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00:24A CIDADE NO BRASIL
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05:52ABILLET CHESS AND BELLY
05:52STRAIGHT UP TO THE OR
05:53OKAY, EVERYBODY LISTEN UP
05:54THIS IS HOW IT'S GOING TO WORK
05:56OUR AMBULANCE BAY
05:58IS NOW OUR TRIAGE
05:59EMS WILL BE OVERWHELMED
06:01MOST WILL PROBABLY ARRIVE BY CAR
06:03SEVERAL VICTIMS PER VEHICLE
06:05FOR ALL YOU NEWBIES THAT DON'T KNOW
06:07DR. SHEN IS OUR NIGHT SHIFT ATTENDANT
06:09JOHN, I'M GOING TO PUT YOU ON POINT TRIAGE
06:10COOL
06:11TRIAGE WILL DECIDE WHO GOES WHERE
06:13DEPENDING ON THEIR INJURY
06:14EVERY DEPARTMENT WILL HAVE
06:15A DESIGNATED PRIMARY
06:17WHO WILL OVERSEE THEIR STAFF
06:18Se você precisar de alguém, olhe para o vestido.
06:20Nós vamos ter walkies.
06:21Nós vamos ter você o que você precisa.
06:24Não paciente vai entrar em uma sala
06:26se é um trauma bay,
06:27e eles vão ter quatro pacientes cada.
06:29Precisamos de manter todos todos em open
06:31para que possamos um olho em tudo.
06:33Triage vai assessar e assinar cada paciente
06:36a uma zona específica com a colorido de slap band.
06:40A paciente que vem com a reda de slap band
06:42vai para a reda zona,
06:43que são os trauma rooms com o overflow aqui.
06:45Estes são os mais críticos que vão die
06:48sem imediatura de atenção.
06:49Samira, onde você está?
06:50Você está aqui com Dr. Abbott e eu.
06:53Jax, vamos lá para o tráfico.
06:53Nós temos cinco minutos para tentar estabilizar.
06:55A reda, depois disso, é o RICU ou morgue.
06:58O centro e centro comunidade
07:00vai ser a pinka zona.
07:01Isso é para os pacientes que vão die
07:02em uma hora de uma hora sem tratamento.
07:04Mckay e Javadi, você está lá
07:06com o apoio de night shift e a surgical staff.
07:09A yellow zona é a north corredor.
07:11Os vão ser mais extremidades ruins.
07:13Good vitals, talking.
07:15Mel, you're going to run point there
07:16with Santos and Whittaker.
07:18Uh, what if there's a pulseless extremity?
07:22Oh, if you can't feel a pulse,
07:25check for Doppler flow with this.
07:26It's a mini ultrasound.
07:28Follow the screen prompts.
07:30But a yellow can change to a red
07:31if they go south.
07:32You got to stay on top of them,
07:33even if they seem stable.
07:34Okay, yeah.
07:34You got this, Dr. King.
07:35Green, minor lax and sprains
07:36as they go to family medicine.
07:38Black and white bands are DOA.
07:39Imminent death.
07:40Peds is now our morgue.
07:41Let's hope we don't get too many of these.
07:44We're a mass unit now.
07:46There's no charting,
07:47no electronic medical records,
07:49no board.
07:50How do we document treatment?
07:52Oh, you'll all get Sharpies
07:53and every patient has a wrist chart
07:54to document treatment and procedures.
07:56We're not a room,
07:57right on the patient's forehead.
07:59Really?
08:00Yeah, really.
08:00Each wrist chart has a unique
08:02mass casualty incident,
08:03barcode and patient number.
08:05That's how the patients
08:05are going to get identified.
08:06This is no frills,
08:08combat zone medicine.
08:10No ultrasound,
08:11no x-rays,
08:11no CT,
08:12no labs.
08:13Assess based on mental status
08:15and pulse strength.
08:16Every critical patient
08:18gets an IO,
08:19intubation,
08:19a unit of blood
08:20and chest tube
08:21if needed.
08:22Everything you need,
08:23blood, drugs,
08:24bandages,
08:24everything will be
08:25in the behavioral health rooms.
08:26That's our supply depot.
08:29Oh, keep a couple of 11 blades
08:31in your pocket.
08:32Goal is to resuscitate ASAP
08:34so they'll make it upstairs
08:35for definitive care.
08:36Trauma surgery
08:37and neurosurgery
08:38will decide who goes up
08:39to the OR immediately
08:40and who goes to the ICU
08:41for further treatment
08:42and evaluation.
08:45Communicate.
08:46Ask for help
08:47if you need it.
08:49Trust your attendings.
08:50We will get through
08:51this together.
08:52Damn right we will.
08:53Okay, you three,
08:54I want to talk to you.
08:57I need you three
08:58to raid Central Supply
08:59and bring back
09:00all the chest tubes,
09:01ET tubes,
09:02thoracels,
09:02normal saline.
09:03I thought that was
09:04all in behavior, huh?
09:04We can burn through
09:05all that in the first hour.
09:06West Basement
09:06just passed nuclear medicine.
09:08West Basement, got it.
09:08Wait, wait, wait, wait, wait.
09:09Take one of these
09:09empty disaster bins
09:10so you can grab everything
09:11and get your hands on.
09:12It's a disaster bin?
09:12Empty plastic boxes
09:13right there.
09:14You can't miss them.
09:15Where's Collins?
09:16She went home.
09:17But Dana is calling her now.
09:19Don't worry.
09:20It's okay.
09:20We got plenty of people
09:21coming in.
09:22Just follow Dr. Abbott's lead.
09:24John, I'm going to help
09:25you get started in triage.
09:26Sounds good.
09:28Dana, what do you need?
09:29Oh, I have the yellow zone
09:31for extremity wounds.
09:31We need a shitload of bandages,
09:33tourniquins, split slings,
09:34and IV antibiotics.
09:35Come on.
09:37Myrna.
09:41Where the hell did Myrna go?
09:42Antoine,
09:42did you take the cuffs off Myrna?
09:43Hell no.
09:44That woman scares the shit out of me.
09:45She keeps trying to bite me.
09:47Son of a bitch.
09:55Oh, that's a lot of wrist charts.
09:57300.
09:59Let's hope we don't need them all.
10:01Were you at the last
10:02mass casualty faculty meeting?
10:04Oh, no.
10:05I was still a resident
10:06three months ago.
10:08Right.
10:09Oh.
10:10Wow.
10:11Well, one patient at a time, right?
10:14The goal is to triage
10:16each patient in 10 seconds.
10:1810 seconds.
10:19Got it.
10:19Mental status is AVPU.
10:21Alert, responsive.
10:22Verbal, responsive.
10:23Pain, unresponsive.
10:24Yep.
10:25Next to the evipulse.
10:27Radial carotid ephemeral.
10:29Tells you where to send them.
10:30That's it.
10:31Okay.
10:32Pull.
10:34Ah, I heard of my rain today.
10:37John.
10:38Yeah, man.
10:39Mental status and pulse.
10:41You do everything you need.
10:43Cool.
10:44Unresponsive with no pulses.
10:45Slap a black and white band on them.
10:47Send them to work.
10:49Responsive pain with a faint groan.
10:51Weak femoral pulse.
10:52No radial.
10:53Uh, red.
10:54Right.
10:55Slap a red band on them.
10:56Send them back.
10:57Awake, alert with strong radial.
10:59That's your question.
11:00Could be green.
11:01Family medicine for scrapes or sprains,
11:03but stable penetrating
11:04and ceremony wounds go to yellow.
11:05Perfect.
11:06Dude.
11:07Relax.
11:07I got the front door.
11:08You worry about the back.
11:14Hey, Paolo, everybody,
11:15let's put the heads of these gurneys
11:16up 30 degrees
11:17so they all roll in the right way.
11:19Dr. Robbie.
11:20You talking to your son?
11:21No, but I have the form
11:22to put him on a psychiatric hold.
11:24The social worker signed it.
11:26I just need you.
11:27Okay.
11:27You should probably go home, Teresa.
11:29This hospital is essentially closed.
11:31David wouldn't do this.
11:33I really hope you're right.
11:35I got four shooting victims.
11:37What's your name?
11:39Duncan.
11:40Show me.
11:42Right chest, strong radial, pink.
11:45What's this?
11:46That's priority boarding.
11:46You're going to be okay.
11:48Back when he's red,
11:49shoulder is yellow,
11:49neck when he's red.
11:51Okay.
11:52Let's check out this van.
11:53Yeah.
11:57Hey.
11:58See that woman over there?
11:59You need to speak to her.
12:00What?
12:00Your son has something
12:01to do with the shooting.
12:02I'm not sure for certain,
12:03but you need to talk to her.
12:04Sit.
12:05Okay.
12:10What's your name?
12:11I'm Sylvia.
12:12This is my son Omar.
12:13Omar, can you open your eyes for me?
12:15He's deaf.
12:16Gurney!
12:17Sir, can you hear me?
12:19Black and white, peds.
12:20Yes.
12:21Yes.
12:21Yes.
12:21Yes.
12:24Red zone.
12:25You need to let go now.
12:26Oh, I want to stay with my son.
12:28You will be very close by,
12:30I promise.
12:32What happened to your leg?
12:33I got hit by a car
12:34when we were wheeling me.
12:35Okay, we'll see you inside too.
12:41You got this?
12:42I'll check back in a minute.
12:43No problemo.
12:44Dr. Ellis,
12:45thanks for coming in early.
12:45Put me in, coach.
12:46You're on triage with Shen.
12:48Shen's a patient, right?
12:49You got it.
12:49Let me know if you need any help.
12:51Help.
13:01I'm in.
13:02Bag her.
13:03Oneg's pouring in.
13:05Stronger pulse.
13:06I'll take her up.
13:07Dr. Mohan,
13:08that kid came in with his mom.
13:09She says he's deaf.
13:11Ready to go with the Oneg.
13:12Wait, wait, stop.
13:13O positive for males over 13,
13:14women over 55.
13:15Oneg for everybody else.
13:18Hook me up.
13:23It's really pouring out.
13:24Squeeze in two units.
13:26$1,500 out,
13:26buys him a trip to the OR.
13:27If he stabilizes,
13:28surgical eyes to you instead.
13:30I'm going to see who needs help.
13:31Yeah.
13:32North corridor, please.
13:33PDF, north corridor.
13:34I-O's in.
13:35Go with O-Paz.
13:37When there's no time,
13:38bone marrow infusion's
13:39as good as an IV.
13:41Robbie, stabilize for the flip.
13:46Oh.
13:49He's got a wound on both sides.
13:50He's going to need two chest tubes.
13:51Yeah.
13:51Need a hand?
13:52Hell no.
13:53I got two hands.
13:57Roll.
13:59Okay, quick I-O.
14:00Tom and eight in sex.
14:00Prepping the innovation.
14:12Document the tourniquet time.
14:14Mark the arm.
14:15Mark the chart.
14:16Let it down briefly once an hour.
14:18Okay.
14:18Four more scene repeat if needed.
14:20Mel, this is Sylvia.
14:22Hi, Sylvia.
14:23I'm Dr. King.
14:25Oh.
14:25Oh.
14:26Looks like closed hip did fractures.
14:28Strong pedal pulses.
14:29Great flow with the butterfly.
14:30Great.
14:31Okay, I got separated
14:32from my son, Omar.
14:34He shot in the chest.
14:35Okay, um,
14:36I'll let you know
14:37as soon as I find out anything.
14:38He is deaf,
14:39ASO only.
14:40They need to know that.
14:41Okay, um,
14:42I'll make sure it's in his chart.
14:43She needs x-rays,
14:44AP and lateral.
14:45Well, um,
14:46radiologists need to be
14:47closed for hours.
14:48Put her in a long cam boot
14:49and pain meds.
14:50We're just going to
14:50make you comfortable.
14:51Thank you.
14:56Coming in with plants now.
15:01Okay, pressure dressing on this.
15:03Okay.
15:06But what if he dropped a lung?
15:08Then I'll throw in a pigtail.
15:11Who needs help?
15:12Everyone.
15:13Pigs are supposed to be stable
15:14for the next hour.
15:15If you think they need
15:15the OR sooner,
15:16send them to the red zone.
15:18Will do.
15:19If I got this,
15:20go with your ma.
15:21I mean,
15:21Dr. Shamsi.
15:27How we doing in here?
15:29So far,
15:30so good.
15:30Blood's primed and ready.
15:321,500 cc,
15:33it's time for the OR now?
15:34Definitely.
15:34Move him up.
15:39Um,
15:39a 17-year-old
15:41with the right chest wound?
15:42Going up to the OR now.
15:44Hold on one second.
15:47They need to know
15:47he's deaf when he wakes up.
15:50I'm all autistic
15:51what I put here.
15:52Looks like this one's renal.
15:53Golden ticket
15:54directly to surgery.
15:58That's three out of four ORs down.
16:00Another floor about to open
16:01and all 25
16:01will be ready
16:02by the time we need them.
16:03We could be buried by then.
16:05No, you won't.
16:05We'll blast through these
16:06tying off bleeders
16:07and slapping on vacuum dressings
16:08and finish the job
16:09in a day or two
16:10when the dust settles.
16:12Unresponsive.
16:13Had a weak femoral.
16:14Lost it.
16:14Two units of blood.
16:15There's no response.
16:16Call it.
16:16Propulsive OR.
16:18Gunshot to the head.
16:19It's running through.
16:21You still got a strong pulse.
16:22This one can make it
16:22because the intracranial bleed
16:23can decompress
16:24through the bullet holes.
16:25Walsh,
16:26neurosurgery in the house?
16:27Yes,
16:27send them to the
16:27neurocred ICU.
16:28The churros from there.
16:31Okay,
16:32you guys good in here?
16:32You got this.
16:33You got this.
16:34Bring me a few more
16:34before I get bored.
16:41Going through?
16:43Doesn't look like it.
16:45Back up out there.
16:55Easy peasy, I'm in.
16:57Back her up.
17:00Entitle CO2 looking bad.
17:0120 French on a Kelly.
17:03What the fuck are you doing?
17:04I'm staying alive.
17:05You should not be here.
17:06None of these people
17:07should be here.
17:09Larry, Larry.
17:11Edwards don't go to yellow.
17:12Wait, what?
17:13Triage says yellow.
17:14Hold on.
17:15Go.
17:16I've got this.
17:18Trust me.
17:18Oh,
17:19we're a little late for that.
17:25This is Grayson Cooper,
17:2768.
17:28Will it graze his scalp?
17:29I got lucky.
17:29Dude just clipped me.
17:31You got a headache?
17:32Not really.
17:32A little burning.
17:33Good for yellow.
17:34In a million concerts.
17:35Whatever happened
17:35to Peace and Love, man?
17:37That's a great question.
17:40Should be numb.
17:41Israeli bandage
17:41starts with
17:42hemostatic gauze
17:43then turns into
17:44a pressure dressing.
17:45Is that arterial?
17:46No, but it's bleeding
17:47pretty briskly.
17:48Okay, change it to a
17:48turning kit only
17:49if it soaks through.
17:51I got a superficial
17:51scalp wound.
17:52Wrap it tight
17:53with frequent neurochecks.
17:54I need to assess
17:55your injury.
17:56I'm fine.
17:56Help the others first.
17:57Please, I'm fine.
17:59Sir, are you taking
18:00any medication?
18:01Just medicinal marijuana.
18:02Yeah, what do you
18:02take that for?
18:04Everything.
18:06IVs on everyone?
18:09How is my son?
18:11Omar, he was shot
18:12in the chest
18:13and we were
18:13putting up on my van.
18:14He is upstairs
18:15with the surgeons
18:16in the OR.
18:17I will come and find you
18:17when I know more.
18:19Coming through.
18:21Wait, right here.
18:24Oh, yeah.
18:25Going for action.
18:26Take care of this charge.
18:31No exit.
18:33Jesse, hang a unit
18:34then right up to the OR.
18:37She shot?
18:38No, looks like
18:39she got trampled.
18:40Unresponsive in the field.
18:41Three more in the rig.
18:43Hey, Javani.
18:44Got a possible
18:45bloodhead trauma here.
18:46Peoples are good.
18:49Strong pulses.
18:50Okay, assess for
18:51bloodhead, chest, belly.
18:52With who?
18:53Anybody.
18:54How we doing?
18:55Heads above water so far.
18:56Anything about the shooter?
18:57Haven't heard,
18:58but I'll try and get an update.
19:00Is he laying this back?
19:00Yeah, not by choice.
19:02I'll deal with that
19:02when the shift is over.
19:03Comments?
19:04Not answering.
19:05I told her to turn off
19:06her fucking phone.
19:07Keep trying her.
19:09Jake?
19:10No.
19:11Probably got his mom
19:11on the landmine.
19:12Don't recall both of us
19:13when she reached us.
19:14Yeah.
19:17One for pink
19:18and one for green.
19:19On it.
19:19I'm sorry.
19:20All press need to stay
19:22in the waiting room.
19:22We have two minutes.
19:23The public needs to know
19:24what's going on.
19:24Front of the hospital.
19:25Let's go.
19:25A gestrian entrance.
19:26I'm not telling you again.
19:30What's this?
19:32Response to pain only.
19:33Thready pulse.
19:33Chest wall contusions
19:34with boot prints on his shirt.
19:35Yellow hair wheelchair.
19:36Okay, sounds good.
19:37Do you need anything?
19:38Well, I was hoping
19:39for Thanksgiving
19:39and Christmas off this year.
19:42We can talk about it later.
19:45Will proper chest tube placement
19:46keep going under
19:47the last ministration
19:48as intrataracit?
19:49Stop.
19:50What?
19:50I don't need you
19:51teaching me right now.
19:52You're already an expert.
19:54I mean the fucking room.
19:55There's nobody free.
19:56All right.
19:58Here you go, Soak.
19:59About to place
20:00a horizontal mattress
20:01in case you're wondering.
20:06Looks like you've got this.
20:17Soak through his pressure dressing.
20:20Okay, yeah.
20:21We can fix that
20:21with rainy clips.
20:22What are those?
20:23I'm going to neurosurgery
20:24to clamp off the scalp
20:25before opening the skull.
20:26All right, I'll be right back.
20:27Santos, keep pressure.
20:28You guys are swamped.
20:29I got this.
20:31Takes a village.
20:36Sylvia?
20:36Whitaker?
20:37Sylvia.
20:38Sylvia, can you hear me?
20:40Sylvia?
20:41Can you hear me?
20:42I lost her radio pulse.
20:43I lost her radio pulse.
20:43From her broken leg?
20:44What did we miss?
20:45I don't know.
20:45Heart attack?
20:46Another injury from the car crash?
20:47That's for pulses.
20:48It has an e-fast mode.
20:55Diagnosis made?
20:56Blood and Morrison's.
20:56Liver laceration.
20:58Car hit the belly.
20:58Leg was a distracting injury.
21:00Drilling an IO.
21:01I'm going to get some blood
21:02and then we'll move her to pink.
21:08This sends another up to the OR.
21:09I got room for one more red.
21:10On it.
21:11Didn't make it.
21:11Going to Pete's.
21:12Another red and trauma one.
21:13Copy that.
21:19Careful, kid.
21:20I need Rainy Clips and a unit of O-Neg.
21:23Rainy's left to come down from the OR.
21:24I need them now.
21:25Okay.
21:25Okay, I'll get them.
21:26O-Neg here.
21:30Here you go.
21:30Thanks.
21:31We need EVS with the mop.
21:33Not much blood, but a big rush of air.
21:35Got trampled.
21:36Collapsed as long.
21:37Tension pneumo.
21:38We're going to be.
21:38I did.
21:39Moorhead is on fire.
21:40House is coming up.
21:41Okay, great.
21:42Slide to pink as soon as there's room.
21:43Got it.
21:45Hey, uh, how many ORs available?
21:47One now.
21:48Two more in less than five.
21:49Can you take a belly and one more chest and pray?
21:52No problem.
21:53MCI-21's going to ICU.
21:54I'll be back.
21:55Got it.
21:56Red zone.
21:57Red zone.
21:59Three less is full.
22:00Take them to two staff.
22:02I need zero for them, cut four by fours, and elastoplast tape.
22:05You're here.
22:06Got a pink coming in.
22:07In the flesh.
22:08What do you got?
22:10Uh, auto versus ped.
22:11We thought it was just a tip-fit fracture.
22:13Then we found in the colt liver laceration.
22:15Leg is low priority right now.
22:16If she stabilizes with blood, she can wait an hour for the OR.
22:19And if not?
22:19Run the line, baby.
22:20Your son's in the OR with the GSW to the chest.
22:22Sweet.
22:23Family reunion and post-op.
22:24Whitaker?
22:25I'll be right back once this unit's in.
22:27Uh-huh.
22:28Hey!
22:29Good catch, you two.
22:31Hey, Lincoln, we're out of zero form.
22:32I'll try to find him.
22:33Come on, Sylvia.
22:38Oh, I'm sorry, sir.
22:39The ER is closed.
22:40You'll have to exit out the pedestrian entrance.
22:42I'm a patient.
22:43Then you need to go to family medicine and building it.
22:44No, I'm waiting for surgery on the fourth floor.
22:46Okay, well then go back to your bed.
22:48My son is down here.
22:50I'm sorry, sir, but no one's in and out unless they're on a gurney.
22:54Okay, look, um, my wife is an ER doc, Dr. McKay.
22:59She needs me to get our son home.
23:00He's in the staff lounge.
23:04All right, make it quick.
23:05Thank you.
23:07But hey, I am timing you.
23:11If you're not back in five, I'm coming after you.
23:13Got it?
23:14Yeah, okay.
23:17I need some help over here.
23:22Back looks good.
23:23New exit now.
23:24Red zone!
23:26Okay, I'll be right back.
23:30Javadi, IO.
23:34Here, too.
23:35Socks is on board.
23:37I got it.
23:43I'm in, beggar.
23:46Chad, what are you doing here?
23:48They, uh, they postponed my surgery.
23:51You can't be in here.
23:52Go sit with Harrison in the staff lounge.
23:54Okay.
23:55Now!
23:56Okay.
24:01I got it!
24:03Another one for the morgue.
24:04Eddie, repeat.
24:07I fell on my left side.
24:09I'm in, beggar.
24:10I'm in, beggar.
24:12I'm in, beggar.
24:12I'm in, beggar.
24:14I'm in, beggar.
24:14I'm in, beggar.
24:15I'm in, beggar.
24:15I'm in, beggar.
24:16I'm in, beggar.
24:16Looks like I was feeling like some shrapnel.
24:21Hey, buddy.
24:23Did you have your surgery?
24:25No, it got delayed.
24:27Ready to go home?
24:29Mom said that Grandma and Grandpa McCain were picking me up.
24:32Yeah, I'm not sure they can get here right now, and neither can Chloe, but, you know, we can
24:36Uber to my place.
24:39I'd rather go home with Mom, if that's okay.
24:42Uh, your mom's got her hands full, dude, and I think she's going to be here pretty late.
24:47I can wait.
24:50Okay.
24:52Yeah, okay.
24:54Okay.
25:03Should we watch something?
25:04You want to watch a movie?
25:06Yeah, sure.
25:07What do you got on there?
25:09Not much.
25:10That's one unit in.
25:12Her pulse is stronger, but she needs more blood.
25:14Not today.
25:15Only one unit if the pulse picks up.
25:17We're already rationing our blood supply.
25:18What if we run out?
25:19Who wanted rainy clips?
25:20Oh, me.
25:21Thank you.
25:22I thought you left.
25:23All hands on deck, right?
25:25Is there any word on Omar?
25:26He's this woman's deaf son.
25:28Teenage boy, shot in the chest.
25:29Kid got lucky.
25:30Missed the aorta.
25:31He should pull through.
25:31Oh, that's amazing.
25:33Um, well, her name is Sylvia.
25:34Would you please tell her about her son when she wakes up?
25:36What are you using the...
25:39Mateo, MCI 29.
25:45What's this?
25:46Unresponsive, even to pain.
25:47No GSW.
25:49Strong pulse, but tachycardic and diaphoretic.
25:51Looking for internal hemorrhage.
25:54Fast negative.
25:55Help me, Roller.
25:58Tim!
25:59Yeah?
25:59Ampity 50 now.
26:00Got it.
26:00Seriously?
26:01Look, glucose monitor.
26:02She's diabetic and probably hypoglycemia.
26:04So check a blood sugar.
26:05No time for that.
26:06Still could be hedgehog.
26:07If it's decay, you're making it worse.
26:08My spidey sis is telling me she took her morning insulin, but she skipped lunch.
26:11She's in a coma from low blood sugar.
26:14Will you look at that?
26:15These are healing hands.
26:16Too bad they're so tiny.
26:18Hello, what's your name?
26:21Dawn, where am I?
26:22Pittsburgh Trauma Medical Center.
26:24You dropped your blood sugar, but you're going to be okay.
26:26You see, you don't need me here?
26:27Don't even say it.
26:29Let's get her to yellow.
26:31What happened?
26:32Uh, there was a shooting at Pit Fest, but you're safe now.
26:37Wherever you can spare, thanks.
26:39MCI 33 to yellow for monitoring.
26:43What are you doing?
26:44Ran out of laryngoscopes.
26:45No time to autoclave.
26:46Oh, man.
26:47Almost had a chest tips, too.
26:48More coming from Presby.
26:50Run up every low and no nag.
26:51Perfect storm.
26:58Do you feel anything, Grayson?
27:00No pain.
27:02Just a lot of sadness for the world we live in.
27:04I hear you.
27:05Any room at the inn?
27:06Uh, what's her story?
27:07This is Dawn.
27:08No trauma.
27:09Insulin reaction.
27:10Responding to D50.
27:11D10 at 100 an hour?
27:12Perfect.
27:13Oh, and I borrowed your butterflies on the gurney.
27:16So just like that?
27:17Yep, yep.
27:17What are you doing?
27:18Treating a patient.
27:20Rainy Clips.
27:22Clamping off a bunch of subcube leaders.
27:24Good work.
27:25Keep it up.
27:27Yep, perfect.
27:28That's it.
27:29Room for another pain.
27:32I need suction.
27:34We don't have any.
27:35Too many secretions.
27:35I can't see shit.
27:36Here, wipe it out with 4x4.
27:38Are you kidding me?
27:39You guys have a fiber optic laryngoscope?
27:41Yep, just a rigid glidescope.
27:42Damn.
27:43Except we don't have any room for it,
27:44so just pull out one bag for a minute.
27:47When did this guy last eat?
27:48We never know down here.
27:49Sneaked in there.
27:50Team Crackley pressure.
27:51If his vomits, we're fucked.
27:52Doctor?
27:55Hold on, hold on, hold on, hold on.
27:57Oh, yeah, this is a tough one.
27:59Oh, yeah, this one looks tough.
28:01No shit.
28:02Prep the neck.
28:02Hold on, okay?
28:04Yeah.
28:04Come over here.
28:05Just give me a chest compression.
28:06CPR?
28:07Did we lose the pulse?
28:08Just give me one good push.
28:09Yep.
28:09Okay, give me two.
28:11And do it again.
28:16Okay.
28:17I think I am in.
28:18Bag him.
28:19Check the end title.
28:21Yellow, we're good.
28:22How did you do that?
28:23Bubble intubation.
28:24You gave the compression
28:25off all the air bubbles up.
28:26More than one way to tube a cat.
28:28Coming through.
28:30Robbie?
28:31Down, please.
28:32Wow.
28:32What was that?
28:35Anything from Drake?
28:36Hey, how much room do we have in here?
28:38Intubated chest tube, but massive subcutaneous emphysema.
28:41Air from the chest is leaking under the skin.
28:44Loosen the pulse.
28:45What do you think?
28:46Tamponaut from pneumomediastinum.
28:47About to cut blowhole incisions to release the air.
28:49Do it.
28:50In for clavicular.
28:51Yeah.
28:52Yeah.
29:01Pulse is coming up.
29:02Nicely done.
29:03Okay, send him to cardiothoracic.
29:04I see you.
29:11We'll get you pain medicine.
29:12A nurse will be by soon.
29:17Hey, where'd this guy go?
29:18Uh, which patient?
29:20LCI 28 arm injury who refused treatment.
29:22Uh, maybe he left.
29:24There's a gunshot wound?
29:31Hey.
29:32Hey, what the hell are you doing?
29:33I'm fine.
29:34Leave me alone.
29:34You can't do that.
29:35Back off.
29:36Give me that clap.
29:37I need security in here.
29:44He's hypotensive.
29:50Nice move, Suck.
29:52What happened?
29:56Fucker.
29:58I think this guy stole a victim's hoodie and faked an injury to get inside.
30:01He's probably fucking the heart.
30:02Asshole.
30:03Hey.
30:04Hey, wake up, you faker.
30:07You don't mean response to pain.
30:10Her little bloodhead trauma goes to pink.
30:11Soft restraints.
30:12Six hours observation.
30:14Going to the hub.
30:15Be right back.
30:16I'm fine.
30:17I'm fine.
30:18Great.
30:18You can give a statement to the cops.
30:20Get them out of here.
30:21Yeah.
30:21Where's my phone?
30:23Oops.
30:24My bad.
30:31Chest tube, please.
30:32We're out of chest tubes.
30:33What the hell?
30:34You could have told me that before we started.
30:35I didn't know.
30:36I already made the incision.
30:37Now, what am I supposed to do?
30:39How about this?
30:41An ET tube.
30:42A tube's a tube, and if you inflate the balloon, it won't pull out.
30:46Fine.
30:46Set up a thoracel.
30:47Out of those two.
30:48Oh, for the love of God.
30:49Hearing bag?
30:50How am I supposed to connect to that?
30:52Christmas tree adapter.
30:53It'll work.
30:55This is all very unconventional.
30:58No.
30:58This is genius.
31:03Oh, um, and four of ANSEF.
31:05Sorry, I forgot the ANSEF.
31:13Mel.
31:13Mel, I need you to reassess, please, now.
31:16Sylvia?
31:20Her pulse is weak and thready.
31:22She's bleeding out from her liver lack.
31:24I need Oneg.
31:25Oneg's gone, honey.
31:26Glory's got more flying in.
31:27Incident command.
31:28What's the ETA on our blood?
31:30The patient's going to have to get by with a liter of ceiling.
31:32No, no, she needs blood, not crystalloid.
31:34Um, can she go to surgery?
31:36All right, she's next to go.
31:37As soon as we get an open OR.
31:39It's time to last that long.
31:40Dr. Robbie.
31:41Dr. Robbie?
31:42Dr. Robbie.
31:43We're out of Oneg, but I'm Oneg.
31:44Can I donate?
31:45Glory's got more blood flying in.
31:46But I need it now.
31:48What is our blood status?
31:49Just use the last units of Oneg and Opaz more flying in.
31:51ETA?
31:52Less than 10.
31:53Some patients are not going to last that long.
31:54And I'm sure there are other Oneg donors that probably work here.
31:58It would take hours to screen for HIV and hepatitis.
32:00I have neither, and I donate all the time.
32:04Please.
32:06Fuck it.
32:07If the patient's going to die before they get to the OR, then the benefits outweigh the risks.
32:10My man.
32:11All right, kid.
32:12Roll up your sleeve.
32:12I'll meet you in 7.
32:13Listen up.
32:15Central 789 is now the blood donor center.
32:18Anyone who's Oneg or Opaz, we need you to donate now.
32:21Hands where I can see them.
32:24Okay.
32:25Let's do this.
32:30You two work here, right?
32:32Yes.
32:32Can you tell me how my mom is?
32:34Her name's Patricia Gregory.
32:35Or Trish.
32:36She was shot in her arm.
32:38We're here to help.
32:40One second.
32:40Bear with us.
32:48Hello.
32:49Can I have your attention, please?
32:50My name is Kiara Alfaro.
32:52I'm an emergency department social worker.
32:55This is Lupe Perez, one of our ward clerks.
32:58I know you all want information about your friends and family.
33:01In order to help you, we have a QR code you can scan for our patient identification website.
33:07Cell phones are down, but you can log on to the hospital guest Wi-Fi.
33:12That information is on these papers.
33:14We'll distribute around the room.
33:15Once you log on, send us the name and birth date of whomever you're concerned about.
33:21If you could tell us what they were wearing, upload photos, pictures of tattoos, piercings,
33:26anything to help identify them would be useful.
33:28If we get a match, we'll let you know.
33:30We're setting up phone chargers, water, snacks, and if anyone needs to change clothes,
33:35we've got paper scrubs coming.
33:36Give us some time.
33:38We're doing everything we can to help get you the information you need.
33:52Okay, I'm done.
33:54Give me the cover.
33:56Come on, come on, come on.
33:58There you go.
33:59There you go.
34:00Next!
34:02How's she doing?
34:03Yeah, 500 of saline in.
34:05She's barely with us, no.
34:06Okay, well, this unit of whole blood should help.
34:10Yeah, see if you can find a pressure bag.
34:12No, no.
34:13Much faster if I just squeeze it in myself.
34:21You need some help with an airway?
34:25What is it?
34:27GSL beats the neck with expanding hematoma and distorted anatomy.
34:30Can't intubate him, probably hit the carotid.
34:32Okay, I'll do the airway.
34:34Give me a 6.5 and, uh, bougie, I got the bleeder.
34:38Foley catheter with a 30cc balloon.
34:40Are you doing anything?
34:41Oh, an egg.
34:42Yeah.
34:47It's too bloody to see a bougie.
34:48Enough of this.
34:49Three-step process.
34:50Step one, scalpel.
34:52Step two, finger.
34:53Step three, bougie.
34:59Okay, railroad in the tube.
35:04Good, that's far enough.
35:06Okay, bag him.
35:08Dressing off.
35:11Pulleys in.
35:11Blow, blow, blow.
35:15Three cc's in.
35:17Clamping.
35:19Look at that.
35:22Brian's a bone.
35:24Room for another red.
35:25Dr. Walsh, you have an OR for a head and neck case.
35:28MCI 48.
35:29We've got 16 ORs up and running.
35:31We've got room for one more.
35:32Liverlock came back after a second unit.
35:34Needs an X lab.
35:35Turning over two ORs now.
35:36Send them up.
35:38Where the hell did Meldo?
35:39I don't know, but she needs to get back to yellow.
35:42That's two grams of ANSF.
35:43Great.
35:46That's a girl.
35:47Adjusting.
35:48That looks good.
35:49The bleeding stopped.
35:50Can you wiggle your fingers?
35:53Ma'am.
35:54Ma'am, can you move your fingers for me?
35:57Okay, does it feel the same on both sides?
36:00Great.
36:00How's the pain?
36:06Well, the bullet probably went through the two forearm bones,
36:09but there's no damage to the nerves or arteries,
36:12so that's a good sign.
36:17You're going to be okay.
36:21I'll find you some tissues.
36:27Robert, let's arrive.
36:29All right on.
36:31Eviscerated bowel.
36:32Fresh ABD and saline.
36:34Get back for a sec.
36:373.375 Zosin in a sterile dressing.
36:39I can't believe I'm saying this.
36:40Another Christmas tree in Foley bag.
36:42How did we run out of chest tubes?
36:46Less than 500 cc's at surgical ICU.
36:48You can take him.
36:4850 tubes in the chest.
36:49They're going to wonder what the hell we're doing down here,
36:50but it was a great save.
36:51Hey, Jabadi, I need you to find Whitaker.
36:53Go up to the hill pad.
36:54We've got blood flying in.
36:55Okay.
36:55Stay behind the yellow line between 10 o'clock and 2 o'clock
36:57so the pilot can see you the whole time.
36:59Okay.
36:59You got this?
37:00Moving them up as fast as we can.
37:03More chest tubes.
37:04Got to see a press bee.
37:05Awesome.
37:05I'm going to go check out triage.
37:07Copy that.
37:10They finally shoot her yet?
37:11Not yet, but we'll find him.
37:12Half the county's looking.
37:14What about with her?
37:14Waiting for the FBI to get here.
37:16Did they find her son?
37:17No, but they pinged his cell phone to the area to shoot him.
37:19Does she know that?
37:20She's about to find out.
37:22What's with all these bloody handprints?
37:24That's when people were trying to stop us to get a ride in,
37:26but we were already packed.
37:27Chest, belly, arm, and leg.
37:29Red, pink, yellow, and a lucky green.
37:30Two gargings, a little tear.
37:34Okay, I got it.
37:34I got it.
37:35The partner's in bad shape.
37:36What's his name?
37:37Rich.
37:37Where's Stefano?
37:38Hey, Rich.
37:38How you doing?
37:40Oh, shh.
37:41You got...
37:42You got a sound in the face?
37:43No, I'm just on the other side.
37:44Neck.
37:45Above his vest.
37:46Cheek his exit wound.
37:47Okay.
37:47Come on, red zone.
37:48He needs an airway.
37:49Come with me.
37:50Come with me.
37:51I got you.
37:52We'll get you fixed it.
37:56Take him.
37:59Hey, what's up with the SWAT team?
38:01This is a precaution in case the shooter heads this way.
38:04Is that a possibility?
38:05There was some chatter.
38:07Are we going to be safe out here?
38:09Should be now.
38:10Focus on the patients.
38:10Focus on the patients.
38:12The only way out is through.
38:14Any idea how many more come?
38:16Incident command is sending all these ambulances back to the seat for more victims.
38:19We may not even be halfway through yet.
38:22Jesus.
38:23When is this going to end?
38:24Is this going to end?
38:24O que é isso?
38:58O que é isso?
39:29O que é isso?
39:54O que é isso?
39:59O que é isso?
40:00O que é isso?
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