The second episode of series 33 is the 1094th episode of Casualty overall. The episode was directed by Steve Brett and written by Patrick Homes. This episode features the posthumous appearance of paramedic Sam Nicholls, portrayed by Charlotte Salt, who was killed in the previous episode.
It also sees the return of guest character Ciara Cassidy, portrayed by Belinda Stewart-Wilson, who had previously appeared for one episode during the 32nd series. The events of this episode take place two days after the events of Episode 44 and Episode 1, which took place in-universe on 29 July.
Iain continues to reel following Sam and Mia's deaths. At work, he admits to Jan that he ignored Mia's warning and omitted it from her clinical record; she warns him that he could be fired. At the seaside, Iain and Ruby treat an internet prankster named Sheridan, and Iain is taken aback when he asks him if Mia is alright.
Back at the ambulance station, Rash asks Iain that Gem is worried about him. He insists that he is coping, but Rash is sceptical and implores him to talk to someone about what happened. Iain visits Sam's body at the morgue to pay his respects and apologise, believing that he is responsible for her death. Later, Ruby contemplates writing about Mia's warning in his statement, but Iain lambastes her and tells her that she shouldn't be a paramedic if she didn't realise that the crash was Mia's fault.
After Jan informs him that the pranksters from earlier want a word with him, Iain pays them a visit. Sheridan asks him again if Mia is alright. They proceed to tell him that they were there on the night and show him a video of Mia on the footbridge. Iain berates them for not doing anything to stop her until Sheridan tells him that he had to tell someone. At the ambulance station, Iain revises his statement and takes responsibility for leaving Mia alone, resulting in him being suspended. Before he leaves, Iain, Ruby and Jan decide to wash Sam's blood out of the ambulance.
Meanwhile, Dylan speaks to his AA sponsor who is concerned that Sam's death may cause him to relapse. Dylan prevaricates and asks him about the process of becoming a sponsor. Upon arriving, he attends a meeting with Connie and the other senior staff, and she warns them about the possibility of a CQC investigation. David informs him that a patient named Amy, who has been taken in after drinking methylated spirits, specifically wants him to treat her, and he finds out that Ciara Cassidy is accompanying her. Believing that she is responsible for Amy's methanol poisoning, he asks her to leave, but he soon finds her outside experiencing DTs.
After taking her in, Ciara tells Dylan that she and Amy decided to go cold turkey so the latter could retain custody of her son Harry. He agrees to find her help with her addiction, but David informs him that there is currently nobody who can take her. Frustrated, Dylan asks him to take Ciara off the system and keep her in the department. Amy's mother Estelle later arrives and tells her that Harry is now in her custody. Ciara soon experiences a withdrawal seizure, and Dylan asks David to put her back on the system. However, Connie reprimands him as Ciara has breached the four-hour rule by eight hours, and tells him that a CQC investigation is now inevitable. In cubicles, Dylan agrees to look after Ciara's dog Bacchus. Later, at Ciara's house, he decides to become her AA sponsor.
Elsewhere, Blake overhears Connie's speech about Sam and goes to pay his respects at the ambulance station. Later that day, Jacob tells him about their relationship and comforts Blake as he breaks down.
This episode saw a change to the 'Previously on Casualty' recap. Unlike the previous version, which consisted of a montage of clips from earlier episodes and a 'PREVIOUSLY' text graphic, this new style of recap featured the series title card dissolving into the clip montage with a cast member saying 'Previously on Casualty' - in this case being Charles Venn.