911 S2/E2: Determining Death

In Episode 2 of this season’s Fox series 9-1-1, a devastating earthquake has hit LA county.

The team is searching for victims when they come upon a patient where only her lower legs are visible. The paramedic reaches down and assesses her pulse at her foot and determines that she’s dead. Time to move on.

Can you feel someone’s pulse in their foot? Yes, you can. He’s palpating what’s called the dorsalis pedis pulse.

Should it be used to determine if the patient is dead? To this, I would say no. The problem is, when the body goes into shock, it shunts blood toward the central aspects of your body to ensure blood flow to your vital organs so even though the person is alive, you may not be able to feel the pulses in the feet. This is why when checking for life, the use of central pulses is encouraged— for instance the femoral or carotid pulses. Also, this victim could just have two broken legs with compromised blood flow to her feet causing the lack of pulse.

However, I’m not going to give them too much grief for this. In a mass casualty situation, sometimes you do just need to move on and save who you can.

Medical Review of Fox’s 9-1-1

I’m so happy to be back blogging! I hope everyone had a fantastic holiday season and is ready for a new year. Today is officially my 20th wedding anniversary! Can you believe that? I know I can’t. It’s crazy to think how much time has gone by.

Considering the occasion, I thought it would be best to write a positive (well, mostly positive) review of a new TV show— Fox’s series 9-1-1. I know . . . you can pop your eyeballs back in. This is truly a rare event considering much of this blog’s time is spent skewering medical inaccuracies in print, movies, and the small screen.

9-1-1 is a series devoted to dispatch, police, and fire calls. I’ve watched the first two episodes and was pleasantly surprised at how much I liked it. Now, it does have some problems. Writing completely to stereotype would be the biggest.

Let’s look at what they did well.

1. The characters face consequences for their actions. I’ve said all along that it’s okay for medical people to do bad things in fiction, but there must also be consequences for their actions. The point of this are many. It increases the conflict in the story AND reflects real life. Too many times in fiction medical people are shown doing bad things without consequence. One firefighter is shown facing some serious repercussions for his poor (saying that lightly) choices.

2. There is respect for HIPAA and also how hard that is for medical people. HIPAA is the patient privacy law. Because of HIPAA, most of us who work on the front lines (EMS and emergency departments) rarely ever hear how our patients do after they leave our care. This is, flat out, not easy for any of us and it makes closure difficult.

3. Shows the problem of poor coping mechanisms. It is true that healthcare people do not always have the best coping mechanisms. Hello, to all the nursing units with the mandatory chocolate drawer. Some develop addictions  and can have bad co-dependent relationships. It was nice to see highlighted that the stress of this work does take an emotional toll.

4. Highlights the difficulty of work/life balance. Of course, all professionals face work/life balance issues, but I also feel like the nature of our work makes it hard to feel like you’re getting a break. If you’re taking care of a medically/terminally ill loved one at home, and then go to work doing the same thing— there can be little room to breathe.

5. Medical information was not distracting. The medical information was kept pretty light in the first two episodes and not too distracting. There were a few minor medical errors I’ll keep close to the vest for now.

Have you watched the new Fox show 9-1-1. What did you think?