Jack falls off the wagon and is gambling again.
This is the second time Dr. McNeil has had to improvise to perform emergency surgery in a non-medical setting. Previously, he performed surgery on a trans-atlantic flight with Dr. Austin.
Mandy Patinkin (Dr. Jeffrey Geiger) does not appear in this episode.
The episode's title, "The Golden Hour", is a term used in emergency medicine referring to the first hour after a trauma occurs that treatment needs to take place to increase the odds of survival.