Published May 19, 2023, 5:20 p.m. by Monica Louis
It's no secret that the medical industry is under a lot of pressure these days. With budget cuts and staff shortages, hospitals are struggling to provide adequate care for their patients. So it's no surprise that when a medical drama like casualty comes on TV, it's often met with a lot of criticism from doctors.
But what do doctors really think about casualty? We asked Doctor Mike, a GP from London, for his thoughts.
"I think it's important to remember that casualty is just a TV show," he said. "Of course, it's not realistic and there are some things that are just plain wrong. But I think it's important to remember that it's entertainment and not to take it too seriously.
"That said, I do think that the show does have some value in terms of raising awareness of certain medical issues. For example, I remember one episode where a patient was diagnosed with a rare condition that I had never heard of before.
"So I think the show can be educational, as well as entertaining. But at the end of the day, it's just a TV show and it shouldn't be taken too seriously."
So there you have it, doctors are divided on casualty. Some think it's important to remember that it's just a TV show, while others believe it can be educational. What do you think?
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- The longest running British med drama.
We have to review it, season 36, what?
- [Young Woman] Hey!
- By both parties.
- Hey, what you doing?
- Don't road rage, that's not healthy.
- Abusing fellow road users isn't very constructive, is it?
(car engine going)
- Never grab a moving vehicle.
That is an argument/fight you will never win.
And whatever sound effect I just heard
from her grabbing the car door there, didn't sound good.
Also, didn't sound super realistic.
I'm assuming she's gonna have like a dislocated shoulder
here or something, but it didn't sound real.
It sounded too meaty, it was like (meat squishing).
- He must have driven off at some speed
to dislocate your shoulder.
- Dislocated shoulder, the most common type
of dislocation is an anterior shoulder dislocation.
- Hey Billy, how are you feeling?
- Yeah, I'm all good, I'm ready to rock and roll.
- In general, I don't like keeping patients in slings
like this, because it actually causes a increased rate
of frozen shoulder where you have decreased mobility,
you get less range of motion, thereby having less healing.
- Look, thank you for everything, I just,
I really wanna get back to my van.
- Yeah so, x-rays look okay.
- All right, well obviously,
you can't drive with that shoulder.
- I can't just leave it there and, it's my home.
- Yeah, yeah, it's your home, I get it.
- It's my dad.
He's in the back.
He's got early onset dementia.
You wouldn't know if you met him,
he just forgets a bit sometimes.
- Even mild dementia can become problematic when it comes
to tasks like managing your money,
paying bills, being susceptible to scams.
Think about it, if you don't have a good memory,
somebody can call and say, you didn't pay a certain bill
asking you for personal information.
You can just give it up to him.
And speaking of scams, if you see someone that looks like me
or using a name similar to me, giving
out WhatsApp phone numbers, that's not me.
Just like the fake accounts on Instagram,
that's a fake account on YouTube, report that bad boy.
- You're gonna look for Clive, aren't you?
- Who's Clive?
- Ugh, Lily's dad.
- Look, I've just been calling the police.
Let them deal with it.
- The police are over stressed, I'm saving them a job.
- The ambulances looks so different in the UK
than they do in the US, I've never seen
them that color, but I guess they stand out,
so, it actually makes sense that they're this color.
- He's not here.
- Did she just leave her dad in the van?
Like I don't understand, was he awake, was he alert?
- Come on, Cardigan, waltzers.
- And she said mild dementia,
like mild dementia shouldn't interfere with navigation.
- Think I might need a bit of help.
- Yeah, it's quite nasty cut you got there.
Let's try and stop it bleeding, shall we?
- What are they gonna do? - [Clive] I couldn't get up.
- You got anything in there I can use as a tourniquet?
- Yeah, you can do a makeshift tourniquet,
but those are never as good as commercial grade tourniquets.
Those can actually cut off the circulation and you also need
to make the decision of how bad the person's bleeding out.
You can stop the bleeding with just some pressure.
That's a better option.
Having a tourniquet on, especially a serious one
for a long period of time can cause harm to the limb.
- Anything in there we can use as a dressing?
- What, like a nappy, maybe?
- How about calling for help?
Like they're making a tourniquet, but
at the same time, they're like, so what's up?
Well, you got diapers?
- That's the next best thing.
- Did she just apply a pad like this and hope
that it's gonna stop the bleeding in a high pressure system?
No, put some pressure on it.
- [Sam] I thought it was extremely weird, he got on a ride
at a carnival and there's no one there.
- Look at me, ladies!
- No, stop it, please.
Can someone help?
- Okay, okay, Clive, let's get you back in.
Clive, it's okay, it's okay.
Clive, Clive look at me, look at me, it's Faith.
Remember, from the fairground?
Now look at your arm, your arm is bleeding, do you remember?
- That's not mild dementia anymore.
If you're starting to forget where you are
and you start acting this inappropriately,
that's already starting to become moderate to severe.
Also could point to other medical problems.
It could even be acute medical problems
like normal pressure hydrocephalus.
- Come on Ethan, let's get you inside.
- No, I never want to come back here.
- We need to get you inside, get some treatment.
You've got a virus.
- Vitals look semi-realistic.
We have a 91 pulse, a 96 pulse, ox.
I do not see a blood pressure on that machine.
Maybe they didn't check it recently.
- Ethan's got the Huntington's gene.
- So Huntington's disease is a progressive
neurologic disorder where, essentially the brain
and the neurologic system starts breaking down over time.
And it's a deadly, deadly illness.
I mean like from the time the disease presents itself,
you have like 10 to 30 years before death, it's that quick.
And there are genetic tests available for that.
And it's even sometimes a highly debated topic
of whether you should be tested for this.
If you're not doing it for genetic planning
for future children, finding that out could seriously
impact your life for the good or for the bad.
So it really depends on what kind of personality you have,
whether or not you wanna know.
(car engine roaring)
- Oi, watch it!
- Sorry, turn away.
- Maybe you should, uh!
- Oh, that was a serious collision.
My thing is, if you just crashed into someone,
have the courtesy to hit that bad boy in reverse
and pull out so the person's not trapped.
- Keep still, I know it's scary, but try and keep still.
My name's Jade, what's your name?
- She's really good at keeping this person calm.
- [ER Doctor] What have we got?
- Hi, this is Emma Nash, 31 years old, driver involved
in an RTC car versus Lori cab about 40 minutes ago.
She was extra cared by the firefighters.
Top to toe, buggy hematoma on the side of her head,
chest wall bruising from the seatbelt, got laceration
with arterial bleed on her leg, RPC stable, GCS is 12.
- This is literally not how this should happen.
This is a serious trauma, she's bleeding out.
We should have blood drawn already,
we should have tests going, she should
actually be fully undressed because you need
to do a visual exam to see where she's bleeding,
where the bruising's happening.
If you've missed a laceration somewhere.
Because that delay in diagnosis could cost her her life.
- Okay, you ready to incubate?
- It should be a full team here,
like everyone's to calm and cool.
This doesn't seem realistic at all.
What is he even doing?
- Okay, let's get laryngoscope,
ET tube and Ambu bag on standby, please.
- Okay, those are the right tools for intubation.
I loved that, it was him opening her jaw,
but she actually went, and opened it for him.
- What happened here?
- [ER Doctor] Sorry, you can't be in here.
- Emma, Emma, who did this, what happened?
- Can I get you to wait outside, please?
- This is why he needs more staff,
so he's not doing this alone.
This is so weird for me to watch.
There's literally usually seven more people in the room.
Drawing labs, controlling the patient's family,
doing chest compressions if need be, putting in IVs,
gathering the patient's belongings,
entering data into the system, putting more orders.
Like there's so many things that need
to happen all at the same time.
- You can't be in here right now.
- She's my sister!
- Also, you need to make sure that
you've intubated correctly and it's not
in the patient's stomach.
Inside the patient's stomach.
- I'm a doctor, just tell me what happened.
- Okay, I'll explain everything outside.
- Oh my God, did he intubate it into her stomach?
- She's been seriously injured.
I need to speak to the neurosurgeons and they'll,
they'll decide whether she'll need surgery.
- I wanna stay with her.
- Can I get you to wait in reception?
I promise I'll look after her.
- This is such an awkward conversation.
Nothing about this seems genuine or authentic.
- Uh, hello, yes, it's Ethan Hardy calling from the ED.
- He's calling for a neurosurgery consult,
which like, okay, fine, you can call that, place the order,
whatever, call who you need to call it.
But like the fact that he's like not taking care
of the patient right now is a big problem.
- How long has she'd been like this?
Didn't you check the placement of the tubes in esophagus?
- Oh no, that's why you need more people in the room.
Who is the one bagging the patient?
Remember he didn't hook her up to a ventilator,
he hooked her up to a bag, so someone had
to be sitting there, squeezing it
and watching her pulse go up
and her oxygen saturation go down.
- You're here for Emma Nash, is that right?
You're her sister?
- I am.
- If this is about Emma, I'm her fiancee.
- She suffered a significant head injury
and she may need neurosurgery
once the surgeons have assessed her.
Her brain was starved of oxygen for short while.
And we won't know yet if there's been any permanent damage.
- What does that mean, how did she end up like that?
I thought you said this was a car accident.
- It's too early to tell.
And if the neurosurgeons can't offer an operation,
we'll need to stabilize her.
- You didn't say any of this before, what changed?
- You intubated, patients don't just lose oxygen.
Something else happened, something he's not telling me.
- That's so not true.
Patients absolutely do, in the process
of intubation go a short time without oxygen.
It's not like a patient stops breathing
and you right away are now inserted
into the patient's airway.
The fact that this doctor knows
that something's wrong already is weird.
Obviously they're being sketch.
That's part of it, but, just a whole weird situation.
- I intubated her esophagus by mistake.
- [Man] But you recovered it straight away,
you've tracked the O2 trace on it.
- Yeah, yeah, I've done that.
- I could've killed her.
- [Man] It's a recognized complication of an intubation.
- It's true, when you're intubating a patient,
the risk is that you intubate their esophagus by accident.
That's why you check, you can check the O2 sensor
or you could put the little stethoscope on the lovely chest
and see if the chest is rising, not the stomach.
But another thing you can do is obviously
get a portable chest x-ray for placement,
but, that is obviously not ideal because it takes longer.
- [Stevie] Gonna introduce me?
- Of course, sorry, Ethan now our new consultant, Dr. Nash.
- Stevie, please, and I know who you are.
You're Dr. Hardy, right?
- Yes, I am.
- Well that's her daughter or sister or whatever.
Is she gonna do something bad?
I don't know.
But I do know you should watch
my favorite med drama reviews here.
So click that, check it out and as always,
stay happy and healthy.
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