- 9 months ago
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00:00I examined their knee, and I did an x-ray. There's nothing there.
00:03Yeah, maybe not this time, but you need to expose the whole limb.
00:06Because if you don't look, you don't see, and you could have missed any number of important diagnostic clues.
00:11You know Emmett's in recess, in case you were wanting him to give you a little gold star.
00:15Isn't that the guy he said that you should sort out?
00:18Oh, God, sore toe guy?
00:20That's the one.
00:21You need to clear him into a room.
00:25MVA, restrained diver, no airbags, suspected TBI, significant bruising to lower abdomen.
00:30GCS 8, BP 100 on 80.
00:32Let's go to recess.
00:33Resource is full.
00:35Then I guess we'll put him here.
00:40On my count.
00:41Three, two, one.
00:44Let's get prepped to intubate.
00:45Well, don't you, Mara?
00:47I didn't recognise you without that thing stuck to the side of your head.
00:52Start a fluid bolus, one litre of normal saline.
00:54Hold off some fluids, let's intubate first and see where we stand.
00:56Okay, on it.
00:57Wait, he's hypertensive.
00:59Maybe he needs fluids first?
01:00ABCs, Poppy.
01:01Airwave breathing, circulation.
01:03Don't make me pick favourites, Hendrix.
01:04Why don't you go set up the fluids for when I need them?
01:06All right?
01:06Sage can do it.
01:07It's a nursing job.
01:08He's busy prepping for intubation.
01:10Um, hello, guys, I'm right here.
01:11Sage, the state saline.
01:13Need you here, okay?
01:13I'm not doing it.
01:15Sage, the fluids.
01:16Yes, you are.
01:16Sage, the tube.
01:17You're not my boss.
01:18Okay, I'm going to hug him up to the monitors and you two can fight it out.
01:20And tube in.
01:31You've got to come up to the vent for me, would you?
01:34You know I'm a doctor too, right?
01:36Yeah.
01:36Stop doing that.
01:43Oh, crikey, you two.
01:44Don't let the patient get in the way of whatever Harry met Sally think you've got going on here, eh?
01:48Possible TBI and internal abdominal injury.
01:51What?
01:52Oh, bloody hell.
01:53Pip, eyes on the patient.
01:54You're 24-gauge IV cannulas.
02:04Thanks.
02:06And I wanted to say thank you, and I'm sorry if I've been stressing you out.
02:10Why does everyone think I'm stressed?
02:13Sorry.
02:14Sorry, not your problem.
02:16A lot of people don't know this, but I'm actually a pretty good listener.
02:19I'm good.
02:21It's just some things you can never leave behind you, you know?
02:25Oh, I know.
02:27Thank you for making up with Logan.
02:28It's been a lot easier in here today without your...
02:30Relentless scrapping?
02:31Yeah, I like it too.
02:33Hey, we've got a compound fracture to the right radius and only a head injury.
02:36Okay.
02:37What are we talking?
02:39NBA, unrestrained passenger, no airbags, unconscious hadn't seen the older male drivers in the ED.
02:43Okay, transfer on my count.
02:45One, two, three.
02:47EPs 110 over 60, pulse 120, GCS of 9, then improved to 14 during transport.
02:52Okay.
02:53It's a nasty scalp like he's going to need a head CT.
02:57That's it?
02:58Um.
03:01Rural road speed, much like the effect discovered by another motorist, time of accident, I don't
03:05know.
03:05You all right, Logan?
03:07Yeah.
03:07Okay, we're going to need to give this a thorough clean-out before we close it up.
03:10You offer that?
03:11Yeah, yeah, yeah.
03:12Glover it up.
03:14Okay.
03:15Mate, you see how it extends into the hairline?
03:17We just need to make sure there's no gravel left in there at all.
03:19You're good?
03:20Yeah.
03:21You're good.
03:21I'm good.
03:22Okay.
03:23I will call radiology and organize the skin.
03:25All right.
03:25Thanks, Phil.
03:31Comfy?
03:32I'm good.
03:33You just look a bit tired.
03:35Oh, but beautiful.
03:36Still beautiful.
03:38You're so good to me.
03:40But I am a little bit tired.
03:42I mean, real little night owl in here.
03:45I really miss coffee right now.
03:47Sorry.
03:49Oh, you could probably have one, right?
03:51Hold on.
03:52Keep that pose.
03:53It's not a pose.
03:55Ah, it is so cute.
03:57It's actually making me sick.
03:59Posting it.
04:00Oh, can you not?
04:01Too late.
04:01No.
04:03Okay, fine.
04:04Why not?
04:05You are literally glowing.
04:07Well, can you show me?
04:08Yeah.
04:10Oh, bad angle.
04:12No, thank you.
04:13I'm fine.
04:14Ah, damn it.
04:14I need to get to work, but you're all good.
04:17You don't need anything before I go.
04:18I'm good.
04:19Okay, then.
04:20We'll see you soon.
04:20Bye.
04:21Bye, Brad.
04:22Bye.
04:24Okay, I am not even here.
04:29Look at you two.
04:30More shenanigans than you could shake a stick at,
04:33and still somehow you became happy families.
04:36Hey, I'll see you guys at the scan.
04:382 p.m.?
04:39Yeah.
04:40Yeah, you will.
04:41Might just be me, though.
04:42Is he really in theater?
04:45Yeah.
04:46In theater, yeah, he is.
04:47Really?
04:48The heart transplant?
04:50Mm-hmm.
04:52On the conjoined twins?
04:54Um.
04:55Why are you lying?
04:56I just don't want to bother him.
04:58Bother him?
04:59Sis, what's up with you?
05:01Well, have you heard of hormones?
05:03I'm pregnant and moody.
05:04Yeah, okay, sure.
05:06But do you really think Daddy of the Year and Waiting
05:08wouldn't want to be in his kid's scan?
05:11Well, of course he does.
05:12He wants to be involved in all of it.
05:14Yeah, but it sucks because...
05:16Because...
05:18You know.
05:19Because it might not be his.
05:21Yeah.
05:22But he does know that.
05:24Does he really?
05:26I mean, I'm worried he's deluding himself.
05:28Sis, you need to talk to him.
05:31Yeah, well, right now I have to go back to work.
05:33Okay.
05:33Well, I'll see you at the scan, Madonna.
05:35And you better not show up by yourself.
05:44Pupils are sluggish.
05:45High suspicion of a cerebral bleed?
05:47We need to get him a CT as fast as we can.
05:50I'll call them.
05:51I swear if you don't put that thing on silent,
05:55I'm going to chuck it in the dunny.
05:56Yeah, my bad.
05:58Don't like the look of that mottling on his abdomen.
06:00Could be a ruptured spleen.
06:02BP's only fast systolic and he's tacky at 1.30.
06:06Abdo's firm.
06:07He's full of blood.
06:08Let's get bloods up here.
06:09Try and replace it faster than he can lose it.
06:12Good luck.
06:13Radiology has someone in the scan already.
06:14They can see our guy in 20 minutes.
06:16No, he doesn't have 20 minutes.
06:17I'll do a peritoneal aspirate.
06:19That'll confirm the bleed
06:20and then we can get him upstairs for surgery.
06:22A diagnostic peritoneal aspirate.
06:24What, do you want, Safari?
06:25I can help.
06:26No, because it's not happening.
06:27Emmett, keep to his blood's back.
06:29You're right, she's pregnant.
06:30Yeah, I'll deal with that in a minute.
06:32Okay, but you're telling her, not me.
06:34Let me try.
06:35A CT will tell us everything we need to know.
06:38But my way's faster.
06:39Okay, and what about his brain?
06:41The DPA could increase his intracranial pressure
06:44and he could herniate.
06:45Yeah, I didn't think about that.
06:46Yeah, well, you're a bit busy showing off.
06:49Make yourself useful.
06:50Go out there and tell Mrs. Byrne and Cube 2
06:52she's pregnant, but...
06:53You heard the man.
07:00You're my surgical consult.
07:02Yeah, I'm on call.
07:03Absolutely not.
07:04Nope, bitty no.
07:05Get out of here and don't come back
07:06until you've got a senior with you.
07:12You're doing so well, bud.
07:13That hurts.
07:15I'll give you some more pain relief.
07:16I don't want it.
07:17It's okay, mate.
07:18You don't have to do anything you don't want to do.
07:19It's okay to be scared, right?
07:22I'm not.
07:23Okay, all good.
07:25What were you and your dad getting up to?
07:26I don't know.
07:28Well, it looks like you're just for outdoors.
07:29Maybe a bit of camping.
07:31I don't know.
07:32What about school?
07:33You know, he must be an intermediate now.
07:36I don't know.
07:37Maybe they have the third degree.
07:39He's just been through a big shock.
07:40You okay, mate?
07:42His sets are dropping.
07:43I'm just going to have a listen to your chest.
07:46Help.
07:47I can't.
07:48He's got decreased air entry on the right.
07:50Preparate chest drain now.
07:52Ow.
07:52Okay, buddy.
07:53It's okay.
07:59BP's tanking.
08:01Get the central line in, Bobby.
08:03When you're ready.
08:06Five centimetres superior to the clip.
08:10Preferably before he dies.
08:13I can step in?
08:14No.
08:15I've got it.
08:19I don't...
08:20I don't think it's in the right place.
08:23Just say the word and I'll step in.
08:24Where the hell is surgical?
08:26Can everyone shut up?
08:27Okay.
08:28Step aside.
08:31Flashback.
08:32It's in.
08:35Guidewire, please.
08:40How long have you seen my dad?
08:45I know, mate, but we can't get you to him just yet.
08:48Maybe I could call your mum?
08:49No.
08:50Okay.
08:51You sure you can't tell me your name?
08:53All right.
08:56If it's okay with you, I'm just going to check your fingers.
08:58You can tell me if they feel funny or numb.
09:00Don't touch me.
09:01Hey, have you ever been to a hospital before, mate?
09:04When I was eight, I fell out of my friend's treehouse that I helped build, and I broke
09:15my leg, and I was so freaked out about going to hospital, you know, all the sounds, the
09:20smells, the groaning, and my dad said I freaked out so much I bit the nurse.
09:26I mean, I did do a bit of biting in kindergarten, but I reckon I was done by eight.
09:29I think he was just having me on.
09:31He was a bit of a joker.
09:31Be cool to meet your dad when he feels up to it.
09:35I just want to see him.
09:37Why won't you let me?
09:38Hey, we will.
09:39Okay?
09:39I promise.
09:41But he's just getting treated real nicely right now, and we want to do the same for you.
09:45Otherwise, he'll have some words with us, you know?
09:48Look, I'll tell you what.
09:49You let Marty check your fingers, and if you don't like how he does it, I'll bite him.
09:53What?
09:53And no one wants that, eh?
09:56Is that okay?
09:57He'll walk you through step by step, all right?
09:59All right, man.
10:02I'm just going to check two fingers, and you tell me if they feel funny, all right?
10:06How's that?
10:06That all good?
10:07Yeah.
10:08Okay.
10:10Look, I'm right by your side.
10:12I got you.
10:12And what complications should we prepare for?
10:20Uh, suspected splenic injuries, so...
10:23Can't be easy being here.
10:24Appreciate it.
10:25Better not to talk about it.
10:27Got it.
10:28That's why it's cramps.
10:30Cool.
10:32Uh, are you okay?
10:33I know dealing with an MVA.
10:35Crap, he's in VF.
10:38Uh, what should I do?
10:39Should I get more bloods?
10:41He'll just lose it in his abdominal cavity.
10:42Clear.
10:43How can I help?
10:44We need to get him up to theatre so we can fix the spleen.
10:47Sinus rhythm.
10:47What can I do?
10:48We're not close to bed.
10:50Pip, this is not your patient.
10:52Get back to yours.
10:58Scraps.
10:59Guy doesn't have time for you to work around.
11:00Hurry up.
11:00Hey, finally getting to your main, isn't there?
11:07Yes.
11:07A little busy, okay?
11:08Doing actual doctor stuff.
11:09Okay.
11:10All good.
11:11If you're good.
11:12Okay.
11:12Don, here I am.
11:14Let's get you sorted so you can get back home to Jellybean.
11:17Jelly baby.
11:18Jellybean.
11:19She needs her dad.
11:20So, tell me what's going on so we can get you sorted.
11:24Get your toe again.
11:27Come on, Don.
11:28A nod.
11:29Yes or a no.
11:29Because honestly, if you've come to talk about your cat again, we've got people who actually
11:33need help.
11:34Help.
11:35Help.
11:37Oh, my God.
11:38Um, Mana.
11:40Mana.
11:44Open, displace, transverse fracture of the right radius and owner.
11:47Tell me your plan.
11:48Surgical orif with compression plating.
11:50Great.
11:52And explain the implications of the situation with the father.
11:54Given the seriousness of the fracture, we can proceed without brain talking.
11:58It's okay, mate.
11:59It's what they were talking to us about before.
12:01About fixing your arm up.
12:02I'm not having an operation without my dad.
12:04You told me I could see him.
12:05But, I know.
12:06I totally know.
12:07But your dad's getting ready for surgery.
12:08Okay?
12:09And we need to do the same for you.
12:10We can't let him get all the special treatment.
12:12I just want to see him.
12:13I know.
12:15His vitals are stable and I've given him some Cervazolin to cover for any infection.
12:19Let's get him out to pre-op.
12:21Will he be okay, my dad?
12:24Look, when you're out of your operation and these guys have fixed your arm up, then we'll
12:28get you to your dad.
12:29Okay?
12:29The quicker we get you sus, the quicker we get you guys together.
12:32All right?
12:32I'll tell you what.
12:33I'll walk you up to pre-op.
12:34That's where they get ready for surgery.
12:35And then I'll get an update on your dad.
12:37But I need you to tell me your name so he knows it's you I've been talking to.
12:40Otherwise, I just have to say this muddy kid.
12:43Okay.
12:43It's James.
12:46James?
12:47Of course it is.
12:48Awesome, man.
12:49Okay, James, let's get you ready, eh?
12:53Fire up.
12:53I can't let go.
12:55Reiceless?
12:56We can't move him.
12:59No, Don, don't speak.
13:03How long has he been on this?
13:04Stay as still as you can.
13:05Don, still as you can.
13:07What do you need?
13:08You're going to need a look at this.
13:09Deep back to the trachea and I'm assuming only one coronet because he's still alive.
13:12What happened?
13:13It doesn't matter right now.
13:14Keep your head still, okay, Don?
13:16We need to get him to stator.
13:17Not yet.
13:17We're losing his airway.
13:18We need to try and tube him.
13:20He needs blood.
13:21Do you want me up some propofol?
13:22We need him under before we tube him.
13:28Don't force it.
13:30Stop, stop.
13:31Oh, the trachea is too damaged.
13:32There's too many blood clots.
13:34All right, we're losing him.
13:35What are you going to do?
13:36I need a scalpel.
13:37Are you serious?
13:37A reposurgical airway scalpel now.
13:40I should be doing this.
13:42No, I'm doing it.
13:42He's my patient.
13:46Tilt the head.
13:47Just a little.
13:49Through the cricothyroid membrane.
13:53Size A tube.
13:54Beg.
14:02Beg.
14:17Good earring tree.
14:19He did it.
14:20Yeah, he bloody did.
14:26Poor little guy.
14:28Who was supposed to be looking after him?
14:30We don't have a lot of answers yet.
14:32Phil?
14:32Okay, I have washed out the fracture site.
14:38Ready to your line.
14:39Good.
14:40Joe?
14:43He wasn't belted in.
14:45Can't have been.
14:46Unbelievable.
14:46Some people should not have kids.
14:49We don't know the full story.
14:50No, we don't know.
14:52Would you let your kid ride unrestrained?
14:54No, but...
14:54I'm not happy to go.
14:56Madonna.
14:56You and Billy will make great parents.
14:58Through your suture, please.
15:03Madonna.
15:07Are you crying?
15:09No, no.
15:10Do you need to step out?
15:12No, I'm fine.
15:13It just sometimes happens.
15:15Okay.
15:16Can I have the through your suture?
15:17Suture.
15:23Patient in three.
15:24You want bloods and an ECG, please?
15:25Sure.
15:26Well done.
15:30You heard about my emergency tracheotomy?
15:32Yeah, I did, and it's good to know where your priorities lie.
15:34With the patients?
15:37Mm-hmm.
15:37As long as they've got a gory injury.
15:40Huh?
15:40As long as their bone is sticking out or their head is on backwards.
15:43I didn't realise that Don's injury was going to be so...
15:44Yeah, no, that's pretty obvious, Poppy.
15:47You didn't give a toss about Don once we had our John Doe here.
15:50So you left the poor bugger to get closer and closer to death so you could buzz around us and get in the way.
15:55Well, I didn't realise...
15:55Please listen to me, Poppy.
15:58Now, Don may have wanted to die, but it's not our job to get him there.
16:02Yeah, okay, you came up with a good solution in the end, but there's no way he would have bled out to the extent he did if you'd just done your bloody job.
16:08Now leave all this and get your arse out there.
16:16I don't want any more slip-ups.
16:17So, where is he?
16:28I didn't get a chance to tell him.
16:31Ah, so we're seriously doing this all over again.
16:33And I've been doing some super un-Selena holding back for you to do what's right.
16:38You haven't even tried.
16:39I'm sorry, okay?
16:41I know I'm terrible.
16:42I wanted to just spend some time enjoying being back together before I ruin everything.
16:47Okay, sis, calm down.
16:48I'm just saying you should talk to him.
16:50I know, but it's not that simple.
16:52Oh, he should be here.
16:54It's just a routine scan.
16:56Right.
16:58He's seen them before.
17:00Okay, fine.
17:04Everything's okay?
17:06Yeah, looks cute to me.
17:08The radiographer will send you all the stats, but let me just be completely honest with you.
17:13I feel sorry for bubs.
17:14Everything's going to be sorted out before the baby's born.
17:17Oh, so you've talked to Fed.
17:18What am I even supposed to say?
17:21Remember when you always used to know the exact right thing to do?
17:25No, the exact right thing that everyone should do, and you never held back from telling them?
17:30This is different.
17:32Is it?
17:33Can you just make it quick, please?
17:35I need to go pick up a patient in recovery in like ten minutes.
17:42Yeah, I talked to Esther, but when she just accuses me like that out of nowhere,
17:45is it ever going to change?
17:46Is she ever going to trust me again?
17:48Yeah, actions.
17:52I know.
17:54All right.
17:55I appreciate it.
17:56Thanks.
17:58Hey, mate.
17:59Hey.
17:59Do you reckon James is like a farm kid, like rural?
18:02This doesn't really seem like you're taking a break.
18:04I just know you're good with research.
18:06I thought maybe you could help me find him.
18:07It's just his first name?
18:08Chalipo, maybe.
18:10Look, you did well to get that out of him.
18:12He trusts you more than any of us anyway.
18:14And maybe you'll get a last name, but I reckon just call your jets for now.
18:18Oh, something's off, man.
18:19Can you feel it?
18:21Maybe.
18:22Leaky helped me find what it is.
18:24Look, mate, you're new to this.
18:26Well, I've dealt with a lot of patients.
18:28To peds.
18:29To working with kids and seeing their cases through.
18:32You're not just dropping people off an ED anymore, so you're going to care more.
18:35But you have to protect yourself, too.
18:37I'm okay.
18:39I'm fine.
18:41Look, whatever's made James scared of us, you're not going to fix it.
18:44Not straight away, anyway.
18:45But I could help.
18:46Just trust me when I tell you this.
18:49Actually, no.
18:49You know what?
18:50You do what you think.
18:53Huh?
18:53I trust you.
18:54I trust your instincts.
18:56And so should you.
18:58Right.
18:59But just know that you don't have anything to prove, Logan.
19:03You're a good man and a good medic.
19:05I know what it's like to mess up.
19:07But you just have to trust that the people who matter, they'll forgive you.
19:13And you have to trust that you can forgive yourself.
19:16I'm just so sick of bawling all the time.
19:18You didn't kill Harper, Logan.
19:20You know better than anyone that accidents happen.
19:23People make mistakes.
19:24What matters is what you do afterwards.
19:27You want to tell Drew that?
19:29No way.
19:33Thanks, Mike.
19:34For what?
19:35For taking a chance on me.
19:37Anytime, Mike.
19:43I'm sorry.
19:43I just can't...
19:45Stop crying.
19:46Yeah, that happens to some people.
19:48You must think I'm awful.
19:50I don't.
19:50I'm just so mad with myself.
19:53It's the whole mess.
19:55Is it really not the fact that I'm ruining everything?
20:00You're sure you don't want to talk about it?
20:02No.
20:03No, it's okay.
20:04But it's not, though, because poor Villy.
20:10What the...
20:11What did you say?
20:13She was like this when I found her.
20:15Phil's being nice to me for once.
20:18Okay, Ruth.
20:19Villy, I'm really sorry.
20:21What for?
20:22I didn't tell you about my scan, and I went without you.
20:27Oh, um...
20:28Hey, that's okay.
20:29That's...
20:29Really?
20:30As long as you're okay.
20:32I am.
20:33And you didn't tell me because...
20:36Because I was worried.
20:38About the baby.
20:39About you.
20:40I mean, you're so invested, and...
20:44As long as you're okay, and the baby's okay, that's honestly all I care about.
20:52Cool.
20:53So I'm going to head back and check on James.
20:55He's probably awake.
20:56Oh, sorry.
20:57Did you want me there?
20:58No, no.
20:59It's fine.
20:59You just stay and talk or whatever.
21:03Everything's okay.
21:06Don't worry.
21:07It's going to take more than a secret scan to hurt me.
21:10I really am sorry.
21:12I mean, you're more than I could ever ask for.
21:15Just remember, I'm choosing this.
21:17Okay, and I'm choosing you.
21:25Poppy, what are you doing up here?
21:27Can I just have a quick sec?
21:28No.
21:28We're taking Don's surgery.
21:29Yeah, I know.
21:31Don?
21:32I'm so sorry.
21:33He can't hear you.
21:34Yeah.
21:35Cleo, I know.
21:36I should have been there for you, but I'm going to be there for you after.
21:40Okay?
21:41After Cleo and her awesome team take care of you.
21:44So...
21:44Look, we have to go.
21:46I know.
21:47Me too.
21:48Look after him.
21:50Of course.
21:50Next time, I promise I will tell you.
22:00Maybe we could create a shared calendar?
22:02No, I'm useless at checking those things.
22:04Oh, but a parent has got to be all over that stuff, right?
22:07So, yeah, sign me up.
22:09Let's do it.
22:10Hey, it won't be long now before you can't reach me for a kiss.
22:13This thing in the way, eh?
22:16Hey, no need to tell me off.
22:18We've talked and look at us now.
22:22I'll sort everything, okay?
22:25It's, um, the report from the radiographer.
22:28What is it?
22:31Well, the scan shows there.
22:35I'm sorry, sis, but it looks like baby's a lot smaller than what it should be.
22:41No.
22:43No, really, this is exactly like last time.
22:47I knew it.
22:48I knew it.
22:48Urgent support is available for you or someone you know by calling Need to Talk on 1737.
23:05The Suicide Crisis Helpline on 0508 828 865 or Lifeline on 0800.