[Translation] Chiba Hokusoh Hospital blog - CB episode 2 (2017.07.25)
Hi guys. Chiba Hokusoh Hospital, where Code Blue is being filmed, has a blog and they are blogging the explanations of the medical scenes in code blue drama.
You can check out their blog here. The code blue website also has a banner that links to the blog.
I tried to translate their blog on episode 2 to help myself understand the procedures.XD Their blogs are very medical (obviously haha), but if you're interested to know the medical procedure, feel free to have a read. I'm no doctor, so if any medical person see any errors, feel free to correct XD
2017.07.25 Episode 2
Hello everyone. This is Manager O.
Yesterday, Code Blue The Third Season 2nd episode, how was it?
It was mentioned as well in the previous blog before the broadcast, but coaching someone in a real clinical practice is very difficult, it's a very worrying problem for a lot of instructors. However, there he shined, Aizawa-sensei.
Personally, mo matter how strict their guidance, if it's accompanied by consideration for the juniors, I believe the juniors will understand. Aizawa-sensei embodied this very well. Right, that's all for manager's opinion. Here's what everyone's been waiting for, the explanation for the medical scenes.
This time, the fellows were given guidance on various skills. Normally, after graduation, they go through 2 years of clinical training experience, but depending on the hospital you train at, it is not that rare to spend 2 years without being able to get a lot of experiences either. Both Haitani and Yokomine are in this state. When I was a medical intern (that was almost 30 years ago), there was no senior doctor who teaches so politely like Shiraishi. They are so lucky. (Although, Aizawa's way of teaching in this era, I think, that's his way of showing affection? His teaching method.)
Just before Yokomine decided on the transportation order in the ambulance, Aizawa moved his fingers with a bit of impatience while folding his arms. 'Until when should I endure from intervening myself', while checking the timing, he lets Yokomine make a decision just in time, Aizawa's emotion in that scene was done really well. In between training and medical treatment, the instructor is also tested.
Shiraishi teaches Haitani to do a central vein puncture. Nowadays, for patient's safety, we puncture (to stick a needle in) while confirming the blood vessel by ultrasound. But like Shiraishi said, in an emergency site, there's no time to follow all the steps, so the needle is pierced the traditional way by targeting certain marks on the body surface. Only that much risk is accompanied to the patient. Yokomine practices the thorax drain on a doll simulator. But there are a lot of things you won't understand until you try it on a real patient. Aizawa would have wanted to teach her this. Although patient's safety is absolutely necessary, but "learning medicine and medical treatment" can't survive on just that. I want the audience to understand this.
A highlight of episode 2 is Aizawa's scene where he release the cardiac tamponade. Cardiac tamponade is when the heart has a tear and blood collects in the space between the heart and the pericardium (outer sac covering the heart), causing the heart's movement to be restricted. If left alone, the heart will go into cardiac arrest. Aizawa first decided to do a pericardium paracentesis to drain the blood that have collected in the pericardium, but the blood couldn't be aspirated. As blood coagulates in the case of acute bleeding, pericardium paracentesis often cannot be done. Naturally, Aizawa probably knows this, but he tried it once according to theory. From there on, he immediately decides to operate on the chest, to directly make an incision to remove the blood inside the pericardium. There is also a method called pericardial window, it is minimally invasive for the patient but it takes time. In circumstances when the heart rate dropped, performing open chest surgery is always faster. As per usual, the pericardium is filled with hematoma. Once Aizawa made the incision, blood flowed out in one go.
After removing the hematoma, Aizawa draws out another "skill". He located the damaged part at the right ventricle, and he used his finger to stop the bleeding. However the patient can't be transported in that condition to the hospital. Having said that, he can't perform the operation to stitch up the damaged part. So he used the "Foley catheter".
This catheter is used to measure urine volume by inserting into the urethra. A balloon is attached at the pointed end. This is inserted from the damaged part of the heart, when the balloon is inflated in the heart, it is pulled a little, and the damaged part can be closed from the inside. Emergency measures at the moment. While it seems strange to use a tool used to accumulate urine for heart damage, it is important for an emergency doctor to have the creativity and flexibility to apply anything. Of course it is also included in the Hokusoh's lifesaving heli-bag.
This concludes my explanation of the medical scenes in Episode 2. With limited time and medical equipment, you have to provide maximum medical care before reaching the hospital, can you feel the difficulty and the thrill of emergency medical treatment?
The drama is showing a good surge (of course? laughs)
From now on, together with drama, I hope you visit our blog.
You can check out their blog here. The code blue website also has a banner that links to the blog.
I tried to translate their blog on episode 2 to help myself understand the procedures.XD Their blogs are very medical (obviously haha), but if you're interested to know the medical procedure, feel free to have a read. I'm no doctor, so if any medical person see any errors, feel free to correct XD
2017.07.25 Episode 2
Hello everyone. This is Manager O.
Yesterday, Code Blue The Third Season 2nd episode, how was it?
It was mentioned as well in the previous blog before the broadcast, but coaching someone in a real clinical practice is very difficult, it's a very worrying problem for a lot of instructors. However, there he shined, Aizawa-sensei.
Personally, mo matter how strict their guidance, if it's accompanied by consideration for the juniors, I believe the juniors will understand. Aizawa-sensei embodied this very well. Right, that's all for manager's opinion. Here's what everyone's been waiting for, the explanation for the medical scenes.
This time, the fellows were given guidance on various skills. Normally, after graduation, they go through 2 years of clinical training experience, but depending on the hospital you train at, it is not that rare to spend 2 years without being able to get a lot of experiences either. Both Haitani and Yokomine are in this state. When I was a medical intern (that was almost 30 years ago), there was no senior doctor who teaches so politely like Shiraishi. They are so lucky. (Although, Aizawa's way of teaching in this era, I think, that's his way of showing affection? His teaching method.)
Just before Yokomine decided on the transportation order in the ambulance, Aizawa moved his fingers with a bit of impatience while folding his arms. 'Until when should I endure from intervening myself', while checking the timing, he lets Yokomine make a decision just in time, Aizawa's emotion in that scene was done really well. In between training and medical treatment, the instructor is also tested.
Shiraishi teaches Haitani to do a central vein puncture. Nowadays, for patient's safety, we puncture (to stick a needle in) while confirming the blood vessel by ultrasound. But like Shiraishi said, in an emergency site, there's no time to follow all the steps, so the needle is pierced the traditional way by targeting certain marks on the body surface. Only that much risk is accompanied to the patient. Yokomine practices the thorax drain on a doll simulator. But there are a lot of things you won't understand until you try it on a real patient. Aizawa would have wanted to teach her this. Although patient's safety is absolutely necessary, but "learning medicine and medical treatment" can't survive on just that. I want the audience to understand this.
A highlight of episode 2 is Aizawa's scene where he release the cardiac tamponade. Cardiac tamponade is when the heart has a tear and blood collects in the space between the heart and the pericardium (outer sac covering the heart), causing the heart's movement to be restricted. If left alone, the heart will go into cardiac arrest. Aizawa first decided to do a pericardium paracentesis to drain the blood that have collected in the pericardium, but the blood couldn't be aspirated. As blood coagulates in the case of acute bleeding, pericardium paracentesis often cannot be done. Naturally, Aizawa probably knows this, but he tried it once according to theory. From there on, he immediately decides to operate on the chest, to directly make an incision to remove the blood inside the pericardium. There is also a method called pericardial window, it is minimally invasive for the patient but it takes time. In circumstances when the heart rate dropped, performing open chest surgery is always faster. As per usual, the pericardium is filled with hematoma. Once Aizawa made the incision, blood flowed out in one go.
After removing the hematoma, Aizawa draws out another "skill". He located the damaged part at the right ventricle, and he used his finger to stop the bleeding. However the patient can't be transported in that condition to the hospital. Having said that, he can't perform the operation to stitch up the damaged part. So he used the "Foley catheter".
This catheter is used to measure urine volume by inserting into the urethra. A balloon is attached at the pointed end. This is inserted from the damaged part of the heart, when the balloon is inflated in the heart, it is pulled a little, and the damaged part can be closed from the inside. Emergency measures at the moment. While it seems strange to use a tool used to accumulate urine for heart damage, it is important for an emergency doctor to have the creativity and flexibility to apply anything. Of course it is also included in the Hokusoh's lifesaving heli-bag.
This concludes my explanation of the medical scenes in Episode 2. With limited time and medical equipment, you have to provide maximum medical care before reaching the hospital, can you feel the difficulty and the thrill of emergency medical treatment?
The drama is showing a good surge (of course? laughs)
From now on, together with drama, I hope you visit our blog.