- There's Chicago P.D.,
there's Chicago Fire, but I'm most concerned
with, you guessed it, Chicago Med, let's get started. (lively hip-hop music) (train tracks) - Doesn't look too bad, all right? You're gonna be all right. - Good triage. - 45 year old male left leg amputation. - Treatment two. - Trey Moderman, GCS
three BP of 90 by palp. - GCS three is the Glasgow Coma Scale, three is very bad you
need to be intubated, you're basically in a
life or death situation at that moment. - He keeps biting down and
I can't get the blade in. - Pressure - You bag him, I'll do CPR. - If you can't insert a
tube to help someone breathe the one thing you can do is
you can continue bagging them. That still oxygenates their airway, it's obviously not as ideal as
putting an endotracheal tube in but the most important thing is CPR. Chest compressions, chest
compressions, chest compressions. - Almost there it's not time yet. (grunting) - Never ideal to do chest
compressions with one arm like that but I can
understand if he's been doing chest compressions for 15
minutes, it's really tough it's tiring to do chest compressions. I've done chest compressions
for a while and generally after each round you have
a student or a resident standing behind you ready to jump in and start doing the chest compressions. Cause it's all about at least getting two inches of compressions
to the chest which can sometimes break ribs, but
it's all about getting them enough time to get to the hospital to hopefully save their life. - I got it from here man. - Nope, he's mine. - Okay who the hell is this guy? - [Nurse] He says he's a doc. - All right get off the gurney, Doc. I'm senior resident in this ER. - Yeah, well I'm your new trauma fellow. - Doesn't happen like that. Trauma fellows don't just
run in, this guy could be anybody you need to see some ID. I'm all for the show trying
to set up the stage for this character, but
people don't just run into the hospital and say
"I'm the doctor now!". - [Doctor] Get a BP keep giving him blood. Send a rainbow of tubes
and and a type and cross. Get his blood gas and get him to the OR. - Type and cross again you
try and find out the correct blood type for now
getting O-negative is fine but you don't wanna keep
wasting the O-negative blood. So you wanna do a type and cross. When he says the rainbow
of tubes that's basically tubes that are sent off for
a wide variety of tests-- a wide array of tests like
a CBC which is a complete blood count, BMP or CMP
which is a metabolic panel, a PT/INR which shows clotting
abilities and clotting times. - No gag reflex didn't even
need sedation, not good. - We got another problem,
this woman's pregnant. - What he's doing there with
the ultrasound is called a FAST scan, it basically
allows you to see if there's any internal bleeding going
on especially in the abdomen cause you can lose a lot
of blood in the abdomen without even knowing
that you're bleeding into the abdomen. But obviously the situation
he's found that this patient is pregnant which complicates
a situation even more. - 20 year old male, cystic
fibrosis, complaining of chills, labored breathing, temp's 98. - Jamie, that you? - Hi Maggie. - Back so soon? - I missed you guys. - Cystic fibrosis is a-- it's
a deadly illness unfortunately and it basically you build up
so much mucus in your airway because you cannot clear the
mucus out of your airways efficiently as someone
who is healthy and doesn't have cystic fibrosis. So you get very often lung
infections, obstruction in your airway and most people
live somewhere into their 40's or 50's with the illness
and that's pretty much a life expectancy with someone
who has cystic fibrosis. - Mr. Delson I see that you're
using inhaled antibiotics, Tobramycin, Albuterol. You wear
a vibration jacket at night and use a humidifier? - Yeah. - The vibration jacket actually
helps break up some of that mucus and allows it to
naturally come out when that patient coughs. Very commonly we use something known as Chest Physical Therapy,
which is almost like clapping on the chest to help
clear some of the mucus. Parents of young children
who have cystic fibrosis are trained in giving their
children this procedure. - Baby checks out fine. (relieved gasp) Healthy heartbeat, amniotic
sac and placenta are intact. Gina though, I'm afraid,
suffered a traumatic head injury and so far she's unresponsive. We need to contact her family,
if you have any information. - My husband and I are
pretty much her family she-- she's been living with us since before the embryo was implanted. - That's such a difficult
situation, I mean to have someone be a surrogate to carry your baby and then they are living
with you and they're involved in this horrible accident and they have a traumatic brain injury
where they're being kept alive by machines. That's gonna be a tough
decision whether or not to keep her alive using machines so
that the baby can continue growing and it get to at
least to a stage where the baby can survive on it's
own following a C section. Man! - Jamie I've got your test results back. I wish they were a
little more encouraging. You're pancytopenic which means that your cell counts are low. You've got a blood Ph of 7.14. - When your blood Ph is
that low that means you're trapping carbon dioxide within your body and you're having
obstruction which comes from the cystic fibrosis. That's very dangerous
because when you go into an acidotic state like
that your enzymes think your body can't function and you can die. - I'd like to intubate
you, put you to sleep, get you on a ventilator. You're getting fatigued, this
would just allow you to rest so that the antibiotics can do their job. - I've been intubated eight
times, I think I'll skip it. - The purpose of intubating
someone who has such a strong acidosis is
when you put the tube in it allows the person to not
work to breathe so heavy to expel all that carbon dioxide. The machine basically does it for them, and again it allows them to
rest, it allows the antibiotics to do their job and it
improves the Ph quicker than the person can do themselves. Very uncomfortable, not a
lot of patients like it. I've never seen-- and again
I'm not a trauma surgeon, I'm not an ER doctor but
I haven't seen options given that frankly to patients. If a Ph was that low in my
hospital generally we would strongly advice the patient
to intubate them, but again I'm not super specialized in this field so I'm just going off based
off my own experiences. (beeping) - Sherri? - [Sherri] Dr. Halstead. - You need to blow down her CO2, take her off the vent and bag her, give her a dose of Mannitol
and increase her dopamine drip to 12. - Right away.
- Doctor? - Gina's intercranial pressure is rising. - What happens after an
injury to the brain is just like any part of the body. There exist inflammation,
swelling, edema and the problem with having swelling
inside the cranium is that the cranium is a skull, it's
meant to keep things from coming in and protect you
but it also crams the brain when there's edema and swelling
and it actually damages the brain further and can be fatal. So, you try and control it
with medications, you try and give the patient something
to reduce the swelling in the brain, there's also some
physical things you can do. Like elevating the head to
hopefully get some of the fluid to come down. But, in reality if the
condition gets worse you need to do the surgery to
open a piece of the cranium to allow the brain to swell and
not cause increased pressure within the brain. - Intubating Jamie is the
only hope we have of keeping him alive. - What's that gonna get him? A week? 10 days? - It could be six months, a year, more. - This goes to the heart of
the issue of patient autonomy. That they have the right to choose what happens to their body. I don't know how old Jamie is,
once you're at the age of 18 or older you have the right to
turn down medical treatments, you have the right and say
that as long as you understand the consequences of what
you're doing, you can undergo or skip any treatment that you want. Nobody can force treatments upon you. I understand what the ER
doctor's doing, I also understand what the psychiatrist is doing. - As soon as we hear
something we'll let you know. Rachel? Rachel can you hear me? - What's wrong? What's happening? - I can't find a pulse. - Oh my god. (alarm blares) - [Woman over PA] Treatment three. - Well the medical student is
doing the exact right thing. Call the alert, start doing
chest compressions right away. - You're not compressing the heart Sarah, you've gotta go harder. - But she's so small I don't wanna-- - Harder, do it, let's go! (ribs cracking) Come on Sarah, harder! Hold! (beeping) There we go back in sinus, get a BP. - What happened? - She arrested, we got her back. - Can you get an IV? - Hand me a drill, get an IO line. - An IO line is an intraosseous line. In children sometimes it's
difficult to put an IV line sometimes they need extra
fluids, what we can do is drill a little needle right-- it
sounds brutal but it's really not that bad, drill a little
needle directly into the shinbone and what that allows us to do is to give extra fluids and
medications to that area. - I just broke a little girls ribs. - Reese, you saved the girls life. - Breaking someones ribs
while doing proper CPR is par of the course and the
CPR actually saves lives, the ribs are an unintended
consequence but they're a side effect of trying to
keep the young girl alive. - This is Jorge's?
(speaks spanish) - Yes. - Inside, I found this. - Why would you give that
to her in this moment? That's so unnecessary! I promise this will not
happen in the hospital. - What happened with the little girl? - She had a cardiac contusion, bruising caused her to arrest. She's good now, but it was a real scare. - Sometimes when you have a
direct injury to the heart that can cause a a contusion
which is just a bruise, and sometimes that can mess
with the electrical activity of your heart and cause
it-- cause you to have a cardiac arrest which means that it just stops the cardiac rhythm. Actually this is a common
scenario during baseball games if someone hits a line
drive and it hits someone in the infield directly in
the chest, if it hits in the specific time of the electrical
rhythm you can actually stop the heart. - Jorge's brain was without
oxygen for too long. (speaking spanish) - We have translators in the
hospital for moments like this. If you're gonna have a
conversation that's about life or death you need a translator there. Your broken Spanish isn't the right way to communicate with a patient. - He's 20 years old, without
new lungs he will die. - (speaking spanish) - Your fiance, the man you love-- - (speaking spanish) - The man who loved you, can save his life. - A little unethical here,
they're talking about the patient's condition to
a non family member, it's technically breaking
information protocol, but I don't think they'd
get in trouble for this I think they're doing the right thing and that's why a lot of rules
are open to interpretation and I think here they're
looking out for the best interest of the patient and
maybe telling his patient information to somebody else
but in hopes to save his life. So I think legally this isn't
right but I think morally and ethically it's the right move. - Going back to the hospital? - Yeah. Wouldn't mind being
there when he wakes up. - Can I come? - Sure. - I appreciate that the doctors
wanna spend their off time with a patient but you
know, you gotta recharge your own batteries. You gotta get the seven
to nine hours of sleep so you can make the best
decisions for your patients the following day. Again, you wanna be
empathetic but you don't wanna burn out either because then
your future patients will suffer also so it's a
fine line between being a good empathetic doctor
and burning yourself out. (dramatic music) This is a good show, quality
actors, quality script, good medical info, showed
some very unique situations that have inherent drama built into them, but they were realistic. Based off this pilot
episode I'm definitely a fan so thank you for recommending this. If there's another
medical show you wanna do drop it down below in the
comment section and don't forget to subscribe and click
that little bell logo to make sure you know every
time I'm publishing a new video. As always, stay happy and healthy. (lively hip hop beat)
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