Casualty spoilers: Will Iain Dean die in Christmas special?

Casualty's Iain Dean in his red HEMS uniform looking worried and scared.

Will Iain Dean's first Christmas with Faith and her family be his last? (Image credit: BBC Studios.)

Fans of Iain Dean have cause for concern when Casualty unwraps its standalone festive special All I Want for Christmas on BBC1 on Saturday 21 December 2024 at 9.20pm (See our TV Guide for listings).

This seasonal outing of the medical drama is a thrilling gift for fans and one-off viewers alike, as the festive nailbiter - which includes moving real life stories from key workers and families directly affected by blood donation - makes for gripping viewing.

Inspired by the life-saving properties of blood donations, the Holby ED team pull together as they face a challenging Christmas Day shift when a multi-vehicle crash puts pressure on their dangerously low supplies.

Inside the hospital, the doctors and nurses battle to save patients, while outside the paramedics risk their lives in perilous, snowy conditions.

Full Casualty spoilers for All I Want For Christmas below…

Iain Dean's last Christmas?

Getting ready for his Christmas Day shift at the home he shares with nurse Faith Cadogan (Kirsty Mitchell) is something of a scramble for Iain Dean when the medical drama returns after being off air for over three months.

The paramedic is anxiously awaiting a very special present, which arrives just as he’s leaving, delivered by exhausted driver Andrei Reid (Joseph Charles). Happy that he’s got the gift sorted, Iain (Michael Stevenson) heads off to work, looking forward to returning home later. But his joy is short-lived, as he joins the HEMS team to help out at a multi-casualty road traffic accident.

Iain Dean works on a critically ill patient at the crash site. (Image credit: BBC Studios.)

Siobhan McKenzie announces an amber alert

Meanwhile at Holby ED, acting clinical lead Siobhan McKenzie (Melanie Hill) reveals the hospital’s blood supply is running low and encourages anyone who has time to donate if they can.

Siobhan talking to a worried patient's ex-wife provides a steady guiding hand during an emotional shift. — Siobhan provides a steady guiding hand during an emotional shift. (Image credit: BBC Studios.)

Jacob Masters and Teddy Gowan uncover a catastrophe

Prior to Iain's involvement, paramedic duo Jacob Masters (Charles Venn) and Teddy Gowan (Milo Clarke) make their way to a car crash in a tunnel, where they discover divorced dad Dominic Ryder (Tristan Sturrock) in a bad way.

At first they believe he’s a solo casualty, but when Jacob hears a disturbing noise he follows it into the foggy tunnel where he makes a shocking discovery… There’s a multi-car pile up and numerous seriously injured people in need of urgent help.

Jacob and Teddy in a foggy tunnel call for backup. — Jacob and Teddy quickly realise that they need backup. (Image credit: BBC/ALISTAIR HEAP.)

Stevie rises to the challenge

As the news filters back to Holby ED, the emergency services on-location work tirelessly to free as many people as quickly as possible, while the hospital staff led by consultant Stevie Nash (Elinor Lawless) brace themselves for an influx of injured patients.

Meanwhile, nurse Rida Amaan (Sarah Seggari) and Stevie treat poorly six-year-old Leah Thompson (Mia Millichamp-Long), who has been brought into the ED by her worried mum Adele (Lucy-Jo Hudson).

Stevie breaks news to Leah's mum Adele, who looks deeply worried by what she's hearing. — Will Stevie be forced to break bad news to Leah's mum Adele (Lucy-Jo Hudson) on Christmas Day. (Image credit: BBC Studios.)

Lives on the line

When the injured from the crash site are admitted, the team springs into action to save lives while the dwindling blood supply reaches a critical point.

Then the unthinkable happens - the hospital completely runs out blood.

Everyone is anxiously awaiting a new supply, but there’s more bad news - with the worsening weather conditions, deliveries can’t get through.

Dylan Keogh anxiously watches the clock as Holby ED's blood supply runs out. (Image credit: BBC Studios.)

Iain gives the gift of hope…

As Iain’s shift ends he’s eager to get home and spend his first family Christmas with Faith and her children Natalia (Zoe Brough), Ana (Isla Merrick-Lawless) and Luka (Tom Mulheron). Yet, when he realises the dire need of the ED, he offers to pick up a new batch.

Before he sets off Iain gives Dylan Keogh (William Beck) a special gift to look after until he returns.

Shocked Iain Dean sees something on the road ahead that causes him to swerve... — Shocked Iain sees something on the road ahead that causes him to swerve... (Image credit: BBC.)

Dead or alive?

With numerous patients critical and several lives on the verge of slipping away, the anxiety at the ED is palpable while Iain makes his long and dangerous journey.

Meanwhile, Iain manages to pick up a fresh blood supply but on the return leg he's forced to swerve to avoid something discarded on the road. This leads to his vehicle violently overturning, which leaves him trapped, unconscious and alone in the middle of nowhere...

Will the brave paramedic survive?

An image of the outside of a snow covered Holby ED at night with a bloody paramedic jacket lying on the ground beside a bag that reads "Blood products in transit." — Will there be a Christmas miracle in Holby? (Image credit: BBC/James Pardon.)

Also in Casualty’s All I Want for Christmas…

Rash Masum (Neet Mohan) and Jacob share a quiet yet meaningful moment as they treat a patient with a condition that is sadly familiar to them both.

Rida gleefully sets the cat among the pigeons when she reminds Dylan that he and Stevie have drawn each other in the department’s Secret Santa. Will Dylan rise to the occasion when Rida reveals that Stevie has gotten him a very meaningful gift!?

Siobhan goes on the hunt for the person leaving empty wrappers in the sweet tin. Will she catch the culprit?

Stevie makes a heartbreaking phone call to her estranged father.

And, finally, watch out for a gentle moment among the chaos and violence when nurse Ngozi Okoye (Adesuwa Oni) sees snow for the first time.

Ngozi sees snow for the first time and shares the moment with Cam. — Ngozi shares a serene moment with Cam. (Image credit: BBC Studios)

Casualty episode All I Want for Christmas airs on BBC1 at 9.20pm on 21 December 2024. It will also be available on BBC iPlayer.

If you are affected by any of the storylines in this episode of Casualty, help and support is available via BBC Action Line: https://www.bbc.co.uk/actionline/