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doctor-reacts-to-house-md-quotclimaxquot-episode

Doctor Reacts To House MD &quot;Climax&quot; Episode

house is not a better doctor than me we're going to fight this out throughout this episode huge thanks to ship station for sponsoring this video let's get started if you go too fast Slow It Down Speed freaks me out as a doctor cuz as a regular person I've went in an F-16 and that one went really fast I also pulled 9.3 GS oh you know that fall wasn't terrible there wasn't an abrupt stop there was a lot of rolling involved head oh see what is he chasing him for the gr like 40 mil hour you're not running that fast all first of all there's no way he got there that fast I don't think you have any idea how fast I really am what do you got 16-year-old status po ATV crashed 40% of burns on his body okay so the way they estimate those Burns is based on the rule of nines here's an image that we use to estimate the amount of body that's burned important to know that adults are different than young babies babies have bigger heads in relative proportion to their limbs and rest of their body so interesting Nas tral intubation start a bag of lactated ringers wide open yeah fluids are one of the most important things that we give in the midst of a burn not only do you dehydrate quickly but you also need very careful management of your electrolytes that's why one of the first things you get is an IV inserted to pull some blood and see what the person's electrolyte status is through what's known as either a BMP a basic metabolic padal or a CMP which is a complete metabolic paddle it's potassium's law which can also be explained by the burn which is what we were talking about earlier when we said that electrolyte disturbances are common one of those electrolytes is potassium but also sodium except I'm sure the Burn Unit it's pumping with fluids which means this pottassium should be going up not down could be amphetamin or bacteria lunching on his heart or cardiomyopathy or some other very bad thing I mean those are all possibilities but naming things that are just totally random probably doesn't help in the situ a you okay no skin no EKG we need help from a Belgian dog named einthoven I mean that's so typical from house now let's wait for his body to stabilize and see what happens which is what happens at every other hospital he calls a Belgian DOC for his help while he was alive he invented a little diddy called the galvanometer what do we get one go to any electronic store that's been opened since before 1905 there's a good chance they got one in the corner in the base because of the burn we can't perform any of our normal tests to see what's wrong so we're going to try a galvanometer that's a good question how do you do an EKG on a person with significant Burns we have modified the ECG electrode by welding the ECG button to a crocodile clip so you just have a little clip instead of a a pad but in House MD instead of following what the uh what is this the European Journal of of Anese anesthesiology why can't I speak today tells you just use a modifi ECG electrode he's like get a galvanometer he's got all these Burns and uh and now there's something wrong with his heart we're trying to figure out if the two are somehow connected yeah that happens very commonly arrhythmias are not rare in those who had significant Burns if he was experimenting with amphetamines or cocaine no I mean how do they get there because his heart rate's elevated he's in the midst of a terrible accident we gave him some pot about a year ago to try it was just once we thought if we took the mystery drugs and alcohol the L need experiment we'll know more after the tests looks like they're going to electrocute him prominate U waves now in a Twi there is cameia qwave normal that's not a normal Rhythm I don't know what it's drawing cuz I don't know this device that does not look normal seizure activity Chase turn it off turn it off I don't think that's because of the device I think he's just having a seizure no who electrocuted my patient what he had a seizure he wasn't electrocuted what does the seizure tell us okay thank you at least house has my back I mean low potassium levels can precipitate a seizure differential diagnosis go could be epilepsy or seizure disorder he just named two seizure disorders could be Ms seizures could be caused by plaques and lesions on the brain they're basically acting as WebMD did one of the symptoms match the disease yes say it no nuclear Imaging he wouldn't survive the move the Radiology MRI and CT scan are both found why wouldn't he survive the move I guess infection lumbar puncture will tell us if his proteins are elevated at least we're can exclude Ms can't do a lumbar puncture either we'd be inserting a needle into an area that's teing with bacteria if he doesn't have a brain infection already we'd give him one for sure why don't they just clean the area I'm so confused there's no other way to look at a brain transcranial Doppler sonography what he's going to get an ultra sound of his brain for what you're not going to get a diagnosis of Ms from a sonogram not definitively but patients with MS have more reactive neurons in their oxital cortex oh my God so ridiculous the idea this is Ms is so wild without having any symptom knowledge of the patient is just beyond me are they trying to wake him up they can't do that right he'll be in too much pain don't worry he's still under but the brain never completely sleeps it's always working the eyes respond to visual stimuli blood flow increases in certain areas in the brain and we can track that with the sonogram functional MRIs maybe but on a patient that is under anesthesia I mean I can't I can't imagine the imagination of the person who created this with Ms blood vessels are more reactive so flows faster no one would make a diagnosis of Ms using this technique Chase NE the sub no in space aneurism what are they seeing we fin a subag bleed bleed in the head isn't causing seizures I mean it totally can I don't know why he said it doesn't it could be 10% with damage the cerebral cortex have seizure thank you can someone else defend me oh bacterial menitis viral intis how are they getting here he doesn't have a fever he doesn't have a white count that we know of he has one two issues at most one is he has a fast heart rate and two that he has a disrupted electrolyte imbalance which all can be blamed on a myriad of reasons that are more likely than Ms or bacterial menitis he just had a literally a trauma and he's bleeding in the brain and they're thinking about blaming it on a bacteria as opposed to the trauma that he just had fix the bleed or he dies I'll talk to you in a couple hours I'm in the subarachnoid space can you get it I think so put the probe back where it was so I can see the wire we're looking for the bleeding the look when I get there I'm Flying Blind without a contrast CT here he's going blind with an ultrasound this is so unethical illegal this literally would never happen never something that disrupts brain function plaques are perfect interrupt neuronal communication Ms no Ms is complicated I think this is more basic hyperbaric chambers are used for those who have really bad wounds I love that he has no problem going to a hyperbaric chamber but going to get a CT scan will be way too big of a problem let's go house wants to Adam's waking up get the anesthesiologist in here now what do you mean you were just sticking a wir iner brain you can't do some sedating meds that's no pain need some help in here Adam had an orgasm oh house empd yep yep yep let's take a minute and talk about ship station the leading web-based order management and shipping software summertime is my favorite time of year because I get to be outside swimming with bear playing basketball I was actually considering a side career riding quad bikes but after this episode maybe not along with being a doctor and YouTuber I do have a side business though of selling my own merch and the last thing I want to do when I'm trying 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to sign up for your free 60-day trial all right let's get back to the case maybe pain caus the orgasm you get a tattoo the brain releases endorphins which create pleasure most people don't orgasm from a needle prick if sensory information got Miss interpreted by the medial forbrain bundle it's possible for bad to feel good and good to feel bad so what attacks the medial forbrain bundle infective neuropath these vasculitic neopath these crabs disease metromatic Luc distrophy let's name every disease that impacts the brain and hope we find one because he had one seizure after a trauma and because he has low pottassium do you know how many patients of mine have had low potassium in the hospital if I did this to all of them Jesus what if it's just a regular old infection string in the burn skin puss on his arm isn't causing problems in the forebrain he's on 20 different medications to manage his pain his heart he's also probably on like quad antibiotic therapy in the hospital maybe not quad but he's definitely on big guns they're not allowing him to lay there un antibiotic the brain is stressed an infection elsewhere could put it over the edge so we just wait for his Burns to heal to see if you're right if you're wrong he doesn't have that kind of time what makes you think he doesn't have that kind of time like your assumption is wild Dominic Larry he another dead Doctor he's Napoleon surgeon and chief oh that's clean a lot of battle wounds by amputating legs and with bugs maggots are implanted directly into Adam's Burns yeah that's not unusual we do do that therapy sometimes to consume the necrotic tissue cuz they only feed on the necrotic tissue not the live maggots eat dead people I maggots eat dead flesh only dead flesh so they're perfectly suited to clean wounds they also killed a Bia that thrive in injured tissues maggots did great for the burn but the brain waves are still all over the map who is checking a patient's brain wave this has never happened in the history of hospitals something's interrupting his neurons chitchat like lesions we can't scan for them the only test we can do we just did and it was negative I'm pretty sure you can scan him cover him up send him to get a CAT scan he has no tingling no numbness and you read his history how do you know he has no tingling no num you can't ask ask him parents didn't say anything about what about Adam we can't look into his brain but you want us to read his mind good point I need to talk to him house you can't wake up a burn victim to play 20 questions it's torture he won't remember he's going to be an extraordinary God you're good you're putting me to sleep I know he's going to be in pain I know you disapprove I'm his attending wake him up are you his attending like I don't even know what role he plays in this Hospital oh my God I'm Dr house and he's going to thrash he's going to pull out his wires and then congratulations house it hurts it's going to get a lot worse so answer fast before the accident you experience any numbness or tingling in your fingers oh he's going to remember that in this moment any tingling in your arms or legs do something I can't Adam you got to listen to me you got to listen to me champ listen let me tell you something let me tell you something this my pants and then I don't remember God that was a huge load whatever he injected him with that was a lot urinating oneself losing control of one's bladder could be a sign of Ms not saying that house is right still it could also be a seizure and know what's wrong with our patient he's depressed he told you that when you woke him up told me he pissed his pants and blacked out it's not diagnostic of depression lack of appetite isolating yourself thank God Foreman came in with the symptoms of depression urination and blacking out are good predictors of what seizure which means the seizure he had when you tested his heart was at least his second seizure depression and seizures aren't correlated no do you know what is self-medication drug use anti-depressants have been known to cause seizures in kids but not orgasms this is a brain in trouble this is a brain with too much serotonin are they saying he has serotonin syndrome he' be so hot right now if Adam had has serotonin storm it's deadly but treatable s he today these are not the symptoms of serotonin syndrome but usually it's like multiple medications given at the same time where you going going to talk to the kid again seems nice you can't why did he say he doesn't like me anesthesiologist told the parents what you did everyone's a tattletail I mean how does he keep his job after that I guess he's going to save the kids's life uh I think he's going to wake him up again I know he is house you can't do this relax they going to sue us if I'm right I save his life if I'm wrong he's dead no matter what I do why is no one else in the hospital worried about this child except house like if there was a serious threat to his life the entire department would be trying to figure this out you got to stop this you're right he's not depressed oh you're right I was about to murder the child I'm not letting you go till you give me that syringe what's that on his wrist a burn cigarette burn it's perfect circle so a drop of burning gasoline fell on his wrist a screw from the ATV yellow cigarette he has a cigarette burn on his wrist fading nicotine stain between two fingers bad news your son has a filthy unhealthy habit good news he's trying to quit bad news the quitting is killing him he took too much nicotine no smoke meds or anti-depressants crappy ones you get over the Internet loaded with whatever anti-depressants they can get cheap since mommy and daddy obviously didn't take to a pediatrician sorry I was wrong about him being depressed so he was taking an illegally bought anti-depressant and an illegally purchased smoking sensation product which likely meant he was taking an SSRI and then he purchased like well Butrin to help him stop smoking also as buproprion which is also an anti-depressant which can lead to serotonin syndrome wow what I don't understand is he was stable his blood pressure was fine his pulse was fine repl his potassium he would have healed up he wouldn't have been taking those meds cuz he's fine he would have just recovered house y'all need to chill on the good doctor they had a giant tumor on an episode click here check that out let me fact check it as always stay happy and healthy [Music]

Dr.

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