At the end of the episode there is a shot of Dr. Carter's reflection in a puddle as he walks out to the ambulance bay. This is a recreation of the same shot of Dr. Greene from the pilot which was featured in the opening credits for the first 12 seasons.
The title comes from the type of countdown used by NASA for rocket launches involving either unmanned satellite launches or the reusable manned space shuttle. It also alludes to the fact that this episode is the first of the last six episodes of the series.