Medical Bullshit in TV Series (Part 2)

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Featuring: The Vampire Diaries. Does not contain spoilers. Season 6 Episode 5.

Road traffic accident. Woman making weak gasping efforts, fully awake. Allegedly trachea (windpipe) is deviated (shifted away from the midline; not clearly shown but clearly stated by a character).

Guy sticks a freaking tracheostomy in her neck and relieves everything.

Wait what???

First of all, trachea deviation is not treated that way. It is usually caused by a tension pneumothorax (collapsed lung with pressure pushing on the outside of the lungs so the actually lungs can’t expand, can’t get oxygen in, person dies), but other causes can be bronchiectasis, pneumonectomy, pulmonary fibrosis, etc. It CAN happen in RTAs. But note the causes are all LUNG-related things, INSIDE THE CHEST, DOWN the way from the windpipe and throat.

Tension pneumothoraces need urgent decompression. That’s the typical “stick a needle in the front of their chest on the relevant side and it hisses and person feels relief”. Again. Further DOWN the way. NOT at the throat.

How do tracheostomies work? Usually relieves difficulty breathing if there is an obstruction UP the way ABOVE the chest. You essentially drill a hole in the neck (the tracheostomy) so the person breathes via that hole into the lungs and bypass the nose and mouth. You can do that in airway obstruction (choking, blockages, swelling of the nose/mouth) or facial trauma.

Basically you do NOT treat tracheal deviation with tracheostomies. Tracheal deviation indicates pathology INSIDE the chest. Tracheostomies treat blockages ABOVE THE THROAT.

Also if the trachea is deviated I’m not quite sure how this kid (who has apparently practised on a grapefruit before and has had NO MEDICAL TRAINING WHATSOEVER) can stick it in without spearing the carotids on either side of the trachea.

*tears out more hairs*

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