Rabbits in Headlights Casualty


Rabbits in Headlights

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Transcript


LineFromTo

MUSIC: "We Are Young" by Fun

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PHONE VIBRATES

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BELL RINGS

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Excuse me.

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Excuse me. Sorry.

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SIREN WAILS

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-Oi!

-Sorry!

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Watch where you're going, you mug!

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-Mind your back, please, lovely!

-Oops.

-Thank you.

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Don't let the staff see you.

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-They can refuse you stuff if they know you're a smoker.

-Oh, thank you.

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-Robyn!

-Excuse me...

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I thought I'd get here early.

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-Hey!

-Hey.

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-About time!

-Can you get out of the way there, please?

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And watch where you're going next time, young man,

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otherwise it's going to be you I'm bringing in.

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James?

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-I'm Jamie now.

-Yeah. I knew you'd been placed here.

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-I meant to get in touch...

-Dad said he'd rung...

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This is Robyn and Ally, on final placement too.

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-This is my uncle, Jeff.

-Can you do us a favour, girls?

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Can you grab these bags for me, please? Jamie?

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Take that, mate.

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OK, Mrs Morris, let's have you in, sweetheart.

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Where's Aoife?

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-I don't have her number.

-Mrs Morris.

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-Happy New Year, Mrs Morris.

-Cause of the collapse is unclear.

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-BM at the scene 2.5.

-I'd love to date a doctor.

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You are so unoriginal.

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I know, it's my USP.

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That's why people like me, though. I'm not a challenge.

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Excuse me. We're looking for Senior Sister Tess Bateman?

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She should be in Resus.

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Can we have Mrs Morris's bags, please?

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Yeah, I've got them!

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Resus?

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That way.

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Come on, then.

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Is there anyone you'd like us to call, Mr Timms? We're just waiting.

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I can't wait to get in there.

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I'm dreading it.

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-Can I help you?

-Excuse me.

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-Nice hair.

-Thank you.

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We're looking for the Senior Nurse, Tess Bateman.

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We're supposed to be inducted this morning.

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-I'm Tess.

-Hi. Robyn Miller.

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PHONE RINGS I'll be right back.

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-Oh, my God, that's so embarrassing.

-TESS: Emergency Department.

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I saw her outside this morning. I thought she was a patient.

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She's got my lighter!

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Thank you. Zoe.

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Big RTC. Number of serious casualties unconfirmed at present.

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-ZOE:

-OK, let's get Mr Timms up to the cardiac cath lab.

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Let them know we need to clear some space.

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And Tess, we need some more doctors

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so put a red call out and let theatre and X-ray know.

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Excuse me.

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3006 to control, received that.

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-We're heading to the ambulance now, over.

-What's going on?

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It's a big pile-up. Police are all over it apparently.

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I've found it on Twitter - a school bus or something.

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What's the hash tag?

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Louise, I want a briefing in admin with all Resus staff in two minutes.

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Will you put a call out?

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Right. The staffroom's just there.

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Be back, ready for briefing in two minutes.

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Sorry! Sorry I'm late.

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I took my boyfriend to the airport. I left loads of time, just...

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Who are you?

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Aoife O'Reilly. I'm on placement with these guys.

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Perhaps I could speak with Tess...

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-..Bateman?

-I'm Tess Bateman, the Senior Nurse.

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I am really sorry. I ran all the way, I tried my best...

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This is your best?

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'Resus team to admin, directly please.'

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Go through to the staff room with the others.

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And that needs to come off. You can't work with it on.

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It's your choice. Quickly!

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MUSIC: "I Gotta Feeling" by The Black-Eyed Peas

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# And do it, and do it, and do it

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# Cos I got a feeling

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# That tonight's going to be a good night

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# That tonight's going to be a good night... #

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Happy New year.

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But I didn't get you anything.

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We can share it.

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You free tonight?

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Um...

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Maybe.

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So you'll Let me know.

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They are so perfect.

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OK, everyone, I've got an update.

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There's been a coach crash on the Holby Ring Road.

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There's about 30 kids and their teachers on board.

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So we're dealing with walking wounded, entrapments,

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serious casualties and possible fatalities. You know the score.

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-Sam, you're with me in Resus. Tom, you're overseeing cubicles.

-Yeah.

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OK, guys. Normal induction is now out of the window

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so I now want you to assist your mentors in whatever they ask.

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Stick with them.

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You must be Jamie? You're with Lloyd.

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-You're...

-Robyn Miller.

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With Linda.

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Aoife, you're with Fletch.

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Keep in touch!

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And you're with Charlie. OK. Let's go.

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-Right, Ally.

-Yeah.

-Charlie!

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-Can we get some help over here, please?

-Yeah. Ready?

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Right. Just take a deep breath.

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-Can we get her over, please, ladies and gents?

-Get a piece.

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Nice and gently. OK, on three.

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One, two, three.

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Pulse is 110,

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resps are 28, BP's 110 over 70,

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sats are 95. I've given her ten of morphine and 750 of saline.

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-OK, thanks, Dixie.

-Can you just look after this for me, please?

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How many units do you want cross-matched?

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I want eight cross-matched first.

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Let's start with O neg while we're waiting

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and we'll need some tranexamic acid as well, please.

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Charlie, what's that?

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That's a procoagulant. It stops the bleeding.

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I'm also not happy with her airway or her GCS.

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OK, can you intubate, Sam? Can we bleep the orthopods?

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Not just a window to the soul,

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a window to the brain.

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Pupils equal and reactive.

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OK, let's keep pushing the bloods, please, and we'll need a CT scan.

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We're now going to sedate her and put her on a ventilator.

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Where's me tea?

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Two sugars and a biscuit.

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-NEWSREADER:

-The group is actually made up

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of approximately 30 teenagers and some adults.

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The injured are being taken to Holby's Emergency Department

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and we are being told that the coach driver himself

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is refusing to leave the scene.

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Imagine that on your conscience.

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-They were around ten minutes from their destination...

-Jamie!

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Catch you later.

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This is Ella Amson, 15 years old.

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Trapped in the coach for 45 minutes with a suspected fractured leg.

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She was conscious and alert the whole time.

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However, during the course of extrication,

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she suffered a blunt trauma to the back of her head

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which rendered her unconscious.

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We intubated when we got her out.

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She went into cardiac arrest, so we shocked her twice on the way in.

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She's had two of adrenaline, 300 of Amiodarone and constant CPR.

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-LLOYD:

-Do you want me to take over?

-No, I'm fine, mate, thanks.

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Can I help?

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OK, Jamie, we're going to transfer. Copy me exactly.

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OK, everybody ready? On my count. One, two, three.

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Get the defib. What's her name?

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-Ella Amson.

-That's Zoe Hanna.

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Clinical lead. Brilliant.

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Someone put a catheter in. Have ITU called back with a bed?

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-Not yet. I'll update the police on her condition.

-Shall I bag these?

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-We'll need the anaesthetist to stay with her in the CT.

-Excuse me?

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Let's get her down there fast.

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-Her leg - it was trapped, that was all.

-Hold off, Jeff.

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MONITOR PINGS

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She's in VF.

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OK, stand back. Charging.

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Shocking.

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ALARM CONTINUES

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OK, continue CPR.

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Continue CPR for two minutes.

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This is Daniel Heaton.

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He was initially confused with a GCS of 14, now 15.

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He's refused spinal care. His airway's clear,

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but he's hyperventilating with a respiratory rate of 33.

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He's got altered sensation in his hands and feet.

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He's vomited three times en route.

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-Daniel!

-Wait, Mum. Hang on.

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Reece, it's me. You OK, Reece?

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Reece?

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Quick.

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What's the matter with his hands?

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Reece. Reece?

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They couldn't get him out.

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He was next to me.

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-The battery's dead.

-I'm sure the nurse will recharge it for you.

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-You can borrow mine. I don't mind.

-Paramedics are there.

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The fire brigade's cutting him out. He's in good hands, sweetheart.

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HE VOMITS

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Robyn, can you get a receiver?

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OK, just breathe.

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Have you been drinking, Daniel?

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I'm sorry. I couldn't find one!

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Answer the nurse, Daniel. Have you been drinking?

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We used to smuggle cider after netball. Backseat.

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-Everybody does it, don't they?

-Not when they're the head of year's son.

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Please, Mum. You're stressing.

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There's more important stuff going on.

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Alcohol is against school rules!

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I know that. Don't tell me.

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Tell Steve.

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OK, that's two minutes. Let's do a pulse check.

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There's a trace.

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Sinus tachy.

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We've got a carotid output there. Well done, Jeff.

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Well done, everyone. Let's get a BP, bloods, ABG and a portable chest.

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-Yeah, I got it.

-Good girl.

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Hang on.

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Pupils are unequal.

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-Can I have some mannitol on standby?

-I thought we'd just got her back?

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-And let's get an urgent CT scan.

-We got her heart back

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but they're seeing signs of her brain shutting down.

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OK, there's a large boggy haematoma over the occiput.

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I'm not sure if that's blood.

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No, it's brain tissue.

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Call the theatre. Can't you get a neurosurgeon?

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-She's got a catastrophic head injury.

-Do a CT!

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-You haven't done a CT.

-Come and have a look, Jeff.

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What's she doing?

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Indicating the signs for severe brain damage.

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-Panda Eyes, CSF, Battle's Sign.

-I don't understand. She was conscious.

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-Rhinorrhoea.

-She was concerned about her friend.

-So that's it?

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-You did all you could. We have to wait for the neurosurgeons.

-We went out for a fractured leg.

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-It's not looking good.

-Excuse me, I found this.

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OK. We've got a donor card. How old is she?

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15.

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Right, we'll need parental consent. Give that to Charlie.

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Charlie, can you contact the transplant co-ordinator?

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Well done. That was a good find.

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Well done.

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So, what happened to your arm, them?

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Broke it. First day.

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First day? What, so no skiing at all?

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A break?

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Wouldn't that need a plaster?

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Um...

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Good diagnostic skills, but bedside manner - little bit confrontational.

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Right, can you wiggle your fingers for me?

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OK, squeeze my hand.

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-Yeah, they're all right. Let's have a look.

-Please don't.

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-Got to do our job.

-Hey, Daniel. You OK? Have you seen Joe?

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He was with Reece. They can't get him out.

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That is brand new.

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-You pulled a sickie to get that done.

-It's nice.

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Robyn, he needs to go to his own cubicle for a full ATLS assessment.

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OK, come on, let's go and get your phone charged.

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That's well drawn.

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You got any tattoos?

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That's for me to know and you to wonder.

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You have, haven't you?

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What is it, where is it and can I have a look at it?

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She doesn't look the type.

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Guess she was a '60s chick, though.

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She's not that old!

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QUIET GROANING

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Hey. You OK?

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-RADIO:

-Holby Control to 3006.

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Back-up needed back at the Ring Road RTC.

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3006 to Holby Control, received that and on our way, over.

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Just one of those days, you know.

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She was the same age as my John.

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I was with him last weekend.

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He thought it was wicked, us working together.

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We should all go out for a drink. He'd love to see you.

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Look, at work, we are just professionals, OK?

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I'm a paramedic. You're just a student nurse.

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-That's it, nothing more, you understand?

-Yeah, sure.

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I just don't want anyone knowing anything about my personal life!

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Jamie?

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You his mentor, yeah?

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Teach him some discretion, will you?

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Breathe.

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Please breathe. Please breathe.

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43S. Date of birth is the third of the first, '98.

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OK, thanks. We'll be standing by.

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That was the UK Transplant Service.

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They need her blood group if we get consent.

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There's no evidence patient's state is drug induced.

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They need to do all these tests

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to make absolutely certain she's brain dead

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-before we can push on with the retrieval.

-OK, let's do a log roll.

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This actually very rarely happens in the ED.

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One, two, three.

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I'm sorry. I'm really sorry. I...

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It's OK. Take a break.

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-I'll be fine. I'm OK.

-Look...

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I'll see you back in ten minutes.

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OK, back down.

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One, two...

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Emergency services are still working to free the last injured teenagers

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who are still in the coach that crashed earlier today.

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You can see pictures of the scene, see emergency services at work.

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We've had confirmation through now

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that they are actually all from Wyvern West Academy

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-and we understand...

-Aoife.

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Ally. We may need some extra hands here if you're free.

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(It's the driver.)

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At least two of the passengers, we believe, are critically ill.

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This is Steve. He was the driver of the coach.

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He's got a dislocated right shoulder and severe neck pains.

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His GCS was 15, BP 140 over 60 and pulse 100.

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He refused all spinal treatment and he wouldn't leave his bus

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until everyone else had been taken care of.

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-Gave him a bit of entonox.

-We're here, Steve. Get you sorted.

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This is Joe. He has laceration and bruising to his face.

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Aoife, can you take Joe through to cubicles with the other students?

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-I'm actually a teacher. Well, student teacher.

-Sorry.

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I'm a student nurse. Follow me.

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Steve! Oh my God, Steve.

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-Can you step back, please? We need to go...

-This is my husband.

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I don't want to be here.

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Reece Allan is still on the coach. I should be back out there.

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-This is yours, Lloyd.

-Thanks, Tess.

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Hello, Steve, My name is Dr Sam Nicholls.

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We're going to transfer you to the bed to assess your injuries.

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Jump up on there for us, mate,

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in your own time, please. Nice and slowly.

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STEVE GROANS IN PAIN

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I'm all right.

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-Try and encourage him to hold it himself using his good hand, OK?

-OK.

0:17:040:17:08

Steve, if you'd like to breathe into this?

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I've already done a breath test!

0:17:100:17:12

-I would never drink and drive.

-Steve...

-Have some respect! Please!

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This isn't a breathalyser, Steve. It's more entonox. Gas and air, OK?

0:17:150:17:19

-It's pain relief.

-Sorry.

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-Sorry. I didn't mean to...

-OK, Steve, you have to realise

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everyone here is trying to help you, OK?

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You have a dislocated shoulder. The quicker we get you settled,

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-the quicker we can sort that out for you, OK?

-OK.

0:17:290:17:32

Right, let's get that shoulder X-rayed, we need a CT

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to make sure there's no neck injury before we do an MUA.

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Get a line in, please, and a drip bag up.

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What happened?

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I don't know.

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I don't know.

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Guess she wanted something a bit different. Bit of rough?

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None of our business.

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-Just chill out, man. Come on, chat.

-Hey.

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We do medicine, not chat.

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And we don't "chill".

0:17:580:18:00

On shift means on constant alert.

0:18:000:18:02

That's going to be some black eye.

0:18:040:18:07

Here. This is Reece.

0:18:070:18:09

That one.

0:18:090:18:11

He's cute.

0:18:110:18:13

-Who's that?

-My stepdad.

0:18:130:18:16

Is that legit?

0:18:160:18:18

We couldn't get served at the bar.

0:18:180:18:20

He's cool. But...

0:18:200:18:22

Tries too hard?

0:18:220:18:24

My stepdad does the same.

0:18:240:18:25

Useful, though, sometimes.

0:18:250:18:28

-What's happening? What's going on with my hands?

-Linda!

0:18:280:18:31

You all right?

0:18:310:18:33

-All right, have a look at this. Know what this is?

-No.

0:18:330:18:36

It's a carpopedal spasm.

0:18:360:18:38

It's usually a side effect of anxiety or a reaction to drugs.

0:18:380:18:43

Sir, what's happening? How's Reece?

0:18:430:18:46

They were still cutting him out when I left. I came in with Steve.

0:18:460:18:51

-That's Reece's, isn't it? Want me to give it to his dad?

-It's OK.

0:18:510:18:56

It's got my stuff too.

0:18:560:18:57

Time of brain stem death - 13:29.

0:18:590:19:03

The mother's here.

0:19:050:19:08

She's been informed of the severity of the head injury.

0:19:080:19:11

She's in the relatives' room awaiting news.

0:19:110:19:16

-Shall I do it? I'll do it.

-Thanks.

0:19:160:19:18

Right, Ally, do you want to fetch her from the relatives' room

0:19:200:19:23

and bring her to my office?

0:19:230:19:24

Me? How do I? What am I meant to...?

0:19:240:19:26

You don't. That's my job.

0:19:260:19:29

And if she asks?

0:19:290:19:31

You simply say you don't know. It's a very delicate situation.

0:19:310:19:34

Just bring her to me.

0:19:340:19:36

PHONE RINGS

0:19:360:19:37

Holby ED.

0:19:400:19:42

-OK, thanks, Ally.

-Charlie, should I take these through?

0:19:420:19:46

Yeah. OK, I've got that.

0:19:480:19:49

Can you do me a favour? Give this to Steve.

0:19:530:19:55

He said I could count on him.

0:19:550:19:57

What is it?

0:19:570:19:58

Stuff. Boys' stuff.

0:19:590:20:03

Dirty magazines!

0:20:030:20:04

Please. I don't want Mum upset.

0:20:040:20:07

All right.

0:20:080:20:10

It is quite an unusual injury.

0:20:160:20:17

What's happened is the top of the arm has pushed back, pushing

0:20:170:20:21

the shoulder out and it's pressing against the scapula.

0:20:210:20:24

Which is why he is in so much pain.

0:20:240:20:25

Excuse me. I've got a message for Steve from Daniel. Can I?

0:20:250:20:28

-Yes, we have finished here.

-Thank you. How is he doing?

0:20:280:20:31

Good. You've got a very lively son!

0:20:310:20:34

You're joking me. How did that happen? Look at the gap.

0:20:350:20:39

That's a rare and interesting dislocation.

0:20:390:20:41

Excuse me, Mr Green, I've got a message from your stepson, Daniel.

0:20:410:20:45

He says you always said he could count on you.

0:20:450:20:47

Father to son. And could you hold on to this?

0:20:470:20:50

No, not this time. Tell him he's on his own.

0:20:530:20:56

OK, so, Steve, the good news is there is no cervical fracture.

0:20:580:21:02

So we will be able to reduce it. OK, come with me.

0:21:020:21:06

Thanks, Lloyd.

0:21:060:21:07

-What's happened?

-I've messed up. Big time.

0:21:150:21:18

-You turned up. Thank you.

-What have you done?

0:21:200:21:22

I got the text, but I can't stay. You OK?

0:21:220:21:24

These are legal highs.

0:21:290:21:31

My mate got GML over the internet packaged like this.

0:21:310:21:33

I thought it was dirty magazines.

0:21:330:21:35

What?

0:21:350:21:36

It's Daniel's. His mum's the teacher.

0:21:360:21:39

-You're a drugs mule!

-It's not funny.

0:21:390:21:41

Tell your mentor. I've got to go. Sorry.

0:21:410:21:45

What's her problem?

0:21:450:21:46

Just give them back to the kid. It's his business.

0:21:470:21:50

You can't now you know what they are. Just come clean.

0:21:500:21:53

TV: We are getting reports through that there is one pupil

0:21:530:21:57

still trapped in the wreckage.

0:21:570:22:00

Sorry.

0:22:000:22:01

Excuse me.

0:22:120:22:14

Erm...I'm looking for the mother of Ella...

0:22:140:22:19

Mrs Malin. I'm Ellie's mother.

0:22:190:22:20

If you follow me,

0:22:200:22:22

the Charge Nurse will be able to update you on your daughter.

0:22:220:22:25

Can I see her, please?

0:22:250:22:26

Erm...the Charge Nurse would like to speak to you first.

0:22:270:22:30

Is she OK? Please just tell me.

0:22:320:22:35

Please. Just follow me.

0:22:350:22:37

Would you like some support?

0:22:380:22:40

It's OK. I'm OK.

0:22:430:22:45

-Where've you been?

-Toilet. I was desperate.

0:22:580:23:01

He's had a bit of an accident. Needs a change. Thanks.

0:23:010:23:06

I'm concerned about his behaviour. He's confused, has vomited again.

0:23:070:23:12

Let's push another litre of saline through. Rebalance his electrolytes.

0:23:120:23:17

OK, CT's negative and no history of drink or drugs.

0:23:170:23:22

He says you're on your own.

0:23:220:23:23

Robyn, when got a minute can you go and get Daniel's mum for me?

0:23:230:23:27

Thanks.

0:23:270:23:29

-I'm done if they find them on me.

-I could lose my job.

0:23:290:23:32

Just bin it? Please.

0:23:320:23:34

Robyn?

0:23:340:23:35

Please. It'll kill Mum if they find out.

0:23:350:23:38

I'm sorry.

0:23:380:23:40

What you're signing here is a conscious sedation form

0:23:440:23:47

so we can pop your arm back into place without putting you under. OK? Thank you.

0:23:470:23:51

Is that the coach driver?

0:23:510:23:53

-On behalf of the parents, we've got some questions.

-Later, sir.

0:23:530:23:56

My daughter says he provided them with alcohol.

0:23:560:23:59

-Did you know they were drinking on the back of the coach?

-No.

0:23:590:24:03

I had better go and talk to them.

0:24:040:24:07

OK, drugs in.

0:24:070:24:09

-Lloyd, could you get on the other side for me, please?

-Mmm.

0:24:090:24:12

-OK, you got it, Jamie?

-Yep.

0:24:120:24:14

OK, I need you to breathe nice and steady for me, OK, Steve?

0:24:140:24:17

That's it.

0:24:170:24:18

HE MOANS IN PAIN

0:24:180:24:21

OK, guys, let's go.

0:24:210:24:25

-It's like a tug of war.

-It's a modified Kocher's procedure.

0:24:250:24:30

Aaarrgghh!

0:24:300:24:31

OK, there we go. Well done, Steve.

0:24:310:24:34

Good job, guys.

0:24:340:24:35

Daniel!

0:24:350:24:37

Daniel, what are you doing? Come on, let's get you back to bed.

0:24:370:24:41

Is that an offer? Holly? I need to use your phone again.

0:24:410:24:46

-Holly?

-I was just showing him my tattoo.

0:24:480:24:50

-What's happening? What's he doing?

-What shall I do?

0:24:510:24:54

OK, Aoife, get that trolley, it's got a portable suction on it.

0:24:540:24:56

Can you get a receiver for the teacher, give him some support?

0:24:560:25:00

Thank you.

0:25:000:25:02

Right, should we get him to Resus? He's not coming out of it.

0:25:050:25:07

-No, I think you should treat him here. He's going to need lorazepam.

-Could you get Tom?

0:25:070:25:12

Daniel? Oh my God, what's happening to him?

0:25:120:25:14

OK, Mum, just give us a second.

0:25:140:25:16

-Robyn, can you look after Daniel's mum?

-Yeah.

0:25:160:25:19

Did you tell them about the drugs?

0:25:190:25:21

It's all right, all right, he's in safe hands.

0:25:230:25:26

-This is the Charge Nurse.

-Charlie.

0:25:350:25:39

I'm sorry.

0:25:420:25:43

Tell me.

0:25:570:25:58

We did everything we could...

0:26:020:26:04

..but your daughter has a very severe head injury.

0:26:100:26:14

A series of special tests were carried out by the intensive care team

0:26:140:26:21

and I'm afraid they showed no brain activity at all.

0:26:210:26:24

This means there is no possibility of her recovering. I'm very sorry.

0:26:260:26:31

Will she die?

0:26:340:26:36

I'm afraid she will not survive this level of injury.

0:26:360:26:40

She is on a ventilator at the moment

0:26:420:26:44

because she cannot breathe for herself.

0:26:440:26:47

There's no hope?

0:26:480:26:50

There is no possibility of any recovery.

0:26:520:26:54

Were you aware that your daughter carried a donor card?

0:26:570:27:01

No.

0:27:040:27:06

I didn't know. No.

0:27:060:27:08

I just want to see her, please!

0:27:110:27:14

Can I see her, please?

0:27:140:27:18

Yes, of course you can.

0:27:180:27:20

Vicky? Vicky?

0:27:250:27:27

Stop, stop. What's happening?

0:27:270:27:30

He's been taking something and he's had a bad reaction or he's OD'd or something.

0:27:300:27:35

Where are these drugs, Robyn?

0:27:350:27:37

Well, after you wouldn't take them, I looked, and once I knew what they were,

0:27:370:27:40

-I didn't want anything to do with them.

-What's she talking about?

0:27:400:27:44

They were in a bag. A backpack. I think it was Reece's.

0:27:440:27:47

These were full when I gave them back to him.

0:27:580:28:00

Wayne, can you take these through to Resus to Tom?

0:28:020:28:05

Tell him we think this is what Daniel ingested.

0:28:050:28:08

-OK, sure.

-Why did he think Steve would hide them?

0:28:080:28:11

We need to have the full picture to be able to treat Daniel.

0:28:110:28:14

Is there anything he has confided in you that we should know about?

0:28:150:28:19

He had a quite close bond with you, didn't he?

0:28:210:28:24

And you helped with the party.

0:28:240:28:26

What party? What party?

0:28:260:28:30

I bought in a few drinks for a last night gathering, that's all.

0:28:310:28:34

You what?!

0:28:340:28:35

Did you know the kids had drugs on them?

0:28:380:28:40

I knew Daniel was experimenting. I gave him a warning.

0:28:410:28:45

But I didn't know the kids had drugs on the trip.

0:28:450:28:48

Why didn't you tell me?!

0:28:480:28:50

He trusted me not to.

0:28:500:28:52

-Take me to my son.

-OK.

0:28:530:28:55

No. I've been defending you to the parents.

0:28:590:29:03

You want to do something for me, you'll go and talk to them.

0:29:030:29:06

-Let's get you back to your cubicle.

-Where are the parents?

0:29:090:29:12

Now's not the time - we need to get you back to X-ray so they can check your shoulder...

0:29:120:29:16

Ellie Malin's in theatre. Can you take me up?

0:29:160:29:18

I know her mother. I'd like to offer my support.

0:29:180:29:20

-You don't have to.

-I do.

0:29:200:29:23

Would you like us to come in?

0:29:330:29:35

Oh, God!

0:29:400:29:42

This... This is not my daughter.

0:29:520:29:55

This is her best friend. This is Ella. Ella Amson.

0:29:580:30:06

Tests all clear. How's he doing?

0:30:080:30:11

He's still tachycardic and he's got a raised temperature.

0:30:110:30:14

How long has this been here?

0:30:140:30:16

-I hadn't noticed that before.

-Mind if I have a look, Joe?

0:30:200:30:23

Looks like we've found the cause of the infection.

0:30:260:30:28

-That's the same as Holly's.

-That's the point, ain't it?

0:30:280:30:31

But you're her teacher.

0:30:350:30:37

Can you get me a swab, please? Just there.

0:30:370:30:40

Excuse me.

0:30:420:30:44

Aoife? Aoife? Where are you doing?

0:30:440:30:48

He's abusing his position.

0:30:480:30:50

I know. And we will point that out to him.

0:30:500:30:51

But first we need to treat him.

0:30:510:30:53

Now, you can either help me or you can go and explain yourself to Sister Bateman.

0:30:530:30:57

Right, can I have the swab and some saline, please?

0:31:050:31:07

Even if Holly isn't a minor, as her teacher,

0:31:090:31:15

having a relationship with her is still illegal.

0:31:150:31:18

She's leaving school next year.

0:31:180:31:20

You could lose your job and go to prison.

0:31:200:31:23

I know what it looks like, but I love her.

0:31:230:31:25

So what are you still doing in the job?

0:31:270:31:29

Don't you think you should do the right thing and quit?

0:31:310:31:34

It was a mistake. There were so many parents in there.

0:31:430:31:47

They all came at me.

0:31:470:31:49

No-one ever taught us how to talk to parents who are waiting to

0:31:490:31:52

find out if their kids are dead.

0:31:520:31:55

So what happened?

0:31:550:31:56

This mum saw the bag of effects. She saw the brown hoodie.

0:31:560:32:00

The one that Ella had been wearing.

0:32:000:32:03

But she said, "It's Ellie's. "It's Ellie's."

0:32:030:32:07

And you were confused.

0:32:070:32:10

They were friends. They'd swapped tops.

0:32:120:32:15

OK, can we get this bed ready, please?

0:32:200:32:22

We've got the last student coming through.

0:32:220:32:25

Right, where did you get this from?

0:32:250:32:27

My friend got it.

0:32:270:32:29

There's no smell. Looks like "coma in a bottle".

0:32:290:32:31

Yes, GML's not dissimilar to ecstasy, plus very nasty side effects.

0:32:310:32:35

Let's get it tested by the police, please.

0:32:350:32:37

PHONE VIBRATES Who is it?

0:32:370:32:40

Reece. Seems to be delayed coming through.

0:32:400:32:43

Let's see.

0:32:430:32:46

He's going to be OK.

0:32:480:32:50

You ready?

0:32:530:32:55

Mrs Amson, Mrs Malin. I'm so sorry for the mix-up.

0:33:050:33:12

I don't know what to say.

0:33:140:33:16

This is actually Ally's first day in the Emergency Department.

0:33:160:33:20

I should not have delegated to her.

0:33:200:33:23

That was a misjudgement on my part.

0:33:230:33:26

I'm so sorry.

0:33:270:33:28

Darling. It's OK. Don't beat yourself up, yeah?

0:33:300:33:35

I told her about the donor card.

0:33:380:33:40

She doesn't want to go through with it.

0:33:400:33:44

Right.

0:33:440:33:45

She was 15 three days ago.

0:33:450:33:46

We weren't with her on her last birthday.

0:33:490:33:51

I respect your reservations and it is your choice

0:33:530:33:59

but can I just say we believe it was your daughter's wish to be a donor?

0:33:590:34:04

Could you just give me a few moments alone with her?

0:34:160:34:19

Shall we go and see what they've got in the vending machine?

0:34:230:34:26

Is all that for Reece?

0:34:310:34:33

Resus. OK. Thank you.

0:34:360:34:38

Tom, don't worry, he's not coming in after all.

0:34:420:34:45

He is! He just sent me a message. He said he was on his way.

0:34:450:34:50

I'm so sorry, Daniel.

0:34:540:34:56

-There he is.

-What happened? Tell us.

-Can you let the patient through, please?

0:35:080:35:12

It's all over the internet! What are you doing driving after partying all night with the kids?

0:35:120:35:18

You OK?

0:35:180:35:19

-They lost the kid trapped in the coach.

-Reece Allan?

0:35:230:35:29

He didn't make it.

0:35:290:35:31

-What would you like?

-"I have joined the NHS Organ Donor Register

0:35:390:35:46

"as I want to donate my organs

0:35:460:35:51

"and/or tissue for transplantation after my death."

0:35:510:35:56

-Come on, pick.

-That, please.

0:35:560:36:00

What's an organ?

0:36:000:36:03

Erm...the heart or the lungs or the liver.

0:36:030:36:07

-The bits that make our bodies work.

-What does do-nate mean?

0:36:070:36:14

Donate? It means give away. I have a card like this.

0:36:140:36:20

It means that you want to share healthy parts of yourself, like your heart,

0:36:200:36:25

with other people when you die.

0:36:250:36:27

-Yeah, but doesn't your heart die if you die?

-Not always. It depends on how you die.

0:36:270:36:34

Lots of very ill people need new hearts.

0:36:340:36:37

But there aren't that many to give out.

0:36:370:36:39

I can't. I'm sorry.

0:36:530:36:55

That's absolutely fine, Mrs Amson. We completely understand and respect your feelings.

0:36:570:37:03

It's a big ask.

0:37:030:37:05

I'll call the transplant co-ordinator.

0:37:050:37:08

Can I have a card like this, Mum? Mum! Can I have one too? Like Ella.

0:37:080:37:14

-How did she get that?

-I don't know.

-Shall I take that for you?

0:37:140:37:18

I want to be like Ella. I want to share my heart too.

0:37:180:37:23

Come here.

0:37:230:37:24

I've changed my mind.

0:37:370:37:39

I would like to go with Ella's wishes after all.

0:37:390:37:44

Thank you. Thank you very much.

0:37:440:37:47

-TV:

-As the operation moves from rescue to investigation, serious questions will need to be answered.

0:37:580:38:02

Stop, stop.

0:38:020:38:04

Crucial information will be sought from the coach driver to uncover how

0:38:040:38:09

this tragedy occurred in what seemed like normal driving conditions.

0:38:090:38:13

As you've been hearing, two of the teenage passengers on board have died,

0:38:130:38:17

whilst at least one other remains in a critical condition.

0:38:170:38:20

I had a bad night before the journey.

0:38:200:38:24

Unsettled.

0:38:240:38:26

I woke nervy.

0:38:260:38:28

Do you think I shouldn't have driven?

0:38:330:38:36

It could have happened to anyone.

0:38:360:38:39

-We should go.

-Just give me a minute.

0:38:390:38:42

I'll go check how Eleanor Malin's doing.

0:38:430:38:46

On you go, son. I'm fine. I'll be there in a minute.

0:38:460:38:49

Is your hand OK?

0:39:050:39:07

How long can this drug affect you for?

0:39:070:39:09

Not long. A few hours.

0:39:090:39:11

How about after-effects?

0:39:110:39:12

You might feel a bit shaky, loss of concentration,

0:39:140:39:18

co-ordination might suffer.

0:39:180:39:20

How about if you'd never taken them before?

0:39:200:39:22

Depends on the individual.

0:39:220:39:23

Why, Daniel? What is it?

0:39:250:39:27

Have you taken something else?

0:39:300:39:32

It's Steve.

0:39:320:39:34

-What's he done?

-It wasn't him.

0:39:340:39:36

-What did you do?

-At the party...

0:39:360:39:38

He got drunk?

0:39:380:39:40

It was meant to be a bit of fun.

0:39:400:39:42

You spiked his drink?

0:39:430:39:46

-It might it might have affected his driving. It might have...

-I know!

0:39:470:39:52

Tell them.

0:39:570:39:59

Jamie. The police want Steve downstairs when he can.

0:40:070:40:11

-Why?

-The kids spiked his drink.

0:40:110:40:13

There could be a direct causational link between that and the accident.

0:40:130:40:16

What?!

0:40:160:40:17

Where is he?

0:40:230:40:24

I left him right here.

0:40:260:40:27

Please. No.

0:40:300:40:31

Quick. Can't get down that way.

0:40:440:40:46

Body fallen from the fourth floor. Possibly nearly 40 feet.

0:40:480:40:52

Near Oncology.

0:40:520:40:53

Yeah. Come on.

0:40:530:40:55

Hello?

0:40:590:41:01

Hello, can you hear me? I'm Lloyd. I'm a nurse in the hospital.

0:41:010:41:05

Steve. Steve? What happened?

0:41:050:41:07

OK, I'm going to need a trolley and some O2.

0:41:080:41:11

Did you see this man fall?

0:41:110:41:12

No. But I was the last person with him...

0:41:120:41:14

OK, Lloyd, can you check his airway?

0:41:140:41:15

I'm going to need a portable suction over here.

0:41:150:41:17

This is Steve, the coach driver. I relocated his shoulder earlier.

0:41:170:41:21

OK Steve, Steve. Can you hear me?

0:41:210:41:24

You try and speak to him, OK?

0:41:240:41:25

Steve, Steve, it's me. The nurse who took you upstairs.

0:41:250:41:28

STEVE GROANS IN PAIN

0:41:280:41:30

COUGHING

0:41:300:41:31

You stay with him, he clearly recognises you.

0:41:310:41:35

Lloyd, when we get inside, O neg, crossmatch eight units, because we'll need loads of it, OK?

0:41:350:41:39

-OK.

-Right, come on, let's get him in. Pressure. Portable suction.

0:41:390:41:44

STEVE WHEEZES IN PAIN

0:41:510:41:52

Steve? Steve?

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Can I go in?

0:42:060:42:07

No, let's just let the doctors do their job, eh?

0:42:070:42:09

-Would you like to see your son?

-No.

0:42:090:42:11

Joe!

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SHE SOBS

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Did you hear about Reece?

0:42:140:42:17

Holly?

0:42:180:42:19

Inappropriate!

0:42:190:42:21

Miss, sorry. I didn't...

0:42:210:42:24

I'm sorry, Vicky, I think I should hand in my resignation.

0:42:240:42:27

Let's get the O neg up.

0:42:370:42:39

The femur's totally shattered. Looks like the tib

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and fib have both gone too.

0:42:410:42:43

Right, he's losing a lot of blood even with the tourniquet on.

0:42:430:42:45

OK, shall I get a pelvic sling just to be safe?

0:42:450:42:48

Yes, please. Lloyd, can you loosen off the tourniquet?

0:42:480:42:50

I want to have a look at the bleeding points first.

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Jamie, come on.

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OK.

0:42:550:42:57

Whoa! Yeah, yeah, it's definitely the femoral.

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tourniquet back on, please, and tight!

0:42:590:43:01

You all right? Right, let's stand by with a Doppler.

0:43:010:43:05

-OK, Tom?

-Yeah. You all right, Lloyd?

0:43:050:43:08

He's lost his output and can't palpate a BP.

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-He's losing blood faster than we can get it in.

-Can we tie off that vessel?

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Everything is such a mess in this wound.

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I can't even identify the end of the artery.

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He's losing pressure. I think he may arrest.

0:43:200:43:23

OK, I'm not having this bloke bleed to death.

0:43:230:43:25

I doubt the leg's viable, so let's get artery clips, please,

0:43:250:43:28

and something to tie the vessel off with as well, please, Tess?

0:43:280:43:31

-Tom, will you assist me?

-Yep.

0:43:310:43:33

Lloyd, can I have some light over here?

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Watch carefully, you may not see this again.

0:43:370:43:40

KNOCK ON DOOR

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< Hello?

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Come in.

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OK, I'll show you what to do.

0:44:050:44:07

It would be a good learning experience.

0:44:150:44:19

Sometimes laying out a patient can be...

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peaceful...

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..it can give you closure.

0:44:250:44:26

I'm sorry. I don't think I can.

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< Sister Bateman in ED here.

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< Can you crossmatch six units for Steve Green, thanks.

0:44:410:44:43

I want to go in. I need to tell him what I did.

0:44:430:44:46

Come on. Let's get you cleaned up.

0:44:510:44:54

Yes, there. That should hold him until we get him up to theatre. >

0:44:570:44:59

Excuse me, Daniel wants to come over.

0:45:030:45:05

He wants to apologise about the drugs.

0:45:050:45:08

Yeah, anything that might make him feel better can only be good thing at this stage.

0:45:080:45:12

He has some very serious challenges to face.

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Her heart's gone to Birmingham.

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Her liver and lungs will be sent to Manchester.

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It's an amazing thing, isn't it?

0:45:360:45:38

OK, thanks.

0:45:560:45:58

Hey.

0:46:020:46:04

No-one is holding you responsible for what happened, Jamie.

0:46:040:46:07

You did nothing wrong.

0:46:070:46:09

I think he could do with a bit of family support.

0:46:190:46:22

All right, OK.

0:46:220:46:24

Thanks, mate.

0:46:240:46:25

Jamie.

0:46:260:46:27

You all right?

0:46:310:46:32

Hey, come on.

0:46:350:46:36

I know.

0:46:400:46:42

I know, son, you just got to let it out.

0:46:440:46:46

Why did you want to be a nurse, Robyn?

0:46:560:46:58

It's my avocation.

0:46:580:47:00

Vocation?

0:47:000:47:01

That's the one.

0:47:020:47:03

If you'd come straight to me, things might have been different.

0:47:030:47:06

It's not about patients liking you. It's about doing the right thing for them.

0:47:060:47:10

Please, just give me another chance?

0:47:100:47:12

No, I'm not sacking you. I'm telling you off.

0:47:120:47:15

Because this cannot happen again.

0:47:150:47:17

You know, you come to me, you ask questions and we talk.

0:47:170:47:20

OK?

0:47:200:47:22

-TV:

-"Investigations are continuing into why the Wyvern Academy coach crashed."

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"Meanwhile, the school community is left mourning

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"and in shock at the tragic loss of two of its pupils."

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Come on. Onwards and upwards.

0:47:380:47:41

MUSIC ON STEREO: "We Are Young" by Fun.

0:47:430:47:47

We're going for a drink, if you'd like to join us?

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And the first round's on Charlie. He said well done for today.

0:47:590:48:04

You did good.

0:48:040:48:05

So the pub is just across the road, see you there in ten.

0:48:050:48:08

-Yeah, we'll be there.

-OK.

0:48:080:48:10

Sorry I'm late.

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You're always late.

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WHISTLING

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< Wait for us then.

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I can't believe it starts all over again tomorrow.

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I can't believe this is my day job.

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Well, I feel exactly the same and I've been doing it for 30 years.

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Welcome to our world.

0:48:380:48:40

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0:48:540:48:58

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