WEBVTT 00:00:07.880 --> 00:00:10.759 You're in the bay. Once you get over to the bed, 00:00:10.919 --> 00:00:13.560 we'll give you the story. Everything's going 00:00:13.560 --> 00:00:17.339 to happen super fast. Welcome to the emergency 00:00:17.339 --> 00:00:47.799 room. Alright guys, so another crazy story this 00:00:47.799 --> 00:00:54.289 one happened, I would say probably two months 00:00:54.289 --> 00:00:58.950 ago, three months ago, something like that. So 00:00:58.950 --> 00:01:03.710 if you guys have been in nursing school, I don't 00:01:03.710 --> 00:01:06.750 know what nursing program you are in. I have 00:01:06.750 --> 00:01:09.689 listeners like literally all over the globe. 00:01:09.689 --> 00:01:14.989 And that's pretty cool. But recently, the Netherlands 00:01:16.650 --> 00:01:21.969 Hey, hey Netherlands, what's going on guys? But 00:01:21.969 --> 00:01:28.750 Yeah, I've had a lot of Have listeners basically 00:01:28.750 --> 00:01:31.849 all over all over the globe all around the world 00:01:31.849 --> 00:01:36.390 and so I don't know what nursing program you 00:01:36.390 --> 00:01:40.549 guys are in but in my particular nursing program 00:01:40.549 --> 00:01:45.849 They made it sound like or seem like Like I wouldn't 00:01:45.849 --> 00:01:48.870 take care of a lot of LVADs. And so if you're 00:01:48.870 --> 00:01:53.170 not familiar with what an LVAD is an LVAD is 00:01:53.170 --> 00:01:58.670 a left ventricular assistive device. My hospital 00:01:58.670 --> 00:02:04.969 we take care of a ton of LVADs. It is the complete 00:02:04.969 --> 00:02:08.129 opposite of what they told us in nursing school. 00:02:08.689 --> 00:02:11.729 They made it sound like I might not ever see 00:02:11.729 --> 00:02:16.810 one in my entire nursing career. And I see at 00:02:16.810 --> 00:02:20.789 least two or three a week and I only work two 00:02:20.789 --> 00:02:24.169 days three days a week. Okay, so at least once 00:02:24.169 --> 00:02:29.930 a day and so If you're not familiar with what 00:02:29.930 --> 00:02:32.030 I know that is because you haven't made it that 00:02:32.030 --> 00:02:37.210 far into your program yet What it is is that 00:02:37.210 --> 00:02:40.889 for our particular hospital in our at our facility? 00:02:41.449 --> 00:02:45.650 an LVAD criteria patient is a patient with significant 00:02:45.650 --> 00:02:49.150 heart failure with an injection fraction of less 00:02:49.150 --> 00:02:55.310 than 20%. Now, a healthy ejection fraction is 00:02:55.310 --> 00:02:59.610 over 50%. That is where you're supposed to be 00:02:59.610 --> 00:03:08.240 is anywhere over 50. The better. So If I'm not 00:03:08.240 --> 00:03:11.039 mistaken, I'm not in cardiology. I'm an ER nurse, 00:03:11.039 --> 00:03:16.180 but if I'm not mistaken, I believe you're diagnosed 00:03:16.180 --> 00:03:19.259 with heart failure. If your ejection fraction, 00:03:19.439 --> 00:03:24.240 your EF is below 30. If I'm not mistaken, if 00:03:24.240 --> 00:03:27.419 you're in cards, please, you know, leave a comment 00:03:27.419 --> 00:03:31.560 or something for the correction there. But or 00:03:31.560 --> 00:03:34.639 if you know what it is, but if I'm not mistaken, 00:03:34.719 --> 00:03:41.330 I believe it's below 30. And so it then you qualify 00:03:41.330 --> 00:03:44.930 for like again at my hospital if your ejection 00:03:44.930 --> 00:03:49.469 fraction is below 20. Now, the significance of 00:03:49.469 --> 00:03:54.509 that is because if your ejection fraction is 00:03:54.509 --> 00:03:56.669 low, then whenever you put your heart under stress, 00:03:56.889 --> 00:03:59.330 your body is not going to be able to handle it 00:03:59.330 --> 00:04:02.310 because your blood is not your heart is not able 00:04:02.310 --> 00:04:04.629 to pump the blood to meet the demands of that 00:04:04.629 --> 00:04:07.830 particular activity. And so it can lead to a 00:04:07.830 --> 00:04:12.150 sinkable episode. Now, if you are just listening 00:04:12.150 --> 00:04:15.090 to this, just listen to it, you know, because 00:04:15.090 --> 00:04:18.089 of whatever the reason and you're not in the 00:04:18.089 --> 00:04:23.310 medical field. If you by chance at any point 00:04:23.310 --> 00:04:28.470 in your life was like running or walking or just 00:04:28.470 --> 00:04:30.870 walking up a flight of stairs or a hill and you 00:04:30.870 --> 00:04:34.550 just passed out for an unknown reason, you need 00:04:34.550 --> 00:04:38.040 that checked out. Because you're not supposed 00:04:38.040 --> 00:04:42.079 to have a Syncopal episode, which is just passing 00:04:42.079 --> 00:04:44.879 out. You're not supposed to be passing out just 00:04:44.879 --> 00:04:50.259 doing ADLs your active daily living type stuff 00:04:50.259 --> 00:04:55.720 so That right there is it so the LVAD what it 00:04:55.720 --> 00:04:58.620 does on the rough end of stuff again I'm not 00:04:58.620 --> 00:05:03.319 a cardiologist and I'm not a CV nurse Basically 00:05:03.319 --> 00:05:07.600 what it is is that the LVAD will take over for 00:05:07.600 --> 00:05:12.019 the LV part of the LVAD the left ventricle the 00:05:12.019 --> 00:05:15.800 left ventricle. So like it'll just kind of like 00:05:15.800 --> 00:05:18.939 bypass the left ventricle in the machine will 00:05:18.939 --> 00:05:22.379 pump it directly into the aorta to kind of perfuse 00:05:22.379 --> 00:05:26.660 the rest of the body. Okay. And so on paper, 00:05:26.660 --> 00:05:29.300 it sounds legit, right? It sounds pretty cool. 00:05:30.040 --> 00:05:33.980 And so But when you start looking at some of 00:05:33.980 --> 00:05:37.420 the pathologies that kind of go on, you know, 00:05:37.480 --> 00:05:41.300 with the heart here, it kind of like defies the 00:05:41.300 --> 00:05:49.439 pathologies of a lot of stuff. And so. Like. 00:05:50.699 --> 00:05:57.300 The story is that I was walking down this hallway 00:05:57.300 --> 00:06:00.959 and one of my friends, his name is Kevin. He 00:06:00.959 --> 00:06:03.680 like pulls me off to the side because he was 00:06:03.680 --> 00:06:06.839 an LVN at one point that worked in this ER. He 00:06:06.839 --> 00:06:10.860 got his RN and BSN. And so he kind of like helps 00:06:10.860 --> 00:06:14.800 mentor, you know, the LVNs, you know, into becoming 00:06:14.800 --> 00:06:20.800 a better nurse. So he pulls me off to the side. 00:06:20.800 --> 00:06:23.920 He's like, Hey, man, come check this out. Because 00:06:23.920 --> 00:06:28.259 again, we are in the med center. And we see a 00:06:28.259 --> 00:06:31.439 bunch of crazy shit, right? We see a bunch of 00:06:31.439 --> 00:06:34.139 crazy traumas. And so in the Med Center in Houston, 00:06:34.399 --> 00:06:39.079 it is the largest medical center of like a conglomerate 00:06:39.079 --> 00:06:45.740 of hospitals that officially, unofficially, officially 00:06:45.740 --> 00:06:51.399 have like a specialty. And so, like, for instance, 00:06:52.100 --> 00:06:58.600 you have in the Med Center, we have I want to 00:06:58.600 --> 00:07:01.319 say it's common spirit St. Luke's now previously 00:07:01.319 --> 00:07:07.379 known as St. Luke's or CHI St. Luke's, previously 00:07:07.379 --> 00:07:12.279 known as just St. Luke's Medical Center. And 00:07:12.279 --> 00:07:17.740 so fun fact that hospital a few years back is 00:07:17.740 --> 00:07:21.959 the reason why a lot of blood protocols got changed 00:07:21.959 --> 00:07:25.199 as of recently within the last five, 10 years 00:07:25.199 --> 00:07:28.850 or so. because they had a sentinel event regarding 00:07:28.850 --> 00:07:33.870 blood products. And so regardless, I divert. 00:07:34.949 --> 00:07:40.589 But they are known for their incredible transplant 00:07:40.589 --> 00:07:45.550 program. And they are also home to the Texas 00:07:45.550 --> 00:07:51.970 Heart Institute, THI. And so they are leading 00:07:51.970 --> 00:07:58.959 medicine in the ways of transplantation and cardiology 00:07:58.959 --> 00:08:05.399 for like THI stuff, right? They also have an 00:08:05.399 --> 00:08:11.740 extremely robust oncology program. Now talking 00:08:11.740 --> 00:08:16.819 about oncology. Where the the med center really 00:08:16.819 --> 00:08:19.060 kind of shines is if you're going to get sick 00:08:19.060 --> 00:08:21.620 in anywhere in the world You're more than likely 00:08:21.620 --> 00:08:23.779 going to want to come to the med center because 00:08:23.779 --> 00:08:29.019 we have MD Anderson Now MD Anderson's rival is 00:08:29.019 --> 00:08:31.939 going to be Johns Hopkins University like they 00:08:31.939 --> 00:08:35.159 are direct competitors, you know when it comes 00:08:35.159 --> 00:08:43.539 to stuff and so Common spirit st. Luke's they 00:08:43.539 --> 00:08:49.720 are right behind MD Anderson and their oncology 00:08:49.720 --> 00:08:52.419 program like their rank number two, or something 00:08:52.419 --> 00:08:58.159 like that, when it comes to cancer. And so that's 00:08:58.159 --> 00:09:01.200 their specialty. So now, in if you're sick, and 00:09:01.200 --> 00:09:04.639 you have a heart problem, you can go to CA or 00:09:04.639 --> 00:09:08.289 not CHI common spirit, St. Luke's. And if you 00:09:08.289 --> 00:09:10.269 have cancer, you can either go to St. Luke's 00:09:10.269 --> 00:09:12.029 or you can go to MD Anderson. Now we're going 00:09:12.029 --> 00:09:16.149 to kind of keep moving along the spectrum. If 00:09:16.149 --> 00:09:21.590 you are a high risk pregnancy, okay. Whether 00:09:21.590 --> 00:09:26.169 you have pre eclampsia, eclampsia, placental 00:09:26.169 --> 00:09:39.559 or credo that has invaded other organs or Or 00:09:39.559 --> 00:09:44.799 you have like a complete placental previa, or 00:09:44.799 --> 00:09:49.039 maybe even just like a complete placental abruption, 00:09:49.879 --> 00:09:53.039 a molar pregnancy, all this stuff that you learn 00:09:53.039 --> 00:09:55.539 about in nursing school that you're like, never 00:09:55.539 --> 00:09:59.600 heard of it. If you have like a high risk pregnancy, 00:10:00.200 --> 00:10:02.820 where your resting blood pressure is 190 over 00:10:02.820 --> 00:10:07.480 110, then you're going to want to go to the Texas 00:10:07.480 --> 00:10:11.799 Women's Hospital of Texas or the women the Women's 00:10:11.799 --> 00:10:17.200 Hospital of Texas. And they, you know, can handle 00:10:17.200 --> 00:10:19.340 your high risk pregnancy because they are what 00:10:19.340 --> 00:10:22.480 we would call a level four maternity center. 00:10:23.179 --> 00:10:27.980 And so like your level four, you know, pregnancies 00:10:27.980 --> 00:10:33.100 will get shuttled to, you know, the Women's Hospital 00:10:33.100 --> 00:10:38.350 of Texas. If you have a baby or a very, very 00:10:38.350 --> 00:10:44.149 sick child that is not cancer related, then you 00:10:44.149 --> 00:10:47.409 can also go to the Women's Hospital of Texas 00:10:47.409 --> 00:10:52.470 because they have a level four NICU. And if I'm 00:10:52.470 --> 00:10:56.350 not mistaken, they might be one of two or just 00:10:56.350 --> 00:10:59.490 the only one in the med center with a level four 00:10:59.490 --> 00:11:03.899 NICU. Maybe Texas children's will get to them 00:11:03.899 --> 00:11:09.500 in a second. They might be they might be level 00:11:09.500 --> 00:11:13.879 four as well. And then if you have a sick child, 00:11:14.379 --> 00:11:17.360 and you the mom are not sick, you know, you can 00:11:17.360 --> 00:11:19.879 either choose to go to the Women's Hospital of 00:11:19.879 --> 00:11:24.639 Texas or you can go to Texas Children's Hospital. 00:11:25.519 --> 00:11:31.080 And they have a level one pediatric trauma program 00:11:31.080 --> 00:11:34.620 and they have either a level four or level three. 00:11:34.620 --> 00:11:37.080 Nick, you I don't know. I don't work there and 00:11:37.080 --> 00:11:43.220 I don't want to. So you have those. OK, now, 00:11:44.159 --> 00:11:50.000 if you are hit in a car, you know, and you have 00:11:50.000 --> 00:11:52.620 like a really, really bad car accident, your 00:11:52.620 --> 00:11:57.879 shot, your stab, whatever, and you. you need 00:11:57.879 --> 00:12:00.940 emergency services that's where you you'll go 00:12:00.940 --> 00:12:07.779 to Herman Hospital Texas Medical Center. Herman 00:12:07.779 --> 00:12:12.700 Texas Medical Center is the busiest level one 00:12:12.700 --> 00:12:20.019 trauma center in the United States and is the 00:12:20.019 --> 00:12:26.419 only the only hospital in the Texas Medical Center 00:12:26.679 --> 00:12:30.519 With a level one pediatric emergency services 00:12:30.519 --> 00:12:35.059 and a level one pediatric level one adult trauma 00:12:35.059 --> 00:12:39.559 services and so Morial Herman prides themselves 00:12:39.559 --> 00:12:44.919 on the ability to if a Pregnant mother gets into 00:12:44.919 --> 00:12:47.980 a car accident that is bad enough to be classified 00:12:47.980 --> 00:12:52.379 as a level one They pride themselves on the ability 00:12:52.379 --> 00:12:56.440 to be able to keep mom and baby together the 00:12:56.440 --> 00:12:59.919 same hospital because if you If you get taken 00:12:59.919 --> 00:13:01.639 somewhere else, let's say if you got a level 00:13:01.639 --> 00:13:06.259 one trauma for a mother Then the baby is going 00:13:06.259 --> 00:13:09.720 to go and they they take you to Texas Children's 00:13:09.720 --> 00:13:12.220 The baby will stay at Texas Children's and the 00:13:12.220 --> 00:13:14.620 mother will get some sense somewhere else over 00:13:14.620 --> 00:13:19.820 If you get taken to Ben Taub Hospital, which 00:13:19.820 --> 00:13:23.399 is also a level one hospital that's funded by 00:13:23.399 --> 00:13:29.909 the county You will sit there and the mom will 00:13:29.909 --> 00:13:32.809 stay at Ben Taub and then the baby will get sent 00:13:32.809 --> 00:13:36.570 to Texas Children's or Memorial Hermann. But 00:13:36.570 --> 00:13:39.809 if you are a mother that gets injured in a car 00:13:39.809 --> 00:13:42.029 accident, that is a level one classification 00:13:42.029 --> 00:13:44.990 and you get taken to Memorial Hermann. You and 00:13:44.990 --> 00:13:48.090 baby will stay together throughout the entire 00:13:48.090 --> 00:13:51.669 stay of your state, right? The entire time of 00:13:51.669 --> 00:13:57.019 your state. event you have Those are kind of 00:13:57.019 --> 00:14:02.879 like the major kind of services, right? and so 00:14:02.879 --> 00:14:05.820 You have like I said you have if you're a child 00:14:05.820 --> 00:14:08.019 and you're super sick you go to Texas Children's 00:14:08.019 --> 00:14:10.519 or you can go to the Women's Hospital of Texas 00:14:10.519 --> 00:14:13.080 If you have cancer you have two options. You 00:14:13.080 --> 00:14:15.299 can either go to common spirit st. Luke's or 00:14:15.299 --> 00:14:19.179 MD Anderson And then if you are injured in a 00:14:19.179 --> 00:14:22.080 really bad accident or you fall from a ladder 00:14:22.080 --> 00:14:24.220 or a building or something like that, then you 00:14:24.220 --> 00:14:28.100 can go to one of two adult level trauma centers. 00:14:28.120 --> 00:14:31.179 And one is going to be Harris Health Ben Taub 00:14:31.179 --> 00:14:34.419 Medical Center. Or you can go to Memorial Herman 00:14:34.419 --> 00:14:41.279 Texas Medical Center. So so what that entails 00:14:41.279 --> 00:14:46.700 is that we see a lot of weird stuff. Stuff that 00:14:46.700 --> 00:14:49.700 you only read about in textbooks one of the weirdest 00:14:49.700 --> 00:14:53.500 cases that I have It's not medical or anything. 00:14:53.500 --> 00:14:57.820 It's not life threatening is a sickle cell sickle 00:14:57.820 --> 00:15:01.559 cell as you guys know predominantly effects, 00:15:01.559 --> 00:15:05.240 you know the black community and But there's 00:15:05.240 --> 00:15:09.419 like a 1 % chance of it affecting people from 00:15:09.419 --> 00:15:13.340 the Middle East And I shit you not I have taken 00:15:13.340 --> 00:15:16.820 care of a patient with sickle cell that was from 00:15:16.820 --> 00:15:20.320 Saudi Arabia and that was Like one of the kind 00:15:20.320 --> 00:15:22.500 of like the coolest things I've ever done, you 00:15:22.500 --> 00:15:25.919 know, it's sad for him but cool for me Was that 00:15:25.919 --> 00:15:28.820 he was a Middle Eastern guy that had sickle cell 00:15:28.820 --> 00:15:31.659 and I was like man I never thought I would ever 00:15:31.659 --> 00:15:34.860 take care of you know, like that 1 % in the world 00:15:34.860 --> 00:15:39.059 and that's the craziest thing so back to the 00:15:39.059 --> 00:15:43.019 original story Kevin pulls me aside to look at 00:15:43.019 --> 00:15:46.879 this guy, and the monitor is going crazy. The 00:15:46.879 --> 00:15:51.240 guy is in ventricular fibrillation. Now, if you're 00:15:51.240 --> 00:15:55.639 not a CLS certified vfib is a unsustainable rhythm 00:15:55.639 --> 00:15:59.259 because the ventricles are literally just quivering. 00:15:59.679 --> 00:16:02.019 And so they're not contracting, they're not pumping. 00:16:02.820 --> 00:16:07.879 But because the guy has an L pad, His body is 00:16:07.879 --> 00:16:10.179 getting perfused while his heart is literally 00:16:10.179 --> 00:16:16.000 dying, right? And so he was awake. He was talking 00:16:16.000 --> 00:16:19.639 to the nurses. He was making jokes He was having 00:16:19.639 --> 00:16:23.639 himself a grand old time He was technically dead 00:16:23.639 --> 00:16:26.840 He was technically classified as being dead, 00:16:26.840 --> 00:16:29.460 but because he had this LVAD in place It was 00:16:29.460 --> 00:16:32.960 literally keeping him alive and he was awake 00:16:32.960 --> 00:16:36.539 And I think he might have been there Because 00:16:36.539 --> 00:16:38.700 his driveline got infected or something like 00:16:38.700 --> 00:16:41.720 that, which is very common for L that patients 00:16:41.720 --> 00:16:44.240 is for the driveline to kind of get infected. 00:16:45.600 --> 00:16:51.059 So, but yeah, crazy story, right? A guy on an 00:16:51.059 --> 00:16:54.600 L that in ventricular fibrillation, awake walking, 00:16:54.940 --> 00:16:58.299 you know, could walk if you wanted to. Talking, 00:16:58.940 --> 00:17:02.039 laughing, joking with nursing staff and the doctors 00:17:02.039 --> 00:17:04.759 while he while he's technically dead and he said, 00:17:05.569 --> 00:17:08.690 So yeah, all right. There's one of the crazy 00:17:08.690 --> 00:17:11.210 craziest stories. I think I'll ever encounter 00:17:11.210 --> 00:17:15.730 in my life Sorry about that tangent about the 00:17:15.730 --> 00:17:19.549 med center But yeah guys, so that right there 00:17:19.549 --> 00:17:21.750 is another crazy story. Just a guy that's dead 00:17:21.750 --> 00:17:25.529 on vfib What is all that just chilling in the 00:17:25.529 --> 00:20:03.589 bay? All right, you guys peace out Me and the 00:20:03.589 --> 00:20:09.589 nurse For the RN Me and the nurse that were in 00:20:09.589 --> 00:20:12.829 the room. We had already done everything So the 00:20:12.829 --> 00:20:14.950 only thing that needed to be done was rock and 00:20:14.950 --> 00:20:18.769 atomic date and then like kind of get the monitor 00:20:18.769 --> 00:20:23.750 set up that way we can go to scanner and The 00:20:23.750 --> 00:20:28.329 pelvic fracture was so bad that the trauma attending 00:20:28.329 --> 00:20:32.630 like walks in as we have the monitor and brain 00:20:32.630 --> 00:20:34.650 on the monitor ready to go to scanner he was 00:20:34.650 --> 00:20:38.630 like you guys are going straight to the OR shit 00:20:38.630 --> 00:20:44.430 okay so um like if you work in the OR go to hell 00:20:44.430 --> 00:20:47.230 okay and that's all i'm going to say about that 00:20:47.230 --> 00:20:49.609 because the story kind of continues this that 00:20:49.609 --> 00:20:53.369 that mentality so we got this dude like he's 00:20:53.369 --> 00:20:55.890 literally bleeding everywhere at this point you 00:20:55.890 --> 00:20:59.150 know he's not in DIC but he just has open holes 00:20:59.150 --> 00:21:02.789 everywhere blood it's just kind of pouring onto 00:21:02.789 --> 00:21:05.750 the stretcher, you know, and like we got blood 00:21:05.750 --> 00:21:08.089 going and we got fluids going and like we're 00:21:08.089 --> 00:21:11.390 hitting them all different types of liquid stuff 00:21:11.390 --> 00:21:15.490 to kind of prop up that volume. And so we get 00:21:15.490 --> 00:21:19.690 up the ORs for us are like one or two floors 00:21:19.690 --> 00:21:23.930 up and we have a special elevator dead designated 00:21:23.930 --> 00:21:26.289 for those types of events where we could just 00:21:26.289 --> 00:21:28.210 hit it hit a button and it goes straight to the 00:21:28.210 --> 00:21:33.069 ORs and that's where we're at. So we get we get 00:21:33.069 --> 00:21:36.930 on the elevator we get to the OR and they see 00:21:36.930 --> 00:21:41.049 they see you guys at work in the OR you see us 00:21:41.049 --> 00:21:43.910 Walk in with this dude that has all this stuff, 00:21:43.930 --> 00:21:47.089 you know, because it's like an entourage of us 00:21:47.089 --> 00:21:51.769 Coming into the OR and you guys want to sit there 00:21:51.769 --> 00:21:54.980 try to hold us up because we don't have a little 00:21:54.980 --> 00:21:57.740 hat thing on a little bouffant and we don't have 00:21:57.740 --> 00:22:00.099 little booties on and we're walking into your 00:22:00.099 --> 00:22:04.259 O .R. like, dude, we are literally keeping this 00:22:04.259 --> 00:22:09.099 dude alive with. All right, we have literally 00:22:09.099 --> 00:22:12.839 lactate ringers and blood keeping this dude alive 00:22:12.839 --> 00:22:14.359 and you're going to sit there and tell us you 00:22:14.359 --> 00:22:15.980 need to grab a bouffant. Get the fuck out of 00:22:15.980 --> 00:22:20.490 my way, dude. So we we get in there the whole 00:22:20.490 --> 00:22:22.809 or team is trying to throw a fit and the surgeons 00:22:22.809 --> 00:22:24.529 like yo We need to get him over and we need to 00:22:24.529 --> 00:22:26.150 get going quit worrying about what they're wearing 00:22:26.150 --> 00:22:28.890 We'll worry about that with some vancomycin and 00:22:28.890 --> 00:22:32.589 I'm like, thank you Thank you, you know, like 00:22:32.589 --> 00:22:34.490 you're gonna throw antibiotics at this dude. 00:22:34.650 --> 00:22:37.769 Anyways, so just throw some more antibiotics 00:22:37.769 --> 00:22:39.549 at him Don't worry about what the hell we got 00:22:39.549 --> 00:22:43.450 going on because he's laying in rocks and grass 00:22:44.079 --> 00:22:47.299 You know the stretcher has literal rocks and 00:22:47.299 --> 00:22:53.599 grass on the sheet so So that that right there 00:22:53.599 --> 00:22:58.279 is the story right and The anticipatory stuff 00:22:58.279 --> 00:23:00.779 of hey when you have something like that that 00:23:00.779 --> 00:23:05.160 shows up it shows up in in whatever you got going 00:23:05.160 --> 00:23:10.259 on That's where the nurse anticipates this I 00:23:10.259 --> 00:23:15.980 was anticipating Two large bore IVs. I was anticipating 00:23:15.980 --> 00:23:21.079 fluids. I was anticipating blood and I was anticipating 00:23:21.079 --> 00:23:25.279 on Closing this pelvic this pelvis long enough 00:23:25.279 --> 00:23:28.759 for us to get to the OR those were the anticipatory 00:23:28.759 --> 00:23:33.579 things that The doc didn't need to say now that 00:23:33.579 --> 00:23:36.819 right there is where that stuff comes into play 00:23:36.819 --> 00:23:42.750 in real life It's not you know A stupid question 00:23:42.750 --> 00:23:45.349 always like the nurse is going to anticipate, 00:23:45.809 --> 00:23:48.509 you know, ambulating the patient to the bathroom 00:23:48.509 --> 00:23:51.109 like it's not it's not always going to be stupid 00:23:51.109 --> 00:23:55.329 shit like that. You know, it's going to be, you 00:23:55.329 --> 00:23:59.430 know, it can be not going to be, but it can be. 00:23:59.609 --> 00:24:02.089 Hey, you know, you got this patient, they got 00:24:02.089 --> 00:24:04.890 hit by a car going 30 miles an hour and he was 00:24:04.890 --> 00:24:08.890 drug 100 feet. What are you anticipating? It's 00:24:08.890 --> 00:24:13.609 going to be stuff like that. You know, so I just 00:24:13.609 --> 00:24:15.549 wanted to hop on and kind of talk about that 00:24:15.549 --> 00:24:18.690 real quick, you know, because yesterday, like 00:24:18.690 --> 00:24:22.549 our our cohort, we had a really rough pediatric 00:24:22.549 --> 00:24:27.490 pediatric OB exam. We had a really tough OB exam, 00:24:27.490 --> 00:24:30.230 and we all kind of like walked out of there mad 00:24:30.230 --> 00:24:35.630 as hell. So it just brought up like, man, this 00:24:35.630 --> 00:24:37.930 anticipatory stuff like I know it's applicable, 00:24:37.930 --> 00:24:42.690 but the way that they're using it is not. So 00:24:42.690 --> 00:24:45.109 I just wanted to talk about that as a story and 00:24:45.109 --> 00:24:47.710 there's like a meaning behind it. So there you 00:24:47.710 --> 00:24:49.970 go. All right, guys. Thank you for listening 00:24:49.970 --> 00:24:52.589 and keep enjoying the educational material.