Cardiology Consulting GI

2 mortal enemies, forever at odds. Blood thinners, pressors and more!

[@shortforsophie]

HAAAAAA!!! My first job was in cardiac, and I will never forget the day the I overheard the GI consult poring over my pt’s chart and mumbling, “Jeeeesus, they’re gonna kill this guy!” So he writes a bunch of orders and flags it “Cardiology to Approve.” An hour and a half later Cardiology wanders in and takes a look at the orders, and *immediately* starts vigorously shaking his head, saying, “oh no! No. Oh... no. What, they wanna kill this guy??” So, so surreal.

[@TheN7Dragon]

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[@DonnyBaker45]

In medicine everyone is sure that everyone else is an idiot.

[@annacarter6559]

@@DonnyBaker45 I understand, I still just wish that most of them were wrong

[@kaponkotrok]

@@DonnyBaker45 is that really called medicine?

[@ThBlueSalamander]

I don't understand 🤔

[@maggierobertson2962]

"He was dead before, but now he's alive" = Shift report in CCUs all the time. Its fine.

[@superbray1]

Saw this and had to come back to like it

[@coffeejesushomeschool5949]

Yep standard CCU shift report

[@abbyram8901]

Hearing my husband and his coworkers talk about people dying during a shift always makes me ask to clarify, "yeah but was it permanent?"

[@mmmmmmmm1942]

I love working in cardiology

[@Platypi007]

"I got better!"

[@sawa139]

"Can you come scope him" I can call the chapel and ask them to send the priest.

[@erichenningfeld]

Having done a unit of CPE, we're happy to come! Just make sure the family either requested a chaplain or knows we're coming. Please! Lol

[@davidh9844]

The Mt Sinai term for the chart is PBAB. Pine Box at Bedside.

[@sumayahwardah5666]

Lmao he even nailed the way cardiologists are so lax when talking about obviously extremely unnerving and troubling things hah

[@xSwordLilyx]

'why are you nervous for your echo?' 🙃 I dunno, I'm the youngest person in this room by at least 3 decades! This is another day to you but you're taking pictures of my heart! It went well btw! Not sure why I had chest pain. Possibly anxiety, I have been feeling better. My family has heart problems at any age so I was extremely nervous.

[@StolenPw]

@@xSwordLilyx I remember when I got to go get one they had a new machine so there were like 10 doctors looking at me all super fasinated by the machine it was so nerve racking

[@bossysimon900]

I thought that was just me :)

[@nicholasbyram296]

The sixth pressor is just super tight compression stockings and a CPM device on each leg.

[@voidpunkprincess]

Stick their arms and legs in ice and head and body they use heating blankets! Or ya know, not.... Maybe Trendelenburg for a few minutes until you know the code team gets there.

[@slaplapdog]

@@voidpunkprincess Trendelenburg?

[@KatieCottingham]

@@slaplapdog Hung at an incline from the ankles. Commonly used for endoscopic surgeries in the abdomen to let gravity pull organs out of the way. Also one of the big contributors to women having strokes during pelvic floor repair surgeries, hysterectomies, and basically any other uro or gynecological procedure, but it's women so no one cares.

[@shortforsophie]

Abdo binder. The doc actually had to write orders because the nurses kept taking the Abdo binder off because “he doesn’t have a peg tube, he doesn’t need it.” My dudes, his SBP drops below eighty when you sit him up without it…

[@grayskindablue]

@@shortforsophie I love dr “logic” like that, that doesn’t even remotely track lol

[@livesouthernable]

This is why doctors are often accused of treating conditions and not patients. Cardiology: Good news! The high blood pressure is gone, and he’s no longer at risk for a stroke! Pathology: Well, he’s not at risk for anything anymore…

[@mmmmmmmm1942]

Lol oncology is similar

[@livesouthernable]

@@mmmmmmmm1942 you’re so right. I’ve had breast cancer, and my oncology team tried so hard to kill me. 😂 I’m kidding, of course, but the treatment is rough!

[@clickpause8732]

@@livesouthernable Oncology does not know the meaning of the term “pyrrhic victory”

[@livesouthernable]

@@clickpause8732 I love this comment! Very true.

[@AkaiAzul]

Sure he is! He's at risk of no longer aliving anymore!

[@1323GamerTV]

Coming from a nurses perspective, when that doc says “but he needs it” and the other doctor says “yea tru” is so unintentionally funny

[@cookimonstar907]

When you work for both specialities this conversation is even funnier because of how tru it is 😂😂😂

[@kohlrabenschwanz]

very precise... whats missing is the gi guy calling surgery cause they perforated the stomach.

[@Missmethinksalot1]

lol nailed it and a rush call to anesthesia for threatened airway from the oral bleed

[@dianeridley9804]

And the anesthesiologist dealing with the 6 pressors WAAAAAY before that perforation

[@fil4648]

We're at the receiving end of this conversation and trust me, they're not as chilled as the cardiologist in this video. They're panicky and guilty. And you don't even need to take the next available OR in these cases most of the times, as they haven't eaten and have had the scoped organ cleaned before the scope, so the bacteria are not infecting the abdominal cavity so quickly. Most of the times you open up and there's no peritonitis yet.

[@normalchannel2185]

I observed this in just one department while i have having my surgery lol. The anesthesiologist, the podaitrsit, the nurses, the physio therapist, the dressers lol it was so funny

[@wholeNwon]

More likely the esophagus.

[@nathantripathy]

I'm a CNA on a cardiac surgery unit. This reminds me of the reports I get from nurses. I've even had pts who came in for one night for a minor cardiac issue or who have to stay overnight due to elevated troponins and are given a blood thinner as a precaution. They end up with a GI bleed and end up in the hospital for days. I also love the cardiologists mannerisms. A hallmark of cardiology seems to be both being incredibly manner of fact and being unphased by just about everything.

[@wholeNwon]

Matter of fact.

[@dreamwolf7302]

The other day i was asked to check in on a patient in the Cardiology unit. I must admit, i was confused. Usually Cardiology sends their patients to me, not the other way around. So i walk in, greet the patient and ask the nurse why i was called. "To do your thing." "Nurse, it would be highly unethical for me to do that." "Why?" "Because I'm a Pathologist." My last name, my legal name, is Wolf. There are three Dr. Wolfs in the hospital.

[@samanthasearl4505]

Omg, they had to bring an Internalist in to mediate between my dad's cardiologist and GI. 🤣🤣🤣

[@ZenergyHQ]

As a nurse I have overheard these conversations. This is funny but real

[@papercut931]

Sometimes i wonder if doctors ever think “maybe we should just let this guy go-“

[@pennychurchward1481]

My thoughts exactly…..I’m Oncology and Pall Care RN…..so death and dying is one of my soap boxes.

[@trucluu7894]

Since the hippocratic oath has the “do no harm” and a bunch of law in it, unless the patient has a dnr or a release form by the family, the doctors have the legal obligation to keep him alive

[@cjboyo]

I know a doc who worked in geriatric care for a bit and apparently often thought “can we please stop flogging this poor man to keep him alive?”

[@cjboyo]

@@trucluu7894 Doctors can absolutely recommend DNR orders though

[@trucluu7894]

@@cjboyo true, but until the patient sign it, the rule is “keep him alive”

[@paulamiller7564]

❤️❤️❤️”Yeah, but we want to keep giving it to him.” ❤️❤️❤️ These are so funny because they’re so real. 😀

[@k.r.3598]

As a former CICU RN at a major academic medical centre, I can attest to the veracity of this video. 🤣😂

[@barbraprosper9065]

not too funny if u are the patient...care seems more like a coin toss🙄

[@dianeridley9804]

But, as usual, you totally left out the anesthesiologist, who is managing those 6 pressors-- WHILE the pt is in the CTICU-- including the IV running at KVO

[@pablomo1300]

​@@barbraprosper9065i think the same as you. They see patients as objects

[@mijuajua4820]

“We had to make one up” I’m dying here....🤣😂 LOVE your vids!

[@helenscho4769]

The double stethoscope look 😂

[@patriciaobrien6600]

Hahahaha, I didn't catch that the first time 😅 Ty!

[@valerianaranjocruz25]

One is his, the other is the floor's stethoscope that he took by mistake when he forgot that he had his own hanging from his neck. Or is the intern's, now the poor fella is dying of nervousness as to how to ask it back.

[@fionnbarrcasey5247]

lol “SIX! I didn’t even know there were six!?!” “Yeah we had to make one up” 🤣🤣 my god that is gold

[@susanmohamed7951]

He was so sick, we had to make one up (7th, unexisting presser). Too funny !

[@lachyt5247]

Pharmacy really pulling through there!

[@ryanbeebe8336]

Gave methylene blue as a pressor once. It is usually given by intermittent IV push, but we had to have an order created for Epic by pharmacy who them made the piggy back for us in order to give it.

[@Liuhuayue]

"He's on six pressors" "SIX?!!!" "Yeah, we had to make one up because of how unstable he was."

[@SaschaGerstner]

We heard it

[@ryanbaker709]

Milrinone!

[@owinfrey6231]

OMG! So funny!

[@joestevenson5568]

​@@ryanbaker709 is not a pressor

[@FoxxyYaps]

Epinephrine, Levophed, Dopamine, Dobutamine, Phenylephrine, Vasopressin boom lmao

[@JohnnyWishbone85]

When I was still an EMT doing CCT, my team had to transport a person on *five* pressors (all maxed out) about sixty miles to the nearest facility with CRRT. There was a lot of puckering on that transport.

[@loganclemons4961]

So then GI calls us (anesthesia) and be like “hey we got a guy we need to scope real quick should be like 10min NBD can you help?”

[@bnnnnnnnnnnn]

Soo true , then he would die on the table , and all of a sudden it's anesthesia's fault

[@Phil4Jesus]

@@bnnnnnnnnnnn Everything is anesthesia’s fault...

[@Phil4Jesus]

“10 min”...if I had a nickel...

[@kaerligheden]

@@Phil4Jesus 🤣😂🤣😂🤣😂🤣😂🤣

[@iz2333]

@@bnnnnnnnnnnn weeeeeeeelll anaesthesiologists are the guys who are supposed to keep the patient alive while under anaesthesia so teeechnicallyy...

[@juliag.1231]

I once had to take medicine and the neurologist said I need to take it, but I gained a lot of weight and got problems because of that. So the endocrinologist wrote a letter to my neurologist saying she needs to stop the medicine from his point of view but the neurologist just shrug his shoulders and I had to keep them. There was no alternative working. Difficult situation to decide who is more right.

[@NurseQuipy]

"we had to make one up cause of how unstable he was" omg lol

[@aamirrazak3467]

Yeah the patient was dead earlier but he’s alive now.... my god

[@idalarsen2540]

Well that's normal 😃😉

[@MrSpencerMcIntosh]

"Like he literally died" That was a close one, he almost assumed you weren't being serious 😂😂

[@catherinedefreitas5715]

"6 pressors" I am deceased 🤣🤣🤣

[@whitecross7648]

I'm a Cardiology patient & now I am worried. 😆 Not sure how I managed to miss you before, but I am now subscribed. ❤

[@barbraprosper9065]

don't watch if u need surgery

[@fozf9193]

🤣🤣🤣🤣And the hospitalist is in the middle of these scenarios 🤪🙈

[@ninjason57]

Seriously when was the last time two consulting services talked to each other without having the hospitalist as their "go between secretary". This is fake.

[@carolinasmedicalillustrati6760]

It's ok, the hospitalist rarely speaks English well enough to understand what's going on...

[@annacarter6559]

@@ninjason57 it’s making a point in a 1min attention span world

[@DoeintheThicket]

Oh I am dying!!! Former ICU/Recent Cath Lab RN, I can see both sides of how hilarious this is.

[@VvsBuck5293]

GI never scopes on same day. It can ALWAYS wait 3-5 business days. Keep the patient NPO and give blood and fluids until the patient out of pure hunger eats a bag of flagyl.

[@karenfolan56]

I wish.....

[@considerthelilies91]

Reminds me of why I am happy I retired! Vanity plate on car-"RNNOMOR"

[@mikeericaful]

Ohhh, you make me laugh. “But we want to KEEP giving it to him. He NEEDS it. Lol!

[@heartnurse0900]

Like talking to a toddler…

[@aremedyproject9569]

Poor cardiologist’s put at the end of this messy line. “Ya, but we don’t want to” lol.

[@elenastarr8962]

I'm neither a cardiologist nor a GI but this stuff is pretty hilarious.

[@DrShivvv]

“Soooo can you come scope him?” LOL

[@CJGfarm]

I love how this doc made it all the way through med school and still sees how whacked it all is.

[@andie361]

I have von willibrands and am a heart patient..my cardiologist and hematologist went back and forth, lol.

[@ChahtaAnumpa]

You forget the internal medicine busting in through the door yelling to everyone STOP 🛑.

[@knightdad9969]

As an ICU nurse I laughed so hard at the 'we invented a new pressor for this patient' line

[@Missmethinksalot1]

you deserve a million views

[@wolfbones666]

We want to keep giving it to him, he needs it for uhh...... Research purposes.

[@aliciascott3176]

How have I only just found you. Brilliant!

[@marykent2024]

I was the nurse with those patients! This is soooo on point!

[@backwoodstherapy]

Bro on six pressors needs a palliative care consult stat lol.

[@CJ-uo5cl]

This was like my daughter when she crashed because of her Wilson's Disease. She was in a coma for 40 days.

[@drscorpio100]

The cardio guy had two steth 😂😂😂😂😂

[@Sailor86To]

Man… when they don’t come to You … they come to Urology with Haematuria 😂😂

[@xavierbrown4051]

My granddad had a heart attack (not the first one he'd had.) Decides since the doctor isn't open, nothing he can do till morning. Wheels in next midday, doctor tries to get blood, cant get any, sends to hospital and forces them to give him a button monitoring his heart that would call and ambulance automatically if needed. 😂😂😂

[@JayNizzy]

"Don't worry, he's alive now." 😳😂

[@Dominus_Anulorum]

LVADs and GI bleeds, two mortal enemies.

[@dillonhughes1417]

Sounds like grim reaper is standing next to that dude just going "...any minute now and i can clock out"

[@nstefani]

Every single time. When they call I don’t even argue anymore. I surrender to their requests, it’s a lot easier…

[@kerryfitting6070]

These are brilliant!

[@asafupps]

The second guy is Mr Jones isn’t it?

[@savagegardenrox]

I am a veterinary nurse at a specialty and emergency hospital. I work with the internal medicine doctors (in vet med they cover GI) and sometimes sub in with the cardiologist. The other day we had a cat see the IM doctor in the morning and the cardio doctor in the afternoon! And, yeah, there is always the struggle with patients like that to balance the needs of various organs.

[@ShelleHolley]

Left a like because I love your content, but the second guy, this is exactly how my father died.

[@cnb1243]

When he said six pressors I said wtf so loud 😂

[@danw918]

I have just decided to return to nursing after attempting some different ways of making a living for a few years. In truth I have been feeling quite scared and unsure about this decision, but these videos are making me remember the silliness of it all. Thanks 👍

[@macgirl1234]

We had to make one up because of how unstable he was.... Anyway, when can I tell him you'll be down? 😂😂😂😭

[@andreykovachev7002]

As ICU doctor a have a lot of those conversations aswell :) And i was having the same thought about pressors - i was like hol up! 6?

[@yektaagra741]

"So can you come scope him?" "Is he..."

[@marleakudlauskas8853]

hahaha, we had to make up a pressor - classic

[@Mars-zgblbl]

In the 18th century, the doctor was the most feared man on a ship. I’m even more scared now

[@besehee]

Lol, as a specialist nurse in cardiology, I confirm this is true story.

[@MrsCasa]

As a specialist nurse in GI, I concur.

[@rosedawn8046]

I counted with my hand for “six pressers” 😂 Seriously four is maximum I have experienced in CCU

[@aizazali6500]

I used three, like norad,dobuta,dopa, But maybe they are talking of ad. and phenyleph

[@rosedawn8046]

@@aizazali6500 norepinephrine, adrenaline, Dopamine, Dobutamine. That’s all 😅

[@finalremnant777]

@@rosedawn8046 probably said 6 and made up 1 due to some places considering vasopressin a pseudo 5th pressor. but their isn't a 6th that I know of. unless you throw milrinone and dobutamine... but those are rather specific.

[@tradenmyr]

Dopamine, Epinephrine, Phenylephrine, Norepinephrine, Vasopressin, Angiotensin II

[@zimshah]

The first story is a perfect description of what happened to a family member. It was so tragic. They insisted on blood thinners which opened a bleeding duodenal ulcer. They did an emergency surgey to save him from the bleeding ulcer, then insiated on giving him the blood thinner again. Then within the week they insisted on sending him home. After a real health struggle for the following year, he passed away from internal bleeding. His hemoglobin was low while in the hospital and required something like 15 bags of blood over a few days. It was so frustrating. He didn't want to die and did everything he was asked to do. He was 89 when he passed. It all started with a gall bladder surgery.

[@pablomo1300]

Yea but these people are laughing in the comments. Seems like for some workers people are just like objects.

[@enuh7356]

This is the best one so far

[@Labroidas]

These skits are really funny but they also make me really anxious xD i'm so glad I'm not a doctor, i'd never be able to handle this

[@andylarson6877]

LMFAO!!!! THE BEST ONE YET!! I'm going through this sh1t right now (been here for a month already)

[@shelikestuff]

These are GREAT

[@southerngraceglamour]

These are gold!!!!!

[@KebabJimmy]

I love how he has an iPhone 1 and hasn't sold it yet

[@alietheartist734]

“He died, but we fixed it.”

[@MrsMBash22]

"I don't like where this is going" Lmfao 🤣🤣🤣

[@semievilsquirrel]

I just had a surprise pacemaker put in last week. Thank goodness I also didn't need a scope, too!

[@dlane7539]

Eek! This reminds me of my mom. She's been on coumidin for 20+ years but they had to adjust it higher than usual after her blood test. She was home alone after my dad had a heart attack so I stopped over to visit her. She was sheet white & said she felt woozy and was passing blood. I told her that I need to take her to ER. She said "no, it'll probably go away soon". 🙄 She went into bathroom & I heard Thud! I ran in & there was blood everywhere.. It looked like a crime scene! Luckily the hospital was 5 blocks away so ambulance was there immediately. Her Dr said if she would had fallen asleep that she would had bled out internally & pass away. Scary Bless doctors who saved her life.

[@davidh9844]

THIS GUY IS AMAZING!!! Brings back horrible memories. GI wouldn't use 3 blood thinners. Ortho would! (I can only think of 3 pressors, but I've been out of residency a long time.)

[@stargirl6659]

Haha the 6 pressors thing was great, happens all the time

[@AustinDaGaming]

You nailed it!!

[@kidaz]

I feel personally attacked.

[@JaneDoe-ip5yl]

This guy is hilarious😂

[@bipolartorecovery1485]

Of what I remember from this channel comma do not scope until stable is the general advice

[@nrsjewlzshats6257]

Best one yet!

[@oscargoldfield1593]

Hilarious!

[@uniquegarcia7484]

I can't decide whether to laugh or cry

[@slaplapdog]

The cardiologist has a nice soothing voice.

[@purplefn3587]

He was so unstable we had to make one up. Can we get that scope now?

[@katrinat.3032]

🤣🤣🤣🤣 One of your best ones yet!

[@brookegunn8663]

Everyday in CVICU 🤣🤣🤣

[@pablomo1300]

It's not funny if you are the patient

[@Readabout123]

From an ICU RN, this is soooooo accurate! Lol!!

[@ishgumi44]

"We had to make one up because of how unstable he was" LMAO

[@gabrielbarrantes6946]

My view of the GI diseases changed completely once I understood that the GI tract is specialized skin tissue.

[@elliesharp401]

6 pressors “yeah we made one up” 😂

[@MisterRorschach90]

Years ago my dad had a ui so they gave him sulpha drugs. He got stupid sick. Like a dr. House episode sick. It took them over a week to realize that’s what it was. Kinda funny. They flew in a specialist. And the specialist was just like “did you stop the sulpha drugs..?”

[@twistedbambi2370]

How is this so accurate!?!? 😂

[@mddroege]

I'm not in the medical field but this is still fucking hilarious

[@nickisnyder3450]

Cardiology versus GI with blood thinners is as funny as cardiology versus renal with fluids.

[@Whiteraven194]

Was waiting for the we’ll scope him in the morning

[@DocTami]

OMG😂 "...we had to make one up..." The guy knows his cards peeps for sure

[@tinaperez7393]

Doc Schmidt, I'm not in healthcare but I'm finding yours and other med KZbin channels (Dr. Glaucomflecken) are so good at skewering the med field, I don't know, once people really know what it's like, why people would want to work in it. It seems so awful. And insurance and private equity seem to making it even worse. 🤔