1 00:00:14,014 --> 00:00:15,056 - Robby. - Hi. 2 00:00:16,474 --> 00:00:19,477 Cellulite on the back of the foot, now going up the leg. 3 00:00:20,311 --> 00:00:22,564 Hi, I'm Dr. Robby. May I take a look at it? 4 00:00:24,024 --> 00:00:25,400 How long do you think it will take? 5 00:00:25,483 --> 00:00:26,776 Leave early for lunch. 6 00:00:28,028 --> 00:00:30,488 I don't know if you can do it go back to work today. 7 00:00:31,197 --> 00:00:33,992 Erythema and heat up to half of the knee. When did you answer her, Donnie? 8 00:00:34,075 --> 00:00:35,118 Not him, I answered. 9 00:00:36,494 --> 00:00:37,829 - When? - About four hours ago. 10 00:00:37,912 --> 00:00:40,623 I gave a dose of cephalexin and said for her to come back if it got worse. 11 00:00:40,957 --> 00:00:42,292 And it really got worse. 12 00:00:43,084 --> 00:00:44,627 - Dana, what do we have free? - Trauma 2. 13 00:00:44,753 --> 00:00:47,589 Jesse, take her to trauma 2 and I want vancomycin and blood cultures. 14 00:00:47,672 --> 00:00:49,257 - Understood, boss. - I'll go along. 15 00:00:49,424 --> 00:00:50,467 Feel free. 16 00:00:51,718 --> 00:00:53,511 Santos, do you want to join trauma 2? 17 00:00:54,846 --> 00:00:56,556 Many medical records, little time. 18 00:00:57,932 --> 00:00:59,642 62 year old man. 19 00:01:00,101 --> 00:01:02,687 Presents chief complaint of left lumbar pain. 20 00:01:02,812 --> 00:01:04,063 Considering the diagnosis... 21 00:01:04,147 --> 00:01:05,190 - Hey. - Jesus Christ! 22 00:01:05,565 --> 00:01:07,442 - I'm filling out a medical record. - Sorry. 23 00:01:10,028 --> 00:01:12,655 - Did I do something wrong? - Besides interrupting me? Probably. 24 00:01:12,822 --> 00:01:14,240 Then I apologize. 25 00:01:14,866 --> 00:01:17,952 I know that the 2nd year of residency can be stressful, 26 00:01:18,411 --> 00:01:19,913 so if I can help with something... 27 00:01:21,789 --> 00:01:23,750 - Like, stop talking. Right. - Great idea. 28 00:01:25,001 --> 00:01:28,838 Considered the diagnosis of aneurysm or aortic dissection. 29 00:01:28,922 --> 00:01:30,381 I have a new one for you at 13. 30 00:01:30,715 --> 00:01:32,175 I'm 20 late records 31 00:01:32,258 --> 00:01:34,844 and the new doctor in charge is threatening to repeat my year 32 00:01:34,928 --> 00:01:36,346 - if I don't catch up. - Poor thing. 33 00:01:36,429 --> 00:01:38,765 Elderly woman with a lot of abdominal pain. Someone needs to answer. 34 00:01:38,848 --> 00:01:40,600 Dana, please help me with this. 35 00:01:40,683 --> 00:01:43,645 Holiday weekend, Westbridge closed and waiting room crowded. 36 00:01:43,728 --> 00:01:46,856 I'm sorry, your records will have You have to wait until the end of your shift. 37 00:01:47,607 --> 00:01:48,650 Ogilvie. 38 00:01:49,025 --> 00:01:51,945 Dr. Santos needs you to see a new patient on 13. 39 00:01:53,571 --> 00:01:54,739 Yes, ma'am. I am going. 40 00:01:56,866 --> 00:01:59,410 Complete while supervising. It's the most I can do. 41 00:02:03,331 --> 00:02:05,959 Her generation does lots of kitties like this. 42 00:02:06,042 --> 00:02:07,752 This is how they help each other. 43 00:02:08,002 --> 00:02:10,255 - Doctor, tell him. - Your wife is right. 44 00:02:10,755 --> 00:02:12,799 Staying here will be more expensive than we can afford. 45 00:02:13,174 --> 00:02:14,551 Look, I'm feeling better. 46 00:02:14,801 --> 00:02:16,261 - No. - I'm leaving. 47 00:02:16,386 --> 00:02:19,222 Mr. Diaz, even if your blood sugar has normalized, 48 00:02:19,305 --> 00:02:21,266 we need to continue with insulin infusion 49 00:02:21,349 --> 00:02:23,434 until we eliminate ketones of the bloodstream. 50 00:02:23,518 --> 00:02:25,853 Otherwise, you can present electrolyte disturbances 51 00:02:25,937 --> 00:02:27,313 and heart and kidney problems. 52 00:02:28,523 --> 00:02:30,108 Your health is what matters. 53 00:02:30,483 --> 00:02:31,526 Let's make a deal. 54 00:02:32,067 --> 00:02:33,862 Agree to continue treatment with insulin 55 00:02:33,945 --> 00:02:37,198 and we will discuss reduction options costs with our case manager. 56 00:02:37,281 --> 00:02:38,324 Combined. 57 00:02:38,491 --> 00:02:40,702 And I stay here, just in case let him be quiet. 58 00:02:41,202 --> 00:02:42,245 I should look for Ana. 59 00:02:43,121 --> 00:02:44,164 I find her. 60 00:02:44,454 --> 00:02:45,498 I'll be right back. 61 00:02:48,084 --> 00:02:49,127 Vanco administered. 62 00:02:49,210 --> 00:02:50,253 What is Vanco? 63 00:02:50,628 --> 00:02:53,089 A very strong antibiotic to eliminate bacteria from the skin. 64 00:02:53,173 --> 00:02:55,591 - Do you need help? - No, we're fine. 65 00:02:55,675 --> 00:02:56,718 I'll just watch. 66 00:02:57,552 --> 00:02:58,636 Pretend I'm not even here. 67 00:02:58,803 --> 00:03:02,557 Let's ask for a complete blood count, blood cultures and metabolic panel. 68 00:03:02,765 --> 00:03:05,643 And also lactic acid, CRP and calcitonin. 69 00:03:05,727 --> 00:03:08,646 Wait, she's not feverish nor tachycardic, no signs of SIRS. 70 00:03:09,564 --> 00:03:10,940 - �. - What is SIRS? 71 00:03:11,232 --> 00:03:13,359 Response syndrome systemic inflammatory disease. 72 00:03:14,819 --> 00:03:15,862 Sorry. 73 00:03:15,945 --> 00:03:17,405 An exaggerated defense reaction. 74 00:03:17,488 --> 00:03:18,531 Sorry, a what? 75 00:03:18,615 --> 00:03:21,117 Sometimes the human body can have an exaggerated reaction 76 00:03:21,201 --> 00:03:22,911 to an infection, then we will monitor you 77 00:03:22,994 --> 00:03:24,579 to make sure it doesn't get worse. 78 00:03:27,290 --> 00:03:28,708 He's my boss. 79 00:03:28,791 --> 00:03:30,001 Sorry, I have to answer 80 00:03:30,084 --> 00:03:31,377 - otherwise he will fire me. - Right. 81 00:03:32,879 --> 00:03:33,922 Al�. 82 00:03:34,422 --> 00:03:36,174 No, I'm still in the hospital. 83 00:03:37,716 --> 00:03:39,260 They are assisting me now. 84 00:03:40,553 --> 00:03:42,680 No, they're done to give a needle. 85 00:03:43,640 --> 00:03:44,849 I don't know. 86 00:03:45,892 --> 00:03:46,935 Do you want to talk to them? 87 00:03:48,478 --> 00:03:50,021 They're kind of busy right now. 88 00:03:50,897 --> 00:03:52,023 I know you are too. 89 00:03:52,649 --> 00:03:53,691 Second access ready. 90 00:03:54,234 --> 00:03:55,652 No, I'm not exaggerating. 91 00:03:55,735 --> 00:03:57,278 It's my body that's overreacting. 92 00:03:58,696 --> 00:04:00,323 Please don't fire me, I... 93 00:04:01,491 --> 00:04:04,994 This is Dr. Michael Robinavitch. Sou the head of the PTMC emergency room. 94 00:04:05,078 --> 00:04:08,706 If you fire her, she will sue you and I will testify on her behalf. 95 00:04:10,041 --> 00:04:11,084 All good. 96 00:04:12,252 --> 00:04:13,753 Don't worry, we will take care of you. 97 00:04:19,007 --> 00:04:21,010 Do you know how long Will Jackson be unconscious? 98 00:04:21,094 --> 00:04:24,222 It is not possible to predict exactly with the sedatives we use, 99 00:04:24,305 --> 00:04:26,015 but he should wake up soon. 100 00:04:26,099 --> 00:04:27,475 Have you spoken to your parents yet? 101 00:04:27,558 --> 00:04:29,060 Now, they're coming back from Columbus. 102 00:04:29,227 --> 00:04:32,522 Maybe you should rest a little while until they arrive. 103 00:04:32,939 --> 00:04:34,607 The cafeteria is at the end of the corridor. 104 00:04:34,816 --> 00:04:36,859 The cheese sandwich is good. The tuna one, forget it. 105 00:04:37,193 --> 00:04:38,653 Thank you, but I'm not hungry. 106 00:04:39,279 --> 00:04:42,991 I can't believe a security guard from campus gave my brother a shock. 107 00:04:43,324 --> 00:04:46,286 Shouldn't they help and protect the students instead of shooting them? 108 00:04:46,869 --> 00:04:50,999 You have every right to be mad and you should certainly go after the person responsible. 109 00:04:51,207 --> 00:04:53,126 But now we are taking care of your brother. 110 00:04:53,835 --> 00:04:55,586 And you should take care of yourself too. 111 00:04:56,671 --> 00:04:57,714 I have your number. 112 00:04:57,797 --> 00:05:00,383 Notification as soon as the result is out Jackson's lumbar puncture 113 00:05:00,466 --> 00:05:01,509 or if he wakes up. 114 00:05:02,385 --> 00:05:03,428 Okay. 115 00:05:04,178 --> 00:05:05,221 Okay, thank you. 116 00:05:05,346 --> 00:05:06,389 You're welcome. 117 00:05:09,475 --> 00:05:11,811 Decreased bowel sounds and soft abdomen 118 00:05:11,894 --> 00:05:14,355 with moderate sensitivity in the lower left quadrant. 119 00:05:14,439 --> 00:05:17,400 Mrs. Randolph, Do you take Percocet every day? 120 00:05:17,567 --> 00:05:18,568 No. 121 00:05:19,569 --> 00:05:21,446 - And do you drink a lot of water? Because... - Wait. 122 00:05:22,196 --> 00:05:24,699 The lady said who doesn't take Percocet every day, 123 00:05:24,782 --> 00:05:26,451 but when was the last time who took? 124 00:05:26,659 --> 00:05:29,829 I think three or four times last week. 125 00:05:29,996 --> 00:05:32,415 - Right. - The nursing home held a competition 126 00:05:32,498 --> 00:05:35,293 ballroom dancing and I hurt my back. 127 00:05:36,085 --> 00:05:37,503 Any more questions, Ogilvie? 128 00:05:40,131 --> 00:05:41,632 When was your last bowel movement? 129 00:05:43,593 --> 00:05:46,012 I don't know, I think last week. 130 00:05:46,262 --> 00:05:49,349 It's been about five or six days that I don't go to the bathroom. 131 00:05:50,224 --> 00:05:52,602 Painkillers can cause constipation. 132 00:05:52,685 --> 00:05:53,728 I know. 133 00:05:53,978 --> 00:05:57,899 That's why they gave me a laxative and then they tried an enema. 134 00:05:57,982 --> 00:05:59,650 - And nothing yet? - Nothing. 135 00:05:59,942 --> 00:06:02,904 And then they gave me a horrible drink. 136 00:06:03,196 --> 00:06:04,238 Magnesium citrate. 137 00:06:04,822 --> 00:06:07,200 That's magnesium citrate. 138 00:06:08,117 --> 00:06:09,369 Made me vomit. 139 00:06:09,494 --> 00:06:10,870 Okay, what's next, Ogilvie? 140 00:06:11,871 --> 00:06:14,290 We will do an x-ray to see how we can help you. 141 00:06:14,374 --> 00:06:15,416 Thanks. 142 00:06:17,043 --> 00:06:18,086 Differential? 143 00:06:18,628 --> 00:06:21,881 Fecal impaction is likely, but with a history of cholecystectomy, 144 00:06:21,964 --> 00:06:23,674 could be obstruction of the small intestine. 145 00:06:23,758 --> 00:06:24,801 Or worse. 146 00:06:25,301 --> 00:06:26,344 Sigmoid valve? 147 00:06:27,428 --> 00:06:30,890 But this is a surgical emergency. Wouldn't she feel a lot of pain? 148 00:06:31,224 --> 00:06:33,810 Not always, especially when you are in your 80s. 149 00:06:40,191 --> 00:06:43,444 I'm getting worried. It was a millimeter over the limit. 150 00:06:44,445 --> 00:06:45,655 Or my brand was crooked. 151 00:06:45,738 --> 00:06:46,781 Has the pain increased? 152 00:06:47,198 --> 00:06:48,241 Okay, sorry. 153 00:06:48,491 --> 00:06:49,700 Let's try 4mg of morphine. 154 00:06:49,784 --> 00:06:53,079 Leukocyte count only at 10 thousand. For SIRS it has to be above 12 thousand. 155 00:06:53,287 --> 00:06:54,831 There are other criteria. 156 00:06:54,956 --> 00:06:56,165 Still no fever. 157 00:06:56,249 --> 00:06:57,792 Did you ask if she had ever had MRSA? 158 00:06:57,875 --> 00:07:00,128 Not specifically, but she was never hospitalized. 159 00:07:00,253 --> 00:07:01,462 Is there a sign of immunosuppression? 160 00:07:01,546 --> 00:07:03,047 - No. Never. - Use of steroids? 161 00:07:03,548 --> 00:07:05,049 Maximum heart rate, it's 89. 162 00:07:05,133 --> 00:07:07,552 - Is this good? - That's good, very good. 163 00:07:08,344 --> 00:07:09,387 Keep it. 164 00:07:09,470 --> 00:07:10,555 Monitor closely. 165 00:07:10,888 --> 00:07:13,724 Any change in her condition, call me. Any change at all. 166 00:07:17,061 --> 00:07:18,104 Roxie Hamler, 42 years old, 167 00:07:18,187 --> 00:07:19,647 home palliative care, 168 00:07:19,730 --> 00:07:21,023 history of lung cancer. 169 00:07:21,149 --> 00:07:24,068 Technical-clinical convulsive crisis recent and pain in the right leg. 170 00:07:24,485 --> 00:07:25,778 She knocked on the coffee table. 171 00:07:28,197 --> 00:07:30,158 Initially non-verbal, recovering now. 172 00:07:30,241 --> 00:07:32,618 It is normal after a seizure. Hi, I'm Dr. Al-Hashimi. 173 00:07:32,702 --> 00:07:33,911 - Do you need help? - No. 174 00:07:33,995 --> 00:07:35,037 Did she hit her head? 175 00:07:35,121 --> 00:07:36,664 No, I was there and I held her. 176 00:07:36,956 --> 00:07:38,749 - No venous access? - I couldn't apply. 177 00:07:38,832 --> 00:07:41,002 I gave 4mg of midazolam intramuscular for seizure 178 00:07:41,085 --> 00:07:42,587 - and 25 of fentanyl for pain. - Right. 179 00:07:42,670 --> 00:07:43,880 - Dana, where to? - Trauma 1. 180 00:07:43,963 --> 00:07:44,964 This way. 181 00:07:45,089 --> 00:07:46,883 I haven't seen you for a long time. 182 00:07:47,758 --> 00:07:49,302 Coming from the penitentiary JonesForge. 183 00:07:50,386 --> 00:07:51,554 I was supposed to go to Westbridge, 184 00:07:51,637 --> 00:07:53,973 - but they redirected it to you. - Yeah, you and everyone. 185 00:07:54,056 --> 00:07:55,808 Princess, I need you at center 9. 186 00:07:55,892 --> 00:07:57,268 - I'm going. -Gus Varney, 187 00:07:57,351 --> 00:07:59,770 54 years old, victim of aggression, multiple blunt traumas. 188 00:07:59,896 --> 00:08:01,939 Bruises on the face, on the right chest 189 00:08:02,023 --> 00:08:03,691 and 10cm laceration in the left arm. 190 00:08:03,774 --> 00:08:07,612 Pressure, 136 by 84, pulse, 102, good saturation, 95 on room air. 191 00:08:08,070 --> 00:08:09,530 How are you feeling, Mr Varney? 192 00:08:09,780 --> 00:08:11,032 - It sucks. - Where? 193 00:08:11,115 --> 00:08:12,158 All. 194 00:08:12,241 --> 00:08:14,368 I'm Dr. Robby. This is Dr. Al-Hashimi. 195 00:08:14,452 --> 00:08:15,745 We'll give you something for pain. 196 00:08:15,828 --> 00:08:17,163 I have progressive cellulite. 197 00:08:17,246 --> 00:08:18,372 - Come on, I'll solve it here. - It cost. 198 00:08:19,582 --> 00:08:21,334 Gus, do you know who hurt you? 199 00:08:21,834 --> 00:08:24,128 One of the honored citizens and honest people from block 6. 200 00:08:24,295 --> 00:08:27,089 It's a deep laceration in the muscular fascia. 201 00:08:27,173 --> 00:08:28,216 We can take off the handcuffs 202 00:08:28,299 --> 00:08:29,842 - when he calms down? - No way. 203 00:08:29,926 --> 00:08:30,968 Orange jumpsuit. 204 00:08:31,052 --> 00:08:33,011 - There's a reason he's in handcuffs. - Let's go. 205 00:08:42,480 --> 00:08:44,480 ADAPTATION | REVIEW | SYNCHRONY: EMAIL | loschulosteam@gmail.com 206 00:08:44,482 --> 00:08:47,401 Alright, guys, no three. 207 00:08:47,944 --> 00:08:49,320 One, two... 208 00:08:49,403 --> 00:08:50,446 Wait. 209 00:08:54,492 --> 00:08:55,535 Go. 210 00:08:55,618 --> 00:08:57,537 One, two, three. 211 00:08:58,412 --> 00:08:59,455 Mel, E-FAST. 212 00:08:59,580 --> 00:09:01,082 Whitaker, primary assessment. 213 00:09:01,165 --> 00:09:02,208 It can leave. 214 00:09:07,547 --> 00:09:08,714 What a strange bruise. 215 00:09:08,965 --> 00:09:10,550 - Did he fall on something? - Footprint. 216 00:09:10,633 --> 00:09:12,260 - He was trampled. - Jesus. 217 00:09:14,470 --> 00:09:16,889 - Do you really need this? - Unfortunately, yes. 218 00:09:18,432 --> 00:09:20,184 Private airways. 219 00:09:21,310 --> 00:09:22,979 Left lung ventilating well. 220 00:09:24,438 --> 00:09:26,274 Sorry, right too. 221 00:09:26,399 --> 00:09:27,441 How are the lungs? 222 00:09:28,025 --> 00:09:30,695 Good breath sounds. No crackling. 223 00:09:30,778 --> 00:09:31,821 No spillage. 224 00:09:31,946 --> 00:09:32,989 Saturation, 97, 225 00:09:33,072 --> 00:09:35,032 pressure, 118 by 78, heart rate, 112. 226 00:09:35,116 --> 00:09:37,285 - Tachycardic because of pain. - Four of morphine. 227 00:09:37,368 --> 00:09:38,536 - Repeat if necessary. - Right. 228 00:09:38,953 --> 00:09:40,955 Okay, swollen jaw. 229 00:09:41,205 --> 00:09:42,456 Open your mouth for me, Gus. 230 00:09:42,915 --> 00:09:44,125 A little more. 231 00:09:44,292 --> 00:09:45,334 - It doesn't work. - Whitaker, 232 00:09:45,418 --> 00:09:46,961 Know the blade test of language? 233 00:09:47,211 --> 00:09:49,714 - I know. - It is great for jaw fractures. 234 00:09:49,964 --> 00:09:52,425 Gus, bite it hard for me. 235 00:09:55,761 --> 00:09:57,597 Sorry, Gus. Positive test. 236 00:09:58,764 --> 00:10:00,141 No free fluid in the abdomen. 237 00:10:00,224 --> 00:10:02,685 - How long do you think it will take? - It's still too early to say. 238 00:10:02,768 --> 00:10:05,229 - Whitaker, your assessment? - Fracture in the left jaw, 239 00:10:05,313 --> 00:10:06,731 multiple rib fractures, 240 00:10:07,523 --> 00:10:08,899 complex laceration on the forearm. 241 00:10:09,066 --> 00:10:10,985 Turn it to the left and take him to the CT scan. 242 00:10:11,068 --> 00:10:13,154 Where were you When was Mr. Varney attacked? 243 00:10:13,279 --> 00:10:14,572 Just transport, I don't know them. 244 00:10:14,780 --> 00:10:15,990 The atom is ready for us. 245 00:10:16,324 --> 00:10:17,366 Repeating the pressure. 246 00:10:17,992 --> 00:10:20,661 The redness is one centimeter above the line. 247 00:10:20,745 --> 00:10:22,121 It could be a bubble forming. 248 00:10:22,204 --> 00:10:25,249 - Vancomycin takes time to take effect. - Vital signs are still stable, 249 00:10:25,333 --> 00:10:26,709 122 by 78. 250 00:10:27,043 --> 00:10:28,085 I answer. 251 00:10:28,252 --> 00:10:29,545 How are you feeling, Debbie? 252 00:10:31,130 --> 00:10:34,133 - I'm feeling a little hot. - It can happen with vancomycin. 253 00:10:34,216 --> 00:10:35,259 Thanks, man. 254 00:10:36,177 --> 00:10:37,803 Lactic acid, 4.2. 255 00:10:38,638 --> 00:10:39,805 Okay. 256 00:10:39,972 --> 00:10:41,015 Wait, what was it? 257 00:10:41,182 --> 00:10:43,684 This could be a sign of a more serious infection, 258 00:10:43,809 --> 00:10:46,020 but the good news It's just that we know what to do. Jesse, 259 00:10:46,103 --> 00:10:48,147 two liters of lactated ringer fully open. 260 00:10:49,148 --> 00:10:50,358 - This is severe sepsis. - I know, 261 00:10:50,441 --> 00:10:52,068 but at 7am it was simple cellulite. 262 00:10:52,151 --> 00:10:53,819 Anyone would have gave her cephalexin. 263 00:10:53,944 --> 00:10:55,571 Can we add carbapenems or Zosyn 264 00:10:55,655 --> 00:10:57,907 - to expand our antibiotic coverage. - I agree. 265 00:10:57,990 --> 00:10:59,033 Thanks. 266 00:10:59,533 --> 00:11:02,453 Jesse, 1g of meropenem, 900mg clindamycin 267 00:11:02,536 --> 00:11:04,288 and call Dr. Garcia, please. 268 00:11:04,538 --> 00:11:07,333 - What's going on? - We are adding new antibiotics. 269 00:11:07,458 --> 00:11:08,584 Is it serious? 270 00:11:08,668 --> 00:11:11,295 We want to prevent and guarantee that it doesn't turn into something serious. 271 00:11:13,339 --> 00:11:15,633 - What else can I do? - I think you've done enough. 272 00:11:15,716 --> 00:11:16,759 You can go. 273 00:11:20,429 --> 00:11:21,472 Everything okay there? 274 00:11:21,555 --> 00:11:22,598 Sepsis code. 275 00:11:22,682 --> 00:11:23,724 Stable for now. 276 00:11:24,058 --> 00:11:25,101 And you? 277 00:11:25,184 --> 00:11:27,645 Perfect vital signs, E-FAST negative, going to CT. 278 00:11:27,728 --> 00:11:28,771 Great. 279 00:11:28,854 --> 00:11:29,897 Keep me informed. 280 00:11:30,272 --> 00:11:31,315 Idem. 281 00:11:35,569 --> 00:11:36,612 How's it going? 282 00:11:36,904 --> 00:11:38,864 Great, if you ignore the mess in the waiting room. 283 00:11:38,948 --> 00:11:40,574 News about our abandoned baby? 284 00:11:40,658 --> 00:11:43,703 Security is reviewing cameras from last night and this morning. 285 00:11:45,955 --> 00:11:49,333 - Have you already kissed and made up? - I think someone needs to smoke a cigarette. 286 00:11:49,417 --> 00:11:51,919 - I'm trying to stop. - Why not stop when I travel? 287 00:11:52,002 --> 00:11:53,963 - Everyone is happy to have returned. - Idiot. 288 00:11:54,046 --> 00:11:55,589 Well, not all. 289 00:11:57,883 --> 00:11:59,301 Want to join the betting board? 290 00:12:00,177 --> 00:12:02,930 You just need to choose why did the Westbridge stop, 291 00:12:03,222 --> 00:12:06,058 how many of their patients will we receive and when they will work again. 292 00:12:06,600 --> 00:12:08,936 Hey, we're already at $500. 293 00:12:10,604 --> 00:12:13,190 It won't work, I'm still paying rehabilitation bills. 294 00:12:13,858 --> 00:12:14,900 Respect. 295 00:12:17,361 --> 00:12:18,404 All good. 296 00:12:18,529 --> 00:12:20,406 What are the rules to change my bet? 297 00:12:20,489 --> 00:12:22,241 Only if you double the bet. 298 00:12:24,702 --> 00:12:25,745 Sinkhole. 299 00:12:28,956 --> 00:12:30,249 You watch a lot of movies. 300 00:12:32,418 --> 00:12:36,255 It was considered a diagnosis aortic aneurysm or dissection, 301 00:12:36,338 --> 00:12:37,840 but the ultrasound at the site of... 302 00:12:37,923 --> 00:12:39,258 Don't you want grandma to be clogged up anymore? 303 00:12:40,092 --> 00:12:42,845 I ordered an acute abdominal series to rule out obstruction. 304 00:12:42,928 --> 00:12:44,054 I'm waiting for the x-ray. 305 00:12:44,138 --> 00:12:47,141 Then you are free to deal with what is newer and better on the south 16. 306 00:12:47,391 --> 00:12:48,517 What's up, D.? 307 00:12:48,642 --> 00:12:51,187 Every time I get a little time to make a medical record, 308 00:12:51,270 --> 00:12:53,147 - I start a sentence and you... - Does it get in the way? 309 00:12:54,106 --> 00:12:55,149 What a pity for you, 310 00:12:55,274 --> 00:12:57,693 But believe me, it's worse still for the poor thing at 16. 311 00:12:58,360 --> 00:13:00,696 I'm starting to find that you like to torture me. 312 00:13:00,905 --> 00:13:02,031 Advantages of this work. 313 00:13:02,823 --> 00:13:03,866 Ogilvie, come on. 314 00:13:07,870 --> 00:13:08,913 Reach out, Louie. 315 00:13:11,373 --> 00:13:12,416 It's a little shaky. 316 00:13:13,083 --> 00:13:14,126 I'm not even surprised. 317 00:13:14,502 --> 00:13:16,170 I've been here since 4am. 318 00:13:16,337 --> 00:13:17,671 We can give you something for that. 319 00:13:17,755 --> 00:13:20,633 Or I can solve this myself if you release me. 320 00:13:21,509 --> 00:13:23,302 Let's give 50mg of Librium to Louie. 321 00:13:23,427 --> 00:13:24,470 I will place the order. 322 00:13:27,556 --> 00:13:29,350 I'll get it straight from the pharmacy. 323 00:13:33,729 --> 00:13:35,773 Since I am the doctor in charge by Louie, 324 00:13:35,856 --> 00:13:37,441 it makes perfect sense I prescribe it. 325 00:13:38,526 --> 00:13:39,735 Yes of course. 326 00:13:45,616 --> 00:13:48,035 Any change with our septic waitress? 327 00:13:48,202 --> 00:13:49,703 - Not yet. - If you have a second... 328 00:13:49,787 --> 00:13:50,830 I don't have it. 329 00:13:50,996 --> 00:13:53,790 But the ultrasound In bed, both tested negative. 330 00:13:54,040 --> 00:13:56,502 I considered the diagnosis of Cauda Equina Syndrome. 331 00:13:56,585 --> 00:13:57,795 Are you writing a novel? 332 00:13:59,171 --> 00:14:01,423 Filling out medical records and supervising. 333 00:14:01,632 --> 00:14:02,675 Dana's idea. 334 00:14:02,967 --> 00:14:04,093 Who is the lucky patient? 335 00:14:04,218 --> 00:14:06,178 Homeless woman with bad cough. 336 00:14:06,262 --> 00:14:07,429 Ogilvie is assisting her. 337 00:14:07,847 --> 00:14:08,889 Okay. 338 00:14:12,768 --> 00:14:14,270 Great, take a deep breath. 339 00:14:14,562 --> 00:14:16,146 Release with force. 340 00:14:16,522 --> 00:14:17,898 Haven't you heard enough? 341 00:14:18,107 --> 00:14:20,192 I have to check if there are any hissing sounds on forced expiration. 342 00:14:25,823 --> 00:14:27,032 This cough is killing me. 343 00:14:27,366 --> 00:14:28,492 Do you smoke, Mrs. Yardley? 344 00:14:28,784 --> 00:14:29,827 Smoke, 345 00:14:29,952 --> 00:14:32,663 but I haven't been able to smoke for a couple of years days because of this cough. 346 00:14:32,746 --> 00:14:33,914 Have you ever thought about stopping? 347 00:14:34,874 --> 00:14:37,459 Have you ever thought in minding your own business? 348 00:14:42,256 --> 00:14:46,552 The good news is that the testing we did tested negative for Covid and influenza, 349 00:14:46,635 --> 00:14:48,178 but I will ask a chest x-ray 350 00:14:48,262 --> 00:14:50,973 to see what's in those lungs. Do you have time for us to do this? 351 00:14:53,058 --> 00:14:55,102 Where do you think I would go? 352 00:14:56,103 --> 00:14:57,479 - And that's it. - Right. 353 00:14:57,563 --> 00:14:59,273 Three grams of Keppra in 10 minutes. 354 00:14:59,356 --> 00:15:01,025 This will prevent another seizure. 355 00:15:01,108 --> 00:15:02,151 Thanks. 356 00:15:02,234 --> 00:15:03,736 Nobody can put serum on her. 357 00:15:04,236 --> 00:15:07,197 �, the central catheter is the best option when the veins are difficult. 358 00:15:07,907 --> 00:15:11,076 Tachycardia, 114, pressure, 94 by 70, 359 00:15:11,160 --> 00:15:12,912 - saturation, 91 with two liters. - It's fine. 360 00:15:13,245 --> 00:15:14,288 Cold. 361 00:15:14,705 --> 00:15:18,334 You can pack a blanket and some socks for her? 362 00:15:18,834 --> 00:15:19,877 Yes, yes. 363 00:15:20,586 --> 00:15:21,879 When was she diagnosed? 364 00:15:22,713 --> 00:15:23,756 Seven years ago. 365 00:15:24,632 --> 00:15:25,716 They removed a wolf. 366 00:15:27,468 --> 00:15:30,512 Four cycles of chemotherapy with platinum they gave us some good years, 367 00:15:30,804 --> 00:15:32,264 but then spread to the bones. 368 00:15:32,389 --> 00:15:33,933 Did she have radiotherapy? 369 00:15:34,516 --> 00:15:36,810 Reduced metastases, but it's still there. 370 00:15:36,936 --> 00:15:38,938 That's why you have palliative care at home. 371 00:15:39,146 --> 00:15:40,689 - �. - I'm very sorry. 372 00:15:41,732 --> 00:15:42,775 Me too. 373 00:15:45,819 --> 00:15:46,862 Sorry. 374 00:15:47,112 --> 00:15:48,155 Do you have children? 375 00:15:48,530 --> 00:15:49,865 We have two boys. 376 00:15:50,908 --> 00:15:52,159 One 15 years old and one 9 years old. 377 00:15:52,993 --> 00:15:54,078 My son is 12. 378 00:15:54,578 --> 00:15:55,621 It goes by quickly. 379 00:15:56,914 --> 00:15:57,957 Very fast. 380 00:15:58,707 --> 00:16:01,001 Swelling and hematoma in the distal tibia. 381 00:16:03,253 --> 00:16:05,798 Gives 50 fentanyl when pressure systolic blood pressure exceeds 100. 382 00:16:06,298 --> 00:16:07,841 What do you Do you usually take it for pain? 383 00:16:11,595 --> 00:16:14,264 MS Contin, 30mg twice a day, 384 00:16:14,682 --> 00:16:15,849 oxycodone for pain 385 00:16:15,933 --> 00:16:19,061 and Actiq sublingual when the situation gets really bad. 386 00:16:20,688 --> 00:16:21,730 It's a lot. 387 00:16:22,064 --> 00:16:23,482 Do you administer her medication? 388 00:16:23,774 --> 00:16:24,817 Sometimes. 389 00:16:25,693 --> 00:16:26,735 Always. 390 00:16:26,902 --> 00:16:29,989 A palliative care nurse goes home a few times a week, 391 00:16:30,072 --> 00:16:32,116 but I was alone when she had the seizure. 392 00:16:32,241 --> 00:16:34,368 They said that this could happen, 393 00:16:34,660 --> 00:16:36,245 but she couldn't breathe. 394 00:16:37,204 --> 00:16:39,206 I panicked and called emergency. 395 00:16:40,124 --> 00:16:41,165 Sorry. 396 00:16:42,459 --> 00:16:43,502 I apologize. 397 00:16:44,586 --> 00:16:45,629 Sorry. 398 00:16:56,098 --> 00:16:58,017 Because of your family income, 399 00:16:58,308 --> 00:17:01,020 you earn a lot to enter in the government health program 400 00:17:01,103 --> 00:17:02,813 or in solidarity care from the hospital. 401 00:17:03,355 --> 00:17:05,607 But we cannot pay the amount of medical assistance. 402 00:17:05,691 --> 00:17:09,819 Unfortunately, it is very common people get a little lost. 403 00:17:09,903 --> 00:17:11,446 It is an imperfect system. 404 00:17:11,530 --> 00:17:13,781 The hospital can help somehow with the costs? 405 00:17:14,157 --> 00:17:16,160 We can offer financial assistance. 406 00:17:16,492 --> 00:17:19,079 You would pay the same as Medicare and Medicaid would charge. 407 00:17:19,788 --> 00:17:20,830 How much is that? 408 00:17:20,914 --> 00:17:23,375 You pay 60%, we cover 40%. 409 00:17:25,002 --> 00:17:26,045 Thanks. 410 00:17:29,423 --> 00:17:30,466 Where were you? 411 00:17:31,341 --> 00:17:32,384 How are you? 412 00:17:32,634 --> 00:17:33,677 Sorry, daughter. 413 00:17:34,136 --> 00:17:36,305 You were being considerate and I lost my mind. 414 00:17:37,264 --> 00:17:41,477 Mrs. Noelle was saying that the hospital will give us a good discount. 415 00:17:41,643 --> 00:17:44,021 We can reduce 40% of your final bill. 416 00:17:44,396 --> 00:17:45,397 That's great. 417 00:17:46,231 --> 00:17:47,649 If I stay here for a few days, 418 00:17:47,816 --> 00:17:49,943 my account may be over of US$ 100 thousand, right? 419 00:17:52,112 --> 00:17:53,238 It can, unfortunately. 420 00:17:53,864 --> 00:17:55,657 It may end up being smaller, 421 00:17:55,741 --> 00:17:58,077 depending on the level of care you need. 422 00:17:58,368 --> 00:17:59,411 Or bigger. 423 00:18:00,412 --> 00:18:03,165 Then we would have to pay US$60 thousand? 424 00:18:04,291 --> 00:18:05,334 Which we don't have. 425 00:18:05,709 --> 00:18:07,711 He has to stay here to improve, right? 426 00:18:08,003 --> 00:18:09,046 - He has. - No. 427 00:18:10,506 --> 00:18:12,007 - What? - I mean, 428 00:18:12,758 --> 00:18:13,842 not necessarily. 429 00:18:13,926 --> 00:18:16,553 We couldn't admit him to the wing medical-surgical instead of the ICU? 430 00:18:16,678 --> 00:18:17,971 Wouldn't it be much cheaper? 431 00:18:18,097 --> 00:18:20,307 They don't accept patients with insulin infusion. 432 00:18:20,432 --> 00:18:22,101 Normally not, 433 00:18:22,184 --> 00:18:24,603 but let me talk with the head nurse upstairs 434 00:18:25,145 --> 00:18:27,481 - and I'll see what she says. - Thanks. 435 00:18:30,692 --> 00:18:32,653 The patient with poisoning food wants to leave 436 00:18:32,736 --> 00:18:34,446 to take the children to the water park. 437 00:18:34,780 --> 00:18:36,657 These places They are a breeding ground for diseases. 438 00:18:37,116 --> 00:18:38,158 Don't even talk to me. 439 00:18:38,325 --> 00:18:40,202 If she is okay with Zofran, can release. 440 00:18:40,369 --> 00:18:43,080 Okay. Louie is on South 15th. The medication is coming. 441 00:18:43,163 --> 00:18:45,499 A few more hours of monitoring and he can leave. 442 00:18:45,582 --> 00:18:47,918 - Straight to the liquor store. - Without thinking twice. 443 00:18:48,001 --> 00:18:50,254 And the case of the rib cage who went up? Any news? 444 00:18:50,379 --> 00:18:52,381 Came out of surgery, recovering, still sedated. 445 00:18:52,589 --> 00:18:54,049 Great, keep me posted. 446 00:18:54,174 --> 00:18:55,217 It can leave. 447 00:18:58,095 --> 00:19:00,597 Three times in the same day. To what do we owe the honor? 448 00:19:00,681 --> 00:19:02,224 I came for a consultation 449 00:19:02,349 --> 00:19:04,893 and to convince Ahmad to open a new betting board. 450 00:19:05,144 --> 00:19:07,104 Why? The frame Is the Westbridge already full? 451 00:19:07,187 --> 00:19:10,190 I was going to ask him to open one from his trip and his midlife crisis. 452 00:19:11,024 --> 00:19:12,192 I give it four weeks. 453 00:19:12,901 --> 00:19:13,902 Seven at most. 454 00:19:15,487 --> 00:19:16,655 Woman of little faith. 455 00:19:16,738 --> 00:19:18,490 It's not faith, it's facts. 456 00:19:18,949 --> 00:19:19,992 Facts? 457 00:19:20,450 --> 00:19:23,162 In my experience, you are the kind that gets sick in seven weeks. 458 00:19:24,079 --> 00:19:26,915 Hey, Robby, a student is with a pickleball player in the north 459 00:19:26,999 --> 00:19:28,750 with possible rupture of the Achilles tendon. 460 00:19:28,876 --> 00:19:30,627 - He's asking for your opinion. - Thanks, Perlah. 461 00:19:30,711 --> 00:19:33,088 At least someone down here have a little faith in me. 462 00:19:35,757 --> 00:19:38,510 Do you know what this sabbatical from Mike Biker really mean? 463 00:19:38,594 --> 00:19:40,888 I never try to guess what's going on in his head. 464 00:19:41,263 --> 00:19:44,016 Three months traveling alone on the road. 465 00:19:44,516 --> 00:19:46,810 He can't stand being alone more than a few hours. 466 00:19:46,894 --> 00:19:48,520 He sleeps with the TV on in the room. 467 00:19:49,813 --> 00:19:51,607 I don't think I needed it know that. 468 00:19:54,484 --> 00:19:56,069 Maybe he is looking for something new 469 00:19:57,112 --> 00:19:58,864 or trying to escape of old ghosts. 470 00:20:00,115 --> 00:20:02,117 �, I hope he find what you are looking for. 471 00:20:03,327 --> 00:20:04,494 He deserves some peace. 472 00:20:05,245 --> 00:20:06,288 Am�m. 473 00:20:06,538 --> 00:20:09,499 I considered the diagnosis Cauda Equina Syndrome, 474 00:20:09,583 --> 00:20:13,128 but the motor and sensory examination From the sacral roots it was intact... 475 00:20:13,212 --> 00:20:14,838 The homeless patient is with pneumonia. 476 00:20:14,922 --> 00:20:16,632 I'm fucking cursed. 477 00:20:17,841 --> 00:20:18,884 Damn. 478 00:20:19,551 --> 00:20:20,594 What? 479 00:20:20,677 --> 00:20:23,513 It is a cavitary lesion in the right upper lobe. 480 00:20:23,972 --> 00:20:25,015 Active tuberculosis. 481 00:20:25,182 --> 00:20:26,225 What to do now? 482 00:20:26,767 --> 00:20:30,145 AFB exam to confirm, take it to a room with negative pressure 483 00:20:30,229 --> 00:20:31,939 and start treatment with medications. 484 00:20:32,022 --> 00:20:34,316 Call control of infections and public health. 485 00:20:34,399 --> 00:20:36,443 And now you will have to register as a patient 486 00:20:36,526 --> 00:20:38,362 and take the QuantiFERON Gold exam. 487 00:20:38,987 --> 00:20:40,572 It's too early to test positive. 488 00:20:40,656 --> 00:20:41,823 Yes, but you were exposed. 489 00:20:41,907 --> 00:20:44,076 Need an exam base and another in eight weeks 490 00:20:44,159 --> 00:20:45,369 to see if there was a conversion. 491 00:20:46,912 --> 00:20:47,955 What if it's positive? 492 00:20:48,038 --> 00:20:50,332 You will take medication every day for three or four months 493 00:20:50,415 --> 00:20:52,918 with regular blood tests to check toxicity. 494 00:20:53,210 --> 00:20:54,378 - Jesus. - All good. 495 00:20:54,461 --> 00:20:55,921 Tell Dana what is happening 496 00:20:56,046 --> 00:20:58,298 and, for the love of God, wear a mask when you take it. 497 00:21:07,641 --> 00:21:09,393 - Dr. Langdon. - What's up, man? Alex. 498 00:21:09,476 --> 00:21:10,519 Let's take a look. 499 00:21:15,857 --> 00:21:16,900 Is it bad? 500 00:21:17,192 --> 00:21:18,819 It's not good. 501 00:21:18,986 --> 00:21:21,530 Sorry, your chart says who burned himself with dry ice. 502 00:21:21,655 --> 00:21:23,490 - What happened? - My idiot brother. 503 00:21:23,740 --> 00:21:24,950 Does he not like you? 504 00:21:25,450 --> 00:21:26,910 I asked him to do this, 505 00:21:27,035 --> 00:21:28,537 but not exactly like that. 506 00:21:28,787 --> 00:21:31,373 - What? Why? - He was going to mark me like I marked him. 507 00:21:32,165 --> 00:21:33,792 To mark? Like cattle? 508 00:21:34,001 --> 00:21:37,087 Instead of branding with a hot iron, you place the iron on dry ice, 509 00:21:37,170 --> 00:21:38,255 let it cool well 510 00:21:38,422 --> 00:21:39,923 and then puts it on your skin. 511 00:21:40,299 --> 00:21:41,341 Cool, right? 512 00:21:41,758 --> 00:21:42,801 You are an idiot. 513 00:21:42,926 --> 00:21:44,052 We'll give you an anesthetic. 514 00:21:44,136 --> 00:21:45,554 I'll get scissors to debride. 515 00:21:48,473 --> 00:21:49,516 Are you okay? 516 00:21:49,808 --> 00:21:50,851 I am. 517 00:21:50,976 --> 00:21:52,019 I'm great. 518 00:21:52,185 --> 00:21:53,228 He is sure? 519 00:21:53,520 --> 00:21:56,023 Looks like Robby isn't very happy that I came back. 520 00:21:57,024 --> 00:21:59,192 Well, he won't be here. 521 00:21:59,609 --> 00:22:01,069 And I'm glad you're back. 522 00:22:01,820 --> 00:22:02,821 Thanks. 523 00:22:07,659 --> 00:22:10,787 Negative head and neck tomography, less for jaw fractures. 524 00:22:12,748 --> 00:22:13,790 Let's get him off the stretcher. 525 00:22:14,041 --> 00:22:16,585 - Turn it to the right side. - We'll need to take off the handcuffs. 526 00:22:20,380 --> 00:22:22,799 Ready. And one, two, three! 527 00:22:22,883 --> 00:22:23,925 Slowly. 528 00:22:25,093 --> 00:22:26,887 Dr. King, How are your chest and belly? 529 00:22:26,970 --> 00:22:29,723 We have three fractures anterior rib 530 00:22:30,140 --> 00:22:32,017 and a small lung contusion. 531 00:22:32,100 --> 00:22:33,143 It's not bad. 532 00:22:33,352 --> 00:22:35,103 When lung contusion does it peak? 533 00:22:35,187 --> 00:22:36,938 - After a few hours. - And we always admit 534 00:22:37,022 --> 00:22:39,191 - for three rib fractures? - In the elderly, yes, 535 00:22:39,274 --> 00:22:40,817 but if the patient can bear the pain 536 00:22:40,901 --> 00:22:42,778 and not need of supplemental oxygen, no. 537 00:22:42,861 --> 00:22:43,904 Great. 538 00:22:44,363 --> 00:22:45,739 He's in a lot of pain here. 539 00:22:45,822 --> 00:22:47,282 Do you think you can make a block 540 00:22:47,407 --> 00:22:48,909 - from the anterior serractile plane? - Of course. 541 00:22:49,701 --> 00:22:51,953 If Dr. Al-Hashimi agrees. 542 00:22:52,037 --> 00:22:53,789 If the patient agrees. 543 00:22:54,581 --> 00:22:58,210 Mr. Varney, we want to give you an injection to numb your broken ribs 544 00:22:58,293 --> 00:22:59,503 and make your breathing easier. 545 00:23:00,462 --> 00:23:02,047 Alright, prepare Mr. Varney. 546 00:23:02,130 --> 00:23:03,340 Dr. Mohan, you take over. 547 00:23:03,632 --> 00:23:05,425 Let's identify the reference points. 548 00:23:05,509 --> 00:23:06,551 The handcuffs. 549 00:23:08,220 --> 00:23:09,721 Okay, take it off, man. 550 00:23:09,805 --> 00:23:11,681 Clearly he won't move alone. 551 00:23:12,933 --> 00:23:16,103 We follow protocol for his safety and yours. 552 00:23:19,606 --> 00:23:20,649 Do you need to answer? 553 00:23:21,316 --> 00:23:22,984 No, it's my mother. 554 00:23:23,735 --> 00:23:26,029 Ignore, just ignore. 555 00:23:26,113 --> 00:23:28,573 - Amen, sister. - Anesthetized forearm, we can irrigate. 556 00:23:28,949 --> 00:23:30,867 If I ignore a problem for quite some time, 557 00:23:30,951 --> 00:23:31,993 It disappears, doesn't it? 558 00:23:32,619 --> 00:23:34,538 I would like of being able to ignore my statement. 559 00:23:34,955 --> 00:23:36,331 This cannot be ignored. 560 00:23:36,957 --> 00:23:38,083 But it'll be okay. 561 00:23:38,250 --> 00:23:40,794 What is it, Whitaker? Roommate problems? 562 00:23:41,211 --> 00:23:42,462 No, not really. 563 00:23:42,671 --> 00:23:45,257 I think I exaggerated with Dr. Langdon before. 564 00:23:45,340 --> 00:23:46,341 Like this? 565 00:23:47,008 --> 00:23:49,886 He would prescribe benzodiazepines for a patient 566 00:23:49,970 --> 00:23:52,848 and I said it would be better if I did that. 567 00:23:53,598 --> 00:23:56,059 I only did this because I already was the doctor in charge. 568 00:23:56,852 --> 00:23:58,186 But now I feel like an asshole. 569 00:23:58,478 --> 00:23:59,729 Langdon is fine. 570 00:23:59,938 --> 00:24:02,732 He went to rehab and is following the program. 571 00:24:03,275 --> 00:24:05,193 We hope that all has already passed. 572 00:24:07,028 --> 00:24:10,282 Place the needle on the plane, superficially to the serratus anterior, 573 00:24:10,365 --> 00:24:12,367 between it and the latissimus dorsi. 574 00:24:13,618 --> 00:24:16,079 You can see the fluid spread and spread... 575 00:24:16,204 --> 00:24:17,539 Dr. Mohan, we need you. 576 00:24:17,622 --> 00:24:19,916 We have two more ambulances from Westbridge arriving. 577 00:24:21,376 --> 00:24:22,419 See, we take over. 578 00:24:22,627 --> 00:24:23,670 Thanks. 579 00:24:24,004 --> 00:24:25,130 How are things here? 580 00:24:25,839 --> 00:24:28,842 The temperature rose to 39 degrees. I gave Tylenol. 581 00:24:29,801 --> 00:24:31,052 Look at her leg. 582 00:24:31,761 --> 00:24:33,180 It's a big bubble. 583 00:24:33,513 --> 00:24:34,848 Has the surgery gone yet? 584 00:24:34,931 --> 00:24:36,766 - Not yet. - Will I need surgery? 585 00:24:36,850 --> 00:24:39,519 Call them again. A Surgery will be a last resort. 586 00:24:39,853 --> 00:24:44,483 We want them to see your leg in case need to remove this infected skin. 587 00:24:44,691 --> 00:24:47,402 I thought it was just swelling because I'm on my feet all day. 588 00:24:49,070 --> 00:24:50,697 The pressure dropped to 85 by 40. 589 00:24:50,822 --> 00:24:52,574 - How much of a ringer has it been? - Full bolus. 590 00:24:52,657 --> 00:24:54,618 Administer another 1L and take norepinephrine. 591 00:24:54,701 --> 00:24:55,827 Adjust to a MAP of 65. 592 00:24:56,369 --> 00:24:58,246 Can anyone tell me What's going on? 593 00:24:58,413 --> 00:25:01,208 - Saturation dropped to 89. - Non-rebreathing mask at high flow. 594 00:25:01,291 --> 00:25:04,586 Sometimes an infection can make the pressure drop 595 00:25:04,669 --> 00:25:06,671 and reduce the amount of oxygen in the blood. 596 00:25:07,047 --> 00:25:08,089 Will I be okay? 597 00:25:08,173 --> 00:25:10,550 We are doing everything What can we do to make you stay. 598 00:25:10,634 --> 00:25:11,676 Jesse. 599 00:25:14,763 --> 00:25:16,932 - What it was? - Be ready to intubate if you need to. 600 00:25:17,015 --> 00:25:19,267 - Do you want me to call Langdon? - No, I'll be right back. 601 00:25:19,351 --> 00:25:22,646 Call the surgery and tell them to stop to scratch your bag and come down here. 602 00:25:32,155 --> 00:25:34,658 - Did you call Langdon back here? - No, it was Al-Hashimi. 603 00:25:35,116 --> 00:25:36,326 You sent him to purgatory. 604 00:25:36,409 --> 00:25:39,204 He did everything you would have done with the patient with cellulite. 605 00:25:39,287 --> 00:25:40,747 If you think he made a mistake, tell him. 606 00:25:40,914 --> 00:25:43,833 We will probably have to intubate and we will need a bed in the ICU. 607 00:25:43,917 --> 00:25:44,918 What happened? 608 00:25:45,043 --> 00:25:47,254 She's in septic shock, using vasopressors. 609 00:25:47,337 --> 00:25:49,297 - The exposed dislocation of the shoulder has returned. - Jesus. 610 00:25:49,422 --> 00:25:52,092 Westbridge closed its rooms surgery and sent him back. 611 00:25:52,175 --> 00:25:53,843 Are you kidding? This is not a hotel. 612 00:25:54,052 --> 00:25:55,554 It's not my problem. Where do I leave it? 613 00:25:56,012 --> 00:25:57,931 - On the wall. - Call Noelle, the orthopedic 614 00:25:58,014 --> 00:26:00,767 and surgery and let us know we have a case of surgery and hospitalization. 615 00:26:00,850 --> 00:26:04,896 Sorry about that ambulance ride in Allegheny County, Mr. Billings, 616 00:26:04,980 --> 00:26:06,481 but now we will take care of you, I swear. 617 00:26:06,565 --> 00:26:09,276 I'm starving. Can I eat something? 618 00:26:09,526 --> 00:26:10,902 Sorry, not before surgery. 619 00:26:11,403 --> 00:26:12,862 - Can I receive a visit? - Of course. 620 00:26:13,780 --> 00:26:16,032 Gloria didn't say What's going on at Westbridge? 621 00:26:16,116 --> 00:26:19,160 Total silence on the lost island and the head nurse there doesn't respond. 622 00:26:19,286 --> 00:26:21,913 It must be bad. Is it something What does security need to know? 623 00:26:21,997 --> 00:26:23,331 - I'll let you know. - Hey, 624 00:26:23,623 --> 00:26:25,166 You're kind of friends with Gloria. 625 00:26:25,292 --> 00:26:27,252 She told you What's going on at Westbridge? 626 00:26:27,335 --> 00:26:28,378 No, and for you? 627 00:26:28,461 --> 00:26:29,504 No. 628 00:26:29,588 --> 00:26:30,714 How are your patients? 629 00:26:30,922 --> 00:26:33,008 Our prisoner, Gus, have stable injuries 630 00:26:33,091 --> 00:26:35,427 and our law student at center 10 is awake 631 00:26:35,510 --> 00:26:38,138 and with a normal lumbar puncture, awaiting psychiatric consultation. 632 00:26:38,221 --> 00:26:40,223 Great. The more quickly treat, release 633 00:26:40,307 --> 00:26:41,975 and move on to the next cases, better. 634 00:26:42,434 --> 00:26:43,476 Question. 635 00:26:44,102 --> 00:26:46,855 Why are you treating me as if I were one of its residents? 636 00:26:48,607 --> 00:26:49,649 I'm not. 637 00:26:49,899 --> 00:26:52,527 As a responsible physician, I like to know the status of patients 638 00:26:52,611 --> 00:26:55,071 and emergency room doctors, in case I need to act quickly. 639 00:26:55,614 --> 00:26:57,449 It makes sense. Now it's your turn. 640 00:26:59,242 --> 00:27:00,285 What? 641 00:27:00,368 --> 00:27:02,871 As your fellow doctor in charge in our emergency room, 642 00:27:02,954 --> 00:27:06,291 It makes perfect sense for me to know the status of all patients and doctors, 643 00:27:06,833 --> 00:27:08,793 in case I need to act quickly. 644 00:27:10,086 --> 00:27:11,129 Touch�. 645 00:27:14,174 --> 00:27:16,384 You have a nondisplaced fracture in the distal tibia, 646 00:27:16,760 --> 00:27:18,678 So, if you look at that bone, is well aligned. 647 00:27:18,887 --> 00:27:19,929 Sorry, hi. 648 00:27:20,305 --> 00:27:23,725 Hi, I was in the shower and came as soon as I received Paul's message. 649 00:27:23,808 --> 00:27:25,310 - Lena? - Hi. 650 00:27:25,685 --> 00:27:26,728 What happened? 651 00:27:27,520 --> 00:27:28,563 I had a seizure. 652 00:27:29,105 --> 00:27:30,148 Did you administer Keppra? 653 00:27:30,815 --> 00:27:33,610 Yes, she came back to normal mental state. 654 00:27:33,693 --> 00:27:35,987 Sorry, I'm confused. Weren't you off duty? 655 00:27:36,404 --> 00:27:37,781 I'm Roxie's death doula. 656 00:27:39,157 --> 00:27:40,200 is what? 657 00:27:41,117 --> 00:27:44,537 I help people like Roxie to make the transition to death 658 00:27:44,621 --> 00:27:45,914 in a more peaceful way. 659 00:27:45,997 --> 00:27:48,792 It's like the birth doula, but for the end of life. 660 00:27:48,917 --> 00:27:50,960 She's been a lifesaver for our family. 661 00:27:52,587 --> 00:27:54,756 My husband making jokes while I'm dying. 662 00:27:55,256 --> 00:27:56,383 Did you see why I married him? 663 00:27:57,133 --> 00:28:00,178 Whatever you have to say about my condition, You can tell Lena too. 664 00:28:01,262 --> 00:28:03,973 We were explaining that Roxie has a pathological fracture 665 00:28:04,057 --> 00:28:05,558 caused by a metastatic lesion. 666 00:28:06,101 --> 00:28:07,143 Is there a way to fix this? 667 00:28:07,394 --> 00:28:10,230 The bones are well aligned, so She won't need surgery. 668 00:28:10,313 --> 00:28:12,982 Treatment is immobilization and an orthopedic boot. 669 00:28:14,859 --> 00:28:16,277 Can we increase the painkillers? 670 00:28:16,569 --> 00:28:18,363 Yes of course. We can do this. 671 00:28:19,489 --> 00:28:21,491 Bones must recover in six weeks. 672 00:28:22,075 --> 00:28:23,410 If I live until then. 673 00:28:25,870 --> 00:28:26,996 Is it still dormant here? 674 00:28:27,163 --> 00:28:28,206 Yeah, bro. 675 00:28:28,707 --> 00:28:29,749 Great. 676 00:28:31,167 --> 00:28:32,752 Do you think there will be a scar? 677 00:28:32,877 --> 00:28:34,170 I don't think so, I'm sure. 678 00:28:36,631 --> 00:28:37,966 Holy crap. 679 00:28:38,633 --> 00:28:39,884 What are you doing here? 680 00:28:40,135 --> 00:28:41,177 Sorry, who are you? 681 00:28:41,261 --> 00:28:42,303 The worried brother. 682 00:28:42,387 --> 00:28:43,805 It doesn't look so bad. 683 00:28:45,098 --> 00:28:46,141 Are you kidding me? 684 00:28:46,391 --> 00:28:47,434 Yeah, it's ugly. 685 00:28:47,976 --> 00:28:49,018 Thanks to you. 686 00:28:49,102 --> 00:28:50,145 Was it you who did this? 687 00:28:50,437 --> 00:28:51,479 Yes, do you want to see the video? 688 00:28:54,065 --> 00:28:55,150 - I want. - For sure. 689 00:28:55,775 --> 00:28:56,818 Here. 690 00:28:58,653 --> 00:29:00,989 Okay, come closer. 691 00:29:01,364 --> 00:29:02,407 Brothers, united! 692 00:29:04,576 --> 00:29:07,871 Dude, why did you ask for him to do this to you? 693 00:29:07,954 --> 00:29:10,707 He was marking me with our family coat of arms. 694 00:29:13,877 --> 00:29:16,045 Your family's coat of arms Is it the Penguins logo? 695 00:29:16,212 --> 00:29:17,756 We would be linked forever. 696 00:29:17,922 --> 00:29:19,507 You already are, by DNA. 697 00:29:19,716 --> 00:29:20,884 �, but... 698 00:29:20,967 --> 00:29:22,010 I love you, man. 699 00:29:22,761 --> 00:29:24,304 - It was really bad. - All good. 700 00:29:24,387 --> 00:29:27,891 The doctor said he will It takes a while, but it will heal. 701 00:29:27,974 --> 00:29:29,017 Great. 702 00:29:29,350 --> 00:29:31,144 We can try again in a few months? 703 00:29:31,227 --> 00:29:32,270 - No! - No! 704 00:29:34,439 --> 00:29:35,482 All right, intubate her. 705 00:29:37,984 --> 00:29:39,027 Yellow capnography. 706 00:29:39,194 --> 00:29:41,029 - Sorry, I'm late. - A bit humid sound. 707 00:29:41,112 --> 00:29:43,364 - Did they request a surgical evaluation? - It's because of the fluid. 708 00:29:43,490 --> 00:29:44,532 Leave the roads open. 709 00:29:44,616 --> 00:29:46,201 Ventilation, 50%, tidal volume, 500, 710 00:29:46,284 --> 00:29:48,119 - assist-controlled, 12? - Yeah, perfect. 711 00:29:48,787 --> 00:29:51,581 - Surgery here. Hi. - Hey, it's about time. And Garcia? 712 00:29:51,664 --> 00:29:53,333 In an emergency. She sent me. What is it? 713 00:29:53,458 --> 00:29:56,628 Septic shock, respiratory failure and possible necrotizing fasciitis. 714 00:29:56,711 --> 00:29:58,254 Need to go right to the surgical center. 715 00:29:58,379 --> 00:30:00,799 The infection was isolated on the back of the foot for five hours, 716 00:30:00,882 --> 00:30:03,718 but now we're almost at our knees, with blisters, crepitus and edema. 717 00:30:03,802 --> 00:30:05,345 - Right. - Have you ever seen necrotizing fasciitis? 718 00:30:05,470 --> 00:30:07,806 In books. I was a student of medicine two weeks ago. 719 00:30:10,600 --> 00:30:12,143 I have to show this � Dr. Garcia. 720 00:30:12,227 --> 00:30:14,854 Okay, Jesus Christ. Go look for someone else on your team. 721 00:30:14,938 --> 00:30:16,981 - Shamsi, Miller, Walsh. - I don't know them... 722 00:30:17,065 --> 00:30:19,609 Don't take it personally, I just need one adult here. 723 00:30:21,694 --> 00:30:23,655 Good work on the subcutaneous tissues. 724 00:30:23,738 --> 00:30:25,490 It relieved the tension in the wound. 725 00:30:25,657 --> 00:30:27,742 - Thanks. - I can help with the skin layer. 726 00:30:28,201 --> 00:30:29,786 Four hands are faster than two. 727 00:30:34,165 --> 00:30:35,750 It just ripped the skin. 728 00:30:36,125 --> 00:30:39,337 Maybe you need to get bigger points and further away from the edges of the wound. 729 00:30:39,420 --> 00:30:40,463 Right. 730 00:30:41,589 --> 00:30:44,592 The skin appears very fragile. 731 00:30:50,473 --> 00:30:52,141 Yeah, this isn't working. 732 00:30:52,308 --> 00:30:54,102 He has skin of an 80 year old man. 733 00:30:54,477 --> 00:30:57,438 Place Steri-Strips with benzo�ne, not on top of the wound, 734 00:30:57,522 --> 00:30:59,607 along each edge, on both sides. 735 00:30:59,691 --> 00:31:00,775 This will hold the sutures in place. 736 00:31:01,234 --> 00:31:02,277 Right. 737 00:31:02,610 --> 00:31:03,987 What do you think, Dr. Robby? 738 00:31:04,988 --> 00:31:07,031 Excellent. MacGyver style, go ahead. 739 00:31:09,701 --> 00:31:12,078 There is a Dr. MacGyver working here? 740 00:31:13,288 --> 00:31:14,330 I don't know. 741 00:31:15,957 --> 00:31:18,877 The patient's symptoms are compatible with lumbar radiculopathy 742 00:31:18,960 --> 00:31:20,003 in the L4 and L5 vertebrae, 743 00:31:20,086 --> 00:31:21,921 probably because of disc herniation. 744 00:31:22,005 --> 00:31:25,675 Patient with cough admitted in isolation for verified medication administration 745 00:31:25,758 --> 00:31:26,843 and starting RIPE therapy. 746 00:31:26,968 --> 00:31:29,596 Why do I bother? Reprove me soon. Okay. 747 00:31:30,305 --> 00:31:31,764 Speak to social assistance. 748 00:31:31,848 --> 00:31:34,767 They will do contact tracing and will help you find a place 749 00:31:34,851 --> 00:31:36,394 for her to live in when she is discharged. 750 00:31:36,519 --> 00:31:39,564 - Understood. - See if infection control has responded. 751 00:31:39,647 --> 00:31:41,900 People in the waiting room may have been exposed. 752 00:31:41,983 --> 00:31:43,526 Need to be notified and tested. 753 00:31:44,861 --> 00:31:45,904 Okay. 754 00:31:48,281 --> 00:31:50,700 Relax, you can take off the mask. You don't have tuberculosis. 755 00:31:51,492 --> 00:31:52,535 At least not yet. 756 00:31:54,245 --> 00:31:55,455 Great. 757 00:31:57,206 --> 00:31:58,291 This is fucked up. 758 00:32:00,251 --> 00:32:01,544 How can you stay so calm? 759 00:32:01,920 --> 00:32:04,422 Expected risk of the profession. You get used to it. 760 00:32:04,923 --> 00:32:06,007 Yes, no, thank you. 761 00:32:06,591 --> 00:32:09,385 Seventy percent of doctors in training in urban hospitals 762 00:32:09,469 --> 00:32:10,595 are exposed to tuberculosis 763 00:32:10,678 --> 00:32:12,472 - and end up taking medication. - Jesus. 764 00:32:13,932 --> 00:32:15,308 They don't teach that in college. 765 00:32:16,225 --> 00:32:17,727 Mrs. Randolph returned. 766 00:32:18,311 --> 00:32:19,395 I have her x-ray. 767 00:32:20,229 --> 00:32:23,441 Alright, no valve, no buildup abnormal air and liquid. 768 00:32:23,524 --> 00:32:25,193 What do you think of this? 769 00:32:26,319 --> 00:32:27,487 Fecal matter? 770 00:32:28,279 --> 00:32:29,322 A hell of a lot of shit. 771 00:32:29,989 --> 00:32:31,491 Sorry, I had to say this. 772 00:32:31,699 --> 00:32:32,992 So she needs an enema? 773 00:32:33,201 --> 00:32:35,286 - No, we tried and failed, remember? - I remember. 774 00:32:35,787 --> 00:32:36,913 Time for manual removal. 775 00:32:37,538 --> 00:32:38,581 How will we do this? 776 00:32:39,040 --> 00:32:42,377 There is no "us" during disimpaction. 777 00:32:48,007 --> 00:32:49,175 I never did that. 778 00:32:50,301 --> 00:32:51,636 Isn't it better to observe first? 779 00:32:53,346 --> 00:32:54,931 I know the right guy to teach you. 780 00:33:05,233 --> 00:33:07,735 I spoke to the nurse in charge of the medical-surgical ward. 781 00:33:07,860 --> 00:33:09,112 They can take Orlando today. 782 00:33:09,195 --> 00:33:10,738 - That! - How wonderful! 783 00:33:10,822 --> 00:33:12,615 They know he is in insulin infusion? 784 00:33:12,699 --> 00:33:14,867 They know and can change for the SQulD protocol. 785 00:33:15,326 --> 00:33:16,744 - SQulD? - Subcutaneous insulin 786 00:33:16,828 --> 00:33:18,955 - from diabetic ketoacidosis. - So no IV? 787 00:33:19,038 --> 00:33:22,333 Only short-acting insulin injections every four hours, if necessary. 788 00:33:22,417 --> 00:33:24,460 The nurses from the medical-surgical ward have time 789 00:33:24,502 --> 00:33:25,878 to measure glucose every hour? 790 00:33:25,962 --> 00:33:28,548 They say yes. And five days in the medical-surgical ward 791 00:33:28,631 --> 00:33:31,342 will reduce two thirds of your hospital bill. 792 00:33:32,844 --> 00:33:33,886 Okay. 793 00:33:34,429 --> 00:33:35,555 So how much will it cost? 794 00:33:36,222 --> 00:33:38,975 I can't give an exact value, but approximately US$35 thousand. 795 00:33:39,600 --> 00:33:41,310 So, taking 40%, 796 00:33:41,978 --> 00:33:44,522 I still have to pay about US$20 thousand? 797 00:33:44,647 --> 00:33:46,691 The hospital can organize a payment plan. 798 00:33:46,899 --> 00:33:49,277 Orlando, it's going to work. Let's find a way. 799 00:33:50,403 --> 00:33:52,113 I'll make time extra in the cafeteria. 800 00:33:52,947 --> 00:33:53,990 We will take care of you, father. 801 00:33:56,075 --> 00:33:57,744 We'll leave you alone with your family. 802 00:33:58,619 --> 00:33:59,620 Thanks. 803 00:34:01,539 --> 00:34:04,208 Sorry, thank you. I was left worried that he would give up. 804 00:34:04,375 --> 00:34:05,418 The pleasure is mine. 805 00:34:05,793 --> 00:34:08,713 True gratitude goes for beginner for thinking outside the box. 806 00:34:11,299 --> 00:34:13,801 Sorry for doubting your idea of the medical-surgical ward. 807 00:34:14,092 --> 00:34:15,136 No problem. 808 00:34:15,553 --> 00:34:16,596 How did you think of that? 809 00:34:17,847 --> 00:34:20,308 My family had to think in many creative ways 810 00:34:20,391 --> 00:34:22,435 to help my grandma no health plan. 811 00:34:23,311 --> 00:34:24,353 Leukemia. 812 00:34:24,812 --> 00:34:27,440 When the system doesn't help you, you have to bend the system. 813 00:34:28,399 --> 00:34:29,442 Did she survive? 814 00:34:30,568 --> 00:34:32,277 For a while, she survived. 815 00:34:32,862 --> 00:34:34,781 Died before my first year in college. 816 00:34:35,197 --> 00:34:36,239 I am really sorry. 817 00:34:37,574 --> 00:34:38,909 Her death taught me a lot. 818 00:34:40,036 --> 00:34:42,538 Mainly I don't want being around dying people. 819 00:34:44,581 --> 00:34:47,210 So they took her and can we get out of here soon? 820 00:34:47,293 --> 00:34:48,335 Yes, I think so. 821 00:34:48,710 --> 00:34:49,712 - I think so. - Right. 822 00:34:49,837 --> 00:34:50,880 Hi. 823 00:34:52,672 --> 00:34:55,051 The morphine pump seems ready to use. 824 00:34:55,760 --> 00:34:57,220 This should resolve the issue. 825 00:34:58,012 --> 00:35:00,056 - Do you feel any difference? - It's better. 826 00:35:00,181 --> 00:35:01,224 Great. 827 00:35:01,849 --> 00:35:02,892 Great. 828 00:35:02,975 --> 00:35:04,018 How does this work? 829 00:35:04,685 --> 00:35:06,938 He has a continuous dose of morphine. 830 00:35:07,063 --> 00:35:09,857 And if you feel pain, you can squeeze this button and receive a little more. 831 00:35:09,941 --> 00:35:12,860 You can press to apply another dose every 10 minutes if needed. 832 00:35:12,944 --> 00:35:14,529 It's a morphine butler. 833 00:35:17,323 --> 00:35:18,366 Amazing. 834 00:35:18,783 --> 00:35:20,159 Can she go home with this? 835 00:35:20,451 --> 00:35:21,494 Can, 836 00:35:21,911 --> 00:35:23,955 but you will need more equipment at home now 837 00:35:24,038 --> 00:35:25,873 that she can't more support your legs. 838 00:35:26,082 --> 00:35:27,667 Okay, like what? 839 00:35:28,376 --> 00:35:30,837 A wheelchair to go to the bathroom, 840 00:35:30,920 --> 00:35:31,963 a shower chair, 841 00:35:32,088 --> 00:35:34,132 grab bars on the wall if you haven't already 842 00:35:34,799 --> 00:35:36,884 and a hospital bed can also help. 843 00:35:37,593 --> 00:35:38,803 How do we achieve all this? 844 00:35:39,095 --> 00:35:40,680 Not you, me yes. 845 00:35:40,763 --> 00:35:43,224 I will arrange everything so you can get out of here 846 00:35:43,307 --> 00:35:44,350 and stay with the children. 847 00:35:44,559 --> 00:35:45,601 At home. 848 00:35:45,893 --> 00:35:46,936 Thanks. 849 00:35:54,193 --> 00:35:55,653 I'm glad you showed up, matuto. 850 00:35:55,903 --> 00:35:56,946 What do you need? 851 00:35:57,029 --> 00:35:58,573 Help with disimpaction. 852 00:36:00,950 --> 00:36:02,910 This is procedure of medical students. 853 00:36:02,994 --> 00:36:06,414 You know the saying: "See one, do one, teach one." 854 00:36:06,831 --> 00:36:08,791 Say hi to your student, Ogilvie here. 855 00:36:10,459 --> 00:36:11,502 Okay. 856 00:36:11,586 --> 00:36:12,628 Two gloves, Ogilvie. 857 00:36:13,171 --> 00:36:14,338 Okay, Mrs. Randolph, 858 00:36:14,422 --> 00:36:17,049 we need to unclog manually your rectum 859 00:36:17,133 --> 00:36:19,093 for your intestine to work again. 860 00:36:19,177 --> 00:36:20,219 I know. 861 00:36:20,636 --> 00:36:21,679 Let's go. 862 00:36:23,014 --> 00:36:24,056 Mrs. Randolph, 863 00:36:24,515 --> 00:36:27,977 I would like you to relax as if he was evacuating. 864 00:36:29,145 --> 00:36:30,438 Very deep. 865 00:36:32,773 --> 00:36:33,816 Right. 866 00:36:34,233 --> 00:36:35,276 Curl your finger, 867 00:36:35,735 --> 00:36:37,403 like an ice cream scoop, 868 00:36:38,446 --> 00:36:41,115 and pull. 869 00:36:43,034 --> 00:36:44,076 Your turn, Ogilvie. 870 00:36:49,040 --> 00:36:50,791 A little more pressure, Mrs. Randolph. 871 00:36:51,083 --> 00:36:52,126 I'm ready. 872 00:36:59,133 --> 00:37:01,636 And I think that you didn't learn quickly. 873 00:37:03,596 --> 00:37:04,639 Continue. 874 00:37:05,556 --> 00:37:08,184 Mrs. Randolph, to avoid May this happen again, 875 00:37:08,309 --> 00:37:10,353 I think you need it of a better laxative. 876 00:37:10,645 --> 00:37:11,854 Try Miralax. 877 00:37:11,938 --> 00:37:15,441 A tablespoon with a large glass of water every morning should do the trick. 878 00:37:15,608 --> 00:37:16,651 Okay. 879 00:37:20,488 --> 00:37:21,530 Sorry. 880 00:37:21,614 --> 00:37:22,740 Releasing gas is good. 881 00:37:22,865 --> 00:37:24,367 Means that we are progressing. 882 00:37:24,700 --> 00:37:26,077 So can I stop? 883 00:37:26,160 --> 00:37:27,536 No, continue. 884 00:37:32,667 --> 00:37:33,709 Okay, Ogilvie, you... 885 00:37:34,252 --> 00:37:35,294 maybe you... 886 00:37:41,842 --> 00:37:42,885 Much better. 887 00:37:44,637 --> 00:37:48,224 Stable mean pressure with norepinephrine. One microgram per kilogram per minute. 888 00:37:48,599 --> 00:37:50,434 A favor, Give me some 4x4 with Betadine. 889 00:37:50,518 --> 00:37:53,479 Sorry, we're stuck with Westbridge transfers. 890 00:37:53,562 --> 00:37:55,564 Mesenteric ischemia, intestinal perforation... 891 00:37:55,648 --> 00:37:57,191 - I have a serious one here. - �. 892 00:37:57,441 --> 00:37:58,734 Possible necrotizing fasciitis. 893 00:37:58,901 --> 00:37:59,944 Possible? 894 00:38:00,069 --> 00:38:02,446 - Need to confirm with a CT scan. - It's spreading fast. 895 00:38:02,530 --> 00:38:04,323 When the result comes out, it will be at the waist. 896 00:38:04,448 --> 00:38:06,784 - Need a hemicorporectomy. - Need a CT scan. 897 00:38:06,867 --> 00:38:08,995 How about a stainless steel one? 898 00:38:09,620 --> 00:38:11,789 For God's sake, Robinavitch! 899 00:38:12,498 --> 00:38:14,250 Robby, What the fuck are you doing? 900 00:38:15,793 --> 00:38:17,211 Oh my God, I think I'm going to throw up. 901 00:38:17,295 --> 00:38:19,588 This is called dirty water exudate no pus. 902 00:38:19,672 --> 00:38:21,257 The fascia has a grayish appearance 903 00:38:21,382 --> 00:38:24,093 and, in the operating room, you will see It is easy to separate the fabrics. 904 00:38:24,218 --> 00:38:25,678 When it starts your sabbatical period? 905 00:38:25,761 --> 00:38:27,138 - Tomorrow. - It's about time. 906 00:38:27,221 --> 00:38:28,264 Thanks for coming. 907 00:38:32,310 --> 00:38:34,812 I'm updating my records as quickly as possible. 908 00:38:36,147 --> 00:38:38,232 Why don't you use my app of generative AI? 909 00:38:38,733 --> 00:38:40,192 It is 30% more efficient. 910 00:38:40,276 --> 00:38:43,029 Professionals reported an increase in job satisfaction. 911 00:38:43,154 --> 00:38:45,740 And you'll rarely need to stay after the shift filling in. 912 00:38:45,823 --> 00:38:46,866 �? 913 00:38:47,742 --> 00:38:48,784 Okay. 914 00:38:48,868 --> 00:38:50,578 I usually stay at least a couple of hours 915 00:38:50,661 --> 00:38:52,496 after each shift trying to catch up on everything. 916 00:38:52,580 --> 00:38:54,915 Of course, the AI will let the most efficient doctors, 917 00:38:54,999 --> 00:38:57,418 but hospitals will want that we serve more patients 918 00:38:57,501 --> 00:38:59,170 without a salary increase, of course, 919 00:38:59,462 --> 00:39:02,506 and they will also cut doctor vacancies supervisors and residents. 920 00:39:02,590 --> 00:39:06,302 Dr. Robby, I'm not in favor to end my profession, 921 00:39:06,761 --> 00:39:09,513 but I stand for power spend more time with my son. 922 00:39:10,264 --> 00:39:11,682 Nothing replaces family. 923 00:39:13,267 --> 00:39:15,061 What is the situation of your septic patient? 924 00:39:15,144 --> 00:39:17,563 Necrotizing fasciitis. The surgery is taking her upstairs. 925 00:39:17,938 --> 00:39:19,690 Do you think you can do it? save her leg? 926 00:39:20,608 --> 00:39:22,318 I hope they can save her life. 927 00:39:22,818 --> 00:39:24,695 So, how is Ogilvie? 928 00:39:24,779 --> 00:39:28,491 A little exposure to tuberculosis, a little intestinal explosion. 929 00:39:28,574 --> 00:39:30,159 Overall, a very good day so far. 930 00:39:30,659 --> 00:39:31,786 Kaison, you came. 931 00:39:31,911 --> 00:39:35,289 I wouldn't let you miss the party Peter and Aubrey's 4th of July epic. 932 00:39:35,706 --> 00:39:36,749 Let's do it. 933 00:39:38,000 --> 00:39:39,418 I brought some beers. 934 00:39:39,502 --> 00:39:40,711 You're the man! 935 00:39:40,920 --> 00:39:41,962 Very beautiful friendship, 936 00:39:42,046 --> 00:39:44,465 but no food because you may need surgery. 937 00:39:44,548 --> 00:39:46,884 And no beer because we are in a damn hospital. 938 00:39:50,971 --> 00:39:52,598 Your sabbatical will begin earlier? 939 00:39:52,681 --> 00:39:54,683 I know who needs it of a drink now. 940 00:39:54,767 --> 00:39:55,810 In the hospital? 941 00:39:56,268 --> 00:39:57,436 As a parting gift. 942 00:40:03,067 --> 00:40:04,735 - How are you doing? - Good. 943 00:40:05,569 --> 00:40:06,946 The Steri-Strips did the trick. 944 00:40:07,321 --> 00:40:08,447 The tomography is ready. 945 00:40:08,531 --> 00:40:09,573 We already did. 946 00:40:09,657 --> 00:40:11,617 The head team and neck wants fine cuts 947 00:40:11,700 --> 00:40:14,203 and 3D reconstruction of the jaw before deciding 948 00:40:14,328 --> 00:40:15,871 if Mr. Varney needs of surgery. 949 00:40:15,955 --> 00:40:17,873 At least they went down to examine in person? 950 00:40:18,082 --> 00:40:19,208 No, they must be busy. 951 00:40:19,625 --> 00:40:22,211 Or there's a 4th of July sale at the BMW dealership. 952 00:40:23,254 --> 00:40:24,296 The exams have arrived. 953 00:40:24,380 --> 00:40:26,298 The albumin and total protein are low. 954 00:40:26,382 --> 00:40:28,008 He also has megaloblastic anemia. 955 00:40:28,092 --> 00:40:30,386 - Malnutrition. - It must be because of the prison food. 956 00:40:30,469 --> 00:40:31,804 Whitaker, tests to add? 957 00:40:31,929 --> 00:40:33,931 B12, folate and iron levels. 958 00:40:34,014 --> 00:40:35,057 Good. 959 00:40:35,724 --> 00:40:38,018 We will do some more tests, Mr Varney. Hang in there. 960 00:40:43,274 --> 00:40:44,608 I need to pee. 961 00:40:45,609 --> 00:40:47,361 There is no urinary catheter here, 962 00:40:47,945 --> 00:40:49,196 but I'll help you with the bedpan. 963 00:40:49,280 --> 00:40:51,031 No, no bedpan. 964 00:40:51,532 --> 00:40:53,742 I can walk to the bathroom, I just need help. 965 00:40:53,826 --> 00:40:55,161 - He is sure? - I'm here, love. 966 00:40:55,327 --> 00:40:56,620 We help, Mr. Hamler. 967 00:40:56,704 --> 00:40:58,998 You will have to take the serum and portable oxygen. 968 00:41:00,124 --> 00:41:01,167 Please. 969 00:41:02,251 --> 00:41:03,627 I'll get a wheelchair. 970 00:41:04,628 --> 00:41:05,671 We will try to seat you 971 00:41:05,754 --> 00:41:07,465 - and let your legs dangle. - Right. 972 00:41:10,593 --> 00:41:13,637 One, two, three. 973 00:41:19,852 --> 00:41:21,270 It's not a good idea. 974 00:41:21,479 --> 00:41:22,897 I don't think we'll need that. 975 00:41:23,939 --> 00:41:27,193 Hey, Paul, why don't you come Have a coffee with me? 976 00:41:27,526 --> 00:41:29,653 I'm still a little dizzy for staying up all night 977 00:41:29,737 --> 00:41:31,864 and I want to pass it on discharge instructions with you. 978 00:41:33,115 --> 00:41:34,158 Of course. 979 00:41:35,951 --> 00:41:37,328 Rox, are you okay? 980 00:41:38,412 --> 00:41:39,455 Yes, everything is fine. 981 00:41:47,213 --> 00:41:48,589 I'm actually going with a bedpan. 982 00:41:56,931 --> 00:41:58,599 Lost your oximeter again, friend? 983 00:42:04,563 --> 00:42:05,606 Louie. 984 00:42:05,856 --> 00:42:06,899 Louie! 985 00:42:07,775 --> 00:42:09,151 He kept taking the oximeter out. 986 00:42:10,361 --> 00:42:11,612 It's on, reading 71. 987 00:42:11,695 --> 00:42:12,738 Louie, wake up. 988 00:42:14,782 --> 00:42:16,700 - I don't feel the carotid artery. - I have an airline. 989 00:42:16,784 --> 00:42:19,245 Hey Perlah, intubation tray and emergency cart. 990 00:43:59,928 --> 00:44:01,930 Subtitles: Winicius Sturm