how' you get to be so strong you're doing great chest and belly clear okay honey BP 86 over 47 heart rate 135 I know I know okay okay that's it you're free unstable pelvis and hypotensor close it down and stop the bleeding grab a sheep I need some help in here what do you need this might hurt give 25 mics of fentel copy okay honey okay all right all right okay make sure it's tight okay heart rate's coming down bleeding's temporized for now let's get x-rays chest and pelvis let me know the second there's an opening and Interventional Radiology we need to embolize the bleed got it chest and abdomen are clear cold foot I can't get a pulse on this leg fractur is probably kinking the femoral AR we've got to reduce this now let's push 2 Mig of set 25 mic fentanyl okay Josh we're going to have to do something right now and I need you to be so brave for me can you do that yeah yeah are you ready it's all done that's it it's over great job get a post multi spin on him Paige Ortho he's going to need surgery to wash out and X fix that fracture as soon as we can get an O you all right okay can you keep being that you are so brave so brave heart rates 150 BP 70 over 40 what are his injuries femoral fractures in both legs lots of soft tissue injuries looks like bilateral thigh hematomas so blood's accumulating in his legs we need to transfuse him yes but first let's get a leader of lactated ringers dopamine of 10 titrate to systolic BP of 90 Maggie need some help in here coming blood pressure is coming up 80 over 50 90 over 60 he's stable for now call up to the blood bang and tell we need two units of O Negative for this boy I need the same for his cousin in the Next Room okay hold on you're both going to have to talk to Miss Goodwin about this I don't understand we're very sorry but it's up to you to decide which of the boys gets the blood decide who gets the blood the doctors have their opinion but it is a decision you and your husband should make and he's still in surgery but without blood is one of them going to die it is a possibility but we are going to do whatever we can to prevent that and you want me to decide between my son and my sisters how our recommendation is to give the blood to your nephew Josh Josh why because he has the greater chance of survival that means Ben we are going to do our best to keep him alive until we have more blood how can you make me do this I can't I can't if you'd prefer we can make the decision on your behalf Mrs Porter I assure you we will do what's medically and ethically correct BP's down heart rate's up to 152 we could add another presser he's per arrest his heart's working to compensate we've tried every stop Gap we have without oxygen rich red blood cells I'm afraid there's nothing more we can do for them it's good when we typed a few Universal donors in the doctor's Lounge what is taking so long everything has to go through the lab if we transfuse blood that hasn't been screened for HIV and hepatitis we are in direct violation of FDA guidelines we'll just have to wait hold on I'm O Negative I'm screened routinely by the name maybe I don't know if military testing meets our standards please if this could save my boy heart rate's up to 160 connect me to a bag now we can push whole blood directly through the rapid transfuser that's good one okay do it be's coming up heart rate's going down thank you Ethan of course good news we should be able to get him up to Interventional Radiology soon Susan his father was right I was willing to let him die no no we made the decision to give J wash the blood but that doesn't mean we ever gave up on your son I'm his mother I should have fought for him what will he think when he finds out