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1
00:00:05,100 --> 00:00:07,570
You're more important
to me than the army is.
2
00:00:07,620 --> 00:00:09,820
That's why I'm staying.
3
00:00:13,180 --> 00:00:16,010
You're absolutely sure?
No nagging doubts?
4
00:00:16,060 --> 00:00:17,800
No, it's time.
5
00:00:18,820 --> 00:00:19,890
Call me.
6
00:00:19,940 --> 00:00:21,490
Why don't you give
me a call some time?
7
00:00:21,540 --> 00:00:23,010
I am SO calling you, babes.
8
00:00:23,060 --> 00:00:24,600
THEY LAUGH
9
00:00:25,260 --> 00:00:27,260
When's the big day?
10
00:00:27,380 --> 00:00:30,050
I asked him not to say anything.
11
00:00:30,500 --> 00:00:32,370
Congratulations.
12
00:00:43,740 --> 00:00:45,450
OK, if you'll just let me explain.
13
00:00:45,500 --> 00:00:47,090
Doesn't matter.
14
00:00:47,140 --> 00:00:50,700
Glen, it's important to me that
you understand the reason why...
15
00:00:50,820 --> 00:00:52,490
Really. What?
16
00:00:55,260 --> 00:00:56,410
Glen.
17
00:00:56,460 --> 00:00:59,000
You and Tom have a nice life.
18
00:01:21,820 --> 00:01:23,090
Glen?
19
00:01:27,900 --> 00:01:29,980
TYRES SCREECH
20
00:01:33,620 --> 00:01:34,890
Shit.
21
00:01:59,300 --> 00:02:00,690
COMPUTER: 'Glen Boyle.
22
00:02:00,740 --> 00:02:02,050
'Calling.'
23
00:02:02,100 --> 00:02:04,040
Come on, come on.
24
00:02:07,620 --> 00:02:09,220
PHONE RINGS
25
00:02:10,780 --> 00:02:13,250
'Hello this is Glen Boyle,
I can't take your call.'
26
00:02:13,300 --> 00:02:14,650
'Glen Boyle.
27
00:02:14,700 --> 00:02:15,930
'Calling.'
28
00:02:15,980 --> 00:02:17,740
PHONE RINGS
29
00:02:21,260 --> 00:02:24,300
Glen? The last thing I
wanted was to hurt you.
30
00:02:26,060 --> 00:02:29,340
You needed help and I came running.
31
00:02:29,500 --> 00:02:32,860
You knew exactly what would happen,
and you just didn't give a shit.
32
00:02:33,020 --> 00:02:36,740
~ Did you?
~ I called you in a moment of weakness because I needed you.
33
00:02:37,940 --> 00:02:42,260
I convinced myself, almost
certainly, you wouldn't come.
34
00:02:42,380 --> 00:02:43,450
But I...
35
00:02:43,500 --> 00:02:45,250
I'm sorry, I can't hear
you - you broke up.
36
00:02:45,300 --> 00:02:46,850
I said, but I did.
37
00:02:46,900 --> 00:02:48,330
Yes, you did.
38
00:02:48,380 --> 00:02:50,010
Two years too late.
39
00:02:50,060 --> 00:02:53,100
~ Oh, come on.
~ I lost our baby, Glen.
40
00:02:54,220 --> 00:02:55,970
I was on my knees.
41
00:02:56,020 --> 00:02:58,010
~ That's when I needed you.
~ You wanted me to go...
42
00:02:58,060 --> 00:03:00,130
I didn't. I... You ran.
43
00:03:00,180 --> 00:03:02,720
Just like you're running now.
44
00:03:03,420 --> 00:03:05,760
Where are you even going?
45
00:03:11,380 --> 00:03:13,580
I don't actually know.
46
00:03:15,260 --> 00:03:16,930
Turn around.
47
00:03:18,060 --> 00:03:19,660
Let's talk.
48
00:03:24,500 --> 00:03:26,450
No, you've made your choice.
49
00:03:26,500 --> 00:03:28,730
What the hell is there to talk about?
50
00:03:28,780 --> 00:03:30,450
'Call ended.'
51
00:03:38,380 --> 00:03:40,020
PHONE RINGS
52
00:03:50,980 --> 00:03:52,720
I'm sorry, OK.
53
00:03:55,860 --> 00:03:57,420
I am.
54
00:03:57,540 --> 00:03:59,090
Tom asked me out of the blue.
55
00:03:59,140 --> 00:04:00,930
He's a good... he's...
56
00:04:00,980 --> 00:04:02,480
CALL FAILS
57
00:04:02,530 --> 00:04:03,530
Shit.
58
00:04:03,580 --> 00:04:04,610
~ Shit.
~ 'Call ended.'
59
00:04:04,660 --> 00:04:06,460
Come on.
60
00:04:06,580 --> 00:04:08,220
PHONE RINGS
61
00:04:13,860 --> 00:04:14,890
Glen?
62
00:04:14,940 --> 00:04:17,130
~ Can you hear me?
~ Yes.
63
00:04:17,180 --> 00:04:18,810
What about Tom?
64
00:04:18,860 --> 00:04:20,530
He loves me.
65
00:04:22,140 --> 00:04:23,740
I love you.
66
00:04:25,220 --> 00:04:27,820
You know, I came back for you.
67
00:04:29,140 --> 00:04:31,340
Put myself on the line.
68
00:04:32,340 --> 00:04:33,740
For you.
69
00:04:34,860 --> 00:04:37,400
And now you're leaving again.
70
00:04:41,420 --> 00:04:43,490
You've made your choice, so...
71
00:04:43,540 --> 00:04:45,940
I don't want you to leave.
72
00:04:47,740 --> 00:04:50,410
I don't want you to leave again.
73
00:04:51,620 --> 00:04:53,500
Glen?
74
00:04:53,620 --> 00:04:55,690
What DO you want, Fiona?
75
00:04:55,740 --> 00:04:59,460
Tell me, right now, what do you want?
76
00:04:59,580 --> 00:05:00,810
I don't know!
77
00:05:00,860 --> 00:05:02,530
Hello? Shit.
78
00:05:04,220 --> 00:05:05,370
Glen?
79
00:05:05,420 --> 00:05:07,930
ELECTRONIC VOICE:
Glen Boyle. Calling.
80
00:05:07,980 --> 00:05:09,860
RINGTONE
81
00:05:13,140 --> 00:05:14,480
Hello?
82
00:05:18,380 --> 00:05:20,450
~ Hello?
~ Hello, Glen?
83
00:05:25,380 --> 00:05:27,620
Glen!
84
00:05:27,740 --> 00:05:29,010
Glen!
85
00:05:37,540 --> 00:05:39,410
CAR ALARM BLARES
86
00:05:55,940 --> 00:05:57,340
Glen!
87
00:05:57,460 --> 00:05:58,900
Glen!
88
00:06:01,100 --> 00:06:06,140
Glen! Can you hear me? Talk to me.
89
00:06:06,260 --> 00:06:07,730
I'm fine.
90
00:06:14,700 --> 00:06:19,420
~ 'Ambulance Service.'
~ My name's Fiona Lomas, I'm a trauma fellow at CGH.
91
00:06:19,580 --> 00:06:23,660
First on scene at an RTC,
two vehicles involved.
92
00:06:23,820 --> 00:06:26,210
~ 'What is your location?'
~ Sorry?
93
00:06:26,260 --> 00:06:28,570
~ 'Your location, madam.'
~ Of course, bear with me.
94
00:06:28,620 --> 00:06:31,860
We're on the B9144
95
00:06:31,980 --> 00:06:34,580
at the crossroads of the A782.
96
00:06:34,740 --> 00:06:37,730
Stand by for further
information on casualties.
97
00:06:37,780 --> 00:06:39,570
Glen, tell me how you're feeling?
98
00:06:39,620 --> 00:06:43,380
I don't know. I'll be OK. You
go and check on the other car.
99
00:06:43,540 --> 00:06:45,970
Go! Check on the other
car, I'll be...
100
00:06:46,020 --> 00:06:50,780
First casualty, GCS 15,
no apparent trauma.
101
00:06:50,900 --> 00:06:52,450
Two further casualties...
102
00:06:52,500 --> 00:06:56,300
Sir, can you hear me? Can
you tell me your name?
103
00:06:56,420 --> 00:06:59,540
Apparent major trauma P1/P2.
104
00:06:59,700 --> 00:07:02,570
I can't give you any further
information now, I'm sorry.
105
00:07:02,620 --> 00:07:04,570
I need to attend to the patients.
106
00:07:04,620 --> 00:07:07,580
Sir, my name is Fiona Lomas,
107
00:07:07,740 --> 00:07:11,220
I'm a trauma doctor at
City General Hospital.
108
00:07:11,380 --> 00:07:14,480
Can you hear me? Can
you tell me your name?
109
00:07:16,500 --> 00:07:19,500
Sir, can you hear me? Can you
open your eyes for me, sir?
110
00:07:25,900 --> 00:07:28,050
~ Glen?
~ Yes. What have we got?
111
00:07:28,100 --> 00:07:29,490
Weak pulse, crushed chest.
112
00:07:29,540 --> 00:07:31,660
~ OK, tubes?
~ Yes.
113
00:07:33,900 --> 00:07:36,250
Don't turn your head
and try not to move.
114
00:07:36,300 --> 00:07:38,450
My name is Glen, I'm
a trauma surgeon.
115
00:07:38,500 --> 00:07:40,170
Can you tell me your name, please?
116
00:07:40,220 --> 00:07:43,010
~ Rory.
~ OK, Rory, I'm going to examine you.
117
00:07:43,060 --> 00:07:45,890
OK, I'm just going
to get this door open.
118
00:07:45,940 --> 00:07:48,100
Shit! It's jammed.
119
00:07:49,940 --> 00:07:53,100
Chest... OK.
120
00:07:53,260 --> 00:07:56,660
Rory, I just need to
feel your abdomen, OK?
121
00:08:07,820 --> 00:08:09,210
Shit. His legs are crushed.
122
00:08:09,260 --> 00:08:12,660
~ Clinically, there's a tension pneumothorax.
~ OK.
123
00:08:13,940 --> 00:08:16,880
Output's gone! We're losing this one!
124
00:08:30,729 --> 00:08:33,159
Releasing tension pneumothorax.
125
00:08:33,209 --> 00:08:34,689
Pulse?
126
00:08:36,089 --> 00:08:37,489
Nothing.
127
00:08:43,969 --> 00:08:46,169
OK, let's get him out.
128
00:08:47,489 --> 00:08:50,089
~ Help him!
~ You OK to lift him?
129
00:08:50,209 --> 00:08:52,529
I'm OK.
130
00:08:52,689 --> 00:08:57,089
~ Forward, you got it?
~ Yep. ~ A little more. Got him.
131
00:08:58,769 --> 00:09:00,509
Take his feet.
132
00:09:05,209 --> 00:09:07,879
~ OK. Take his head.
~ OK. Got it.
133
00:09:10,769 --> 00:09:11,909
OK.
134
00:09:19,689 --> 00:09:22,689
We'll start with bilateral thoracostomies.
135
00:09:25,169 --> 00:09:27,439
Cut his top off, please.
136
00:09:40,849 --> 00:09:42,589
Light, please.
137
00:09:50,809 --> 00:09:52,749
Scissors, please.
138
00:09:54,809 --> 00:09:56,349
Thank you.
139
00:10:04,329 --> 00:10:06,329
Any haemothorax?
140
00:10:06,489 --> 00:10:09,589
Nothing. It's still
on the other side.
141
00:10:12,889 --> 00:10:14,809
What's going on?
142
00:10:14,969 --> 00:10:18,569
Help is on the way, Rory,
just try and stay calm.
143
00:10:20,409 --> 00:10:21,839
Anything?
144
00:10:21,889 --> 00:10:25,789
~ Nothing this side either.
~ OK, I've got to open him up.
145
00:10:30,969 --> 00:10:32,639
Not exactly sterile.
146
00:10:32,689 --> 00:10:35,489
Welcome to operating in the field.
147
00:10:36,129 --> 00:10:39,129
~ SIRENS BLARE IN DISTANCE
~ Nice timing.
148
00:11:02,449 --> 00:11:05,549
Left anterolateral
thoracotomy nearly done.
149
00:11:20,809 --> 00:11:23,479
~ OK, I need your help here.
~ OK.
150
00:11:27,489 --> 00:11:29,559
Examining the heart.
151
00:11:29,809 --> 00:11:33,249
~ BOTH: Tamponade.
~ Got to open the pericardium.
152
00:11:33,369 --> 00:11:35,569
~ Over here!
~ Yes, ma'am!
153
00:11:36,929 --> 00:11:38,039
What can I do for you?
154
00:11:38,089 --> 00:11:40,359
We're trauma surgeons from CGH.
155
00:11:40,409 --> 00:11:44,449
I need you to hold up this light
high so we can see inside his chest.
156
00:11:44,569 --> 00:11:45,679
Oh, my God.
157
00:11:45,729 --> 00:11:49,609
He's got pressure round his heart
that's stopping it from pumping.
158
00:11:49,729 --> 00:11:50,999
What's going on?
159
00:11:51,049 --> 00:11:52,999
Your friend's got fluid
squeezing his heart
160
00:11:53,049 --> 00:11:56,039
and we need to release it so we
can get his heart going again.
161
00:11:56,089 --> 00:11:58,829
It's going to be all right, Rory.
162
00:11:58,889 --> 00:12:01,489
I'm getting some contractions.
163
00:12:02,729 --> 00:12:04,759
OK, that's his heart beating again.
164
00:12:04,809 --> 00:12:07,209
What output are we getting?
165
00:12:09,009 --> 00:12:10,479
Carotid pulse.
166
00:12:10,529 --> 00:12:13,609
~ It isn't enough to give a radial pulse.
~ BVM. In my bag.
167
00:12:26,649 --> 00:12:28,719
Evacuating the clot.
168
00:12:29,849 --> 00:12:32,789
This guy needs to be in theatre. Now.
169
00:12:35,009 --> 00:12:38,489
~ I'm managing his airway. I
need you to get him some oxygen. ~ Yeah.
170
00:12:38,649 --> 00:12:41,119
There's a passenger still
trapped inside the vehicle.
171
00:12:41,169 --> 00:12:44,569
We'll work round you guys
- keep talking. Thank you.
172
00:12:44,729 --> 00:12:46,959
~ I need to RSI.
~ What do you need?
173
00:12:47,009 --> 00:12:49,279
OK, can you continue bagging?
174
00:12:49,329 --> 00:12:52,069
Thio, sux, and a size eight tube.
175
00:12:52,129 --> 00:12:54,599
In the blue bag, just there.
176
00:12:55,689 --> 00:12:59,589
We're going to work on getting
you out of there, mate.
177
00:13:08,889 --> 00:13:11,599
~ All right, what's your name, please?
~ Rory.
178
00:13:11,649 --> 00:13:15,549
All right, Rory, I need you
to hold still for me, OK?
179
00:13:22,009 --> 00:13:24,209
Can I just get in here?
180
00:13:25,209 --> 00:13:29,449
All right, Rory, just keep breathing
deeply and I'll be back in a few seconds, OK? Just keep that on.
181
00:13:34,089 --> 00:13:36,209
OK, cricoid on.
182
00:13:36,329 --> 00:13:39,169
250 milligrams thio going in now.
183
00:13:44,849 --> 00:13:46,649
Intubating now.
184
00:13:49,889 --> 00:13:51,289
Tube in.
185
00:13:59,449 --> 00:14:00,849
Cuff up.
186
00:14:03,129 --> 00:14:04,269
OK.
187
00:14:09,209 --> 00:14:10,609
Breath.
188
00:14:14,089 --> 00:14:15,489
Breath.
189
00:14:16,289 --> 00:14:19,229
~ OK, it's inflating now.
~ Cricoid off.
190
00:14:20,689 --> 00:14:22,489
Cardiac output?
191
00:14:25,409 --> 00:14:26,839
OK, it's 120, but it's weak.
192
00:14:26,889 --> 00:14:29,079
OK, it's about as stable
as he's going to get.
193
00:14:29,129 --> 00:14:31,439
~ I agree. Cas-evac?
~ We've got scoops and blocks.
194
00:14:31,489 --> 00:14:33,889
Let's get it done, please.
195
00:14:37,169 --> 00:14:38,679
Anything we can do?
196
00:14:38,729 --> 00:14:40,729
Is David all right?
197
00:14:40,809 --> 00:14:43,439
Someone take over the
transfer for me, please.
198
00:14:43,489 --> 00:14:45,399
OK, I need you to hold his head.
199
00:14:45,449 --> 00:14:49,449
Rory, he's in a bad way but we're
doing the very best we can for him.
200
00:14:49,609 --> 00:14:51,719
OK, he needs to be in an
operating theatre ASAP.
201
00:14:51,769 --> 00:14:53,359
Call that in, please.
202
00:14:53,409 --> 00:14:55,999
~ Do you know David's surname?
~ Hanson.
203
00:14:56,049 --> 00:14:59,889
~ And by any chance would
you know his date of birth? ~ 6th April, 1981.
204
00:15:00,009 --> 00:15:02,289
~ OK.
~ Are we ready to go?
205
00:15:02,449 --> 00:15:05,529
~ I want to say goodbye to him!
~ Your mate needs to be in a hospital, Rory.
206
00:15:05,649 --> 00:15:08,749
He's not my mate...
He's my boyfriend.
207
00:15:09,449 --> 00:15:10,729
OK.
208
00:15:13,049 --> 00:15:16,329
Let's get the trolley round to
the other side, please, now.
209
00:15:17,689 --> 00:15:20,689
~ Quick as we can.
~ OK.
210
00:15:20,809 --> 00:15:22,679
He's on his way.
211
00:15:26,289 --> 00:15:28,429
Can I touch his hand?
212
00:15:43,729 --> 00:15:45,329
I love you.
213
00:15:50,049 --> 00:15:53,049
It's OK. It's OK.
214
00:15:54,569 --> 00:15:57,649
I'm sorry, we need to get
him to the hospital now.
215
00:15:57,769 --> 00:15:59,839
Let's go. Thank you.
216
00:16:05,209 --> 00:16:07,279
~ You should go with him.
~ Glen...
217
00:16:07,329 --> 00:16:09,359
He needs a surgeon with him.
218
00:16:09,409 --> 00:16:12,709
I'll see you when you
bring that one in, yes?
219
00:16:15,089 --> 00:16:19,449
This is Fiona Lomas, I'm one
of the surgical registrars.
220
00:16:19,609 --> 00:16:22,909
Please can you connect
me to the Alert Phone?
221
00:16:25,129 --> 00:16:28,449
Nicola, it's Fiona.
222
00:16:28,609 --> 00:16:31,849
Glen and I are first
on scene at an RTC.
223
00:16:32,009 --> 00:16:36,569
We've two patients coming your
way. First, male, 30s, driver,
224
00:16:36,689 --> 00:16:38,689
blunt chest trauma.
225
00:16:39,089 --> 00:16:43,569
Yes. His name is David Hanson,
date of birth, 6th...
226
00:17:10,096 --> 00:17:13,036
On three. One, two, three, and lift.
227
00:17:37,853 --> 00:17:39,763
Vehicle's made safe
if you want to go in.
228
00:17:39,813 --> 00:17:41,563
Thank you very much.
229
00:17:41,613 --> 00:17:45,113
~ Can you get control of the C-spine please?
~ Sure.
230
00:17:47,373 --> 00:17:49,773
Let's get him flat, please.
231
00:17:51,653 --> 00:17:53,453
Gently, slowly.
232
00:17:56,973 --> 00:17:59,643
All right, Rory, we're just going
to check your blood pressure
233
00:17:59,693 --> 00:18:01,723
and your oxygen levels, all right?
234
00:18:01,773 --> 00:18:04,043
Put this on your finger.
235
00:18:06,013 --> 00:18:08,973
Abdomen is tense and full.
236
00:18:26,293 --> 00:18:29,293
BP 60 over 35.
237
00:18:29,413 --> 00:18:30,813
Christ.
238
00:18:35,133 --> 00:18:36,563
All right, Billy?
239
00:18:36,613 --> 00:18:39,533
Er, I was just passing.
240
00:18:52,173 --> 00:18:55,693
~ You've been listening in on
a police channel, haven't you? ~ No.
241
00:18:55,813 --> 00:18:58,683
~ No.
~ Either way - glad you're here.
242
00:19:03,853 --> 00:19:06,253
~ Mr Boyle.
~ Yeah?
243
00:19:06,373 --> 00:19:08,913
I might be of some help here.
244
00:19:09,973 --> 00:19:13,013
You might have some ketamine
in your grab-bag.
245
00:19:14,253 --> 00:19:18,533
I couldn't possibly have
it. I'm just an ODP.
246
00:19:21,413 --> 00:19:23,953
Billy, could you possibly see
247
00:19:24,013 --> 00:19:26,443
if you can find some ketamine
in my grab-bag, please?
248
00:19:26,493 --> 00:19:28,893
I'll have a look, Mr Boyle.
249
00:19:49,333 --> 00:19:52,853
~ There's your ketamine, Mr Boyle.
~ OK.
250
00:19:53,013 --> 00:19:55,923
I'm just giving you something
to make you comfortable, OK?
251
00:19:55,973 --> 00:19:59,133
Can you tell me what your surname
is and your date of birth, please?
252
00:19:59,253 --> 00:20:00,763
Billy, can you get this down?
253
00:20:00,813 --> 00:20:05,093
Roberts. 19th January 1983.
254
00:20:05,213 --> 00:20:06,753
Thank you.
255
00:20:09,133 --> 00:20:11,073
20mg ketamine in.
256
00:20:13,653 --> 00:20:16,603
OK, guys, let's make some
space. Get his legs free.
257
00:20:16,653 --> 00:20:19,133
ENGINE SPLUTTERS
258
00:20:19,253 --> 00:20:22,253
ENGINE WHIRS
259
00:20:22,413 --> 00:20:25,513
~ Bit of noise, you'll be all right.
~ Yeah...
260
00:20:29,453 --> 00:20:31,573
METAL GROANS
261
00:20:31,733 --> 00:20:33,803
~ HE SCREAMS
~ All right, it's all right.
262
00:20:33,853 --> 00:20:37,013
~ STOP! Let me get in.
~ You're doing really well. ~ You OK?
263
00:20:37,133 --> 00:20:38,673
That's it.
264
00:20:39,533 --> 00:20:42,633
~ Just going to get your leg out.
~ HE WHIMPERS
265
00:20:46,453 --> 00:20:49,523
~ You're doing really well, really well.
~ Thank you.
266
00:20:49,573 --> 00:20:52,653
~ Billy, can we release the tourniquet
nice and slowly, please? ~ (Yeah.)
267
00:20:56,693 --> 00:20:58,233
Thank you.
268
00:21:00,053 --> 00:21:03,053
Yep, OK, this is doing the job.
269
00:21:03,213 --> 00:21:06,203
~ Let's go again, let's get
this other leg out please. ~ Carry on!
270
00:21:06,253 --> 00:21:07,563
ENGINE SPLUTTERS,
271
00:21:07,613 --> 00:21:09,683
METAL CREAKS AND GROANS
272
00:21:09,733 --> 00:21:11,493
HE WHIMPERS
273
00:21:13,533 --> 00:21:15,773
HYDRAULICS WHIR
274
00:21:15,893 --> 00:21:17,293
Cut it!
275
00:21:18,653 --> 00:21:21,733
~ Let me see, please.
~ No, you need to keep going.
276
00:21:21,893 --> 00:21:24,563
We can't get any more
clearance. The leg is stuck.
277
00:21:24,613 --> 00:21:27,123
~ OK.
~ You're doing really well, mate.
278
00:21:27,173 --> 00:21:28,883
Let's have another BP please.
279
00:21:28,933 --> 00:21:31,013
Yeah.
280
00:21:31,173 --> 00:21:34,043
So, Rory, I'm just going to
have to feel your belly again.
281
00:21:34,093 --> 00:21:37,043
Nah, it's 50 over
unreadable. It's dropping.
282
00:21:37,093 --> 00:21:39,363
INSTRUMENTS BEEP RAPIDLY
283
00:21:41,013 --> 00:21:44,213
It's looking like there's only one
way to get him out of there in time.
284
00:21:44,373 --> 00:21:46,403
Unless you've got something
you can come up with
285
00:21:46,453 --> 00:21:49,163
in the next five minutes
that will release that leg?
286
00:21:49,213 --> 00:21:51,883
Not in five minutes. I'm sorry.
287
00:21:55,373 --> 00:21:58,043
~ Hey, Rory, can you hear me?
~ HE GASPS
288
00:21:58,093 --> 00:21:59,613
Rory?
289
00:21:59,733 --> 00:22:01,683
Listen, your right leg's trapped.
290
00:22:01,733 --> 00:22:05,133
And I'm very concerned that you might
have a massive bleed in your belly.
291
00:22:05,253 --> 00:22:06,963
I'm going to be honest with you.
292
00:22:07,013 --> 00:22:10,173
If I don't get you to a hospital within
the next hour, you're going to die.
293
00:22:11,253 --> 00:22:13,393
Do you understand me?
294
00:22:13,733 --> 00:22:17,133
I'm sorry, but that's why
I have to amputate your leg.
295
00:22:17,293 --> 00:22:20,933
Now, you listen to me.
I've done this before.
296
00:22:21,093 --> 00:22:23,443
So, I know that I can
save your knee joint.
297
00:22:23,493 --> 00:22:25,563
And that means that with
a simple prosthetic,
298
00:22:25,613 --> 00:22:29,213
you will be able to walk again,
and you'll even be able to run.
299
00:22:29,373 --> 00:22:32,373
OK? We're going to pump you
full of some painkillers.
300
00:22:32,533 --> 00:22:34,923
~ .. Any more of that ketamine left?
~ Yes, you do.
301
00:22:34,973 --> 00:22:36,493
OK.
302
00:22:36,653 --> 00:22:39,283
~ Make it up to a total of 120.
~ Coming up.
303
00:22:39,333 --> 00:22:40,473
OK.
304
00:22:40,613 --> 00:22:44,053
I'm going to need gloves and
antiseptic from your truck.
305
00:22:44,213 --> 00:22:46,803
I've got blast dressings,
but I need you to get me
306
00:22:46,853 --> 00:22:49,523
~ a couple of blankets
and some bandages, please. ~ Yep.
307
00:22:49,573 --> 00:22:51,913
~ There you go.
~ Thank you.
308
00:22:52,013 --> 00:22:54,323
Listen, you wouldn't happen
to have sux and a tube,
309
00:22:54,373 --> 00:22:56,773
would you? We've used mine.
310
00:22:58,213 --> 00:23:00,613
I've got roc. In your bag.
311
00:23:01,853 --> 00:23:03,603
OK. And are you up to tubing him,
312
00:23:03,653 --> 00:23:06,323
under my supervision, obviously?
313
00:23:07,093 --> 00:23:09,093
Er, yeah.
314
00:23:09,213 --> 00:23:11,413
~ Good man.
~ All right.
315
00:23:11,533 --> 00:23:14,473
Let's get that head rest off, please.
316
00:23:15,693 --> 00:23:17,493
Come down here.
317
00:23:18,853 --> 00:23:20,563
~ Have you got him?
~ Yep.
318
00:23:20,613 --> 00:23:23,153
~ There's your roc.
~ Thank you.
319
00:23:26,253 --> 00:23:28,093
HE EXHALES
320
00:23:30,973 --> 00:23:34,373
There's a tube, Thomas.
321
00:23:38,733 --> 00:23:40,733
Cricoid on, please.
322
00:23:40,813 --> 00:23:42,883
Let me get the mask.
323
00:23:44,533 --> 00:23:46,133
Cricoid on.
324
00:23:47,773 --> 00:23:51,573
80mg roc going in now.
325
00:23:51,733 --> 00:23:54,453
HE EXHALES Here we go.
326
00:23:54,573 --> 00:23:56,643
Bring him this way a little bit.
327
00:23:56,693 --> 00:23:58,893
HE EXHALES Here we go.
328
00:24:08,613 --> 00:24:09,883
Tube.
329
00:24:20,493 --> 00:24:21,893
Cuff up.
330
00:24:22,013 --> 00:24:23,813
OK. I'll do it.
331
00:24:25,493 --> 00:24:26,693
Bag.
332
00:24:27,693 --> 00:24:28,973
Ta.
333
00:24:29,093 --> 00:24:30,893
Here we go.
334
00:24:34,293 --> 00:24:36,123
~ Breath.
~ HISSING
335
00:24:36,173 --> 00:24:39,373
~ Breath.
~ HISSING
336
00:24:39,493 --> 00:24:41,693
Both lungs ventilated!
337
00:24:42,653 --> 00:24:44,803
Cricoid off, please. HE PANTS
338
00:24:44,853 --> 00:24:46,763
Well done, Billy.
339
00:24:46,813 --> 00:24:50,013
~ Ta. Let's get that brace on here.
~ Brace.
340
00:24:56,173 --> 00:24:58,293
FABRIC RIPS
341
00:25:07,573 --> 00:25:10,363
I don't have enough
room here for a saw.
342
00:25:10,413 --> 00:25:11,803
Do you have bolt-cutters?
343
00:25:11,853 --> 00:25:13,733
Bolt croppers?
344
00:25:13,893 --> 00:25:15,843
OK, listen. This is going
to need to be fast.
345
00:25:15,893 --> 00:25:18,003
Billy, I need you to move
this tourniquet down
346
00:25:18,053 --> 00:25:20,443
to just above his knee and
then pull it tight, please.
347
00:25:20,493 --> 00:25:23,283
~ And I mean tight as a drum. Yes?
~ Yeah.
348
00:25:23,333 --> 00:25:24,673
Sorry.
349
00:25:28,293 --> 00:25:30,373
Tell me when.
350
00:25:30,493 --> 00:25:31,843
Yeah, got it.
351
00:25:31,893 --> 00:25:34,833
~ Fresh blade in there, please.
~ Yeah.
352
00:25:39,853 --> 00:25:41,573
There you go.
353
00:25:43,093 --> 00:25:44,893
~ We good?
~ Yeah.
354
00:25:45,013 --> 00:25:46,413
Cutting.
355
00:25:59,053 --> 00:26:00,793
Coming around.
356
00:26:18,453 --> 00:26:21,283
~ Do you have any more
of that antiseptic, Billy? ~ Yeah.
357
00:26:21,333 --> 00:26:23,693
~ Throw it on there.
~ Yep.
358
00:26:23,813 --> 00:26:25,933
~ And here.
~ Yep.
359
00:26:28,813 --> 00:26:30,333
OK.
360
00:26:34,893 --> 00:26:37,363
I'm going to snap the tibia.
361
00:26:43,093 --> 00:26:44,433
CRACK!
362
00:26:45,733 --> 00:26:47,643
Still with me, Billy?
363
00:26:47,693 --> 00:26:51,133
~ Put it this way, I won't be having
barbecue ribs for a while... ~ GLEN CHUCKLES
364
00:26:51,253 --> 00:26:53,053
Now the fibula.
365
00:26:59,333 --> 00:27:00,673
CRACK!
366
00:27:01,573 --> 00:27:03,773
Here. Get me the blade.
367
00:27:05,573 --> 00:27:07,643
I'm not going to spend
any time prettifying it
368
00:27:07,693 --> 00:27:09,523
until we get him in hospital.
369
00:27:09,573 --> 00:27:12,973
~ I'm just going to wrap the
stump. Billy - antiseptic. ~ Yep.
370
00:27:15,293 --> 00:27:17,833
~ And the blast dressing.
~ Yep.
371
00:27:20,253 --> 00:27:22,893
~ Got it.
~ Thank you.
372
00:27:28,413 --> 00:27:32,333
~ Billy?
~ Yeah. ~ Call CGH, tell them that
373
00:27:37,293 --> 00:27:40,853
Ah, Mrs Hicklin, yeah, it's Billy
Finlay, at the scene with Glen.
374
00:27:40,973 --> 00:27:42,963
~ 'What?'
~ Don't ask.
375
00:27:43,013 --> 00:27:46,333
We've extracted the second
casualty via a BK amputation.
376
00:27:46,493 --> 00:27:49,533
Rory Roberts. Date of birth,
19th of the first, 1983.
377
00:27:49,693 --> 00:27:52,363
Suspected severe
intra-abdominal haemorrhage.
378
00:27:52,413 --> 00:27:56,053
Suspected severe
intra-abdominal haemorrhage.
379
00:27:56,213 --> 00:27:59,163
Thanks. Nicola says she'll
have a theatre ready for him.
380
00:27:59,213 --> 00:28:00,603
OK, this is a scoop-and-run.
381
00:28:00,653 --> 00:28:03,043
He needs to be opened up in
theatre. Can we go, please?
382
00:28:03,093 --> 00:28:05,683
~ Can I get a trolley, please?
~ Tell me when we're ready, please.
383
00:28:05,733 --> 00:28:07,803
Get the board ready!
384
00:28:18,773 --> 00:28:20,533
WHIRRING
385
00:28:20,653 --> 00:28:24,053
On three. One, two, three.
386
00:28:28,973 --> 00:28:32,533
This time, all the way
to the trolley. We ready?
387
00:28:32,653 --> 00:28:35,323
Then on three. One, two, three.
388
00:28:45,773 --> 00:28:47,913
OK, let's get him in.
389
00:28:49,733 --> 00:28:52,133
Thank you, the other side.
390
00:28:59,133 --> 00:29:01,403
Quick as we can, please.
391
00:29:04,573 --> 00:29:06,243
OK, that's us. Thank you.
392
00:29:06,293 --> 00:29:08,683
~ Good work.
~ Cheers. ~ Thanks a lot, guys, let's go.
393
00:29:08,733 --> 00:29:10,563
Well done, everyone.
394
00:29:10,613 --> 00:29:13,083
OK, have you got everything?
395
00:29:20,773 --> 00:29:22,243
Mind out.
396
00:29:23,373 --> 00:29:24,893
In.
397
00:29:26,373 --> 00:29:29,313
~ I'll take over, mate.
~ Thank you. Ta.
398
00:29:29,973 --> 00:29:33,073
Need to give another
30 bolus for ket.
399
00:29:33,293 --> 00:29:35,633
~ There you go.
~ Thank you.
400
00:29:39,373 --> 00:29:41,173
DOOR SLAMS SHUT
401
00:29:44,813 --> 00:29:46,613
~ It's done.
~ Ta.
402
00:29:53,173 --> 00:29:56,973
~ You, er... You written off your motor, then?
~ I have yeah.
403
00:29:58,493 --> 00:30:00,633
Want to buy a Fiesta?
404
00:30:04,933 --> 00:30:06,003
Here.
405
00:30:06,053 --> 00:30:08,323
~ What?
~ Give me the keys.
406
00:30:09,573 --> 00:30:12,173
Amazing! Is a grand all right?
407
00:30:13,053 --> 00:30:15,603
Send me the logbook,
I'll send you the cash.
408
00:30:15,653 --> 00:30:18,323
Can you hold that door, please?
409
00:30:19,493 --> 00:30:24,133
You did really well tonight, Billy.
It's been great working with you.
410
00:30:24,253 --> 00:30:25,653
Thanks.
411
00:30:29,053 --> 00:30:31,393
I'll see you back at CGH?
412
00:30:32,133 --> 00:30:33,893
~ Go.
~ Glen!
413
00:30:34,013 --> 00:30:35,553
DOOR SLAMS
414
00:30:37,573 --> 00:30:39,653
ENGINE STARTS
415
00:30:45,293 --> 00:30:48,013
SIREN WAILS
416
00:30:55,693 --> 00:30:57,893
SIREN FADES
417
00:31:07,400 --> 00:31:09,000
Ms Lomas! >
418
00:31:10,480 --> 00:31:12,160
Thank you.
419
00:31:20,920 --> 00:31:22,710
(Cheeky bastard!)
420
00:31:22,760 --> 00:31:24,470
Fiona Lomas, Trauma Fellow.
421
00:31:24,520 --> 00:31:26,310
Debbie Wong, Scrub Nurse.
422
00:31:26,360 --> 00:31:29,110
Sarah Molloy, Consultant Anaesthetist.
423
00:31:29,160 --> 00:31:32,280
Adrian Sands, Anaesthetic ODP. Bruce
Corby, Rapid Infuser Operator...
424
00:31:41,200 --> 00:31:44,880
.. Alice Murkherjee, Consultant
Cardiothoracic Surgeon.
425
00:31:45,040 --> 00:31:49,560
Patient is David Hanson, date of
birth, 6th of the fourth, 1981.
426
00:31:49,680 --> 00:31:51,230
Patient was the driver in an RTC,
427
00:31:51,280 --> 00:31:54,400
and has sustained blunt chest trauma.
428
00:31:54,520 --> 00:31:56,070
I've signed a Consent Form 4
429
00:31:56,120 --> 00:31:59,070
for exploration of thoracic
cavity plus proceed.
430
00:31:59,120 --> 00:32:00,790
ENGINE STARTS
431
00:32:05,760 --> 00:32:07,500
Swabs, please.
432
00:32:09,760 --> 00:32:11,160
Scalpel.
433
00:32:14,560 --> 00:32:16,870
First, we'll explore the chest cavity
434
00:32:16,920 --> 00:32:18,510
for any ruptures or bleeds,
435
00:32:18,560 --> 00:32:22,320
and then we'll get on with repairing
the damage to the heart.
436
00:32:26,200 --> 00:32:28,600
< Ready when you are, sir!
437
00:32:39,920 --> 00:32:42,120
Finochietto retractor.
438
00:32:43,960 --> 00:32:45,500
Thank you.
439
00:32:56,320 --> 00:32:58,060
Packs, please.
440
00:33:09,080 --> 00:33:12,080
~ Where's Glen?
~ Probably already broken down and on to the AA.
441
00:33:12,240 --> 00:33:15,680
Trauma Theatre's occupied at the
minute, we're just waiting on one.
442
00:33:17,000 --> 00:33:20,200
~ Theatre 6.
~ Great! ~ Theatre 6. Thanks, Giles.
443
00:33:22,560 --> 00:33:24,040
Pack A.
444
00:33:24,160 --> 00:33:26,160
Two units of O pos.
445
00:33:27,800 --> 00:33:30,550
~ Quick handover to
~ Dr Bennett-Edwardes.
446
00:33:30,600 --> 00:33:32,140
That's me.
447
00:33:32,750 --> 00:33:34,580
Rory Roberts, 32-year-old,
448
00:33:34,630 --> 00:33:37,630
front seat passenger involved
in a multi vehicle RTC
449
00:33:37,790 --> 00:33:40,830
at approximately 2230.
Crush injuries both legs.
450
00:33:40,990 --> 00:33:44,060
Prolonged extrication requiring
right-sided below-knee amputation.
451
00:33:44,110 --> 00:33:46,060
Suspected intra-abdominal haemorrhage...
452
00:33:46,110 --> 00:33:47,780
This is Mrs Hicklin.
Theatres, please.
453
00:33:47,830 --> 00:33:50,470
Pulse 160, BP 60 over 30.
454
00:33:50,590 --> 00:33:53,130
RSI'd with 120mg of ketamine,
455
00:33:53,190 --> 00:33:57,230
rocuronium 80 mg, plus bolus
for transfer of another 30 ket.
456
00:33:59,390 --> 00:34:02,670
~ Great, thanks. Ready.
~ Great, let's do it.
457
00:34:03,910 --> 00:34:07,550
I need to know who's on for general
surg. Who will be the anaesthetist?
458
00:34:07,670 --> 00:34:09,740
Who'll be operating?
459
00:34:11,150 --> 00:34:14,630
~ Yes, I'll hold. Guys,
please can you do this? ~ < the necessary paperwork
460
00:34:14,790 --> 00:34:18,030
~ < with Giles Dhillon at the front desk?
~ Yep, will do. ~ Thank you.
461
00:34:19,230 --> 00:34:20,900
Cheers, guys.
462
00:34:22,590 --> 00:34:24,940
Well, we're en route
to Theatre 6 now.
463
00:34:24,990 --> 00:34:27,790
Who's there for the patient? Fine.
464
00:34:30,470 --> 00:34:33,340
Dr Jones is just covering
the transfer.
465
00:34:33,390 --> 00:34:36,300
Ramakrishna Chandramohan will
be your anaesthetist in theatre.
466
00:34:36,350 --> 00:34:39,290
~ Who's the surgeon?
~ I'll get you one.
467
00:34:41,350 --> 00:34:44,550
Three blood, two FFP, straight
in. Filling him up.
468
00:34:44,670 --> 00:34:45,990
OK.
469
00:34:48,430 --> 00:34:51,030
~ BEEPING
~ How's it going?
470
00:34:52,430 --> 00:34:55,420
No active bleeding at present.
No pelvic fractures.
471
00:34:55,470 --> 00:34:58,670
FAST scan shows there's no
free fluid in the abdomen.
472
00:34:58,790 --> 00:35:00,020
Patient is stable.
473
00:35:00,070 --> 00:35:02,460
Great. Alice, I need Fiona urgently.
474
00:35:02,510 --> 00:35:04,820
I'm good here. Thanks, Fiona.
475
00:35:04,870 --> 00:35:07,740
~ Thanks.
~ All done? ~ Thank you.
476
00:35:09,710 --> 00:35:13,590
~ The other trauma from the RTC,
he's on his way to theatre. ~ OK.
477
00:35:19,310 --> 00:35:21,910
~ Is Glen with the patient?
~ No.
478
00:35:22,510 --> 00:35:24,380
Glen confirmed to me this week
479
00:35:24,430 --> 00:35:28,150
that he's not taking up the
extension on his contract.
480
00:35:28,270 --> 00:35:30,610
He's resigned. I'm sorry.
481
00:35:31,550 --> 00:35:34,490
Theatre 6, Rory Roberts, laparotomy.
482
00:35:41,190 --> 00:35:42,530
Billy!
483
00:35:42,630 --> 00:35:44,030
BEEPING
484
00:35:45,350 --> 00:35:49,390
I didn't want to say in front of the
others but... you were brilliant.
485
00:35:54,150 --> 00:35:55,750
Call me.
486
00:36:03,750 --> 00:36:05,670
MONITORS BEEP
487
00:36:25,430 --> 00:36:27,230
You'll be fine.
488
00:36:36,030 --> 00:36:37,370
Blade.
489
00:36:41,870 --> 00:36:43,510
OK to cut?
490
00:36:43,630 --> 00:36:44,870
OK.
491
00:36:49,390 --> 00:36:50,790
Cutting.
492
00:36:58,670 --> 00:37:00,470
Swabs to Harry.
493
00:37:06,030 --> 00:37:07,550
Forceps.
494
00:37:11,710 --> 00:37:13,180
Scissors.
495
00:37:19,470 --> 00:37:21,620
I'm going to open the peritoneum.
496
00:37:21,670 --> 00:37:23,070
Suction.
497
00:37:24,830 --> 00:37:26,700
Everybody ready?
498
00:37:27,990 --> 00:37:29,530
OK, ready.
499
00:37:30,110 --> 00:37:32,300
Just follow my lead, Harry,
500
00:37:32,350 --> 00:37:34,710
and you'll be fine.
501
00:37:36,150 --> 00:37:37,750
Here we go.
502
00:37:51,150 --> 00:37:52,940
Packs. Packing!
503
00:37:52,990 --> 00:37:55,150
Just whack it in.
504
00:38:06,230 --> 00:38:08,180
Five packs in the abdomen.
505
00:38:08,230 --> 00:38:10,710
~ Five in.
~ Packs!
506
00:38:16,710 --> 00:38:18,100
Five more in.
507
00:38:18,150 --> 00:38:19,300
Ten in.
508
00:38:19,350 --> 00:38:21,110
Morris.
509
00:38:24,070 --> 00:38:25,740
Hold it here.
510
00:38:26,990 --> 00:38:28,390
Morris.
511
00:38:30,550 --> 00:38:32,150
ALARMS BEEP
512
00:38:32,310 --> 00:38:34,740
~ Shit.
~ OK, BP's dropped back to 60 over 30.
513
00:38:34,790 --> 00:38:36,620
There's no point us putting blood in
514
00:38:36,670 --> 00:38:38,820
if he's going to leak
it out everywhere...
515
00:38:38,870 --> 00:38:41,580
~ Haemorrhaging from the left upper quadrant.
~ Spleen?
516
00:38:41,630 --> 00:38:43,500
Yes. Management?
517
00:38:43,550 --> 00:38:44,940
Splenectomy.
518
00:38:44,990 --> 00:38:46,750
Yep. Roberts.
519
00:38:52,310 --> 00:38:53,780
Swapsies.
520
00:38:56,110 --> 00:38:58,050
Keep at it, Harry.
521
00:39:00,350 --> 00:39:04,750
~ In with suction, I need
you to keep the field clear. ~ Mm-hm.
522
00:39:07,310 --> 00:39:08,620
OK, I'm struggling.
523
00:39:08,670 --> 00:39:09,980
METAL CLATTERS
524
00:39:10,030 --> 00:39:12,900
I need you to hold the bowel clear.
525
00:39:20,670 --> 00:39:22,210
Oh, God...
526
00:39:24,190 --> 00:39:25,460
OK...
527
00:39:27,550 --> 00:39:30,110
Got it. Roberts.
528
00:39:34,710 --> 00:39:37,950
Splenic vessels clamped.
529
00:39:38,070 --> 00:39:39,540
McIndoes.
530
00:39:39,630 --> 00:39:41,180
Fill him up.
531
00:39:41,230 --> 00:39:42,430
Yep.
532
00:39:51,670 --> 00:39:54,540
I've divided the splenic ligaments.
533
00:39:58,550 --> 00:40:01,290
Splenic vessels divided. Roberts.
534
00:40:10,030 --> 00:40:12,910
Short gastric vessels clamped.
535
00:40:13,030 --> 00:40:14,500
McIndoes.
536
00:40:24,430 --> 00:40:27,030
Short gastric vessels divided.
537
00:40:35,750 --> 00:40:37,420
Stop suction.
538
00:40:41,270 --> 00:40:43,670
The bleed's under control.
539
00:40:45,310 --> 00:40:47,380
~ MONITORS BEEP
~ Good.
540
00:40:49,470 --> 00:40:51,140
Ramakrishna?
541
00:40:55,990 --> 00:40:57,660
BP coming up.
542
00:41:02,630 --> 00:41:04,170
Coming up.
543
00:41:06,470 --> 00:41:08,150
BP holding.
544
00:41:08,270 --> 00:41:10,870
Systolic 80. That's good work.
545
00:41:11,350 --> 00:41:13,750
We'll keep filling him up.
546
00:41:14,750 --> 00:41:18,230
So, blood, FFP, platelets, 3-to-2-to-1.
547
00:41:18,350 --> 00:41:19,820
Got that.
548
00:41:19,910 --> 00:41:21,450
OK, what?!
549
00:41:23,910 --> 00:41:25,980
Good work, everyone.
550
00:41:30,590 --> 00:41:31,860
OK...
551
00:41:33,910 --> 00:41:37,630
I'm going to remove the spleen to
make room for tying off the vessels.
552
00:41:39,870 --> 00:41:41,350
McIndoes.
553
00:41:43,670 --> 00:41:45,070
Fiona...
554
00:42:08,910 --> 00:42:11,910
~ Have you found someone to replace me yet?
~ Yes.
555
00:42:12,070 --> 00:42:15,950
~ I'll phone her in the morning
and tell her to stand down. ~ Thank you.
556
00:42:16,070 --> 00:42:17,870
You're welcome.
557
00:42:28,670 --> 00:42:31,310
~ All right, Billy.
~ Mr Boyle.
558
00:42:45,310 --> 00:42:47,580
Do you want to scrub in?
559
00:42:47,950 --> 00:42:50,550
No, I think you should finish.
560
00:42:53,710 --> 00:42:54,980
Dish.
561
00:43:08,070 --> 00:43:10,140
Removing the spleen.
562
00:43:11,950 --> 00:43:13,420
DULL THUD
563
00:43:15,950 --> 00:43:18,830
See, you don't need me at all.
564
00:43:22,830 --> 00:43:24,430
I wouldn't say that.
565
00:43:24,480 --> 00:43:29,030
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