470 – Hero Soup: 07

470

Young doctors at an Alberta, Canada hospital have been performing a run of incorrectly handled intubations, according to the National Post. (That’s when the one dude can’t breathe for some weird reason, like he’s allergic to the watermelon sauce covering his filet mignon, and this other dude yells, “Get me a bottle of brandy and a Bic pen!” and that dude slices the first dude’s throat open and shoves the pen in the hole while splashing brandy all over him, and the first dude is all happy cause now he has a pen-hole in his neck to breathe through and blow brandy bubbles out of and he takes the second dude to his private jet and… well, anyway, that’s what it is.) Asked why so many doctors appear not to know how to handle the procedure, the hospital responded that the doctors in question had apparently learned intubation techniques from medical dramas on TV… where the doctors, the patients, and the intubations were not real. (Out of 80 doctors questioned, an unrevealed yet reportedly “large proportion” admitted to learning what they knew about the emergency surgery from TV.)

Dr. Peter Brindley, critical-care specialist at the University of Alberta Hospital and colleagueΒ Dr. Craig Needham studied a season of ER, and observed 22 intubations, 100% of which were performed incorrectly.

Next: School bus drivers in hot water try Dukes of HazzardΒ defense.

13 Responses to 470 – Hero Soup: 07

  1. Wow, TV really can make people stupid. Even would-be doctors, apparently…
    Isn’t this the sort of thing that’s supposed to be covered on the exams? You know, the ones that you supposedly have to pass to become a doctor in the first place?

  2. Gross-incompetence and other forms of malpractice are a hidden shame of the Canadian medical system and probably its biggest problem. Unlike in America we don’t really have a legal malpractice system to get the serious screwups sued out of practice and doctors everywhere protect their own.
    Considering how the medical profession operates it’s no surprise. What can we really expect from a group that has the highest tuition cost of all professional training paths to enter, gives literal control over life and death to its members and has 100+ hour work-weeks as a formal and mandatory part of its hazing-rituals (medical residency)?

  3. What the…? Where did these clowns get their medical diplomas? From clown college?

    Actually, not every endotracheal intubation requires a tracheotomy as well. But every treacheotomy requires an intubation. Intubation is needed not only where patients cannot breathe on their own, but also whenever a patient is unconscious or in a coma and in danger of breathing in blood or vomit.

    With a normal intubation (through the mouth or nose) you should take care not to shove the tube down the wrong path… as in through the oesophagus into the stomach. Or the patients will start to puke when you push air into their stomachs (and then breathe in the vomit), or if they can’t breathe on their own they will suffocate.

    But even when you manage to properly hit the trachea, you should’ve checked first if the patient’s airways are clear and open, and then make sure you don’t injure the larynx while you push the tube between the vocal folds, or the patient might never be able to speak again. Oh and don’t push the tube down too far or you might ventilate only one lobe of the lung not both. Fun.

    So yes, intubation is quite difficult even with a lighted laryngoscope so that you can see what you’re doing, and even here in Germany medical associations lament that too many normal doctors (those not trained as anaesthetists or emergency medicine) are unsure how to properly handle the procedure because they don’t train enough or the training dummies are not lifelike enough. Not to mention many doctors in hospitals are overworked.

    But good god… some people complain that it takes so damn long for physicians here in Germany until they get their degrees and are allowed to practice, especially if they go on to gain a medical specialist diploma (another 5 years of study on top of what is one of the longest university education already). And that we should follow the example of America and shorten the college period so that we get younger doctors, blablabla (that’s why the bureaucrats cut the physician-in-training year) and you know what? Bullshit.

    “We were a bit shocked,” said Dr. Peter Brindley, the critical-care specialist at the University of Alberta Hospital who discovered the students’ extra-curricular secret. “The important lesson here is that we can’t leave medical education to chance alone.”

    No kidding??

    Dr. Brindley said he and his colleague, Dr. Craig Needham, noticed that many students and residents — medical-school graduates training in specialities such as anesthesia, surgery and emergency care — positioned the head incorrectly. (…)

    Dr. Brindley said his findings are more evidence that the traditional approach to teaching doctors needs improving. Medical students typically learn about procedures such as intubation in a lecture hall, then find themselves practising on a real, perhaps critically ill patient, often with minimal supervision. Later, the same doctors sometimes train others.

    There’s something wrong about this picture. πŸ™

  4. Back to the comic,… you know, I dislike Enkidu and Martin and cheer everytime they get kicked in the teeth as they so deserve it, but I also passionately hate the Sword of Truth series, so I’m not sure whose side to be on here. πŸ˜‰ Perhaps they’ll eliminate each other, hurray.

  5. Yeah, heard about the Sword of Truth as a very good series, read the first tome, and got bored. The only fun part was the sm-like relationship between the hero and that vilainess whose name I can’t remember. This was so ridiculous!

  6. Great now doctors are gonna watch House and experiment on multiple treatments before getting a concrete diagnosis. Then patients start dying. Oh, and they’ll act like jerks while they do it.

  7. Yeah, Kevin. What Christina said… seems you described a tracheotomy, not an intubation.

    Tracheotomy = cutting a hole in the throat.
    Intubation = shoving a tube through the mouth down the throat.

    Both sound to be so much fun! and based on this article, I hope I need neither procedure…ever.

  8. In theory, it is during residency (read “internship”) that prospective MDs learn how to put the theory that was covered in classwork into practice. This should be done one-on-one under close supervision by a well-experienced doctor. In practice this mentoring is absent or, at best, rudimentary.

  9. Remind me to never need to be hospitalized until -after- I take over the world and have imposed some reforms on medical training…

  10. Tracheotomy, intubation β€” Kleenex, tissue β€” I guess when you need one it’s more important to keep it straight. Still, I really appreciate you guys letting me know. I love how much I learn from these comments. You guys are really smart!

    Whenever it comes up Enkidu and Martin are always listed (in that order) as the most popular characters. I think it’s totally cool (and no offense) that there are people out there who hate them, since they are not really meant to be portrayed as very likable or sympathetic. (Not villains either, but Enkidu IS an ass and you’d have to be an idiot to trust Martin with a paperclip.)

    Thanks for that Christina!

  11. Do you know what hospital that was? I live in Alberta and would like to avoid it at all costs. It was not the U of A hospital was it? I was in there on Saturday, and I hope that I was not treated by incompetent doctors.

    • Sorry Justin, I don’t. I’m pretty sure the original article (now unavailable) said, so if you do some searches for the information, I bet you can find out.