ER Docs Done Goofed on Grey's Anatomy

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DrDrummer

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Spoilers Below!

I am almost hesitant to post this, because, well I guess that's self-evident but I was too pleased with the ridiculousness to not-- I read a brief thing in the newspaper talking about how Grey's Anatomy was ending or something and how the staff lost McDreamy because he was at some other hospital after an accident, bemoaning how only if he'd been at Seattle Grace, he might've made it. In an instant, I knew how this episode would go. So today, I managed to summon the strength to watch enough of it to find out if I was right in my assumptions-- for what it's worth, I think this is the 2nd episode of this show I have attempted to watch, and I skipped through what looked like any parts of people talking outside the plot outlined below, so I may have missed some details.

Spoiler alert: Dr. McDreamy gets T-boned, coincidentally after using his surgeon skills to save a bunch of other MVC patients on the roadside, and ends up in a semi-rural ED and dies of bleeding into head (! - I believe he's a neurosurgeon) while being boarded in the ED / taken back to the OR for a ex-lap without pre-operative imaging. Sadly, his hair did not seem to offer much in the way of protection. To her credit, while jogging the bed down the hall, a young ED attending does try to advocate for a quick scan before OR before being overruled by the somewhat aggressive surgeon-- who also manages the airway in this particular center-- so maybe the ED doesn't get all the blame here, but you know how these things go.

Those of you with too much time on your hands can see it yourself at abc.go.com/shows/greys-anatomy/episode-guide/season-11/21-how-to-save-a-life -- highlights include the discussion of the positive FAST, his excellent roadside laparotomy skills, and when the faces of the ER doctors when they're told "He's a surgeon!", and his inner monologue during what was apparently not enough general anesthesia at ex-lap. Oh, and some really great and inspiring pep talks from Dr. Grey to the attendings at the rural hospital when she goes there to withdraw care.

I think the overall theme of this is a valuable lesson we can all take away about intra-departmental cooperation in the management of trauma patients, and it provides a great example of the importance of serial neuro exams, as well as the necessity of careful consideration of what "really needs the OR now". Would rate 6/10. Would probably not watch again, however will harvest footage from this for use in later lectures on trauma management and ED/surgery communication.

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Honestly its difficult to even say they are ER doctors. I watch the show and there is NEVER an ER doc at the main hospital in the show. May be 1-2x I can remember. There are hardly any nurses either. Theres always the surgeons running all the ER stuff. I think this was the case during this episode at the smaller hospital. The "ER doc" ended up doing the surgery and what not with the other surgeon who didn't want the scan.
 
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There's no EM physicians in the Grey's Anatomy Universe. All EDs (including Seatle-Grace and the smaller ED) are staffed exclusively by Surgeons. If anything, the lesson is we should be have ED Attendings in EDs. Or the lesson is that Neurosurgeons oncalls shouldn't take 2 hours to come to a trauma patient. Or don't take a job at a hospital with 50% staff turnover from dying.
 
My favorite part of this whole episode is when the nurse starts turning off all of Derek's "life saving"drips. First one, gentamicin. Second, gentamicin.... I don't know how many drips there were maybe 4? But they were all gentamicin as he obviously is dying from an extremely aggressive pseudomonas infection and did not need any pressors, seadatives, etc.
 
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I actually interviewed with an attending at UCLA for residency who used to be one of the medical consultants for the show. He quit because no one ever listened when he told them something was ridiculous.

I've seen the show a few times. Clearly, they do not use medical consultants.
 
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