Episode 28 is the 1120th episode of Casualty and the 28th episode of the 33rd series. It was preceded by Episode 27 and followed by Episode 29. The episode was directed by Andy Newbery and written by Hamish Wright. This episode marks the first appearance of registrar Archie Hudson, portrayed by Genesis Lynea.
At her induction, believing it to be a waste of time, registrar Archie Hudson decides to leave prematurely. As she arrives for her first shift at Holby City Hospital's emergency department, she meets Connie who tells her to move her car. Connie is called to a meeting with Hanssen and leaves Elle to give Archie a tour of the department. As she treats an impatient patient named Trina, Archie is called into resus to treat Shane, a man with burns. As she tries to get him to calm down so she can administer an injection, Shane hits her in the face.
Connie calls Archie into her office and tells her that she has spoken with the Ostwyn - Archie's previous hospital. According to them, she left under a cloud and is "arrogant" and "quick-tempered with both patients and colleagues"; on the other hand, her reference labels her as a brilliant doctor. Although Archie asserts that the latter is more trustworthy, Connie warns her that, if she finds out that she has withheld information from her, she will make sure that she can never work in the NHS again. In admin, Archie struggles to order a CT scan and is told by Noel that she should have been given a radiology password during her induction. She decides to go to the IT department herself, but she is told by Gregory, who was leading her induction, that she needs to complete her induction day modules to obtain a staff ID.
In cubicles, Archie treats a young man named Ropey who has suffered a fall, and Duffy questions her decision to not order a full examination. Later, it transpires that Ropey's fall was worse than they originally thought, but Archie decides to prioritise a patient in resus, prompting Duffy to question her clinical judgement. In resus, Shane's pregnant wife Denise begins to bleed internally, and Elle asks Archie if she is thinking about leading the caesarian section, but she claims that she is comfortable with just assisting. With Elle's guidance, Archie helps to deliver Shane and Denise's baby and clamp her renal artery. Denise is then rushed to theatre, and Elle praises Archie's good work. However, Connie informs Archie that Trina is unhappy about her treatment of her. Archie confronts her in reception and admonishes her for her rudeness and stupidity, much to Connie's disapproval. Outside, Archie finds out that she has been given a parking fine and tells Connie that she was let go from the Ostwyn for exposing their unfair treatment of their staff. Connie tells her that, if she receives another patient complaint or hides something like this from her again, she will be fired.
Meanwhile, Duffy attends an appointment with her neurologist who believes that she is in the early stages of vascular dementia. At the ED, as she tries to make sure that her work is thorough, Charlie tells her that she needs to free up one of her patients' cubicles. She tells him to back off, prompting him to ask her what's wrong. In his office, she informs him about her dementia diagnosis, leaving him in shock. He asks her if anybody else knows, and she tells him that it is up to him to decide whether or not her condition needs to be made public. Later, Charlie tells her that he has taken her off night shifts. She implores him to tell the rest of the team about her diagnosis, but he is adamant about keeping it to themselves until they know for sure.
A patient agrees to take part in Dylan's larval therapy trials, but they soon decide to drop out. After he explains to Jade how the treatment works, she manages to convince the patient to continue with the trial. Elsewhere, Elle is delighted to hear that the department's mortality and morbidity stats were low during her tenure as acting Clinical Lead.