Upstairs, Dean angles through the apparently deserted hallways with a little flashlight-fu, ducking around the police floodlights, all the while whipping his head around at every single one of the old building's many, many creaks and groans.
Down in the vault, one imprisoned teller thumbs through her rosary beads -- nice touch -- as the aging guard slowly doubles over, suffering from some ominous shortness of breath. As Sam and Ron arrive and open the vault door to allow those inside some fresh air, the phone unexpectedly starts ringing. Ron foolishly answers to find the police negotiator on the other end just as the ailing security guard clutches at his left arm and pleads to be released. Oh, shit. "Well, it would be a moment of unendurable crisis," Raoul opines, "had we not already known that Dean escorts this elderly gentleman out to a waiting ambulance." Doy! You're totally right, and I completely forgot about that. At any rate, Sam's not privy to that information and, increasingly keyed up, tries in vain to cope with dim Ron on the phone and the growing panic among the hostages in the vault at the same time, finally deciding to deal with both situations by shutting them down completely, grabbing the handset out of Ron's hand to slam it back into its base while ordering everyone in the vault to shut up. "You just gonna let the man die?" a particularly strapping hostage demands. "No one's dying in here!" Sam shouts back before angrily shoving Ron over to guard the vault. He then picks up the phone to dial.
Dean keeps playing with his flashlight. No, not like that. "Dirty!" shrieks Raoul.
Meanwhile, Sam's on the line with the lead detective, telling the guy to send in a paramedic, and no one else. "We don't have time for that!" the particularly strapping hostage protests. "He's dying right in front of you!" Ron offers a few weak -- yet heartfelt -- apologies to everyone present while Sam frets.