Doctors Operate Without OR | Chicago Med | NBC

0:01 -Dr.

0:01 Ripley, you're up.

0:02 Trauma one!

0:04 -Got a minivan versus a flatbed truck full of rebar, head on.

0:07 8-year-old male, unrestrained, right arm fracture,

0:09 impalement, degloving on the right leg.

0:11 Tourniquet was applied for pulsatile bleeding.

0:12 -Gonna need a surgeon.

0:13 -You've got one.

0:14 Let's give one gram ancef.

0:16 And we got to get that tourniquet off and save his leg.

0:17 -Tourniquet has been on for over an hour.

0:19 -Well, I don't start worrying till at least six.

0:21 Dr.

0:21 Howard, you're with me.

0:22 Dr.

0:22 Ripley, on to the next.

0:26 -Trauma two.

0:27 -13-year-old female.

0:28 Her feet were up on the dash.

0:30 Deformity of bilateral tib-fibs.

0:32 Heart rate 112.

0:33 BP 109/62.

0:35 -Okay.

0:35 I'll help.

0:36 -All fractures closed.

0:37 Let's get some labs and then off to CT for pan scan.

0:40 Screaming] -Trauma three.

0:44 Female, late 30s.

0:46 -Impalements to the neck and abdomen.

0:47 -I can see that.

0:48 How's she conscious?

0:49 -She keeps calling out for her kids.

0:50 Gave 50 fentanyl en route.

0:52 Heart rate 115, BP 100/60.

0:55 -I guess we're waiting for the driver of the truck.

0:56 -He walked away from it.

0:58 -Lucky him.

0:59 -Alright, hang two units packed cells, please.

1:01 I'm sorry if this is uncomfortable.

1:04 Screaming] -We need X-rays fast.

1:11 And let's get her to the O.R., please.

1:12 -We don't have one.

1:13 Lennox took the last O.R.

1:14 upstairs.

1:15 -Well, then just cancel elective surgery.

1:16 -I already did.

1:17 It's all the gas explosion.

1:18 -Alright, then we'll just do it here.

1:21 -Uh, okay.

1:21 I'll get set up.

1:22 -Come on.

1:23 -Colin!

1:23 Sarah!

1:24 Please, please, my children!

1:27 Sobbing] -Dr.

1:31 Asher!

1:32 Dr.

1:32 Ripley!

1:34 -What happened?

1:34 -I'm here.

1:35 -She crashed in imaging.

1:36 She became unresponsive, hypotensive, and tachy.

1:38 They had to intubate.

1:40 -Hey, did they get any images in CT?

1:41 -They got part of it done.

1:42 Tech said that she's got free fluid in her abdomen,

1:44 but they don't know where it's coming from.

1:45 -She's bleeding into her belly.

1:46 We need a trauma surgeon and an O.R.

1:48 -And we've got neither.

1:55 -Hey, trying to do surgery here.

1:57 -So are we.

1:59 We'll need your help.

2:03 -More suction, please.

2:04 I need to see the field.

2:06 Over here, please.

2:07 -Sorry.

2:08 Not a surgical nurse.

2:09 -Just suck better.

2:11 How's it going over there?

2:13 -Got six laps in the space of Retzius.

2:15 -Still suctioning quite a bit.

2:17 -Dean, her pressure's better,

2:18 but there's still a lot of serosanguinous fluid in the field.

2:21 -It's likely a bladder injury.

2:22 Use methylene blue to find the tear.

2:24 -Okay.

2:25 Pickups.

2:28 Okay.

2:29 Okay.

2:30 Yep.

2:30 Found it.

2:31 3-0 Vicryl, please.

2:33 -Lacs are controlled.

2:34 No further bleeding.

2:35 I think we are good to remove.

2:38 Alright, here we go.

2:41 Monitor dinging] -BP's still dropping.

2:44 -Hold it.

2:45 Damn it!

2:46 I'm missing something here.

2:47 -Okay.

2:48 Almost done.

2:48 Closing the daughter's bladder.

2:49 -No, no no, no, just hold it a minute.

2:51 Mom's still unstable, but nothing's bleeding intra-abdominally here.

2:54 -How deep was the rebar?

2:56 -Looks like it went through the cervical cuff.

2:58 -Okay, she's likely bleeding vaginally,

2:59 so grab a balloon catheter and put it in her pelvis.

3:02 -Good thought.

3:03 Thank you.

3:05 -She's hemorrhaging.

3:06 Unpack spleen and liver.

3:09 -I don't see anything glaring.

3:11 -Got to be retroperitoneal.

3:13 What are we missing?

3:14 Dean, what are we missing?

3:16 -One second.

3:17 Coming over.

3:19 Okay, mobilize the ascending colon up

3:20 to the liver along the white line of Toldt.

3:23 -Okay.

3:23 Found it.

3:24 The bleeding is coming deep under the liver.

3:26 -We're on our fourth MCP pack.

3:28 -Need to start on Levophed.

3:29 -We should put a REBOA in.

3:30 -Give me a REBOA kit.

3:32 -Bradycardic and hypotensive.

3:34 -I'm not feeling a femoral pulse.

3:36 -Okay, we need more blood, stat!

3:38 Starting compressions.

3:39 -Should we do a shunt?

3:41 -No.

3:41 No, no, no.

3:42 Don't.

3:42 Never works.

3:42 Usually stabilizes after the REBOA.

3:44 -Giving one of epi.

3:48 Come on, come on.

3:52 -I can't get arterial access.

3:56 -Come on.

3:57 We'll get you.

3:58 -It's a vena cava injury.

3:59 She's lost too much blood.

4:04 Hannah.

4:06 Hannah!

4:08 Flatline]♪♪ -Time of death, 11:43.

4:26 -The father is here.

4:34 -Mr.

4:35 Bennett?

4:36 -Yes.

4:38 What is happening?

4:40 Uh, I just know there was an accident with a truck and— But...what is happening?

4:46 -I'm Dr.

4:47 Asher.

4:47 This is Dr.

4:48 Ripley.

4:49 Your wife, your son, and your daughter were brought in this morning.

4:53 Your daughter initially presented with broken legs.

4:56 But...

4:59 But...

5:02 -But...

5:06 ...she was later discovered to have severe internal bleeding.

5:12 We attempted to repair her injuries...

5:15 ...but we weren't able to do so.

5:19 And she died.

5:23 I am so sorry.

5:43 -I...

5:45 I was supposed to be the one driving today.

5:48 I was supposed to be there.

5:50 Should have been me.

5:53 Should...

5:54 Our trauma surgeon, Dr.

5:56 Archer, has stabilized your wife,

5:58 and he's currently working on repairing the injuries.

6:01 Your son is still in the O.R., and Madeline here can take you upstairs.

6:07 -We can go up whenever you're ready, Mr.

6:09 Bennett.

6:14 Exhales sharply]♪♪♪♪