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