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1
00:00:05,219 --> 00:00:07,139
I thought she was still off sick.
2
00:00:10,579 --> 00:00:14,099
I don't know if you know, but
I teach an intubation tutorial...
3
00:00:15,859 --> 00:00:18,139
What did you tell him?
"There's a slapper in the ED,
4
00:00:18,299 --> 00:00:20,939
"just give her a bit of teaching
and she'll feel your tube."
5
00:00:23,179 --> 00:00:25,059
It's Clive. He's gunning for you.
6
00:00:25,219 --> 00:00:26,859
And this could
turn into a shit storm.
7
00:00:28,619 --> 00:00:30,979
When Clive told me
that you were under my supervision
8
00:00:31,099 --> 00:00:32,579
I assumed that he had told you too.
9
00:00:32,739 --> 00:00:35,099
Bastard wants us
to fight for the same job.
10
00:00:35,219 --> 00:00:37,019
I was mad to call you.
11
00:00:37,139 --> 00:00:40,699
Lorraine's back. You should go.
12
00:00:40,819 --> 00:00:42,379
We don't need you.
13
00:00:50,739 --> 00:00:52,259
PHONE RINGS
14
00:00:52,419 --> 00:00:54,299
What do you want?
'You in yet?'
15
00:00:54,459 --> 00:00:56,619
Missing me?
'Always. Get us a coffee, will you?'
16
00:00:56,779 --> 00:00:59,699
Why don't you ask your paramedic
friend, I'm sure she'd love to.
17
00:00:59,819 --> 00:01:01,419
'Triple shot capp, no sugar. Go on.'
18
00:01:01,579 --> 00:01:03,099
I've just been past the
coffee place
19
00:01:03,219 --> 00:01:04,659
and I haven't got any hands free.
20
00:01:04,819 --> 00:01:07,459
'No bloody heart.' Well,
it's comments like that that mean...
21
00:01:07,579 --> 00:01:08,499
THUMP
22
00:01:08,619 --> 00:01:09,979
SCREAMING
23
00:01:10,139 --> 00:01:12,699
'Harry? What was that? What's going
on? Harry?'
24
00:01:14,299 --> 00:01:18,019
There's been an accident, you should
come. 'What accident? Are you OK? What's happened?'
25
00:01:19,739 --> 00:01:20,699
Oh, God.
26
00:01:25,499 --> 00:01:26,659
Hello.
27
00:01:29,259 --> 00:01:30,539
Can you hear me?
28
00:01:33,019 --> 00:01:34,699
Can you... ?
29
00:01:34,859 --> 00:01:40,699
Oh, my God. Nuala? Nuala?
Are you OK?
30
00:01:40,819 --> 00:01:42,939
Oh, God. Oh, God.
31
00:01:44,339 --> 00:01:46,819
She's Harry and I'm Justin
and we're going to take care of you.
32
00:01:46,939 --> 00:01:48,899
Yeah?
33
00:01:50,299 --> 00:01:52,059
Airway. Airway.
34
00:01:52,179 --> 00:01:53,419
What?
35
00:01:53,539 --> 00:01:54,819
She's got an airway.
36
00:01:54,939 --> 00:01:57,339
OK. I'll check the pulse, yeah?
37
00:02:00,139 --> 00:02:01,499
She's breathing.
What?
38
00:02:01,619 --> 00:02:02,859
She's... Take them...
39
00:02:02,979 --> 00:02:04,019
Be careful!
40
00:02:07,339 --> 00:02:09,739
What are you doing? Get back!
41
00:02:09,859 --> 00:02:11,019
Back!
42
00:02:11,179 --> 00:02:13,379
Moving back please.
Yeah. Would you mind?
43
00:02:13,539 --> 00:02:15,459
Come on, give them some room to...
Oh, my word.
44
00:02:15,619 --> 00:02:18,179
Mind out,
doctor coming through. Harry?
45
00:02:18,339 --> 00:02:20,179
13.
Look, I'll take it from here.
46
00:02:20,299 --> 00:02:22,819
26 resps. She's breathing? Yes.
47
00:02:22,939 --> 00:02:24,779
Is this the cardiac arrest?
48
00:02:24,899 --> 00:02:27,499
No, she just fell, from up there.
49
00:02:27,659 --> 00:02:30,499
We need suction, O2,
a guedel and NPs.
50
00:02:30,659 --> 00:02:34,499
It's not us, it's not an arrest.
Put out a trauma call.
51
00:02:34,619 --> 00:02:36,019
Leave the kit, leave the kit.
52
00:02:36,179 --> 00:02:39,179
Right, there's a suction
pump in there and a green guedel.
53
00:02:39,339 --> 00:02:41,339
Harry? You OK?
It's not a cardiac arrest.
54
00:02:41,499 --> 00:02:44,099
Did you put out a trauma call?
Yes. She's breathing.
55
00:02:44,219 --> 00:02:45,499
Pulse 120.
56
00:02:45,699 --> 00:02:48,619
You taking it?
It's not an arrest, and if you're on call...
57
00:02:49,819 --> 00:02:52,499
What's going on?
Trauma call, prep for an RSI.
58
00:02:52,659 --> 00:02:55,059
And tell someone to bring a scoop.
Might need a binder too.
59
00:02:55,179 --> 00:02:56,179
All right.
60
00:02:56,339 --> 00:02:58,619
If you feel you can't handle
it... Fine, I'll take it.
61
00:02:58,739 --> 00:02:59,819
Thanks, Harry.
62
00:02:59,979 --> 00:03:04,099
I'm sure Doctor Busby's got to
rush off and give another SHO an
63
00:03:04,219 --> 00:03:06,099
intubation tutorial(!)
64
00:03:10,379 --> 00:03:13,299
Have you done a primary?
I'm trying to get an adjunct in.
65
00:03:13,459 --> 00:03:14,859
Harry?
Not complete.
66
00:03:14,979 --> 00:03:17,699
OK. Doesn't look like you need this.
67
00:03:17,859 --> 00:03:22,179
Just bleep me
if you get into trouble, yeah?
68
00:03:22,339 --> 00:03:24,819
High flow O2 please.
Yep, coming.
69
00:03:24,939 --> 00:03:26,419
Cheers.
70
00:03:26,579 --> 00:03:29,659
Nicola, is there anything I can do?
You could book her in.
71
00:03:29,779 --> 00:03:31,419
Yeah, yeah, I'll leave you to it.
72
00:03:31,539 --> 00:03:33,379
It's not going in.
73
00:03:33,539 --> 00:03:38,099
OK, we need to roll her.
Harry, come on.
74
00:03:38,259 --> 00:03:42,899
Yeah, so we're rolling
gently on three. One, two, three.
75
00:03:43,059 --> 00:03:44,859
OK. Are we there?
OTHERS: Yeah.
76
00:03:44,979 --> 00:03:46,339
OK. Well done.
77
00:03:51,339 --> 00:03:53,099
O2 ready? Yeah.
78
00:03:53,259 --> 00:03:58,139
Tolerating a guedel.
Pulse 120, resps 24.
79
00:04:01,819 --> 00:04:04,419
I need everybody to take a step
back, please.
80
00:04:04,579 --> 00:04:08,179
All of you, right now, take a step
back so we can do our jobs.
81
00:04:08,379 --> 00:04:11,579
We need a scoop.
Billy's on it. Should be bringing a binder too.
82
00:04:11,739 --> 00:04:15,379
Primary? Already doing it. Airway
clear with a guedel.
83
00:04:15,499 --> 00:04:18,179
Pulse 120, resps 24.
84
00:04:18,299 --> 00:04:21,859
Can you hear me? My name is Fiona.
85
00:04:21,979 --> 00:04:23,899
We're going to help you.
86
00:04:24,019 --> 00:04:25,979
Patient has an obvious head injury.
87
00:04:29,419 --> 00:04:32,939
Pupils equal and reactive,
a little sluggish, possibly a four.
88
00:04:36,459 --> 00:04:39,539
She fell from up there, yes?
Anyone know who she is?
89
00:04:39,659 --> 00:04:41,419
No?
90
00:04:41,579 --> 00:04:48,299
E1, V1, no response from trap pinch.
M1, GCS3.
91
00:04:48,419 --> 00:04:50,819
Who was first on scene?
92
00:04:50,979 --> 00:04:54,059
Me.
You see it happen?
93
00:04:54,219 --> 00:04:57,019
Yep.
Need to know how she landed.
94
00:04:57,179 --> 00:05:00,339
Feet first, and then
she hit her head on the floor.
95
00:05:00,499 --> 00:05:03,299
OK. There's a slight
fullness in the abdomen.
96
00:05:03,459 --> 00:05:06,859
So she's fallen from height,
onto marble, feet first.
97
00:05:07,019 --> 00:05:10,339
She's got a serious head wound
and possible spinal fractures
98
00:05:10,499 --> 00:05:13,579
and intra-abdominal injuries,
and there's an open tib-fib.
99
00:05:13,739 --> 00:05:18,139
So we'll be doing scoop and binder,
resus, repeat primary and then CT.
100
00:05:18,299 --> 00:05:20,979
Everybody clear?
ALL: Yeah. I'll grab a trolley
101
00:05:21,139 --> 00:05:22,739
and I'll let CT know
that we're on our way.
102
00:05:22,899 --> 00:05:24,819
Bleep me if you need me.
What in heavens...?!
103
00:05:27,179 --> 00:05:28,619
Harry, collar and blocks.
104
00:05:33,619 --> 00:05:35,019
Fiona, can you take the pelvis?
105
00:05:35,179 --> 00:05:37,779
Harry, I need you on the shoulders,
and I've got the legs.
106
00:05:37,899 --> 00:05:40,339
Sorry, bloody lifts, I was just...
107
00:05:40,459 --> 00:05:42,739
Ohh, nasty-looking tib-fib.
108
00:05:42,859 --> 00:05:44,739
Can you do the scoop first, please?
109
00:05:44,859 --> 00:05:46,539
From the head.
110
00:05:46,659 --> 00:05:49,579
Rolling on three - one, two, three.
111
00:05:49,699 --> 00:05:51,019
Tell me when. Yep.
112
00:05:51,139 --> 00:05:52,659
Back on three - one, two, three.
113
00:05:52,779 --> 00:05:54,979
Let's reverse, please.
114
00:05:55,099 --> 00:05:57,019
Rolling on three - one, two, three.
115
00:06:00,459 --> 00:06:04,779
Ready. OK, back on three -
one, two, three.
116
00:06:04,939 --> 00:06:07,379
I know this girl!
Haven't we seen her before?
117
00:06:08,539 --> 00:06:09,819
She's not staff, is she?
118
00:06:09,939 --> 00:06:10,979
No, a patient.
119
00:06:16,139 --> 00:06:18,019
There's no vascular compromise.
120
00:06:18,139 --> 00:06:19,819
Thank you.
121
00:06:19,979 --> 00:06:23,579
I started the clock.
We're just over three minutes in.
122
00:06:23,699 --> 00:06:25,459
We need the trolley.
123
00:06:25,579 --> 00:06:26,819
Ow!
124
00:06:28,699 --> 00:06:29,859
You been lying on that?
125
00:06:30,019 --> 00:06:32,659
I didn't expect to find glass on the
floor! You should sue, mate.
126
00:06:32,779 --> 00:06:34,099
I will. Ow!
127
00:06:34,219 --> 00:06:35,659
Can we focus, please? I need the BP.
128
00:06:35,779 --> 00:06:39,339
104 over 65. Pulse 113.
129
00:06:39,499 --> 00:06:41,539
OK, let's get ready
for the transfer, please.
130
00:06:44,659 --> 00:06:46,339
Everybody ready? Yep.
131
00:06:46,459 --> 00:06:48,699
One, two, lift.
132
00:06:48,819 --> 00:06:50,499
And down.
133
00:06:52,699 --> 00:06:54,579
CT's occupied at the moment.
Excellent(!)
134
00:06:54,699 --> 00:06:56,819
Come on. Resus, go. Brakes off, go.
135
00:07:03,819 --> 00:07:06,259
Under the circumstances,
I'll let you off about the coffee.
136
00:07:08,219 --> 00:07:11,419
Almost four minutes.
Could do better.
137
00:07:11,539 --> 00:07:13,179
What are you doing here?
138
00:07:13,299 --> 00:07:14,659
I'm leading the trauma call.
139
00:07:14,779 --> 00:07:16,299
You know what I mean.
140
00:07:16,459 --> 00:07:18,539
Am I supposed to give you a call
and ask permission?
141
00:07:18,699 --> 00:07:21,139
I thought you'd have gone.
Why's that?
142
00:07:22,779 --> 00:07:25,939
I don't think either of us
wants history to repeat itself.
143
00:07:31,099 --> 00:07:34,099
Nuala. That's it.
I knew I had the name.
144
00:07:36,299 --> 00:07:38,099
Nuala Barrington.
145
00:07:38,219 --> 00:07:39,939
You remember her, Harry?
146
00:07:40,059 --> 00:07:41,179
I need to change.
147
00:08:28,666 --> 00:08:31,146
GLEN: Has the patient's identity
been established?
148
00:08:31,266 --> 00:08:32,786
CONSTANCE: Yes, Nuala Barrington.
149
00:08:32,906 --> 00:08:34,186
Trachea central.
150
00:08:34,306 --> 00:08:36,266
Thanks, Harry. What?
151
00:08:36,426 --> 00:08:38,746
You just volunteered
to be the scribe.
152
00:08:38,866 --> 00:08:40,506
Oh. Right.
153
00:08:41,746 --> 00:08:43,866
Good bilateral chest expansion.
154
00:08:44,026 --> 00:08:46,586
Breathing symmetrical,
resps rate 16.
155
00:08:46,706 --> 00:08:48,186
You were also the first on the scene,
156
00:08:48,346 --> 00:08:51,266
so you'll have to do
the handover as well.
157
00:08:51,386 --> 00:08:53,106
Er...sure.
158
00:08:53,226 --> 00:08:55,546
Patient's name is Nuala Barrington.
159
00:08:55,666 --> 00:08:57,346
IV's in. What bloods do you want?
160
00:08:57,506 --> 00:09:01,986
FBC, U and Es, LFTs,
give me glucose, a VBG,
161
00:09:02,106 --> 00:09:04,906
clotting and crossmatch, please.
162
00:09:05,026 --> 00:09:07,386
Ramakrishna? Pretty much there.
163
00:09:07,506 --> 00:09:10,666
Can we see if CT's free, please?
164
00:09:10,786 --> 00:09:13,186
Harry? Is she on the system?
165
00:09:13,346 --> 00:09:17,226
Ah, yeah,
Major Trauma Foxtrot Charlie.
166
00:09:19,146 --> 00:09:22,466
Resus, are you ready for patient
Nuala Barrington,
167
00:09:22,626 --> 00:09:25,986
Major Trauma Foxtrot Charlie,
in the system?
168
00:09:26,146 --> 00:09:28,346
Thanks.
They've got someone in there.
169
00:09:28,466 --> 00:09:30,626
(Excellent...)
170
00:09:30,746 --> 00:09:32,146
Harry?
171
00:09:32,266 --> 00:09:34,386
Harry! You're up.
172
00:09:36,346 --> 00:09:37,786
Er, right, right...
173
00:09:41,506 --> 00:09:44,546
Em... This is Nuala Barrington.
174
00:09:44,706 --> 00:09:47,266
She fell about 30 feet
onto the Atrium floor
175
00:09:47,386 --> 00:09:48,746
about 13 minutes ago.
176
00:09:48,906 --> 00:09:50,986
GCS three,
she has a likely head injury,
177
00:09:51,146 --> 00:09:54,146
a possible pelvic fracture
and an open tib-fib.
178
00:09:54,266 --> 00:09:57,146
Haemodynamically, she's...stable.
179
00:09:58,226 --> 00:09:59,386
Trauma call?
180
00:09:59,506 --> 00:10:00,986
Yes, Lorraine.
181
00:10:04,306 --> 00:10:06,146
It's good to have you with us.
182
00:10:09,266 --> 00:10:10,946
Look at that.
183
00:10:11,106 --> 00:10:14,786
Blood. You guys are witnesses
for my personal injury claim, right?
184
00:10:14,946 --> 00:10:18,186
Got to be worth
a fortnight in Ibiza at least.
185
00:10:18,306 --> 00:10:19,386
Nice pants.
186
00:10:19,506 --> 00:10:21,106
Yeah. Your dad got them for me.
187
00:10:21,226 --> 00:10:22,146
BILLY SNIGGERS
188
00:10:25,826 --> 00:10:27,986
The abdo's tight.
189
00:10:28,106 --> 00:10:29,546
Where's the Fast scanner?
190
00:10:29,706 --> 00:10:31,826
Justin, the Fast!
Yeah, I'm there, I'm there.
191
00:10:36,106 --> 00:10:38,826
She's lost the dorsalis pedis.
Let's get the scoop off.
192
00:10:38,946 --> 00:10:40,546
Unclip top and bottom.
193
00:10:40,666 --> 00:10:42,346
One, two, three.
194
00:10:43,466 --> 00:10:44,946
I've got it.
195
00:10:45,106 --> 00:10:47,906
Brace, one, two, three. Go on three.
One, two, three
196
00:10:48,066 --> 00:10:50,626
Justin, give us a hand, please?
Yeah.
197
00:10:54,266 --> 00:10:55,666
No.
198
00:10:55,826 --> 00:10:58,586
We really need to pull this tib-fib,
or she'll lose her foot.
199
00:10:58,706 --> 00:11:00,706
OK. But quick as you can, yes?
200
00:11:00,826 --> 00:11:02,106
Thank you.
201
00:11:03,826 --> 00:11:06,106
Sorry, would you mind...?
202
00:11:06,226 --> 00:11:07,986
Lift to 30 degrees when I say.
203
00:11:09,226 --> 00:11:10,826
Ready, brace...
204
00:11:10,946 --> 00:11:12,426
lift.
205
00:11:23,946 --> 00:11:26,506
WHISPERS: Is it me,
or is this really arousing?
206
00:11:28,706 --> 00:11:31,186
BONES CRUNCH
207
00:11:31,346 --> 00:11:33,586
(Ooh!) Sorry, could I have a hand,
please?
208
00:11:36,746 --> 00:11:37,986
Ready, brace...down.
209
00:11:40,466 --> 00:11:41,426
I'm ready to go.
210
00:11:44,306 --> 00:11:46,146
We have dorsalis pedis.
211
00:11:46,266 --> 00:11:47,386
Excellent.
212
00:11:47,506 --> 00:11:48,706
RSI now, please.
213
00:11:48,826 --> 00:11:50,946
Harry, can I get cricoid, please?
214
00:11:51,066 --> 00:11:52,626
Er...sure.
215
00:11:52,746 --> 00:11:54,826
I'll do this. No, I...I got it.
216
00:11:55,906 --> 00:11:56,866
Thio, 200.
217
00:11:56,986 --> 00:11:59,186
Thiopentone, 200 milligrams.
218
00:11:59,346 --> 00:12:02,266
Can we give Neuro a shout, please?
Sure.
219
00:12:02,386 --> 00:12:03,826
Head injury from this height,
220
00:12:03,986 --> 00:12:06,266
it'd be nice if they came
and looked at her CT wouldn't it?
221
00:12:06,386 --> 00:12:07,426
You'd think.
222
00:12:07,546 --> 00:12:09,306
Mrs Hicklin, Trauma.
223
00:12:09,466 --> 00:12:11,426
We need an opinion
on a serious head injury.
224
00:12:11,586 --> 00:12:15,826
Major Trauma Foxtrot Charlie,
she's on the system.
225
00:12:15,946 --> 00:12:17,426
We'll be in CT.
226
00:12:17,586 --> 00:12:20,226
Free fluid in the abdomen
and the pelvis.
227
00:12:23,626 --> 00:12:24,586
Sorry.
228
00:12:27,746 --> 00:12:29,146
Shit.
229
00:12:29,266 --> 00:12:31,426
BOTH: She needs to...
230
00:12:31,586 --> 00:12:34,466
CT and then we need to get her
to theatre, fast.
231
00:12:34,586 --> 00:12:35,666
Ready to intubate.
232
00:12:35,786 --> 00:12:39,346
BP 152/79, pulse 99.
233
00:12:39,466 --> 00:12:41,146
Sats 82. Alert Theatre.
234
00:12:41,306 --> 00:12:43,026
Tell them
we could be there on the run.
235
00:12:43,146 --> 00:12:45,386
Mrs Hicklin, Trauma.
236
00:12:45,546 --> 00:12:49,866
We have Major Trauma Foxtrot Charlie
for you. She is on the system.
237
00:12:49,986 --> 00:12:51,746
Thank you.
238
00:12:55,186 --> 00:12:56,386
Scope.
239
00:12:56,506 --> 00:12:57,426
There you go.
240
00:12:57,546 --> 00:12:58,746
WHISPERS: Billy!
241
00:13:01,986 --> 00:13:03,106
OK, that's time.
242
00:13:03,226 --> 00:13:05,946
Hello, CT? Mrs Hicklin, Trauma.
243
00:13:06,106 --> 00:13:09,306
Are you ready for
Major Trauma Foxtrot Charlie yet?
244
00:13:09,426 --> 00:13:10,786
Bougie.
245
00:13:13,506 --> 00:13:14,626
Thank you.
246
00:13:14,746 --> 00:13:16,706
CT. They'll call us when it's free.
247
00:13:16,826 --> 00:13:18,106
Right...!
248
00:13:20,906 --> 00:13:22,346
Tube.
249
00:13:22,466 --> 00:13:23,546
Sorry, who's scribing?
250
00:13:23,706 --> 00:13:26,586
There we go. That's me.
That's through.
251
00:13:26,746 --> 00:13:28,706
- No rush.
- Bougie out.
252
00:13:30,186 --> 00:13:31,186
Got it.
253
00:13:34,306 --> 00:13:35,266
Breath.
254
00:13:36,466 --> 00:13:37,706
Breath.
255
00:13:40,466 --> 00:13:41,506
We're in.
256
00:13:41,626 --> 00:13:43,186
Cricoid off, thanks.
257
00:13:45,946 --> 00:13:47,546
There you go.
258
00:13:48,666 --> 00:13:50,706
Regarding Major Trauma
Foxtrot Charlie...
259
00:13:50,866 --> 00:13:53,546
Tell me about her pupils, please.
I'm concerned about the head.
260
00:13:53,666 --> 00:13:55,026
Nuala Barrington.
261
00:13:55,186 --> 00:13:58,026
Her medical files
are on the system already.
262
00:13:58,146 --> 00:13:59,346
They should be linked?!
263
00:14:06,786 --> 00:14:09,506
Pupils equal,
but much slower to react.
264
00:14:16,666 --> 00:14:19,386
Yep, there we are.
Regular, apparently.
265
00:14:19,506 --> 00:14:21,026
Just so we're all up to speed.
266
00:14:21,146 --> 00:14:22,306
Come on, back to work!
267
00:14:24,466 --> 00:14:26,546
CT? They'll call us.
268
00:14:27,786 --> 00:14:30,706
OK, I'll take the head,
you get the blocks on.
269
00:14:30,866 --> 00:14:33,826
You've never been a first responder
before, have you?
270
00:14:33,946 --> 00:14:36,506
She made it to resus, Harry.
271
00:14:36,626 --> 00:14:37,666
You did fine.
272
00:14:37,786 --> 00:14:39,186
Numbers, please?
273
00:14:39,306 --> 00:14:44,626
BP 156/81, pulse 78, sats 81.
274
00:14:44,746 --> 00:14:46,786
That's really pushing the ICP.
275
00:14:46,946 --> 00:14:49,426
Could be Cushing's response.
We should get a catheter in.
276
00:14:51,986 --> 00:14:53,146
Yep, let's do that.
277
00:14:53,266 --> 00:14:54,466
Constance?
278
00:14:54,586 --> 00:14:56,106
Right away, Mrs Rappaport.
279
00:14:56,266 --> 00:14:59,746
Stow lines and prep for a move
to CT now, please.
280
00:14:59,866 --> 00:15:01,199
PHONE RINGS
281
00:15:01,200 --> 00:15:02,480
Mrs Hicklin.
282
00:15:02,600 --> 00:15:03,760
CT's ready.
283
00:15:03,880 --> 00:15:05,680
Forget the catheter and let's go.
284
00:15:06,840 --> 00:15:07,840
Now, please.
285
00:15:08,000 --> 00:15:10,520
Lines attached, brakes off.
Let's go.
286
00:15:10,640 --> 00:15:11,560
Let's do it.
287
00:15:14,920 --> 00:15:17,120
I'm sorry. Sorry.
288
00:15:23,680 --> 00:15:26,560
Have you been involved
in an accident at work? I have.
289
00:15:26,680 --> 00:15:27,840
Oooh, no...
290
00:15:27,960 --> 00:15:29,520
Justin! Door, please.
291
00:15:31,160 --> 00:15:32,560
Glen? Yes?
292
00:15:32,720 --> 00:15:34,800
This incident,
Major Trauma Foxtrot Charlie,
293
00:15:34,960 --> 00:15:36,960
it's probably going to be
declared an SI.
294
00:15:37,120 --> 00:15:39,480
I thought you should know,
so you can document everything,
295
00:15:39,640 --> 00:15:42,240
make sure those files are buffed.
Not that I actually said that!
296
00:15:43,640 --> 00:15:45,000
Thanks, Giles.
297
00:15:45,160 --> 00:15:46,800
I just thought you should know.
298
00:15:56,960 --> 00:15:58,160
Pupils unequal.
299
00:15:58,320 --> 00:16:00,440
Can we chase Neurosurgery, please?
Yep.
300
00:16:00,600 --> 00:16:04,240
It's not working. You're making it
very difficult for Lorraine.
301
00:16:04,400 --> 00:16:06,760
Mrs Hicklin, CT.
We need that opinion.
302
00:16:08,640 --> 00:16:09,960
Yes.
303
00:16:10,080 --> 00:16:11,280
Everybody ready?
304
00:16:11,440 --> 00:16:14,440
So, yeah, we'd appreciate... Yes.
Yes. Thank you.
305
00:16:14,560 --> 00:16:17,160
Very good. Control scan.
306
00:16:19,760 --> 00:16:23,480
I must apologise for not clearing
the previous patient more quickly.
307
00:16:23,640 --> 00:16:27,440
This was due to unfortunate
but understandable technical errors.
308
00:16:27,560 --> 00:16:29,200
I'm still here.
309
00:16:29,320 --> 00:16:31,360
Control scan complete.
310
00:16:31,520 --> 00:16:34,280
Major Trauma cases
need to be prioritised.
311
00:16:34,400 --> 00:16:36,120
Neurosurgeon needs more information.
312
00:16:36,240 --> 00:16:38,680
Like what? Her hat size? What?
313
00:16:39,920 --> 00:16:43,920
This is something I've learned in my
CBT sessions that I've been taking.
314
00:16:48,440 --> 00:16:49,840
Starting head scan.
315
00:16:54,000 --> 00:16:55,960
LORRAINE: Right-sided extradural,
316
00:16:56,080 --> 00:16:58,160
midline shift
317
00:16:58,320 --> 00:17:00,440
and associated contusions
on the right.
318
00:17:00,600 --> 00:17:04,280
And fractures to the right-side
occipital and parietal bones.
319
00:17:04,400 --> 00:17:05,880
This brain looks really tight.
320
00:17:06,000 --> 00:17:08,760
Let's fast bleep Theatre, please.
321
00:17:08,880 --> 00:17:11,040
Head scan complete.
322
00:17:11,200 --> 00:17:13,680
No, no, put me back through
to Switchboard.
323
00:17:13,840 --> 00:17:18,440
I would appreciate it if you would
avoid touching any buttons.
324
00:17:21,200 --> 00:17:23,480
Who replaced Brian with
a friendly robot?
325
00:17:23,640 --> 00:17:27,200
Mrs Hicklin, CT. Can you fast bleep
the trauma theatre team, please?
326
00:17:27,360 --> 00:17:29,680
Stepford Radiographers.
I, Radiographer.
327
00:17:29,800 --> 00:17:31,680
Rise Of The Radiographers.
328
00:17:31,800 --> 00:17:33,520
HE MAKES ROBOT NOISES
329
00:17:33,680 --> 00:17:35,920
ROBOT VOICE: Robot radiographers.
Oi!
330
00:17:36,040 --> 00:17:38,440
Sorry.
331
00:17:38,560 --> 00:17:40,200
Mrs Hicklin, CT.
332
00:17:40,360 --> 00:17:43,160
(That was our best material.)
We need an ETA on the neurosurgeon.
333
00:17:46,320 --> 00:17:49,400
Contrast connected,
I think we can continue.
334
00:17:54,360 --> 00:17:55,760
Starting contrast run.
335
00:18:00,280 --> 00:18:03,240
Rib fractures.
That's the least of her worries.
336
00:18:05,520 --> 00:18:07,400
Jesus Christ.
337
00:18:09,480 --> 00:18:13,080
What the hell's that? Some kind
of foreign material. Brian?
338
00:18:13,240 --> 00:18:15,800
I wouldn't like to say without
more information. I'm uploading
339
00:18:15,960 --> 00:18:18,440
these images for the
radiologist's report.
340
00:18:18,600 --> 00:18:20,720
PHONE RINGS
Mrs Hicklin, CT. Thank you.
341
00:18:21,920 --> 00:18:23,280
Trauma theatre's ready.
342
00:18:23,400 --> 00:18:25,440
MACHINE BEEPS, THEY GROAN
343
00:18:31,440 --> 00:18:33,560
She's blown a pupil
and she's coning.
344
00:18:33,720 --> 00:18:36,240
I need neurosurgery
down here, right now!
345
00:18:37,366 --> 00:18:39,966
Gently on three. One, two, three.
346
00:18:40,086 --> 00:18:41,726
Quick as you can, folks.
347
00:18:43,446 --> 00:18:45,086
Brakes off.
348
00:18:45,206 --> 00:18:46,686
Hypertonic's going in.
349
00:18:46,846 --> 00:18:49,046
Is the intra-abdominal fluid
due to extravasation?
350
00:18:49,206 --> 00:18:53,286
Yeah, there's bleeding. What is the
material in her stomach? God knows.
351
00:18:53,446 --> 00:18:57,326
Get the Radiologist to report to me
in theatre, please. I'll go ahead.
352
00:19:00,286 --> 00:19:01,446
Right.
353
00:19:02,566 --> 00:19:04,086
You're welcome.
354
00:19:04,246 --> 00:19:08,206
Lorraine didn't create this
situation. Neither did I.
355
00:19:08,326 --> 00:19:10,366
She's a good surgeon.
356
00:19:10,526 --> 00:19:13,286
But maybe we need better
than good right now.
357
00:19:13,406 --> 00:19:14,686
SHE SCOFFS
358
00:19:14,806 --> 00:19:16,806
You're incredible.
359
00:19:16,926 --> 00:19:18,326
I'll see you in there.
360
00:19:24,326 --> 00:19:27,686
Patient is Major Trauma
Foxtrot Charlie,
361
00:19:27,806 --> 00:19:29,966
AKA Nuala Barrington.
362
00:19:31,366 --> 00:19:32,766
Consent, please.
363
00:19:37,166 --> 00:19:40,606
We need to prep for a laparotomy
and a craniotomy, please.
364
00:19:40,766 --> 00:19:44,406
Someone from neurosurgery may or
may not be on his way.
365
00:19:46,086 --> 00:19:48,246
CLOCK BEEPS
Thank you.
366
00:19:49,566 --> 00:19:51,966
Have you seen Fiona?
367
00:19:52,086 --> 00:19:53,326
Changing.
368
00:19:54,446 --> 00:19:55,646
What's the numbers?
369
00:19:58,606 --> 00:20:00,606
156 over 78, pulse is 61.
370
00:20:01,886 --> 00:20:04,526
Hypertonic's bought us some time.
Yeah, not long.
371
00:20:07,526 --> 00:20:09,806
Keep checking her pupils, please.
Yep.
372
00:20:28,286 --> 00:20:31,086
Fiona, can I have a word?
373
00:20:31,206 --> 00:20:33,246
If you're quick.
374
00:20:33,406 --> 00:20:36,446
I saw her in the ED yesterday.
Who?
375
00:20:36,566 --> 00:20:37,846
Nuala.
376
00:20:39,366 --> 00:20:42,086
She came in complaining
of stomach pains.
377
00:20:42,246 --> 00:20:45,126
I've seen her before, everyone
knows her, she's a regular...
378
00:20:45,246 --> 00:20:47,046
Did you examine her?
379
00:20:47,206 --> 00:20:50,246
Yes. I palpated her abdomen,
BP, heart rate -
380
00:20:50,406 --> 00:20:52,806
I even did bloods
just to keep her happy.
381
00:20:52,926 --> 00:20:54,846
Did you assess her mental state?
382
00:20:56,646 --> 00:20:59,886
She seemed normal at first.
Normal for Nuala.
383
00:21:00,046 --> 00:21:04,366
But she did kick up more than usual,
and I did... Yeah?
384
00:21:06,606 --> 00:21:09,646
I did think she needed
a psych assessment.
385
00:21:09,766 --> 00:21:11,566
Did you discuss this with anyone?
386
00:21:13,846 --> 00:21:17,886
The duty consultant.
Doctor Archerfield.
387
00:21:18,006 --> 00:21:19,646
Clive.
388
00:21:19,766 --> 00:21:21,246
I told him her history,
389
00:21:21,406 --> 00:21:24,366
and that I thought she should
see a psych liaison nurse.
390
00:21:24,526 --> 00:21:27,806
But he said she was about to
breach the four hour rule
391
00:21:27,926 --> 00:21:29,406
and to discharge her.
392
00:21:31,326 --> 00:21:33,966
Does it say this in your notes?
393
00:21:34,086 --> 00:21:36,326
Just says I discussed it with him.
394
00:21:37,526 --> 00:21:39,886
OK.
395
00:21:40,006 --> 00:21:41,646
Don't worry.
396
00:21:41,766 --> 00:21:43,366
I've got this.
397
00:21:57,206 --> 00:21:59,686
Radiologist has just
uploaded her report.
398
00:21:59,846 --> 00:22:03,286
There's free fluid in the abdomen
with active bleeding.
399
00:22:07,086 --> 00:22:09,726
Any news on the material in her gut?
400
00:22:09,846 --> 00:22:11,286
Take a look.
401
00:22:12,726 --> 00:22:15,366
"Dense foreign bodies within the
stomach and the small bowel
402
00:22:15,486 --> 00:22:17,566
"suggesting recent ingestion.
403
00:22:17,686 --> 00:22:20,766
"The largest measures 1.9 by 2.4cm."
404
00:22:20,926 --> 00:22:24,606
So, not prepared to risk an opinion
about what it actually could be?
405
00:22:24,766 --> 00:22:27,046
There's an active
bleed in the abdomen.
406
00:22:27,206 --> 00:22:30,646
We need to unzip her now.
Right behind you.
407
00:22:30,766 --> 00:22:32,046
I'll do this unless...
408
00:22:33,286 --> 00:22:35,446
OK. Numbers, please.
409
00:22:35,606 --> 00:22:39,806
158 over 80, pulse 60.
SATS could be better.
410
00:22:39,966 --> 00:22:43,486
Let's do a WHO. I'm Glen Boyle,
I'm the trauma consultant.
411
00:22:43,646 --> 00:22:46,726
Lorraine Rappaport, consultant
vascular surgeon.
412
00:22:46,886 --> 00:22:49,526
Khaali Osman, scrub nurse.
Heather Dooley, support nurse.
413
00:22:49,686 --> 00:22:52,806
Ramakrishna Chandramohan, gas reg.
Billy Finlay, anaesthetic ODP.
414
00:22:52,926 --> 00:22:55,006
Jason Marshall, support nurse.
415
00:22:55,166 --> 00:22:57,766
Fiona Lomas, trauma fellow.
Armeh Khalor, ODP.
416
00:22:57,926 --> 00:22:59,806
Daniel Insalaco,
rapid infuser operator.
417
00:22:59,966 --> 00:23:05,366
Patient is Major Trauma Foxtrot
Charlie. Date of birth 17/4/1988.
418
00:23:05,526 --> 00:23:08,966
She fell from a height, there's
a right-sided extradural haematoma,
419
00:23:09,126 --> 00:23:12,846
intra-abdominal bleeding
plus foreign bodies.
420
00:23:13,006 --> 00:23:16,726
I've signed a consent form four
for laparotomy plus proceed.
421
00:23:16,846 --> 00:23:19,286
Any word from neurosurgery?
422
00:23:19,406 --> 00:23:21,406
No.
423
00:23:21,526 --> 00:23:22,646
Packs to me, please.
424
00:23:24,846 --> 00:23:26,166
OK, let's have the blade.
425
00:23:31,126 --> 00:23:33,286
Am I OK to cut?
OK.
426
00:23:33,406 --> 00:23:34,326
Cutting.
427
00:23:46,246 --> 00:23:48,606
Standby Suction, please.
428
00:23:48,726 --> 00:23:50,766
Give me two clips, please.
429
00:23:57,166 --> 00:23:58,246
Let's have the mayo.
430
00:24:06,086 --> 00:24:07,326
You do the other side.
431
00:24:17,846 --> 00:24:20,126
OK, there's plenty of blood there.
432
00:24:20,286 --> 00:24:24,886
Let's get ready to flush with warm
saline, please. Everybody ready?
433
00:24:25,006 --> 00:24:26,326
Yeah. Yeah. Yeah.
434
00:24:28,286 --> 00:24:29,366
Cutting.
435
00:24:31,246 --> 00:24:33,486
Oh!
Jesus Christ.
436
00:24:33,606 --> 00:24:35,286
Thank you very much(!)
437
00:24:35,446 --> 00:24:37,006
Was that you, Billy?
No.
438
00:24:40,806 --> 00:24:42,326
Take this, please.
439
00:24:48,366 --> 00:24:52,326
There's generalised peritonitis
with loculated pus just everywhere -
440
00:24:52,446 --> 00:24:53,806
the pelvis...
441
00:24:55,086 --> 00:24:56,766
..paracolic gutters...
442
00:24:56,926 --> 00:25:00,886
Is it caused by the foreign bodies?
I don't know. Just a mess in here.
443
00:25:01,046 --> 00:25:02,646
We should get Gen Surg
to have a look at it.
444
00:25:02,806 --> 00:25:05,606
Yeah, that's not a bad idea.
OK. Fast bleep Gen Surg, please.
445
00:25:05,726 --> 00:25:08,766
Balfour and Morris retractor, please.
446
00:25:08,926 --> 00:25:12,566
The bleeding's mostly in the left
upper quadrant. Let's have a look.
447
00:25:16,806 --> 00:25:18,686
Yep, ruptured spleen.
448
00:25:18,846 --> 00:25:21,166
We're gonna have to have that.
Packs, please.
449
00:25:24,046 --> 00:25:25,006
Hit me.
450
00:25:28,166 --> 00:25:29,446
Again.
451
00:25:31,646 --> 00:25:32,926
Let's move down, again.
452
00:25:35,526 --> 00:25:38,046
Hit me. Keep 'em coming.
453
00:25:40,766 --> 00:25:42,606
Hit me.
454
00:25:42,726 --> 00:25:44,206
Again.
455
00:25:44,366 --> 00:25:47,206
How many's that in?
Eight.
456
00:25:47,326 --> 00:25:48,246
Hit me.
457
00:25:49,526 --> 00:25:50,606
Yep.
458
00:25:50,766 --> 00:25:54,086
Ten in the abdomen.
Ten packs in. How we doing?
459
00:25:54,246 --> 00:25:57,046
Better, but let me catch up with some
volume before you go any further.
460
00:25:57,206 --> 00:25:59,086
Two units of blood, two FFP.
Yep.
461
00:25:59,206 --> 00:26:01,246
Left eye looking very sluggish.
462
00:26:01,366 --> 00:26:03,606
Two dardik, please.
463
00:26:03,726 --> 00:26:04,886
Thank you.
464
00:26:13,006 --> 00:26:14,086
Mayo.
465
00:26:22,486 --> 00:26:23,446
Dish.
466
00:26:28,126 --> 00:26:30,366
Here comes the spleen.
467
00:26:30,486 --> 00:26:32,486
Let's have 2-0 VICRYL, please.
468
00:26:32,606 --> 00:26:34,486
Thank you.
469
00:26:34,606 --> 00:26:36,326
I'm ligating the artery.
470
00:26:40,526 --> 00:26:43,326
What are the numbers?
She's looking a little better.
471
00:26:44,686 --> 00:26:46,926
This pus has been here a while.
472
00:26:47,086 --> 00:26:50,286
There's got to be a perforation in
there somewhere. Shall I flush it?
473
00:26:50,446 --> 00:26:53,326
Yeah, just let me finish off
these ties first, please.
474
00:26:57,126 --> 00:26:59,126
Shit.
What?
475
00:26:59,286 --> 00:27:01,886
You really don't wanna hear this,
but she's blown the other pupil.
476
00:27:02,046 --> 00:27:04,326
Come on! Where the
bloody hell is neuro?!
477
00:27:04,486 --> 00:27:06,606
Pressure's killing her.
Prep for a burr hole.
478
00:27:09,086 --> 00:27:11,766
That means you need to go
and rescrub and I need someone
479
00:27:11,886 --> 00:27:14,166
to hold the head, now, please.
480
00:27:14,326 --> 00:27:17,926
Is there anyone here who's been
cleared to scrub in?
481
00:27:18,086 --> 00:27:20,326
Maybe call someone down from
Theatres? Not enough time.
482
00:27:20,486 --> 00:27:22,166
What about Harry?
Yes. Harry.
483
00:27:22,286 --> 00:27:25,046
Fast bleep Doctor Bennett-Edwards.
484
00:27:25,166 --> 00:27:26,886
Have you done a burr before?
485
00:27:27,046 --> 00:27:29,726
Twice in the field. Once at Brum.
When was that?
486
00:27:29,886 --> 00:27:32,046
It was a few years back.
Cut, please.
487
00:27:32,206 --> 00:27:34,006
I'd prefer it if you waited
for neurosurgery.
488
00:27:34,166 --> 00:27:37,126
And I'd prefer neuro were here right
now with their fingers in her head,
489
00:27:37,286 --> 00:27:40,806
but they're not,
and if we wait we lose her.
490
00:27:40,966 --> 00:27:42,726
I'm not happy with you
doing a burr hole.
491
00:27:42,846 --> 00:27:44,726
But if I don't do it, she dies.
492
00:27:46,286 --> 00:27:48,646
Look, I know this puts you
in a difficult situation.
493
00:27:48,806 --> 00:27:51,446
It puts us all in
a difficult position.
494
00:27:51,566 --> 00:27:52,486
Yes.
495
00:27:54,286 --> 00:27:55,886
It does.
496
00:27:56,046 --> 00:27:59,006
I know you're concerned about the
mess you're in with management.
497
00:27:59,166 --> 00:28:01,766
But my only concern is I've got
a patient who's going to die
498
00:28:01,886 --> 00:28:04,126
unless someone cracks her skull.
499
00:28:04,286 --> 00:28:06,646
And that someone should be
a neurosurgeon.
500
00:28:09,366 --> 00:28:10,326
OK.
501
00:28:14,366 --> 00:28:16,166
You know I'm right.
502
00:28:16,286 --> 00:28:17,286
So do you.
503
00:28:22,166 --> 00:28:23,566
What is it?
504
00:28:23,726 --> 00:28:26,726
We're opening up the head.
You need to scrub in.
505
00:28:29,566 --> 00:28:31,086
Short back and sides, boys.
506
00:28:52,250 --> 00:28:54,970
Let's have a couple of swabs
ready as well, please.
507
00:29:01,690 --> 00:29:03,770
Harry, hurry up.
508
00:29:05,690 --> 00:29:08,130
Pressure right here, please.
509
00:29:08,250 --> 00:29:09,250
Blade.
510
00:29:25,050 --> 00:29:26,050
Retractor.
511
00:29:40,250 --> 00:29:43,210
Brace with the cutter burr, please.
512
00:29:43,370 --> 00:29:46,850
I need you to hold the head here
and here, please. Saline, please.
513
00:29:47,010 --> 00:29:49,970
I'm going to have to run this bowel
through to find the perforation.
514
00:29:50,130 --> 00:29:51,930
Thank you.
How's she doing?
515
00:29:52,050 --> 00:29:54,250
I'm worried she's gonna arrest.
516
00:29:57,010 --> 00:29:58,090
OK.
517
00:30:06,370 --> 00:30:08,530
HE EXHALES
518
00:30:08,650 --> 00:30:10,330
Whatever you do, Harry...
519
00:30:12,290 --> 00:30:13,690
..don't sneeze.
520
00:30:25,530 --> 00:30:27,130
HE EXHALES
521
00:30:29,570 --> 00:30:32,010
I can't see. I need
some light here, please.
522
00:30:34,330 --> 00:30:35,770
How's that?
Yep.
523
00:30:44,330 --> 00:30:45,930
OK.
524
00:30:46,090 --> 00:30:48,890
Let's get some irrigation here.
Suction.
525
00:30:52,210 --> 00:30:54,490
Pass me the burr, please.
526
00:30:54,610 --> 00:30:55,690
Thank you.
527
00:31:00,730 --> 00:31:02,090
Come on.
528
00:31:14,770 --> 00:31:17,090
Let's have some more irrigation,
please.
529
00:31:30,730 --> 00:31:32,130
OK.
530
00:31:33,770 --> 00:31:34,810
The flush.
531
00:31:38,010 --> 00:31:39,610
Pressure is released.
532
00:31:41,410 --> 00:31:43,450
Ramakrishna?
533
00:31:43,610 --> 00:31:46,690
Shock versus ICP, these numbers
are impossible to interpret.
534
00:31:46,810 --> 00:31:49,210
Yeah. Let's lift the drape, please.
535
00:31:57,850 --> 00:31:58,890
Yeah.
536
00:32:01,770 --> 00:32:03,290
OK.
537
00:32:03,410 --> 00:32:05,450
It's slow, but it's reactive.
538
00:32:05,610 --> 00:32:07,650
Nice work.
Thank you.
539
00:32:07,770 --> 00:32:09,210
The burr hole did the job.
540
00:32:09,330 --> 00:32:10,330
Brains.
541
00:32:11,770 --> 00:32:13,010
Here we go.
542
00:32:13,170 --> 00:32:16,650
What the hell's going on?
Burr hole. She was coning.
543
00:32:21,330 --> 00:32:23,370
Not bad. For an amateur.
544
00:32:23,530 --> 00:32:25,890
We're just so happy
to have you with us.
545
00:32:26,010 --> 00:32:27,410
At last.
546
00:32:28,770 --> 00:32:31,330
Prep the power perforator.
547
00:32:31,450 --> 00:32:33,370
It's not the 18th century.
548
00:32:34,650 --> 00:32:35,610
HE MOUTHS
549
00:32:38,450 --> 00:32:41,530
Help them to scrub in, please.
And, Harry...
550
00:32:41,650 --> 00:32:42,890
good job.
551
00:32:45,330 --> 00:32:50,170
I can finish this if there's
somewhere else you need to be.
552
00:32:50,290 --> 00:32:52,130
Sure.
553
00:32:52,250 --> 00:32:55,290
I'll just...rescrub.
554
00:32:56,930 --> 00:32:59,010
Seems like you two make a good team.
555
00:33:01,090 --> 00:33:02,970
Torvill and Dean.
556
00:33:06,530 --> 00:33:08,770
Let's tidy up this mess, shall we?
557
00:33:12,330 --> 00:33:13,330
Knife.
558
00:33:41,810 --> 00:33:43,290
Raney clips.
559
00:34:19,405 --> 00:34:20,685
Retractor.
560
00:34:33,765 --> 00:34:35,245
Perforator.
561
00:34:35,365 --> 00:34:36,685
Shit!
562
00:34:36,845 --> 00:34:39,725
There's a tear in this
splenic flexure.
563
00:34:39,845 --> 00:34:41,925
Drilling second burr.
564
00:34:49,405 --> 00:34:51,645
I've located one of
the foreign bodies.
565
00:35:05,445 --> 00:35:07,645
What's that?
Glass.
566
00:35:09,765 --> 00:35:12,405
She swallowed glass.
Radical approach to dieting.
567
00:35:12,565 --> 00:35:14,805
Well, at least we found
the perforation.
568
00:35:14,965 --> 00:35:16,285
Got it.
Last burr.
569
00:35:18,085 --> 00:35:19,485
All yours.
570
00:35:24,125 --> 00:35:25,845
Linear stapler, please.
571
00:35:30,845 --> 00:35:33,165
How are the OBS now?
572
00:35:33,285 --> 00:35:35,045
Uh, not good.
573
00:35:35,165 --> 00:35:36,085
Curette.
574
00:35:38,045 --> 00:35:39,005
Flush.
575
00:35:41,245 --> 00:35:43,925
So, who was that
supporting the head?
576
00:35:45,725 --> 00:35:47,605
The ED SHO.
577
00:35:47,725 --> 00:35:50,085
Not Harry, by any chance?
578
00:35:50,245 --> 00:35:53,045
Yeah, that's right.
Heard all about her.
579
00:35:53,205 --> 00:35:56,605
One of our Reg's
smashed it last month.
580
00:35:56,725 --> 00:35:58,085
Craniotome.
581
00:36:04,085 --> 00:36:07,045
DRILL WHINES
582
00:36:11,485 --> 00:36:14,445
Gen Surg. Got held up in theatre.
583
00:36:14,565 --> 00:36:15,965
What's the situation?
584
00:36:16,125 --> 00:36:18,525
We're sealing the perforation
in the splenic flexure.
585
00:36:18,685 --> 00:36:21,005
We did a splenectomy.
And a burr hole.
586
00:36:21,165 --> 00:36:24,085
Well, leave some for me.
Be right with you.
587
00:36:38,845 --> 00:36:39,965
Almost there.
588
00:36:43,285 --> 00:36:44,365
Mayo.
589
00:36:54,165 --> 00:36:56,005
Let's have a dish, please.
590
00:36:56,125 --> 00:36:57,165
Thank you.
591
00:36:58,845 --> 00:36:59,845
Yes.
592
00:37:01,205 --> 00:37:02,605
Elevator.
593
00:37:18,085 --> 00:37:20,845
Here's the boy.
Malleable retractor.
594
00:37:22,445 --> 00:37:23,525
Suction.
595
00:37:26,325 --> 00:37:28,845
You gonna pull the clot
or you gonna frame it?
596
00:37:29,005 --> 00:37:31,005
Spend as much time
as I do in the brain,
597
00:37:31,165 --> 00:37:33,285
and you'd know you don't
wanna rush things.
598
00:37:41,085 --> 00:37:42,405
Swab.
599
00:37:55,325 --> 00:37:56,725
Bipolar diathermy.
600
00:37:57,885 --> 00:38:01,405
BP 141 over 74, pulse 72, SATS 95.
601
00:38:01,565 --> 00:38:04,645
It's going the right direction.
She won't be Einstein after this,
602
00:38:04,805 --> 00:38:07,645
but as she jumped 30 feet
on to a marble floor
603
00:38:07,765 --> 00:38:09,685
I'm guessing she wasn't that before.
604
00:38:12,565 --> 00:38:15,925
I'm sure he's got the wrong
end of the stick. About Harry.
605
00:38:17,325 --> 00:38:20,445
There's another perforation
in the D-colon. Right.
606
00:38:22,045 --> 00:38:23,605
Well, let's have a look.
607
00:38:29,805 --> 00:38:32,045
I think we've got this now.
Yes?
608
00:38:36,965 --> 00:38:37,925
Fine.
609
00:38:42,605 --> 00:38:43,725
Thank you.
610
00:38:51,965 --> 00:38:53,765
Is she out of the woods?
Seems so.
611
00:38:53,925 --> 00:38:56,725
She's stable.
Tickety-boo.
612
00:39:06,045 --> 00:39:08,085
Hi.
Hi.
613
00:39:09,925 --> 00:39:12,125
Oh, God, I'm gonna stink
all day now.
614
00:39:16,845 --> 00:39:19,325
I'm sorry about Glen.
615
00:39:19,485 --> 00:39:21,925
Well, I'm sorry you got
caught in the middle.
616
00:39:25,485 --> 00:39:28,685
You did your Gen-Surg up
in Birmingham, didn't you?
617
00:39:28,805 --> 00:39:31,005
At the QE, yeah.
618
00:39:31,125 --> 00:39:32,885
With Glen?
619
00:39:33,005 --> 00:39:34,925
I wouldn't say "with."
620
00:39:39,165 --> 00:39:40,885
It didn't end well.
621
00:39:41,045 --> 00:39:43,525
Well enough for you to get him
to come here and take my job.
622
00:39:46,205 --> 00:39:47,565
Sorry.
623
00:39:47,685 --> 00:39:50,165
I didn't know what to do.
624
00:39:50,325 --> 00:39:53,125
Clive gave me the impression
that you weren't coming back.
625
00:39:54,725 --> 00:39:58,085
You know she came in to
the ED yesterday? Who did?
626
00:39:58,205 --> 00:40:00,365
Nuala.
627
00:40:00,525 --> 00:40:03,645
Harry wanted to do a psych assessment
but Clive insisted
628
00:40:03,805 --> 00:40:07,325
that she be discharged
to meet the four hour target.
629
00:40:09,925 --> 00:40:11,445
Thank you.
630
00:40:11,605 --> 00:40:13,885
PA SYSTEM: 'Trauma call,
attend emergency department.
631
00:40:14,045 --> 00:40:16,645
'Trauma call, attend
emergency department.'
632
00:40:18,845 --> 00:40:21,685
Hi. Is the next case coming in here?
633
00:40:21,845 --> 00:40:24,005
ETA three minutes.
CT available?
634
00:40:24,165 --> 00:40:26,525
Here. Holding for us.
How's Nuala?
635
00:40:26,685 --> 00:40:29,165
Oh, she's fine, yeah,
it's looking good.
636
00:40:29,285 --> 00:40:31,525
Great. Listen...
637
00:40:31,685 --> 00:40:34,965
Nuala Barrington is one case that
you don't need to worry about, OK?
638
00:40:49,205 --> 00:40:50,165
Hi!
639
00:40:57,445 --> 00:40:58,445
Yep?
640
00:41:00,685 --> 00:41:02,485
What can I do for you, Lorraine?
641
00:41:02,645 --> 00:41:04,925
I hear you're going to
call it an SI?
642
00:41:05,085 --> 00:41:08,245
Yes, it's a very unfortunate
incident. Very sad.
643
00:41:08,365 --> 00:41:09,965
How's the patient?
644
00:41:10,125 --> 00:41:13,005
Looks like she's going to make it.
Which is probably just as well. Mmm.
645
00:41:13,165 --> 00:41:16,365
Y'know HSE are going to be
all over us. Yes.
646
00:41:16,525 --> 00:41:19,245
I'm sure they'd be particularly
interested to learn that she was
647
00:41:19,405 --> 00:41:23,605
discharged from the ED last night,
with a stomach full of glass.
648
00:41:23,765 --> 00:41:26,125
When she should have had
a psych assessment.
649
00:41:26,285 --> 00:41:29,245
Yes, well, I see how that might raise
questions about the member of staff
650
00:41:29,405 --> 00:41:32,085
who examined her. I can see
how it might raise questions
651
00:41:32,245 --> 00:41:36,605
about the duty ED consultant who
puts targets before patient welfare.
652
00:41:51,325 --> 00:41:53,125
Oh, you know what?
653
00:41:53,245 --> 00:41:55,525
I can take this one.
654
00:41:55,685 --> 00:41:57,405
OK.
655
00:41:57,525 --> 00:41:58,845
Thank you.
656
00:42:08,045 --> 00:42:11,765
So, with everything going on, you
really think she's up to the job?
657
00:42:11,925 --> 00:42:15,685
That isn't fair.
I'm making this work.
658
00:42:15,845 --> 00:42:19,565
You said so yourself. Whatever's
going on between me and you,
659
00:42:19,725 --> 00:42:23,085
that's what's really important
is that I am making this unit work.
660
00:42:23,245 --> 00:42:26,765
Yes, of course, but you have to
understand - I'm not going anywhere.
661
00:42:30,045 --> 00:42:31,525
I'm not leaving.
662
00:42:47,925 --> 00:42:49,885
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00:42:51,975 --> 00:42:56,525
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