Hippocrates: hyperbaric chamber, exsufflation, FFI … The medical terms of the series explained – News Series on TV

While Canal + this evening broadcast episodes 3 and 4 of season 2 unpublished, return to the medical jargon and hospital specificities illustrated in the series which may seem obscure to neophytes.

Launched on April 2 on Canal +, season 2 of Hippocrates illustrates the tenacity of doctors and young interns in the face of the hellish pace of the emergency department. A new season in which the screenwriter former doctor Thomas Lilti approaches without taking gloves the reality of the public hospital, and which finds a particularly chilling echo with the current health crisis.

On the screen, we find Chloé (Louise Bourgoin), the promising resident in intensive care now partially disabled after a serious heart attack, Alyson (Alice Belaïdi) and Hugo (Zaccharie Chasseriaud), overwhelmed by the weight of their new mission but being able to rely on each other, and Arben (Karim Leklou), back after suddenly leaving the hospital following a terrible revelation about his diploma.

Around them, two newcomers enter the hospital. Bouli Lanners plays Doctor Brun, chief emergency doctor with an unconventional look and communication methods, and Théo Navarro-Mussy plays Igor, an intern who made an appearance in the first season and is now taking a bigger role.

If we easily regain our marks by finding the characters several months after the last events of season 1, the frantic pace of the episodes leaves us no respite from the medical jargon used, as close as possible to the field and the reality of practices caregivers.

Diagnosis, protocols and medical procedures are linked together sometimes leaving us somewhat on the sidelines, to the point of having to press “pause” the time to look up the meaning of a word or a practice in a lexicon. We take stock of the first episodes together.

The box

Illustrated in episode 2, the hyperbaric chamber, also called the decompression chamber or hyperbaric chamber, is a system used by emergency physicians to give priority treatment to patients heavily intoxicated with carbon monoxide with a vital prognosis. We see Hugo “descend” with three patients in a spherical shaped chamber in order to allow them to recover by breathing medicinal oxygen, absorbed more quickly by their body thanks to a system of artificial pressure higher than normal.

This impressive system, which allows the body’s tissues to oxygenate more quickly, is often connected to the emergency department in public hospitals. He allows to treat carbon monoxide poisoning as is the case in the series, but also scuba diving accidents when swimmers rise too quickly to the surface, or acute mountain sickness, following a climb at altitude too fast. A means of rebalancing the body in oxygen following a bad absorption, either too intense for the organism, or too much reduced or contaminated, which can put the survival of the patient in danger.

Each dive in the chamber lasts between 60 and 90 minutes, and operates in three stages: compression, or “descent”, the bottom pressure during which the treatment is carried out, then decompression. Hence the effect of “blocked ears” illustrated in the series which occurs during variations in atmospheric pressure.

Exsufflation

At the beginning of episode 3, Alyson lends a hand to Doctor Brun and finds himself confronted with a patient in respiratory distress, suffering from a suffocating pneumothorax. She must then perform an exsufflation, an emergency rescue gesture; trembling, she could not cut the skin with the scalpel. Brun complies and then orders him to puncture the patient’s pleura by hand, using his fingers.

In practice, this operation allows the patient with a vital prognosis to breathe again for the duration of the treatment, by releasing the air pressure accumulated under the pleura. If the method of exsufflation employed by Alyson may seem somewhat barbaric, it is in fact the best way to incise the pleura without risking injury to the patient’s lung, before placing the life-saving chest tube there.

“FFI” and “Anapath”: the case of Arben

In the same episode, Arben, recovered from his carbon monoxide poisoning, remains under observation in the emergency room. Unable to keep still, he offers to help Hugo, who sends him to the pediatric ward to have a baby examined. He then crosses paths with a former intern, Kim (Pierre Cévaer), who presents him as “FFI in anapath“to one of his colleagues.

The first abbreviation means “Acting internally”: according to the Public health code, in the event that a position in a health structure likely to be offered to an intern or to a resident has not been offered to them or if the position has not been chosen, the director of the establishment may decide whether to bring in a medical student, pharmacist or pharmacy student, called “Anapath” (for pathology, namely the study of lesions taken from organic tissue.)

These students must meet different criteria: for anapath students, they must have been received in the internship examination at the end of their fourth year of studies. This is the case of Arben in season 1: while he then works under the supervision of the hospital forensic scientist, he is requisitioned to lend a hand to internal medicine and therefore becomes FFI.

In season 2, however, we find him in a very bad position: after having left the hospital in a hurry when the director of the emergency department discovered that he had never validated his medical degree in Albania, his country of origin, Arben is now a stretcher bearer, and refuses any explanation to those around him. Having noticed his remarkable diagnostic abilities, Doctor Brun unofficially recruited him to help out in the emergency department on a drip. An illegal tacit arrangement, because Arben cannot practice medicine without a diploma.

Former doctor, Thomas Lilti testified, during the promotion of his book The oath, of his decision to put on the white coat again at the time of the first wave of COVID in order to provide assistance to caregivers, even if it means delaying the filming of season 2 of Hippocrates. A return, however, made difficult because he could not return to his former functions after ten years of interruption of his practice, no longer being registered with the Council of the Order of Physicians.

Moreover, it was impossible for him to “give a helping hand“at the same level as the interns faced with the emergency situation and hospital tension that presented itself. To this end, he was asked to go back to a long expertise to ensure his ability to practice medicine, or else”nurse“, a specialty radically different from his.

A contradictory situation facing the needs of the public hospital, where 50% of doctors in emergency departments today have foreign diplomas, like the character of Arben before his secret was discovered. The moral impotence experienced by the latter in season 2, to want to help his colleagues at all costs in the face of the overload of emergencies without being able to legally exercise his practice, seems to be an echo to this observation.

Hippocrates season 2, every Monday at 9:05 p.m. on Canal +

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