"Survivor's Guilt" is the 895th episode of Casualty and the 28th episode of the 28th series. It was preceded by "The Last Chance Saloon" and was followed by "Gravity". The episode was directed by Paul Murphy and written by Kevin Rundle. In addition, the episode acted as the first of a two parter due to the fact the events of the next episode start directly where this episode left off.
At a B&B in Holby, Iain's ex army colleague Kenny Archer and his wife Beth are spending a romantic break together. She goes for a walk and messages Iain to tell him that they're in Holby. Due to Kenny's PTSD she sees him as a changed man, and explains that she has issued with trust now due to the fact she woke up to him screaming in her face the night before. Despite this, he lights candles in the room for when she returned but she goes to put on her coat to leave again due to her mistrust. However, he grabs her coat and throws it across the room and it lands on a candle starting a small fire. Beth attempts to put it out with her hands, and Kenny manages to extinguish it with a wet towel. He calls for an ambulance due to the burns Beth received.
Back in the ED, Zoe asks Ash to try to make amends with Lily to try to prevent her from going ahead with a formal complaint against him for bullying. She tells Lily that they will speak about a plan of action at the end of the day, to which she agrees. Iain and Big Mac arrive at the B&B and Iain is surprised to see Kenny there. When Kenny leaves the room, Beth begs Iain not to tell him that they met up to see each other as he's already paranoid. They take Beth back to the ED with Kenny and Kenny later admits to Iain that he thinks she's seeing another man as she disappeared one night and didn't tell him where she went.
Elsewhere three teenage boys steal some alcohol from a local shop. Whilst running, one of them finds himself out of breath. Another decides to climb atop a large container but when he falls, they're forced to call for an ambulance. They're taken back to the ED where the boy is treated by Ash. Lofty's keen eye helps one of the boys stand up to his brother. Meanwhile Beth gets a text from her mum on her phone whilst she's sleeping, but she wakes up to find Kenny suspiciously reading it. Later, Iain goes to visit Beth and explains to her that they all went through the same thing Kenny did when the bomb went off but they just deal with it in different ways.
In reception, Big Mac goes to comfort Kenny but inadvertently reveals that Iain received a phonecall one day from someone and was left with a grin on his face. When Kenny asks for the date, it coincides with the date when he supposes Beth contacted the man he thought she was having an affair with. He goes through to cubicles to find Beth and Iain talking at which point Beth apologises for her behaviour and promises to try to be more calm in future. Meanwhile, Ethan is frustrated when Cal flirts with Jenny, the nurse who took care of their dying mother.
Beth and Kenny arrive back at the B&B where the landlady tells them that they'll have to pay for damage caused by the fire which angers him. She sends him up to the room whilst she sorts it out, but when she goes up Kenny has her phone which has texts and calls from Iain. It pushes him over the edge and he ends up punching a mirror and storming out. Back at the ED Zoe calls Lily in for a chat and although Zoe tries to dissuade her, she decides to go ahead with the formal complaint against Ash for bullying, despite the fact they had got along better during their shift.
Iain receives a call from Beth informing him that she's in trouble, and Iain gets permission from Dixie to take an hour break to go and help her. He arrives at the B&B room to comfort her and he notices the smashed mirror. Back at the ambulance station, Big Mac is busy refilling the oxygen tanks alone and is surprised to see Kenny turn up. Big Mac asks what he's doing there, and he replies by asking where Iain is.