
Doctor John Parente returns with another episode of Emergency Minute
Doctor John Parente
Welcome back to another episode of Emergency Minute. This is Doctor John Parente. Today is going to be a lot of fun. We're going to talk about some crazy scenes in movies that we've seen before that you've probably all seen relating to medical issues that came up during those scenes. So we're going to talk about what's accurate and what's not accurate and kind of move on. But before we get into that, I want to thank everyone for joining. This is the fourth episode for 2024. 22nd episode overall, hard to believe that people are out there still listening to me. I appreciate both of my listeners. Just joking. Thanks. Appreciate all of you guys. I apologize for the lack of shows. What's happening right now in the emergency room is actually quite daunting over the past decade. You know, with corporatization of medicine and, you know, people trying to make as much money as humanly possible, but given less and less resources, especially by the idiots in Washington, we just have to work harder and harder and harder and have less and less and less staffing. So • when I used to have some downtime at work, could put some time into, you know, putting these podcasts together. You probably don't realize this, judging by the quality of my shows, but this actually does take a lot of work. There's a lot of research that goes into this, a lot of planning, a lot of note taking and things like that. I used to have some downtime to be able to do that at work, and that's really not the case anymore. We pretty much get to work and just sprint for 12 hours, which is really fun and it's why everyone's leaving healthcare. Okay, moving on. So I just wanna let you guys know that we are growing the show. The show is growing together and I could not do this without your support. • • If you enjoy this show, please consider leaving me a review on Apple or Spotify or wherever you listen to your podcasts, just know that anytime you share comment on social media posts, specifically those related to my podcast, know that you are helping a brother out. Know that I see you and I'm truly grateful.
Hollywood should hire a physician consultant to help make crazy medical scenes believable
All right, today's topic, crazy medical scenes in well known Hollywood movies. Are they accurate? Are they not? Should Hollywood give a crap about the accuracy or just the drama and the entertainment value? Or am I just the jerk who sits there and thinks to himself, come on, man, how do they not have a physician consultant to at least make some of these scenes a little bit more believable? Side note, if you know any producers looking for, you know, a relatively bright, super opinionated, not that really good looking physician consultant, I know just the guy for the job, and I guarantee I'll beat anyone's consulting rates. I mean, come on. The average budget in Hollywood is 65 million, according to Google. Y'all can't find an extra $200 laying around in the couch cushion to consult with the doc?
Many movies show people getting shocked with flatlines, which is not realistic
All right, to start off, what are some of the general inconsistencies that we see in movies in general? Well, you know, first and foremost, we see people getting shocked. And a lot of times, it's sort of hilarious when you see this on the monitor and you're watching someone undergo CPR and they're getting shocked on tv, it's with a flatline. Now, a flat line means asystole, which means the shock is completely and totally worthless. Will not work no matter how many times you do it, no matter what you see on Hollywood. Now, if you saw it on tv, it must be true. Now, there are shockable rhythms out there, such as VTAC and V fib. You know, those are very realistic. We see these all the time in the emergency room. And, yes, we do shock people, or as we like to say, we electrocute them. But basically, you know, that's the thing that we see, probably most commonly, is people getting shocked with a flat line. I got news for you. If you've got a flatline, you're pretty much already onto the other side. Another thing that we see, and this was actually studied, ironically, is people undergoing CPR in the movies. And obviously, they can't. They can't push down as far, • • as they should if they were doing real CPR with. You're getting, you know, two or three inches of compression down in the chest, because the person that's there is probably not a mannequin. They're probably like a real life actor. So that part, you know, obviously, you get a pass. The study does show, though, that people that are undergoing CPR in movies undergo, • • at a much, much slower rate than real CPR. So found that kind of interesting when I was doing some notes for the show. Also, just if you are curious, if you undergo CPR, your odds of walking out of the hospital, meaning, like, you survived and you're relatively back to normal ish, depending on the circumstances, of course, is about 10% tops, maybe 15%. They've studied this, in the movies, when people undergo CPR, it's 85%, which is just not realistic, and unfortunately, creates this sort of societal expectation that if we just shock everyone and do CPR, everyone's going to be just fine. And that's unfortunately not the case.
Many movies portray taking bullets out as a cure for gunshot wounds
All right. Another thing that we see is very commonly taking the bullets out, and this will cure the patient, really. Taking the bullet out really has nothing to do with anything other than, yes, the bullet is hot, and so removing it from that tissue can save some of the surrounding tissue. So there is some value in getting the bullet out, but it's not like, you know, in the movies, they portray a bullet going in, and then they have to go find this rogue doctor or dentist or veterinarian that can, you know, work in his, like, cd surgical suite at his house and remove the bullets. And as soon as that happens, you know, we'll just patch you up and send you on your way, and, you know, all the pain goes away, and you're just so much better. Yet, that's not how this works. • • do you guys remember the scene from minority report with Tom Cruise, the eyeball surgery scene? that's pretty horrifying. That place was disgusting. Hopefully, you're not having surgery in a seedy place like that anytime soon, or maybe you already have. I don't know. And then lastly, another thing we see is the villains getting hit with some sort of dart or substance that puts them down instantaneously. There's really not a substance in the world that does that. Guess we'll get into some of the different substances in this podcast here a little bit. But the reality is, yeah, that doesn't really exist, where you could just hit someone with a dart and they just fall over. Trust me, if that substance existed, we would use it in the ER. When someone comes in high on meth with an alcohol of 300 and they're taking swings at the nurses, which, yes, that does happen all the time.
In Mission Impossible 3, Tom Cruise undergoes CPR during cardiac arrest
All right, moving on. First up, we're going to talk about mission impossible three. Now, this is a Tom Cruise movie, and the character's name is Ethan Hunt. He has this sort of device in his head and has Michelle Monaghan electrocute him in order to deactivate it so it doesn't explode in his head. Now, this sends him into a dysrhythmia a heart rhythm issue, and he undergoes CPR. So. Okay, that's. That's pretty good so far, other than the thing that's implanted in the head and, you know, whatever, the entire scenario obviously is very unlikely and far fetched. That's how, you know, mission impossible works and Hollywood works. but there, there are some kind of good takeaways from this scene. First and foremost, you know, she does perform very fast, very quick bystander CPR. And this is statistically your best chance of survival in the event that you have a sudden cardiac arrest. Plug, a selfish plug for me. If you want to listen to another podcast of mine, I would check out sudden cardiac death in athletes when I specifically address, Damar Hamlin collapsing on the football field last year. The other thing I really liked about this scene is something called the precordial thump. Now, obviously, Hollywood has to make this very dramatic. She's doing CPR, it's not working. And so she's crying and she's getting overly emotional and, you know, so she starts to sort of punch him in the chest. Now, this actually is a real medical thing. you know, in this case, Tom Cruise gets electrocuted, likely sent into VTAC or v fib, and, you know, would need defibrillated. If you don't have a defibrillator or even if there's a delay in getting one, the quickest way to try to • • manually defibrillate someone or cardiovert them is to punch them in the chest. This is a real thing. It's called a precordial thump. I've done this probably about five times in my career now, you would say, you know, why on earth would doctor parente punch somebody in the chest when he has all these great medical tools at his disposal? Well, keep in mind that sometimes people, go into dysrhythmias and just sort of pass out. They go into vtac or v fib or nasty things that, you know, could take their lives without us having something on them. Like, not everyone presents to the ER and says, hey, I'm about to die. My rhythm is about to change here. In about 30 minutes, my rhythm is going to change. So we don't always know when this is going to happen. So there have been some cases in my career where someone would pass out or whatever. We hook them up to the monitor and we're like, oh, crap, this person's in v tac. You know, this is a big deal. Hey, let's get the pacer pads, and so we can, you know, cardiovert this person. Well, that. That takes time. It takes a few minutes to. We could do it very quickly. But you know what else is really quick is for me just to jack somebody right in the chest. And I've done it a few times. It does sometimes work. I think I've had it happen, probably about five or six times in my career, and it's worked about two times. And what's hilarious is, you know, you jack somebody with, you know, pretty good force right in the middle of the sternum. And the one time the guy, I literally jacked this guy in the chest, and, like, in one motion, he just was like, why the hell did you do that? And I'm like, because your heart was about to stop. So you're welcome, I think, is the word that you're looking for there. So, yeah, so, I mean, obviously, what's going to be faster? Is it going to be faster for me to do that, or is it going to be faster for me to have the nerves, you know, go find the machine, bring it over, you know, hook them up to the monitor, hook them up to the pacer pads, all those things. It's gonna. It's gonna take some time. So if you see somebody out there and they're collapsed and relatively pulseless and look like they need a good punch in the chest, my implore you to do so. That would be hilarious. Also, looking at this from a stadium standpoint, from the Demar Hamlin, you know, case, I don't know if he had that done on the field. I obviously wasn't there. It sounds like he was undergoing CPR in the field. There was a lot of people surrounding him, so that, you know, no one could really see what the heck was going on. But imagine being the team physician on the side guideline for a football game, and someone collapses and goes into cardiac arrest. You got to find an AED, right? You got to find the thing to hook the patient up to. You got to get him off his, you know, his jersey and the shoulder pads and everything else. You got to hook him up, wait for the rhythm to be analyzed, then you got to wait for the response. You know, click the button that says, okay, it's time to go ahead and shock this person, or you just jack them in the chest as fast as you can. I mean, that's something that you can actually try. So I think that's, something that's kind of good to see, because a lot of people don't know that or think that, you know, that that wasn't real. But in the movie, she did, you know, sort of do the precordial thump, and then he, like, wakes right up, which is pretty realistic in that regard because he did need to be defibrillated. So overall, I think the movie did a good job for creating this very suspenseful scene, you know, somewhat accurate with good CPR technique. And then, you know, bonus points for the pre cordial thump, which, you know, really could save a life. So I'll give it two thumbs up, or maybe one and a half. I don't know, one and a half thumbs is. But that seems right.
There's a memorable medical scene in a Quentin Tarantino movie
Moving on to the second movie is a Quentin Tarantino classic pulp fiction, very memorable movie and medical m scene in this movie where obviously a person gets stabbed in the heart. Bit of a stretch, but medically does make some sense. So we have Mia Wallace, who's played by Uma Thurman, finding heroin in Vincent Vega's jacket, and she mistakes it for cocaine, and she snorts it and essentially overdoses. So he does the only logical thing and then goes to find the local neighborhood drug dealer, slash, I don't know, street physician • who tries to help him out and gets a medical • bottle, of medicine that's labeled adrenaline, which is first, you know, off hilarious, because adrenaline is a hormone in the body. It is not a medication. But they figured that most people would understand adrenaline and not understand the term epinephrine, so that's why they chose that. But it is epinephrine. That is the medication that's sort of being in implied there. And that would jumpstart the heart. Now, that would work if the patient had gone into, like, v tac or v fib, like a dysrhythmia for the heart. It does not reverse the opioid overdose. That likely is the cause of this here. Does anybody know what reverses that? Yes. Narcan. So that sort of is issue number one. Now, the other part is how they administer the medication. They did pretty good, as far as anatomically, the location just above her left breast, that is, is where your heart, • • • • they do, you know, sort of take too long to give the medication. In reality, if she was truly pulseless, which we don't really know, obviously she wasn't, like, hooked up to a monitor for the movie, then you would be doing CPR or precordial thump, at least while waiting to give the medication. Because if this was just like, a respiratory arrest, then maybe you had some time. So respiratory arrest is when someone stops breathing and by the way, that doesn't mean that their heart stops. Usually that happens moments later or minutes later, depending on how bad off the person is. But, yeah, if there, if they're truly pulseless, you know, there's not a lot of time. I mean, you have seconds to get this thing together. But, of course, it's Hollywood. And they create this sort of build up that leads to him stabbing her right in the heart, which is pretty hilarious and obviously a very iconic movie scene. Now, in this scene, the drug dealer makes it very clear that he has to stab her hard to get through the breastplate, which really isn't true because they're not going through the sternum. You could just go between the ribs, which would, you know, be the most likely pathway and the most successful pathway. It'd be awfully hard to get a needle through the rib and then into the heart. But obviously, that doesn't make for good tv. So I get that part now. You know, the other part of this that's kind of humorous is that as soon as she gets the medication, after, you know, a millisecond, you know, she just sits right up and is, like, wide awake. You know, in reality, even if this was to work, it would take a few seconds, to have the heart kind of start back up and for her to regain consciousness. And quite frankly, the best thing to do would be to administer the medication and then do another round of, CPR in order to sort of, you know, get the heart moving and kind of circulate the medications, things like that. So, you know, that that's the reality. she would not, you know, in all likelihood, just sit right up. But it made for a very humorous, very well done medical • scene. So, you know, can this actually work? It is possible. It's been done in medicine before. • • We, do have it. It's called intracardiac epinephrine. And this is a scenario where, like, if you don't have an iv or you don't have an IO, which is an intraosseous line where we can give medications through, like, a line that's hooked into your bone that's very easy to get, or if someone's not intubated with, like, a tube down their throat, because we can shoot medications down the tube. If you don't have any other chance of giving this medication, yes, it theoretically could work, but obviously it's not something that's done, you know, routinely in healthcare.
Quentin Tarantino filmed this scene in reverse
Kind of a cool note about this movie. Quentin Tarantino filmed this scene in reverse. So that kind of makes some sense as to like, how would you stab an actress and kind of make it look realistic. So he sort of did it backwards. Also, I thought it was very interesting in doing the research for the show that he thought it would be sort of good imagery for an anti drug campaign • • to kind of show what an overdose looked like and how you could almost die and how it would take something drastic to sort of bring you back. Very interesting that, you know, as much as we see in this movie with like drugs and everything else, it's, it's interesting to see that he actually had, you know, some, well, intentions regarding, you know, drug use and that kind of stuff that's kind of, blew me away when I was doing the research. So overall, how did the movie do? You know, I think it did a great job of creating a very suspenseful scene that is obviously, you know, iconic in history. I can only really give one thumbs up from a medical side of things because there's a lot of inaccuracies and kind of far fetched things here. But I do give two thumbs up for creating one of the most memorable medical scenes in cinematic history.
Vx gas is an irreversible acetylcholinesterase inhibitor
Alright, moving on to my next movie is the rock with Stanley Goodspeed and John Mason, which is Sean Connery and Nicolas Cage, who take the vx gas from the rocket. So what is Vx gas? Well, Vx gas is real. It's a organophosphate. Think of like pesticides, only it's a lot more volatile, it's a lot more dangerous. So you have this, you know, final fight scene where, you know, everybody's fighting and they're trying to get that last set of the organophosphate balls, the vx gas balls out of the rocket. But he puts one into his pocket that has sort of escaped and fell onto the ground. He's fighting with another dude and he puts the ball in his mouth and punches him, spraying the vx gas all over. Alright, so what does that mean? Well, question one, is Vx gas real? Yes, Vx gas is very real. It is an irreversible acetylcholinesterase, • • • • inhibitor. And so what that means is that it basically takes the nerve signal that normally is able to be stopped at some point and makes it so that it cannot be stopped. Meaning those nerves are just going to continue to fire and fire and fire and fire and just go through all of their conductions without ever being stopped. So that's kind of, obviously very dangerous thing because • normally the signal can be stopped by acetylcholinesterase but if you have acetylcholinesterase inhibitor, then you just have this perpetual firing of the nerve. So this vx gas really inhibits the nerve signal from ever stopping. So the nerve signals just go on and on and on. So that creates, obviously, a lot of the bad impacts of this type of medication or this type of poisoning, you know? So question two. Is this Vx gas as nasty as the movie makes it seem? Yeah, it is ridiculously toxic. Like, straight up nasty. A little drop on your finger would kill a full grown adult. Now, it won't cause the, like, boils on the face within seconds, like in the movie, kind of this, like, almost zombie look to it, but it will make all of your muscles essentially contract without any end in sight. And ultimately, you'll suffocate from not being able to breathe, and you'll die from respiratory arrest, which will send you into cardiac arrest. Now, there's a lot of other symptoms that go along with this. There's. There's drooling, excessive tears, excessive sweating, salivation, urination. • • Basically, just imagine fluid coming out of every place in your body. It's extremely unpleasant. Eventually, you'll become short of breath, convulsing in seizures, and die. I mean, this is a highly, highly toxic, you know, chemical warfare type of agent. Now, they do use atropine in the movie, which is an anticholinergic, agent. Is that the antidote? Well, sort of. It's used to treat a lot of the symptoms because you have, like we talked about before, this continual firing of. Of these nerves, which causes, like, the slow heart rate. And, you know, all those things we talked about with the fluids, the urine, the tears, the vomiting, the atropine will sort of counteract those symptoms. But it's not necessarily the antidote. as the movie sort of depicts, you would actually need something called tupam, which is extremely rare and something very hard to find. But you would have to really give both of those agents in the field very, • very, very quickly for this to have any chance of working. And you. There's a good chance you'd still die regardless. But you couldn't really give these things in a hospital hours later. This person would already be dead. way less effective once this sort of cascade has been set in motion.
Vx gas was outlawed per chemical weapons convention in 1993
So do we still have Vx gas? No, this was, sort of, outlawed per the chemical weapons convention, signed in 1993. It's pretty nasty stuff. And there is a very famous and successful assassination. I don't know if anybody knows about this one, but this would be. And I'm gonna butcher these names, so I apologize. Kim Young, um's brother, King Young nam from Korea, had basically two ladies throw some gas in his face at an airport, and he was rushed to the hospital dead within 15 minutes. So this is a real thing. it's very toxic. Overall, I think the movie did a very good job with a high risk scene, and they did pull it off. I. Because I'm a nerd and I like the talk stuff and all that stuff. I give it two thumbs up. I thought they did a great job with what they had.
James Bond drinks martini that was poisoned by his adversary in Casino Royale
All right, moving on. Casino Royale. All right, so we have James Bond here playing some Texas hold'em poker. He's drinking his martini that was poisoned by his adversary, who is le Chiffre. Le Chiffre. I don't know how to say his name. I don't speak French. Sorry. But he drinks this one sip out of his, martini that's been poisoned. He then runs to the bathroom, knowing that he's been poisoned. He tries to drink some water, and that's not gonna do the trick. So then he runs out to his magical car that has, like, all these fancy contraptions. He's, by some miracle, able to put an iv into his wrist, which allows him to communicate with the physician remotely, who immediately diagnoses the problem within. Within a moment, hooks up a defibrillator to his chest that just, you know, happened to be laying around in the glove box. I'm sure you guys got these as well, I think. Get him at autozone now.
The scene where Bond takes digoxin is hilarious, but also inaccurate
All right, so a couple of issues with this scene. First issue is that he took one sip of the martini that had, like, an ounce of the substance in there. You know, some of the strongest substances on earth would be diluted 100 or a thousand times, not really have an impact, or, certainly not that quick. The physician that speaks to bond on the phone is like, you'll be dead in two minutes unless you do exactly as I say. But, then, like, in further conversation, about 30 seconds later, he's like, I don't know the identification of the poison yet because it's still scanning. So somehow they are remotely checking the blood for toxins, but he knows he's going to be dead in two minutes unless they do exactly as he says. Now, the final diagnosis here, and this is where from, like, a medical, • professional. This is, like, hilarious, because it's completely inaccurate. They identify the toxin as digitalis, or digoxin, which is a cardiac medication. And the heart rhythm is v. Tac or ventricular tachycardia. So a lot to unpack here. First, dig toxicity is something that takes a very long time to create symptoms. • It's something that happens over hours and hours and hours, if not days and days and days. And where do we see this? We see this in someone in the emergency room who has a very slow heart rate, not a fast one, because they've usually gone into, like, kidney failure. Something bad has happened in that regard. And their didge levels then start to climb and climb and climb, and that causes your heart rate to slow down, slow down, slow down. So, you know, obviously, not a good look for Hollywood here if they're trying to be accurate, because did slows your heart rate down, does not send you into V tac. And furthermore, obviously, it takes a very long time. But for the purpose of the movie, they need something that is sort of rare, that not many people have probably heard of, and then, you know, make an entertaining scene in the movie. He does delay shocking himself so that he can give himself the antidote, which is called Digibynd, and he gives it in his neck. Now, this would take a lot longer to sort of counteract the digoxin. You'd need a pretty darn big dose as well, and very little chance, if, not zero, that you're just gonna stab yourself in the neck and get it into a van blindly. Now, he passes out at this point. So in all likelihood, he would progress, at least in this fictional scenario, from v tac to v fib, which is the last rhythm you see before you go to Jesus. And then his lady friend discovers him in the car, hooks him up to a defibrillator, and shocks him. He immediately wakes up, which is probably the most accurate part of the scene, and, like, moves on and goes back inside to play cards, which is hilarious, you know, well done for an entertaining scene.
The villain in Casino Royale bleeds from a tear duct, a rare medical condition
interesting fact, the villain in Casino Royale, Les Scheffer, bleeds from a tear duct in his eye, a rare medical condition. Does anyone know the name of it? It's hemolacria, which is really simple. If you speak Latin and you break down the word, it's hemo, which is blood and lacria, referring to the lacrimal system, the tear duct system. So thanks, mom, for making me take Latin in high school. Paying off in dividends. Overall, how did the movie do? I think it was very far fetched. It's outlandish, • completely unrealistic, and most of all, medically inaccurate. I give it a zero thumbs up. But admittedly, I enjoyed the movie, especially because part of it is filmed in the Bahamas at one of my favorite places on Earth, the ocean club, which is part of the four Seasons on Paradise island. In, fact, you can go to the, bar on the beach there. There's a restaurant called Dune, and you can actually order a casino Royale martini right there where the movie was filmed. Fun fact. I'll be there next week on vacation.
Mark Wahlberg gets shot in the chest and develops a pneumothorax
Moving on to another favorite medical scene of mine is three kings. This is featuring Mark Wahlberg, Ice Cube, and George Clooney. If you haven't seen this movie, I'd recommend it. The scene is pretty accurate, and they do a good job of blending a very serious medical issue and pepper in some humor, and are actually remarkably accurate with the diagnosis and treatment and things like that. So, in the. In the scene here, Mark Wahlberg gets shot in the right chest, and he develops what's called a tension pneumothorax. So this is where you get a hole in your chest. And essentially, you know, people don't realize this, but your chest is like a vacuum, and that's where the lungs are maintained, and there's pressures that allow you to breathe in, breathe out, etcetera. So if you get shot and you put a hole in such vacuum system, everything is disrupted. And what happens is air gets let into your chest, but not necessarily coming out of your chest. And so what happens is it starts to constrict your lungs, and your lungs collapse, and it makes it harder and harder for you to breathe. Now, attention. Pneumothorax is a true emergency where you will be dead within minutes very quickly if this does not get resolved. And that's where you have to put the tube into your chest. So this scene actually does a really good job of trying to show some different things. So, first and foremost, it tries to show a flail chest, which are paradoxical movements, meaning the segment of chest that's involved looks like you're inhaling when you're exhaling, and vice versa. So that was kind of cool to see. I'm, not sure I've ever seen that in Hollywood in a. In an actual movie form. And then they do these kind of cartoonish animations of the lung, where they show you what it looks like with a lung starting to collapse. So they did a good job sort of explaining exactly what was happening. Now, George Clooney, who ironically played an emergency medicine pediatrician on the show, er. If you're old enough like me to remember that, and he actually puts a large needle with a stopcock in the middle of the mid clavicular line, meaning he puts a big, giant iv type thing into the chest. For those of you that are not in medical field, he opens up the stopcock, and a rush of air can be heard as the lung re expands. That is extremely accurate in the sense that, you know, when we do put these tubes in, you can literally hear the air being let out like you just, you know, poked a tire with a knife. And again, they do kind of a good job with this cartoonish depiction showing that this would look like when the lung starts to re expand. Now, the only flaws that they make it seem like he just has this, like, permanent valve in his chest that will just last forever. And, you know, he can just run around with this thing, and in reality, you know, that's not going to last forever. At some point, he's going to have to have that converted to a tube in his chest because it's going to get clotted off with blood or debris. And ultimately, you know, every time air is getting into this, this cavity, not all of it's getting out. So it's going to eventually create another tension pneumo at some point. But it made for good, you know, cinematic entertainment, relatively medically accurate as well, so. But, yeah, he would have to have this chest tube in order to not have his lung completely collapsed. So, overall, how did the movie do? I think it was one of the most accurate depictions of a medical emergency and diagnosis in the field with treatment, not to mention the addition of humor and some cool, cartoonish type of stuff that I've really ever seen in a movie. I give them two thumbs up, for sure. This might be my all time favorite medical scene in any movie I've ever seen. And, there's no chance they did this without some type of input from an ER physician. And again, selfish plug m. Give me $100, $200 a movie, and I will be your consultant and make sure that some of this stuff isn't as crazy or far fetched, unless that's kind of what you're going for.
Will Ferrell accidentally shoots himself in the neck with Ketamine
All right, moving on to old school. One of my favorite movies, it's so dumb and so funny, though. one of the funniest movie scenes ever recorded is Frank Rickard, played by Will Ferrell, is at a birthday party, picks up a tranquilizer with, quote, the most powerful animal, animal tranquilizer in the world. End quote. whatever that means. I don't know. He maybe Ketamine he accidentally shoots himself in the neck and has a dart sticking out of his side of his neck at 90 degrees. Dude, you got a freaking dart in your neck, man. So, you know, he does say that it hit his jugular • • • • a lot to unpack here, you know, what is the medication first and foremost? Most likely would be ketamine. If they're talking about animal tranquilizers, ketamine is a medication that's been around forever. We use it all the time. It kind of fell out of favor, I don't know, maybe 20 years ago, but then sort of has made a comeback. Very safe medication when used appropriately. We use it in the emergency room a lot of times, especially if, like, you know, for example, you have a kid that falls off the, • • monkey bars or the trampoline. Oh, God, I hate the trampolines. It is trampoline season coming up and, you know, you have these fractures all over the place and these kids need to have these reduced. Rather than putting an iv in and giving them medicines that sedate them and suppress their respiratory system, a lot of times we'll just use a one time shot of ketamine, which is really nice. You don't need an ivy. It doesn't suppress their breathing at all. It just kind of knocks them out. But they're still awake, sort of. They're sort of alert, but not really able to feel pain. And, you know, works within about three to five minutes. So, you know, in this scenario, you know, if, if by some miracle it hit the jugular, which, you know, would be almost impossible because it's at 90 degrees, the dart sticking out the side of the neck, and, it's buried into the neck. But, if it did get into the jugular, it still would take about a minute to two minutes before it would fully take effect. Now, if it got into the muscle, it's about three to five minutes for it to actually work. Now, interesting fact for this movie, Will Ferrell was completely nude, running down the street during the streaky scene, which I thought was very interesting when doing the research for the show. And no, I was not Googling, you know, will ferrell nude or anything like that. I simply was trying to find interesting facts for this movie, which this one popped right up great for my Google search history. Alright, so overall, how did the movie do? I think it was one of the funniest scenes of any movie I've ever seen. The concept is great, but the execution, or at least the accuracy, just isn't there. So I can only give them one thumbs up, but they get a pass for creating a completely hilarious cinematic scene.
Dr. J. Parente: Thank you for listening to Emergency Minute
I wanted to thank everyone for joining me today. I did have a good time with this one. Did you guys have some fun? What did you think about this topic? Send me some ideas for additional topics you'd like me to see and discuss on the show. If you'd like to be a guest on the show, let me know. Let's make it happen. We can get that done and talk about, whatever's going on, whatever's trending in healthcare care. And as long as we can kind of connect the real world with the medical world, I'm down. We can do this. Please don't forget to leave a review for the show. Even if you thought it was not very good, chances are if you're still listening at this point in the show, you either thought it was entertaining or you can't believe you're still listening and wondering if you're ever going to get this 30 minutes of your life back. Join me next time for the next episode of where should I take my sick child? We're going to talk about kind of what's the difference between taking your child to a pediatrics office, to an urgent care? Dont ever go to the urgent care or go to the emergency room. But in all seriousness, hope you guys are doing well, enjoying this beautiful weather, living life to the fullest because tomorrow is never promised. Peace, love and happiness to everyone out there. Cheers guys.
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