A 19-year-old casualty is stuck 150 feet down cliffs in the north of Shetland. The deteriorating weather makes the rescue extremely challenging, and the team are concerned he may succumb to hypothermia. Dr Lalla reopens a nasty wound when patient Martyn is transferred by helicopter to hospital from his oil rig. He sliced his hand open with a metal grinder, and Dr Lalla is concerned about serious infection. Farmer Derek arrives in A&E having been trampled by a calf. Nurse Thelma Irvine needs to find out whether his cheek and nose have been fractured by the bovine bashing.

Shetland's above-average birth rate gets a further boost with the arrival of the latest islander. A patient with several complex medical problems faces a serious operation. The prognosis is very poor, but the team do everything they can to make him comfortable, knowing that he may not survive. The island of Yell gets a visit from popular locum GP Dr Gardner. He's ready to treat and care for anything and everything but also hopes he gets a chance to do some fly fishing while he's here.

A medical mystery concerns the team in A&E. Gary has been transferred from his North Sea rig to hospital after feeling dizzy with blurred vision. It may be a problem with blood sugar or a vascular issue, but it may also be signs of multiple sclerosis. Fish factory worker Richard thinks he might have scratched his eye removing a contact lens, but Dr Lalla suspects something much more serious and there is a race against time to get the treatment that Richard urgently requires. Three-year-old Summer gets the attention of occupational therapist Marc Beswick. The youngster has a condition that means it's hard for her to move her arms and legs. Marc is working to make sure she can gain the skills she needs and also learn how to use an electric wheelchair to get around.

A retired university administrator is treated for serious chest pains. Tests reveal he has had a heart attack and needs specialist surgery - and an air ambulance. Pharmacy technician Kieran Groat visits an elderly patient who has had trouble remembering to take her medication. A new plan to remind her and streamline her medicines means she can maintain her independence. And senior charge nurse Aimee Sutherland organises Shetland's biggest biker rally.

The coastguard helicopter takes a 24-year-old oil rig worker to Lerwick for urgent medical treatment. After appendicitis is diagnosed, he's rushed into surgery. A 64-year-old member of the Jarl Squad, stars of the annual fire festival Up Helly Aa, comes in to A&E complaining of breathlessness. The cause turns out to be a deadly blood clot, discovered in the nick of time. And community nurse Margaret Cooper gets an introduction to Out Skerries, one of Shetland's more remote islands.

The annual fire festival Up Helly Aa gets under way with a traditional visit to the hospital from the squads of men dressed in Viking garb. It is a night to remember for one reveller, who ends up in A&E with serious burns after an accident with a kettle. A specialist retrieval team beats the weather to get to a critically ill patient who needs urgent treatment on the mainland. And an 84-year-old marathon runner is stopped in his tracks by a fall that breaks his hip. But after an operation, he is determined to get back to fitness.

Walter, a 57-year-old man, has been brought in to A&E suffering serious chest pains. Nurse Amanda Brown provides pain medication, but it is confirmed that Walter is having a heart attack and will need an air ambulance to take him to the mainland for vital heart surgery. Paramedics are called to Scalloway to reach an elderly patient who has fallen and hurt herself. It isn't the first incident, and she is having trouble taking medication. Consultant physician Professor Chris Isles is determined to find the answer. And nurse Marie Stemp and Dr Hazel Thompson need to improvise when a patient arrives at A&E with an injured foot. French fisherman Jimmy speaks no English, and the medics don't speak French.

Dr Lalla is frustrated by summer fog which means the air ambulance cannot land. To get his patient to specialist care, he urgently needs the coastguard helicopter - and the fog to clear. A South African with Shetland roots learns to always listen to his mother. She convinces him to get his foot x-rayed after a nasty stumble, and a fracture is diagnosed. And senior staff nurse Emma Williamson suspects the cause of an asthma attack is more serious than it first appears.

A carrot cake causes a major emergency when an oil rig worker with a nut allergy eats some after his shift. Evacuated to Lerwick, he is treated by the team in A&E. A young man's attempt to vault a fence after a few drinks doesn't go as planned when he fractures his ankle in three places. And Dr Ruth Booth starts a six-day stint as GP on Unst, the northernmost inhabited island in the UK.

Offshore worker Tony is evacuating to the Gilbert Bain with severe abdominal pain. Dr Lalla diagnoses appendicitis and Tony is rushed to theatre, where surgeon Mr Gordon McFarlane is assisted by surgical trainee Dr Jemma Langschmidt. Two ambulances and a ferry were needed to get Ingrid from Whalsay to A&E. She was knocked unconscious when a horse kicked the metal door of a horsebox into her face. Senior charge nurse Aimee Sutherland assesses the damage. And on a stunning summer's evening, the latest crop of junior doctors are taken to the tiny island of Oxna as part of their induction to Shetland life.