The Saga of a GI Bleed: IR vs GI (with
ฝัง
- เผยแพร่เมื่อ 25 ส.ค. 2024
- GI bleeding isn’t always straightforward. It takes a lot tests, specialists and phone calls. I've spent a lot of time making calls like this both as a medicine resident and a GI doc.
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Thanks to Dr Cellini for joining me in this video. Check out his channel here! @DrCellini
This is so accurate it hurts!
hey it’s dr cellini
Gave me flashbacks
I almost fell on the floor when I saw you in the video. Nice job 👏🏼👏🏼👍
When I saw that you were the featured collaborator on this video i instantly clicked knowing it would be quality content
Ha! Well done fellas. So so accurate. I’m an ER PA. We are the middleman frequently caught in that scenario… thanks for the laugh and for all you do for our patients 🙏🏻
As an internal medicine resident I can confirm this is 100% accurate. Damn all those phone calls we have to make for a single patient.
imagine a world where we can put them all in a room together
You guys charge a lot
What's extra frustrating is that this conversation takes about 100 times longer than shown here all the while the patient is decompensating in the ER asking the ER doc "Am I going to die?" and the family saying "ugh these doctors don't do anything!"
So dysfuctional
Correct
Chaotic
Amen
Or in the ICU
The finish with surgery at the end was perfect. And so realistic it hurt.
I love the collab with other TH-cam docs, I think it adds a level of realism to the skit. The fainting at the end got me 🤣🤣🤣
I saw it more as a "Head hits keyboard" moment!
So true! So damn true!! GI here, my goodness I can totally relate, it happened so many times… 👍🏻👍🏻👍🏻
I can relate to the nurse falling over! 🤣😂😁
You’ve heard of a face palm? 🤦♂️
Yeah. She did that. With her desk. 😁
As a IM doc, this was the bane of my existence during residency.
Peds and I felt the same way. Wasn't it just the best being the go-between with multiple specialties!? 😑
@@sarahb7626 YAAAAAS. Even worse when you work in a small hospital with limited attendings from limited specialties
This is my nightmare as a medicine resident….sometimes I feel like the child mediating between divorced parents
Sometimes
As a nurse I encourage the doctors to speak to each other, I don’t like being the go between lol
Spot on!!!!
Right, you could possibly not hear the Dr. clearly then pass on wrong info. I hated talking to Dr.s who were driving, shopping, etc. Sometimes it’s a noisy conversation!
Amen to that!
I have an attending that hates texting or calls like this. He prefers to walk over and speak face to face. Says it saves time and confusion.
Right!!!
People who have not worked in a hospital will never know the struggle.
Hi!! My name is Bre, I’m 26 years old and have spent my entire life in and out of hospitals due to a chronic and progressive genetic disorder. Last year I was admitted 10 out of 12 months. I just wanted to thank you for making these videos! They are so accurate and it’s so amazing how you portray each profession as well as the perspective/crazy things that inpatients say and do!!🤣 As a “frequent flyer” in the hospital whose has learned how the entire hospital works as a system; it cracks me up when I get a roommate that has no experience being admitted and they act/say the most hilarious things to doctors and nurses!😝😂Keep up with making videos!
Hi there! So glad to hear you can enjoy my videos. So sorry to hear you’ve required so much time in the hospital but I’m honored that my videos can be a bright spot for you
I am glad you can see the lighter side
As an ER physician I can attest this is 100% Accurate.
I'm sure Mr Jones will be eventually DNAR status 😀
He deserves some time away from the hospital it’s sad he’s in there literally every day
@@aamirrazak3467 yep
NEVER! Jones will never die! He's immortal 😜
@@kelly1827 DNAR is not the same as DNR
@@resourceress7 googled it...you are correct. Also AND...allow natural death. Never heard that one before.
Interestingly, it's actually more straightforward if there are fewer treatment alternatives. In the rural hospital I just finished working in, there is no gastroenterology or IR, so the surgical team deals with GI bleeds. We both scoped and resected, therefore one team sorted everything out with no poor middleman being bounced back and forth between specialties. Back in the city, the scenario is much more like you portrayed.
Trueee.
In my college , even tho we are a tertiary centre, we have Gen Surgery or Gastro specialists look into GI bleeds. We don't have an IR dept.
Where do you work, I want to move immediately. Any nice houses for sale?
As a surgeon I can tell you this is 100% accurate.
Another surgeon here! High five!
Oh yeah sometimes you just have to call the cavalry in at the end
and for those who aren't in the medical profession, we are not taking care of only one patient at a time. doctors at my hospital have 20+ patients
Also really underscores how medicine is rarely an exact science and why they can’t just “fix” what you want and send you on your way. Humans are complicated!
Sometimes medical decisions are complicated too.
Too much, I couldn't stop laughing.
That happened to me as a patient and the cheery on the cake was that, they lost me for 6 hours from the ER to OR. Drug out of existence. Two operations later and after serious bleeding. Docs didn't lose me again.
This is the greatest physician collaboration I've ever seen! As a fan of both channels and someone who wants to be a GI physician all I can say is, more of this please!
So that was happening while I was in the ER and being admitted, twice. First the lower GI bleed, that much bleeding is frightening. Near the end of chemo I had an upper GI bleed. My doctors, NP, ICU nurses, nurses on the cancer floor, etc were kind and reassuring. I am in remission.
I'm happy to hear you're in remission.☺
This is very accurate, but if I were the nurse for this patient and had to take them to ct scan x 3, help with a scope and take them to IR, I would be fuming!!! Love your content. Always makes me laugh 😆
Don't forget that bowel prep!
I was thinking the VERY same thing!!! And all while unstable and receiving blood, fluid, and maybe pressors, etc. And MOST times, never coming to talk to YOU about it any of it, you have to SEE the orders come through on the chart that you are NOT always in front of, bc you're too busy trying to save them. Lol Ahhhhh, the good ol'days. 😂😂 Don't forget if you had to work in an older, sometimes more rural hospital, that there's only one set of elevators that will hold the bed with the head almost flat and all the pumps and the amount of humans it takes to move the bed and equipment from place to place, and OF COURSE that elevator is the farthest one away from you! Lol So add on an extra 20-30 min just to get them down there and back, not including the time the tests take, all of them, ESPECIALLY the tagged RBC scan, are time consuming, not like an x-ray or regular CT scan. And the scope will be done at the bedside if they are that unstable, so I'm helping with that as well. Don't forget that in the bigger hospitals, I would also have a second patient to care for as well. HOPEFULLY they knew about this guy BEFORE assignments were made and so my other patient won't be a trainwreck. . And they wonder why we're staying late to finish charting. It was great while doing it for 16 years, but....
I'm very happy in Hospice now! ☺️🥰
They would be in a high dependency bay or step down ICU though - so 1 to 1 nursing ish - which would be happening anyway bc that many units of blood and you have to sit with someone when giving blood
As an IR tech (who scrubs cases as well as sets them up/ circulates) this is so painfully true. And somehow one of the nurses or techs has found out about this possible bleed & we’ve been waiting allllll day to know whether we’re doing it or not. GI decides to scope them at 3:30, I leave at 4 and get called back 20 min later because GI couldn’t stop the bleed 😭😭😭
This is so accurate my head is spinning 😂: the back and forth between departments of a hospital over what one might seemingly think to be a simple decision to take from the beginning.
Very annoying to be the resident caught up trying to get the consult and informing your boss (consultant/attending) why there’s been a delay (sometimes).
Great job guys.
Wow. Recently out of peds residency and you're making ME tachycardic with this incredibly accurate video! That poor IM resident. I really feel for her 💜
This is so accurate. I'm a Family Medicine resident and whenever I get a GI bleed case, the same exact situation happens with me. It takes at least 30-60 mins to solve this "call X, call Y" issue. And it's not just IR and GI by the way, surgery is thrown in the mix too. Maybe ICU as well.
As an inpatient nurse care manager I can truly say this is spot on !!!
Awesome 👏🏼
Gotta say. This is the most efficient Gi and IR Dept I’ve ever seen. 20 min and the Cscope is done?? Lol 😂
I hated being the messenger owl like that. Sometimes I could give one the other’s number & let them talk to each other; other times I suffered.
It's always the resident the one who runs around trying to see if they are going to decide anytime soon
Good to see Dr. Tortellini try his hand at humor
OMG it's Dr. Cellini! Excellent Dr. Schmidt. I hope you both do more together. You Doctors are excellent and the best!!!!!! on you tube. Oh btw how about Adriana too?
I was an RT and the things the nurse would say having to be the go-between AND care for an unstable patient... would make you blush 😊.
That's a pretty darn good hospital there. Everything is getting done so quickly! At where I work, that would have taken at least a whole day.
This is so true and funny. I had to 3 way text GI and IR to get them to talk to each other at 2AM instead of having them try to convince me to have the other come in. (IR ended up coming and coiling)
That was smart.
Dayum this was so precise! Loved it
I have worked in all 3 areas. This is so accurate.
I work in Transfusion Services, and sometimes we’re in the dark going, “But why can’t they fix the bleed?!” Such a humorous representation of what goes on on the clinical side!
hey it’s patient jones again
That guy is a mess
The hospitals favorite patient poor guy can’t catch a break
These videos really help me understand the medical system, and i would be a patient. Thanks for doing them! Even though I’m in Canada, I have a feeling it’s very similar, just the patient doesn’t usually have to worry about the bill :)
Living with UC has gotten me to be very familiar with my GI and even colorectal surgeons very well. I seriously love how amazing they are with their bed side manners by making these poop issues less poopy.
Uuumm…have you been listening in on my work calls? I felt HARD for that nurse.
The back and forth with GI and IR is soooo true! 🤣🤣🤣
Jones has got to have 9 lives 🤣 the ending though lmao felt that
100 day jones
This is better than any House MD, Grey’s Anatomy, etc and with real Doctors 🔥🔥
I think Mr and Mrs. Jones have gold membership of the hospital
Why is this sooo accurate, I’m laughing sooo hard. I legit have been that person in the middle….
As a nurse this says a lot about what’s going on behind the scenes. Love it!
Omg I love Dr. Cellini and his wife!!! They are awesome
How on earth did I miss this?!?! The accuracy is incredible 🤣😂🤣
As soon as I heard IR I was gonna say better be Dr. Cellini!
This was crazy accurate! We need more of this!
Thanks! Will keep that in mind
I appreciated seeing Dr Cellini consulting with you. What a great skit.
This is fantastic, and so accurate! (Even though I'm in Newborn Medicine, I still remember my [Rotating] Internship days on Medicine and Surgery.) Love the collaboration, too!! I love both of your TH-cam channels, Drs. Schmidt and Cellini!
For the love of all things RN, please Drs, talk to each other. So many things get lost and miscommunication can delay patient care , extend their stay and become a huge emotional stressor (for both the patients and the RNs😭) It sucks being yelled at by Doctors when they have you playing operator instead of nurse.
This video allows me to see and appreciate the complexity of behind the scenes work that doctors do to come to a conclusive diagnosis and course of treatment for their patients! Thank you so very much for making this video!
So many people (myself included until now) have gone to the hospital with a complaint (any complaint) and thought that care would be as simple as explaining the situation and the doctor doing a physical exam and possibly a scan of some kind and then be able to right a prescription and send the person on there way...
This video has taught me to think differently! Thank you!
Being the resident stuck relaying messages is the worst. Also, I hope the consultants were as easy to approach as shown in the video. Other than that, the content is to the point. Good work doctors !
3 days later, while everyone is playing "Phone Tag", the Patient's Hemoglobin is down to SIX😓🤦♀️:(
I'm loving all of these collabs!
I am usually the one on the table they are talking about, and yes, this is all facts!
I laughed at the part where the IR said the GI embo only took 30 minutes 😂
03:30 -perfectly encapsulates the frustration of nursing staff caught in this constant back and forth
Love this collaboration!
This gives me pain. As a hospitalist this sort of thing happens a lot and I finally ask if the specialists if they can just talk to each other because it feels like I am a monkey relaying information.
I love these collaborations!! Next you should do a skit with Dr Mike!
Help me get his attention! 😁
He is so popular he might not read his messages🙁 but I hope to see one with him- see his acting skills
Doc Schmidt makes a very good looking blonde lady😂❤️ Great video again, Doc and great Collab with Dr Cellini.
Truth!!! keep up the great work!
Good one. I watch Dr. cellini so this was fun
The collaborations are so fun! Thank you Doctors.
Poor Jones sitting there pooping blood wondering when it’ll all stop
Poor Mr. Jones if he's doing a bowl prep after blood loss and feeling like crap, literally.
He’s in a crappy situation for sure
I have very common GI bleeds due to ehlers danlos & marfans. GI doctors get shocked when I say blood comes out of my gastric orifices at least once a week 😅 oh well not dead yet. So much love to the GI docs that have been able to stabilise me without surgery! Surgery would be disastrous due to my fragile tissue, and would likely give more bleeding
That last 2 seconds made me bust out laughing. That really seems like how things go sometimes though. Everybody, their brothers, sisters, aunts, uncles and maybe grandparents are involved, and the person in the middle is pulling their hair out by the roots!
Loved how she just banged her head on the desk! I know the feeling!😂.
Loved this ! Needed a good laugh this morning! 🤣🤣🤣
Please do other skits like this !
Me at the ER, pulling my hair out, possibly cursing and trying to keep the patient stable: Am I a joke to you?
This is the most accurate thing I've ever seen.
I was a GI nurse and this is just how it is.
Lol as a surgeon i can approve of what the surgeon said in this video.. because that’s exactly what I would say rofl - ER doc should just say upfront he’s discussed with GI and IR and both IR and endoscopic treatments have failed - then there’s no way the surgeon would ever turn the referral down. We all love a nice left hemicolectomy after all!
As a FNP, one of my favorite phrases is "Well, yes that is likely the issue but let's leave that to the specialist..let me order a consult" --it warms my heart...
I can understand the medicine resident in so many levels 😂
Sad!! My dad was bleeding from ascending lower tract (neuc scan) BP low & heart rate high, both controlled with IV drip but throat was too fragile to prep for colonoscopy. This is a real and serious problem. He received blood and plasma, Bleeding stop on own and started again 2 days later, even worse. GI couldn't see it without prep and determined nothing else could be done. We brought my dad home on hospice. Even though my dad was old that is no reason not try. He fought for his life. They gave him no choice. He bled out. They need to come up w/better tools like a controled water spray attached to camera or maybe laser. Heartbreaking!
Definitely what happens - It is almost easier sometimes if you get 4 people calling in parallel to get opinions of the same patient about possible intervention. MDT in its finest!
That was great! Love the collab. Omg so realistic
The end is always my favorite part! Haha it’s always a vicious cycle.
This is so accurate it hurts. But yea, don't call surgery until IR and GI have agreed they can't do anything. Nobody needs to lose their colon if something less invasive can be done about it
Love you doc.Just got my booster shot!!
Officially my favorite skit of yours. I’m a Hospitalist. Lolll
I have an interest in medicine, but by no means I'll pursue a career in the medical field but i found this so funny! This is really comedy, Dr Schmidt!
This reminds me of conversations with my kids “Go ask your Dad”…dad, “go ask your mom”…kid, “I did”…dad, “what did she say?”…kid, “she said to ask you”…and the conversation circle continues…lol😂
That was great! And to top it off.... patient and/or family is asking for answers.
This is gold! I love it!
Been there! By the time my patient was finally in surgery his hgb was 3
Love the vids brother God bless you and your work brother Love from Canada 🇨🇦🙏
These are actually so informative thank you
The funny part for me is how I tell triage about the blood loss, the color and frequency leading me to assume its upper or lower, that I've been NPO 12+ hrs and they look at me like I'm crazy. I know what to expect after 10+ years! 😂
I’ve been in the resident’s position so many times. That medicine resident’s never ending pass it on telephone game is pretty much what critical care nurses experience in hospitals that are not teaching hospitals. I think that the person that invents and successfully implements a HIPAA compliant communication method that keeps anyone providing care to a specific patient all informed and allows for more informed decision making…. That person will not only be rich, but admired and revered throughout the medical community.
Mr. Jones needs to meet Bill from Dr Glaucomflecken
They already have a video up.
I'm a patient who recently was admitted and seen this happen. Still months later (after discharge) waiting for the IR to happen while keeping an eye on hemoglobin regularly hoping not to have another transfusion. It does take way longer than this video for sure and very frustrating but I know this kind of stuff is part of the process to "troubleshooting" the body.
This is so painfully accurate
Omg. This is sooo painfully funny because it’s exactly what happens. Thank you.
The surgeon will save the day... all day every day!!!
LOVED this…!! 😳😳🤣🩴👣
I genuinely went through this this morning. It's painful how frecuent it is and how is always the residents who ends up runing around between services.
Lol I love it. Lol That is exactly what my life has been since November. Except it has been a feeding tube and a Gastric Stimulator!
I'm so sorry you're going through that right now. I hope you get to more of a comfortable place very soon!!!
-a fellow GI patient 🙏
So spot ON!