1 00:00:23,773 --> 00:00:24,816 Robby! 2 00:00:28,862 --> 00:00:29,904 Robby! 3 00:00:30,405 --> 00:00:32,449 - We have a university student with bronchospasm. - Yes. 4 00:00:33,116 --> 00:00:34,159 - Are you okay? - I am. 5 00:00:34,951 --> 00:00:38,371 I wanted to speak to the patient's son from 12-center, but he ran away. 6 00:00:38,580 --> 00:00:39,622 Any problems? 7 00:00:39,748 --> 00:00:41,373 According to the mother, he made a list 8 00:00:41,374 --> 00:00:44,044 named after some school girls that he wanted to kill. 9 00:00:44,627 --> 00:00:46,921 What is the problem with young people? today? 10 00:00:47,213 --> 00:00:52,134 I mean, in addition to social media, of the pandemic and the environmental crisis? 11 00:00:52,135 --> 00:00:54,346 - How optimistic you are today. - What about armed violence? 12 00:00:55,305 --> 00:00:58,223 Nick Bradley, 19 years old, found unconscious by his parents. 13 00:00:58,224 --> 00:01:01,101 Denies the use of medications or allergies. He arrived with dyspnea, 14 00:01:01,102 --> 00:01:03,480 with miotic pupils and bradycardia with 38 BPM. 15 00:01:03,605 --> 00:01:06,941 The pupils responded to Narcan, but we intubated, breathing didn't improve. 16 00:01:07,776 --> 00:01:10,195 - Sign of drugs or alcohol on site? - No. 17 00:01:10,528 --> 00:01:11,821 - Signs of trauma? - Nothing. 18 00:01:12,447 --> 00:01:13,490 Open your eyes, Nick. 19 00:01:14,282 --> 00:01:16,451 On three. One two three. 20 00:01:18,578 --> 00:01:20,455 - Where was it found? - In bed, for his mother. 21 00:01:22,040 --> 00:01:25,585 Pupils 6mm, non-reactive. 22 00:01:26,503 --> 00:01:28,713 Heart rate: 64. Fluctuating blood pressure. 23 00:01:28,963 --> 00:01:31,466 No response to pain. Glasgow three. 24 00:01:31,800 --> 00:01:33,843 - Does it fit into any toxidrome? - No. 25 00:01:34,427 --> 00:01:37,972 If it were just opiates, with Narcan he would already be breathing on his own. 26 00:01:39,015 --> 00:01:41,517 Beta blockers should not cause constriction of the pupils. 27 00:01:41,518 --> 00:01:43,769 Parents can have a medicine prescribed at home. 28 00:01:43,770 --> 00:01:44,896 They are coming. 29 00:01:45,647 --> 00:01:47,731 Level 1 trauma code, arrival in 5 minutes. 30 00:01:47,732 --> 00:01:50,651 Electric scooter against car door. No helmet. 31 00:01:50,652 --> 00:01:54,030 There is no blood in the abdominal cavity, absence of pericardial effusion 32 00:01:54,406 --> 00:01:57,242 and the lungs are clean. 33 00:01:57,409 --> 00:01:58,952 Normal hemoglobin, 15. 34 00:01:59,202 --> 00:02:01,413 - Pressure 84 by 58. - Okay. 35 00:02:02,288 --> 00:02:03,373 What is the recommended course of action? 36 00:02:03,957 --> 00:02:07,377 Prepare 0.1mg of epinephrine. 37 00:02:08,086 --> 00:02:10,171 bladder catheter, stabilization for tomography 38 00:02:10,672 --> 00:02:12,215 and carry out an investigation wider. 39 00:02:17,887 --> 00:02:18,972 Where are we going now? 40 00:02:19,097 --> 00:02:22,099 We need a bed for someone else, but you can stay in the hallway 41 00:02:22,100 --> 00:02:23,393 until we receive your exams. 42 00:02:25,770 --> 00:02:29,190 Your parents should be proud of having a son who is a doctor. 43 00:02:30,400 --> 00:02:31,568 Yeah, I think so. 44 00:02:34,529 --> 00:02:37,282 I was the first person in the family to go to college. 45 00:02:38,992 --> 00:02:40,702 They sacrificed themselves for me to get here. 46 00:02:42,620 --> 00:02:43,872 How's the pain, Mr. Milton? 47 00:02:44,080 --> 00:02:47,083 I'm fine, but I could have a latte now. 48 00:02:47,459 --> 00:02:49,252 This could cause biliary colic return. 49 00:02:49,878 --> 00:02:52,422 - And a bourbon? - It's eight o'clock in the morning! 50 00:02:52,714 --> 00:02:54,591 How about some ice cubes? 51 00:02:55,717 --> 00:02:56,760 No thanks. 52 00:02:57,093 --> 00:02:58,470 I like whiskey neat. 53 00:02:59,054 --> 00:03:00,305 Yeah, that's not going to happen. 54 00:03:05,226 --> 00:03:06,811 Systolic is back in the 90s. 55 00:03:07,812 --> 00:03:09,105 Make another 0.1mg of epinephrine. 56 00:03:09,731 --> 00:03:12,150 Flaccid paralysis from the four ends. 57 00:03:14,611 --> 00:03:17,863 - No nystagmus after stimulation with cold water. - No brain stem function. 58 00:03:17,864 --> 00:03:18,989 Because of... 59 00:03:18,990 --> 00:03:21,284 Hypoxic injury, severe hemorrhage. 60 00:03:21,659 --> 00:03:23,661 Samira, take him to the CT scan. 61 00:03:24,162 --> 00:03:25,455 Take the medicine box. 62 00:03:26,206 --> 00:03:27,248 Call me if you need. 63 00:03:28,083 --> 00:03:29,125 Hey, are you okay? 64 00:03:30,210 --> 00:03:31,252 - I am. - He is sure? 65 00:03:31,920 --> 00:03:33,296 Have you ever had to worry about me? 66 00:03:34,172 --> 00:03:37,300 No, but it doesn't hurt to check. It's part of my job. 67 00:03:38,468 --> 00:03:39,636 You can consider it checked. 68 00:03:40,762 --> 00:03:41,805 He is well. 69 00:03:45,517 --> 00:03:46,559 Is there anything? 70 00:03:46,768 --> 00:03:48,269 I have a case for Dr. Collins. 71 00:03:48,520 --> 00:03:49,562 Can I see? 72 00:03:49,771 --> 00:03:50,814 He can. 73 00:03:50,939 --> 00:03:53,900 He is a man, 68 years old, history of hypertension, 74 00:03:54,109 --> 00:03:57,696 abdominal pain, right upper quadrant, 1 hour after eating fatty food. 75 00:03:58,029 --> 00:04:01,199 Now he is pain-free and fever-free. The ultrasound showed a gallstone. 76 00:04:01,533 --> 00:04:03,909 The electro showed no ischemic changes sharp, 77 00:04:03,910 --> 00:04:06,203 but I'm still waiting liver function and lipase. 78 00:04:06,204 --> 00:04:07,580 Why did you ask for an electro? 79 00:04:08,665 --> 00:04:11,959 Because the nurse suggested, to rule out any heart problems. 80 00:04:11,960 --> 00:04:14,087 Great decision by you both. 81 00:04:14,796 --> 00:04:17,132 Nurses know what they are doing, always listen to them. 82 00:04:17,424 --> 00:04:19,676 Call when exams arrive. How's that finger? 83 00:04:19,926 --> 00:04:21,052 - It's great. - Dr. Robby? 84 00:04:21,594 --> 00:04:23,303 - Hey. - Mr. Spencer's son and daughter, 85 00:04:23,304 --> 00:04:25,223 - from the nursing home, they are here. - Right. 86 00:04:25,348 --> 00:04:26,391 I am going. 87 00:04:33,940 --> 00:04:35,066 Your father has pneumonia 88 00:04:35,483 --> 00:04:37,068 and a condition called sepsis. 89 00:04:37,235 --> 00:04:38,652 What is this exactly? 90 00:04:38,653 --> 00:04:42,240 It means that the bacteria have left the lung and went into the bloodstream. 91 00:04:42,782 --> 00:04:44,659 He is responding well to treatment. 92 00:04:45,618 --> 00:04:46,661 Hi, dad. 93 00:04:48,079 --> 00:04:49,539 It's Helen and Jereme. 94 00:04:51,708 --> 00:04:52,751 Jeremy... 95 00:04:54,169 --> 00:04:55,211 Hillary... 96 00:04:55,962 --> 00:04:57,005 Boob... 97 00:04:57,714 --> 00:04:58,757 Fud. 98 00:05:01,259 --> 00:05:03,886 It's the song "Nowhere Man" from Yellow Submarine. 99 00:05:03,887 --> 00:05:06,056 He called me that when I didn't do my homework. 100 00:05:06,639 --> 00:05:07,849 Is this his normal state? 101 00:05:08,475 --> 00:05:09,976 He has good days and bad days. 102 00:05:11,936 --> 00:05:13,313 Why don't we go out for a minute? 103 00:05:18,818 --> 00:05:22,030 Your father arrived hypotensive, but it's already getting better. 104 00:05:22,322 --> 00:05:23,781 Can he go back to the nursing home? 105 00:05:23,782 --> 00:05:25,200 Later, we hope so. 106 00:05:25,700 --> 00:05:27,368 Your father has an advance directive 107 00:05:27,369 --> 00:05:31,247 which says that venous hydration and medications are allowed, 108 00:05:31,581 --> 00:05:33,791 but without artificial life support nor resuscitation. 109 00:05:33,792 --> 00:05:36,169 He doesn't want to depend on machines to survive. 110 00:05:37,003 --> 00:05:38,046 All good. 111 00:05:38,463 --> 00:05:42,217 So let's continue with oxygen, intravenous hydration and antibiotics. 112 00:05:42,842 --> 00:05:45,469 But if his lungs fail, we can't intubate him 113 00:05:45,470 --> 00:05:46,721 for mechanical ventilation. 114 00:05:47,055 --> 00:05:48,431 But is pneumonia treatable? 115 00:05:49,474 --> 00:05:51,101 Most of the time, it is. 116 00:05:52,435 --> 00:05:55,647 - If he doesn't improve, put him on the machine. - It's not what he wanted. 117 00:05:56,398 --> 00:05:59,025 Do any of you have a power of attorney for health care? 118 00:05:59,984 --> 00:06:01,027 - We have. - We both do. 119 00:06:01,194 --> 00:06:02,237 He is well. 120 00:06:02,445 --> 00:06:05,115 No one needs to make a decision now. 121 00:06:05,615 --> 00:06:06,658 Why don't they think? 122 00:06:07,075 --> 00:06:08,118 Talk about it. 123 00:06:08,827 --> 00:06:10,912 If things get worse, 124 00:06:11,579 --> 00:06:15,000 sometimes a comfortable natural death may be the most humane path. 125 00:06:18,503 --> 00:06:21,172 No routine cases until we assess level 1. 126 00:06:21,756 --> 00:06:23,425 - Thank you. - Dr. Langdon? 127 00:06:25,135 --> 00:06:27,929 So, What was it like in the veterans unit? 128 00:06:28,263 --> 00:06:31,683 It was good and challenging. I learned a lot. 129 00:06:32,726 --> 00:06:37,396 I think it should be mandatory for everyone doctors spend time there regularly 130 00:06:37,397 --> 00:06:39,482 because of everything they sacrificed for us. 131 00:06:39,649 --> 00:06:41,609 It's a great idea. Why did you want to come here? 132 00:06:42,110 --> 00:06:43,861 I have a sister with special needs 133 00:06:43,862 --> 00:06:46,114 and she went to a great institution in Pittsburgh. 134 00:06:46,531 --> 00:06:49,033 And this medical teaching center has an excellent reputation. 135 00:06:49,034 --> 00:06:50,159 I thought it would be good. 136 00:06:50,160 --> 00:06:52,162 - Do you want to know my headache? - What is it? 137 00:06:52,620 --> 00:06:56,373 Woman, 36 years old, severe headache caused by a paracervical trigger point. 138 00:06:56,374 --> 00:06:58,250 Her pain went from 11 to zero 139 00:06:58,251 --> 00:07:00,377 - after 2ml of intramuscular Marcaine... - Wait. 140 00:07:00,378 --> 00:07:02,671 Had injection for a trigger point without presenting? 141 00:07:02,672 --> 00:07:03,797 I did. 142 00:07:03,798 --> 00:07:05,842 Residents have to present their case before. 143 00:07:06,051 --> 00:07:07,552 I spent a month in the pain clinic. 144 00:07:07,677 --> 00:07:08,927 - Arriving! - It's not right. 145 00:07:08,928 --> 00:07:11,013 That's not right at all. 146 00:07:11,014 --> 00:07:14,266 Ben Kemper, 23 years old, no helmet, He crashed his scooter into a car door. 147 00:07:14,267 --> 00:07:16,519 Neck against the handlebars and hit his face on the floor. 148 00:07:16,686 --> 00:07:19,689 Obvious facial fractures, but lucid and with normal vital signs. 149 00:07:22,609 --> 00:07:23,651 Let's go. 150 00:07:25,653 --> 00:07:26,863 One two three. 151 00:07:30,033 --> 00:07:31,076 How are we, Ben? 152 00:07:31,743 --> 00:07:33,745 There's blood in my throat. 153 00:07:33,912 --> 00:07:35,538 It must be from the nosebleed. 154 00:07:35,955 --> 00:07:37,457 Nose plug with balloon, please. 155 00:07:37,791 --> 00:07:40,502 Tachycardia 120, oxygen saturation 90. 156 00:07:40,627 --> 00:07:42,044 Go to 15L for now. 157 00:07:42,045 --> 00:07:45,256 Cervical contusion. Larynx with deviation to the right, without crackling. 158 00:07:45,674 --> 00:07:46,758 Four of morphine. 159 00:07:47,092 --> 00:07:49,928 I'll put a plug in your nose to stop the bleeding. 160 00:07:52,180 --> 00:07:53,223 No hemotympanum. 161 00:07:53,848 --> 00:07:54,891 Inflate the balloon. 162 00:07:56,434 --> 00:07:57,477 What now, Ben? 163 00:07:59,104 --> 00:08:00,563 - It got better. - What do we have? 164 00:08:01,064 --> 00:08:02,232 Normal vital signs, 165 00:08:02,649 --> 00:08:04,401 lucid and oriented, Let's take a look. 166 00:08:09,781 --> 00:08:10,864 Craniofacial dissociation. 167 00:08:10,865 --> 00:08:12,117 Le Fort III fracture. 168 00:08:12,492 --> 00:08:13,701 You don't see this every day. 169 00:08:13,702 --> 00:08:16,079 Prepare for airway. Double priming, just in case. 170 00:08:31,094 --> 00:08:32,137 Good job. 171 00:08:33,054 --> 00:08:34,097 Thanks. 172 00:08:34,472 --> 00:08:36,474 Alright, Mr. Tagari, is released. 173 00:08:36,725 --> 00:08:37,892 Thanks. 174 00:08:38,226 --> 00:08:41,688 Don't forget: 10% discount for doctors and nurses. 175 00:08:42,605 --> 00:08:43,648 I study medicine. 176 00:08:44,107 --> 00:08:45,150 Sorry. 177 00:08:45,775 --> 00:08:46,817 I hit my head, remember? 178 00:08:46,818 --> 00:08:49,737 My son loves pizza, So I will accept. 179 00:08:49,738 --> 00:08:51,613 - Thanks. - Thanks. Wait for the nurse. 180 00:08:51,614 --> 00:08:52,907 Okay, thanks. 181 00:08:54,576 --> 00:08:57,454 I just realized that it seems that I give bad food to my son. 182 00:08:57,912 --> 00:08:59,997 He knows? Pizza, marshmallows... 183 00:08:59,998 --> 00:09:02,625 No, nothing. I like pizza and marshmallows. 184 00:09:03,126 --> 00:09:04,169 Who doesn't like it? 185 00:09:04,336 --> 00:09:05,378 Thanks. 186 00:09:05,879 --> 00:09:06,963 How many children do you have? 187 00:09:07,130 --> 00:09:09,214 Just one, Harrison. 188 00:09:09,215 --> 00:09:10,675 He is eleven years old. 189 00:09:11,801 --> 00:09:12,844 What does your husband do? 190 00:09:12,969 --> 00:09:14,721 I don't have a husband, It's just me and my son. 191 00:09:15,263 --> 00:09:16,264 And you don't have children? 192 00:09:16,473 --> 00:09:18,266 Not because of your age. 193 00:09:19,142 --> 00:09:20,684 Or maybe it is. 194 00:09:20,685 --> 00:09:22,687 Many medical students they have no children. 195 00:09:22,854 --> 00:09:25,899 Yeah, no, I don't have kids. 196 00:09:26,399 --> 00:09:29,361 Not even a boyfriend. Just studies for now. 197 00:09:29,486 --> 00:09:33,490 Yeah, we're super busy. I don't miss it. 198 00:09:33,865 --> 00:09:35,575 It must have been difficult being a young mother. 199 00:09:35,784 --> 00:09:37,202 At times it was. 200 00:09:37,410 --> 00:09:39,120 My life has always been full of challenges. 201 00:09:39,329 --> 00:09:41,956 Medical school was not one of the hardest things. 202 00:09:42,916 --> 00:09:44,417 It was one of the best things, 203 00:09:45,126 --> 00:09:46,419 besides having my son. 204 00:09:47,504 --> 00:09:48,546 Hi. 205 00:09:48,838 --> 00:09:51,256 Facial laceration with a possible foreign body in the eye, 206 00:09:51,257 --> 00:09:54,511 which is always a solid level 7 on the FMV scale, 207 00:09:54,844 --> 00:09:56,388 "It makes Mateo throw up." 208 00:09:59,391 --> 00:10:00,433 Are you well? 209 00:10:01,267 --> 00:10:03,186 I am. 210 00:10:03,478 --> 00:10:06,314 He's funny, the nurse. 211 00:10:06,439 --> 00:10:07,982 Mateo. You can say his name. 212 00:10:10,151 --> 00:10:14,447 Yeah, a foreign body in the eye it can be very serious. 213 00:10:22,539 --> 00:10:23,540 Hey, Frutinha. 214 00:10:25,792 --> 00:10:27,752 - I'm talking to you, Frutinha. - Myrna, 215 00:10:28,003 --> 00:10:30,171 I already told you a hundred times that my name is Dr. Robby. 216 00:10:31,339 --> 00:10:32,799 Do you want to see my vagina? 217 00:10:33,466 --> 00:10:35,093 I've seen it once. 218 00:10:35,552 --> 00:10:37,929 And once was enough, thank you. 219 00:10:38,471 --> 00:10:41,516 Robby, Nick Bradley's parents, the young man with the overdose, are here. 220 00:10:41,641 --> 00:10:44,768 Okay, take them to trauma 1. He hasn't come back from the CT scan yet. 221 00:10:44,769 --> 00:10:45,895 I'm already going there. 222 00:10:46,354 --> 00:10:48,773 - Are you behaving, Myrna? - Yes, ma'am. 223 00:10:53,361 --> 00:10:55,362 - How are we? - Ketamine and Succinylcholine. 224 00:10:55,363 --> 00:10:57,072 Maintaining 94 saturation. 225 00:10:57,073 --> 00:10:59,409 - Preparing the neck, just in case. - Let's see. 226 00:11:01,578 --> 00:11:02,620 A little deeper. 227 00:11:03,580 --> 00:11:05,790 - I can't see the vocal cords. - To the right. 228 00:11:06,541 --> 00:11:07,584 Left. 229 00:11:08,001 --> 00:11:10,419 It's distorted by trauma and the edema will only get worse. 230 00:11:10,420 --> 00:11:11,587 A cricothyroidotomy. 231 00:11:11,588 --> 00:11:13,589 You can't cripple a fracture of larynx. 232 00:11:13,590 --> 00:11:16,800 Don't listen to Edwarda Scissorhands here. Surgery won't solve it. 233 00:11:16,801 --> 00:11:18,719 The bruise is above of the thyroid cartilage, 234 00:11:18,720 --> 00:11:22,974 so keep watching, Dr. Ken, and let me sort this out. 235 00:11:23,975 --> 00:11:26,644 - We arrived in 85. - Laryngeal mask, ventilation and crico. 236 00:11:26,936 --> 00:11:28,145 - Laryngeal mask. - The alarm. 237 00:11:28,146 --> 00:11:29,730 I have never had a cricothyroidotomy. 238 00:11:29,731 --> 00:11:30,982 No, Mel will do the crico. 239 00:11:31,107 --> 00:11:32,984 You've already had a busy morning. Come on, honey. 240 00:11:33,318 --> 00:11:34,944 No, I'll do the crico, doctor. 241 00:11:35,111 --> 00:11:37,196 Would you, doctor, if it wasn't an odd day. 242 00:11:37,197 --> 00:11:40,449 The surgery has even days and the emergency room with the odd number. 243 00:11:40,450 --> 00:11:42,368 You are too strange down here. 244 00:11:42,369 --> 00:11:44,078 Teamwork and patient focus. 245 00:11:44,079 --> 00:11:46,081 Thank you for your gracious understanding. 246 00:11:46,206 --> 00:11:47,832 I'll help if she messes up. 247 00:11:47,957 --> 00:11:49,459 Yolanda, be nice. 248 00:11:49,793 --> 00:11:51,211 Saturation rose with the mask. 249 00:11:51,711 --> 00:11:53,254 Are you ready? Hey? 250 00:11:54,089 --> 00:11:55,131 Hi. 251 00:11:55,757 --> 00:11:56,800 Have you already done this? 252 00:11:57,258 --> 00:11:59,260 Now, in the anatomical laboratory. 253 00:12:00,720 --> 00:12:02,931 I hope this poor soul Don't end up there either. 254 00:12:03,556 --> 00:12:05,975 - We will do an open technique, we have time. - Right. 255 00:12:07,894 --> 00:12:09,854 You will do a vertical incision 256 00:12:10,105 --> 00:12:12,232 to avoid the jugulars and the carotids. 257 00:12:14,776 --> 00:12:16,777 If this criticism needed to be done in seconds, 258 00:12:16,778 --> 00:12:18,947 could use a 10 blade, your finger is a bougie. 259 00:12:23,743 --> 00:12:24,911 This is called weitlaner. 260 00:12:25,203 --> 00:12:27,330 And that's the tracheal hook. 261 00:12:27,706 --> 00:12:30,165 Cervical spine, head CT, oral and maxillofacial surgery. 262 00:12:30,166 --> 00:12:31,417 Propofol drip. 263 00:12:31,418 --> 00:12:35,005 Now we will make a horizontal incision crossing the cricothyroid membrane. 264 00:12:37,966 --> 00:12:39,009 That. 265 00:12:39,968 --> 00:12:41,094 Shiley 4.0 cannula now. 266 00:12:42,178 --> 00:12:43,221 Prepare to ventilate. 267 00:12:45,306 --> 00:12:46,558 That's good. 268 00:12:54,190 --> 00:12:55,233 Sorry. 269 00:12:55,400 --> 00:12:56,443 No problem. 270 00:12:57,527 --> 00:13:01,281 - Exhaled carbon dioxide is yellow. - Yellow is good, very good. You can suture. 271 00:13:02,032 --> 00:13:03,241 I'll be here next door. 272 00:13:05,201 --> 00:13:07,620 Your resident knows how to suture Or do I need to teach? 273 00:13:07,871 --> 00:13:08,997 You are an example, Yoyo. 274 00:13:09,456 --> 00:13:10,790 I know, thank you. 275 00:13:10,999 --> 00:13:13,335 That doesn't mean anything coming from you. 276 00:13:13,460 --> 00:13:15,462 - Honey, are you okay? - If they've already finished fighting. 277 00:13:15,879 --> 00:13:18,923 We're not fighting, we're playing. Langdon is too weak to fight. 278 00:13:19,132 --> 00:13:21,342 I have a lot of respect by Dr. Garcia. 279 00:13:21,343 --> 00:13:23,928 I think she would be a great receptionist at Applebee's. 280 00:13:24,512 --> 00:13:25,555 Bye, weirdos. 281 00:13:28,141 --> 00:13:29,184 Let's go. 282 00:13:30,226 --> 00:13:31,269 Okay, thanks. 283 00:13:31,728 --> 00:13:34,022 They said your son's head CT it's normal 284 00:13:34,272 --> 00:13:35,857 and heart rate is good. 285 00:13:36,024 --> 00:13:37,484 - Saved him. - Good blood pressure. 286 00:13:37,734 --> 00:13:39,735 - Thank God. - Now he is unconscious, 287 00:13:39,736 --> 00:13:41,613 intubated to maintain oxygenation. 288 00:13:43,073 --> 00:13:44,907 Let's hang out while they get it right everything, 289 00:13:44,908 --> 00:13:46,910 then you can keep it as much as they want. 290 00:13:48,912 --> 00:13:50,538 Nicky, it's mom. I'm here, love. 291 00:13:50,872 --> 00:13:51,915 It's going well, son. 292 00:13:53,416 --> 00:13:54,459 Critical. 293 00:13:56,753 --> 00:13:57,879 Alright, let's go out. 294 00:13:59,089 --> 00:14:00,131 He is well. 295 00:14:05,970 --> 00:14:09,641 So we don't know how long he stayed at home without breathing. 296 00:14:10,058 --> 00:14:11,101 He's breathing. 297 00:14:11,601 --> 00:14:12,644 Not on your own. 298 00:14:13,311 --> 00:14:15,230 - But he will wake up. - We hope so. 299 00:14:16,272 --> 00:14:18,483 We will know better with other exams. 300 00:14:19,109 --> 00:14:22,695 Are you sure he didn't take anything? what could have caused this? 301 00:14:22,696 --> 00:14:26,615 No, he's a good boy. He is in college and works part time. 302 00:14:26,616 --> 00:14:29,577 He even wanted to live at home so you can focus on your studies. 303 00:14:30,078 --> 00:14:32,288 - Dr. Robby, urine. - What is that? 304 00:14:34,416 --> 00:14:37,293 It is a test that detects drugs. And it tested positive for fentanyl. 305 00:14:38,420 --> 00:14:40,505 No, that's impossible. Nick doesn't do drugs. 306 00:14:41,131 --> 00:14:44,258 There are many medicines sold illegally that have fentanyl, 307 00:14:44,259 --> 00:14:47,302 It's not just painkillers. Xanax, Ativan. 308 00:14:47,303 --> 00:14:48,555 No, not our son. 309 00:14:49,764 --> 00:14:52,851 Maybe he didn't know he was taking something with fentanyl, I don't know. 310 00:14:53,518 --> 00:14:55,020 The hows and whys they don't matter. 311 00:14:55,311 --> 00:14:56,855 What matters is staying with Nick. 312 00:14:57,272 --> 00:14:59,732 We have to do more tests and we will know the options later, 313 00:14:59,733 --> 00:15:02,027 but in the meantime they feel and talk to him. 314 00:15:05,447 --> 00:15:06,489 Can he hear us? 315 00:15:06,781 --> 00:15:09,826 We are never sure, then we believe you can. 316 00:15:10,076 --> 00:15:12,036 We talk again when we have news, 317 00:15:12,037 --> 00:15:13,163 - are you okay? - Right. 318 00:15:19,878 --> 00:15:21,713 Nick Bradley may have a private room? 319 00:15:22,172 --> 00:15:23,214 Will the boy survive? 320 00:15:25,216 --> 00:15:26,384 Have you not responded to Narcan? 321 00:15:26,509 --> 00:15:28,927 I think the pupils became miotic and then mydriatics 322 00:15:28,928 --> 00:15:30,262 because of the brain injury. 323 00:15:30,263 --> 00:15:31,348 Shit. 324 00:15:32,474 --> 00:15:34,768 AND. He's not much older than Jake. 325 00:15:36,102 --> 00:15:37,145 Don't do that. 326 00:15:38,813 --> 00:15:39,981 Hard not to do it sometimes. 327 00:15:41,524 --> 00:15:42,567 Mr. Spencer's room. 328 00:15:44,402 --> 00:15:47,613 Robby, Theresa, David's mother who ran away, 329 00:15:47,614 --> 00:15:48,781 is calling his son. 330 00:15:48,782 --> 00:15:50,116 Okay, I'll be right there. 331 00:15:50,742 --> 00:15:54,162 - What is happening? - His oximetry is dropping. 332 00:15:54,996 --> 00:15:56,539 Mr. Spencer, how are you? 333 00:15:56,998 --> 00:15:59,376 I don't remember where I parked my car. 334 00:15:59,793 --> 00:16:01,418 Mr. Spencer, do you know where you are? 335 00:16:01,419 --> 00:16:02,962 There's a lot of noise here. 336 00:16:04,297 --> 00:16:06,465 Father? Do you know where we are? 337 00:16:06,466 --> 00:16:08,385 Father, look at me. What is my name? 338 00:16:09,219 --> 00:16:11,805 I don't know where my car is. 339 00:16:13,139 --> 00:16:15,475 BiPAP, 15/5. Let's go out for a bit. 340 00:16:20,355 --> 00:16:21,355 What is BiPAP? 341 00:16:21,356 --> 00:16:24,859 Equipment that generates positive pressure, helping with oxygenation. 342 00:16:25,485 --> 00:16:27,027 Or the pneumonia condition has worsened 343 00:16:27,028 --> 00:16:30,615 or his heart couldn't handle the liquid that we infuse to treat sepsis. 344 00:16:30,907 --> 00:16:33,785 - It is progressing with acute pulmonary edema. - Can you drain the liquid? 345 00:16:33,993 --> 00:16:37,121 No, his blood pressure will drop and we will have serious consequences. 346 00:16:37,122 --> 00:16:39,039 Let's cheer for BiPAP to work. 347 00:16:39,040 --> 00:16:40,166 What if it doesn't work? 348 00:16:41,084 --> 00:16:44,754 Then I'll need to know whether they will authorize putting him on the respirator. 349 00:16:44,921 --> 00:16:46,172 We are still thinking. 350 00:16:46,881 --> 00:16:50,885 We know he wrote what he wanted: "Do not intubate." 351 00:16:51,219 --> 00:16:52,971 We're thinking about trying for a week. 352 00:16:54,389 --> 00:16:56,683 It would be a very painful week. 353 00:16:57,726 --> 00:17:01,520 He couldn't rest because of the bunch of monitors and exams. 354 00:17:01,521 --> 00:17:04,023 You may need to be sedated and contained, 355 00:17:04,024 --> 00:17:05,859 because it would be in a place unknown 356 00:17:06,234 --> 00:17:08,153 with a very uncomfortable tube in the throat 357 00:17:08,987 --> 00:17:10,363 and unaware of the situation. 358 00:17:11,406 --> 00:17:13,742 Elderly patients frequently develop psychosis. 359 00:17:14,159 --> 00:17:15,702 But he can improve. 360 00:17:15,952 --> 00:17:16,995 Or it could get worse. 361 00:17:17,954 --> 00:17:19,039 What would you do? 362 00:17:20,540 --> 00:17:22,750 I can't answer that, is your father. 363 00:17:22,751 --> 00:17:25,003 The decision is yours. What I can guarantee 364 00:17:25,170 --> 00:17:27,129 that we will leave you as comfortable as possible 365 00:17:27,130 --> 00:17:28,756 if they choose a natural death. 366 00:17:28,757 --> 00:17:29,883 But he is not your father. 367 00:17:30,633 --> 00:17:32,218 And he can recover. 368 00:17:32,719 --> 00:17:35,722 My sister wants to say that we are still deciding the best thing to do. 369 00:17:39,017 --> 00:17:40,852 The sooner you decide, the better. 370 00:17:41,353 --> 00:17:43,271 I'm sorry, I wish I could do more. 371 00:17:44,647 --> 00:17:46,524 I don't know if he still has it a long time. 372 00:17:53,323 --> 00:17:54,324 Dr Robby. 373 00:18:01,873 --> 00:18:02,916 I was right. 374 00:18:03,333 --> 00:18:06,001 She doesn't know if it was accidental or if she was pushed on purpose. 375 00:18:06,002 --> 00:18:07,712 - There are no other witnesses? - No. 376 00:18:08,171 --> 00:18:09,214 None. 377 00:18:09,547 --> 00:18:12,384 We got the security footage. I hope she tripped. 378 00:18:13,760 --> 00:18:16,721 Not that I wanted it, but I would that it wasn't on purpose. 379 00:18:17,681 --> 00:18:19,099 That would be a hate crime. 380 00:18:19,641 --> 00:18:20,684 Yes, ma'am. 381 00:18:22,268 --> 00:18:23,937 - Madam? - Doctor. 382 00:18:24,604 --> 00:18:26,314 Sorry, I'm sorry. 383 00:18:27,190 --> 00:18:28,316 Okay, no problem. 384 00:18:28,733 --> 00:18:31,319 You let me know if she says anything else? 385 00:18:34,155 --> 00:18:35,198 Notice. 386 00:18:39,035 --> 00:18:41,203 - At the risk of seeming... - Then it shouldn't. 387 00:18:41,204 --> 00:18:43,039 - I just... - No, trust me. 388 00:18:43,832 --> 00:18:45,250 - As you know... - I know. 389 00:18:45,583 --> 00:18:47,502 - I just wanted... - I know. 390 00:18:48,461 --> 00:18:50,963 Look, I'll let you know if she says anything else 391 00:18:50,964 --> 00:18:53,049 that might be important for your investigation. 392 00:18:57,595 --> 00:18:58,638 Thanks. 393 00:18:59,681 --> 00:19:01,057 - And just for the record... - No. 394 00:19:12,736 --> 00:19:14,738 It worked to take the psychiatrists up there? 395 00:19:15,488 --> 00:19:18,241 It gave. At least the Kraken is still sleeping. 396 00:19:20,368 --> 00:19:22,412 - Is it my impression or this police officer... - No. 397 00:19:22,871 --> 00:19:25,331 - What? You don't even know what I... - What were you going to say? 398 00:19:27,000 --> 00:19:28,043 Maybe you know. 399 00:19:30,003 --> 00:19:32,213 - He looks cool. - Definitely not. 400 00:19:33,882 --> 00:19:37,552 There's not the slightest chance for the two of us to have this conversation. 401 00:19:37,761 --> 00:19:39,471 You know this best than anyone. 402 00:19:39,888 --> 00:19:40,972 - I just... - No. 403 00:19:42,640 --> 00:19:43,683 Go do your thing. 404 00:19:44,184 --> 00:19:46,478 It's better this way, go. 405 00:19:48,980 --> 00:19:51,441 You have to stop mixing Adderall with energy drink. 406 00:19:51,816 --> 00:19:52,859 I'll stop, believe me. 407 00:19:53,526 --> 00:19:54,778 He is well. Thanks. 408 00:19:56,571 --> 00:19:59,615 The cool thing about emergency medicine is that you never know what will happen. 409 00:19:59,616 --> 00:20:00,950 We have everything. 410 00:20:01,493 --> 00:20:04,120 - Is that why you chose this area? - Maybe a little because of that. 411 00:20:04,371 --> 00:20:07,916 And because I can choose my shifts, which is a blessing for a single mother. 412 00:20:08,625 --> 00:20:10,960 But the main thing was because I like people. 413 00:20:11,419 --> 00:20:14,506 They are always there when we need them. Who doesn't want to be part of this? 414 00:20:25,600 --> 00:20:29,062 This is the monitoring center. We saw that it is not in the inclusion zone. 415 00:20:29,187 --> 00:20:31,188 You have permission to be outside that area? 416 00:20:31,189 --> 00:20:33,358 Yes, I'm at work, 417 00:20:34,025 --> 00:20:36,611 like last time and the other. 418 00:20:38,863 --> 00:20:39,906 I'll be right back. 419 00:20:42,534 --> 00:20:46,079 What's the point of this shit if it doesn't work? 420 00:20:54,337 --> 00:20:55,379 Sorry. 421 00:20:55,380 --> 00:20:57,007 It's going very well. No rush. 422 00:20:57,757 --> 00:20:58,842 - Are you cool? - I am. 423 00:21:00,135 --> 00:21:02,721 I get frustrated when it seems that I can't do things. 424 00:21:03,263 --> 00:21:04,472 Yeah, you and me. 425 00:21:05,432 --> 00:21:08,351 Thank you, but my frustration manifests itself emotionally, 426 00:21:08,685 --> 00:21:12,814 then I get upset, I can't seem to handle things 427 00:21:13,231 --> 00:21:15,983 and I can't cry in front of the patient, nobody wants to see that. 428 00:21:15,984 --> 00:21:17,110 This is a danger. 429 00:21:17,277 --> 00:21:18,945 You did a perfect crico. 430 00:21:19,654 --> 00:21:20,697 It's going very well. 431 00:21:24,034 --> 00:21:25,577 Hey you! Whitey! 432 00:21:26,286 --> 00:21:27,328 Can you see me a sandwich? 433 00:21:28,913 --> 00:21:30,415 What brings you here today, sir? 434 00:21:30,874 --> 00:21:33,293 I came here to eat the cum of a sandwich. 435 00:21:33,668 --> 00:21:34,711 I understood. 436 00:21:35,670 --> 00:21:37,047 All good. Excuse me... 437 00:21:38,381 --> 00:21:39,424 - Perlah. - Perlah. 438 00:21:39,674 --> 00:21:42,761 - Can this patient eat a sandwich? - I already gave you a sandwich, Earl. 439 00:21:42,886 --> 00:21:44,971 I haven't eaten anything all week. 440 00:21:46,639 --> 00:21:49,350 Okay, give him another sandwich, are in the meal cart. 441 00:21:49,351 --> 00:21:52,062 Just don't give one that has eggs, otherwise he throws it on the floor. 442 00:21:52,187 --> 00:21:53,563 Cool, good to know. Thanks. 443 00:21:56,900 --> 00:21:58,151 Very good. 444 00:22:08,745 --> 00:22:09,788 Is there any quick here? 445 00:22:10,413 --> 00:22:13,041 It's only 8:30am and Robby is already on my case because of the delay. 446 00:22:13,917 --> 00:22:16,252 He just usually starts chasing me after my lunch. 447 00:22:16,753 --> 00:22:18,128 Give him a break today, 448 00:22:18,129 --> 00:22:20,131 It's the anniversary of death by Dr. Adamson. 449 00:22:21,216 --> 00:22:22,258 How sad. 450 00:22:23,927 --> 00:22:25,553 But that's no reason to discount in me. 451 00:22:26,888 --> 00:22:27,931 I think. 452 00:22:28,348 --> 00:22:30,266 - Dr. Mohan? - Samira, please. 453 00:22:30,767 --> 00:22:32,352 I wanted to apologize. 454 00:22:32,769 --> 00:22:35,772 When my phone rang at that time, It wasn't professional at all. 455 00:22:35,897 --> 00:22:38,232 All good. Believe me, we need to laugh, 456 00:22:38,233 --> 00:22:39,526 otherwise we won't stop crying. 457 00:22:40,151 --> 00:22:41,194 Thanks. 458 00:22:41,569 --> 00:22:43,988 And with all the madness that happens here every hour, 459 00:22:44,280 --> 00:22:45,573 no one cares or notices. 460 00:22:45,990 --> 00:22:48,243 There is an unconscious homeless person arriving. 461 00:22:48,576 --> 00:22:50,829 It could be a good clinical case, Little song. 462 00:22:54,541 --> 00:22:55,582 Let's go. 463 00:22:55,583 --> 00:22:59,795 Caucasian male, around 60 to 70 years old, found unconscious. 464 00:22:59,796 --> 00:23:01,548 No signs of trauma, without identification. 465 00:23:03,633 --> 00:23:04,676 On three. 466 00:23:05,301 --> 00:23:07,137 One two three. 467 00:23:11,349 --> 00:23:13,767 - Did you take anything? - I smell the alcohol from here. 468 00:23:13,768 --> 00:23:16,187 He's wearing the spring collection, summer and autumn. 469 00:23:17,772 --> 00:23:19,315 - Jesus! - What the hell? 470 00:23:21,151 --> 00:23:22,152 What the fuck... 471 00:23:23,153 --> 00:23:24,571 What was it? What is happening? 472 00:23:25,822 --> 00:23:27,866 The patient tested positive for mice. 473 00:23:28,450 --> 00:23:29,492 No. 474 00:23:30,368 --> 00:23:31,953 If anything matters, I only counted three. 475 00:23:33,496 --> 00:23:34,539 There's one there. 476 00:23:39,294 --> 00:23:43,548 Since your son tested positive for THC, the psychoactive ingredient of cannabis, 477 00:23:43,882 --> 00:23:46,801 we will have to keep it monitored under observation at night. 478 00:23:47,385 --> 00:23:48,428 And his brain? 479 00:23:49,471 --> 00:23:51,930 This amount of weed can cause any problems? 480 00:23:51,931 --> 00:23:53,057 He's only four years old. 481 00:23:53,058 --> 00:23:54,767 Honestly, we don't know. 482 00:23:54,768 --> 00:23:58,187 There are no consistent studies on this, but the fact that it was just one episode 483 00:23:58,188 --> 00:24:00,481 indicates that it must not have caused permanent sequel. 484 00:24:00,482 --> 00:24:01,608 But you don't know. 485 00:24:02,108 --> 00:24:05,235 My child may have a deficit learning, psychiatric disorders 486 00:24:05,236 --> 00:24:08,531 - or even autism because of it. - There is no evidence to suggest any of this. 487 00:24:09,032 --> 00:24:13,161 Hi, I'm Kiara Alfaro, social worker in this sector. 488 00:24:13,286 --> 00:24:15,163 Kiara will help you in the next steps. 489 00:24:16,331 --> 00:24:17,332 What steps? 490 00:24:17,540 --> 00:24:20,459 Well, a case like this requires a mandatory report 491 00:24:20,460 --> 00:24:23,421 to Child Protective Services and sometimes to the authorities. 492 00:24:23,838 --> 00:24:25,506 - No. - Why involve the police? 493 00:24:25,507 --> 00:24:28,217 - It is a controlled substance. - They won't take my son. 494 00:24:28,218 --> 00:24:29,343 Nobody suggested this. 495 00:24:29,344 --> 00:24:32,430 Fuck your suggestions! No one will touch my son! 496 00:24:32,764 --> 00:24:35,057 - Actually, let's go. - You can't take your son. 497 00:24:35,058 --> 00:24:37,810 - He may have a respiratory arrest. - I'll take care of him at home. 498 00:24:37,811 --> 00:24:39,353 - Amanda, please. - Fuck you! 499 00:24:39,354 --> 00:24:41,980 Call security. If you don't cooperate, I'll ask you to leave. 500 00:24:41,981 --> 00:24:44,191 Amanda, please. He needs to stay here. 501 00:24:44,192 --> 00:24:46,151 And you need to fix a fucking hotel. 502 00:24:46,152 --> 00:24:48,904 Your child cannot leave the hospital, But I can get you out of here. 503 00:24:48,905 --> 00:24:51,491 Don't you dare touch me. Get out! All! 504 00:24:51,700 --> 00:24:53,909 Mrs. Jones, I know this is scary and stressful. 505 00:24:53,910 --> 00:24:58,330 Go fuck yourself! It's my son, man! And no one will touch him! 506 00:24:58,331 --> 00:24:59,832 - What there was? - How can I help? 507 00:24:59,833 --> 00:25:01,667 - Going to the whore who gave birth to you! -Amanda! 508 00:25:01,668 --> 00:25:03,294 Alright, that's enough! 509 00:25:04,379 --> 00:25:06,631 This is a hospital, It's not Jerry Springer Show. 510 00:25:07,215 --> 00:25:09,134 Madam, no one wants to take your child. 511 00:25:09,926 --> 00:25:14,139 Stay here while your husband talks with the social worker and resolve everything. 512 00:25:14,681 --> 00:25:17,349 I don't want him to speak for me and for my son. 513 00:25:17,350 --> 00:25:19,185 It's you or him. 514 00:25:19,644 --> 00:25:22,021 Your son will not leave, but you might be asked to leave 515 00:25:22,022 --> 00:25:24,190 and even get arrested refuse to cooperate. 516 00:25:24,399 --> 00:25:25,442 Nobody wants that. 517 00:25:25,650 --> 00:25:27,527 So tell us: what do you want to do? 518 00:25:30,780 --> 00:25:31,906 I'm staying with my son. 519 00:25:32,323 --> 00:25:34,451 Cool, great. Keep it. 520 00:25:35,368 --> 00:25:36,661 Are we all in agreement here? 521 00:25:37,829 --> 00:25:38,871 Thank you, Olsen. 522 00:25:38,872 --> 00:25:40,957 - Are you well? - Yes, let's solve it. 523 00:25:41,750 --> 00:25:43,168 - All very well. - It's all yours. 524 00:25:43,293 --> 00:25:44,878 Mrs. Jones, we have some questions. 525 00:25:48,715 --> 00:25:52,343 - Is everything okay out there? - Yeah, just another day in paradise. 526 00:25:52,344 --> 00:25:53,845 - How are you feeling? - Better. 527 00:25:54,429 --> 00:25:55,472 Where is David? 528 00:25:55,805 --> 00:25:59,684 He left. He said he had to go to school. 529 00:26:01,811 --> 00:26:03,897 Maybe you can call him and make him come back. 530 00:26:07,650 --> 00:26:09,277 What will happen to him if I call? 531 00:26:10,236 --> 00:26:12,364 I hope he's willing talking to someone. 532 00:26:12,822 --> 00:26:13,865 Do you talk to him? 533 00:26:14,157 --> 00:26:16,326 I can try, but he didn't want to talk to me. 534 00:26:18,161 --> 00:26:21,998 Did you tell someone from the list you found? 535 00:26:22,123 --> 00:26:23,166 No. 536 00:26:23,833 --> 00:26:27,087 I didn't know who to talk to. I don't want to see him get hurt. 537 00:26:28,254 --> 00:26:29,297 Neither do we. 538 00:26:39,140 --> 00:26:41,267 - It went to voicemail. - Try sending a message. 539 00:26:54,656 --> 00:26:56,074 He's not responding. 540 00:26:56,658 --> 00:26:59,744 - Sorry about all this. - Everything is fine. 541 00:27:00,203 --> 00:27:01,913 What you are doing for David is courageous. 542 00:27:03,248 --> 00:27:05,834 I'm his mother. I'll do anything to protect him. 543 00:27:08,586 --> 00:27:10,588 - Do you think he would hurt anyone? - No. 544 00:27:13,049 --> 00:27:14,092 But... 545 00:27:17,262 --> 00:27:19,222 Surely many parents could find, 546 00:27:21,016 --> 00:27:23,226 before their children did unimaginable things. 547 00:27:26,604 --> 00:27:28,105 Does he have a history of violence? 548 00:27:28,106 --> 00:27:30,525 - Have you ever gotten into any trouble? - No, never. 549 00:27:30,859 --> 00:27:32,068 He is very quiet. 550 00:27:33,361 --> 00:27:34,988 And he takes good care of me. 551 00:27:35,947 --> 00:27:40,285 He is fighting with the death of his father. 552 00:27:41,411 --> 00:27:42,454 We both are. 553 00:27:43,288 --> 00:27:45,497 Ambulance arriving in 10 minutes, electric shock. 554 00:27:45,498 --> 00:27:47,042 Call Collins, I'll be right there. 555 00:27:48,710 --> 00:27:51,379 Keep trying. If you can, ask someone to call me. 556 00:27:51,963 --> 00:27:53,006 - Right. - He is well? 557 00:27:54,132 --> 00:27:56,009 - Thanks. - You're welcome. 558 00:27:56,217 --> 00:27:57,927 - Good news for me? - For sure. 559 00:27:58,261 --> 00:27:59,888 There are two beds being freed up in the ICU. 560 00:28:00,180 --> 00:28:01,514 - They should be ready by now. - Excellent. 561 00:28:01,639 --> 00:28:03,767 - And I left bagels in the break room. - Thanks. 562 00:28:07,312 --> 00:28:09,272 - And truth? - You have to be more specific. 563 00:28:09,606 --> 00:28:13,193 - Are there rats in the emergency room? - It would seem so, if someone has already reported it. 564 00:28:13,318 --> 00:28:15,362 Do you know how bad that is? 565 00:28:15,820 --> 00:28:17,489 One more reason to close this place. 566 00:28:17,906 --> 00:28:21,534 - Only the emergency room accepts rats. - The emergency room would never accept rats, 567 00:28:21,785 --> 00:28:23,036 only with health insurance. 568 00:28:23,244 --> 00:28:24,287 Did you catch any? 569 00:28:24,412 --> 00:28:26,080 One, and charged a full consultation. 570 00:28:26,081 --> 00:28:28,750 - I'm glad you think this is funny. - Too bad you don't. 571 00:28:29,000 --> 00:28:30,251 Did you call pest control? 572 00:28:30,835 --> 00:28:32,295 He is waiting for a 2nd opinion. 573 00:28:34,547 --> 00:28:35,715 You're playing with your luck. 574 00:28:36,091 --> 00:28:38,300 Don't worry, were going to the cafeteria, 575 00:28:38,301 --> 00:28:39,844 then they must die in an hour. 576 00:28:40,762 --> 00:28:42,597 - I'll be here all week. - Maybe not. 577 00:28:48,061 --> 00:28:51,606 Drug user kicked off the bus for disorder and disturbance of passengers, 578 00:28:51,981 --> 00:28:53,817 screaming nonstop because of narcotics. 579 00:28:53,942 --> 00:28:56,069 We found an empty Percocet bottle five days ago. 580 00:28:56,611 --> 00:28:59,489 - What are you doing? - She's been combative since we picked her up. 581 00:28:59,614 --> 00:29:01,408 Release her, set her free! 582 00:29:01,658 --> 00:29:02,659 Stop fighting. 583 00:29:02,826 --> 00:29:04,785 Stay calm or I'll call the police. 584 00:29:04,786 --> 00:29:06,537 My medications don't work effect! 585 00:29:06,538 --> 00:29:09,124 Please I have sickle cell anemia! 586 00:29:09,290 --> 00:29:10,291 Everyone, stop! 587 00:29:10,458 --> 00:29:11,710 Stop! 588 00:29:13,461 --> 00:29:15,171 - What's your name? - Joyce. 589 00:29:15,505 --> 00:29:18,508 - Joyce St. Claire. - Joyce, is this pain from sickle cell anemia? 590 00:29:18,925 --> 00:29:19,967 AND! 591 00:29:19,968 --> 00:29:21,302 10mg of intravenous morphine. 592 00:29:21,553 --> 00:29:23,679 - Do you really want ten? - Yes, repeat in 5 minutes if necessary. 593 00:29:23,680 --> 00:29:26,015 And do a dripping of Dilaudid. It's a CVO! 594 00:29:26,016 --> 00:29:28,308 I'm sorry this happened. You'll be fine. 595 00:29:28,309 --> 00:29:29,686 You're safe here. 596 00:29:30,103 --> 00:29:31,146 Let's go. 597 00:29:31,646 --> 00:29:32,939 You'll be safe here, I promise. 598 00:29:33,440 --> 00:29:34,566 Breathe, okay? 599 00:30:00,800 --> 00:30:03,635 Perform deep venous access on the forearm and shock once. 600 00:30:03,636 --> 00:30:04,845 Did a power pole fall? 601 00:30:04,846 --> 00:30:05,971 No, abandoned factory. 602 00:30:05,972 --> 00:30:07,973 There was a screw cutter. He got shocked. 603 00:30:07,974 --> 00:30:09,851 - Did you try to steal copper? - Probably. 604 00:30:10,018 --> 00:30:13,063 The power line burned his arm and the current stopped his heart. 605 00:30:15,106 --> 00:30:16,149 Ready? 606 00:30:17,984 --> 00:30:19,069 Carefully get up. 607 00:30:21,529 --> 00:30:24,199 Myoglobin and CK dose. 608 00:30:24,324 --> 00:30:26,325 Two liters of saline wide open. 609 00:30:26,326 --> 00:30:27,869 Dr. Santos, what's your concern? 610 00:30:28,161 --> 00:30:31,997 Rhabdomyolysis due to tissue rupture which can lead to kidney failure 611 00:30:31,998 --> 00:30:34,458 - and serious risk of cardiac arrhythmia. - Excellent. 612 00:30:34,459 --> 00:30:36,795 - Defibrillator pads ready. - Did he fall from a pole? 613 00:30:37,337 --> 00:30:38,672 No, it was on a platform. 614 00:30:39,089 --> 00:30:40,924 - How boring. - Cut a live wire. 615 00:30:42,425 --> 00:30:43,635 Distended abdominal wall. 616 00:30:43,968 --> 00:30:45,303 Measure intra-abdominal pressure. 617 00:30:46,304 --> 00:30:48,222 - Ventricular fibrillation. - Loading with 300. 618 00:30:48,223 --> 00:30:50,600 - Who's controlling this? - Sorry, it was reflex. 619 00:30:50,809 --> 00:30:51,851 Move away! 620 00:30:52,435 --> 00:30:53,478 Damn! 621 00:30:54,270 --> 00:30:55,313 Sorry. 622 00:30:55,855 --> 00:30:56,898 Sorry. 623 00:30:57,440 --> 00:30:59,067 So what happened? 624 00:31:00,026 --> 00:31:01,903 I bought it for the dog from my girlfriend. 625 00:31:02,529 --> 00:31:06,408 I work at night and he keeps barking all day. 626 00:31:06,700 --> 00:31:09,160 When I woke up, was using it. 627 00:31:09,327 --> 00:31:10,662 Fucking slut! 628 00:31:12,038 --> 00:31:13,707 Sorry. 629 00:31:15,000 --> 00:31:17,334 I think she must have used instant glue. 630 00:31:17,335 --> 00:31:19,671 Yes, it seems so. 631 00:31:21,047 --> 00:31:22,590 Have you tried taking out the batteries? 632 00:31:22,757 --> 00:31:23,800 Of course. 633 00:31:24,467 --> 00:31:25,510 She glued the box. 634 00:31:26,761 --> 00:31:29,597 I think we have some options, Gary. 635 00:31:30,265 --> 00:31:33,934 We can try to find a solvent that dissolves or at least softens the glue 636 00:31:33,935 --> 00:31:36,438 so you can take it off without hurting your skin. 637 00:31:37,272 --> 00:31:38,314 Or... 638 00:31:39,482 --> 00:31:40,525 Dr. Javadi? 639 00:31:42,152 --> 00:31:45,779 Guess the skin cells on your neck will flake off naturally 640 00:31:45,780 --> 00:31:47,657 and you'll be able to take it off soon. 641 00:31:48,700 --> 00:31:49,743 How long? 642 00:31:50,869 --> 00:31:52,454 - Two weeks, maybe. - Two weeks? 643 00:31:52,912 --> 00:31:54,414 I think this guy has scurvy. 644 00:31:54,581 --> 00:31:55,623 Is he a pirate? 645 00:31:55,915 --> 00:31:59,586 No, he is a homeless person who lives almost exclusively R$ 1.99 noodles. 646 00:31:59,753 --> 00:32:01,546 Has perifollicular hemorrhage, 647 00:32:01,755 --> 00:32:03,381 gingivitis, gingivorragia 648 00:32:03,882 --> 00:32:06,258 and no fruits or vegetables in the diet. 649 00:32:06,259 --> 00:32:08,552 I think this explains if we rule out piracy. 650 00:32:08,553 --> 00:32:11,348 No parrot, no stilt, Doesn't it smell like sweat and rum? 651 00:32:12,766 --> 00:32:14,434 Now that you said it, it had a smell. 652 00:32:14,851 --> 00:32:15,894 Must be a pirate. 653 00:32:17,604 --> 00:32:20,231 Tell him to buy vitamin C when you go to the R$1.99 store. 654 00:32:22,776 --> 00:32:24,777 - I don't know if you're joking. - No. 655 00:32:24,778 --> 00:32:26,987 Captain Scurvy has a disability of vitamin C. 656 00:32:26,988 --> 00:32:28,656 The cheapest solution is a supplement. 657 00:32:29,324 --> 00:32:30,700 Captain Scurvy is another joke. 658 00:32:31,159 --> 00:32:32,702 - I wish it were. - It's good. 659 00:32:33,161 --> 00:32:36,663 Dr. Langdon, Dr. King, Arthur Carlson, of the childhood, youth and family sector. 660 00:32:36,664 --> 00:32:38,750 He wants to talk to Tyler Jones' parents. 661 00:32:38,875 --> 00:32:43,129 Of course. Honey, do you mind taking him? even Kiara and her family? 662 00:32:43,254 --> 00:32:44,297 Of course, here. 663 00:32:49,886 --> 00:32:51,221 - Beto? - Hi, doctor. 664 00:32:51,721 --> 00:32:54,474 - What are you doing here? - I'm working during the day now. 665 00:32:54,766 --> 00:32:57,352 - Didn't you retire about two years ago? - No. 666 00:32:58,228 --> 00:33:00,480 - I have to work today. - I know. 667 00:33:01,272 --> 00:33:02,856 I understood. Stay here, okay? 668 00:33:02,857 --> 00:33:04,733 I have a lot of cleaning to do. 669 00:33:04,734 --> 00:33:06,777 I'll just take a second. 670 00:33:06,778 --> 00:33:09,071 Hey, doctor! How about a sandwich? 671 00:33:09,072 --> 00:33:12,659 Of course, Earl. Turkey, without egg. I'll go get it, just a minute. 672 00:33:15,161 --> 00:33:16,871 Beto said who is working here. 673 00:33:17,122 --> 00:33:18,622 Yeah, he started wandering. 674 00:33:18,623 --> 00:33:20,458 Glad it always comes back over here. 675 00:33:20,792 --> 00:33:22,210 You think you still work here. 676 00:33:22,711 --> 00:33:25,088 I called his family. They'll come get you in a few hours. 677 00:33:25,213 --> 00:33:26,256 Serious? 678 00:33:26,506 --> 00:33:29,174 So they have a rest and he talks to people, 679 00:33:29,175 --> 00:33:31,386 feel useful and exercise. 680 00:33:31,803 --> 00:33:33,138 I wanted to be happy like that. 681 00:33:33,471 --> 00:33:35,473 - Do you think he's good at catching mice? - Stop. 682 00:33:36,433 --> 00:33:39,185 - Earl wants a sandwich. - He always wants a sandwich. 683 00:33:39,644 --> 00:33:40,687 Hey, check this out. 684 00:33:41,187 --> 00:33:42,230 I got a puppy. 685 00:33:42,647 --> 00:33:44,441 Cute. I hope it wasn't your idea. 686 00:33:44,858 --> 00:33:46,443 - Why? - Why? 687 00:33:47,027 --> 00:33:49,279 Do you think your wife needs something more? to take care of? 688 00:33:49,529 --> 00:33:50,571 Abby loves dogs. 689 00:33:50,572 --> 00:33:52,782 I love penguins, But I don't want to take care of one. 690 00:33:53,074 --> 00:33:54,492 I think it's illegal to have a penguin. 691 00:33:54,617 --> 00:33:55,910 And you didn't understand the point. 692 00:33:56,244 --> 00:33:58,455 The thing is, Tanner promised who would take care of him. 693 00:33:58,747 --> 00:34:01,207 A four year old? He is well. 694 00:34:07,047 --> 00:34:08,089 How is she? 695 00:34:08,882 --> 00:34:11,426 Still breathing after 20mg of morphine. 696 00:34:14,137 --> 00:34:15,180 How's the pain, Joyce? 697 00:34:16,389 --> 00:34:17,432 A little better. 698 00:34:18,141 --> 00:34:19,684 We asked for an exchange transfusion. 699 00:34:20,101 --> 00:34:21,353 I thought I would really need it. 700 00:34:22,771 --> 00:34:24,189 What is your normal dosage at home? 701 00:34:25,231 --> 00:34:28,735 90mg extended-release morphine every 12 hours 702 00:34:29,235 --> 00:34:31,696 and oxycodone for severe pain, 703 00:34:32,447 --> 00:34:33,490 but it had no effect. 704 00:34:33,990 --> 00:34:36,368 Let's start intravenous Dilaudid, 0.4mg per hour. 705 00:34:37,202 --> 00:34:39,079 Press this button if you need more. 706 00:34:39,204 --> 00:34:42,499 It only works once an hour, so don't overdo it. 707 00:34:43,249 --> 00:34:45,210 - Can I talk to you? - Of course. 708 00:34:54,636 --> 00:34:56,388 Seems surprised by the dosage of opioids. 709 00:34:57,347 --> 00:34:59,099 - It seems a little high. - Her pain too. 710 00:35:00,141 --> 00:35:03,019 - She doesn't want to take drugs? - A hemoglobin of 6 cannot be falsified. 711 00:35:03,353 --> 00:35:05,105 What does sickle cell anemia do with the body? 712 00:35:05,480 --> 00:35:08,525 Red blood cells clog capillaries, blocking cellular oxygenation. 713 00:35:08,858 --> 00:35:11,443 It is described as a pain of an electrical discharge 714 00:35:11,444 --> 00:35:14,489 that feels like it's breaking your bones and passing glass over the body. 715 00:35:15,365 --> 00:35:17,282 Okay, But I never thought of it that way. 716 00:35:17,283 --> 00:35:19,619 A little empathy goes a long way for those who are suffering. 717 00:35:23,373 --> 00:35:25,249 Relax, you will learn to identify fakes. 718 00:35:25,250 --> 00:35:29,212 In most cases, people need of someone who listens to your stories. 719 00:35:32,966 --> 00:35:37,261 Intra-abdominal pressure is in 49. 720 00:35:37,262 --> 00:35:38,805 The burn caused a lot of swelling. 721 00:35:39,014 --> 00:35:40,098 What is the procedure? 722 00:35:40,849 --> 00:35:43,476 fasciotomy, but he still has a radial pulse. 723 00:35:43,935 --> 00:35:45,769 More than 100 pressure to lose your pulse. 724 00:35:45,770 --> 00:35:47,355 Under these conditions, he would lose his arm. 725 00:35:47,480 --> 00:35:50,775 49 is enough to compromise innervation and muscles in a few hours. 726 00:35:51,317 --> 00:35:52,318 Is intra pressure 49? 727 00:35:52,485 --> 00:35:54,529 Yes, I'm going to make the initial incision here. 728 00:35:55,071 --> 00:35:56,448 Orthopedics ends in surgery. 729 00:35:56,865 --> 00:35:57,907 Good plan, I'll let you know. 730 00:35:58,533 --> 00:35:59,867 - Hi, Robby. - Good to see you, Fred. 731 00:35:59,868 --> 00:36:01,452 - How about the Rock star? - It's good. 732 00:36:01,453 --> 00:36:03,371 - He has a good teacher. - A good teacher. 733 00:36:04,164 --> 00:36:06,124 Sterile gloves for Dr. Santos. 734 00:36:06,750 --> 00:36:09,419 We do not teach forearm fasciotomies for residents. 735 00:36:09,544 --> 00:36:12,297 And if she's alone someday, no support? 736 00:36:15,675 --> 00:36:18,844 This is the way to avoid the median nerve 737 00:36:18,845 --> 00:36:20,929 and all main vessels. 738 00:36:20,930 --> 00:36:22,849 It's better to just watch the first time. 739 00:36:23,308 --> 00:36:24,642 She holds the blade and I cut. 740 00:36:25,810 --> 00:36:27,062 Blade 10 for Dr. Santos. 741 00:36:30,899 --> 00:36:31,941 Starting with the proximal one. 742 00:36:33,276 --> 00:36:34,277 What is the pressure? 743 00:36:34,861 --> 00:36:37,280 More or less like this. 744 00:36:46,206 --> 00:36:47,874 Through the skin and subcutaneous tissue. 745 00:36:53,213 --> 00:36:54,255 Good. 746 00:36:59,010 --> 00:37:00,053 How are they? 747 00:37:01,012 --> 00:37:02,055 Still talking. 748 00:37:04,015 --> 00:37:06,017 - Are you well? - I am, of course. 749 00:37:06,267 --> 00:37:07,769 I just hate seeing families separating. 750 00:37:08,228 --> 00:37:09,270 They'll be fine. 751 00:37:09,896 --> 00:37:11,981 - How are you sure? - They are white. 752 00:37:12,482 --> 00:37:14,067 They should only receive a warning. 753 00:37:14,609 --> 00:37:19,197 If they weren't, she would probably lose son and he would end up in jail. 754 00:37:20,657 --> 00:37:22,659 Sorry, I specialized in cynicism. 755 00:37:23,785 --> 00:37:26,329 - Are you sure you're okay? - Absolutely, I'm just going to get some air. 756 00:37:33,044 --> 00:37:36,423 I am fierce, stylish, chic, sassy, 757 00:37:36,715 --> 00:37:38,883 full of attitude, temperamental, bold. 758 00:37:39,426 --> 00:37:40,635 I'm fierce... 759 00:37:41,636 --> 00:37:42,679 I need help! 760 00:37:43,263 --> 00:37:44,806 - I got shot. - Can you help? 761 00:37:46,266 --> 00:37:47,308 What is your name? 762 00:37:47,809 --> 00:37:50,270 -Alex. - Okay, Alex, let me take a look. 763 00:37:51,312 --> 00:37:52,355 It's hurting too much. 764 00:37:52,522 --> 00:37:53,565 I know. 765 00:37:53,773 --> 00:37:56,901 - We'll take good care of you. Do you help? - Let me lift you up, Alex. 766 00:37:59,195 --> 00:38:00,238 Gotcha. 767 00:38:00,655 --> 00:38:03,992 Abdominal gunshot wound in the area of ambulances, trauma code. 768 00:38:05,452 --> 00:38:07,911 One firearm victim was left here by a van. 769 00:38:07,912 --> 00:38:09,039 Do you assume here? 770 00:38:09,289 --> 00:38:10,331 I assume, go. 771 00:38:10,874 --> 00:38:12,625 2g of Cefazolin. Orthopedics is coming. 772 00:38:18,256 --> 00:38:21,050 Systolic pressure 80. Access on the left arm with Jelco 14. 773 00:38:21,051 --> 00:38:23,218 Two bags of blood running in the rapid infuser. 774 00:38:23,219 --> 00:38:24,429 Call surgery. 775 00:38:24,637 --> 00:38:26,639 Clean lungs. Do you take any daily medication? 776 00:38:27,098 --> 00:38:28,141 - Do you have allergies? - No. 777 00:38:29,059 --> 00:38:30,810 Morrison space is full of blood. 778 00:38:31,227 --> 00:38:32,270 Lacerated his liver. 779 00:38:32,437 --> 00:38:33,687 - What's his name? -Alex. 780 00:38:33,688 --> 00:38:36,524 Alex, you lost a lot of blood. We'll have to operate on you now. 781 00:38:36,649 --> 00:38:38,485 - Am I going to die? - Not now that I'm here. 782 00:38:38,902 --> 00:38:40,235 It's the humility of a surgeon. 783 00:38:40,236 --> 00:38:41,363 Surgical center ready. 784 00:38:41,529 --> 00:38:42,947 - The pressure is rising. - Let's go. 785 00:38:43,281 --> 00:38:45,825 - Tell my mother, it's Gelada in the contacts. - Of course. 786 00:38:47,994 --> 00:38:50,246 He didn't have to wait an operating room? 787 00:38:50,538 --> 00:38:53,082 No, we are a trauma center, We always have a free room. 788 00:38:53,083 --> 00:38:54,501 We are ready and equipped. 789 00:38:55,126 --> 00:38:56,169 How incredible! 790 00:38:58,463 --> 00:39:01,174 And if you have several cases of trauma needing surgery? 791 00:39:01,341 --> 00:39:02,384 We get busier. 792 00:39:04,803 --> 00:39:05,845 Mr. Milton, 793 00:39:05,970 --> 00:39:09,557 we had to bring you into the hallway. I know it's very chaotic and noisy here. 794 00:39:10,350 --> 00:39:11,393 Mr. Milton? 795 00:39:12,560 --> 00:39:14,646 Hey, Bennet, wake up. 796 00:39:17,357 --> 00:39:20,068 Shit, shit, shit! I need help here! 797 00:39:21,695 --> 00:39:22,736 Help! 798 00:39:22,737 --> 00:39:23,862 When did you examine it? 799 00:39:23,863 --> 00:39:26,783 I don't know, half an hour at most. I was waiting for the exams. 800 00:39:26,908 --> 00:39:28,910 - What it was? - He's my patient with gallstones. 801 00:39:29,035 --> 00:39:30,745 Unknown stopping time. 802 00:39:31,830 --> 00:39:32,872 Stop cart! 803 00:39:37,252 --> 00:39:38,294 Leave it to me. 804 00:39:41,172 --> 00:39:42,215 Hold compressions. 805 00:39:45,343 --> 00:39:46,386 Asystole. 806 00:39:46,636 --> 00:39:47,679 Resume compressions. 807 00:39:48,304 --> 00:39:49,389 An ampoule of epinephrine. 808 00:39:50,390 --> 00:39:52,350 - Slower, slower. - Intube? 809 00:39:52,517 --> 00:39:54,686 No, use a laryngeal mask airway. Continue compressions. 810 00:39:56,438 --> 00:39:58,064 Fixed and dilated pupils. 811 00:39:58,440 --> 00:39:59,607 It's been unanswered for a long time. 812 00:40:11,953 --> 00:40:12,996 How are we here? 813 00:40:13,371 --> 00:40:14,622 Much better. 814 00:40:14,831 --> 00:40:17,292 Dr. Mohan, this is my wife, Undine. 815 00:40:17,584 --> 00:40:19,711 Dr. Samira Mohan, nice to meet you, Undine. 816 00:40:20,170 --> 00:40:22,380 - Thank you for helping her. - You're welcome. 817 00:40:22,881 --> 00:40:26,051 And once again, I'm sorry how she was treated when she arrived. 818 00:40:26,676 --> 00:40:29,554 Not everyone here is used to dealing with vaso-occlusive crisis. 819 00:40:29,929 --> 00:40:33,475 We will do our best to manage Joyce's crisis. 820 00:40:34,184 --> 00:40:35,643 Can I help you with something? 821 00:40:36,102 --> 00:40:37,186 - I am fine. - Undine? 822 00:40:37,187 --> 00:40:38,313 No, thank you. 823 00:40:38,480 --> 00:40:40,774 If you want something, ask the nurse to call me. 824 00:40:43,777 --> 00:40:46,111 Take a deep, slow breath, Ian. 825 00:40:46,112 --> 00:40:48,948 They asked for nebulization, 5 of Salbutamol and 125 of Solumedrol IV. 826 00:40:49,407 --> 00:40:50,450 Excellent. 827 00:40:50,575 --> 00:40:52,369 Keep an eye out and introduce him to Dr. Langdon. 828 00:40:52,577 --> 00:40:54,120 - He is well. - Excellent. 829 00:40:54,704 --> 00:40:56,581 See you at screening as soon as it stabilizes. 830 00:40:56,831 --> 00:40:57,874 Yes. 831 00:40:58,750 --> 00:40:59,792 Let's get this out. 832 00:40:59,793 --> 00:41:00,959 Stay strong, Ian. 833 00:41:00,960 --> 00:41:02,337 This should help with your asthma. 834 00:41:12,931 --> 00:41:13,972 How can I help? 835 00:41:13,973 --> 00:41:15,475 I'm looking for Dr. Langdon. 836 00:41:15,600 --> 00:41:16,810 Let me see where he is. 837 00:41:20,939 --> 00:41:23,692 Dr. Langdon, there's a medical student looking for you. 838 00:41:25,944 --> 00:41:27,237 Understood. He's coming. 839 00:41:27,737 --> 00:41:28,780 Thanks. 840 00:41:30,198 --> 00:41:32,826 Hi, Sleepy. You missed a pretty cool fasciotomy. 841 00:41:34,077 --> 00:41:36,370 I don't know if I would describe a fasciotomy how cool. 842 00:41:36,371 --> 00:41:38,331 I would describe, if you had done it. 843 00:41:39,499 --> 00:41:42,002 How are you in the waiting room? 844 00:41:44,504 --> 00:41:46,089 Do you know anything about Dr. McKay? 845 00:41:47,757 --> 00:41:52,470 I've been here less than two hours. I don't know anyone, including you. 846 00:41:53,304 --> 00:41:55,432 I thought it was some kind of child genius. 847 00:41:55,974 --> 00:41:57,809 I'm like any student of medicine. 848 00:41:58,268 --> 00:41:59,310 It can be seen. 849 00:42:01,438 --> 00:42:03,857 I'm just trying to break the ice, I don't want to irritate you. 850 00:42:04,774 --> 00:42:07,819 But you're still calling me Sleepy and I asked not to call. 851 00:42:08,111 --> 00:42:09,487 Serious? Are you still at it? 852 00:42:09,904 --> 00:42:10,947 I still am. 853 00:42:12,907 --> 00:42:14,993 Yeah, okay, sorry. 854 00:42:16,077 --> 00:42:18,163 I didn't imagine that the genius was so sensitive. 855 00:42:20,540 --> 00:42:21,583 But I understand. 856 00:42:21,833 --> 00:42:23,585 Big brain, big emotions. 857 00:42:23,752 --> 00:42:24,794 It makes a lot of sense. 858 00:42:25,211 --> 00:42:26,296 I'll try to take it easier. 859 00:42:30,175 --> 00:42:36,306 Twenty dollars and one of them gets slapped before the shift ends. 860 00:42:37,557 --> 00:42:39,976 I think this one is tougher than it seems. 861 00:42:50,945 --> 00:42:52,905 We take turns every few minutes, stop. 862 00:42:52,906 --> 00:42:54,616 - I am fine. - Hold compressions. 863 00:42:57,077 --> 00:42:58,203 Still in asystole. 864 00:42:58,870 --> 00:42:59,913 Resume compressions. 865 00:43:01,373 --> 00:43:02,415 Are we going to clash? 866 00:43:02,582 --> 00:43:03,708 In asystole there is no use. 867 00:43:04,125 --> 00:43:06,211 - It could be fine ventricular fibrillation. - It cannot. 868 00:43:07,253 --> 00:43:09,463 Right, When was the last epinephrine? 869 00:43:09,464 --> 00:43:12,091 - Three minutes ago. - The ACLS protocol indicates 3 to 5 minutes, 870 00:43:12,092 --> 00:43:13,343 then we will do another cycle. 871 00:43:14,344 --> 00:43:15,387 - Right. -Robby, 872 00:43:15,970 --> 00:43:18,097 Mr. Spencer's children are looking for you 873 00:43:18,098 --> 00:43:20,641 and Nick Bradley's parents, the case of fentanyl overdose, 874 00:43:20,642 --> 00:43:22,018 they want to talk to you too. 875 00:43:22,686 --> 00:43:24,979 Three ampoules of epinephrine and then we close. 876 00:43:26,064 --> 00:43:28,816 Mr. Spencer is at the limit of BiPAP, 25 for 10. 877 00:43:28,817 --> 00:43:30,902 - What about saturation? - Not good, just above 80. 878 00:43:34,698 --> 00:43:36,281 Hi, They said they wanted to talk to me. 879 00:43:36,282 --> 00:43:37,909 Yeah, This alarm keeps going off. 880 00:43:38,159 --> 00:43:39,327 Shall we go out for a bit? 881 00:43:41,287 --> 00:43:43,081 The alarm indicates low oxygenation. 882 00:43:43,540 --> 00:43:45,291 He needs more of that, of BiPAP? 883 00:43:45,917 --> 00:43:47,711 Unfortunately, we are already at maximum. 884 00:43:47,919 --> 00:43:49,461 So the decision at this point is... 885 00:43:49,462 --> 00:43:51,589 We want them to bring our father on the respirator. 886 00:43:54,467 --> 00:43:57,178 Even if it goes against his wishes of not being intubated? 887 00:43:58,596 --> 00:43:59,723 We can't let him go. 888 00:44:01,141 --> 00:44:03,435 And is your father there? 889 00:44:05,645 --> 00:44:07,272 He was a stubborn son of a bitch 890 00:44:07,480 --> 00:44:09,315 who would never have given up on us. 891 00:44:09,566 --> 00:44:10,859 We won't give up on him. 892 00:44:12,527 --> 00:44:15,905 Are you sure you want to do this? after everything I explained? 893 00:44:20,994 --> 00:44:23,705 It may be that I need to honor his advance directive. 894 00:44:25,457 --> 00:44:28,710 No, you have to honor our power of attorney for healthcare. 895 00:44:29,502 --> 00:44:32,255 Otherwise we can talk to the lawyer from the hospital. 896 00:44:35,258 --> 00:44:36,509 Are you in agreement with this? 897 00:44:37,886 --> 00:44:39,137 I am, I think. 898 00:44:41,473 --> 00:44:43,558 Okay, you can have it until we're ready. 899 00:44:44,142 --> 00:44:45,643 - And when will it be? - Soon. 900 00:44:58,073 --> 00:45:00,449 Please don't tell me you're going to intubate this poor guy. 901 00:45:00,450 --> 00:45:03,870 - It's what the family wants. - So what? Do they want to torture him? 902 00:45:04,245 --> 00:45:05,372 I explained all of this. 903 00:45:07,082 --> 00:45:10,126 If I sign too, you can void their power of attorney. 904 00:45:10,502 --> 00:45:12,336 They threatened to speak to the lawyer from the hospital. 905 00:45:12,337 --> 00:45:14,839 Call the ethics committee, will agree with us. 906 00:45:14,964 --> 00:45:17,425 You're right, but we don't have time. 907 00:45:18,009 --> 00:45:19,052 Our hands are tied. 908 00:45:19,928 --> 00:45:22,222 - What are you talking about? - Shit. 909 00:45:24,849 --> 00:45:25,892 What? 910 00:45:26,393 --> 00:45:28,937 I have to tell them that their son is in brain death. 911 00:45:30,355 --> 00:45:31,439 Do you want me to go with you? 912 00:45:32,065 --> 00:45:33,858 - No, it's okay. - What are you going to say? 913 00:45:33,983 --> 00:45:35,609 I'll say it's likely, 914 00:45:35,610 --> 00:45:38,947 but we have to do an apnea test and a brain perfusion exam. 915 00:45:40,281 --> 00:45:42,199 He has no activity cerebral. 916 00:45:42,200 --> 00:45:43,326 They need hope. 917 00:45:44,035 --> 00:45:45,078 A false hope. 918 00:45:45,870 --> 00:45:47,163 - Hope is hope. - It will be? 919 00:45:47,914 --> 00:45:49,708 Are we praying for miracles today? 920 00:45:51,835 --> 00:45:54,421 They need time to process everything before accepting. 921 00:45:56,214 --> 00:45:58,967 Have you ever thought about following that advice? 922 00:46:00,010 --> 00:46:01,386 "Physician, heal yourself." 923 00:46:02,762 --> 00:46:03,847 Don't you have patients? 924 00:46:25,577 --> 00:46:28,955 No, no, no. People wake up from comas. 925 00:46:29,581 --> 00:46:30,623 You can wake him up. 926 00:46:31,666 --> 00:46:34,209 You can do this, you can shock, 927 00:46:34,210 --> 00:46:36,046 you can bring it back. 928 00:46:42,177 --> 00:46:43,219 Nick. 929 00:46:53,021 --> 00:46:56,775 - Hey, hey, hey. - Nick, please don't! 930 00:47:00,153 --> 00:47:01,196 Nick! 931 00:47:01,946 --> 00:47:03,490 No! 932 00:48:09,139 --> 00:48:10,181 No change. 933 00:48:11,224 --> 00:48:14,644 No pericardial effusion, without tension pneumothorax, 934 00:48:14,936 --> 00:48:15,937 no cardiac activity. 935 00:48:16,688 --> 00:48:18,815 Try to replace calcium. It could be hyperkalemia. 936 00:48:18,940 --> 00:48:20,525 No, potassium is normal. 937 00:48:21,317 --> 00:48:22,861 - Ready to wrap up? - Not yet. 938 00:48:23,486 --> 00:48:25,321 Dr. Robby said three cycles of epinephrine. 939 00:48:25,572 --> 00:48:26,906 Let's make another ampoule. 940 00:48:27,115 --> 00:48:28,158 This might work. 941 00:48:31,453 --> 00:48:32,495 Let's go. 942 00:50:07,298 --> 00:50:09,300 Winicius Sturm