Then, a call comes in on Iain's radio about a woman suffering severe bleeding after being pushed through a door. Iain recognises the address of the injured casualty as Alicia Munroe (Chelsea Halfpenny) and tells Ruby that they need to leave. Ruby is sceptical about leaving Mia, but Iain tells Ruby not to question him. After collecting Alicia, Iain drives her and Ruby down to the emergency department (ED) via the dual carriageway. As Iain is driving, he notices Mia standing on the bridge over the carriageway, preparing to jump. Mia jumps off the bridge and Iain swerves the ambulance to avoid hitting her. The ambulance flips on its side and obstructs the lanes of the carriageway. A fuel tanker containing butane swerves to avoid the ambulance, which in turn causes a huge pile-up. At the ED, clinical lead Connie Beauchamp (Amanda Mealing) is informed of the crash. She tells paramedics Sam Nicholls (Charlotte Salt) and Jan Jenning (Di Botcher) that Iain and Ruby have been involved in the pile-up. Consultant Dylan Keogh (William Beck) is also sent out to the scene of the crash to help treat the injured. The trio arrive at the scene and begin looking after patients. Alicia and Ruby are freed from the ambulance. Iain treats Mia and after stabilising her, sends Ruby to the ED with her. As Sam and Jan free their final two patients from the car trapped under the fuel tanker, it ignites, and explodes. The force of the explosion slams Sam into the side of the ambulance. Back the ED, Alicia is recovering from her injuries; her friend Ethan Hardy (George Rainsford) visits her and comforts her. Mia dies from her injuries and Iain is devastated. At the ambulance station, Sam falls forward in agony – her liver has been nicked by shrapnel. She stumbles to the ambulance to treat herself. Iain later finds Sam in the ambulance and continues to treat her, but he is too late, and Sam dies in his arms. On 9 May 2018, Sophie Dainty of entertainment website "Digital Spy" reported that "Casualty" would broadcast a car crash and an explosion involving a petrol tanker in August. The "Gazette Series" billed the stunts as "one of the most expensive scenes ever made" for the series. Actress Charlotte Salt, who portrays paramedic Sam Nicholls in the series, confirmed that the stunt would mark the beginning of the show's thirty-third series, which series producer Lucy Raffety billed as "The Year of the Paramedic".