[Holly]
Ooh.
-[woman screaming] -Ooh.
I can honestly say this is probably
one of the worst leg injuries I've seen in my career.
She's missing half the back of her leg.
Hey, sweetie. We're gonna take care of you.
[Holly] All right, don't move.
[Nick] Remember everything that happened?
-[woman] Uh-uh. -No? What's your name?
-[woman] Stacey. -Stacey?
Nick recognized that she needed to be soothed at that point,
which gives me the room to get this extremity splinted.
[Nick] All right, Stacey, we're gonna take care of it.
She's waving around this injured leg
in ways that she could cause further damage.
One of you coming? You want to grab that?
[Stacey screams]
[Nick] Listen, listen...
[groaning]
Listen, your leg's broken.
We gotta straighten it out to make sure you don't lose it.
So you got to be tough and strong for me right now.
-[Holly] The worst part's over. -[Nick] Just relax. Listen.
Arms on your chest. I got to put you on this board.
Oh, my God!
Ah! Please!
Please give me something.
[Nick] Baby, I can't give you anything right now.
[Stacey] Oh, my God, please!
[Holly]
but I need to get her in the back of the truck.
I need to know what her vital signs are
because there are parameters that I need them to be within
so that I can give her this pain medicine.
[Stacey] Oh, my God, please give me something!
All right, look, now, does any of this hurt?
-[Stacey] Yes! -All right.
-Your leg or your back? -[Stacey] Both.
[Nick] Can you wiggle your toes of your left foot?
-No, I can't move it at all! -[Nick] All right.
[Stacey screaming]
Okay, honey, I need to take your blood pressure
so we can give you pain medicine.
-Okay. -[Nick] That's my girl.
[Holly]
to cause this much damage to her leg,
I want to know what other injuries she has.
-[Nick] Can you feel that? -[Stacey] No.
[Nick] You can't feel that at all? Okay.
[Holly] Relax that arm right there.
[Stacey] Oh, my God.
-Does your belly hurt at all? -Uh-huh.
It hurts up here when I push it?
[Stacey] Yeah. Ah!
[Holly]
when I push on it.
And that makes me suspect internal bleeding.
So she's got really bad upper quadrant pain.
[groaning]
[Nick] 32-32... [indistinct]
[siren wailing]
[Holly, indistinct]
38-year-old female patient, pedestrian struck by a vehicle.
Left lower extremity's completely mangled.
Obvious fractures. She's got huge avulsion
with exposed muscle tissue, bone.
[Stacey] Ow!
Maybe five minutes.
[man on radio]
The main thing I'm worried about is making sure
that we get her to the hospital
before the damage to her leg is irreparable,
or before that internal bleeding has gone too far.
All right, baby, I'm about to give you
some pain medicine now, okay?
Take some slow, deep breaths. You're doing good.
This is the type of patient whose injuries
could potentially be fatal to her.
[gasps and coughs]
You okay?
[man]
Yes.
[Holly] We're almost to the hospital, okay?
We'll be there in about...
In your chest? Okay.
All right.
Okay, baby, nobody's pressing on it.
We're at the hospital, okay?
32-32, at the hospital.
[Holly] And we're about to take you out now.
[Stacey] Okay.
[Holly]
ahead of her, but we can hope for the best.
She's in the best hands possible.
She's at our trauma center.
Got a pulse back in that foot.
-Really? Good. -[Nick] Yeah.
So she's gonna get some blood, go up to surgery, and...
Yup.
[radio chirps]
[dispatcher]
En route.
817-C, requesting EMS
to location for a male that fell
and broke his finger.
Bone sticking out.
[Lori] They made it a code three because his bone's sticking out.
That's literally all it is.
[Lori]
It's a bone that's exposed. You have a laceration,
plus you have a bone that's broke.
So I'm just very curious
to see this broken bone and what caused this.
It's gonna be right up here, to the right.
[Arkady] It should be, like, right there.
Oh, look at him. He's an old man.
[woman] Oh! Okay. He's sideways.
He looks sideways.
[Arkady] 32-46 area.
[Lori] Whoa, buddy!
Look what you done did to your finger.
Goodness gracious.
[Arkady] Ooh, I think it's two of them.
-[Lori] Right at the knuckle. -[Arkady] Yup, it's dislocated.
I have never seen finger deformity like this
from just a simple trip and fall.
He has a bone sticking out of his finger.
Let's put a C collar and a stretcher on him.
[Arkady] Does that hurt?
[Lori] Okay.
Are you a veteran?
Well, thank you for your service, sir.
All right, my love, I gotta put this around your neck.
I can smell that he's had way too much to drink.
And we put a C collar on him.
Being intoxicated could make him not feel pain.
We're gonna stand up.
-[man] All right. -[Lori] One, two, three.
-[man groans] -[Arkady] All right.
[Lori] Get those feet under you.
-[Arkady] I don't think he can. -[man] Oh, Lord.
[laughter]
[Lori] Stand up. Come on, brother.
Well, this is how you--
[man] Whoa, baby, I'm gonna fall again.
-[Lori] No, no, come on. -[Arkady] Stop moving.
[Lori] Let me grab his legs.
[Arkady] Hold on. Get on that end.
[Lori] All right. Whoo!
You drank way too much tonight.
[man] Yes, I did.
[Lori] You made me work for my money today.
[man laughs]
He's had a little bit too much to drink.
Or maybe, in his situation, the right amount
that he's not feeling any of this pain.
[Lori] Are you right-handed?
-[man] Yes. -[Lori] Well, I don't think
you're gonna be shining much of anything tonight.
[man] I'm ambidextrous.
[Lori] You're ambidextrous? Well, hey.
[man] [bleep] damn.
[Lori] I know. Look at that thing.
Yeah, that don't look pretty.
[Arkady] I don't think those are facing the right way.
[overlapped chatter]
[man] I can't believe this [bleep].
-[Lori] Oh, no. -[man laughs]
You're a character.
[man] Well, like I say, I'm a Vietnam vet.
[Arkady] Thank you for your service.
[man] I've been through a hell of a lot worse than this.
[Arkady] I'm sure.
Did you check refill?
[laughing] No, not--
-You want me to check it? -No, I could do it.
-I just don't want him to move. -[Lori] All right, keep still.
[man] Huh? I know.
[Arkady] It's slow in the middle...
-[Lori] Right. -[Arkady] ...but it's there.
[Arkady]
to the tip of those fingers,
that he could lose those fingers.
So we need to get him to the hospital
as quickly as we can.
I'm talking to you!
-[Arkady] Okay! -[laughs]
[Lori] Mr. Michael, you are something else.
-Who, me? -Yeah!
-Not me! -I like you.
-[man laughs] -I like you.
Don't move it too much.
The more you move it, the more it's gonna bleed.
-[man] All right, baby. -[Arkady] All right, love.
And I'm gonna bounce you down the street, okay?
-I'll be back in a minute. -[man] Okay.
[Lori] All right, Mr. Michael.
-Yes, baby. -Here we go!
[man laughs]
Here we go. We gonna be rolling.
Let's roll, baby. Let's get it on.
-[man laughs] -Let's get it on.
Oh, he is 100% my new favorite patient.
[man laughing]
[Lori] Well, I'm sorry this happened to you tonight.
So did we learn a little bit of a lesson tonight?
Yes, I do.
And what's that? Not to drink so much?
-Yeah. -Because look what happened.
I normally don't drink that much.
You just felt like you needed to do that
-on a big Saturday night? -Yes, I did.
I hear you. Well, everybody deserves it every now and then.
-[man] Yes. -[Lori] I know, bae.
Were you born and raised in New Orleans,
or you come from the Bayou?
No, I come from Alexandria.
-Oh, up north of Louisiana. -Oh, yes, child.
-Yeah, buddy. -[man laughs]
And where are you from?
Oh, I was born and raised in New Orleans.
-I'm a New Orleans... -Shame on you.
[laughs] Shame on you!
I hear you, bae.
Well, we are here already.
[man] Okay.
Damn, it's cold.
I'm gonna get you a nice, warm blanket
when we get inside.
-Mm-hmm. -Okay?
-Yeah. -And the doctors
are gonna ask you some questions
when we get in there, okay?
[man] Yeah.
[Lori] Hope they can figure out what to do with these fingers.
-They don't look too pretty. -[man] Not many of them.
-[Lori] They don't look pretty. -[man] Oh, my God.
You can't even do the peace sign.
-You got a crooked peace sign. -Mm.
[Arkady] Why are you messing with him like that, Lori?
[Lori] Kady's gonna pull you out.
Just keep still for me, all right, Mr. Michael?
[Arkady] Tuck that hand in.
[Lori] We don't want to catch it on nothin'.
[man laughs]
[man] You gotta laugh when you go into the [bleep].
[Gavin] Teddy! We got a call.
Damn, frigging iceberg in here.
[dispatcher]
Oh, damn.
Think she broke her ankle, or she thinks her sprain--?
No, the ones I'm going to pick up,
probably 80% of them had broken.
[sirens wailing]
[woman] Oh, my damn. Like, oh, my God.
[Gavin] Damn.
[Ted] Gavin, it's definitely...
[Gavin] Did she hit her head? Okay.
Okay, all right, I need you to quit moving for me.
[woman] No!
[Gavin] I know it hurts, baby.
-Teddy. -[Ted] Yo!
Make sure that ankle doesn't pierce through when you move it.
[Ted] It's about to come through, Gavin.
Don't move!
[Gavin]
[Ted] Yeah.
It's a bad fracture. You can see the bone
against the skin.
That's when you start getting obstruction
with the blood circulation.
I want to make sure she's got a pulse.
Yeah, Gavin, I got a pulse. Give me your blue pen.
[Gavin] Yeah, it's opened up.
Hey, darling. Are you allergic to anything?
[woman]
So you can't take morphine?
[woman]
[Ted] Hey, sweetie, I'm picking up your legs, okay?
[Gavin] All right.
She's allergic to morphine.
-[Ted] Are you serious? -[Gavin] I'm serious.
[Ted]
to certain drugs,
because with them having to set that ankle,
you know it's gonna be painful.
I mean, there's no two ways about it.
[Gavin] One, two, three.
Oh, my God. Oh!
Oh, my God, I can't [bleep] believe it.
Why did I come to New Orleans?
[Gavin] You wanted to have a good time, I guess.
[woman] I did. My foot hurts.
Have you ever had fentanyl before?
You don't want no pain meds?
All right.
That's fine.
I can give you something for the pain.
[Ted]
because if I got a broken ankle and I see it like that,
I think I'd be crying, "Give me everything you got."
[woman]
That's just the way it broke, baby.
[Gavin] They're gonna fix it.
-[Ted] All right, now. -[Gavin] She asked me
why we put her foot in that position.
I can assure you...
I did not put it in that position.
I left it in the position which I found it.
[woman screaming over radio]
[dispatcher]
[woman shouting indistinctly]
[officer]
[woman]
[dispatcher]
[woman]
[dispatcher]
[woman]
[alarm ringing]
[man] Let's get going. Auto vs. pedestrian.
Let's go.
[dispatcher]
[Doug]
southbound, one-way-only street.
Right there on the sidewalk. Right there on the sidewalk.
[Doug]
to the one-ways,
car accidents happen all the time.
Rescue 4 on the scene.
All right, load and go.
[Stokes]
Has he spoken to you at all?
[woman]
[Stokes] Somebody give me a collar real fast,
put it on him, let's get out of here.
There was a nurse on scene performing CPR
when we arrived.
We know this is gonna be a critical call.
Somebody feel for a pulse real quick.
He's swelling respiration.
-Let's go. -[Stokes] Come on, let's roll.
[Doug] Get him up. Going up.
And wheel him.
[Stokes]
Crepitus in the back of the head.
Crepitus in his left arm,
his left leg and his neck.
[man] His neck?
[Stokes] Yeah, the collar's on him.
[man] I need to see the back of that head.
-Is it open? Is it shut? -[Doug] It's open.
There's a whole bunch of blood on my hands, so yes.
This [bleep] right now.
Let's get him a hyperventilator real quick.
[man] You got an IO in the right leg.
[Stokes]
we'll do IO access.
That's basically an IV that goes into the bone,
and we're able to administer the medications
down through the bone marrow.
[man] No CSF. Pupils are constricted.
[Stokes] Okay.
[Doug] Got a broken left wrist.
[man] All right.
[Stokes]
but our number-one priority
is securing an airway for this patient.
And this patient does not have a pulse,
and we don't know why.
Where's my tube? Where's my tube?
Good?
[Stokes] Fine.
[sirens wailing]
Teeth are clenched.
Mind giving me a little pressure here?
We need to breathe for him. He's unable to breathe himself.
So we intubate the patient.
That was it right there.
-[Doug]
Same. Feels the same.
-Resistance? -Yeah.
We get the patient intubated, and something's not right.
[Doug] His color's not looking good.
[Stokes]
from our intubation from our airway.
Go. Squeeze.
[Stokes] D, may be busted up.
-Where are we at, Bubba? -[Doug] Go again.
He's gone, but he's got some fluid in there.
[Stokes]
We have bad lung sounds on the left.
So much that's it getting harder to bag now.
Hey, we're about to decompress this dude.
We have some sort of fluid in the lungs.
And he has pressure on the left side of his chest,
which is basically pushing his lung closed flat.
Decompress that [bleep].
[Doug] Yup.
What do we got, Bubba?
[Phil] Bag [bleep].
That's better.
-You good? Okay. -Yeah.
[Stokes]
it allows that left lung to expand.
Therefore we're getting more oxygenated blood
through our compressions to the brain,
to the vital organs.
-Good? Okay. -[Phil] Yeah.
[Doug] Good, let's go.
[Phil] Bag the [bleep] out of him.
He's starting to get a little color back now.
[Stokes]
But he does have a pulse,
he does have an airway and lung sounds.
Patient is better than when we found him.
[Doug] CT, multiple bleeds.
Yeah.
[Doug] C spine's clear up to now.
No, no, C1 maybe.
Yeah, sorry, I didn't want to turn his head.
[Stokes] Brain bleed, so he's got a little ways to go.
They say he just stepped right out.
Really? So they're walking him and his girlfriend?
That's what I got.
They just stepped right out, pop.
[Doug] Didn't look.
Lucky he's alive.
[dramatic music playing]