1. Prep to intubate.Copy !req
2. Ketamine and Roc on board.Copy !req
3. Chest tube is in. Hook me up.Copy !req
4. {\an8}Yellow zone, we are running
out of everything.Copy !req
5. {\an8}Only change bandages that
are completely bled through.Copy !req
6. Overheard a nurse say the shooter's here.Copy !req
7. Holy shit.Copy !req
8. Oh, my God.Copy !req
9. Sorry.Copy !req
10. He's handcuffed, but he's in a room.Copy !req
11. He gets a room while the rest of us
are stacked up like firewood.Copy !req
12. Sorry to interrupt.Copy !req
13. Anything you could tell us
about the shooter?Copy !req
14. - Is he here?
- Where'd you hear that?Copy !req
15. Nurses be talking.Copy !req
16. I don't know anything about that.Copy !req
17. Yeah, let's keep the rumor mill in check.Copy !req
18. The cops will alert us
when they know something.Copy !req
19. Okay. Dawn, how are you doing?
Do you need anything?Copy !req
20. I'm better.
Kind of hungry, though.Copy !req
21. Well, we can discontinue your IV,Copy !req
22. give you a sandwich
so your sugar doesn't tank,Copy !req
23. - and then you can go home.
- Thanks.Copy !req
24. But my phone died at PittFest,
so I wasn't gettingCopy !req
25. any alerts from my glucose monitor.Copy !req
26. What about me?Copy !req
27. Can I go home?Copy !req
28. Since you OD'd, we need to keep you here
for a couple more hours,Copy !req
29. make sure you don't need any more Narcan.Copy !req
30. How's your pain doing, Buster?Copy !req
31. I mean, my arm still hurts pretty bad.Copy !req
32. Hey, can I get a sandwich, too?Copy !req
33. We can up your pain meds,Copy !req
34. but you're on the list for the OR,
so we need to keep you NPO.Copy !req
35. - Meaning?
- Nothing more to eat.Copy !req
36. We'll keep you hydrated
with IV fluids.Copy !req
37. {\an8}Can I at least get a blanket?
It's so cold in here.Copy !req
38. {\an8}Yeah...Copy !req
39. All the blankets are in Pedes...Copy !req
40. The morgue.Copy !req
41. Rock Paper Scissors?Copy !req
42. Shit.Copy !req
43. - Dawn, I can charge your phone for you.
- Thank you.Copy !req
44. Fucking circus.Copy !req
45. - Robby here?
- No. Check trauma rooms.Copy !req
46. - 500 cc's from the chest tube already.
- We're out of O-neg again.Copy !req
47. Hang the cell saver for autotransfusion.Copy !req
48. - This is weird.
- What?Copy !req
49. Shot in the chest, but nothing
out of the thoracostomy tube.Copy !req
50. You got through the pleura okay?Copy !req
51. Yeah, I definitely felt
the lung with my finger.Copy !req
52. I lost the radial pulse. I got a femoral.Copy !req
53. This guy's bleeding out.
Probably tore through the spleen.Copy !req
54. How?Copy !req
55. Okay, nipples to navel is no man's land.Copy !req
56. If he got shot while exhaling, the bullet
possibly passed below the diaphragm.Copy !req
57. Start a second IO,
transfuse two units O-positive.Copy !req
58. Where's Robby?
Let's find him and call Walsh.Copy !req
59. This guy needs the next OR immediately.Copy !req
60. - Dana!
- Yeah?Copy !req
61. - Have you seen Robby?
- I was about to ask you the same thing.Copy !req
62. - McKay!
- Yeah?Copy !req
63. You seen Robby?Copy !req
64. No, not in Pink.Copy !req
65. I was at the festivalCopy !req
66. with my husband and my daughter.Copy !req
67. My husband is in a wheelchair from MS.Copy !req
68. I did my best to protect him.Copy !req
69. A bullet went through my arm
and through his head.Copy !req
70. The medics declared him dead.Copy !req
71. What about your daughter?Copy !req
72. What's her name?Copy !req
73. Morgan.Copy !req
74. Some family members
are meeting in the cafeteria.Copy !req
75. I can see if she's there.Copy !req
76. How do you deal
with all this death and carnage?Copy !req
77. I don't...Copy !req
78. I don't know.Copy !req
79. Any more Pleur-evacs in Pink?Copy !req
80. - Maybe.
- What do you need?Copy !req
81. - A couple units of blood.
- Good luck.Copy !req
82. {\an8}Princess.Copy !req
83. Dr. Robby?Copy !req
84. Dr. Robby, you okay?Copy !req
85. You have to go. You have to go.
They need you out there.Copy !req
86. We need you out there.Copy !req
87. Okay, come on, give me your hand.Copy !req
88. I can't.Copy !req
89. You have to...Copy !req
90. Because if you don't, we're fucked.Copy !req
91. Okay.Copy !req
92. See you out there, Captain.Copy !req
93. Once your phone is charged
and able to monitorCopy !req
94. - your blood sugar, we'll let you go.
- Thank you.Copy !req
95. - Any update on the guy who did this?
- Nothing yet.Copy !req
96. I'm kind of glad I was out of it
when the shit went down.Copy !req
97. You OD'd. You could have died.Copy !req
98. - You okay, Huckleberry?
- Yeah.Copy !req
99. You sure? I know it's tough in there
with all the bodies.Copy !req
100. Yeah.Copy !req
101. Can I get help
with a pressure dressing here?Copy !req
102. Yeah, I'm on it.Copy !req
103. 2 grams of Ancef primed for your leg guy.Copy !req
104. With pleasure.Copy !req
105. You okay, Dr. Robby?Copy !req
106. Do you need something to eat or drink?Copy !req
107. No, no. I'm good. Thank you.Copy !req
108. Thank you, Esme.Copy !req
109. Your team's doing a great job
staying on top of all this.Copy !req
110. I need another four of morphine here.Copy !req
111. Yeah, coming right up.Copy !req
112. Yeah, that's two.Copy !req
113. Tourniquet's down on MCI-9, looks dry.Copy !req
114. Good job, Whitaker, Donahue.Copy !req
115. Dr. King, keep it up.Copy !req
116. All right, maintenance fluids
at 125 an hour for all NPOs.Copy !req
117. - Heard.
- Turn them down.Copy !req
118. Well, it looks like you have
everyone tucked in, Huckleberry.Copy !req
119. Yeah, we're getting there.Copy !req
120. Well, I'm going to leave you
in charge of the boring Yellow stuff.Copy !req
121. Where are you going?Copy !req
122. Get in on the Red Zone action.Copy !req
123. Robby, are you okay?Copy !req
124. Right. Well, I got some good news.Copy !req
125. County Public Health
is sending out a truckload of suppliesCopy !req
126. from Magee-Womens and Mercy.Copy !req
127. Gloria, are we gonna have
to call in more blood donors?Copy !req
128. - Already done.
- Donated.Copy !req
129. I don't...Copy !req
130. My blood, needles...Copy !req
131. Choppers are coming from blood banks
in Erie and Youngstown.Copy !req
132. Oh, thank God.Copy !req
133. I appreciate the way
you've handled logistics today.Copy !req
134. Wait, hold on.
What does she mean, more blood donors?Copy !req
135. You didn't use
unscreened blood donations, did you?Copy !req
136. We did what we had to do
to save as many people as we could.Copy !req
137. You're killing me,
Robinavitch.Copy !req
138. And for the love of God, can you tell meCopy !req
139. that you didn't know
about a shooter's hit list,Copy !req
140. and then you let him go this morning?Copy !req
141. He didn't do it.Copy !req
142. - Police confirmation?
- No.Copy !req
143. Then this nightmare--Copy !req
144. Jesus, Gloria!Copy !req
145. The police are still looking.Copy !req
146. Why don't you go back
to your micro-managerial ivory towerCopy !req
147. and let us get the fuck back to work?Copy !req
148. Robby, get some air, brother.Copy !req
149. Check on triage.Copy !req
150. Dr. Abbot, I got your carotid
bypass guy up to the OR.Copy !req
151. Vascular surgery says
to give you mad props.Copy !req
152. Okay.Copy !req
153. You think he told Jake
his girlfriend died?Copy !req
154. - Yeah.
- Fuck.Copy !req
155. Hey. Hey.Copy !req
156. - How's it going out here?
- Good.Copy !req
157. - 12 minutes since the last pink or red.
- I think it's quieting.Copy !req
158. - Jesus!
- What?Copy !req
159. Don't say that.Copy !req
160. Come on, don't tell me you believe
in that superstitious shit.Copy !req
161. It's like saying "Macbeth" in the theater.Copy !req
162. And you call yourself a person of science.Copy !req
163. Watch out!Copy !req
164. Hands up!Copy !req
165. Any weapons?Copy !req
166. Everyone stand back!Copy !req
167. No, no weapons.Copy !req
168. All clear!Copy !req
169. - Are you okay, sir?
- Yeah, I'm good.Copy !req
170. Guy in the back needs help.Copy !req
171. Sorry about the parking job.
Getting a little woozy.Copy !req
172. Okay, what happened?Copy !req
173. I found him in the festival parking lot.Copy !req
174. Gave him Narcan from my kit,
but he didn't respond.Copy !req
175. - Might be benzos--I don't know.
- You a medical worker?Copy !req
176. Navy corpsman.
I'm okay.Copy !req
177. Your leg does not look okay.Copy !req
178. I got shot through and through.Copy !req
179. I stayed to help as long as I could.Copy !req
180. Bullets flying everywhere.
It was a fucking nightmare.Copy !req
181. Hey, Ellis.
How's the passenger?Copy !req
182. No sign of trauma,
but he's pretty cyanotic.Copy !req
183. Needs oxygen.
Let's move him in.Copy !req
184. Grabbing a gurney.Copy !req
185. Any headache, neck pain,
chest pain, belly pain?Copy !req
186. Sir!Copy !req
187. No, I'm good.Copy !req
188. I'm gonna get a wheelchair.
Do not try to walk.Copy !req
189. Must have missed the bone
because I could--Copy !req
190. - Cancel the wheelchair. Bring a gurney.
- Gurney!Copy !req
191. Any new customers for the OR?Copy !req
192. - Yes.
- Yeah.Copy !req
193. This one looked like chest,
but it was intra-abdominal.Copy !req
194. Nipples to navel is no man's land.Copy !req
195. Am I the only one who missed that day
in medical school?Copy !req
196. I need high-flow O2,
maybe BiPAP for this guy.Copy !req
197. - Trauma rooms open?
- No, still getting cleaned.Copy !req
198. - South 15 is avail.
- Okay, South 15 it is.Copy !req
199. Find out if the ICU is ready for her.Copy !req
200. All right, get me a tech and an RT,
and we'll take him up.Copy !req
201. Yeah, I'm on it.Copy !req
202. Hey, McKay.Copy !req
203. +There's someone
from Allegheny County CourthouseCopy !req
204. - on the line.
- Not now!Copy !req
205. I'm in. Bag her.Copy !req
206. - Dr. McKay, you have a visitor.
- I said not now!Copy !req
207. Jesus Christ.Copy !req
208. Sorry, Dad. Hey.Copy !req
209. Thank you so much for coming in
to pick up Harrison.Copy !req
210. Are you okay?Copy !req
211. I mean, relatively speaking,
I'm fan-fucking-tastic.Copy !req
212. Good.Copy !req
213. Hey, Dr. Abbot, can you keep
an eye on this one?Copy !req
214. - Stable after 1 unit pRBCs.
- No problem.Copy !req
215. Ellis, get him started.
Holler if you need me.Copy !req
216. Copy.Copy !req
217. Dana, hypotensive and altered.Copy !req
218. Untreated GSW to the thigh.Copy !req
219. Perfect timing.
Trauma One's open, but be careful.Copy !req
220. Floor's probably still wet.Copy !req
221. - Mohan, you're on this.
- Okay.Copy !req
222. Dr. Abbot, you need anything?Copy !req
223. Check with Ellis in South 15.Copy !req
224. - What do we got?
- What do we got?Copy !req
225. Pulse ox is low, 85 on room air.Copy !req
226. 100% non-rebreather mask.Copy !req
227. This guy needs a major workup.Copy !req
228. Everyone in Yellow is stable.Copy !req
229. - Okay. Check in with Robby.
- Holy shit.Copy !req
230. See where he can use another set of hands.Copy !req
231. Okay, great. Thanks.Copy !req
232. Trauma One, I know that guy.Copy !req
233. His sister's in the cafeteria.
Her husband was shot and killed today.Copy !req
234. Oh, sweet Jesus.Copy !req
235. Do you think I can bring the lady in
to see her brother?Copy !req
236. Robby, lady in the cafeteria,
dead husband,Copy !req
237. brother in Trauma One,
can we bring her back?Copy !req
238. It seems like it's slowing down
around here. Go ahead.Copy !req
239. I have a patient in Central 9.Copy !req
240. She was shot trying to protect
her husband, who died.Copy !req
241. But her daughter is in the cafeteria.Copy !req
242. I don't think I can spare
any doctors right now.Copy !req
243. In fact, why don't you go cover triageCopy !req
244. - until Shen and Ellis get back?
- Okay.Copy !req
245. Give me her name. I'll find her.Copy !req
246. Oh, thank you so much.Copy !req
247. Her name is Morgan.
Her mom is Trish Gregory.Copy !req
248. Okay if we bring her up here, too?Copy !req
249. Sure. Why not?Copy !req
250. Pulse ox is still 85 on high-flow oxygen.Copy !req
251. BP is borderline.Copy !req
252. Dr. Santos, differential diagnosis
of cyanosis?Copy !req
253. Hypoxia, low oxygen from lung disease--Copy !req
254. pneumonia, PE, asthma.Copy !req
255. Good breath sounds,
no crackles, no wheezing.Copy !req
256. Pulmonary problems should improve with O2.Copy !req
257. - What else?
- Heart disease, heart failure.Copy !req
258. - No B line.
- Right to left shunt?Copy !req
259. That's usually
in congenital heart disease.Copy !req
260. PDA, Tetralogy of Fallot.Copy !req
261. Cardiac ECHO looks good.Copy !req
262. Normal ejection fraction,
no valvular disease.Copy !req
263. What else could it be?Copy !req
264. Okay, is Dr. Ellis running
this resuscitation, or are you?Copy !req
265. Because last time I checked,
you're not supposed to be here.Copy !req
266. We both are.Copy !req
267. The senior resident's job is to teach.Copy !req
268. What else, Dr. Santos?Copy !req
269. Hemoglobinopathies?Copy !req
270. Excellent.Copy !req
271. Blood is chocolate brown.Copy !req
272. Santos?Copy !req
273. Methemoglobinemia?Copy !req
274. Bingo.Copy !req
275. Put him on BiPAP.Copy !req
276. Send off a blood gas.
Order methylene blue.Copy !req
277. Etiology?Copy !req
278. Drugs, toxins.Copy !req
279. Smart money is poppers, amyl nitrates,
partied a little too hard at PittFest.Copy !req
280. Langdon, got a sec?Copy !req
281. Yep.Copy !req
282. Keep me posted.Copy !req
283. - Can I do the intubation?
- Not necessary yet.Copy !req
284. But his pulse ox is low. He's altered.Copy !req
285. All the oxygen in the world
won't fix that.Copy !req
286. His methemoglobin level is sky-high.
Nothing but methylene blue will help.Copy !req
287. I'll run the blood gas up to the lab,Copy !req
288. see if they're caught up
on all the traumas yet.Copy !req
289. First day?Copy !req
290. Yeah.Copy !req
291. What's the beef with Langdon?Copy !req
292. Are you good here?Copy !req
293. Yeah, methemoglobinemia,
ordered methylene blue.Copy !req
294. Perfect. Keep it up.Copy !req
295. Will do.Copy !req
296. And here he is.Copy !req
297. - Hey.
- Grandpa!Copy !req
298. How's my favorite grandchild?Copy !req
299. I'm your only grandchild.Copy !req
300. Chadwick Harrison Ashcroft III.Copy !req
301. Please don't call me that.Copy !req
302. Douchebag name for a douchebag guy.Copy !req
303. - Dad!
- Are you ready?Copy !req
304. 'Cause Grandma is making your favorite--Copy !req
305. carbonara.Copy !req
306. Thanks for taking him, Dad.Copy !req
307. Will you save some pasta for me?Copy !req
308. Okay.Copy !req
309. Tapping in.Copy !req
310. - Thanks, brother.
- Yeah.Copy !req
311. EFAST normal.Copy !req
312. No abdominal hemorrhage, no tamponade.Copy !req
313. Pulse ox borderline, 89% on 15 liters.Copy !req
314. BP's only 95 over 58.Copy !req
315. Vinny Rivera--is he here?Copy !req
316. I'm not sure, man.Copy !req
317. I'm so sleepy.Copy !req
318. Were you tired right after you got shot?Copy !req
319. No.Copy !req
320. I helped move 20, 30 people.Copy !req
321. What's causing his oxygen levels to tank?Copy !req
322. Up the oxygen.Copy !req
323. 15's as high as it goes.Copy !req
324. Gauge only goes to 15.
Keep cranking. You can get to 50.Copy !req
325. Brian?Copy !req
326. Vinny got shot.Copy !req
327. I sent him with the first car I saw.Copy !req
328. Is he okay?Copy !req
329. You fight, Brian, okay?Copy !req
330. You fight like
the stubborn bastard you are.Copy !req
331. I tried, Whit.Copy !req
332. I tried.Copy !req
333. - Oh, no, thanks.
- It's not coffee.Copy !req
334. It's bourbon.Copy !req
335. That was a joke.Copy !req
336. Robby did everything he could
to save your girlfriend.Copy !req
337. If he couldn't save her, nobody could.Copy !req
338. Wait, wait, wait.
What do you mean, neutralized?Copy !req
339. Means he's dead.Copy !req
340. Wait. I thought the kid
in BH-2 was the shooter.Copy !req
341. What's going on?Copy !req
342. SWAT found the shooter.Copy !req
343. Self-inflicted gunshot to the head.Copy !req
344. He had a duffel bag full of ammo.Copy !req
345. He was in some bushes down by the riverCopy !req
346. with his AR-15.Copy !req
347. Do we know why he did it?Copy !req
348. Does it matter?Copy !req
349. Are we expecting any more victims?Copy !req
350. SWAT cleared the festival grounds.
Probably no more coming our way.Copy !req
351. What you've done down here...Copy !req
352. All the lives you've saved...Copy !req
353. There aren't adequate words.Copy !req
354. Thank you.Copy !req
355. We need to prep
to open back up to the public.Copy !req
356. Walk-ins only.Copy !req
357. No traumas until we get word from surgery
that a few ORs have cleared.Copy !req
358. {\an8}That could be hours.Copy !req
359. Blood Bank, pick up line two.Copy !req
360. Everybody seems to know
exactly what to do.Copy !req
361. - Is this kind of thing normal?
- Thankfully, no.Copy !req
362. But preparing for the worst
and hoping for the best,Copy !req
363. that's what we do.Copy !req
364. - Hey, is Dr. King still outside?
- Yep.Copy !req
365. We don't need a doctor covering triage.Copy !req
366. - We can bring her back in.
- Yeah.Copy !req
367. And, everybody else, let's process
these remaining patientsCopy !req
368. so my day shift can finally go home.Copy !req
369. On it, Cap.Copy !req
370. You hear that?Copy !req
371. - Hear what?
- It's quiet.Copy !req
372. It's over.Copy !req
373. Oh, son of a--Copy !req
374. Hey, we're closed.Copy !req
375. We're way over capacity.
Take them to West Penn.Copy !req
376. Kid in extremis.
You were the closest EDAP.Copy !req
377. 13-year-old hypoxic and hypertensive.Copy !req
378. He looks pale and tachypneic.Copy !req
379. Flynn Edwards, home alone
with his little sister.Copy !req
380. Cough, fever, rash, altered.Copy !req
381. Tachy at 150, BP 80 over 55,
breathing at 36,Copy !req
382. and satting low 80s on the face mask.Copy !req
383. Hi.Copy !req
384. - What's your name?
- Georgia.Copy !req
385. Hi, Georgia. I'm Mel.Copy !req
386. Oh, yeah. That's scary.Copy !req
387. Yep.Copy !req
388. - Georgia, where are your parents?
- At the movies.Copy !req
389. - Did you try calling them?
- I texted.Copy !req
390. Can you give us their numbers?Copy !req
391. Do you remember what happened
before you called 911?Copy !req
392. Flynn was talking weird.Copy !req
393. Okay.Copy !req
394. And then after he was talking weird?Copy !req
395. He got super sleepy,
and then I couldn't wake him up.Copy !req
396. This is Princess.Copy !req
397. I have to go help your brother now,
but Princess is going to get you a snack.Copy !req
398. - I already brushed my teeth.
- Then maybe just a glass of water?Copy !req
399. My count, one, two, three.Copy !req
400. Flynn, open your eyes, buddy.Copy !req
401. Start a second line.
2 liters of Ringer's wide open.Copy !req
402. 100% non-rebreather.Copy !req
403. Crackles bilaterally.Copy !req
404. Temp 101, O2 sat only up to 82.Copy !req
405. Shit. It's code sepsis.Copy !req
406. Blood cultures, labs,
portable chest, gram of ceftriaxone.Copy !req
407. Dr. King, what are you thinking?Copy !req
408. Well, rash, altered with sepsis--Copy !req
409. could be meningococcus, Strep pneumo,Copy !req
410. something viral like disseminated HSV, encephalitis?Copy !req
411. BP's 82 over 49.Copy !req
412. Sat up to 87.Copy !req
413. What about the rash?Copy !req
414. It's more prominent on the lower body,
not much on the face.Copy !req
415. There's no vesicles.Copy !req
416. It doesn't look like chicken pox
or typical Lyme rash.Copy !req
417. Agreed.Copy !req
418. Do you know what this is?Copy !req
419. Nope.Copy !req
420. Resuscitate first, diagnose later.Copy !req
421. We're moving patients from the Yellow ZoneCopy !req
422. into real rooms along the South
and Central Corridors.Copy !req
423. Till now, all these patients
have just been numbers to us.Copy !req
424. Time to ask them their names.Copy !req
425. So we scan their wristbands
and put them into the big board.Copy !req
426. Yeah, and then Dana and I will assign
rooms based on medical priority.Copy !req
427. Ortho extremity wounds go get X-rays.Copy !req
428. Dr. McKay, can you finish up
whatever it is you're doingCopy !req
429. and come meet me in BH-2?Copy !req
430. Yeah, sure.Copy !req
431. I told you he didn't do it.Copy !req
432. I know.Copy !req
433. But you said yourself
his threats were serious.Copy !req
434. At least now we're nipping it in the bud.Copy !req
435. You think this is that easy?Copy !req
436. Think again.Copy !req
437. He's on 100% oxygen.
His pulse ox is still only 88.Copy !req
438. - How's it going upstairs?
- Regular spa day at the OR.Copy !req
439. - 42 ex-laps and thoracotomies.
- Impressive.Copy !req
440. What do you got?Copy !req
441. GSW through and through the thigh,
not arterial, now hypotensive and hypoxic.Copy !req
442. - Sounds like blood loss.
- No.Copy !req
443. Hemoglobin times 2 is stable.Copy !req
444. Vena cava is plump.
It would be flat with hemorrhage.Copy !req
445. It's actually a little too plump.
Let me see the phased array probe.Copy !req
446. Any history of heart disease?Copy !req
447. Not sure, but he's a strong guy.Copy !req
448. Got shot, strapped a T-shirt
and a belt around his thighCopy !req
449. and ran around helping people
for a few hours.Copy !req
450. Holy shit.Copy !req
451. Check out the four chamber apical view.Copy !req
452. Dilated right atrium and right ventricle.Copy !req
453. Right-sided strain
with bowing of the septum.Copy !req
454. Sounds like a PE. He throw a clot
from having the tourniquet on?Copy !req
455. Way too soon for a DVT.Copy !req
456. Okay, let's get him
in left lateral decubitus.Copy !req
457. One, two.Copy !req
458. Trendelenburg ASAP.Copy !req
459. - What for?
- Intracardiac air embolism.Copy !req
460. All that running around introduced airCopy !req
461. into the femoral vein
right up to the heart.Copy !req
462. Now it's blocking blood flow to the lungs.Copy !req
463. Need a CT to confirm.Copy !req
464. They're still backed up
with other patients.Copy !req
465. Well, maybe the cath lab can take him.
They have fluoro.Copy !req
466. - I'll go check.
- Yeah, good luck with that.Copy !req
467. I need a central line kit
and a 5 French pigtail catheter.Copy !req
468. - I got it.
- He doesn't have a collapsed lung.Copy !req
469. - Yeah?
- So what are you going to do?Copy !req
470. I'm not gonna do anything.
You are.Copy !req
471. Thank you, Casey.Copy !req
472. Hey, David.
How you doing?Copy !req
473. Hi, David.Copy !req
474. I didn't shoot anybody.Copy !req
475. I wouldn't do that.Copy !req
476. I know.Copy !req
477. Did you make a list
of girls you wanted to hurt?Copy !req
478. - Where's my mom?
- Did you make a list?Copy !req
479. I want to go home.Copy !req
480. You're gonna get to go home.Copy !req
481. But, first, we have to keep you here
for a mandatory 72-hour hold.Copy !req
482. What? Why?
I didn't do anything.Copy !req
483. I know you're upset.Copy !req
484. We're only doing what we think
is in your best interest.Copy !req
485. No, fuck you! You don't know me!Copy !req
486. You don't know anything about me!Copy !req
487. Look, I know it's a lot to process, but--Copy !req
488. No, no!Copy !req
489. I want to see my mom.Copy !req
490. Where is she? Is she out there?Copy !req
491. Mom!Copy !req
492. - This is not helping your case, David.
- Mom! Mom!Copy !req
493. - This is not helping your case--
- Oh, fuck you!Copy !req
494. Let's go outside.Copy !req
495. I just want to see my mom, please!Copy !req
496. Please, I just want to see my mom.Copy !req
497. Mom!Copy !req
498. BP's 92 over 60 after 2 liters.Copy !req
499. Still tachy.Copy !req
500. Sats are way down at 84
on the non-rebreather.Copy !req
501. Flynn, open your eyes.
How you doing, bud?Copy !req
502. He's still having trouble breathing.Copy !req
503. He's more lethargic than before.Copy !req
504. Let's give him a third liter
and prep for intubation.Copy !req
505. - Can we do that without parental consent?
- We wait, he dies.Copy !req
506. Tech is here for a portable chest.Copy !req
507. Dr. King, what are your intubation meds?Copy !req
508. - Etomidate and Roc.
- Great.Copy !req
509. Gather up everything you need.
What size tube?Copy !req
510. Age divided by 4 plus 3Copy !req
511. would be 6.5 cuffed.Copy !req
512. Let's do it.Copy !req
513. - And find his parents.
- Okay.Copy !req
514. Prep these.Copy !req
515. What time you start today?Copy !req
516. 7:00 a.m.Copy !req
517. - Thanks.
- Can I get one of those?Copy !req
518. I'm starving.Copy !req
519. No can do.Copy !req
520. But I'm hungry.Copy !req
521. We can't give you any food
in case you need surgery.Copy !req
522. You might aspirate.Copy !req
523. You need to work on your bedside manner.Copy !req
524. Asshole reporter.Copy !req
525. - ABG back on the blue man?
- Not yet.Copy !req
526. Should we just give him
the methylene blue?Copy !req
527. Pulse ox holding at 85.
We can wait a little.Copy !req
528. Dr. Santos...Copy !req
529. How do we evaluate methemoglobinemia
and determine a treatment plan?Copy !req
530. Tired?Copy !req
531. Yeah.Copy !req
532. Feet hurt?Copy !req
533. Brain feeling like mush?Copy !req
534. Absolutely.Copy !req
535. That patient doesn't give a shit.Copy !req
536. He needs you.Copy !req
537. Methemoglobinemia.Copy !req
538. Let's go.Copy !req
539. Robby?Copy !req
540. Hey, Janey.Copy !req
541. Where's Jake?Copy !req
542. I got here as fast as I could,
but there were street closures--Copy !req
543. He's okay. He's okay.Copy !req
544. He had some minor injuries that are going
to need to be treated, but he's okay.Copy !req
545. - He's gonna go home tonight.
- Oh, thank God.Copy !req
546. Leah didn't make it.Copy !req
547. She's dead?Copy !req
548. Oh, my God.Copy !req
549. He is kind of blaming me
for not saving her.Copy !req
550. Robby, he's just a kid.Copy !req
551. So was she.Copy !req
552. Don't do that to yourself.Copy !req
553. Hey, look at me.Copy !req
554. Jake loves you, okay?Copy !req
555. - Where is he?
- Hey, Dana.Copy !req
556. - You remember Janey?
- Of course.Copy !req
557. - Thank you for calling me.
- Do you mind taking her to go find Jake?Copy !req
558. Yeah, no problem. Come on.Copy !req
559. Tube's in.Copy !req
560. Good color change.Copy !req
561. Nicely done.Copy !req
562. Present.Copy !req
563. We have a septic 13-year-old
with pneumonia.Copy !req
564. I just intubated,
and ceftriaxone is on board.Copy !req
565. Patchy consolidation, maybe some nodules.Copy !req
566. It could be viral pneumonia
with or without bacterial superinfection.Copy !req
567. Kid's got a weird rash, too.Copy !req
568. Oh, and it's maculopapular on the legs.Copy !req
569. Pretty faded on the neck and chest.Copy !req
570. Starting to desquamate.Copy !req
571. You ever seen anything like this before?Copy !req
572. - Nope.
- Me neither.Copy !req
573. Well, that just goes
to show you how old I am.Copy !req
574. This looks like measles.Copy !req
575. - "Measles"?
- Holy shit.Copy !req
576. Any travel history?Copy !req
577. He wasn't able to talk
before we intubated.Copy !req
578. Measles is super contagious.Copy !req
579. It's not contagious if it's resolving.Copy !req
580. We need more history.Copy !req
581. - Where are the parents?
- Oh, they're at the movies.Copy !req
582. I'm sure their phone's off.Copy !req
583. But he came in with his little sister.
We can talk to her.Copy !req
584. - What theater?
- I don't know.Copy !req
585. Shen, try every theater.Copy !req
586. There's got to be
over a dozen in Pittsburgh.Copy !req
587. Start with the ones closest
to where they live.Copy !req
588. We need to find those parents.
And call Public Health.Copy !req
589. Tell them we might have
a measles outbreak.Copy !req
590. We get blood gas results back?Copy !req
591. I just got them.Copy !req
592. Methemoglobin level of 42%,
enough for cyanosis and lethargy.Copy !req
593. Party on, Wayne.Copy !req
594. Okay, let's go ahead
and start methylene blue.Copy !req
595. 1 mg per kg, slow IV push
over five minutes.Copy !req
596. On it.Copy !req
597. Gonna need somebody to stand bedside,
push it with a syringe.Copy !req
598. Santos, tag, you're it.Copy !req
599. How long until his cyanosis resolves?Copy !req
600. Five minutes, bright spark.Copy !req
601. Oh, you two definitely got beef.Copy !req
602. Hi, Georgia.Copy !req
603. This is Dr. Robby.Copy !req
604. He's gonna ask you some questions
so we can help Flynn.Copy !req
605. Is that okay?Copy !req
606. Hi, Georgia.Copy !req
607. Can you tell me
when your brother first got sick?Copy !req
608. A week ago.Copy !req
609. I was already getting better.Copy !req
610. You were sick, too?Copy !req
611. Fever, rash like Flynn?Copy !req
612. Has your family traveled anywhere recently
on an airplane or to another state?Copy !req
613. Orlando for a dance competition
a couple of weeks ago.Copy !req
614. And where on your body did the rash start?Copy !req
615. On my face.Copy !req
616. Then it went down to my legs.Copy !req
617. Okay. Thank you, Georgia.Copy !req
618. - Is Flynn gonna be okay?
- Oh, well, yeah.Copy !req
619. We're gonna do everything
we can to help him.Copy !req
620. The story is consistent with measles.Copy !req
621. Plenty of opportunity
for exposure in OrlandoCopy !req
622. with all the international travelers.Copy !req
623. - Isolation?
- No, 'cause you're only infectiousCopy !req
624. for four days after the rash starts,
so we're past that point.Copy !req
625. But the altered mental status,
he's in the right time frame for ADEM.Copy !req
626. ADEM?Copy !req
627. Acute Disseminated Encephalomyelitis,
post-infection immune response.Copy !req
628. - So a head CT and an LP?
- Afraid so.Copy !req
629. It has a 20% death rate.Copy !req
630. - Dr. King, this is Morgan.
- Trish Gregory's daughter.Copy !req
631. - Is my mom okay?
- Oh, yeah, she's fine.Copy !req
632. Dr. Robby, do you mind
if I show Morgan to her mom?Copy !req
633. No, go ahead. I'm going
to send Flynn for a head CTCopy !req
634. and get Shen to prep the LP.Copy !req
635. - What about the parents?
- I think he's still trying to find them.Copy !req
636. - I can help. Go. We got this.
- Thanks, Lupe.Copy !req
637. Just this way.Copy !req
638. So she's gonna need surgery, but she's...Copy !req
639. - Take a seat.
- What?Copy !req
640. Why?Copy !req
641. Adrenaline crash after a big event.Copy !req
642. A juice box? Thanks.Copy !req
643. What happened here today, it's not normal.Copy !req
644. But you...Copy !req
645. You were a rock star, Victoria.Copy !req
646. He knows my name.Copy !req
647. Got the IJ.Copy !req
648. Okay, back to business
as usual, thank God.Copy !req
649. - Guidewire and introducer.
- What the hell are you doing?Copy !req
650. Dr. Mohan is about to pull
air from the right atriumCopy !req
651. - and right ventricle.
- With what?Copy !req
652. - 5 French pigtail catheter.
- Inside his heart?Copy !req
653. Multiple side-holes
gives you a better shotCopy !req
654. at sucking out all the air.Copy !req
655. Dr. Abbot showed me a case report
from South Korea.Copy !req
656. What the actual fuck?Copy !req
657. I just talked to cardiology.
They want a CT scan.Copy !req
658. If it's showing air,
then you need to dive himCopy !req
659. - in the hyperbaric chamber.
- He'll be dead by then.Copy !req
660. Not if you kill him first
with this banana-pants procedure.Copy !req
661. We don't have time to wait
for your fancy-pants machine.Copy !req
662. If we don't get the air
out of his heart, he'll die.Copy !req
663. - This is not the standard of care.
- Oh, fuck standard of care.Copy !req
664. If we want to save him, we go in now.Copy !req
665. - Maybe I should--
- Thread in the pigtail?Copy !req
666. Excellent idea, Dr. Mohan.Copy !req
667. Go down to 24 centimeters,
and then we'll confirm with X-ray.Copy !req
668. Good.Copy !req
669. Think I'll stick around in case you need
another set of handsCopy !req
670. to resuscitate your patient
when he crashes.Copy !req
671. Oh, my God. You're bleeding. What--Copy !req
672. - Are you okay?
- Mom, I'm fine.Copy !req
673. You got to get me out of here.Copy !req
674. Well, they just want to help you.
We all do.Copy !req
675. I don't need help.
I just want to go, okay?Copy !req
676. David, you haven't called me back
or texted me all day.Copy !req
677. Mom.Copy !req
678. You didn't go to school.Copy !req
679. I saw the Instagram post you made.Copy !req
680. And I found the list about all the girls.Copy !req
681. You went through my stuff?Copy !req
682. - I love you.
- No, Mom, Mom.Copy !req
683. - And I don't--
- Those are my things.Copy !req
684. Can I just say
that we all have scary thoughts?Copy !req
685. It does not make you a bad person.Copy !req
686. And dealing with those feelings
can be hard.Copy !req
687. Talking to somebody can really help.Copy !req
688. Oh, my God, just shut up.Copy !req
689. I'm not gonna fucking talk
to anyone, okay?Copy !req
690. You can't make me.Copy !req
691. David, I signed a petition.Copy !req
692. What the fuck?Copy !req
693. What, you signed some paper
to get me locked up?Copy !req
694. I signed a petition to get you help.Copy !req
695. This is fucking bullshit.Copy !req
696. Seeing all those people
come in here today...Copy !req
697. All those hurt people
and the death and the blood...Copy !req
698. I was so afraid
of you being that sad and angry.Copy !req
699. I cannot bear to lose you.Copy !req
700. I would never do something like that.Copy !req
701. There's nothing wrong with me.Copy !req
702. It's me, Mom.
You know I'd never hurt someone like that.Copy !req
703. Please, don't do this to me.Copy !req
704. Why are you doing this?Copy !req
705. All we're asking is that you speak
with a professional.Copy !req
706. It's important to talk to somebody
about how you're feeling.Copy !req
707. You think you might be open to that?Copy !req
708. Fuck you.Copy !req
709. Fuck all of you.Copy !req
710. Can you just get out?Copy !req
711. Get out!Copy !req
712. Hey, Perlah, can you take Theresa
to go find a cup of tea?Copy !req
713. Yeah, of course.Copy !req
714. Jesus.Copy !req
715. What now?Copy !req
716. Well, I suggested a better way,Copy !req
717. but you had him taken down
by the police, handcuffed,Copy !req
718. and dragged in here.Copy !req
719. You made this fucking mess.
You're gonna have to fix it.Copy !req
720. Pigtail's in the right atrium,
good position.Copy !req
721. Aspirate, see what you get.Copy !req
722. Pulling back blood from the heart...Copy !req
723. Along with some air.Copy !req
724. How about that?Copy !req
725. BP's still only 85 systolic.Copy !req
726. No improvement.Copy !req
727. Advance slowly into the right ventricle.Copy !req
728. - How do I know when I'm--
- PVCs.Copy !req
729. That's how you know. Aspirate again.Copy !req
730. Run of three.Copy !req
731. More blood and air coming out.Copy !req
732. - Run of five.
- Non-sustained V tach.Copy !req
733. - Charge to 200 for when he deteriorates.
- Mainly blood now.Copy !req
734. Pull the pigtail back to the RA.Copy !req
735. - Step aside.
- Pull the pigtail, Dr. Mohan.Copy !req
736. - Step aside!
- You got this.Copy !req
737. Normal sinus rhythm, 92.Copy !req
738. Pulse ox is improving.
BP's 112 over 84.Copy !req
739. Not too shabby, huh, Dr. Walsh?Copy !req
740. I think we can admit him
to General Surgery now.Copy !req
741. Hell, no.Copy !req
742. - He's a gunshot victim.
- Admit him to the cardiac ICU.Copy !req
743. We'll consult from there.Copy !req
744. Well, you can admit him yourself,
with Cardiology consulting.Copy !req
745. I thought you liked flying the plane.Copy !req
746. Not when it's gonna crash.Copy !req
747. Solid work.Copy !req
748. That was your save, not mine.Copy !req
749. Take the win, Dr. Mohan.Copy !req
750. Thanks.Copy !req
751. Besides, it was a little too risky
for me to do myself.Copy !req
752. - What?
- Suture.Copy !req
753. This is so cool.Copy !req
754. Blue plus blue equals pink.Copy !req
755. Can you tell us your name?Copy !req
756. Max.Copy !req
757. Max, can you tell us what you took?Copy !req
758. Sleep.Copy !req
759. Yeah, he might need a second dose
of methylene blueCopy !req
760. if his methemoglobin level stays above 30.Copy !req
761. This definitely wasn't poppers.Copy !req
762. He would have had to have sniffed,
like, a gallon of it.Copy !req
763. So what caused the overdose?Copy !req
764. Got to wait for him to wake up
so we can get more answers.Copy !req
765. Trish...Copy !req
766. I have a special visitor for you.Copy !req
767. Mom, are you okay?Copy !req
768. Yeah, I'm fine.Copy !req
769. Okay.
I was so scared.Copy !req
770. - I know.
- And Dad.Copy !req
771. You okay?Copy !req
772. Just--my patient hasn't seen her daughter,Copy !req
773. and it won't happen again.Copy !req
774. Never apologize for feeling
something for your patients.Copy !req
775. Today was chaos.Copy !req
776. You were awesome.Copy !req
777. I'm really glad you're with us, Dr. King.Copy !req
778. Robby, Flynn's parents
are here, the measles kid.Copy !req
779. You should go home.Copy !req
780. How did Flynn get measles?Copy !req
781. From his sister. Hi. I'm Dr. Robby.Copy !req
782. Georgia is fine. She's in our staff room.Copy !req
783. She's the one who actually called 911
and probably saved her brother's life.Copy !req
784. Georgia was sick, but she got better
on her own quickly.Copy !req
785. Yeah, many people get better
on their own, like Georgia.Copy !req
786. However, as many as 1 in 20 kids
that get measlesCopy !req
787. get pneumonia, like your son.Copy !req
788. Are your children vaccinated
against measles?Copy !req
789. No.Copy !req
790. The MMR vaccine is perfectly safe.Copy !req
791. Measles is not.Copy !req
792. We're concerned about inflammationCopy !req
793. and possible damage
to Flynn's brain and spinal cord.Copy !req
794. The measles got to his brain?Copy !req
795. Well, his head CT was normal,Copy !req
796. but the only way to find out if he's okay
is to perform a lumbar puncture.Copy !req
797. A spinal tap?Copy !req
798. I've read about kids who've been paralyzed
from a spinal tap.Copy !req
799. There is zero risk of paralysis.Copy !req
800. What about bleeding or infection?Copy !req
801. It's a perfectly safe procedure.
We do it every day.Copy !req
802. We need spinal fluid to see if Flynn has
acute disseminated encephalomyelitis.Copy !req
803. And if he does?Copy !req
804. We treat with high-dose steroids
to decrease the riskCopy !req
805. of blindness, deafness,
intellectual disability, even death.Copy !req
806. He could die from this?Copy !req
807. The death rate from ADEM is high,
one in five.Copy !req
808. Do the spinal tap.Copy !req
809. No!Copy !req
810. Can't you just give him steroids
without the spinal tap?Copy !req
811. If there's no ADEM, the steroids
could suppress his immune system,Copy !req
812. making it harder to fight off
the pneumonia.Copy !req
813. But it says here that--Copy !req
814. Can you put your damn phone away?Copy !req
815. Your son is critically ill.Copy !req
816. The longer that we wait, the higher
the risk of permanent brain damage.Copy !req
817. What is not clear here?Copy !req
818. Hillary, he has a tube down his throat.
He can't breathe on his own.Copy !req
819. They're not poking holes
in my son's spine!Copy !req
820. Wow. Okay.Copy !req
821. Let's just wait and see if he gets better.Copy !req
822. Dr. King, could you please take
Flynn's parents to see their daughter?Copy !req
823. No problem.Copy !req
824. They are going to see their daughter.Copy !req
825. Fucking Dr. Google bullshit.Copy !req
826. They want medical treatment,
but they don't want medical advice.Copy !req
827. - What the actual fuck are we doing?
- Yeah, I know, and we'll keep trying.Copy !req
828. - Hey, you okay, boss?
- Yes.Copy !req
829. Hey, Whitaker.Copy !req
830. - You got a minute?
- Yeah, yeah.Copy !req
831. I just wanted to say thank youCopy !req
832. for earlier when I was...Copy !req
833. Oh, your brief moment
of silent reflection?Copy !req
834. Yeah. You didn't mention that to anybody?Copy !req
835. - No, no. God, no. No.
- I don't know what that was.Copy !req
836. I was just--felt like I was drowning.Copy !req
837. What was that you were reciting?Copy !req
838. It's called the Shema prayer.
It's a declaration of faith in God.Copy !req
839. I lived with my grandmother
when I was little,Copy !req
840. and she and I used to recite it
every morning.Copy !req
841. "Even youths grow tired and weary,
and young men stumble and fall.Copy !req
842. But those who hold hope in the LordCopy !req
843. will renew their strength
and soar on wings like eagles."Copy !req
844. It's Isaiah 40.Copy !req
845. I was an undergrad theology major.Copy !req
846. I don't know why I said that.Copy !req
847. I don't know if I actually believe in God,
especially on days like today.Copy !req
848. A wise man once told me
that you learn to live with it,Copy !req
849. learn to accept it,Copy !req
850. and find balance if you can.Copy !req
851. I hope we all do.Copy !req
852. Only one pink left.Copy !req
853. The rest all went up.Copy !req
854. Hey.Copy !req
855. You guys need any help
with new patients, or...Copy !req
856. No, no, no. We're good.
It's quick and easy stuff. Go home.Copy !req
857. - Yeah?
- Yeah.Copy !req
858. - Hey, you got a second?
- Yeah.Copy !req
859. What is up with Robby?Copy !req
860. He's been better.Copy !req
861. I'm really worried about him.Copy !req
862. I've never seen him like this.
Have you?Copy !req
863. No.Copy !req
864. How about you, slugger?Copy !req
865. Been better.Copy !req
866. - Preach.
- Yeah.Copy !req
867. Sorry to interrupt.Copy !req
868. Oh, if you guys are looking
for Officer Stefano,Copy !req
869. - he went up to surgery about an hour ago.
- We're looking for Dr. Cassie McKay.Copy !req
870. Yeah, that's me.Copy !req
871. We were alerted about your ankle monitor
being tampered with.Copy !req
872. County probation called to check in
earlier, but you never responded.Copy !req
873. Yeah, it was beeping
and giving an error message.Copy !req
874. And we were in the middle
of a mass casualty from PittFest.Copy !req
875. Did you tamper with your ankle monitor?Copy !req
876. Yeah, I might have drilled a hole in it.Copy !req
877. Officers, look around.
She was saving lives.Copy !req
878. - Put your hands behind your head.
- Hang on a second.Copy !req
879. - Are you joking?
- Officers, wait a second.Copy !req
880. You're under arrest.Copy !req
881. Great.Copy !req