NBC's primetime lineup is already laden with cop and hospital dramas, so it hardly seems necessary to add yet another to the schedule. And initially, the new medical series "Trauma" seems to be the same old tune, different verse.

Five minutes in, however, makes it clear that "Trauma" is not the same old song. Instead, it's a riveting, multilayered show about fallout; survival amidst the ruins -- a standout among the fall season's offerings.

"Trauma" focuses on a team of San Francisco paramedics devastated in the aftermath of a horrific (though spectacularly filmed) helicopter collision. The meat of the show picks up a year postcrash, focusing on the survivors -- world-weary Nancy (Anastasia Griffith); repressed Boone (Derek Luke) and reckless Reuben (aka Rabbit, played intriguingly by Maori actor Cliff Curtis). They're collectively struggling to emerge from their mental wreckage while racing to save others, and none of them have put the disaster behind them.

There's a lot to chew on: Creator-writer Dario Scardapane doesn't underestimate his audience, and by creating bickering leads with enigmatic shared histories he doesn't provide outsiders with an immediate entry into the narrative. But then disaster strikes and "Trauma" grabs its audience by the throat, thrusting viewers into a world where things go bad, get worse, and then get terrible -- a highway pileup becomes a gas explosion that sends shrapnel into a young boy. Medical jargon and details whiz past without exposition, mere parts of the chaos, a device "ER" weaned its viewers on. And suddenly, it's happened -- viewers are grafted into the anarchic slipstream of the story, and hooked solid.

"Trauma" is far from perfect -- three anti-heroes are a bit much to stomach at once, and the bigger-than-life disaster scenarios surely can't be sustained every week. But there's a lot of subtle interplay sandwiched between the emergencies, and with luck, diligent viewers should be rewarded. Anyone still wondering whether "Trauma" is a keeper should stick around for the sweetly underplayed and near-wordless end scene, for proof that this patient has strong vital signs.

Airdate: 9 p.m. Monday, Sept. 28 (NBC)

Production: Universal Media Studios, Film 44
Cast: Cliff Curtis, Derek Luke, Anastasia Griffith, Aimee Garcia, Kevin Rankin, Taylor Kinney, Jamey Sheridan
Executive producers: Peter Berg, Sarah Aubrey, Jeffrey Reiner, Peter Noah, Dario Scardapane
Creator-writer: Dario Scardapane
Co-executive producer: Bruce Rasmussen, David Schulner
Supervising producers: Janet Tamaro
Producer: Steve Sassen
Director: Jeffrey Reiner
Director of photography: Alan Caso
Production designer: Stuart Blatt
Costume designer: Jill Newell
Casting: Linda Lowy, Nina Henninger