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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:09,600 --> 00:00:10,794 (MOBILE CHIMING) 2 00:00:10,880 --> 00:00:14,316 AUTOMATED VOICE: Trauma call, attend emergency department. 3 00:00:14,400 --> 00:00:16,436 - Whoa! Bad luck! - Sorry, Billy. 4 00:00:19,240 --> 00:00:21,470 Morning. Full English, please. 5 00:00:21,560 --> 00:00:23,232 (MOBILE CHIMING) 6 00:00:24,000 --> 00:00:26,070 AUTOMATED VOICE: Trauma call, attend emergency department. 7 00:00:26,160 --> 00:00:28,355 - BILLY: That's us, Justin. - Awesome! 8 00:00:31,100 --> 00:00:39,100 Ripped By mstoll 9 00:00:42,200 --> 00:00:43,189 (MOBILE CHIMING) 10 00:00:43,280 --> 00:00:45,316 AUTOMATED VOICE: Trauma call, attend emergency department. 11 00:00:45,400 --> 00:00:47,516 Trauma call, attend emergency department. 12 00:00:51,280 --> 00:00:54,397 You're all right. We're going to take care of you. 13 00:00:54,480 --> 00:00:55,549 Stay calm. 14 00:01:18,400 --> 00:01:19,833 Sorry, early. 15 00:01:21,440 --> 00:01:23,078 - Sorry. - Oh, sorry. 16 00:01:25,680 --> 00:01:27,272 - Hi. - Morning. 17 00:01:27,360 --> 00:01:28,349 Morning. 18 00:01:31,200 --> 00:01:33,714 AUTOMATED VOICE: Major trauma, ETA, one minute. 19 00:01:33,800 --> 00:01:35,597 Major trauma, ETA, one minute. 20 00:01:35,680 --> 00:01:36,669 Thanks, Justin. 21 00:01:44,560 --> 00:01:47,199 - Thanks. Er, Harry. - Fiona. 22 00:01:51,680 --> 00:01:53,352 6, 6.5. 23 00:01:54,680 --> 00:01:56,477 - That's a bit harsh. - Tube. 24 00:01:57,040 --> 00:01:58,029 6.5. 25 00:02:02,480 --> 00:02:04,596 - Hi, everyone. Morning. - JUSTIN: Morning. 26 00:02:14,800 --> 00:02:15,915 Here we go. 27 00:02:20,360 --> 00:02:21,349 (SIGHING) 28 00:02:24,600 --> 00:02:26,591 (THEME SONG PLAYING) 29 00:02:33,400 --> 00:02:34,913 AUTOMATED VOICE: Level six. 30 00:02:35,840 --> 00:02:37,398 Level five. 31 00:02:38,120 --> 00:02:39,519 Level four. 32 00:02:48,160 --> 00:02:49,798 - (COUGHING) - Oh, shit! 33 00:02:50,920 --> 00:02:52,717 Shit! Let's go, let's go! 34 00:02:52,800 --> 00:02:53,869 - Here we go. - Let's go! 35 00:02:53,960 --> 00:02:55,075 Get the door! 36 00:02:55,720 --> 00:02:56,869 Coming through! 37 00:02:58,280 --> 00:03:00,316 We're taking you straight through to our resus room. 38 00:03:08,800 --> 00:03:09,789 This way. 39 00:03:11,760 --> 00:03:12,988 Starting the clock. 40 00:03:13,360 --> 00:03:18,593 Ejected passenger, found unconscious, pulse 130, weak, BP 90/70. 41 00:03:18,680 --> 00:03:21,319 - Diminished breath, sounds on the left. - Let's move the scoop on your count. 42 00:03:21,400 --> 00:03:22,674 Okay, unclip top and bottom, please. 43 00:03:22,760 --> 00:03:24,751 - Clear a space around him. - Oh, sorry. 44 00:03:24,840 --> 00:03:25,955 - Everyone ready? - ALL: Yeah. 45 00:03:26,040 --> 00:03:27,917 One, two, three. 46 00:03:28,440 --> 00:03:30,908 Thank you. One, two, three. 47 00:03:31,920 --> 00:03:33,353 Great, well done. 48 00:03:33,960 --> 00:03:36,190 - Mate, has he got thoracostomies? - No. Massive haematemesis, 49 00:03:36,280 --> 00:03:37,349 scarlet yawn... 50 00:03:37,440 --> 00:03:39,556 - Suction... - (ALL TALKING INDISTINCTLY) 51 00:03:39,640 --> 00:03:41,392 One conversation at a time, please. 52 00:03:41,480 --> 00:03:42,515 ALL: Sorry. 53 00:03:42,600 --> 00:03:43,589 Okay, great. 54 00:03:43,680 --> 00:03:45,875 All right, mate, all right, we're sorting you out. 55 00:03:46,840 --> 00:03:47,829 (GROANING) 56 00:03:48,680 --> 00:03:51,274 Mate, you're in the emergency department at CGH. 57 00:03:51,360 --> 00:03:52,952 I'm Dr Chandramohan, one of the anaesthetists. 58 00:03:53,040 --> 00:03:54,837 I need to look down your throat. 59 00:03:54,920 --> 00:03:58,071 - I'm just going to take this strap off. - Leg support, please. 60 00:03:58,160 --> 00:03:59,912 - Blocks coming off. - Thanks. 61 00:04:00,000 --> 00:04:03,072 Sir, I'm just going to hold your head to keep it still. 62 00:04:04,120 --> 00:04:05,519 Sorry I'm late. 63 00:04:06,720 --> 00:04:08,438 Nice of orthopaedics to show up. 64 00:04:08,520 --> 00:04:10,590 - Airway clear. - Resps 30. 65 00:04:10,680 --> 00:04:13,797 Sir, my name is Fiona Lomas, I'm the trauma registrar. 66 00:04:13,880 --> 00:04:15,598 We're going to do our best to get you better. 67 00:04:15,680 --> 00:04:18,035 - Tachypneic, decent pulses. - Okay, thank you. 68 00:04:18,120 --> 00:04:21,396 Okay, nice and quiet everyone while we listen to the handover, thanks. 69 00:04:21,480 --> 00:04:24,040 Trauma Air Service arrived on the scene at 6:45 70 00:04:24,120 --> 00:04:26,395 after an RTC called in at 6:30. 71 00:04:26,480 --> 00:04:28,038 Multiple vehicles involved in a collision 72 00:04:28,120 --> 00:04:29,633 on the Kingsgate underpass. 73 00:04:29,720 --> 00:04:31,039 Patient was found on the roadside 74 00:04:31,120 --> 00:04:33,680 after having been an ejected passenger from a bus. 75 00:04:33,760 --> 00:04:37,196 Multiple soft tissue injuries, lacs, grazes, haematomas, top to toe. 76 00:04:37,280 --> 00:04:39,191 There is a lac on the interior chest wall, 77 00:04:39,280 --> 00:04:42,829 left wrist is fractured, left tib is an open fracture. 78 00:04:42,920 --> 00:04:44,558 Diminished breath sounds on the left. 79 00:04:44,640 --> 00:04:47,438 100% oxygen given via mask at the scene. 80 00:04:47,520 --> 00:04:49,909 Haematemesis in the service lift and corridor. 81 00:04:50,000 --> 00:04:50,989 Thank you very much. 82 00:04:51,080 --> 00:04:52,308 You wanna sign off some paperwork with Nerys? 83 00:04:52,400 --> 00:04:53,628 Come and sign your lives away. 84 00:04:55,160 --> 00:04:58,675 I could act as scribe if you'd like. 85 00:05:02,080 --> 00:05:03,513 - (GROANING) - Ugh! 86 00:05:04,920 --> 00:05:05,989 Need to tube him. 87 00:05:06,800 --> 00:05:07,789 Fiona. 88 00:05:11,880 --> 00:05:13,518 Dullness to percussion on left side. 89 00:05:13,600 --> 00:05:15,192 - He needs a thoracostomy. - Yeah. 90 00:05:15,560 --> 00:05:17,551 Sir, we're going to do something to help your breathing. 91 00:05:17,640 --> 00:05:19,835 - Justin, thoracostomies. - Oh, right. 92 00:05:19,920 --> 00:05:21,956 Trachea deviated to right. 93 00:05:22,040 --> 00:05:23,598 Loads more on the way. First of many, apparently. 94 00:05:23,680 --> 00:05:25,193 - Oh, great! - Oh, great! 95 00:05:25,280 --> 00:05:27,589 - Okay, let's get him intubated. - (BEEPING) 96 00:05:28,480 --> 00:05:29,595 Oh, what now? 97 00:05:29,680 --> 00:05:31,159 - VT. - Argh. 98 00:05:31,240 --> 00:05:33,708 - Carotid output. - Femoral output, defibbing. 99 00:05:33,800 --> 00:05:36,030 Off the chest, please, Justin, VT with output. 100 00:05:36,120 --> 00:05:38,270 - All right. - LORRAINE: Shockable rhythm, no CPR. 101 00:05:38,360 --> 00:05:40,157 Sync shock, 150 joules. 102 00:05:42,720 --> 00:05:46,349 AUTOMATED VOICE: 150 joules selected. Charging. 103 00:05:47,720 --> 00:05:49,631 Okay, everyone, clear oxygen away. 104 00:05:49,720 --> 00:05:51,756 - Away. - Shocking on three. 105 00:05:51,840 --> 00:05:53,034 One, two, three. 106 00:05:56,440 --> 00:05:57,555 Still in VT. 107 00:05:58,920 --> 00:06:00,797 - Output. - Oh, damn it! 108 00:06:01,240 --> 00:06:02,309 Charging. 109 00:06:02,400 --> 00:06:05,790 - AUTOMATED VOICE: Charging. - Shocking on three. One, two, three. 110 00:06:07,240 --> 00:06:08,355 Shit! 111 00:06:08,920 --> 00:06:09,909 Come on! 112 00:06:10,000 --> 00:06:11,479 - Output. - Charging. 113 00:06:11,560 --> 00:06:15,030 - AUTOMATED VOICE: Charging. - Shocking on three. One, two, three. 114 00:06:19,120 --> 00:06:20,633 Sinus rhythm. Good output. 115 00:06:20,720 --> 00:06:22,790 Okay. We have ROSC. 116 00:06:23,040 --> 00:06:24,393 Well done. Thank you. 117 00:06:26,120 --> 00:06:27,155 Well done. 118 00:06:27,240 --> 00:06:30,550 Okay, I'll do the thoracostomies to help with his breathing. 119 00:06:30,640 --> 00:06:32,949 Give him, um, Ramakrishna? 120 00:06:33,040 --> 00:06:35,349 - 30 of ket? - Ketamine. 121 00:06:35,440 --> 00:06:38,716 Okay, and I'll pause for a top-up if he protests too much. 122 00:06:41,400 --> 00:06:43,516 There's an open tib that needs IV Augmentin? 123 00:06:43,600 --> 00:06:45,477 Thank you, in a minute. 124 00:06:45,560 --> 00:06:47,915 - (MOBILE CHIMING) - Phones off, please. 125 00:06:48,960 --> 00:06:51,315 Mate, just going to give you something to take the edge off. 126 00:06:51,640 --> 00:06:53,596 (WHISTLING) 127 00:06:57,440 --> 00:06:58,873 Can you bring me the trolley, please? 128 00:06:58,960 --> 00:07:00,632 Try looking in the pockets of her coat. 129 00:07:07,240 --> 00:07:09,071 Well, he's not protesting, I think we're all right. 130 00:07:09,160 --> 00:07:10,229 Yep. 131 00:07:13,000 --> 00:07:16,436 Pulse 130, BP 80/65. 132 00:07:16,520 --> 00:07:17,919 I think he'd benefit from some more blood. 133 00:07:18,000 --> 00:07:20,719 Okay. Thank you. Constance, could you, please? 134 00:07:20,800 --> 00:07:21,789 Yep. 135 00:07:21,880 --> 00:07:23,438 LORRAINE: Let's keep a close eye on the BP, please. 136 00:07:24,760 --> 00:07:26,716 - Thank you. - No response to trap pinch. 137 00:07:27,160 --> 00:07:28,912 - One. - GCS? 138 00:07:29,000 --> 00:07:31,434 - Four. - Four with sedation. 139 00:07:31,520 --> 00:07:32,509 Sorry. 140 00:07:34,160 --> 00:07:36,435 Bilateral thoracostomy patent. 141 00:07:36,520 --> 00:07:39,034 - Time for drains? - Sats 88. 142 00:07:39,120 --> 00:07:40,838 - Prefer to get him under first. - Okay. 143 00:07:41,320 --> 00:07:42,514 That's the lads off. 144 00:07:42,600 --> 00:07:45,672 - Okay, thanks, guys, have a good one. - See you next time, lads. 145 00:07:45,760 --> 00:07:46,749 (COUGHING) 146 00:07:47,040 --> 00:07:48,314 I thought he was sedated? 147 00:07:48,400 --> 00:07:49,753 He was. He was. 148 00:07:50,160 --> 00:07:52,116 - Suction. - Okay. 149 00:07:55,720 --> 00:07:58,029 - Need to RSI, Billy. - Yeah, I'm on it, I'm on it. 150 00:07:58,120 --> 00:08:01,476 - Okay, do it fast, please. - BP's dropping. 151 00:08:07,920 --> 00:08:10,559 Severely hypotensive, no radial pulse. 152 00:08:10,640 --> 00:08:11,629 You need to put the tube in. 153 00:08:11,720 --> 00:08:14,359 Yeah. I can't get a tube in with the BP down this low. 154 00:08:14,440 --> 00:08:16,351 Okay, blood straight away, just squeeze it in. 155 00:08:16,440 --> 00:08:17,839 Justin! Quickly. 156 00:08:17,920 --> 00:08:19,558 We need to get his blood pressure up. 157 00:08:19,640 --> 00:08:22,108 Sir, we're going to clear your throat. 158 00:08:22,200 --> 00:08:24,555 Please try to be calm so we can help you. 159 00:08:24,640 --> 00:08:26,756 The sats are going down, we really need to get the tube in. 160 00:08:26,840 --> 00:08:28,114 For God's sake, I'm trying. 161 00:08:35,320 --> 00:08:36,435 I've got a radial pulse. 162 00:08:36,520 --> 00:08:38,829 Okay, you've got enough pressure, you need to get the tube in, please. 163 00:08:38,920 --> 00:08:40,194 Okay, here we go. 164 00:08:40,920 --> 00:08:42,319 Are you the new SHO? 165 00:08:42,400 --> 00:08:44,595 Er, yeah, everyone calls me Harry. 166 00:08:44,680 --> 00:08:46,432 Okay, can you give me inline C-spine immobilisation 167 00:08:46,520 --> 00:08:48,750 while we take the blocks off, please? 168 00:08:48,840 --> 00:08:50,273 No, get your hands in there. 169 00:08:52,160 --> 00:08:53,513 Okay. Hold tight. 170 00:08:54,520 --> 00:08:56,431 - That's it. - Oh! 171 00:08:56,520 --> 00:08:58,397 Jesus. You got him? 172 00:08:58,480 --> 00:08:59,549 Yeah. 173 00:08:59,640 --> 00:09:01,153 - Yeah. - Ta. 174 00:09:01,640 --> 00:09:02,755 - Hold tight. - Yeah. 175 00:09:02,840 --> 00:09:04,353 (PATIENT COUGHING) 176 00:09:07,360 --> 00:09:09,828 - Thiopentone, 250 mg. - Okay. 177 00:09:09,920 --> 00:09:12,593 Thio, 250, going in. 178 00:09:15,400 --> 00:09:17,436 Going in. Just sending you off to sleep, mate. 179 00:09:19,920 --> 00:09:21,319 Push. Yeah. 180 00:09:30,680 --> 00:09:31,669 (BEEPING STOPS) 181 00:09:31,840 --> 00:09:33,558 Finally, some peace and quiet. 182 00:09:34,120 --> 00:09:36,236 Sux 100, 183 00:09:37,320 --> 00:09:38,548 going in. 184 00:09:40,320 --> 00:09:42,515 We use sux in trauma 'cause it works fast. 185 00:09:43,480 --> 00:09:45,357 That's not the only thing around here. 186 00:09:47,440 --> 00:09:48,759 (CHUCKLING) 187 00:09:48,840 --> 00:09:51,035 Takes a while to paralyse the patient. 188 00:09:57,240 --> 00:09:58,229 Here we go. 189 00:10:08,840 --> 00:10:10,353 Okay, yeah. 190 00:10:10,920 --> 00:10:12,035 Suction. 191 00:10:16,560 --> 00:10:19,677 - Make sure you do ABGs and an ECG. - WOMAN: Yes, Dr Archerfield. 192 00:10:20,720 --> 00:10:22,711 All those staff to one patient. 193 00:10:22,800 --> 00:10:24,677 No, that's a trauma call, critical injuries. 194 00:10:25,840 --> 00:10:27,273 It's madness. 195 00:10:31,160 --> 00:10:32,832 This guy feels cold. Did we get a temperature? 196 00:10:32,920 --> 00:10:34,751 Not that anyone's given me. 197 00:10:34,840 --> 00:10:35,909 How long till they scooped him? 198 00:10:36,000 --> 00:10:39,310 They were there in 15 minutes, scooped after 25. 199 00:10:40,880 --> 00:10:42,472 Carotid core, 36.1. 200 00:10:42,560 --> 00:10:44,630 Yeah, he's cold for someone they scooped inside 30 minutes. 201 00:10:44,720 --> 00:10:47,473 - 15 and 25 is 40. - 40 minutes then. 202 00:10:47,560 --> 00:10:48,993 How much blood is left in the fridge? 203 00:10:49,080 --> 00:10:50,798 CONSTANCE: We're down to three bags. 204 00:10:59,520 --> 00:11:02,114 Intrathoracic haemorrhage, get me a swab, please. 205 00:11:03,720 --> 00:11:05,711 Okay, here we go. I'm calling a code. 206 00:11:05,800 --> 00:11:07,313 - We need more blood. - Another Venflon? 207 00:11:07,400 --> 00:11:09,630 - Yes, and a trauma line. - I can do Venflon. 208 00:11:09,720 --> 00:11:12,314 Sister Merrick, resus, we're coding. 209 00:11:12,400 --> 00:11:14,436 - Tranexamic acid, please. - Coming up. 210 00:11:14,520 --> 00:11:17,432 - Let's stop this haemorrhage. - Major transfusion protocol. 211 00:11:17,520 --> 00:11:19,238 No, no, don't put me through to blood bank. 212 00:11:19,320 --> 00:11:21,959 Oh, I know you don't need me to say this, everyone, 213 00:11:22,040 --> 00:11:23,837 but nice and fast, please. 214 00:11:23,920 --> 00:11:24,909 Crosscheck. 215 00:11:25,000 --> 00:11:27,560 - O pos, dated and checked. - Crosschecked. 216 00:11:28,120 --> 00:11:29,235 WOMAN: Hello, 24? 217 00:11:29,320 --> 00:11:31,038 No, I know, I'm still holding. 218 00:11:35,960 --> 00:11:37,359 CONSTANCE: Two units of O pos remaining. 219 00:11:37,440 --> 00:11:40,113 TXA, one gram IV, one gram infusion to follow. 220 00:11:40,200 --> 00:11:43,829 Yes, this is Mrs Rappaport, I'm the consultant on call 221 00:11:43,920 --> 00:11:45,876 for major trauma and we have just enacted 222 00:11:45,960 --> 00:11:47,791 the major transfusion protocol. 223 00:11:47,880 --> 00:11:51,509 You send us 12 units of O positive immediately. 224 00:11:51,600 --> 00:11:53,909 Eight of FFP and four of platelets. 225 00:11:54,000 --> 00:11:56,275 - WOMAN: Do you have authorisation? - What? 226 00:11:56,360 --> 00:11:58,669 I make that the third unit of blood now. 227 00:11:58,760 --> 00:12:02,150 - One unit of O pos. - Okay, then, please put me through. 228 00:12:02,840 --> 00:12:04,193 LORRAINE: No, thank you! 229 00:12:04,720 --> 00:12:06,597 Let's put the next unit of O pos 230 00:12:06,680 --> 00:12:09,399 through the trauma line and pressure on the thoracostomy bleed. 231 00:12:09,480 --> 00:12:10,799 Harry, pressure, please. 232 00:12:16,840 --> 00:12:19,274 Okay, let's take bloods as I do the trauma line. 233 00:12:24,040 --> 00:12:27,350 Oh, hi, yes, this is Lorraine Rappaport, consultant on call... 234 00:12:27,440 --> 00:12:30,000 Let's have another bag of O pos from the store, please. 235 00:12:30,080 --> 00:12:31,911 We have a major trauma patient in resus 236 00:12:32,000 --> 00:12:34,673 and blood bank won't enact the major transfusion protocol 237 00:12:34,760 --> 00:12:35,795 without your say-so. 238 00:12:35,880 --> 00:12:37,711 MAN: You have his haemoglobin measured? 239 00:12:37,800 --> 00:12:39,916 No, we haven't measured the patient's Hb, 240 00:12:40,000 --> 00:12:41,399 and if we did, it would be normal 241 00:12:41,480 --> 00:12:43,675 because the concentration of haemoglobin in his blood 242 00:12:43,760 --> 00:12:44,875 won't have changed. 243 00:12:44,960 --> 00:12:47,793 But what has changed is he has a lot less blood circulating 244 00:12:47,880 --> 00:12:49,359 than he did half an hour ago. 245 00:12:49,440 --> 00:12:51,510 And if we don't transfuse him, he will die. 246 00:12:52,560 --> 00:12:53,993 - Excuse me. - Thank you! 247 00:12:55,880 --> 00:12:56,915 Sorry. 248 00:13:00,920 --> 00:13:02,638 (MONITOR BEEPING) 249 00:13:12,280 --> 00:13:13,633 - Sorry! - Yes. 250 00:13:13,720 --> 00:13:16,029 This thoracostomy's really bleeding. 251 00:13:16,120 --> 00:13:17,314 He's bleeding out. 252 00:13:18,600 --> 00:13:20,238 We need more blood, we're losing him. 253 00:13:20,320 --> 00:13:21,639 What the hell's going on in this guy's chest? 254 00:13:22,280 --> 00:13:24,111 We need someone to do a chest drain, please. 255 00:13:25,120 --> 00:13:26,712 - Me. - We have a volunteer. 256 00:13:26,800 --> 00:13:28,791 Justin, get on that bleed now. 257 00:13:30,840 --> 00:13:33,149 Swap gloves, eye guards, gown. 258 00:13:33,240 --> 00:13:35,515 I want you ready to go in two minutes. 259 00:13:43,360 --> 00:13:45,828 Billy, where are those blood gases? 260 00:13:47,360 --> 00:13:51,399 PaO two, 5.3. PaCO two, 4.5. 261 00:13:51,640 --> 00:13:54,279 PH, 7.1. Lactate, 8. 262 00:13:54,360 --> 00:13:56,874 - Base excess, minus six. - Thank you. 263 00:13:56,960 --> 00:13:58,951 Airway secure. Patient ventilated. 264 00:13:59,040 --> 00:14:01,429 O pos transfusing, bloods away, 265 00:14:01,520 --> 00:14:03,272 patient maintaining sats and blood pressure. 266 00:14:03,360 --> 00:14:04,998 Anything outstanding? 267 00:14:05,080 --> 00:14:06,957 - Anaesthetists, happy? - Over the moon. 268 00:14:07,040 --> 00:14:08,029 Good. 269 00:14:08,120 --> 00:14:10,873 Elapsed time, 11 minutes 30. 270 00:14:11,360 --> 00:14:12,475 BP's down. 271 00:14:13,880 --> 00:14:15,598 Keep squeezing the blood in, please. 272 00:14:15,680 --> 00:14:17,875 - That's it through now. - Thank you. 273 00:14:17,960 --> 00:14:20,554 You've got to start that chest drain now, please. 274 00:14:22,480 --> 00:14:23,629 This an RTA? 275 00:14:23,880 --> 00:14:25,632 First of multiple casualties. 276 00:14:26,560 --> 00:14:27,834 Is that me done? 277 00:14:28,760 --> 00:14:31,069 I thought trauma was mainly RTAs? 278 00:14:31,160 --> 00:14:32,718 Why are you doing the drain? 279 00:14:32,800 --> 00:14:33,835 You're the new SHO. 280 00:14:33,920 --> 00:14:35,592 Yeah, everyone calls me Harry. 281 00:14:35,680 --> 00:14:38,114 I'm Mrs Hicklin, everyone calls me Mrs Hicklin. 282 00:14:39,200 --> 00:14:40,189 I'm Ramakrishna. 283 00:14:40,280 --> 00:14:42,669 Yeah, it's mainly car crashes and stabbings. 284 00:14:42,760 --> 00:14:43,749 Thanks. 285 00:14:44,760 --> 00:14:47,115 - There's a bit of resistance. - Push. 286 00:14:47,200 --> 00:14:50,078 - Cardiac kebab, here we come. - Just push. 287 00:14:51,160 --> 00:14:52,229 Ugh! 288 00:14:53,160 --> 00:14:54,798 Ooh, God! Oh, okay. Is that good? 289 00:14:54,880 --> 00:14:57,235 Yes, yes, that's exactly what we expect. 290 00:14:57,320 --> 00:14:59,390 - Suture it, please. - DR HARRY: Er, yes. 291 00:14:59,480 --> 00:15:02,517 Can someone please phone ahead to CT, let them know we're on our way? 292 00:15:02,600 --> 00:15:05,353 And blood bank will be delivering some blood very soon. 293 00:15:05,440 --> 00:15:07,158 If they're not here in the next two minutes, 294 00:15:07,240 --> 00:15:08,229 we need to chase them. 295 00:15:08,320 --> 00:15:09,992 Yeah, I'll call CT and blood bank. 296 00:15:12,280 --> 00:15:14,316 Is this anyone's Twix? 297 00:15:16,840 --> 00:15:19,308 Are we getting x-rays of the wrist and tibia? 298 00:15:19,680 --> 00:15:20,829 Wait for the CT. 299 00:15:20,920 --> 00:15:22,512 Yeah, sorry. Um... 300 00:15:23,080 --> 00:15:24,957 - I could reduce the tibia now? - Sure. 301 00:15:25,040 --> 00:15:26,189 Okay. 302 00:15:26,720 --> 00:15:29,314 Shall we replace the TXA infusion? 303 00:15:30,040 --> 00:15:32,508 Uh, yes, of course, yes, thank you. 304 00:15:54,280 --> 00:15:56,236 Justin, can you expose the leg, please? 305 00:15:59,760 --> 00:16:01,352 - Just a sec. - (CAMERA CLICKING) 306 00:16:01,440 --> 00:16:02,668 - BILLY: Cheers. - Prick. 307 00:16:03,600 --> 00:16:04,589 BILLY: Nice one. 308 00:16:06,120 --> 00:16:07,109 Traction? 309 00:16:09,480 --> 00:16:10,993 Yes, this is Mrs Hicklin. 310 00:16:11,080 --> 00:16:14,914 We'll be bringing in major trauma, Mike Alpha, for CT, very shortly. 311 00:16:15,000 --> 00:16:16,228 Will you be ready for us? 312 00:16:17,040 --> 00:16:18,029 Good. 313 00:16:18,600 --> 00:16:19,589 Thank you. 314 00:16:20,280 --> 00:16:23,272 O positive, FFP and platelets for Mike Alpha. 315 00:16:23,360 --> 00:16:27,353 Great. Let's get a couple of bags of this O pos up immediately, please. 316 00:16:27,440 --> 00:16:29,510 Patient Mike Alpha. O positive. 317 00:16:29,600 --> 00:16:31,431 Has anyone seen my cardie? 318 00:16:32,240 --> 00:16:33,309 And a Twix? 319 00:16:37,400 --> 00:16:38,389 Sorry. 320 00:16:39,480 --> 00:16:42,438 Okay, soon as the blood's up, transfer to CT. 321 00:16:42,520 --> 00:16:43,509 You can leave that. 322 00:16:49,160 --> 00:16:52,470 - Nerys, this TXA is ready to go up. - Yep, of course. 323 00:16:57,560 --> 00:16:59,551 I'm so sorry that's taken so long. 324 00:17:00,200 --> 00:17:02,077 Make sure those x-rays are uploaded straight away 325 00:17:02,160 --> 00:17:04,230 this patient's been here for three hours. 326 00:17:05,640 --> 00:17:07,631 Lorraine. How's it going? 327 00:17:07,920 --> 00:17:09,558 - Trauma call. - Anything juicy? 328 00:17:10,040 --> 00:17:12,190 We agreed that the major transfusion protocol 329 00:17:12,280 --> 00:17:14,430 was to be acted by the trauma team leader. 330 00:17:14,520 --> 00:17:15,509 Absolutely. 331 00:17:15,600 --> 00:17:18,751 So why, then, yet again, am I talking to a haematology consultant 332 00:17:18,840 --> 00:17:21,035 who pompously asks me the patient's Hb? 333 00:17:21,120 --> 00:17:23,076 Well, agreeing to the trauma protocol is one thing, 334 00:17:23,160 --> 00:17:24,229 getting the other departments to actually 335 00:17:24,320 --> 00:17:25,912 put it into practise is something completely different. 336 00:17:26,000 --> 00:17:27,558 You said it had been agreed. 337 00:17:27,640 --> 00:17:29,517 Well, they're territorial, and I'm stuck in the middle. 338 00:17:29,600 --> 00:17:31,909 No, I am, and the patient is. 339 00:17:32,000 --> 00:17:33,399 I know, I can see you're upset. 340 00:17:33,480 --> 00:17:35,710 This used to be a bog standard A&E. 341 00:17:35,800 --> 00:17:38,030 - We are now a major trauma centre... - Whoa! Just a second. Hold on. 342 00:17:38,120 --> 00:17:40,076 I resent that description. 343 00:17:40,160 --> 00:17:43,232 We used to be the best-performing unit in the region. 344 00:17:43,320 --> 00:17:44,958 Now we take more patients overall, 345 00:17:45,040 --> 00:17:47,031 more critical patients, resources are stretched. 346 00:17:47,880 --> 00:17:49,632 Supposedly, we're not doing as well. 347 00:17:52,240 --> 00:17:54,629 Well, then, some of us need to raise their game. 348 00:18:03,320 --> 00:18:05,072 Where is this going exactly? 349 00:18:16,480 --> 00:18:17,469 Good morning. 350 00:18:17,560 --> 00:18:21,155 I will be ready to start the scan in approximately one and a half minutes. 351 00:18:21,240 --> 00:18:22,229 Thank you, Brian. 352 00:18:22,320 --> 00:18:23,833 He's already bled 1000 mills. 353 00:18:23,920 --> 00:18:26,229 - He's coagulopathic because he's cold. - Cold. 354 00:18:26,320 --> 00:18:28,959 So if he was on the road for longer than 40 minutes... 355 00:18:31,040 --> 00:18:33,076 Wait, let's deal with the coagulopathy. 356 00:18:33,160 --> 00:18:35,879 I want FFP and platelets up now. 357 00:18:40,240 --> 00:18:41,639 Where's our leader got to? 358 00:18:49,840 --> 00:18:52,479 Can someone please just go and check that Lorraine's on her way back? 359 00:18:52,560 --> 00:18:54,312 - (BEEPING) - Kill the alarm. 360 00:18:54,400 --> 00:18:55,389 Nerys. 361 00:18:55,480 --> 00:18:58,995 Will you bring either Mrs Rappaport or Dr Archerfield? 362 00:18:59,080 --> 00:19:00,991 - Just right now, please. - Yes, Mrs Hicklin. 363 00:19:01,080 --> 00:19:02,593 - Shit, he's in VF. - Billy. 364 00:19:03,240 --> 00:19:04,229 Yeah. 365 00:19:05,720 --> 00:19:06,914 BOTH: No output. 366 00:19:09,920 --> 00:19:10,955 Fail. 367 00:19:11,040 --> 00:19:12,029 Back into resus. 368 00:19:12,120 --> 00:19:14,554 - Slowly with CPR. - Fast, and we'll do it there. 369 00:19:14,640 --> 00:19:16,119 - Come on. - Quickly, let's go. 370 00:19:19,560 --> 00:19:20,549 Turn. 371 00:19:25,040 --> 00:19:26,473 Careful. Get the door. 372 00:19:30,440 --> 00:19:31,953 Yeah, got that, got that. 373 00:19:32,800 --> 00:19:34,518 Justin, take over compressions. 374 00:19:37,200 --> 00:19:40,431 AUTOMATED VOICE: Connect electrodes. Electrodes connected. 375 00:19:40,520 --> 00:19:42,272 Diagnosing rhythm. 376 00:19:42,360 --> 00:19:44,191 Ventricular fibrillation. 377 00:19:44,280 --> 00:19:47,955 Advising 150 joules by fading shock. 378 00:19:48,040 --> 00:19:51,510 150 joules selected. 379 00:19:51,600 --> 00:19:52,635 Charging. 380 00:19:54,040 --> 00:19:55,393 Justin, off the chest. 381 00:19:55,880 --> 00:19:57,916 - Shocking, three, two, one. - Stand clear. Warning... 382 00:20:03,720 --> 00:20:06,837 Two minutes of CPR to come at 31 minutes. 383 00:20:06,920 --> 00:20:09,593 Adrenaline and amiodarone on standby, please. 384 00:20:09,680 --> 00:20:10,669 Yeah. 385 00:20:10,760 --> 00:20:12,876 - Where's Lorraine? - Lorraine wasn't there. 386 00:20:12,960 --> 00:20:14,916 - Well, where is she? - I don't know. 387 00:20:15,000 --> 00:20:16,592 Fetch Clive then. 388 00:20:16,680 --> 00:20:18,033 He wasn't there either. 389 00:20:24,800 --> 00:20:27,109 CPR counting towards two minutes. 390 00:20:27,200 --> 00:20:30,317 Then get ready to give another 150 biphasic. 391 00:20:30,400 --> 00:20:33,039 After that, be ready with adrenaline one mg, 392 00:20:33,120 --> 00:20:35,111 amiodarone, 300 mgs. 393 00:20:35,880 --> 00:20:37,552 Staying alive, staying alive... 394 00:20:41,400 --> 00:20:42,958 LORRAINE: Hello, this is Lorraine Rappaport. 395 00:20:43,040 --> 00:20:44,678 Please leave a message. 396 00:20:44,760 --> 00:20:46,716 Lorraine, it's Fiona. 397 00:20:46,800 --> 00:20:48,631 Please call me right back. 398 00:20:48,720 --> 00:20:50,233 I need you here, boss. 399 00:20:52,640 --> 00:20:53,868 (MURMURED SINGING) 400 00:20:59,160 --> 00:21:01,151 Absolutely starving. 401 00:21:01,720 --> 00:21:03,392 BILLY: I missed breakfast because of this. 402 00:21:03,480 --> 00:21:05,675 - You shouldn't have a... - FIONA: One minute to go. 403 00:21:05,760 --> 00:21:07,876 Ordered it, then the beeper went. 404 00:21:07,960 --> 00:21:09,029 It's just sat there then? 405 00:21:09,120 --> 00:21:11,111 I don't know, I didn't pay for it, so I doubt it. 406 00:21:11,200 --> 00:21:13,395 - (CHUCKLING) - Not good for your insides. 407 00:21:13,480 --> 00:21:15,755 Staying alive, staying alive... 408 00:21:16,840 --> 00:21:18,717 You're in a bit earlier, aren't you? 409 00:21:19,440 --> 00:21:22,159 The Fiesta didn't start this morning so I was a bit late. 410 00:21:22,520 --> 00:21:24,033 FIONA: 40 seconds to go. 411 00:21:58,600 --> 00:22:00,591 Coming up to two minutes. 412 00:22:03,800 --> 00:22:06,109 Check pulses, stop compressions. 413 00:22:06,200 --> 00:22:07,679 (BEEPING) 414 00:22:09,320 --> 00:22:11,470 - No pulse. Still VF. - Justin. 415 00:22:11,880 --> 00:22:14,030 AUTOMATED VOICE: Joules selected. Charging. 416 00:22:18,480 --> 00:22:19,993 Charged. Warning... 417 00:22:20,080 --> 00:22:21,274 - Everybody clear. - Stand clear. 418 00:22:21,840 --> 00:22:23,558 Justin, off the chest. 419 00:22:23,640 --> 00:22:25,517 Shocking in three, two, one. 420 00:22:28,200 --> 00:22:29,918 AUTOMATED VOICE: Diagnosing rhythm. 421 00:22:30,000 --> 00:22:31,228 JUSTIN: Sinus rhythm. 422 00:22:31,320 --> 00:22:32,673 Follow the guidelines, please, Justin. 423 00:22:32,760 --> 00:22:34,034 Sorry, Mrs Hicklin. 424 00:22:39,320 --> 00:22:40,958 I'm hearing heart sounds. We might have ROSC. 425 00:22:41,040 --> 00:22:42,837 - Justin, you need to stop for a second. - Stop. 426 00:22:48,360 --> 00:22:49,349 BOTH: Output. 427 00:22:52,400 --> 00:22:53,799 - Thank you. - Good job. 428 00:22:53,880 --> 00:22:55,632 FIONA: We have ROSC. 429 00:22:55,720 --> 00:22:56,914 Put the bloods up, please. 430 00:22:57,000 --> 00:22:59,389 - All right, now what? - CT. 431 00:22:59,480 --> 00:23:02,472 You're happy the patient's stable enough to be moved? 432 00:23:02,560 --> 00:23:04,198 Lorraine wanted a CT next. 433 00:23:04,280 --> 00:23:05,315 That was before he arrested. 434 00:23:05,400 --> 00:23:06,833 Well, we need to know what's going on in the chest. 435 00:23:06,920 --> 00:23:08,911 That's a decision for the trauma team leader. 436 00:23:09,000 --> 00:23:10,638 Lorraine isn't here. 437 00:23:16,040 --> 00:23:17,598 So, someone needs to lead. 438 00:23:23,480 --> 00:23:24,469 CT. 439 00:23:26,560 --> 00:23:28,676 CHANDRAMOHAN: Take two, let's get him ready to go. 440 00:23:30,240 --> 00:23:32,071 Let's get him on the fourth floor... 441 00:23:33,640 --> 00:23:35,153 LORRAINE: Hello, this is Lorraine Rappaport. 442 00:23:35,240 --> 00:23:37,151 Please leave a message. 443 00:23:37,240 --> 00:23:39,276 Lorraine, the patient just had a VF arrest. 444 00:23:39,360 --> 00:23:40,873 I've no idea why. 445 00:23:40,960 --> 00:23:43,190 I'm really worried I'm missing something here. 446 00:23:43,280 --> 00:23:44,269 (MONITOR BEEPING) 447 00:23:44,800 --> 00:23:47,030 We're going to take him to CT. 448 00:23:47,280 --> 00:23:48,599 I'll see you there. 449 00:24:13,600 --> 00:24:16,637 Are you doing anything about the wrist and tib? 450 00:24:16,720 --> 00:24:18,631 We need to fix the chest first. 451 00:24:18,720 --> 00:24:20,756 Okay. I'll be on the ward if you need me. 452 00:24:21,800 --> 00:24:23,836 - She's got the right idea. - What? 453 00:24:23,920 --> 00:24:25,990 Not being here if all this goes tits-up. 454 00:24:26,080 --> 00:24:27,069 Smart. 455 00:24:32,040 --> 00:24:34,474 - Shall we try again? - Sorry, Brian. 456 00:24:56,120 --> 00:24:57,553 Patient clock synchronised. 457 00:24:57,640 --> 00:24:59,517 On three. One, two, three. 458 00:24:59,880 --> 00:25:01,472 - Well done. - (PHONE RINGING) 459 00:25:02,680 --> 00:25:04,113 Brian Zhao, CT radiographer 460 00:25:04,200 --> 00:25:06,270 and deputy assistant department coordinator. 461 00:25:08,560 --> 00:25:09,629 For you. 462 00:25:10,000 --> 00:25:10,989 Lorraine? 463 00:25:11,520 --> 00:25:13,909 Oh, just a second. 464 00:25:16,800 --> 00:25:18,552 All the results you've got please. 465 00:25:23,160 --> 00:25:24,957 Er, nobody touch any buttons. 466 00:25:28,120 --> 00:25:30,315 One, two, three. 467 00:25:32,520 --> 00:25:33,919 Thank you. Bye. 468 00:25:44,280 --> 00:25:46,430 - Do you know what? - What? 469 00:25:47,160 --> 00:25:49,196 I think we're going to lose this one. 470 00:25:49,800 --> 00:25:50,915 BRIAN: Control scan. 471 00:25:56,560 --> 00:25:58,118 - Have I missed anything? - Just starting. 472 00:25:58,200 --> 00:26:00,839 - Starting head scan. - Where's Lorraine? 473 00:26:01,160 --> 00:26:02,149 Hmm? 474 00:26:02,760 --> 00:26:03,749 She's not with you? 475 00:26:04,200 --> 00:26:05,679 BRIAN: Head scan complete. 476 00:26:05,760 --> 00:26:07,512 Nobody touch any buttons. 477 00:26:09,200 --> 00:26:11,077 Right, your head is NAD, 478 00:26:11,160 --> 00:26:13,435 you've got no obvious intracranial lesions or bleeding. 479 00:26:13,520 --> 00:26:15,158 Are you happy, Fiona? 480 00:26:15,240 --> 00:26:16,593 - Here. - Hmm. 481 00:26:20,680 --> 00:26:21,669 Right. 482 00:26:27,160 --> 00:26:28,479 BRIAN: Contrast run. 483 00:26:30,840 --> 00:26:32,398 Tube's in the right place. 484 00:26:35,040 --> 00:26:36,029 (CHUCKLING) 485 00:26:36,760 --> 00:26:37,749 If I'd messed up the tube, 486 00:26:37,840 --> 00:26:39,398 he'd be on his way to pathology outpatients. 487 00:26:39,480 --> 00:26:42,278 I really wish I'd had more practise at it. 488 00:26:42,360 --> 00:26:44,794 We could find some time this week. 489 00:26:45,720 --> 00:26:48,837 - Only if it's not too much trouble. - I'll find a way to fit you in. 490 00:26:52,960 --> 00:26:54,154 Back to the ED. 491 00:26:54,600 --> 00:26:55,589 And you. 492 00:26:55,680 --> 00:26:57,910 I really wanted to see this case through. 493 00:26:58,000 --> 00:27:00,753 When we lose you to a major trauma, patients stack up. 494 00:27:02,120 --> 00:27:03,109 Right. 495 00:27:05,800 --> 00:27:07,392 Best bit's over anyway. 496 00:27:08,080 --> 00:27:09,593 The left side's filled up with blood again. 497 00:27:09,880 --> 00:27:11,871 CLIVE: We've got an uncontrolled intrathoracic haemorrhage. 498 00:27:12,520 --> 00:27:13,794 Where is Lorraine? 499 00:27:13,880 --> 00:27:16,758 - I told you, I don't know. - (MOBILE RINGING) 500 00:27:17,160 --> 00:27:18,275 Clive Archerfield. 501 00:27:18,920 --> 00:27:20,399 Yeah, thanks for getting back to me. 502 00:27:20,480 --> 00:27:22,038 If you need me, I'm in ED. 503 00:27:22,560 --> 00:27:25,074 Hello. Yes, sorry about that. 504 00:27:25,160 --> 00:27:26,593 Yes, we're being advised... 505 00:27:31,520 --> 00:27:33,272 Streaks! Metal! 506 00:27:33,360 --> 00:27:34,759 Who put metal in my machine? 507 00:27:34,840 --> 00:27:36,910 - Going in. - Er, clear to enter. 508 00:27:51,960 --> 00:27:53,029 What's that? 509 00:27:53,120 --> 00:27:55,793 Manifestly, it is the blade of a knife. 510 00:27:56,960 --> 00:27:58,234 Is it penetrating the heart? 511 00:28:09,440 --> 00:28:10,429 Okay. 512 00:28:10,520 --> 00:28:11,589 - Turn. - Yeah. 513 00:28:12,440 --> 00:28:14,476 - Got it? - Open the door. 514 00:28:14,560 --> 00:28:15,549 Clear the bay! 515 00:28:21,120 --> 00:28:23,839 Get all the monitors back as they were. Defib on standby. 516 00:28:23,920 --> 00:28:26,070 Can you see if the ED reg can help? 517 00:28:26,160 --> 00:28:27,673 Let's get these bags up. 518 00:28:32,920 --> 00:28:35,434 - MRS HICKLIN: Justin, back to resus. - Excellent! 519 00:28:36,520 --> 00:28:39,478 - Yes, Harry, and you. - Yes! Um... 520 00:28:40,120 --> 00:28:42,509 Can you get the reg to sign off on this? Thank you. 521 00:28:50,600 --> 00:28:52,591 - The reg coming? - Just me. 522 00:28:53,520 --> 00:28:55,238 They're never going to give you the reg. 523 00:28:55,320 --> 00:28:57,072 Too busy keeping admissions moving. 524 00:28:57,160 --> 00:28:59,310 He seems to be maintaining a blood pressure. 525 00:28:59,400 --> 00:29:02,153 Let's keep transfusing him while we chase cardiothoracics. 526 00:29:04,240 --> 00:29:05,992 Hello, switch, it's Sister Merrick. 527 00:29:06,080 --> 00:29:08,753 Please can you fast bleep cardiothoracic again for us? 528 00:29:08,840 --> 00:29:09,909 Thanks. 529 00:29:10,000 --> 00:29:11,433 Cardiothoracic's fast bleeped. 530 00:29:11,520 --> 00:29:13,351 Told you, car crashes and stabbings. 531 00:29:16,000 --> 00:29:17,956 - Where's Lorraine? - I don't know. 532 00:29:20,120 --> 00:29:21,155 CHANDRAMOHAN: We're fine here. 533 00:29:21,240 --> 00:29:23,356 Just grab a coffee or something, you look like shit. 534 00:29:23,440 --> 00:29:25,396 Tsk, Dr Chandramohan, 535 00:29:25,480 --> 00:29:27,596 using strong language in front of a patient? 536 00:29:27,680 --> 00:29:28,874 He's unconscious. 537 00:29:30,280 --> 00:29:31,793 Police are already checking the traffic cams 538 00:29:31,880 --> 00:29:33,518 to establish the cause of the accident. 539 00:29:33,600 --> 00:29:35,591 No-one was ejected from the bus. 540 00:29:35,680 --> 00:29:38,274 Instead, there was a body in the road which caused vehicles to swerve 541 00:29:38,360 --> 00:29:39,873 and that's how the collisions happened. 542 00:29:39,960 --> 00:29:41,871 They now think our patient must have fallen 543 00:29:41,960 --> 00:29:44,076 or been thrown from a bridge following an assault. 544 00:29:44,160 --> 00:29:45,798 - Thanks, Giles. - You're welcome. 545 00:29:47,200 --> 00:29:49,475 Cardiothoracics will be here in five minutes. 546 00:29:49,560 --> 00:29:51,357 - Good. - What did I say? 547 00:29:51,440 --> 00:29:52,919 Too cold just to have been there since the crash? 548 00:29:53,000 --> 00:29:54,353 Oh, genius! 549 00:30:08,240 --> 00:30:09,593 (MONITOR BEEPING) 550 00:30:16,400 --> 00:30:18,072 He's bleeding out. 551 00:30:19,920 --> 00:30:21,114 BOTH: No output. 552 00:30:21,200 --> 00:30:22,189 PEA. 553 00:30:22,880 --> 00:30:24,950 No compressions, there's a knife in the heart. 554 00:30:25,040 --> 00:30:26,758 We need to stop this bleeding. 555 00:30:26,840 --> 00:30:28,068 Cardiothoracics needs to stop this bleeding. 556 00:30:28,160 --> 00:30:29,434 They're not here. 557 00:30:29,520 --> 00:30:31,272 (BEEPING INTENSIFIES) 558 00:30:31,640 --> 00:30:32,629 No BP. 559 00:30:33,800 --> 00:30:35,313 - Clamshell. - Brilliant! 560 00:30:37,920 --> 00:30:38,989 I'll find Clive. 561 00:30:44,760 --> 00:30:46,273 - Bag him, please. - Yeah. 562 00:30:58,040 --> 00:30:59,359 Take this. 563 00:31:00,320 --> 00:31:01,912 - What, me? - Yes. 564 00:31:52,120 --> 00:31:53,269 Okay to cut? 565 00:31:54,120 --> 00:31:55,439 It's not my call. 566 00:31:57,400 --> 00:31:59,516 - Cutting. - Shit, shit. 567 00:32:16,960 --> 00:32:18,029 Oh, my God! 568 00:32:20,640 --> 00:32:21,868 Harry, get in here. 569 00:32:24,440 --> 00:32:26,749 Grab the wound edges, and pull apart. 570 00:32:36,880 --> 00:32:38,279 Mind your fingers. 571 00:32:56,280 --> 00:32:57,395 Hold it open. 572 00:33:05,320 --> 00:33:06,548 Turn the lever. 573 00:33:08,040 --> 00:33:09,029 Other way. 574 00:33:10,840 --> 00:33:12,034 That's it. 575 00:33:12,760 --> 00:33:13,749 Wider. 576 00:33:18,000 --> 00:33:18,989 Suction. 577 00:33:38,000 --> 00:33:38,989 Do this. 578 00:33:50,800 --> 00:33:52,074 I can feel the knife. 579 00:34:05,400 --> 00:34:06,753 Switching. 580 00:34:06,840 --> 00:34:08,876 - Justin, bring the light over, will you? - JUSTIN: Yeah. 581 00:34:10,600 --> 00:34:12,397 FIONA: Contractions but no output. 582 00:34:23,840 --> 00:34:26,912 The blade has made a tiny hole in the ventricular wall. 583 00:34:28,120 --> 00:34:30,759 - Any bigger, he'd be long dead. - Yeah, he's got all the luck. 584 00:34:33,280 --> 00:34:34,474 I need scissors. 585 00:34:38,960 --> 00:34:41,918 Listen, love, you can't do this without a consultant here. 586 00:34:42,000 --> 00:34:44,798 - Best wait for Clive. - Or cardiothoracics. 587 00:34:47,120 --> 00:34:48,439 He can't wait. 588 00:34:57,600 --> 00:34:59,033 Heart exposed. 589 00:35:16,280 --> 00:35:18,430 Keep the suction going, clear as much blood as you can. 590 00:35:19,200 --> 00:35:20,428 Suture. 591 00:35:20,520 --> 00:35:21,748 Justin, wait. 592 00:35:32,200 --> 00:35:34,236 I need you to do something very important for me. 593 00:35:36,840 --> 00:35:40,435 I need you to put your finger in this hole in the patient's heart. 594 00:35:40,520 --> 00:35:43,159 Will you do that for me, please? Harry? 595 00:36:18,600 --> 00:36:19,589 Okay. 596 00:36:21,600 --> 00:36:22,953 Oh, my God. 597 00:37:09,240 --> 00:37:10,309 Finger out. 598 00:37:22,920 --> 00:37:24,194 That's got it. 599 00:37:28,600 --> 00:37:30,238 FIONA: Bring another bag of blood up, please. 600 00:37:53,440 --> 00:37:54,873 CHANDRAMOHAN: Still no output. 601 00:37:54,960 --> 00:37:56,279 FIONA: Give it a minute. 602 00:38:15,440 --> 00:38:16,429 Got a pulse. 603 00:38:26,880 --> 00:38:28,677 NERYS: Cardiothoracics are here. 604 00:38:35,600 --> 00:38:37,431 WOMAN: Good. Who did this? 605 00:38:41,760 --> 00:38:44,194 Let's transfer to theatre and complete the repair job. 606 00:38:44,280 --> 00:38:45,349 Sister Merrick, TNP. 607 00:38:45,440 --> 00:38:48,352 We need trauma theatre staff fast bleeped. 608 00:38:48,440 --> 00:38:49,509 Thank you. 609 00:38:54,600 --> 00:38:56,431 You just helped save his life. 610 00:38:57,120 --> 00:38:58,109 Thank you. 611 00:38:58,320 --> 00:39:00,595 Orthopaedics, Sister Merrick, resus. 612 00:39:00,680 --> 00:39:02,875 Mike Alpha is ready for you now. Thank you. 613 00:39:20,720 --> 00:39:22,233 You shouldn't have done that. 614 00:39:22,320 --> 00:39:24,117 You're right. 615 00:39:24,200 --> 00:39:25,792 Clive should have. 616 00:39:25,880 --> 00:39:28,553 Clive has a responsibility to this entire department. 617 00:39:29,200 --> 00:39:31,191 It supersedes the needs of individual cases. 618 00:39:32,280 --> 00:39:33,759 Two questions. 619 00:39:34,600 --> 00:39:36,079 What's happened to Lorraine? 620 00:39:36,480 --> 00:39:37,879 Not your concern. 621 00:39:37,960 --> 00:39:40,713 - And the other question? - Who's covering? 622 00:39:41,280 --> 00:39:43,350 It's in your best interest to stay out of this, 623 00:39:43,440 --> 00:39:44,634 so stay out of this. 624 00:39:48,360 --> 00:39:51,716 Hi, Mum. You won't believe what I've just been doing. 625 00:39:55,440 --> 00:39:57,078 No, no, I'm fine. 626 00:40:02,120 --> 00:40:03,269 MAN OVER PA: Colleague announcement. 627 00:40:03,360 --> 00:40:05,430 Multiple incoming casualties. 628 00:40:05,520 --> 00:40:07,670 Will trauma team please return to resus? 629 00:40:08,080 --> 00:40:10,116 (SIREN BLARING) 630 00:40:10,200 --> 00:40:11,189 Colleague announcement. 631 00:40:11,280 --> 00:40:13,350 Multiple incoming casualties. 632 00:40:13,440 --> 00:40:16,193 Will trauma team please return to resus? 633 00:40:37,400 --> 00:40:38,992 (MOBILE CHIMING) 634 00:40:51,400 --> 00:40:52,515 Morning, sir. 635 00:40:53,280 --> 00:40:54,269 Morning. 636 00:40:58,680 --> 00:40:59,829 GLEN: Hello, this is Glen Boyle. 637 00:40:59,920 --> 00:41:02,559 I can't take your call, please leave a message. 638 00:41:03,840 --> 00:41:05,273 It's me. I... 639 00:41:08,120 --> 00:41:11,271 You're the last person I want to call, but... 640 00:41:11,640 --> 00:41:13,358 You're the only one who can help. 641 00:41:15,560 --> 00:41:18,028 I think my boss just got suspended. 642 00:41:20,680 --> 00:41:21,954 Hi, Glen. 643 00:41:22,040 --> 00:41:23,439 Come in. 644 00:41:23,520 --> 00:41:24,509 Thanks. 645 00:41:27,360 --> 00:41:29,191 Good to see you again. 646 00:41:40,440 --> 00:41:41,839 How are you? 647 00:41:47,520 --> 00:41:48,999 You could have opened with an easier one. 648 00:41:50,840 --> 00:41:52,068 (CHUCKLING) 649 00:42:01,560 --> 00:42:04,438 Whatever the grown-ups think, that was the dog's bollocks. 650 00:42:19,200 --> 00:42:20,553 Right here. 651 00:42:24,600 --> 00:42:25,794 Who's leading? 652 00:42:41,360 --> 00:42:43,715 Okay, let's get him wired up, let's get to work. 653 00:42:54,320 --> 00:42:56,117 What's with the whole Elephant Man thing? 654 00:42:56,200 --> 00:42:57,918 - Right. - Oh, my God. 655 00:42:59,280 --> 00:43:01,874 A major trauma case needs a trauma team leader. 656 00:43:01,960 --> 00:43:03,678 CLIVE: Somebody coming in, isn't he here yet? 657 00:43:05,320 --> 00:43:06,719 It's good to see you. 658 00:43:09,160 --> 00:43:11,515 I've practised all over the world. 659 00:43:11,600 --> 00:43:14,194 In the forces, and civilian hospitals. 660 00:43:14,280 --> 00:43:16,714 I specialise in critical injuries. 661 00:43:18,700 --> 00:43:26,100 Ripped By mstoll 662 00:43:26,440 --> 00:43:28,431 (THEME SONG PLAYING) 663 00:43:28,481 --> 00:43:33,031 Repair and Synchronization by Easy Subtitles Synchronizer 1.0.0.0 47717

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