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🔥 EP 13: Tensions explode as secrets are finally revealed. 😱 The story takes a dramatic turn.
🔥 EP 13: Tensions explode as secrets are finally revealed. 😱 The story takes a dramatic turn.
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TVTranscript
00:14We're called in SWAT.
00:15Just a precaution.
00:16They still haven't found the shooter yet.
00:17They get to stay out there, not in here.
00:19Officer down.
00:20You know the drill.
00:2216 gauge in the right AC.
00:23Definitely needs an airway.
00:24And left leaning.
00:25Need a sponge stick for the back.
00:26And 100 Academy.
00:27Get some 4x4s on the Kelly.
00:28You guys are doing a great job.
00:29Keep it up.
00:30I know, Ricky.
00:31You're in good hands.
00:33You'll be okay, man.
00:35Hey, guys.
00:36Back it up.
00:36We're trying to work here.
00:37Come on.
00:38Both of you.
00:38Go.
00:39And chest tube output is minimal.
00:42Good for cardiothoracic ICU.
00:44Nice.
00:44Okay.
00:45As soon as transplocumabas end.
00:47What's up with the SWAT team?
00:48Maybe they think the shooter's coming here.
00:50Shit, is that true?
00:51What?
00:51My kid's in the break room.
00:52They think the shooter's heading this way.
00:54Anything is possible.
00:57Don't spread rumors.
00:59I'm taking this one to the OR.
01:06How are you doing?
01:08Yeah, I'm good.
01:08You?
01:10I'm good.
01:11How much blood are we getting?
01:12I don't know.
01:13I hope it's enough.
01:14We're supposed to stop here and stay between 10 o'clock and 2 o'clock.
01:18Where's 12?
01:18I think the pilot's 12.
01:20I think we just stay back and they bring the blood to us.
01:25I think.
01:29Yeah.
01:30Yep.
01:36Do we take these to our supply room and behavioral health?
01:38Trauma rooms first, then we'll make our way out to the patients in the hub.
01:41Is that the only I delivered?
01:42Yeah, straight from the roof.
01:43Jesse, hang your unit, then right up to the OR.
01:45Who else needs blood?
01:47Everybody.
01:48Leave us four units, four next door, and then check in with Robbie and Abbott.
01:52Okay, I've got next door.
01:54The blood's here.
01:55Wait.
01:56Squeeze my hands fast again.
01:57Back from me.
01:59You guys need blood?
02:01No, not just yet.
02:02Leave it with Dana.
02:03Hey, Whitaker, how you doing?
02:05Yeah, fine.
02:06Ask for help if you need it.
02:08I can't see the cords.
02:09Let's bag him.
02:10Sorry I'm used to the glidescope.
02:12Spoiled by technology.
02:13Dana, you got a bougie back there?
02:15Completely out.
02:15Used them all up.
02:17Is he awake?
02:18He was.
02:19No, he's sedated.
02:20Should be intubated by now.
02:22Yeah, what's his pulse ox?
02:23All right, it's their first partner, all of you.
02:25Into PH2 now.
02:26You can watch from the window, but you need to zip it, capisce?
02:29Oh, God.
02:30Rigid, thank God.
02:31Night shift to the rescue.
02:32What the hell happened to your eye?
02:34Just another happy customer.
02:35Looks a lot worse than it is.
02:36Yeah, right.
02:37I tried to get here sooner, but it is gridlocked out there.
02:40It's not much better in here.
02:41Did you hear anything about the shooter?
02:43They may have slipped away in the crowd with all this chaos.
02:46Hey, where do you need me?
02:47North is yellow.
02:48Keep an eye on the new kids.
02:49Got it.
02:50You holler if you're in trouble.
02:51Yes, ma'am.
02:54Jamie, what do you need?
02:56Ivy's on everyone.
02:57Hi, I'm Dr. King.
02:59Buster Pirelli.
03:00I take it you're a children's entertainer?
03:03Impressive observational skills.
03:05No active bleeding.
03:07Can you tell me your pain on a scale of one to ten?
03:09At least a three.
03:10And can you wiggle your fingers?
03:12Uh-huh.
03:14The other hand.
03:15Uh-oh.
03:17Well, it doesn't seem like you have broken bone, but we're going to put you on some IV antibiotics
03:21and some pain meds.
03:22Got it.
03:25You, uh, see who shot you?
03:27No, I'm not even sure which direction the bullet came from.
03:31Hey, am I going to lose any dexterity?
03:34It's too soon to tell, but probably not.
03:37I make balloon animals for a living.
03:39Two birthday parties booked every Saturday and Sunday for the next year, so...
03:43Wow, you must really love kids.
03:45Not really.
03:47Okay, you're going to feel a little pimp-ricked here.
03:49Ah!
03:50Fuck me!
03:51Um, it's in.
03:52It's just so we can give you antibiotics.
03:54Oh!
03:55I hurt just as bad as when I got shot!
03:57You put in an aisle?
03:58Ah!
03:59Yeah.
04:00Um, don't worry, sir.
04:01There will be no more pain.
04:04Whitaker.
04:04Um, team huddle.
04:07Join us, will you?
04:08Uh-huh.
04:09Oh, my God.
04:11Okay.
04:12Um, why'd you do that?
04:14Dr. Robby said everyone gets an I.O.
04:17If they are unconscious or unresponsive.
04:21If the patient is awake and alert, it's just a standard IV.
04:24Not an I.O.
04:25Unless it's a mime.
04:26They can't scream.
04:28Lidocaine for the clown.
04:30More at the door.
04:32Is this how we're going to end?
04:34Pardon.
04:34Coming through.
04:36Complete advantage here.
04:38Get him out.
04:38Uh.
04:39Back here?
04:40Ugh, too much blood.
04:42Move that killer to the right a little bit.
04:43Any better?
04:44Not really.
04:45Radial pulse?
04:46Still has it.
04:47Maybe a little weaker.
04:48I can try and give you a bubble.
04:49Yeah, yeah.
04:49Go for it.
04:52Nah, nothing.
04:53I'm not seeing anything.
04:54Okay.
04:55This bag, I'm going to prep the neck.
04:56You don't have a bougie.
04:57I have an 11 blade and a prayer.
05:00Without a bougie, you could create a false passage on top of the trachea and kill him.
05:03You doing a craic?
05:04Yep.
05:05No skin hooks.
05:06No bougie.
05:07Old school.
05:07Got a tactical airway in my bag here.
05:10What is that?
05:10It's a control craic kit.
05:12Oh, that's perfect.
05:13He's out on the battlefield.
05:14It looks in the pitch dark when you're under fire.
05:17I can do these with my eyes closed.
05:18Uh-huh.
05:20Okay.
05:23Knife leaves a trachea hook behind so you can't miss.
05:27All right, just, good.
05:32Slide in the introducer.
05:36Okay.
05:36Go the tracheal rings, good.
05:39Bob's your uncle.
05:41That was incredibly fast.
05:43Yeah.
05:44Balloon is up.
05:45Why don't we stop these?
05:47No wrong, but it's not.
05:50Yellow and entitled.
05:52It's okay now.
05:54Yeah.
05:54Thank you, Dr. Abbott.
05:59Okay, let's pack the oral cavity with acrylics and see how fast Edna can take him up to the
06:02oar.
06:02Great job, everybody.
06:04What else have you got in your go-back?
06:05Oh, just wait and see.
06:06Okay.
06:41Javadi, this is Sally.
06:43What does she need?
06:44A gunshot wound to the back of T-11.
06:46Good pulse, but probable spinal cord injury.
06:48Can you move your legs?
06:50I'm trying.
06:52Am I paralyzed?
06:54There's some hope for recovery.
06:55Keep her on the backboard and monitor for intra-abdominal hemorrhage and neuro-ICU will
06:59triage the CT, okay?
07:00Sally, pinprick right here, okay?
07:02Uh, Walsh knows about the case.
07:04They're holding an oar.
07:05And the hits keep coming.
07:07Let's go.
07:10What do you have?
07:12Semi-conscious, only response to pain.
07:15Decent karate.
07:16Strip him.
07:19Oh, left upper quadrant entrance.
07:24Grab his foot, grab his foot!
07:25Whoa, do it, do it!
07:27He's going for his gun.
07:28Get down, get down!
07:32Stay down, stay down!
07:38SIG P365, nine mil.
07:40Driver's license?
07:41He just got here.
07:42Not responding to pain now?
07:45All clear.
07:47You sure?
07:49He's unconscious.
07:49Everybody back to work.
07:51Agnel breathing, he needs an airway.
07:53Working on an I.O.
07:53Drawing up ketamine and sucks.
07:55Yeah, how about it?
07:56Until carry permit.
07:58We'll run his ID.
08:00These wounds are too big for a nine.
08:02Failed I.O.
08:03Guy's huge.
08:04Needle won't reach the bone.
08:05He needs induction meds and blood.
08:07I'm having the same problem here.
08:08I don't see anything usable for an I.B.
08:10Robbie!
08:10What?
08:11Guy needs access, but the I.O. won't reach for humerus.
08:14Proximal tibia?
08:15Tibia?
08:17Yes?
08:18Yeah.
08:20Tibia's not great access.
08:21You can only get a liter an hour down there.
08:23You get what you get.
08:26God damn it!
08:29Whatever that is, can you please turn it off?
08:30I can't hear myself think!
08:32Save it for the ICU.
08:33Get her up.
08:34I'll be right back.
08:35Copy that.
08:44I already have one.
08:45Keep that away from me.
08:46It's not for you.
09:02Show's over.
09:03Uh, uh, are you going to get in trouble for that?
09:08Probably.
09:25Hey.
09:28What's going on out there?
09:30A lot of people were hurt at the festival.
09:35I need to use the bathroom.
09:37I told him to use the sink.
09:40What is wrong with you?
09:41Would you rather I take him out there?
09:43Hang on.
09:43I'll be right back, okay?
09:53Here.
09:55What's that?
09:56It's a urinal.
09:57You pee in it.
09:59I think I'll just hold it in.
10:04Pull out.
10:05I found a four blade.
10:07This is better.
10:10Shit.
10:11Lost the light.
10:12The battery must be dead.
10:14This one's dead too.
10:15Anybody have a laryngoscope with a light that still works?
10:17We will check.
10:18Check quick.
10:19This guy's paralytics are wearing off.
10:20Keep bagging.
10:21Give me a 7-0 ET tube.
10:22He's a big guy.
10:22He needs an 8.
10:23Not for this.
10:24Number 7.
10:25What are you doing?
10:26Tactile at the beach.
10:29My index finger goes to the molecula.
10:33My little finger will guide the tube past the upper glottis.
10:36But if you hit the esophagus, he's toast.
10:38You told us never to pass the tube unless we see the vocal cords.
10:40Correct.
10:40Not today.
10:42If I stay in the midline, I should be able to get it past the cords.
10:47Loan up.
10:48Bag him.
10:50Looks good on the end title.
10:52Slip move, boss.
10:53No pulse.
10:54Start compressions.
10:55Okay, get him up.
10:59Try to get him back with two liters.
11:01That is as much as we can afford per patient.
11:04Leg is too slow.
11:05Upper arm is five times as fast.
11:06The best that we can do.
11:07Keep at it.
11:07We'll get him back.
11:08Robbie, you need help here.
11:12Langdon?
11:13Keep clean.
11:19How are you making out?
11:22Lots of emails and photos coming in from concerned families.
11:25It'll be easier once they've entered every patient's MCI number.
11:28Here we go.
11:29Looks familiar?
11:31MCI7.
11:32His name is Vincent Rivera.
11:34He must have had friends or family in the cafeteria who sent in the photo.
11:38I'll text them.
11:39We're coming.
11:43What are you doing?
11:44Give him this guy a chance.
11:45He needs a big central line for a fast transfusion.
11:47You can't do an IJ without an ultrasound, especially on a guy this big.
11:50You'll kill him if you collapse along or hit the carotid.
11:52I'm not doing an IJ.
11:53I'll hook that bloodline and bring it up here.
11:56This is a supra-clavicular subclavian.
12:00If you have to go in blind, this is the only safe way to access a giant vein.
12:06And hold compressions.
12:09A centimeter from the lateral head of the sternocleidomastoid.
12:14A centimeter off the clavicle, aiming at the contralateral nipple.
12:22I'm in.
12:25Okay.
12:26Resume compressions.
12:29And squeeze blood.
12:32Where'd you learn that?
12:34In-wrap podcast.
12:34We'll be ready for a second unit in under a minute.
12:37Boom.
12:38Okay.
12:39Not too much blood on your dressing, Mr. Grayson.
12:42You're looking good.
12:44Mr. Grayson.
12:45Hey, Mr. Grayson.
12:48Oh, must have dozed off.
12:50It's like a bad dream.
12:51Yeah, no kidding.
12:54You, um, did you happen to see who shot you?
12:58No.
12:59I heard the shots.
13:01They just kept coming.
13:03Gunshots and screaming.
13:06I'm never going to get that out of my head.
13:08GSW to the right-in-one region.
13:09Yeah.
13:11Uh, hi.
13:12I'm Dr. Whitaker Academy.
13:14It's, uh, nice to meet you.
13:17Uh, I'm just going to take this.
13:20Hey.
13:21How's the pain?
13:22I can handle it.
13:24Okay.
13:26Uh, what is this, uh, team bleak?
13:28What does that mean?
13:29The malec is a coconut pudding from Puerto Rico.
13:31We top it up with canela.
13:33See you.
13:34Well, so you got a food truck.
13:36Just a folding table for you.
13:37Petopulses are strong.
13:39Okay, let's start with antibiotics, pain meds,
13:40and let's try to stop this bleeding.
13:43Okay.
13:44Here we go.
13:46Okay.
13:46Uh, could you take over?
13:47Thank you, thank you, thank you.
13:49Hey, hey, hey.
13:49No, no, no, no.
13:50Uh.
13:52Ingrinal GSW with active bleeding.
13:54Um, try an Israeli bandage.
13:56What if it bleeds through?
13:57It's at the top of the leg.
13:59There's no room for tourniquet above the wound.
14:00Well, let's just top the hemesthetic bandage works.
14:05Okay.
14:06Coming in?
14:07Good.
14:08Hey.
14:09So, coconut?
14:12I love coconut.
14:13Good night.
14:20Kiara?
14:21Yes.
14:22This is Lupe.
14:23Whitney, you texted me?
14:25Let's take a walk over here.
14:27Can you tell us your husband's name?
14:30Vincent Rivera?
14:33We're going to show you some photos.
14:35Can you tell us if this is Vincent?
14:38He's not talking?
14:39No, he's not.
14:45Yes, that's Vincent.
14:47Can I see him?
14:49Vincent had a gunshot to the head.
14:52When he arrived here, there was no pulse or breathing.
14:59My husband is dead?
15:01You're so sorry.
15:04What about my brother, Brian?
15:06Vincent and Brian went to the festival together.
15:08Is my brother okay?
15:09Can you send us his name and photo?
15:11I did.
15:12Okay, well, as of now, he's not one of our fatalities.
15:15Do you have some relatives or friends we can call to come be with you?
15:23Our kids are with my parents.
15:31Second unit's in.
15:32Holding compressions.
15:34Carotid pulse.
15:35You feeling it?
15:36You feeling it?
15:36He goes right after pre-op.
15:40Hey.
15:42Not a person of interest.
15:43Jewelry store owner.
15:44No priors.
15:45Yo, he's not our shooter.
15:46You guys good in here?
15:47We got this.
15:49Take a two-hour lunch.
15:51Let me go check out a triage.
15:52We'll save a spot for you.
15:54You're looking for wheelchair.
15:55Hey, your mom, what number are we up to?
15:57Uh, 85 patients so far.
15:59Need a gurney for pink.
16:00How are you guys doing?
16:01Still going strong.
16:03Not bad, I guess.
16:03You guys are triaging great.
16:04Believe me.
16:05This is not easy.
16:06Not everybody can pull this off.
16:08Is this your halftime locker room speech?
16:09Yeah, possibly.
16:10Are we winning or losing the game?
16:11Too soon to tell.
16:14Come on, these heads have to be up 30 degrees.
16:16Let's go.
16:16We've got four back here.
16:20Through the head.
16:22No pulse.
16:23Black and white.
16:24Pink zone.
16:25Strong pulse.
16:25Unresponsive.
16:26No obvious.
16:26GSW.
16:27Red zone.
16:27GSW.
16:28Left chest.
16:29She was talking when we first got in the truck.
16:31We carotid.
16:32Unresponsive.
16:32There was so much blood, I tried to stop it.
16:36Jake?
16:37Robbie?
16:37Leah got shot.
16:38It's really bad.
16:44I've been putting pressure on the wound the whole time.
16:45Yeah, that's good.
16:46That's good.
16:46Are you shot?
16:47Maybe my leg.
16:48Most of this is her blood.
16:50Somebody you know, boss?
16:51Yeah.
16:53You got this?
16:53Oh, yeah.
16:54Okay, come on.
16:54Let's go.
16:54Let's go.
16:55I got you.
16:55Come on.
16:57Great.
16:57Hold on.
16:58Right here.
17:05Jake, you can't stay with her.
17:07I have to.
17:08There's no room, and we need to work on Leah right now,
17:10and you need to get your leg checked.
17:11So please go sit down.
17:12Please go tell me how she's doing, okay?
17:14Please?
17:14I will.
17:17Jake?
17:18I'm okay.
17:19Leah's with Robbie.
17:30Any available for me to be in charge of Central Florida?
17:38Yeah, I got a couple of minutes.
17:42I can't feel crowded.
17:43Okay, start compressions.
17:45Swap out with me.
17:46I need an IO.
17:47Hang a unit or a bone egg.
17:48Got the IO.
17:51Leah?
17:51Yeah.
17:52You need help over there?
17:54No, we're good.
17:56It's Jake's girlfriend.
17:57Oh, shit.
17:58Who's Jake?
17:59It's like Robbie's stepson.
18:02I'll be right with you, sir.
18:04My mom would be very happy.
18:06She always says,
18:06wear a clean underwear in case you end up in the hospital.
18:10Just let us know if anything is too uncomfortable.
18:13It's okay.
18:14This needs to be tighter.
18:15You bled through the last one pretty fast.
18:18Try a 180-degree twist.
18:20It'll put more pressure.
18:21Got it.
18:21I usually faint when my blood gets drawn.
18:24Must be all the adrenaline today.
18:26Whitaker?
18:26Old hippie's looking pretty out of it.
18:29No, he's sleeping.
18:30Keep going.
18:31No response to pain.
18:33Shit.
18:35Mr. Grayson?
18:36Mr. Grayson?
18:37Could be a delayed head bleed.
18:39He's going to need a head CT.
18:41He's not getting one anytime soon.
18:44Equal and reactive.
18:46No-blown people.
18:46Santos, go get an attending.
18:48I'll try, but no promises.
18:51Excuse me.
18:52I think I'm still bleeding.
18:53I'll be with you in a minute.
18:57So we're back ready.
18:58Here you go.
19:02Princess, take over its primary.
19:04What am I preaching?
19:05She's stuck in yellow.
19:07Mel needs an attending.
19:08Find somebody who's free.
19:09Let's get more.
19:10Dr. Abbott, can you come here?
19:12It's going to be a minute.
19:13Dr. Walsh, take one up to the O.R.
19:17Hey, I need a portable pulse ox for Mr. Grayson.
19:20Here you go.
19:23Hey, what happened to the kid in the wheelchair with the bloody right leg?
19:27No idea.
19:29Pinpoint pupils.
19:30Probable O.D.
19:31Blood on his clothes wasn't his.
19:32Oh, graph and arcane.
19:33Uh, sublingual injection.
19:35Okay here?
19:36Uh, looks like an opiate overdose.
19:39How's Robbie with Leah?
19:42If this guy doesn't wake up, he'll check for occult trauma.
19:461,400 of blood out the chest.
19:47First unit's in.
19:48Sweets in a second unit.
19:49Fasten, then we'll do another pulse check.
19:50You need the second line?
19:52For FFP and platelets.
19:53You sure, Robbie?
19:55Sophie, get the plasma.
19:57I'm just take over compressions and swap.
20:01Social worker in the South Corridor.
20:02Social worker in the South Corridor.
20:12Jimmy, wheelchair?
20:14Hey, man, you can't be in here.
20:16They're working on my girlfriend.
20:17I need to see what's going on.
20:18What's going on is you're losing a lot of blood.
20:19You're going to pass out if we don't stop it.
20:21No, I'm not moving, man.
20:22Leave me alone.
20:23Jake, get in the damn wheelchair.
20:24No!
20:25Now!
20:25Go!
20:28Ah!
20:30Ah!
20:32Welcome back, sir.
20:33You're in the ER PTMC.
20:35What's your name?
20:38Martin?
20:38What'd you take, Martin?
20:40You overdosed at Pit Fest.
20:41It took one Percocet so I could dance.
20:43I've got a bad knee.
20:44Where'd you get the pill?
20:46From a friend.
20:47Hey, while you were overdosing from the fentanyl on a fake pill,
20:49there was a mass shooting at Pit Fest.
20:50What?
20:51Hey, Samira?
20:53See if you can go help Mel in the yellow zone?
20:55Take my new friend, Martin, with you.
20:57Javadi?
20:58Roll with me.
20:59Okay.
21:05Two units of Percocet's cell's in.
21:07FFP still going?
21:08Almost there.
21:09Okay.
21:10Hold the compressions.
21:12I can't feel carotid.
21:15No febrile.
21:16We're seeing the compressions.
21:18What's your next move, boss?
21:20Platelets, another unit.
21:21Then we can transfuse her with her own blood for the pleurivac to get ahead.
21:24Hang the cell saver.
21:26Squeeze all this in?
21:27No.
21:28Three-way stopcock got a 60cc syringe.
21:30I'll push-pull.
21:30Okay.
21:31Not exactly in our mass casualty game plan.
21:37I tried.
21:38No attendings available.
21:39Okay.
21:44All right.
21:46Hey, those look pretty superficial.
21:48Might have been fragments from the ricochet off the ground.
21:50Just lost a lot of blood, but you're going to be okay, bro.
21:53It's not bad.
21:54Just put me back in the wheelchair.
21:55No, no.
21:55Stay in bed with your leg up.
21:56We don't want you oozing to death.
21:57Samira, what you got?
21:59Opiate OD needs observation after Narcan.
22:01Oh, boring.
22:02No, thank you.
22:02Mel, how's gone to Grayson?
22:04Um, we can put him in pink while he waits for ICU.
22:08Okay, one second.
22:12What are you doing?
22:13Checking the retina.
22:15For detachment?
22:15For intracranial pressure by measuring the optic nerve sheath, which is...
22:19Holy shit, 10 millimeters.
22:21What's normal, five?
22:22Yeah, five.
22:23It's an intracranial bleed.
22:24The pressure's been building up.
22:25There's no blown pupil.
22:26Yeah, not yet.
22:27But if he keeps bleeding in his skull, he's going to die.
22:29Yeah, he needs a one-inch burr hole in his...
22:32With a cranial drill.
22:34I'm just going to see if neurosurgery's here.
22:35We don't have time to wait for Nero.
22:38I got betadine and a 10cc syringe.
22:40Well, should we intubate hyperventilating?
22:42Vanatol decreases ICP.
22:45Holy shit!
22:50Relieving intracranial pressure so he doesn't die.
22:54With an IO drill?
22:55How much room do we have to do this?
22:57How much room do we have to do this?
22:57That's sick.
22:58I'll get the next one.
23:00Well, all that's not on me.
23:05Dana, is neurosurgery down here?
23:07Ask Princess.
23:09Princess.
23:10I need a neurosurgeon.
23:11They're all in the OR.
23:13Dr. Walsh!
23:14I have an epidural in the north corridor with an elevated ICP.
23:17Is there a blown pupil?
23:18No, but a 10mm optic sheath on the ultrasound.
23:21We need a burr hole.
23:25What the fuck?
23:27Training the ICH with an ECIO.
23:2940 cc's out so far.
23:31Like she said, what the fuck?
23:33There was a case report in the 2022 Journal of Emergency Medicine.
23:36Patients survive.
23:36Went home neurologically intact.
23:39Optic sheath is back to normal.
23:41Starting purposeful movements.
23:42Ready to intubate.
23:44Propofol, rock, and mannitol.
23:45I'll let neurosurgery know.
23:46We'll get him up ASAP.
23:48Incredible save.
23:49If he lives.
23:50Third unit's in.
23:52Okay.
23:52Hold your hand.
23:55Okay, what's the output like?
23:56I think I'm feeling a femoral.
23:58I got a carotid.
23:59Emery, I got a chest case.
24:00Needs to go to the OR.
24:01Saw you doing CPR on this girl.
24:03Two liters out of the left chest.
24:04Got a pulse back after three-pack cells.
24:07600 out of the cell saver.
24:08Two of FFP.
24:13I'm not feeling it.
24:14Take a carotid.
24:19Nothing, sorry.
24:21Resume compression.
24:23Nehme, we should take her up.
24:23She just had a pulse.
24:24Not now.
24:25We need a pulse to go to the OR.
24:26Call me if anything changes.
24:28Do we have any more whole blood from the donors?
24:30Think so.
24:30Okay, get another unit.
24:31It's got platelets and plasmid.
24:32It'll help her clot.
24:33Got it.
24:35Four units.
24:37Glutters for the ones we can save.
24:38She is right on the edge.
24:40One more can make the difference.
24:46I'm in.
24:51End title looks good.
24:52Okay, OR team can take it from here.
24:54We need to check on the others.
24:55I should get back to pink.
24:57Stay strong, Crash.
25:00You must act bandage still in place.
25:02How you doing, Carmen?
25:03Not so great.
25:05Let's see.
25:07It looks arterial.
25:09Agreed.
25:09Can you stop it?
25:11Uh, direct pressure for now.
25:13Yeah.
25:14We may have a junctional tourniquet in the disaster supplies.
25:18Can you get that?
25:19Cool.
25:20Um, Whitaker, in the meantime, just put pressure on it.
25:23Try and stop the bleeding.
25:24For how long?
25:24As long as it takes.
25:26Glutters, Kerlex.
25:28Um, elastic, elastic pressure dressing, yep.
25:31Okay, got it.
25:34Great.
25:35Got a better bandage, and we're gonna elevate your leg.
25:38Do you know what's happening to my girlfriend?
25:39Her name is Leah.
25:40She was shot in the chest.
25:41I'm sorry.
25:42We have a ton of patients, and they're only marked by numbers.
25:45Robbie and Dana were working on her.
25:46They were doing CPR.
25:48How do you know Robbie and Dana?
25:49Robbie and my mom were together for a couple years, and I would come and hang out here.
25:54Well, I'm sure if they're helping her, then she's in great hands.
25:58Can you check for me, please?
26:00Sure.
26:01Of course.
26:01Just after I finish this.
26:07There's no additional bleeding.
26:10Strong pulse.
26:12Two grams of insects running in.
26:15Can you spread your fingers?
26:19No, like this.
26:23Are you okay?
26:25Found the junctional tourniquet.
26:27Um, okay.
26:28Uh, I'll be right back.
26:33How much blood you pushing off the self-saver?
26:36Every last drop.
26:39Oneg, monitor the pulse.
26:40She's stable for trauma ICU if an OR is not ready.
26:45More Oneg.
26:46Let's just plant the herd.
26:48We can stop all the time.
26:54How many units so far?
26:56Four.
26:57Plus the self-saver.
26:59Last one?
27:02I don't know.
27:04Dana, why don't we try a little TXA?
27:06A thousand milligrams TXA might help her clap.
27:07Got it.
27:09Bullet tore through her heart.
27:12Anyone else with a wound like this is pronounced dead in the field.
27:15You can't keep up with the blood loss if she was our only patient.
27:18We'd do it for her economy, maybe ECMO.
27:20But even then, I doubt we'd get her back.
27:25Well, there's ten other patients if you put all your efforts on saving this girl.
27:33Got the TXA.
27:36Okay, push it fast, then we'll do another pulse check.
27:38And then, can you get me a vascular doppler, too, please?
27:45GSW to the chest.
27:46Paint pulse.
27:48Intubation, IO, chest tube, and a unit of blood.
27:50I'll do that.
27:51All non-essential personnel, safety work to the facial waiting room.
27:55All non-essential personnel, safety work to the facial waiting room.
28:01Go!
28:04Anything I can do?
28:08You can check on Shannon Ellis in the ambulance bag.
28:11On it.
28:17Whitaker lay down some fresh gauze so we can assess the hemostasis.
28:21How you doing, Carmen?
28:22I'm hanging out there.
28:24You want the circle of compression directly over the wound.
28:28Tighten it.
28:29Yeah.
28:31Inflate the balloon.
28:32Okay.
28:32Come on, pump it up, Whitaker.
28:33Uh, how much pressure?
28:34Until the bleeding stops.
28:37Oh, excuse me, ma'am.
28:39No worries.
28:41Uh, Whitaker, stay on this.
28:42Ma'am?
28:43Ma'am?
28:45Do you need something?
28:48Do you need?
28:52I need one more over there.
28:54I need one more over there.
28:55Hey, do you have any all-in positive over there?
28:58God bless you, man.
29:02All available transports to the ER immediately.
29:04All available transports to the ER immediately.
29:07Give me a box, please.
29:07Where's that over there?
29:08Okay.
29:10Let me just, just put your arm like that.
29:12Just keep your hand like that.
29:17Just...
29:18How we doing out here?
29:19Dancing as glass as we can.
29:21I'm pretty sure I'm past my union-mandated bathroom break.
29:24Never should have had that second coffee.
29:28Hey, son, I need arms closed unless you're injured.
29:31Oh, my mom's inside.
29:32I need to take her home, so...
29:33David?
29:35Mom?
29:36You're the kid?
29:37You need to come with me.
29:39Hey!
29:40Grab him!
29:41Stop!
29:41Grab him!
29:42What are you doing?
29:43Stay down!
29:44What the hell's going on?
29:464-H of Pexels, 2 of FFP, 1,000 of TXA,
29:50and 1,200 of auto-transfuse.
29:52Did you check this?
29:53Not yet.
30:03Okay, it's working.
30:04More compressions.
30:17Okay, more compressions.
30:18All right, we got pressure on.
30:23All right, I'm going to come to the ground.
30:27Okay, we're done.
30:35I'm going to come to the ground.
30:37All right, I'm going to come to the ground.
30:45I'm going to come to the ground.
30:49All right, I'm going to go with you.
30:57You need to question him about the student.
30:58Okay. After we clear him medically, you know the drill.
31:00He has head trauma. Probable concussion.
31:02Dr. Mohan, why don't we do a complete neurological exam of DH2
31:05and put him in line for a CT?
31:14Where's his mom?
31:15Still outside talking to the police.
31:18This is fucked up. I didn't do anything.
31:21Then who saw all of these people, huh?
31:22I don't know. How about you go look for him, dumbass?
31:25David.
31:26Are you all right?
31:26No, man. I'm fucking far from okay.
31:28Okay, okay. We're going to get this straightened out right now.
31:33Dr. Sances, please report the nurse's face at 3-West.
31:37Dr. Sances, nurse's face at 3-West.
31:39I'm going to take your eyes.
31:41Follow my finger.
31:44Still bleeding, please. I need something.
31:47No heat, no tympanum, no head trauma.
31:49Pulse is strong at 72.
31:51O2 sat perfect at 99.
31:54Do you need pain medicine?
31:57Ma'am, we're trying to help you. We just need you to let us know.
32:03Okay, let's try and find her a gurney and give her a full neuro exam.
32:06Can you put her in line?
32:08Drug overdose?
32:09No. Normal pupils, normal pulse.
32:12Brain injury?
32:14No, she's walking with a steady gait.
32:16Still needs a head CT.
32:17Well, it's not going to be for hours.
32:18I could drill easy aisles on both sides.
32:21They've worked on the last guy.
32:24Maybe it's PTSD from all she's seen.
32:26It's like even here.
32:28No, but maybe she just needs a quiet place.
32:30Well, knock yourself out.
32:32What's up, Whitaker?
32:33Uh, junctional tourniquet appears to be working.
32:36No new blood on the gauze.
32:37You're looking good, Carmen.
32:41Is she?
32:42Carmen?
32:43Carmen?
32:43Pulse is ready.
32:44How long has she been like this?
32:45She was awake and alert a minute ago.
32:49All that blood loss is catching up with her.
32:50Running a liter wide open?
32:54Uh, huge collection of blood near the bladder.
32:57The bullet must attract north and hit the external ilio.
32:59We stopped the bleeding near the leg, but she's still bleeding internally.
33:01We need Mal.
33:02No, we need to give a unit of blood and move her to the red zone.
33:04Okay, let me see if they have space.
33:08Where's Robbie?
33:09The H2 with a possible shooter.
33:11Can you guys take a new patient?
33:12Not right now.
33:13What do you got?
33:14Uh, hypotensive pelvic bleed?
33:16Transfuse two units.
33:17We'll get to it.
33:18Abby!
33:19I got a carotid injury.
33:20Pop the clot.
33:21I'll be right there.
33:22Hook me up.
33:25Is that Robbie with David?
33:27Yeah.
33:28I saw the cops bring him in.
33:30Who's David?
33:31High school kid who was making threats.
33:33You think he did this?
33:34Guys, focus on the patients.
33:36What do you got?
33:37Ooh, okay.
33:38Sterile IV tubing, umbilical tape, and red rubber Robinson.
33:41And sterile gloves.
33:54Let's take the long way around.
34:00I can put Jake in the family room.
34:02No, it's a calendar.
34:04Defect bypass with IV tubing.
34:06You ever done a Rommel turnkey?
34:07Left side by left.
34:08Robbie, can you help me with a Rommel?
34:26The toughest part is getting the umbilical tape through the tubing.
34:31And clamps.
34:32Very cool.
34:33You guys got this?
34:34Oh, we're good.
34:46Dr. Robbie, I have a retroperitoneal bleed.
34:49Get out of it.
34:49He's busy.
34:50Okay, stabilize and find a surgeon.
34:52Sure.
35:03What's going on?
35:14Leah's injuries were really serious.
35:18She stopped breathing.
35:19We put a tube down her throat to deliver oxygen.
35:24We were able to drain the blood that was collapsing our lungs.
35:28We gave her as much blood as we could.
35:31We even transfused some of her own blood that was in her chest.
35:35But we were unable to get ahead of the massive blood loss.
35:43Our heart stopped.
35:46You saw me doing CPR.
35:50We did everything that we could.
35:53She's dead.
36:04I don't know, but I was talking to her after she got shot, and she was talking.
36:09Her heart was damaged beyond repair.
36:13There was nothing that we could do to save her.
36:16I want to see her.
36:18I'm really sorry, man, but you can't.
36:20Why not?
36:21Because this is an active police and FBI investigation.
36:25She's dead.
36:26I know.
36:27They're going to release her to her parents in a couple days.
36:31Please.
36:32You have to.
36:32Let me see her.
36:33Please.
36:33Please.
36:37Bringing a male?
36:38How's she doing?
36:39Still has a pulse.
36:44What are you doing?
36:45Prepping for Riboah.
36:46Are you crazy?
36:47Did Abbott approve of this?
36:48He said, do what you have to do.
36:51The tendings are all tied up.
36:53If I can blow up a balloon in the aorta, it'll stop the bleeding.
36:57You've never cut off the blood supply to half her body.
36:59I'll only go in a few inches, zone three, below the kidneys, until she gets up to the OR.
37:05Love up, Huckleberry.
37:08Okay, you're going to need an ultrasound, x-ray.
37:10Not today.
37:12Have you done this before?
37:14It's a central line.
37:15Just need to hit the femoral artery.
37:18Like that.
37:19Piece of cake.
37:21All right, guide wiring, introducer sheet.
37:23Santos is doing a Mabobah.
37:25Oh, no, no, no way.
37:26Yes way.
37:27Um, no, we need an attending or a senior resident for that.
37:30Oh, ye of little faith.
37:35Treat them identification.
37:40Are you sure?
37:41Yes.
37:51All these people are dead?
37:54Yes.
37:59Which one is Leo?
38:04What number do you have on your wrist?
38:09Only one.
38:38I'm at 15 centimeters with five pcs of saline so far.
38:44Roboa, are you shitting me?
38:46I told her to stop.
38:47Uncontrollable bleeding from a pelvic artery.
38:49No other options.
38:50We need an art line to know if the BP is up.
38:52We'll go with pulse strength and mentation.
38:54Carotids weak.
38:55Radial's barely there.
38:56Another three cc's in the balloon.
38:58Conjecting?
38:58I'll try for palp.
38:59You can stall it.
39:00Yes, go for it.
39:06Whoa, radial's much stronger now.
39:08Lock the balloon.
39:09Check the wound.
39:10Go.
39:11BP's 110 by palp.
39:13That'll do.
39:14Wound's dry.
39:15Barely a trickle.
39:16That's because there's no blood going to her legs.
39:18Okay, the clock is ticking.
39:19Balloon can stay up for one hour tops.
39:20Get IR and vascular on the kids.
39:25Hey, hang in there, Carmen.
39:27You're good, okay?
39:28Okay, you never should have done that on your own, ever.
39:31Do you understand?
39:35That was pretty badass.
39:36You saved your life.
39:37Good job.
39:46Did you call her parents?
39:49They'll give the number to our social worker who will contact them very soon.
39:54I got their daughter killed.
39:56This is not your fault.
40:02Why couldn't you save her?
40:04I mean, this is what you do.
40:11I tried.
40:13I really tried.
40:14We all did.
40:15If this had been any other day, man.
40:16If it had been any other day?
40:17What the fuck does that mean?
40:18Any other day?
40:19What, you would have saved her life?
40:21I tried.
40:25I tried.
40:25Yes, no, I don't know.
40:28I don't, I don't know.
40:32We're getting slammed up there.
40:33We've had dozens of shooting victims.
40:34You've seen it.
40:36The fact that we've saved as many people as we have is a fucking miracle.
40:41What, you didn't save Leah?
40:44No, no, I didn't.
40:48And I don't know how many people I've helped today, but I can tell you every other person
40:53who has died.
41:00There was a man named Mr. Spencer who died in front of his children, and an 18-year-old
41:04who was brain dead from a fentanyl overdose, and a guy with a heart condition, and a little
41:09girl who drowned trying to save her sister, and I'm going to remember Leah Long after
41:13you've forgotten her.
41:14Oh, fuck.
41:15Oh, fuck.
41:16I'm sorry.
41:17I'm sorry.
41:17You've got to go, man.
41:18You've got to go.
41:19You've got to go.
41:20You've got to go.
41:20I've got to go.
41:21Wait, Robbie.
41:21Robbie, wait, wait.
41:22Can you put him back in his bed, please?
41:27Jesus.
42:06A little bit fucked up.
42:08A little bit fucked up in my head
42:16No, I don't get the rest yet
42:19Plenty of rest when I'm dead
42:27I'm a little bit roughed up
42:30But not from regret
42:32If the fail is the game
42:38I'll fail again
42:45Failure is the worst
42:48I'll fail for worse
43:14You've got to go, man.
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