We had a break in the system for a couple of hours around noon.
- But now a second cycle... - Did they clear the Eisenhower yet?
- Forget about it. - I swear I took out $40 yesterday.
Are we doing this? Because I have a pilonidal cyst waiting.
She's finishing her last patient.
Chuny, Nolemad's PTT is 96.
Hold up heparin for an hour, then reduce the rate to 1100.
- Ok. After the party. - How long is that?
Five minutes. Don't go anywhere.
Stick this back in the fridge. It's melting.
- Malik, I'm waiting on the L-spine series. - She had a couple sutures to go.
- Does she know we're waiting? - It's a surprise.
- What surprise? - Dr. Finch's last day.
- Already? - Yep, and you owe me $10...
...for the massage and facial we got.
It's not here. Can I pay you tomorrow?
- Whatever. I offer rolling credit. - Are you backing up?
No, kicking butt. Storm knocked out six traffic lights south of Division.
There's three sets of multiple MVAs all tucked in.
Construction on Wacker's all mud. A crane fell in the river.
Hey, Abby, when you get a chance, I need a repeat CBC and a Beta HCG in 4.
- Where are you going? - Come get me when she gets here.
- Me too. - Wait. You leave, other people leave.
- No one will be here. - I have to pee.
- Well, then pee fast. - Gallant.
I got a disimpaction for you in 3. Go help Cleo with her sutures when you're done.
- You're gonna supervise my first couple? - Don't send him. She'll just take longer.
All right. Just clean the old girl out, then.
- Haleh, Medical Records needs help. - I don't work for Medical Records.
- Basement is flooding. Losing charts... - Then call Housekeeping.
- ... payroll. - Be right there.
Dr. Weaver? Michael Gallant, third-year on ER rotation.
I know. Frank, did Maintenance get those sandbags out in the bay yet?
- Doubt it. - I didn't see any.
Call them. I don't want water coming through the doors. Then help Haleh.
- Can we talk about this warning letter? - I write a lot of letters.
I missed journal club last night. I had another commitment.
We all have commitments.
ER conferences are a requirement of your rotation.
- Is she here yet? - Hey, Abby, can you call Telecom?
The switch is in the basement. I don't want internal lines going down.
- Do you know the number? - Find it.
I had a mandatory exercise involving my scholarship.
Financial aid offers multiple meetings.
- No, no. This is Army Reserve duty. - Okay. All right, just review the notes.
- You'll remove the letter from my file? - Yeah. Get me a schedule.
Stab wound to the abdomen en route. Five to 10, depending on traffic.
Prep Trauma 2, break out a cutdown tray, and page Surgery.
- So did I miss the cake or what? - We're still waiting for her to finish.
Messenger dropped this by for you. Genetadine Labs.
What, are you having yourself cloned?
Genetadine. That's the cloning place, right?
- They mainly do DNA analysis. - Yeah, cloning.
- Hi. - Hey.
- You need something? - No.
- I said, any history of heart disease? - You didn't.
- Yes, I did. - No, you didn't.
- Yes, I did. - Do you get spiral CTs...
- ... to rule out PEs now? - Hold on.
- How many heart attacks have you had? - Just one. Angioplasty fixed me right up.
- Angioplasty? - Until this morning when I woke up.
So instead of seeing a doctor, you stayed on your feet directing traffic.
- Aren't you a doctor? - Now it's too late.
- What, I'm gonna die? - No.
I just meant any damage you did to your heart is already done.
I'm gonna be okay, right?
I need you to stay overnight for observation, and stay on the monitor.
And no. We're still doing V/Qs because they keep promising us a better scanner.
What kind of bedside manner is that?
The idiot has had an MI after stenting, he stands out in the rain for eight hours.
- I don't think yelling's gonna help. - It might.
You know, you might want to think about getting out of the ER.
That advice is only about nine years too late, but thank you.
Seriously. You never talked to patients like that.
I've had an epiphany.
Dr. Greene.
Medevac coming in. Diverting from Children's. Near-drowning.
- Did he arrest? - I don't know.
He must be pretty sick if they're flying him in the rain.
- It's supposed to be a surprise. - I hate chocolate mint.
- Yeah, I didn't pick it. - You think I should stick around?
- They're going to gather everyone soon. - Hey, you're not supposed to see that.
I'll be upstairs. Page me if anyone needs me for anything.
- I'm sure that we will. - Carter, isn't it? John Carter?
- And you would be? - The girl by the pool.
Oh, right, yeah. The one without the answering machine.
It broke in the move. I haven't had time to go shopping.
- That's convenient. - Hey, I called you.
- Did not. - I spoke to your manservant, Harry.
Henry? The night butler? He didn't say anything about it.
It is the 21 st century. You can get voicemail.
- You need to get better help. - You volunteering?
- Any benefits? - Well, there's the outfit.
- Dream on. - Hey, Carter.
- Hey, how'd it go? - He did good.
Couple pounds of stool. Only gagged once.
Yeah, those old ladies can surprise you, huh?
- Yeah. How do I know when I'm done? - You develop a feel for it.
- Where's the stab wound? - Should be here by now.
Call Dispatch. Make sure it's rolling up. Gallant, you're with me.
Don't worry about it. It will only hurt for a day or two.
Do you think I'm mean to the patients?
- Only the ones who deserve it. - What about the ones who don't?
- You're nicer than I am. - That's not much solace.
Sorry.
Oh, my God.
- I distinctly heard him. - Who?
The weatherman this morning. He said, "Party cloudy, chance of rain."
Well, he warned you.
Twelve-year-old boy. One-story fall and near-drowning.
Moderate respiratory distress, crackles on the right.
- What's his name? - Daniel.
- Daniel, having trouble breathing? - I let go of him.
- Who? - Joey. I couldn't hold on.
His brother. They were playing by the river.
- Where is Joey? - Rescue's still looking for him.
All right, let's slide him out.
Here it comes.
Must be a police car.
- Does it usually take so long in the rain? - Shouldn't.
- You need a jacket? - No. We won't be out here long.
- I can go get one for you if you- - I'm fine.
Sorry I haven't looked at your file. You're military?
- Yes, ma'am. U.S. Army Reserve. - ROTC?
No, I did a year of active duty. Now I'm in a scholarship program.
So work in the ER might not be so crazy to you.
I think it's a whole different kind of crazy, ma'am.
- There you are. I was looking for you- - No, listen, I need to see you.
I'm gonna pick up my son and drive to your office.
Well, if you're not there, I'll get another attorney.
You're damn right I'm upset. You told me not to-
You told me not to fight this thing. Now Roger's gonna try to hang me with it.
- Fine. I'll see you in a half an hour. - What happened?
The DNA analysis shows that I'm not Reece's biological father.
Oh, God, Peter. I'm so sorry.
I told myself a long time ago it wouldn't matter, that I'm his father.
- I won't let that son of a bitch change it. - I'm going with you.
No. They're getting ready to throw a party for you.
I don't give a damn about a party. Let's go.
- Frank, where the hell is this thing? - What thing?
- Cleo, are you done? - I'll call to say goodbye.
- Where's the stab wound? - I don't know.
I was sloshing around downstairs. I'm billing you for these shoes.
- Find out what happened. - Dr. Weaver, it's here.
Twenty-four-year-old female pedestrian, hit by a car in a crosswalk.
- Miss, can you tell me your name? - Jill. He hit my dog.
Probable LOC. GCS, 13. BP,100/75. Pulse, 95.
- Where were you stabbed? - What?
- No, she was hit by a car. - Wait, where's the stab wound?
- What stab wound? - Get her inside.
Your dispatch needs to get it together. We didn't know you were coming.
The one we're waiting on is over half an hour late.
Dr. Weaver, Unit 37 got slammed by an SUV in a downed intersection.
- Ashville and Western. - Who's 37?
- Our stab wound. - Pickman.
- Rescue is trying to cut him out. - Is she okay?
Don't know about the driver. The pregnant woman is in bad shape.
- The stab wound's pregnant? - And bleeding.
- Okay. Wait! I'm going with you! - What, you're leaving?
She could be a dropsy. Have Carter take this case. I'll be right back.
- What do I do? - Get in.
I couldn't hold him.
Daniel, I need to listen.
He's retracting.
ABG. He's decreased on the right.
BP's 80 over palp.
- Got ahold of the parents? - Firefighters did.
Get on the radio and make sure.
Sucking chest wound.
Abby, Vaseline gauze, Elastoplast, chest tube tray,
and page Surgery.
Daniel, you got a hole in your chest sucking in air every time you breathe.
We need to plug it up, all right?
BP's 110/70. Still no sats.
- Ready? - Yep.
- That should be better. - They find Joey?
I don't know. We're gonna ask the firemen.
- Please, they have to find my brother. - Everything's gonna be okay. All right?
10 blade.
Stay close to me and watch where you're going.
- You okay? - Yeah. Both airbags deployed...
- ... but he has a bad seat belt side. - Sir, do you know where you are?
- The middle of the street. - Lake had a flail chest. We moved him.
- Pickman's in back with an open tib-fib. - She conscious?
Yeah, but her patient might be hemorrhaging.
Listen to his lungs on the way in. You might need to needle him.
Okay, got it!
You okay, Doris?
I messed up my leg bad. It's open, but I got a pulse in the foot.
- I had to move it myself. - I need you to stand back!
- I'm an emergency physician at County. - Good for you.
Stand back! We need to open up this can. You help us.
What's the status of your patient?
A 28-year-old woman, eight months pregnant, mugging victim.
Son of a bitch!
- You okay? - I cut my hand!
Gallant, help them. You have vitals?
- Okay, again! - BP, 90/60.
- Grab yourself anything? - I couldn't reach the bag.
- Okay, get her out, then 10 of morphine. - I'll get the board.
- Get the C-collar. What's her name? - Vicki.
Vicki, my name is Dr. Weaver. Where are you having pain?
All over.
- Can you see the bone? - Careful. Careful.
Does it feel like you're having contractions?
Brody!
No! Don't touch him!
Gallant!
Brody! Brody, are you okay?
He's unresponsive. Get a monitor, and let's roll him.
Airway's patent. Checking for a carotid.
He's not breathing. No pulse.
- You know CPR? - Yes.
Start compressions.
- I'll do it! - No! I need you to check on that woman.
- He's in my unit! - Check on her!
Zadro, I need the defibrillator and an ambu-bag.
- Coming. - Come on, breathe!
That was stupid. That was really stupid. You could have both been electrocuted.
- Stop. - Sorry. It was instinct.
I told you not to touch him.
You're okay if your feet don't touch the ground.
Guess what? It's raining. Water conducts electricity.
- I'm all right. - You were lucky.
- Still no pulse. Bag him. - Got it.
- It's charging to 200. - She's okay.
- Clear. - The tires are insulating the rig.
I can't get in. That hot wire keeps lighting it up.
- Is she conscious? - Yeah. She's in labor.
You go back and tell her it's gonna be okay.
- He's one of my men! - Do it.
Three hundred. Clear.
- He's venting. - Got it.
- You got a rhythm? - Yeah.
Intubate him.
A hundred of lido down the ET until you get a line.
That's two milligrams a minute.
Please help me. I'm bleeding.
Hang in there. We're gonna get you out of there.
Vicki, it's Dr. Weaver again. Did you feel a shock?
- No, I don't think so. - Is he breathing?
We got him back for now. Vicki, tell me if you're bleeding from your vagina.
The baby's not moving.
I need you to feel down there and tell me if you're bleeding.
Hold on! I'm coming in.
- No, no. I can't let you do that. - Her baby's probably in distress.
First rule of an accident site, don't create more casualties.
Casualties?
We need an engineer out here. They're not showing fault in the power grid.
- It looks like a fault to me. - That's what they're telling me.
- Hey, I told you not to do that! - Just turn the damn power off!
Did you hit your head, lose consciousness?
I don't know. I remember walking in the street, seeing Gordon lying in the rain.
- Gordon? - Her dog.
BP's 100/40.
He kept scratching at the door. I had to take him for a walk.
- Breath sounds equal. - No hemotympanum.
- But I wanna get a head CT. - Is this the hit-and-run?
He didn't stop?
- Pulse ox is 94 on 4 liters. - Miss...
- ... can you describe the car that hit you? - It was silver, I think.
- Are you sure? - No.
- Does that hurt? - Yes.
- Did you take my dog to the vet? - I'm afraid your dog died.
Full trauma panel, C-spine,
chest, AP pelvis, Foley, give her 10 of morphine.
HemoCue's 9.8. Let's get an ultrasound before a CT.
- Dr. Greene is using it. - Go see if he's done.
- What kind of dog was he? - He was a terrier mix.
Those are the best kind. You know, he probably went really fast.
Don't hear a dorsalis pedis pulse. Go get me a Doppler.
Check an ICON before she goes to Radiology.
Little fluid in Morrison's pouch.
- Can we have that when you're done? - It's all yours.
Page Pedes Surgery. Another crit in 20 minutes.
- You want to cath urine? - On a CPK and another portable chest.
Daniel, you're doing much better.
We need to keep an eye on you for the next couple hours...
...just in case you need any surgery.
- He's dead, isn't he? - What?
Joey. He drowned.
- I don't know. They're looking for him. - He didn't want to go.
- Where? - To the river.
He was scared, but I called him a baby.
- You didn't know this would happen. - He's only 6.
- Parents are on their way. - They're gonna hate me now.
- They're gonna be happy you're safe. - It should have been me.
- Watch the monitor. His heart's irritable. - Looks like regular sinus rhythm.
- Okay, let's go! Shut the door. - Okay.
Hey, stay clear of that rig!
- Hey, hold on. - It's okay.
- Is she okay? - Hypertonic contractions.
BP's dropping, 68/40.
That's way too low, right?
- What?! - Nothing, Vicki.
I need you to be quiet. I just need to listen.
- What was that? - It's the power line!
- Fetal heart tones are 70. - Is that bad?
Maybe the transformer will blow out and kill the line!
Dr. Weaver!
I need your help. Can you get in here safely?
- Yeah, I'd have to jump. - Okay, then jump.
Got it.
Search through the cabinets. Find me an amp of cardiac lidocaine.
- Lidocaine? - Just do it.
Vicki, your placenta is detaching. It's bleeding into your uterus.
Oh, God!
Hey! I told you to stay away from the damn vehicle!
She's bleeding out! Why is the power still on?
There's a crew on the way!
The only way to stop the bleeding is to deliver your baby surgically.
- It's too early. - it's not. Thirty-six weeks is full-term.
Take me to the hospital!
Honey, I want to. I want to, but I can't right now, all right?
Shut it off from the plant!
It's supposed to burn through on its own.
They need to authorize the shutdown.
Vicki. Vicki, I need you to listen to me. I'm an emergency physician.
I'm trained to perform a C-section only after the mother has died.
And in about 15 minutes, that's what's gonna happen.
Meanwhile, your baby is in danger. But I might be able to save you both...
...if we take the baby now and stop your internal bleeding.
Are you willing to take that risk with me?
- I think so. - You sure?
- You've observed a C-section? - I haven't done OB before.
- Well, you'll be ahead of the curve. - Lidocaine.
- Know how to take a blood pressure? - Yeah.
Okay, take one. I need it every couple of minutes.
Squeeze that saline bag...
and find me every 4-by-4 and bandage we have.
Okay, Vicki. Vicki, hang in there.
I'm gonna give you a shot in your spine that will numb your belly and legs.
All right, find me a 10 blade.
That's a scalpel.
When's the last time you've done this?
- Peter, the DNA test was inevitable. - There has to be a precedent.
Not in a custody battle between two men without genetic ties to a child...
...they raised. It's stepfather versus stepfather.
- I'm not his stepfather. I'm his father. - Sorry. Father.
Until Carla died, Roger never questioned that Peter was Reece's dad.
- Irrelevant. - She put my name on the birth certificate.
If she were alive, Carla couldn't contest the paternity.
- But Roger can? - Ironically, yes.
Peter, you are going to have to allow Roger to resume partial visitation.
- No. No way. - As we speak...
...Roger's attorney is drafting a pre-trial motion for visitation...
...until this is resolved.
You don't stipulate now, you'll lose that hearing and be painted as the heavy.
I'm the heavy? He's trying to take my son from me and I'm the heavy?
You need to be seen by the judge as someone who's interested...
- ... in Reece's well-being. - I am.
Good. Then you need to listen to me.
You have to stay focused on the endgame.
And not let anger or fear impede that goal.
Vicki, stay awake. I need you to stay awake.
- BP's dropping. 50. - Spike another liter.
- "Spike"? - Take the pointy end of the bag...
...and hang it up. Hey, you! Firefighter!
- Lopez! - Lopez, I need more light!
Scotty! Scotty, turn up the brights!
I need you over here. Get out.
- You're doing a vertical incision? - Yeah.
Be ready with that hemostat.
We're gonna clamp the big bleeders and pack up everything else with gauze.
All right, here we go.
I need you to put your hands there and pull back.
- Where? - Just do what I do from the other side.
Vicki, you feel that?
- Just some pulling. - Okay.
Okay, fascia's exposed.
Okay, separate the rectus, down to the fascia.
All right, more retraction.
- Okay. - Pull back.
- My baby. - Hang on. Hang on, Vicki.
Okay. I'm into the peritoneal cavity.
Here's the uterus. Give me the scalpel.
You want me to let go?
- Scanner 1 will be ready in 10. - Do a sound on the chest.
They're gonna take you upstairs and scan your whole body for other injuries.
I want you to tell the nurse if you need any more pain medication, okay?
I'm sorry about your dog.
What?
- "He probably went really fast." - She was upset.
She could have solid-organ rupture. The dog's the least of her concerns.
It can be traumatic to lose a pet, especially if you saw it happen.
- What was his name? - Who?
Your dog.
Happy. He was a Lhasa apso, and he got run over by a car when I was 11.
Oh, did he go really fast?
No. Crushed his pelvis.
- In the river earlier today... - Someone drowned?
- Brother of the boy in Trauma 2. - Oh, I'm sorry. Did they find him?
- Not yet. - You can't leave anything around here.
- What? - Some derelict stole my PalmPilot.
- Maybe you misplaced it. - I had it two minutes ago.
- Dr. Carter. - Alger. Alger, what are you-?
It's your grandmother. I found her in the driveway. I think she broke her hip.
Get a gurney!
There's a cut on her head.
- She was driving? - She went during the break in the storm.
- Gamma? - Oh, John, it's terrible. It hurts.
Okay, I know it does. Just lay still.
- Did she fall down? - I don't know.
But the right leg is shortened and externally rotated.
- I think I broke my hip. - I think you did too.
- What happened to your head? - I thought it was best if I drove home.
I didn't realize how much I was bleeding, so I slipped.
- You were in an accident? - Well, I don't-
It was raining. I couldn't see. I think I hit a dog.
- Where were you driving? - It was supposed to be clear and sunny.
- Retract the bladder anteriorly. - Like that?
More. Watch your fingers.
- I'm opening the lower uterine section. - Is that the amniotic fluid?
Yeah. I'm in.
It looks like a lot of blood.
Auto recloser is stuck open or something. He's trying to bypass it.
- I don't care. Just shut it down! - It ain't that simple, lady!
- Damn it! - What?
I cut a uterine vein. Another clamp now!
- BP's dropping. 60 systolic. - Keep squeezing in that saline.
- Doesn't she need blood? - I don't have any blood!
- Fundal pressure. - What?
Push the baby down towards me from the top of the uterus.
- Okay. Right here? - Yes. Yes. Now.
- Is the other ambulance here? - It's pulling up.
Call County General. Say we need an O.R., OB Attending, and a neonatologist.
- Grab the bulb syringe. - Okay.
Suck out his nose and mouth.
- Is there an exit wound? - Sure is. Blew off his boot.
A transthoracic current pathway.
- You saw it? - He lit up like a Christmas tree.
I need the room. Post-arrest electrocution.
- What's open with a monitor? - He's a fireman.
Daniel, we're gonna shuffle you to another room.
CK is normal. Tox screen tested positive for marijuana.
- Marijuana? Were you smoking dope? - C-spine, chest, pelvis.
- I'm sorry. - You're sorry.
For getting high and taking Joey out to the river?
- I didn't smoke today. - I knew it. I knew it.
We saw the river on the news. We wanted to see it.
- "We"? Joey's 6 years old. - He said he wanted to see it.
- You're gonna blame it on him now? - No, it's my fault.
- You're damn right it's your fault! - Hold on.
I'm Dr. Greene. We need to get Daniel into a room.
Then I'll come out and brief you on your son's condition.
- I'm sorry, Mom. - You heard from the fire department...
- ... about Joey? - Not yet. They're still searching.
- Between these clamps, right? - Yes.
- Vicki! Vicki, are you still with me? - Is that my baby?
Yes, honey. You have a boy.
He's crying. Do you hear that? He's crying.
Could be stronger. We need to get a heart rate.
Okay, 10 minutes! They're gonna shut the entire grid off!
Why can't they do it right now?
They have to warn emergency facilities they're going off-line.
- Okay. It's 88, I think. - You think or you know?
It's 88.
- One-minute Apgar is seven out of 10. - It'll get better, right?
We need to wrap him up. He needs fluids, oxygen, maybe blood.
You said we didn't have any blood.
You need to get him to the hospital.
Nine minutes!
Vicki?
Vicki, wake up!
Damn it! She's exsanguinating! I have to clamp off the uterine artery.
Okay, I'm going! Get out of the way!
- No! - It's this or I throw him to you!
- No! No! Tell him to stop! - Go.
- Is he okay? - I got him.
- Okay, get him out of here. Go! - Let's go. Let's go.
Transformer just blew. Does that mean the circuit's dead?
I'm gonna sew this up.
You won't feel anything.
You okay?
I see a lot of fathers who come in here...
...and they're upset when their kids are hurt or missing.
Sometimes they say things they don't mean.
He's not my father. He's my stepfather. Joey's the real kid.
- And that makes you...? - A pain in the ass.
Did it come back?
- What? - You were waiting for a chest x-ray.
Right. Lungs re-expanded. Tube's in a good position.
I'm repairing the chest laceration now.
- Mom? - So he's fine?
For now. He'll need to be monitored in the PICU.
- Mom, I'm sorry. - You shouldn't have been out there.
- Yeah, I know. - Mrs. Pendry-
Why did you take him there? You didn't think. You never think.
I know. It should have been me that drowned.
- Yes. But it wasn't, was it? - Mrs. Pendry-
- It was Joey. - Mrs. Pendry...
...I need to talk to you outside.
In here.
What are you doing?
My son is missing. No one can find him.
Right. And your other son is in there who needs your comfort and love.
This is none of your business.
You want him to feel responsible? Guess what? He already does.
You want him to hurt? He already hurts.
You want him to hate himself, keep it up.
- They found him. - What?
- He's stuck down river. - Is he all right?
I don't know. They're trying to get to him.
It'll be okay, Peter.
We don't know that.
I see you two together. I know.
What did you do that for?
You wanted to?
Are you expecting someone?
- Yeah? - Peter.
No, Peter! This doesn't have to go any further, man!
Look, please. Just hear me out, okay?
Come on.
Look, Reece lived under my care and my roof for most of his life.
All I'm asking for is some kind of arrangement that recognizes that.
- It's too late for that. - Look, come on, brother.
- You want to put him through a trial? - I'm keeping my son.
- I guess I'll see you there. - Yeah, you will.
There's been a search going on ever since the boy's brother was pulled out...
...earlier this evening.
Swift Water 43. County General waiting.
- Open, channel two. - Copy that.
- Is he alive? - They don't know.
Frank, call the burn unit. Brodoff is going to the O.R. for a fasciotomy first.
Is that your electrocution?
Compartmental pressure is almost 60. Otherwise, he's lucky.
- Anyone want anything from the store? - It's pouring outside.
Malik and Yosh don't like the lounge coffee. It hurts their stomach.
- Grande vanilla cappuccino. - It's okay. It's on me.
He's in arrest, but they're flying him in. ETA,15 minutes.
- Does he have a pulse? - P.E.A.
Luka, our new med student's coming in BOA.
Weaver opened up a pregnant woman trapped in an ambulance.
- Opened up? - C-section.
- In the field? - She'll have some explaining to do.
- Can I get you something, Abby? - Nope.
- Cigarettes? - No, thanks.
- What's that? - What?
- What time is it? - Seven.
- What's wrong? - Give me your bag!
- Let me see inside your bag. - No!
What are you doing?
My PalmPilot alarm goes off at 7 to remind me to take my Vioxx.
- Come on, let go of her bag. - After I see inside.
- Frank! - For chrissakes.
Fabulous! First you steal it, then you break it!
- That's not yours. - I'm calling the police.
Hey, hold on. This is a mistake.
Oh, yeah! Yeah, my stuff just leapt into her bag!
Nicole?
And it's not just me, pal, she's ripping off everybody. Ask Abby.
Nicole!
- I need some help here! Newborn! - Luka, the baby.
Dr. Weaver says he might need a transfusion.
Is he premature?
No. We gave him O-2. He needs an IV.
Elevate her legs. Cycle the dynamap.
Tilt the monitor toward me. I got it.
- I said, I got it. How bad is that hand? - It'll keep.
Sats are plummeting. She's not moving air.
Stop! Airway blocked!
- I thought you had to move her! - Need to protect her airway.
Cricoid pressure.
Cover!
Exposed flexor tendon. You're gonna need a hand surgeon.
I need to control the scene.
Get somebody else.
All right, I'm in.
Bag her! Let's go!
Draw a milligram of epi and have atropine standing by.
- Get in! - No, I'm good.
- No, you're not! - Go on, get out of here. Come on.
People think kids don't listen to their parents, but they do.
If they tell you you're nothing, you think you're nothing.
- How cold do you think that water is? - I don't know, 40.
Hope it's colder than that.
- You got a pulse? - No. No pulse.
No spontaneous resps. GCS, 3. For real.
- How long was he under? - I don't know.
We found him in debris a mile from where he fell in.
- I thought it was P.E.A. - No. Asystole the whole flight.
Hey, Gam.
Does it still hurt?
- On a scale of one to 10- - It hurts, John.
- Did she get the full amount? - In two doses.
- Give her four more of morphine. - Okay.
But I'll put her on the monitor.
Well, Gam, you definitely broke your hip.
Looks like an impacted fracture of the femoral neck.
Please speak English, John.
I need to get a more sophisticated scan to determine if you need surgery or not.
I should have listened to you about the car. I'm sorry.
Gamma...
...I think you hit more than just a dog.
You also hit a young woman.
She's okay. We're taking care of her here.
I called Mr. Stern in case you need an attorney.
- I hit a girl? - Yeah.
- I left. I drove away. - You didn't know.
But I should have checked to see. Oh, my God!
Gam, you were confused, okay? It's crazy out there. Visibility's terrible.
I'm gonna be right back, then I'll take you for that scan.
- What's wrong? What is it? - Nothing. It's just another patient.
- Page Surgery. I need a HemoCue. - What happened?
- Dropped her sats in the elevator. 88. - Any chest pain?
No. Just passed out. BP's 80/60.
I can't see the cords. I need a fiber-optic scope.
ABG, set up the ultrasound, and mix up 7500 units of heparin.
There's a lot of fluid in here. Could be pulmonary edema.
Grab the thrombolytics box. DIC panel. Troponin, CK, EKG...
- ... and a portable chest. - Two large-bore IVs.
Nuke the saline in the microwave. Get that collar off him.
- We'll need a bear-hugger. - Coming.
- Tube's out. - God, he's blue.
Number 51/2 uncuffed ET tube. Suction.
Still no pulse. Asystole on the monitor.
- Joey, wake up. Baby, wake up. - Ma'am, you need to back up.
- Oh, my God! - What is that?
- River water.
Cords are closed. I need a fiber-optic laryngoscope.
Prep the neck. I might have to crike him.
Daniel, get back to bed. I'll come get you.
Can't get a line, and he's totally clamped down.
Two cutdown trays.
Daniel, now. Lily, can you...?
- You heard him, out! Get out of here! - You too.
- What? - Out!
Cross-match her for 6 units. Two units FFP.
Stick her and send a clot.
- Is the O.R. ready? - They're waiting for you.
- I have an emergency C-section. - No kidding. I can see that.
Coburn called me, screaming. I said she must have heard wrong.
28-year-old woman trapped in an ambulance, abrupted and hemorrhaging.
And ER docs don't perform C-sections until the mother arrests.
- She will if we don't get her upstairs. - BP's up to 90.
Have dopamine standing by. Add a coag panel.
I got it from here, Kerry. Go back in the ER and stay dry.
I don't want you dying of pneumonia before your public flogging.
- I could've let everybody die. - That's the safe play.
Now if she lives, you're a hero. If she doesn't, I don't know you.
The baby.
Chuny, where's the baby?
He's pinking up. They're waiting for the NICU fellow.
Nice save, Dr. Weaver.
One milligram of vitamin K, I.M.
Erythromycin ophthalmic ointment, 0.5 percent.
Good neuro check?
Moves all four symmetrically. Lungs are clear. No retractions.
- You get a heel-stick? - Glucose, 70. Pulse, 120.
You did it.
Okay.
CBC, lytes, BUN, creatinine and a bilirubin.
Luka?
Can I talk to you?
- Bradying down to 60. - Hurry up, she'll arrest.
I'm in, I think.
Sats are falling.
There's too much edema. Is Mark done yet? I need that fiber-optic.
- Air in the stomach. - What are you doing?
Try to suction the cords. Inflate the balloon.
- Keep it in, you'll have a better shot. - No, just- Pull back really slowly.
There we go. Slowly, slowly.
Little more.
All right, there are the cords. Give me the tube.
Open a crash cart. Draw one of atropine and an amp of epi.
Got it.
Come on, hold on.
89, 90.
Pulse ox is climbing.
Good breath sounds. Nice work.
Saline's running.
Dilute two mgs of atropine and one mg of epi down the tube.
How high does the temp go on that vent?
Forty centigrade.
Set tidal volume at 200 on 100 percent.
Still no pulse and no pressure.
All right, keep warming him.
We got to get that Foley in. We're gonna irrigate the bladder.
We're gonna save this one.
- You want me to...? - No, no, he can stay.
Cycle the lavage fluids. Repeat the temp, max out the blower.
- Cardiac activity on the monitor. - What?
- Looks like P.E.A. - That's good.
Amp of bicarb. Charge the paddles to 60.
- We don't have anything to shock. - We will.
- Pacing pads. - Good lung sounds.
- Come on, Joey. Come on. - V-tach.
Yeah, baby, let's go. Clear.
- Polymorphic. - Okay, charge to 120.
Check for a pulse. Clear.
Bingo. Normal sinus.
Thank you, God.
Fem stick him for labs.
Full trauma panel, ABG and an art line.
Get a second cutdown. Eighteen-gauge angiocath.
- Anything after the line? - Wait and see.
-10 blade. - Hey, it stopped raining.
Impaction with mild or no displacement. Probably a type 1.
The fracture line traverses straight from the greater to lesser trochanters.
What do you think, orthopedic surgery?
Depends on the orthopod, but I'd try to keep them away from her.
One third of the elderly who go under the knife for these kind of injuries...
...die within a year from post-op complications.
She's panicking. Heart rate's up. BP's falling.
Get her out!
- Gam? - John.
- John, are you there? - I'm here.
I want to go home.
- Not quite yet. - Call your grandfather to pick me up.
I want to go home.
- Grandpa's not here. - Get him.
Grandpa's dead.
- Where am I? - You're in the hospital.
You were in a car accident. Remember, Gam? You broke your hip?
Oh, yes.
Of course.
I hit a dog. I hit a dog. He was in the middle of the street.
Is she okay?
No.
Not really.
That baby okay?
Yeah.
Dr. Greene revived a drowned hypothermic boy tonight.
Came in ice-cold and not breathing, no pulse, and he got him back.
It was a miracle.
You all right?
What is it?
- She's pregnant. - Who?
Nicole.
I see.
- Is that why she was stealing? - No. That's a-
That's a habit. She doesn't know how to trust people.
Trusting people isn't really the problem.
Her father kicked her out when she was 16.
She's had to learn to live on her own.
Her father?
She panicked, I guess. I don't know.
I was just trying to help her. I didn't think I'd be with her.
It just happened.
You sure it's yours?
- And that she's really pregnant? - She's not like that. You don't know her.
Do you?
We gave him what's called an EEG, which is a brain scan.
Everything looks completely normal.
- So that's good? - That's good.
You're gonna get your brother back, Daniel.
- Thank you for saving him. - You're welcome.
Is my mom with him?
Yeah. They're gonna move him upstairs...
...and you're gonna be up in the same room soon.
I'm gonna tell you something, but you can't tell any other kids, okay?
Okay.
Parents don't always know what they're doing.
Just because they're adults doesn't mean they know what's right.
In fact...
...some adults are wrong most of the time.
- I know that. - Good.
And I want you to promise me something.
What?
Don't listen to them.
Don't believe that you're not just as good as your brother.
Just as smart.
Just as special.
One day they may realize that...
...but you can tell them it doesn't matter because you already knew.
You knew before they did.
Dr. Weaver, Dr. Romano is looking for you. The mother came out of surgery.
They had to perform a hysterectomy, but she's doing all right.
Yeah, I know. Thanks.
He also told me that I should try to stay away from you...
...if I'm gonna survive med school.
Well, nobody actually listens to Dr. Romano down here.
Yeah, I figured that.
It was pretty amazing what you did out there.
I was a little out of my element.
Well, you wouldn't know it.
Thank you.
Why don't you go up and take her baby to her?
- They'd let me? - It's one of the perks.
- She's gonna think you're an angel. - Yeah, well...
- ... she did almost see me glowing. - You did great.
I mean, you took a risk, stayed focused, listened.
You did what was necessary. That's an ER doc.
I was scared out there for a while.
- Gallant, I was scared the whole time. - Right.
The fireman is sitting well in ICU. He's gonna keep his hands.
- Cardiac activity is normal. - Good. He got quite a jolt.
We saved everybody, didn't we?
Those people are all right now because we were there.
Some days are good days.
Yeah, I like the good days.
Enjoy them when they come.
- I'll see you tomorrow. - Good night.
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