Tuesday, May 14, 2013

Face Off: John Travolta and Nic Cage should have been dead after surgery






Ahh, Face Off.  The tale of two men whose faces are switched, and then they blow a lot of stuff up trying to kill each other. The scene here focuses on the operating room, when the actual face transfer occurs between John TRavoltas character and Nic cage's. I know Im quibbling with a plot thats as ridiculous as John Travoltas chin (that line was in the movie), but in an agae in which facial transplants are actualluy occurring, its importance for people to understand how extensive these surgeries are, and the role that the anesthesioologist plays.  What is particularly absurd about this scene is that there is no breathing tube for the patients.  Anesthesiologists play a vital role protecting the heart and lungs of a patient during surgery, among other things.  When a patient is to undergo an incredibly invasive and painful surgery like a face transplant, they are given anesthetic medications/anesthetic gas/muscle paralysis that will help keep the patient asleep and make the patient have no movement. Unfortunately all of the above put the patient's airway at risk as the patient is too out/too paralysed to protect their airway (meaning stuff from the mouth or stomach can go into the lungs), nor can they breath particualrly well.  As a result, the anesthesiologist at the beginning of the case will place a breathing tube into the patients lungs, and this will protect the airways and allow the anesthesiologist to breathe for the patients by placing the patient on a breathing machine. 
 
Amount of Hollywood Med Help Needed? Like a million much.  I get it, its Hollywood.  But even Hollywood is trying to sell reality in its movies.  Face off, put a breathing tube in your patient undergoing surgery, it makes it seem like you at least tried, a little.

Monday, May 13, 2013

Swimfan, the reason I exist




This is the scene that started it all for me. The main character played by Jesse Bradford goes to visit one of the previous victims of his current stalker played by Erika Christensen in a sort of nursing home.  Here the patient is in a coma, breathing on a ventilator. As you can see has a breathing tube going down into his lungs. What is curious about this scene is the presence of those nasal prongs also called nasal cannulas, going into the patient's nose. Nasal prongs deliver oxygen when placed on non-intubated, breathing patients.  The presence of a breating tube, though, basically created a closed circuit from the patients lungs to the ventilator which is giving the patient breaths and oxygen.  Placing a nasal cannula would be kinda like putting a sprinkler on top of a garden hose and thinking the water from the sprinkler would be deivered 50m down to that rose garden where the end of your garden hose is sitting. Aint gonna happen. Oh yeah, there are no monitors in the room either to monitor the patient's heart rate or oxygen levels or blood pressure. We doctors like to know that kind of stuff. 
 
Amount of Hollywood Med Help needed?   Boat loads! This was real amateur, Swimfan. Take off the nasal prongs, the breathing tube is more than enough. Some monitors in the room would have been nice too but this might be asking too much for such a poorly constructed scene. Goodness.