WEBVTT 00:12.721 --> 00:14.221 Need some help over here! 00:14.222 --> 00:15.764 - Who called in SWAT? - Just a precaution. 00:15.765 --> 00:17.307 They still haven't found the shooter yet. 00:17.308 --> 00:19.268 They need to stay out there, not in here. 00:19.269 --> 00:21.687 Officer down. You know the drill. 00:21.688 --> 00:23.814 - 16 gauge in the right AC. - Definitely needs an airway. 00:23.815 --> 00:25.149 Can you handle that bleeding? 00:25.150 --> 00:26.859 Need a sponge stick for the back. 00:26.860 --> 00:28.736 Dana, 100 of ketamine and get some 4x4s on a kelly. 00:28.737 --> 00:30.320 You guys are doing a great job. Keep it up. 00:30.321 --> 00:33.157 Hang in there, Richie. You're in good hands. 00:33.158 --> 00:35.826 - You're gonna be okay, man. - Hey, guys. 00:35.827 --> 00:37.286 Back it up. We're trying to work here. 00:37.287 --> 00:39.121 Come on. Both of youse, go. 00:39.122 --> 00:42.207 And chest tube output is minimal. 00:42.208 --> 00:44.918 - Good for cardiothoracic ICU. - Nice. Okay. 00:44.919 --> 00:46.587 As soon as transpo can lend us a hand. 00:46.588 --> 00:48.464 What's up with the SWAT team? 00:48.465 --> 00:49.965 Maybe they think the shooter's coming here. 00:49.966 --> 00:51.258 - Shit, is that true? - What? 00:51.259 --> 00:52.760 My kid's in the break room. 00:52.761 --> 00:54.386 They think the shooter's heading this way? 00:54.387 --> 00:56.847 Anything is possible. 00:56.848 --> 00:59.516 Don't spread rumors. 00:59.517 --> 01:01.144 I'm taking this one to the OR. 01:06.191 --> 01:07.483 How are you doing? 01:07.484 --> 01:09.777 Yeah, I'm good. You? 01:09.778 --> 01:11.320 I'm good. 01:11.321 --> 01:12.863 - How much blood are we getting? - I don't know. 01:12.864 --> 01:14.281 I hope it's enough. 01:14.282 --> 01:15.491 We're supposed to stop here 01:15.492 --> 01:17.826 and stay between 10:00 and 2:00. 01:17.827 --> 01:20.204 - Where's 12? - I think the pilot's 12. 01:20.205 --> 01:24.042 I think we just stay back, and they bring the blood to us. 01:25.627 --> 01:27.253 I think. 01:29.631 --> 01:30.589 - Here. - Thank you. 01:30.590 --> 01:31.966 Yep. 01:36.054 --> 01:37.471 Do we take these to our supply room 01:37.472 --> 01:39.223 - in Behavioral Health? - Trauma rooms first. 01:39.224 --> 01:41.225 Then we'll make our way out to the patients in the hub. 01:41.226 --> 01:43.352 - That the O-neg delivery? - Yeah, straight from the roof. 01:43.353 --> 01:45.062 Jesse, hang a unit, then right up to the OR. 01:45.063 --> 01:46.897 Who else needs blood? 01:46.898 --> 01:48.732 Everybody. 01:48.733 --> 01:50.359 Leave us four units, four next door, 01:50.360 --> 01:52.152 and then check in with Robby and Abbot. 01:52.153 --> 01:54.655 Okay, I've got next door. 01:54.656 --> 01:56.198 - Blood's here. - All right. 01:56.199 --> 01:57.533 Squeeze one in as fast as you can. 01:57.534 --> 01:59.618 Bag for me. 01:59.619 --> 02:02.246 - You guys need blood? - No, not just yet. 02:02.247 --> 02:03.789 Leave it with Dana. 02:03.790 --> 02:05.415 Hey, Whitaker. How you doing? 02:05.416 --> 02:06.458 Yeah, fine. 02:06.459 --> 02:07.751 Ask for help if you need it. 02:07.752 --> 02:10.462 I can't see the cords. Let's bag him. 02:10.463 --> 02:11.964 Sorry, I'm used to the GlideScope. 02:11.965 --> 02:13.382 Spoiled by technology. 02:13.383 --> 02:14.842 Dana, you got a bougie back there? 02:14.843 --> 02:17.177 Completely out. Used them all up. 02:17.178 --> 02:20.681 - Is he awake? - He was. Now he's sedated. 02:20.682 --> 02:23.016 - Should be intubated by now. - Yeah, what's his pulse ox? 02:23.017 --> 02:24.476 All right, except for his partner, 02:24.477 --> 02:26.311 all of you into BH-2 now. 02:26.312 --> 02:27.813 You can watch from the window, 02:27.814 --> 02:29.815 but you need to zip it, capisce? 02:29.816 --> 02:31.441 Oh, God. Bridget, thank God. 02:31.442 --> 02:32.693 Night shift to the rescue. 02:32.694 --> 02:33.902 What the hell happened to your eye? 02:33.903 --> 02:35.404 Just another happy customer. 02:35.405 --> 02:37.239 - Looks a lot worse than it is. - Yeah, right. 02:37.240 --> 02:39.741 I tried to get here sooner, but it is gridlocked out there. 02:39.742 --> 02:41.160 It's not much better in here. 02:41.161 --> 02:43.036 Did you hear anything about the shooter? 02:43.037 --> 02:45.622 They may have slipped away in the crowd with all this chaos. 02:45.623 --> 02:48.208 - Hey, where do you need me? - North is yellow. 02:48.209 --> 02:49.918 - Keep an eye on the new kids. - Got it. 02:49.919 --> 02:51.003 You holler if you're in trouble. 02:51.004 --> 02:53.380 Yes, ma'am. 02:53.381 --> 02:55.841 Jamie, what do you need? 02:55.842 --> 02:57.342 IVs on everyone. 02:57.343 --> 03:00.220 - Hi, I'm Dr. King. - Buster Pirelli. 03:00.221 --> 03:03.140 I take it you're a children's entertainer. 03:03.141 --> 03:04.808 Impressive observational skills. 03:04.809 --> 03:06.393 Well, no active bleeding. 03:06.394 --> 03:08.854 Can you tell me your pain on a scale of 1 to 10? 03:08.855 --> 03:10.147 At least a 3. 03:10.148 --> 03:11.857 And can you wiggle your fingers? 03:11.858 --> 03:14.109 Uh-huh. 03:14.110 --> 03:15.527 The--the other hand. 03:15.528 --> 03:17.613 Oh. 03:17.614 --> 03:19.406 Well, it doesn't seem like you have a broken bone, 03:19.407 --> 03:21.366 but we're gonna put you on some IV antibiotics 03:21.367 --> 03:22.868 and some pain meds. 03:22.869 --> 03:23.953 Got it. 03:25.663 --> 03:27.497 You, uh, see who shot you? 03:27.498 --> 03:31.418 No, I'm not even sure which direction the bullet came from. 03:31.419 --> 03:34.922 Hey, am I going to lose any dexterity? Like... 03:34.923 --> 03:37.174 It's too soon to tell, but probably not. 03:37.175 --> 03:39.384 I make balloon animals for a living. 03:39.385 --> 03:41.470 Two birthday parties booked every Saturday, Sunday 03:41.471 --> 03:43.096 for the next year, so... 03:43.097 --> 03:45.599 Wow, you must really love kids. 03:45.600 --> 03:47.142 Not really. 03:47.143 --> 03:49.145 Okay, you're gonna feel a little pinprick here. 03:50.104 --> 03:51.480 Fuck me! 03:51.481 --> 03:53.732 Uh, it's--it's in. It's just so we can give you antibiotics. 03:53.733 --> 03:55.192 Oh. 03:55.193 --> 03:57.110 That hurt just as bad as when I got shot. 03:57.111 --> 03:58.612 You put in an IO? 03:58.613 --> 04:00.155 Yeah. 04:00.156 --> 04:01.490 Um, don't worry, sir. 04:01.491 --> 04:02.824 There will be no more pain. 04:02.825 --> 04:03.909 Okay. 04:03.910 --> 04:05.745 Whitaker, um, team huddle. 04:07.622 --> 04:09.373 - Join us, will you? - Mm-hmm. 04:09.374 --> 04:11.500 Oh, my God. 04:11.501 --> 04:14.586 Okay, um, why'd you do that? 04:14.587 --> 04:17.839 Dr. Robby said everyone gets an IO. 04:17.840 --> 04:20.759 If they are unconscious or unresponsive. 04:20.760 --> 04:23.428 If the patient is awake and alert, 04:23.429 --> 04:25.639 it's just a standard IV, not an IO. 04:25.640 --> 04:28.558 Unless it's a mime. They can't scream. 04:28.559 --> 04:30.310 Lidocaine for the clown. 04:30.311 --> 04:31.561 More at the door. 04:31.562 --> 04:34.106 Is this ever gonna end? 04:34.107 --> 04:36.358 Pardon. Coming through. 04:36.359 --> 04:38.277 Bleed and bandage it. Bring him out. 04:38.278 --> 04:40.028 To the other side? 04:40.029 --> 04:41.738 Ah, too much blood. 04:41.739 --> 04:43.365 Move that kelly to the right a little bit. 04:43.366 --> 04:45.033 - Any better? - Not really. 04:45.034 --> 04:46.660 - Radial pulse? - Still has it. 04:46.661 --> 04:47.828 Maybe a little weaker. 04:47.829 --> 04:48.829 I can try and give you a bubble. 04:48.830 --> 04:50.623 Yeah, yeah, go for it. 04:52.208 --> 04:53.750 No, nothing. I'm not seeing anything. 04:53.751 --> 04:56.420 Okay, let's bag him. I want to prep the neck. 04:56.421 --> 04:57.838 You don't have a bougie. 04:57.839 --> 04:59.881 I have an 11 blade and a prayer. 04:59.882 --> 05:01.550 Without a bougie, you could create a false passage 05:01.551 --> 05:03.176 on top of the trachea and kill him. 05:03.177 --> 05:04.928 - You're doing a crike? - Yep. 05:04.929 --> 05:08.223 No skin hooks, no bougie-- old school. 05:08.224 --> 05:09.850 I got a tactical airway in my bag here. 05:09.851 --> 05:11.935 - What is that? - It's a control crike kit. 05:11.936 --> 05:13.395 Oh, that's perfect. 05:13.396 --> 05:15.063 Use that on the battlefield. 05:15.064 --> 05:17.107 Works in the pitch-dark when you're under fire. 05:17.108 --> 05:18.985 I can do these with my eyes closed. 05:19.861 --> 05:20.986 For you. 05:20.987 --> 05:23.405 Okay. 05:23.406 --> 05:25.782 The knife leaves a trach hook behind, 05:25.783 --> 05:27.826 so you can't miss, right? 05:27.827 --> 05:30.037 Just... 05:30.038 --> 05:31.997 good. 05:31.998 --> 05:35.751 You slide in the introducer. 05:35.752 --> 05:36.877 Okay. 05:36.878 --> 05:39.379 Feel the tracheal rings. Good. 05:39.380 --> 05:41.256 Bob's your uncle. 05:41.257 --> 05:44.134 - That was incredibly fast. - Eh... 05:44.135 --> 05:45.719 Balloon is up. 05:45.720 --> 05:48.348 - Why don't we stock these? - No room in the budget. 05:50.600 --> 05:52.476 Yellow on end-tidal. 05:52.477 --> 05:54.644 - It's okay now? - Yeah. 05:54.645 --> 05:56.481 Thank you, Dr. Abbot. 05:58.691 --> 06:00.942 Okay, let's pack the oral cavity with Kerlix 06:00.943 --> 06:02.903 and see how fast Head and Neck can take him up to the OR. 06:02.904 --> 06:04.279 Great job, everybody. 06:04.280 --> 06:05.530 What else do you got in your go bag? 06:05.531 --> 06:07.492 Oh, just wait and see. 06:40.942 --> 06:43.110 Javadi, this is Sally. 06:43.111 --> 06:44.444 What does she need? 06:44.445 --> 06:46.196 Gunshot wound to the back at T11. 06:46.197 --> 06:48.448 Good pulse, but probable spinal cord injury. 06:48.449 --> 06:52.327 - Can you move your legs? - I'm trying. 06:52.328 --> 06:53.703 Am I paralyzed? 06:53.704 --> 06:55.288 There's some hope for recovery. 06:55.289 --> 06:56.998 Keep her on the backboard and monitor 06:56.999 --> 06:58.291 for intra-abdominal hemorrhage, 06:58.292 --> 07:00.335 and neuro-ICU will triage to CT, okay? 07:00.336 --> 07:02.671 Sally, pinprick right here, okay? 07:02.672 --> 07:05.132 Walsh knows about the case. They're holding an OR. 07:05.133 --> 07:07.175 And the hits keep coming. 07:07.176 --> 07:09.345 Let's go. 07:10.763 --> 07:11.805 Who do you have? 07:11.806 --> 07:14.308 Semiconscious, only responds to pain. 07:15.601 --> 07:17.602 - Decent carotid. - Strip him. 07:17.603 --> 07:19.646 Let's go. 07:19.647 --> 07:21.774 Ah, left upper-quadrant entrance. 07:23.192 --> 07:24.443 Hold him down. 07:24.444 --> 07:25.819 Grab his foot! Grab his foot! 07:25.820 --> 07:28.613 Whoa, gun! Gun! He's going for his gun! 07:28.614 --> 07:30.199 Get down, get down. 07:31.951 --> 07:34.245 Stay down. Stay down. 07:37.832 --> 07:39.916 Sig P365 9 mil. 07:39.917 --> 07:42.335 - Driver's license? - He just got here. 07:42.336 --> 07:44.046 Not responding to pain now. 07:45.423 --> 07:47.424 All clear. 07:47.425 --> 07:49.176 - You sure? - He's unconscious. 07:49.177 --> 07:51.136 Everybody back to work. 07:51.137 --> 07:52.846 Agonal breathing. He needs an airway. 07:52.847 --> 07:55.223 - Working on an IO. - Drawing up ketamine and sux. 07:55.224 --> 07:56.600 Here, have at it. 07:56.601 --> 07:58.602 Concealed carry permit. 07:58.603 --> 08:00.395 We'll run his ID. 08:00.396 --> 08:02.397 These wounds are too big for a 9. 08:02.398 --> 08:03.815 Failed IO. 08:03.816 --> 08:05.734 Guy's huge. Needle won't reach the bone. 08:05.735 --> 08:07.402 He needs induction meds and blood. 08:07.403 --> 08:08.778 I'm having the same problem here. 08:08.779 --> 08:09.988 I don't see anything usable for an IV. 08:09.989 --> 08:11.615 - Robby. - What? 08:11.616 --> 08:14.284 Guy needs access, but the IO won't reach the humerus. 08:14.285 --> 08:16.286 Proximal tibia? 08:16.287 --> 08:18.163 Yes? 08:18.164 --> 08:19.873 Yeah. 08:19.874 --> 08:21.291 Tibia's not great access. 08:21.292 --> 08:22.834 You can only get a liter an hour down there. 08:22.835 --> 08:24.086 You get what you get. 08:26.464 --> 08:28.632 God damn it! 08:28.633 --> 08:30.550 Whatever that is, can you please turn it off? 08:30.551 --> 08:33.094 - I can't hear myself think! - Stable for the ICU. 08:33.095 --> 08:35.597 Get her up. I'll be right fucking back. 08:35.598 --> 08:36.807 Copy that. 08:44.315 --> 08:46.191 I already have one. Keep that away from me. 08:46.192 --> 08:47.902 It's not for you. 08:52.698 --> 08:54.241 This is the monitoring center. 08:54.242 --> 08:56.576 We see that you're not in your inclusion zone. 08:56.577 --> 08:58.371 Do you have permission-- 09:02.166 --> 09:05.418 - Show's over. - Uh... 09:05.419 --> 09:07.754 are you gonna get in trouble for that? 09:07.755 --> 09:09.507 Probably. 09:25.106 --> 09:26.524 Hey. 09:28.192 --> 09:30.235 What's going on out there? 09:30.236 --> 09:34.948 A lot of people were hurt at the festival. 09:34.949 --> 09:37.534 I need to use the bathroom. 09:37.535 --> 09:41.037 - I told him to use the sink. - What is wrong with you? 09:41.038 --> 09:42.914 Would you rather I take him out there? 09:42.915 --> 09:46.043 Hang on. I'll be right back, okay? 09:52.800 --> 09:55.385 Here. 09:55.386 --> 09:57.554 - What's that? - It's a urinal. 09:57.555 --> 10:01.225 - You pee in it. - I think I'll just hold it in. 10:04.353 --> 10:06.688 Pull out. I found a 4 blade. 10:06.689 --> 10:09.482 This is better. 10:09.483 --> 10:10.900 Shit. 10:10.901 --> 10:13.486 I lost the light. The battery must be dead. 10:13.487 --> 10:15.280 This one's dead, too. 10:15.281 --> 10:17.407 Anybody have a laryngoscope with a light that still works? 10:17.408 --> 10:18.908 - We will check. - Check quick. 10:18.909 --> 10:20.410 This guy's paralytics are wearing off. 10:20.411 --> 10:21.995 Keep bagging. Give me a 7.0 ET tube. 10:21.996 --> 10:23.371 He's a big guy. He needs an 8. 10:23.372 --> 10:25.123 - Not for this. - Number 7. 10:25.124 --> 10:28.668 - What are you doing? - Tactile intubation. 10:28.669 --> 10:32.464 My index finger goes into the vallecula. 10:32.465 --> 10:36.468 And my middle finger will guide the tube past the epiglottis. 10:36.469 --> 10:37.927 But if you hit the esophagus, he's toast. 10:37.928 --> 10:39.512 You told us never to pass a tube unless we see 10:39.513 --> 10:41.598 - the vocal cords. - Correct. Not today. 10:41.599 --> 10:43.224 If I stay in the midline, 10:43.225 --> 10:45.435 I should be able to get it past the cords. 10:45.436 --> 10:47.270 Okay. 10:47.271 --> 10:50.482 Balloon up. Bag him. 10:50.483 --> 10:53.318 - Looks good on the end-tidal. - Slick move, boss. 10:53.319 --> 10:54.861 No pulse. Start compressions. 10:54.862 --> 10:56.238 OK. Get him up. 10:59.492 --> 11:01.284 Try to get him back with two liters. 11:01.285 --> 11:03.912 That is as much as we can afford per patient. 11:03.913 --> 11:06.039 Leg is too slow; upper arm is five times as fast. 11:06.040 --> 11:08.333 Best that we can do. Keep at it. We'll get him back. 11:08.334 --> 11:10.378 Robby, need help here! 11:12.546 --> 11:14.173 - Langdon! - Keep squeezing. 11:19.804 --> 11:22.097 How are you making out? 11:22.098 --> 11:23.723 Lots of emails and photos coming in 11:23.724 --> 11:25.266 from concerned families. 11:25.267 --> 11:26.685 It'll be easier once they've entered 11:26.686 --> 11:28.228 every patient's MCI number. 11:28.229 --> 11:30.230 Here we go. Look familiar? 11:30.231 --> 11:32.232 MCI-7. 11:32.233 --> 11:34.025 His name is Vincent Rivera. 11:34.026 --> 11:36.361 He must have had friends or family in the cafeteria 11:36.362 --> 11:38.405 who sent in the photo. 11:38.406 --> 11:40.991 I'll text them we're coming. 11:43.077 --> 11:45.161 - What are you doing? - Giving this guy a chance. 11:45.162 --> 11:47.455 He needs a big central line for fast transfusion. 11:47.456 --> 11:49.165 You can't do an IJ without an ultrasound, 11:49.166 --> 11:50.959 - especially on a guy this big. - You'll kill him 11:50.960 --> 11:52.627 if you collapse a lung or hit the carotid. 11:52.628 --> 11:54.003 I'm not doing an IJ. 11:54.004 --> 11:56.214 Unhook that blood line. Bring it up here. 11:56.215 --> 12:00.677 This is a supraclavicular subclavian. 12:00.678 --> 12:02.220 If you have to go in blind, 12:02.221 --> 12:05.598 this is the only safe way to access a giant vein. 12:05.599 --> 12:09.227 And hold compressions. 12:09.228 --> 12:10.979 A centimeter 12:10.980 --> 12:14.190 from the lateral head of the sternocleidomastoid, 12:14.191 --> 12:16.526 a centimeter off the clavicle, 12:16.527 --> 12:20.531 aiming at the contralateral nipple. 12:22.491 --> 12:23.868 I'm in. 12:25.703 --> 12:28.788 Okay, resume compressions. 12:28.789 --> 12:31.500 And squeeze blood. 12:32.626 --> 12:34.753 - Where'd you learn that? - "EM:RAP" podcast. 12:34.754 --> 12:37.213 We'll be ready for a second unit in under a minute. 12:37.214 --> 12:38.965 Boom. 12:38.966 --> 12:42.135 Okay, not too much blood on your dressing, Mr. Grayson. 12:42.136 --> 12:44.053 You're looking good. 12:44.054 --> 12:46.473 Mr. Grayson? Hey, Mr. Grayson! 12:46.474 --> 12:47.807 Oh. 12:47.808 --> 12:49.809 Oh, I must've dozed off. 12:49.810 --> 12:51.519 This is like a bad dream. 12:51.520 --> 12:54.272 Yeah, no kidding. 12:54.273 --> 12:57.942 You, um--did you happen to see who shot you? 12:57.943 --> 12:59.611 No. 12:59.612 --> 13:01.738 But I heard the shots. 13:01.739 --> 13:05.658 They just kept coming, gunshots and screaming. 13:05.659 --> 13:07.744 I'm never gonna get that out of my head. 13:07.745 --> 13:09.954 GSW to the right inguinal region. 13:09.955 --> 13:11.039 Yeah. 13:11.040 --> 13:13.583 Uh, hi, I'm Dr. Whitaker. 13:13.584 --> 13:15.043 Carmen. 13:15.044 --> 13:16.544 It's, uh, nice to meet you. 13:16.545 --> 13:17.629 Uh... 13:17.630 --> 13:19.839 I'm just gonna take this. 13:19.840 --> 13:21.299 Okay. 13:21.300 --> 13:24.385 - How's the pain? - I can handle it. 13:24.386 --> 13:26.346 Okay. 13:26.347 --> 13:28.848 What does this--"tem-bleek"? What does that mean? 13:28.849 --> 13:31.601 Tembleque--it's a coconut pudding from Puerto Rico. 13:31.602 --> 13:34.270 We top it off with canela--cinnamon. 13:34.271 --> 13:36.397 Okay, wow. So you got a food truck? 13:36.398 --> 13:39.067 - Just a folding table for now. - Pedal pulses are strong. 13:39.068 --> 13:40.693 Okay, let's start with antibiotics, pain meds, 13:40.694 --> 13:42.320 and let's try to stop this bleeding. 13:42.321 --> 13:44.280 Okay. 13:44.281 --> 13:45.698 Here we go. 13:45.699 --> 13:47.659 Okay, uh, could you take over? 13:47.660 --> 13:48.993 Thank you, thank you, thank you. 13:48.994 --> 13:51.538 Hey, hey, hey. 13:51.539 --> 13:54.290 Inguinal GSW with active bleeding. 13:54.291 --> 13:56.084 Um, try an Israeli bandage. 13:56.085 --> 13:58.711 What if it bleeds through? It's at the top of the leg. 13:58.712 --> 14:00.964 There's no room for a tourniquet above the wound. 14:00.965 --> 14:05.009 Well, let's just hope the hemostatic bandage works. 14:05.010 --> 14:06.886 Okay. 14:06.887 --> 14:08.888 Coming in. Good. 14:08.889 --> 14:10.974 Hey, so... 14:10.975 --> 14:12.308 coconut. 14:12.309 --> 14:14.061 Love coconut. 14:20.401 --> 14:21.943 - Kiara? - Yes. 14:21.944 --> 14:23.611 This is Lupe. 14:23.612 --> 14:25.905 Whitney. You texted me. 14:25.906 --> 14:27.782 Let's take a walk over here. 14:27.783 --> 14:29.909 Can you tell us your husband's name? 14:29.910 --> 14:31.662 Vincent Rivera. 14:33.205 --> 14:35.748 We're gonna show you some photos. 14:35.749 --> 14:38.334 Can you tell us if this is Vincent? 14:38.335 --> 14:41.213 - He's not talking? - No, he's not. 14:45.217 --> 14:46.926 Yes, that's Vincent. 14:46.927 --> 14:49.262 Can I see him? 14:49.263 --> 14:52.140 Vincent had a gunshot to the head. 14:52.141 --> 14:54.142 When he arrived here, 14:54.143 --> 14:57.271 there was no pulse or breathing. 14:59.231 --> 15:01.816 My husband is dead? 15:01.817 --> 15:04.068 - I'm so sorry. - We're sorry. 15:04.069 --> 15:05.945 What about my brother, Brian? 15:05.946 --> 15:08.197 Vincent and Brian went to the festival together. 15:08.198 --> 15:09.699 Is my brother okay? 15:09.700 --> 15:11.075 Can you send us his name and photo? 15:11.076 --> 15:12.744 I did. 15:12.745 --> 15:15.288 Okay, well, as of now, he's not one of our fatalities. 15:15.289 --> 15:17.749 Do you have some relatives or friends we can call 15:17.750 --> 15:19.919 to come be with you? 15:22.922 --> 15:25.257 Our kids are with my parents. 15:31.347 --> 15:34.474 - Second unit's in. - Holding compressions. 15:34.475 --> 15:36.809 - Carotid pulse--you feeling it? - I'm feeling it. 15:36.810 --> 15:38.645 He goes right up to pre-op. 15:38.646 --> 15:40.563 Let's go. Let's go. I need some help over here! 15:40.564 --> 15:43.149 Hey. Not a person of interest. 15:43.150 --> 15:44.984 Jewelry store owner, no priors. 15:44.985 --> 15:46.486 He's not our shooter. 15:46.487 --> 15:49.197 - You guys good in here? - We got this. 15:49.198 --> 15:50.907 Take a two-hour lunch. 15:50.908 --> 15:52.533 I'm gonna go check on triage. 15:52.534 --> 15:54.577 We'll save a spot for you. 15:54.578 --> 15:55.912 Yellow gets a wheelchair. 15:55.913 --> 15:57.413 Hey, Ahmad, what number are we up to? 15:57.414 --> 16:00.166 - 85 patients so far. - Need a gurney for pink. 16:00.167 --> 16:02.669 - How are you guys doing? - Still going strong. 16:02.670 --> 16:04.671 - Not bad, I guess. - You guys are triaging great. 16:04.672 --> 16:06.130 Believe me. This is not easy. 16:06.131 --> 16:07.548 Not everybody can pull this off. 16:07.549 --> 16:08.967 Is this your half-time locker room speech? 16:08.968 --> 16:10.218 Yeah, possibly. 16:10.219 --> 16:11.594 Are we winning or losing the game? 16:11.595 --> 16:14.389 Too soon to tell. 16:14.390 --> 16:16.099 Come on, these heads have to be up 30 degrees. 16:16.100 --> 16:18.018 - Let's go. - Got four back here. 16:19.728 --> 16:22.230 Through and through the head. 16:22.231 --> 16:24.065 No pulse. Black and white. 16:24.066 --> 16:26.943 Pink zone. Strong pulse. Unresponsive, no obvious GSW. 16:26.944 --> 16:28.736 Red zone, GSW left chest. 16:28.737 --> 16:30.321 She was talking when we first got in the truck. 16:30.322 --> 16:32.490 Weak carotid, unresponsive. 16:32.491 --> 16:33.700 There--there was so much blood. 16:33.701 --> 16:36.869 - I tried to stop it. - Jake! 16:36.870 --> 16:39.665 Robby! Leah got shot! It's really bad! 16:43.669 --> 16:45.503 I've been putting pressure on the wound the whole time. 16:45.504 --> 16:46.796 Yeah, that's good. That's good. 16:46.797 --> 16:48.339 - Are you shot? - I don't--maybe my leg. 16:48.340 --> 16:49.966 Most of this is her blood. 16:49.967 --> 16:52.468 - Somebody you know, boss? - Yeah. 16:52.469 --> 16:54.137 - You got this? - Yeah. 16:54.138 --> 16:56.681 Okay, come on, let's go. Let's go. I got you. Come on. 16:56.682 --> 16:58.475 Ready? Pull. 17:05.232 --> 17:08.276 - Jake, you can't stay with her. - I have to. 17:08.277 --> 17:10.236 There's no room, and we need to work on Leah right now, 17:10.237 --> 17:11.320 and you need to get your leg checked, 17:11.321 --> 17:12.822 so please go sit down. 17:12.823 --> 17:14.073 Please come tell me how she's doing, okay? 17:14.074 --> 17:16.993 - Please? - I will. 17:16.994 --> 17:19.245 - Jake? - I-I'm okay. 17:19.246 --> 17:21.248 Leah's with Robby. 17:42.352 --> 17:44.771 - Can't feel carotid. - Start compressions. 17:44.772 --> 17:46.105 Swap out with me. 17:46.106 --> 17:48.816 I need an IO. Hang a unit of O-neg. 17:48.817 --> 17:50.735 Got the IO. 17:50.736 --> 17:52.487 - Leah? - Yeah. 17:52.488 --> 17:55.531 - You need help over there? - No, we're good. 17:55.532 --> 17:58.451 - That's Jake's girlfriend. - Oh, shit. 17:58.452 --> 18:02.205 - Who's Jake? - It's, like, Robby's stepson. 18:02.206 --> 18:03.831 I'll be right with you, sir. 18:03.832 --> 18:05.750 My mom would be very happy. 18:05.751 --> 18:07.585 She always says, wear clean underwear 18:07.586 --> 18:10.505 in case you end up in the hospital. 18:10.506 --> 18:13.382 Just let us know if anything is too uncomfortable. 18:13.383 --> 18:15.802 - It's okay. - This needs to be tighter. 18:15.803 --> 18:17.804 You bled through the last one pretty fast. 18:17.805 --> 18:21.015 Try a 180-degree twist. It'll put more pressure. 18:21.016 --> 18:22.350 Got it. 18:22.351 --> 18:24.018 I usually faint when my blood gets drawn. 18:24.019 --> 18:25.645 Must be all the adrenaline today. 18:25.646 --> 18:27.105 Whitaker? 18:27.106 --> 18:28.815 Old hippie's looking pretty out of it. 18:28.816 --> 18:31.275 No, he's sleeping. 18:31.276 --> 18:34.654 - No response to pain. - Shit. 18:34.655 --> 18:37.448 Uh, Mr. Grayson. Mr. Grayson. 18:37.449 --> 18:39.325 Could be a delayed head bleed. 18:39.326 --> 18:41.661 He's gonna need a head CT. 18:41.662 --> 18:44.789 He's not getting one anytime soon. 18:44.790 --> 18:46.666 Equal and reactive. No blown pupil. 18:46.667 --> 18:50.753 - Santos, go get an attending. - I'll try, but no promises. 18:50.754 --> 18:53.005 Excuse me. I think I'm still bleeding. 18:53.006 --> 18:55.092 I'll be with you in a minute. 18:57.177 --> 18:59.096 Pleur-evac ready. Here you go. 19:01.849 --> 19:04.142 Princess, take over as primary. 19:04.143 --> 19:07.019 - What about Bridget? - She's stuck in yellow. 19:07.020 --> 19:09.856 - Mel needs an attending. - Find somebody who's free. 19:09.857 --> 19:11.691 - Let's get blood. - Dr. Abbot, can you come-- 19:11.692 --> 19:13.526 Gonna be a minute. 19:13.527 --> 19:15.862 - Dr. Walsh. - Taking one up to the OR. 19:15.863 --> 19:17.947 Okay. 19:17.948 --> 19:20.366 Hey, I need a portable pulse ox for Mr. Grayson. 19:20.367 --> 19:23.035 Here you go. 19:23.036 --> 19:25.037 Hey, what happened to the kid in the wheelchair 19:25.038 --> 19:26.664 with the bloody right leg? 19:26.665 --> 19:28.916 No idea. 19:28.917 --> 19:31.460 Pinpoint pupils-- probable OD. 19:31.461 --> 19:32.962 Blood on his clothes wasn't his. 19:32.963 --> 19:35.548 - I'll grab some Narcan. - Sublingual injection. 19:35.549 --> 19:36.799 Okay here? 19:36.800 --> 19:39.051 Uh, looks like a opioid overdose. 19:39.052 --> 19:40.429 How's Robby with Leah? 19:42.139 --> 19:45.892 If this guy doesn't wake up, we'll check for occult trauma. 19:45.893 --> 19:47.894 1,400 of blood out the chest. First unit's in. 19:47.895 --> 19:49.187 Squeeze in a second unit fast, 19:49.188 --> 19:50.813 and then we'll do another pulse check. 19:50.814 --> 19:52.982 - She's needs a second line? - For FFP and platelets. 19:52.983 --> 19:54.567 You sure, Robby? 19:54.568 --> 19:57.028 Sophie, get the plasma. 19:57.029 --> 19:58.779 I'm gonna take over compressions. 19:58.780 --> 20:00.823 And swap. 20:00.824 --> 20:04.453 Social worker to the south corridor. 20:11.960 --> 20:14.670 Jamie, wheelchair. 20:14.671 --> 20:16.130 You can't be in here. 20:16.131 --> 20:17.173 They're working on my girlfriend. 20:17.174 --> 20:18.841 I need to see what's going on. 20:18.842 --> 20:20.301 What's going on is, you're losing a lot of blood. 20:20.302 --> 20:21.761 You're gonna pass out if we don't stop it. 20:21.762 --> 20:23.095 No, I'm not moving, man! Leave me alone! 20:23.096 --> 20:24.472 Jake, get in the damn wheelchair. 20:24.473 --> 20:26.266 - No! - Now! Go! 20:32.397 --> 20:35.733 Welcome back, sir. You're in the ER at PTMC. 20:35.734 --> 20:38.569 - What's your name? - Martin. 20:38.570 --> 20:41.697 What'd you take, Martin? You overdosed at Pitt Fest. 20:41.698 --> 20:43.199 I took one Percocet so I could dance. 20:43.200 --> 20:44.784 I've got a bad knee. 20:44.785 --> 20:46.702 - Where'd you get the pill? - From a friend. 20:46.703 --> 20:48.412 Okay, while you were overdosing from the fentanyl 20:48.413 --> 20:50.873 in a fake pill, there was a mass shooting at Pitt Fest. 20:50.874 --> 20:53.167 - What? - Hey, Samira, 20:53.168 --> 20:54.752 see if you can go help Mel in the yellow zone. 20:54.753 --> 20:56.712 Take my new friend Martin with you. 20:56.713 --> 20:59.216 Javadi, roll with me. 21:05.347 --> 21:06.806 Two units packed cells in. 21:06.807 --> 21:09.475 - FFP still going? - Almost there. 21:09.476 --> 21:12.728 Okay, holding compressions. 21:12.729 --> 21:14.647 Can't feel carotid. 21:14.648 --> 21:15.898 No femoral. 21:15.899 --> 21:18.109 Resuming compressions. 21:18.110 --> 21:21.153 - What's your next move, boss? - Platelets, another unit. 21:21.154 --> 21:22.863 And then we can transfuse her with her own blood 21:22.864 --> 21:24.740 from the Pleur-evac to get ahead. 21:24.741 --> 21:26.367 Hang the cell saver. 21:26.368 --> 21:28.160 - Squeeze all this in? - No. 21:28.161 --> 21:29.870 Three-way stopcock on a 60-cc syringe. 21:29.871 --> 21:31.289 - I'll push-pull. - Okay. 21:31.290 --> 21:33.834 Not exactly in our mass casualty game plan. 21:37.254 --> 21:39.380 I tried. No attendings available. 21:39.381 --> 21:40.757 Okay. 21:44.428 --> 21:45.970 All right. 21:45.971 --> 21:47.972 Okay, those look pretty superficial. 21:47.973 --> 21:50.349 Might've been fragments from a ricochet off the ground. 21:50.350 --> 21:53.185 Lost a lot of blood, but you're gonna be okay, bro. 21:53.186 --> 21:54.895 It's not bad. Just put me back in the wheelchair. 21:54.896 --> 21:56.439 No, no, stay in bed with your leg up. 21:56.440 --> 21:57.857 We don't want you oozing to death. 21:57.858 --> 21:59.358 Samira, what you got? 21:59.359 --> 22:00.901 Opiate OD needs observation after Narcan. 22:00.902 --> 22:02.528 Ugh, boring. No, thank you. 22:02.529 --> 22:04.322 Mel, how's Ganja Grayson? 22:04.323 --> 22:08.159 Um, we can put him in pink while he waits for ICU. 22:08.160 --> 22:10.287 Okay, one second. 22:11.872 --> 22:14.665 - What are you doing? - I'm checking the retina. 22:14.666 --> 22:17.001 - For detachment? - For intracranial pressure 22:17.002 --> 22:19.712 by measuring the optic nerve sheath, which is-- 22:19.713 --> 22:21.255 holy shit--10 millimeters. 22:21.256 --> 22:23.174 - What's normal? 5? - Yeah, 5. 22:23.175 --> 22:24.550 It's an intracranial bleed. 22:24.551 --> 22:25.885 The pressure's been building up. 22:25.886 --> 22:27.511 - There's no blown pupil. - Yeah, not yet. 22:27.512 --> 22:29.388 But if he keeps bleeding in his skull, he's gonna die. 22:29.389 --> 22:32.475 Yeah, he needs a one-inch, uh, burr hole in his-- 22:32.476 --> 22:33.934 with a cranial drill. 22:33.935 --> 22:35.644 I'm just gonna see if Neurosurgery's here. 22:35.645 --> 22:38.397 We don't have time to wait for Neuro. 22:38.398 --> 22:40.775 I got Betadine and a 10-cc syringe. 22:40.776 --> 22:42.234 Should we intubate, hyperventilate? 22:42.235 --> 22:44.529 Mannitol decreases ICP. 22:45.947 --> 22:48.075 - Holy shit! - What the hell? 22:49.993 --> 22:52.203 Relieving intracranial pressure 22:52.204 --> 22:53.746 so he doesn't die. 22:53.747 --> 22:56.707 With an IO drill? 22:56.708 --> 22:58.000 That's sick. 22:58.001 --> 22:59.460 I get the next one. 22:59.461 --> 23:02.130 Long as it's not on me. 23:05.175 --> 23:06.801 Dana, is Neurosurgery down here? 23:06.802 --> 23:08.844 Ask Princess. 23:08.845 --> 23:10.846 - Princess... - Cardiothoracic ICU. 23:10.847 --> 23:13.307 - I need a neurosurgeon. - They're all in the OR. 23:13.308 --> 23:16.060 Dr. Walsh, I have an epidural in the north corridor 23:16.061 --> 23:17.186 with an elevated ICP. 23:17.187 --> 23:18.896 Is there a blown pupil? 23:18.897 --> 23:21.273 No, but a 10-millimeter optic sheath on the ultrasound. 23:21.274 --> 23:23.151 We need a burr hole. 23:25.529 --> 23:27.363 What the fuck? 23:27.364 --> 23:29.448 Draining the ICH with an EZ-IO. 23:29.449 --> 23:31.242 40 cc's out so far. 23:31.243 --> 23:33.661 - Like she said, what the fuck? - There was a case report 23:33.662 --> 23:35.663 in the 2022 "Journal of Emergency Medicine." 23:35.664 --> 23:37.415 Patient survive? 23:37.416 --> 23:39.041 Went home neurologically intact. 23:39.042 --> 23:40.793 The optic sheath is back to normal. 23:40.794 --> 23:42.795 Starting purposeful movements. 23:42.796 --> 23:45.506 - Ready to intubate. - Propofol, rock, and mannitol. 23:45.507 --> 23:47.883 I'll let Neurosurgery know. We'll get him up ASAP. 23:47.884 --> 23:50.302 - Incredible save. - If he lives. 23:50.303 --> 23:53.515 - Third unit's in. - Okay, pulse check. 23:56.184 --> 23:57.810 I think I'm feeling a femoral. 23:57.811 --> 23:59.395 I got a carotid. 23:59.396 --> 24:01.522 Emery, I got a chest case, needs to go to the OR. 24:01.523 --> 24:03.399 I saw you doing CPR on this girl. 24:03.400 --> 24:04.733 Two liters out of the left chest. 24:04.734 --> 24:06.652 Got a pulse back after three packed cells. 24:06.653 --> 24:09.072 600 out of the cell saver, 2 of FFP. 24:12.951 --> 24:15.120 - I'm not feeling it. - Check the carotid. 24:19.583 --> 24:22.418 - Nothing. Sorry. - Resume compressions. 24:22.419 --> 24:24.336 No, no, we should take her up. She just had a pulse. 24:24.337 --> 24:26.213 Not now. We need a pulse to go to the OR. 24:26.214 --> 24:28.382 - Call me if anything changes. - Got a Pink coming in. 24:28.383 --> 24:30.009 Do we have any more whole blood from the donors? 24:30.010 --> 24:31.260 - Think so. - Okay, get another unit 24:31.261 --> 24:32.511 that's got platelets and plasma. 24:32.512 --> 24:35.306 - It'll help her clot. - Got it. 24:35.307 --> 24:36.932 Four units. 24:36.933 --> 24:38.642 Blood is for the ones we can save. 24:38.643 --> 24:40.269 She is right on the edge. 24:40.270 --> 24:42.230 One more can make the difference. 24:46.735 --> 24:48.028 I'm in. 24:50.739 --> 24:52.364 Uh, end-tidal looks good. 24:52.365 --> 24:54.116 Okay, OR team can take it from here. 24:54.117 --> 24:55.743 We need to check on the others. 24:55.744 --> 24:57.913 - I should get back to Pink. - Stay strong, Crash. 24:59.456 --> 25:01.832 Uh, hemostatic bandage still in place. 25:01.833 --> 25:04.418 - How you doing, Carmen? - Not so great. 25:04.419 --> 25:07.254 Okay, let's see. 25:07.255 --> 25:09.715 - Looks arterial. - Agreed. 25:09.716 --> 25:11.383 Can you stop it? 25:11.384 --> 25:14.470 - Uh, direct pressure for now. - Yeah. 25:14.471 --> 25:16.388 We may have a junctional tourniquet 25:16.389 --> 25:17.890 in the disaster supplies. 25:17.891 --> 25:19.558 Can you get that? Cool. 25:19.559 --> 25:21.101 Um... 25:21.102 --> 25:22.728 Whitaker, in the meantime, just put pressure on it. 25:22.729 --> 25:24.647 - Try and stop the bleeding. - For how long? 25:24.648 --> 25:26.565 As long as it takes. 25:26.566 --> 25:28.859 - He bled through his Kerlix. - Um... 25:28.860 --> 25:30.986 elastic--elastic pressure dressing. 25:30.987 --> 25:33.197 - Yep. - Okay, got it. 25:33.198 --> 25:35.491 All right. 25:35.492 --> 25:38.160 Got a better bandage, and we're gonna elevate your leg. 25:38.161 --> 25:39.995 Do you know what's happening with my girlfriend? 25:39.996 --> 25:41.705 Her name is Leah. She was shot in the chest. 25:41.706 --> 25:43.415 I'm sorry. We have a ton of patients, 25:43.416 --> 25:45.209 and they're only marked by number. 25:45.210 --> 25:47.753 Robby and Dana were working on her--they were doing CPR. 25:47.754 --> 25:49.630 How do you know Robby and Dana? 25:49.631 --> 25:51.340 Robby and my mom were together for a couple years, 25:51.341 --> 25:53.968 and I would--I would come, and I'd hang out here. 25:53.969 --> 25:56.428 Well, I'm sure if they're helping her, 25:56.429 --> 25:58.347 then she's in great hands. 25:58.348 --> 26:00.432 Can you check for me, please? 26:00.433 --> 26:02.811 Sure. Of course. Just after I finish this. 26:07.190 --> 26:10.109 Well, there's no additional bleeding. 26:10.110 --> 26:11.819 Strong pulse. 26:11.820 --> 26:15.155 Two grams of Ancef running in. 26:15.156 --> 26:16.950 Can you, uh, spread your fingers? 26:19.119 --> 26:22.746 Uh, no, like this. 26:22.747 --> 26:25.457 Are you okay? 26:25.458 --> 26:27.251 Found the junctional tourniquet. 26:27.252 --> 26:30.130 Um, okay. Uh, I'll be right back. 26:33.925 --> 26:36.302 How much blood you pushing off the cell saver? 26:36.303 --> 26:38.554 Every last drop. 26:38.555 --> 26:40.431 O-neg. Monitor the pulse. 26:40.432 --> 26:44.144 She's stable for trauma ICU if an OR's not ready. 26:54.821 --> 26:56.614 How many units so far? 26:56.615 --> 26:59.575 Four, plus the cell saver. 26:59.576 --> 27:02.077 - Last one? - Getting backed up out there. 27:02.078 --> 27:03.662 I don't know. 27:03.663 --> 27:05.748 Dana, why don't we try a little TXA? 27:05.749 --> 27:07.541 1,000 milligrams of TXA might help her clot. 27:07.542 --> 27:09.501 Got it. 27:09.502 --> 27:12.421 Bullet tore through her heart. 27:12.422 --> 27:13.797 Anyone else with a wound like this 27:13.798 --> 27:15.299 is pronounced dead in the field. 27:15.300 --> 27:16.800 You can't keep up with the blood loss. 27:16.801 --> 27:18.302 If she was our only patient, 27:18.303 --> 27:20.220 we'd do a thoracotomy, maybe ECMO. 27:20.221 --> 27:22.932 But even then, I doubt we'd get her back. 27:25.226 --> 27:26.769 We're gonna lose ten other patients 27:26.770 --> 27:30.106 if you put all your efforts into saving this girl. 27:33.693 --> 27:35.778 Got the TXA. 27:35.779 --> 27:37.029 Okay, push it fast, 27:37.030 --> 27:38.781 and we'll do another pulse check. 27:38.782 --> 27:41.242 And then can you get me a vascular Doppler too, please? 27:45.038 --> 27:47.706 GSW to the chest, faint pulse. 27:47.707 --> 27:50.209 Intubation, IO, chest tube, and a unit of blood. 27:50.210 --> 27:51.335 Copy that. 27:51.336 --> 27:52.961 All nonessential personnel, 27:52.962 --> 27:54.963 please report to the patient waiting room. 27:54.964 --> 27:56.757 All nonessential personnel, 27:56.758 --> 27:59.135 please report to the patient waiting room. 28:03.973 --> 28:05.433 Anything I can do? 28:08.812 --> 28:11.563 You can check on Shen and Ellis in the ambulance bay. 28:11.564 --> 28:12.774 On it. 28:17.445 --> 28:18.696 Whitaker, lay down some fresh gauze 28:18.697 --> 28:19.988 so we can assess the hemostasis. 28:19.989 --> 28:22.199 Yep. How you doing, Carmen? 28:22.200 --> 28:24.159 I'm hanging in there. 28:24.160 --> 28:25.619 You want the circle of compression 28:25.620 --> 28:27.746 directly over the wound. 28:27.747 --> 28:29.249 Tighten. 28:31.167 --> 28:33.460 Inflate the balloon. Come on, pump it up, Whittaker. 28:33.461 --> 28:37.131 - Uh, how much pressure? - Until the bleeding stops. 28:37.132 --> 28:38.966 Uh, excuse me, ma'am. 28:38.967 --> 28:40.884 Ma'am, where are you-- 28:40.885 --> 28:42.386 uh, Whittaker, stay on this. 28:42.387 --> 28:45.222 Ma'am? Ma'am? 28:45.223 --> 28:47.933 Do you need something? 28:47.934 --> 28:49.060 Are you-- 28:52.522 --> 28:55.065 I need one more O-neg. 28:55.066 --> 28:58.402 Hey, do you have any O-positive over there? 28:58.403 --> 29:01.488 This guy bled through his bandage. 29:01.489 --> 29:08.162 All available transport to the ER immediately. 29:08.163 --> 29:09.997 Okay. 29:09.998 --> 29:12.082 Let me just--just put your arm like that. 29:12.083 --> 29:13.710 Just keep your hand like that. 29:16.045 --> 29:17.379 Just-- 29:17.380 --> 29:19.173 How we doing out here? 29:19.174 --> 29:21.049 Dancing as fast as we can. 29:21.050 --> 29:23.886 Pretty sure I'm past my union-mandated bathroom break. 29:23.887 --> 29:26.014 I never should have had that second coffee. 29:28.641 --> 29:30.934 Hey, son, ER's closed unless you're injured. 29:30.935 --> 29:33.353 Oh, my mom's inside. I need to take her home. 29:33.354 --> 29:36.690 - David? - Mom? 29:36.691 --> 29:39.318 You're the kid? You need to come with me. 29:39.319 --> 29:41.111 - Hey! Grab him! - Wait, David! Stop! 29:41.112 --> 29:43.071 - Grab him! - What are you doing? 29:43.072 --> 29:45.032 - Stay down! - Don't hurt him! 29:45.033 --> 29:46.325 What the hell's going on? 29:46.326 --> 29:47.576 Four units of packed cells, 29:47.577 --> 29:50.454 two of FFP, 1,000 of TXA... 29:50.455 --> 29:52.873 and 1,200 auto-transfused. 29:52.874 --> 29:55.168 - Did you check this? - Not yet. 30:03.259 --> 30:04.719 Okay, it's working. Hold compressions. 30:26.574 --> 30:28.076 Okay, we're done. 30:34.624 --> 30:37.876 We stopped at 19:47. 30:37.877 --> 30:38.962 Hey. 30:41.172 --> 30:42.799 Move her to Pedes? 30:44.843 --> 30:46.552 You want me to go with you to talk to Jake? 30:46.553 --> 30:48.846 No, no, thanks, I got it. 30:48.847 --> 30:52.432 Jesus Christ. 30:52.433 --> 30:53.892 What's going on? 30:53.893 --> 30:55.477 This is bullshit. I didn't do anything. 30:55.478 --> 30:57.271 He came back to pick up his mom--they tackled him. 30:57.272 --> 30:58.647 We need to question him about the shooting. 30:58.648 --> 30:59.857 Okay. After we clear him medically. 30:59.858 --> 31:01.316 You know the drill. 31:01.317 --> 31:03.068 He has head trauma-- probable concussion. 31:03.069 --> 31:04.528 Dr. Mohan, why don't we do a complete neurological exam 31:04.529 --> 31:07.156 in BH-2 and put him in line for a CT? 31:10.451 --> 31:13.370 We got a Pink coming in. 31:13.371 --> 31:14.746 Where's his mom? 31:14.747 --> 31:18.208 Still outside talking to the police. 31:18.209 --> 31:20.544 This is fucked up. I didn't do anything. 31:20.545 --> 31:22.379 Then who shot all of these people, huh? 31:22.380 --> 31:24.715 I don't know, how about you go look for him, dumbass? 31:24.716 --> 31:26.508 David, are you all right? 31:26.509 --> 31:28.218 No, man, I'm fucking far from okay. 31:28.219 --> 31:30.178 Okay, okay, we're gonna get this straightened out 31:30.179 --> 31:32.098 right now. 31:43.234 --> 31:47.237 I'm still bleeding! Please. I need something. 31:47.238 --> 31:49.573 No hemotympanum, no head trauma. 31:49.574 --> 31:53.785 Pulse is strong at 72. O2 sat perfect at 99. 31:53.786 --> 31:57.331 Um, do you need pain medicine? 31:57.332 --> 31:58.540 Ma'am, we're trying to help you. 31:58.541 --> 32:01.252 We just need you to let us know. 32:03.046 --> 32:04.838 Okay, let's try and find her a gurney 32:04.839 --> 32:06.298 and give her a full neuro exam. 32:06.299 --> 32:08.091 Can you put her in 9? 32:08.092 --> 32:10.218 - Drug overdose? - No. 32:10.219 --> 32:12.262 Normal pupils, normal pulse. 32:12.263 --> 32:14.389 Brain injury? 32:14.390 --> 32:16.016 No, she was walking with a steady gait. 32:16.017 --> 32:17.392 Still needs a head CT. 32:17.393 --> 32:18.727 Well, that's not gonna be for hours. 32:18.728 --> 32:21.104 I could drill EZ-IOs on both sides. 32:21.105 --> 32:23.815 It worked on the last guy. 32:23.816 --> 32:26.401 Maybe it's PTSD from all she's seen. 32:26.402 --> 32:27.903 Is Psych even here? 32:27.904 --> 32:29.655 No, but maybe she just needs a quiet place. 32:29.656 --> 32:32.074 Well, knock yourself out. 32:32.075 --> 32:33.825 What's up, Whitaker? 32:33.826 --> 32:35.786 Junctional tourniquet appears to be working. 32:35.787 --> 32:37.371 No new blood on the gauze. 32:37.372 --> 32:39.290 You're looking good, Carmen. 32:41.292 --> 32:43.710 Is she--Carmen? Carmen? 32:43.711 --> 32:45.629 Pulse is thready. How long has she been like this? 32:45.630 --> 32:48.632 She was awake and alert a minute ago. 32:48.633 --> 32:50.384 All that blood loss is catching up with her. 32:50.385 --> 32:52.095 Run in a liter wide open. 32:53.930 --> 32:56.723 Uh, huge collection of blood near the bladder. 32:56.724 --> 32:57.766 The bullet must have tracked north 32:57.767 --> 32:59.101 and hit the external iliac. 32:59.102 --> 33:00.602 We stopped the bleeding near the leg, 33:00.603 --> 33:02.437 but she's still bleeding internally--we need Mel. 33:02.438 --> 33:03.772 No, we need to give a unit of blood 33:03.773 --> 33:05.148 and move her to the red zone. 33:05.149 --> 33:06.609 Okay, let me see if they have space. 33:07.610 --> 33:09.736 - Coming through. - Where's Robby? 33:09.737 --> 33:11.279 In BH-2 with the possible shooter. 33:11.280 --> 33:12.948 Can you guys take a new patient? 33:12.949 --> 33:14.241 Not right now. What do you got? 33:14.242 --> 33:15.617 Hypotensive pelvic bleed. 33:15.618 --> 33:18.203 Transfuse two units. We'll get to it. 33:18.204 --> 33:19.621 Abbot! 33:19.622 --> 33:21.415 I got a carotid injury, popped a clot. 33:21.416 --> 33:22.499 I'll be right there! 33:22.500 --> 33:24.960 Help me out. 33:24.961 --> 33:27.963 - Is that Robby with David? - Yeah. 33:27.964 --> 33:30.340 I saw the cops bring him in. 33:30.341 --> 33:31.717 Who's David? 33:31.718 --> 33:33.343 High school kid who was making threats. 33:33.344 --> 33:35.637 - You think he did this? - Guys, focus on the patients. 33:35.638 --> 33:37.264 What do you got? 33:37.265 --> 33:39.599 Ooh, okay, sterile IV tubing, umbilical tape, 33:39.600 --> 33:42.729 and red rubber Robinson, and sterile gloves. 33:51.863 --> 33:53.905 We got a Pink coming in. 33:53.906 --> 33:55.992 Let's take the long way around. 34:00.955 --> 34:02.706 I can put Jake in the family room. 34:02.707 --> 34:04.332 No, it's okay. I'll do it. 34:04.333 --> 34:05.917 Defect bypass with IV tubing. 34:05.918 --> 34:08.211 You ever done a Rummel tourniquet? 34:08.212 --> 34:10.298 Robby, can you help me with a Rummel? 34:26.814 --> 34:28.315 Toughest part is getting the umbilical tape 34:28.316 --> 34:30.150 through the tubing. 34:30.151 --> 34:32.277 And clamps. 34:32.278 --> 34:34.237 - Very cool. - You guys got this? 34:34.238 --> 34:35.823 Oh, we're good. 34:46.334 --> 34:48.752 Dr. Robby, I have a retroperitoneal bleed. 34:48.753 --> 34:50.128 - Get Abbot. - He's busy. 34:50.129 --> 34:51.963 Okay, stabilize and find a surgeon. 34:51.964 --> 34:53.424 Get in the chair. 35:03.643 --> 35:05.853 Hey, what's going on? 35:14.195 --> 35:17.781 Leah's injuries were really serious. 35:17.782 --> 35:19.866 She stopped breathing. 35:19.867 --> 35:23.787 We put a tube down her throat to deliver oxygen. 35:23.788 --> 35:28.500 We were able to drain the blood that was collapsing her lungs. 35:28.501 --> 35:31.545 We gave her as much blood as we could. 35:31.546 --> 35:33.588 We even transfused some of her own blood 35:33.589 --> 35:35.590 that was in her chest. 35:35.591 --> 35:38.385 But we were unable to... 35:38.386 --> 35:41.472 get ahead of the massive blood loss. 35:43.391 --> 35:45.101 Her heart stopped. 35:46.477 --> 35:48.479 You saw me doing CPR. 35:49.981 --> 35:53.024 We did everything that we could. 35:53.025 --> 35:54.694 She's dead? 36:04.495 --> 36:06.079 No, no, but I-- 'cause I was talk-- 36:06.080 --> 36:07.622 I was talking to her after she got shot, 36:07.623 --> 36:09.416 and she was talking. 36:09.417 --> 36:12.961 Her heart was damaged beyond repair. 36:12.962 --> 36:16.631 There was nothing that we could do to save her. 36:16.632 --> 36:18.842 I want to-- I want to see her. 36:18.843 --> 36:20.343 I'm really sorry, man, but you can't. 36:20.344 --> 36:22.137 Why not? 36:22.138 --> 36:24.681 Because this is an active police and FBI investigation. 36:24.682 --> 36:26.641 - She's--she's dead. - I know. 36:26.642 --> 36:28.393 They're gonna release her to her parents 36:28.394 --> 36:30.437 in a couple days. 36:30.438 --> 36:32.856 No, please, you-- you have to let me see her. 36:32.857 --> 36:34.734 Please, please, please. 36:37.320 --> 36:38.528 Bringing in mail. 36:38.529 --> 36:40.698 - How's she doing? - Still has a pulse. 36:44.327 --> 36:46.703 - What are you doing? - Prepping for REBOA. 36:46.704 --> 36:48.663 Are you crazy? Did Abbot approve this? 36:48.664 --> 36:51.708 He said, do what you have to do. 36:51.709 --> 36:53.293 Attendings are all tied up. 36:53.294 --> 36:55.253 If I can blow up a balloon in the aorta, 36:55.254 --> 36:57.255 it'll stop the bleeding. 36:57.256 --> 36:59.382 It'll cut off the blood supply to half her body. 36:59.383 --> 37:03.428 I'll only go in a few inches, zone three, below the kidneys, 37:03.429 --> 37:05.180 until she gets up to the OR. 37:05.181 --> 37:08.058 Glove up, Huckleberry. 37:08.059 --> 37:10.602 Okay, you're gonna need an ultrasound, X-ray. 37:10.603 --> 37:12.395 Not today. 37:12.396 --> 37:13.855 Have you done this before? 37:13.856 --> 37:15.357 It's a central line. 37:15.358 --> 37:17.442 I just need to hit the femoral artery... 37:17.443 --> 37:19.402 like that. 37:19.403 --> 37:20.946 Piece of cake. 37:20.947 --> 37:23.531 All right, guidewire, then introducer sheath. 37:23.532 --> 37:25.075 Santos is doing a REBOA. 37:25.076 --> 37:27.327 - Oh, no, no, no way. - Yes way. 37:27.328 --> 37:30.288 Um, no, we need an attending or a senior resident for that. 37:30.289 --> 37:32.583 Oh, ye of little faith. 37:34.794 --> 37:36.796 Victim identification. 37:40.299 --> 37:42.385 - Are you sure? - Yes. 37:51.936 --> 37:55.022 - All these people are dead? - Yeah. 38:00.027 --> 38:02.196 Which one is Leah? 38:04.365 --> 38:07.827 What number do you have on--on your wrist? 38:09.620 --> 38:11.247 91. 38:38.232 --> 38:40.191 I'm at 15 centimeters 38:40.192 --> 38:43.486 with 5 cc's of saline so far. 38:43.487 --> 38:44.946 A REBOA? 38:44.947 --> 38:46.990 - Are you shitting me? - I told her to stop. 38:46.991 --> 38:48.867 Uncontrollable bleeding from a pelvic artery-- 38:48.868 --> 38:50.410 no other options. 38:50.411 --> 38:52.037 We need an art line to know if the BP's up. 38:52.038 --> 38:53.955 We'll go with pulse strength and mentation. 38:53.956 --> 38:56.249 Carotid's weak. Radial's barely there. 38:56.250 --> 38:57.542 Another 3 cc's in the balloon. 38:57.543 --> 38:58.918 Injecting. 38:58.919 --> 39:00.587 I'll try for palpable systolic. 39:00.588 --> 39:01.714 Yes, go for it. 39:05.509 --> 39:08.053 Whoa. Uh, radial's much stronger now. 39:08.054 --> 39:09.846 Lock the balloon. Check the wound. 39:09.847 --> 39:11.139 Go. 39:11.140 --> 39:14.017 - BP's 110 by palp. - That'll do. 39:14.018 --> 39:15.602 Yeah, wound's dry. Barely a trickle. 39:15.603 --> 39:17.687 That's because there's no blood going to her legs. 39:17.688 --> 39:19.105 Okay, the clock is ticking. 39:19.106 --> 39:20.607 Balloon can stay up for one hour, tops. 39:20.608 --> 39:22.317 Get IR and Vascular on the case. 39:22.318 --> 39:24.694 On it. 39:24.695 --> 39:26.988 Hey, hey, hang in there, Carmen. 39:26.989 --> 39:28.782 You're good, okay? You're good. 39:28.783 --> 39:31.493 Okay, you never should have done that on your own, ever. 39:31.494 --> 39:32.870 Do you understand? 39:34.955 --> 39:36.373 But that was pretty badass. 39:36.374 --> 39:37.833 You saved her life. Good job. 39:46.509 --> 39:49.636 Did you-- did you call her parents? 39:49.637 --> 39:52.055 They'll give the number to our social worker, 39:52.056 --> 39:54.516 who will contact them very soon. 39:54.517 --> 39:56.351 I got their daughter killed. 39:56.352 --> 39:58.270 This is not your fault. 40:02.024 --> 40:04.275 Why--why couldn't you save her? 40:04.276 --> 40:06.237 I mean, this-- this is what you do. 40:10.574 --> 40:12.242 I tried. 40:12.243 --> 40:14.786 I really tried. We all did. 40:14.787 --> 40:16.287 If this had been any other day, man... 40:16.288 --> 40:17.747 "Had been the other day"? 40:17.748 --> 40:19.124 What the fuck does that mean, "any other day"? 40:19.125 --> 40:21.043 What, you would've saved her life? 40:25.256 --> 40:28.049 Yes. No. I don't know. 40:28.050 --> 40:29.969 I don't--I don't know. 40:31.804 --> 40:33.221 We're getting slammed up there. 40:33.222 --> 40:34.848 We've had dozens of shooting victims. 40:34.849 --> 40:36.349 You've seen it. 40:36.350 --> 40:39.102 The fact that we've saved as many people as we have 40:39.103 --> 40:41.521 is a fucking miracle. 40:41.522 --> 40:43.690 But you didn't save Leah. 40:43.691 --> 40:44.899 No. 40:44.900 --> 40:46.694 No, I didn't. 40:48.779 --> 40:51.156 And I don't know how many people I've helped today, 40:51.157 --> 40:53.742 but I can tell you every other person who has died. 41:00.166 --> 41:01.499 There was a man named Mr. Spencer, 41:01.500 --> 41:03.001 who died in front of his children, 41:03.002 --> 41:04.836 and an 18-year-old who-- 41:04.837 --> 41:06.921 who was brain dead from a fentanyl overdose 41:06.922 --> 41:08.715 and a guy with a heart condition 41:08.716 --> 41:11.468 and a little girl who drowned trying to save her sister. 41:11.469 --> 41:12.719 And I'm gonna remember Leah 41:12.720 --> 41:14.596 long after you've forgotten her. 41:14.597 --> 41:17.265 Oh, fuck. Oh, fuck. I'm sorry. I'm sorry. 41:17.266 --> 41:19.225 You got to go, man. You--you got to go. 41:19.226 --> 41:21.060 You got to go. You got to go. 41:21.061 --> 41:22.645 Wait, Robby. Robby, wait, wait. 41:22.646 --> 41:24.523 Put him back in his bed, please.