TRAUMA - Episode 15, April 5, 2010

[Richard B the EMT]

My comments and observations, both medically related, and otherwise, for the "Trauma" episode shown on April 5 are as follows:

1) One cheerleader falls from the pyramid. Per outside sources, I have been led to believe that there are more injuries within the ranks of cheerleaders than the football players they are cheering on. Anyone have documentation either supporting or denying this?

2) Did I misunderstand? I thought Nancy got permission to do the intubation.

3) The seven "P"s? They went too fast for me. What are they, again?

4) Nancy straightened the cheerleader's neck and head out. This is against the protocol of "Splint it as it lays", at least as far as the NY State protocols go. Comments?

5) Tyler plays guitar? Perhaps they'll explore this in some later episode.

6) Tyler takes in Boone for an overnight stay, due to Boone being temporarily evicted due to fumigating of his apartment. Nice partner!

7) Is Asher going to be a fixture, as Tyler's significant other?

8) This cheerleader is definitely not Claire Bennett, of "Heroes", as it is obvious she is hurting (Claire can heal from almost any injury within seconds, for those who don't follow Heroes).

9) Tyler and Asher seem to be too deliberately loud in "getting it on", in Boone's presence. Is it real?

10) Good call on the Sepsis and/or Infection as being Meningitis.

11) Marisa and Rabbit are together in Isolation. What will develop from them being together?

12) The cheerleader is getting worse, to the point of Dr Diane ordering surgery.

13) Either Rabbit was reviewing signs and symptoms of Meningitis for himself, or trying to scare Marisa. If he was trying to scare her, he did a good job of it.

14) Make it official, the cheerleader is paralyzed. Who is going to get sued, Nancy, the SFFD, Doctor Joe, the hospital, or some combination of all of them?

15) Boone was a visitor in Tyler's home. Would that give him any right to complain about Tyler's home activities in Tyler's home in Boone's presence? Something doesn't seem right, here.

16) Patron at strip club hit accidentally by pole dancer's shoe. Patron doesn't want to be known as being a strip club customer, and signs the RMA, then deliberately crashed his car across the street. OK, different address, but it had me thinking the guy might have left the scene and suffered a late developing concussion. Leastwise, he is going to be seen for the MVA, and use it to explain the original head injury.

17) Has Nancy finally been caught for operating outside of her scope of practice as a Paramedic? As argued, she is kind of adrift between Para-Medicine and being a Medical doctor.

18) Nancy's actions seem to be getting between Dr Diane and Glen, they are arguing.

19) Rabbit is not infected, but the question remains if Marisa is or not. Rabbit becomes protective of Marisa, like a good partner should be of whomever their partner should be.

20) Is Nancy suspended?

21) Are Tyler's antics with Asher going to break up the partnership with Boone?

22) I can understand Nancy being interrogated on the "out of scope" practices, but as Rabbit was not on that call, why are they attempting to go after him using her?

23) Neither Rabbit or Marisa has been portrayed as being particularly religious, but it was an interesting touch for her to ask him to pray with her.

24) Nancy's father recuses himself, but instead of leaving, then verbally attacks Dr Joe. What gives?

25) The review panel is attempting blackmail, threatening suspension of Dr. Joe if he doesn't help take Rabbit down.

26) Dr. Joe refuses, and gets the suspension.

27) Dr Diane plays with Marisa's emotions before telling her she doesn't have Meningitis.

28) Asher and Tyler apologize to Boone, their interaction was a bad joke they tried playing on Boone. Asher is just the next door neighbor, and married, to boot!

29) First, Dr. Joe finds out about Glen and Dr Diane, but makes no issue of it, then visits Nancy, and not caring that he's also found out about her and Rabbit, thanks Nancy for turning him in. THIS ain't over.

[Dustdevil]

Dammit, I knew I was forgetting something yesterday. I'll have to catch up on it tonight and chime in later.

Thanks!

[maverick56]

Is RSI actually outside scope of practice in SF? I appologize if it's a stupid question, I'm still a student, but we've covered a bit on RSI already and when it is appropriate. I was way more concerned about the realignment of the neck when, as they stated, that it was obviously broken. Personally, I think I would have splinted as found and done a cric. Thoughts?

[Dustdevil]

Agreed, Maverick.

My observations from this episode:

No RSI protocol, yet she has RSI drugs? That is a MAJOR blooper!

She pushed an empty syringe. The plunger was already all the way down when she hooked it up.

If no RSI protocol, I guess crich was out of the question?

Huge NBC logo on the television screen at Tyler’s house while he plays guitar, lol.

ROFL @ Tyler’s gag on Boone! That was awesome!

Helo responding to nursing home calls now? Had the guy not been critical, were they really going to transport him by air? STOP THIS NONSENSE!!!

Rabbit holds a mask full of vomit against the patient’s face.

Quit having him wearing his aviator sunglasses indoors. It’s so lame and stereotypical.

Who’s watching the helo? Didn’t they learn their lesson after losing it the first time?

Why didn’t Marisa and Rabbit change out of their contaminated clothes?

Dr. Joe says, “San Francisco Fire Departments paramedics are among the finest in this country” ROFL! Maybe you oughta get out of California sometimes, Joe!

Glenn standing up for his partner against his girlfriend is totally unrealistic. I have NEVER had a partner that I would blindly stand up for, much less against my girlfriend. And especially if I was a lowly EMT-B who didn’t know wtf I was talking about to begin with.

Rabbit and his “I’m not leaving my partner!” rant is just as ridiculous. STOP IT!

And then Boone goes on a tirade about Tyler not “being my partner”. FAIL on whoever named this episode. They should have named this episode “Partnership”, because they are wearing that whole angle out tonight.

Rabbit talking to Marisa through the glass. You have to talk louder than that!

And should we all maybe send some disposable razors to the director as a subtle message about these goddamn metrosexual beards? SHAVE GODDAMMIT!

Marisa hung some sort of Saint medal on her control panel her first day, so she had already displayed a religious base. After all, she’s Mexican.

The actors have been in character long enough now that the believability of the acting has significantly improved. They are definitely more comfortable with their characters.

Dr. Joe sure got surprisingly weird over all this. If he's that flaky, I'll be glad to see him go. That guy's unstable and has obviously bad judgement.

I don’t think they’re trying to get at Rabbit. I think they’re just using Rabbit to compound the charges on Dr. Joe, who the big wig (Nancy’s father) doesn’t like because he doesn’t like their relationship.

Still not featuring enough Asians in this show.

[Dustdevil]

Responding to Richard's questions and observations:

1) One cheerleader falls from the pyramid. Per outside sources, I have been led to believe that there are more injuries within the ranks of cheerleaders than the football players they are cheering on. Anyone have documentation either supporting or denying this?

I've seen the stories. But I believe the statistic is that cheerleading accounts for more SERIOUS injuries than other sports, not all injuries total. But a quick search on the Google shows a buttload of articles about it saying pretty much the same thing. One says cheerleading is the top cause of catestrophic injury in young women, period.

Another article says cheerleading is not among the 7 most dangerous sports, however those statistics are based upon total number of all injuries by percentage of participation.

2) Did I misunderstand? I thought Nancy got permission to do the intubation.

Nope. He specifically refused her. Basically saying, "I say no. But you're the one there, and if you do it, it's on your arse."

3) The seven "P"s? They went too fast for me. What are they, again?

Preparation, Preoxygenation, Premedication, Paralyse, Pass the tube, Proof of placement, Post intubation care

4) Nancy straightened the cheerleader's neck and head out. This is against the protocol of "Splint it as it lays", at least as far as the NY State protocols go. Comments?

Yes. How do you splint a neck in the position found? There is a brand new collar out on the market now that supposedly does it, but I don't know of anyone using it.

10) Good call on the Sepsis and/or Infection as being Meningitis.

Although, he really did not have enough info to even suspect that when he blurted it out. He had no assessment yet.

11) Marisa and Rabbit are together in Isolation. What will develop from them being together?

The more I hate Nancy, the more I like Rabbit. But I still will never watch this show again if he and Marisa hook up. That's just WAY overdoing the incestuous nature of the crew.

14) Make it official, the cheerleader is paralyzed. Who is going to get sued, Nancy, the SFFD, Doctor Joe, the hospital, or some combination of all of them?

Well obviously there is a competent legal advisor for this show, so they knew that EVERYBODY gets sued, not just one party. Too bad they don't have an EMS advisor who is as competent.

16) Patron at strip club hit accidentally by pole dancer's shoe. Patron doesn't want to be known as being a strip club customer, and signs the RMA, then deliberately crashed his car across the street. OK, different address, but it had me thinking the guy might have left the scene and suffered a late developing concussion. Leastwise, he is going to be seen for the MVA, and use it to explain the original head injury.

LOL! They don't come right out and say he did the car crash on purpose for that reason, but it sure seems like it! Great plot twist, just like the basketball game set up, where there was pushing and shoving, and you expected a player to get hurt. Oh, and I wish I had a dollar for every run I've ever made in a strip club.

17) Has Nancy finally been caught for operating outside of her scope of practice as a Paramedic? As argued, she is kind of adrift between Para-Medicine and being a Medical doctor.

They really need to get rid of her. That whole MD-Paramedic thing is the worst sub-plot of the entire show. Totally unbelievable plots, and she is not believable in the role.

20) Is Nancy suspended?

I'm not clear on that either. The scene was apparently intended to leave it open ended.

Edited April 7, 2010 by Dustdevil

[VentMedic]

Is RSI actually outside scope of practice in SF?

It is outside the scope of practice for Paramedics in the state of California.

This is why RNs are usually found staffing flight teams in that state and not Paramedics.

[Dustdevil]

This would SO be the perfect way to get rid of that tramp! I really hope they do!

To see her get hauled off in handcuffs would make me love this show forever! After all, not only did she break her SOP, the practised medicine without a licence, AND she must have misappropriated the RSI drugs, since they would not be stocked on an SF ambulance.

[Kiwiology]

If no RSI protocol, I guess crich was out of the question?

Our Intensive Care Paramedics can cric and not all have RSI, some do.

Dr. Joe says, “San Francisco ... paramedics are among the finest in this country” ROFL! Maybe you oughta get out of California sometimes, Joe!

What is this guy smoking? The same stuff the Fire Department did when they raped Department of Public Health and took thier Paramedics away in 1998? Well it IS legal in California ....

[thrutheashes]

I thought that the episode wasn't bad. I agree with Dust, the acting is improveing. However I think that Trauma will be a one season wonder. I heard today that of the 20 episodes that NBC finally ordered, they have stopped production and are calling it done at 18. Season Finale (series?) is going to be at the end of April, two weeks earlier than initially announced.

As far as backing your partner vs. your GF, it would depend on the situation, but I can see myself doing it in the right circumstances. It all depends.

And I don't know if I'm dumb, or just someone who cares too much.....but I can see myself doing exactly what Rabbit did in that situation. Standing by his partner. At least if it was a partner I cared about.

[uglyEMT]

Dont watch Trauma but answering your cheerleader question from personal experience. My squad staffs all the home games for the footbal teams (peewee to highschool) and I can say from personal expeiernce we have transported more cheerleaders then players. Hell in one game we did 3 transports of cheerleaders and had just one "check out" of a player.

Most of what we see are fall injuries, dislocated joints (mostly knees), and funny enough allergic reactions from bee stings (not saying the reaction is funny).

Usually the players get a check out for possible concussions or supplimental O2 for asthma related issues.

The injuries tend to get more severe with age. The younger squads dont do much ariel(sp) display but we see more knee injuries or other dislocated joints. The older squads with the flips and stunts we see more C-spine related injuries or fractured bones instead of sprains or dislocations.