right can't the intern take it it's dr ross so i've been in exactly this position as i said when i worked in austin gyning and i was covering labour ward you'd often get bleeped to do blood so if there was an emergency there in section and you'd wake up and you'd be in this sort of hot days of confusion for a few seconds when you're trying to figure out where everything was and as soon as it dawned on you what you're supposed to do it was like snap out of it and get on with the job dr ross i'll be right there i've done exactly this straw this is basically what i'm like coming out of the encore room yes you are a real friend i want you to know that that's all right real friends yeah we're now the bed to me yeah number three is free three is free so one of the actual doctors i think here has been brought in under the influence of alcohol that's a nice way of saying completely treating other medical professionals definitely happens the hospital is such a big place that it ends up servicing the people that also work there well so i've been involved in a few cases of medical professionals i know it's a really kind of dodgy ground i mean you try and get people to help that maybe don't know them so well so there's not a breach of confidentiality but when you know there's no other choice it has to be you so we need to be extra careful that information isn't spread to the whole medical team d5 ns i need the dextrose d5ns stands for dextrose and normal saline which is a type of infusion fluid the reason why we give people fluids when they're under the influence of alcohol is because to sort of counter the diuretic effect of alcohol so it makes you pee out lots of your fluids we try and replace that and the reason why we give dextrose a type of sugar is when your blood sugar goes low it's the liver's job to bring that blood sugar up by releasing glucose from its stores now if the liver is too busy breaking down alcohol then it is unable to do this effectively so your blood sugar goes down so therefore we replace it with an iv line give them 600 of asa aspirin almost forgot aspirin 600 milligrams aspirin we give high-dose aspirin for pain relief in things like migraines but i wouldn't give it in someone with alcohol issues the reason being is that people who have alcohol excess are more likely to get stomach ulcers that aspirin can make significantly worse it's nice to see other healthcare professionals around the bed in reality they'd usually do a lot more than they're seen to be doing the doctor would literally just be taking the history examining and prescribing the medication so all the cannulas and drugs and would be done by the nurse but clearly in this dr green has taken a sort of role because it's one of his friends and one of his colleagues that has come into the department dr green dr green mark what is it can i give mrs williston more demoral she's complaining of pain 50 milligrams i am thanks mark verbal orders are definitely something that exists but normally when you're too busy to see something that's not as high priority rather than just when you're asleep i had to google what dem roll was because i've never heard of it it's actually pathadin which is an unusual choice for pain relief but obviously this might be because it's back in the 90s although we still use it for pain relief in labor and you'll find that a lot of medications used in pregnancy are kind of the older medications and that's because a lot of the newer and arguably better medications we don't have evidence for because we don't run trials in pregnant ladies just because we don't want to run the risk they might cause birth defects so therefore in pregnancy we go where we have evidence and the evidence it tends to be with older medications good morning dr beth hey jared morning doctor this was the scenics oh i do like coming into the emergency department and saying sort of hello to everyone have you go in it does it gives you a nice little buzz actually to have so many different people from all kind of walks of life and all kind of different parts of their career it is one of the best things about being a doctor not only serving kind of a broad spectrum of society but also working with a broad spectrum as well room four needs a cdc the man in five is a rule out mi waiting for cardiac enzymes another 12 years in dr ross he's in three sleeping the last one this updating of all the patients in the emergency department this happens a lot we do this a few times a day so just to make sure we're not missing anything so we'd have a board round where we all meet together and discuss every single case that's currently in the department that's soon three stories do you know what this is all about the building collapsed in the loop they're sending us yeah well who's on just us okay forget all that call susan lewis call the seventh and eighth floor tell them we need anybody they can spare the way that was shot and taking that pre-alert call it made me tingle i can totally relate to that feeling i've never worked in a major trauma center but having that pre-alert through and you're the one in recess and you just your mind is racing of what you know what's happened to what condition the patient's going to be in and you're having to brief the team and get everything ready i mean it certainly you know the way the music speeds up here and the pace of the the scene seems to change you know that is exactly what happens in real life cutting clothes off very realistic i've had loads of people get upset about cutting their trousers off i had a guy in a sort of fancy dress outfit who was not happy at all presumably he was going to lose his deposit but you know it had a significant injury so you know i i don't give a monkeys about his deposit that can all be sorted out later but when you're trying to look after people you need a bit of tough love here notified the or get us a room okay call vascular and call orthopedic tell them to come down here now it's their lucky day in reality you do a more general assessment of the patient we call this an a to e assessment because you don't want to get too distracted by a hand injury unless there's a lot of blood there but i like the fact that they alert lots of other teams early i mean often in these tv shows you see the doctor doing everything themselves but this is a lot more realistic i mean this ed doctor is only going to really stabilize the patient it's going to need a vascular surgeon to make sure we restore the blood supply to the hand an orthopedic surgeon to make sure we preserve the function of the hand and maybe even a plastic surgeon as well if we're looking at some of the tissues and we're going to save your hand don't worry about the thing okay that shot of the guy randomly get defibrillated it seems a bit off really uh when we yell clear it's because we want everyone to be clear of the bed just so the people don't get an electric shock as well when we get more casualties so and also you'd have kind of more people around if you're having a cardiac arrest i appreciate it's supposed to be emergency so not many people there but this just didn't really look like a realistic arrest really when you you been talking up breathe okay let me take a listen this is a bad job from dr green here he's not getting distracted by the obvious injury he's talking to the patient so he knows the patient's airway is okay and then he's moving on to b so he's listening to the chest to work out the breathing good work matey it goes without saying dr ross should have been working right now even in an emergency like that it's more irresponsible to have someone that's been under the influence of alcohol there and although he doesn't look hungover at all okay all right i want you to tell me if it's hurt you when you breathe at home i don't get a bp so this lady has an upper gi bleed so she's vomiting blood i'm pretty sure she's not part of the trauma call because this isn't usually a presentation of trauma i've seen a few of these in reality they are super scary because it's not like you've got a bleed and obviously that you can compress and stop it happening it's happening from the inside so as dr ross does here we get two iv access points so we can give in lots of blood we and replace the chlorine factors as well we don't tend to give fluids because that can dilute the clotting factors and dilute the blood products so unless that blood pressure is dropping we tend to just go a little bit easy on the fluids we basically get more prepped so they can go and have a scope so a camera down to try and sort out the bleed so uh you think you can save the hand looks pretty good i think so good i told him you could so he's counting on you peter you're a smart ass never promise a patient something like that i mean you can try and be positive in an emergency situation but don't promise something like that there you know that can really stick with people and it can make it difficult for them to get over their injuries they'll often target that as you know a failure in the care so communication issues tend to be one of the biggest problems in medicine beautiful doc thank you you're married no i'm a doctor well then alyssa take it easy mr barr you wouldn't want to fall on your face twice in one day i hear plenty of stories of patients like this pretty accurate so a lady with the upper gi bleed the one that's vomiting blood has a cardiac arrest now usually of these medical shows the cardiac arrest rhythm is a systole but in this one it's ventricular fibrillation which is brilliant because that can respond to a defibrillator so the doctor running the code here really shouldn't be doing the chest compressions and there's no need to keep looking up at the monitor the monitor won't tell you anything because when you're doing the compressions that interrupts the reading of the electrical activity so you can't tell anything for it so we normally do the cpr in cycle so you should just be doing two minutes and then you should stop the cpr briefly just to check the rhythm that's the only time you should stop cpr to do a rhythm check and then get straight back onto the chest compressions so the patient has responded to a defibrillator i'm glad she didn't just sit straight up and take a cup of tea whenever you have downtime like that from a successful cardiac arrest you know just having blood supply denied to some of your organs for a short time will mean your body needs a lot of time to recover so people will end up going to intensive care unit for sort of monitoring and maybe even some support systems as well clearly in this patient the bleeding is still going on so they'll need to go to theater to have the scope the camera test i talked about to stop the bleeding which caused the cardiac arrest relaxing in the doctor's mess or the doctor's office or the common room in some specialties this happens a lot more than in others in the emergency setting it tends to just be when we have designated breaks that we get time off rather than there's never really a time where it's quiet enough to come away and just have these moments away oh damn it the nurses have been in here raiding the coffee again why don't they just make their own i'm going to tell them never mind coffee walls they've definitely done their research on this one there's always some kind of argument over the tea and biscuits and coffee and all that type of thing in the covered ribs that's the first tailored white coat i've ever seen isn't he alone do you think he knows anything how's that a dress medical students in the emergency department i love the fact they've taken time to show this so in my role as well i basically look after the medical students at the hospital so it's really cool just they've given some time to show how they are and i always try and do this kind of walk through when they shadow me for the first time in the department as is going on here mark everything's stacked whether you want it fast or not everybody gets an iv the minute they walk through the door use an android cath with a 16 needle you need a large warranty and this is like really accurate in the emergency setting although we feel like we give tailored care to everyone that comes in there's lots of common things that we do with everyone that comes in the emergency department and although your medical textbooks don't really teach you that it's only when you do the job do you realize kind of the common things that we everyone gets when they come into hospital you have the medical examining rooms this is where the pill pushers kill their victims but this this is the surgical this is where the real action is it's a pretty amazing specialty that someone comes in with something you fix it and then kind of bed up that's a pretty cool thing to do isn't it whereas medicine can be a little bit more hit and miss a little bit more investigating a little bit more trying stuff out so that's why the sort of surgeons disparagingly call the medical team the pill pushers so i've met loads of residents like dr benton in the emergency department and i just love working with them as i've said in my videos before you kind of need every type of personality within medicine because we treat every type of people and we need people to feel the different roles but working with people like is shown here dr benton who are kind of a little bit of a maverick but really know their stuff it's great to work with them because you know they keep you on your toes and they're always when you need them they're kind of always there for you it's medical student carter with this clipboard it does it reminds me of some of the characters i've seen i was never a clipboard medical student yeah you finish okay this isn't gonna hurt at all oh the reason why i would sing is that this is super realistic i mean when you do any kind of invasive procedure for the first time or you know the first few times you get super self-conscious about it you know when i was first suturing i was lucky i had direct supervision from a consultant which you should have and i had a chat that had fallen through some glass and i was just cleaning it up and suturing it up and you know i was so nervous my hand was sort of tremoring like this i remember the consultant really patient guiding me through and the patient as well was amazing he was basically just like the consultant was telling me technically what to do and the patient was basically uh giving me motivation just saying you can do it go on mate and yeah it was so although i was as self-conscious shown here i was had a much luckier opportunity i think tell you i want to belt her right in the mouth i really did then i go and shoot myself in the leg these things happen i bet you see a lot of stuff working in a place like this yeah oh yeah all the time yeah whenever i see something strange i always say to the patient that we've seen it all before you know even if it's you know we haven't seen that particular thing before you've got to expect the unexpected and so much part of when people come out in like this is the kind of embarrassment and sometimes you know the humiliation of what's going on so we need to reassure them just to make sure they're really comfortable with what's going on oh cool so a maternity case in the emergency room this is pretty extreme someone literally about to give birth deja call the pediatrician hook up those stirrups it's pretty impressive that dr green knows what to do i mean that's not necessarily unrealistic because you don't really know what path people have gone through medicine someone's suggesting an episiotomy so that's when we cut the perineum with the babies having difficulty coming through the birth canal that's a bit random isn't it because the doctor hasn't examined them yet and also you'd probably want a kind of specialist to do that again i don't know dr green's background so he may be capable of doing that um but usually that is only when we're struggling i love the way they have lots of other medical professionals they're helping out and it's always kind of busy and doesn't look totally perfect you know this is the reality of medicine i mean in this scenario though the absolute person you'd want is a midwife they are like the powerhouses of labor and some of the most dedicated just awesome people i've worked with are the midwives and i think the reason is that they get this rush every day of seeing a baby delivered like how amazing is that the most brilliant kind of motivation right she'd expected a few more bodily fluids flying around but all in all that was pretty realistic you know babies can happen that quickly and as i say that awesome rush you get when a baby's delivered you feel just an amazing connection with nature really sounds a bit cheesy but that's always kind of how i felt when a baby would come up particularly during a cesarean section when the obstetrician would then lift the baby up above the screen so the mum and dad can see them for the first time and it was always you know sort of like a seed frog the lion king really yeah so it's an unscheduled delivery like this so you definitely have a pediatrician ready to greet the baby so that's a nice little touch density in the soft tissue superficial to the mid shaft of the fib a bullet is what it's called it goes without saying that we use computers now without light boxes but you guys obviously knew that already this kind of weird technical language is still pretty important because often people don't have access to images so if you're calling someone to discuss a case or you're speaking to someone you know just in person we need to have a common scientific language to describe things precisely so although it's kind of sent up here it does have a use and when you're first learning all these terms it can feel like your mind boggles but before you know it you kind of quite okay with everything m-o-r what do you mean we sent this to you an hour ago don't give me that it is 140 it was a stat determination what are you guys doing down there picking your nose delays in investigations oh my god super common the worst is where you someone comes into the emergency department's been waiting a while you take blood from them they then wait for the blood results and then you find out that the blood samples kind of been lost somewhere so then you have to bleed the patient again so you have to have another needle and you have to again wait a couple of hours for the blood results that's the most frustrating thing so someone's definitely done their homework in this regard also i've had it once before where the whole lab at my hospital went down so all the blood samples needed to be sent to a different hospital how mad is that i mean if that was in like a medical tv drama i would be saying how unrealistic that is because it'd be some kind of contingency well our contingency was to send it to another hospital so you know that was a really kind of busy and day that we had to kind of adapt a lot to what was going on i'm gonna go to lunch actually i'm all right there's something else that you want me to do excuse me don't be a hero if i tell you to go to lunch you go it's a long time before dinner and we may be too busy then it's stopping oh this this takes me back i had exactly this conversation with my first ever consultant when he just said you know in medicine you're going to be work like a dog basically so when you have those breaks and those times where you can get your breath back then you should take them so any medical students watching why would you get a red cross on your exam paper for examining a patient like this any ideas yeah so we normally examine patients from their right hand side clearly in practice it's not always possible but that's what we're supposed to do paperwork and you can often feel quite frustrated about writing this paperwork because there's people who need your attention right who are who are waiting to be seen and you when you're doing the paper it can seem like the least important thing to do but it needs to be done promptly sometimes you can store up a few cases and write them but it's always best to write things kind of as you as you go or as soon as you've seen a patient you do get better at it i tend to kind of write less but end up saying more because you kind of know the things that are really important you know both positives and important negatives but even so yeah it is a bit of a slog nowadays i understand but what do you think in the meantime just i think in the meantime you should consider it a potentially serious finding so you're saying i got cancer i'm not saying that is it so hard are you afraid to tell me the truth your history of coughing blood weight loss and this x-ray is suggestive of cancer but the diagnosis has not been confirmed and it may very well be something else and none of us should jump to any conclusions until we know this scene was absolutely brilliantly done you kind of see this a few times in the emergency department every month or so when you pick up something often like incidental so something you didn't expect to pick up or something you picked up that's not necessarily an emergency so nothing we need to do today but something that is going to be life-changing like a cancer and the doctor does exactly the right thing here you know we don't know it's cancer in the emergency department we just have a high suggestion and so there is we shouldn't be giving that kind of news to the patient we're not set up as um a kind of place to be able to deliver that and follow that up it needs to be dealt with in the right way um she doesn't dodge the question you know she answers the patient's questions very clearly and she tells them what we know what we don't know and the plan we're going to have to figure it all out so i thought this was a really nice moment actually felt very very genuine very realistic are you serious it could be a matter of life and death and i'm not exaggerating i'm not pregnant and she's got a pain in the lower left quadrant she's not pregnant can you tell me how long has it been since you've had your last period i don't know well just think back tell me roughly it was after christmas okay and you've had sexual intercourse i love this is brilliant okay for two reasons working in a e people denying that they can be pregnant happens all the time and secondly when you take a history of a patient and they categorically say this happened and then you know you report that to your consultant and then your consultant comes and takes the history with you and the patient sort of says something totally different and just you know it makes you look like a complete idiot uh i think the consultants kind of know that you often don't necessarily ask the question in the best way so dr benton asked when she had her last period so that's the skill isn't it finding a different line of questioning to you know find out exactly what's going on all right move around three one two three [Music] come on people let's get our clothes off let's go let's go so the drug overdose that comes in is one of the nurses that works on the unit that went home earlier this so again you know they're treating people medical professionals that they work with you see so many overdoses in a e and it is super sad because although you're dealing with that acute problem you're not doing the hardest bit which is actually managing it long term obviously the acute problem can sometimes cause life-changing issues it can kill you the common misconception is that we have the kind of reversal agents for a lot of drugs when we don't really kind of monitor patients and support any kind of abnormal things that are going on and just wait for the body to kind of break down the drug itself so for example some drugs will suppress your breathing so we may need to ventilate the patient some drugs may interrupt the electrical activity of the heart so we make sure we monitor the heart and stabilize it with medications if need be i can't give this up no no no not you you're fine dr green your wife on 2204. yeah i have to call her back oh man i like dr green he's he's a cool guy isn't he i totally appreciate that sentiment cool it's a clever little ending tying it all together and when you do night shifts you do end up kind of losing track of what day it is because you end up going into work the same day that you left work which is really surreal so this kind of you know being disoriented like this definitely fits so that's the end of the episode that was absolutely amazing it blew me away absolutely loved it i mean the set was incredible with it just looked so real i mean it looked like a documentary the way it was filmed made you feel part of it wasn't all these crazy artistic camera angles the kind of the set as well the way it looked messy and kind of disorganized that is very much what hospitals are kind of still like and the characters as well they i could see in them people that i knew like the fact they had lots of medical professionals there and the patients we saw lots of different patients bringing in problems you know that were made worse by their kind of personal issues we had serious problems we had things that weren't serious we had lots of standard issue problems as well not crazy diagnosis i absolutely loved it absolutely brilliant i mean i saw so much in what you know what i see day to day so definitely going to watch another episode of it despite it being so old which is kind of like a testament to what's going on so thank you to everyone that suggested i take a look at this i'm still running the poll down below so you can still vote on other shows you want me to take a look at as always thank you so much for the re support that you're giving me on this channel i mean the subscribers and the views and everything the comments are just awesome thank you so much i'll just keep making videos as long as you keep watching them so well until next time then [Music] goodbye [Music] you

Channel: Dr Hope's Sick Notes

Views: 248,585

Rating: 4.9426231 out of 5

Keywords: ER, doctor reacts, medical drama review, ER tv show, medical TV show review, doctor reaction, real life doctor, doctor reacts to ER, how accurate is ER, medical accuracy, ER S1E1, doctor watches medical drama, george clooney, dr green, dr ross, dr benton, dr watches medical tv show, doctor review, doctor breaks down, doctor watches, dr reacts, dr watches, dr breaks down

Id: YSnbV-8zerY

Length: 28min 35sec (1715 seconds)

Published: Tue Apr 24 2018