Trauma Doctors Are Called to the Scene of a Stabbing | Trauma Investigators Full Episode

when someone gets critically injured on the Streets of London it's down to an Elite Squad of trauma doctors to get there fast five minutes away in this series we go inside the minds of these highly specialized Medics I'm worried that you may have a bleed into his brain on the road you've got pain in your neck there yeah in the air on your left lung or your right lung and in the emergency department she's obviously got significant head injury but I'm more worried about her chest as they make the Split Second decisions my gut feeling is he needs to get to hospital quickly that make the difference between life and death she may not survive this when every second counts we're gonna get going now just after midnight and the trauma doctors are on their way to another call when it's dark London's air ambulance Medics race to emergencies in high-speed cars yeah there's probably many things it's a Bishop's game a 20 year old man has been stabbed in central London near the next traffic lights you're going to turn right if you can speeding to the incident at Dr Gareth Grier and paramedic Karen King see some emergency vehicles up here I think I'm not sure where the patient is whether they're in an ambulance or not so we've been called to someone who's been stabbed we don't have any other information on that at the moment but we'll look and see red base Medic One on scene takes a little pack just in case we hello hello how are you doing all right it's all right to pop in 20 year old Sandy is a student from France he's been in the UK for just two months and he's been stabbed in the chest under his left arm at the top got one one second thank you foreign is right over his heart and lungs on the left side small wound in the armpit the size of the weapon is largely irrelevant that wound could have gone from one side of the chest to the other question okay the neck frames are up a bit his neck veins are swollen this could be a cardiac tamponade could deteriorate really quickly over the next few minutes so we're going to get going now it's been on scene for just two minutes he isn't wasting any time he thinks the knife has nicked Sandy's heart if he's right blood from the wound is filling the sack that surrounds it as the pressure builds the blood is forced up into the neck veins and they swell it's unable to be properly and within minutes it can stop okay see okay all right don't worry don't worry sir okay the Royal London Hospital is five minutes away red base from Medic One decision is a ground escort to Royal London uh leaving scene now Gareth needs to get in there in case his heart fails working it wasn't anyone you knew over London we're bringing you a gentleman in his twenties who's got a stubborn to the left axilla GCS 15. with distended neck veins gareth's call gives the trauma team a vital snapshot of what to expect it may save Sandy's life one of the signs of the heart not beaten effectively because blood collects around the heart is that the veins in your neck get swollen and I'm a little bit anxious about what's happening here and very difficult to tell when someone's lying down whether that is the case or not for Sandy the next few minutes are critical if he has a tamponade his heart could stop beating at any moment it's 15 minutes since Sandy a 20 year old French student was stabbed under his left arm thinks the knife may have hit his heart his heart could stop at any minute but his gentleman's name is Sandy about 15 minutes ago he was stabbed to the left axilla my main worry is he's got distending neck veins um last blood pressure was eight years heart rate is normal but I'm worried about a tamponade Sandy you're in hospital at the moment okay heart rate of 85 no blood pressure yeah Dr Tom corendon must find out how much damage the knife has done okay x-rays please and base seven Tom orders X-rays and an ultrasound scan to see if there is any blood in the sack around Sandy's heart in the moment we're going to put this transducer onto your chest and we're gonna have a look at your heart I just want to make sure that that knife hasn't caused any bleeding Professor Tim Harris has come to do the ultrasound big breath in circle big breath s so that's good news because your heart's beating beautifully and there's no fluid around your heart it's going to get down a little bit so we can have a better look in your tummy because sometimes although the stab wound's gone into your chest it can cause problems down in your tummy a big breath in Sandy's heart's okay but Tim's found a serious problem with his lung the lung on this side bursts and it's caused a little bit of bleeding at the bottom of the chest Sandy's left lungs been punctured by the knife and has collapsed right yeah so we can sing very easily and he's got some good acrossing which is blood and air are collecting in Sandy's chest cavity the pressure builds up it will stop his heart so ladies and gents we've got a young man with a significant pneumothorax or human thorax so we're going to give him a little bit of ketamine pop in the drain and then we're going to move and search the rest of his body for wounds and then we're going to pop him the CT scan surgeon Claire Webster is going to put a plastic tube into Sandy's chest to let the blood and air drain out whereabouts in France on the Monday is that okay oh almost done this is just the last holiday deep breaths deep breaths that's it got you happy yeah and you can breathe deeply it's better to take nice deep breaths it will feel tight because you've got a tube there now the drain is in Sandy needs to use his damaged lung to help it re-inflate the hole in the lung should heal itself it's fine your breathing's fine your oxygen levels are perfect you just need to check you haven't got any more wounds now Tom must get Sandy to CT he needs to find out if the knife has caused any other damage if Sandy's got a hidden internal bleed his life is still in danger London's ambulance is bringing in a critically injured patient a man has fallen head first through a roof onto concrete we're expecting a patient apparently he's got a head injury they've given the patient an anesthetic already so that must be quite a serious head injury the patience is unconscious and the team are managing his breathing the first thing that can happen is you can stop breathing when you get a severe knock on the head and the most important thing the team would have done is to take over the breathing for the patient the other thing that can happen is that you can get bleeding into the brain when that happens that can be a very time critical emergency so we have all of the Specialists from the hospital here ready to look at this patient time is the main thing now okay then guys this is Simon Simon's approximately 35 years of age around an hour and a half ago he fell 10 foot through a plastic roof hitting the back of his head on concrete and our rival was GCS 13 with a motor score of five has been seen to move all four limbs okay so first things first let's just get the sides down on the trolley equipment away 38 year old Simon it's a snooker Club manager he was cleaning leaves from a roof when he fell we're going to do head blocks and tape primary survey chest x-ray pelvic X-ray and let's see some numbers on the screen if we can Gareth must think fast a Blow To The Head can set off a fatal chain reaction in the brain if there is bleeding we may need to go for an operation I've got to make absolutely sure we're not missing anything he can't tell us where his pain is at the moment we'll have to examine him fully to work out if he has any hidden injuries chest x-ray three two one we'll get our x-rays complete and let's just take some blood tests we'll see a blood pressure in a minute pulse of 97 regular blood pressure well done the team need to keep Simon deeply asleep if he moves it could make any brain bleed worse they also need to check the size of Simon's pupils someone's got an injury in the brain that's pushing on the nerves in the brain then that can cause pupils to enlarge as well this gentleman's pupils are normal they're nice and small a good sign but gareth's concerned about something he was told by the trauma doctor who brought Simon in this gentleman was very agitated and combative at the time and that's sometimes quite a nasty sign after a bang on the head if can mean that you've got some bleeding into the brain the other thing it can mean is that you're not getting the oxygen in because the breathing's been affected by the bang on the head itself and when you get a lack of oxygen to the brain that makes you agitated not able to keep still the injury to Simon's brain may be getting worse as the seconds tick by Simon hit the back of his head which caused his brain to impact against the front of his skull this can cause bruising bruising kills brain cells causes swelling and reduces oxygen supply the longer a brain is starved of oxygen the more damage is done and let's just head to the CT scanner if we can tube's in the right place Gareth needs Simon and CT fast if this chain reaction is happening it may be profoundly life-changing I'm hoping that by the air ambulance team get in there quickly and correcting the lack of oxygen that was probably happening at that time that the changes that we see on the CT scan will be relatively minimal it's always difficult to guess what's going to happen if Simon's brain is damaged Gareth will see signs of it on the scan it's just not pretty scan is it and I think there's some subarachary blood in there and uh what's concerning me at the moment is that this whiteness here looks like some bleeding that's happened from when the brain has had a knock there isn't a single bleed but Simon's brain is badly bruised this is Simon's brain scan just to orientate us this is the front of Simon skull here with his nose and then his mouth with the breathing tube going in to his mouth this white area here is what we call a contusion or a bruise at the front of Simon's brain and those contusions and bruises can be a little bit worrying we tend to look at things from different angles when we look at the pictures and this is looking from the front to the back so these are the eye sockets here at the front and then just above the eye sockets in the front of Simon's brain you can see some again white contusions which are in the part of the brain that we call the frontal lobe it's to the frontal lobe just behind the forehead is serious these contusions can make people's personality slightly different not often in a dramatic way but in a in a way that sometimes people's families will notice that there's a change in in people's behaviors and so on so we're at the beginning of a journey here for Simon of having some bruises in the front of his brain and we just have to wait and see now what happens to him when he wakes up guys the plan at the moment and is just keep him asleep we'll make sure his buds have gone off and all that and then um I'll be in in a sec sorry lovely thank you this type of bleed is not treatable with surgery and Simon's bruising could increase over the next few hours the risk is that there can be swelling of the brain that puts the pressure up in the head and when there's too much pressure in the head then the blood supply can't get into the head properly if more swelling does develop Simon's brain damage will get worse what we really wish we could do is look down a microscope at all the different changes that were taking place and allow those pictures to come through and to tell us what to do sometimes we've just got this big picture that we can see if an injury is bad enough to bruise your brain then we know that that can be hugely significant the injuries to Simon's brain could be seriously life-changing how he is when he wakes up remains to be seen foreign it's 7 30 on a Wednesday evening a man's been knocked down by a car in central London racing to the incident is trauma Dr Claire Park and paramedic Jody lasage and I'll give you an ETA in a minute all Clan knows at this point is an ambulance is on the scene and the crews say the patience is gcs3 he's in a deep coma the risk of a gcs-3 headinger person is that they're hypoxia when someone has a bad head injury there's an immediate thing that happens which stops you breathing and the longer someone has not adequate ventilation the more damage is being done to the brain I'll go with sw5 because it looks like it's the closest Jody specially trained to drive safely at speed but with traffic like this there's a danger they won't get there before the ambulance leaves or received a patient is still just history but they're loaded and ready to go so they're going to run to St Mary's already the ambulance has picked up the casualty and wants to go about still about five minutes away Claire wants to get to the patients he could develop serious breathing problems before they get to the hospital yeah let's keep running he's going to try to meet up with the ambulance on route it's better when we're heading down Knightsbridge if they start moving that finding it may be the difference between life and death read it when we're just approaching Hyde Park corner do we wait here or should we carry on to Cromwell Road over thank you Claire is racing across London to meet an ambulance that has an unconscious patient on board the patience in a coma and maybe dying from lack of oxygen what you got and we've got this approximately 30 year old male okay I'm crossing the road um he's been hit by a car approximately about 10 miles an hour Johnny a supermarket manager is unconscious and Claire must work out why fast and you can't see any head injury can't see nothing obvious when we first got there there was no blood on cement can you open your eyes for me can you stick your tongue out can you stick your tongue out for me stick your tongue out he smells very very strongly of alcohol his eyes are randomly flickering as not a normal eye response that doesn't really fit with the patient I'm seeing in front of me who has no injuries one we've got one male patient and he's a little more than gcs3 but I'm still not verbalizing and not obeying command so we're going to RSI him here and then carry on to St Mary's over Claire needs to put a tube in his Airway so they can take control of his breathing if he's in a coma Johnny could stop breathing at any moment so we're going to spin around heading to next to where Jodi is she needs to anesthetize him once she does he will stop breathing it's a risk she must now take to keep him alive stay just behind us to take over the tube okay perfect so just for pre-rsi GCS when I do that really hard it looked like he was starting to move his hand but I think he's just resting it now he's not opening his eyes and he's not speaking okay I think he's 80. so we'll give um 80 mics 100 mics which is two miles ketamine 2 160 16 mils and rock 188 mils okay just a couple of flashes of that in for me now Claire has just seconds to get the tube into his lungs hey and I've got a grade one view Beauty tube it's vital that Claire places it accurately in the airway if she misdirects it it could be fatal okay busier 20 minutes after Claire got to Johnny she had taken control of his breathing is this old that tube so it doesn't move we need to start moving and get him back into the ambulance now Claire needs to get Johnny to the nearest major Trauma Center so they can find out just what is wrong with him about 15 more okay we've got quite high blood pressure and so I'm just going to give them a bit more fentanyl which to help to bring that down and the heart rate down get that down there hi it's uh Claire Park here one of the hems doctors I'm just can I give you a blue call please this is a patient that I think you've already had a blue call from the ambulance crew who is a pedestrian versus a car um who's gcs3 at the scene um yeah they met us on Route um so I'm afraid we just don't RS item and he certainly wasn't speaking or meeting anything we are just on our way to you I think we'll probably we're just coming up to Hyde Park corner so we'll probably be about 10 minutes and he's stable okay bye this actually is the gentleman who has been potentially hit by Cobb but looking at him he doesn't have any obvious interests he doesn't look like he's been hit very hard he doesn't have an obvious head injury to explain his low conscious level all we're doing now is making sure there's no further damage to his brain if he does have a brain injury and we're making sure his oxygenation's okay but he's well sedated that his blood pressure is okay um and that everything else is monitored very closely is now he's asleep he was taking away his own ability to breathe we have to make sure that we make that a safer place closed on all she can it's now down to the doctors at St Mary's to work out just why Johnny is so deeply unconscious 20 year old French student Sandy was stabbed near his heart his lung collapsed and his chest was filling with blood and Air the team inserted a drain to relieve the buildup of pressure in his chest now Sandy needs a CT scan to find out if he has any other life-threatening injuries Sandy just lift your head up a little bit are you happy for us to give you the injection of time now that's going to give you a warm sensation all over your body the dye will make Sandy's blood vessel show up in the scanner and reveal if he has any internal bleeding this is an image through the the chest this is the top this is the bottom left and right this is the lever on the right side and we're coming up into the lungs and we can see on this side there's nice normal lung tissue if we can compare it to the lung tissue on the patient's left side we can see this black here that separates the heart from the wall of the chest and this black is air so that's what we call a pneumothorax and we can see that the lung is smaller than it should be and some of the tissue is collapsed so it's come together and there's some fluid at the bottom of the lung the chest drain the team inserted earlier is working but it needs time to complete the job once all the air and blood has drained out Sandy's punctured lung will heal if it doesn't he'll need an operation the next 24 hours will be critical 10 a.m on Thursday morning hello my London lovely four minutes thank you trauma doctor is bringing in another patient by ambulance a woman's been knocked over by a motorbike Dr Kareem Ahmed knows she could have multiple life-threatening injuries which was he's about to find out thank you all right everyone ready for Handover okay this is um Paloma who's a 34 year old lady who's struck by a motorcycle she's a pedestrian this morning just uh north side of London Bridge she's been conscious throughout moving all four limbs her injuries top stage she's got a facial laceration uh frontal uh query fracture pelvis and obviously deformed left femoral fracture closed okay guys can we get her off the scoop so we untape her head broken at the bottom we're going to Breeze from this side we're going to take out the scoop on that side four-year-old Paloma has three young children she was on her way to her cleaning job when she was knocked down Grant did we get our set of odds on and start the primary serving Karim needs to work out the full extent of her injuries and prioritize which to treat first she's got a nasty cut on her head there is a chance that the head wound is associated with an underlying skull fracture for a brain injury but she's talking we know that she's conscious she has an injury to her leg everything from her neck through her chest abdomen pelvis backbone could also be damaged she's speaking so we start loading her with morphe yeah three millimeters thank you remember what happens do you remember what happened tell me full set of x-rays are taken and the team check Paloma for signs of confusion that could mean a brain injury and we just need to see um if she's moving or falling this side yeah it could you think you can wiggle your toes for me the team move on to look for any other injuries if she has got a broken pelvis then that could lead to bleeding that could be life-threatening she's not showing signs of catastrophic bleeding but that may be being masked by the situation what we need to try and do is find the injuries before they've had time to deteriorate seconds later the X-ray is ready her pelvis looks normal but Karim is still concerned your pelvis is a sort of a bowl-shaped bone a collection of Bones and you can have a fracture where it opens up and then you put the binder on and that closes it back up and when you look on the X-ray you don't see the fractures because the binders to reposition the bones back to their normal position um so we worry about just clearing a pelvis based on an electro on its own Karim needs more information from the doctor who brought Paloma in from the mechanism were you like properly worried off I thought she had an isolated from fracture and an electro head so she's right up against the curb of her yeah and obviously he's got a distracting injury but she seemed to be fairly confident we should have any pain yes yeah okay yeah thank you very much karim's Happy that paloma's pelvis isn't broken so he moves on to deal with her broken leg can you shoot a view of the left femur everyone thank you as you come down the edge here you see this discontinuity of the bone so you get to this point you can clearly see that part of the bone is not connected to this part as you come up here the two parts of the femur moved up against each other overlapping and you get this more dense area a second angle shows the full damage my name is Dr Ahmed how are you doing it's a bit all a bit scary but we've got everything seems fine at the moment okay the only thing that we found so far is that you've got a broken leg on the left side which I think you know about already we haven't found anything else yet can you take a deep breath forward can you take a deep breath Paloma will need an operation on her leg but first Karim needs to make sure there are no other hidden injuries that could be life-threatening does it hurt when you breathe in just blow your tummy out for me blow your tummy out it's like um and then tuck it in any pain in the tummy I'll get you to bring your this arm out for me any pain down here can you paint down here so what we're going to do we're going to turn you onto your side so we can examine your back okay it's going to be a bit sore in that leg when we turn you but we'll make it as quick as possible okay ready race yeah yeah we've examined her abdomen again and again her blood pressure's fine her pulse level is fine her abdomen is nice and soft no tenderness in abdomen and again the same with the pelvis the X-ray is normal the clinical examination is normal it's all normal at the back so our last third decision we need to make is really whether we need to do a city head and neck I suspect that we do really yeah yeah all right we'll do a seating on the neck Karim wants to find out if Paloma has any hidden damage to her brain she's had a nasty head injury so we'll scan her head and her neck to make sure he has got no spine and nose so um no neck bone injuries and and then otherwise we'll just keep an eye on her and just observe her to see if anything develops over the next few hours that we haven't picked up already we're going to find out it's 29 minutes since Paloma arrived at the Royal London her broken leg May well be life-changing in the next few minutes Bell discover whether her head injury will be too Paloma a mother of three was hit by a motorbike while crossing the road it's 30 minutes since she arrived at the Royal London with a badly broken leg and an injury to her head corrine's worried the damage to her head means she might have a brain injury I'm just having a quick look at her brain now I haven't found anything that would cause us any concern so far obviously we need to wait for the former report but there's nothing life-threatening going on nothing that we need to be getting her up to theater four straight away paloma's leg is badly broken she'll need an operation to repair it but first Karim wants to give her some targeted pain relief have you ever been to the dentist you know when they put the injection in at the dentist is the same thing okay but it's going to be down in your groin to try and take the pain away from your leg so the injection is going to be into here okay so if you relax your hand on your chest sharp scratch coming up still hurting or creating less once paloma's pain is under control she will be moved to a ward this is a major injury for her I mean she's going to be you know her life has basically stopped her life is on hold now for um for a good six weeks as a minimum so it's probably going to take her six weeks before she can get back to some some relatively routine experiences within life but actually the full healing process takes one to two years only time will tell if Paloma will ever be able to walk properly again Paloma had an operation to insert a metal rod down the center of her thigh bone it will stay there for the rest of her life since harab she's been having physio to help her walk again ah painful there okay is that is that your usual pain or is that a new pain your pain a new pain okay I'm feeling very better it's like so I'm very happy like that just relax if she doesn't do her exercises there's a risk Paloma may never walk properly again hold it up there strong as you can fight me off okay strong as you can ah okay it's really important to do your exercises more frequently yeah I know you're a busy lady but but I'll go free kids at home let's go in the shop you know okay if you want milk she won't eat four years later that one is freezing again I do understand and it's up to you how you fit it into your day right but it's my job to give you the best advice that I can that will help you get where you want to go yeah she showed me and said neutral okay every day the day four times a day or if I spent four times a day or more if you want that's okay good and continue good news 20 year old French student Sandy came close to death when he was stabbed in the chest we're going to move them search the rest of his body for wounds the knife punctured his lung and narrowly missed his heart Sandy is making a good recovery but is still coming to terms with what happened there was alone in the streets I was coming back to my to my work and I saw the two guys when I saw just the eyes I understood the situation when Jay started me with a knife I dropped down and I ran and the guys didn't follow me but after I saw blood I was panicked when the ambulance arrived I couldn't speak very well to to the policy I quit my parents yesterday and they were very surprised but um I don't want pan exam but I think for for them is very difficult I couldn't describe anybody which has been assaulted had a knife put into their chest with sufficient Force to burst their lung and cause internal bleeding lucky but from the perspective of what damage that knife could have done it certainly could have made a hole into the heart and that could have Spilled Out blood that actually killed him Sandy is now back at college I'm really feeling lucky here because I don't want to imagine what happened for example I stayed on the floor when I dropped on a I don't want to imagine but I I think I'm very lucky here because it could be really worse yeah I'm working like before I'm studying and I go out with my friend and when I can and yeah I want to enjoy my life because I'm still here and so in the most important and she was my parents are still worried but they know I want to finish my sixth month and foreign of course my parents will be very happy to to send me back to France here and that's from yeah of course

Channel: Trauma Investigators

Views: 1,641,380

Keywords: Trauma Investigators, Nurses, Doctors, Paramedics, Reality, Channel 5, Patients, Emergency, Trauma, Full Episodes, Investigations, Hospital, UK, London, Surgeons, Medical, Investigators

Id: uhqhJZnlVHs

Length: 45min 53sec (2753 seconds)

Published: Fri Jun 17 2016