1 00:00:00,000 --> 00:00:03,260 Most people don't like it to spend time in a hospital, 2 00:00:03,300 --> 00:00:07,260 of course you will say, but perhaps you don't study medicine like me and you don't have a doctor 3 00:00:07,260 --> 00:00:11,200 retired as an uncle. He knows everyone and decided to help me choose the 4 00:00:11,200 --> 00:00:14,880 specialization. It's not a pill morphine. And as a pass for 5 00:00:14,880 --> 00:00:18,140 all the sets of the greatest show medical television in the history of 6 00:00:18,140 --> 00:00:21,600 of advanced search, even if the My uncle's hospital practice is 7 00:00:21,600 --> 00:00:22,600 experimental. 8 00:00:23,320 --> 00:00:26,180 Robert is charming, come down again more. 9 00:00:26,820 --> 00:00:29,180 Really too late to sign up for jurisprudence? 10 00:00:41,770 --> 00:00:43,630 Time is the enemy of trauma. 11 00:00:44,350 --> 00:00:48,750 We can only do something in first 60 minutes. We are the ones who bring you 12 00:00:48,750 --> 00:00:52,990 accident site in the center nearest trauma center, where in 13 00:00:52,990 --> 00:00:56,050 a team of doctors and full surgeons. 14 00:00:56,310 --> 00:00:59,730 We enable them to do theirs work, that is, to prevent you from dying. 15 00:01:03,170 --> 00:01:07,750 We are where speed and therapy are they meet and the minutes do the 16 00:01:07,750 --> 00:01:09,890 life and death. We are in traumatology. 17 00:01:15,150 --> 00:01:18,910 Two minutes and seventeen seconds of delay, you don't save anyone's life 18 00:01:18,910 --> 00:01:22,790 arriving late. I couldn't find it parking. Ah, Doctor Rezzec. Yes? 19 00:01:23,010 --> 00:01:27,350 It is true that the latter are also important in traumatology? 20 00:01:27,490 --> 00:01:28,490 in fact I'm going now. 21 00:01:28,670 --> 00:01:33,470 I was in the MESH unit during the war. And a field medic? Certainly not 22 00:01:33,470 --> 00:01:36,990 greenhouse. And now let's hurry, we have some emergencies. 23 00:01:37,830 --> 00:01:41,490 Personal emergencies or interventions first aid? Yes or no? 24 00:01:44,640 --> 00:01:48,700 Often in orthopedic trauma you need to know make decisions quickly, in a 25 00:01:48,700 --> 00:01:50,820 moment, it is one of the aspects that most appeal to me like it. 26 00:01:51,220 --> 00:01:55,900 Traumas have always represented the most interesting part in mine 27 00:01:55,900 --> 00:01:57,120 of thoracic surgeon. 28 00:01:57,400 --> 00:02:01,980 If you have an allergic problem and come from me I don't know what to tell you, but if you are 29 00:02:01,980 --> 00:02:05,840 victim of a bad accident automotive and in hypotension come 30 00:02:06,040 --> 00:02:12,320 The most frequent traumas come from road accidents, from accidents 31 00:02:12,320 --> 00:02:13,740 simply from bad falls. 32 00:02:14,760 --> 00:02:18,880 I fell 14 meters. The palace was surrounded by flames. I am 33 00:02:18,880 --> 00:02:23,160 broken wrists, spine. I my lungs burned. And both 34 00:02:23,160 --> 00:02:26,740 ankles. Trauma is a peculiarity of the younger ones. 35 00:02:27,120 --> 00:02:32,280 How to give up being rotten, competitive and unpredictable? For this 36 00:02:32,280 --> 00:02:35,300 Traumatology you can find doctors for any specialization. 37 00:02:35,680 --> 00:02:39,720 Our model is patient right, in right place, at the right time. How 38 00:02:39,720 --> 00:02:42,380 on TV, the first to arrive are the paramedics. 39 00:02:42,670 --> 00:02:45,930 Then rushed to the hospital. If the patient the state of the streets is lucid or not 40 00:02:45,930 --> 00:02:49,710 airways, breathing, circulation, type of injuries, all things I need to know 41 00:02:49,710 --> 00:02:53,690 before putting him in the ambulance and leave. In traumas you have to hurry, there 42 00:02:53,690 --> 00:02:56,650 emergency vehicles cannot stop last more than 10 minutes. 43 00:02:56,950 --> 00:03:00,850 Paramedics use an index of assessment for severity of trauma. 44 00:03:01,170 --> 00:03:03,010 Levels range from 1 to 6. 45 00:03:03,370 --> 00:03:06,130 And in this game no one wants the highest score. 46 00:03:06,430 --> 00:03:10,130 The score also helps paramedics in choosing the most suitable hospital 47 00:03:10,130 --> 00:03:14,430 welcome you. It is a system that is inspired by that of hospitals from 48 00:03:14,430 --> 00:03:15,690 Korea and Vietnam. 49 00:03:17,230 --> 00:03:21,790 The doctors who served in those wars were continually witnessed 50 00:03:21,790 --> 00:03:25,830 speed with which the military carried the wounded from the battlefield to the units 51 00:03:25,830 --> 00:03:26,830 MES. 52 00:03:26,930 --> 00:03:31,450 Emergency surgery units placed near the front and reported 53 00:03:31,450 --> 00:03:32,450 the model at home. 54 00:03:32,830 --> 00:03:36,810 They had experienced it themselves how essential it was to reduce time 55 00:03:36,810 --> 00:03:38,350 injury and medical intervention. 56 00:03:38,810 --> 00:03:40,950 The traumatologist acts sequentially. 57 00:03:41,330 --> 00:03:45,170 He intervenes first on what kills more quickly. So get started 58 00:03:45,170 --> 00:03:48,530 from the respiratory tract, without oxygen you die. If the airways are 59 00:03:48,530 --> 00:03:52,130 blocked, we will free them immediately. Then we need to verify that the lungs do 60 00:03:52,130 --> 00:03:55,950 expand and function and then the circulation. We make sure that the 61 00:03:55,950 --> 00:03:59,630 is okay and if there is bleeding, let's try to find out the source and 62 00:03:59,630 --> 00:04:00,990 we plan how to intervene. 63 00:04:01,860 --> 00:04:06,600 Doctors and paramedics practice on super technological mannequins, more like it 64 00:04:06,600 --> 00:04:11,280 robots and puppets. They come with a very sophisticated software package, 65 00:04:11,300 --> 00:04:14,580 able to emulate the symptoms of each type of syndrome or trauma. 66 00:04:15,360 --> 00:04:20,160 The pupils dilate and respond to light and drugs. The pressure 67 00:04:20,160 --> 00:04:25,120 blood rises and falls. They have cardiac arrests. They bleed. Maybe they are 68 00:04:25,120 --> 00:04:26,280 even smarter than me. 69 00:04:27,180 --> 00:04:31,140 In a chest pneumo under tension that causes a drop in blood pressure e 70 00:04:31,140 --> 00:04:34,260 breathing difficulties, our team must implement the right one 71 00:04:34,260 --> 00:04:38,020 procedure that restores vital signs. If it reminds you of training 72 00:04:38,020 --> 00:04:42,180 military, it's no coincidence. It's the army to promote the creation of 73 00:04:42,180 --> 00:04:46,520 Super dolls and models are on the way even more equipped. But for the 74 00:04:46,520 --> 00:04:51,280 these are enough and more to do practice and practice and more practice. 75 00:04:52,860 --> 00:04:56,140 You also learn the maneuvers of immobilization of a patient. 76 00:04:56,590 --> 00:04:59,530 when a gesture in consultation could break his back. 77 00:05:00,290 --> 00:05:05,990 You have to feel the air coming in effect of the pump and see what shape 78 00:05:05,990 --> 00:05:07,210 support around the patient. 79 00:05:07,590 --> 00:05:12,010 The inside of the mattress is composed of thousands of nylon fibers that when 80 00:05:12,010 --> 00:05:16,230 are inflated they transform into a container customized for yours 81 00:05:16,470 --> 00:05:20,350 If there was such a thing as packaging for beings humans this would be perfect. 82 00:05:20,940 --> 00:05:24,640 We train for crisis situations so that when we have to face them 83 00:05:24,640 --> 00:05:29,260 actually the team already has experience of how to move and operate. The approach 84 00:05:29,260 --> 00:05:34,800 as a team it works. A study conducted in 1988 he had already highlighted how i 85 00:05:34,800 --> 00:05:40,260 deaths after trauma had decreased from 50 to 18%. And since the method is in 86 00:05:40,260 --> 00:05:45,080 constant improvement, in the last few years has dropped to 8.9%. If too 87 00:05:45,080 --> 00:05:48,660 interest on my loan yes behaved like this, they have not changed 88 00:05:48,660 --> 00:05:51,080 doctors. The hospitals have not changed. 89 00:05:51,920 --> 00:05:55,920 Except now the whole system is conceived as teamwork. Come on 90 00:05:55,920 --> 00:06:00,040 paramedics up to specialists rehabilitation and facilities 91 00:06:00,040 --> 00:06:04,360 they are coordinated and work together. It is so that we passed by one 92 00:06:04,360 --> 00:06:08,840 from 50% to 8% of decades. Soon i traumas in sport. 93 00:06:09,040 --> 00:06:12,080 You can win, score, but also stay marked. 94 00:06:16,490 --> 00:06:21,110 The importance of time in traumatology it was becoming a catchphrase. And then 95 00:06:21,110 --> 00:06:23,630 his uncle used the word too often emergency. 96 00:06:24,270 --> 00:06:27,330 Personal emergencies or interventions first aid. Uncle! 97 00:06:28,350 --> 00:06:32,530 When a patient comes in traumatology, doctors identify 98 00:06:32,530 --> 00:06:34,270 problem, even if invisible. 99 00:06:34,690 --> 00:06:37,450 Check each answer, observe and check everything. 100 00:06:38,070 --> 00:06:41,750 I only ask you this. Ready? When feels my finger, she contracts the 101 00:06:41,750 --> 00:06:44,890 muscle, okay? When he feels the finger of the doctor, contract, even a little. 102 00:06:45,760 --> 00:06:47,720 We stick fingers and tubes into every orifice. 103 00:06:48,240 --> 00:06:50,280 It's kind of a mantra in traumatology. 104 00:06:50,580 --> 00:06:54,040 Well yes, the doctor stuck a finger in the patient's anus. 105 00:06:54,360 --> 00:06:58,240 Look for any spinal cord injury spinal. If you don't feel it and don't 106 00:06:58,400 --> 00:07:02,460 bad sign. If there are anomalies in the response and pupil functioning, 107 00:07:02,500 --> 00:07:06,520 the brain can immediately have a injury. If liquid drips from 108 00:07:06,520 --> 00:07:07,840 there may be brain damage. 109 00:07:08,220 --> 00:07:11,840 If the pressure drops quickly, you are probably in a state of shock. 110 00:07:12,100 --> 00:07:16,640 In the presence of trauma it is more frequent hemorrhagic shock, a shock caused by 111 00:07:16,640 --> 00:07:20,880 blood loss. Think of one pipe with a leak. The liquid 112 00:07:20,880 --> 00:07:22,840 in the wrong place causing many damage. 113 00:07:23,260 --> 00:07:26,320 You may have internal bleeding that it is not visible from the outside. 114 00:07:26,540 --> 00:07:30,460 While looking for the causes, they make you one transfusion with a high infuser 115 00:07:30,460 --> 00:07:34,920 pressure. A bag of is hung here blood, you close the door and yes 116 00:07:34,920 --> 00:07:35,920 under pressure. 117 00:07:36,160 --> 00:07:39,780 Once under pressure it travels through this facility that 118 00:07:39,780 --> 00:07:42,160 is transposed into the patient via route intravenous. 119 00:07:42,540 --> 00:07:46,380 Here the pressure is very high, a lot that once you place the bag here and 120 00:07:46,380 --> 00:07:50,860 closed the door after a moment you can reopen it, the bag is empty. 121 00:07:51,080 --> 00:07:56,360 Doctors use ultrasound to locate the bleeding and evaluate whether 122 00:07:56,360 --> 00:08:00,160 and suture or send you in angiography where they will stop the bleeding 123 00:08:00,160 --> 00:08:01,160 'internal. 124 00:08:01,550 --> 00:08:05,530 If you lose a lot of blood, give it pelvis, this is the best place for 125 00:08:05,530 --> 00:08:08,090 locate the bleeding and stop it as soon as possible. 126 00:08:08,390 --> 00:08:11,770 The patient is placed under it 'image intensifier, yes 127 00:08:11,770 --> 00:08:14,870 catheter to the great vessels and yes place in the hole of the artery. 128 00:08:16,130 --> 00:08:19,730 Then a material is injected specific, there are different kinds, 129 00:08:19,730 --> 00:08:20,730 stops the bleeding. 130 00:08:21,730 --> 00:08:23,530 It looks more like plumbing than surgery. 131 00:08:24,090 --> 00:08:27,690 They insert these rolls of wires covered in datron fiber that once 132 00:08:27,690 --> 00:08:29,750 unrolled they close the hole in the 'artery. 133 00:08:30,920 --> 00:08:34,840 And while all this is happening, the doctors they also have to keep an eye on the 134 00:08:34,840 --> 00:08:38,179 natural response of the organism to hemorrhage. One of the possible 135 00:08:38,179 --> 00:08:42,400 complications following an event The clots that form are traumatic 136 00:08:42,400 --> 00:08:46,580 in the great vessels of the legs and in the pelvis. The organism, to stem a 137 00:08:46,580 --> 00:08:51,320 blood loss, use platelets, which they create a sort of organic plaster. 138 00:08:51,400 --> 00:08:56,000 But in stressful situations, the organism it can go crazy and form clots too 139 00:08:56,000 --> 00:08:57,000 where they are not needed. 140 00:08:57,260 --> 00:09:00,880 If the clot is very large it can block the blood supply to 141 00:09:00,880 --> 00:09:02,560 destroy lung tissue. 142 00:09:03,040 --> 00:09:07,580 Thus a is inserted into the vena cava temporary filter, little gem of which the 143 00:09:07,580 --> 00:09:09,120 Dr. Resek is very enthusiastic. 144 00:09:09,480 --> 00:09:13,640 We insert this metal filter into the vena cava, the large vein that connects the 145 00:09:13,640 --> 00:09:17,400 lower body to the heart. The clot that can block the vessel 146 00:09:17,400 --> 00:09:20,880 blood is trapped by the filter which prevents him from going back up to the 147 00:09:20,880 --> 00:09:22,760 heart and pulmonary circulation. 148 00:09:22,960 --> 00:09:25,720 As soon as I saw it it seemed like one to me species of spider. 149 00:09:26,240 --> 00:09:30,360 With lots of metal legs full of black spots. You could also see them 150 00:09:30,360 --> 00:09:32,720 little stones stuck all around. It's here. 151 00:09:38,440 --> 00:09:40,040 So, situation. 152 00:09:40,440 --> 00:09:44,740 A patient ends up in the emergency room with an unidentifiable disorder. You have 153 00:09:44,740 --> 00:09:47,240 an hour to save his life. Which patient? 154 00:09:47,540 --> 00:09:51,020 Use one of the mannequins available of the hospital. Oh, thanks, good idea. 155 00:09:51,240 --> 00:09:53,700 It's no use, doctor. I brought mine. 156 00:09:56,079 --> 00:10:00,660 Ah, here it is. This is the mannequin that I gave my uncle, which my great uncle had 157 00:10:00,660 --> 00:10:03,340 given to him and which I now give to you, Robert. Thank you. 158 00:10:07,020 --> 00:10:11,360 Situation. A patient arrives at the emergency room rescue. Wounds, abrasions and possible 159 00:10:11,360 --> 00:10:14,840 fractures. You have an hour to bring him back to stable condition. 160 00:10:15,160 --> 00:10:16,160 Possible fractures? 161 00:10:16,680 --> 00:10:17,940 Off to the stopwatch. 162 00:10:18,880 --> 00:10:23,340 In real life, some of the fractures you can't even see more series, how 163 00:10:23,340 --> 00:10:24,500 those at the cervical. 164 00:10:24,890 --> 00:10:28,870 You can break your neck and not have it ongoing spinal cord injury. It's not 165 00:10:28,870 --> 00:10:32,370 It is safe to move an injured patient of the kind. And so we immobilize the 166 00:10:32,370 --> 00:10:36,550 neck and the vertebrae cervical with a collar, so as to 167 00:10:36,550 --> 00:10:39,510 protect them and be able to keep them in right position. 168 00:10:39,730 --> 00:10:43,870 They are males between 15 and 35 years old suffer more from spinal injuries 169 00:10:43,870 --> 00:10:49,130 vertebral. We have fun like this, but... many accidents are avoidable, as 170 00:10:49,130 --> 00:10:50,130 the hockey ones. 171 00:10:50,330 --> 00:10:52,490 It's usually a shot from behind. 172 00:10:54,150 --> 00:10:58,750 Some think that the weight of mask can contribute, but it is 173 00:10:58,750 --> 00:11:02,670 'hyperextension or a change sudden position and this causes 174 00:11:02,670 --> 00:11:08,050 fracture of a neck vertebra e spinal cord injury. The player 175 00:11:08,050 --> 00:11:09,550 finds himself paralyzed on the ice. 176 00:11:10,030 --> 00:11:14,010 How many times during a game of hockey or football we see players 177 00:11:14,010 --> 00:11:18,310 do they get hurt? This is why the staff sports doctors have created their own 178 00:11:18,310 --> 00:11:23,620 mesh. Clubs are real weapons. The hard, frozen rubber of the disc is a 179 00:11:23,620 --> 00:11:26,260 'weapon. The goal posts are stiff. 180 00:11:26,600 --> 00:11:29,420 All things that contribute to accidents. 181 00:11:29,640 --> 00:11:33,740 The first traumatic event he has faced in the hockey was with 182 00:11:33,740 --> 00:11:39,820 McCleary when he got shot here to the larynx. Fracture of the larynx 183 00:11:39,820 --> 00:11:41,340 closed the airways. 184 00:11:42,020 --> 00:11:45,320 Seven of them took him to the operating room net minutes. 185 00:11:45,550 --> 00:11:49,750 We intubated him, we operated on him a tracheotomy and he still had the 186 00:11:49,750 --> 00:11:54,410 skates on. The collapse of the streets aerial kills you in minutes. I 187 00:11:54,410 --> 00:11:58,190 they have to make an incision in the trachea so that is possible 188 00:11:58,330 --> 00:11:59,710 This is the tracheotomy. 189 00:12:00,190 --> 00:12:05,130 I still can't free myself from it anxious and I don't take my eyes off for a moment 190 00:12:05,130 --> 00:12:09,570 when the boys play. If I see I'll make someone fall on the ice 191 00:12:09,570 --> 00:12:13,770 a precise idea of what it could be success. We'll see Sege soon. 192 00:12:14,110 --> 00:12:18,630 Dwellers, no, we must not build a table. We need to fix broken bones. 193 00:12:25,710 --> 00:12:28,510 This horror movie dummy it's not the best. 194 00:12:28,990 --> 00:12:32,490 Anyway, better to practice on him than on a patient in danger of life. 195 00:12:32,870 --> 00:12:37,490 We are in another sector of the traumatology, orthopedic surgery, 196 00:12:37,510 --> 00:12:40,610 or the art of fixing limbs underneath pressure. 197 00:12:41,640 --> 00:12:46,340 If there is a blood relationship in the limbs, within 4 -8 hours at most, i 198 00:12:46,340 --> 00:12:51,660 tissues, his muscles will die and the patient will probably have to undergo a 199 00:12:51,660 --> 00:12:55,960 amputation. In orthopedic surgery there are essentially two phases. The 200 00:12:55,960 --> 00:13:00,460 fracture reduction, where the bones are realigned, and the fixation, 201 00:13:00,520 --> 00:13:03,760 i.e. keeping it in position correct until complete welding. 202 00:13:04,100 --> 00:13:06,760 Bone is a material very similar to wood. 203 00:13:07,440 --> 00:13:09,260 We use many... 204 00:13:10,020 --> 00:13:15,720 tools and utensils that derive from carpentry this is a drill in 205 00:13:15,720 --> 00:13:20,280 ergonomic handle with accessories and multiple tips that allow us 206 00:13:20,280 --> 00:13:24,880 several of the same instrument and less material on the work table I don't think so 207 00:13:24,880 --> 00:13:29,260 of having to explain what a drill and not even a saw apart from the 208 00:13:29,260 --> 00:13:34,230 that it's bones. There's something to die for DIY fanatics are envious. Yes 209 00:13:34,230 --> 00:13:35,790 they tolerate blood, of course. 210 00:13:35,990 --> 00:13:39,670 There's a lot of mechanical engineering going on orthopedics. Or rather, a perfect one 211 00:13:39,670 --> 00:13:42,510 combination of carpentry and mechanical engineering. 212 00:13:43,070 --> 00:13:48,730 And to top it off, a vast assortment of nails, screws, plates and all that 213 00:13:48,730 --> 00:13:51,150 which is needed for bones and joints more delicate. 214 00:13:58,480 --> 00:14:00,780 So, how's it going? At a fast pace. 215 00:14:01,320 --> 00:14:04,880 It's all about time, right? Exactly like that. Time is one of 216 00:14:04,880 --> 00:14:07,340 basic elements to save the life of a patient. 217 00:14:07,580 --> 00:14:11,140 Unfortunately, sometimes, assistants don't they work as they should. Instead, yes 218 00:14:11,140 --> 00:14:15,080 be very careful, because if you don't proceeds on schedule, there is a risk 219 00:14:15,080 --> 00:14:18,740 that the patient is unable to survive. And the relationship with the world 220 00:14:18,740 --> 00:14:20,960 changed. I think it's not bigger appreciation now. 221 00:14:22,480 --> 00:14:25,460 Let's go back. Time's up, Robert. What? 222 00:14:25,860 --> 00:14:27,360 Uncle, I need a doctor. 223 00:14:28,410 --> 00:14:31,290 My usual mistake, stopping at appearance. 224 00:14:31,490 --> 00:14:35,470 There is a lot in orthopedic surgery more than meets the eye. The fractures 225 00:14:35,470 --> 00:14:39,830 they heal better when it's there compression between the two fragments, therefore 226 00:14:39,830 --> 00:14:43,550 they compress the two surfaces and yes they keep pressed together, there is 227 00:14:43,550 --> 00:14:45,730 chance of success than by keeping them separate. 228 00:14:46,010 --> 00:14:49,770 When paramedics bring a patient with fracture of the pelvic bones, the 229 00:14:49,770 --> 00:14:50,950 procedure becomes complicated. 230 00:14:52,090 --> 00:14:53,970 In case of pelvic fracture. 231 00:14:54,360 --> 00:14:58,040 There can be no compression as long as the bones were not arranged into one 232 00:14:58,040 --> 00:15:02,540 precise position and this means traction. Once upon a time, traction was a 233 00:15:02,540 --> 00:15:07,480 distressing and painful process. I patients lay for months between ropes and 234 00:15:07,480 --> 00:15:13,100 pulleys. But today devices exist portable traction devices with which patients 235 00:15:13,100 --> 00:15:15,140 they can move. I'll proceed with this way. 236 00:15:15,640 --> 00:15:19,780 I insert pins on both sides of the pelvic ring, at the level of 237 00:15:19,780 --> 00:15:23,980 iliac crest, which is the palpable part of the pelvis, the one that commonly comes 238 00:15:23,980 --> 00:15:24,980 called hip. 239 00:15:25,380 --> 00:15:29,900 I take the drill and insert the guide inside the pelvic bone, in the position 240 00:15:29,900 --> 00:15:34,160 correct. Then I take a cannula screw and I begin to inhabit it deeply 241 00:15:34,160 --> 00:15:35,160 in the pelvis. 242 00:15:36,200 --> 00:15:40,120 I remove the guide and the screw is inserted exactly where it needs to be. 243 00:15:40,680 --> 00:15:44,380 I push hard on the pins in order to bring the pelvis back from one position 244 00:15:44,380 --> 00:15:48,180 open to a closed position. I mount the external fixator, called by us 245 00:15:48,180 --> 00:15:52,000 mobile traction, which pulls the fracture to the appropriate length, the 246 00:15:52,000 --> 00:15:56,820 stabilizes and allows you to get up and move. It's better for the patient and 247 00:15:56,820 --> 00:15:58,160 all sorts of complications. 248 00:15:58,750 --> 00:16:02,810 I was in a bad car accident, I was lucky. I can lift it 249 00:16:02,810 --> 00:16:06,890 bed by doing this. Okay, but not there try. It doesn't hurt. A little scared, a 250 00:16:06,890 --> 00:16:10,330 some appreciation, but no pain. After two months of traction, today we remove the 251 00:16:10,330 --> 00:16:12,010 external fixator. Yes, it's been two months. 252 00:16:13,130 --> 00:16:17,230 This is a special screwdriver that grab the pins inserted into the pelvis and there 253 00:16:17,230 --> 00:16:18,270 removes gently. 254 00:16:18,730 --> 00:16:19,930 It shouldn't hurt. 255 00:16:20,490 --> 00:16:21,850 At least that's what they told me. 256 00:16:23,430 --> 00:16:26,850 Another rather serious fracture is the fracture of the femoral bones. 257 00:16:27,150 --> 00:16:31,010 These bones are hollow, so for to repair them it is necessary to install a 258 00:16:31,010 --> 00:16:34,650 nail. The implant is inserted into the center of the bone, like this. 259 00:16:35,050 --> 00:16:37,770 To do this, a screw is used interlocking. 260 00:16:38,010 --> 00:16:42,670 The function of this screw is to prevent that the two fragments rotate on themselves 261 00:16:42,670 --> 00:16:45,190 also prevent them from collapsing inside the other. 262 00:16:45,530 --> 00:16:49,450 And unlike the students of medicine, stress is good for bones. 263 00:16:50,190 --> 00:16:53,510 Try to think of the astronauts when they are found in space. 264 00:16:53,880 --> 00:16:57,740 They have to practice every day to make the skeletal system work, 265 00:16:57,780 --> 00:17:02,000 otherwise the bones could suffer a resorption process why not 266 00:17:02,000 --> 00:17:06,220 are exposed to any type of stress mechanical due to lack of 267 00:17:06,220 --> 00:17:07,220 gravity. 268 00:17:10,940 --> 00:17:15,420 A femur strengthened by a door nail easily the weight of a human body. 269 00:17:15,980 --> 00:17:19,960 It's different when using a plate, because she is the one who supports the majority 270 00:17:19,960 --> 00:17:22,619 part of the load that the bone he usually supports himself. 271 00:17:22,880 --> 00:17:27,280 So the bone works less and the organism responds by sending in that 272 00:17:27,280 --> 00:17:28,780 a lower amount of calcium. 273 00:17:29,260 --> 00:17:33,640 When plates and screws are removed, the bones often fracture again. 274 00:17:33,880 --> 00:17:36,620 There is a downside to removing the facilities. 275 00:17:36,840 --> 00:17:41,080 And that's why they often orthopedists tend not to remove them, 276 00:17:41,080 --> 00:17:42,180 airports complain. 277 00:17:42,920 --> 00:17:47,120 If the bone does not heal or the plaque is under too much load, the steel could 278 00:17:47,120 --> 00:17:52,720 break. The two ends should be a compact whole, and instead l 279 00:17:52,720 --> 00:17:54,040 The steel broke. 280 00:17:54,240 --> 00:17:59,320 Steel, if it is bent constantly, undergoes a load 281 00:17:59,320 --> 00:18:01,160 they are much more flexible and elastic. 282 00:18:01,460 --> 00:18:04,680 A new possibility is concrete reinforced. 283 00:18:04,960 --> 00:18:08,880 Just think about the fact that the concrete is the mineral component 284 00:18:08,880 --> 00:18:11,260 gives bones resistance to compression. 285 00:18:12,220 --> 00:18:16,580 The internal soul, the fibro reinforcement that we insert into the concrete, it's like the 286 00:18:16,580 --> 00:18:18,640 collagen fibers that provide elasticity. 287 00:18:19,040 --> 00:18:23,220 The collagen that takes the place of steel, the future of implantology, 288 00:18:23,420 --> 00:18:28,020 lies in emulating bone flexibility. Doctors are looking at titanium. 289 00:18:28,180 --> 00:18:33,720 It has a consistency and a form of elasticity very close to those of 290 00:18:33,720 --> 00:18:39,020 human and is very resistant underneath effort. And also in the dirty world of 291 00:18:39,020 --> 00:18:41,740 traumatology the least has transformed more. 292 00:18:42,110 --> 00:18:46,290 The trend that is most popular among us he is the minimalist man, the one with the 293 00:18:46,290 --> 00:18:50,550 thinner plaques, with the fewer number of screws as possible, so you put it underneath 294 00:18:50,550 --> 00:18:57,390 the rays and then do... We'll look at it in a bit col 295 00:18:57,390 --> 00:19:00,170 breathless like these doctors they work against the clock. 296 00:19:05,230 --> 00:19:08,630 The prehistoric mannequin was definitively dead. 297 00:19:08,950 --> 00:19:12,610 I was thinking about traumatologists, who they bet on life always and 298 00:19:14,810 --> 00:19:21,670 Trauma is the leading cause of death for people under 299 00:19:21,670 --> 00:19:26,550 45 years old. Who falls into the category know that there are those who work to raise the 300 00:19:26,550 --> 00:19:28,610 threshold of the fateful 60 minutes. 301 00:19:29,030 --> 00:19:30,670 We have artificial blood. 302 00:19:31,649 --> 00:19:35,250 We administer a bag of fluid which it has the same function as blood and 303 00:19:35,250 --> 00:19:36,790 transport oxygen to tissues. 304 00:19:38,450 --> 00:19:42,690 Keep artificial blood within reach hand means gaining time for i 305 00:19:42,690 --> 00:19:46,870 patients with internal and non-internal bleeding you have to worry about blood types 306 00:19:46,870 --> 00:19:47,870 compatibility. 307 00:19:48,450 --> 00:19:54,210 If we are late in intervening on a patient who has suffered a trauma, 308 00:19:54,210 --> 00:19:56,770 minutes, he leaves. 309 00:19:57,320 --> 00:20:01,120 But doctors have some tricks trick to trick the body e 310 00:20:01,120 --> 00:20:03,860 some time, inducing hypothermia for example. 311 00:20:04,360 --> 00:20:08,600 In extreme cases they can do it and also stop the heart for 30 minutes while 312 00:20:08,600 --> 00:20:13,200 they intervene. There is a variator temperature on the heart machine 313 00:20:13,200 --> 00:20:17,420 through it the blood temperature as much as you want e 314 00:20:17,420 --> 00:20:18,840 also raise as much as you want. 315 00:20:19,100 --> 00:20:23,840 A device has been devised that can induce hypothermia already in the ambulance. It is 316 00:20:23,840 --> 00:20:26,380 a freezing blanket, it's called Arctic Sun. 317 00:20:27,000 --> 00:20:31,200 In case of head injuries, it can slow down your metabolism to the point of 318 00:20:31,200 --> 00:20:33,680 coma and avoid brain edema. 319 00:20:35,860 --> 00:20:40,640 The most desirable thing is that 60 minutes reset to zero and the doctors 320 00:20:40,640 --> 00:20:44,860 at the scene of the accident. It's not a video game, it's not science fiction, it's 321 00:20:44,860 --> 00:20:49,260 on which the United States Army stands working. In the future we will be able to see 322 00:20:49,260 --> 00:20:53,160 doctors treating injured through remote controlled robots. This one 323 00:20:53,160 --> 00:20:55,940 sophisticated structure is called TraumaPod. 324 00:21:04,620 --> 00:21:07,340 I'm not much of a trauma surgeon, am I uncle? 325 00:21:07,540 --> 00:21:09,140 You did your best, Robert. 326 00:21:09,360 --> 00:21:13,160 When you got your hands on it, it was already there pretty beat up. Thank you. 327 00:21:13,800 --> 00:21:19,840 Okay, let's put it in a bag of plastic and put it in the trunk. 328 00:21:20,140 --> 00:21:24,820 Do you want to keep it? Oh, I owe him. I am an incurable sentimentalist. 329 00:21:26,440 --> 00:21:30,240 It's hard to see yourself thrown out of the window of a 330 00:21:30,240 --> 00:21:33,140 'car. It's inconceivable. Instead it is very possible. 331 00:21:34,120 --> 00:21:36,620 A good help is given by the belts safety. 332 00:21:36,840 --> 00:21:42,440 Prevention is the key. I believe that the requirement for seat belts is an obligation 333 00:21:42,440 --> 00:21:46,640 wonderful. The eye masks, the Pads are tools 334 00:21:46,640 --> 00:21:52,660 prevention. Yes, it's all back to place. There were no complications 335 00:21:52,660 --> 00:21:58,580 -operative. I stayed too surprised and I consider myself very lucky. 336 00:21:58,880 --> 00:22:04,680 24 hours a day, 365 days a year your complete service. I find that 337 00:22:04,680 --> 00:22:09,140 be of immense value in helping them people not to die. 338 00:22:09,420 --> 00:22:15,260 L 'helping people recover afterwards devastating traumas and injuries to say the least. 339 00:22:15,620 --> 00:22:20,160 The pelvis is perfect, as before 'accident. Everything is fine. Are you healed? 340 00:22:20,360 --> 00:22:21,660 Okay? Thank you. 341 00:22:22,160 --> 00:22:23,119 Happy, huh? 342 00:22:23,120 --> 00:22:23,879 Oh, yes. 343 00:22:23,880 --> 00:22:26,080 I had a fixator until a few minutes ago. 344 00:22:26,680 --> 00:22:28,340 And now I walk freely. 345 00:22:33,020 --> 00:22:36,680 I failed with the dummy, but I have learned a lot anyway. 346 00:22:36,980 --> 00:22:41,680 I learned that speed can kill if you are behind the wheel and what to do many 347 00:22:41,680 --> 00:22:46,100 things too quickly can end us bad. But in other hands, those of the gods 348 00:22:46,100 --> 00:22:48,900 traumatologists, speed saves lives. 349 00:22:50,120 --> 00:22:51,660 However, I don't run fast. 350 00:22:51,960 --> 00:22:56,080 And even if we're talking about speed here, no pedestrian, despite what he says 351 00:22:56,080 --> 00:22:58,680 uncle, I don't have what it takes to traumatology.