In this second episode, 84 year-old Ralph is at St Mary’s Major Trauma Centre after falling at home and suffering a fracture down the entire length of his thigh bone that needs emergency surgery. Due to his medical history of heart and lung conditions, Ralph has been given a 50:50 chance of surviving the operation but as Consultant Anaesthetist Ian puts it, “if we don’t fix it, he’ll never get out of bed…that’s a miserable end of life for anyone.” Ralph is keen for some good news and Ian explains that his “heart scans are looking better and I think this is our best shot’. As Ralph heads off to surgery,
his fellow ward patient Jamie says he will order his cheese and potato bake for when he comes back; Ralph says “I just want to wake up and be here.”

Meanwhile, in the Tactical Operations Centre at London’s Ambulance Service, Flight Paramedic Jason is dealing with an influx of trauma calls. He reflects “some are predictable and some are completely random acts.” 33 year-old Zoltan is one of those in the wrong place at the wrong time and is in St Mary’s Hospital after he was hit by a van whilst walking along a pavement, being crushed against metal railings then thrown into the basement of a Mayfair property. His fiancée Julia admits “at first I didn’t really want to believe it”. She has tried to explain everything to her two daughters and to remain
strong but “for him and for the girls … it is difficult. It’s a life-changing accident”.

Orthopaedic surgeon Chris explains that his leg “was so badly damaged it was unsalvageable” and they had to amputate his leg below the knee. In order to give Zoltan any chance of walking on a prosthetic limb, the team need to stabilise his pelvis, which is fractured on both sides. In the same operation, plastic surgeons examine the remaining tissue, cutting away any infected muscle and skin, and trimming the bone to give them the best chance of saving what is left of Zoltan’s leg and fitting him with a prosthetic leg. In the words of orthopaedic surgeon Chris, “this is where the trauma system really shines … having all those specialties in one place and working together for the good of the

At King’s Major Trauma Centre, a call is put out for an adult ‘code red’ trauma as a 42 year old-man is being flown in by Kent Surrey and Sussex Air Ambulance after a collision on the M25. Father-of-two Karl was trapped in the vehicle for over two hours. Emergency Medicine Consultant George leads the trauma team and quickly gives Karl a transfusion to replace the blood he has lost to prevent him going into cardiac arrest. CT scans reveal significant fractures to both legs and also his elbow. The radiographer is particularly concerned that there may be a vascular injury to Karl’s arm, and Consultant
George says “the lack of blood flowing to his arm…could result in…having his arm amputated”.

Meanwhile, Karl’s wife Lulu and hisson Brendan arrive at King’s to hear the devastating news that Karl will need emergency surgery to the break in his femur. Orthopaedic Surgeon, Ibraheim will carry out the operation and is worried about the crush injuries to his chest and his ability to breathe whilst under anaesthetic. As he finishes the operation, Anaesthetists become concerned about Karl’s breathing and refer him to ICU where he will be kept on a ventilator to help him breathe.

Over at the Royal London, 13 year-old Alicia is about to have surgery after she collided with a lamppost when riding an e-scooter and suffered a deep wound to her thigh. A talented athlete, Alicia and her mum are concerned about how her injury could impact her sporting future. Orthopaedic surgeon Anouska explores the wound and is concerned about the damage to her hamstring. She says it’s “much worse than I expected” and how “you do feel a certain pressure when you’re operating on children because what you’re doing can impact the rest of their lives”.