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Practice English Speaking&Listening with: Surgeon Breaks Down 22 Medical Scenes From Film & TV | WIRED

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- [Nurse] He's not breathing.

- [Dr. Benton] Wouldn't you agree, doctor?

- Incoming.

- [Nurse] In here, Dr. Connors.

- Hi, I'm Annie Onishi.

[bell chiming]

- [Narrator] Annie Onishi is a surgery resident.

- No, no, no.

I graduated residency. [bell chiming]

I'm fellow in trauma surgery and critical care now.

You asked for it.

I'm back, breaking down more clips from film and TV.

Roadside liver surgery, "The Good Doctor."

- Here's your liver.

I'm gonna need you to sign for it.

- How long ago did you take it out?

- [Shaun] Three hours.

- We just lost three hours.

- [Shaun] Technically, three hours and five minutes.

Chill clock's on the cooler.

- So, once an organ has been removed from a donor,

that starts the clock for what's called

a cold ischemic time.

That is the amount of time that the organ

is not actively receiving blood flow

from the original patient, and then from the recipient.

- What about a police escort?

[siren whooping]

- [Officer] You my doctors?

- And MD does actually personally deliver that cooler.

You get to ride on an airplane sometimes.

You get to ride in the back of an ambulance,

lights and sirens.

It could be pretty exciting.

- I don't know what you're looking for, Shaun.

- Yes, I can feel it.

It's firmer.

- I don't know what that means.

- There must be a clot,

but there isn't a clot.

The scans shows no clot.

- There's no way you would be able to detect a clot

or a thrombus inside the liver.

That's just not.

Unless you had ultrasound vision

at the tips of your fingers,

you wouldn't be able to do that.

- We have to immediately remove the clot

and flush the left lope to protect it from the ice bath.

- You don't need to protect the liver from the ice bath.

I'm not sure what he's talking about.

- Hey, we need to stop the car.

- Here?

- Yes, yes, we need to operate right here, right now.

[horns honking]

- So, great, they Googled Couinaud segments.

That's like super cutting edge, super accurate.

So, the Couinaud segments are how we

anatomically divide the liver based on

its blood supply and its biliary drainage.

So, there are segments one through eight.

This is correctly labeled.

It's missing segment IV-A and IV-B,

but other than that,

that's pretty good.

This is also not what a liver looks like.

So, when a liver is procured from a donor,

it actually comes with a bunch of stuff attached to it.

So, it comes with the big portal triad attached to it.

That has a, basically, the business end of liver,

how the liver drains.

It comes in a little piece of intestine

attached to it still,

a bunch of blood vessels in the back.

We bring more than we're gonna need, basically.

It does not look like that.

[horns honking] - This is better

than better than having a baby in my car.

- Do not put that liver into me.

Subcutaneous infestation, "Evolution."

- [Harry] Get this guy the [beep] our of me.

- It's gonna be okay, Harry.

Cut him open.

Let's get this thing.

- Cut me open, there goes your Christmas gift, Judas.

- [Doctor] All right, it's moving down his leg.

[Harry groaning]

- I would put a tourniquet on the leg

and trap it and then go after there.

That's what I would do.

- Wait, wait, wait.

- [Harry] No, no, no, no, no, no.

- It's going the other way.

How you goin' in?

- Rectally.

[Harry screams]

- Personally, I don't think I could get this rectally.

It does look pretty subcutaneous.

- I'll get the lubricant.

- [Doctor] There's no time for lubricant.

- There's always time for lubricant.

- Agree, there's always time for lubricant.

- Don't clinch, don't clinch!

- So, as an expert in rectal form body surgery,

telling the patient not to clench is not gonna work.

You really have to give these people a lot of sedation

and get them pretty much totally to sleep

if you're gonna go up there and fish something out.

[Harry screaming]

He looks like he's in a ton of pain

and obviously very uncomfortable.

There's no chance of getting anything out.

- [Allison] Oh, it's over, it's over.

- I've never personally seen a bug like

that crawl from the leg into the colon.

- What do we do?

- The only bugs I've ever encountered have been in Kenya.

There's an intestinal parasite called

ascariasis. [bell chiming]

It's a series of tapeworms that end up

living inside the intestinal tract

and actually cause obstructions.

- Don't you ever do that again!

- Cricothyroidotomy from "Anaconda."

- There's something in the mouth.

- [Danny] Damn, what's that?

- [Denise] Oh, he's still not breathing.

What are we gonna do?

- [Paul] Quickly.

- [Denise] What's that for?

[squishing] [Denise gasping]

[metal clinking]

- That's not exactly how you do that.

A cricothyroidotomy is an emergency procedure

that is performed when a patient that has their airway

that cannot be intubated from their mouth.

So, looks to me like the indication here for a crike

is that this patient has

some sort of wasp in his upper airway.

So, maybe there's some swelling in the airway.

So, typically a breathing tube will go into the mouth,

into the trachea, then we can connect that tube

to a breathing machine so the patient can still breathe.

- [Denise] What are you?

- In an emergency situation like this, yeah,

I would probably just use my knife,

get down to their cricothyroid membrane and yes,

enter sharply like the did there.

I'm not sure what kind of tube that is

but it looks like reasonably sized tube.

But then we need to start ventilating right away.

It just doesn't work if you just stick it in there.

You have to breath for the person.

- It's gonna be all right.

- Chaotic emergency, "Grey's Anatomy."

- How are his vitals?

- They're bad.

We've got no airway. - Oh, yeah.

- I can't crike.

- The doctor here says that she can't crike,

and I don't know why.

You can almost always crike.

- He's got sub-Q emphysema.

- Okay stop.

And this thing that she says,

subcutaneous emphysema, [bell chiming]

what that refers to is that child has air

in the skin and in soft tissues on the chest.

That's usually a sign that something really bad

has happened to this kid.

He probably needs an emergency chest tube

ad he certainly needs his airway controlled somehow.

- All right, I need an ET tube.

Orange drawer.

Orange drawer.

- I knew that.

- No chest sounds in the right.

I can throw in a chest tube.

- Wait a second, does anybody actually have chest tubes?

- So, clearly, in this chaos, the nurses are not here

so the doctors are trying to the job

of both the doctors and the nurses

and this is what would happen.

- I'm trying to set up this saline drip

and I can't get this thing to stop beeping.

Anyone?

- So, that's 100% accurate.

So, when doctors like me try to set up IV pumps,

which is normally the nurses job,

usually we can't figure it out.

Usually, there's bubbles, there's beeping,

there's alarms, nothing works,

and a nurse usually has to come and rescue me.

- IV drip rate.

It's different for kids depending on the size.

Anybody have a calculator?

- Broselow tape says he's 30 kilos.

- That Broselow tape, that's a real thing.

So, when a child comes in,

it is a tape that you literally

measure their body length, width

and it will give you the best estimate

for how much that kid weighs.

- Broselow tape says he's 30 kilos.

Standing concentration of dopine is 1,600 marks per cc.

So, five times 30 is 150, times 60 minutes an hour is 9,000.

Divide that by 1,600.

Fusion rate is 5.625 ccs per hour.

- So, that's the kind of math

that nurses do in their heads all the time

or they have memorized from

giving this medication so frequently.

- [Female Doctor] Well, I feel like an idiot.

- Brain transplant in "Get Out."

So, in "Get Out," they perform a series of really

barbaric and racially-driven brain transplants.

Luckily, in my opinion, brain transplant is not a thing

and probably won't ever be thing.

[ominous chorale music]

Rookie mistake.

You're all sterile, you're all scrubbed in,

and then you touch your mask.

Start over.

[machines beeping]

So, technically, those glasses

don't count as eye protection.

He's a psychopath, but he should really

know more about sterile technique.

In real brain surgery,

you don't actually remove the skull cap.

You make sort of a curvilinear incision

along the plane of what part of the skull

you're gonna remove.

[suspenseful music]

So, this is clearly Doctor Armitage's

special torture brain surgery tray.

- Oh, wait, I am so confused.

- I don't really recognize any of those instruments.

I think the instrument second from the bottom

looks a little bit like something called a rongeur,

which is ho you remove bone fragments from things.

I see some suture scissors up next.

Honestly, the thing on the left looks like

a speculum for lady parts, but I'm not 100% sure.

- I mean, I told you not to go in the house.

- Directing your own surgery, "Ronin."

- Easy.

I've done this many times before.

Here, just cut up there, just a little cut.

- The operating surgeon here is using an 11 blade.

That's typically not really used on skin in this manner.

Typically, to make the first incision on the skin,

you use a 15 blade or a 10 blade.

- Take the clamp.

- This is a sponge stick.

You see a ton of sponge sticks in medical dramas.

It's unbelievable.

- 12 inches below. - Clamp.

- [Doctor] Can you see where the blood's coming?

- This is not how you use a sponge stick.

A sponge stick is typically used deep in the body.

It's a piece of gauze wrapped around

what's called a ring forcep.

- I'm sorry.

- It's used to very gently retract

very delicate structures that are deep and in the way.

It's not used to blot.

- Did not.

Open it up, spread it, spread it.

- Robert De Niro is describing spread, spread, spread,

which means actually, inserting the tips of that instrument

and spreading tissue so you can make a cavity bigger.

It is a maneuver that we use in surgery very commonly

if we need to get access to a certain place.

- If you don't mind, I'm gonna pass out.

- Dropping someone off at the ER

and then leaving, "Hustlers."

- Please help, this is my husband [crying].

- This is actually a thing.

We sort, tongue and cheek, refer to this as the homey drop.

Usually, it's because either they happen to be

right by the hospital when they got hurt

or somebody's too scared to call the cops or call EMS.

Usually, we're just grateful that they brought

the patient to medical attention so we can help them.

Heart surgery from "Crank 2."

[slurping]

- Oh.

- That is not what the human heart looks like.

First of all, it doesn't continue

beating once it's all disconnected.

[doctor speaks foreign language]

Without sounding too creepy, yes,

we do comment on people's insides.

[squishing]

[doctor peaks foreign language]

So, as silly as that looks,

that does actually exist in real life.

It's called a

total artificial heart. [bell chiming]

It's usually used as bridge to a transplant

for a patient who has something very, very wrong

with their actual muscle of their heart.

[air hissing] [doctor screaming]

This is definitely some back alley heart surgery.

I really would not recommend going to these doctors.

- Ah, it's not so bad.

- Jacks appendectomy, "Lost."

[dramatic music]

So, you do actually flick the needle like that.

That's to get the little air bubbles out

so you don't inject air into the patient.

- You know, Jack, they found some chloroform

at the medical station.

I could knock you out.

- No, I'll manage with the lidocaine.

- Lidocaine is a local anesthetic

that's used to numb the area.

It's what you commonly might get

in your gums at the dentist.

[Jack grunting]

That is massive incision for an appy.

That is huge, totally unnecessary.

Appy is short for appendectomy,

which is the surgical operation to remove the appendix.

- Spreader.

- I think that she's probably asking for

what's called a self-retaining retractor.

That's a little skin retractor

that would stay open by itself,

so freeing your hands.

Oh, there we go. [clicking]

Look, that's actually what's called a Finochietto retractor,

not typically used on the abdomen.

- No, hey.

No, I don't wanna be unconscious.

- You don't wanna be out of control.

Dammit, Bernard, knock him out.

- I'm sorry, Jack, but I agreed.

- Well, he's just being loud and fidgety.

I would want him knocked out, too.

But we actually, there's a lot of reasons

we put patients under general anesthesia for surgery.

Obviously, one is comfort.

The other is total muscle relaxation.

So, we actually give you a little bit of paralytic

so your muscles completely relax

and that actually makes incisions

on the abdominal wall much easier.

- Wouldn't you rather be dreaming

about something nice back home?

Eating human brain from "Hannibal."

- See the brain itself, feels no pain, Clarice,

if that concerns you.

- So, it is actually true.

The brain itself has no pain fibers.

So, once the patient has been sedated

and the craniectomy part has been performed,

they don't actually need to numb the brain in any way.

- [Hannibal] Now, here's the sac that contains the brain.

- So, here this little membrane Dr. Lector

is removing is something

called the dura. [bell chiming]

It's not really that stretchy

or kind of shiny like that or rippable like that,

but that is an actual layer that protects the brain

between the brain tissue itself and the skull.

And if you look at this diagram here,

you can see all the different layers in the head.

So, you have the scalp, the skull,

the there's a potential space

with the different layers of dura, followed,

finally, by the brain tissue actually below all that.

[sizzling] - That smells great.

- I personally prefer mine with a little more

garlic than that, but I'm sure this is fine.

Though I'm not a brain surgeon,

I do know that in some neurosurgical procedures,

the patient is actually wide awake

so that fine, elegant tasks such as speech

or fine motor movement can continue to be tested

while the surgeon is operating on

that particular area of the brain.

So, that way the surgeon knows this is the area

that's controlling this for this patient.

We shouldn't cut that, we shouldn't touch that.

Self surgery in "Wolverine."

[electronic buzzing]

[heart thumping] [suspenseful music]

- I gotta get that thing outta me [grunts].

- No, listen to me, Logan.

- First of all, I wish my scalpel

was attached to my hand like that.

That'd be pretty cool.

[Logan gasping]

That looks like pretty pure CGI to me.

It doesn't look like real x-ray.

[scratching]

- [Mariko] No, stop!

No, listen to me, please no! [Logan grunting]

Stop!

Listen to me! [Logan screaming]

- There are some operations that we do use

active x-ray so we can monitor certain parts of the body

while we operate on them.

- Keep going.

- So, our orthopedic colleagues

always use something called the C-arm,

which is a dynamic, moveable x-ray

to take pictures of the bones

as they're getting fixed.

Same thing with vascular surgeons.

They very commonly use x-ray to take pictures

of the blood vessels that they're operating on

and to fix those blood vessels.

So, the use of x-ray in and of itself

during surgery is very common.

The surgical checklist, "ER."

- [Surgeon] I don't remember being asked

if Dr. Benton could scrub in for this.

- And this is an example of how a surgeon comes in

with his hands sterile

and somebody else helps him get dressed.

- [Surgeon] Put him under, let's do this.

- Whoa, whoa.

What about the checklist?

- [Surgeon] Excuse me?

- Safe surgery checklist?

- The safe surgery checklist is a real thing

that's practiced every day in every operating room

in this country.

- [Surgeon] I've had 10 cases a day, doctor.

- [Dr. Benton] It'll only take a minute.

- [Surgeon] One minute.

- John Cotter here for a right cadaveric renal allograft.

Does the patient have a known allergy?

- No.

- Does anesthesia anticipate a difficult array?

- [Anesthesiologist] No.

- Is the risk of bleeding greater than 500 ccs?

- So, that's a great representation of a surgical time-out.

That's really thorough.

It goes through all the major important things.

- Any nursing concerns?

- [Nurse] We don't have reperfusion solution.

- [Surgeon] We won't be needing it.

- [Nurse] I'll have some sent up.

- They said they didn't have enough perfusion solution

in the room so the nurse went to go get it.

And that's gonna save them some trouble later on

in the operation so people aren't

rushing around trying to get what's needed.

- [Dr. Benton] I think that this is

an excellent teaching opportunity, doctor.

- We take this practice from airline safety.

So, before an airplane takes off,

the pilot, the co-pilot, and the air traffic controller

go through a checklist where they check

every single system on the airplane

and make sure everything's in working order

before the plane takes off.

A surgical checklist is the same thing.

We make sure that we have identified the proper patient,

that we're doing the correct operation,

that we have all the equipment we could possibly need.

And it really is meant to reduce

medical errors and surgical errors.

- No, let's just take out time and introduce the room.

- [Sheila] Sheila Ling, scrub nurse.

- [Paula] Paula Cheney, circulating nurse.

- [Kay] Kay Schumacher, anesthesiologist.

- [Randall] Randall Okerman, chief surgical resident.

- [Nathan] Nathan Dean, surgical intern.

- So, that's actually a great representation

of who all is in an operating room.

You had the attending, you had two assistants,

the resident, and the intern, those two nurses there,

the circulator and the scrub tech,

as well as the anesthesiologist.

This is actually very accurate.

- Were any antibiotics given in the last 60 minutes?

- [Kay] Just starting them now.

- [Surgeon] 10 blade.

- Wait, hold on, hold on, hold on.

If you run the antibiotics prior to incision,

you cut the risk of infection by half.

- [Surgeon] Dr. Benton, you're a guest here.

And I don't like guests.

As a friend of the patient,

you're welcome to sit, observe, and shut up.

10 blade.

- In real life, surgeons are definitely not that impatient.

They will absolutely wait for the antibiotic to go in

'cause they don't want the patient to get an infection.

- Any concerns from the surgical team?

- [Surgeon] Only that you're wasting my time.

- So, it seems like this surgeon

who is about to do this operation

is sort of anti-checklist.

That's really a no-go these days.

So, we always do a time-out no matter what.

Well, that is a lawsuit waitin' to happen.

- Impersonating a nurse, "The Dark Knight."

[Harvey gasps]

[Harvey grunts]

- Hi.

- So, nurses do wear nursing uniforms.

That's a little outdated, a little old school.

Most of them are just regular scrub tops

and a uniform top that just says RN

and the name of the hospital.

So, if Harvey Dent really had a burn like that in real life,

he would be intubated, he'd be on a bunch of medications,

receiving a ton of IV fluids.

He would be really, really sick

and really not able to fight back when the Joker comes.

[Harvey gasps]

and here in the background,

you see some coronal images, [bell chiming]

which means a picture taken in this dimension of the body

that looks like an MRI slice of a brain.

It looks pretty normal.

I'm not sure why Harvey Dent

would have needed to have an MRI.

- I don't want there to be any

hard feelings between us, Harvey.

- A patient intake survey, "Parks and Rec."

- Everything you write down is confidential.

We need you to give real answers.

- Fine.

- So, there are definitely some patients I meet

that are not super trusting of doctors.

It's okay, it all, it usually comes from

probably a bad experience.

But there are better ways than what she's doing

to sort of work around that and get the patient

to warm up to you a little bit.

- Ron, you redacted all the information.

- I answered some of 'em.

- For date of birth you wrote springtime.

- You should be a little more friendly.

Her tone is a little terse.

She looks a little impatient.

Her facial features are not super friendly,

warm, welcoming, or patient.

So, she could probably take a chill pill and try again.

- Organ procurement, "Robocop 2."

- Make it fast.

We've got six minutes before the brain's useless.

[patient gasps] [flat line beeps]

- I'm not sure what she's talkin' about.

The brain is always gonna be useless.

There's no such thing as a brain transplant.

[metal clacking]

[drill whirring]

[skull popping]

So, this is the way Hollywood brain surgeons

like to do craniectomies,

which is like a full top skull cap craniectomy.

[bell chiming]

But that's not really how it's done in real life.

[skull popping]

As far as I know, there's no [sucks air]

suction cup effect.

But correct me if I'm wrong.

- [Juliette] Here it comes, thing of beauty.

- So, this makes no sense at all.

So, this guy's suppose to be dead.

This is a bypass machine.

So, the bypass machine is pumping blood for him

in a supposedly dead body.

So, just not terribly consistent.

[water bubbling] [dramatic music]

I have never a dissection like that.

I don't think you could get all those parts

out together or on block like that.

I mean, to transplant organs,

you just 'em in a little bag with ice and a plastic bucket.

You don't use this bubbling fish tank sort of set up.

I've never seen that before.

- We're only human.

- A gunshot wound from "Seraphim Falls."

[Gideon moaning]

[fire crackling]

- You don't necessarily need to remove a bullet

just because you have a bullet inside.

But if you wanna have Pierce Brosnan

take his shirt off and flex,

this is a good excuse to do it.

[sizzling] [Gideon stifled screaming]

So, you could definitely use a red-hot metal blade

to cauterize a wound but that thing was not

actively bleeding, so I really,

I would have just have left that alone.

Another shirtless guy using fire

to cauterize his wound, "Rambo III."

[dramatic music]

[scraping]

[fire flaring] [Rambo screaming]

Here's another guy with limited medical resources

and what appears to be a soft-tissue injury.

In the absence of, you know, hemorrhage

or something that really need to be controlled,

I would just leave these wounds alone.

But I think this is a pretty reasonable technique

to cauderize, but again, completely unnecessary.

- You're not serious?

- Oh, yeah, I'm serious.

- The janitor makes the diagnosis, "The Fugitive."

- Al, get over here, I need you.

Make some room, we got another head comin' through.

Hey, could you give us a hand here?

Can you bring this kid down to observation room two?

- It would not be typical for someone

from the housekeeping staff to transport a patient.

[x-ray rustling]

- Deep breaths, that's good, that's good.

- This doctor slash janitor is looking

at the x-ray of what looks like a baby.

You can tell sort of from the dimensions

of the chest and the way the bones look.

He's also looking at that x-ray backwards.

You can tell because the heart

is not where it's suppose to be.

- [Richard] Hold that elevator, watch out.

How are you, kiddo?

- It just hurts.

- [Richard] Yeah?

Where's your mom, pal?

- I don't know.

- Is she home?

- She with my brother.

- Your brother?

Are they downstairs?

- [Joel] I don't know.

- I can't exactly tell what he's crossing out

and what he's about to write,

but on any medical record,

it would be really suspicious

to cross something out.

You'd have to get a new form.

- [Richard] They sent this one up from downstairs.

- So, patient handoff doesn't really

work like that these days.

Usually, it's a series of phone calls

from the nurse in the ER to the accepting nurse

in the OR or on the floor.

Same thing with the doctors.

There's a series of what we call handoffs

about the patient, what their diagnosis is,

what work up has been done,

what other tests still need to get done.

It's usually not like this

where it's kind of a word of mouth

and a trust this guy in the janitorial uniform

to give me the kid and his diagnosis.

That's a little suspect.

- [Richard] Bye, bye, Joel.

- I don't typically, affectionately rub the faces

of my patients before they get wheeled off to surgery, no.

That's not really my style.

Horse tranquilizer straight to the neck, "Old School."

- [Frank] What kind of gun is this?

- That's a tranquilizer gun from a hunt--

[air rushing] - Ow.

- Not exactly sure what tranquilizer

was in that tranquilizer dart,

but one common tranquilizer that we might use

in the emergency setting is something called ketamine.

- Yes.

- It is a drug that works very quickly.

It doesn't cause any major hemodynamic shifts,

meaning it won't alter your blood pressure too much.

And it's a quick on, quick off kind of drug.

So, it's a pretty good medication to sedate

a person in the emergency room if you

have to do some quick procedures.

- Wait, pull what out?

- So, definitely, as the medication is setting in,

patients will start to feel foggy, start to feel groggy,

and may, yeah, have some mental slowing.

- [laughs] Whoa.

- Impersonating a doctor, "Catch Me if You Can."

- Gentlemen, [patient crying]

what seems to be the problem?

- Bicycle accident.

- Sponge stick strikes again. [bell chiming]

- Fractured tibia about five inches below the toe.

- Doctor Harris?

- Yes?

- Do you concur?

- I mean, he sort of looks like a doctor.

He talks like a doctor.

I think he could probably trick a couple people.

But I think that this is a little bit of a stretch.

- I think we should take an x-ray

then stitch him up and put him in a walking cast.

- [Nurse] Hold on.

- So, I completely disagree with his suggestion

to get this kid in a walking cast.

What that looks like is what we would call an open fracture,

meaning you can see the bone through the injury.

So, that actually, is pretty involved.

It's usually more of a severe injury.

That patient should probably go up to the operating room,

get a really good wash out for concern for infection,

and probably get some surgery to fix that bone.

[retching]

A dead giveaway here is the nausea.

Most doctors aren't too squeamish.

Here's an example of a patient arrival in "Code Black."

- 16-year-old boy fell down stairs,

minor burns, no KO.

- Hey, how ya doin', buddy?

- Fine, I fell.

This is all probably overkill.

- Did you see the incident, sir?

- [Man] No, I didn't.

- Anything else you can tell us?

- [Man] Nothin'.

- So, this is a pretty good example of the first responders

dong what's called giving report.

They are bringing the patient in.

They are telling the doctors

and nurses in the hospital what happened to the patient.

It sounds like this patient fell down a set of stairs.

- [Paramedic] Minor burns, no KO.

- When they say, "No KO," means no loss

of consciousness or no knockout.

- Anything else you can tell us?

- So, here we have two nurses

sort of dividing and conquering.

One nurse is getting what's called collateral history

from the person who came into the hospital with the kid

and the other is attending to the child's

medical needs right now.

- Ah, it's really dumb, actually.

I fell down some stairs.

- This seems like a pretty stable patient

with a relatively minor mechanism of injuries.

So, for that reason, there's no trauma team

or a bunch of surgeons running around

trying to figure out what happened to the kid.

It's pretty much just nurses at this point.

Tick-borne illness, "House."

- He has tick paralysis.

Dan tracked a tick onto his jeans.

- Tick bites don't ordinarily cause anaphylactic shock.

- This girl's allergies are not ordinary.

[girl gasps] [device beeps]

- Devon? - I'm administering atropine.

- This us just gonna get worse.

- So, that bag valve mask,

that's like atrocious right there.

Bag valve mask ventilation is seen here

with this purple.

That's called an ambu bag

as well as that's on the patient's face.

That ambu bag should be squeezed

in a very particular way to observe

the chest rise at a certain rate.

So, the rate at which she is squeezing,

which is really fast,

that's gonna cause a couple things.

Number one is hyperventilation.

Number two, she's just gonna fill

that patient's stomach with air,

which can cause a lot of other problems down the road.

- As long as we're stuck here, [alarm chiming]

this might be a good time to look for that tick.

[patient gasping]

- Atropine's wearing off.

- So, he says here the atropine is wearing off.

Atropine is a medication

that we would use for bradycardia,

which is when the heart rate is really slow.

So, it sounds like she got really bradycardic,

they gave her atropine, it's wearing off,

meaning her heart is slowing down again.

And on the monitor, you see that her heart rate is 45,

so that's pretty slow.

- We treat her symptoms, she dies.

We find the cause, she lives.

That tick an IV drip of poison.

We unhook it, she'll be fine.

- [Mother] Oh, my God!

- Whoa, whoa, whoa.

See? [monitor beats steadily]

- Usually with tick-borne illness,

you get like a, what's called a dilated cardiomyopathy.

But that takes like weeks to month to develop.

This is, that's just, this is not real.

I don't know what to tell ya.

- Conclusion. [bell chiming]

- I realize that a lot of what Hollywood

does in the OR and the ER is for dramatic effect,

but it's pretty fun to check out what they do right

and what they do wrong.

And don't forget, if you're enjoying "Technique Critique,"

subscribe to "Wired."

[clapboard snapping]

The Description of Surgeon Breaks Down 22 Medical Scenes From Film & TV | WIRED