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Transcript
00:00So Grey's Anatomy has a plane crash episode. I've been on a plane where there's been an
00:04emergency. Let's see how it compares to Grey's Anatomy. Let's get started.
00:21Post-plane crash, that's gonna happen.
00:30Oh, that is a bad place for that object to be.
00:44Oh my God, don't pull it out just like that. I don't know where they are in this plane crash,
00:48but if you're in society and there's an object that enters your skin, don't rush to pull it out.
00:54Allow first responders to get there because sometimes that object is putting pressure
00:59so much so on an artery that it actually stops blood loss. I know it's counterintuitive to leave
01:04an object inside of you, but if you're stopping bleeding, it's better than ripping it out and
01:08causing a ton more bleeding. Oh, she did it so abruptly. At least put massive pressure
01:15on that area right now. She's looking for boo. That's commitment to boo.
01:29They're like, we don't have enough drama in the hospital. Put them in midair.
01:46Is she under the plane? Well, Mr. Obvious, her heart's racing and she's short of breath? Yes,
01:55she's bleeding out and she was just involved in a plane accident.
01:58You're all out of breath and you're all tachycardic.
02:01We gotta get her out of there.
02:08Pop it back in. Pop it back in.
02:11Oh, what is he, what is he doing? Wait, wait, wait.
02:13With her shoulder? Shoulder dislocations are very, very painful, but then once
02:17they're reset, they feel better. And then if you need surgery in order to reduce it,
02:20it's called an open reduction internal fixation, meaning that usually you need
02:24hardware for a fracture and such. Oh my God, that was so dramatic.
02:30It did not need to be like that. Oh, there's my boy.
02:42Oh no. How did he survive?
02:44Knowing nothing about this plane crash, there is nothing around him to pad his fall.
02:50He just fell on his body from the sky and pieces of the plane fell on him and he's chilling.
02:57Should be played by Hugh Jackman at this point.
02:59That's a Wolverine reference for those who didn't know.
03:10Grey's Anatomy, where you go to the hospital to get your heart broken.
03:15Yeah! Again. One, two, three.
03:22Someone has not been doing his deep squat protocol.
03:27Lexi, run it down for me.
03:30My legs and my pelvis are crushed.
03:32See, crush injuries are incredibly complicated,
03:34especially when you return circulation to an area.
03:36Sometimes you can have massive inflammation response, massive electrolyte imbalance.
03:40Certain bones can create a fatty embolism,
03:42which can get into the circulation and end up in your lungs.
03:44My chest feels like it's gonna explode, so it's probably a massive hemothorax.
03:52The hemothorax is massive bleeding inside the thoracic cavity.
03:56And that's problematic because if there's massive bleeding in the hemothorax,
03:59it can interfere with the heart's ability to pump,
04:01because the heart needs to expand to fill and then pump and contract.
04:05We gotta get the oxygen from the plane.
04:07Okay, and fluids, fluids. You need water bottles.
04:09And the tubes, the oxygen tubes.
04:12We can get the fluids. We can get the fluids. Okay, go get them.
04:15I just don't know what you're doing. Like, maybe you're buying some time.
04:18Oral rehydration in a situation like this probably won't be fast enough.
04:22I always make fun of people going to IV drip spas,
04:24thinking that this is somehow gonna cure their hangover
04:27faster than just drinking water in terms of hydration.
04:29But in a situation like this where you're hypotensive and dying, big difference.
04:34I can't find him. I looked everywhere. I can't find him.
04:37Maybe he's fine. Maybe he went for help.
04:39Maybe, but I gotta keep looking.
04:41Meredith, help Lexi.
04:47You could just tell, like, he's not filling out those scrubs.
04:50Like, if he was just a little bit more into the lifting lifestyle,
04:53he was following the Dr. Mike Izzertel protocol.
04:56He would have thrown that wing like it was butter.
04:59Butter?
05:02I feel like he has, like, a little olecranon bursitis going on there,
05:05maybe from the trauma.
05:06The bursa is actually a sac that lubricates the joint,
05:08and if you have trauma there, it can get swollen.
05:10Develop, like, a golf ball on the elbow.
05:11I love you. I've always been in love with you.
05:15I will always be in love with you.
05:18Which is why you have to stay alive.
05:21We...
05:22We're gonna get married.
05:24I don't know the love backstory here,
05:26but if he never said that until now,
05:29and he's using that as a lie,
05:30and he's really just gaslighting her into this,
05:32don't gaslight someone to stay alive.
05:36See what happens when you love bomb somebody?
05:40Keep it together anyway.
05:41Do you think Derek is dead?
05:43I've got PTSD, so you know I'm not reliable.
05:50I heard your voice.
05:51He heard screaming.
05:53I thought I was driving.
05:55Oh.
05:56Oh, you're more worried about that than him falling out of the sky?
06:06With eyewash solution too?
06:07I mean, anything to clean out the wound, I guess, is smart.
06:10That tourniquet is smart.
06:11Not just wrapping an article of clothing,
06:13but actually creating a lever on it is smart.
06:16You need that extra ratchet right there.
06:17They actually sell some supplies.
06:19You can keep it in your first aid kit,
06:20and I think that's quite valuable.
06:37I don't know if he has sensation to that arm anymore.
06:45It looks like it's mangled.
06:47Just closing it lightly like that is not gonna do much.
06:50Remember, it's about putting pressure.
06:52He has a tourniquet on there, for God's sakes.
06:54You're already cutting off massive circulation to that area.
06:56Doing that, I don't even know what's the added thing.
06:58What, are you gonna take off the tourniquet?
06:59It's gonna bleed like crazy.
07:03Sorry, I'm laughing at this gruesome scene,
07:05but I just can't.
07:06It's so ridiculous.
07:07They're putting a safety pin in hopes the safety pin
07:09will stop the bleeding.
07:10How ridiculous.
07:11Mark, we need to start a fire.
07:14Mark.
07:15Mark looks like he's stressed.
07:16Mark, get up and help Mark.
07:18Get up.
07:20He looks unwell.
07:21What if he's bleeding internally?
07:23Mark.
07:23He looks blue.
07:24He looks cyanotic.
07:25He's not getting enough oxygen.
07:29Oh, blood force trauma to the chest.
07:32Cardiac bleed.
07:34Tell me they're gonna do open heart surgery in the forest
07:36with a safety pin.
07:38It's a cardiac tamponade.
07:39Oh, yeah, I'm sure.
07:42I'm sure without your little ultrasound probe,
07:44you were able to do that.
07:45Are you sure?
07:4675%.
07:49Oh, man.
07:50That's not very sure.
07:51If you want me to be sure, get me an ultrasound.
07:53Well, at least she's honest about the ultrasound.
07:55Have a cardiac sac and relieve the pressure
07:57or his heart will stop.
07:58With what?
07:59We don't even have an 18 gauge.
08:00Okay, hold this.
08:01Keep the top off.
08:02Is that hairspray?
08:03Use the tube.
08:04Brilliant, brilliant, okay.
08:05Brilliant?
08:06Is that brilliant?
08:06I don't know what they're planning to do.
08:08This tube be long enough?
08:10I'm going in subcycloid knife.
08:12They're creating a chest tube, but this is ridiculous.
08:14The heart sits within a sac called the pericardium
08:17is the covering of the heart.
08:18If the heart is damaged in some way
08:20or the pericardium is damaged
08:21and the blood vessels start leaking blood
08:24into the pericardial sac,
08:25imagine it starts putting massive pressure on the heart
08:27and as it beats and it keeps secreting more blood,
08:30pumping more blood into the sac,
08:32the less room the heart has to function.
08:34And as a result, the person slowly starts dying.
08:36And if you put some kind of tubing into said pericardium,
08:40you could actually allow that pressure and the blood out,
08:44therefore allowing that person
08:46to potentially heal and stay alive.
08:47Oh my God, it's a helicopter.
08:59He couldn't figure out how to use the flare gun?
09:01Come on, man, you're a surgeon.
09:03Oh, they found them.
09:05Or they're dreaming about being found.
09:06My sister.
09:07Where's Lexi?
09:08Where's my husband and Christina?
09:10Just lay back and relax.
09:11I have to get, all right.
09:12I have to get to my sister.
09:13All right, hold on, hold on.
09:14Hey, you can't go in there.
09:17That looks like reactive psychosis
09:19where she had like a really traumatic event happen.
09:22And then as a result, maybe some hallucinations,
09:25auditory or visual delusions.
09:27They actually call that brief psychotic disorder
09:31based on DSM-5.
09:33If they sedated them,
09:34would there be a benefit to sedating everybody
09:36once they're on the plane?
09:38If they're putting them on a coma, yeah.
09:39But otherwise I don't understand
09:40the benefit of sedating everybody.
09:42Unless they were just wild and out of control.
09:44Sedating people that don't have capacity
09:46to protect their airway actually can be quite dangerous.
09:50Oh, that's a broken hand.
09:51There was damage to the second metacarpal
09:53but the first MCP joint was completely crushed.
09:55Oh, his thumb's not gonna work.
09:57So Boise did an X-fix.
09:59I revised it to an internal fixator.
10:00Well, that's an ORIF as we talked about earlier.
10:03Your hand was badly damaged.
10:05And I think conservatively,
10:07I can get you back to 80% function.
10:09That's very hard to know
10:11in the beginning stages of an injury.
10:13You need to see how progress is going in rehab
10:15in order to make any kind of reasonable estimate.
10:17What's that line?
10:18Hold her.
10:19Get someone to straighten her out.
10:20Get somebody else to straighten her out.
10:22I got it.
10:22Oh my God, is everyone going through reactive psychosis?
10:26And why is she in a C-spine stabilizer?
10:28Wasn't she up and moving and running around?
10:29Or do they just not know who's who?
10:31The combination of extreme exhaustion,
10:33dehydration and exposure
10:35seems to have put her in a state.
10:37What do you mean?
10:37We think it's reactive psychosis.
10:39I mean, it could also be just full-on brain damage
10:41or a post-sictal state.
10:42Sometimes after a seizure,
10:44patients will behave very, very abnormally
10:46and not know that that's even happening to them.
10:48And these kinds of reactive psychosis, if you will,
10:51lasts for like one to 30 days
10:54based on the DSM-5 criteria.
10:56What the hell did they do to this guy out there?
11:07If he's got a pulse, why are we still shocking him?
11:10God, where the hell is Shepard?
11:11Avery, tell me what's going on.
11:13Torres, where you been?
11:16Pretty amazing recovery, right?
11:17Yeah, his stats are good.
11:18He's been weaned off pressers.
11:20Yeah, BP's 110 over 60.
11:21You think it's a surge?
11:23It might be.
11:24I don't know. I don't think it is.
11:26What's the surge?
11:27Oh, they're saying like terminal lucidity.
11:29That's a wild call to make
11:31and something you could easily rule out.
11:33Basically what they're saying is
11:34before like the last few hours to maybe days in some cases,
11:39some people have a resurgence of energy
11:42where their brain sparks this massive,
11:44specifically a gamma wave function
11:47where they seem more lucid than they've ever been.
11:49Patients get hope.
11:50So you have to do a lot of counseling
11:51and explain that in situations
11:53where end-of-life care is being given,
11:54that could be something to expect.
11:56However, in this case, he had a heart issue.
11:58They fixed it.
12:00Why would there be terminal lucidity?
12:02But this is not that.
12:04But in a little while, he'll do what all patients do.
12:07He'll have epiphanies.
12:08He'll tell you what really matters in life.
12:10Ask for his family.
12:11Man is telling dirty jokes.
12:12It's not a surge.
12:14If you think it's that,
12:15please scan his heart and see what it is
12:18and fix it for God's sakes.
12:20He doesn't have a terminal condition.
12:22And if he does, you should be acting on it.
12:25And no one's doing chest compressions,
12:39chest compressions, chest compressions.
12:41How typical, Grey's Anatomy.
12:43Click here to hear about a story of a woman
12:45that survived falling out of an airplane.
12:48Hard to believe, but worth watching.
12:50Click here to check that out.
12:50And as always, stay happy and healthy.
12:54Transcribed by https://otter.ai