It's a busy night for trauma team leader Julie Norton, who is juggling two life-threatening cases who arrive at the emergency department within minutes of each other. Both have potentially fatal hidden injuries. Lewis, 18, is an emergency transfer from another hospital and has suffered a cardiac arrest after being stabbed in the chest with a 20cm kitchen knife. While his life has been saved by open heart massage, Julie knows that there's a huge risk that he has suffered other internal injuries in the attack that may be still be bleeding, and she must act fast before his condition deteriorates again. At the same time, Welsh farmer Eric arrives in huge pain after being headbutted by his favourite cow. While Eric's laboured breathing immediately suggests a chest injury, Julie is also worried about any other damage that might not be so obvious. A CT scan reveals a bleeding artery in Eric's liver and the race is on to get him to surgery before it's too late. For Vivienne, too, time is of the essence. She's been diagnosed with an aneurism in one of the body's major vessels and has a ‘ticking time bomb' in her head she's worried will erupt. For surgeon Dr Nayak, there's not a moment to lose, as he knows that if Vivienne's artery bursts, her chances of survival are slim. Finally, Andy is brought in with multiple injuries after a motorcycle accident. With broken ribs, spinal fractures and chest injuries, Julie Norton breaks the news to his wife and teenage family that while Andy has miraculously avoided paralysis, it's likely that his condition will deteriorate before he improves.

In this final episode of the series, when 52-year-old Helen is rushed into Royal Stoke emergency department after a headon collision with a bus, trauma team leader Paul Hancock fears the worst. With a blown right pupil indicating a serious brain injury, an urgent scan reveals a devastating skull fracture that could be fatal. Neurosurgeons act quickly to relieve the pressure on her brain, but when her partner arrives, Paul has to prepare him for the fact that Helen might not make it. Meanwhile, 65-year-old HGV driver Michael was at work when he suddenly began to display worrying symptoms of a stroke. Tests reveal he has a severe lack of co-ordination on his right side, and Dr Janaka knows that if he doesn't act fast, his patient could suffer permanent paralysis. The race is on to shift the blood clot causing the stroke to give Michael a fighting chance of making a full recovery. Across the hospital, 35-year-old Daria is preparing for emergency surgery to treat an aneurysm in her brain. It could rupture at any minute, potentially killing her in an instant. She's one of the youngest patients Dr Nayak has ever treated with this condition, and he urgently needs to insert a stent into her brain to block off the aneurysm. But when the procedure doesn't go to plan, Dr Nayak has to think on his feet to save the life of his young patient. Finally, 80-year-old Fred has fallen down the stairs at home and has a significant head injury. Trauma team leader Richard Hall isn't only concerned about Fred's external injuries, but also, crucially, as to why his patient fell in the first place. An ECG confirms his worst fears: Fred has suffered a heart attack and Richard now knows that his patient is at risk of having a second, potentially fatal arrest. With his patient's life in the balance, Richard has to work quickly both to treat Fred's external injuries and the serious cardiac condition he has just uncovered.