The Pitt

All right, everybody, settle down!

Good.

Now, Robby has something important to say.

I know that this isn't easy.

We're going to help you address any challenges

that you might be having.

If you have any concerns, just raise your hand.

- Emma, write all this down. - Dr. Mohan.

Medication orders aren't coming up from the pharmacy.

Check with the clinical pharmacist to see if it's in the PDS.

If it's not, then give the third copy of the order sheet to Dr. Nordt.

We're gonna need more people to run it down.

- We'll work on it. Langdon. - I can't find the patient clipboards.

Clipboards need to stay here for orders and labs.

Wait, so how do we write our notes?

Take the T sheet to the bedside, not the whole chart.

Same goes for nursing notes.

- Princess. - Fax machine is down.

- Error message E6. - What the hell does that mean?

- You can check the manual. - There isn't one.

Okay, Perlah, why don't you take your phone out to the base?

See if you can get service, find a manual online.

What else? Ogilvie, put your hand down.

- Santos. - We've gotten a few CT results back

but nothing on plain films.

That's probably because they're all sitting

on the portable machine not getting to radiology.

- I'll take care of this. - You be patient.

Help each other. Thank you.

We need to call in extra help.

At 3:00 p.m. on a holiday? I know people, buddy.

I have a 32-year-old woman with severe abdominal pain.

- Do we have a bed? - Not at the moment.

- I'll take her. - Incoming.

Thank you.

Santos, Javadi, you're up.

Trauma one's open.

12-year-old Jude Augustin...

Firecracker exploded, non dominant left hand.

Good vitals. 25 of fent so far.

Any other injuries?

No, but seems to have lost two of his fingers.

- Did you bring 'em? - Blown to bits.

- It really hurts. - I'm sure it does.

We'll do something for that.

- Parents? - Not on scene.

Ready?

One, two, three.

Hey, Jude, do you know your mom or your dad's telephone number?

No. But I know my sister's.

Okay.

- Good breath sounds. - Abdomen non tender.

Heart rate 112.

Put this around his left forearm.

- Is that good? - That is very good.

I want to do another 25 of fent before we open this bandage.

Can you tell us what happened?

- My friends had firecrackers. - 25 fent on board.

I lit one, and it went off fast.

I-I dropped it, but...

We're gonna take your bandage off now, okay?

- I don't want to see. - You don't have to.

Just look at me.

Okay.

Cutting.

Sorry.

You're doing great.

That looks like a lot more than a firecracker.

- More like an M-80 or a cherry bomb. - It's really good that you dropped it.

You saved the rest of your hand.

Digits 4 and 5 avulsed.

Distal metacarpals 4 and 5 also gone with exposed bone.

Soft-tissue damage on the palmar aspect, less so on dorsal...

Some burns on wound edges.

Jude, can you bend your fingers for me up and down?

Really good job. Really good job.

- How bad is it? - You lost two fingers.

But it seems like the rest are gonna be okay.

Oh, no. I fucked up!

All right, can we do a wrist block for the pain?

I want to do a very detailed motor and sensory exam first.

We're gonna continue our exam now, okay, Jude?

Okay, thanks.

ICU can take her after the next neuro exam.

The ICU?

It's just so she can be monitored for the rest of the day.

4 millimeters and reactive.

Mel.

- 4 millimeters and reactive. - Yep, got it.

I could sort of make out your hand.

Can you cover your good eye?

How many fingers am I holding up?

Three.

That's good news.

So the medicine worked? She's out of the woods?

Possibly.

It's...

Okay, cover your eye again.

All right, what do you see?

- Top line is E. - All right, and the next one?

Nothing.

Okay, well, that's 20/200.

Meaning?

What a healthy eye can see at 200 feet, she can see at 20 feet.

- Is that good? - Yeah. It's much better.

And it can continue to improve over time.

Thank you, Dr. King.

I'm gonna take a quick break before my deposition.

So I'll let Robby know that I'm off the clock for the time being.

- Good luck. - Thanks.

- Mel. - Hey.

You have a visitor in chairs.

- What? Who? - Said she's your sister.

Becca?

Yep. You have heat exhaustion.

It usually gets better with Aleve, but today was really bad.

Same pain you had before?

- From a cyst? - I think so.

I have PCOS.

Is the pain always on your left?

Today it is.

We will check a UA and urine pregnancy test,

and I'll give you a shot of Toradol.

It's something a little stronger for the pain.

I'm not pregnant, I promise.

No, we have to. It's hospital policy.

You guys still write stuff down on paper?

Today we do, yeah.

Are you a doctor? I've been waiting hours to be seen.

Quick question...

- Hey, watch the walker. - This thing is useless.

Sorry, I just...

We're really busy, and someone will see you in a second.

- Becca. - Mel, hi.

- Is everything okay? - Yeah, I have a stomachache.

Did you see the residential-care nurse?

She was out for the Fourth, but I talked to her on the phone.

She told me to come here, and Geri brought me.

- Thank you. - No problem.

- I'll wait for you. - Okay.

Okay. Come on, this way.

Just through here.

- Is it always like this? - Yeah, pretty much.

Wow. There are a lot of smelly people.

Yeah.

Are you going to help them all?

Yeah, but let's start with you first.

Okay.

- How's the pain? - I can't feel my hand anymore.

Ancef's on board.

Okay, we're going to clean out your hand with saline... salt water.

Okay.

What's up?

- Hand versus M-80. - Surprised we've only seen one of these.

The day's still young yet.

Lost fourth metacarpal, mid-shaft on the fifth.

Bummer.

Hello, I'm Dr. Garcia from surgery.

- I'm gonna have surgery? - Yes.

The first operation is to clean everything up

and cover where the skin is missing.

But you still have your thumb and your most important fingers.

- What'd you give him for pain? - We did regional blocks.

Hand surgery always wants to document their own neuro exam.

Sensation is intact to light touch and pinprick

throughout the digits in the remaining hand.

Yeah, FDS and FTPs and extensor function was all intact.

- Need parental consent for surgery. - Yeah, we're working on that.

Dr. Robby?

I smell alcohol on his breath.

He's in line for the OR. Might be a little bit of a wait.

Ortho's still in with Allen Billings...

That open shoulder dislocation that came back from Westbridge.

He's still in surgery?

He waited an hour to be cleared by anesthesia.

Is the insurance company gonna cover the cost of the surgery?

Yeah, since Westbridge is still down.

Well, good, because the delay in care

definitely increased the chance of a post-op infection.

You got to love it when insurance companies make medical decisions.

- Hey. - What's up?

Do you still need a rain check for watching fireworks tonight?

I thought you were coming over.

I made other plans.

Okay, cool.

I'll try hitting you up tomorrow.

We're just keeping it casual, right?

For sure.

Yeah. Thank you. Yeah, bye.

Oh, hey.

I just got a hold of the sister of the heavy patient

Abbot's taking to Presby.

She still lives in Arizona,

but she is willing to talk to him when he's back.

That's good news.

When do you think that might be?

Depends on how crazy it is over at Presby.

If it's anything like here, who knows?

Yeah.

- Is help on the way? - Ah, ye of little faith.