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26 HOUR CALL SHIFT with CODE BLUE EMERGENCY: Day in the Life of a Doctor

26 HOUR CALL SHIFT with CODE BLUE EMERGENCY: Day in the Life of a Doctor

Code blue, level 0: Diagnostic Imaging. Code blue, level 0: Diagnostic Imaging. Hey guys. I’m Siobhan, a 3rd-year medical resident. Right now it’s Saturday morning and I’m heading to the hospital to start a 26-hour call shift in the intensive care unit. Oh, good morning Siobhan. Morning, how was the night? It was great actually. Yeah? I had a new patient come in. It’s a really interesting story, so I was hoping for your advice. Each morning we do a handover where the resident who was on call overnight passes on information to the incoming resident. So Kevin and I discussed each patient one-by-one so that I’m up to date on everything. And a lot can change in just 1 night in the ICU. Oh Kevin, I just realized thinking as I found you before you left, I didn’t get the pager from you. Oh yeah, here you go! Oh, okay. Here we go. Now it’s time to meet up with the attending physician and together we’ll walk around and see our 14 patients. And then comes the less glamorous part of medicine: all the notes and paperwork. *Pager goes off* Code blue, level 0: Diagnostic Imaging. Code blue, level 0: Diagnostic Imaging. When I arrived at the CT scanner, the patient was lying unconscious and a nurse was doing CPR. Seconds later the anesthetist arrived, positioning herself behind the patient’s head. Skillfully she intubated the patient while CPR was ongoing. And just 2 minutes later another round of CPR was done and we got a pulse back. Ok, so it always feels really good when you get the patient back. So our patient now has a heartbeat, a blood pressure… We basically brought him back to life, but this is just the beginning of the work in ICU. We’re transferring the patient up to the ICU right now and we’re gonna continue to try to resuscitate him, figure out what caused the cardiac arrest and then go from there. So this is just the beginning of the night in ICU. First thing I’m gonna do is try to call the patient’s family to update them. Still no answer. Okay, I’m gonna call back again later or see if someone can track down another number. The next step is to read through the patient’s chart carefully, looking through old notes, X-rays and blood work to help figure out what caused his cardiac arrest. Okay, so it looks like there are actually a lot of things going on with this patient. He has underlying heart disease, he’s had a heart attack in the past, he’s had some funny rhythms in the past that I can see in the computer. Plus his x-ray clearly shows an infection and I wonder if he’s gonna have an infection in his blood too. I’m kind of waiting for that to grow. So it’s a couple things we can do: we’re gonna make sure we manage his blood pressure with some special medications called pressors, which kind of squeeze the blood vessels tight. We’re gonna give antibiotics and we’re gonna support him and continue to do some more investigations. And let’s actually call the family back again. We’re trying to try to get ahold of them. I’ve got a new number, so we’ll see. Hi, my name is Siobhan. I’m a doctor in the ICU. Can I ask who I’m speaking with? Great, okay. Well, I look forward to meeting you in person. Again, I’m so sorry to have to tell you this over the phone. Okay, see you soon. I find it so much more difficult to break bad news to people over the phone, because you just… You don’t get that kind of feedback from body language, someone’s facial expression. You don’t… You have no clue what they’re feeling, what they’re thinking. So anyway, I’ll meet the family when they come in and I think I’ll get a better sense of where they’re at. In order to give all these medications safely at the same time, it’s helpful to insert a central line, which is basically a large IV that I’ll be inserting into the patient’s neck right into the jugular vein. Because the vein is so close to the carotid artery, I’ll be using an ultrasound machine so that I can see exactly where my needle is at all times. Okay, so the central line went in well. So now we just need to actually order a chest x-ray to make sure it’s going in the right place. Meaning it’s in the vein and it’s not in the artery, cuz that would be a nightmare. So it’s something you worry about. And then we also look for any complications, make sure there’s no pneumothorax. So it didn’t actually puncture the lungs, all these things that you would never ever ever want to do to a patient, but they’re complications that are possible even when you use ultrasound. So we’re just going to double check with the x-ray, but I think everything’s fine. How much oxygen is she on? Oh you already intubated here?! Oh okay. Yeah, absolutely. Okay, I’ll come by soon. Alright, thanks. So that was the emerge doc and it sounds like he just intubated a woman, which automatically means that the patient is being admitted to the ICU. Because once you’ve been admitted and you’re hooked up to a machine breathing for you, the only place you can go is the ICU. So that makes it easy. But the reason this patient got intubated is because she came in just gasping for air, breathing super fast and she has a condition called COPD. So she’s been a really heavy smoker for the last 40 years, smoking about 2 packs per day, that’s what he’s telling me. In the emergency department I met with the patient’s husband. He tells me that his wife ran out of her puffers about a week ago. They planned on going to the doctor today, but her breathing became so severe that they came to the emergency department instead. So now I’m gonna prescribe some steroids puffers, antibiotics and hopefully her breathing will improve and we can get her extubated in a few days. Alright. So now that we have admitted that patient in the emerge, we need to follow up on some blood work on the patient who had that code blue. So I ordered some repeat blood work, so we can see what we’re at in terms of resuscitating and how he is doing: his heart, lungs, liver, kidney, all of that stuff. So, let’s see. Oh boy. Okay, so when blood work is abnormal, it turns red and unfortunately most of his blood work right here is red. So you can see that he’s got strain to the heart, even just the act of CPR is gonna put some strain on the heart, the muscle of the heart. Um, you can see he’s got shock liver, meaning he didn’t get great blood flow to the liver for a period of time. Which means that you can see those enzymes are up. Same thing with the kidneys. So I mean… The reality is it’s expected at this point. We’re gonna keep giving him fluids, we’re giving the antibiotics. I’m gonna repeat some more blood work in the morning and hopefully we’ll be able to see things trending in a better direction, because right now it’s not looking so great. Okay, but let’s actually let’s go see the patient himself and see what he looks like clinically. So is he looking any better?! Okay, 4 o’clock. Finally back in my call room. I’m actually gonna try to go to sleep for the first time today. But I’m this weird combination of being a little bit wired from all the admissions and the excitement and then I’m also exhausted from the day. So I’m pretty sure when my head hits the pillow, I will be able to sleep. Problem is the light, it’s all the way over here and away from the bed. Good morning. Okay, it’s time to look at blood work and to get ready to hand over to the morning team now. Okay, so just looking at the blood work from the patient with the code blue yesterday. Things look like they are at least holding steady right now, which honestly is all that we can ask for right now. I’m glad to see that he’s turning the corner and stabilizing. So we’ll know in the next 24-48 hours are gonna be critical to finding out about his long-term prognosis, but I think we’re making some good steps forward right now. Morning, Kevin. Hey Siobhan. Hey, you’re back again. I’m back again. Alright, so I need to tell you about some of the patients that you handed over and what happened today. Yeah. Okay, but I won’t forget to give you the pager. Responsibility is all yours… For another 24 hours. Heading home, finally done and that was a satisfying call shift. I really feel like being there really impacted someone’s life. So I’m walking away at a high. But anyway, if you have any questions if you want to say hi, just leave a comment. I really love to hear from you guys. And if you want to see more like this, don’t forget to subscribe. Otherwise, I’ll be chatting with you in the next video. So bye for now!

100 thoughts on “26 HOUR CALL SHIFT with CODE BLUE EMERGENCY: Day in the Life of a Doctor”

  1. Doctor for training, doctor laugh and smile on there face when they put fingers inside vaginal area, while female patient put sleep for surgery, do you always just do for training or for fun.

  2. I have a mental illness and have been to the ER more than twice I’m ashamed to say. I was also very recently diagnosed with a seizure disorder and went to the hospital because of how many episodes( 30) and was admitted due to high heart rate turns out I have PNES. Do you have any experience dealings with the psychological doctors? I’ve always wondered what they think dealing with us and the same for seizer disorders in the ER and beyond. I LOVE your videos and I’m trying to watch them all to catch up. Pls respond and thank you

  3. Hello Dra new viewers from🇵🇭🇵🇭🇵🇭 and Im desperate nurse due to some health reasons andnI love to watch this kind of vlogs.Keep it up Dra

  4. That code blue in the beginning brought me tears. It was the first time i ever heard that and didnt know what it meant until they told us my moms heart had suddenly stopped. It was the worst day of my life. Pray for all the angels in heaven. ♥️😢

  5. Hello! Every star in the night, some are bright in the night (like you 🙂 )

    I have a question to ask:
    So, I wanna be a vet. But I heard there’s pagers depending on where you work. And so, I have a fear of alarms because I think of code red. Do you get used to the fact of getting alerted about a emergency or consult during night and not get scared it’s a fire or something?

  6. You are such a GREAT doctor, violinist, and woman. Your videos inspire and encourage me to pursue a career path in the medical field, watching you do your daily duties make me realize that I do care about people, and clearly you do as well . You always think of your patients first and want the best for them. You’ve changed my perspective on my career journey. Although I’m only 16, I think I’m gonna become a doctor . 😄👩‍⚕️

  7. So like do you pull out your camera when running to your patient during a code blue or do you reenact the whole scene later in the day?

  8. ''Oh you alreaady intubated her?'' That's one of the things doctors don't mind hearing. How good does it feel to leave the hospital after a long shift? I'm already super happy after an 8 hour shift lol

  9. Questions! 1. How in the world do you practice violin and work this much? 2. Have you ever called a code blue? Or just ran to them? 3 How do you spell your name? I really like it! Thanks! I’m also Canadian!

  10. That's really responsible thinking of others in calling the family. The patient is in ICU and I'm sure the family would like to know the condition of their loved one changed. Good job. Did the patient possibly get the wrong mediation. I've seen antidepressants meditations cause arrhythmia's on overdose and if you look at the ECG carefully you can tell it's particular wave pattern often seen in the ICU

  11. I'm 36 years old and 18 years ago I decided to not study medicine (eventhough I got the points for it) because I didnt believe in myself to do it……now I think I'm too old to study it. but I love your videos. Makes me think "I could have done that"….


  13. It’s so awesome that you can just do a central line when you need to! I’m in Ontario too, but my hospital can only do central lines on sundays and thursdays 😱

  14. When they called the code blue! 😱 the adrenaline just kicked in and I felt like I was watching greys anatomy! Love the video girl! 💕

  15. I've decided that I will do my best to get to med and become a doctor and I'm seeing your vids in different light. Before it was curiosity n fun to watch, now I'm so inspired and I have a lot of respect for u.

  16. Your energy is so inspirational. I don’t know how you do this & still wear that smile so genuine but you wear it so well!! ❤️ I work 12hr days & by the time I get home I feel so close to death 😂 Can’t imagine doing more than double that. You are amazing

  17. Have you met any rude parents or patients? How do you handle rude behavior by any patients or parents?

  18. so i’m new.. are you in a surgical residency or something else? i’m still not sure what i want to be but i know it’s definitely going to be something in the medical field

  19. Hi there! I was trying to search for your videos about the Goals of Care. It is very interesting to watch you explain it rather than just reading it in the module. 🙂 You mentioned it on your Code Bleue: What happens video so that brought me in your blog. 🙂

  20. Code black went at the hospital I was staying in like 1 month ago and what it was is someone had left a bag unattended the reason why the code was called is the bag was making a beeping noise

  21. The fact you're dealing with life and death situations, and then are able to explain calmly what's happening is just amazing. I truly couldn't imagine what you deal with or facing what you do daily. Like completely different worlds

  22. I have a question: Is a heart attack the same thing as a cardiac arrest, or can a heart attack lead to cardiac arrest, or something else? Some people have told me that they are the same thing, but as I was learning about Congenital Heart Disease, I was told that a heart attack is when oxygen-rich blood can't get to the heart due to plaque build-up. I was wondering what the similarities/differences/causes of a heart attack and cardiac arrest are.

    Can anyone explain?

  23. You inspire me so much and I've been wanting to be a surgen when I'm older so I'm looking forward to watching your videos

  24. I absolutely love your videos I dream of becoming a pediatrician one day and working in intensive care so I love learning all these new things from you

  25. I pulled a 16 hour shift 2 days in a row at a care home…obviously not a doc.. just a clinical support professional. And I'll tell ya.. NO :O .. How does ANYONE work from 7:30am to 4am before getting a nap and snapping back into action O_o

  26. Just want to say thank you for the subtitles! I am part deaf, so I can hear noise but I lip read to make out words. Your channel is so cool ❤️

  27. 26 hours is insane. At least here in Germany, the most negative incidents happen when the personel has been on a 10+hr shift.

  28. If that was my loved one being used in a freaking YouTube video I would go ballistic. This young doc needs an older veteran doctor so she can get experience in diagnosing people, that’s an art. And then she should go into the military, that will take that stupid smirk off her face. IMHO she is a lab coat doctor, wants title more than anything else. Gets through residency attends some BS continuing ed and becomes a specialist specializing in children that suffer from motion sickness or something else just as ridiculous. The hospital that employees this young doctor should shut this channel down before lawsuits fly.

  29. Just throwing this out there… When chosing a career such as being a doctor or pilot or etc etc you have to seriously LOVE your job or your gonna be miserable your whole entire life! 💯 You have to also remember that your work place is your 2nd home your there half of your lifetime, I unfortunately had to learn that the hard way! Seriously tho, Please ALWAY'S choose a career that you honestly love doing!!

    Also, This may be hard for some of you to believe but there are actually people in the world that do what they do for the love of it, not just the money! 💯💯💯💯

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