Rushing to attend the birth of his child, a fuel tanker driver crashes into Holby General's Acute Assessment Unit. Immediate evacuation of the hospital has begun as the tanker leaks petrol into the hospital basement. The driver's wife delivers a mixed-race son who is identifiably the result of an extra-marital affair. The driver dies unaware of his wife's infidelity, and as the baby begins to experience breathing difficulties, his mother rejects him. Connie Beauchamp and Alistair Taylor are forced to complete open heart surgery on a child as the evacuation continues, held hostage by the child's father. Paramedic Luke Warren fails to spot the deadly symptoms of a student with Lassa fever, and receptionist Bex Reynolds is lured up to Nightingale Wing pharmacy by a fake pharmaceutical representative. As the generator is switched off in the basement, the petrol explodes and the Nightingale building bursts into flames, trapping numerous staff members inside.

As firefighters struggle to contain the aftermath of the explosion, Connie is joined in theatre by Harry as they continue the transplant by torchlight. Rosie and Jim manage to get the baby to safety, but as debris falls, Rosie is impaled on a piece of metal. Bex is discovered by firemen and carried to safety. Alistair abandons the transplant and jumps from a fifth floor window. Critically injured, he talks nurse Donna Jackson through a life saving procedure on another patient before dying. From outside, Ric Griffin guides Connie to a maintenance corridor and bridge which will lead those trapped to a point where firefighters are waiting for them. Suddenly, the fake pharmaceutical representative rushes across behind them, damaging the bridge further and falling to his death. Jim and Rosie are left hanging from the broken bridge holding on to one of Harry's arms each. Knowing Harry will be unable to hold both their weight for much longer, Jim saves Rosie's life by letting go.

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Alistair's world comes crashing down around him.

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