Trauma: Life in the ER

[Firebird]

Last night as I was watching the show on TLC, I started wondering if anyone here on the forums have been in a hospital that has been on the show. If so, did you get on TV?

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[Colorado_2]

I love watching Trauma, but they should also do segments that focus more on ER Doctors that are less overworked, poor, and tired. They always seem to highlight the residents, or really strange attendings (i.e. that guy at NM General who wore goggles all the time), which gives people a somewhat skewed perception of the occupation.

 

[tussy]

I love the show, but now that I spend my time in the real thing, i find the show gets me a little tense rather than relaxing. It's also cool to see all the traumas; We don't have near the volume of trauma that they do in the USA; I've only ever seen 2 GSWs, one was self inflicted and the other was a hunting accident!

As for the wierd docs they show -- it's not far off from the truth. Most of the ER guys I know are a little off. That's what makes it so fun in the ER! Also, you never see a real resident who isn't exhausted while on surgery call! I don't think it's a skewed impression, I find it quite realistic overall.

 

[Winged Scapula]

Firebird...

I was at the University of Louisville and they shot an episode of the show there. Unfortunately, I didn't get on camera although I was down in the ER a couple of times for consults with my resident (on another service; I didn't do an ER rotation). There is a newby here who is a resident there; maybe he got his mug on camera!

 

[EnRoute]

Hey Everyone,

This isn't something I normally would post, but since we're on the topic of Trauma: Life in the ER, did anyone see the episode two weeks ago in Savannah, GA? There was an intoxicated 21 year old male who fell on his face a couple of times. He was with his sister, who was also a drunken mess. Anyway, he was conscious and claimed he couldn't feel anything. The doctors then gave him a rectal exam, which he most certainly felt by the expression on his face. Pardon, my ignorance, but what was the purpose of the rectal? Were they just trying to see if he was lying, or was their a real medical need for this exam? I imagine this poor guy will never drink again after being filmed on TV for not only being dropped off at the ER for being drunk, but also for having a rectal!

 

[Mango]

First off, a rectal exam is a normal part of an ED exam. They are looking for blood, not for prostate cancer.

Also, the hospital I used to work at as a PCT is CURRENTLY being filmed for the show!! They are spending an entire month there. It's Grant Medical Center in Columbus, OH. So I am very excited to see the show. They said they will air this fall. And the director of Emergency Medicine at Grant is friend of mine (we were neighbors). So I can't wait to see him. He's hysterical, so it should be fun to watch!

Incidentally, the film crew was there when one of the Columbus Blue Jacket's (NHL) players got smacked in the face with a puck. He fracture his maxilla in two places. So that should be an interesting episode!

I'll post a reminder on SDN when they are going to be on!

 

[tussy]

Enroute,

In the trauma patient the digital rectal exam is for more than just blood. It is an essential part of the neuro exam (looking for the tone of the sphincter muscle). Also, blood, prostate changes (high, boggy prostate might mean urethral injury/pelvic fracture), and I'm sure there are other things. One would be negligent not to do the DRE.

Here's something that I've always wondered about the show. How do they get consent from the patients to film them? I know if I was a trauma patient I certainly wouldn't want to be filmed whilst I screamed in pain, had someone cut off my clothes and stick tubes and fingers in every oriface. Also, most of the patients have altered LOC due to trauma, drugs, etc. They certainly don't have the capacity to give consent. Does the show find them and ask them afterwards? Do they get paid?

 

[EnRoute]

Thanks for the response to the rectal exam question. As I said in my previous post, "pardon the ignorance." I still in the very beginning stages of learning, and I have never been (knock on wood) a patient in an ER.

EnRoute

 

[Firebird]

Originally posted by Kimberli Cox:
•Firebird...

I was at the University of Louisville and they shot an episode of the show there. Unfortunately, I didn't get on camera although I was down in the ER a couple of times for consults with my resident (on another service; I didn't do an ER rotation). There is a newby here who is a resident there; maybe he got his mug on camera! •

Cool...so why were you in Louisville, if you went to Penn State?

Just out of curiosity, what'd you think about Louisville? Were you there for a while? The few times I've been there have been for the KY state Beta convention and it was a lot of fun...but all I got to see was downtown.

How's the Medical School there? It will certainly be one of the places I apply.

 

[Winged Scapula]

Hi Firebird...

I was doing a visiting 4th year elective at U of Louisville. My father's family is from there and Lexington so I thought it would be fun to go there (plus the Chief of Plastics was a friend of one of my professors).

While the University Hospital is pretty standard, the surrounding private hospitals are nice and posh: Jewish and Norton. I tried to spend most of my time there! The library certainly seemed adequate, although the hours left something to be desired on the weekends (as I recall it didn't open until 1 pm on Sundays). Most of the students seemed happy, except those doing Surgery there (its pretty traditional, teach by intimidation sort of situation). The SDNer who is a surgical resident there agrees with that statement but feels he is getting excellent training and I have no doubt whatsoever he is.

Since I was on a specialty rotation I didn't have too much contact with other students except in the library, occasionally in the ER or in the OR, but I'm sure it would be a great choice for school. I must say the bus system there was extremely convenient and cheap compared to other places I went to.

 

[Homunculus]

A little off topic, but we have a student here that was in one of the "Paramedic" episodes. It was the one where a tornado rips through Oklahoma City, and he had to set up a triage by himself in a powerless gymnasium... I'm sure he had a lot to talk about during his interview ..

take it easy

homonculus

 

[kris]

Originally posted by Homonculus:
•A little off topic, but we have a student here that was in one of the "Paramedic" episodes. It was the one where a tornado rips through Oklahoma City, and he had to set up a triage by himself in a powerless gymnasium... I'm sure he had a lot to talk about during his interview ..

take it easy

homonculus•

Wow. I saw that episode, and I think it's the only episode I've ever seen. He was amazing in the midst of being absolutely overrun and left with critical cases for which he could do nothing but wait.

My hat's off to him.

--kris

 

[Pilot]

He is a super nice guy too.. Apparently he was on 48 hours tonight but I missed it. My wife came outside to tell me that a classmate was on t.v., but by the time I rounded up the boy and the dog, the shopw had shifted to a couple in Nebraska saved by their dog.

 

[draper]

Hey Firebird,

Life in the ER came to Yale last month, and I was able to get onto TV. The camera guys and crew are pretty laidback and funny- they ask you lots of silly questions while you work. I was sewing up a lac and my patient was spewing profanities.

 

[Hopkins2010]

Pilot,

Do you go to OU Med or OSUCOM?

 

[droliver]

TWO COMMENTS:
1. The trauma life in the ER from Louisville segment focusing on the ER residents smuggling ETOH into the KY Derby infield was disgraceful, especially with alcohol being such a causative factor in so many of the patients that end up in the ER in the first place. It showed a tremendous lack of both judgement & professionalism to be documented in such a fashion. I for one would lose my job over something like that.

2. The "life in the ER" shows tend to portray a somewhat skewed view of trauama mangement with their editing. In real life @ level I trauma centers, much less of the decision making is in the hands the ER staff & is more directed by the Surgery/Neurosurgery staffs with the more severly injured patients. The show "E.R." also portrays this kind of unrealistic picture of what is done (ie. frequent ER thoracotomies & tracheostomies). The real utility of well-trained ER physicians is not heroic interventions, but rather an efficient & reliable triage to specialists who can take care of life-threatening injury and the screening of patients who do not require trauama specialist (unfortunately this second function is sometimes infrequently employed resulting in tons of CYA surgical consults).

 

[Winged Scapula]

I had TOTALLY forgotten about that part droliver. Guess I only remembered the good stuff about that episode (ha ha unlike my memory of my rotation there! ; ) ). You're right - it was unprofessional and pretty immature; I can't believe they allowed it to be caught on camera.

What kind of release rights do these shows expect? Do those that are included in the show have to sign waivers on everything, or can they have final right of edit? I've been hoping that one most shows of this ilk (and including Hopkins 24/7) that they are trumping up the glamour/weird personality stuff for ratings because frankly some of the residents and attendings they show on these programs are sorely in need of some major personality overhauls.

 

[relentless11]

I was at UC Davis Medical Center one day in the PICU just observing with an MD, i saw some camera men, but not sure if it was TLC.

However i've met the surgeons that were on the episode with UCD Med Center if that counts?

 

[droliver]

Kimberli,

I was strictly cuttting room floor material at the episode filmed here. They really film a lot of hours & edit it down to one or two depending on how much good material they get. I did manage to get my face in the background in one or two scenes to mug for the camera

To use any of the footage they must have a release from both the patients & any MD's they interview/follow. Issues of consent can be quite ethically concerning in my opinion for some of these intoxicated patients & many families declined to participate (especially some of the bad head injuries in younger folks)

 

[Winged Scapula]

Too bad I didn't tape it - I could look for you frame by frame! I tried my best to stay away from any tv cameras in any hospital I worked at - figured it couldn't ever amount to any good!

I agree - the issue with consenting someone who is under the influence of some substance, with a head injury or really under any kind of severa stress (as would commonly be seen in Trauma patients) is extremely ethically challenging. I often wondered who consented for these patients. My other query was whether or not the participants had final editing approval - it wasn't so apparent in the UofL episode but on several of these shows I've seen some of the staff come off so bad, you gotta wonder do they even realize how pompous/arrogant/ignorant/general pain in the ass they appear to be? And if so, why didn't they ask to have that deleted? I for one would not want to the world to see me in that light (unless of course it was my dominant personality characteristic).

 

[Annette]

The local news was doing a story on heroin abuse (too common in Brighton), and wanted footage from the A+E. Of course, someone came in OD'd and they filmed him! After he was semi-awake, the consultant asked if he wanted to be on telly. The news showed this poor guy being berated and lectured by the consultant. Then, they showed the guy with a just say no message. They guy didn't get any follow-up, or even a referral for a detox program (which has a long waiting list). This guy had no ability to consent, was used, and gained nothing from the whole fiasco. What was the whole point? The consultant got his ego stroked (he is a very odd person). I felt slimey for even being there.

 

[droliver]

Kimberli,

there is a waiver that you sign releasing you from any editorial control of the content. What they showed was not previewed for the University prior ro airing (except a screening about 24 hrs prior for the ER residents), otherwise I believe someone would have edited the whole Derby episode.

 

[mcprotein]

WOW! sphincters are tight in here. Smuggling of ETOH into the derby is no big deal. I'm sure they drank responsibly. God forbid someone wants to cut loose a little. Everyone loosen up. xoxoxo mcp

 

[droliver]

I agree, taking alcohol into the derby is kind of a tradition, like sneaking booze into college football games.

What is NOT appropriate is being documented as the representative of 1) the University of Louisville 2) the University E.R. program & the 3) Medical community at large while taking IV bags full of grain alcohol or Vodka after an episode (like all the Life in the E.R. episodes) demonstrating the destructive force that alcohol abuse is & the consequences to society. This was a clearly supreme lack of judgement on their part & again, in contrast to them, if I was videotaped doing this I would be fired the next day (rightly so).

 

[TechMan]

For those of us who have not seen the episode you guys are referring to, could you please explain what happened. I have sort of pieced it together from the various posts, but i'm not sure exactly what happened at the derby.

 

[Winged Scapula]

This belongs in The Lounge...I'll move it over for ya.