It only takes a moment for Sam to turn back, immediately reaching out to take hold of Castiel, wrap an arm around his chest and hold him close. Just give him a moment to settle. "All right, Cas, all right. I'll take care of it."

It's really not what he wants to be thinking about right now. But he'd seen the blood and he knew he'd have to check, anyway. There might be tearing. Hopefully, it was all superficial.

He keeps hold of Castiel, arm across his chest as he reaches down to take hold of the base of the plug. "Just keep breathing and push, okay?" Sam says, keeping his voice low in Castiel's ear. "I know it hurts, but it'll feel better once it's out. Okay. Now, push."

Sam starts pulling at the same time. Not hard or fast, but steady and not letting Castiel go.