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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:04,800 --> 00:00:06,995 - Clive's all right. - Be careful. 2 00:00:07,080 --> 00:00:08,638 You don't know what he's like. 3 00:00:10,040 --> 00:00:11,189 Now I can see you're upset. 4 00:00:11,280 --> 00:00:13,350 Well, then some of us need to raise their game. 5 00:00:15,960 --> 00:00:17,188 Where is Lorraine? 6 00:00:17,280 --> 00:00:18,872 I told you. I don't know. 7 00:00:20,480 --> 00:00:22,948 Did you come straight to us from active service? 8 00:00:23,040 --> 00:00:25,110 Sorry. Dying man waiting for me. 9 00:00:26,840 --> 00:00:28,671 I'm actually heading back to my digs. 10 00:00:29,700 --> 00:00:37,700 Ripped By mstoll 11 00:00:38,840 --> 00:00:40,319 WOMAN: I saw you do it! 12 00:00:40,400 --> 00:00:42,789 MAN: (OVER PA) Major trauma Foxtrot Hotel. Proceed. 13 00:00:42,880 --> 00:00:43,995 (INDISTINCT ARGUING) 14 00:00:44,080 --> 00:00:46,230 - Major trauma Foxtrot Hotel. Proceed. - If you go into the queue. 15 00:00:46,320 --> 00:00:47,673 Take him in there, will you, please, love? 16 00:00:47,760 --> 00:00:50,069 Calm down, we can't treat you if you're shouting. 17 00:00:50,680 --> 00:00:53,274 Sister Nerys, staff nurse Costello! 18 00:00:54,320 --> 00:00:55,435 Nice party. 19 00:00:55,520 --> 00:00:57,033 Uh, we have this invention called a Tannoy. 20 00:00:57,120 --> 00:00:58,758 - Do you know what that is? - NERYS: We need more security. 21 00:00:58,840 --> 00:01:01,638 - JUSTIN: It's mental in there. - Oh, dear. Major trauma, Foxtrot Hotel, 22 00:01:01,720 --> 00:01:03,915 gunshot wound started to unload two minutes ago. 23 00:01:04,000 --> 00:01:05,035 - Right. - (MIMICS GUNSHOT) 24 00:01:05,120 --> 00:01:06,758 - Oh, funny. - Hi, Bob. 25 00:01:06,880 --> 00:01:08,472 (MACHINE BEEPING) 26 00:01:14,920 --> 00:01:17,036 Major trauma Foxtrot Hotel for you, love. 27 00:01:17,240 --> 00:01:19,595 - Gunshot wound. - Bay 8 please, Nerys. 28 00:01:23,080 --> 00:01:26,231 Nerys, you don't mind if I scribe on this one, do you? 29 00:01:26,320 --> 00:01:27,878 - Scribe away, love. - Thank you. 30 00:01:27,960 --> 00:01:29,393 (MACHINE BEEPING) 31 00:01:29,480 --> 00:01:30,549 CHANDRAMOHAN: Where's this bullet hole then? 32 00:01:30,640 --> 00:01:31,629 Left lumbar region. 33 00:01:32,400 --> 00:01:33,913 Mmm, no exit wound. 34 00:01:34,000 --> 00:01:35,956 - BOB: Probably still in there. - Oh, we'll try and find you 35 00:01:36,040 --> 00:01:38,270 something more exciting, next time. 36 00:01:39,800 --> 00:01:41,597 Clooo... 37 00:01:41,680 --> 00:01:42,715 - Clover. - Clover. 38 00:01:42,880 --> 00:01:44,711 - Mmm. - Thought they had you chained to a desk. 39 00:01:44,800 --> 00:01:45,835 I broke loose. 40 00:01:46,800 --> 00:01:49,678 - Ready to transfer? - BOTH: One, two, three. 41 00:01:50,920 --> 00:01:52,035 Unclipping top and bottom. 42 00:01:53,160 --> 00:01:55,116 ALL: One, two, three. 43 00:01:55,200 --> 00:01:56,792 My name is Fiona Lomas. 44 00:01:56,920 --> 00:01:59,514 We're at City General Hospital. Can you hear me? 45 00:02:00,080 --> 00:02:01,911 - On to taxpayer's oxygen? - Yeah. 46 00:02:02,400 --> 00:02:04,152 - Immediate needs? - BOB: Uh, sat rate's at 2, 47 00:02:04,240 --> 00:02:06,390 we bagged with100% oxygen, but her numbers didn't improve. 48 00:02:06,760 --> 00:02:09,672 - BP? - 110 over 95 and stable. 49 00:02:09,920 --> 00:02:12,070 Just check if there's any obvious obstructing the airway. 50 00:02:15,120 --> 00:02:16,519 There's nothing to see. 51 00:02:16,600 --> 00:02:17,874 What are the sats now? 52 00:02:18,040 --> 00:02:19,712 Uh, 81. 53 00:02:20,000 --> 00:02:21,228 - Let's get a tube in. - Yeah. 54 00:02:21,320 --> 00:02:22,389 I'll do a GCS. 55 00:02:22,480 --> 00:02:23,913 Any other points before we start primary? 56 00:02:24,000 --> 00:02:26,116 Uh, who do I put in as the team leader? 57 00:02:26,200 --> 00:02:28,077 FIONA: Uh, Glen will be here shortly. 58 00:02:28,160 --> 00:02:29,195 Has anyone seen him? 59 00:02:29,720 --> 00:02:30,835 DR HARRY: Sorry, I'm late. 60 00:02:31,560 --> 00:02:33,391 - I got puked on. Can you believe it? - Nice. 61 00:02:34,120 --> 00:02:36,839 Harry, I need IV access, right side. 62 00:02:37,040 --> 00:02:38,951 All the usual bloods through the Venflon 63 00:02:39,040 --> 00:02:40,792 - plus beta HCG. - Okay. 64 00:02:40,880 --> 00:02:42,233 And, Nerys, would you put up another bag 65 00:02:42,320 --> 00:02:44,117 - of O-neg for me, please? - Yes, of course. 66 00:02:44,240 --> 00:02:46,435 C-spine is protected. 67 00:02:46,960 --> 00:02:48,632 Trachea, central. 68 00:02:49,120 --> 00:02:52,476 CHANDRAMOHAN: Pupils are equal and reactive. 69 00:02:52,560 --> 00:02:54,073 O-pos dated and checked. 70 00:02:54,160 --> 00:02:57,197 Breathing laboured, lips cyanose. 71 00:02:57,280 --> 00:03:00,033 My name's Dr Chandramohan, can you hear me? 72 00:03:01,600 --> 00:03:03,670 Patient doesn't open eyes in response to verbal stimulus, 73 00:03:03,760 --> 00:03:05,432 that's E1. 74 00:03:05,760 --> 00:03:07,239 Making incomprehensible sounds, V2. 75 00:03:07,840 --> 00:03:09,034 Strong pulses. 76 00:03:11,440 --> 00:03:13,829 Withdrawals from trach pinch, M4. 77 00:03:13,960 --> 00:03:15,075 GCS 7. 78 00:03:16,640 --> 00:03:18,039 A round of my usual, please, Billy. 79 00:03:18,280 --> 00:03:19,998 Coming right up, boss. 80 00:03:20,400 --> 00:03:22,197 Can we have a bit of speed there please, Justin? 81 00:03:22,920 --> 00:03:25,309 - Yeah. - Forensic bag, Justin. 82 00:03:25,400 --> 00:03:27,436 - Okay. - Why, isn't she already exposed? 83 00:03:28,480 --> 00:03:30,311 Uh, there were loads of people about. 84 00:03:30,680 --> 00:03:31,829 For God's sake, Bob. 85 00:03:31,920 --> 00:03:33,273 Patient dignity. 86 00:03:34,440 --> 00:03:35,509 Yeah, good call. 87 00:03:37,280 --> 00:03:38,759 It's not that dignified if she died? 88 00:03:42,000 --> 00:03:43,956 Okay, let's do a log roll and get this coat out. 89 00:03:44,680 --> 00:03:45,999 (RIPPING) 90 00:03:46,240 --> 00:03:48,674 ALL: One, two, three. 91 00:03:48,760 --> 00:03:49,795 Thank you, Bob. 92 00:03:51,320 --> 00:03:53,117 Let me have a look? 93 00:03:53,480 --> 00:03:54,469 (EXHALES) 94 00:03:58,800 --> 00:04:01,872 Okay, let's have a look at the other side. Harry. 95 00:04:02,160 --> 00:04:03,195 Scooch down, Bob? 96 00:04:03,960 --> 00:04:06,155 ALL: Okay, one, two, three. 97 00:04:06,240 --> 00:04:07,753 CHANDRAMOHAN: Thank you, Bob. 98 00:04:08,920 --> 00:04:10,069 Let's have a look. 99 00:04:11,240 --> 00:04:14,596 There's a small penetrating wound consistent with a gunshot. 100 00:04:15,280 --> 00:04:16,872 One, two, three. 101 00:04:17,320 --> 00:04:19,072 - Justin, collar. - Yeah. 102 00:04:19,360 --> 00:04:20,634 (KEYBOARD CLACKING) 103 00:04:21,360 --> 00:04:22,952 Okay, mate. Grab on. 104 00:04:25,920 --> 00:04:28,514 (WHISPERING) I thought she was still off sick. 105 00:04:34,880 --> 00:04:36,518 Billy, cricoid. 106 00:04:37,120 --> 00:04:38,235 (BILLY CLEARS THROAT) 107 00:04:38,600 --> 00:04:41,956 250 of Thio going in. 108 00:04:50,560 --> 00:04:51,913 And a 100 109 00:04:53,360 --> 00:04:54,475 of sats. 110 00:04:54,680 --> 00:04:55,874 Wash. 111 00:04:56,240 --> 00:04:58,959 Diminished breath sounds and hyper resonance on the right side. 112 00:04:59,640 --> 00:05:00,868 Clinically there's a pneumo. 113 00:05:01,520 --> 00:05:03,875 - Chest drain kit please, Nerys. - Yes. 114 00:05:06,520 --> 00:05:07,669 FIONA: Three minutes gone. 115 00:05:07,920 --> 00:05:10,798 I'm gonna put in a chest drain to relieve the pneumothorax. 116 00:05:10,880 --> 00:05:12,791 Scope, please. 117 00:05:20,640 --> 00:05:23,552 Okay, scoping chords, visualise tube... 118 00:05:25,440 --> 00:05:26,953 And... 119 00:05:30,360 --> 00:05:33,158 - Bulls-eye. - Mmm-hmm. Nice one, Rama. 120 00:05:35,400 --> 00:05:37,231 CHANDRAMOHAN: Cath up. 121 00:05:39,280 --> 00:05:40,998 - Justin, can you do bloods, please? - JUSTIN: Yeah. 122 00:05:51,920 --> 00:05:54,195 Patient is on vent. 123 00:05:56,840 --> 00:05:58,432 - Let's do the handover. - Yeah. 124 00:05:58,520 --> 00:06:00,351 Uh, patient is female, 125 00:06:00,440 --> 00:06:02,954 no ID, appears to be late 20s. 126 00:06:03,440 --> 00:06:05,317 Uh, we arrived at 00:37 127 00:06:05,400 --> 00:06:07,630 time of the injury was 00:15. 128 00:06:07,720 --> 00:06:09,438 According to police, a witness saw her being shot 129 00:06:09,520 --> 00:06:12,080 falling down three concrete steps. 130 00:06:12,160 --> 00:06:14,390 Small penetrative injury to the left lumbar region, 131 00:06:14,480 --> 00:06:16,471 three centimetres from the lumbar spine. 132 00:06:16,560 --> 00:06:18,391 Police on scene believe that to be a gunshot wound. 133 00:06:18,480 --> 00:06:20,152 Suspect bullet still inside. 134 00:06:20,240 --> 00:06:21,275 Stats at scene, 135 00:06:21,360 --> 00:06:24,033 GCS 9, sats 82%. 136 00:06:24,120 --> 00:06:25,599 Resp, spontaneous but laboured. 137 00:06:25,680 --> 00:06:27,716 BP, 118 over 74. 138 00:06:27,800 --> 00:06:29,199 Pulse, 119. 139 00:06:29,280 --> 00:06:31,430 We gave her 100% of oxygen by mask. 140 00:06:31,840 --> 00:06:33,432 IV established on the left arm 141 00:06:34,000 --> 00:06:36,434 and one 250 ml bonus of saline given. 142 00:06:36,600 --> 00:06:37,669 Okay, guys, thank you. 143 00:06:38,400 --> 00:06:40,197 (SIGHS) VBGs. 144 00:06:42,400 --> 00:06:44,675 - FIONA: Ramakrishna. - Hey, do want me to finish the primary? 145 00:06:44,760 --> 00:06:46,512 Yes, thank you, Harry. 146 00:06:47,880 --> 00:06:50,633 - Nice seeing you again, Rama. - Yeah, you too. 147 00:06:50,840 --> 00:06:52,239 Call me. 148 00:06:54,360 --> 00:06:56,157 BILLY: (MIMICS) Why don't you give me a call sometime? 149 00:06:56,240 --> 00:06:57,832 I'm so calling you back. 150 00:06:57,920 --> 00:06:59,638 (BOTH LAUGH) 151 00:07:05,200 --> 00:07:07,953 Don't forget, the muscle relaxant masks abdominal signs. 152 00:07:08,440 --> 00:07:10,590 Really? Cause I'm stupid, me. 153 00:07:10,680 --> 00:07:12,318 - (MOCKINGLY) Rama. - (CHUCKLES) 154 00:07:12,400 --> 00:07:14,709 Okay, let's prep for CT. 155 00:07:14,800 --> 00:07:16,677 Justin, will you call Brian, tell him we're on our way? 156 00:07:16,760 --> 00:07:17,749 Yeah. 157 00:07:18,280 --> 00:07:19,315 Hi. 158 00:07:22,440 --> 00:07:23,429 Lorraine. 159 00:07:24,440 --> 00:07:27,512 - It's good to see you. - Yeah. It's good to see you, too. 160 00:07:28,160 --> 00:07:29,639 I'm glad you're well again. 161 00:07:30,040 --> 00:07:31,189 Yeah. 162 00:07:34,800 --> 00:07:36,233 So, what have we got? 163 00:07:37,640 --> 00:07:39,039 FIONA: Gunshot wound, but she's stable. 164 00:07:39,120 --> 00:07:42,271 - That's you for the night. - Oh, hallelujah for that. 165 00:07:42,360 --> 00:07:44,396 Lorraine, good to have you back. 166 00:07:44,480 --> 00:07:46,232 - Well, it's good to be back. - Good. 167 00:07:46,320 --> 00:07:48,914 Nerys, would you do the sitrep for Lorraine, please? 168 00:07:49,200 --> 00:07:50,792 Yes, be glad to. 169 00:07:51,800 --> 00:07:53,870 JUSTIN: Hi, yeah, yes, this is staff nurse Costello in resus, 170 00:07:53,960 --> 00:07:55,916 we've got a major trauma, Foxtrot Hotel here. 171 00:07:56,440 --> 00:07:57,793 Lorraine, sweetie. 172 00:07:57,880 --> 00:07:59,518 Uh, do I put you down as team leader? 173 00:07:59,600 --> 00:08:01,113 Yeah, of course. 174 00:08:01,680 --> 00:08:03,159 Do you mind if I nip out for a second? 175 00:08:03,720 --> 00:08:05,438 - Is everything okay? - Yeah. 176 00:08:07,440 --> 00:08:08,839 (BEEPS) 177 00:08:09,040 --> 00:08:11,759 GILES: I'm not interested in you given time off. 178 00:08:11,840 --> 00:08:12,989 - It's not my problem. Listen. - Giles. 179 00:08:13,080 --> 00:08:14,911 Listen, I've had three fights in ED already. 180 00:08:15,000 --> 00:08:16,319 - I need some backup. - Giles. 181 00:08:16,400 --> 00:08:17,469 Yeah, we've got the police... 182 00:08:17,560 --> 00:08:19,232 Can you tell me who the on-call consultant is tonight? 183 00:08:19,320 --> 00:08:21,038 Yeah, I'll get back to you. I've had the police. 184 00:08:21,120 --> 00:08:22,473 What's going on? 185 00:08:22,560 --> 00:08:23,709 I just got called out by Clive. 186 00:08:24,560 --> 00:08:25,788 I mean with the rota. 187 00:08:26,280 --> 00:08:27,429 Nothing. 188 00:08:32,320 --> 00:08:35,073 - GLEN: What have we got? - A GSW in the lumbar region. 189 00:08:35,280 --> 00:08:36,679 The patient is stable, 190 00:08:36,760 --> 00:08:38,990 and we're imaging the bullet track in CT. 191 00:08:39,080 --> 00:08:40,433 - GLEN: Good. - Oh. Uh... 192 00:08:40,520 --> 00:08:43,239 Hi, I'm Lorraine Rappaport. Trauma consultant. 193 00:08:43,520 --> 00:08:45,158 Glen Boyle, same. 194 00:08:45,880 --> 00:08:47,518 Oh, why has that happened? 195 00:08:48,880 --> 00:08:50,313 Look, as we're both here, 196 00:08:50,400 --> 00:08:52,118 I suggest we get on with it together 197 00:08:52,200 --> 00:08:54,839 and sort it out later, if that's okay with you? 198 00:08:54,920 --> 00:08:57,115 Yeah. Sounds very sensible. 199 00:09:01,000 --> 00:09:02,956 Can I assume all lines and tubes are safe? 200 00:09:03,040 --> 00:09:04,917 All safe and secure, Brian. 201 00:09:06,080 --> 00:09:07,832 Everybody in position, please. 202 00:09:07,920 --> 00:09:09,239 (MACHINE BEEPING) 203 00:09:16,240 --> 00:09:17,878 Starting control scan. 204 00:09:21,120 --> 00:09:23,236 She's just being friendly. 205 00:09:23,720 --> 00:09:24,789 And what were you doing? 206 00:09:25,880 --> 00:09:28,348 I was just being friendly as well. 207 00:09:28,880 --> 00:09:30,233 Okay. 208 00:09:35,240 --> 00:09:37,151 Control scan complete. 209 00:09:37,480 --> 00:09:38,708 Running head scan. 210 00:09:42,520 --> 00:09:44,351 No abnormalities. 211 00:09:46,800 --> 00:09:48,597 Nobody touch any buttons. 212 00:09:52,040 --> 00:09:53,632 How did the flat hunting go? 213 00:09:54,360 --> 00:09:57,477 There's not much out there on short-term leases. 214 00:09:57,640 --> 00:10:00,313 Well, you can't stay in that hospital room. 215 00:10:00,400 --> 00:10:02,516 Why? It's not that bad. 216 00:10:02,920 --> 00:10:04,558 FIONA: No, it's terrific, 217 00:10:04,640 --> 00:10:06,358 - if you're a student. - (CHUCKLES) 218 00:10:07,880 --> 00:10:10,599 But like I said, there's not much choice. 219 00:10:10,680 --> 00:10:12,398 Contrast connected. 220 00:10:14,400 --> 00:10:16,356 Go long term and cancel. 221 00:10:18,320 --> 00:10:20,231 Starting contrast run. 222 00:10:22,560 --> 00:10:24,551 (WHIRRING) 223 00:10:30,920 --> 00:10:31,955 What is that? 224 00:10:35,240 --> 00:10:36,798 Can we see that again, please, Brian? 225 00:10:43,520 --> 00:10:44,873 Could it be a cyst? 226 00:10:48,720 --> 00:10:49,755 That's a skull. 227 00:10:51,440 --> 00:10:52,759 She's pregnant. 228 00:10:53,840 --> 00:10:56,035 How the hell did we miss that? 229 00:10:57,520 --> 00:11:01,399 It's Fiona Lomas, trauma fellow, we need an O&G consultant immediately. 230 00:11:02,600 --> 00:11:04,431 Can you tell me who's on call today, please? 231 00:11:04,520 --> 00:11:06,238 MAN: (ON PHONE) Tom Farrow. 232 00:11:06,320 --> 00:11:08,356 All right, okay. Thank you. 233 00:11:09,680 --> 00:11:10,749 Brian, 234 00:11:10,840 --> 00:11:14,276 could we get the images with the reduced artefacts, please? 235 00:11:18,920 --> 00:11:20,319 How did we miss this pregnancy? 236 00:11:21,000 --> 00:11:22,513 I was responsible for the primary. 237 00:11:22,640 --> 00:11:24,358 We skipped fast and went straight to CT. 238 00:11:24,440 --> 00:11:26,351 I palpated the abdomen. 239 00:11:26,840 --> 00:11:28,034 BRIAN: Images up. 240 00:11:28,120 --> 00:11:31,669 Okay, so we have piece of metal, possibly a bullet... 241 00:11:31,800 --> 00:11:32,915 Or a bullet fragment. 242 00:11:33,120 --> 00:11:35,873 About 12 millimetres long 243 00:11:36,000 --> 00:11:37,638 against the left common iliac artery 244 00:11:37,720 --> 00:11:39,950 about four centimetres below the bifurcation. 245 00:11:40,120 --> 00:11:41,269 3D, please, Brian. 246 00:11:42,000 --> 00:11:45,515 We also have a rupture of the left common iliac artery 247 00:11:45,600 --> 00:11:49,149 which looks like a seizure aneurysm of about six centimetres. 248 00:11:49,240 --> 00:11:52,152 There's no active extravasation of contrast, 249 00:11:52,240 --> 00:11:54,754 but there is some retroperitoneal fluid. 250 00:11:54,840 --> 00:11:56,398 Fast bleep the trauma theatre staff, please. 251 00:11:57,080 --> 00:11:58,877 Justin, pack A from resus, please. 252 00:11:59,120 --> 00:12:01,634 FIONA: Nerys, we need a trauma line kit and rapid infuser, please. 253 00:12:01,720 --> 00:12:03,517 Harry. You may as well return to ED. 254 00:12:04,000 --> 00:12:05,831 No, Harry, you come with me. 255 00:12:05,920 --> 00:12:09,230 Fiona Lomas, trauma reg, we need trauma theatre immediately. 256 00:12:09,320 --> 00:12:10,912 Can you fast beep trauma theatre staff 257 00:12:11,000 --> 00:12:14,037 and we need the radiographer and a vascular C-arm, thank you. 258 00:12:14,720 --> 00:12:17,029 Lines and tubes secure, prep for transfer. 259 00:12:17,120 --> 00:12:19,111 GLEN: We're not moving her until we've got a trauma line in. 260 00:12:19,200 --> 00:12:20,713 Uh, you can't do that there. 261 00:12:20,800 --> 00:12:23,155 One knock and her iliac artery could haemorrhage. 262 00:12:23,360 --> 00:12:26,033 Mother and foetus will die, we're doing it. 263 00:12:26,640 --> 00:12:28,471 I think her weight's made it almost impossible to pick up. 264 00:12:30,200 --> 00:12:31,599 These things happen, yes? 265 00:12:32,440 --> 00:12:33,555 Yeah. 266 00:12:39,520 --> 00:12:40,555 (MOUTHING) Thank you. 267 00:12:40,640 --> 00:12:42,870 Good blood, got products, got Bruce. 268 00:12:42,960 --> 00:12:44,188 Oh, that's an improvement. 269 00:12:44,280 --> 00:12:46,919 We'll prime the rapid infuser in theatre, thank you. 270 00:12:47,000 --> 00:12:49,594 LORRAINE: Good decision. NURSE: Okay. Yes, thank you. 271 00:12:50,400 --> 00:12:51,833 FIONA: Trauma theatre's prepped and ready. 272 00:12:51,920 --> 00:12:53,035 Trauma line's in place. 273 00:12:53,200 --> 00:12:54,918 Let's get some blood running through her, then, please. 274 00:12:55,000 --> 00:12:56,069 O-pos, dates have been checked. 275 00:13:01,480 --> 00:13:03,152 CHANDRAMOHAN: Starting across on three. Everyone ready? 276 00:13:03,400 --> 00:13:06,790 - One... - Like she is an IED, please. 277 00:13:07,240 --> 00:13:08,514 Gently across, on three. 278 00:13:08,920 --> 00:13:10,911 One, two, three. 279 00:13:17,000 --> 00:13:18,353 (BEEPS) 280 00:13:19,880 --> 00:13:21,757 - Excuse me. - (INDISTINCT CHATTER) 281 00:13:26,320 --> 00:13:28,550 - Shit. Sorry. - Sorry. 282 00:13:29,200 --> 00:13:30,474 Sorry. 283 00:13:30,560 --> 00:13:31,834 It's okay, BP's stable. 284 00:13:32,040 --> 00:13:34,110 Yeah, in the corridor. Yeah. They got out of ED. 285 00:13:34,320 --> 00:13:35,719 Be back in a second. 286 00:13:35,800 --> 00:13:37,836 GILES: I've got one nurse and one security guard... 287 00:13:39,920 --> 00:13:41,831 They're all over the place. 288 00:13:42,240 --> 00:13:44,879 Why can't you just send someone down? 289 00:13:45,080 --> 00:13:48,675 - How about the basic security? - Giles, the on-call trauma consultant. 290 00:13:48,760 --> 00:13:50,637 Uh, it's, it's Glen Boyle. 291 00:13:50,720 --> 00:13:54,633 Okay, what if one of this nutters gets out of here and gets into theatre? 292 00:13:54,720 --> 00:13:56,199 Of course, it could happen. 293 00:13:56,280 --> 00:13:58,236 There's no on here. No one to stop 'em. 294 00:13:58,320 --> 00:13:59,673 Harry. 295 00:14:04,720 --> 00:14:05,709 Hello, darling. 296 00:14:05,920 --> 00:14:06,989 You rang? 297 00:14:08,080 --> 00:14:09,149 Tom. 298 00:14:11,640 --> 00:14:12,789 Are you okay? 299 00:14:14,160 --> 00:14:15,752 Glen Boyle's in there. 300 00:14:17,720 --> 00:14:20,154 - (CHUCKLES) What? - He's the locum consultant. 301 00:14:20,600 --> 00:14:22,238 How long has he been working here? 302 00:14:22,400 --> 00:14:24,391 They brought him in to cover for Lorraine's suspension. 303 00:14:24,560 --> 00:14:25,595 Couple of months? 304 00:14:25,720 --> 00:14:27,472 Look, I was wrong not to tell you, 305 00:14:29,520 --> 00:14:30,919 but let's not argue about it now. 306 00:14:37,400 --> 00:14:38,549 So, what's happened here? 307 00:14:38,640 --> 00:14:40,278 Yeah, the police think she was shot in the back 308 00:14:40,360 --> 00:14:42,112 then fell down some concrete steps. 309 00:14:42,200 --> 00:14:43,474 All right. 310 00:14:50,080 --> 00:14:51,308 (BEEPS) 311 00:14:53,360 --> 00:14:54,395 Is it alive? 312 00:14:59,960 --> 00:15:01,871 - Yes. - What's the gestation? 313 00:15:08,680 --> 00:15:10,750 22 to 24 weeks. 314 00:15:11,880 --> 00:15:14,519 Given as a question mark over viability, 315 00:15:14,600 --> 00:15:17,194 - I suggest... - You put the neonatal team on standby. 316 00:15:17,280 --> 00:15:19,794 I want to keep the foetus where it is, if that's at all possible. 317 00:15:20,760 --> 00:15:23,194 Billy, she needs to be on the table now. 318 00:15:23,280 --> 00:15:24,315 Yeah. 319 00:15:34,720 --> 00:15:35,914 Thank you. 320 00:15:36,760 --> 00:15:38,955 Hi, it's Tom Farrow, O&G consultant. 321 00:15:39,040 --> 00:15:41,600 Can I have a neonatology team on standby, please? 322 00:15:41,680 --> 00:15:43,716 I'm at the trauma theatre. 323 00:15:44,120 --> 00:15:45,633 Yeah, thanks. Bye. 324 00:15:51,080 --> 00:15:53,913 Have you dealt with a foetus in a trauma situation before? 325 00:15:54,360 --> 00:15:56,032 Can get intense. 326 00:15:56,120 --> 00:15:57,439 Bastion. 327 00:15:58,440 --> 00:15:59,714 M�decins Sans Fronti�res. 328 00:15:59,960 --> 00:16:01,313 Hanoi province. 329 00:16:02,480 --> 00:16:03,469 Tom Farrow. 330 00:16:04,320 --> 00:16:06,117 - Glen Boyle. - Yeah. 331 00:16:07,000 --> 00:16:07,989 I know. 332 00:16:19,960 --> 00:16:22,190 Could we tilt the table to the left, please? 333 00:16:22,280 --> 00:16:23,315 CHANDRAMOHAN: Yeah. 334 00:16:23,720 --> 00:16:25,278 Say when. 335 00:16:27,080 --> 00:16:28,399 - Yeah. - CHANDRAMOHAN: Yeah? 336 00:16:30,800 --> 00:16:31,949 Angio packs. 337 00:16:42,920 --> 00:16:44,194 23 minutes gone. 338 00:16:44,320 --> 00:16:47,232 I intend to stent the tear on the left common iliac artery 339 00:16:47,320 --> 00:16:49,276 by the right femoral artery. 340 00:16:50,280 --> 00:16:51,269 You're going to lead. 341 00:16:52,240 --> 00:16:53,468 I am the vascular. 342 00:16:53,680 --> 00:16:54,715 Excuse me. 343 00:16:55,720 --> 00:16:56,709 Can I have a word, please? 344 00:16:58,800 --> 00:17:00,028 Uh... 345 00:17:01,920 --> 00:17:02,955 Fiona. 346 00:17:09,320 --> 00:17:12,630 Lorraine, you'll be under Glen's supervision tonight. 347 00:17:14,400 --> 00:17:16,072 (STUTTERING) What does that mean? 348 00:17:16,760 --> 00:17:19,194 I'm sorry, it came from Clive. 349 00:17:23,680 --> 00:17:24,874 We should just get started. 350 00:17:36,960 --> 00:17:38,313 Could I have the jelly, please? 351 00:17:39,920 --> 00:17:42,150 I'm sorry, Mrs Rappaport. We haven't done a who. 352 00:17:42,600 --> 00:17:43,635 Oh. 353 00:17:45,280 --> 00:17:46,713 I suppose that's over to you. 354 00:17:46,800 --> 00:17:48,711 I'm Glen Boyle, I'm the trauma consultant. 355 00:17:48,800 --> 00:17:50,313 Fiona Lomas, trauma fellow. 356 00:17:50,400 --> 00:17:52,675 Ramakrishna Chandramohan, anaesthetic registrar. 357 00:17:52,760 --> 00:17:54,876 Billy Finlay, anaesthetic ODP. 358 00:17:54,960 --> 00:17:56,871 Bruce Colby, rapid infuser operator. 359 00:17:56,960 --> 00:17:58,837 Dalisay Guinto, scrub nurse. 360 00:17:58,920 --> 00:18:00,353 Tom Farrow, ONG consultant. 361 00:18:00,600 --> 00:18:02,158 Shelley Imms, radiographer. 362 00:18:02,240 --> 00:18:03,878 Jason Marshall, staff nurse. 363 00:18:04,000 --> 00:18:05,479 Joe Allen, documentation nurse. 364 00:18:06,800 --> 00:18:09,792 Lorraine Rappaport, consultant vascular surgeon. 365 00:18:09,880 --> 00:18:12,440 CHANDRAMOHAN: Our patient is major trauma 366 00:18:12,520 --> 00:18:14,078 Foxtrot Hotel, 367 00:18:14,200 --> 00:18:16,509 date of birth, 1-1-1900. 368 00:18:16,600 --> 00:18:18,477 And I've signed consent from four 369 00:18:18,560 --> 00:18:21,438 to stent the tear in the common iliac artery 370 00:18:21,520 --> 00:18:22,714 via the right femoral artery. 371 00:18:22,800 --> 00:18:26,110 The patient is between 22 and 24 weeks pregnant. 372 00:18:28,280 --> 00:18:29,633 LORRAINE: Ultrasound, please. 373 00:18:36,120 --> 00:18:37,439 Needle. 374 00:18:47,520 --> 00:18:48,999 Femoral artery located. 375 00:18:51,720 --> 00:18:52,914 Swab. 376 00:18:56,600 --> 00:18:57,919 Wire, please. 377 00:19:03,320 --> 00:19:04,469 Wire going in. 378 00:19:04,560 --> 00:19:05,549 Scion, please. 379 00:19:11,880 --> 00:19:13,279 Needle out. 380 00:19:14,800 --> 00:19:16,074 Blade. 381 00:19:17,160 --> 00:19:18,479 Screening. 382 00:19:22,200 --> 00:19:23,269 Okay. 383 00:19:23,400 --> 00:19:24,799 Cutting. 384 00:19:28,400 --> 00:19:29,389 Terumo sheath, please. 385 00:19:40,280 --> 00:19:41,713 Pigtail catheter, please. 386 00:20:03,360 --> 00:20:05,555 - Position's good. - LORRAINE: Thank you. 387 00:20:05,720 --> 00:20:06,869 Contrast, please. 388 00:20:09,320 --> 00:20:12,118 - Let's have a run of 10 at 10. - Sure. 389 00:20:16,400 --> 00:20:17,674 - LORRAINE: Breathing off. - Breathing off. 390 00:20:17,760 --> 00:20:18,749 (BEEPS) 391 00:20:20,880 --> 00:20:21,869 Screening. 392 00:20:27,040 --> 00:20:30,237 - LORRAINE: Breathing on. - Breathing on. 393 00:20:32,320 --> 00:20:33,469 Road map, please. 394 00:20:37,080 --> 00:20:38,911 Terumo wire, please. 395 00:21:03,000 --> 00:21:04,194 Cobra catheter, please. 396 00:21:36,160 --> 00:21:38,549 - You're on the road map. - I can see. 397 00:21:52,600 --> 00:21:54,238 - God damn it! - You're off the road map. 398 00:21:54,400 --> 00:21:56,675 LORRAINE: I'm going to have a second attempt 399 00:21:56,760 --> 00:21:59,320 at getting the wire across the tear. 400 00:22:08,080 --> 00:22:09,718 - FIONA: Lorraine. - Oh, shit! I'm off! 401 00:22:10,080 --> 00:22:12,799 - I've gone through the tear. - BP dropping 100 over 78. 402 00:22:13,040 --> 00:22:15,190 - GLEN: Sat's dropping. 87, 86... - Heart rate's rising. 403 00:22:15,280 --> 00:22:16,429 Let's get the BP up, shall we? 404 00:22:16,520 --> 00:22:18,238 LORRAINE: Uh, contrast, please. 405 00:22:18,520 --> 00:22:20,829 - Run of 5 at 10. - Okay. 406 00:22:21,040 --> 00:22:22,632 - Breathing off. - CHANDRAMOHAN: Breathing off. 407 00:22:22,720 --> 00:22:23,709 (BEEPS) 408 00:22:23,840 --> 00:22:25,273 DALISAY: Screening. 409 00:22:27,200 --> 00:22:29,634 Shit. Pseudoaneurysm is expanding. 410 00:22:29,800 --> 00:22:31,233 To about eight centimetres. 411 00:22:31,320 --> 00:22:32,469 - Breathing on. - Breathing on. 412 00:22:32,600 --> 00:22:34,272 Another run of 5 at 10, please. 413 00:22:34,440 --> 00:22:35,953 - Breathing off. - Breathing off. 414 00:22:36,040 --> 00:22:37,075 Screening. 415 00:22:40,000 --> 00:22:41,911 Nine centimetres. It could burst. 416 00:22:42,000 --> 00:22:44,434 - Come on. - Another run of 5 at 10, please. 417 00:22:44,520 --> 00:22:45,589 Screening. 418 00:22:49,600 --> 00:22:52,797 No further expansion. No extravasation of contrast. 419 00:22:55,560 --> 00:22:57,278 DALISAY: Breathing on. CHANDRAMOHAN: Breathing on. 420 00:22:57,360 --> 00:22:58,554 BP is holding. 421 00:22:58,640 --> 00:23:01,473 There's a large defect in the artery. I can't get around. 422 00:23:01,560 --> 00:23:03,869 I want to put an occlusion balloon across the tear. 423 00:23:12,520 --> 00:23:13,509 (SIGHS) 424 00:23:16,480 --> 00:23:17,913 (INHALES SHARPLY) 425 00:23:21,280 --> 00:23:22,599 Can I have a moment, please? 426 00:23:22,680 --> 00:23:24,477 - Now? - Please. 427 00:23:25,240 --> 00:23:27,595 LORRAINE: Fiona, please. FIONA: Yes. 428 00:23:31,800 --> 00:23:34,314 - So, you don't have to do this. - That could have happened to anyone. 429 00:23:34,400 --> 00:23:36,914 No, no, I agree. That's not what I meant. 430 00:23:37,000 --> 00:23:41,198 It's Clive. He's gunning for you, and this could turn into a shit storm. 431 00:23:42,200 --> 00:23:45,590 So, let's not give him the ammunition, yes? 432 00:23:51,200 --> 00:23:54,317 Fiona, are you okay to take over? 433 00:23:55,280 --> 00:23:58,750 Of course, if that's all right with you. 434 00:23:59,400 --> 00:24:00,992 In which case, I shall leave you to it. 435 00:24:14,880 --> 00:24:16,154 Let's go, please! 436 00:24:16,320 --> 00:24:17,833 FIONA: Cobra catheter coming out. 437 00:24:24,520 --> 00:24:25,839 Berenstein balloon, please. 438 00:24:27,840 --> 00:24:28,875 Check the balloon. 439 00:24:34,320 --> 00:24:35,548 GLEN: Yeah. 440 00:24:39,240 --> 00:24:40,468 Hey. 441 00:24:40,840 --> 00:24:42,273 You're fine. 442 00:25:09,960 --> 00:25:11,871 Inflating the balloon. 443 00:25:17,240 --> 00:25:20,869 No. Deflate it. It's not conforming to the artery. 444 00:25:20,960 --> 00:25:22,916 CHANDRAMOHAN: BP dropping. It's 105 over 84. 445 00:25:23,000 --> 00:25:25,468 - GLEN: Let's increase the blood. - 90 over 76. 446 00:25:25,560 --> 00:25:27,596 Tear extends higher than I thought. 447 00:25:28,800 --> 00:25:30,279 I'm going to occlude it more proximally. 448 00:25:30,440 --> 00:25:32,317 Okay, but that's not going to take care of the back-bleed. 449 00:25:32,480 --> 00:25:34,072 I can't risk enlarging the tear. 450 00:25:41,240 --> 00:25:42,309 BP's still dropping. 451 00:25:47,080 --> 00:25:50,595 The left common iliac artery is occluded above the tear. 452 00:25:51,720 --> 00:25:53,199 Stop screening, please. 453 00:25:53,360 --> 00:25:56,113 - Uterus is becoming tense and woody. - Can you relax it? 454 00:25:56,280 --> 00:25:58,350 250 micrograms of terbutaline, please. 455 00:25:58,480 --> 00:26:01,278 - Yeah, um... Billy, have we got it? - It's in there. 456 00:26:09,320 --> 00:26:11,390 250 mics going in now. 457 00:26:14,240 --> 00:26:16,356 - Another 250, please. - Come on. 458 00:26:17,760 --> 00:26:18,954 Another 250 going in. 459 00:26:20,680 --> 00:26:22,511 TOM: May I see the BP, please? CHANDRAMOHAN: Yeah, sorry. 460 00:26:23,720 --> 00:26:25,631 It's not going to go up until you get that baby out. 461 00:26:26,960 --> 00:26:28,916 (SIGHS) It's relaxing a bit, but it's unstable. 462 00:26:29,280 --> 00:26:30,713 I need to get the foetus out immediately. 463 00:26:30,800 --> 00:26:32,233 What are its chances of survival? 464 00:26:32,320 --> 00:26:34,436 Uh, depending on weight, between 30 and 40 percent max. 465 00:26:34,520 --> 00:26:36,272 And the long-term prognosis, if it does survive? 466 00:26:36,360 --> 00:26:38,954 There is about 60 percent risk of some impairment. 467 00:26:39,040 --> 00:26:40,712 More, if there's been significant hypoxia. 468 00:26:40,800 --> 00:26:42,199 GLEN: No. I want to control the back-bleed 469 00:26:42,280 --> 00:26:44,236 - with the foetus in place. - TOM: The uterus is irritable, 470 00:26:44,320 --> 00:26:46,834 it could contract or the placenta could abrupt. 471 00:26:47,800 --> 00:26:50,712 Caesarean now, or you could lose mother and the foetus. 472 00:26:59,080 --> 00:27:00,354 - Okay. - Right. 473 00:27:00,440 --> 00:27:03,432 - DALISAY: Excuse me. - Twelve units of O-neg, eight FFP, 474 00:27:03,520 --> 00:27:05,988 - four platelets and two cryo, please. - CHANDRAMOHAN: Yeah. 475 00:27:06,880 --> 00:27:08,791 TOM: I need my team here now. 476 00:27:10,320 --> 00:27:11,799 We're doing an emergency C-section. 477 00:27:12,000 --> 00:27:14,116 DALISAY: Billy, we need neonatal here right now. 478 00:27:16,760 --> 00:27:19,593 Hello. Yes. Billy Finlay, ODP in trauma theatre. 479 00:27:19,960 --> 00:27:24,112 We have a neonatal team on standby. We need them here right away. 480 00:27:24,200 --> 00:27:25,315 Thanks. 481 00:27:25,960 --> 00:27:27,109 On their way. 482 00:27:29,360 --> 00:27:30,679 Okay, we have to wait. 483 00:27:31,280 --> 00:27:32,315 (EXHALES) 484 00:27:34,040 --> 00:27:35,189 So, what made you hang up your boots? 485 00:27:37,440 --> 00:27:38,429 Who said I have? 486 00:27:39,720 --> 00:27:40,709 (CLANKING) 487 00:27:41,240 --> 00:27:42,275 (SIGHS) 488 00:27:46,440 --> 00:27:50,149 Twelve units of O-neg, eight FFP, four platelets, two cryo. 489 00:27:50,880 --> 00:27:52,074 Bosch. 490 00:27:53,120 --> 00:27:55,190 - There you go, Bruce. - What about you? 491 00:27:56,760 --> 00:27:58,398 Oh, I just thought it was time to settle down. 492 00:28:06,520 --> 00:28:09,592 All right. We are prepping for a classical C-section. 493 00:28:09,880 --> 00:28:11,677 Sign in as you set up, please. 494 00:28:11,760 --> 00:28:13,512 Faye Ovenden, consultant neonatologist. 495 00:28:13,800 --> 00:28:15,074 Steven Ken Jung, midwife. 496 00:28:15,160 --> 00:28:17,549 - Midwife? - Anna Simison, neonatal... 497 00:28:17,640 --> 00:28:20,313 - Zorton Vacques, neonatal nurse. - Ready, Faye? 498 00:28:20,840 --> 00:28:21,909 Ready. 499 00:28:22,000 --> 00:28:23,069 Yeah, namaste, boys. 500 00:28:23,160 --> 00:28:24,195 Right. Let's get cracking then, shall we? 501 00:28:24,280 --> 00:28:25,429 Excuse me. 502 00:28:28,800 --> 00:28:30,313 The uterus is relaxed. 503 00:28:32,000 --> 00:28:34,594 Means there's no immediate need to do a C-section now, is there? 504 00:28:35,600 --> 00:28:38,114 Fiona, if I did a laparotomy, can you clamp the artery? 505 00:28:41,600 --> 00:28:43,352 - Maybe. - With the foetus still in place? 506 00:28:43,440 --> 00:28:45,431 - Yes. - Could you move the uterus? 507 00:28:45,640 --> 00:28:47,232 Not much. 508 00:28:47,320 --> 00:28:49,117 And it could trigger placental abruption. 509 00:28:49,480 --> 00:28:51,198 She abrupts, she dies. 510 00:28:54,200 --> 00:28:56,555 - Let's prep for a laparotomy, everyone. - Oh, God. 511 00:29:00,520 --> 00:29:01,669 (SIGHS) 512 00:29:04,920 --> 00:29:06,592 This can't be easy for you. 513 00:29:08,200 --> 00:29:09,792 - It's a tough case. - Hmm. 514 00:29:10,400 --> 00:29:11,389 We'll talk about it at home. 515 00:29:24,280 --> 00:29:26,919 48 minutes. I'll take a blade, please. 516 00:29:29,880 --> 00:29:31,916 - Am I okay to cut? - Yeah. 517 00:29:36,640 --> 00:29:37,868 Cutting. 518 00:30:08,240 --> 00:30:09,229 Mayo, please. 519 00:30:13,920 --> 00:30:15,478 RAMC finesse. 520 00:30:16,520 --> 00:30:19,876 - You can join in anytime you want. - Happy to watch and learn. 521 00:30:23,000 --> 00:30:24,592 Deaver retractor, please. 522 00:30:27,080 --> 00:30:28,354 You ready? 523 00:30:30,800 --> 00:30:32,472 - Yeah. - Over to you. 524 00:30:34,920 --> 00:30:36,069 Tom. 525 00:30:37,200 --> 00:30:38,713 (CLEARS THROAT) 526 00:30:39,720 --> 00:30:41,790 TOM: Moving the uterus. 527 00:30:46,640 --> 00:30:47,868 That's as far it will go. 528 00:30:48,840 --> 00:30:50,114 BP's holding. 529 00:30:52,560 --> 00:30:53,754 Dissecting scissors, please. 530 00:30:56,640 --> 00:30:58,631 I'm going to enter the retroperitoneum. 531 00:31:07,320 --> 00:31:09,436 - Suction. - (SUCTION GURGLING) 532 00:31:11,920 --> 00:31:13,035 Dardik clamp, please. 533 00:31:14,800 --> 00:31:16,119 - (SUCTION GURGLING) - OK. 534 00:31:18,880 --> 00:31:20,074 A bit further. 535 00:31:21,520 --> 00:31:22,509 That's it. 536 00:31:22,600 --> 00:31:24,511 - I need more room. - BP dropping. 537 00:31:24,600 --> 00:31:25,919 94 over 78. 538 00:31:26,040 --> 00:31:28,429 - In danger of stimulating uterus. - I have to get in. 539 00:31:32,160 --> 00:31:34,469 - CHANDRAMOHAN: 73 over 61. - Unstable. 540 00:31:34,560 --> 00:31:35,675 Bruce, increase the blood. 541 00:31:35,960 --> 00:31:38,554 Tom, just give me 30 more seconds, please. 542 00:31:43,400 --> 00:31:44,628 30 seconds. 543 00:31:55,040 --> 00:31:56,029 I've got it. 544 00:31:59,280 --> 00:32:00,554 - A bit further, please! - I can't. 545 00:32:00,640 --> 00:32:03,791 - I have to stop the back-bleed. - BP dropping 79 over 68. 546 00:32:07,200 --> 00:32:08,519 FIONA: I can't get it. 547 00:32:14,400 --> 00:32:16,356 - It's 30 seconds. - Few more seconds. 548 00:32:16,440 --> 00:32:17,429 CHANDRAMOHAN: 75 over 64. 549 00:32:18,920 --> 00:32:24,074 Okay. Common iliac artery clamped distal to the metal fragment. 550 00:32:24,160 --> 00:32:25,991 Good. Keep going. 551 00:32:26,920 --> 00:32:30,037 You controlled the back-bleed. I need to put this back now! 552 00:32:30,120 --> 00:32:32,350 - We need to clamp proximal to the metal. - Dardik, please. 553 00:32:32,440 --> 00:32:34,112 - It's controlled by the balloon. - It's not enough. 554 00:32:36,120 --> 00:32:37,348 (EXHALES) 555 00:32:38,840 --> 00:32:40,114 - Ten seconds. - Okay. 556 00:32:42,640 --> 00:32:43,709 Uterus is contracting. 557 00:32:44,640 --> 00:32:45,834 Jesus! I think she's about to abrupt. 558 00:32:45,920 --> 00:32:47,592 I need a little more space and a little more time. 559 00:32:47,680 --> 00:32:49,033 You're out of both. Get out now! 560 00:32:49,120 --> 00:32:50,599 Okay! (BREATHING HEAVILY) 561 00:32:50,680 --> 00:32:51,829 Still unstable. 562 00:32:53,680 --> 00:32:55,750 Right, why is this baby still in there? 563 00:32:56,440 --> 00:32:59,398 - We need to stabilise the iliac... - Let me make myself crystal clear. 564 00:32:59,480 --> 00:33:01,675 If that mother dies, it's going to be all over national news. 565 00:33:01,760 --> 00:33:04,957 Foetal death doesn't make local radio. Get it out! 566 00:33:06,320 --> 00:33:07,719 Ultrasound, please. 567 00:33:08,960 --> 00:33:10,439 Why didn't you tell me he was working here? 568 00:33:10,960 --> 00:33:13,315 - I was going to. - Right. 569 00:33:21,360 --> 00:33:23,157 Placenta's position is normal. 570 00:33:25,920 --> 00:33:27,319 (MUFFLED HEARTBEATS) 571 00:33:27,840 --> 00:33:29,990 Foetus is in distress. Thank you. 572 00:33:30,880 --> 00:33:31,915 Let's get cracking. 573 00:33:32,000 --> 00:33:33,069 - Ta. - Joins? 574 00:33:33,200 --> 00:33:34,189 Thank you. 575 00:33:38,320 --> 00:33:40,675 - Scalpel. - We should try to shunt it. 576 00:33:41,480 --> 00:33:42,913 Give the baby a chance. 577 00:33:43,560 --> 00:33:44,675 You're kidding, right? 578 00:33:44,760 --> 00:33:46,512 The iliac's just on the balloon. 579 00:33:46,840 --> 00:33:48,592 The C-section could just as easily dislodge it. 580 00:33:48,680 --> 00:33:49,908 You've had your chance. 581 00:33:50,040 --> 00:33:51,553 - Step away. - BOYLE: I won't. 582 00:33:51,920 --> 00:33:54,150 Cause we should at least try. We should give it a shot. 583 00:33:56,640 --> 00:33:57,629 Tom. 584 00:34:00,960 --> 00:34:02,393 (SIGHS) For God's sake. 585 00:34:04,880 --> 00:34:05,869 (EXHALES) 586 00:34:08,920 --> 00:34:10,194 Shunt kit, please. 587 00:34:10,880 --> 00:34:12,279 55 minutes gone. 588 00:34:12,960 --> 00:34:15,474 I'm going to try and shunt the left common iliac artery. 589 00:34:15,720 --> 00:34:17,199 Set the Lahey ready, please. 590 00:34:17,280 --> 00:34:19,669 I'm going to need you to retract it. Think you can do that? 591 00:34:19,760 --> 00:34:21,637 - Yeah. - Thank you. Tom. 592 00:34:24,280 --> 00:34:25,269 Please. 593 00:34:27,880 --> 00:34:29,552 (BREATHES DEEPLY) 594 00:34:37,760 --> 00:34:39,273 That is as far as it will go. 595 00:34:40,760 --> 00:34:42,034 Numbers are stable for now. 596 00:34:51,240 --> 00:34:52,275 Okay, I got it. 597 00:34:52,560 --> 00:34:53,834 Lahey. 598 00:34:54,000 --> 00:34:55,558 (SUCTION GURGLING) 599 00:35:01,280 --> 00:35:04,272 GLEN: Okay. I'm around the artery distal to the tear. 600 00:35:05,000 --> 00:35:06,513 Vicryl ties, please. 601 00:35:07,640 --> 00:35:08,629 Thank you. 602 00:35:15,480 --> 00:35:16,799 Okay. Clip. 603 00:35:16,880 --> 00:35:19,189 (SUCTION GURGLING) 604 00:35:19,720 --> 00:35:20,709 Let's do it again. 605 00:35:29,720 --> 00:35:32,314 - Any more room you can give me? - I can't risk moving it. 606 00:35:35,160 --> 00:35:36,149 Okay. 607 00:35:44,320 --> 00:35:45,639 Come on. 608 00:35:48,520 --> 00:35:49,589 Clip. 609 00:35:50,960 --> 00:35:53,235 The vicryl ties are in position 610 00:35:53,320 --> 00:35:55,993 distal and proximal to the tear. 611 00:35:56,560 --> 00:35:58,118 Shunt, please. 612 00:35:59,320 --> 00:36:00,355 Thank you. 613 00:36:04,800 --> 00:36:06,472 Uterus is hardening a little. 614 00:36:07,760 --> 00:36:09,398 - Let's remove the Dardik. - Yeah. 615 00:36:13,920 --> 00:36:15,751 GLEN: Okay. The shunt is in 616 00:36:15,840 --> 00:36:19,276 and I'm passing it down the left common iliac distal to the tear. 617 00:36:22,280 --> 00:36:23,269 Just need to ligate it. 618 00:36:28,240 --> 00:36:30,117 - Scissors, please. - It's unstable. 619 00:36:30,240 --> 00:36:31,229 Cut. 620 00:36:32,120 --> 00:36:35,556 Shunt is ligated distal to the tear. Can we get a clamp on this, please? 621 00:36:35,640 --> 00:36:36,675 Clip. 622 00:36:39,240 --> 00:36:41,674 Now we're going to try and shunt proximal to the tear. 623 00:36:44,080 --> 00:36:45,718 Give me as much space as you can, please. 624 00:36:45,800 --> 00:36:46,915 I can't. I need to put it back. 625 00:36:47,000 --> 00:36:49,992 I just need 30 seconds. Oh, come on! 626 00:36:50,080 --> 00:36:51,752 BP crashing 71 over 60. 627 00:36:51,840 --> 00:36:53,398 The balloon's failed. Fill her up, please. 628 00:36:53,480 --> 00:36:54,469 Let's get the balloon out. 629 00:36:55,120 --> 00:36:56,838 - Dardik. - The uterus is hardening again. 630 00:36:56,920 --> 00:36:58,069 65 over 44. 631 00:37:02,240 --> 00:37:03,309 No, I can't get a hold of it. 632 00:37:03,400 --> 00:37:04,719 It's too traumatised. Give me your hand. 633 00:37:05,440 --> 00:37:07,192 I need you to compress with your fingers. 634 00:37:07,280 --> 00:37:09,510 - She's going to abrupt! - Just a few more seconds! 635 00:37:09,680 --> 00:37:11,113 It's slipping. I can't keep a hold of it. 636 00:37:11,200 --> 00:37:12,428 She hasn't got a few more seconds. 637 00:37:13,160 --> 00:37:15,310 - I've lost it. - 55 over unreadable. 638 00:37:15,400 --> 00:37:17,152 As much blood as you can get into her, please! 639 00:37:17,240 --> 00:37:20,869 - The uterus needs to go back now! - Everybody, just be calm. 640 00:37:29,760 --> 00:37:33,230 Okay. The shunt is in 641 00:37:33,680 --> 00:37:36,911 and it's going up the left common iliac artery 642 00:37:37,880 --> 00:37:39,552 proximal to the tear. 643 00:37:43,240 --> 00:37:46,152 - Okay. Ligate it. - I need to put it back. 644 00:37:46,240 --> 00:37:47,275 Ten seconds. 645 00:37:49,480 --> 00:37:50,469 Ten. 646 00:37:51,720 --> 00:37:52,914 Nine. 647 00:37:53,120 --> 00:37:54,348 Eight. 648 00:37:54,680 --> 00:37:55,874 Seven. 649 00:37:56,280 --> 00:37:57,315 Six. 650 00:37:57,960 --> 00:37:59,075 Five. 651 00:37:59,640 --> 00:38:00,834 - Four. - Systolic dropping. 652 00:38:01,000 --> 00:38:02,035 - TOM: Three. - Cut it. 653 00:38:02,560 --> 00:38:04,790 - Two. One. - Clamp off, check. 654 00:38:04,880 --> 00:38:05,915 - FIONA: Clamp off. - Done. 655 00:38:06,000 --> 00:38:06,989 Jesus Christ. 656 00:38:10,520 --> 00:38:11,839 I could have just worked in my dad's chippy. 657 00:38:12,840 --> 00:38:14,114 (SIGHS) So could I. 658 00:38:14,200 --> 00:38:15,235 Ultrasound, please. 659 00:38:16,760 --> 00:38:17,749 Thank you. 660 00:38:26,280 --> 00:38:28,714 Her placenta appears to be intact. 661 00:38:33,720 --> 00:38:35,711 - (SIGHS) I can't find a heartbeat. - Come on. 662 00:38:40,440 --> 00:38:42,078 (MUFFLED HEARTBEATS) 663 00:38:43,480 --> 00:38:44,469 I feel a heartbeat. 664 00:38:48,560 --> 00:38:49,879 (SIGHS) 665 00:38:51,120 --> 00:38:52,633 I'll get the bullet. 666 00:38:54,960 --> 00:38:56,359 (GRUNTS) 667 00:39:04,600 --> 00:39:06,318 Metal one, please. 668 00:39:11,400 --> 00:39:12,435 (CLATTER) 669 00:39:12,640 --> 00:39:15,234 (SCOFFS) Take the surgeon out of the Army... 670 00:39:15,520 --> 00:39:16,919 - (GLOVES SNAP) - (CLEARS THROAT) 671 00:39:20,120 --> 00:39:21,439 The patient needs to stay here for a while 672 00:39:21,520 --> 00:39:23,556 - and then go up to ICU, yes? - Yeah. 673 00:39:26,040 --> 00:39:28,190 - Fiona, you okay? - She's fine. 674 00:39:36,040 --> 00:39:37,268 That was good work, everyone. 675 00:39:37,600 --> 00:39:38,953 Nice one. 676 00:39:45,560 --> 00:39:47,232 Pack up, guys. 677 00:39:49,680 --> 00:39:50,669 (INDISTINCT CHATTERING) 678 00:39:59,000 --> 00:40:00,638 You didn't follow my guidance. 679 00:40:01,880 --> 00:40:03,154 No. 680 00:40:04,840 --> 00:40:06,592 Police still here? 681 00:40:14,800 --> 00:40:17,109 WOMAN: (OVER PA) Duty hygiene assistant to staff canteen. 682 00:40:20,400 --> 00:40:22,118 - You the GSW? - I am. 683 00:40:22,680 --> 00:40:24,318 This ricocheted off of a hard surface 684 00:40:24,400 --> 00:40:27,039 but it's a piece of copper jacket from a high-velocity round. 685 00:40:27,120 --> 00:40:28,872 It's an SA80. 686 00:40:29,680 --> 00:40:31,033 How'd he get hold of that? 687 00:40:31,120 --> 00:40:32,951 Well, he's ex-army. 688 00:40:33,680 --> 00:40:36,877 He shot his wife. This should send him down. 689 00:40:37,320 --> 00:40:39,515 - Thank you. - (DOOR BUZZES OPEN) 690 00:40:39,600 --> 00:40:41,795 - Dr Archerfield. - Yes. 691 00:40:42,200 --> 00:40:44,509 - We all thought Lorraine was off sick. - Yes. 692 00:40:45,120 --> 00:40:48,510 Well, someone told me that she's now working under supervision. 693 00:40:48,600 --> 00:40:50,556 Lorraine's better than that. 694 00:40:50,640 --> 00:40:51,789 Indeed she is. 695 00:41:01,400 --> 00:41:02,594 (DOOR CLOSES) 696 00:41:03,720 --> 00:41:07,076 Glen's CV said he finished deployment immediately before starting here, 697 00:41:07,160 --> 00:41:09,993 but his last deployment ended three months before. 698 00:41:10,080 --> 00:41:11,479 - What did he do for those three months? - (DOOR OPENS) 699 00:41:12,720 --> 00:41:14,199 Lorraine, I'm in the middle of a conversation. 700 00:41:14,680 --> 00:41:15,669 We need to talk. 701 00:41:15,760 --> 00:41:18,718 There's a blank he refuses to account for. 702 00:41:18,800 --> 00:41:21,109 - Thank you. - (DOOR OPENS) 703 00:41:24,440 --> 00:41:26,271 You cancelled the competency hearing 704 00:41:26,360 --> 00:41:28,749 because the complaints against me were unsubstantiated. 705 00:41:28,840 --> 00:41:31,354 - Yes, but the accusations remain. - Remain? 706 00:41:31,800 --> 00:41:33,711 Well, how can they remain? They're unsubstantiated. 707 00:41:33,800 --> 00:41:35,358 - That means they're bullshit! - Lorraine, please. 708 00:41:35,440 --> 00:41:36,634 Where do they remain? 709 00:41:36,720 --> 00:41:38,915 Look, this hasn't been easy for either of us. 710 00:41:40,920 --> 00:41:43,718 Now, I'll keep the file closed. In return, I want you back to work. 711 00:41:44,000 --> 00:41:46,150 - (SCOFFS) - I'm trying to help you. 712 00:41:55,480 --> 00:41:56,959 (BEEPS) 713 00:41:58,680 --> 00:42:00,557 - Excuse me. Can you take this? - WOMAN: Sure. 714 00:42:01,640 --> 00:42:03,790 When Clive told me that you were under my supervision, 715 00:42:03,880 --> 00:42:05,598 - I assumed that he had told you too. - (SCOFFS) 716 00:42:05,880 --> 00:42:07,552 I'm sorry he put you in a difficult position. 717 00:42:07,640 --> 00:42:08,629 Both of us. 718 00:42:08,720 --> 00:42:10,915 Bastard wants us to fight for the same job! 719 00:42:11,160 --> 00:42:12,593 (DOOR BUZZES OPEN) 720 00:42:12,880 --> 00:42:14,108 - See you later. - Bye. 721 00:42:32,920 --> 00:42:34,194 Shall we talk? 722 00:42:34,920 --> 00:42:37,115 Maybe we should leave it alone. 723 00:42:42,320 --> 00:42:43,514 Why didn't you tell me about Tom? 724 00:42:46,360 --> 00:42:48,237 Why didn't you even mention him? 725 00:42:50,040 --> 00:42:53,237 - Fiona... - You'll fight for a stranger's baby. 726 00:42:56,240 --> 00:42:57,229 (CHUCKLES) 727 00:42:58,760 --> 00:43:01,069 I was mad to call you. (INHALES) 728 00:43:02,400 --> 00:43:03,958 Lorraine's back. 729 00:43:05,600 --> 00:43:07,079 You should go. 730 00:43:08,640 --> 00:43:10,278 We don't need you. 731 00:43:20,280 --> 00:43:21,713 Oh, God. (SOBS) 732 00:43:23,960 --> 00:43:25,996 (THEME SONG PLAYING) 733 00:43:27,900 --> 00:43:35,900 Ripped By mstoll 734 00:43:35,950 --> 00:43:40,500 Repair and Synchronization by Easy Subtitles Synchronizer 1.0.0.0 52203

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