"Buried Alive" is the 990th episode of Casualty and the 29th episode of the 30th series. It was preceded by "Sweet Child of Mine" and followed by "Hopelessly Addicted". The episode was directed by David Beauchamp and written by Matthew Barry. It is Connie centric, and primarily revolves around Connie and Jacob being trapped in a partial building collapse. It doesn't take place on the day it aired, but a weekday near that date.
At the start of the day, Jacob comes to see Connie and Grace but he's surprised by how rude they both are to him, and after he leaves Grace realises that Connie hasn't yet broken up with him. She later speaks to him and tells him that they can't stay together as Grace needs her. Soon after, Jacob asks Jez and Iain if he can attend a call out with them in an attempt to distance himself from Connie. The rescue crews are initially reluctant to let them in, but eventually grant them access.
Elsewhere in Holby, Shelle turns up at Mercedes' house demanding money, and Connor flees to the ED to find Max. He initially tells Max that he's there with his grandmother who's being treated but he later catches on that he's just there to get away from home.
Back at the ED, Dylan answers a phone call from the scene requesting more medical backup and when Connie hears it's Jacob, she sets off to the scene. They end up performing an emergency arm amputation in order to free the man trapped, but just before they're able to get out themselves, the floor gives way leaving them trapped in a small basement room with sand quickly pouring in.
Meanwhile, Ethan reveals his Huntington's news to Lily after she asks him what's wrong, and in anger he tells her that she wishes it were Cal who had inherited it, but Cal overhears this from outside the staff room. Ethan and Robyn also work together in treating a young boy with cancer and she begins to have empathy for him upon learning that he's living all alone away from his family in a hospice.
Back at the scene of the collapse, Connie realises that Jacob's leg is trapped and he's unable to stand or move and with the sand quickly rising she'll have to act quickly. She attempts to stop the sand but can't as the gap in the ceiling is too high, and shortly after she's knocked unconscious by a falling rock. By the time she awakens, she too is buried under too much sand and unable to move. In the fear they may both die, she requests that Jacob call the ED on his radio to get through to the ED and talk to Grace. He does so, and she's able to tell Grace how much she loves her before the transmission cuts off. Meanwhile, Jez and Iain are trying to get the rescue crews to let them in to save Connie and Jacob but they don't allow it.
Back in the ED, Connor follows Max around treating it as work experience despite Zoe's orders not to. Robyn calls them both up to the boardroom and it's revealed that she's acting out a wedding to Russell, the boy suffering from cancer. He had told her that getting married was on his bucket list, and Robyn wanted to make it happen.
Jez and Iain are eventually allowed to enter the building, and they managed to get to the other side of the wall to where Connie and Jacob are trapped. The sand is covering their faces and Iain is desperately hammering at the wall when Jez has the idea to attempt to pull down a section of the wall by using a tow rope attached to a truck. They do it, and a gap is made in the wall and Iain is able to make the hole wider, releasing the sand and saving Connie and Jacob. They return to the ED and Connie goes straight to Grace, abandoning Jacob.
Meanwhile, Charlie tells Ethan that Cal has gone AWOL and Ethan tells him he has an idea where he is. Ethan goes to Conleth Bay to find Cal sitting in his car with Emilie's ashes in the back. Ethan apologises and says he wants to be more "Cal" and enjoy life more. They run down the beach and into the sea together like they had done in the past.
It was the first episode to air featuring scenes included in the March 2016 trailer. Coincidentally, the scenes included were regarded as one of the most popular due to the fact they saw lead couple Connie and Jacob in peril during a building collapse. Despite concerns among fans that one of them may have died during this disaster, this wasn't possible due to the fact that in the same trailer they both appeared in scenes involving Elle Gardner who made her first appearance in May, well after the events of "Buried Alive".
From behind the scenes images released by the BBC, it appeared that the set for the filming of the collapse and basement scenes was constructed above ground with the gap in the ceiling being used for camera shots.
Filming also took place in Porthcawl in South Wales for scenes set at Conleth Bay which was last seen during the episode "High Tide" which aired in March.