Doctor Reacts To Deadliest Catch Injuries

What is discussed, and when

1. 0:00 – 3:00: Francis Katungan, MH60 J-Hawk, the Coast Guard
2. 3:00 – 6:00: Mike Vanderfeld, the Coast Guard
3. 6:00 – 9:00: Cody Rhodess, the Bearing Sea

Notable quotes from "Doctor Reacts To Deadliest Catch Injuries"

• Based on the mechanism of injury. With the MH60 J-Hawk batted by 39 headwinds the Coast Guard now has only 20 minutes to lower the rescue swimmer to the pitching deck, secure Francis, and hoist each of them back up.

  about the Coast Guard · at 2:31

• 42-year-old, deck, boss, Mike, Vanderfeld slipped and got his finger caught between the launcher and the 800 lb crab pot.

  about Mike Vanderfeld · at 4:33

• Two, hours, ago,, Deckan, Cody, Rhodess, took the falling force of a,000 lb steel crab pot to his left leg.

  about Cody Rhodess · at 7:05

Who and what is mentioned in this episode?

People

• Francis Katungan — Person · 1 mention · first at 2:00
  Dean, Francis, Katungan, suffers, from, blunt force trauma to his pelvis and possible life-threatening injury to the iliac artery. A lot of these concerns can be ruled out by checking simple vitals.
• Mike Vanderfeld — Person · 1 mention · first at 4:33
• Cody Rhodess — Person · 1 mention · first at 7:05

Companies & orgs

• the Coast Guard — Company · 2 mentions · first at 2:36

Products & tech

• MH60 J-Hawk — Product · 1 mention · first at 2:32
  Deteriorate quite quickly, especially based on the mechanism of injury. With the MH60 J-Hawk batted by 39 headwinds the Coast Guard now has only 20 minutes to lower the rescue…

Concepts & topics

• transient ischemic attack (TIA) — Concept · 1 mention

Places & events

• the Bearing Sea — Place · 1 mention · first at 7:49
  Put them together, they heal. Even in a trip's final moments, one man learns the hard way just how unforgiving the bearing sea can be.

Full transcript with timestamps

0:00 I've handled medical emergencies up in the air, but never at sea. Let's check out what medical injuries and situations can happen when you're on the deadliest catch. Let's get started. Be whoop.

0:12 228, mi, southwest, of, Dutch, Harbor. While setting, a rogue wave ambushes the Patricia Lee from the starboard stern.

0:23 Oh, my, god., If, waves, come, onto, the, ship like this, you can just get sucked out to sea. How can anyone ever save you? This This ship can barely handle it.

0:34 Ejecting, the, anchor, pot, out, of, the, ramp, crushing 29-year-old deckand Francis Katongan against the stack.

0:41 Oh, my, god., Is, he, being, pinned? Broken hips, right? Yeah,, probably. Oh, my, god., How, do, they, know, that, it's, a broken hip? That's That's unbelievable. Based on the way that that fracture happened, probably a femoral neck, maybe a inter troantenteric fracture. and they feel the pain every time the motors.

1:01 Yeah., Uh, hip, fracture, is, very, painful. Usually needs morphine pretty quickly. Another thing you want to be concerned about given the fact that where he was hit that he's not having any intraabdominal or chest bleeding because bleeding into those areas can be problematic. Obviously losing blood anywhere is bad but uh you could lose a ton of blood without realizing it into the retroparitinal or peritineal space and in the chest. It could uh impact your heart's ability to beat, which obviously is lethal.

1:31 Three, hours, after, being, crushed, by, 2,000 pounds of steel this, they, they, don't, secure, the, steel.

1:38 I, can't, take, any, chances, with, having internal bleeding. That's, what, I, was, going, to, say., Internal bleeding is obviously the biggest risk. But also if there's a femur fracture you could be uh worried about developing a fatty embolis where actually from the bone breaking a piece of fat can travel into the circulatory system and get lodged in the lungs leading to someone dying.

2:00 Dean, Francis, Katungan, suffers, from, blunt force trauma to his pelvis and possible life-threatening injury to the iliac artery. A lot of these concerns can be ruled out by checking simple vitals. Even having a pulse oximter, being able to check oxygen status and pulse, give you a good amount of information because if someone's pulse is normal, odds are they're not losing a lot of blood especially if they're not pale. But you definitely want to keep monitoring them because a situation like that can deteriorate quite quickly, especially based on the mechanism of injury. With the MH60 J-Hawk batted by 39 headwinds the Coast Guard now has only 20 minutes to lower the rescue swimmer to the pitching deck, secure Francis, and hoist each of them back up.

2:45 And, imagine, how, much, that's, going, to hurt. He's in severe pain even when the ship rocks. Pain control here is of utmost importance.

2:52 Don't, go, to, sleep. Yeah., Stay, with, us,, buddy. I, wish, they, told, us, his, vitals., Uh, blood pressure and pulse would go a long way to understanding his cardiac output. I don't see how they're going to do this.

3:03 It's, just, not., Here, he, is., Me. No, way. Badass., That's, That's, That's, what, I'm talking about. Medical rescue. This is basically what I do every No, it's not at all.

3:20 Whoa. Rolling your right side. Roger. Oh,, man., He's, in, so, much, pain., They, got to get a backboard on there to hoist him up. That's another thing we didn't even discuss, whether or not he has sacral or lumbossacral fractures.

3:36 It, does, not, get, any, more, intense. Oh, my, god., It, looks, like, they're, faking the waves, but this is real life.

3:45 Oh, my, god., That, can't, be, comfortable. Oh my god. Oh my god. I'm so worried that he's going to hit his head or something., Did, they, at least, put, him, in a helmet?

3:54 10, hours, after, his, injury, his, pass., Is, he, passed, out, from, the medications or from the condition? Cuz then I'm really worried about checking his pulse, making sure that we don't need to do chest compressions.

4:05 Hey, guys,, I, just, talked, to, Francis's doctor and uh he's going to be okay.

4:09 Wow. He's, going, to, be, fine., So yeah,, that's, good, news. That's, amazing, news., The, fact, that, the Coast Guard came in there and they put him on the winch.

4:25 Oh, my, god., Why, are, their, faces, always making contact with the rusty bucket? Crab bucket. You

4:31 okay,, Mike? Oh,, it's, his, finger. 42-year-old, deck, boss, Mike, Vanderfeld slipped and got his finger caught between the launcher and the 800 lb crab pot.

4:46 Oh,, he, lost, full, on, the, fingertip., See, given the fact of where he is and it the fact that it's just the tip, it it's probably not going to be reattached. just about washing it out with saline dressing it really well to prevent future bleeding, and getting him to a hand surgeon. That's that's all you could really do in a scenario like this. And some people if they, you know, lose a finger, they'll throw it on ice. Don't do that. That actually damages the finger. What you should do is wrap it up in a towel, paper towel, ideally something sterile, but if you don't have anything, just a paper towel, and then take that and put that on ice so that the finger itself is not making contact with the ice. and keeping uh the hand that's bleeding above the heart which decreases the amount of blood flow therefore decreasing the amount of blood loss and obviously with an open wound like that out in sea dirty wound you

5:35 need antibiotics you're worried about osteomiitis because there's a lot of small bones in the finger that can get infected septic arthritis the joints can get infected those now require IV antibiotics if that were to happen

5:48 so, that's, why, in, a, serial, like, this, just massive amount of saline just to wash it off and then pressure pressure.

5:54 Put, compression, on, it, right, now., Wrap, it up., No matter, how, bad, it, hurts,, you're going to, need, to, wrap, it, up., It's control bleed.

6:01 And, in, this, in, these, scenarios,, what, I see patients do is they put a lot of pressure, 30 seconds, a minute, and they go, "Let me see if it's still bleeding." Not enough. At least 10 minutes before you reassess, maybe even 15 in some scenarios.

6:16 You, going, to, put, it, in, there, and, rinse it. Okay. Pull it out. Okay, this is going to hurt.

6:24 This, I, don't, necessarily, like., Uh, I think rinsing it is usually enough. Putting any kind of alcohol peroxide can actually irritate the tissue.

6:32 Okay,, let, go, of, these., Hold, with, that hand. Hold, it, hard., You, got, to, be, squeezing.

6:38 Trying, to, calm, down, and, control. Yep., Look, at, that., Above, the, head., Good job. No. No. Keep put it back up there.

6:44 Oh,, yeah., That's, just, the, angle., It's too small. I don't think that's ever going to be reattached. leg. I don't know.

6:56 Oh,, what, happened, here? Oh, I know what happened here. A serious fracture happened there of what looks like to be the tibia.

7:05 Two, hours, ago,, Deckan, Cody, Rhodess, took the falling force of a,000 lb steel crab pot to his left leg.

7:12 My, god,, that's, a, bad, fracture. Twisting, the, flesh, and, bone,, resulting in a gruesome spiral fracture. Oh, a spiral fracture from the force just literally circumferentially just breaking the bone

7:24 of, his, fibula, and, tibia. So,, both, of, the, shin, bones, are, broken, not just the tibia. And usually that happens from a very high velocity, high weight fall, unless you're someone who's older and has osteoporosis. You need uh open reduction internal fixation here which is a surgery where they basically put hardware in and allow the bones to heal. Cuz bones are really cool. If you put them together, they heal. Even in a trip's final moments, one man learns the hard way just how unforgiving the bearing sea can be.

7:52 That's, a, really, good, pain, control method. The fact that it's inflated like that. I wonder if these guys have really good life and health insurance

7:59 on, the, Cape, Caution. Hold, on, to, that, train. Oh, my, god., Did, he, get, cracked, in, the face?

8:06 Hey,, just, stay, down. Is, there, no, better, way, to, get, crabs, out of the ocean into the ship? Oh my god, that's a broken nose. That doesn't look straight. I'm concerned about that. You got to be careful for a septal hematoma, too. That buildup of the hematoma, which is basically just a collection of blood, it can put so much pressure that it can lead to necrosis and totally destroy the septum there.

8:30 How, you, feel?, Are, you, dizzy, at, all? I, can't, tell. Obviously,, because, it's, a, head, injury, you got to rule out a concussion as well.

8:36 We, need, to, put, pressure, on, this., It's going to hurt. Okay. Oh,, yeah., It's, going, to, hurt.

8:40 And, the, pot, hit, the, bug, and, bounced back. hit him in the nose, broke his nose.

8:45 I, mean,, besides, putting, pressure, on, the area, there's not much you can do given that this was like a rusty cage that ended up hitting him. I would want to make sure his tetanus vaccines are up to date as well. If it's been more than 10 years, you obviously need treatment. In certain situations, if a deep or dirty wound, even 5 years, is not enough.

9:05 Are, you, all, right? I, feel, like, there's, always, an, uh, to start a scene. Are you all right?

9:16 Oh, my, god., Is, he, just, down? Hey,, bro. If, if, you, see, your, loved, one, in, the middle of the day fall face flat down not get up. You don't need to ask, "Hey buddy, are you all right?" You can right away start calling for help and uh trying to see if they have a pulse, if they're breathing. And if not, you know what to do. Say it with me. Chest compressions. Chest compressions. Chest compressions. Are you okay? Is he joking right now? I feel like THIS IS A SKIT. NO, he's not. He's not faking it. Just taking a nap on the ground.

9:53 It's, baby, aspirin, right, now. Baby, aspir., Is, he, having, a, heart, attack?

9:58 Yes. Give me those and then you want get go ahead and get chest and see if you got the nitro in there, would you?

10:05 Oh,, nitro., He, really, thinks, he's, having a heart attack. So nitroglycerin is a type of medication that reduces pressure uh in the vascule essentially lowering blood pressure allowing the arteries to relax and when that happens usually you can get blood flow to areas that were blocked off usually in your heart related to coronary arteries. We used to recommend that adults call 911 uh and then right away chew up a baby aspirin or a lowd dose aspirin. We don't give aspirin to babies. That's why we changed that. But now we've moved away from it.

10:38 Unless your doctor explicitly recommends that you take uh the medication because it it wasn't right for everybody and it did cause some adverse events.

10:50 No. How, does, he, know, it's, not, a, stroke? What? You're, kidding. Can, you, get, a, hold, of, THE, CLINIC?

11:00 THE, CLINIC?, GET, HIM, OFF, THE, SHIP. THIS, is, This, is, Dr., Miller., Um,, I've gotten a little background on the situation.

11:07 Yeah,, we, have, a, person, who, seems, to, be having a heart attack. I would do more of a neurologic exam and confirm that it is in fact a heart attack as opposed to a stroke. Remember, BAST is the acronym for stroke related symptoms.

11:21 At, this, point,, my, concern, is, that, he possibly had you know, possibly a minstroke. Do you happen to have a heart rate Captain? We we don't have a heart.

11:35 Why, does, no, one, on, a, ship, that, is, always at sea not know the basics of how to check a pulse? Even these days, the camera on the iPhone can take a pulse. Apple watches take a pulse. It really doesn't require much skill set to check a pulse.

11:51 He's, still, really, stressed, out. You know,, back everything else, right? Oh, my, god., He, cracked, his, head,, too., Why is he walking around?

12:04 You're, bleeding. This, is, the, most, nonchalant, crew., Their guy's laying on the floor. No one checks his pulse. They let him walk up and down the steps while the guy's having a stroke. We don't know if the stroke is hemorrhagic or eskeemic. Remember, a hemorrhagic stroke means you're bleeding out. Eskeemic means that you're not getting enough circulation and oxygen because of a blockage. So, he just took aspirin. If he had a hemorrhagic stroke and he took aspirin, he's going to make it worse. So, I don't know any there is no logic to what's happening right now.

12:35 And the fact that he fell and he's bleeding because aspirin impairs platelet function, it's going to bleed uncontrollably unless you put uh really good pressure on it.

12:44 The, initial, incident, did, he, start, feeling, numb, on, the, side, of his body or did he start by having chest pain?

12:51 See,, the, doctor, is, trying, to, ask questions from the history perspective to figure out if this is a heart attack or stroke. It it's leaning more stroke now, but initially when he was grabbing at his chest, asking for nitroglycerin saying left-sided uh symptoms, could have been more heart attack.

13:05 Were, you, having, any, chest, pains, before you fell? No,, I fell. The, fact, that, he's, having, word, finding difficulties also uh this aphasia is making me nervous that it's a stroke.

13:18 Okay,, so, now, let, me, just, give, you, his blood pressure. 150 over 120. Oh,, that's, really, high., the, diastolic number, the the lower number.

13:29 So I would say a mini stroke, an early stroke. It could be that you know he had a a TIA, trans eskeemic attack.

13:39 A, TIA, is, like, a, minstroke, where, it's, a transient eskeemic attack where you start having some neurologic symptoms and they quickly resolve. But this doesn't seem to be that. It seems like a full-on stroke given the fact that the symptoms keep going. He's probably going to have to be put on anti-coagulation to make sure more clots don't form. and he needs good quality blood pressure control. That's most important. He suffered a mini stroke but returned for the following season. Wow.

14:01 A, serious, injury, on, board, got, his fingers into a fish grinder. Oh, my, god., Not, only, does, that, hurt, so much cuz there's so many nerves that intervate the fingertips because you have some of your greatest fine point sensation, but that's not really fixable because that's not a clean slice of a finger that you could reattach. That's grinded. That's no good. And a lot of bleeding.

14:25 You, know,, the, discussion, from, the beginning was, is there anything to save on, the, fingers?, You're, probably, going to need to see a hand surgeon.

14:32 Probably., You're, definitely, going, to need to see a hand surgeon. Couldn't, get, all, my, glove, off.

14:38 Oh, god. How, is, he, not, writhing, in, pain?, I'm, so impressed. Ah. See,, look., This, is, how, we, clean, wounds in the hospital. Just sine. An X-ray will show the doctors the full extent of his injuries

14:52 because, remember, X-rays, show, the, bones because you could see the soft tissue injuries, but then you'd want to see how much of the bone is there to decide whether or not any kind of reattachment or correction can be made.

15:04 Oh, man,, you, got, a, fracture, right, in here. I, don't, know, if, they're, going, to, be, able to save those two digits there.

15:12 I, took, a, little, tumble, and, I, think, I pulled my toenail back too far. So, it's been throbbing. It's all swollen.

15:20 Ah,, that's, so, painful., It's, like, an avulse nail bed. Why are they wearing Crocs on the ship? I feel like they need to have more strong footwear.

15:29 What, can, happen, if, you, have, an infection? So, about to beat the needle up and let the blood out.

15:37 Letting, the, blood, out, plays, no, role, in the infection, but it can make the area more comfortable because what he could be developing is known as a subunal hematoma. There's a pocket of blood, but because it's underneath the nail, it builds up. That pressure builds up. It's quite uncomfortable. So, you heat up uh a piece of metal, and I don't ever recommend people just do this on their own, but they heat it up, they put it against the nail, it creates an opening blood comes out, pressure gets resolved.

16:02 Oh,, yeah. Oh,, THERE, IN, THERE. I, believe, that's, more, injury, related than infection related. I obviously didn't see it super carefully, but if you see a lot of pus, that is now pointing to a paranechia, an infectious state that perhaps would warrant either antibiotic soaks or even oral antibiotic medicine.

16:26 Okay. And, do, you, feel, like, dizzy?, Is it, hard to go off right now? I, just, need, to, sit.

16:34 Maybe, get, the, cigarette, out, of, his, face. It, had, like, an, ingrown, hair., It's, turned into quite the blister.

16:39 Oh,, where, is, it?, Where, is, it?, ingrown hair. Is it in the groin? Hurts, at, the, moment.

16:45 And, you, know, what's, terrible, for, healing wounds? Smoking. It's one of the big conversations I have with my patients who are uh about to undergo surgery. And I tell them that the rate of complication is higher. Not just cuz their cardiovascular risk is higher their healing abilities is depressed.

17:01 I've, got, my, scalpel,, got, some, alcohol wipes, got some ladine to numb the area for him. I'm going to lance it open and we're going to get all that stuff out of there.

17:12 I'm, curious, if, this, is, a, cyst, or, is, this an abscess? Because if it's an abscess that's a walled off infection. And actually, the treatment for an abscess most people think because it's infection is antibiotics. It's actually incision and drainage where you let the the fluid to drain out the pus and all the bacteria out of there and it should heal on its own. Uh just because the body basically walled off that section of bacteria away from itself. Oh, it's in the armpit. This is almost like a It's a fernicle. That's what I would call this. It's an infected hair follicle. There is a condition called hydraodinitis superativa, which people get recurrent infections like this under their armpits, sometimes in their groin and it's very, very uncomfortable.

17:57 Are, you, ready? Oh,, no., Don't, have, a, wave., Hit, him. This is definitely editing there. I I I have a feeling it didn't happen this way.

18:16 Oh, yeah, this, is, where, having, a, lot, of, gauze ready to go is very valuable.

18:21 See,, a, lot, of, times, it'll, come, out, it'll come out, it'll come out. But then sometimes there's cavitations inside the cyst or the abscess where you have to sometimes go in with a Q-tip and break those walls to get the rest of the fluid out. And the idea is not to have that area closed. You'd want to keep it moist. You want to keep it wet so that it continues to drain. So, putting warmth on that area is going to be very smart. And checking it daily to make sure redness is not starting to spread from the area or streak because that could be a sign of cellulitis. There are some sports I think should be illegal.

18:52 Click here to check that out. And as always, stay happy and healthy.

Questions about this episode

What is discussed in "Doctor Reacts To Deadliest Catch Injuries"?

In order: 0:00 Francis Katungan, MH60 J-Hawk, the Coast Guard; 3:00 Mike Vanderfeld, the Coast Guard; 6:00 Cody Rhodess, the Bearing Sea.

What is mentioned in this Doctor Mike episode?

7 people, works and ideas are mentioned, including the Coast Guard, Francis Katungan, MH60 J-Hawk, Mike Vanderfeld, Cody Rhodess, the Bearing Sea. Each one on this page links to its own page with every episode that mentions it.

How long is "Doctor Reacts To Deadliest Catch Injuries"?

The episode runs 19 min; the transcript is about 3,459 words in 82 timestamped sections.

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