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doctor-reacts-to-worst-grey39s-anatomy-episode-lvad

Doctor Reacts To Worst Grey&#39;s Anatomy Episode | LVAD

some have said this is the most controversial Gray's Anatomy episode I think it's time for me to chime in let's get started I know Denny's cardiac parameters I know how his lvad works better than any other intern I also know his meds better I know the frequency the dosage the quantity and his physical limitations that's actually a really important factor in the success of any medical treatment if your medical team is well versed on your chart the chance of a mistake occurring drops down significantly and by the way patients need to take some initiative here on their own to know what medications they're taking to be interested ask questions advocate for themselves if not themselves their family members advocate for them because I can't even begin to say how many of my patients come in taking 10 different medications not knowing what they're for what their dosages are and that's a mistake waiting to happen I have some names for you oh this is our guy from Walking Dead and um he looks like Lewis Espino from the channel by the way does he not oh he was in Magic City one of my favorite canceled TV shows you're getting a heart Danny I don't mean to be dramatic at all but I'm gonna need you to repeat that he looks and sounds exactly like hispina it's crazy what's the weirdest reaction you had from a patient in doing a prostate exam I've had strange sounds I had one guy almost break my finger off you are getting hurt I'll give you more what the hell happened to my daughter he went into v-fib oh no give me the palace grab take over compressions okay please please don't shock the Flatline patient he's a stock I don't get it he's Ace of solid because his heart is no longer having any electrical activity and you trying to restart his heart by Shocking is not how it works you give the epinephrine if not it fails it fails just because your donor's heart died doesn't mean I have to give you mine is your patient higher on the transplant list I have no idea the way that they decide is based on proximity matching obviously and matching includes HLA typing blood typing cross-typing and then one of the most important things for a heart is actually the size and shape of the recipient's chest cavity so imagine you have a very small person getting a very big heart that heart may not be able to beat properly and therefore it's not a good match as of this morning Dr Hans patient was 22 hundredths of a point ahead that's basically a tie the point ahead based on Whose scoring system I know like for liver transplants to put people on a list there's actually scores that we use called meld scores I forgot what the other one is called for heart transplant I wasn't even aware there was a score and there were two donors is he our guy's hard flat line now he's trying to get the other guys there's a list yes then the higher guy gets the heart Denny's getting worse by the second Saturday now in the 70s and dropping is he I'm not I understand advocating for ones you care about but you can't lie this is like the equivalent of killing someone else did she put him on a Nitro trip um yes yes of course she could be putting paddles directly on his heart he's still not getting this thing the amount of animosity in this hospital is bewildering to me the fact that one doctor is like I don't care if you're patient on the death but you ain't get my heart and then the other person is just making it up and acting like their patient's dying when they're absolutely not what is happening Dr Han what if Dr Berg wants to run Labs do an echo and a BNP to fully ascertain the status of his patient will allow it that'll take an hour that's going to take longer than an hour by the way especially in most busy Hospital Systems getting an echo means getting attacked then getting a cardiologist to read it like that's just not gonna happen stat he'll get the next heart is no he needs to get this heart he'll probably get a heart at some point but as long as Denny's doing well on the lvad and there's someone ahead of him on the transplant list he's not going to get this hard they're almost saying it and stuff like honeybee have to follow the rules no no this is the right thing to do rules or not the person who is in Act of danger deserves the heart not the person you want to go on the date deserves the heart you're right okay thank you if she starts poisoning him I'm gonna lose my mind in order for you to get the heart you would have to get worse much worse and you would have to do it very quickly well I don't see that happening you see that happening I am going to make it happen I had Gray's Anatomy on my list I don't remember where it was but I just demoted it I retroactively I'm going to go back into that video and demote Gray's Anatomy after seeing me like this Catherine Heigl deserves to be like the evil version of House MD that doesn't try and secretly make their patients better by being unethical but just secretly wants to kill her patients by being unethical don't worry you're not gonna die I will be here the whole time oh my gosh I didn't expect this all right this is wrong you've waited a year and a half to get this thing who knows when the next one is going to come along is this how she gets kicked off the show please okay I'll do it you know like when you a conversation goes too far and you have to like walk it back I'm gonna walk this back you have two patients that need a heart there's only one heart available one patient is actually sick but the other patient who's okay and stable waiting for a heart is in love and because they're in love and their manipulative doctor girlfriend or person whoever they are in this relationship wants the heart's so bad that they're actually going to screw over the person who's dying in order to get the heart and Lobby for the heart to come to their lover holy okay after I do this I might have to shock you a few times do what Izzy um I feel like we should stay stuff does anybody want to say stuff a person is actively about to be murdered and this other resident George has no qualms about this unplug it why are you you could law breaker man all I have to do is confirm that his condition is worse and then Burke and call you knows and he'll move up on the list and he will get his heart she's gone insane right it's not just me he's been shot what this is a comedy oh this is I don't know if the writers deserve a raise or someone should take away their Adderall because this is a problem this is bad this is bad and serious and it gets a lot of rules it's not fun for me I don't want to play what if you remain well I wouldn't have fallen in love with a patient do you fell in love with an attention what sort of bear what's the point the point is we can't help but we fall in love with okay I think this is a point that I have to say this doesn't happen in hospitals this is the equivalent of saying that like that crazy story that happened on Netflix with the murdering nurse that happens everywhere no no no it doesn't happen everywhere how's this heart looking just laugh ventricle is shot and he's barely pushing blood out when a heart starts having a very low ejection fraction that puts you into a risk for developing arrhythmias in the heart potentially fatal ones because then you're not able to adequately supply the heart with the blood that it needs to function and keep beating because remember the heart's job is not just to pump blood to the body but also to itself and actually in patients who fall below a certain ejection fraction threshold they actually get something known as an implantable defibrillator that if their heart starts failing so bad that it stops or goes into an abnormal Rhythm it actually shocks them back I love him you don't even know him I do know him you've never even seen him outside the four walls of this Hospital you don't know him I know him do you know who should be most afraid of her the dude because if she's willing to kill you for love do you know what she's gonna do if you try and break up with her there's possibility here and and given the choice of running or staying you should a sane person a person who values her career and everything she's worked for how about the other person's heart how about Humanity he's hypoxic he doesn't know what he's saying he said marry me right he did any wake up wait stop dying and tell me you want to marry me ah he's Flatline no no he's not Flatline there's movement in his Hearts okay um let's shock him uh charge the people later they don't even know what Rhythm Is it is it shockable is it not talkable but let's shock them we need that medicine one medicine I'll know it when I see it I think the one that stops the heart is keep my heart beating no no it only stopped your heart for six seconds adenosine is a medication that we use to break supraventricular tachycardia which is the SVT that they just mentioned and basically it's a pretty scary medication to give because when you give it it actually completely stops the heart and allows the heart to restart and sometimes it could break it there's also some unique things that we do to try and trigger a Breaking of an SVT like dunking a patient's head in cold water like I'm not even joking or having them try and bear down and do Val Salva Maneuvers kind of interesting okay pending Doom does happen with adenosine can't see flat lines for a few seconds and then it should come back fools try to have a good explanation for this people in medical school and residency would throw you under the bus because you came four minutes late to lecture here their residents are so tight-knit that they'll help prevent the murder to help out a romance in the hospital he's gonna get the heart right you're gonna sign the charts and talk to the transplant coordinator okay the labs I'm gonna guess that his BNP is significantly elevated on his Echo he has a worsening ejection fraction and if they did a chest x-ray they're going to see significant pulmonary edema see his BUN and creatinine are increasing okay B1 creating because these kidneys are failing he clearly has pulmonary edema he deserves to move up to one a status on the transplant list okay by the way bun creatinine is not what decides pulmonary edema pulmonary edema is decided by a chest x-ray so this is complete horse poop oh and by the way I keep saying BNP but I'm not defining it BNP is brain naturic peptide but it's a marker that is released uh when there is significant strain on the heart and a lot of times it is reflective of when a heart is failing signaling that there's worsening of congestive heart failure look at that thing the left ventricle is excessively dilated when we talk about congestive heart failure a lot of times we talk about an enlarged left ventricle the left ventricle is the part of the heart that actually sends blood to the rest of the body so when that part of the heart can get actually too big it hypertrophes it doesn't fill and relax as well in order to fill with blood and then send blood to the rest of the body including the heart so there's two types of dysfunctions when it comes to heart failure systolic heart failure when the heart can't pump as well and in diastolic heart failure where the heart can't relax as well both are big problems slightly for different reasons but the treatments medication wise change depending on whether it's systolic or diastolic heart failure you look God you look amazing is it bad that I secretly want him to break up with her right now and then she goes into cardiac arrest from stress-induced cardiomyopathy like tacosobo and then he has to do CPR while the rest of the rescue people arrive that would be really fun he's flatlining why is no one being notified of this why is it the monitoring alerting anybody if he just had a heart transplant he's in the Cardiac Care Unit at the very least he's hooked up to Telemetry and someone is being notified of that I think it was a stroke he was prone to blood clots a clot could have formed on a sutures travel to his brain it only takes it could have been a lot of other things but you know guessing in A Moment Like This is really appropriate because clearly you have zero medical ethics speaking of scams here are some Tick Tock scams of when they're trying to get you to purchase products that are absolute BS click here to check that out and as always stay happy and healthy and don't become a criminal and cut people's hell that wires [Music]

Dr.

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