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Grey's Anatomy

Grey's AnatomyABC

Season 11, Episode 21

9 medical diagnoses portrayed

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Hip dislocationsupporting

Also known as: Dislocated hip

Vascular compromise to leg

Sarah sustains a hip dislocation in the car accident that cuts off blood supply to her leg. Derek manually reduces the dislocation at the scene to prevent her from losing the leg.

Also known as: Head laceration

Loss of consciousnessConfusionAmnesia

Charlie sustains a significant head injury in the accident with confusion and repeated loss of consciousness. Derek tends to him at the scene before paramedics arrive.

Splenic injurysupporting

Also known as: Ruptured spleen

Intra-abdominal bleeding

Alana sustains a grade-2 splenic laceration from the car accident requiring surgical exploration. The team decides to leave the spleen rather than remove it.

Also known as: Torn colon

Alana's colon is avulsed in the accident requiring resection and creation of a temporary colostomy during emergency surgery.

Hemothoraxsupporting

Also known as: Blood in chest cavity

Decreased breath soundsHypoxia

Derek develops a massive hemothorax from his injuries requiring chest tube placement and thoracotomy to evacuate blood.

Grey's Anatomy — S11E21Patient: Derek Shepherd
Flail chestsupporting

Also known as: Multiple broken ribs on both sides

Respiratory compromise

Derek sustains a right-sided flail chest from the car accident, identified on examination in the emergency room.

Grey's Anatomy — S11E21Patient: Derek Shepherd

Also known as: Brain bleed

Blown pupilBrain herniationBrain death

Derek develops an epidural hematoma from his head trauma that goes undiagnosed due to failure to obtain timely head CT. By the time neurosurgery arrives, the bleeding has caused irreversible brain damage leading to brain death. This is the central medical tragedy of the episode.

Grey's Anatomy — S11E21Patient: Derek Shepherd

Also known as: Shock from blood loss

HypotensionTachycardia

Derek presents with persistent hypotension and tachycardia after blunt trauma, requiring multiple fluid boluses and blood transfusions.

Grey's Anatomy — S11E21Patient: Derek Shepherd

Also known as: Skull fracture with brain exposure

Patient from the freeway accident presents with open skull fracture and blunt force trauma, mentioned as arriving at the hospital.

Grey's Anatomy — S11E21Patient: Jerome Davis