ER

There. You got us.

- Gates is my boyfriend. - Ah, you got in!

It's a little on the pricey side, but for you, there will be a discount.

You can't abandon me in the middle of my training.

- You're not my responsibility. - You need to get laid.

- Oh, is that right? - Yeah, I'm pretty certain of it.

We're going to be okay. So let's just get past it.

Let's just go someplace new.

We've got room for one more. Who's it going to be?

Gates, the board is a mess. You're only seeing three patients.

- Feel free to pitch in. - No, no, no, my job

is to supervise and teach. Your job is to move the meat.

You know , when I was a resident, I had what was called a work ethic.

- Yes, you set the bar high. - You bet I did.

And now, as an attending-- it's not as easy as it looks.

I gotta keep a close eye on all you guys.

Exam Three is clear. Bring me syncope, impetigo and nausea.

Poor guy... heard he just quit.

No way.

- I'm looking for Dr. Lockhart. - Me, too.

When you see her, tell her I need one more prescription.

- He's got something in his eye. He can't see. - What happened?

- We were down the street from the expsision - Explosion?

Over on Michigan, they said it was an ambulance.

- Who went in that rig? - Get Bardelli on the radio.

Set up the trauma rooms.

- Dumar, you seen Sam? - No.

- All right, let's roll. - I didn't get a call.

Unit 62, respond to an explosion and car fire.

800 block South Michigan.

This is Unit 62 responding. Go! Drive!

Hold on, hold on... Hold on! Hold on!

Greg, are you okay?

Yeah, I think so. What about...

what about the guys in the back?

Hey, Bardelli.

Hey, Bards, come on, wake up, man.

Ma'am, you need to sit and wait for the paramedics.

I'm an E.R. doc at County; so's he.

- Yeah, we can help. - All right, you can assess him, but that's it.

How's your neck? Any pain?

My stomach...

- Oh, man! - Dannaker, we need a saw.

You get your guy to the sidewalk. I got him.

All right, just hang in there, Bards.

Take it easy. Take it slow.

Abby, what are you doing here?

- Wrong place, wrong time. - How's your breathing?

- Something hit my jaw. - All right, sit down.

I think I broke my wrist.

Bardelli's impaled.

We need two large bore I.V.s, some O-2...

Don't worry about it. They're on it, okay? You're the patient now.

- You two, sit down. - I can work with one hand.

Oh, come on, guys, this is stupid.

- We can be helping out, triaging. - Have you been walking on this?

- You have an open fracture. - Just stings a little.

Irrigate with saline.

It's just a little blood. I'm all right.

- You know, when I said I thought you needed... - Shut up.

We've got trauma.

Okay, everyone needs to sign in at the window.

We'll get to you as soon as we can.

Coming through. Clear a path.

- Gates, are they okay? - Yeah, so far.

Come on, come on, out of the way-- move, move, move!

- How you doing, Bards? - Pressure's up to 90.

Hold an O.R. for him.

Hey, Greg. Sorry about this.

- Broken jaw, open fibula. - Pulse ox is borderline.

Hang tough, Greg.

Oh, God, what happened?

He's got a facial fracture, he shouldn't talk.

Neela, Brenner, I need you with Bardelli in Two.

- We're on it. - One, two, three...

Trauma panel, chest, facial series and tib-fib.

- Need an ultrasound for a FAST. - Sats 93, up him to five.

- Open up, buddy. - I need a gram of Ancef, 100 of gent.

Some jelly for the belly.

Small lac to the oropharynx...

- Hey, hey, hey. - Everybody stop, stop, stop!

All right, get me one percent with epi... gel foam.

Morris and Sam, you stay here. Abby, go fix your wrist.

- Gates, get in there with Bardelli. - I'm fine. I don't need...

Go, go! Go.

You heard the man. 27 gauge on a three cc syringe.

Hey, Brenner!

You better be aching in there, man.

- All right, come on. - What do you guys need?

Lateral c-spine. Deep breath, please. How is he?

- He's good enough to boss us around. - Kaya, pre-op antibiotics.

Ceftriaxone covers gram positives and negatives.

Okay, but not the anaerobes. Ertepenum gets 'em all.

Tony, you mind calling my mom?

I don't want her to hear something on the news...

- No problem. - First unit of O-neg is up.

- Might as well intubate. - What for? He's got a good airway.

- He's going to need it for surgery. - That's why we have anesthesiologists.

I'm gonna put in a central line and take him right up to the O.R.

I'm going to go make that call. You guys all right?

Yeah.

- How's that feel? - Much better.

Oh, there you are.

Mrs. Gaines, this is really not a good time.

Oh... oh, dear.

- Yeah, shall I...? - Come back later.

Oh, yes.

Did I see Luka stop by today?

And...?

And I think things are going to be okay.

I'm glad to hear that.

Everything was going really well...

until the ambulance blew up.

How about we X-ray your ankle now?

It's just a sprain.

Thank you.

Hold up here. I'll take those.

- Bleeding stopped with epi. - Yeah, I told you it would.

- This doesn't make sense. - What?

There's no fracture. The tibia and fibula are intact.

- Did they X-ray the wrong leg? - No.

Pratt, that's not your bone.

What?

- It's a two inch bony fragment. - Yeah, someone else's.

- Someone from the back of the rig? - Most likely.

Ugh, gnarly.

Good thing you sat up front.

Yeah.

Let me numb it up.

No, just pull it out.

- Without local? - You sure?

- Yeah. - Okay.

Send that up for HIV and hepatitis.

- Pulse ox down to 88. - Put him on 100%.

- Pneumothorax on the chest X-ray? - No diffuse bilateral contusions.

Blast lungs.

The shock wave caused bleeding and bruising throughout the chest.

I know.

It might get worse before it gets better.

I'll get the non-rebreather.

How come he's not in the O.R.?

Surgery wants a central line first.

- How you doing, Lou? - Hangin' in there.

How's Greg?

Sats are down.

Hang two more O-neg.

We're giving her a real-time guidance in the sterile field.

- Is that the I.J.? - Perfect.

- Can you see, Doctor? - It's crystal clear.

- Decreased breath sounds. - Pulse ox is dropping.

The damaged alveoli are filling with fluid.

We need to talk about intubation, Greg.

Okay...

- Let's do it. - Etomidate and sux are ready.

- Push it. - Lower his head.

Assisting ventilations.

Morris...

Don't screw this up.

Abby, you want to give it a try?

With this?

Gates...?

- I think he wanted you to do it. - Okay, you know,

I need to take a step back

and keep an eye on the big picture. I'm running this, you're doing it.

All right, laryngoscope and suction.

Sats up to 90.

I need a doctor in here.

I got it.

- Check the cuff. - We have an end-tidal detector?

- Yes, it's ready to go. - This is Jasmine.

She has tight wheezing, she was in the back of a burning car.

I couldn't get my seat belt off.

That must have been scary, huh?

Can you sit forward? I'm Dr. Lockhart.

I have moderate persistent asthma.

I'm on inhaled Beclomethasone,

Albuterol, and an oral leukotriene modifier.

Wow, you know a lot.

Can you tilt your head back?

- Who's with her? - Uh, the nanny.

- She's calling her mom right now. - Okay, no evidence of thermal damage.

I'll be back.

Keep her on ten an hour; order a portable chest.

You got it.

- Do you see the cords? - Too much blood.

What about cricoid?

Anatomy's distorted. Now you're making it worse.

Pulse ox down to 80.

All right that's enough, bag him up.

You do this, Arch-- you're better at it.

Here, come on.

Open up a 7-O and a bougie.

I need the rapid infuser.

- What's going with Bardelli? - He might be bleeding out.

- Neela still in there? - Oh, yeah.

- Let's take another look. - We're here if she needs us.

- Chuny? - They're tubing him.

- It's not slowing down. - Okay, apply more pressure.

The blood's from deeper inside. Maybe a mesenteric artery.

- You need to take him to the O.R. - You over-transfused,