1 00:00:10,093 --> 00:00:11,510 Hey, Jake, it's Robby. 2 00:00:11,511 --> 00:00:13,679 Listen, man, just call me or text me 3 00:00:13,680 --> 00:00:15,472 the second that you get this message, OK? 4 00:00:15,473 --> 00:00:16,473 OK. 5 00:00:16,474 --> 00:00:18,308 I can't reach Jake. 6 00:00:18,309 --> 00:00:19,810 I'm sure he's OK. 7 00:00:19,811 --> 00:00:21,645 - Active shooter at PittFest. - We heard. 8 00:00:21,646 --> 00:00:23,647 Code Triage, Emergency Department now. 9 00:00:23,648 --> 00:00:25,733 Code Triage, Emergency Department now. 10 00:00:25,734 --> 00:00:27,276 What's that mean? Has that happened before? 11 00:00:27,277 --> 00:00:28,902 We're locking down the hospital 12 00:00:28,903 --> 00:00:30,779 and setting up a command center in Administration. 13 00:00:30,780 --> 00:00:32,906 We'll coordinate logistics, supplies, communication. 14 00:00:32,907 --> 00:00:34,324 How many casualties? 15 00:00:34,325 --> 00:00:36,493 Unclear, but initial reports are not good. 16 00:00:36,494 --> 00:00:37,494 OK. 17 00:00:37,495 --> 00:00:39,121 The night shift is gonna be here soon, 18 00:00:39,122 --> 00:00:40,622 but we are gonna need more help, 19 00:00:40,623 --> 00:00:42,332 especially from Surgery and Anesthesiology. 20 00:00:42,333 --> 00:00:44,334 MCI group text and email went out to everyone, 21 00:00:44,335 --> 00:00:46,503 including Transport and Environmental Services. 22 00:00:46,504 --> 00:00:48,005 OK, good. 23 00:00:48,006 --> 00:00:50,299 Hey, everyone's gonna want to come in to help. 24 00:00:50,300 --> 00:00:51,550 Keep enough in reserve. 25 00:00:51,551 --> 00:00:53,844 Tell them to come in eight hours later to give us a break. 26 00:00:53,845 --> 00:00:56,805 - And can you try and reach Jake? - Of course. 27 00:00:56,806 --> 00:00:58,015 Surgery's got to call in the cavalry. 28 00:00:58,016 --> 00:01:00,642 - We're gonna need all 25 ORs. - Ahead of you. 29 00:01:00,643 --> 00:01:02,186 Four ORs are prepped and staffed, 30 00:01:02,187 --> 00:01:03,771 and we're working on getting the rest up and running. 31 00:01:03,772 --> 00:01:06,857 - What about disaster supplies? - On their way. 32 00:01:06,858 --> 00:01:09,026 Every patient in the ER needs to go up. 33 00:01:09,027 --> 00:01:10,694 Beds or no beds, they'll get better care 34 00:01:10,695 --> 00:01:12,738 in an upstairs hallway than ignored down here. 35 00:01:12,739 --> 00:01:14,531 Agreed. 36 00:01:14,532 --> 00:01:17,326 There's a whole wing that's empty on the eighth floor. 37 00:01:17,327 --> 00:01:19,995 - I don't know if that's... - But no nurses to staff it. 38 00:01:19,996 --> 00:01:21,997 No comment on that one. 39 00:01:21,998 --> 00:01:24,208 Waiting room and Triage can go to Family Medicine Urgent Care. 40 00:01:24,209 --> 00:01:25,542 And we should turn off the TVs. 41 00:01:25,543 --> 00:01:26,710 We don't need to cause any extra panic. 42 00:01:26,711 --> 00:01:27,878 Will do. 43 00:01:27,879 --> 00:01:28,879 The cafeteria will handle 44 00:01:28,880 --> 00:01:30,547 the family members and survivors. 45 00:01:30,548 --> 00:01:33,217 What else do you need? 46 00:01:33,218 --> 00:01:34,843 Prayers wouldn't hurt. 47 00:01:34,844 --> 00:01:36,178 Amen to that. 48 00:01:36,179 --> 00:01:38,639 - Keep the press out of here. - Gladly. 49 00:01:38,640 --> 00:01:40,057 Call me directly if you need anything else. 50 00:01:40,058 --> 00:01:41,350 OK, will do. Thank you. 51 00:01:41,351 --> 00:01:44,103 - Hey, what's going on? - Mass casualty at PittFest. 52 00:01:44,104 --> 00:01:45,562 How many victims? 53 00:01:45,563 --> 00:01:47,439 We don't know. Expect the worst. 54 00:01:47,440 --> 00:01:49,108 Did the police find David? 55 00:01:49,109 --> 00:01:50,400 [crowd murmuring] 56 00:01:50,401 --> 00:01:52,736 OK, everybody listen up. 57 00:01:52,737 --> 00:01:54,446 [clears throat] 58 00:01:54,447 --> 00:01:56,907 There is an active shooter at PittFest. 59 00:01:56,908 --> 00:01:58,575 As the nearest trauma center, 60 00:01:58,576 --> 00:02:00,577 we are going to be getting the majority of the victims. 61 00:02:00,578 --> 00:02:02,496 We don't know yet how many we are getting, 62 00:02:02,497 --> 00:02:04,081 but we are instituting 63 00:02:04,082 --> 00:02:06,542 hospital-wide emergency protocols. 64 00:02:06,543 --> 00:02:09,586 We need to move every patient out of here. 65 00:02:09,587 --> 00:02:11,380 They either go home, they go upstairs, 66 00:02:11,381 --> 00:02:13,590 or they go to Family Medicine. 67 00:02:13,591 --> 00:02:15,717 Call your loved ones now if you need to. 68 00:02:15,718 --> 00:02:17,594 I can guarantee you cell service 69 00:02:17,595 --> 00:02:19,263 will soon be overwhelmed. 70 00:02:19,264 --> 00:02:20,639 Eat something. Stay hydrated. 71 00:02:20,640 --> 00:02:22,307 Use the bathroom while there's time 72 00:02:22,308 --> 00:02:24,143 and meet back here for a full briefing in five minutes. 73 00:02:24,144 --> 00:02:25,727 Brother, I'm so fucking glad to see you. 74 00:02:25,728 --> 00:02:27,146 Heard it on the police scanner. 75 00:02:27,147 --> 00:02:28,605 How many we expecting? 76 00:02:28,606 --> 00:02:29,731 I don't know, but it doesn't sound good. 77 00:02:29,732 --> 00:02:31,066 [sighs] 78 00:02:31,067 --> 00:02:32,609 Let's go to the back first in order. 79 00:02:32,610 --> 00:02:34,736 Those guys got to get out of there. 80 00:02:34,737 --> 00:02:37,281 [indistinct chatter] 81 00:02:37,282 --> 00:02:39,283 How many patients can you take? 82 00:02:39,284 --> 00:02:41,369 [elevator bell dings] 83 00:02:45,081 --> 00:02:46,999 Where do we put the disaster bins? 84 00:02:47,000 --> 00:02:49,126 Behavioral Health. That's now our central supply. 85 00:02:49,127 --> 00:02:50,503 Let's go. 86 00:02:51,754 --> 00:02:53,506 We got more bins coming. 87 00:02:55,008 --> 00:02:56,466 OK. 88 00:02:56,467 --> 00:02:57,843 Right side. 89 00:02:57,844 --> 00:02:59,636 Left side. 90 00:02:59,637 --> 00:03:01,805 I'm gonna need you to grab folding tables from facilities 91 00:03:01,806 --> 00:03:03,640 - to organize all this stuff. - Copy that. 92 00:03:03,641 --> 00:03:04,975 Go. Thank you. 93 00:03:04,976 --> 00:03:07,227 Code Triage, Emergency Department now. 94 00:03:07,228 --> 00:03:10,647 Code Triage, Emergency Department now. 95 00:03:10,648 --> 00:03:13,650 [muttering indistinctly] 96 00:03:13,651 --> 00:03:16,153 Blood Bank, call 7113. 97 00:03:16,154 --> 00:03:18,155 [indistinct chatter continues] 98 00:03:18,156 --> 00:03:20,490 Thank you for your cooperation and understanding 99 00:03:20,491 --> 00:03:23,368 as we prepare for a mass-casualty event. 100 00:03:23,369 --> 00:03:25,704 Your medical records will be available to urgent care 101 00:03:25,705 --> 00:03:27,623 and Family Medicine. 102 00:03:27,624 --> 00:03:30,626 They know you're coming. [indistinct chatter] 103 00:03:30,627 --> 00:03:32,127 OK, please make sure to take 104 00:03:32,128 --> 00:03:34,004 all your personal belongings with you. 105 00:03:34,005 --> 00:03:35,339 This is stupid. 106 00:03:35,340 --> 00:03:37,090 Sorry for any inconvenience, sir, 107 00:03:37,091 --> 00:03:38,342 but this is an emergency. 108 00:03:38,343 --> 00:03:40,677 This is an emergency room. It's fucking stupid. 109 00:03:40,678 --> 00:03:41,845 Olsen, get back here 110 00:03:41,846 --> 00:03:43,680 as soon as the waiting room is cleared. 111 00:03:43,681 --> 00:03:45,432 Copy that. 112 00:03:45,433 --> 00:03:47,309 Telemetry. 113 00:03:47,310 --> 00:03:48,644 OB/GYN. 114 00:03:48,645 --> 00:03:50,854 CCU. ICU. 115 00:03:50,855 --> 00:03:53,148 - Ortho. - MCI protocols. 116 00:03:53,149 --> 00:03:54,858 Make sure you bring all these gurneys and wheelchairs back. 117 00:03:54,859 --> 00:03:56,235 They're going to the ambulance bay. 118 00:03:56,236 --> 00:03:57,861 We need as many as we can get our hands on. 119 00:03:57,862 --> 00:03:58,862 What's next, Cap? 120 00:03:58,863 --> 00:04:00,364 Pharmacy needs to come down and open the PDS. 121 00:04:00,365 --> 00:04:01,949 They also need to bring up all the narcotics, 122 00:04:01,950 --> 00:04:03,700 paralytics, and sedatives that they can. 123 00:04:03,701 --> 00:04:05,369 - Consider it done. - Jake? 124 00:04:05,370 --> 00:04:06,954 Not yet, but you know teenagers. 125 00:04:06,955 --> 00:04:08,038 I'll keep trying. 126 00:04:08,039 --> 00:04:09,456 OK, maybe try his mom, Janey. 127 00:04:09,457 --> 00:04:11,333 She's in my phone. Tell her what's going on. 128 00:04:11,334 --> 00:04:14,002 And try Collins... see if you can get her to come back. 129 00:04:14,003 --> 00:04:15,295 Will do. 130 00:04:15,296 --> 00:04:16,672 OK, let's go. Let's go. 131 00:04:16,673 --> 00:04:18,507 Bring all these gurneys and wheelchairs back. 132 00:04:18,508 --> 00:04:20,926 They're all going to the ambulance bay. 133 00:04:20,927 --> 00:04:22,219 Um, hi. 134 00:04:22,220 --> 00:04:23,720 Can you just tell my sister, Becca, 135 00:04:23,721 --> 00:04:26,932 that I'm gonna be a little late picking her up? 136 00:04:26,933 --> 00:04:30,852 Um... uh, I don't... I don't know. 137 00:04:30,853 --> 00:04:33,355 Hey. Hey, Mom, I need you or Dad to come to the hospital 138 00:04:33,356 --> 00:04:34,731 right now to pick up Harrison, 139 00:04:34,732 --> 00:04:36,650 or he's gonna be stuck here for hours. 140 00:04:36,651 --> 00:04:38,652 I know, I'll explain when you get here, OK? 141 00:04:38,653 --> 00:04:40,487 Love you. Bye. 142 00:04:40,488 --> 00:04:41,863 Hey. 143 00:04:41,864 --> 00:04:43,700 Can we leave yet? 144 00:04:45,827 --> 00:04:47,327 I can't, 145 00:04:47,328 --> 00:04:49,621 but Grandma and Grandpa are gonna come pick you up. 146 00:04:49,622 --> 00:04:52,249 And in the meantime, you can play some games. 147 00:04:52,250 --> 00:04:55,043 Can I watch a movie? 148 00:04:55,044 --> 00:04:58,130 Yes, but nothing scary. 149 00:04:58,131 --> 00:04:59,881 I mean it. 150 00:04:59,882 --> 00:05:02,259 And don't leave this room until I come get you, OK? 151 00:05:02,260 --> 00:05:03,427 OK, Mom. 152 00:05:03,428 --> 00:05:04,845 - Love you. - Bye. 153 00:05:04,846 --> 00:05:06,263 We're gonna be putting four gurneys 154 00:05:06,264 --> 00:05:07,931 in each of these trauma rooms, so make sure 155 00:05:07,932 --> 00:05:09,766 you stock both rooms to handle the additional patients. 156 00:05:09,767 --> 00:05:11,101 Not a problem. 157 00:05:11,102 --> 00:05:13,520 And let's broom all these WOWs, ultrasounds out of here. 158 00:05:13,521 --> 00:05:15,355 We're not gonna have time or space for anything but gurneys. 159 00:05:15,356 --> 00:05:16,440 OK. 160 00:05:16,441 --> 00:05:17,858 Any word on what we're expecting? 161 00:05:17,859 --> 00:05:19,401 Not yet. How's it looking upstairs? 162 00:05:19,402 --> 00:05:21,486 Should have all 25 ORs running within the hour. 163 00:05:21,487 --> 00:05:22,904 We could be buried by then. 164 00:05:22,905 --> 00:05:24,906 Everyone's rolling in as fast as they can. 165 00:05:24,907 --> 00:05:26,950 Surgery is ready. We're here. We're ready. 166 00:05:26,951 --> 00:05:29,161 - I am taking Primary ER. - Have at it. 167 00:05:29,162 --> 00:05:31,289 Who's taking Primary Surgery? 168 00:05:32,582 --> 00:05:34,291 Heavy is the head that wears the crown. 169 00:05:34,292 --> 00:05:35,459 Dr. Walsh. 170 00:05:35,460 --> 00:05:37,044 - Anesthesiology? - Gladden will be down. 171 00:05:37,045 --> 00:05:38,962 He's got four in place, more on the way. 172 00:05:38,963 --> 00:05:40,464 OK, this is yours. 173 00:05:40,465 --> 00:05:42,257 Thank you. What you got in there? 174 00:05:42,258 --> 00:05:45,052 A couple of CAT tourniquets, hemostatic dressings, LMAs. 175 00:05:45,053 --> 00:05:46,595 We got plenty of that stuff. 176 00:05:46,596 --> 00:05:48,972 Butterfly ultrasound works off a cell phone. 177 00:05:48,973 --> 00:05:50,766 - Ooh, that's cool. - Yeah. 178 00:05:50,767 --> 00:05:52,142 But we're gonna send all the unstable chest and belly 179 00:05:52,143 --> 00:05:53,602 straight up to the OR. 180 00:05:53,603 --> 00:05:54,978 OK, everybody listen up. 181 00:05:54,979 --> 00:05:57,189 [claps hands] This is how it's going to work. 182 00:05:57,190 --> 00:05:59,649 Our ambulance bay is now our Triage. 183 00:05:59,650 --> 00:06:01,193 EMS will be overwhelmed. 184 00:06:01,194 --> 00:06:03,111 Most will probably arrive by car, 185 00:06:03,112 --> 00:06:05,155 several victims per vehicle. 186 00:06:05,156 --> 00:06:07,074 For all you newbies that don't know, 187 00:06:07,075 --> 00:06:08,658 Dr. Shen is our night shift attending. 188 00:06:08,659 --> 00:06:10,285 John, I'm gonna put you on Point Triage. 189 00:06:10,286 --> 00:06:11,578 Cool. 190 00:06:11,579 --> 00:06:12,996 Triage will decide who goes where 191 00:06:12,997 --> 00:06:14,289 depending on their injury. 192 00:06:14,290 --> 00:06:16,625 Every department will have a designated primary 193 00:06:16,626 --> 00:06:18,085 who will oversee their staff. 194 00:06:18,086 --> 00:06:20,087 If you need someone, look for the vest. 195 00:06:20,088 --> 00:06:21,463 We're all gonna have walkies. 196 00:06:21,464 --> 00:06:24,174 We can get you whatever you need. 197 00:06:24,175 --> 00:06:27,052 No patient goes into a room unless it's a trauma bay, 198 00:06:27,053 --> 00:06:29,012 and they will have four patients each. 199 00:06:29,013 --> 00:06:31,014 We need to keep everybody out in the open 200 00:06:31,015 --> 00:06:32,974 so we can keep an eye on everything, OK? 201 00:06:32,975 --> 00:06:36,395 Triage is gonna assess and assign every patient 202 00:06:36,396 --> 00:06:39,481 to a specific zone with a colored slap band. 203 00:06:39,482 --> 00:06:41,650 Patient who comes in with a red slap band 204 00:06:41,651 --> 00:06:44,027 goes to the Red Zone, which is the trauma rooms, 205 00:06:44,028 --> 00:06:45,362 with overflow out here. 206 00:06:45,363 --> 00:06:47,781 These are the most critical patients 207 00:06:47,782 --> 00:06:49,032 who will die without immediate attention. 208 00:06:49,033 --> 00:06:50,325 Samira, where are you? 209 00:06:50,326 --> 00:06:52,202 You are here with Dr. Abbot and me. 210 00:06:52,203 --> 00:06:53,870 Jack's gonna run traffic. 211 00:06:53,871 --> 00:06:56,081 We have five minutes to try and stabilize the reds. 212 00:06:56,082 --> 00:06:58,750 After that, it's OR, ICU, or morgue. 213 00:06:58,751 --> 00:07:00,377 The south and central common area over there 214 00:07:00,378 --> 00:07:01,920 will be the Pink Zone. 215 00:07:01,921 --> 00:07:03,338 That is for patients who will die in under an hour 216 00:07:03,339 --> 00:07:04,714 without treatment. 217 00:07:04,715 --> 00:07:06,716 McKay and Javadi, you are over there, 218 00:07:06,717 --> 00:07:09,386 with help from incoming night shift and surgical staff. 219 00:07:09,387 --> 00:07:11,471 Yellow Zone is the North Corridor. 220 00:07:11,472 --> 00:07:13,348 Those are gonna be mostly extremity wounds... 221 00:07:13,349 --> 00:07:15,225 good vitals, talking. 222 00:07:15,226 --> 00:07:18,311 Mel, you're gonna run point there with Santos and Whitaker. 223 00:07:18,312 --> 00:07:21,982 Uh, what if... what if there's a-a pulseless extremity? 224 00:07:21,983 --> 00:07:24,734 Oh, if you... if you can't feel a pulse, 225 00:07:24,735 --> 00:07:26,445 check for Doppler flow with this. 226 00:07:26,446 --> 00:07:27,904 It's a mini-ultrasound. 227 00:07:27,905 --> 00:07:29,698 Follow the screen prompts. 228 00:07:29,699 --> 00:07:31,700 But a yellow can change to a red if they go south. 229 00:07:31,701 --> 00:07:33,743 You got to stay on top of them, even if they seem stable. 230 00:07:33,744 --> 00:07:35,245 - OK, yeah. - You got this, Dr. King. 231 00:07:35,246 --> 00:07:37,914 Green... minor lacs and sprains. They go to Family Medicine. 232 00:07:37,915 --> 00:07:39,708 Black and white bands are DOA, imminent death. 233 00:07:39,709 --> 00:07:41,668 Pedes is now our morgue. 234 00:07:41,669 --> 00:07:44,171 Let's hope we don't get too many of these. 235 00:07:44,172 --> 00:07:46,047 We're a MASH unit now. 236 00:07:46,048 --> 00:07:48,925 There's no charting, no electronic medical records, 237 00:07:48,926 --> 00:07:50,051 no board. 238 00:07:50,052 --> 00:07:51,595 How do we document treatment? 239 00:07:51,596 --> 00:07:53,930 Oh, you'll all get Sharpies, and every patient 240 00:07:53,931 --> 00:07:55,974 has a wrist chart to document treatment and procedures. 241 00:07:55,975 --> 00:07:57,434 You run out of room, 242 00:07:57,435 --> 00:07:58,894 write on the patient's forehead. 243 00:07:58,895 --> 00:08:00,479 - Really? - Yeah, really. 244 00:08:00,480 --> 00:08:01,771 Each wrist chart has 245 00:08:01,772 --> 00:08:04,816 a unique mass-casualty-incident barcode and patient number. 246 00:08:04,817 --> 00:08:06,610 That's how the patients are gonna get identified. 247 00:08:06,611 --> 00:08:09,946 This is no-frills combat-zone medicine. 248 00:08:09,947 --> 00:08:13,033 No ultrasound, no X-rays, no CT, no labs. 249 00:08:13,034 --> 00:08:16,703 Assess based on mental status and pulse strength. 250 00:08:16,704 --> 00:08:19,873 Every critical patient gets an IO, intubation, 251 00:08:19,874 --> 00:08:22,042 a unit of blood and chest tube if needed. 252 00:08:22,043 --> 00:08:24,127 Everything you need... blood, drugs, bandages... 253 00:08:24,128 --> 00:08:26,546 everything will be in the Behavioral Health rooms. 254 00:08:26,547 --> 00:08:28,340 That's our supply depot. 255 00:08:28,341 --> 00:08:29,966 Um... 256 00:08:29,967 --> 00:08:32,636 oh, keep a couple of 11 blades in your pocket. 257 00:08:32,637 --> 00:08:34,304 Goal is to resuscitate ASAP 258 00:08:34,305 --> 00:08:36,473 so they'll make it upstairs for definitive care. 259 00:08:36,474 --> 00:08:38,141 Trauma surgery and neurosurgery 260 00:08:38,142 --> 00:08:39,976 will decide who goes up to the OR immediately 261 00:08:39,977 --> 00:08:41,436 and who goes to the ICU 262 00:08:41,437 --> 00:08:43,356 for further treatment and evaluation. 263 00:08:45,107 --> 00:08:46,608 Communicate. 264 00:08:46,609 --> 00:08:48,860 Ask for help if you need it. 265 00:08:48,861 --> 00:08:50,320 Trust your attendings. 266 00:08:50,321 --> 00:08:51,655 We will get through this together. 267 00:08:51,656 --> 00:08:53,031 Damn right we will. 268 00:08:53,032 --> 00:08:54,824 OK, you three, I want to talk to you. 269 00:08:54,825 --> 00:08:57,619 [indistinct chatter] 270 00:08:57,620 --> 00:08:59,496 I need you three to raid Central Supply 271 00:08:59,497 --> 00:09:01,498 and bring back all the chest tubes, ET tubes, 272 00:09:01,499 --> 00:09:02,999 thora-seals, normal saline... 273 00:09:03,000 --> 00:09:04,584 I thought that was all in Behavioral Health. 274 00:09:04,585 --> 00:09:06,002 We can burn through all that in the first hour. 275 00:09:06,003 --> 00:09:07,796 West basement, just past nuclear medicine. 276 00:09:07,797 --> 00:09:09,297 - West basement. Got it. - Wait, wait, wait, wait, wait. 277 00:09:09,298 --> 00:09:10,674 Take one of these empty disaster bins 278 00:09:10,675 --> 00:09:12,342 so you can grab everything you get your hands on. 279 00:09:12,343 --> 00:09:13,677 What's a disaster bin? 280 00:09:13,678 --> 00:09:15,011 Empty plastic boxes right there. 281 00:09:15,012 --> 00:09:16,471 - You can't miss them. - Where's Collins? 282 00:09:16,472 --> 00:09:19,432 She went home, but Dana is calling her now. 283 00:09:19,433 --> 00:09:20,433 Don't worry. It's OK. 284 00:09:20,434 --> 00:09:22,018 We got plenty of people coming in. 285 00:09:22,019 --> 00:09:24,271 Just follow Dr. Abbot's lead. 286 00:09:24,272 --> 00:09:26,189 John, I'm gonna help you get started in Triage. 287 00:09:26,190 --> 00:09:27,524 Sounds good. 288 00:09:27,525 --> 00:09:29,734 - Dana. What do you need? - Oh! 289 00:09:29,735 --> 00:09:31,528 Prep the Yellow Zone for extremity wounds. 290 00:09:31,529 --> 00:09:33,405 We need a shitload of bandages, tourniquets, 291 00:09:33,406 --> 00:09:34,906 splint slings, and IV antibiotics. 292 00:09:34,907 --> 00:09:37,409 - I'm on it. - Yep. 293 00:09:37,410 --> 00:09:38,828 Myrna. 294 00:09:40,663 --> 00:09:42,038 Where the hell did Mryna go? 295 00:09:42,039 --> 00:09:43,832 Antoine, did you take the cuffs off Myrna? 296 00:09:43,833 --> 00:09:45,917 Hell, no. That woman scares the shit out of me. 297 00:09:45,918 --> 00:09:47,419 She keeps trying to bite me. 298 00:09:47,420 --> 00:09:49,379 Son of a bitch. 299 00:09:49,380 --> 00:09:52,048 [indistinct chatter] 300 00:09:52,049 --> 00:09:54,676 [distant siren wailing] 301 00:09:54,677 --> 00:09:55,844 Whoa. 302 00:09:55,845 --> 00:09:57,429 That's a lot of wrist charts. 303 00:09:57,430 --> 00:09:59,389 300. 304 00:09:59,390 --> 00:10:01,057 Let's hope we don't need them all. 305 00:10:01,058 --> 00:10:03,893 Were you at the last mass-casualty faculty meeting? 306 00:10:03,894 --> 00:10:06,772 Oh, no. I was still a resident three months ago. 307 00:10:08,399 --> 00:10:10,066 Right. 308 00:10:10,067 --> 00:10:11,568 Wow. 309 00:10:11,569 --> 00:10:14,821 Well, one patient at a time, right? 310 00:10:14,822 --> 00:10:17,907 The goal is to triage each patient in ten seconds. 311 00:10:17,908 --> 00:10:19,242 Ten seconds, got it. 312 00:10:19,243 --> 00:10:21,036 Mental status is AVPU. 313 00:10:21,037 --> 00:10:24,372 Alert, response to verbal, response to pain, unresponsive. 314 00:10:24,373 --> 00:10:25,582 Yep. 315 00:10:25,583 --> 00:10:27,417 Next, do they have a pulse? 316 00:10:27,418 --> 00:10:30,003 Radial, carotid, or femoral tells you where to send them. 317 00:10:30,004 --> 00:10:32,714 - That's it. - OK. 318 00:10:32,715 --> 00:10:34,132 Cool. 319 00:10:34,133 --> 00:10:37,594 Oh, I heard it might rain today. 320 00:10:37,595 --> 00:10:39,471 - John? - Yeah, man. 321 00:10:39,472 --> 00:10:42,599 Mental status and pulse gives you everything you need. 322 00:10:42,600 --> 00:10:43,933 Cool. 323 00:10:43,934 --> 00:10:45,644 Unresponsive with no pulses, 324 00:10:45,645 --> 00:10:47,270 slap a black and white band on them, 325 00:10:47,271 --> 00:10:48,730 send them to the morgue. 326 00:10:48,731 --> 00:10:51,399 [sighs] Responds to pain with a faint groan, 327 00:10:51,400 --> 00:10:53,276 weak femoral pulse, no radial? 328 00:10:53,277 --> 00:10:55,070 - Uh, red. - Right. 329 00:10:55,071 --> 00:10:56,738 Slap a red band on them, send them back. 330 00:10:56,739 --> 00:10:58,740 Awake, alert with strong radial? 331 00:10:58,741 --> 00:11:00,283 Trick question. 332 00:11:00,284 --> 00:11:02,911 Could be green, Family Medicine for scrapes or sprains, 333 00:11:02,912 --> 00:11:05,288 but stable, penetrating extremity wounds go to yellow. 334 00:11:05,289 --> 00:11:07,540 - Perfect. - Dude, relax. 335 00:11:07,541 --> 00:11:09,918 I got the front door. You worry about the back. 336 00:11:09,919 --> 00:11:12,545 [distant sirens wailing, indistinct shouting] 337 00:11:12,546 --> 00:11:14,255 [slurps] 338 00:11:14,256 --> 00:11:15,965 Hey, Paolo, everybody, let's put the heads 339 00:11:15,966 --> 00:11:17,300 of these gurneys up 30 degrees 340 00:11:17,301 --> 00:11:19,052 so they all roll in the right way. 341 00:11:19,053 --> 00:11:21,304 - Dr. Robby. - Did you talk to your son? 342 00:11:21,305 --> 00:11:23,890 No, but I have the form to put him on a psychiatric hold. 343 00:11:23,891 --> 00:11:25,809 A social worker signed it. 344 00:11:25,810 --> 00:11:27,727 - I just need you. - OK. 345 00:11:27,728 --> 00:11:29,604 You should probably go home, Theresa. 346 00:11:29,605 --> 00:11:31,398 This hospital is essentially closed. 347 00:11:31,399 --> 00:11:33,566 - David wouldn't do this. - [sirens approaching] 348 00:11:33,567 --> 00:11:35,151 I really hope you're right. 349 00:11:35,152 --> 00:11:37,529 - I got four shooting victims. - [tires screeching] 350 00:11:37,530 --> 00:11:38,780 What's your name? 351 00:11:38,781 --> 00:11:40,115 Duncan. 352 00:11:40,116 --> 00:11:41,991 - Show me. - [groaning] 353 00:11:41,992 --> 00:11:44,661 Right chest, strong radial. Pink. 354 00:11:44,662 --> 00:11:46,329 What's this? 355 00:11:46,330 --> 00:11:48,164 That's priority boarding. You're gonna be OK. 356 00:11:48,165 --> 00:11:49,499 Back wound is red. Shoulder is yellow. 357 00:11:49,500 --> 00:11:51,167 Neck wound is red. [horn honking] 358 00:11:51,168 --> 00:11:53,169 OK. Let's check out this van. 359 00:11:53,170 --> 00:11:54,296 Yeah. 360 00:11:57,633 --> 00:11:59,175 Hey. See that woman over there? 361 00:11:59,176 --> 00:12:00,677 - You need to speak to her. - Why? 362 00:12:00,678 --> 00:12:02,345 Her son had something to do with the shooting. 363 00:12:02,346 --> 00:12:04,222 I'm not sure for certain, but you need to talk to her. 364 00:12:04,223 --> 00:12:06,516 Shit. OK. 365 00:12:06,517 --> 00:12:10,145 [helicopter rotors thrumming] 366 00:12:10,146 --> 00:12:12,147 - What's your name? - Uh, I'm Sylvia. 367 00:12:12,148 --> 00:12:13,523 This is my son, Omar. 368 00:12:13,524 --> 00:12:14,983 Omar, can you open your eyes for me? 369 00:12:14,984 --> 00:12:16,192 He's deaf. 370 00:12:16,193 --> 00:12:17,527 Gurney! 371 00:12:17,528 --> 00:12:19,279 Sir, can you hear me? 372 00:12:19,280 --> 00:12:21,198 Black and white, Pedes. 373 00:12:23,868 --> 00:12:25,452 Red zone. 374 00:12:25,453 --> 00:12:27,537 You need to let go now. One, two, three. 375 00:12:27,538 --> 00:12:28,997 I want to stay with my son. 376 00:12:28,998 --> 00:12:31,708 He will be very close by, I promise. 377 00:12:31,709 --> 00:12:33,293 What happened to your leg? 378 00:12:33,294 --> 00:12:35,545 Uh, I got hit by a car when we were wheeling him in. 379 00:12:35,546 --> 00:12:37,590 OK, we'll see you inside, too. 380 00:12:41,802 --> 00:12:43,386 You got this? I'll check back in a minute. 381 00:12:43,387 --> 00:12:44,429 No problema. 382 00:12:44,430 --> 00:12:46,014 Dr. Ellis, thanks for coming in early. 383 00:12:46,015 --> 00:12:47,724 - Put me in, Coach. - You're on Triage with Shen. 384 00:12:47,725 --> 00:12:49,225 Ten seconds a patient, right? 385 00:12:49,226 --> 00:12:51,436 You got it. Let me know if you need any help. 386 00:12:51,437 --> 00:12:52,563 Help. 387 00:12:53,981 --> 00:12:55,857 [horn honking] 388 00:12:55,858 --> 00:12:56,941 Behind you. 389 00:12:56,942 --> 00:12:58,443 Coming through. 390 00:12:58,444 --> 00:13:00,737 [indistinct chatter] 391 00:13:00,738 --> 00:13:01,905 I'm in. 392 00:13:01,906 --> 00:13:03,198 Bag her. 393 00:13:03,199 --> 00:13:05,074 O-neg's pouring in. 394 00:13:05,075 --> 00:13:06,201 Stronger pulse. 395 00:13:06,202 --> 00:13:07,660 I'll take her up. 396 00:13:07,661 --> 00:13:09,496 Dr. Mohan, that kid came in with his mom. 397 00:13:09,497 --> 00:13:10,914 She says he's deaf. 398 00:13:10,915 --> 00:13:12,207 Ready to go with the O-neg. 399 00:13:12,208 --> 00:13:13,249 Wait, wait. Stop. 400 00:13:13,250 --> 00:13:15,418 O positive for males over 13, women over 55. 401 00:13:15,419 --> 00:13:16,921 O-neg for everybody else. 402 00:13:18,422 --> 00:13:19,673 Hook me up. 403 00:13:23,928 --> 00:13:25,887 - It's really pouring out. - Squeeze in two units. 404 00:13:25,888 --> 00:13:27,555 1500 out buys him a trip to the OR. 405 00:13:27,556 --> 00:13:30,099 If he stabilizes, surgical ICU instead. 406 00:13:30,100 --> 00:13:31,726 I'm gonna see who needs help. 407 00:13:31,727 --> 00:13:33,728 Yeah. 408 00:13:33,729 --> 00:13:34,729 [whirring] 409 00:13:34,730 --> 00:13:37,357 IO's in. Go with O pos. 410 00:13:37,358 --> 00:13:39,275 When there's no time, bone marrow infusion 411 00:13:39,276 --> 00:13:41,444 is as good as an IV. 412 00:13:41,445 --> 00:13:43,405 Robby, stabilize for the flip. 413 00:13:45,950 --> 00:13:46,950 Go. 414 00:13:46,951 --> 00:13:48,785 - OK. - [grunts] 415 00:13:48,786 --> 00:13:50,119 He's got a wound on both sides. 416 00:13:50,120 --> 00:13:51,246 He's gonna need two chest tubes. 417 00:13:51,247 --> 00:13:52,455 - Yeah. - Need a hand? 418 00:13:52,456 --> 00:13:54,041 Hell, no. I got two hands. 419 00:13:57,044 --> 00:13:58,795 Roll. 420 00:13:58,796 --> 00:14:00,463 OK, quick IO, Etomidate and sux, 421 00:14:00,464 --> 00:14:02,173 prep for the intubation. 422 00:14:02,174 --> 00:14:05,677 [tense music] 423 00:14:05,678 --> 00:14:07,971 [whirring] 424 00:14:07,972 --> 00:14:09,305 [screaming] 425 00:14:09,306 --> 00:14:10,974 Got another one for yellow. 426 00:14:10,975 --> 00:14:12,267 [indistinct shouting] 427 00:14:12,268 --> 00:14:14,394 Document the tourniquet time. 428 00:14:14,395 --> 00:14:16,271 Mark the arm. Mark the chart. 429 00:14:16,272 --> 00:14:17,814 Let it down briefly once an hour. 430 00:14:17,815 --> 00:14:19,399 - OK. - Four of morphine. 431 00:14:19,400 --> 00:14:20,567 Repeat if needed. 432 00:14:20,568 --> 00:14:22,443 Mel, this is Sylvia. 433 00:14:22,444 --> 00:14:24,571 Hi, Sylvia. I'm Dr. King. 434 00:14:24,572 --> 00:14:26,155 Oh! Mm. 435 00:14:26,156 --> 00:14:28,074 Looks like closed tib-fib fractures. 436 00:14:28,075 --> 00:14:30,326 Strong pedal pulses, great flow with the butterfly. 437 00:14:30,327 --> 00:14:31,786 Great. 438 00:14:31,787 --> 00:14:33,788 OK, I got separated from my son, Omar. 439 00:14:33,789 --> 00:14:35,665 He got shot in the chest. 440 00:14:35,666 --> 00:14:38,585 OK, um, I'll let you know as soon as I find out anything. 441 00:14:38,586 --> 00:14:41,170 He is deaf, ASL only. They need to know that. 442 00:14:41,171 --> 00:14:43,298 OK. Um, I'll make sure it's in his chart. 443 00:14:43,299 --> 00:14:45,508 She needs X-rays... AP and lateral. 444 00:14:45,509 --> 00:14:47,510 Well, um, Radiology's gonna be closed for hours. 445 00:14:47,511 --> 00:14:49,971 Put her in a long CAM boot and pain meds. 446 00:14:49,972 --> 00:14:51,347 We're just gonna make you comfortable. 447 00:14:51,348 --> 00:14:52,474 Thank you. 448 00:14:56,520 --> 00:14:58,021 Coming in with clamps now. 449 00:14:58,022 --> 00:15:00,148 Environmental service manager to the ER. 450 00:15:00,149 --> 00:15:01,900 Environmental service manager to the ER. 451 00:15:01,901 --> 00:15:03,860 OK. Pressure dressing on this. 452 00:15:03,861 --> 00:15:05,695 OK. 453 00:15:05,696 --> 00:15:07,739 - [stammering] - What if he dropped a lung? 454 00:15:07,740 --> 00:15:11,200 Then I'll throw in a pigtail. 455 00:15:11,201 --> 00:15:13,161 - Who needs help? - Everyone. 456 00:15:13,162 --> 00:15:15,163 Pinks are supposed to be stable for the next hour. 457 00:15:15,164 --> 00:15:16,956 If you think they need the OR sooner, 458 00:15:16,957 --> 00:15:19,542 - send them to the red zone. - Will do. 459 00:15:19,543 --> 00:15:20,877 I got this. Go with your mom... 460 00:15:20,878 --> 00:15:22,463 I mean, Dr. Shamsi. 461 00:15:27,426 --> 00:15:29,218 How we doing in here? 462 00:15:29,219 --> 00:15:32,055 So far, so good. Blood's primed and ready. 463 00:15:32,056 --> 00:15:33,848 1500 CCs. Time for the OR now? 464 00:15:33,849 --> 00:15:35,391 Definitely. Move him up. 465 00:15:35,392 --> 00:15:39,062 ♪ ♪ 466 00:15:39,063 --> 00:15:41,856 Um... uh, 17-year-old with a right chest wound? 467 00:15:41,857 --> 00:15:43,900 Going up to the OR now. 468 00:15:43,901 --> 00:15:46,778 Hold on one second. 469 00:15:46,779 --> 00:15:48,948 They need to know he's deaf when he wakes up. 470 00:15:50,407 --> 00:15:52,200 Not a lot of test tube output here. 471 00:15:52,201 --> 00:15:53,618 Looks like this one's renal. 472 00:15:53,619 --> 00:15:55,578 Golden ticket... directly to surgery. 473 00:15:55,579 --> 00:15:58,414 ♪ ♪ 474 00:15:58,415 --> 00:15:59,791 That's 3 out of 4 ORs down. 475 00:15:59,792 --> 00:16:01,250 Another 4 about to open, 476 00:16:01,251 --> 00:16:02,752 and all 25 will be ready by the time we need them. 477 00:16:02,753 --> 00:16:05,421 - We could be buried by then. - No, you won't. 478 00:16:05,422 --> 00:16:07,215 We'll blast through these, tying off bleeders 479 00:16:07,216 --> 00:16:08,883 and slapping on vacuum dressings. 480 00:16:08,884 --> 00:16:11,928 We'll finish the job in a day or two when the dust settles. 481 00:16:11,929 --> 00:16:13,972 Unresponsive, had a weak femoral, lost it. 482 00:16:13,973 --> 00:16:15,181 Two units of blood. 483 00:16:15,182 --> 00:16:16,432 If there's no response, call it. 484 00:16:16,433 --> 00:16:17,934 No pulse, no OR. 485 00:16:17,935 --> 00:16:19,602 Gunshot to the head. 486 00:16:19,603 --> 00:16:20,895 Through and through? 487 00:16:20,896 --> 00:16:22,230 Yeah, we still got a strong pulse. 488 00:16:22,231 --> 00:16:23,856 This one can make it because the intracranial bleed 489 00:16:23,857 --> 00:16:25,525 can decompress through the bullet holes. 490 00:16:25,526 --> 00:16:26,859 Walsh, neurosurgery in house? 491 00:16:26,860 --> 00:16:28,611 Yes, send him to the neurocrit ICU. 492 00:16:28,612 --> 00:16:31,197 They'll triage from there. 493 00:16:31,198 --> 00:16:32,615 OK, you guys good in here? You got this? 494 00:16:32,616 --> 00:16:34,075 We got this. 495 00:16:34,076 --> 00:16:36,911 Bring me a few more before I get bored. 496 00:16:36,912 --> 00:16:38,538 ER immediately. 497 00:16:38,539 --> 00:16:41,290 All available transport to the ER immediately. 498 00:16:41,291 --> 00:16:42,875 Through and through? 499 00:16:42,876 --> 00:16:44,460 It doesn't look like it. 500 00:16:44,461 --> 00:16:46,337 Getting backed up out there. 501 00:16:46,338 --> 00:16:49,466 [indistinct chatter] 502 00:16:52,928 --> 00:16:54,637 Good view of the chords. 503 00:16:54,638 --> 00:16:56,764 Easy peasy, I'm in. 504 00:16:56,765 --> 00:16:58,307 Bag her up. 505 00:16:58,308 --> 00:17:00,018 We have more ambulances coming. 506 00:17:00,019 --> 00:17:01,477 End tidal CO2 looking good. 507 00:17:01,478 --> 00:17:02,979 20 French on a kelly. 508 00:17:02,980 --> 00:17:04,522 What the fuck are you doing? 509 00:17:04,523 --> 00:17:06,315 - I'm saving lives. - You should not be here. 510 00:17:06,316 --> 00:17:09,610 None of these people should be here. 511 00:17:09,611 --> 00:17:10,820 Larry, Larry! 512 00:17:10,821 --> 00:17:12,363 Head wounds don't go to yellow. 513 00:17:12,364 --> 00:17:14,323 Wait, what? Triage says yellow. 514 00:17:14,324 --> 00:17:15,867 - Hold on. - Go. 515 00:17:15,868 --> 00:17:18,619 I've got this. Trust me. 516 00:17:18,620 --> 00:17:21,164 Oh, we're a little late for that. 517 00:17:21,165 --> 00:17:23,416 Any available transport to the ER now. 518 00:17:23,417 --> 00:17:25,668 Any available transport to the ER now. 519 00:17:25,669 --> 00:17:27,628 This is Grayson Cooper, 68. 520 00:17:27,629 --> 00:17:28,963 Bullet grazed his scalp. 521 00:17:28,964 --> 00:17:30,506 I got lucky. Dude just clipped me. 522 00:17:30,507 --> 00:17:31,758 Let me see. Got a headache? 523 00:17:31,759 --> 00:17:33,342 Not really. A little burning. 524 00:17:33,343 --> 00:17:35,303 - Good for yellow. - Been to a million concerts. 525 00:17:35,304 --> 00:17:37,263 Whatever happened to peace and love, man? 526 00:17:37,264 --> 00:17:39,682 That's a great question. 527 00:17:39,683 --> 00:17:41,142 - [screaming] - It should be numb. 528 00:17:41,143 --> 00:17:43,269 Israeli bandage starts with hemostatic gauze 529 00:17:43,270 --> 00:17:45,104 then turns into a pressure dressing. 530 00:17:45,105 --> 00:17:46,189 Is that arterial? 531 00:17:46,190 --> 00:17:47,857 No, but it's bleeding pretty briskly. 532 00:17:47,858 --> 00:17:50,693 OK, change it to a tourniquet only if it soaks through. 533 00:17:50,694 --> 00:17:52,737 I got a superficial scalp wound. 534 00:17:52,738 --> 00:17:54,697 Wrap it tight with frequent neuro checks. 535 00:17:54,698 --> 00:17:56,532 - I need to assess your injury. - I'm fine. 536 00:17:56,533 --> 00:17:58,701 Help the others first, please. I'm fine. 537 00:17:58,702 --> 00:18:00,578 Um, sir, are you taking any medication? 538 00:18:00,579 --> 00:18:02,080 Just medicinal marijuana. 539 00:18:02,081 --> 00:18:03,915 Yeah? What do you take that for? 540 00:18:03,916 --> 00:18:05,833 [chuckles] Everything. 541 00:18:05,834 --> 00:18:09,545 - IVs on everyone. - I need some help over here. 542 00:18:09,546 --> 00:18:11,422 How is my son? 543 00:18:11,423 --> 00:18:13,174 Omar. He was shot in the chest. 544 00:18:13,175 --> 00:18:14,717 We were in the plumber van. 545 00:18:14,718 --> 00:18:16,719 He is upstairs with the surgeons in the OR. 546 00:18:16,720 --> 00:18:19,305 I will come and find you when I know more. 547 00:18:19,306 --> 00:18:20,973 Coming through! 548 00:18:20,974 --> 00:18:25,187 [indistinct chatter] 549 00:18:32,569 --> 00:18:35,196 Jesse, hang a unit, then right up to the OR. 550 00:18:35,197 --> 00:18:37,198 [distant siren wailing] 551 00:18:37,199 --> 00:18:38,366 She shot? 552 00:18:38,367 --> 00:18:40,159 No, looks like she got trampled. 553 00:18:40,160 --> 00:18:42,537 Unresponsive in the field. Three more in the rig. 554 00:18:42,538 --> 00:18:43,913 Hey, Javadi! 555 00:18:43,914 --> 00:18:46,499 Got a possible blunt head trauma here. 556 00:18:46,500 --> 00:18:48,668 Pupils are good. 557 00:18:48,669 --> 00:18:50,086 Strong pulses. 558 00:18:50,087 --> 00:18:52,088 OK, assess for blunt head, chest, belly. 559 00:18:52,089 --> 00:18:54,048 - With who? - Anybody. 560 00:18:54,049 --> 00:18:56,092 - How are we doing? - Heads above water so far. 561 00:18:56,093 --> 00:18:57,593 Anything about the shooter? 562 00:18:57,594 --> 00:18:59,595 Haven't heard, but I'll try and get an update. 563 00:18:59,596 --> 00:19:01,639 - I see Langdon's back. - Yeah, not by choice. 564 00:19:01,640 --> 00:19:03,599 I'll deal with that when this shift is over. 565 00:19:03,600 --> 00:19:05,434 - Collins? - Not answering. 566 00:19:05,435 --> 00:19:07,728 I told her to turn off her fucking phone. 567 00:19:07,729 --> 00:19:09,438 Keep trying her. Jake? 568 00:19:09,439 --> 00:19:10,606 No. 569 00:19:10,607 --> 00:19:12,275 But I got his mom on the landline. 570 00:19:12,276 --> 00:19:13,985 Told her to call both of us when she reaches him. 571 00:19:13,986 --> 00:19:15,069 - OK. - Yep. 572 00:19:15,070 --> 00:19:17,155 Environmental services manager to the ER. 573 00:19:17,156 --> 00:19:18,990 One for pink and one for green. 574 00:19:18,991 --> 00:19:20,324 - On it. - I'm sorry. 575 00:19:20,325 --> 00:19:22,076 All press needs to stay in the waiting room. 576 00:19:22,077 --> 00:19:23,286 Come on, man, two minutes. 577 00:19:23,287 --> 00:19:24,370 The public needs to know what's going on. 578 00:19:24,371 --> 00:19:25,913 Front of the hospital! 579 00:19:25,914 --> 00:19:27,874 Pedestrian entrance. I'm not telling you again. 580 00:19:27,875 --> 00:19:30,585 [siren chirping] 581 00:19:30,586 --> 00:19:31,919 What's this? 582 00:19:31,920 --> 00:19:33,421 Responds to pain only, thready pulse, 583 00:19:33,422 --> 00:19:35,047 chest wall contusions with boot prints on his shirt. 584 00:19:35,048 --> 00:19:36,924 - Yellow here, a wheelchair. - OK, sounds good. 585 00:19:36,925 --> 00:19:38,217 Do you need anything? 586 00:19:38,218 --> 00:19:39,635 Well, I was hoping for Thanksgiving 587 00:19:39,636 --> 00:19:41,971 and Christmas off this year. 588 00:19:41,972 --> 00:19:44,640 But we can talk about it later. 589 00:19:44,641 --> 00:19:46,601 For proper chest tube placement, 590 00:19:46,602 --> 00:19:49,061 keep going until the last fenestration is intrathoracic. 591 00:19:49,062 --> 00:19:50,980 - OK, stop. - What? 592 00:19:50,981 --> 00:19:52,481 I don't need you teaching me right now. 593 00:19:52,482 --> 00:19:55,861 - You're already an expert? - Read the fucking room, Mom! 594 00:19:58,238 --> 00:19:59,322 3-0 silk. 595 00:19:59,323 --> 00:20:01,449 I'm about to place a horizontal mattress, 596 00:20:01,450 --> 00:20:02,951 in case you're wondering. 597 00:20:05,913 --> 00:20:07,581 Looks like you've got this. 598 00:20:09,541 --> 00:20:11,710 This one should go to yellow. 599 00:20:13,378 --> 00:20:15,255 Hey, could you help me? 600 00:20:17,591 --> 00:20:20,176 Soaked through his pressure dressing. 601 00:20:20,177 --> 00:20:22,345 OK, yeah, we can fix that with Raney Clips. 602 00:20:22,346 --> 00:20:23,679 What are those? 603 00:20:23,680 --> 00:20:25,514 They use them in neurosurgery to clamp off the scalp 604 00:20:25,515 --> 00:20:27,016 - before opening the skull. - All right. 605 00:20:27,017 --> 00:20:28,684 I'll be right back. Santos, keep pressure. 606 00:20:28,685 --> 00:20:30,478 You guys are swamped. I got this. 607 00:20:30,479 --> 00:20:32,104 It takes a village. 608 00:20:32,105 --> 00:20:34,523 [screaming] 609 00:20:34,524 --> 00:20:36,442 Sylvia. Sylvia? 610 00:20:36,443 --> 00:20:38,277 Whitaker! Sylvia. 611 00:20:38,278 --> 00:20:39,654 Sylvia, can you hear me? 612 00:20:39,655 --> 00:20:41,864 Sylvia, can you hear me? 613 00:20:41,865 --> 00:20:44,033 - I lost her radial pulse. - From a broken leg? 614 00:20:44,034 --> 00:20:45,993 - Well, what did we miss? - I don't know. Heart attack? 615 00:20:45,994 --> 00:20:47,536 Another injury from the car crash? 616 00:20:47,537 --> 00:20:49,622 - That's for pulses. - It has an EFAST mode. 617 00:20:49,623 --> 00:20:52,709 [tense music] 618 00:20:54,711 --> 00:20:55,878 Diagnosis made. 619 00:20:55,879 --> 00:20:57,546 Blood in Morrison's, liver laceration. 620 00:20:57,547 --> 00:20:59,840 Car hit the belly. Leg was a distracting injury. 621 00:20:59,841 --> 00:21:01,050 Um, drill in an IO. 622 00:21:01,051 --> 00:21:02,218 I'm gonna get some blood, 623 00:21:02,219 --> 00:21:03,886 and then we'll move her to pink. 624 00:21:03,887 --> 00:21:07,556 [tense music] 625 00:21:07,557 --> 00:21:09,100 Just sent another up to the OR. 626 00:21:09,101 --> 00:21:11,060 - I got room for one more red. - On it. 627 00:21:11,061 --> 00:21:12,395 Didn't make it. Going to Pedes. 628 00:21:12,396 --> 00:21:13,729 Another red in Trauma One. 629 00:21:13,730 --> 00:21:15,274 Copy that. 630 00:21:17,609 --> 00:21:20,027 - Dana, if I... whoa! - Careful, kid. 631 00:21:20,028 --> 00:21:22,697 Um, I need Raney Clips and a unit of O-neg. 632 00:21:22,698 --> 00:21:24,282 Raneys will have to come down from the OR. 633 00:21:24,283 --> 00:21:25,741 - I need them now. - OK. 634 00:21:25,742 --> 00:21:26,909 OK, I'll get them. 635 00:21:26,910 --> 00:21:29,829 O-neg here. 636 00:21:29,830 --> 00:21:31,580 - There you go. - Thanks. 637 00:21:31,581 --> 00:21:33,374 We need EVS with a mop. 638 00:21:33,375 --> 00:21:35,251 Not much blood, but a big rush of air. 639 00:21:35,252 --> 00:21:36,919 Got trampled. Collapsed his lung. 640 00:21:36,920 --> 00:21:38,087 Tension pneumo. 641 00:21:38,088 --> 00:21:39,547 - Who intubated? - I did. 642 00:21:39,548 --> 00:21:40,673 Mohan is on fire. 643 00:21:40,674 --> 00:21:41,924 - Pulse is coming up. - OK, great. 644 00:21:41,925 --> 00:21:43,426 Slide to pink as soon as there's room. 645 00:21:43,427 --> 00:21:44,927 Got it. 646 00:21:44,928 --> 00:21:47,596 Hey, uh, how many ORs available? 647 00:21:47,597 --> 00:21:49,724 One now. Two more in less than five. 648 00:21:49,725 --> 00:21:51,559 Can you take a belly and one more chest in pre? 649 00:21:51,560 --> 00:21:52,893 No problem. 650 00:21:52,894 --> 00:21:55,271 MCI 21 is going to ICU. I'll be back. 651 00:21:55,272 --> 00:21:56,522 Got it. 652 00:21:56,523 --> 00:21:58,065 Red Zone, Red Zone. 653 00:21:58,066 --> 00:21:59,942 Environmental service manager to the ER. 654 00:21:59,943 --> 00:22:02,320 Three West is full. Take them to Two South. 655 00:22:02,321 --> 00:22:05,448 I need Xeroform, cut 4x4s, and elastoplast tape. 656 00:22:05,449 --> 00:22:07,283 You're here! 657 00:22:07,284 --> 00:22:09,785 In the flesh. What do you got? 658 00:22:09,786 --> 00:22:11,245 Uh, auto versus ped. 659 00:22:11,246 --> 00:22:13,122 We thought it was just a tib-fib fracture. 660 00:22:13,123 --> 00:22:14,999 Then we found an occult liver laceration. 661 00:22:15,000 --> 00:22:16,500 Leg is low priority right now. 662 00:22:16,501 --> 00:22:17,835 If she stabilizes with blood, 663 00:22:17,836 --> 00:22:19,295 she can wait an hour for the OR. 664 00:22:19,296 --> 00:22:20,755 - And if not? - Front of the line, baby. 665 00:22:20,756 --> 00:22:22,298 Her son's in the OR with a GSW to the chest. 666 00:22:22,299 --> 00:22:24,467 Sweet. Family reunion in post-op. 667 00:22:24,468 --> 00:22:27,261 Whitaker, I'll be right back once this unit's in. 668 00:22:27,262 --> 00:22:29,472 - Uh-huh. - Hey! 669 00:22:29,473 --> 00:22:30,806 Good catch, you two. 670 00:22:30,807 --> 00:22:32,600 Hey, Langdon, we're out of Xeroform. 671 00:22:32,601 --> 00:22:33,809 I'll try to find some. 672 00:22:33,810 --> 00:22:35,061 Come on, Sylvia. 673 00:22:35,062 --> 00:22:37,980 [elevator bell dings] 674 00:22:37,981 --> 00:22:39,815 Oh, I'm sorry, sir. The ER is closed. 675 00:22:39,816 --> 00:22:41,400 You'll have to exit out the pedestrian entrance. 676 00:22:41,401 --> 00:22:42,985 I'm a patient. 677 00:22:42,986 --> 00:22:44,820 Then you need to go to Family Medicine in Building 8. 678 00:22:44,821 --> 00:22:46,572 No, I'm waiting for surgery on the fourth floor. 679 00:22:46,573 --> 00:22:48,157 OK, well, then go back to your bed. 680 00:22:48,158 --> 00:22:49,784 My son is down here. 681 00:22:49,785 --> 00:22:51,619 I'm sorry, sir, but no one's in and out 682 00:22:51,620 --> 00:22:53,079 unless they're on a gurney. 683 00:22:53,080 --> 00:22:55,831 [scoffs] OK, look, um, 684 00:22:55,832 --> 00:22:59,001 my wife is an ER doc, Dr. McKay. 685 00:22:59,002 --> 00:23:00,628 She needs me to get our son home. 686 00:23:00,629 --> 00:23:02,005 He's in the staff lounge. 687 00:23:03,465 --> 00:23:05,174 [sighs] All right, make it quick. 688 00:23:05,175 --> 00:23:07,718 - Thank you. - Mm-hmm. 689 00:23:07,719 --> 00:23:09,637 But, hey... 690 00:23:09,638 --> 00:23:11,514 I am timing you. 691 00:23:11,515 --> 00:23:13,474 If you're not back in five, I'm coming after you. 692 00:23:13,475 --> 00:23:14,683 - Yeah. - Got it? 693 00:23:14,684 --> 00:23:16,561 - Yeah, OK. - Yeah, OK. 694 00:23:18,939 --> 00:23:21,857 - I need a tourniquet now! - Need some help over here. 695 00:23:21,858 --> 00:23:24,402 Back looks good. No exit wounds. 696 00:23:24,403 --> 00:23:26,070 Red Zone! 697 00:23:26,071 --> 00:23:28,240 OK, I'll be right back. 698 00:23:29,699 --> 00:23:31,659 - [whirring] - Javadi, IO. 699 00:23:31,660 --> 00:23:33,285 Yeah. 700 00:23:33,286 --> 00:23:35,204 - [whirring] - Here too. 701 00:23:35,205 --> 00:23:36,872 Sux is on board. 702 00:23:36,873 --> 00:23:39,041 - She's not breathing. - I got it. 703 00:23:39,042 --> 00:23:43,170 [indistinct chatter] 704 00:23:43,171 --> 00:23:44,589 I'm in. Bag her. 705 00:23:45,924 --> 00:23:47,883 Chad, what are you doing here? 706 00:23:47,884 --> 00:23:50,636 Uh, they... they, uh... they postponed my surgery. 707 00:23:50,637 --> 00:23:52,054 You can't be in here. 708 00:23:52,055 --> 00:23:54,723 Go sit with Harrison in the staff lounge! 709 00:23:54,724 --> 00:23:56,725 - OK. OK. - Now! 710 00:23:56,726 --> 00:23:59,855 [indistinct chatter continues] 711 00:24:02,149 --> 00:24:03,441 I got it! I'm trying! 712 00:24:03,442 --> 00:24:05,902 Another one for the morgue. Heading to Pedes. 713 00:24:20,917 --> 00:24:23,252 Hey, buddy. 714 00:24:23,253 --> 00:24:25,087 Did you have your surgery? 715 00:24:25,088 --> 00:24:27,381 No, it got delayed. 716 00:24:27,382 --> 00:24:28,757 Ready to go home? 717 00:24:28,758 --> 00:24:30,718 Mom said that Grandma and Grandpa McKay 718 00:24:30,719 --> 00:24:31,927 were picking me up. 719 00:24:31,928 --> 00:24:33,929 Yeah, I'm not sure they can get here right now, 720 00:24:33,930 --> 00:24:35,347 and neither can Chloe. 721 00:24:35,348 --> 00:24:38,726 But, you know, we can Uber to my place. 722 00:24:38,727 --> 00:24:42,605 I'd rather go home with Mom if that's OK. 723 00:24:42,606 --> 00:24:45,107 Uh, your mom's got her hands full, dude, 724 00:24:45,108 --> 00:24:47,067 and I think she's gonna be here pretty late. 725 00:24:47,068 --> 00:24:48,487 I can wait. 726 00:24:50,197 --> 00:24:52,114 OK. 727 00:24:52,115 --> 00:24:54,034 Yeah, OK. 728 00:25:03,210 --> 00:25:05,419 - Should we watch something? - You want to watch a movie? 729 00:25:05,420 --> 00:25:07,087 Yeah, sure. 730 00:25:07,088 --> 00:25:08,797 What do you got on there? 731 00:25:08,798 --> 00:25:10,591 Not much. 732 00:25:10,592 --> 00:25:12,426 That's one unit in. 733 00:25:12,427 --> 00:25:14,345 Her pulse is stronger, but she needs more blood. 734 00:25:14,346 --> 00:25:16,805 Not today. Only one unit if the pulse picks up. 735 00:25:16,806 --> 00:25:18,307 We're already rationing our blood supply. 736 00:25:18,308 --> 00:25:20,476 - What if we run out? - Who wanted Raney Clips? 737 00:25:20,477 --> 00:25:22,144 Oh, me! Thank you. 738 00:25:22,145 --> 00:25:25,105 - I thought you left. - All hands on deck, right? 739 00:25:25,106 --> 00:25:26,482 Is there any word on Omar? 740 00:25:26,483 --> 00:25:29,276 He's this woman's deaf son. Teenage boy shot in the chest? 741 00:25:29,277 --> 00:25:30,778 Kid got lucky. Missed the aorta. 742 00:25:30,779 --> 00:25:31,862 He should pull through. 743 00:25:31,863 --> 00:25:33,822 Oh, that's amazing. Um, well, her name is Sylvia. 744 00:25:33,823 --> 00:25:36,283 Would you please tell her about her son when she wakes up? 745 00:25:36,284 --> 00:25:37,827 What are you using to... 746 00:25:39,246 --> 00:25:41,747 Mateo, MCI-29 goes to the OR. 747 00:25:41,748 --> 00:25:44,500 [continues speaking indistinctly] 748 00:25:44,501 --> 00:25:45,793 What's this? 749 00:25:45,794 --> 00:25:47,419 Unresponsive even to pain. 750 00:25:47,420 --> 00:25:48,504 No GSW. 751 00:25:48,505 --> 00:25:51,006 Strong pulse, but tachycardic and diaphoretic. 752 00:25:51,007 --> 00:25:53,842 Looking for internal hemorrhage. 753 00:25:53,843 --> 00:25:55,678 - FAST negative. - Help me roll her. 754 00:25:55,679 --> 00:25:58,180 All transport to the ER immediately. 755 00:25:58,181 --> 00:25:59,306 - Tim! - Yeah. 756 00:25:59,307 --> 00:26:00,599 - Amp of D50, now. - Got it. 757 00:26:00,600 --> 00:26:02,601 - Seriously? - Look... glucose monitor. 758 00:26:02,602 --> 00:26:04,186 She's diabetic and probably hypoglycemic. 759 00:26:04,187 --> 00:26:05,354 - So check the blood sugar. - No time for that. 760 00:26:05,355 --> 00:26:06,689 Still could be head trauma. 761 00:26:06,690 --> 00:26:08,691 If it's DKA, you're making it worse. 762 00:26:08,692 --> 00:26:10,401 My Spidey sense is telling me she took her morning insulin, 763 00:26:10,402 --> 00:26:11,569 but she skipped lunch. 764 00:26:11,570 --> 00:26:13,654 She's in a coma from low blood sugar. 765 00:26:13,655 --> 00:26:16,490 Will you look at that? These are healing hands. 766 00:26:16,491 --> 00:26:18,033 Too bad they're so tiny. 767 00:26:18,034 --> 00:26:19,910 Hello. What's your name? 768 00:26:19,911 --> 00:26:21,036 Dawn. 769 00:26:21,037 --> 00:26:22,371 Where am I? 770 00:26:22,372 --> 00:26:23,831 Pittsburgh Trauma Medical Center. 771 00:26:23,832 --> 00:26:25,833 You dropped your blood sugar, but you're gonna be OK. 772 00:26:25,834 --> 00:26:27,167 Guess you don't need me here. 773 00:26:27,168 --> 00:26:29,169 Don't even say it. 774 00:26:29,170 --> 00:26:31,338 Let's get her to yellow. 775 00:26:31,339 --> 00:26:32,715 What happened? 776 00:26:32,716 --> 00:26:34,758 Uh, there was a shooting at PittFest. 777 00:26:34,759 --> 00:26:36,927 But you're safe now. 778 00:26:36,928 --> 00:26:38,721 Whatever you can spare. Thanks. 779 00:26:38,722 --> 00:26:42,474 MCI-33 to yellow for monitoring. 780 00:26:42,475 --> 00:26:43,726 What are you doing? 781 00:26:43,727 --> 00:26:45,811 Ran out of laryngoscopes. No time to autoclave. 782 00:26:45,812 --> 00:26:47,146 Oh, man. 783 00:26:47,147 --> 00:26:48,647 Almost out of chest tubes, too. 784 00:26:48,648 --> 00:26:50,065 More coming from Presby. 785 00:26:50,066 --> 00:26:51,692 We're running very low on O-neg. 786 00:26:51,693 --> 00:26:54,195 - Perfect storm. - Yeah. 787 00:26:55,905 --> 00:26:57,906 I got a pink coming in! 788 00:26:57,907 --> 00:26:59,158 [person screams] 789 00:26:59,159 --> 00:27:00,868 Do you feel anything, Grayson? 790 00:27:00,869 --> 00:27:02,161 No pain. 791 00:27:02,162 --> 00:27:04,413 Just a lot of sadness for the world we live in. 792 00:27:04,414 --> 00:27:06,582 - I hear you. - Any room at the inn? 793 00:27:06,583 --> 00:27:07,916 Uh, what's her story? 794 00:27:07,917 --> 00:27:09,293 This is Dawn, no trauma, 795 00:27:09,294 --> 00:27:11,295 insulin reaction, responded to D50. 796 00:27:11,296 --> 00:27:13,088 - D10 at 100 an hour? - Perfect. 797 00:27:13,089 --> 00:27:14,423 Oh, and I borrowed your butterfly. 798 00:27:14,424 --> 00:27:15,758 It's on the gurney. 799 00:27:15,759 --> 00:27:17,301 - So just like that. - Yep. 800 00:27:17,302 --> 00:27:20,429 - What are you doing? - Treating the patient. 801 00:27:20,430 --> 00:27:21,764 Raney Clips. 802 00:27:21,765 --> 00:27:23,932 Clamping off a bunch of sub-Q bleeders. 803 00:27:23,933 --> 00:27:26,061 Good work. Keep it up. 804 00:27:27,854 --> 00:27:29,480 Yep, perfect. That's it. 805 00:27:29,481 --> 00:27:31,191 Room for another pink. 806 00:27:32,776 --> 00:27:34,735 - I need suction! - We don't have any. 807 00:27:34,736 --> 00:27:36,612 Too many secretions. I can't see shit. 808 00:27:36,613 --> 00:27:38,113 Here, wipe it out with 4x4s. 809 00:27:38,114 --> 00:27:39,281 Are you kidding me? 810 00:27:39,282 --> 00:27:41,116 You guys have a fiberoptic laryngoscope? 811 00:27:41,117 --> 00:27:42,534 Nope, just a rigid Glidescope. 812 00:27:42,535 --> 00:27:43,702 That'll do. 813 00:27:43,703 --> 00:27:45,621 Except we don't have any room for it, so just pull out, 814 00:27:45,622 --> 00:27:47,122 and we'll bag for a minute. 815 00:27:47,123 --> 00:27:48,540 When did this guy last eat? 816 00:27:48,541 --> 00:27:50,542 We never know down here. Let me get in there. 817 00:27:50,543 --> 00:27:52,586 I'll keep cricoid pressure. If he vomits, we're fucked. 818 00:27:52,587 --> 00:27:54,296 - Doctor. - [groaning] 819 00:27:54,297 --> 00:27:55,589 We may need a surgical airway. 820 00:27:55,590 --> 00:27:56,882 Hold on, hold on, hold on, hold on. 821 00:27:56,883 --> 00:27:59,051 Oh, yeah. This is a tough one. 822 00:27:59,052 --> 00:28:01,387 Oh, yeah, this one looks tough. 823 00:28:01,388 --> 00:28:03,222 - No shit. Prep the neck? - Hold on. 824 00:28:03,223 --> 00:28:04,723 - McKay? Come over here. - Yeah. 825 00:28:04,724 --> 00:28:06,058 Just give me a chest compression. 826 00:28:06,059 --> 00:28:07,476 CPR? Did we lose the pulse? 827 00:28:07,477 --> 00:28:09,228 No, just give me one good push. 828 00:28:09,229 --> 00:28:10,729 Yep. OK, two. 829 00:28:10,730 --> 00:28:12,147 And do it again. 830 00:28:12,148 --> 00:28:14,359 [grunts] 831 00:28:15,860 --> 00:28:16,944 OK. 832 00:28:16,945 --> 00:28:18,529 I think I am in. 833 00:28:18,530 --> 00:28:20,489 - Bag him. - Check the end tidal. 834 00:28:20,490 --> 00:28:21,865 Uh, yellow. We're good. 835 00:28:21,866 --> 00:28:23,534 - Whoo-hoo-hoo! - How'd you do that? 836 00:28:23,535 --> 00:28:24,785 - Bubble intubation. - [sighs] 837 00:28:24,786 --> 00:28:26,704 You gave the compression, I followed the air bubbles up. 838 00:28:26,705 --> 00:28:28,330 More than one way to tube a cat. 839 00:28:28,331 --> 00:28:29,623 Coming through. 840 00:28:29,624 --> 00:28:31,041 Robby! 841 00:28:31,042 --> 00:28:32,501 - Now, please! - Wow. 842 00:28:32,502 --> 00:28:34,962 - Imagine that. - Whew. 843 00:28:34,963 --> 00:28:36,547 Anything from Jake? 844 00:28:36,548 --> 00:28:38,173 How much room do we have in pink? 845 00:28:38,174 --> 00:28:39,550 Intubated chest tube, 846 00:28:39,551 --> 00:28:41,677 but massive subcutaneous emphysema. 847 00:28:41,678 --> 00:28:43,971 Air from the chest is leaking under the skin. 848 00:28:43,972 --> 00:28:45,639 - Losing the pulse. - What do you think? 849 00:28:45,640 --> 00:28:47,307 Tamponade from pneumomediastinum. 850 00:28:47,308 --> 00:28:49,143 About to cut blowhole incisions to release the air? 851 00:28:49,144 --> 00:28:51,687 Do it. Infraclavicular. 852 00:28:51,688 --> 00:28:53,605 Yep. 853 00:28:53,606 --> 00:28:56,693 [soft hissing] 854 00:29:00,864 --> 00:29:03,031 Pulse is coming up. Nicely done. 855 00:29:03,032 --> 00:29:05,702 OK, send him to cardiothoracic ICU. 856 00:29:10,248 --> 00:29:11,373 [groaning] 857 00:29:11,374 --> 00:29:14,209 We'll get you pain medicine. A nurse will be by soon. 858 00:29:14,210 --> 00:29:17,504 [sighs] 859 00:29:17,505 --> 00:29:19,548 - Hey, where'd this guy go? - Uh, which patient? 860 00:29:19,549 --> 00:29:22,593 MCI-28, arm injury who refused treatment? 861 00:29:22,594 --> 00:29:24,052 Uh, maybe he left? 862 00:29:24,053 --> 00:29:26,097 With a gunshot wound? 863 00:29:30,643 --> 00:29:32,102 Hey! 864 00:29:32,103 --> 00:29:33,353 Hey, what the hell are you doing? 865 00:29:33,354 --> 00:29:34,772 I'm fine. Leave me alone. 866 00:29:34,773 --> 00:29:37,024 - You can't do that. - Back off. 867 00:29:37,025 --> 00:29:38,735 [scoffs] 868 00:29:40,153 --> 00:29:42,238 I need security in here! 869 00:29:43,907 --> 00:29:46,074 Hey! 870 00:29:46,075 --> 00:29:47,910 [grunts] 871 00:29:47,911 --> 00:29:49,370 [laughs] 872 00:29:50,580 --> 00:29:51,914 Nice move, Slick. 873 00:29:51,915 --> 00:29:53,833 What happened? 874 00:29:55,960 --> 00:29:58,086 Fucker! 875 00:29:58,087 --> 00:29:59,588 I think this guy stole a victim's hoodie 876 00:29:59,589 --> 00:30:01,048 and faked an injury to get inside. 877 00:30:01,049 --> 00:30:02,424 He's probably a fucking reporter. 878 00:30:02,425 --> 00:30:03,759 - Asshole. - What? 879 00:30:03,760 --> 00:30:06,345 Hey! Hey, wake up, you faker! 880 00:30:06,346 --> 00:30:07,888 [groans] 881 00:30:07,889 --> 00:30:09,723 Yep, he responds to pain. 882 00:30:09,724 --> 00:30:11,725 Perlah, blunt head trauma goes to pink. 883 00:30:11,726 --> 00:30:14,269 Soft restraints, six hours observation. 884 00:30:14,270 --> 00:30:16,063 - Gurney to the hub. - Be right back. 885 00:30:16,064 --> 00:30:17,773 I'm fine. 886 00:30:17,774 --> 00:30:19,942 Yeah, great, you can give a statement to the cops. 887 00:30:19,943 --> 00:30:21,443 - Get him out of here. - Yeah. 888 00:30:21,444 --> 00:30:22,653 Where's my phone? 889 00:30:22,654 --> 00:30:24,321 Oops. 890 00:30:24,322 --> 00:30:26,074 My bad. 891 00:30:30,912 --> 00:30:32,287 Chest tube, please. 892 00:30:32,288 --> 00:30:33,997 - We're out of chest tubes. - What the hell? 893 00:30:33,998 --> 00:30:35,999 You could have told me that before we started. 894 00:30:36,000 --> 00:30:37,918 - Well, I didn't know. - I already made the incision. 895 00:30:37,919 --> 00:30:39,670 Now what am I supposed to do? 896 00:30:39,671 --> 00:30:42,464 - What about this? - An ET tube? 897 00:30:42,465 --> 00:30:43,507 A tube's a tube. 898 00:30:43,508 --> 00:30:45,676 And if you inflate the balloon, it won't pull out. 899 00:30:45,677 --> 00:30:47,135 Fine. Set up a Thoraseal. 900 00:30:47,136 --> 00:30:49,304 - Out of those, too. - Oh, for the love of God! 901 00:30:49,305 --> 00:30:50,556 Urine bag? 902 00:30:50,557 --> 00:30:51,974 How am I supposed to connect to that? 903 00:30:51,975 --> 00:30:54,142 Christmas tree adapter. It'll work. 904 00:30:54,143 --> 00:30:57,604 [sighs] This is all very unconventional. 905 00:30:57,605 --> 00:31:00,316 No. [chuckles] This is genius. 906 00:31:03,236 --> 00:31:05,320 Oh, um, and four of Ancef. 907 00:31:05,321 --> 00:31:07,155 Sorry, I forgot the Ancef. 908 00:31:07,156 --> 00:31:09,116 Thank you. 909 00:31:09,117 --> 00:31:12,911 [distant siren wailing] [sighs] 910 00:31:12,912 --> 00:31:15,831 Mel! Mel, I need you to reassess, please, now. 911 00:31:15,832 --> 00:31:17,458 Sylvia? 912 00:31:19,002 --> 00:31:20,377 Oh, Sylvia. 913 00:31:20,378 --> 00:31:22,045 Her pulse is weak and thready. 914 00:31:22,046 --> 00:31:23,839 She's, uh, bleeding out from her liver lac. 915 00:31:23,840 --> 00:31:25,674 - I need O-neg! - O-neg's gone, honey. 916 00:31:25,675 --> 00:31:27,175 Gloria's got more flying in. 917 00:31:27,176 --> 00:31:29,177 Incident Command, what's the ETA on our blood? 918 00:31:29,178 --> 00:31:30,512 Eight to ten minutes. 919 00:31:30,513 --> 00:31:31,889 The patient's gonna have to get by 920 00:31:31,890 --> 00:31:32,890 with a liter of saline. 921 00:31:32,891 --> 00:31:34,641 No, no, she needs blood, not crystalloid. 922 00:31:34,642 --> 00:31:35,851 Um, can she go to surgery? 923 00:31:35,852 --> 00:31:38,520 All right, she's next to go, as soon as we get an open OR. 924 00:31:38,521 --> 00:31:40,230 She's not gonna last that long. 925 00:31:40,231 --> 00:31:42,357 Dr. Robby. Dr. Robby! 926 00:31:42,358 --> 00:31:44,234 Dr. Robby, we're out of O-neg, but I'm O-neg. 927 00:31:44,235 --> 00:31:45,527 Can I donate? 928 00:31:45,528 --> 00:31:47,154 Gloria's got more blood flying in. 929 00:31:47,155 --> 00:31:49,072 - But I need it now. - What is our blood status? 930 00:31:49,073 --> 00:31:50,949 Just used the last units of O-neg and O-pos. 931 00:31:50,950 --> 00:31:52,034 - More flying in. - ETA? 932 00:31:52,035 --> 00:31:53,035 Less than 10. 933 00:31:53,036 --> 00:31:54,536 Some patients are not gonna last that long. 934 00:31:54,537 --> 00:31:57,039 And I'm sure there are other O-neg donors 935 00:31:57,040 --> 00:31:58,665 that probably work here, so... 936 00:31:58,666 --> 00:32:00,375 It would take hours to screen for HIV and hepatitis. 937 00:32:00,376 --> 00:32:02,794 Well, I have neither, and I donate all the time. 938 00:32:02,795 --> 00:32:04,004 [sighs] 939 00:32:04,005 --> 00:32:05,881 Please. 940 00:32:05,882 --> 00:32:07,215 Fuck it. 941 00:32:07,216 --> 00:32:09,217 If the patient's gonna die before they get to the OR, 942 00:32:09,218 --> 00:32:11,136 then the benefits outweigh the risks. 943 00:32:11,137 --> 00:32:12,387 My man. 944 00:32:12,388 --> 00:32:14,181 All right, kid, roll up your sleeve... I'll meet you in 7. 945 00:32:14,182 --> 00:32:15,223 Listen up. 946 00:32:15,224 --> 00:32:18,060 Central 7, 8, 9 is now the blood donor center. 947 00:32:18,061 --> 00:32:21,521 Anyone who's O-neg or O-pos, we need you to donate now. 948 00:32:21,522 --> 00:32:23,066 Hands where I can see them. 949 00:32:24,651 --> 00:32:27,069 OK, let's do this. 950 00:32:27,070 --> 00:32:30,405 [indistinct chatter] 951 00:32:30,406 --> 00:32:32,532 - You two work here, right? - Yes. 952 00:32:32,533 --> 00:32:34,034 Can you tell me how my mom is? 953 00:32:34,035 --> 00:32:36,453 Her name is Patricia Gregory... or Trish. 954 00:32:36,454 --> 00:32:38,622 She was shot in her arm. 955 00:32:38,623 --> 00:32:42,250 We're here to help. One second. Bear with us. 956 00:32:42,251 --> 00:32:44,337 [sighs] 957 00:32:47,757 --> 00:32:48,966 Hello? 958 00:32:48,967 --> 00:32:50,759 Can I have your attention, please? 959 00:32:50,760 --> 00:32:52,594 My name is Kiara Alfaro. 960 00:32:52,595 --> 00:32:54,930 I'm an emergency-department social worker. 961 00:32:54,931 --> 00:32:58,016 This is Lupe Perez, one of our ward clerks. 962 00:32:58,017 --> 00:33:01,436 I know you all want information about your friends and family. 963 00:33:01,437 --> 00:33:04,231 In order to help you, we have a QR code 964 00:33:04,232 --> 00:33:07,609 you can scan for our patient-identification website. 965 00:33:07,610 --> 00:33:10,278 Cell phones are down, but you can log on 966 00:33:10,279 --> 00:33:12,197 to the hospital guest Wi-Fi. 967 00:33:12,198 --> 00:33:13,865 That information is on these papers 968 00:33:13,866 --> 00:33:15,617 we'll distribute around the room. 969 00:33:15,618 --> 00:33:18,954 Once you log on, send us the name and birth date 970 00:33:18,955 --> 00:33:20,747 of whomever you're concerned about. 971 00:33:20,748 --> 00:33:22,374 If you could tell us what they were wearing, 972 00:33:22,375 --> 00:33:26,128 upload photos, pictures of tattoos, piercings. 973 00:33:26,129 --> 00:33:28,630 Anything to help identify them would be useful. 974 00:33:28,631 --> 00:33:30,424 If we get a match, we'll let you know. 975 00:33:30,425 --> 00:33:33,969 We're setting up phone chargers, water, snacks. 976 00:33:33,970 --> 00:33:35,846 And if anyone needs to change clothes, 977 00:33:35,847 --> 00:33:37,139 we've got paper scrubs coming. 978 00:33:37,140 --> 00:33:38,140 Give us some time. 979 00:33:38,141 --> 00:33:39,599 We're doing everything we can 980 00:33:39,600 --> 00:33:42,185 to help get you the information you need. 981 00:33:42,186 --> 00:33:45,648 [indistinct chatter] 982 00:33:52,113 --> 00:33:54,156 OK, I'm done. 983 00:33:54,157 --> 00:33:56,742 OK, give me the Coban. Come on, come on, come on. 984 00:33:56,743 --> 00:33:58,660 I got this. Here you go. 985 00:33:58,661 --> 00:34:00,245 Here you go. There you go. 986 00:34:00,246 --> 00:34:02,080 Next! 987 00:34:02,081 --> 00:34:03,290 How's she doing? 988 00:34:03,291 --> 00:34:04,666 We have 500 of saline in. 989 00:34:04,667 --> 00:34:06,168 She's just barely with us, Mel. 990 00:34:06,169 --> 00:34:10,297 OK, well, this unit of whole blood should help. 991 00:34:10,298 --> 00:34:12,591 Yeah, see if you can find a pressure bag. 992 00:34:12,592 --> 00:34:15,762 No, no. Much faster if I just squeeze it in myself. 993 00:34:21,184 --> 00:34:23,019 Need some help with an airway! 994 00:34:26,064 --> 00:34:27,397 What is it? 995 00:34:27,398 --> 00:34:29,149 GSW to the neck with expanding hematoma 996 00:34:29,150 --> 00:34:31,359 and distorted anatomy... can't intubate him. 997 00:34:31,360 --> 00:34:34,029 - Probably hit the carotid. - OK. I'll do the airway. 998 00:34:34,030 --> 00:34:36,239 Give me a 6.5 and a bougie. 999 00:34:36,240 --> 00:34:37,574 I got the bleeder. 1000 00:34:37,575 --> 00:34:40,327 Foley catheter with a 30 cc balloon. 1001 00:34:40,328 --> 00:34:42,704 - Are you donating? - O-neg, yeah. 1002 00:34:42,705 --> 00:34:44,581 ♪ ♪ 1003 00:34:44,582 --> 00:34:46,708 Coming through! 1004 00:34:46,709 --> 00:34:48,335 [sighs] It's too bloody to see a bougie. 1005 00:34:48,336 --> 00:34:49,920 Not for this. Three-step process. 1006 00:34:49,921 --> 00:34:51,880 Step one, scalpel. 1007 00:34:51,881 --> 00:34:55,176 Step two, finger. Step three, bougie. 1008 00:34:58,805 --> 00:35:00,640 OK, railroad in the tube. 1009 00:35:02,266 --> 00:35:04,309 I'm doing all I can to stop it! 1010 00:35:04,310 --> 00:35:05,852 Good, that's far enough. 1011 00:35:05,853 --> 00:35:07,562 OK, bag him. 1012 00:35:07,563 --> 00:35:10,649 Dressing off. 1013 00:35:10,650 --> 00:35:13,444 Foley's in. Blow up a balloon. 1014 00:35:15,613 --> 00:35:17,322 30 cc's in. 1015 00:35:17,323 --> 00:35:19,574 Clamping. 1016 00:35:19,575 --> 00:35:21,743 Look at that. 1017 00:35:21,744 --> 00:35:24,037 - Dry as a bone. - Hoo-hoo-hoo! 1018 00:35:24,038 --> 00:35:25,664 Room for another red. 1019 00:35:25,665 --> 00:35:27,749 Dr. Walsh, you have an OR for a head-and-neck case? 1020 00:35:27,750 --> 00:35:29,042 MCI-48. 1021 00:35:29,043 --> 00:35:30,794 We've got 16 ORs up and running. 1022 00:35:30,795 --> 00:35:32,254 We've got room for one more. 1023 00:35:32,255 --> 00:35:33,964 Liver lac came back after a second unit, 1024 00:35:33,965 --> 00:35:35,090 needs an ex-lap. 1025 00:35:35,091 --> 00:35:38,093 Turning over two ORs now. Send them up. 1026 00:35:38,094 --> 00:35:39,636 Where the hell did Mel go? 1027 00:35:39,637 --> 00:35:41,805 I don't know, but she needs to get back to yellow. 1028 00:35:41,806 --> 00:35:43,598 That's 2 grams of Ancef. 1029 00:35:43,599 --> 00:35:45,600 Great. 1030 00:35:45,601 --> 00:35:47,978 Let's take a look at your dressing. 1031 00:35:47,979 --> 00:35:50,564 All right, that looks good. The bleeding stopped. 1032 00:35:50,565 --> 00:35:52,275 Can you wiggle your fingers? 1033 00:35:53,484 --> 00:35:56,320 Ma'am? Ma'am, can you move your fingers for me? 1034 00:35:57,655 --> 00:35:59,948 OK, does it feel the same on both sides? 1035 00:35:59,949 --> 00:36:02,034 Great. How's the pain? 1036 00:36:06,122 --> 00:36:08,415 Well, the bullet probably went through 1037 00:36:08,416 --> 00:36:09,624 the two forearm bones, 1038 00:36:09,625 --> 00:36:12,419 but there's no damage to the nerves or arteries, 1039 00:36:12,420 --> 00:36:14,505 so that's a good sign. 1040 00:36:16,883 --> 00:36:18,301 You're gonna be OK. 1041 00:36:21,137 --> 00:36:23,096 I'll find you some tissues. 1042 00:36:23,097 --> 00:36:27,142 [sobbing] 1043 00:36:27,143 --> 00:36:29,311 Robby, blood's arrived. 1044 00:36:29,312 --> 00:36:31,146 Oh, right on. 1045 00:36:31,147 --> 00:36:34,149 Eviscerated bowel, fresh ABD and saline. 1046 00:36:34,150 --> 00:36:36,610 OK, bag for a sec? 1047 00:36:36,611 --> 00:36:38,862 3.375 Zosyn and a sterile dressing. 1048 00:36:38,863 --> 00:36:40,447 I can't believe I'm saying this... 1049 00:36:40,448 --> 00:36:42,199 another Christmas tree and Foley bag. 1050 00:36:42,200 --> 00:36:45,619 How did we run out of chest tubes? 1051 00:36:45,620 --> 00:36:48,163 Less than 500 cc's out. Surgical ICU can take him. 1052 00:36:48,164 --> 00:36:49,998 ET tubes in the chest... they're gonna wonder 1053 00:36:49,999 --> 00:36:51,791 what the hell we're doing down here, but it was a great save. 1054 00:36:51,792 --> 00:36:53,501 Hey, Javadi, I need you to find Whitaker 1055 00:36:53,502 --> 00:36:55,212 and go up to the helipad... we got blood flying in. 1056 00:36:55,213 --> 00:36:56,671 - OK. - Stay behind the yellow line 1057 00:36:56,672 --> 00:36:58,048 between 10:00 and 2:00 so the pilot 1058 00:36:58,049 --> 00:36:59,174 - can see you the whole time. - OK. 1059 00:36:59,175 --> 00:37:00,508 You got this? 1060 00:37:00,509 --> 00:37:02,177 Moving him up as fast as we can. 1061 00:37:02,178 --> 00:37:03,678 This one's going to yellow. 1062 00:37:03,679 --> 00:37:05,138 More chest tubes, courtesy of Presby. 1063 00:37:05,139 --> 00:37:06,848 Awesome. I'm gonna go check on Triage. 1064 00:37:06,849 --> 00:37:08,141 Copy that. 1065 00:37:08,142 --> 00:37:10,268 [siren chirping] 1066 00:37:10,269 --> 00:37:12,312 - They find the shooter yet? - Not yet, but we'll find him. 1067 00:37:12,313 --> 00:37:14,481 - Half the county is looking. - What about with her? 1068 00:37:14,482 --> 00:37:15,774 Waiting for the FBI to get here. 1069 00:37:15,775 --> 00:37:16,858 They find her son? 1070 00:37:16,859 --> 00:37:18,109 No, but they pinged his cell phone 1071 00:37:18,110 --> 00:37:19,486 to the area of the shooting. 1072 00:37:19,487 --> 00:37:20,862 Fuck. Does she know that yet? 1073 00:37:20,863 --> 00:37:22,697 - She's about to find out. - OK. Thanks. 1074 00:37:22,698 --> 00:37:24,199 What's with all these bloody handprints? 1075 00:37:24,200 --> 00:37:25,700 That's when people were trying 1076 00:37:25,701 --> 00:37:27,661 to stop us to get a ride in, but we were already packed. 1077 00:37:27,662 --> 00:37:28,995 Chest, belly, arm, and leg. 1078 00:37:28,996 --> 00:37:30,705 Red, pink, yellow, and a lucky green. 1079 00:37:30,706 --> 00:37:32,540 Two gurneys, two wheelchairs. 1080 00:37:32,541 --> 00:37:34,709 [tires screeching] 1081 00:37:34,710 --> 00:37:36,670 - My partner's in bad shape. - What's his name? 1082 00:37:36,671 --> 00:37:38,046 Rich. Rich Stefano. 1083 00:37:38,047 --> 00:37:39,214 Hey, Rich. How you doing? 1084 00:37:39,215 --> 00:37:41,383 - [gurgling] - Oh, shit. 1085 00:37:41,384 --> 00:37:43,051 He got... he got shot in the face? 1086 00:37:43,052 --> 00:37:44,219 No, entrance is on the other side... 1087 00:37:44,220 --> 00:37:45,887 neck, above his vest. 1088 00:37:45,888 --> 00:37:47,347 - Cheek is the exit wound. - OK. 1089 00:37:47,348 --> 00:37:49,266 Come on, Red Zone. He needs an airway. 1090 00:37:49,267 --> 00:37:50,934 Come with me. Come with me. 1091 00:37:50,935 --> 00:37:52,894 I got you. We'll get you fixed up. 1092 00:37:52,895 --> 00:37:55,689 [siren approaching] 1093 00:37:55,690 --> 00:37:57,065 Take him. 1094 00:37:57,066 --> 00:37:59,234 [siren chirping] 1095 00:37:59,235 --> 00:38:00,944 Hey, what's up with the SWAT team? 1096 00:38:00,945 --> 00:38:02,529 It's just a precaution 1097 00:38:02,530 --> 00:38:04,322 in case the shooter heads this way. 1098 00:38:04,323 --> 00:38:07,033 - Is that a possibility? - There was some chatter. 1099 00:38:07,034 --> 00:38:08,576 Well, are we gonna be safe out here? 1100 00:38:08,577 --> 00:38:10,745 - Should be now. - Focus on the patients. 1101 00:38:10,746 --> 00:38:12,247 Focus on the patients. 1102 00:38:12,248 --> 00:38:14,082 Only way out is through. 1103 00:38:14,083 --> 00:38:15,875 Any idea how many more are coming? 1104 00:38:15,876 --> 00:38:17,585 Incident Command is sending all these ambulances 1105 00:38:17,586 --> 00:38:19,379 back to the scene for more victims. 1106 00:38:19,380 --> 00:38:21,881 We might not even be halfway through yet. 1107 00:38:21,882 --> 00:38:23,049 Jesus. 1108 00:38:23,050 --> 00:38:24,843 When is this gonna end? 1109 00:38:24,844 --> 00:38:27,554 [indistinct shouting] 1110 00:38:27,555 --> 00:38:29,931 [dramatic music] 1111 00:38:29,932 --> 00:38:33,059 [sighs] Fuck. 1112 00:38:33,060 --> 00:38:36,147 [siren wailing] 1113 00:38:41,110 --> 00:38:44,070 [soft music] 1114 00:38:44,071 --> 00:38:51,162 ♪ ♪