Paramedic Rates 9 Medical Emergencies in Movies and TV | How Real Is It? | Insider
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- Опубліковано 8 сер 2022
- Paramedic and EMS captain Randy Li rates nine medical emergencies in movies and TV, such as "Ambulance" and "Pulp Fiction," for realism. Li breaks down the accuracy of emergency medical service protocols in "Ambulance" (2022), "Chicago Fire" (2019), and "9-1-1" (2019) starring Nicolas Cage. He looks at the realism of first-line treatments in "Pulp Fiction" (1994) and "Mad Max: Fury Road" (2015), starring Tom Hardy. He also breaks down first-aid procedures such as choking protocols, CPR, and defibrillation in "The Abyss" (1989), "Mrs. Doubtfire" (2005), and "Doctor Strange" (2016), starring Benedict Cumberbatch.
Li has been a paramedic in New York City for the past 11 years. He also has a UA-cam channel, where he covers all things related to emergency medical services.
You can follow Randy here:
/ rescuerandy
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Paramedic Rates 9 Medical Emergencies in Movies and TV | How Real Is It? | Insider - Навчання та стиль
He’s calm, funny and likable. I can imagine that in moments of emergency, he can stay really focused and rational. Just shows that some people truly find their professions and purpose in life!
Agreed. I was floored when he caught the mistake of lifting the motorcycle over the guy's head. He must've had something like that happen to him or his team.
@Brett Why are you floored by something that anyone should have caught? It's a 350-450 lb or more hunk of metal, plastic, rubber, etc, and you're going to lift it up and over an individuals head? Moving it with manpower alone is risky as it is, but moving it over his head is flat-out dangerous.
As a 30-year paramedic, thanks for representing the profession well.
Hope I did! Thank you
Thank you for your service. Y'all were the soldiers of the pandemic and your work is not appreciated enough.
@@RescueRandy Great job man! Represented us really well. Brother from Canada.
@@BrainBubbled my brother!
Thank you all for your service.
I had to do chest compressions on a woman a couple months ago. I've had training in the past that made me "certified" but it was years ago. It was the 911 operator that got me doing them. He had a metronome I could hear to keep pace with. I couldn't believe how tiring it was. I kept slowing down and the 911 guy kept me going at the right rate. I remembered how far you had to compress on the dummy and after only a minute, I felt her sternum break. I told the the 911 guy about it and he said that's ok, keep going. A decade or so ago, the woman had open heart surgery where they broke (cut?) The sternum to get in. I imagine that was the weak point that broke.
Anyway, I must've done something right. I was doing the compressions for about 10 minutes and the woman is alive and kicking today.
Good job!! Glad you weren't afraid to step in and help! That's an awesome story! Even in people without a 'zipper', it's very common to break ribs doing CPR. Specifically with elderly folks.
What do they care about a broken bone? They're dead.
Awesome! Praise God you were able to help her!
Doing CPR for 10 minutes is honestly pretty impressive haha, I applaude for your help man!
I had a cardiac arrest , luckily in the back of an ambo and I ended up with numerous broken ribs. The fact that I was in pain meant they did it right and I was grateful for being alive to feel the pain.
Just off the jump, I would happily trust Captain Li with my life. His calm demeanor and professionalism just scream "trustworthy" at me.
He has a stethoscope around his neck, 100% trustworthy!
Thank you so much. That’s super high praise
@@chrisdixon299 hackers have fingerless gloves, castles have ditches, and trustworthy people wear stethoscopes 😎
@@chrisdixon299 It's the equivalent of walking around a place where you're not supposed to be while holding a clipboard and/or wearing a high-vis vest
@@chrisdixon299 lol idk, man, as a veterinary technician myself, I very often have a stethoscope around my neck, trust me with your pets, absolutely 100%, i treat every pet like their my own, but trust me otherwise? Not sure if that's a great idea 🤣
I'm a paramedic with 30 years service... your NY man was 110% correct on everything... Bravo Sir !
woo! passed the most important test. thanks!
Did you get an official dinosaur certificate from NREMT?
@@macmedic892 underrated comment hahahaha
@@halofanjp A few years ago, I received a 20-year paramedic certificate from NREMT, so I know of what I speak.
So how much does it cost just to ride in an ambulance these days.
“ that’s call murder “ 🤣🤣🤣 that part took me out (6:53 time stamp)
Lmaooooooo
Time stamp?
@@zooolieee 6:35
More than what he does know, I'm impressed with this man's ability to admit when he doesn't know, and I appreciate that. As a patient, I appreciate it when my PCP admits to not knowing something and works to get me to someone who might. I've had plenty of professionals try to skirt around their ignorance rather than accept it, and it always fills me with unease. I've always respect healthcare workers who are honest. This gent seems like the reliable, honest sort.
Thank you! Gotta be honest
I really liked this expert. Loved his knowledge, how he analyzed the scenes, explaining the reasoning. Plus his reactions really felt genuine and were hilarious, like "Yep, that's called murder. He stabbed her!". I would love for him to come back and make another batch of ratings!
My favourite genre of youtube video is experts analysing tv and film. Look forward to more with Captain Li. Thanks for uploading.
Theres trully not enough
Aww thanks! Appreciate you watching
I was mentored by this guy, he’s the real goods. Thank you for what you do for the profession.
I had the Ukrainian-American version of him for my mentor back in the day. You gotta appreciate medics like them, totally committed, great demeanor, and super-knowledgeable! Those are the medics I would easily trust with my life if crap ever hit the fan!
Worked with him when he was an LT and I was new born fresh baby EMT. Great and funny man.
😁🤫
Much respect to this dude and other paramedics out there. I can’t imagine how stressful and emotionally draining this job can be
Finally an episode from a Paramedic’s pre-hospital point of view.
As a registered Paramedic in the UK, it’s interesting the differences between the skills and equipment we use in the UK, compared to the US.
It’s also interesting how many similarities there are, from clinical interventions, and administrations of medication.
Next episode, get a clinician to review ‘Bringing Back the Dead’ with Nicholas Cage.
I’ve received a few messages from UK medics over the years and have done competitions with you guys. I like the differences and similarities too! A big little EMS world!
Scope of practice also range widely in US, for example my protocol in Washington States allow simple thoracostomy, pericardiocentesis and blood transfusion(if provided)
Just finished paramedic school today. This guy was spot on. Well done Capt Li!
Congrats!
Good luck!
I shattered my hip and broke nine vertebrae last February. And some ribs. Those fine paramedics in Flagstaff gave me fentanyl in the ambulance twice, and I didn't even ask. Thanks guys, for all that you do with people having their worst moments.
Lucky. I had broken ribs, a collapsed lung and the other on the verge of collapse. They didn’t give me a damn thing until I started flipping out at the hospital and tearing at my bandages because of the pain. I don’t remember much because eventually I was given fentanyl. I could barely speak or breathe.
I broke my hip back in 2020 when I was 11 I'm 13 now
As bad a reputation as it has, fentanyl is common in medical treatment for the simple reason that it works, but it should only be prescribed for things like surgical anaesthesia (personally had it twice in the last three years for knee surgeries) or emergencies, and not things like chronic pain where the constant dosing means the risk of physical reliance and addiction becomes higher. Medical grade fentanyl is also unlike the street drugs that're often badly made or contaminated, which is a big cause of deaths and big reason why it has a bad rep.
Also, while the OP's story sounds positive, l have issues over the fact that they administered the drug without asking. I don't know what the laws of consent are in the US, but here in Australia if you are even remotely aware and sensible they cannot administer any drug or treatment without first getting your consent. This can be as simple as verbalising what they're about to do ("l'm going to give you some fentanyl, it'll help with the pain") and as long as you don't resist, that equates to consent, so in a way it's asking without asking. If that's what happened with the OP then l have no problem with that, because technically they did "ask". If they just quietly did it and you only found out later it was fentanyl, that's a consent violation.
You have to give the patient every chance to refuse a treatment, no matter for good or bad reasons, because there's always a chance they can reveal something that means that treatment might be unsuitable; a person with a history of recent opioid addiction, for instance, might object to being treated with fentanyl and if they're aware/sensible enough to communicate that you would want to find that out and give them a non-opioid instead.
Fentynal is fine, the issue is drug dealers selling it. My uncle who was dying of cancer did not suffer as much as he would have if not for Fentynal.
@@williamcurtis2145 You can start becoming physically depend to opioids after a week or so. It doesn't take very long.
As a med student, this video was quite educational and useful. Thanks for the clear explanations 👋🏻
Med student?? I’m gonna call you boss one day lol
@@RescueRandy dude you’re awesome for responding to all these people😂 I’m in emt class right Now and I inspire to be a paramedic like you one day
@@koppie4609 thanks! I’m sure you’ll get there. Study hard! Best of luck!
I'm loving these series. Thank you, Insider!
Thank you for the solid assessment of these, and for the representation of our community of first responders so well! I would ride with you!
12:35 great point. While traveling in a bus for a European tour Metallica's bus veered off the road (debatable what caused it ) Cliff Burton the bass player ended up being trapped beneath the bus and it slipped and fell when they attempted to move it landing on top of him for a second time. No one knows if he was already deceased at the time and that's always bothered me. There's a chance he was alive and perhaps he could've survived. But we'll never know. Tragic 😥 RIP Cliff Burton 🤘🏻😤🤘🏻
@Bill Denny wouldn’t you be dead the first time the tour bus crushes you, not the second 🤷♂️
@@fastkarr8256 not necessarily. I've worked as a firefighter and an EMT and now in Nursing and you would be surprised what the human body can withstand. That's why I said there was a chance and that we'll never know.
He was definitely dead at that point. He didn't just "get trapped", he fell from the bus window and the bus fell on him. Sure it added insult to injury to drop the bus on him again, but he definitely was already dead
@@myfaceismyshield5963 I don't speak in absolutes just experience. We got dispatched to an 18 wheeler rollover with a female under it and she survived after rescue. All I was saying was it can happen. I wasn't there so I can't say DEFINITELY either way.
I wonder how long he was “trapped” under the bus in the first place and how exactly his body was positioned under it. Could be Acute Compartment or Crush Syndrome, especially if unrealized at the point of rescue. It’s been shown that even one hour could lead to such severe consequences, not to mention hypovolemic shock to begin with, both which should be treated with fluid overload. I would think that the only substantial prehospital difference between the two would be how careful the fluids should be managed and if bicarb should be considered if within local protocol. Other than that there’s not too much that could be done at the prehospital level.
I just got home from EMT class, what a perfectly timed video upload! It's a great feeling now to have the knowledge to recognize something is wrong before he even says anything.
When I got my EMT cert 2 years ago, we were taught to do chest compressions to the beat of the song “Stayin Alive”, which comes out to 100-120 reps per min. If you’ve ever conducted chest compressions , you know that it will take every single ounce of energy you have in just a few short minutes when done properly.
im in the medical field and this is really tiring to do tbh.
During basic training in the Marines a recruit in my platoon started choking while we were in the "chow hall." Our DI walked over, stood the kid up and gave him the Heimlich maneuver, calm as ever. Then screamed at us to hurry the F up and eat! Good times!
What platoon?
This guy was a pleasure to listen to and watch, hopefully he comes back for more content, big respect to all those in the medical profession
Much appreciated. Thanks!
Glad to see our community represented in such a fantastically professional way. Strong work Cap'n!
Sincerely,
Va Beach EMS Captain
Thanks!
“Yeah that’s called murder” absolutely took me out. Was not expecting that.
Randy is the man!!! A great Paramedic full of so much knowledge and experience. He’s super professional and overall a great person! Awesome seeing him on Insider!!!
This is so far the funniest reaction video I've watched. His facial expressions and practical commentary for each scene was awesome!
It's interesting to me what we "know" from movies/TV. We "know" that defibrillator paddles are used when someone flatlines, so movies/TV continue to depict this, even though it's inaccurate. According to this expert (and other videos), in reality, paddles are no longer used and if someone flatlines, it's too late for a defibrillator or anything else to work. This isn't a big deal with silly stuff (no, you can't shoot off a lock), but when it comes to emergency situations a person might actually experience, then Hollywood should aim to be accurate.
I love shooting off the lock, I can not get into this, ok lets make sure we wont be able to , shoot it , hopefully its a cheap lock and not going to richochet directly into us LOL
Since laypeople won't be using manual defibrillators, I don't see it as a problem honestly.
@@literalantifaterrorist4673 in Germany you find defibrillators in every public building. I rented my local community centre and it came with a defibrillator. So we were all laymen. Glad we didn't have to use it.
@@1IGG Yeah, same here in America, but those are automatic defibrillators. The difference is that with manual defibrillators, you have a screen showing you the patient's heart rhythm and you choose whether to give them a shock or not. With an automatic one, the machine analyzes it for you. You'll only find manual defibrillators in hospitals and ambulances really.
You CAN shoot off a lock, but not with one bullet, and not up close.
Sirens was hysterical! I remember being disappointed that was short, too. Thank for this.
My dad is a paramedic and I hear all of this during every single medical show or movie scene
As an ex ER Nurse, Retrieval Nurse (who did primary retrievals) and PHTLS instructor- loved it, couldn't fault it, great episode! I was once first on scene (as a civilian) at a single vehicle accident in rural Australia. The driver was critical with an obvious head injury, GCS3 (deeply unconscious) and obvious major chest trauma. I called the retrieval medical coordinator (benefits of working in the system) and when I described the guy's chest injury and signs, she got the impression he had a tension pneumothorax (TPX) and asked if anyone on scene had a knife so I could do an open thoracostomy (basically make a hole in the chest wall and in to the pleural cavity big enough to release pressure and not close over again- big time out of my scope of practice). Fortunately she was receptive to my explanations as to why I didn't think he had a TPX (he wasn't tachycardic and wasn't deteriorating). Ultimately, after a paramedic arrived (single officer, not advanced trained), the guy did develop a TPX and I successfully decompressed his tension as described by Capt. Li. Sadly, not long after the chopper arrived with a full medical retrieval team the patient arrested and despite our best efforts (intubation, bilateral chest decompressions and even chest tubes), he passed away by the roadside. As an emergency nurse, it was an amazing experience working in the prehospital setting with absolutely no medical tools available (we did have gloves from an off duty cop who also stopped) through to having all the bells and whistles of a medical retrieval team. Still, a sad outcome 😞
I’ve been watching this guy for years! So happy to see him on one of these 🥰
0:29 The Mrs Doubtfire one....if I remember correctly, Stu said no pepper because he was allergic and Daniel dressed as Mrs Doubtfire snuck back and put a crapload of it on there before they brought the food out. So I'm not sure if he was choking because of anaphylaxis due to the throat narrowing and thus unable to swallow it or if he genuinely started choking unrelated to the pepper that Daniel put on.
Yeah Daniel is a real psycho, lol.
I think if he was suffering an anaphylactic reaction, he would have continually had respiratory issues after the shrimp stopped blocking his airway.
@@RescueRandy Agreed...I think he just probably choked on it unknowingly and Daniel thought it was the pepper and that 'he' did it to Stu.
The two are completely seperate processes, but if someone goes into anaphylactic shock then it’s safe to say that is what you should be treating for, and ensuring the airway is clear is part of the care process regardless if he just choked or not. In this case anaphylaxis should set in almost immediately, but I think he was “just” choking and not in anaphylactic shock. Had he been, clearing the airway probably wouldn’t do very much as the shock needs to be reversed or it will just continually to worsen access to the PTs airway. I’m not a medical professional or anything, so this is mostly just by speculation
@@NoobOfShame pretty spot on actually. Bonus info: let’s suppose someone was choking AND had their airway close. It’d be pretty difficult to get the obstruction out so some medics can do a cricothyroidotomy.
This was spot on. I liked the way he explained WHY we do what we do and why some of the treatments we saw were completely asinine. As a former EMS provider and current medical instructor, I enjoy learning and knowing why. GREAT VIDEO.
This guy is awesome! Such a calm and confident demeanour and a really great voice! I fell in love a little bit ❤
Love this series and this is now one of my favorit episodes! Very good stuff.
Always appreciate helping the public understand medicine better. I have a family full of doctors and its amazing how little most people actually know.
Definitely my favorite commentator so far in this genere! So deadpan, but such a great shade-thrower!
Subtle shade 😎
just finished EMT. this is dope to see 💪🏾🤙🏽
I was hoping for a Sirens part but I'm glad he also enjoys the show and gave it a shout out!
yeahhh great show. maybe they'll let me get a part 2 😉
25 year medic here (from NJ), Thank you for representing us so well.
Thanks!
This guy was terrific. I learned a lot b/c he does such a great way of explaining procedures. I would really like to see him review more medical emergencies in movies (I don't really watch TV).
emergency thoracotomys(cutting open someone's chest in the field) are actually a thing, at least here in Europe. indication is a cardiac arrest after a penetrating trauma in the "cardiac box". emergency physicians are called to every life threatening emergency and some of them are using this procedure.
an emergency physician of the Berliner Feuerwehr (Berlin fire brigade) held a very interesting and informative talk about it, which can be found on UA-cam (it's in German though)
I would totally watch more from this guy. I love how he tries to be fair about how different places have different protocols.
Great expert, can't wait to see more of him!
Thank you!
Kid of a paramedic/EMT here! This guy sounds just like my dad! Funny, but overall incredibly professional! I hope to see Captain Li back soon!
Super interesting expert - definitely do more with him!
Great video. Would absolutely let this guy save me. However; Max is living in not only the post apocalypse, but in Australia. Imperitor Furiosa is lucky enough not to have Larry and Barry. A knife, a bone needle, and a field transfusion are the best she's gonna get in the wasteland.
Yeah, even with Ambulance, it isn't, like, a normal ride or anything. It's an extended hijacking with the procedure being done there and then as an absolute last resort, when there's no hope for help and no more time to wait for the hijacking to end so they can think about getting to a hospital. Obviously what they're doing there isn't what's going on in your average 2022 ride to the hospital. Like, yeah, Furiosa's impromptu blood transfusion in the truck isn't living up to modern standards, but is it incredibly unrealistic just for that reason?
"The surgery scenes from The Knick are all very unrealistic. They're not at all how we perform surgery now. Realism: 1/10."
💖thank you, insider 🌻this person is so kind to share the knowledge and waste their time reviewing these 4us🙈💕what a beautiful creature..saving many lives and educating many more! ✨tysm 💖
Common misconception about TXA's function is that is causes increased clotting formation in the case of trauma. It actually prevents the breakdown of current clot formations. Other than that super minor nit pick, thanks for representing the profession very well. 10/10 would trust you to take care of me or my family.
I love that abyss scene. Very emotional. She really was slapped over and over again and is still bitter about it to this day saying she'll never work with Cameron again
Who is this? Or what film?
@@aazh9869 The Abyss is the film, I’m sorry I don’t know the actresses name unfortunately
It's Mary Elizabeth Masterantonio.
Awesome movie tho. It’s about a team of oceanographers finding alien life forms deep under water if anyone was wondering.
“Elevation process failed”, very technical way of saying “dropped”
Probably, but it is better wording since it covers more scenarios.
For example, if the object being removed was itself damaged, it could fall apart and cause a failure, and damage, without anyone simply dropping it.
I mean what would you rather say to the judge if it came to that.
Awesome job brother
Good job. Definitely should do a part 2 but group up with a West coast medic, I.E, Washington state, Oregon, Idaho.
Pericardiocentesis, needle decompression, surgical cricothyrotomy, RSI, all SOP over here. Rumors coming around finger thoracostomy, blood products, central line placement, and chest tubes are coming into protocols too.
Yeah the trick bag changes so much when you go across the states or over the pond. Would love to hear more about what other medics can do
Awesome video!! Would love to get his assessment on some scenes from the TV show "Emergency".
Great work 🥳🥳🥳 Thank you 💜💜💜
Thanks!
Remember, chest compressions, chest compressions, chest compressions
Preach!!! 🙌
@@RescueRandy It is easy to say until you realize you live in rural New Mexico and the nearest hospital with ambulanes is one hour drive, lights and sirens or not. Can a layperson do chest compressions for that long? And do they get any timeframe as to when help arrives? And when it is a case of cardiac arrest, they should send a medevac almost automatically (in Germany, Czech Republic or Switzerland they do), but I doubt they do.
@@paveladamek3502 yes but when the only thing you can do is compressions, you should do it until you can’t no?
Captain Li is a definite asset to the profession and did an amazing job representing it! He comes across as extremely intelligent, capable, but not cocky! I’d certainly trust him with my life if crap truly ever hit the fan!
I just love how cool, laid back and analytical this guy is
In my last first aid course CPR was taught as 15 compessions then 2 breaths (through a special cloth) and repeat. Check every minute for pulse and respiration...
As haven been trained and worked with randy in the city. This was awesome!!!
Woo! 😎
@@RescueRandy You genuinely aspire me to jump into the medical field.
@@DarkZerol best of luck!
This video caught my attention primarily because I have a friend who called our local 911 emergency service center for EMS. He was hospitalized and had an IV procedure, sort of similar to one performed in a clip here. Of course I love several of the films here, but only in Hollywood could most of these things happen.
We no longer use the mid-axillary line for the second site used for needle decompression of the chest, it's now the anterior axillary line. Otherwise very nice and informative!
I love the breakdown for the Pulp Fiction scene. Who knew drug addicts didn’t know the proper treatment for opioid overdose?
Actually…I worked in the Bronx a long time. Most of my regular drug addict patients knew the treatment. They kept it on them pretty much all the time.
As a former Heroin user... we all knew what Narcan/naloxone was. We all knew how to use it in an overdose. You'd be hard pressed to find opioid addicts today that DON'T know the treatment.
9:20 For a cardiac tamponade, the paramedic has ONE tool-
High-flow diesel drip.
In the sense of "Use your right foot and step on it driver!"?
@@book5ter That’s it!
@@macmedic892 thank you for satisfying my curiosity :)
Not everywhere - some states have pericardiocentesis for medics. I think it’s going to come back soon especially with ultrasound becoming big.
@BrugadaBro Absolutely not. Most ER docs at level 1 trauma centers don’t even do them, they have trauma surgeons do them. Chances of pneumothorax, hitting the RV, puncturing/perforating nearby arteries etc are too high for the low probability of correct placement.
He's so freaking chill.. I like that.. His blood pressure is still low while he's helping someone during a gunshot! I would love to see his series, just him!! Definitely saw the guy who passed away from colloidal silver and he was blue for years like her...
In the UK for choking we ask the patient to cough it out then do backslaps first (x5), then abdominal thrusts (x5) on repeat until it works.
RE: pericardiocentesis. You can do the procedure blind but for obvious reasons it's usually done with ultrasound. A LONG time ago the system I used to work in allowed medics to do blind pericardiocentesis in the field. For what again I think are obvious reasons they took that out of the SOPs decades ago.
That’s awesome! I never had the opportunity to learn that skill. Guess I’m still a rookie 🤣
Curious where did you work? That’s a lot of lead way to preform that blind on the bus. I remember a old medic was telling me they were doing mouth to mouth back on the 80s. Eff that 😂😂😂
@@johnlewis399 I spent most of career in the Bronx. I remember my old partner talking about the unofficial blood-letting procedure that people used to do on A.P.E. patients. So many old school procedures lol
@@RescueRandy I know where you work. Lol. Was asking the other guy. I wrk 23. 17w n 17s. Definitely been on arrest with you. 💪🏽💪🏽👍🏼
@@johnlewis399 😁🤫
I am so glad Siren’s got a shout at the end!!
I love professional wrestling, but I actually found his insights on the Foxcatcher clip the most interesting part of this video! I'd love to see more of that
(4:30) I've seen narcan deployed on two of my friends at different points (we were all fentanyl addicts at the time) and they do come around surprisingly fast. it's definitely not like in the movie where they shoot up immediately. But they do seem to regain consciousness, sit up, and begin talking again in anywhere from 5 to 60 seconds (not always though- and some people actually end up needing a second round of Narcan). It's really wild to see. LIke 10 seconds ago they were basically dead. Not breathing, unresponsive, drooling and gurgling. And then boom, they're up and talking to you, asking what just happened. Narcan is seriously a miracle drug. It's saved so many lives.
That and CPR. I personally believe everyone should know how to do CPR. I think its teaching should be mandatory in schools (maybe in Health classes). I had to use CPR on my friend in the situation I talked about previously. I'm the one who noticed my friend was overdosing and I had to give her CPR until paramedics arrived. I don't know what shape she would have been in if I didn't start CPR immediately.
In conclusion- I think everyone should learn CPR and Narcan should be more easily accessible to the public.
Im sitting in the cab of my rig right now watching this. Way to represent our profession well!
Tried my best! Thanks!
I just had (unexpected) open heart surgery [bleeding from an A-Clip procedure]. I have also been an EMT, it was interesting and painful to experience what I have seen and done before.
Hope you’re feeling better!
Cutting open the chest with trauma scissors is a real thing. There was a trauma surgeon where I used to work that used to say there wasn't a trauma procedure done in the ER that couldn't be done with a pair of trauma shears. As a resident doctor I never really believed him until one of his patients went into cardiac arrest getting loaded into the elevator up to the OR. He pulled the shears out of the resident doctors pocket, did a full clamshell thoracotomy, and started open cardiac massage in the 60 sec before the elevator made it to the OR on the second floor.
Since this video was posted, I actually got sent some information regarding this clamshell procedure. Pretty cool stuff. Definitely not used in my system 🤬
I assume the shears were much sharper?
In defense of some of the more questionable CPR techniques you see in older movies, when I took my first CPR course in the early 90s the standard procedure was 15 compressions with 2 breathing/ventilation cycles and even older procedures called for a 5 to 1 ratio. Shocking a flat line was also a legit procedure in some situations (single shock at 200J), motivated by the fact that older defibrillators could misrepresent a small wave V-fib as a false flat line (due to low resolution monitors and pad conductivity issues). Shocking a true flat line is pointless but doesn't do any harm as long as it doesn't impede other CPR procedures, so many still do it and I still hear of some occasional success despite the technical advances in modern CPR equipment.
Yup! In my system, we did a pilot program where we dual-shocked persistent asystole in case it was fine vfib.
Yep, I'm old enough to have been taught all those protocols also 😊Thank god for research which keeps us on our toe to stay current in our practice, Hollywood, not so much 😊
Remember the precordial thump technique?! 😂
Times have changed!
@@jayrose6312 Well, if I don't have a defibrillator I may still try that, as it only takes a second, doesn't do any harm and there's a tiny chance it may actually work in some cases (success rate was thought to be around 5% if I remember correctly).
@@Dr_V I still keep these things in mind because the best tool you have in any emergency is yourself! I was an AHA instructor before I retired and even CPR has a low-ish success rate when considering those who made it all the way home after their in-hospital care. I’m pretty certain you’re spot-on regarding the 5%, and that’s likely because of timing since it has to be “just right.” Now, when thinking about CPR, what is it now, 10% or 15%, but without any CPR it’s ZERO percent! The only time CPR is truly not viable is a traumatic arrest, which most protocols say to call it. Personally, when I was the lead, I told the junior guys to initiate CPR even when I knew that it wouldn’t be successful, like an obvious AAA, simply because they don’t get to practice on an actual human being very often and it may help save the next person’s life! Be well. ✌️
Emergency Pericardiosentsis - in the Mid 1990s we were familiarized with the procedure. Find your landmark (I honestly forget what it was, probably 5th intercostal space medial to the midaxilary line, while watching the cardiac monitor, insert the needle until you see a run of V-Tach withdrawal slightly and then aspirate the blood from the pericardial sack.
I'll Drive the Bus for ya anytime Capt. Li! This was great and well presented. although I'm a little surprised that they didn't do anything from bringing out the dead?
"How Real Is It? " is the BEST type of videos you publish.
06:50 "Yeah... that's called murder" 🤣😂 Man... I about split my sides laughing!!!
I like 9-1-1 and love talking about the inaccuracies and fell in love with the characters lol
I always wanted to know how true about the pulp fiction scene. Thank you!
I love that he ended mentioning Sirens!!! That is a hilarious series!! Short lived though :(
I’m watching it right now and I haven’t gotten to that part yet
For some strange reason I seem to be to there alot when people are choking. I've used the classic hiemlich many times and it absolutely works.
Cool guy, lots of knowledge. Faith in humanity restored. Thanks!
5:30 it´s a Clamshall Thorakotomie. Here in Berlin (Germany) we can do this with a Doctor even outside on the streets or in the Ambulance.
Um, that’s awesome! Best we can do is assist in amputations…
This guy is great. I would hope if I needed a paramedic, they would be as knowledgeable as him
Wow, I had no idea that defibrillation doesn't work for flatlining. That's just something I blindly accepted because it's so pervasive in Hollywood.
Lol it really is the human equivalent of "Have you tried turning it off and back on again?"
Is nobody going to talk about the casual "Huh, it's a smurf."?
Methaline blue is also used in the aquarium industry as an anti fungal treatment for fish.
There's quite a lot of treatments that cross over between humans and animals/fish etc. Another good example is Ivermectin. It was first produced for use in humans but now is predominantly used in veterinary medicine.
The crossover is pretty cool to see. We use ketamine in my system and I remember it as the horse tranquilizer lol
First thing I thought of when I saw methyl blue. 🙂
Love it!!
My goal is to be a special forces medic this guy's breakdown of everything really allows me to grasp the knowledge.
Best expert on youtube!
It's fun that he says the protocol they use is the 30x2 while, at the same time this video was published, we were using and still use compressions non-stop while another person is using the ambu bag. We temporarily stop CPR when the AED says so and, as an extra safety protocol, we have to put our hands in the air and yell "clear" so the person pushing the shock button knows "ok, nobody is touching the patient, I can hit the red button safely"
Just curious is the I/O needle placement in the sternum is standard in for exemple where this paramedic lives.
Were i work we place it in the humerus or tibia.
Please do more Episodes with this Expert
I remember Sirens. That show was great.
The show 911 is one of my favorites rn and I always wonder how accurate it is, even when I recognise when something is obviously dramatized.
Nice. Great expert.
Thanks!
Note: The song Stayin Alive from Bee Gees runs at 100 bpm so you can use that tempo to count down the crp rythm, 2 inches deep every compression
It's so cool to see professionals stay calm under pressure when everyone else is losing their sh*t