critical (uk) 1x13 - episode 13

7/18/2019 Critical (UK) 1x13 - Episode 13

http://slidepdf.com/reader/full/critical-uk-1x13-episode-13 1/41

100:00:04,500 --> 00:00:06,900You're more important to methan the army is.

200:00:07,020 --> 00:00:08,300That's why I'm staying.

300:00:12,580 --> 00:00:15,340You're absolutely sure?No nagging doubts?

400:00:15,460 --> 00:00:16,380No, it's time.

500:00:18,220 --> 00:00:19,180Call me.

600:00:19,340 --> 00:00:20,820

Why don't you give mea call some time?

700:00:20,940 --> 00:00:22,340I am SO calling you, babes.

800:00:22,460 --> 00:00:23,380THEY LAUGH

900:00:24,660 --> 00:00:25,700

When's the big day?

1000:00:26,780 --> 00:00:28,820I asked him not to say anything.

1100:00:29,900 --> 00:00:30,940Congratulations.

1200:00:43,140 --> 00:00:44,780OK, if you'll just let me explain.

1300:00:44,900 --> 00:00:46,380Doesn't matter.

1400:00:46,540 --> 00:00:50,100Glen, it's important to me that youunderstand the reason why...



1500:00:50,220 --> 00:00:51,660Really. What?

1600:00:54,660 --> 00:00:55,740Glen.

1700:00:55,860 --> 00:00:57,260You and Tom have a nice life.

1800:01:21,220 --> 00:01:22,380Glen?

1900:01:27,300 --> 00:01:29,380TYRES SCREECH

2000:01:33,020 --> 00:01:33,980Shit.

2100:01:58,700 --> 00:02:00,020COMPUTER: 'Glen Boyle.

2200:02:00,140 --> 00:02:01,380'Calling.'

2300:02:01,500 --> 00:02:02,860Come on, come on.

24

00:02:07,020 --> 00:02:08,340PHONE RINGS

2500:02:10,180 --> 00:02:12,580'Hello this is Glen Boyle,I can't take your call.'

2600:02:12,700 --> 00:02:13,980'Glen Boyle.

27

00:02:14,100 --> 00:02:15,260'Calling.'

2800:02:15,380 --> 00:02:17,140PHONE RINGS

2900:02:20,660 --> 00:02:23,700Glen? The last thing



I wanted was to hurt you.

3000:02:25,460 --> 00:02:28,740You needed help and I came running.

3100:02:28,900 --> 00:02:32,260You knew exactly what would happen,and you just didn't give a shit.

3200:02:32,420 --> 00:02:36,140Did you? I called you in a momentof weakness because I needed you.

3300:02:37,340 --> 00:02:41,660I convinced myself, almostcertainly, you wouldn't come.

3400:02:41,780 --> 00:02:42,740But I...

3500:02:42,900 --> 00:02:44,580I'm sorry, I can't hear you -you broke up.

3600:02:44,700 --> 00:02:46,180I said, but I did.

3700:02:46,300 --> 00:02:47,660Yes, you did.

3800:02:47,780 --> 00:02:49,300Two years too late.

3900:02:49,460 --> 00:02:52,500Oh, come on.I lost our baby, Glen.

4000:02:53,620 --> 00:02:55,260I was on my knees.

4100:02:55,420 --> 00:02:57,340That's when I needed you.You wanted me to go...

4200:02:57,460 --> 00:02:59,460I didn't. I... You ran.



4300:02:59,580 --> 00:03:01,180Just like you're running now.

4400:03:02,820 --> 00:03:04,260Where are you even going?

4500:03:10,780 --> 00:03:12,940I don't actually know.

4600:03:14,660 --> 00:03:15,780Turn around.

4700:03:17,460 --> 00:03:18,420Let's talk.

4800:03:23,900 --> 00:03:25,780No, you've made your choice.

4900:03:25,900 --> 00:03:28,060What the hell is there to talk about?

5000:03:28,180 --> 00:03:29,580'Call ended.'

5100:03:37,780 --> 00:03:39,420PHONE RINGS

52

00:03:50,380 --> 00:03:51,340I'm sorry, OK.

5300:03:55,260 --> 00:03:56,820I am.

5400:03:56,940 --> 00:03:58,420Tom asked me out of the blue.

5500:03:58,540 --> 00:04:00,260

He's a good... he's...

5600:04:00,380 --> 00:04:01,820CALL FAILS

5700:04:01,940 --> 00:04:02,860Shit.



5800:04:02,980 --> 00:04:03,940Shit. 'Call ended.'

5900:04:04,060 --> 00:04:05,860Come on.

6000:04:05,980 --> 00:04:07,620PHONE RINGS

6100:04:13,260 --> 00:04:14,220Glen?

6200:04:14,340 --> 00:04:16,460Can you hear me? Yes.

6300:04:16,580 --> 00:04:18,140What about Tom?

6400:04:18,260 --> 00:04:19,180He loves me.

6500:04:21,540 --> 00:04:22,500I love you.

6600:04:24,620 --> 00:04:26,180You know, I came back for you.

67

00:04:28,540 --> 00:04:29,780Put myself on the line.

6800:04:31,740 --> 00:04:32,700For you.

6900:04:34,260 --> 00:04:35,900And now you're leaving again.

7000:04:40,820 --> 00:04:42,820

You've made your choice, so...

7100:04:42,940 --> 00:04:44,260I don't want you to leave.

7200:04:47,140 --> 00:04:48,860I don't want you to leave again.



7300:04:51,020 --> 00:04:52,900Glen?

7400:04:53,020 --> 00:04:55,020What DO you want, Fiona?

7500:04:55,140 --> 00:04:58,860Tell me, right now, what do you want?

7600:04:58,980 --> 00:05:00,140I don't know!

7700:05:00,260 --> 00:05:01,820Hello? Shit.

7800:05:03,620 --> 00:05:04,660Glen?

7900:05:04,820 --> 00:05:07,260ELECTRONIC VOICE: Glen Boyle.Calling.

8000:05:07,380 --> 00:05:09,260RINGTONE

8100:05:12,540 --> 00:05:13,620Hello?

8200:05:17,780 --> 00:05:19,380Hello? Hello, Glen?

8300:05:24,780 --> 00:05:27,020Glen!

8400:05:27,140 --> 00:05:28,260Glen!

85

00:05:36,940 --> 00:05:38,340CAR ALARM BLARES

8600:05:55,340 --> 00:05:56,740Glen!

8700:05:56,860 --> 00:05:58,300Glen!



8800:06:00,500 --> 00:06:05,540Glen! Can you hear me? Talk to me.

8900:06:05,660 --> 00:06:06,980I'm fine.

9000:06:14,100 --> 00:06:18,820'Ambulance Service.' My name's FionaLomas, I'm a trauma fellow at CGH.

9100:06:18,980 --> 00:06:23,060First on scene at an RTC,two vehicles involved.

9200:06:23,220 --> 00:06:25,500'What is your location?'Sorry?

9300:06:25,660 --> 00:06:27,900'Your location, madam.'Of course, bear with me.

9400:06:28,020 --> 00:06:31,260We're on the B9144

9500:06:31,380 --> 00:06:33,980at the crossroads of the A782.

9600:06:34,140 --> 00:06:37,060Stand by for furtherinformation on casualties.

9700:06:37,180 --> 00:06:38,860Glen, tell me how you're feeling?

9800:06:39,020 --> 00:06:42,780I don't know. I'll be OK.You go and check on the other car.

9900:06:42,940 --> 00:06:45,260Go! Check on the other car,I'll be...

10000:06:45,420 --> 00:06:50,180First casualty,GCS 15, no apparent trauma.



10100:06:50,300 --> 00:06:51,740Two further casualties...

10200:06:51,900 --> 00:06:55,700Sir, can you hear me?Can you tell me your name?

10300:06:55,820 --> 00:06:58,940Apparent major trauma P1/P2.

10400:06:59,100 --> 00:07:01,900I can't give you any furtherinformation now, I'm sorry.

10500:07:02,020 --> 00:07:03,900I need to attend to the patients.

106

00:07:04,020 --> 00:07:06,980Sir, my name is Fiona Lomas,

10700:07:07,140 --> 00:07:10,620I'm a trauma doctorat City General Hospital.

10800:07:10,780 --> 00:07:13,540Can you hear me?Can you tell me your name?

10900:07:15,900 --> 00:07:18,900Sir, can you hear me? Can you openyour eyes for me, sir?

11000:07:25,300 --> 00:07:27,380Glen? Yes. What have we got?

11100:07:27,500 --> 00:07:28,820Weak pulse, crushed chest.

11200:07:28,940 --> 00:07:31,060OK, tubes? Yes.

11300:07:33,300 --> 00:07:35,540Don't turn your headand try not to move.

114



00:07:35,700 --> 00:07:37,780My name is Glen,I'm a trauma surgeon.

11500:07:37,900 --> 00:07:39,460Can you tell me your name, please?

11600:07:39,620 --> 00:07:42,300Rory. OK, Rory, I'm goingto examine you.

11700:07:42,460 --> 00:07:45,220OK, I'm just going toget this door open.

11800:07:45,340 --> 00:07:47,500Shit! It's jammed.

11900:07:49,340 --> 00:07:52,500

Chest...OK.

12000:07:52,660 --> 00:07:56,060Rory, I just need tofeel your abdomen, OK?

12100:08:07,220 --> 00:08:08,500Shit. His legs are crushed.

12200:08:08,660 --> 00:08:11,380

Clinically, there's a tensionpneumothorax. OK.

12300:08:13,340 --> 00:08:15,900Output's gone!We're losing this one!

12400:08:32,452 --> 00:08:34,812Releasing tension pneumothorax.

125

00:08:34,932 --> 00:08:36,412Pulse?

12600:08:37,812 --> 00:08:38,972Nothing.

12700:08:45,692 --> 00:08:47,452OK, let's get him out.



12800:08:49,212 --> 00:08:51,772Help him!You OK to lift him?

12900:08:51,932 --> 00:08:54,252I'm OK.

13000:08:54,412 --> 00:08:58,812Forward, you got it? Yep.A little more. Got him. OK.

13100:09:00,492 --> 00:09:01,892Take his feet.

13200:09:06,932 --> 00:09:09,012OK. Take his head. OK. Got it.

133

00:09:12,492 --> 00:09:13,532OK.

13400:09:21,412 --> 00:09:23,612We'll start with bilateralthoracostomies.

13500:09:26,892 --> 00:09:28,892Cut his top off, please.

136

00:09:42,572 --> 00:09:43,532Light, please.

13700:09:52,532 --> 00:09:53,572Scissors, please.

13800:09:56,532 --> 00:09:57,492Thank you.

13900:10:06,052 --> 00:10:08,052

Any haemothorax?

14000:10:08,212 --> 00:10:10,252Nothing.It's still on the other side.

14100:10:14,612 --> 00:10:16,532What's going on?



14200:10:16,692 --> 00:10:19,452Help is on the way, Rory,just try and stay calm.

14300:10:22,132 --> 00:10:23,452Anything?

14400:10:23,612 --> 00:10:26,492Nothing this side either.OK, I've got to open him up.

14500:10:32,692 --> 00:10:34,292Not exactly sterile.

14600:10:34,412 --> 00:10:36,292Welcome to operating in the field.

147

00:10:37,852 --> 00:10:39,932SIRENS BLARE IN DISTANCENice timing.

14800:11:04,172 --> 00:11:06,452Left anterolateral thoracotomynearly done.

14900:11:22,532 --> 00:11:23,892OK, I need your help here. OK.

15000:11:29,212 --> 00:11:30,372Examining the heart.

15100:11:31,532 --> 00:11:34,972BOTH: Tamponade.Got to open the pericardium.

15200:11:35,092 --> 00:11:37,132Over here! Yes, ma'am!

15300:11:38,652 --> 00:11:39,692What can I do for you?

15400:11:39,812 --> 00:11:41,932We're trauma surgeons from CGH.

15500:11:42,132 --> 00:11:46,172



I need you to hold up this lighthigh so we can see inside his chest.

15600:11:46,292 --> 00:11:47,292Oh, my God.

15700:11:47,452 --> 00:11:51,332He's got pressure round his heartthat's stopping it from pumping.

15800:11:51,452 --> 00:11:52,612What's going on?

15900:11:52,772 --> 00:11:54,612Your friend's got fluidsqueezing his heart

16000:11:54,772 --> 00:11:57,692and we need to release it

so we can get his heart going again.

16100:11:57,812 --> 00:12:00,492It's going to be all right, Rory.

16200:12:00,612 --> 00:12:02,372I'm getting some contractions.

16300:12:04,452 --> 00:12:06,412OK, that's his heart beating again.

16400:12:06,532 --> 00:12:08,012What output are we getting?

16500:12:10,732 --> 00:12:12,092Carotid pulse.

16600:12:12,252 --> 00:12:15,332It isn't enough to givea radial pulse. BVM. In my bag.

16700:12:28,372 --> 00:12:29,532Evacuating the clot.

16800:12:31,572 --> 00:12:33,572This guy needs to be in theatre. Now.

169



00:12:36,732 --> 00:12:40,212I'm managing his airway. I need youto get him some oxygen. Yeah.

17000:12:40,372 --> 00:12:42,732There's a passenger stilltrapped inside the vehicle.

17100:12:42,892 --> 00:12:46,292We'll work round you guys -keep talking. Thank you.

17200:12:46,452 --> 00:12:48,612I need to RSI.What do you need?

17300:12:48,732 --> 00:12:50,932OK, can you continue bagging?

174

00:12:51,052 --> 00:12:53,732Thio, sux, and a size eight tube.

17500:12:53,852 --> 00:12:55,332In the blue bag, just there.

17600:12:57,412 --> 00:13:00,332We're going to work on getting youout of there, mate.

177

00:13:10,612 --> 00:13:13,212All right, what'syour name, please? Rory.

17800:13:13,372 --> 00:13:16,092All right, Rory, I need you to holdstill for me, OK?

17900:13:23,732 --> 00:13:24,892Can I just get in here?

18000:13:26,932 --> 00:13:31,172All right, Rory, just keep breathingdeeply and I'll be back in a fewseconds, OK? Just keep that on.

18100:13:35,812 --> 00:13:37,932OK, cricoid on.



18200:13:38,052 --> 00:13:40,892250 milligrams thio going in now.

18300:13:46,572 --> 00:13:48,292Intubating now.

18400:13:51,612 --> 00:13:52,812Tube in.

18500:14:01,172 --> 00:14:02,132Cuff up.

18600:14:04,852 --> 00:14:05,892OK.

18700:14:10,932 --> 00:14:12,052Breath.

18800:14:15,812 --> 00:14:16,772Breath.

18900:14:18,012 --> 00:14:20,652OK, it's inflating now.Cricoid off.

19000:14:22,412 --> 00:14:23,372Cardiac output?

19100:14:27,132 --> 00:14:28,452OK, it's 120, but it's weak.

19200:14:28,612 --> 00:14:30,692OK, it's about as stableas he's going to get.

19300:14:30,852 --> 00:14:33,092I agree. Cas-evac?We've got scoops and blocks.

19400:14:33,212 --> 00:14:34,532Let's get it done, please.

19500:14:38,892 --> 00:14:40,332Anything we can do?

196



00:14:40,452 --> 00:14:42,372Is David all right?

19700:14:42,532 --> 00:14:45,092Someone take overthe transfer for me, please.

19800:14:45,212 --> 00:14:47,012OK, I need you to hold his head.

19900:14:47,172 --> 00:14:51,172Rory, he's in a bad way but we'redoing the very best we can for him.

20000:14:51,332 --> 00:14:53,372OK, he needs to be inan operating theatre ASAP.

20100:14:53,492 --> 00:14:54,972

Call that in, please.

20200:14:55,132 --> 00:14:57,612Do you know David's surname?Hanson.

20300:14:57,772 --> 00:15:01,612And by any chance would you knowhis date of birth? 6th April, 1981.

204

00:15:01,732 --> 00:15:04,012OK. Are we ready to go?

20500:15:04,172 --> 00:15:07,252I want to say goodbye to him! Yourmate needs to be in a hospital, Rory.

20600:15:07,372 --> 00:15:10,092He's not my mate. He's my boyfriend.

207

00:15:11,172 --> 00:15:12,452OK.

20800:15:14,772 --> 00:15:18,052Let's get the trolley roundto the other side, please, now.

20900:15:19,412 --> 00:15:22,412



Quick as we can. OK.

21000:15:22,532 --> 00:15:23,972He's on his way.

21100:15:28,012 --> 00:15:29,572Can I touch his hand?

21200:15:45,452 --> 00:15:46,412I love you.

21300:15:51,772 --> 00:15:54,772It's OK. It's OK.

21400:15:56,292 --> 00:15:59,372I'm sorry, we need to get himto the hospital now.

215

00:15:59,492 --> 00:16:01,412Let's go. Thank you.

21600:16:06,932 --> 00:16:08,932You should go with him. Glen...

21700:16:09,052 --> 00:16:10,972He needs a surgeon with him.

21800:16:11,132 --> 00:16:14,092

I'll see youwhen you bring that one in, yes?

21900:16:16,812 --> 00:16:21,172This is Fiona Lomas, I'mone of the surgical registrars.

22000:16:21,332 --> 00:16:23,972Please can you connect me tothe Alert Phone?

22100:16:26,852 --> 00:16:30,172Nicola, it's Fiona.

22200:16:30,332 --> 00:16:33,572Glen and I are firston scene at an RTC.

223



00:16:33,732 --> 00:16:38,292We've two patients coming your way.First, male, 30s, driver,

22400:16:38,412 --> 00:16:39,652blunt chest trauma.

22500:16:40,812 --> 00:16:45,292Yes. His name is David Hanson,date of birth, 6th...

22600:17:20,952 --> 00:17:23,232On three. One, two, three, and lift.

22700:17:47,992 --> 00:17:49,832Vehicle's made safeif you want to go in.

22800:17:49,952 --> 00:17:51,592

Thank you very much.

22900:17:51,752 --> 00:17:54,192Can you get controlof the C-spine please? Sure.

23000:17:57,512 --> 00:17:59,112Let's get him flat, please.

23100:18:01,792 --> 00:18:03,392

Gently, slowly.

23200:18:07,112 --> 00:18:09,712All right, Rory, we're just going tocheck your blood pressure

23300:18:09,832 --> 00:18:11,792and your oxygen levels, all right?

23400:18:11,912 --> 00:18:13,512

Put this on your finger.

23500:18:16,152 --> 00:18:19,112Abdomen is tense and full.

23600:18:36,432 --> 00:18:39,432BP 60 over 35.



23700:18:39,552 --> 00:18:40,952Christ.

23800:18:45,272 --> 00:18:46,632All right, Billy?

23900:18:46,752 --> 00:18:49,672Er, I was just passing.

24000:19:02,312 --> 00:19:05,832You've been listening in ona police channel, haven't you? No.

24100:19:05,952 --> 00:19:08,232No. Either way - glad you're here.

24200:19:13,992 --> 00:19:16,392Mr Boyle. Yeah?

24300:19:16,512 --> 00:19:17,992I might be of some help here.

24400:19:20,112 --> 00:19:23,152You might have someketamine in your grab-bag.

24500:19:24,392 --> 00:19:28,672I couldn't possibly have it.

I'm just an ODP.

24600:19:31,552 --> 00:19:33,992Billy, could you possibly see

24700:19:34,152 --> 00:19:36,512if you can find someketamine in my grab-bag, please?

24800:19:36,632 --> 00:19:38,232

I'll have a look, Mr Boyle.

24900:19:59,472 --> 00:20:02,992There's your ketamine, Mr Boyle. OK.

25000:20:03,152 --> 00:20:05,952I'm just giving you something tomake you comfortable, OK?



25100:20:06,112 --> 00:20:09,272Can you tell me what your surname isand your date of birth, please?

25200:20:09,392 --> 00:20:10,832Billy, can you get this down?

25300:20:10,952 --> 00:20:15,232Roberts. 19th January 1983.

25400:20:15,352 --> 00:20:16,672Thank you.

25500:20:19,272 --> 00:20:20,95220mg ketamine in.

25600:20:23,792 --> 00:20:26,672

OK, guys, let's make some space.Get his legs free.

25700:20:26,792 --> 00:20:29,272ENGINE SPLUTTERS

25800:20:29,392 --> 00:20:32,392ENGINE WHIRS

25900:20:32,552 --> 00:20:35,232

Bit of noise, you'll be all right.Yeah...

26000:20:39,592 --> 00:20:41,712METAL GROANS

26100:20:41,872 --> 00:20:43,832HE SCREAMSAll right, it's all right.

262

00:20:43,992 --> 00:20:47,152STOP! Let me get in. You're doingreally well. You OK?

26300:20:47,272 --> 00:20:48,192That's it.

26400:20:49,672 --> 00:20:51,952



Just going to get your leg out.HE WHIMPERS

26500:20:56,592 --> 00:20:59,552You're doing really well,really well. Thank you.

26600:20:59,712 --> 00:21:02,792Billy, can we release the tourniquetnice and slowly, please? Yeah.

26700:21:06,832 --> 00:21:08,032Thank you.

26800:21:10,192 --> 00:21:13,192Yep, OK, this is doing the job.

26900:21:13,352 --> 00:21:16,272Let's go again, let's get this

other leg out please. Carry on!

27000:21:16,392 --> 00:21:17,632ENGINE SPLUTTERS,

27100:21:17,752 --> 00:21:19,752METAL CREAKS AND GROANS

27200:21:19,872 --> 00:21:21,632HE WHIMPERS

27300:21:23,672 --> 00:21:25,912HYDRAULICS WHIR

27400:21:26,032 --> 00:21:27,392Cut it!

27500:21:28,792 --> 00:21:31,872Let me see, please.No, you need to keep going.

27600:21:32,032 --> 00:21:34,632We can't get any more clearance.The leg is stuck.

27700:21:34,752 --> 00:21:36,232OK. You're doing really well, mate.



27800:21:37,312 --> 00:21:38,952Let's have another BP please.

27900:21:39,072 --> 00:21:41,152Yeah.

28000:21:41,312 --> 00:21:44,072So, Rory, I'm just going to haveto feel your belly again.

28100:21:44,232 --> 00:21:47,112Nah, it's 50 over unreadable.It's dropping.

28200:21:47,232 --> 00:21:49,112INSTRUMENTS BEEP RAPIDLY

28300:21:51,152 --> 00:21:54,352

It's looking like there's only oneway to get him out of there in time.

28400:21:54,512 --> 00:21:56,432Unless you've got somethingyou can come up with

28500:21:56,592 --> 00:21:59,232in the next five minutesthat will release that leg?

28600:21:59,352 --> 00:22:01,232Not in five minutes. I'm sorry.

28700:22:05,512 --> 00:22:08,112Hey, Rory, can you hear me?HE GASPS

28800:22:08,232 --> 00:22:09,752Rory?

28900:22:09,872 --> 00:22:11,712Listen, your right leg's trapped.

29000:22:11,872 --> 00:22:15,272And I'm very concerned that you mighthave a massive bleed in your belly.

291



00:22:15,392 --> 00:22:16,952I'm going to be honest with you.

29200:22:17,152 --> 00:22:20,312If I don't get you toa hospital within the next hour,you're going to die.

29300:22:21,392 --> 00:22:22,592Do you understand me?

29400:22:23,872 --> 00:22:27,272I'm sorry, but that's whyI have to amputate your leg.

29500:22:27,432 --> 00:22:31,072Now, you listen to me.I've done this before.

296

00:22:31,232 --> 00:22:33,472So, I know that I can saveyour knee joint.

29700:22:33,632 --> 00:22:35,592And that means that witha simple prosthetic,

29800:22:35,752 --> 00:22:39,352you will be able to walk again,and you'll even be able to run.

29900:22:39,512 --> 00:22:42,512OK? We're going to pump youfull of some painkillers.

30000:22:42,672 --> 00:22:44,992..Any more of that ketamine left?Yes, you do.

30100:22:45,112 --> 00:22:46,632

OK.

30200:22:46,792 --> 00:22:49,352Make it up to a total of 120.Coming up.

30300:22:49,472 --> 00:22:50,592OK.



30400:22:50,752 --> 00:22:54,192I'm going to need glovesand antiseptic from your truck.

30500:22:54,352 --> 00:22:56,832I've got blast dressings,but I need you to get me

30600:22:56,992 --> 00:22:59,592a couple of blanketsand some bandages, please. Yep.

30700:22:59,712 --> 00:23:01,992There you go. Thank you.

30800:23:02,152 --> 00:23:04,392Listen, you wouldn't happento have sux and a tube,

30900:23:04,512 --> 00:23:05,752would you? We've used mine.

31000:23:08,352 --> 00:23:10,312I've got roc. In your bag.

31100:23:11,992 --> 00:23:13,672OK. And are you up to tubing him,

31200:23:13,792 --> 00:23:15,632under my supervision, obviously?

31300:23:17,232 --> 00:23:19,232Er, yeah.

31400:23:19,352 --> 00:23:21,552Good man. All right.

315

00:23:21,672 --> 00:23:23,632Let's get that head rest off, please.

31600:23:25,832 --> 00:23:27,032Come down here.

31700:23:28,992 --> 00:23:30,632Have you got him? Yep.



31800:23:30,752 --> 00:23:32,792There's your roc. Thank you.

31900:23:36,392 --> 00:23:38,232HE EXHALES

32000:23:41,112 --> 00:23:44,512There's a tube, Thomas.

32100:23:48,872 --> 00:23:50,832Cricoid on, please.

32200:23:50,952 --> 00:23:51,912Let me get the mask.

32300:23:54,672 --> 00:23:56,112Cricoid on.

32400:23:57,912 --> 00:24:01,71280mg roc going in now.

32500:24:01,872 --> 00:24:04,592HE EXHALESHere we go.

32600:24:04,712 --> 00:24:06,672Bring him this way a little bit.

32700:24:06,832 --> 00:24:08,872HE EXHALESHere we go.

32800:24:18,752 --> 00:24:19,872Tube.

32900:24:30,632 --> 00:24:32,032Cuff up.

33000:24:32,152 --> 00:24:33,232OK. I'll do it.

33100:24:35,632 --> 00:24:36,792Bag.

332



00:24:37,832 --> 00:24:39,112Ta.

33300:24:39,232 --> 00:24:41,032Here we go.

33400:24:44,432 --> 00:24:46,152Breath.HISSING

33500:24:46,312 --> 00:24:49,512Breath.HISSING

33600:24:49,632 --> 00:24:51,512Both lungs ventilated!

33700:24:52,792 --> 00:24:54,872Cricoid off, please.

HE PANTS

33800:24:54,992 --> 00:24:56,792Well done, Billy.

33900:24:56,952 --> 00:24:59,672Ta. Let's get that brace on here.Brace.

34000:25:06,312 --> 00:25:08,432

FABRIC RIPS

34100:25:17,712 --> 00:25:20,432I don't have enough roomhere for a saw.

34200:25:20,552 --> 00:25:21,872Do you have bolt-cutters?

34300:25:21,992 --> 00:25:23,872

Bolt croppers?

34400:25:24,032 --> 00:25:25,872OK, listen.This is going to need to be fast.

34500:25:26,032 --> 00:25:28,032Billy, I need you to move



this tourniquet down

34600:25:28,192 --> 00:25:30,472to just above his kneeand then pull it tight, please.

34700:25:30,632 --> 00:25:33,352And I mean tight as a drum. Yes?Yeah.

34800:25:33,472 --> 00:25:34,432Sorry.

34900:25:38,432 --> 00:25:40,512Tell me when.

35000:25:40,632 --> 00:25:41,912Yeah, got it.

35100:25:42,032 --> 00:25:43,992Fresh blade in there, please. Yeah.

35200:25:49,992 --> 00:25:51,712There you go.

35300:25:53,232 --> 00:25:55,032We good? Yeah.

354

00:25:55,152 --> 00:25:56,392Cutting.

35500:26:09,192 --> 00:26:10,152Coming around.

35600:26:28,592 --> 00:26:31,352Do you have any more ofthat antiseptic, Billy? Yeah.

357

00:26:31,472 --> 00:26:33,832Throw it on there. Yep.

35800:26:33,952 --> 00:26:36,072And here. Yep.

35900:26:38,952 --> 00:26:40,472OK.



36000:26:45,032 --> 00:26:46,832I'm going to snap the tibia.

36100:26:53,232 --> 00:26:54,352CRACK!

36200:26:55,872 --> 00:26:57,632Still with me, Billy?

36300:26:57,832 --> 00:27:01,272Put it this way, I won't be havingbarbecue ribs for a while...GLEN CHUCKLES

36400:27:01,392 --> 00:27:02,792Now the fibula.

365

00:27:09,472 --> 00:27:10,432CRACK!

36600:27:11,712 --> 00:27:13,432Here. Get me the blade.

36700:27:15,712 --> 00:27:17,712I'm not going to spendany time prettifying it

368

00:27:17,832 --> 00:27:19,552until we get him in hospital.

36900:27:19,712 --> 00:27:23,112I'm just going to wrap the stump.Billy - antiseptic. Yep.

37000:27:25,432 --> 00:27:26,992And the blast dressing. Yep.

371

00:27:30,392 --> 00:27:33,032Got it. Thank you.

37200:27:38,552 --> 00:27:42,472Billy? Yeah. Call CGH, tell them thatwe're going to be on our way. Yeah.

37300:27:47,432 --> 00:27:50,992



Ah, Mrs Hicklin, yeah, it's BillyFinlay, at the scene with Glen.

37400:27:51,112 --> 00:27:52,992'What?' Don't ask.

37500:27:53,152 --> 00:27:56,472We've extracted the second casualtyvia a BK amputation.

37600:27:56,632 --> 00:27:59,672Rory Roberts. Date of birth,19th of the first, 1983.

37700:27:59,832 --> 00:28:02,392Suspected severe intra-abdominalhaemorrhage.

37800:28:02,552 --> 00:28:06,192

Suspected severeintra-abdominal haemorrhage.

37900:28:06,352 --> 00:28:09,232Thanks. Nicola says she'll havea theatre ready for him.

38000:28:09,352 --> 00:28:10,632OK, this is a scoop-and-run.

381

00:28:10,792 --> 00:28:13,072He needs to be opened up in theatre.Can we go, please?

38200:28:13,232 --> 00:28:15,752Can I get a trolley, please?Tell me when we're ready, please.

38300:28:15,872 --> 00:28:17,432Get the board ready!

38400:28:28,912 --> 00:28:30,672WHIRRING

38500:28:30,792 --> 00:28:34,192On three. One, two, three.

38600:28:39,112 --> 00:28:42,672



This time, all the way tothe trolley. We ready?

38700:28:42,792 --> 00:28:45,032Then on three. One, two, three.

38800:28:55,912 --> 00:28:57,552OK, let's get him in.

38900:28:59,872 --> 00:29:01,792Thank you, the other side.

39000:29:09,272 --> 00:29:10,592Quick as we can, please.

39100:29:14,712 --> 00:29:16,272OK, that's us. Thank you.

392

00:29:16,432 --> 00:29:18,752Good work. Cheers.Thanks a lot, guys, let's go.

39300:29:18,872 --> 00:29:20,632Well done, everyone.

39400:29:20,752 --> 00:29:22,672OK, have you got everything?

395

00:29:30,912 --> 00:29:31,872Mind out.

39600:29:33,512 --> 00:29:35,032In.

39700:29:36,512 --> 00:29:38,552I'll take over, mate. Thank you. Ta.

39800:29:40,112 --> 00:29:42,192

Need to give another 30 bolusfor ket.

39900:29:43,432 --> 00:29:45,312There you go. Thank you.

40000:29:49,512 --> 00:29:51,072DOOR SLAMS SHUT



40100:29:54,952 --> 00:29:56,512It's done. Ta.

40200:30:03,312 --> 00:30:07,112You, er... You written offyour motor, then? I have yeah.

40300:30:08,632 --> 00:30:10,192Want to buy a Fiesta?

40400:30:15,072 --> 00:30:16,072Here.

40500:30:16,192 --> 00:30:18,032What? Give me the keys.

40600:30:19,712 --> 00:30:21,912

Amazing! Is a grand all right?

40700:30:23,192 --> 00:30:25,672Send me the logbook,I'll send you the cash.

40800:30:25,792 --> 00:30:27,472Can you hold that door, please?

40900:30:29,632 --> 00:30:34,272

You did really well tonight, Billy.It's been great working with you.

41000:30:34,392 --> 00:30:35,512Thanks.

41100:30:39,192 --> 00:30:40,792I'll see you back at CGH?

41200:30:42,272 --> 00:30:44,032

Go. Glen!

41300:30:44,152 --> 00:30:45,272DOOR SLAMS

41400:30:47,712 --> 00:30:49,792ENGINE STARTS



41500:30:55,432 --> 00:30:58,152SIREN WAILS

41600:31:05,832 --> 00:31:08,032SIREN FADES

41700:31:23,772 --> 00:31:25,052Ms Lomas? >

41800:31:25,172 --> 00:31:26,452Ms Lomas! >

41900:31:28,252 --> 00:31:29,932Thank you.

42000:31:38,692 --> 00:31:40,412(Cheeky bastard!)

42100:31:40,532 --> 00:31:42,172Fiona Lomas, Trauma Fellow.

42200:31:42,292 --> 00:31:43,972Debbie Wong, Scrub Nurse.

42300:31:44,132 --> 00:31:46,772Sarah Molloy,Consultant Anaesthetist.

42400:31:46,932 --> 00:31:50,052Adrian Sands, Anaesthetic ODP. BruceCorby, Rapid Infuser Operator...

42500:31:58,972 --> 00:32:02,652..Alice Murkherjee,Consultant Cardiothoracic Surgeon.

42600:32:02,812 --> 00:32:07,332Patient is David Hanson, date of

birth, 6th of the fourth, 1981.

42700:32:07,452 --> 00:32:08,892Patient was the driver in an RTC,

42800:32:09,052 --> 00:32:12,172and has sustainedblunt chest trauma.



42900:32:12,292 --> 00:32:13,732I've signed a Consent Form 4

43000:32:13,892 --> 00:32:16,772for explorationof thoracic cavity plus proceed.

43100:32:16,892 --> 00:32:18,332ENGINE STARTS

43200:32:23,532 --> 00:32:25,132Swabs, please.

43300:32:27,532 --> 00:32:28,932Scalpel.

43400:32:32,332 --> 00:32:34,572

First, we'll explorethe chest cavity

43500:32:34,692 --> 00:32:36,172for any ruptures or bleeds,

43600:32:36,332 --> 00:32:40,092and then we'll get on withrepairing the damage to the heart.

437

00:32:43,972 --> 00:32:46,132< Ready when you are, sir!

43800:32:57,692 --> 00:32:59,052Finochietto retractor.

43900:33:01,732 --> 00:33:02,932Thank you.

44000:33:14,092 --> 00:33:15,812

Packs, please.

44100:33:26,852 --> 00:33:29,852Where's Glen? Probably alreadybroken down and on to the AA.

44200:33:30,012 --> 00:33:33,452Trauma Theatre's occupied at the



minute, we're just waiting on one.

44300:33:34,772 --> 00:33:37,252Theatre 6. Great! Theatre 6.Thanks, Giles.

44400:33:40,332 --> 00:33:41,812Pack A.

44500:33:41,932 --> 00:33:42,932Two units of O pos.

44600:33:45,572 --> 00:33:48,252Quick handover toDr Bennett-Edwardes.

44700:33:48,372 --> 00:33:49,812That's me.

44800:33:50,932 --> 00:33:52,652Rory Roberts, 32-year-old,

44900:33:52,812 --> 00:33:55,812front seat passengerinvolved in a multi vehicle RTC

45000:33:55,972 --> 00:33:59,012at approximately 2230.Crush injuries both legs.

45100:33:59,172 --> 00:34:02,132Prolonged extrication requiringright-sided below-knee amputation.

45200:34:02,292 --> 00:34:04,132Suspected intra-abdominalhaemorrhage...

45300:34:04,292 --> 00:34:05,892

This is Mrs Hicklin.Theatres, please.

45400:34:06,012 --> 00:34:08,652Pulse 160, BP 60 over 30.

45500:34:08,772 --> 00:34:11,212RSI'd with 120mg of ketamine,



45600:34:11,372 --> 00:34:15,412rocuronium 80 mg, plus bolus fortransfer of another 30 ket.

45700:34:17,572 --> 00:34:20,852Great, thanks. Ready.Great, let's do it.

45800:34:22,092 --> 00:34:25,732I need to know who's on for generalsurg. Who will be the anaesthetist?

45900:34:25,852 --> 00:34:27,772Who'll be operating?

46000:34:29,332 --> 00:34:32,812Yes, I'll hold. Guys, can you dothe necessary paperwork

46100:34:32,972 --> 00:34:36,212with Giles Dhillon at the frontdesk? Yep, will do. Thank you.

46200:34:37,412 --> 00:34:38,492Cheers, guys.

46300:34:40,772 --> 00:34:43,052Well, we're en route

to Theatre 6 now.

46400:34:43,172 --> 00:34:45,412Who's there for the patient? Fine.

46500:34:48,652 --> 00:34:51,412Dr Jonesis just covering the transfer.

46600:34:51,572 --> 00:34:54,372

Ramakrishna Chandramohan will beyour anaesthetist in theatre.

46700:34:54,532 --> 00:34:56,812Who's the surgeon?I'll get you one.

46800:34:59,532 --> 00:35:02,732



Three blood, two FFP, straight in.Filling him up.

46900:35:02,852 --> 00:35:04,172OK.

47000:35:06,612 --> 00:35:09,212BEEPINGHow's it going?

47100:35:10,612 --> 00:35:13,492No active bleeding at present.No pelvic fractures.

47200:35:13,652 --> 00:35:16,852FAST scan shows there's nofree fluid in the abdomen.

47300:35:16,972 --> 00:35:18,132

Patient is stable.

47400:35:18,252 --> 00:35:20,572Great. Alice, I need Fiona urgently.

47500:35:20,692 --> 00:35:22,932I'm good here. Thanks, Fiona.

47600:35:23,052 --> 00:35:25,652Thanks. All done? Thank you. OK.

47700:35:27,892 --> 00:35:31,772The other trauma from the RTC,he's on his way to theatre. OK.

47800:35:37,492 --> 00:35:39,492Is Glen with the patient? No.

47900:35:40,692 --> 00:35:42,452Glen confirmed to me this week

48000:35:42,612 --> 00:35:46,332that he's not taking upthe extension on his contract.

48100:35:46,452 --> 00:35:47,812He's resigned. I'm sorry.



48200:35:49,732 --> 00:35:51,892Theatre 6, Rory Roberts, laparotomy.

48300:35:59,372 --> 00:36:00,692Billy!

48400:36:00,812 --> 00:36:02,212BEEPING

48500:36:03,532 --> 00:36:07,572I didn't want to say in front ofthe others but...you were brilliant.

48600:36:12,332 --> 00:36:13,932Call me.

48700:36:21,932 --> 00:36:23,852MONITORS BEEP

48800:36:43,612 --> 00:36:44,972You'll be fine.

48900:36:54,212 --> 00:36:55,292Blade.

49000:37:00,052 --> 00:37:01,692OK to cut?

49100:37:01,812 --> 00:37:03,052OK.

49200:37:07,572 --> 00:37:08,852Cutting.

49300:37:16,852 --> 00:37:18,332Swabs to Harry.

494

00:37:24,212 --> 00:37:25,732Forceps.

49500:37:29,892 --> 00:37:30,972Scissors.

49600:37:37,652 --> 00:37:39,732I'm going to open the peritoneum.



49700:37:39,852 --> 00:37:40,892Suction.

49800:37:43,012 --> 00:37:44,372Everybody ready?

49900:37:46,172 --> 00:37:47,252OK, ready.

50000:37:48,292 --> 00:37:50,412Just follow my lead, Harry,

50100:37:50,532 --> 00:37:52,892and you'll be fine.

50200:37:54,332 --> 00:37:55,732Here we go.

50300:38:09,332 --> 00:38:11,052Packs. Packing!

50400:38:11,172 --> 00:38:13,332Just whack it in.

50500:38:24,412 --> 00:38:26,292Five packs in the abdomen.

50600:38:26,412 --> 00:38:28,892Five in. Packs!

50700:38:34,892 --> 00:38:36,212Five more in.

50800:38:36,332 --> 00:38:37,412Ten in.

509

00:38:37,532 --> 00:38:39,292Morris.

51000:38:42,252 --> 00:38:43,492Hold it here.

51100:38:45,172 --> 00:38:46,412Morris.



51200:38:48,732 --> 00:38:50,332ALARMS BEEP

51300:38:50,492 --> 00:38:52,852Shit. OK, BP's droppedback to 60 over 30.

51400:38:52,972 --> 00:38:54,692There's no point us putting blood in

51500:38:54,852 --> 00:38:56,892if he's going to leak it outeverywhere...

51600:38:57,052 --> 00:38:59,692Haemorrhaging fromthe left upper quadrant. Spleen?

51700:38:59,812 --> 00:39:01,612Yes. Management?

51800:39:01,732 --> 00:39:03,052Splenectomy.

51900:39:03,172 --> 00:39:04,932Yep. Roberts.

520

00:39:10,492 --> 00:39:11,732Swapsies.

52100:39:14,292 --> 00:39:15,652Keep at it, Harry.

52200:39:18,532 --> 00:39:21,492In with suction, I need you to keepthe field clear. Mm-hm.

523

00:39:25,492 --> 00:39:26,732OK, I'm struggling.

52400:39:26,852 --> 00:39:28,092METAL CLATTERS

52500:39:28,212 --> 00:39:30,732I need you to hold the bowel clear.



52600:39:38,852 --> 00:39:40,052Oh, God...

52700:39:42,372 --> 00:39:43,612OK...

52800:39:45,732 --> 00:39:48,292Got it. Roberts.

52900:39:52,892 --> 00:39:56,132Splenic vessels clamped.

53000:39:56,252 --> 00:39:57,692McIndoes.

53100:39:57,812 --> 00:39:59,292Fill him up.

53200:39:59,412 --> 00:40:00,532Yep.

53300:40:09,852 --> 00:40:12,132I've divided the splenic ligaments.

53400:40:16,732 --> 00:40:18,332Splenic vessels divided. Roberts.

53500:40:28,212 --> 00:40:31,092Short gastric vessels clamped.

53600:40:31,212 --> 00:40:32,212McIndoes.

53700:40:42,612 --> 00:40:44,412Short gastric vessels divided.

538

00:40:53,932 --> 00:40:54,892Stop suction.

53900:40:59,452 --> 00:41:01,132The bleed's under control.

54000:41:03,492 --> 00:41:05,412MONITORS BEEP



Good.

54100:41:07,652 --> 00:41:09,052Ramakrishna?

54200:41:14,172 --> 00:41:15,812BP coming up.

54300:41:20,812 --> 00:41:21,812Coming up.

54400:41:24,652 --> 00:41:26,332BP holding.

54500:41:26,452 --> 00:41:28,332Systolic 80. That's good work.

54600:41:29,532 --> 00:41:30,772

We'll keep filling him up.

54700:41:32,932 --> 00:41:36,412So, blood, FFP, platelets,3-to-2-to-1.

54800:41:36,532 --> 00:41:37,972Got that.

54900:41:38,092 --> 00:41:39,492

OK, what?!

55000:41:42,092 --> 00:41:43,812Good work, everyone.

55100:41:48,772 --> 00:41:49,732OK...

55200:41:52,092 --> 00:41:55,812I'm going to remove the spleen to

make room for tying off the vessels.

55300:41:58,052 --> 00:41:59,532McIndoes.

55400:42:01,852 --> 00:42:02,932Fiona...



55500:42:27,092 --> 00:42:30,092Have you found someoneto replace me yet? Yes.

55600:42:30,252 --> 00:42:34,132I'll phone her in the morning andtell her to stand down. Thank you.

55700:42:34,252 --> 00:42:36,012You're welcome.

55800:42:46,852 --> 00:42:49,492All right, Billy. Mr Boyle.

55900:43:03,492 --> 00:43:04,972Do you want to scrub in?

56000:43:06,132 --> 00:43:07,812

No, I think you should finish.

56100:43:11,892 --> 00:43:13,052Dish.

56200:43:26,252 --> 00:43:27,812Removing the spleen.

56300:43:30,132 --> 00:43:31,412DULL THUD

56400:43:34,132 --> 00:43:37,012See, you don't need me at all.

56500:43:41,012 --> 00:43:42,612I wouldn't say that.

56600:43:58,612 --> 00:44:01,692Subtitles by Ericsson

56700:44:01,812 --> 00:44:04,[email protected]

critical (uk) 1x13 - episode 13

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