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it goes a little something like this hey bob hey my patient just had a seizure fell out of bed is knocked unconscious broke his femur bone is sticking out of the skin and hes bleeding profusely thats not good he doesnt have any family and hes not awake we should probably take him to the operating room to put the bone back in place stop the bleeding to make sure he doesnt get a life-threatening infection good idea will you agree to a two physician consent