Rorish, Neal, and the residents head out to a massive accident site in the back of an ambulance. There's another doctor in charge when they arrive, ruffling Leanne's feathers. Neal and Christa treat a hospice nurse and her near dead date. Back at the hospital, Perello takes a call from a little girl over the radio. Back at the site, we see the little girl after the call drops, with a flipped over car in a ravine.
Jesse is in cardiac recovery, and the nurses are talking about how he's approved for discharge. Amy talks him through a panic attack that feels like another heart attack. At the accident site, Leanne treats the nurse, who is upset about her date being black-tagged. Angus notices a flipped cement mixer that has dumped it's load onto an unconscious man in the car behind it. Perello calls Christa about Lily. Mario, Heather, and Angus debate whether they should black-tag the man in concrete or not. Neal hears a little boy calling for help, and catches him as he collapses. Angus and Heather warm saline bags on the engine block of another car and leave him with some volunteers while the saline bag empties. Neal gets the boy to the tent, but he freaks out at the idea of leaving his mother behind. Leanne reassure him that they will find his mother and send her to the same hospital, having him describe the car to her. We see the car he described, and Malaya black tags the mother.
Carla is brought into the ER, where Rollie recognizes her. Gina introduces herself. Rollie takes her for an ultrasound. A woman is trapped inside a burning car, and Mario tries to get her out, but she has a compound fracture. Angus and Heather have run out of saline. Jesse has altered heart monitor to be extra sensitive. His roommate tries to reassure him. Carla has fallen a few times, and attributes her vomiting to morning sickness. Perello gets her into CT. The man in cement keeps asking for a cell phone to talk to his family. Heather calls from her phone, and he leaves a touching message. Mario arrives with the ax to pry the door off the car, and they dig him out of the cement. Malaya tells a questioning Rorish about the woman she black tagged, and leaves the tent without the permission of the DIC. He threatens to have her arrested, and Rorish drops her bag. After discussing with Neal and Malaya, she leaves anyway. Carla and Jesse meet each other in the hallway. Carla nags him about being a worrier, and urges him to let go. Mario and heather find a woman in an RV, and they have to black tag her. Leanne and Neal arrive at the car. Neal thinks Malaya made the right call, but Leanne insists on trying to save her. They'll have to do a field amputation on her foot to get her out of the car. Christa finds Lily and her family in a ravine, but injures herself and loses the radio trying to get them.
Christa has a dislocated shoulder and has to have the little girl help her. The mother has a fractured neck and a head laceration. The boy has a fractured trachea and an injury to his hips. The family's cell phone has died, and Christa has no reception. Back at Angels, Rollie breaks the news that Carla's cancer has metastasized to her brain. She doesn't have long, and Rollie urges her to induce, which she objects to. She tells him not to tell Malaya. The DIC is looking for Leanne, and Malaya has to handle a difficult chest tube on her own. The little boy from before arrives at Angels, and Amy and Rollie treat him. Neal and Leanne go ahead with the amputation. Christa has Lily assist her with stitching up the mother's head lac's, and the boy starts to have problems breathing. Christa sends Lily for a pen to trach him. Malaya needs the ultrasound that Leanne took, and has to do the chest tube blind. Jesse is getting over his worry for himself when his roommate flatlines. He disconnects his on leads and starts CPR on the man. The woman that Heather and Mario black-tagged earlier is now conscious and he goes to help her. Christa has Lily help her relocate her shoulder so that she can perform the tracheotomy on the boy.
Jesse defibs his roommate when no help arrives, and gets Jack back to sinus rhythm. The DIC reprimands Neal and Leanne. Angus mentions to them that no one has seen Christa, alarming Neal. Christa gets the trach in with Lily's assistance. Perello calls the docs back, but Neal refuses to come without the rest of the team. Jesse comes down to pitch in. Leanne explains Connie's situation to Jason, and she squeezes his hand before they take her up to the OR. the crisis center starts to shut down, but Christa is still stuck in the ravine with Lily and her family. The man from the RV his holding Mario hostage when Heather arrives to help him.