ok i need to ramble about Dean Miller’s death and how it made no sense
Not going into depth about the why here, but the how
Ok so. I´m a paramedic (not a firefighter) and watching Station 19 is always an experienceTM but most of the time I just ignore medical inaccuracies for the plot, ya know. But. BUT. Dean Miller was a main character, so you`d think they`d put some thought into how they kill him.
Now. Dean was hit by the shockwave of the explosion, lost his goggles, burned the area around his mouth and hit the ground.
That makes for two major injury mechanisms: the burn and the blunt trauma, first trought the shockwave, then when he hit the ground.
The burn: I say is not what killed him, due to two reasons. First of all, we see other firefighters that have similiar burns after the explotion survive. Second of all, the more medical reason, burns in the facial area are dangerous for two reasons, because they can obstruct the airway when the area swells, and bc the patient might have inhaled the hot gas which leads to internal burns. Now. Obstructed airways kill you rather quicky, can be ruled out in Dean Miller’s case as cause of death bc they got an intubation tube in and do ventilate him (although the monitor has a flatline even for the spO2 which, makes no sense, so that`s a mistake). Inhalation injury can be ruled out as cause of death bc we can’t for sure say he even had that and even if he did, people normally dont instantly die from that (normally takes a few days with inflamation and pulmonary edema).
In that case, what most likely caused his heart to stop, was the blunt trauma. The question reamins blunt trauma to what?
For a blunt trauma to kill you instantly (as in Dean Miller’s case), it needs to either hit your head or your chest or your neck.
Since we have two blunt traumas (the shockwave and hitting the ground), in a fairly short span of time, we can assume the forces added to each other. The shockwave hit his entire body, the hitting the ground, since he has fairly broad shoulders, only his thorax. Of yourse he could have broken his neck if he fell on his head, BUT even if he did, that would affect his breathing since the diaphragm as the main breathing muscle is innervated by C4. But this, though intubation, was taken care of and I´ll therefore rule it out. (side note: the heart is funnily enough, not affected if you break your neck, since it has its own pacemaker thats not dependend on the brain). trough spinal injury his blood vessels might have dilated which would lead to hypotension and shock, but since they are giving him fluids and meds (I’m assuming adrenaline), that also would have stabilizied him at least til they were in the hospital. I´m not saying he wouldn`t have died, but not in the ambulance (more about that later).
So. By ruling the other reasons out or declaring them unlikely, we can focus on the blunt injury to the thorax, which most likely ended in a tension pneumothorax, that put pressure on his heart which also makes sense with the constant flatline we see on the monitor. Another reason could be a cardiac tamponade, but those happen more often through a penetrating trauma.
EITHER WAY. Jack is a fully trained paramedic. Ben is a DOCTOR. An anesthesiologist and a surgeon. And what they’re doing is literally just performing chest compressions??? Now dont get me wrong. When someone isn`t breathing anymore, you do chest compressions, chest compressions, chest compressions. BUT. These two are fully trained medical professionals, and that*s not the only thing they could be doing.
When someone’s heart stops, there is something called ‘reversible causes’, which are - you guessed it- reversible. There`s eight of them in total, and relevant for Dean Miller are the following:
-hypoxia: taken care of through intubation
-hypovoluimia: taken care of through fluids and meds
-cardiac tampnade: COULD be taken care of if they fucking wanted it, but didnt happen on screen
-tension pneumothorax: COULD also be taken care of by simply puncturing his thorax.
We`re now getting to the core of what makes me angry here. Regardless of what was the cause of Dean’s death (even if my theory is totally wrong), Jack and Ben didn’t try hard enough to save him. They did not do either of the things mentioned above, and Ben didn’t want Jack to perform chest compressions although he was clearly exhausted. Chest compressions aren’t about honor, they are about pumping blood through a body. After 2 minutes, everybody, even trained professionsl, get worse at chest compressions bc they tire. So what needs to be done is that they take turns! And that didn`t happen! What also doesn`t happen, is that you declare someone, who you really love, dead, before even reaching the hospital! Seattle is smaller then the city i live in, and here it takes only 20 minutes to get to the hospital per ambulance if you use the sirens. 20 minutes taking turns with chest compressions works.
So what I´m saying, is, the writing was shitty concerning the medical aspect. The only reason they did that was so Bailey could say “no lights, no sirens, no rush … there’s a dead person in there” and then worry about Ben some more.
If they had to kill Dean Miller, at least do it in a way that makes sense. Dean Miller deserved better.
And since we’re already on the topic, the captain fo 23 that was injured should have gotten a blanket bc warmth is extremely important in traumativ injuries! And how Miller resuscitated Vic made no sense bc electircution males your heart do funny things, that has got nothing to do with your breathing. But i guess at least Miller got to “kiss” Vic.
