In the ER a beggar boy insists medics check a patient's neck; his tip reveals subcutaneous emphysema and earns shocked praise when the patient stabilizes for surgery. Chaos follows as a car-crash emergency is rushed in and staff note metallic fremitus at the right fifth intercostal space. Some attendings push immediate bleeding control while Dr. Jones argues to operate now. Others demand imaging: 'She really needs a CT.' After heated warnings—'you're not in charge'—Dr. Reynolds orders an urgent enhanced CT and cardiac angio, leaving the next move hinging on the scan.