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season four, episode ten

"You're not doing a very good job," Ray commented to Meredith where she put the pron against Ray's stomach, "I am doing a damn fine job

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"You're not doing a very good job," Ray commented to Meredith where she put the pron against Ray's stomach, "I am doing a damn fine job. Don't you worry." Meredith tells the paramedic, "Can you—Can you close his eyes?"

"What?"

Ryan leaned forwards and putting his hand over the deceased paramedic's eyes closing them, "I'm sorry. I'm so sorry." Meredith apologised to the paramedic, "Meredith, stop. Stop right there." Richard said when looking at the ultrasound, "I want to freeze that frame. Yeah, his pericardium's full of blood." Richard admitted.

Where Ryan sees Ray start to panic, "That's not good. That's not good at all." Richard then got some nurses to come to him, "Oxygen, IV start kits, Arnie, monitor. His anatomy's all screwed up because he's hanging upside down. Get someone from cardio! Go!" Dr Webber ordered.

____

Ryan stood up from his laid down position when Dr Hahn and Dr Stevens came towards them, "Grey, you've got to be careful with this technique. If you aim the needle incorrectly, you could w the very thin-walled right atrium." Dr Erica Hahn admitted.

Dr Stevens looked at her attending, "Which could cause a cardiac rapture," Stevens said to what Ryan then said, "a cardiac rapture, a tension pneumothorax," He said to what Erica nods her head at, "Basically there's about six different ways she could kill him."

"Dr Hahn?"

Meredith looked at the blonde headed attending, "Shut up," She ordered as her patient could hear everything that they were saying, "You too, Ryan," Ryan quickly apologised to his sister who went back to helping Ray, "Stevens, go and get me an eighteen gauge needles before this man's heart explodes in his chest," Hahn ordered her resident.

"I have a patient on the table whose—" Erica Hahn said when her pager went off, "I got to go." Ryan looked at the attending, "Dr Hahn!" He called when the cardio attending looked at her resident, "Page the cardio fellow, then book an OR. Have it waiting when they get him free." Erica said to her resident when Richard looked to Ryan who makes a face.

____

"Hey," Richard knelt down, "You need to find the xiphoid process. You feel it?" Richard then questioned his resident, "Got it." Meredith admitted to the Chief, "Go two fingers breaths to the left of the xiphoid."

"I'm there." Meredith did as said, "Here." Richard handed Meredith a needle, "Eighteen gauge," Ray said where Ryan rounded the flipped ambulance being on Ray's side of the window, "That is a very big needle,"

"I know. I'm sorry."

Ryan looked at the paramedic, "Ray, hey—" He said looking at the injured paramedic, "Focus on me, Ok? Keep your eyes on me." He told the paramedic, "You're going to angle the needle toward the left shoulder. Don't stab. You don't want to hit the ventricle, don't drop the lung. That wouldn't help matters either."

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