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From Present:- The Campaign For Factual Accuracy


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#1 Guest_Smudge_*

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Posted 15 July 2003 - 10:30 PM

I know this is nitpicking, but hey, I'm bored. No admissions at mo. What's happened to the medical accuracy on Casualty/Holby? Don't they have medical advisors? They used to be pretty good, but recent series have just been a bit crap (and if ER can do it...) Or is it just the BBC care more about having a soap opera set in a hospital than a hospital drama?

Firstly my pet hate (fanfare...): Crash Calls

Why do characters persist in waving the paddles about at arrests? Last week the first 200J shock was given, then off came the pads (but not on to the machine) & CPR was continued. Then the second 200J shock was given. Then off with the pads again.

You do NOT wave defib paddles about at arrests. This is how you deliver a 360J shock to your oppo, who then either has a nice electrical burn, or needs resus themselves. You will fail ALS if you do not have the pads either on the machine or the patient at all times.

Also each 3-shock cycle is given as 'OFF O2!'-pads on patient-'CLEAR!'-shock-check rhythm-'CLEAR!'-shock-check rhythm-'CLEAR!'-shock-check rhythm-replace pads on machine-continue CPR. You don't do CPR between shocks, not unless you want an unplanned afro.

Real crash calls don't make good telly. Usually an arrest consists of 2 medical SHO's, a junior anaesthetist, 2 PRHO's, a senior nurse & sundry others steaming into the ward at the rush and shouting a lot (along with fair amounts of extreme sarcasm and black NHS humour). The surgical team, if present, are doing CPR at best, but more usually standing there looking vacant. I appreciate that dramatic licence requires characters you know to be in the exciting bits, rather than a bunch of sweaty, overexcited randoms, but still (and that's another thing - how come HCH has so few juniors, and how come they don't rotate every 6-12/12?)

We also don't shock often. Many patients are in unshockeable rhythyms- 15 minutes of CPR with 3mg IV atropine stat & 1mg IV adrenaline/3mins followed by a decision to stop does not make exciting television. Others are cold & stiff on arrival, or have underlying pathology which renders CPR futile, as the ITU won't touch someone with disseminated Ca Prostate with a 60-foot pole.

Even those we do shock, and I haven't had the pads out for 6/52, easy, often end up looking ###### awful, tubed, central lined & with multiple rib fractures & in ITU. I wouldn't put my granny through it, yet when we come to have the chat on the subject of 'We're not going to resuscitate your relative if their heart stops' you get 'why not - it works on telly all the time'

Which is where I'm going with all this. The BBC has a responsibility to show things how they are in a hospital drama - and as things are, they are not doing so. Tey used to - perhaps it's time for new medical advisors?

Smudge
Bored, on-call & in a DGH somewhere in England.

#2 Ruth

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Posted 15 July 2003 - 10:36 PM

Are you a fairly new doctor or some kind of masacist? Why do you even watch ER/Cas/HC? My parents (both doctors) hate it as do all the other Doctors I know... do you not get sick of all that stuff at work?

#3 Nichola

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Posted 15 July 2003 - 10:38 PM

I will admit, i dont know anything about medicine (although i have learned a little after being totally devoted to Holby for all these years)

Anyway, what i will agree on is your point about Holby being more of a soap than a medical drama now. Back in the good old days of Meyer ( wub.gif )d Nick, the whole eppy would be based around some big operation or a condition someone had. That would be it! And very rarely did we see anything majorly to do with the personal lives of the staff.

As it went on though it seemed to get bogged down in itself, and how it appeared as a 'soap'. In my opinion, the early days were the best...they were gritty, real and exciting! Its quite dull now (well thats only cuz Anton has gone! I'm very biased!) except for Zubin who is fabby!

Anyways, getting back to my point, i look at the first ep of holby (totally medical orientated, just how it should be) and i wonder what the hell happened to it. Although i might not be medically minded (not all of us are!) i still notice the differnce, i dont think the bbc understand how observant and dedicated some of us are! think they can fob us off with any old junk....well not us!

Another thing - We'd all love it to be accurate, but if it was one ep would prob last about 3 hours instead of one haha! laugh.gif

Edited by Nichola, 15 July 2003 - 10:43 PM.


#4 John

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Posted 15 July 2003 - 10:42 PM

Yeh, I've done an ALS course with St. John Ambulance, and I was just explaining to Sammie how some of it is a bit innacurate, for instance the jumping in straight at 360.

We were trained to do CPR inbetween shocks though, but we weren't taught on a manual but an AED, so it may be slightly different?

as for the O2 off...I have seen Kath stand there bagging a patient while Diane was shocking and I was like "noooooooooooo!"

I also agree about the rib fractures (me and Sammie were also discussing this) - the way they perform CPR they're gonna end up with lots and lots of rib fractures, it's hard enough to avoid them at the best of times!

Edited by Mr Meyer, 15 July 2003 - 10:45 PM.


#5 Guest_Smudge_*

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Posted 15 July 2003 - 10:55 PM

To Ruth I would say, you'd be surprised how many people watch Casualty/Holby in the NHS - often just for escapism. Ah! A hospital with no junkies or filthy, fitting alcoholics!

To Nichola - This is the spirit! I entirely agree with you re: Mayer.

P.S. If anyone who writes the rest of the site is reading, 'Thoracic' doesn't have an 'S' in it, and what the hell is a 'fast-track registrar'? Since the Calman reforms, all higher trainees have been Specialist Registrars (SpR's)

Told you I was in a nitpicking mood.

Smudge

'You come out of medical school knowing bugger all. Suddenly you're expected to cope with anything. No wonder August is the killing season - newly qualified doctors hit the wards, and suddenly hospital mortality rates shoot sky high. We all kill a few people while we're learning'

(Coconut for anyone identifying the source of the above quote)

#6 Nichola

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Posted 15 July 2003 - 10:58 PM

Yay!.....

More members for the 'bring him back' brigade!

(Ok there isnt one but..there should be!)

biggrin.gif

#7 Daisy

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Posted 15 July 2003 - 11:15 PM

i must remember never to have an accident in august then! lol!

i reckon its just all "dramatic licence" though i do see your point! - they can't possibly do everything realistically! i heard somewhere (Get Real Casualty?!) that they cant possibly show it realistically because otherwise they would show them doing paperwork all the time - which i can imagine is true!

are you a doctor then - what type? i want details! what uni did you go to?

i am 17 and doing my alevels (maths, biology, chemistry, theatre studies) i am hoping to become a vet but i have to get AAB! you probably did similar alevels to me - what did you get!

sorry - im very curious!

#8 Alex

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Posted 15 July 2003 - 11:16 PM

QUOTE (Smudge @ Jul 15 2003, 11:55 PM)
'You come out of medical school knowing bugger all. Suddenly you're expected to cope with anything. No wonder August is the killing season - newly qualified doctors hit the wards, and suddenly hospital mortality rates shoot sky high. We all kill a few people while we're learning'

umm...Meyer???? lol, i dunno!! lmao!! tho!!! my guess is Meyer abtou the time Victoria joins!!LOL!! awws, i loved her!! Victoria's brill!!!

i totally agree!! bring back Meyer!! and his sending back the 1st class tickets to Paris with a bill!! LMAO!!

#9 Nichola

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Posted 15 July 2003 - 11:20 PM

QUOTE (victoria+janicerule.alex. @ Jul 16 2003, 12:16 AM)


i totally agree!! bring back Meyer!! and his sending back the 1st class tickets to Paris with a bill!! LMAO!!

Ah you totally reminded me of that!!!!

Hahaha, how did i forget that?! That was classic! laugh.gif

#10 John

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Posted 15 July 2003 - 11:21 PM

QUOTE (victoria+janicerule.alex. @ Jul 16 2003, 12:16 AM)
QUOTE (Smudge @ Jul 15 2003, 11:55 PM)
'You come out of medical school knowing bugger all.  Suddenly you're expected to cope with anything.  No wonder August is the killing season - newly qualified doctors hit the wards, and suddenly hospital mortality rates shoot sky high.  We all kill a few people while we're learning'

umm...Meyer???? lol, i dunno!! lmao!! tho!!! my guess is Meyer abtou the time Victoria joins!!LOL!! awws, i loved her!! Victoria's brill!!!

i totally agree!! bring back Meyer!! and his sending back the 1st class tickets to Paris with a bill!! LMAO!!

That doesn't sound very Meyer like to me!




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