the longest running british med drama we have to review it season 36 what let's go [Music] hey good reaction hey by both parties hey what are you doing don't road rage that's not healthy abusing fellow road users isn't very constructive never grab a moving vehicle that is an argument fight you will never win whatever sound effect i just heard from her grabbing the car door there didn't sound good also didn't sound super realistic i'm assuming she's gonna have like a dislocated shoulder here or something but it didn't sound real it sounded too meaty he was like he must have driven off at some speed to dislocate his shoulder dislocated shoulder the most common type of dislocation is an anterior shoulder dislocation hey lily how are you feeling oh yeah i'm all good i'm ready to rock and roll in general i don't like keeping patients in slings like this because it actually causes uh increased rate of frozen shoulder where you have decreased mobility you get less range of motion thereby having less healing look thank you for everything i just i really want to get back to my van yes so x-rays look okay all right well obviously you can't drive with that shoulder i can't just leave it there and it's my home yeah yeah it's your home i get it it's my dad he's in the back he's got early onset dimension but you wouldn't know if you met him he just forgets a bit sometimes even mild dementia can become problematic when it comes to tasks like managing your money paying bills being susceptible to scams think about it if you don't have a good memory somebody can call and say you didn't pay a certain bill asking you for personal information you could just give it up to them and speaking of scams if you see someone that looks like me or using a name similar to me giving out whatsapp phone numbers that's not me just like the fake accounts on instagram that's a fake account on youtube record that bad boy you're going to look for clive aren't you who's life lily's at dad look i've just been calling the police let them deal with it these are overstressed i'm saving them a job the ambulances look so different in the uk than they do in the u.s i've never seen them that color but i guess they stand out so it actually makes sense that they're this color [Music] he's not here did she just leave her dad in the van like i don't understand was he awake was he alert come on cudigan walters and she said mild dementia like mild dementia shouldn't interfere with navigation i think i might need a bit of help yeah it's quite a nasty cut you got there let's try and stop it bleeding shall we what are they gonna do couldn't get up you got anything in there i can use as a tourniquet yeah you can do a makeshift tourniquet but those are never as good as commercial grade tourniquets those can actually cut off the circulation and you also need to make the decision of how bad the person's bleeding out you can stop the bleeding with just some pressure that's a better option having a tourniquet on especially a serious one for a long period of time can cause harm to the limb anything in the air can use a dressing well like a nappy maybe how about calling for help like they're making a tourniquet but at the same time they're like so what's up you got diapers what's the next best thing did she just apply a pad like this and hopes it's gonna stop the bleeding in a high pressure system no put some pressure on it i thought it was extremely weird he got on a ride at a a carnival and there's no one there look at me ladies no stop it please can someone help okay okay all right let's get you back in come on wait okay clive it's okay it's okay okay clive look at me look at me it's faith remember from the fairground now now look at your arm your arm is bleeding do you remember that's not mild dementia anymore if you're starting to forget where you are and you start acting this inappropriately that's already starting to become moderate to severe also could point to uh other medical problems it could even be acute medical problems like normal pressure hydrocephalus come on ethan let's get you inside no i never want to come back here we need to get you inside get some treatment you've got a virus vitals look uh semi-realistic we have a 91 pulse a 96 pulse ox i do not see a blood pressure on that machine maybe they didn't check it recently ethan's got the huntington's gene so huntington's disease is a progressive neurologic disorder where essentially the brain and the neurologic system starts breaking down over time and it's a deadly deadly illness i mean like from the time the disease presents itself you have like 10 to 30 years before death it's that quick and there are genetic tests available for that and it's even sometimes a highly debated topic of whether you should be tested for this if you're not doing it for genetic planning for future children finding that out could seriously impact your life for the good or for the bad so it really depends on what kind of personality you have whether or not you want to know [Music] oh that was a serious collision my thing is if you just crashed into someone have the courtesy to hit that bad boy in reverse and pull out to the person who's not trapped keep still i know it's scary but try and keep still my name's jade what's your name [Music] emma she's really good at keeping this person calm what have we got this is emma nash 31 years old driver involved in an rtc car versus lorry cab about 40 minutes ago she was executed by the fire fighters top to toe buggy hematoma on the side of her head chest wall bruising from seat belt got a laceration with arterial bleed on her leg opposite stable gts is 12. this is literally not how this should happen this is a serious trauma she's bleeding out we should have blood drawn already we should have tests going she should actually be fully undressed because you need to do a visual exam to see where she's bleeding where the bruising's happening if you've missed a laceration somewhere because that delay in diagnosis could cost her her life okay you ready to inch bait there should be a full team here like everyone's too calm and cool this doesn't seem realistic at all what is he even doing okay let's get laryngoscope et tube and and be back on standby please okay those are the right tools for intubation i love that it was him opening her jaw but she actually went and opened for him what happened here sorry you can't be in here emma emma who did this what happened can i get you to wait outside please this is why he needs more staff so he's not doing this alone this is so weird for me to watch there's literally usually seven more people in the room drawing labs controlling the patient's family doing chest compressions if need be putting in ivs gathering the patient's belongings entering data into the system putting more orders like there's so many things that need to happen all at the same time you can't be in here right now she's my sister also you need to make sure that you've intubated correctly and it's not in the patient's stomach [Music] i'm a doctor just tell me what happened okay i'll explain everything outside oh my god did he intubate into her stomach no she's been seriously injured i need to speak to the neurosurgeons and they'll they'll decide whether she'll need surgery i want to stay with her can i get you to wait in reception i promise i'll look after her this is such an awkward conversation nothing about this seems genuine or authentic uh hello yes it's ethan hardy calling from the ed he's calling for a neurosurgery consult which like okay fine you can call that place the order whatever call who you need to call but like the fact that he's like not taking care of the patient right now is a big problem oh she's been like this did you check the placement the tubes and esophagus oh no that's why you need more people in the room who is the one bagging the patient remember he didn't hook her up to a ventilator he hooked her up to a bag so someone had to be sitting there squeezing it and watching her pulse go up and her oxygen saturation go down you're here for a monash is that right you're her sister i am if this is about emma i'm a fiance she suffered a significant head injury and she made any neurosurgery once the surgeons have assessed her now her brain was starved of oxygen for a short while and we won't know yet in if there's been any permanent damage what does that mean how did she end up like that i thought you said this was a car accident it's too early to tell and if the neurosurgeons can't offer an operation we'll need to stabilise her you didn't say any of this before what changed no you intubated patients don't just lose oxygen something else happens something he's not telling me that's so not true patients absolutely do in the process of intubation go a short time without oxygen it's not like a patient stops breathing and you right away are now inserted into the patient's airway the fact that this doctor knows that something's wrong already is weird obviously they're being sketched that's part of it but just a whole weird situation i i intubated her esophagus by mistake but you recovered it straight away you've checked the o2 tracing yeah yeah i've done that i could have killed her it's a recognized complication of an intubation it's true when you're intubating a patient the risk is that you intubate their esophagus by accident that's why you check you could check the o2 sensor or you could put the little stethoscope on the lovely chest and see if the chest is rising not the stomach another thing you can do is obviously get a portable chest x-ray for placement but that is obviously not ideal because it takes longer gonna introduce me of course so ethan this is our new consultant dr nash stevie please and uh i know who you are you're dr hardy right yes i am that's her daughter or sister or whatever [Music] is she gonna do something bad i don't know but i do know you should watch my favorite med drama reviews here so click that check it out as always stay happy and help [Music]