Rabbits in Headlights Casualty

MUSIC: "We Are Young" by Fun

PHONE VIBRATES

BELL RINGS

Excuse me.

Excuse me. Sorry.

SIREN WAILS

-Oi!

-Sorry!

Watch where you're going, you mug!

-Mind your back, please, lovely!

-Oops.

-Thank you.

Don't let the staff see you.

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

-Oh, thank you.

-Robyn!

-Excuse me...

I thought I'd get here early.

-Hey!

-Hey.

-About time!

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

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

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

James?

-I'm Jamie now.

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

-I meant to get in touch...

-Dad said he'd rung...

This is Robyn and Ally, on final placement too.

-This is my uncle, Jeff.

-Can you do us a favour, girls?

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

Take that, mate.

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

Where's Aoife?

-I don't have her number.

-Mrs Morris.

-Happy New Year, Mrs Morris.

-Cause of the collapse is unclear.

-BM at the scene 2.5.

-I'd love to date a doctor.

You are so unoriginal.

I know, it's my USP.

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

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

She should be in Resus.

Can we have Mrs Morris's bags, please?

Yeah, I've got them!

Resus?

That way.

Come on, then.

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

I can't wait to get in there.

I'm dreading it.

-Can I help you?

-Excuse me.

-Nice hair.

-Thank you.

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

We're supposed to be inducted this morning.

-I'm Tess.

-Hi. Robyn Miller.

PHONE RINGS I'll be right back.

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

-TESS: Emergency Department.

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

She's got my lighter!

Thank you. Zoe.

Big RTC. Number of serious casualties unconfirmed at present.

-ZOE:

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

Let them know we need to clear some space.

And Tess, we need some more doctors

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

Excuse me.

3006 to control, received that.

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

-What's going on?

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

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

What's the hash tag?

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

Will you put a call out?

Right. The staffroom's just there.

Be back, ready for briefing in two minutes.

Sorry! Sorry I'm late.

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

Who are you?

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

Perhaps I could speak with Tess...

-..Bateman?

-I'm Tess Bateman, the Senior Nurse.

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

This is your best?

'Resus team to admin, directly please.'

Go through to the staff room with the others.

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

It's your choice. Quickly!

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

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

# Cos I got a feeling

# That tonight's going to be a good night

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

Happy New year.

But I didn't get you anything.

We can share it.

You free tonight?

Um...

Maybe.

So you'll Let me know.

They are so perfect.

OK, everyone, I've got an update.

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

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

So we're dealing with walking wounded, entrapments,

serious casualties and possible fatalities. You know the score.

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

-Yeah.

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

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

Stick with them.

You must be Jamie? You're with Lloyd.

-You're...

-Robyn Miller.

With Linda.

Aoife, you're with Fletch.

Keep in touch!

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

-Right, Ally.

-Yeah.

-Charlie!

-Can we get some help over here, please?

-Yeah. Ready?

Right. Just take a deep breath.

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

-Get a piece.

Nice and gently. OK, on three.

One, two, three.

Pulse is 110,

resps are 28, BP's 110 over 70,

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

-OK, thanks, Dixie.

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

How many units do you want cross-matched?

I want eight cross-matched first.

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

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

Charlie, what's that?

That's a procoagulant. It stops the bleeding.

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

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

Not just a window to the soul,

a window to the brain.

Pupils equal and reactive.

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

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

Where's me tea?

Two sugars and a biscuit.

-NEWSREADER:

-The group is actually made up

of approximately 30 teenagers and some adults.

The injured are being taken to Holby's Emergency Department

and we are being told that the coach driver himself

is refusing to leave the scene.

Imagine that on your conscience.

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

-Jamie!

Catch you later.

This is Ella Amson, 15 years old.

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

She was conscious and alert the whole time.

However, during the course of extrication,

she suffered a blunt trauma to the back of her head

which rendered her unconscious.

We intubated when we got her out.

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

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

-LLOYD:

-Do you want me to take over?

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

Can I help?

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

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

Get the defib. What's her name?

-Ella Amson.

-That's Zoe Hanna.

Clinical lead. Brilliant.

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

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

-Shall I bag these?

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

-Excuse me?

Let's get her down there fast.

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

-Hold off, Jeff.

MONITOR PINGS

She's in VF.

OK, stand back. Charging.

Shocking.

ALARM CONTINUES

OK, continue CPR.

Continue CPR for two minutes.

This is Daniel Heaton.

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

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

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

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

He's vomited three times en route.

-Daniel!

-Wait, Mum. Hang on.

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

Reece?

Quick.

What's the matter with his hands?

Reece. Reece?

They couldn't get him out.

He was next to me.

-The battery's dead.

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

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

-Paramedics are there.

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

HE VOMITS

Robyn, can you get a receiver?

OK, just breathe.

Have you been drinking, Daniel?

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

Answer the nurse, Daniel. Have you been drinking?

We used to smuggle cider after netball. Backseat.

-Everybody does it, don't they?

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

Please, Mum. You're stressing.

There's more important stuff going on.

Alcohol is against school rules!

I know that. Don't tell me.

Tell Steve.

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

There's a trace.

Sinus tachy.

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

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

-Yeah, I got it.

-Good girl.

Hang on.

Pupils are unequal.

-Can I have some mannitol on standby?

-I thought we'd just got her back?

-And let's get an urgent CT scan.

-We got her heart back

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

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

I'm not sure if that's blood.

No, it's brain tissue.

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

-She's got a catastrophic head injury.

-Do a CT!

-You haven't done a CT.

-Come and have a look, Jeff.

What's she doing?

Indicating the signs for severe brain damage.

-Panda Eyes, CSF, Battle's Sign.

-I don't understand. She was conscious.

-Rhinorrhoea.

-She was concerned about her friend.

-So that's it?

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

-We went out for a fractured leg.

-It's not looking good.

-Excuse me, I found this.

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

15.

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

Charlie, can you contact the transplant co-ordinator?

Well done. That was a good find.

Well done.

So, what happened to your arm, them?

Broke it. First day.

First day? What, so no skiing at all?

A break?

Wouldn't that need a plaster?

Um...

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

Right, can you wiggle your fingers for me?

OK, squeeze my hand.

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

-Please don't.

-Got to do our job.

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

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

That is brand new.

-You pulled a sickie to get that done.

-It's nice.

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

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

That's well drawn.

You got any tattoos?

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

You have, haven't you?

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

She doesn't look the type.

Guess she was a '60s chick, though.

She's not that old!

QUIET GROANING

Hey. You OK?

-RADIO:

-Holby Control to 3006.

Back-up needed back at the Ring Road RTC.

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

Just one of those days, you know.

She was the same age as my John.

I was with him last weekend.

He thought it was wicked, us working together.

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

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

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

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

-Yeah, sure.

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

Jamie?

You his mentor, yeah?

Teach him some discretion, will you?

Breathe.

Please breathe. Please breathe.

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

OK, thanks. We'll be standing by.

That was the UK Transplant Service.

They need her blood group if we get consent.

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

They need to do all these tests

to make absolutely certain she's brain dead

-before we can push on with the retrieval.

-OK, let's do a log roll.

This actually very rarely happens in the ED.

One, two, three.

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

It's OK. Take a break.

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

-Look...

I'll see you back in ten minutes.

OK, back down.

One, two...

Emergency services are still working to free the last injured teenagers

who are still in the coach that crashed earlier today.

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

We've had confirmation through now

that they are actually all from Wyvern West Academy

-and we understand...

-Aoife.

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

(It's the driver.)

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

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

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

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

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

until everyone else had been taken care of.

-Gave him a bit of entonox.

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

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

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

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

-Sorry.

I'm a student nurse. Follow me.

Steve! Oh my God, Steve.

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

-This is my husband.

I don't want to be here.

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

-This is yours, Lloyd.

-Thanks, Tess.

Hello, Steve, My name is Dr Sam Nicholls.

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

Jump up on there for us, mate,

in your own time, please. Nice and slowly.

STEVE GROANS IN PAIN

I'm all right.

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

-OK.

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

I've already done a breath test!

-I would never drink and drive.

-Steve...

-Have some respect! Please!

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

-It's pain relief.

-Sorry.

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

-OK, Steve, you have to realise

everyone here is trying to help you, OK?

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

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

-OK.

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

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

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

What happened?

I don't know.

I don't know.

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

None of our business.

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

-Hey.

We do medicine, not chat.

And we don't "chill".

On shift means on constant alert.

That's going to be some black eye.

Here. This is Reece.

That one.

He's cute.

-Who's that?

-My stepdad.

Is that legit?

We couldn't get served at the bar.

He's cool. But...

Tries too hard?

My stepdad does the same.

Useful, though, sometimes.

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

-Linda!

You all right?

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

-No.

It's a carpopedal spasm.

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

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

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

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

-It's OK.

It's got my stuff too.

Time of brain stem death - 13:29.

The mother's here.

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

She's in the relatives' room awaiting news.

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

-Thanks.

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

and bring her to my office?

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

You don't. That's my job.

And if she asks?

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

Just bring her to me.

PHONE RINGS

Holby ED.

-OK, thanks, Ally.

-Charlie, should I take these through?

Yeah. OK, I've got that.

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

He said I could count on him.

What is it?

Stuff. Boys' stuff.

Dirty magazines!

Please. I don't want Mum upset.

All right.

It is quite an unusual injury.

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

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

Which is why he is in so much pain.

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

-Yes, we have finished here.

-Thank you. How is he doing?

Good. You've got a very lively son!

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

That's a rare and interesting dislocation.

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

He says you always said he could count on you.

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

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

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

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

Thanks, Lloyd.

-What's happened?

-I've messed up. Big time.

-You turned up. Thank you.

-What have you done?

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

These are legal highs.

My mate got GML over the internet packaged like this.

I thought it was dirty magazines.

What?

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

-You're a drugs mule!

-It's not funny.

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

What's her problem?

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

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

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

still trapped in the wreckage.

Sorry.

Excuse me.

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

Mrs Malin. I'm Ellie's mother.

If you follow me,

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

Can I see her, please?

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

Is she OK? Please just tell me.

Please. Just follow me.

Would you like some support?

It's OK. I'm OK.

-Where've you been?

-Toilet. I was desperate.

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

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

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

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

He says you're on your own.

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

Thanks.

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

-I could lose my job.

Just bin it? Please.

Robyn?

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

I'm sorry.

What you're signing here is a conscious sedation form

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

Is that the coach driver?

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

-Later, sir.

My daughter says he provided them with alcohol.

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

-No.

I had better go and talk to them.

OK, drugs in.

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

-Mmm.

-OK, you got it, Jamie?

-Yep.

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

That's it.

HE MOANS IN PAIN

OK, guys, let's go.

-It's like a tug of war.

-It's a modified Kocher's procedure.

Aaarrgghh!

OK, there we go. Well done, Steve.

Good job, guys.

Daniel!

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

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

-Holly?

-I was just showing him my tattoo.

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

-What shall I do?

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

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

Thank you.

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

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

-Could you get Tom?

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

OK, Mum, just give us a second.

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

-Yeah.

Did you tell them about the drugs?

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

-This is the Charge Nurse.

-Charlie.

I'm sorry.

Tell me.

We did everything we could...

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

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

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

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

Will she die?

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

She is on a ventilator at the moment

because she cannot breathe for herself.

There's no hope?

There is no possibility of any recovery.

Were you aware that your daughter carried a donor card?

No.

I didn't know. No.

I just want to see her, please!

Can I see her, please?

Yes, of course you can.

Vicky? Vicky?

Stop, stop. What's happening?

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

Where are these drugs, Robyn?

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

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

-What's she talking about?

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

These were full when I gave them back to him.

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

Tell him we think this is what Daniel ingested.

-OK, sure.

-Why did he think Steve would hide them?

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

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

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

And you helped with the party.

What party? What party?

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

You what?!

Did you know the kids had drugs on them?

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

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

Why didn't you tell me?!

He trusted me not to.

-Take me to my son.

-OK.

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

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

-Let's get you back to your cubicle.

-Where are the parents?

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

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

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

-You don't have to.

-I do.

Would you like us to come in?

Oh, God!

This... This is not my daughter.

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

Tests all clear. How's he doing?

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

How long has this been here?

-I hadn't noticed that before.

-Mind if I have a look, Joe?

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

-That's the same as Holly's.

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

But you're her teacher.

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

Excuse me.

Aoife? Aoife? Where are you doing?

He's abusing his position.

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

But first we need to treat him.

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

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

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

having a relationship with her is still illegal.

She's leaving school next year.

You could lose your job and go to prison.

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

So what are you still doing in the job?

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

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

They all came at me.

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

find out if their kids are dead.

So what happened?

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

The one that Ella had been wearing.

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

And you were confused.

They were friends. They'd swapped tops.

OK, can we get this bed ready, please?

We've got the last student coming through.

Right, where did you get this from?

My friend got it.

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

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

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

PHONE VIBRATES Who is it?

Reece. Seems to be delayed coming through.

Let's see.

He's going to be OK.

You ready?

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

I don't know what to say.

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

I should not have delegated to her.

That was a misjudgement on my part.

I'm so sorry.

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

I told her about the donor card.

She doesn't want to go through with it.

Right.

She was 15 three days ago.

We weren't with her on her last birthday.

I respect your reservations and it is your choice

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

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

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

Is all that for Reece?

Resus. OK. Thank you.

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

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

I'm so sorry, Daniel.

-There he is.

-What happened? Tell us.

-Can you let the patient through, please?

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

You OK?

-They lost the kid trapped in the coach.

-Reece Allan?

He didn't make it.

-What would you like?

-"I have joined the NHS Organ Donor Register

"as I want to donate my organs

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

-Come on, pick.

-That, please.

What's an organ?

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

-The bits that make our bodies work.

-What does do-nate mean?

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

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

with other people when you die.

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

-Not always. It depends on how you die.

Lots of very ill people need new hearts.

But there aren't that many to give out.

I can't. I'm sorry.

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

It's a big ask.

I'll call the transplant co-ordinator.

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

-How did she get that?

-I don't know.

-Shall I take that for you?

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

Come here.

I've changed my mind.

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

Thank you. Thank you very much.

-TV:

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

Stop, stop.

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

this tragedy occurred in what seemed like normal driving conditions.

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

whilst at least one other remains in a critical condition.

I had a bad night before the journey.

Unsettled.

I woke nervy.

Do you think I shouldn't have driven?

It could have happened to anyone.

-We should go.

-Just give me a minute.

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

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

Is your hand OK?

How long can this drug affect you for?

Not long. A few hours.

How about after-effects?

You might feel a bit shaky, loss of concentration,

co-ordination might suffer.

How about if you'd never taken them before?

Depends on the individual.

Why, Daniel? What is it?

Have you taken something else?

It's Steve.

-What's he done?

-It wasn't him.

-What did you do?

-At the party...

He got drunk?

It was meant to be a bit of fun.

You spiked his drink?

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

-I know!

Tell them.

Jamie. The police want Steve downstairs when he can.

-Why?

-The kids spiked his drink.

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

What?!

Where is he?

I left him right here.

Please. No.

Quick. Can't get down that way.

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

Near Oncology.

Yeah. Come on.

Hello?

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

Steve. Steve? What happened?

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

Did you see this man fall?

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

OK, Lloyd, can you check his airway?

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

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

OK Steve, Steve. Can you hear me?

You try and speak to him, OK?

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

STEVE GROANS IN PAIN

COUGHING

You stay with him, he clearly recognises you.

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

-OK.

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

STEVE WHEEZES IN PAIN

Steve? Steve?

Can I go in?

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

-Would you like to see your son?

-No.

Joe!

SHE SOBS

Did you hear about Reece?

Holly?

Inappropriate!

Miss, sorry. I didn't...

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

Let's get the O neg up.

The femur's totally shattered. Looks like the tib

and fib have both gone too.

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

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

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

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

Jamie, come on.

OK.

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

tourniquet back on, please, and tight!

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

-OK, Tom?

-Yeah. You all right, Lloyd?

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

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

-Can we tie off that vessel?

Everything is such a mess in this wound.

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

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

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

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

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

-Tom, will you assist me?

-Yep.

Lloyd, can I have some light over here?

Watch carefully, you may not see this again.

KNOCK ON DOOR

< Hello?

Come in.

OK, I'll show you what to do.

It would be a good learning experience.

Sometimes laying out a patient can be...

peaceful...

..it can give you closure.

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

< Sister Bateman in ED here.

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

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

Come on. Let's get you cleaned up.

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

Excuse me, Daniel wants to come over.

He wants to apologise about the drugs.

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

He has some very serious challenges to face.

Her heart's gone to Birmingham.

Her liver and lungs will be sent to Manchester.

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

OK, thanks.

Hey.

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

You did nothing wrong.

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

All right, OK.

Thanks, mate.

Jamie.

You all right?

Hey, come on.

I know.

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

Why did you want to be a nurse, Robyn?

It's my avocation.

Vocation?

That's the one.

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

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

Please, just give me another chance?

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

Because this cannot happen again.

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

OK?

-TV:

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

"Meanwhile, the school community is left mourning

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

Come on. Onwards and upwards.

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

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

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

You did good.

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

-Yeah, we'll be there.

-OK.

Sorry I'm late.

You're always late.

WHISTLING

< Wait for us then.

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

I can't believe this is my day job.

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

Welcome to our world.

Subtitles by Red Bee Media Ltd