ISPP 2015

Career Opportunities in Pharmacy
Real Doctor Reacts to UNTOLD STORIES OF THE ER!


– I’ve shared some pretty
wild stories with you guys through the years on this YouTube channel, but I thought we’d watch
a very popular show called “Untold Stories of the ER”. But before we get to
it, I have to urge you. Click that notification bell
and set up all notifications. That way you’re sure to get my videos. Let’s get started. Bee-woop! – These are the real stories of the ER that doctors never talk about. (laughs)
– Already! I’m gonna call BS on that one because ER doctors love
sharing their stories. This isn’t even about ER doctors. Doctors love sharing their stories. And I know many people will jump and say, what about HIPAA? What about patient privacy? If we don’t give the patients identifiers, their name, their date of
birth, a picture of them, it’s totally okay to
talk about their case. Otherwise, how in the world
would doctors ever learn? We have to talk about cases. – Are you alright? (screams) – It’s Scott Reed, I’m a paramedic. I said, send the ambulance routine. We don’t need lights and sirens. We don’t need the fire department. Just send an ambulance routine, I think she just fainted
on the bathroom floor. – If this ever happens to you, call 9-1-1 and tell
’em to bring everybody. In this situation, it’s quite specific ’cause he’s a paramedic,
he knows what’s going on. I prefer that right
away you call for help. If a person’s unconscious
and you aren’t sure, start chest compressions. That could be a difference
between saving their life and them losing their life just because you were self-conscious or weren’t sure if you
should do chest compressions. If you aren’t sure, the
person’s unconscious, you’ve called for help, chest compressions, chest
compressions, chest compressions. – [Operator] We’re on route
with a 38-year-old female who’s had a syncopal episode. She’s semi-conscious. Blood pressure is 60 over 40 and dropping. – Okay, so that’s the most
dangerous part about all of this. The fact that her blood
pressure’s dropping means that she’s not
getting enough circulation to her vital organs. Think brain, kidneys, liver. And when that happens, the only option for us,
in the medical community, is to give a ton of fluids to
increase the blood pressure into the circulatory system. If that doesn’t work, our next resort is to go
to artificial pressers which are basically
adrenaline-like medications that cause all your blood
vessels to constrict really hard to raise the blood pressure to make sure that the blood
reaches everywhere in your body that it’s supposed to. If that doesn’t happen in time, that could be a cause of
death, it’s called shock. So basically she’s going into
shock and we don’t know why. – An ECG, a stat, portable chest x-ray. CBC, E7, (nervous exhale)
Troponin, a D-Dimer, an ABG. The stat did say cardiology consult. I need an Echo right away please. – Okay so all these tests that
he’s ordering all make sense, these are all the tests
that you’d want to know just to possibly get an
idea of what’s going on. When a patient comes into the ER, you don’t know anything. You don’t know if they’re anemic, you don’t know if they have an infection, you don’t know if they
have an pneumothorax. Has their lung collapsed? Is she having a heart attack? So you need all of these tests
done as quickly as possible so you can slowly start
stabilizing the patient and creating a course of action. – She’s apneic, we’re gonna lose her. Bag her, bag her. – So when a person loses
consciousness like that and they’re out of it and you have to breathe for them, right away that’s a sign that that patient may need to be intubated. Intubate is when you put a
breathing tube down for them. Obviously, the most important part of that is to help them breathe. But the second most important part is to protect their airway because if she were to vomit, then that vomit can go
right into her lungs and cause even a more serious problem. When a patient is unconscious, they don’t have a gag
reflex to protect them from inhaling vomit. So that’s why we rush
right away to intubate. – Yet, for Dr. Christopher Michos. – This Dr. Michos needs to tell me what’s going on with his scrubs. I like cool scrubs, but I don’t know what’s
happening with those. Maybe this episode is from
a really long time ago and those were in then. I think I’m gonna have to make him like, send him a sample of
my upcoming scrub line. – His face and whole
body was covered in hives and he was retracting. His muscles were being
pulled into his chest. This is a critically sick child. The serious medical condition
known as anaphylaxis. – So two things happen
during anaphylactic shock that are very dangerous. One is that the oral
airway starts swelling and when that happens, obviously, you can lose your ability to breathe. The second thing that happens
is because you have shock, all of your blood vessels dilate, and therefore it drops
your blood pressure. This is another form of shock
that can be quite deadly ’cause again you’re not
perfusing and getting blood flow to all your vital organs. Anaphylaxis is deadly. That’s why we hand out
epi-pens to all of our patients who have gone into anaphylaxis or are at risk of going into anaphylaxis. That’s why when epi-pens are expensive and people can’t afford them, I get really mad. – We gave him additional antihistamine. We gave him intravenous steroids. – So antihistamines are great
for an allergic reaction but they don’t do anything
to treat the symptoms of anaphylactic shock. What you really want to do is make sure that the
patient has a secured airway and that they’re getting enough blood flow to all their vital organs which can mean giving them
a ton of fluids or pressers. – It was about 3:00 AM on a Saturday night and the bars had been let out, most of the trauma that you’re
gonna see has come and gone and it gets quieter in the ER. – That’s actually true. When you’re on-call, you
do have this eerie silence that starts setting in
around 3:30, 4:00 AM and that’s usually the time
where before our morning rounds, if you’re on a 24-hour shift, maybe you can sneak in a one-hour nap. I will say that after that
nap, you tend to feel worse ’cause you wake up and you’re just jarred and you want to continue sleeping. So my general advice for
medical students, residents or anyone who’s doing
those types of shifts, keep it short. Do a 30-minute nap and then
get up and do some work because if you start
entering the REM cycle and come out too early, that could be really problematic and you’ll wake up all groggy. – [Nurse] 18 years old,
missing left forearm. Didn’t do vitals yet. – [Doctor] Okay, Becky get vitals. Let’s get him on the bed. – Did any of those cuts, are they on the abdomen? Did any of them go into lungs? Into the stomach? Anywhere that we need
to deal with right now? – The first thing we do in
these types of trauma situations is undress the patient
as quickly as possible ’cause it’s very easy to miss a wound if you don’t have the patient
there completely naked. And that sounds like a weird thing to do but if you step one foot into
any level one trauma center, you will see the first thing doctors do, take scissors and cut off all the clothes. We need to see if they’re
bleeding from anywhere because if they have a
puncture wound in their abdomen and we miss it, and they’re pooling
blood into their abdomen, they can just go ahead and
die right in that moment without us being able to even help them. – Let’s open in chest. – You wanna do that here? – [Narrator] The procedure
is called a thoracotomy and it’s almost never performed outside the sterile environment
of an operating room. – I’ve never heard of a thoracotomy being performed in an ER, ever. – Scalpel. – At least try and create a sterile field. Don’t just say we’re gonna
open up her chest, scalpel. Angie doesn’t currently have a pulse. I feel like a lot is inaccurate
in this representation. – What did he say? – I don’t know. You’re gonna have to talk to the mother. – You speak Greek. – You’re Greek? You speak Greek? – My wife is fluent in Greek and she would be happy to help. I’m in a bit of a situation
here and I need your help. Can you help me translate? – So this is kind of messed up because it is a HIPAA violation, it’s like a patient privacy issue. But in an emergent situation, perhaps that could be put on hold. What happens in regular hospitals, we have translator phones for this where one person picks up one phone and the other picks up the other and through a translator or interpreter, we can actually have
a normal conversation. I don’t know why he needs to call his wife and get her involved. – Sometimes it’s like
a needle in a haystack trying to figure out what’s
causing the allergic reaction. – If a child is having a
severe allergic reaction, an anaphylactic shock, it’s not of utmost important in the ER to figure out what it was from. The most important thing
is to stabilize the patient using epinephrine and if that fails, to put a breathing tube
in and then give steroids, high doses of steroids, keep the pressure up through
fluids and or pressers. And then later down the line
we can start figuring this out. I’m surprised he started doing
all this investigation here. – Low and behold, I’m looking at the apron and I’m thinking food. And not because I was hungry. Papu, your apron. Nuts, nuts. (laughs) Whenever a doctor is yelling nuts at you, you’re doing something wrong. – Stay away from those nuts. He would have to carry
an epi-pen to counteract should he ever come in
contact with nuts again. – Please carry your epi-pens and make sure they’re not expired. Don’t want to be over the Atlantic Ocean having me stab you with a giant epi-pen that’s not made to be used as an epi-pen, it’s just epinephrine for
someone’s heart stopping. – [Narrator] Nurse Penny Reed has survived an eight-hour open-heart surgery. – Feeling that my mom might not be able to be a normal person again
after all of that was scary. – That’s the thing, when
someone loses their pulse for that long, patients’ families have
questions for us like how is this gonna affect them? Are they gonna be the same? And many times, we just
don’t have an accurate answer so the most honest thing we can say is we don’t know, but
we’ll hope for the best. Sometimes people don’t like that, but unfortunately
medicine is as much an art as it a science. – When I woke up, they told
me I’d had open-heart surgery for blood clots and they told
me I’d had a thoracotomy. – You don’t always get a lot of victories. So it was the best moment
of my career so far. – That’s one of the great
things of being an ER doctor. When you intervene in a patient’s case, you get the result and that
gratification right away. As a family medicine doctor, a lot of times I’ll give
a treatment or a plan that will take months or
years to even come to fruition when we’re talking about weight loss, reducing cancer risk, it’s not as instantly
gratifying as a surgeon or as an ER doctor but moments like this are
really, really powerful and hard to come by as doctors. – [Narrator] Jason Exner
still works in the same small community hospital along with a new colleague. – Haha, I can’t imagine how
many puns they share together. Hey, if you don’t get me my tools, I’m gonna take your heart back. Okay that was corny, sorry. The YouTube algorithm has
been a little bit funky lately so in case you missed my
last three amazing videos, click here for the playlist and as always, stay happy and healthy. (upbeat music)

100 thoughts on “Real Doctor Reacts to UNTOLD STORIES OF THE ER!

  1. You say chest compressions and 90% I’ll agree but I’ve still seen an epileptic woman get ribs fractured because someone just did what they knew and not what helped. Strokes and seizures need to be more widely recognized.

  2. "When a patient is unconscious they don't have a gag reflex" I'm not going to say you're wrong because you're a doctor and I don't even know what all the organs are for, but boy do I have a story for you.

    So I had an endoscopy done a few years ago, and whatever they have me to put me under had me knocked out in like thirty seconds; the next thing I next I was in recovery. Apparently that's not unconscious though because my gag reflex kicked in. The doctor wrote on the official record that is forever part of my medical history that I "twice wretched the scope out" during the procedure.

    I warned her my gag reflex was bad. When I tell people how bad it is they rarely believe me. But at two doctors were in that room and can confirm that my gag reflex is violent, even when I'm completely under.

  3. Dr. Mike, I’ve worked in a level 1 trauma center in a metropolitan area and thoracotomy was performed in the stabilization room when needed. Especially in cases with multiple GSWs. Thanks for your great YouTube videos!!

  4. Since they added that bell bs; I've never once enabled it and i still get every video from every sub i'm sub'D to – no need to ring it *EVER*!

    That being said.. ER was a great TV show.

  5. That phone for translations you mentioned. Are they available in all hospitals, even in small towns? I don't know where (or when) that particular story happened, but maybe they just didn't have the device?

  6. You dont do chest compressions if they are breathing normally and have a pulse. You cant just go to chest compressions if they are only unconscious.

  7. Maybe you're just not getting as many views… You ever think about THAT, Doctor Mike? Hahaha… Jk. I just had to say that. Good video as always.

  8. OMG the episode where the guy they called George came in with the five hour erection!!! the girlfriend and wife got into a big fight!!

  9. Hey Dr. Mike, I've been wondering for a while about my armpit odour. My armpits smell of maple syrup and I can't figure out why. I've been quiet stressed since every result come up with MSUD (maple syrup urine disease).

    If people could like to get his attention it would be very appreciated

  10. Heeeeeey. Dr. Mike! Can you do a video on the different kinds of bacterial meningitis and what it does to people? My meningitis happened in 2001 before most of these kids were born. I ended up with skin grafts on 38% of my body! I haven’t met any survivors to have this happen.. I hope you see this comment. I am doing my best to stay healthy and happy! Hugs, Kate

  11. I use to watch this show religiously!!! Also sex sent me to the er and I didn’t know I was pregnant… it was weird but I loved it 😅 omg and 1000 ways to die that hilarious

  12. The part of the anaphylaxis story you missed is that the kid had multiple reactions while in the ER. The doctor was scrambling around wondering why the kid was going into shock over and over again for seemingly no reason, but it turned out his family members had walnut residue all over them. So every time they'd come in the room he'd have another reaction. That's why the doctor cared so much about what was causing it.

  13. When the doctor said "Stay away from those nuts" I'm emmediatly reminded me of Latrice Royale's "Get those nuts away from my face" line. Lol. Love the info i was reminded on in this episode. (I have heard of them but forgot) Keep it up Doctor M! (Bee-wwhoop)

  14. Loved this vid. Can you maybe react to some medical horror stories? Like the ones Shane Dawson reacted to. He saw some surgery mishaps.

  15. Chest compressions on someone with a pulse? Questionable.
    I was present at an emergent thoracotomy in the trauma room on a cop who had been shot in the chest. The docs did don masks, sterile gowns,
    sterile gloves. The rest of us were masked, gowned and gloved but not sterile. Sadly, the patient did not survive. It was astounding to stand at the head of the bed simply to apply O2 and PEEP via AMBU as the docs tried to repair a hole in the right ventricle. Half a dozen were simply squeezing bags of packed RBCS, saline and plasma to replace the blood pooling on the floor. Never seen anything like it in my 34 year career.

  16. Regarding the phone translator, it wasn't very common before 2000, even thereafter they were relatively scarce and considering his age and funky clothing it must've been quite a while.
    On a sidenote, there are still plenty of places in which they lack such a thing and commonly seek a translator even if they are not professionals because it saves vital time for the patient, they, however, must sign a confidentiality-thing-whatchamacallit before partaking in it. At least that's how they operate over here in México, I assume other places might have said phone services available, and private hospitals should have them at hand if they didn't hire an actual translator.

  17. I’ve watched these episodes and OMG if you never heard of these stories just be shocked. There are just some stories I’d be like “How did you shove that up your ass?” 💀🤣😂

  18. I almost squealed with delight when I saw this, I love this show. I no longer have cable, though, so I haven't been able to watch it in a while. I wish it were on a streaming platform :/

  19. it always bugs me that Dr Mike always assume that all the hospitals are as well equipped as the hospital he works at , and that is not the case on most hospitals specially community hospitals and those areas outside major cities specially rural areas , so yeah not all the hospitals have translators and many of the ones that do only have translators for certain languages greek is not a common language to have translators for in a hospital in the U.S

  20. Dr Mike. love what you do man…as an ED physician in Detroit, I’ve personally performed 3 ED thoracotomies in the past year (before the trauma team was able to make it to resus bay). only indication is: witnessed cardiac arrest of patient with penetrating chest trauma.

  21. Can you review scrubs styles and your personal faves? (especially considering the hilarious patterns in these episodes)

    Also might as well invent EpiPen holsters while we’re trying to improve protocol up in here!

  22. If you have an epipen/epinephrine autoinjector please don't leave it in a hot car or refrigerator. They are temperature sensitive and can go bad. Keep them at room temperature, check the expiration date and that the little window is clear. There is also a difference between an adult epipen and a child's epipen depending on the weight.

  23. Hey i just wanted to say that I was hard on Dr. Mike. I feel like the people's words means a lot. I said some things that may, emphasis on may because I'm one of maybe millions of viewers, have hindered him creatively. And for that I'm sorry.

  24. I have vasovagal syncope, but I can have it as much as 3 – 5 times per week…but I can wake up w/in seconds to about 2 minutes, so it's not good for someone to just start cpr…I passed out this one time, and I'm thankful my sister was there, because she said this lady was going to start chest compressions, because when it happens my breathing becomes very shallow, but my sister jumped over the table, and said don't she is still breathing, because that can cause damage …as long as I am laying down, and my feet are elevated I wake up, and even if my legs aren't elevated I will come to, it just takes a little longer, and of course there were times they couldn't even get a blood pressure on me at the time, or it was very low, but it's just because my blood pools to my legs, and of course not to my brain..I can see if there is no pulse, than yeah, and of course breathing stops…afterwards I have to stay laying down for quite awhile, because if i get up after it happens, it usually will happen again w/ in a matter of seconds to minutes, so a lot of times I have to lay there for 30 – 45 minutes, the bad thing about it is a lot of people in the medical field, where I live anyway, don't seem to understand it, the ambulance came to my house and I wasn't going there for that issue, but I warned then ahead of time that I have this, and when I was outside before getting on the gurney I passed out on the ground, and I came to and they sat me up, and I said don't sit me up, because it will happen again, they didn't listen to me, and I passed out again, and they even did it again, and it happened again, by that time I guess they knew what I was talking about, and left me there until I felt okay enough to get up, and get on the gurney.

  25. Damn it Doctor Mike, why your videos pop up before Im going to sleep?! Ya know I'm not going to sleep until I watch a marathon of "Bee Woops"

  26. shouldnt you check for pulse first before chest compressions? and check for breathing while doing cpr if the chest doesnt rise

  27. Am I the only one who gets distracted because of Dr. Mike that I'm smiling like a freak and thinking how can he be so that handsome??!!

  28. Has he done a reaction to Threadbangers I died and came back to life video? If not I'd love to see that and get a doctors view on what happened throughout the process. 🙂

  29. As a new grad RN, I can confirm that 90% of our conversations are based of things we have experienced with our patients.

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