Here are my ideas with 1 being most likely and 5 the least likely.
1st option - They will spend the entire episode trying to find ways to save Dean, calling everyone they know and looking in every book, and they will think they have finally found something that will work, but in the final scene it won't work and Dean will die.
2nd - Dean will die at the end of the first act and the rest of the episode will be spent with Dean in Hell and Sam tracking down the colt so he can get Dean out of Hell himself. The ep will end in the cemetery with Sam inserting the colt into the gate of hell and the door unlocks.
3rd - Something unthinkable where Ruby somehow has something to do with anything.
4th - Lilith shows up and Sam trades himself to her for Dean's soul.
5th - The work the whole episode, and call everyone they know trying to find a way to save Dean and in the end they think they've found a way and it works and Dean is saved.
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1st option - They will spend the entire episode trying to find ways to save Dean, calling everyone they know and looking in every book, and they will think they have finally found something that will work, but in the final scene it won't work and Dean will die.
2nd - Dean will die at the end of the first act and the rest of the episode will be spent with Dean in Hell and Sam tracking down the colt so he can get Dean out of Hell himself. The ep will end in the cemetery with Sam inserting the colt into the gate of hell and the door unlocks.
3rd - Something unthinkable where Ruby somehow has something to do with anything.
4th - Lilith shows up and Sam trades himself to her for Dean's soul.
5th - The work the whole episode, and call everyone they know trying to find a way to save Dean and in the end they think they've found a way and it works and Dean is saved.