Original subtitles

Yesterday I promised her I’ll be back earlier. And failed.

- I’ll try today. - And you have Krystian.

Right, my trolley.

It’s the hospital’s.

An accident victim’s incoming. Shortly.

Only I reserved this.

It’s not a bar. We don’t take reservations.

Yeah, right, I see.

What’s so funny?

Nothing, I was just wondering if you’re more pissed…

Spare me your philosophy.

- I think Zuza would like to hear this. - Ambulance’s here.

Sinus bradycardia, supraventricular arrhythmia and hypotension.

And the bleeding? External injuries?

I think he’s mine. Let’s go.

- What about the accident? - Help me, please!

I was about to tell you...

He died on the way, we just got the message.

May I?

You can always help me.

I will if you don’t manage on your own.

Who’s not managing here?

ER

Help me, please!

- Prolonged QT interval in ECG. - He got 5 mg of metoprolol.

Slowing down his pulse? Do you want to kill him?

You didn’t do cardioversion?

We don’t shock them just like that.

Then maybe look for a different job if you’re too scared?

Have you checked his electrolytes?

Piotr?

- Yeah, right. - Do we move him?

Yes, please.

On three.

One, two, three!

Pain in the chest, sharper when breathing.

- Good morning, Katarzyna Zawadzka. - Hello.

We have to check your heart.

Is this a heart attack?

Possibly, but let’s do an EKG, and blood tests. Then we’ll see.

Come with me.

Please leave! I’m done talking to you.

Please, sit down.

- We’re saving lives here. - Call Zuza for this gentleman.

- GPs deal with headaches. - My GP didn’t help me.

- I thought you were better. - Where’s Łukasz, my son?

- An ambulance brought him in. - Please wait.

But he fainted. I need to see him.

- Your son is undergoing tests. - Where?

- You’ll get in once the doctor’s done. - He was barely breathing. And if he dies?

- He’s in good hands, okay? - He better be!

Please come through for tests.

Ola, gasometry, full blood count, biochemistry and coagulation.

- Right. - What was it?

Nothing.

Help me, please.

Only once I know what you took. Opioids, benzo?

- Coughing syrup. - With codeine? How much?

- Two bottles. Two and a half. - Barely impressive.

Basia. Multi-electrolyte fluid, sodium sulfate and an ampoule of naloxone.

Calm down.

- Naloxone already? - Yes, right now.

Did you want to get high?

Just to calm down.

I was studying all night. Could barely stand.

- Naloxone’s in. - Thank you.

Atrial fibrillation. Let’s do the cardioversion.

Perhaps we should consult a cardiologist first.

- Run a urine test. It takes five minutes. - I know what I’m doing, Basia.

Get ketamine ready for sedation.

I’ll put a catheter in.

We’ll send a urine sample to…

toxicology.

I can’t sleep. At all.

I have no appetite.

Are you in any pain?

My head hurts and my stomach feels tight.

Probably it’s the depression.

Are you being treated?

But it’s not helping.

The drugs don’t work.

Neither do sessions with a shrink.

I can’t stand it, it’s getting worse and worse.

Head and stomach ache, insomnia, they could all point to depression,

but I need to examine you first.

Alojzy’s EKG is fine.

I’ll run troponin and D-dimer tests.

- Great. - Need help?

If you could take the man in the hall to his son in the treatment room.

But only if he’s calmed down.

Okay, let me examine your pupils. Look at me, please.

Pupils reactive.

Now for the auscultation. Please take your top off.

Sinus rhythm is back.

Can the patient’s father come in?

The patient is not a minor. Why the father?

- Kaśka sent him. - She has her own patients!

- Piotr, he has a right to know. - What’s wrong with him?

Opioids.

He got naloxone, which should reverse the reaction to the drugs.

My son is not a junkie!

No, but he’s gulping on codeine syrup, which is metabolized into morphine.

He’s a sportsman, a volunteer, the best student in his year.

I had such ideals in my year.

Ola! What’s up with you?

You can sit up.

Your heart is fine.

Neurological reflexes are correct, your stomach is soft without guarding.

So I’m fine.

I’ll send in our resident psychiatrist.

This will come to nothing again.

Then let me send you to a psychiatric hospital,

for further tests.

Please sit down.

I’m sorry.

I’ll call in a transport ambulance.

- Dad? - What were you thinking, you little shit?

I’ve done so much for you!

Extra classes, languages, sports, camps abroad!

I spent a fortune on your education.

- And you’re doing drugs? - Maybe he had too many classes.

- Anything else you’d like to comment on? - Keep your hands to yourself.

- It was too much. - Too much?

I was always there for you!

No, you weren’t.

Perhaps you should take your son to addiction therapy?

The sooner, the better.

Do you have a moment?

- What therapy? - What’s up?

ECG, troponins and D-dimers are fine, but he’s got acute coronary symptoms.

Pain radiating to the center of his chest and sideways.

Well...

Oh, hello, doctor.

You were busy, so I thought Piotr would help me.

This could be an NSTEMI heart attack.

Let’s do a reverse EKG, and then echocardiography.

May I?

- Don’t you have your own patient? - He can wait.

Hello. May I examine you?

Of course.

Okay, please take a deep breath.

And breathe out.

Breathe in.

And out.

Tell me, does the pain get worse when I do this?

My whole chest hurts.

I think I have it.

A sandwich.

- What sandwich? - Intercostal.

It will hurt now.

How is it?

It stopped.

Nothing hurts any more.

How did you do it?

It comes with practice.

- Thank you. - No problem.

Intercostal neuralgia from a pressured nerve.

I call it a sandwich.

- We still need to run the tests. - Of course.

Definitely. Just to be on the safe side.

Don’t be scared to ask should you need any more help.

- You have some nerve. - Do I, doctor?

What do you want? You’re back from out of nowhere...

- Stop it! Stop it! - Catch him!

Łukasz!

- Łukasz! - Calm down!

Back away!

Or I’ll cut her!

Easy.

I’ll cut her.

Piotr, back away.

- Back away. - I’ll cut her.

Łukasz!

- I get it. You’re anxious. - You know shit.

- Not kidding. - I’m Wojtek, and you?

Listen, you don’t really wanna hurt her, right?

You’re not like that.

And you’re safe here. Right, Piotrek?

Look at her. She’s scared.

Shaking.

Take me and let her go, all right?

Dude, she needs to go for tests.

I’ll stay with you.

Okay?

- What are you doing? - Let me go!

- Let go! - Why?

No! Leave me alone!

What’s going on here?

Oh, God.

Kasia, call security.

On three. One, two, three.

Doctor.

- Will he be all right? - We just gave him some sedatives.

He’ll be fine.

Łukasz...

- Breathing is even, pulse is regular. - But he had tachycardia.

We couldn’t do anything before he ripped out the cannula and ran.

Run his EKG again.

- Let’s go. - It’s fine now.

Be careful.

Just drink slowly.

No wonder you’re shaken.

Please close your eyes and touch your nose with your right hand.

Okay, very good. And the other hand.

Right, thank you very much.

Is she your patient?

Yes, drug resistant depression.

I’ve organized transport to a psychiatric hospital.

Run a head CT first.

- The patient’s chart? - By the computer.

- That’s the girl’s chart? - Yes.

- EKG. - Wojtek...

EKG is fine again.

Shit, why is he getting tachycardia? This makes no sense for opioids.

- What did I miss? - Toxicology results are in.

- We have THC along with opioids. - It’s not that either.

Did you take any stimulants?

Methylphenidate.

- What is it? - An ADHD drug.

At what dose?

One hundred.

Wow, his methylphenidate is off the charts,

combined with codeine, THC and naloxone.

Why, son?

Why didn’t you wait for the results?

I needed methyl to study.

Then I couldn’t sleep, so I’d smoke weed.

I felt so bad at dawn, I drank the syrup.

Way to go.

Told you to hold the naloxone!

To get proper history first?

Control Piotrek, he can kill someone!

I don’t know what’s got into him today.

Not just him.

CT showed a lesion on the brain.

How did you know?

Amelia, I noticed you had ataxia.

Meaning lack of coordination.

Plus your drug resistant depression.

Those can be symptoms of something that isn’t obvious...

at first sight.

Cancer is better than depression.

I wouldn’t say so.

We’ll admit you for more tests.

Basia, transfer Amelia to neurology.

Kasia, we’re going for a smoke.

And I’d like Piotrek to join us.

Fight, dear girl. Fight!

This is ER, we have a patient for you.

Great.

You can go.

You treat all the patients in the same manner.

Which is very poor strategy for ER. This is not an outpatient clinic.

You need to keep an open mind.

Look for things overlooked elsewhere. Reach further.

You, on the other hand, failed to complete the basics.

Medical history.

You rushed in with the naloxone.

Did cardioversion without consultation. Left the patient unattended.

- Only with a nurse. - Ola was there, too.

What’s up with you two?

Your past can’t get in the way of your work or someone might die.

What don’t you get? I need a team.

This has to stop.

- Ambulance, code one. - Nine-year-old girl, drowning.

Why here?

Not to the pediatric hospital?

The prosecutor told us.

- Krystian? - Kaśka!

I’ve been calling for 10 minutes! No answer!

- Sudden cardiac arrest, asystole. - Oh, no.

Milenka! Honey!

Quickly, let’s go.

Milenka, I’m here, baby!

Krystian, are you fine?

Yes, I’m okay, I’m okay.

Mommy’s with you, you’re very brave.

You’re brave and everything will be fine.

Core temperature measurement, gasometry and warm fluids.

- You’ll be fine. - Thank you, Ola.

Let’s move her carefully.

On three. One, two, three.

CRT at four seconds.

Why is she so cold?

She fell into your parents’ pool, they’ve only just filled it.

- Krystian, how long was she under? - A few minutes, maybe ten.

- Why didn’t you save her? - What do you mean?

I jumped in immediately.

- Wait, please. - Ania, what time after the call?

- Fifteen minutes. - Fifteen minutes.

Ola, another line, gasometry.

- Doing it. - She’s still asystolic.

We have to warm her up.

Hot water bottles. Hot water bottles!

Move it, Kaśka!

- Temperature? - Twenty four.

Groins and armpits.

Deep hypothermia.

Gastric tube and lets pump it with warm glucose.

Such an aggressive approach is not the answer, Kasia.

- Fuck off, she’s my daughter. - Kasia, Piotrek is right.

The hypothermia center won’t take in a child in the course of CPR.

Shit.

Kasia, just wait. Leave it, leave it.

Kasia, please wait.

Pupils not reacting to light.

No, no, no. Save her, please.

- Save her, I beg you! - Kasia, look at me.

- You’re not helping. Go. - Kasia, please wait outside.

- We’ll take care of your kid. - No. I can’t leave her.

- Let them do their job, honey. - Piotrek! Save her, please!

Save her.

Parameters show metabolic acidosis.

We’re not giving up.

Keep warming her up.

Kasia, Kasia, just let go, please.

Why was she alone by the pool? Where were you when she drowned?

She sneaked out. We started looking the moment we realized. Immediately.

Kasia, blaming him won’t help. I’ll give you some hydroxyzine.

You take one.

I’ve been waiting for an hour. My toenail is crushed.

We’re saving lives, you idiot!

Come on, Kasia, calm down.

I’m begging you, just calm down. Please.

Biker from a road accident.

Conscious, breathing, with signs of hypovolemia.

No external injuries,

fast ultrasound showed no fluids in the peritoneum.

- There. - Temperature is rising but too slowly.

Twenty eight.

Pupils are getting rigid.

No, no, no.

- Acidosis, base excess growing. - Do something, please.

I beg you.

Half an hour since SCA.

Ola, take over. On three.

- One, two, three. - Where are you going?

I’m getting ECMO.

Excuse me!

Confirmed, no fluid in the peritoneum.

Then why is his hemoglobin dropping?

- Stomach soft, no guarding. - His parameters are dropping.

BP 70 over 40.

Zuza, what do we do? Do we wait until Andrzej is done?

There’s no time. We’re taking him to trauma scan.

Temperature at 39 degrees.

- Will you manage? - Go on.

- Hello. How long? - Hello. A few days.

Let me have a look.

Gave me an antibiotic but it’s not working.

I did hear crackles in her lungs.

- She needs a new antibiotic. - Probably. We’ll see.

Thank you, doctor.

Analysis.

She’s still asystolic.

No reaction.

Pupils dilated, non-reactive.

Deep acidosis.

Peripheral cyanosis.

Extremely critical prognosis.

Rafał.

I have ECMO! What’s the situation?

Forty minutes of asystole.

Core temperature went up to 30 degrees.

Just 30.

Low temperature slowed down metabolism and brain damage.

This is good news.

Let’s use ECMO. It will take over circulation and warm her.

There’s a chance her heart will start. We can try at least.

Okay.

All right.

- Ola, the pediatric hospital. - Come on.

Want me to take over?

No.

Everything’s suggesting pneumonia.

Irena, take the patient to X-ray.

Once we have the blood tests, I’ll chose a new antibiotic.

Thank you very much.

And where’s your biker?

In OR.

Burst kidney and bleeding.

But… What? He was not here.

Dude, this is basic stuff. How come you missed it?

Kidneys are not in the peritoneum.

Were you napping during lectures? Or what?

Aleksandra Jóźwiak from the clinic. Hello.

I want to work in the psychiatric ward!

No, come on. Don’t worry, Wojtek.

Andrzej always says that in ER we have to look for what others missed,

so let’s call this team work.

Thanks.

I’ll run an EKG, too.

Temperature at 31.

Piotr.

Saturation at 67. Continued acidosis, but pH is rising.

Lactates are dropping.

- Analysis? - Still asystolic.

But ECMO will increase blood saturation.

Zuza?

- Ola? - What now?

We have ischemic changes in the heart.

I’ll run an ultrasound, too.

- Sorry, it’s cold. - It’s fine.

Fluid in the pericardium.

Is this good?

Great, cause I know what’s wrong.

But it’s not an infection, right, doctor?

Infection, but not of the lungs. Pericarditis.

Everyone missed it, I almost did, too.

- But can it be treated? - Of course.

We’ll admit you, I’ll consult a cardiologist and...

But, gosh, if I only did the X-ray,

and let you go home, then…

- It would have been bad? - Very bad.

Thank you.

Pediatric hospital on stand-by.

Temperature at 35, saturation at 98, still asystolic.

Come back to us, little one.

Analysis?

There! Ventricular fibrillation!

Give 150 joules.

Charging, stand clear.

Shock.

Still fibrillatory.

Add 20 more.

Charging, stand clear.

Shock.

Fibrillation.

Change your tune already.

Give me 200 joules.

Basia, amiodarone.

Charging, stand clear.

Shock.

We have a rhythm.

Now we’re talking!

I’m sorry.

My baby!

I’ll call your father.

Prepare her for transport.

I’m here, with you.

I knew you were brave, that you’d make it.

The ECMO idea was risky but great.

It’s still used rarely for reversible causes of SCA.

We have no procedures, but that’s about to change.

Okay, please transfer Milenka’s documents to the pediatric hospital.

Yes, she’s alive.

They used the machine, which replaces the lungs and heart.

They pumped her warmed-up blood back into her body.

Yes, ECMO, that’s the name.

Right, I’ll call you back.

Bye.

Thank you.

Temperature’s normal, so are the parameters.

I put her in a drug-induced coma.

But we don’t know about her brain.

After such long hypoxia...

She’ll be fine.

Let’s move her, quickly!

Hi, it’s Piotr Hajduk from ER.

Listen, is Krystian Pawłowski a patient of ours?

Yes, and...

Did he have his blood type checked?

Can you tell me? I need it for his daughter’s health report.

Thanks.

Thank you.

Am I her father?

Stop it.

Can you give me a minute, Lucynka?

I need to clean this, doctor.

- Pretty please. - But...

Please!

9 YEARS AGO

Sit down.

This child will ruin your life.

Like I ruined yours?

Well...

It will have a criminal for a father.

A child doesn’t need a father!

I’m sorry.