Saddling up in LA with veteran paramedic Jimmy (Field), young Tom (London) wants to put some miles between himself and a dark episode back East. However, Jimmy's blooding of the greenhorn snuffs out any fantasies Tom might have entertained of redemptive good works. Saving lives, he learns, is what you do when you're not whoring, boozing, thieving, shooting up or subduing uppity patients with the defib paddles. Who then, the film asks, are the real casualties: the unfortunates in the back of the rig or the strung-out pair riding upfront? Recalling elements of Repo Man and Trainspotting, this striking first feature is best enjoyed as an amoral trip to the (needle) sharp end of US healthcare. Desaturated film, overlap editing and time-lapse traffic sequences impart Jimmy and Tom's downward spiral with an impressively entropic feel; the performances too, particularly from Field, are suitably wearied. It's a pity then that this beguilingly textured surface conceals some sketchy characterisation and a standard plot.