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Murray Trial- Day 13- October 19th Discussion

getting on to the standard of care issue. shaffer asked for the video to show murrays lack of care. naming the dr who created the video. saying that the standard of care in this video is what is needed if you give only 25mg of diprivan.

showing it now shaffer is doing a commentry of it
 
Shaffer is commenting the video, as the audio is off, and he can pause the video to provide more explanations. He's explaining what a laryngoscope is right now.
 
Currently going through different items that are used if problems occur with airway etc. Shafer going through in plenty of detail explaining them all, which is good.
 
You can see that he is a great professor, his explanations are easy to understand, even for lay men.
 
preperation of the room is the first part. making sure all the equipment is there and is working naming some of the equipment that is needed to maintain airway and what is needed in an emergency.showing the dr in the video checking his instruments to make sure they are working. showing lots of airway equipment that is used in an emergency
 
Seeing how prepared everything is in a proper setting makes it obvious how stupid and downright foolish it is to use something such as Propofol in a place like a home. Makes you realise just how prepared and orderly you need to be to ensure it's used safely. Defence must be facepalming like crazy right now.
 
wow, he is amazing. he is explaining everything so well that even I can understand. It's very good for the jury to see all this
 
I dont understand what was going on in Murray`s head. He must have known that this is irresponsible.
 
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I knew that he would get to the point were he enters full professor mode, he got carried away with the explanation and tells Walgreen to stop or play as he would tell it to a course assistant :D
 
Louise. said:
Seeing how prepared everything is in a proper setting makes it obvious how stupid and downright foolish it is to use something such as Propofol in a place like a home. Makes you realise just how prepared and orderly you need to be to ensure it's used safely. Defence must be facepalming like crazy right now.
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Absolutely. Seeing this demonstration, I don't ever again want to hear anyone say "Murray probably just made an unfortunate mistake that led to Michael's death. It was an accident".

It was no freakin accident. And a max. sentence of 4 years is a joke.
 
saying that everything has to be organsied and u have to know where everything is as if theres a problem u have to deal with the issue in seconds. if u have to walk 4 feet to get something its 4 feet to far.

showing the dr checking the oxygen tubing. making sure the oxygen flow is working. the nose oygen tubing (what mj had on) has one bit that has oxgen in and the other bit messures your carbon dioxide. the dr checks the carbon dioxide monitor is working by using his own breath

checking an oygen mask thats attached to a bag. (looks like and ambu bag but its not the same) make sure it works

suction equipment being checked. this is very important as its a very bad complication. as getting stuff into your lungs is highly fatal. so u need the suction to clean it out before it can get anywhere near the lungs. its critically important for safe sedation to have a suction machine and that its working

backup oxygen tank checked

ambu bag is there to back up the other bag i mentioned above dr is checking it works

setting up the infusion pump for an IV. explaining what the pump is and how it is set up.very important equipment. take 10 mins to set one up

showing the dr drawing drprivan into a syringe and putting the syringe into the IV showing how long it takes to draw diprivan into the syringe takes several attempts shaffer says in the usa diprivan is done via a drip but in alot of other countries they attach the needle to the IV line. the dr in the video is attaching the syringe into the pump. its locked into place and hes putting in the weight of the paitent and the intial infusion rate into the machine and the concentration.

you do all the above first b4 the paitent comes in. anethatsit interviews the paitent before treatment even if hes treated that person loads of times b4. does a physical exam checks the heart and lungs airway. lungs especially if they have prior issues (like mj). this is done always before each procedure. there are no exceptions

informed consent. every dr must tell the paitent about forseeable risks tell them about alternatives. making sure questions are answered etc. its a process. its not just a peice of paper. after that then the paitent signs the consent form. it must be signed.it documents the process. a verbal form of consent is NOT binding. only in a life threatening emergency during an operation for eg can verbal consent be given
 
He is doing a great job in explaining the responsibility of the anesthesiologist - he is the key doctor in a surgery. My mother explained this to me a long time ago, so I'm familiar with what Shaffer explains, but not everyone knows that if anything goes wrong, in 90% of the cases it's not the surgeon's fault, but the anesthesiologist's.

Explaining informed consent, which must be written. Verbal informed consent does not count.

I respect this man very much. He has been through his own tragedy and is being not only professional but is able to completely forget his personal problems to do something he believes in.
 
showing the paitent on the operating table. pulse oxy monitor on showing the monitoring equipment that is around the paitent.showing the infusion pump being turned on.showing how near the dr is sat next to his paitent.. tapping the paitent to see if hes been effected by the diprivan. the anethatist is making loads of of notes. the B.P the heart rate. does the paitent look ok. recording all the drugs given. .the chart is a apart of the the therapyy. u use it to keep track of the drugs given. u use it to see what the b.P was 10 mins earlier. if something goes wrong they can look back and see what causes it if u see another dr they can see your chart and see if u had an issues b4. its fundemental to have this chart.

dr has to check the paitent carefully as the diaphram doesnt move much when under sedation (murray claimed he watched mj that way !
 
I think now, Murray cut open saline bag and stuck a propofol bottle in the bag and straight away went to the toilet and did emails, phone calls and whatever else he did.
 
showing the dr making more notes from monitoring. showing a B.P monitor B.P always drops when using diprivan. puts ephedrine into the iv line to help bring up the B.P

shows airway monitor.the monitor is howing the airway is obstructed. if u have this machine the dr can tell straight away there is a problem. chin lift will open an airway. so you do that. its done all the time by drs. you dont even think about doing it. very basic thing to do

jaw thrust. is done if the chin lift doesnt work. very basic thing to do .first thing u get taught at med school. u kep doing it until you see the paitent is breathing again

apnea means prolonged case of not breathing. you have to do it for them. puts the mask on the face and squeezes the bag
 
talking about using the suction equipment..highly important. u have to respond in one second b4 it can get to the lungs.

cardiac arrest u have to respond instantly. dr checks the monitor hasnt failed. makes sure that he has had an arrest.next thing he does is call for help. first rule is to call for help. you get cpr training at school for eg u are taught first thing you do is call for help.help comes one person does cpr the other helps with the airway. then u give drugs such as lidocaine.u do these steps to keep the paitent alive b4 u can reverse the arrest. u keep doing this until the paitent recovers of dies.

end of the tape i guess. and lunch break is called. very solum in the court room imo.
 
First thing to do when there is a arrest cardiac. CALL FOR HELP
 
guys thats it for me. i wont be able to do updates for the afternoon session although ill be able to watch the first hour or so of the afternoon session on my phone as im going to work. id really appreciate it if you can keep the updates going so i can check when im at work as i wont have my phone on for the last 1hr 30 of court so will have to check when i get a break

thanks
 
Shows how it must be done properly. Murray did none of this - he should be toast!
 
I really like how he is talking to the jury directly like the other doctors did. I am not a medical person but his explanations were easy to understand. I am glad they showed the video.
 
The more I saw, The more I think Murray should go to hell. What he did to MJ was unforgivable and no excuse. He better be convicted in the trial. I can't believe anyone would say he was found not guilty after seeing all these.
 
Very interesting video and narration by Shafer who really knows his stuff (as he should). I never really knew the reason they make you fast before surgery hehe.
 
I'm wondering if murray warned mj against eating in the hours before their evening sessions with propofol to ward off aspiration (not that he was particular about any of the other safety concerns!). I assumed the weight loss mj had was down to his usual not eating when rehearsing for a tour, but maybe murray was limiting the times mj could eat.
 
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