1
00:00:09,301 --> 00:00:12,720
[distant siren wails]
2
00:00:12,721 --> 00:00:14,263
Need some help over here!
3
00:00:14,264 --> 00:00:15,848
- Who called in SWAT?
- Just a precaution.
4
00:00:15,849 --> 00:00:17,391
They still haven't found
the shooter yet.
5
00:00:17,392 --> 00:00:19,352
They need to stay out there,
not in here.
6
00:00:19,353 --> 00:00:21,729
Officer down.
You know the drill.
7
00:00:21,730 --> 00:00:23,898
- 16 gauge in the right AC.
- Definitely needs an airway.
8
00:00:23,899 --> 00:00:25,233
Can you handle that bleeding?
9
00:00:25,234 --> 00:00:26,901
Need a sponge stick
for the back.
10
00:00:26,902 --> 00:00:28,820
Dana, 100 of ketamine
and get some 4x4s on a kelly.
11
00:00:28,821 --> 00:00:30,404
You guys are doing a great job.
Keep it up.
12
00:00:30,405 --> 00:00:33,241
Hang in there, Richie.
You're in good hands.
13
00:00:33,242 --> 00:00:35,910
- You're gonna be okay, man.
- Hey, guys.
14
00:00:35,911 --> 00:00:37,370
Back it up.
We're trying to work here.
15
00:00:37,371 --> 00:00:39,205
Come on.
Both of youse, go.
16
00:00:39,206 --> 00:00:42,250
And chest tube output
is minimal.
17
00:00:42,251 --> 00:00:44,961
- Good for cardiothoracic ICU.
- Nice. Okay.
18
00:00:44,962 --> 00:00:46,629
As soon as transpo
can lend us a hand.
19
00:00:46,630 --> 00:00:48,548
What's up with the SWAT team?
20
00:00:48,549 --> 00:00:50,049
Maybe they think
the shooter's coming here.
21
00:00:50,050 --> 00:00:51,300
- Shit, is that true?
- What?
22
00:00:51,301 --> 00:00:52,802
My kid's in the break room.
23
00:00:52,803 --> 00:00:54,428
They think the shooter's
heading this way?
24
00:00:54,429 --> 00:00:56,931
Anything is possible.
25
00:00:56,932 --> 00:00:59,600
Don't spread rumors.
26
00:00:59,601 --> 00:01:01,227
I'm taking this one to the OR.
27
00:01:01,228 --> 00:01:04,606
[indistinct PA announcement]
28
00:01:06,275 --> 00:01:07,567
How are you doing?
29
00:01:07,568 --> 00:01:09,861
Yeah, I'm good.
You?
30
00:01:09,862 --> 00:01:11,404
I'm good.
31
00:01:11,405 --> 00:01:12,947
- How much blood are we getting?
- I don't know.
32
00:01:12,948 --> 00:01:14,323
I hope it's enough.
33
00:01:14,324 --> 00:01:15,575
We're supposed to stop here
34
00:01:15,576 --> 00:01:17,910
and stay between 10:00
and 2:00.
35
00:01:17,911 --> 00:01:20,288
- Where's 12?
- I think the pilot's 12.
36
00:01:20,289 --> 00:01:24,126
I think we just stay back,
and they bring the blood to us.
37
00:01:25,669 --> 00:01:27,337
I think.
38
00:01:29,673 --> 00:01:30,631
- Here.
- Thank you.
39
00:01:30,632 --> 00:01:32,050
Yep.
40
00:01:36,138 --> 00:01:37,555
Do we take these
to our supply room
41
00:01:37,556 --> 00:01:39,307
- in Behavioral Health?
- Trauma rooms first.
42
00:01:39,308 --> 00:01:41,309
Then we'll make our way out
to the patients in the hub.
43
00:01:41,310 --> 00:01:43,436
- That the O-neg delivery?
- Yeah, straight from the roof.
44
00:01:43,437 --> 00:01:45,146
Jesse, hang a unit,
then right up to the OR.
45
00:01:45,147 --> 00:01:46,981
Who else needs blood?
46
00:01:46,982 --> 00:01:48,816
Everybody.
47
00:01:48,817 --> 00:01:50,443
Leave us four units,
four next door,
48
00:01:50,444 --> 00:01:52,195
and then check in
with Robby and Abbot.
49
00:01:52,196 --> 00:01:54,697
Okay, I've got next door.
50
00:01:54,698 --> 00:01:56,282
- Blood's here.
- All right.
51
00:01:56,283 --> 00:01:57,617
Squeeze one in
as fast as you can.
52
00:01:57,618 --> 00:01:59,660
Bag for me.
53
00:01:59,661 --> 00:02:02,330
- You guys need blood?
- No, not just yet.
54
00:02:02,331 --> 00:02:03,831
Leave it with Dana.
55
00:02:03,832 --> 00:02:05,499
Hey, Whitaker.
How you doing?
56
00:02:05,500 --> 00:02:06,500
Yeah, fine.
57
00:02:06,501 --> 00:02:07,835
Ask for help if you need it.
58
00:02:07,836 --> 00:02:10,504
I can't see the cords.
Let's bag him.
59
00:02:10,505 --> 00:02:12,006
Sorry, I'm used
to the GlideScope.
60
00:02:12,007 --> 00:02:13,466
Spoiled by technology.
61
00:02:13,467 --> 00:02:14,884
Dana, you got
a bougie back there?
62
00:02:14,885 --> 00:02:17,220
Completely out.
Used them all up.
63
00:02:17,221 --> 00:02:20,723
- Is he awake?
- He was. Now he's sedated.
64
00:02:20,724 --> 00:02:23,059
- Should be intubated by now.
- Yeah, what's his pulse ox?
65
00:02:23,060 --> 00:02:24,518
All right,
except for his partner,
66
00:02:24,519 --> 00:02:26,354
all of you into BH-2 now.
67
00:02:26,355 --> 00:02:27,855
You can watch from the window,
68
00:02:27,856 --> 00:02:29,857
but you need to zip it, capisce?
69
00:02:29,858 --> 00:02:31,525
Oh, God.
Bridget, thank God.
70
00:02:31,526 --> 00:02:32,777
Night shift to the rescue.
71
00:02:32,778 --> 00:02:33,986
What the hell happened
to your eye?
72
00:02:33,987 --> 00:02:35,488
Just another happy customer.
73
00:02:35,489 --> 00:02:37,323
- Looks a lot worse than it is.
- Yeah, right.
74
00:02:37,324 --> 00:02:39,825
I tried to get here sooner,
but it is gridlocked out there.
75
00:02:39,826 --> 00:02:41,202
It's not much better in here.
76
00:02:41,203 --> 00:02:43,120
Did you hear anything
about the shooter?
77
00:02:43,121 --> 00:02:45,706
They may have slipped away in
the crowd with all this chaos.
78
00:02:45,707 --> 00:02:48,251
- Hey, where do you need me?
- North is yellow.
79
00:02:48,252 --> 00:02:50,002
- Keep an eye on the new kids.
- Got it.
80
00:02:50,003 --> 00:02:51,045
You holler if you're in trouble.
81
00:02:51,046 --> 00:02:53,422
Yes, ma'am.
82
00:02:53,423 --> 00:02:55,883
Jamie, what do you need?
83
00:02:55,884 --> 00:02:57,385
IVs on everyone.
84
00:02:57,386 --> 00:03:00,304
- Hi, I'm Dr. King.
- Buster Pirelli.
85
00:03:00,305 --> 00:03:03,224
I take it you're
a children's entertainer.
86
00:03:03,225 --> 00:03:04,892
Impressive observational skills.
87
00:03:04,893 --> 00:03:06,477
Well, no active bleeding.
88
00:03:06,478 --> 00:03:08,896
Can you tell me your pain
on a scale of 1 to 10?
89
00:03:08,897 --> 00:03:10,231
At least a 3.
90
00:03:10,232 --> 00:03:11,899
And can you wiggle your fingers?
91
00:03:11,900 --> 00:03:14,193
Uh-huh.
92
00:03:14,194 --> 00:03:15,569
The... the other hand.
93
00:03:15,570 --> 00:03:17,697
Oh.
94
00:03:17,698 --> 00:03:19,448
Well, it doesn't seem
like you have a broken bone,
95
00:03:19,449 --> 00:03:21,409
but we're gonna put you
on some IV antibiotics
96
00:03:21,410 --> 00:03:22,910
and some pain meds.
97
00:03:22,911 --> 00:03:24,037
Got it.
98
00:03:25,706 --> 00:03:27,581
You, uh, see who shot you?
99
00:03:27,582 --> 00:03:31,502
No, I'm not even sure which
direction the bullet came from.
100
00:03:31,503 --> 00:03:35,006
Hey, am I going to lose
any dexterity? Like...
101
00:03:35,007 --> 00:03:37,258
It's too soon to tell,
but probably not.
102
00:03:37,259 --> 00:03:39,427
[sighs] I make
balloon animals for a living.
103
00:03:39,428 --> 00:03:41,554
Two birthday parties booked
every Saturday, Sunday
104
00:03:41,555 --> 00:03:43,180
for the next year, so...
105
00:03:43,181 --> 00:03:45,683
Wow, you must really love kids.
106
00:03:45,684 --> 00:03:47,226
Not really.
107
00:03:47,227 --> 00:03:48,728
Okay, you're gonna feel
a little pinprick here.
108
00:03:48,729 --> 00:03:51,564
[screams] Fuck me!
109
00:03:51,565 --> 00:03:53,774
Uh, it's... it's in. It's just
so we can give you antibiotics.
110
00:03:53,775 --> 00:03:55,276
Oh.
111
00:03:55,277 --> 00:03:57,153
That hurt just as bad
as when I got shot.
112
00:03:57,154 --> 00:03:58,654
You put in an IO?
113
00:03:58,655 --> 00:04:00,239
- [groans]
- Yeah.
114
00:04:00,240 --> 00:04:01,574
Um, don't worry, sir.
115
00:04:01,575 --> 00:04:02,908
There will be no more pain.
116
00:04:02,909 --> 00:04:03,951
Okay.
117
00:04:03,952 --> 00:04:05,786
Whitaker, um, team huddle.
118
00:04:05,787 --> 00:04:07,621
[sighs]
119
00:04:07,622 --> 00:04:09,457
- Join us, will you?
- Mm-hmm.
120
00:04:09,458 --> 00:04:11,584
Oh, my God.
121
00:04:11,585 --> 00:04:14,628
Okay, um, why'd you do that?
122
00:04:14,629 --> 00:04:17,923
Dr. Robby said
everyone gets an IO.
123
00:04:17,924 --> 00:04:20,801
If they are unconscious
or unresponsive.
124
00:04:20,802 --> 00:04:23,471
If the patient is
awake and alert,
125
00:04:23,472 --> 00:04:25,681
it's just a standard IV,
not an IO.
126
00:04:25,682 --> 00:04:28,642
Unless it's a mime.
They can't scream.
127
00:04:28,643 --> 00:04:30,353
Lidocaine for the clown.
128
00:04:30,354 --> 00:04:31,645
More at the door.
129
00:04:31,646 --> 00:04:34,148
Is this ever gonna end?
130
00:04:34,149 --> 00:04:36,442
Pardon. Coming through.
131
00:04:36,443 --> 00:04:38,319
Bleed and bandage it.
Bring him out.
132
00:04:38,320 --> 00:04:40,112
To the other side?
133
00:04:40,113 --> 00:04:41,822
Ah, too much blood.
134
00:04:41,823 --> 00:04:43,449
Move that kelly
to the right a little bit.
135
00:04:43,450 --> 00:04:45,117
- Any better?
- Not really.
136
00:04:45,118 --> 00:04:46,744
- Radial pulse?
- Still has it.
137
00:04:46,745 --> 00:04:47,912
Maybe a little weaker.
138
00:04:47,913 --> 00:04:48,913
I can try and give you a bubble.
139
00:04:48,914 --> 00:04:50,707
Yeah, yeah, go for it.
140
00:04:52,250 --> 00:04:53,834
No, nothing.
I'm not seeing anything.
141
00:04:53,835 --> 00:04:56,504
Okay, let's bag him.
I want to prep the neck.
142
00:04:56,505 --> 00:04:57,880
You don't have a bougie.
143
00:04:57,881 --> 00:04:59,965
I have an 11 blade and a prayer.
144
00:04:59,966 --> 00:05:01,634
Without a bougie, you could
create a false passage
145
00:05:01,635 --> 00:05:03,219
on top of the trachea
and kill him.
146
00:05:03,220 --> 00:05:05,012
- You're doing a crike?
- Yep.
147
00:05:05,013 --> 00:05:08,307
No skin hooks, no bougie...
old school.
148
00:05:08,308 --> 00:05:09,934
I got a tactical airway
in my bag here.
149
00:05:09,935 --> 00:05:12,019
- What is that?
- It's a control crike kit.
150
00:05:12,020 --> 00:05:13,479
Oh, that's perfect.
151
00:05:13,480 --> 00:05:15,147
Use that on the battlefield.
152
00:05:15,148 --> 00:05:17,191
Works in the pitch-dark
when you're under fire.
153
00:05:17,192 --> 00:05:19,026
I can do these
with my eyes closed.
154
00:05:19,027 --> 00:05:21,028
- [chuckles]
- For you.
155
00:05:21,029 --> 00:05:23,489
Okay.
156
00:05:23,490 --> 00:05:25,866
The knife leaves
a trach hook behind,
157
00:05:25,867 --> 00:05:27,868
so you can't miss, right?
158
00:05:27,869 --> 00:05:30,079
Just...
159
00:05:30,080 --> 00:05:32,039
good.
160
00:05:32,040 --> 00:05:35,835
You slide in the introducer.
161
00:05:35,836 --> 00:05:36,961
Okay.
162
00:05:36,962 --> 00:05:39,463
Feel the tracheal rings.
Good.
163
00:05:39,464 --> 00:05:41,340
Bob's your uncle.
164
00:05:41,341 --> 00:05:44,218
- That was incredibly fast.
- Eh...
165
00:05:44,219 --> 00:05:45,803
Balloon is up.
166
00:05:45,804 --> 00:05:48,432
- Why don't we stock these?
- No room in the budget.
167
00:05:50,642 --> 00:05:52,560
Yellow on end-tidal.
[laughter]
168
00:05:52,561 --> 00:05:54,728
- It's okay now?
- Yeah.
169
00:05:54,729 --> 00:05:58,691
- Thank you, Dr. Abbot.
- [knocking on window]
170
00:05:58,692 --> 00:06:01,026
Okay, let's pack
the oral cavity with Kerlix
171
00:06:01,027 --> 00:06:02,945
and see how fast Head and Neck
can take him up to the OR.
172
00:06:02,946 --> 00:06:04,363
Great job, everybody.
173
00:06:04,364 --> 00:06:05,573
What else do you got
in your go bag?
174
00:06:05,574 --> 00:06:07,576
Oh, just wait and see.
175
00:06:27,971 --> 00:06:31,016
[camera shutter clicking]
176
00:06:40,984 --> 00:06:43,194
[sighs] Javadi, this is Sally.
177
00:06:43,195 --> 00:06:44,528
What does she need?
178
00:06:44,529 --> 00:06:46,280
Gunshot wound
to the back at T11.
179
00:06:46,281 --> 00:06:48,532
Good pulse, but probable
spinal cord injury.
180
00:06:48,533 --> 00:06:52,411
- Can you move your legs?
- I'm trying.
181
00:06:52,412 --> 00:06:53,787
Am I paralyzed?
182
00:06:53,788 --> 00:06:55,331
There's some hope for recovery.
183
00:06:55,332 --> 00:06:57,082
Keep her on the backboard
and monitor
184
00:06:57,083 --> 00:06:58,334
for intra-abdominal hemorrhage,
185
00:06:58,335 --> 00:07:00,419
and neuro-ICU
will triage to CT, okay?
186
00:07:00,420 --> 00:07:02,755
Sally, pinprick
right here, okay?
187
00:07:02,756 --> 00:07:05,174
Walsh knows about the case.
They're holding an OR.
188
00:07:05,175 --> 00:07:07,259
And the hits keep coming.
189
00:07:07,260 --> 00:07:09,428
Let's go.
190
00:07:09,429 --> 00:07:11,889
- [groans]
- Who do you have?
191
00:07:11,890 --> 00:07:14,392
Semiconscious,
only responds to pain.
192
00:07:15,644 --> 00:07:17,645
- Decent carotid.
- Strip him.
193
00:07:17,646 --> 00:07:19,730
Let's go.
194
00:07:19,731 --> 00:07:21,815
Ah, left upper-quadrant
entrance.
195
00:07:21,816 --> 00:07:23,150
[yelling]
196
00:07:23,151 --> 00:07:24,485
Hold him down.
197
00:07:24,486 --> 00:07:25,861
Grab his foot! Grab his foot!
198
00:07:25,862 --> 00:07:28,656
Whoa, gun! Gun!
He's going for his gun!
199
00:07:28,657 --> 00:07:30,282
Get down, get down.
200
00:07:30,283 --> 00:07:31,951
[all shouting]
201
00:07:31,952 --> 00:07:34,329
Stay down.
Stay down.
202
00:07:37,874 --> 00:07:40,000
Sig P365 9 mil.
203
00:07:40,001 --> 00:07:42,419
- Driver's license?
- He just got here.
204
00:07:42,420 --> 00:07:44,130
Not responding to pain now.
205
00:07:45,507 --> 00:07:47,508
All clear.
206
00:07:47,509 --> 00:07:49,260
- You sure?
- He's unconscious.
207
00:07:49,261 --> 00:07:51,178
Everybody back to work.
208
00:07:51,179 --> 00:07:52,930
Agonal breathing.
He needs an airway.
209
00:07:52,931 --> 00:07:55,307
- Working on an IO.
- Drawing up ketamine and sux.
210
00:07:55,308 --> 00:07:56,684
Here, have at it.
211
00:07:56,685 --> 00:07:58,686
Concealed carry permit.
212
00:07:58,687 --> 00:08:00,479
We'll run his ID.
213
00:08:00,480 --> 00:08:02,481
These wounds are too big
for a 9.
214
00:08:02,482 --> 00:08:03,857
Failed IO.
215
00:08:03,858 --> 00:08:05,818
Guy's huge.
Needle won't reach the bone.
216
00:08:05,819 --> 00:08:07,486
He needs induction meds
and blood.
217
00:08:07,487 --> 00:08:08,862
I'm having
the same problem here.
218
00:08:08,863 --> 00:08:10,030
I don't see anything usable
for an IV.
219
00:08:10,031 --> 00:08:11,699
- Robby.
- What?
220
00:08:11,700 --> 00:08:14,368
Guy needs access, but the IO
won't reach the humerus.
221
00:08:14,369 --> 00:08:16,370
Proximal tibia?
222
00:08:16,371 --> 00:08:18,205
Yes?
223
00:08:18,206 --> 00:08:19,957
Yeah.
224
00:08:19,958 --> 00:08:21,375
Tibia's not great access.
225
00:08:21,376 --> 00:08:22,876
You can only get a liter
an hour down there.
226
00:08:22,877 --> 00:08:24,169
You get what you get.
227
00:08:24,170 --> 00:08:26,463
[ankle monitor blaring]
228
00:08:26,464 --> 00:08:28,716
God damn it!
229
00:08:28,717 --> 00:08:30,593
Whatever that is,
can you please turn it off?
230
00:08:30,594 --> 00:08:33,178
- I can't hear myself think!
- Stable for the ICU.
231
00:08:33,179 --> 00:08:35,681
Get her up.
I'll be right fucking back.
232
00:08:35,682 --> 00:08:36,890
Copy that.
233
00:08:36,891 --> 00:08:39,978
[blaring continues]
234
00:08:44,357 --> 00:08:46,233
I already have one.
Keep that away from me.
235
00:08:46,234 --> 00:08:47,943
It's not for you.
236
00:08:47,944 --> 00:08:51,072
[blaring continues]
237
00:08:52,741 --> 00:08:54,283
This is the monitoring center.
238
00:08:54,284 --> 00:08:56,619
We see that you're not
in your inclusion zone.
239
00:08:56,620 --> 00:08:58,412
Do you have permission...
240
00:08:58,413 --> 00:09:02,166
[crowd gasping, murmuring]
241
00:09:02,167 --> 00:09:05,502
- Show's over.
- Uh...
242
00:09:05,503 --> 00:09:07,838
are you gonna get
in trouble for that?
243
00:09:07,839 --> 00:09:09,591
Probably.
244
00:09:25,148 --> 00:09:26,608
Hey.
245
00:09:28,276 --> 00:09:30,277
What's going on out there?
246
00:09:30,278 --> 00:09:34,990
A lot of people were hurt
at the festival.
247
00:09:34,991 --> 00:09:37,618
I need to use the bathroom.
248
00:09:37,619 --> 00:09:41,121
- I told him to use the sink.
- What is wrong with you?
249
00:09:41,122 --> 00:09:42,956
Would you rather
I take him out there?
250
00:09:42,957 --> 00:09:46,126
Hang on.
I'll be right back, okay?
251
00:09:46,127 --> 00:09:48,713
[door opens, closes]
252
00:09:52,842 --> 00:09:55,469
Here.
253
00:09:55,470 --> 00:09:57,638
- What's that?
- It's a urinal.
254
00:09:57,639 --> 00:10:01,309
- You pee in it.
- I think I'll just hold it in.
255
00:10:04,396 --> 00:10:06,772
Pull out.
I found a 4 blade.
256
00:10:06,773 --> 00:10:09,566
This is better.
257
00:10:09,567 --> 00:10:10,984
Shit.
258
00:10:10,985 --> 00:10:13,570
I lost the light.
The battery must be dead.
259
00:10:13,571 --> 00:10:15,322
This one's dead, too.
260
00:10:15,323 --> 00:10:17,491
Anybody have a laryngoscope
with a light that still works?
261
00:10:17,492 --> 00:10:18,992
- We will check.
- Check quick.
262
00:10:18,993 --> 00:10:20,494
This guy's paralytics
are wearing off.
263
00:10:20,495 --> 00:10:22,079
Keep bagging.
Give me a 7.0 ET tube.
264
00:10:22,080 --> 00:10:23,455
He's a big guy.
He needs an 8.
265
00:10:23,456 --> 00:10:25,165
- Not for this.
- Number 7.
266
00:10:25,166 --> 00:10:28,752
- What are you doing?
- Tactile intubation.
267
00:10:28,753 --> 00:10:32,506
My index finger goes
into the vallecula.
268
00:10:32,507 --> 00:10:36,510
And my middle finger will guide
the tube past the epiglottis.
269
00:10:36,511 --> 00:10:38,011
But if you hit the esophagus,
he's toast.
270
00:10:38,012 --> 00:10:39,555
You told us never to pass
a tube unless we see
271
00:10:39,556 --> 00:10:41,682
- the vocal cords.
- Correct. Not today.
272
00:10:41,683 --> 00:10:43,308
If I stay in the midline,
273
00:10:43,309 --> 00:10:45,519
I should be able to get it
past the cords.
274
00:10:45,520 --> 00:10:47,354
Okay.
275
00:10:47,355 --> 00:10:50,524
Balloon up.
Bag him.
276
00:10:50,525 --> 00:10:53,360
- Looks good on the end-tidal.
- Slick move, boss.
277
00:10:53,361 --> 00:10:54,903
No pulse.
Start compressions.
278
00:10:54,904 --> 00:10:56,322
OK. Get him up.
279
00:10:59,534 --> 00:11:01,368
Try to get him back
with two liters.
280
00:11:01,369 --> 00:11:03,996
That is as much
as we can afford per patient.
281
00:11:03,997 --> 00:11:06,123
Leg is too slow; upper arm is
five times as fast.
282
00:11:06,124 --> 00:11:08,375
Best that we can do.
Keep at it. We'll get him back.
283
00:11:08,376 --> 00:11:10,462
Robby, need help here!
284
00:11:12,589 --> 00:11:14,214
- Langdon!
- Keep squeezing.
285
00:11:14,215 --> 00:11:17,343
[indistinct chatter]
286
00:11:19,888 --> 00:11:21,472
How are you making out?
287
00:11:21,473 --> 00:11:23,807
[sighs] Lots of emails
and photos coming in
288
00:11:23,808 --> 00:11:25,350
from concerned families.
289
00:11:25,351 --> 00:11:26,727
It'll be easier
once they've entered
290
00:11:26,728 --> 00:11:28,312
every patient's MCI number.
291
00:11:28,313 --> 00:11:30,314
Here we go.
Look familiar?
292
00:11:30,315 --> 00:11:32,316
MCI-7.
293
00:11:32,317 --> 00:11:34,067
His name is Vincent Rivera.
294
00:11:34,068 --> 00:11:36,403
He must have had friends
or family in the cafeteria
295
00:11:36,404 --> 00:11:38,447
who sent in the photo.
296
00:11:38,448 --> 00:11:41,075
I'll text them we're coming.
297
00:11:43,119 --> 00:11:45,245
- What are you doing?
- Giving this guy a chance.
298
00:11:45,246 --> 00:11:47,539
He needs a big central line
for fast transfusion.
299
00:11:47,540 --> 00:11:49,249
You can't do an IJ
without an ultrasound,
300
00:11:49,250 --> 00:11:51,043
- especially on a guy this big.
- You'll kill him
301
00:11:51,044 --> 00:11:52,711
if you collapse a lung
or hit the carotid.
302
00:11:52,712 --> 00:11:54,087
I'm not doing an IJ.
303
00:11:54,088 --> 00:11:56,256
Unhook that blood line.
Bring it up here.
304
00:11:56,257 --> 00:12:00,761
This is a supraclavicular
subclavian.
305
00:12:00,762 --> 00:12:02,262
If you have to go in blind,
306
00:12:02,263 --> 00:12:05,682
this is the only safe way
to access a giant vein.
307
00:12:05,683 --> 00:12:09,269
And hold compressions.
308
00:12:09,270 --> 00:12:11,063
A centimeter
309
00:12:11,064 --> 00:12:14,274
from the lateral head
of the sternocleidomastoid,
310
00:12:14,275 --> 00:12:16,610
a centimeter off the clavicle,
311
00:12:16,611 --> 00:12:20,615
aiming
at the contralateral nipple.
312
00:12:22,534 --> 00:12:23,952
I'm in.
313
00:12:25,787 --> 00:12:28,872
Okay, resume compressions.
314
00:12:28,873 --> 00:12:31,584
And squeeze blood.
315
00:12:32,669 --> 00:12:34,795
- Where'd you learn that?
- "EM: RAP" podcast.
316
00:12:34,796 --> 00:12:37,297
We'll be ready for a second
unit in under a minute.
317
00:12:37,298 --> 00:12:39,007
Boom.
318
00:12:39,008 --> 00:12:42,177
Okay, not too much blood
on your dressing, Mr. Grayson.
319
00:12:42,178 --> 00:12:44,137
You're looking good.
320
00:12:44,138 --> 00:12:46,515
Mr. Grayson?
Hey, Mr. Grayson!
321
00:12:46,516 --> 00:12:47,850
Oh.
322
00:12:47,851 --> 00:12:49,852
Oh, I must've dozed off.
323
00:12:49,853 --> 00:12:51,603
This is like a bad dream.
324
00:12:51,604 --> 00:12:54,314
- Yeah, no kidding.
- [exhales deeply]
325
00:12:54,315 --> 00:12:57,985
You, um... did you happen
to see who shot you?
326
00:12:57,986 --> 00:12:59,653
No.
327
00:12:59,654 --> 00:13:01,822
But I heard the shots.
328
00:13:01,823 --> 00:13:05,701
They just kept coming,
gunshots and screaming.
329
00:13:05,702 --> 00:13:07,828
I'm never gonna get that
out of my head.
330
00:13:07,829 --> 00:13:09,997
GSW to the right
inguinal region.
331
00:13:09,998 --> 00:13:11,123
Yeah.
332
00:13:11,124 --> 00:13:13,667
Uh, hi, I'm Dr. Whitaker.
333
00:13:13,668 --> 00:13:15,127
Carmen.
334
00:13:15,128 --> 00:13:16,628
It's, uh, nice to meet you.
335
00:13:16,629 --> 00:13:17,671
Uh...
336
00:13:17,672 --> 00:13:19,923
I'm just gonna take this.
337
00:13:19,924 --> 00:13:21,341
Okay.
338
00:13:21,342 --> 00:13:24,469
- How's the pain?
- I can handle it.
339
00:13:24,470 --> 00:13:26,430
Okay.
340
00:13:26,431 --> 00:13:28,932
What does this..."tem-bleek"?
What does that mean?
341
00:13:28,933 --> 00:13:31,685
Tembleque... it's a coconut
pudding from Puerto Rico.
342
00:13:31,686 --> 00:13:34,354
We top it off
with canela... cinnamon.
343
00:13:34,355 --> 00:13:36,481
Okay, wow.
So you got a food truck?
344
00:13:36,482 --> 00:13:39,151
- Just a folding table for now.
- Pedal pulses are strong.
345
00:13:39,152 --> 00:13:40,736
Okay, let's start
with antibiotics, pain meds,
346
00:13:40,737 --> 00:13:42,362
and let's try to stop
this bleeding.
347
00:13:42,363 --> 00:13:44,364
- [whimpers]
- Okay.
348
00:13:44,365 --> 00:13:45,741
Here we go.
349
00:13:45,742 --> 00:13:47,701
Okay, uh, could you take over?
350
00:13:47,702 --> 00:13:49,036
Thank you, thank you, thank you.
351
00:13:49,037 --> 00:13:51,580
Hey, hey, hey.
352
00:13:51,581 --> 00:13:54,374
Inguinal GSW
with active bleeding.
353
00:13:54,375 --> 00:13:56,168
Um, try an Israeli bandage.
354
00:13:56,169 --> 00:13:58,754
What if it bleeds through?
It's at the top of the leg.
355
00:13:58,755 --> 00:14:01,048
There's no room for
a tourniquet above the wound.
356
00:14:01,049 --> 00:14:05,052
Well, let's just hope
the hemostatic bandage works.
357
00:14:05,053 --> 00:14:06,929
Okay.
358
00:14:06,930 --> 00:14:08,931
Coming in.
Good.
359
00:14:08,932 --> 00:14:11,058
Hey, so...
360
00:14:11,059 --> 00:14:12,392
coconut.
361
00:14:12,393 --> 00:14:14,144
Love coconut.
[both chuckle]
362
00:14:14,145 --> 00:14:17,899
[indistinct chatter]
363
00:14:20,443 --> 00:14:22,027
- Kiara?
- Yes.
364
00:14:22,028 --> 00:14:23,695
This is Lupe.
365
00:14:23,696 --> 00:14:25,989
Whitney. You texted me.
366
00:14:25,990 --> 00:14:27,866
Let's take a walk over here.
367
00:14:27,867 --> 00:14:29,993
Can you tell us
your husband's name?
368
00:14:29,994 --> 00:14:31,746
Vincent Rivera.
369
00:14:33,247 --> 00:14:35,832
We're gonna show you
some photos.
370
00:14:35,833 --> 00:14:38,418
Can you tell us
if this is Vincent?
371
00:14:38,419 --> 00:14:41,297
- He's not talking?
- No, he's not.
372
00:14:45,259 --> 00:14:46,969
Yes, that's Vincent.
373
00:14:46,970 --> 00:14:49,304
Can I see him?
374
00:14:49,305 --> 00:14:52,224
Vincent had a gunshot
to the head.
375
00:14:52,225 --> 00:14:54,226
When he arrived here,
376
00:14:54,227 --> 00:14:57,355
there was no pulse or breathing.
377
00:14:59,273 --> 00:15:01,900
My husband is dead?
378
00:15:01,901 --> 00:15:04,111
- I'm so sorry.
- We're sorry.
379
00:15:04,112 --> 00:15:05,988
[crying]
What about my brother, Brian?
380
00:15:05,989 --> 00:15:08,281
Vincent and Brian went
to the festival together.
381
00:15:08,282 --> 00:15:09,783
Is my brother okay?
382
00:15:09,784 --> 00:15:11,118
Can you send us
his name and photo?
383
00:15:11,119 --> 00:15:12,786
I did.
384
00:15:12,787 --> 00:15:15,372
Okay, well, as of now,
he's not one of our fatalities.
385
00:15:15,373 --> 00:15:17,791
Do you have some relatives
or friends we can call
386
00:15:17,792 --> 00:15:19,960
to come be with you?
387
00:15:19,961 --> 00:15:22,921
[crying]
388
00:15:22,922 --> 00:15:25,341
Our kids are with my parents.
389
00:15:29,512 --> 00:15:31,304
[sobs]
390
00:15:31,305 --> 00:15:34,558
- Second unit's in.
- Holding compressions.
391
00:15:34,559 --> 00:15:36,893
- Carotid pulse... you feeling it?
- I'm feeling it.
392
00:15:36,894 --> 00:15:38,729
He goes right up to pre-op.
393
00:15:38,730 --> 00:15:40,647
Let's go. Let's go.
I need some help over here!
394
00:15:40,648 --> 00:15:43,191
Hey.
Not a person of interest.
395
00:15:43,192 --> 00:15:45,027
Jewelry store owner, no priors.
396
00:15:45,028 --> 00:15:46,528
He's not our shooter.
397
00:15:46,529 --> 00:15:49,281
- You guys good in here?
- We got this.
398
00:15:49,282 --> 00:15:50,991
Take a two-hour lunch.
399
00:15:50,992 --> 00:15:52,617
I'm gonna go check on triage.
400
00:15:52,618 --> 00:15:54,661
We'll save a spot for you.
401
00:15:54,662 --> 00:15:55,996
Yellow gets a wheelchair.
402
00:15:55,997 --> 00:15:57,497
Hey, Ahmad,
what number are we up to?
403
00:15:57,498 --> 00:16:00,208
- 85 patients so far.
- Need a gurney for pink.
404
00:16:00,209 --> 00:16:02,711
- How are you guys doing?
- Still going strong.
405
00:16:02,712 --> 00:16:04,713
- Not bad, I guess.
- You guys are triaging great.
406
00:16:04,714 --> 00:16:06,173
Believe me.
This is not easy.
407
00:16:06,174 --> 00:16:07,632
Not everybody can pull this off.
408
00:16:07,633 --> 00:16:09,009
Is this your half-time
locker room speech?
409
00:16:09,010 --> 00:16:10,302
Yeah, possibly.
410
00:16:10,303 --> 00:16:11,678
Are we winning
or losing the game?
411
00:16:11,679 --> 00:16:14,473
Too soon to tell.
412
00:16:14,474 --> 00:16:16,183
Come on, these heads have
to be up 30 degrees.
413
00:16:16,184 --> 00:16:18,101
- Let's go.
- Got four back here.
414
00:16:18,102 --> 00:16:19,686
[distant sirens wailing]
415
00:16:19,687 --> 00:16:22,314
Through and through the head.
416
00:16:22,315 --> 00:16:24,149
No pulse. Black and white.
417
00:16:24,150 --> 00:16:27,027
Pink zone. Strong pulse.
Unresponsive, no obvious GSW.
418
00:16:27,028 --> 00:16:28,820
Red zone, GSW left chest.
419
00:16:28,821 --> 00:16:30,363
She was talking
when we first got in the truck.
420
00:16:30,364 --> 00:16:32,532
- [tires squeal]
- Weak carotid, unresponsive.
421
00:16:32,533 --> 00:16:33,784
There... there was
so much blood.
422
00:16:33,785 --> 00:16:36,953
- I tried to stop it.
- Jake!
423
00:16:36,954 --> 00:16:39,706
Robby! Leah got shot!
It's really bad!
424
00:16:39,707 --> 00:16:43,668
[helicopter blades whirring
overhead]
425
00:16:43,669 --> 00:16:45,545
I've been putting pressure
on the wound the whole time.
426
00:16:45,546 --> 00:16:46,880
Yeah, that's good.
That's good.
427
00:16:46,881 --> 00:16:48,381
- Are you shot?
- I don't... maybe my leg.
428
00:16:48,382 --> 00:16:50,050
Most of this is her blood.
429
00:16:50,051 --> 00:16:52,552
- Somebody you know, boss?
- Yeah.
430
00:16:52,553 --> 00:16:54,221
- You got this?
- Yeah.
431
00:16:54,222 --> 00:16:56,723
Okay, come on, let's go.
Let's go. I got you. Come on.
432
00:16:56,724 --> 00:16:58,558
Ready? Pull.
433
00:16:58,559 --> 00:17:01,646
[distant wailing continues]
434
00:17:05,274 --> 00:17:08,360
- Jake, you can't stay with her.
- I have to.
435
00:17:08,361 --> 00:17:10,278
There's no room, and we need
to work on Leah right now,
436
00:17:10,279 --> 00:17:11,404
and you need to get
your leg checked,
437
00:17:11,405 --> 00:17:12,906
so please go sit down.
438
00:17:12,907 --> 00:17:14,116
Please come tell me
how she's doing, okay?
439
00:17:14,117 --> 00:17:17,077
- Please?
- I will.
440
00:17:17,078 --> 00:17:19,329
- Jake?
- I-I'm okay.
441
00:17:19,330 --> 00:17:21,332
Leah's with Robby.
442
00:17:42,436 --> 00:17:44,855
- Can't feel carotid.
- Start compressions.
443
00:17:44,856 --> 00:17:46,189
Swap out with me.
444
00:17:46,190 --> 00:17:48,900
I need an IO.
Hang a unit of O-neg.
445
00:17:48,901 --> 00:17:50,777
Got the IO.
446
00:17:50,778 --> 00:17:52,571
- Leah?
- Yeah.
447
00:17:52,572 --> 00:17:55,615
- You need help over there?
- No, we're good.
448
00:17:55,616 --> 00:17:58,493
- That's Jake's girlfriend.
- Oh, shit.
449
00:17:58,494 --> 00:18:02,289
- Who's Jake?
- It's, like, Robby's stepson.
450
00:18:02,290 --> 00:18:03,915
I'll be right with you, sir.
451
00:18:03,916 --> 00:18:05,792
My mom would be very happy.
452
00:18:05,793 --> 00:18:07,627
She always says,
wear clean underwear
453
00:18:07,628 --> 00:18:10,589
in case you end up
in the hospital.
454
00:18:10,590 --> 00:18:13,466
Just let us know if anything
is too uncomfortable.
455
00:18:13,467 --> 00:18:15,844
- It's okay.
- This needs to be tighter.
456
00:18:15,845 --> 00:18:17,846
You bled through
the last one pretty fast.
457
00:18:17,847 --> 00:18:21,099
Try a 180-degree twist.
It'll put more pressure.
458
00:18:21,100 --> 00:18:22,434
Got it.
459
00:18:22,435 --> 00:18:24,102
I usually faint
when my blood gets drawn.
460
00:18:24,103 --> 00:18:25,729
Must be all
the adrenaline today.
461
00:18:25,730 --> 00:18:27,147
Whitaker?
462
00:18:27,148 --> 00:18:28,899
Old hippie's looking
pretty out of it.
463
00:18:28,900 --> 00:18:31,318
No, he's sleeping.
464
00:18:31,319 --> 00:18:34,738
- No response to pain.
- Shit.
465
00:18:34,739 --> 00:18:37,490
Uh, Mr. Grayson.
Mr. Grayson.
466
00:18:37,491 --> 00:18:39,409
Could be a delayed head bleed.
467
00:18:39,410 --> 00:18:41,745
He's gonna need a head CT.
468
00:18:41,746 --> 00:18:44,831
He's not getting one
anytime soon.
469
00:18:44,832 --> 00:18:46,750
Equal and reactive.
No blown pupil.
470
00:18:46,751 --> 00:18:50,837
- Santos, go get an attending.
- I'll try, but no promises.
471
00:18:50,838 --> 00:18:53,048
Excuse me.
I think I'm still bleeding.
472
00:18:53,049 --> 00:18:55,176
I'll be with you in a minute.
473
00:18:57,220 --> 00:18:59,180
Pleur-evac ready.
Here you go.
474
00:19:01,891 --> 00:19:04,184
Princess, take over as primary.
475
00:19:04,185 --> 00:19:07,062
- What about Bridget?
- She's stuck in yellow.
476
00:19:07,063 --> 00:19:09,898
- Mel needs an attending.
- Find somebody who's free.
477
00:19:09,899 --> 00:19:11,733
- Let's get blood.
- Dr. Abbot, can you come...
478
00:19:11,734 --> 00:19:13,568
Gonna be a minute.
479
00:19:13,569 --> 00:19:15,904
- Dr. Walsh.
- Taking one up to the OR.
480
00:19:15,905 --> 00:19:18,031
Okay.
481
00:19:18,032 --> 00:19:20,408
Hey, I need a portable
pulse ox for Mr. Grayson.
482
00:19:20,409 --> 00:19:23,119
Here you go.
483
00:19:23,120 --> 00:19:25,121
Hey, what happened to the kid
in the wheelchair
484
00:19:25,122 --> 00:19:26,706
with the bloody right leg?
485
00:19:26,707 --> 00:19:29,000
No idea.
486
00:19:29,001 --> 00:19:31,544
Pinpoint pupils...
probable OD.
487
00:19:31,545 --> 00:19:33,046
Blood on his clothes wasn't his.
488
00:19:33,047 --> 00:19:35,632
- I'll grab some Narcan.
- Sublingual injection.
489
00:19:35,633 --> 00:19:36,883
Okay here?
490
00:19:36,884 --> 00:19:39,135
Uh, looks like
a opioid overdose.
491
00:19:39,136 --> 00:19:40,513
How's Robby with Leah?
492
00:19:42,223 --> 00:19:45,976
If this guy doesn't wake up,
we'll check for occult trauma.
493
00:19:45,977 --> 00:19:47,978
1,400 of blood out the chest.
First unit's in.
494
00:19:47,979 --> 00:19:49,229
Squeeze in a second unit fast,
495
00:19:49,230 --> 00:19:50,897
and then we'll do
another pulse check.
496
00:19:50,898 --> 00:19:53,066
- She's needs a second line?
- For FFP and platelets.
497
00:19:53,067 --> 00:19:54,609
You sure, Robby?
498
00:19:54,610 --> 00:19:57,070
Sophie, get the plasma.
499
00:19:57,071 --> 00:19:58,863
I'm gonna take over
compressions.
500
00:19:58,864 --> 00:20:00,907
And swap.
501
00:20:00,908 --> 00:20:02,742
Social worker
to the south corridor.
502
00:20:02,743 --> 00:20:04,537
Social worker
to the south corridor.
503
00:20:12,003 --> 00:20:14,754
Jamie, wheelchair.
504
00:20:14,755 --> 00:20:16,214
You can't be in here.
505
00:20:16,215 --> 00:20:17,257
They're working
on my girlfriend.
506
00:20:17,258 --> 00:20:18,925
I need to see what's going on.
507
00:20:18,926 --> 00:20:20,385
What's going on is,
you're losing a lot of blood.
508
00:20:20,386 --> 00:20:21,803
You're gonna pass out
if we don't stop it.
509
00:20:21,804 --> 00:20:23,138
No, I'm not moving, man!
Leave me alone!
510
00:20:23,139 --> 00:20:24,556
Jake,
get in the damn wheelchair.
511
00:20:24,557 --> 00:20:26,350
- No!
- Now! Go!
512
00:20:28,101 --> 00:20:30,102
[gasps]
513
00:20:30,103 --> 00:20:32,396
[shouting]
514
00:20:32,397 --> 00:20:35,774
Welcome back, sir.
You're in the ER at PTMC.
515
00:20:35,775 --> 00:20:38,610
- What's your name?
- [gasps] Martin.
516
00:20:38,611 --> 00:20:41,780
What'd you take, Martin?
You overdosed at Pitt Fest.
517
00:20:41,781 --> 00:20:43,282
I took one Percocet
so I could dance.
518
00:20:43,283 --> 00:20:44,867
I've got a bad knee.
519
00:20:44,868 --> 00:20:46,785
- Where'd you get the pill?
- [sighs] From a friend.
520
00:20:46,786 --> 00:20:48,454
Okay, while you were
overdosing from the fentanyl
521
00:20:48,455 --> 00:20:50,956
in a fake pill, there was
a mass shooting at Pitt Fest.
522
00:20:50,957 --> 00:20:53,250
- What?
- Hey, Samira,
523
00:20:53,251 --> 00:20:54,793
see if you can go help Mel
in the yellow zone.
524
00:20:54,794 --> 00:20:56,795
Take my new friend
Martin with you.
525
00:20:56,796 --> 00:20:59,299
Javadi, roll with me.
526
00:21:02,427 --> 00:21:05,304
[breathing heavily]
527
00:21:05,305 --> 00:21:06,847
Two units packed cells in.
528
00:21:06,848 --> 00:21:09,516
- FFP still going?
- Almost there.
529
00:21:09,517 --> 00:21:12,811
Okay, holding compressions.
530
00:21:12,812 --> 00:21:14,688
Can't feel carotid.
531
00:21:14,689 --> 00:21:15,981
No femoral.
532
00:21:15,982 --> 00:21:18,150
Resuming compressions.
533
00:21:18,151 --> 00:21:21,195
- What's your next move, boss?
- Platelets, another unit.
534
00:21:21,196 --> 00:21:22,946
And then we can transfuse her
with her own blood
535
00:21:22,947 --> 00:21:24,823
from the Pleur-evac
to get ahead.
536
00:21:24,824 --> 00:21:26,450
Hang the cell saver.
537
00:21:26,451 --> 00:21:28,243
- Squeeze all this in?
- No.
538
00:21:28,244 --> 00:21:29,953
Three-way stopcock
on a 60-cc syringe.
539
00:21:29,954 --> 00:21:31,330
- I'll push-pull.
- Okay.
540
00:21:31,331 --> 00:21:33,917
Not exactly in our
mass casualty game plan.
541
00:21:37,337 --> 00:21:39,463
I tried.
No attendings available.
542
00:21:39,464 --> 00:21:40,839
Okay.
543
00:21:40,840 --> 00:21:44,426
[indistinct chatter]
544
00:21:44,427 --> 00:21:46,011
All right.
545
00:21:46,012 --> 00:21:48,013
Okay, those look
pretty superficial.
546
00:21:48,014 --> 00:21:50,432
Might've been fragments
from a ricochet off the ground.
547
00:21:50,433 --> 00:21:53,268
Lost a lot of blood,
but you're gonna be okay, bro.
548
00:21:53,269 --> 00:21:54,978
It's not bad. Just put me
back in the wheelchair.
549
00:21:54,979 --> 00:21:56,522
No, no, stay in bed
with your leg up.
550
00:21:56,523 --> 00:21:57,898
We don't want you
oozing to death.
551
00:21:57,899 --> 00:21:59,400
Samira, what you got?
552
00:21:59,401 --> 00:22:00,984
Opiate OD
needs observation after Narcan.
553
00:22:00,985 --> 00:22:02,569
Ugh, boring.
No, thank you.
554
00:22:02,570 --> 00:22:04,363
Mel, how's Ganja Grayson?
555
00:22:04,364 --> 00:22:08,200
Um, we can put him in pink
while he waits for ICU.
556
00:22:08,201 --> 00:22:10,370
Okay, one second.
557
00:22:11,913 --> 00:22:14,706
- What are you doing?
- I'm checking the retina.
558
00:22:14,707 --> 00:22:17,042
- For detachment?
- For intracranial pressure
559
00:22:17,043 --> 00:22:19,753
by measuring the optic nerve
sheath, which is...
560
00:22:19,754 --> 00:22:21,338
holy shit... 10 millimeters.
561
00:22:21,339 --> 00:22:23,215
- What's normal? 5?
- Yeah, 5.
562
00:22:23,216 --> 00:22:24,591
It's an intracranial bleed.
563
00:22:24,592 --> 00:22:25,926
The pressure's been building up.
564
00:22:25,927 --> 00:22:27,553
- There's no blown pupil.
- Yeah, not yet.
565
00:22:27,554 --> 00:22:29,471
But if he keeps bleeding
in his skull, he's gonna die.
566
00:22:29,472 --> 00:22:32,558
Yeah, he needs a one-inch,
uh, burr hole in his...
567
00:22:32,559 --> 00:22:34,017
with a cranial drill.
568
00:22:34,018 --> 00:22:35,727
I'm just gonna see
if Neurosurgery's here.
569
00:22:35,728 --> 00:22:38,480
We don't have time
to wait for Neuro.
570
00:22:38,481 --> 00:22:40,858
I got Betadine
and a 10-cc syringe.
571
00:22:40,859 --> 00:22:42,317
Should we intubate, hyperventilate?
572
00:22:42,318 --> 00:22:44,570
Mannitol decreases ICP.
573
00:22:44,571 --> 00:22:45,904
[drill whirring]
574
00:22:45,905 --> 00:22:48,157
- Holy shit!
- What the hell?
575
00:22:48,158 --> 00:22:49,992
[drill thuds]
576
00:22:49,993 --> 00:22:52,244
Relieving intracranial pressure
577
00:22:52,245 --> 00:22:53,829
so he doesn't die.
578
00:22:53,830 --> 00:22:56,748
With an IO drill?
579
00:22:56,749 --> 00:22:58,083
That's sick.
580
00:22:58,084 --> 00:22:59,543
I get the next one.
581
00:22:59,544 --> 00:23:02,213
Long as it's not on me.
582
00:23:05,216 --> 00:23:06,884
Dana, is Neurosurgery down here?
583
00:23:06,885 --> 00:23:08,927
Ask Princess.
584
00:23:08,928 --> 00:23:10,929
- Princess...
- Cardiothoracic ICU.
585
00:23:10,930 --> 00:23:13,390
- I need a neurosurgeon.
- They're all in the OR.
586
00:23:13,391 --> 00:23:16,101
Dr. Walsh, I have an epidural
in the north corridor
587
00:23:16,102 --> 00:23:17,269
with an elevated ICP.
588
00:23:17,270 --> 00:23:18,937
Is there a blown pupil?
589
00:23:18,938 --> 00:23:21,315
No, but a 10-millimeter
optic sheath on the ultrasound.
590
00:23:21,316 --> 00:23:23,234
We need a burr hole.
591
00:23:25,570 --> 00:23:27,446
What the fuck?
592
00:23:27,447 --> 00:23:29,490
Draining the ICH with an EZ-IO.
593
00:23:29,491 --> 00:23:31,283
40 cc's out so far.
594
00:23:31,284 --> 00:23:33,744
- Like she said, what the fuck?
- There was a case report
595
00:23:33,745 --> 00:23:35,746
in the 2022 "Journal
of Emergency Medicine."
596
00:23:35,747 --> 00:23:37,456
Patient survive?
597
00:23:37,457 --> 00:23:39,124
Went home neurologically intact.
598
00:23:39,125 --> 00:23:40,876
The optic sheath
is back to normal.
599
00:23:40,877 --> 00:23:42,878
Starting purposeful movements.
600
00:23:42,879 --> 00:23:45,589
- Ready to intubate.
- Propofol, rock, and mannitol.
601
00:23:45,590 --> 00:23:47,966
I'll let Neurosurgery know.
We'll get him up ASAP.
602
00:23:47,967 --> 00:23:50,385
- Incredible save.
- If he lives.
603
00:23:50,386 --> 00:23:53,597
- Third unit's in.
- Okay, pulse check.
604
00:23:53,598 --> 00:23:56,141
[grunting]
605
00:23:56,142 --> 00:23:57,893
I think I'm feeling a femoral.
606
00:23:57,894 --> 00:23:59,478
I got a carotid.
607
00:23:59,479 --> 00:24:01,605
Emery, I got a chest case,
needs to go to the OR.
608
00:24:01,606 --> 00:24:03,482
I saw you doing CPR
on this girl.
609
00:24:03,483 --> 00:24:04,816
Two liters out
of the left chest.
610
00:24:04,817 --> 00:24:06,693
Got a pulse back
after three packed cells.
611
00:24:06,694 --> 00:24:09,155
600 out of the cell saver,
2 of FFP.
612
00:24:12,992 --> 00:24:15,160
- I'm not feeling it.
- Check the carotid.
613
00:24:15,161 --> 00:24:18,289
[indistinct chatter]
614
00:24:19,624 --> 00:24:22,501
- Nothing. Sorry.
- Resume compressions.
615
00:24:22,502 --> 00:24:24,378
No, no, we should take her up.
She just had a pulse.
616
00:24:24,379 --> 00:24:26,296
Not now. We need a pulse
to go to the OR.
617
00:24:26,297 --> 00:24:28,465
- Call me if anything changes.
- Got a Pink coming in.
618
00:24:28,466 --> 00:24:30,050
Do we have any more
whole blood from the donors?
619
00:24:30,051 --> 00:24:31,343
- Think so.
- Okay, get another unit
620
00:24:31,344 --> 00:24:32,553
that's got platelets and plasma.
621
00:24:32,554 --> 00:24:35,347
- It'll help her clot.
- Got it.
622
00:24:35,348 --> 00:24:37,015
Four units.
623
00:24:37,016 --> 00:24:38,684
Blood is for the ones
we can save.
624
00:24:38,685 --> 00:24:40,352
She is right on the edge.
625
00:24:40,353 --> 00:24:42,313
One more can make
the difference.
626
00:24:46,776 --> 00:24:48,111
I'm in.
627
00:24:50,780 --> 00:24:52,447
Uh, end-tidal looks good.
628
00:24:52,448 --> 00:24:54,199
Okay, OR team can take it
from here.
629
00:24:54,200 --> 00:24:55,826
We need to check on the others.
630
00:24:55,827 --> 00:24:57,996
- I should get back to Pink.
- Stay strong, Crash.
631
00:24:59,539 --> 00:25:01,873
Uh, hemostatic bandage
still in place.
632
00:25:01,874 --> 00:25:04,501
- How you doing, Carmen?
- Not so great.
633
00:25:04,502 --> 00:25:07,337
Okay, let's see.
634
00:25:07,338 --> 00:25:09,756
- Looks arterial.
- Agreed.
635
00:25:09,757 --> 00:25:11,425
Can you stop it?
636
00:25:11,426 --> 00:25:14,553
- Uh, direct pressure for now.
- Yeah.
637
00:25:14,554 --> 00:25:16,430
We may have
a junctional tourniquet
638
00:25:16,431 --> 00:25:17,931
in the disaster supplies.
639
00:25:17,932 --> 00:25:19,600
Can you get that?
Cool.
640
00:25:19,601 --> 00:25:21,184
Um...
641
00:25:21,185 --> 00:25:22,769
Whitaker, in the meantime,
just put pressure on it.
642
00:25:22,770 --> 00:25:24,730
- Try and stop the bleeding.
- For how long?
643
00:25:24,731 --> 00:25:26,607
As long as it takes.
644
00:25:26,608 --> 00:25:28,900
- He bled through his Kerlix.
- Um...
645
00:25:28,901 --> 00:25:31,069
elastic... elastic
pressure dressing.
646
00:25:31,070 --> 00:25:33,238
- Yep.
- Okay, got it.
647
00:25:33,239 --> 00:25:35,574
All right.
648
00:25:35,575 --> 00:25:38,243
Got a better bandage, and we're
gonna elevate your leg.
649
00:25:38,244 --> 00:25:40,078
Do you know what's happening
with my girlfriend?
650
00:25:40,079 --> 00:25:41,747
Her name is Leah.
She was shot in the chest.
651
00:25:41,748 --> 00:25:43,498
I'm sorry.
We have a ton of patients,
652
00:25:43,499 --> 00:25:45,250
and they're only marked
by number.
653
00:25:45,251 --> 00:25:47,836
Robby and Dana were working
on her... they were doing CPR.
654
00:25:47,837 --> 00:25:49,713
How do you know Robby and Dana?
655
00:25:49,714 --> 00:25:51,423
Robby and my mom were
together for a couple years,
656
00:25:51,424 --> 00:25:54,051
and I would... I would come,
and I'd hang out here.
657
00:25:54,052 --> 00:25:56,511
Well, I'm sure
if they're helping her,
658
00:25:56,512 --> 00:25:58,430
then she's in great hands.
659
00:25:58,431 --> 00:26:00,515
Can you check for me, please?
660
00:26:00,516 --> 00:26:02,894
Sure. Of course.
Just after I finish this.
661
00:26:07,231 --> 00:26:10,150
Well, there's no
additional bleeding.
662
00:26:10,151 --> 00:26:11,902
Strong pulse.
663
00:26:11,903 --> 00:26:15,238
Two grams of Ancef running in.
664
00:26:15,239 --> 00:26:17,033
Can you, uh, spread
your fingers?
665
00:26:19,160 --> 00:26:22,788
Uh, no, like this.
666
00:26:22,789 --> 00:26:25,499
Are you okay?
667
00:26:25,500 --> 00:26:27,292
Found the junctional tourniquet.
668
00:26:27,293 --> 00:26:30,213
Um, okay.
Uh, I'll be right back.
669
00:26:33,966 --> 00:26:36,343
How much blood you pushing
off the cell saver?
670
00:26:36,344 --> 00:26:38,637
Every last drop.
671
00:26:38,638 --> 00:26:40,472
O-neg.
Monitor the pulse.
672
00:26:40,473 --> 00:26:44,227
She's stable for trauma ICU
if an OR's not ready.
673
00:26:54,862 --> 00:26:56,655
How many units so far?
674
00:26:56,656 --> 00:26:59,658
Four, plus the cell saver.
675
00:26:59,659 --> 00:27:02,160
- Last one?
- Getting backed up out there.
676
00:27:02,161 --> 00:27:03,745
I don't know.
677
00:27:03,746 --> 00:27:05,831
Dana, why don't we try
a little TXA?
678
00:27:05,832 --> 00:27:07,624
1,000 milligrams of TXA
might help her clot.
679
00:27:07,625 --> 00:27:09,543
Got it.
680
00:27:09,544 --> 00:27:12,504
Bullet tore through her heart.
681
00:27:12,505 --> 00:27:13,839
Anyone else
with a wound like this
682
00:27:13,840 --> 00:27:15,340
is pronounced dead in the field.
683
00:27:15,341 --> 00:27:16,842
You can't keep up
with the blood loss.
684
00:27:16,843 --> 00:27:18,343
If she was our only patient,
685
00:27:18,344 --> 00:27:20,303
we'd do a thoracotomy,
maybe ECMO.
686
00:27:20,304 --> 00:27:23,015
But even then,
I doubt we'd get her back.
687
00:27:25,268 --> 00:27:26,852
We're gonna lose
ten other patients
688
00:27:26,853 --> 00:27:30,188
if you put all your efforts
into saving this girl.
689
00:27:30,189 --> 00:27:33,692
[indistinct chatter]
690
00:27:33,693 --> 00:27:35,861
Got the TXA.
691
00:27:35,862 --> 00:27:37,070
Okay, push it fast,
692
00:27:37,071 --> 00:27:38,864
and we'll do
another pulse check.
693
00:27:38,865 --> 00:27:41,325
And then can you get me
a vascular Doppler too, please?
694
00:27:45,079 --> 00:27:47,789
GSW to the chest, faint pulse.
695
00:27:47,790 --> 00:27:50,292
Intubation, IO, chest tube,
and a unit of blood.
696
00:27:50,293 --> 00:27:51,376
Copy that.
697
00:27:51,377 --> 00:27:53,044
All nonessential personnel,
698
00:27:53,045 --> 00:27:55,046
please report
to the patient waiting room.
699
00:27:55,047 --> 00:27:56,840
All nonessential personnel,
700
00:27:56,841 --> 00:27:59,217
please report
to the patient waiting room.
701
00:27:59,218 --> 00:28:02,305
[indistinct chatter]
702
00:28:04,056 --> 00:28:05,516
Anything I can do?
703
00:28:08,895 --> 00:28:11,605
You can check on Shen
and Ellis in the ambulance bay.
704
00:28:11,606 --> 00:28:12,857
On it.
705
00:28:17,487 --> 00:28:18,737
Whitaker, lay down
some fresh gauze
706
00:28:18,738 --> 00:28:20,071
so we can assess the hemostasis.
707
00:28:20,072 --> 00:28:22,240
Yep.
How you doing, Carmen?
708
00:28:22,241 --> 00:28:24,242
I'm hanging in there.
709
00:28:24,243 --> 00:28:25,702
You want
the circle of compression
710
00:28:25,703 --> 00:28:27,788
directly over the wound.
711
00:28:27,789 --> 00:28:29,332
Tighten.
712
00:28:31,209 --> 00:28:33,543
Inflate the balloon.
Come on, pump it up, Whittaker.
713
00:28:33,544 --> 00:28:37,214
- Uh, how much pressure?
- Until the bleeding stops.
714
00:28:37,215 --> 00:28:39,049
Uh, excuse me, ma'am.
715
00:28:39,050 --> 00:28:40,926
Ma'am, where are you...
716
00:28:40,927 --> 00:28:42,427
uh, Whittaker, stay on this.
717
00:28:42,428 --> 00:28:45,263
Ma'am? Ma'am?
718
00:28:45,264 --> 00:28:48,016
Do you need something?
719
00:28:48,017 --> 00:28:49,143
Are you...
720
00:28:52,605 --> 00:28:55,106
I need one more O-neg.
721
00:28:55,107 --> 00:28:58,443
Hey, do you have
any O-positive over there?
722
00:28:58,444 --> 00:29:01,571
This guy bled
through his bandage.
723
00:29:01,572 --> 00:29:04,699
All available transport
to the ER immediately.
724
00:29:04,700 --> 00:29:08,245
All available transport
to the ER immediately.
725
00:29:08,246 --> 00:29:10,080
Okay.
726
00:29:10,081 --> 00:29:12,123
Let me just... just put your arm
like that.
727
00:29:12,124 --> 00:29:13,793
Just keep your hand like that.
728
00:29:16,087 --> 00:29:17,462
Just...
729
00:29:17,463 --> 00:29:19,256
- [distant sirens wailing]
- How we doing out here?
730
00:29:19,257 --> 00:29:21,132
Dancing as fast as we can.
731
00:29:21,133 --> 00:29:23,969
Pretty sure I'm past my
union-mandated bathroom break.
732
00:29:23,970 --> 00:29:26,096
I never should have had
that second coffee.
733
00:29:26,097 --> 00:29:28,640
[distant wailing continues]
734
00:29:28,641 --> 00:29:30,976
Hey, son, ER's closed
unless you're injured.
735
00:29:30,977 --> 00:29:33,436
Oh, my mom's inside.
I need to take her home.
736
00:29:33,437 --> 00:29:36,773
- David?
- Mom?
737
00:29:36,774 --> 00:29:39,359
You're the kid?
You need to come with me.
738
00:29:39,360 --> 00:29:41,152
- Hey! Grab him!
- Wait, David! Stop!
739
00:29:41,153 --> 00:29:43,154
- Grab him!
- What are you doing?
740
00:29:43,155 --> 00:29:45,115
- Stay down!
- Don't hurt him!
741
00:29:45,116 --> 00:29:46,408
What the hell's going on?
742
00:29:46,409 --> 00:29:47,659
Four units of packed cells,
743
00:29:47,660 --> 00:29:50,495
two of FFP, 1,000 of TXA...
744
00:29:50,496 --> 00:29:52,956
and 1,200 auto-transfused.
745
00:29:52,957 --> 00:29:55,251
- Did you check this?
- Not yet.
746
00:30:01,257 --> 00:30:03,258
[pulse beating]
747
00:30:03,259 --> 00:30:04,801
Okay, it's working.
Hold compressions.
748
00:30:04,802 --> 00:30:07,889
[pulse beating irregularly]
749
00:30:18,149 --> 00:30:21,067
[tense music]
750
00:30:21,068 --> 00:30:26,531
♪ ♪
751
00:30:26,532 --> 00:30:28,158
Okay, we're done.
752
00:30:28,159 --> 00:30:30,702
[high-pitched ringing]
753
00:30:30,703 --> 00:30:32,622
[machine beeps, flatlines]
754
00:30:34,665 --> 00:30:37,918
We stopped at 19:47.
755
00:30:37,919 --> 00:30:39,045
Hey.
756
00:30:41,213 --> 00:30:42,882
Move her to Pedes?
757
00:30:44,884 --> 00:30:46,593
You want me to go with you
to talk to Jake?
758
00:30:46,594 --> 00:30:48,887
No, no, thanks, I got it.
759
00:30:48,888 --> 00:30:52,515
Jesus Christ.
760
00:30:52,516 --> 00:30:53,975
What's going on?
761
00:30:53,976 --> 00:30:55,560
This is bullshit.
I didn't do anything.
762
00:30:55,561 --> 00:30:57,354
He came back to pick up
his mom... they tackled him.
763
00:30:57,355 --> 00:30:58,730
We need to question him
about the shooting.
764
00:30:58,731 --> 00:30:59,898
Okay.
After we clear him medically.
765
00:30:59,899 --> 00:31:01,399
You know the drill.
766
00:31:01,400 --> 00:31:03,151
He has head trauma...
probable concussion.
767
00:31:03,152 --> 00:31:04,569
Dr. Mohan, why don't we do
a complete neurological exam
768
00:31:04,570 --> 00:31:07,239
in BH-2 and put him
in line for a CT?
769
00:31:10,493 --> 00:31:13,411
We got a Pink coming in.
770
00:31:13,412 --> 00:31:14,829
Where's his mom?
771
00:31:14,830 --> 00:31:18,249
Still outside
talking to the police.
772
00:31:18,250 --> 00:31:20,585
This is fucked up.
I didn't do anything.
773
00:31:20,586 --> 00:31:22,420
Then who shot
all of these people, huh?
774
00:31:22,421 --> 00:31:24,756
I don't know, how about you
go look for him, dumbass?
775
00:31:24,757 --> 00:31:26,591
David, are you all right?
776
00:31:26,592 --> 00:31:28,259
No, man,
I'm fucking far from okay.
777
00:31:28,260 --> 00:31:30,261
Okay, okay, we're gonna
get this straightened out
778
00:31:30,262 --> 00:31:32,138
right now.
779
00:31:32,139 --> 00:31:35,267
[indistinct radio chatter]
780
00:31:43,275 --> 00:31:47,278
I'm still bleeding!
Please. I need something.
781
00:31:47,279 --> 00:31:49,614
No hemotympanum, no head trauma.
782
00:31:49,615 --> 00:31:53,868
Pulse is strong at 72.
O2 sat perfect at 99.
783
00:31:53,869 --> 00:31:57,414
Um, do you need pain medicine?
784
00:31:57,415 --> 00:31:58,623
Ma'am, we're trying to help you.
785
00:31:58,624 --> 00:32:01,335
We just need you to let us know.
786
00:32:03,129 --> 00:32:04,921
Okay, let's try
and find her a gurney
787
00:32:04,922 --> 00:32:06,381
and give her a full neuro exam.
788
00:32:06,382 --> 00:32:08,133
Can you put her in 9?
789
00:32:08,134 --> 00:32:10,301
- Drug overdose?
- No.
790
00:32:10,302 --> 00:32:12,303
Normal pupils, normal pulse.
791
00:32:12,304 --> 00:32:14,472
Brain injury?
792
00:32:14,473 --> 00:32:16,099
No, she was walking
with a steady gait.
793
00:32:16,100 --> 00:32:17,475
Still needs a head CT.
794
00:32:17,476 --> 00:32:18,810
Well, that's not gonna be
for hours.
795
00:32:18,811 --> 00:32:21,146
I could drill EZ-IOs
on both sides.
796
00:32:21,147 --> 00:32:23,857
It worked on the last guy.
797
00:32:23,858 --> 00:32:26,484
Maybe it's PTSD
from all she's seen.
798
00:32:26,485 --> 00:32:27,986
Is Psych even here?
799
00:32:27,987 --> 00:32:29,696
No, but maybe she just needs
a quiet place.
800
00:32:29,697 --> 00:32:32,157
Well, knock yourself out.
801
00:32:32,158 --> 00:32:33,867
What's up, Whitaker?
802
00:32:33,868 --> 00:32:35,827
Junctional tourniquet
appears to be working.
803
00:32:35,828 --> 00:32:37,454
No new blood on the gauze.
804
00:32:37,455 --> 00:32:39,373
You're looking good, Carmen.
805
00:32:41,333 --> 00:32:43,793
Is she... Carmen? Carmen?
806
00:32:43,794 --> 00:32:45,670
Pulse is thready. How long
has she been like this?
807
00:32:45,671 --> 00:32:48,673
She was awake and alert
a minute ago.
808
00:32:48,674 --> 00:32:50,467
All that blood loss
is catching up with her.
809
00:32:50,468 --> 00:32:52,178
Run in a liter wide open.
810
00:32:54,013 --> 00:32:56,806
Uh, huge collection of blood
near the bladder.
811
00:32:56,807 --> 00:32:57,849
The bullet must have
tracked north
812
00:32:57,850 --> 00:32:59,184
and hit the external iliac.
813
00:32:59,185 --> 00:33:00,685
We stopped the bleeding
near the leg,
814
00:33:00,686 --> 00:33:02,520
but she's still bleeding
internally... we need Mel.
815
00:33:02,521 --> 00:33:03,855
No, we need to give
a unit of blood
816
00:33:03,856 --> 00:33:05,190
and move her to the red zone.
817
00:33:05,191 --> 00:33:06,692
Okay, let me see
if they have space.
818
00:33:07,693 --> 00:33:09,819
- Coming through.
- Where's Robby?
819
00:33:09,820 --> 00:33:11,362
In BH-2
with the possible shooter.
820
00:33:11,363 --> 00:33:13,031
Can you guys take a new patient?
821
00:33:13,032 --> 00:33:14,324
Not right now.
What do you got?
822
00:33:14,325 --> 00:33:15,700
Hypotensive pelvic bleed.
823
00:33:15,701 --> 00:33:18,286
Transfuse two units.
We'll get to it.
824
00:33:18,287 --> 00:33:19,704
Abbot!
825
00:33:19,705 --> 00:33:21,498
I got a carotid injury,
popped a clot.
826
00:33:21,499 --> 00:33:22,540
I'll be right there!
827
00:33:22,541 --> 00:33:25,043
Help me out.
828
00:33:25,044 --> 00:33:28,046
- Is that Robby with David?
- Yeah.
829
00:33:28,047 --> 00:33:30,381
I saw the cops bring him in.
830
00:33:30,382 --> 00:33:31,758
Who's David?
831
00:33:31,759 --> 00:33:33,384
High school kid
who was making threats.
832
00:33:33,385 --> 00:33:35,720
- You think he did this?
- Guys, focus on the patients.
833
00:33:35,721 --> 00:33:37,347
What do you got?
834
00:33:37,348 --> 00:33:39,682
Ooh, okay, sterile IV tubing,
umbilical tape,
835
00:33:39,683 --> 00:33:42,769
and red rubber Robinson,
and sterile gloves.
836
00:33:42,770 --> 00:33:45,898
[indistinct radio chatter]
837
00:33:51,904 --> 00:33:53,947
We got a Pink coming in.
838
00:33:53,948 --> 00:33:56,075
Let's take the long way around.
839
00:34:00,996 --> 00:34:02,747
I can put Jake
in the family room.
840
00:34:02,748 --> 00:34:04,415
No, it's okay.
I'll do it.
841
00:34:04,416 --> 00:34:06,000
Defect bypass with IV tubing.
842
00:34:06,001 --> 00:34:08,253
You ever done
a Rummel tourniquet?
843
00:34:08,254 --> 00:34:10,381
Robby, can you help me
with a Rummel?
844
00:34:20,432 --> 00:34:23,435
[indistinct chatter]
845
00:34:26,856 --> 00:34:28,398
Toughest part is getting
the umbilical tape
846
00:34:28,399 --> 00:34:30,233
through the tubing.
847
00:34:30,234 --> 00:34:32,318
And clamps.
848
00:34:32,319 --> 00:34:34,279
- Very cool.
- You guys got this?
849
00:34:34,280 --> 00:34:35,906
Oh, we're good.
850
00:34:46,375 --> 00:34:48,793
Dr. Robby, I have
a retroperitoneal bleed.
851
00:34:48,794 --> 00:34:50,170
- Get Abbot.
- He's busy.
852
00:34:50,171 --> 00:34:52,005
Okay, stabilize
and find a surgeon.
853
00:34:52,006 --> 00:34:53,507
Get in the chair.
854
00:35:03,684 --> 00:35:05,936
Hey, what's going on?
855
00:35:14,236 --> 00:35:17,822
Leah's injuries
were really serious.
856
00:35:17,823 --> 00:35:19,949
She stopped breathing.
857
00:35:19,950 --> 00:35:23,828
We put a tube down her throat
to deliver oxygen.
858
00:35:23,829 --> 00:35:28,541
We were able to drain the blood
that was collapsing her lungs.
859
00:35:28,542 --> 00:35:31,628
We gave her as much blood
as we could.
860
00:35:31,629 --> 00:35:33,671
We even transfused
some of her own blood
861
00:35:33,672 --> 00:35:35,673
that was in her chest.
862
00:35:35,674 --> 00:35:38,468
But we were unable to...
863
00:35:38,469 --> 00:35:41,555
get ahead
of the massive blood loss.
864
00:35:43,432 --> 00:35:45,184
Her heart stopped.
865
00:35:46,518 --> 00:35:48,562
You saw me doing CPR.
866
00:35:50,022 --> 00:35:53,066
[inhales sharply] We did
everything that we could.
867
00:35:53,067 --> 00:35:54,777
She's dead?
868
00:36:01,951 --> 00:36:04,494
[sniffles]
869
00:36:04,495 --> 00:36:06,162
No, no, but I...
'cause I was talk...
870
00:36:06,163 --> 00:36:07,705
I was talking to her
after she got shot,
871
00:36:07,706 --> 00:36:09,499
and she was talking.
872
00:36:09,500 --> 00:36:13,044
Her heart was damaged
beyond repair.
873
00:36:13,045 --> 00:36:16,714
There was nothing
that we could do to save her.
874
00:36:16,715 --> 00:36:18,883
I want to...
I want to see her.
875
00:36:18,884 --> 00:36:20,385
I'm really sorry, man,
but you can't.
876
00:36:20,386 --> 00:36:22,220
Why not?
877
00:36:22,221 --> 00:36:24,722
Because this is an active
police and FBI investigation.
878
00:36:24,723 --> 00:36:26,724
- She's... she's dead.
- I know.
879
00:36:26,725 --> 00:36:28,476
They're gonna release her
to her parents
880
00:36:28,477 --> 00:36:30,520
in a couple days.
881
00:36:30,521 --> 00:36:32,897
No, please, you...
you have to let me see her.
882
00:36:32,898 --> 00:36:34,817
Please, please, please.
883
00:36:37,361 --> 00:36:38,569
Bringing in mail.
884
00:36:38,570 --> 00:36:40,781
- How's she doing?
- Still has a pulse.
885
00:36:44,368 --> 00:36:46,744
- What are you doing?
- Prepping for REBOA.
886
00:36:46,745 --> 00:36:48,746
Are you crazy?
Did Abbot approve this?
887
00:36:48,747 --> 00:36:51,749
He said, do what you have to do.
888
00:36:51,750 --> 00:36:53,376
Attendings are all tied up.
889
00:36:53,377 --> 00:36:55,295
If I can blow up a balloon
in the aorta,
890
00:36:55,296 --> 00:36:57,297
it'll stop the bleeding.
891
00:36:57,298 --> 00:36:59,424
It'll cut off the blood
supply to half her body.
892
00:36:59,425 --> 00:37:03,511
I'll only go in a few inches,
zone three, below the kidneys,
893
00:37:03,512 --> 00:37:05,263
until she gets up to the OR.
894
00:37:05,264 --> 00:37:08,099
Glove up, Huckleberry.
895
00:37:08,100 --> 00:37:10,685
Okay, you're gonna need
an ultrasound, X-ray.
896
00:37:10,686 --> 00:37:12,437
Not today.
897
00:37:12,438 --> 00:37:13,938
Have you done this before?
898
00:37:13,939 --> 00:37:15,440
It's a central line.
899
00:37:15,441 --> 00:37:17,525
I just need to hit
the femoral artery...
900
00:37:17,526 --> 00:37:19,444
like that.
901
00:37:19,445 --> 00:37:21,029
Piece of cake.
902
00:37:21,030 --> 00:37:23,614
All right, guidewire,
then introducer sheath.
903
00:37:23,615 --> 00:37:25,116
Santos is doing a REBOA.
904
00:37:25,117 --> 00:37:27,410
- Oh, no, no, no way.
- Yes way.
905
00:37:27,411 --> 00:37:30,371
Um, no, we need an attending
or a senior resident for that.
906
00:37:30,372 --> 00:37:32,666
Oh, ye of little faith.
907
00:37:34,835 --> 00:37:36,879
Victim identification.
908
00:37:40,341 --> 00:37:42,468
- Are you sure?
- Yes.
909
00:37:51,977 --> 00:37:55,105
- All these people are dead?
- Yeah.
910
00:38:00,069 --> 00:38:02,279
Which one is Leah?
911
00:38:04,406 --> 00:38:07,910
What number do you have
on... on your wrist?
912
00:38:09,661 --> 00:38:11,330
91.
913
00:38:20,589 --> 00:38:22,841
[sighs]
914
00:38:38,273 --> 00:38:40,233
I'm at 15 centimeters
915
00:38:40,234 --> 00:38:43,528
with 5 cc's of saline so far.
916
00:38:43,529 --> 00:38:45,029
A REBOA?
917
00:38:45,030 --> 00:38:47,031
- Are you shitting me?
- I told her to stop.
918
00:38:47,032 --> 00:38:48,908
Uncontrollable bleeding
from a pelvic artery...
919
00:38:48,909 --> 00:38:50,493
no other options.
920
00:38:50,494 --> 00:38:52,078
We need an art line
to know if the BP's up.
921
00:38:52,079 --> 00:38:54,038
We'll go with pulse strength
and mentation.
922
00:38:54,039 --> 00:38:56,332
Carotid's weak.
Radial's barely there.
923
00:38:56,333 --> 00:38:57,583
Another 3 cc's in the balloon.
924
00:38:57,584 --> 00:38:59,001
Injecting.
925
00:38:59,002 --> 00:39:00,670
I'll try for palpable systolic.
926
00:39:00,671 --> 00:39:01,797
Yes, go for it.
927
00:39:05,551 --> 00:39:08,136
Whoa.
Uh, radial's much stronger now.
928
00:39:08,137 --> 00:39:09,887
Lock the balloon.
Check the wound.
929
00:39:09,888 --> 00:39:11,222
Go.
930
00:39:11,223 --> 00:39:14,058
- BP's 110 by palp.
- That'll do.
931
00:39:14,059 --> 00:39:15,685
Yeah, wound's dry.
Barely a trickle.
932
00:39:15,686 --> 00:39:17,728
That's because there's
no blood going to her legs.
933
00:39:17,729 --> 00:39:19,188
Okay, the clock is ticking.
934
00:39:19,189 --> 00:39:20,690
Balloon can stay up
for one hour, tops.
935
00:39:20,691 --> 00:39:22,400
Get IR and Vascular on the case.
936
00:39:22,401 --> 00:39:24,735
- On it.
- [cries]
937
00:39:24,736 --> 00:39:27,071
Hey, hey, hang in there, Carmen.
938
00:39:27,072 --> 00:39:28,865
You're good, okay?
You're good.
939
00:39:28,866 --> 00:39:31,576
Okay, you never should have
done that on your own, ever.
940
00:39:31,577 --> 00:39:32,953
Do you understand?
941
00:39:34,997 --> 00:39:36,414
[whispering]
But that was pretty badass.
942
00:39:36,415 --> 00:39:37,916
You saved her life.
Good job.
943
00:39:43,297 --> 00:39:46,466
[crying]
944
00:39:46,467 --> 00:39:49,719
Did you...
did you call her parents?
945
00:39:49,720 --> 00:39:52,096
They'll give the number
to our social worker,
946
00:39:52,097 --> 00:39:54,599
who will contact them very soon.
947
00:39:54,600 --> 00:39:56,434
I got their daughter killed.
948
00:39:56,435 --> 00:39:58,311
This is not your fault.
949
00:39:58,312 --> 00:40:01,981
[crying]
950
00:40:01,982 --> 00:40:04,317
Why... why couldn't you save her?
951
00:40:04,318 --> 00:40:06,320
I mean, this...
this is what you do.
952
00:40:10,616 --> 00:40:12,283
I tried.
953
00:40:12,284 --> 00:40:14,869
[voice breaking]
I really tried. We all did.
954
00:40:14,870 --> 00:40:16,370
If this had been
any other day, man...
955
00:40:16,371 --> 00:40:17,788
"Had been the other day"?
956
00:40:17,789 --> 00:40:19,207
What the fuck does that mean,
"any other day"?
957
00:40:19,208 --> 00:40:21,126
What, you would've
saved her life?
958
00:40:25,297 --> 00:40:28,132
Yes. No.
I don't know.
959
00:40:28,133 --> 00:40:30,052
I don't... I don't know.
960
00:40:31,845 --> 00:40:33,304
We're getting slammed up there.
961
00:40:33,305 --> 00:40:34,931
We've had dozens
of shooting victims.
962
00:40:34,932 --> 00:40:36,432
You've seen it.
963
00:40:36,433 --> 00:40:39,143
The fact that we've saved
as many people as we have
964
00:40:39,144 --> 00:40:41,604
is a fucking miracle.
965
00:40:41,605 --> 00:40:43,773
But you didn't save Leah.
966
00:40:43,774 --> 00:40:44,982
No.
967
00:40:44,983 --> 00:40:46,776
No, I didn't.
968
00:40:46,777 --> 00:40:48,778
[sniffles]
969
00:40:48,779 --> 00:40:51,197
And I don't know how many
people I've helped today,
970
00:40:51,198 --> 00:40:53,824
but I can tell you every
other person who has died.
971
00:40:53,825 --> 00:40:56,661
[somber music]
972
00:40:56,662 --> 00:41:00,164
♪ ♪
973
00:41:00,165 --> 00:41:01,541
There was a man
named Mr. Spencer,
974
00:41:01,542 --> 00:41:03,042
who died
in front of his children,
975
00:41:03,043 --> 00:41:04,877
and an 18-year-old who...
976
00:41:04,878 --> 00:41:07,004
who was brain dead
from a fentanyl overdose
977
00:41:07,005 --> 00:41:08,798
and a guy with a heart condition
978
00:41:08,799 --> 00:41:11,509
and a little girl who drowned
trying to save her sister.
979
00:41:11,510 --> 00:41:12,802
[sobbing]
And I'm gonna remember Leah
980
00:41:12,803 --> 00:41:14,679
long after you've forgotten her.
981
00:41:14,680 --> 00:41:17,348
Oh, fuck. Oh, fuck.
I'm sorry. I'm sorry.
982
00:41:17,349 --> 00:41:19,308
You got to go, man.
You... you got to go.
983
00:41:19,309 --> 00:41:21,143
You got to go. You got to go.
984
00:41:21,144 --> 00:41:22,687
Wait, Robby.
Robby, wait, wait.
985
00:41:22,688 --> 00:41:24,605
Put him back in his bed, please.
986
00:41:24,606 --> 00:41:27,608
[high-pitched ringing]
987
00:41:27,609 --> 00:41:34,657
♪ ♪
988
00:41:34,658 --> 00:41:37,703
[sobbing]