- 6 settimane fa
Categoria
📚
ApprendimentoTrascrizione
00:00:00È in assoluto agony
00:00:02Oh no!
00:00:04Ha un pollo in la scuola
00:00:06e il cervello è spostato
00:00:08Ah!
00:00:09Mi ha! Mi ha! Mi ha!
00:00:11Mi ha!
00:00:12Mi ha!
00:00:13Mi ha!
00:00:14Mi ha!
00:00:15Il 38 anni fa
00:00:17è venuto a vedere un amico
00:00:19quando il caro ha lasciato la strada
00:00:21e hito a wall
00:00:22Un'ambulanza service
00:00:23è a base di breathing inconsciente?
00:00:25Un'accusa
00:00:26Un'accusa
00:00:27Un'accusa
00:00:28Provelo
00:00:31che
00:00:35Che
00:00:37Un'accusa
00:00:38Un'accusa
00:00:44Allora
00:00:46Un'accusa
00:00:48Un'accusa
00:00:49Provelo
00:00:54ma critical care paramedic Faye is also urgently needed.
00:00:58There's an ambulance crew in attendance with him.
00:01:01They say that he has got, um, thank you sir, a broken leg.
00:01:07He's in quite a bit of pain.
00:01:10They've maxed out on the amount of analgesic drugs that they can give him.
00:01:14So they have requested me to go and give some enhanced care.
00:01:20But if the impact was enough to break his leg,
00:01:23then there might be some underlying injuries that we haven't yet identified, so...
00:01:29More than 300 motorcyclists are killed
00:01:33and over 5,500 seriously injured every year on Britain's roads.
00:01:38Ah, yes. Icy blue lights.
00:01:43Faye arrives 17 minutes after receiving the call.
00:01:48Hello, how are you doing?
00:01:50Oh, he's a motorcyclist versus a car, yeah.
00:01:53Cameron, you say?
00:01:54Cameron, listen, my name's Faye, I'm with the Midlands Air Ambulance, OK?
00:01:57On his way to work,
00:01:5918-year-old Cameron's motorbike collided with a car.
00:02:03He was thrown off the bike,
00:02:04landing 15 feet away on the grass verge.
00:02:08This is where you landed?
00:02:09Yeah, where we landed.
00:02:10I flew straight over the bunnies.
00:02:11OK.
00:02:12The ambulance crew has already reported that Cameron has a broken leg.
00:02:17OK.
00:02:17A gram of IV paracetamol is on his second bottle of Entenox,
00:02:21but he's in absolute agony.
00:02:23Agony, OK.
00:02:24You know, we can't even get the splint on him,
00:02:26that's probably after a little bit more time.
00:02:28No problem.
00:02:28The pain relief given to Cameron by the ambulance crew isn't strong enough,
00:02:34but Faye's special training means she can administer more powerful drugs
00:02:39only carried by the critical care teams.
00:02:42I'm just going to take your T-shirt off.
00:02:44I know it's absolutely freezing, mate, but you're not bothered.
00:02:47I am.
00:02:49Before using it, Faye checks Cameron for any other serious injuries.
00:02:53Any pain in your neck?
00:02:56No, nothing.
00:02:57No, OK.
00:02:57Nothing in your throat here?
00:02:58No, no, nothing.
00:02:59OK.
00:02:59Any pain in your tummy?
00:03:00No, nothing.
00:03:01No, OK.
00:03:02Any pain in your shoulders up here?
00:03:03No, nothing.
00:03:04No.
00:03:04Will you do your right hand for me?
00:03:06No.
00:03:07Brilliant.
00:03:08Will you do your left hand for me?
00:03:09Well done.
00:03:10Can you change your bottom cheeks together?
00:03:12Ah!
00:03:13That will do.
00:03:13OK.
00:03:14It's all this pain in your leg.
00:03:15OK.
00:03:18Cameron has broken his right thigh bone,
00:03:20the largest bone in the body.
00:03:22Which leg am I touching, left or right?
00:03:25Good man.
00:03:26There is also the risk Cameron could have broken his pelvis
00:03:29or damaged his spine, which could cause paralysis.
00:03:33No pain as I'm touching down your back?
00:03:35No.
00:03:35No.
00:03:36OK.
00:03:37OK, wiggle your toes.
00:03:38Good man.
00:03:41Thankfully, Cameron's spine doesn't appear to have been damaged.
00:03:45Faye can now turn her attention to his broken leg.
00:03:48All right, Cameron, I'm sorry.
00:03:50I'm sorry, I'm sorry, it's not helping the fact that it's so bloody cold.
00:03:53I know.
00:03:53Could you plug that into your ATC?
00:03:54Oh, my God, my legs really, come on.
00:03:56Come on, please.
00:03:56Come on, stop going.
00:03:58We're going to help you now, Cameron.
00:04:01Sorry, my friend.
00:04:04Faye wants to get Cameron to hospital,
00:04:06but he's in too much pain to be moved.
00:04:09Oh!
00:04:10At the moment, the reason why it's so uncomfortable
00:04:12is because you have broken your leg.
00:04:14is the two bones are scratching against each other, OK?
00:04:17As soon as it's in line,
00:04:20you will create your own pain relief
00:04:22because it's back where it should be, all right?
00:04:25It's all set up, isn't it?
00:04:27So if we give him a little shot of ketamine in there...
00:04:30Straightening his leg is an excruciating procedure,
00:04:34so Faye prepares to give Cameron
00:04:36a powerful painkiller called ketamine.
00:04:39So, Cameron, I'm just going to give you this drug, OK?
00:04:41It will make you feel a little bit sleepy,
00:04:42but it's just so that we can pull.
00:04:43I'm only going to give you a touch so we can pull that leg.
00:04:46The moment we pull it, it'll actually be all...
00:04:48No, trust us. Trust us.
00:04:50One, two, five.
00:04:52It's essential Faye straightens Cameron's leg
00:04:54as soon as possible.
00:04:56While it's out of alignment,
00:04:57it could be causing internal bleeding
00:04:59with the risk of life-threatening blood clots.
00:05:02You need to speak. Carry on speaking to us.
00:05:13Tell us, what do you do? Where do you work?
00:05:16Just up the road. Doing what?
00:05:18Engineering, OK.
00:05:20We are all in position to give that a good pull.
00:05:23We're nearly ready. We're nearly ready.
00:05:25Manual realignment is agonising,
00:05:27so Faye has given Cameron a strong painkiller
00:05:30and he is also taking gas and air.
00:05:33Can you feel me touching you?
00:05:35Yeah?
00:05:37Oh!
00:05:40Right, right.
00:05:42That's it, Cameron.
00:05:44Oh!
00:05:48Oh, no!
00:05:49Oh!
00:05:52Oh!
00:05:53That's it.
00:05:54That's it, Cameron.
00:06:03It's done, mate.
00:06:03It's done.
00:06:06Now the leg is straight,
00:06:07it needs to be kept in position.
00:06:10That's it.
00:06:10Get ready with the poles.
00:06:11Sorry.
00:06:12OK.
00:06:13Oh!
00:06:13That's it.
00:06:17Come on, Ian.
00:06:19Yeah, pull the red now.
00:06:21Pull the red tab.
00:06:23Yeah, that's it.
00:06:24Faye uses a traction frame to lock it in place.
00:06:28That's it, that's it, that's it.
00:06:29Let's see how that is.
00:06:30Let's see his legs.
00:06:31Let's see his legs.
00:06:32Well.
00:06:32Relax.
00:06:33Oh!
00:06:33Well done.
00:06:36Fabulous.
00:06:37Cameron, how is that feeling?
00:06:39Is that feeling any better now?
00:06:40Yeah, it feels better, yeah.
00:06:42OK, excellent.
00:06:44Well done, everyone.
00:06:45Cameron, what we're going to do
00:06:47is just going to roll you onto your poorly leg
00:06:48for just a second to get the stretcher under you.
00:06:51So it's only going to be for a few seconds.
00:06:53Sorry, mate.
00:06:55Faye!
00:06:57Fine, we're under.
00:06:58Right, ready, set, roll.
00:07:01That's better.
00:07:02Oh!
00:07:02That's it, that's it.
00:07:03Relax.
00:07:04Relax.
00:07:04Relax.
00:07:06Have another step on that, mate.
00:07:07Have another step.
00:07:08I know you feel absolutely rubbish at the moment, mate,
00:07:13but you're quite lucky that you're only dealing with your leg.
00:07:16Three, one, two, quick.
00:07:20Brilliant.
00:07:22We'll get you nice warmed up.
00:07:24To avoid hypothermia,
00:07:26Cameron is wrapped in blankets and foil
00:07:28to keep in as much body heat as possible.
00:07:31Perfect.
00:07:31Now that we've straightened it up,
00:07:36all your muscles are all out of kilter
00:07:39so it will start to spasm.
00:07:436-2, thank you.
00:07:45Faye calls the trauma desk
00:07:46who will inform the hospital to Cameron's arrival.
00:07:49We're going to Russell's Hall,
00:07:50trauma tool positive, stage three,
00:07:53and our ETA now is probably about five minutes.
00:07:56We've alerted the hospital,
00:08:01so there'll be a couple of doctors waiting for us.
00:08:04OK, good man.
00:08:07He was extremely lucky
00:08:09that he hasn't suffered more injuries.
00:08:11He could have bumped his head straight onto concrete
00:08:12and got himself a traumatic brain injury.
00:08:15I appreciate he's probably in a lot of discomfort
00:08:17at the moment with a broken leg.
00:08:19He really is perhaps the luckiest chap around today
00:08:23because it could have been far worse.
00:08:24We're here now, let's see.
00:08:27All right.
00:08:29Now, as comfortable and stable as he can be,
00:08:32Faye can hand Cameron over to the waiting hospital doctors.
00:08:37Just a few bumps, Cameron, OK?
00:08:39OK.
00:08:54What's the location?
00:08:57Where are you, please?
00:08:58We're on a bend.
00:09:00It's a country lane.
00:09:01As we drove out to the corner,
00:09:02we've seen a van on its side,
00:09:04so head on in a tree.
00:09:05How many people are involved?
00:09:06How many cars are involved?
00:09:07One car, four people.
00:09:09One guy, I think, is trapped in the back.
00:09:12From what I can see,
00:09:13there's a guy complaining about his leg.
00:09:15Have they rolled over?
00:09:16They haven't rolled fully, no.
00:09:18Has it partially rolled?
00:09:19Yeah.
00:09:21An ambulance is coming.
00:09:22Blue lights are firing.
00:09:23Multiple units heading towards you as we speak,
00:09:25so we are coming as quickly as the tunnel.
00:09:28We've got an R2C.
00:09:30It's actually in Litchfield.
00:09:31We've got a patient trapped in the vehicle.
00:09:34So if you could not, you might make your way.
00:09:36Yeah, Roger.
00:09:36No problem.
00:09:38Sam.
00:09:39With reports of a serious accident
00:09:40involving an upturned vehicle
00:09:42and multiple casualties,
00:09:44Will and Mark are immediately dispatched.
00:09:46So we're going to Litchfield
00:09:48to a road accident.
00:09:52There's an officer that's seen already
00:09:54who's saying it's a van,
00:09:55a single van,
00:09:57versus a tree that's rolled over into,
00:09:59I guess, a field.
00:10:02I've got four patients in total.
00:10:04I'm not sure there is an ambulance.
00:10:07I'm not sure there's an ambulance.
00:10:08I'm talking, however.
00:10:09I've got one patient
00:10:10sat inside the van by his leg.
00:10:13It's a lot of speed.
00:10:15It's a 20-mile drive to the location
00:10:18and by the time
00:10:19the critical care team arrive,
00:10:2130 minutes have passed
00:10:22since the accident.
00:10:23Oh, oh, oh.
00:10:24Oh, my goodness.
00:10:27Can I know it's on scene?
00:10:30Jackets, helmets,
00:10:31and bread bag initially?
00:10:33Yes.
00:10:33I think so, isn't it?
00:10:34Several emergency response teams
00:10:36are already on scene
00:10:37and are dealing
00:10:38with a complex situation.
00:10:40Hi, guys.
00:10:41I'll give you a rundown
00:10:42of what we've got.
00:10:42Mark and Will
00:10:44are updated
00:10:45by the operational commander.
00:10:47We've got a van
00:10:48that's come off the road.
00:10:51It's gone into this bush here.
00:10:53It's a corner here,
00:10:54so he's misjudged the corner,
00:10:55hasn't he?
00:10:55Probably lost a bit
00:10:56and it's just tipped, isn't it?
00:10:58Four patients in total.
00:11:00One patient is here
00:11:01down by the police car.
00:11:03We've got the second patient
00:11:04down here
00:11:04who's got dislocated knee.
00:11:07Three over in the back there.
00:11:08He's got chest injuries.
00:11:09He is conscious.
00:11:10All of them are conscious
00:11:11and talking.
00:11:11Okay.
00:11:12Patient's four.
00:11:12He's got trapped
00:11:13in the back of the van.
00:11:14Yeah.
00:11:15He's got a head injury
00:11:16and a couple of leg injuries
00:11:17and that's where we're up to
00:11:19at the moment.
00:11:19Okay.
00:11:20All right.
00:11:21Can I do a loop that way?
00:11:22You do a loop that way
00:11:23and we'll meet up again?
00:11:24Yes.
00:11:26Good evening.
00:11:27Hello.
00:11:27I'm Mark on the doctors.
00:11:29You all right?
00:11:30Mark and Will
00:11:31must quickly assess
00:11:32all of the patients
00:11:33to work out
00:11:34where their additional skills
00:11:35are most needed.
00:11:36That'll need an X-ray.
00:11:37You're just going to strap them up?
00:11:38Yeah, and then we'll offer
00:11:39a bit further pain
00:11:40and leave once we're on the truck.
00:11:41Cool.
00:11:42All right.
00:11:42I'm just going to go past you
00:11:43to the next one
00:11:44if that's okay
00:11:44without coupling on it.
00:11:45Sorry.
00:11:46Cheers.
00:11:47Three of the van's occupants
00:11:49have managed
00:11:49to get out by themselves.
00:11:51Observations, as you can see,
00:11:52completely stay.
00:11:53Yeah, yeah.
00:11:53Brilliant.
00:11:54We're not too concerned
00:11:55about injury-wise
00:11:55for this one.
00:11:57Satisfied they've sustained
00:11:58only minor injuries,
00:11:59He's in the middle section,
00:12:00is he?
00:12:00He's in the middle, yeah.
00:12:01Okay.
00:12:02He's against the door.
00:12:03Yeah.
00:12:03Mark turns his attention
00:12:04to the man
00:12:05still inside the vehicle.
00:12:08So what's your name?
00:12:08Is it Rob?
00:12:09Rob, yeah.
00:12:09Okay, and how old are you?
00:12:1037.
00:12:1137, okay.
00:12:12Can you remember
00:12:13everything that's happened
00:12:13this evening?
00:12:15Yeah.
00:12:15Yeah.
00:12:17Labourer Rob
00:12:18was travelling home
00:12:18with his colleagues
00:12:19in their works van
00:12:20when they crashed.
00:12:23Where have you been working today?
00:12:24Been lewish him for a week.
00:12:25Been lewish him for a week.
00:12:26Okay, buddy.
00:12:27Rob's conscious
00:12:28but has a head wound
00:12:30which is bleeding heavily.
00:12:32He's been trapped
00:12:32in the wreckage
00:12:33for over an hour.
00:12:34His legs pinned down
00:12:36underneath heavy chains
00:12:37that were in the van.
00:12:38He's in the middle.
00:12:39So he's not,
00:12:40you can't see him
00:12:41from the front.
00:12:41Right.
00:12:42And you can't see him
00:12:43from the back.
00:12:43There's a sliding door
00:12:44the other side.
00:12:45So he's obviously
00:12:45a compartment in here
00:12:46but you can't get to it.
00:12:47Ah, I see.
00:12:48It's a works van
00:12:49so there's loads of tools
00:12:50on top of him.
00:12:51Stuck in the position he's in,
00:12:53it's impossible to tell
00:12:55how badly Rob's been hurt.
00:12:57A paramedic's managed
00:12:59to squeeze inside the van
00:13:00to make some basic observations.
00:13:02Now lots of consciousness.
00:13:03Laceration on his left eye.
00:13:05Chest clear, that's very soft.
00:13:06Okay.
00:13:07You can feel his toes
00:13:08on this right one
00:13:09but the left one
00:13:10there's a lot of lifting chains
00:13:11that fell on top of it as well.
00:13:13Okay, okay.
00:13:13A bit of numbness.
00:13:14The longer he's trapped in the van
00:13:16the greater the risk
00:13:17of Rob developing
00:13:18serious complications
00:13:19from any injuries he has.
00:13:22Mark and Will
00:13:23want to get him out
00:13:24as soon as possible.
00:13:25The plan is the back row seat
00:13:27we're going to remove first, Will.
00:13:29Yeah.
00:13:30And then we're going to go
00:13:31for base of the seat
00:13:32and the plan is to take him
00:13:33out flat,
00:13:34out the back.
00:13:35Yeah, okay, mate.
00:13:36The fire crew
00:13:37start cutting Rob out.
00:13:39Ah!
00:13:45Ah!
00:13:47He's got quite a bit of
00:13:49chain round
00:13:49for his left leg.
00:13:50Yeah.
00:13:50Obviously when we're cutting
00:13:52the vibrations
00:13:53are making the pain worse.
00:13:54Okay, okay.
00:13:55Ah!
00:13:57So,
00:13:59if we've got IV access
00:14:00that's patent
00:14:00let's get some IV paracetam
00:14:02and get some Ensonauts
00:14:03get a face mask
00:14:04and just do some of it.
00:14:05I'm not going to give him
00:14:06catch me
00:14:06when he's still trapped
00:14:08and I can't get access
00:14:09to his airways.
00:14:11Although efforts
00:14:12to cut Rob out
00:14:13are causing him pain
00:14:14without better access
00:14:15Mark and Will
00:14:16can't risk using
00:14:17some of their
00:14:18stronger painkillers
00:14:19which could compromise
00:14:20his breathing.
00:14:21The chains are on his leg.
00:14:23Yeah.
00:14:23Do we think his legs are damaged
00:14:24or is there any evidence?
00:14:25We, we, I don't know.
00:14:26Nobody can see it fully.
00:14:28Right, so this seat's almost out.
00:14:29The only thing is
00:14:30we've had this leg
00:14:31holding on to this leg.
00:14:32Whoa, whoa, whoa, whoa.
00:14:32Yeah.
00:14:33All right, so I don't want
00:14:34him to stay flat
00:14:35for the moment.
00:14:35Hold.
00:14:37We like whiskey.
00:14:39Oh, my God.
00:14:39Ah!
00:14:40Ah!
00:14:40Ah!
00:14:41Ah!
00:14:41Ah!
00:14:41Ah!
00:14:41Ah!
00:14:41Ah!
00:14:42Ah!
00:14:42Ah!
00:14:43Ah!
00:14:43Ah!
00:14:44So it's a femur, isn't it?
00:15:13Yeah, it's a femur.
00:15:13OK, he's right.
00:15:14The femur's gone.
00:15:15Yeah, it's a femur.
00:15:17Rob has broken his thigh bone.
00:15:18All right, I've got a little bit
00:15:20of fentanyl.
00:15:22Now they have access to him,
00:15:24Mark is able to administer
00:15:25much stronger pain relief.
00:15:27I'll just sneak in, guys.
00:15:28Yeah, go ahead.
00:15:29All right.
00:15:30OK?
00:15:31So we'll try this one initially.
00:15:32This one's a bit like
00:15:33stronger morphine.
00:15:34Fentanyl is a synthetic opioid 50 times stronger than heroin.
00:15:39It can only be administered by a doctor.
00:15:42So we'll get 50 initially, and then we'll see how we go.
00:15:44OK.
00:15:45Flush that through, and then we'll see whether or not
00:15:47that's made any difference.
00:15:48Yeah, that's fine.
00:15:49Does that hurt at all?
00:15:50No?
00:15:51It has the advantage of being
00:15:52fast-acting and powerful.
00:15:55OK, does that make any difference to what you're feeling?
00:15:57I don't know where you're moving.
00:15:58OK.
00:15:59Let's give it a go.
00:15:59Let's see where we're moving.
00:16:00Are you fairly comfortable when we're not moving you, then, Rob?
00:16:02Yeah, we're good.
00:16:03Not too bad.
00:16:04I'm very, very right-handed.
00:16:06That's fine.
00:16:07That's fine.
00:16:07OK, everybody ready?
00:16:10Ready.
00:16:11Steady.
00:16:11Slide.
00:16:12Finally, after nearly two hours trapped inside, Rob is extracted from the vehicle.
00:16:23Right, then.
00:16:24Do you understand that your right thigh bone's broken?
00:16:26No.
00:16:27Right.
00:16:28So what we're going to do, we're going to put it into traction.
00:16:30So we're going to put something to stop it from bending.
00:16:32Yeah.
00:16:33And hopefully, once that's in, you'll feel a lot more comfortable.
00:16:36OK?
00:16:37So if we do ankle strap first.
00:16:40Rob's thigh bone will need surgery.
00:16:42So if you keep taking on the tension, I've got the tension in his leg.
00:16:45Keep coming.
00:16:46Keep coming.
00:16:47Keep coming.
00:16:48Keep coming.
00:16:49Keep going.
00:16:50For now, Mark and a paramedic splint it in place.
00:16:52Keep coming.
00:16:53Keep coming.
00:16:54Keep coming.
00:16:55Keep coming.
00:16:56Keep going.
00:16:57OK.
00:16:58Let's have a look.
00:16:59Let's have a look.
00:17:00There's a reasonable amount of resistance there.
00:17:01Tension there.
00:17:02That's good.
00:17:03That's good.
00:17:04So that right leg, we've now put it in a splint that's holding it straight.
00:17:06Does it feel...
00:17:07I know it's not going to be gone, but does it feel a bit less spasmy?
00:17:10Yeah.
00:17:11So if ten out of ten is the worst pain you could think of, and one out of ten is no pain,
00:17:15what would you say the pain is like at the moment?
00:17:17Oh, five.
00:17:18Right.
00:17:19What we're going to do is get you in the back of a nice ambulance.
00:17:20Yeah.
00:17:21Get a set of numbers and then work out which hospital you're going to go to.
00:17:23OK?
00:17:24Is he ready to go, is he?
00:17:25Right.
00:17:26Yeah.
00:17:27Keep your hands in, Rob.
00:17:28Keep your hands in, mate.
00:17:29That's it.
00:17:30Even with the fentanyl starting to wear off, Rob's pain is under control and he's stable.
00:17:36Dr. Mark leaves him with the ambulance crew to transport him to Birmingham's Queen Elizabeth
00:17:42Hospital.
00:17:43He's got a thigh bone fracture, he's got a knee injury and we are suspicious about his pelvis
00:17:48and whether or not he's damaged that slightly.
00:17:50So the best place is for the major trauma centre.
00:17:53And then we should be hopefully ready to head back into Birmingham and see what other
00:17:57joys are there for us.
00:18:13Ambulance service, is the patient breathing?
00:18:15Can't see only at the moment.
00:18:17Is he breathing?
00:18:18Is he breathing?
00:18:19Is he breathing?
00:18:20Is he breathing?
00:18:21Yes, at the moment.
00:18:22Yes.
00:18:23What's happened?
00:18:24What?
00:18:25What's happened?
00:18:26Oh, he's trying to get up the roof, onto the roof and the ladder's fell.
00:18:29And he's fallen off the ladder?
00:18:30Yes.
00:18:31He's hit his head.
00:18:32And he landed on his head?
00:18:33He's actually landed on his head and his arm.
00:18:34OK, we're coming as quick as we can, OK?
00:18:356-2 on routes.
00:18:36A fall from height, resulting in head trauma, has the potential to change the
00:18:41to leave a patient with life-changing injuries.
00:18:42A 55-year-old male.
00:18:43Can't feel one arm.
00:18:44nausea and dizzy.
00:18:45OK.
00:18:46Is he in the back garden and he's gone?
00:18:47No.
00:18:48Oh, and he's gone.
00:18:49Oh, he's got that.
00:18:50And he's too close to the top of the ladder.
00:18:51And so he's just gone.
00:18:52It's a good thing.
00:18:53I'm going to go.
00:18:54I'm going to go.
00:18:55I'm going to go.
00:18:56I'm going to go.
00:18:57and let me feel or move an arm
00:18:596'2, on route
00:19:00A fall from height, resulting in head trauma
00:19:03has the potential to leave a patient with life-changing injuries
00:19:07A 55-year-old male, can't feel one arm
00:19:12or is he in the back garden and he's landed on concrete
00:19:17An ambulance has been dispatched
00:19:20and the advanced critical care skills of Richard and Alistair
00:19:23are also urgently needed
00:19:25So 55 is where we're starting to have some concerns with age
00:19:30But the injury, there's big potential
00:19:33if he's fallen on concrete
00:19:35He's already reported as having a head injury
00:19:38So again, there's potential for that to develop
00:19:41and become far worse quite quickly
00:19:43We're obviously going to have some concern over his spine
00:19:46with that height of fall
00:19:47So he's likely to end up immobilised
00:19:49and then conveyed to hospital
00:19:52where he really needs CT scans
00:19:55to see what damage he's got on the line
00:19:57When Richard and Alistair arrive
00:20:00the ambulance crew are treating the man
00:20:02Retired glazier John was fixing the guttering on his house
00:20:18when he fell onto concrete
00:20:20hitting his head and arm in the fall
00:20:21With the potential for spinal injury and head trauma
00:20:25John needs urgent treatment
00:20:28I'm going to sort of get some pain relief in a bit, OK?
00:20:31Sharp scratch now, all right?
00:20:32We managed to get a blood pressure on him, yes or no?
00:20:34No
00:20:35All right
00:20:35I would say that lower arm is slightly deformed, isn't it?
00:20:39I think
00:20:39Can you see OK?
00:20:42Don't move your head, just have a look around
00:20:44Before giving John any specialist pain relief
00:20:56Alistair wants to establish
00:20:58whether a medical condition
00:21:00could have caused the fall
00:21:01And do you remember falling off this ladder?
00:21:05Yeah
00:21:06That's all right
00:21:07Just trying to rule out
00:21:08you're having a medical event
00:21:09basically, like somebody going dizzy or something
00:21:11Alistair now needs to be certain
00:21:15there are no life-threatening injuries
00:21:17so checks to see
00:21:18if he has any abnormal sensational movement
00:21:21that would indicate a spinal injury
00:21:23I can't feel my fingers
00:21:25Yeah
00:21:26That's fine
00:21:27Can you feel that?
00:21:28Yeah
00:21:28Can you squeeze or not?
00:21:31No
00:21:31No, you can't
00:21:32Oh, that's OK
00:21:33John, remember, mate
00:21:35try and keep the head as still as you can for us, OK?
00:21:37I can't help him
00:21:37Oh, no, oh, no, mate
00:21:39But just try and keep it as still as you can, all right?
00:21:41Now lifting it up
00:21:42Because as well as our arm
00:21:44you know, I've got a bit of an head injury as well
00:21:46and you've come from some height as well, haven't you?
00:21:49Having assessed John
00:21:50Alistair can now start to get his pain under control
00:21:53Right
00:21:56We're going to get you some pain with him now, buddy, OK?
00:22:01Let's give him at least five over a couple of minutes
00:22:04so do a couple
00:22:05and then another couple more
00:22:06So it's probably going to take quite a bit of morphine
00:22:08to get on top of this, isn't it?
00:22:11The critical care team must get John to hospital
00:22:13for an urgent CT scan of his head and arm
00:22:16But despite the morphine and paracetamol
00:22:19I'm just going to straighten you out, my friend
00:22:21I'm sorry
00:22:21John is still in too much pain to be moved
00:22:24Ah!
00:22:26Ah!
00:22:27All right
00:22:27No
00:22:28No
00:22:28So we're just giving him some pain relief
00:22:33This is paracetamol
00:22:34He's had some morphine
00:22:35Ow!
00:22:36Ow!
00:22:37Ow!
00:22:38As well as a likely broken arm
00:22:41John also had a head injury
00:22:43Alistair and Rich want to get him to hospital
00:22:45where he can be scanned
00:22:47First, though, they need to get his pain under control
00:22:50How's your pain doing?
00:22:54Have we got on top of it or not?
00:22:55Or is it still hurting?
00:22:56No
00:22:56No
00:22:57No
00:22:57No
00:22:58All right
00:22:58OK
00:22:59Scale of one to ten, what is it?
00:23:01Zero is nothing, ten is agony
00:23:03Where are you?
00:23:04Ten at the moment
00:23:05Ten at the moment
00:23:06OK
00:23:06Even after multiple doses of painkillers
00:23:09including morphine and Entonox
00:23:11John is still in agony
00:23:13OK
00:23:15I might do something a bit stronger, mate
00:23:16I've had ten of morphine
00:23:18and one of paracetamol
00:23:20and we're still at a pain score of nine
00:23:22It's going to take a bit of time for the morph to kick in
00:23:26Taking a little, a little squidge of something stronger like that
00:23:30wouldn't actually hurt, but it's
00:23:32So John, I'm going to give you some ketamine in a second
00:23:34which is quite a strong drug
00:23:36and then I'm going to give you a small amount
00:23:38just enough for us to be able to move you
00:23:40hopefully without you knowing what's going on
00:23:42Although it's a highly effective painkiller
00:23:45ketamine can also have side effects
00:23:47including hallucinations
00:23:49So Rich warns John's anxious family
00:23:53who are watching on
00:23:54So it looks like it's just his arm at the moment
00:23:57He's talking to us and communicating normally
00:24:00so that's a good sign
00:24:01I'm going to give him some ketamine
00:24:04Do you want to hold that over his face?
00:24:10Nice deep breaths for a minute, John
00:24:12Deep breaths, John
00:24:13Deep breaths
00:24:14That's all right, that's the drugs that we've given to you
00:24:21Just going to roll you over in a second, John
00:24:24and get you off to hospitals
00:24:25Let's start working around, getting a scoop in
00:24:27With the ketamine taking effect
00:24:30Alistair and Rich prepare to move John onto the scoop
00:24:33Ah, all right, John
00:24:36Ah, all right
00:24:39Ah
00:24:42So I've got all of his weight
00:24:44I've got all of his upper arm here
00:24:45Ah, man
00:24:47I felt that
00:24:51You felt that, did you?
00:24:54When the ketamine wears off
00:24:55John will remember the fall
00:24:57but not the pain
00:24:58What's going on?
00:25:01They're just popping you on a stretcher, John
00:25:03You're all right with a chap
00:25:04Stop it
00:25:05How are we then, everybody?
00:25:07We're going head first
00:25:08Head first
00:25:09Just watch those slabs
00:25:10because they're wobbly
00:25:12Okay
00:25:12All right
00:25:13Everybody happy with the backs?
00:25:14Yes
00:25:14Yeah
00:25:15Okay
00:25:15Ready
00:25:16Ready
00:25:16Steady
00:25:17Lift
00:25:18In case there are any side effects from the ketamine
00:25:25the critical care team will continue to monitor John
00:25:28on the journey to hospital
00:25:30He will need an x-ray to check for any broken bones
00:25:34and a CT scan to assess his head injury
00:25:37This is my house
00:25:39It is your house
00:25:40Watch the elbow
00:25:42Yeah, I've got it
00:25:43Ambulance, sir
00:25:59This is the patient breathing
00:26:01So, one child has run across the road?
00:26:12Yeah, basically what it is
00:26:14I don't know
00:26:15He's managed to open the door
00:26:16and he's basically run across the road
00:26:18and as I was going past
00:26:19he's run out of me
00:26:20and I've ended up running him over
00:26:22Okay
00:26:23How old is he roughly?
00:26:25He's very young
00:26:26I'd say probably three, four years old
00:26:28Okay, is he bleeding from anywhere?
00:26:29Yeah, he's bleeding
00:26:30He's bleeding
00:26:31Where is he bleeding from?
00:26:33From his head
00:26:34So, the ambulance has been arranged
00:26:35It's the nearest vehicle
00:26:36Blue lights and sirens
00:26:37They are going to be there extremely soon
00:26:39A child has been run over
00:26:43and could have potentially life-threatening injuries
00:26:466-2
00:26:486-2, thank you, Richard
00:26:50Can I start you guys towards Whitten, please?
00:26:52It's a three-year-old versus car
00:26:54It's a head injury
00:26:55but no other details currently
00:26:56Richard and Ben are immediately dispatched
00:26:59Yeah, no worries, thanks mate
00:27:01Thank you, hello, bye
00:27:02There were over 10,500 children killed or injured
00:27:06on Britain's roads in the last 12 months
00:27:09I think children are the hardest jobs to go to
00:27:12especially when you have children that are three yourself
00:27:15Try not to relate it to your own lifestyle
00:27:18and your own situation
00:27:19but it's very tricky not to
00:27:20The critical care team has been dispatched
00:27:23because the boys reported to have a head injury
00:27:25Head injuries are always quite hard
00:27:27because they can deteriorate quite quickly
00:27:30so to have those additional skill sets and experience
00:27:34is really important on a job like this
00:27:36From what we can see, the only obvious injury he's got is just in his face
00:27:54Parents don't speak English, so it's kind of hard
00:27:57Three-year-old Asan has visible lacerations to his face
00:28:06From experience, Ben and Rich know he may also have internal injuries
00:28:11that could be life-threatening
00:28:13Ben and Rich are updated by the ambulance crew who arrive first
00:28:25Thankfully, Asan appears to have escaped with only minor injuries
00:28:45Hello, what's your name?
00:28:47Have you got anybody that speaks English?
00:28:50No, no
00:28:50But the language barrier is making it hard to carry out a proper assessment
00:28:55Yeah, if we go down to the children's
00:28:57and we'll put an alert in just because of the mechanism
00:28:59because he's fine now, but we don't know, do we?
00:29:02No
00:29:02Asan will need to be taken to the children's hospital for a check-up
00:29:06Yeah, he still needs to go hospital
00:29:09Needs hospital
00:29:11Have you got shoes? Do you want to put some shoes on?
00:29:19Shoes
00:29:19You need to come now
00:29:20Even though Asan appears to have had a lucky escape
00:29:24Ben and Rich want to be sure he's OK
00:29:26You get some shoes and let's get to hospital
00:29:29OK, little man
00:29:3160
00:29:3560, go ahead
00:29:37Rich updates the control desk
00:29:39I'm just going to do a quick off scene straight to Children's
00:29:44He's GCS 15, but as you can hear
00:29:46Yeah, Roger, no problem
00:29:47Tiene miedo
00:29:48We need to take him to hospital
00:29:50Tiene miedo
00:29:52We've got sats of 100
00:29:59And a pulse 120
00:30:03Temperature's 37.8
00:30:07I'll just check with him, but I think the crew will be happy on their own
00:30:11Yeah, yeah
00:30:11Yeah, it's not good, that's what I'll be vaccinated
00:30:14I'll answer them in at 825
00:30:15Cool
00:30:17Confident that he's in no immediate danger
00:30:20Rich and Ben leave Asan with the ambulance crew
00:30:23To be taken to Birmingham Children's Hospital for a thorough assessment
00:30:27Difficulty here is you've got a language barrier
00:30:31So it's really hard for us to actually gauge from the mum
00:30:34How poorly the child is to her
00:30:37But just from our observations
00:30:39They're all within normal parameters, which is great
00:30:42And no big obvious scary injuries
00:30:45So a really lucky outcome from what we can cover
00:30:48Very lucky
00:30:4913 minutes after they were called
00:31:06Will and Colin arrive on scene
00:31:08To be briefed by the ambulance crew
00:31:10Hi, how are you?
00:31:11Hi, all right, thanks
00:31:12My name's Will
00:31:13Rich has been working on a building site
00:31:16Ground floor just across the road from here
00:31:18He's been using a plunge saw
00:31:20I thought he'd had it all stable and reached underneath it
00:31:23But it's still been going
00:31:24It's dropped and gone through his arm
00:31:26Okay
00:31:27He's just got quite a deep laceration to the right forearm there
00:31:30Quite a
00:31:30The blade has sliced open a deep three-inch-wide wound
00:31:35Clean cut
00:31:39Went quite great
00:31:40Was quite shocked from everything that happened originally
00:31:43Had his legs raised on our arrival
00:31:44Rich was working alone
00:31:46When the mechanical saw caught in his coat
00:31:49And sliced through his arm
00:31:50He ran outside to get help
00:31:53Before collapsing unconscious in the street
00:31:55We've got the first set of rocks done now
00:31:57Just got him inside
00:31:58Too so cold, really
00:31:59Lovely
00:31:59Quite deep
00:32:00I think we have gone through some tendons
00:32:02Ligaments there, haven't we?
00:32:04But not much in the way of blood loss
00:32:06We're unsure
00:32:06The towel that we've wrapped around him
00:32:08Disappeared once we were getting there
00:32:10There was some blood in his left glove
00:32:12So we're not sure exactly
00:32:13There's no blood loss
00:32:14True
00:32:14Well done
00:32:16If the blade has cut through muscles and tendons
00:32:19There's a chance Rich could lose the use of his arm
00:32:22Do you think there is tendon damage?
00:32:24It looks like it
00:32:25Have you got a good sensation in all your fingers?
00:32:27Yeah, completely normal
00:32:28Do you feel like your grip is weak?
00:32:33Last year
00:32:34There were 54,000 injuries on building sites
00:32:37Do you feel sick at all?
00:32:40Yeah, a little bit
00:32:41A little
00:32:41Close
00:32:42This is a 26-year-old chap
00:32:45Who is working on a construction site
00:32:47With what he calls a clone saw
00:32:49Will phones control
00:32:51To update them on Rich's condition
00:32:53And discuss which hospital he should be sent to
00:32:56This saw has come down onto his
00:32:58The inside of his right forearm
00:33:01And he sustains an isolated
00:33:04Open laceration
00:33:07It's quite deep
00:33:08There's a lot of adipose tissue
00:33:10And it looks like there's possible tendon
00:33:12And pigment damage there as well
00:33:13As he was sort of moving
00:33:16You could see stuff moving in the forearm
00:33:19If you know what I mean
00:33:20We'll go with QE as his destination
00:33:23Rich's arm urgently needs to be assessed
00:33:25By a plastic surgeon
00:33:27Which means he will be blue-lighted
00:33:29To the Queen Elizabeth Hospital
00:33:30Major Trauma Centre in Birmingham
00:33:32There's no sort of fine bodies
00:33:35Debris or anything
00:33:36It wasn't dirty
00:33:37It did look clean, didn't it?
00:33:39Yeah
00:33:39Rich's blood pressure and heart rate
00:33:42Are returning to normal
00:33:43So the ambulance crew
00:33:44Can give him some pain relief
00:33:46With less risk of him passing out
00:33:48What we might do then
00:33:49Is pop a little cannula in your arm
00:33:51Give you some paracetam
00:33:52All that way
00:33:53How much pain are you in?
00:33:58Well, it's getting worse
00:33:59As it's got
00:34:00Because I'm calming down a bit
00:34:02Yeah
00:34:03If you had to give the pain you're in a score
00:34:05A mark out of ten
00:34:06Ten being the worst pain
00:34:08I'd say maybe about a six or seven
00:34:1022 minutes after they arrived on scene
00:34:14Rich is ready to start
00:34:15The five-mile journey to hospital
00:34:17Get that arm sorted, won't you?
00:34:19Yes, guys
00:34:19Thank you for your help
00:34:21Take care
00:34:23Be well soon
00:34:24Cheers
00:34:24Satisfied with his progress
00:34:26Will and Colin
00:34:27Are happy to leave him
00:34:28In the care of the ambulance crew
00:34:30Ambulance service
00:34:32How's your breathing?
00:34:33I don't know
00:34:35There's been a fight
00:34:35He's had cold by the looks of it
00:34:38He's not going to be having the right panic
00:34:39You need to get somebody straight away
00:34:41Can you hear it going on?
00:34:45Yeah
00:34:46Okay, a male adult
00:34:47Male adult by the looks of it, yeah
00:34:49Aye, and you said that he's unconscious
00:34:51He's had a cold one
00:34:53Oh, dear, what's happened at all?
00:34:55You're not looking at the fight
00:34:57You know, that's really quick
00:34:58And then all you work is a bit of crack
00:34:59And I'm reckoning his head on the toilet floor
00:35:02He's bleeding
00:35:03Or he's been sick
00:35:05Whatever it is
00:35:06He's not looking good
00:35:07Can you hurry up for the ambulance, please?
00:35:09They're doing CPR, aren't they?
00:35:12They're doing CPR, okay
00:35:13We are coming as quick as we can
00:35:15Blue lights
00:35:169-8
00:35:22An ambulance has been dispatched
00:35:25But the man's injuries are so severe
00:35:27He may be in cardiac arrest
00:35:28And in need of enhanced critical care
00:35:31From Ravi and Richard
00:35:32We are going to central Birmingham
00:35:34To report of
00:35:38A unconscious patient
00:35:40Following an assault
00:35:41In 500 yards
00:35:43Hello, thanks
00:35:44Just a quick update from the scene
00:35:46There's a few crews in attendance
00:35:48The patient you're going to
00:35:50Has a GCF of three
00:35:52He was hit over the head
00:35:53With something
00:35:54He has such pupils
00:35:56Trismas
00:35:57The report is seen as being very chaotic
00:35:59They're scooping the patient
00:36:00And loading him onto the back of the ambulance
00:36:02So they're going to try and get
00:36:03Biolactylise act
00:36:04Because they're ready for you
00:36:04Yeah, that's received
00:36:08If they are having airway issues
00:36:10I would suggest
00:36:11That they go to nearest
00:36:13Whilst we make our way
00:36:15Yes, absolutely
00:36:18They were still on scene
00:36:19When I spoke
00:36:20I think
00:36:20From what I heard
00:36:22You are going to make scene
00:36:23Before they're ready to leave
00:36:25Are we safe?
00:36:28Yep, many thanks
00:36:29The patient is in a life-threatening condition
00:36:35He's deeply unconscious
00:36:37And the ambulance crew already on site
00:36:39Are struggling to get oxygen into him
00:36:41What they're reporting is trismas
00:36:43So essentially the jaw is locked
00:36:46Which means that the patient
00:36:48May not be able to get enough oxygen
00:36:50To the brain
00:36:51And to other organs
00:36:53So if we're struggling with that
00:36:55Then we may have to act pretty swiftly
00:36:58As you're probably aware
00:37:02The brain can only survive so long
00:37:05Without oxygen
00:37:07Before you have irreversible damage
00:37:10He's now on an ambulance
00:37:14The crew brief Ravi
00:37:16What's going on?
00:37:19This is Julian
00:37:19He's been to be assaulted in the house
00:37:21I'll step up to the police yesterday
00:37:2332-year-old lorry driver Julian
00:37:26Was on a night out
00:37:27When he tried to intervene in a fight
00:37:29He was punched and fell to the floor
00:37:32He's now fighting for his life
00:37:34I don't know whether CPL has started or not
00:37:39There's a lot of emotion
00:37:41He's right here
00:37:42He's got several of concealed blood
00:37:46People's left side are sluggish
00:37:48In threes
00:37:49Right side was reactive in threes
00:37:52Julian is completely unresponsive
00:37:55And bleeding from his ear
00:37:56All the indications are
00:37:58He has suffered a traumatic brain injury
00:38:00It was Trismas
00:38:03We couldn't get an APA in
00:38:04So we popped an MPA in
00:38:05Left side side
00:38:07Stats were 92 on air
00:38:09But now 100%
00:38:11On 15 metres
00:38:13Got bilateral access
00:38:14He's been blood pressure stable up and around
00:38:16And we've given him one gram TXA
00:38:19Brilliant
00:38:20Julian's jaw has locked
00:38:23So the paramedics have inserted a tube through his nose
00:38:26To get vital oxygen into him
00:38:27And keep his heart and other organs functioning
00:38:30Looks like a gentleman's been assaulted
00:38:34And it seems deeply unconscious at the moment
00:38:37So Ravi's just going to assess him
00:38:38But we may just travel as we are
00:38:40Because we're not that far from the hospital
00:38:42And reassess on the way
00:38:43So you might as well tell him to get ready
00:38:45Yeah
00:38:46Julian needs all the skills and resources
00:38:48Of a major trauma hospital
00:38:50As the Queen Elizabeth is just 10 minutes away
00:38:54Ravi decides this is the best option
00:38:57Hi, it's Ravi
00:39:00Can you just put a quick alert to the QE
00:39:02To say that we're going to be there
00:39:04In a couple of minutes
00:39:05With a GTS3 heading
00:39:07Go, go
00:39:08Observation stable
00:39:10And have anaesthetics on standby
00:39:12We're not going to RSI here
00:39:14But you'll probably need to
00:39:15Okay, cool
00:39:16All right, see you then
00:39:16Bye, bye, bye
00:39:17Having updated the trauma desk
00:39:22Ravi monitors Julian closely throughout the journey
00:39:25While Richard follows the ambulance
00:39:29Ready to help
00:39:29Should his condition deteriorate further
00:39:32At the hospital
00:39:37Julian is taken straight into the emergency department
00:39:40For ongoing trauma care
00:39:42It's difficult with these conditions
00:39:48And these incidences
00:39:50To determine what the outcome's going to be
00:39:53Because I work in the intensive care setting
00:39:55This is something I see quite regularly
00:39:57And there are people that come in
00:39:58Very unconscious
00:40:00That wake up and walk out of hospital 12 hours later
00:40:03From the other end of the spectrum
00:40:05You've got somebody that's severely disabled
00:40:07That needs care for the rest of their life
00:40:09Until the hospital have done the scans
00:40:11They've given him some time to recover
00:40:13You know, we won't really know what his outcome's going to be
00:40:17Is the patient breathing?
00:40:24I think no breathing
00:40:25I touch him
00:40:26But no reaction
00:40:28Okay, is he breathing?
00:40:29I don't think so
00:40:31We need to start CPR
00:40:33Yeah
00:40:34Okay
00:40:34Put one hand in the centre of his chest
00:40:37And lock your fingers together
00:40:39You're going to keep your arms straight
00:40:41Push down hard and fast
00:40:43Don't be afraid to push too hard, okay?
00:40:46You're going to go push, push, push, push
00:40:49Yes, yes
00:40:50They push out loud every time
00:40:52Push, push, push, push
00:40:54One, two, three
00:40:56One, two, three
00:40:57Keep pushing
00:40:58Don't stop until they tell you to
00:41:00Can you see the ambulance anywhere?
00:41:02Yeah
00:41:03With cardiac arrests
00:41:06Time is crucial
00:41:08When the heart stops beating
00:41:10No blood is pumped around the body
00:41:12Starving vital organs of oxygen
00:41:15Every minute without CPR
00:41:17The chances of survival drops by 10%
00:41:21Oh, yeah, gosh, all right?
00:41:22Switch
00:41:23The man was found 17 minutes ago
00:41:31Collapsed and in cardiac arrest
00:41:33A little bit faster, Chief
00:41:36Keep your elbows straight
00:41:37That's it
00:41:37You've had three shots
00:41:38And you've had one of them
00:41:39Okay, what we'll do
00:41:42Is we'll go on the next rhythm check
00:41:44At 13 minutes past
00:41:45The ambulance crew
00:41:47Found the man's heart in VF
00:41:49Or ventricular fibrillation
00:41:50Which means it's quivering
00:41:52Rather than beating
00:41:53Despite using the defibrillator three times
00:41:57And administering adrenaline
00:41:58It has not regained a normal rhythm
00:42:01Everybody else stand clear for me
00:42:03On one, stand clear
00:42:04Take three, two, one
00:42:05Back on the chest, guys
00:42:06Okay
00:42:07The man is only in his early thirties
00:42:10Mitch and the crew are battling
00:42:12To save his life
00:42:13That looks like VF
00:42:19Georgia, can you charge the monitor?
00:42:23Okay
00:42:23Everybody else stand clear, please
00:42:26Okay, everyone clear?
00:42:27Yeah
00:42:28Five, four, three, two, one
00:42:32Okay
00:42:33Right
00:42:35The man has now had eight shocks
00:42:37From a defibrillator
00:42:38But his heart has not gone back
00:42:40Into a normal rhythm
00:42:42I'm going to get the Lucas device out
00:42:44Open up the Lucas device over there for me, please
00:42:47Despite being very unstable
00:42:50Mitch makes the decision
00:42:51To move the man to hospital
00:42:53Okay
00:42:54So, mate
00:42:55Do you want to sort of go to the other side
00:42:57And feed that under his back for me?
00:43:01To keep blood pumping on the journey
00:43:03He decides to use a Lucas device
00:43:05Only carried by the critical care team
00:43:08It performs automatic chest compressions
00:43:10We're going to place that underneath him
00:43:13So I need you to lift his shoulder up for me
00:43:16Sit him slightly forward
00:43:18So Georgia, can you support his head?
00:43:21And then we'll put that underneath his armpit
00:43:23Slight lift
00:43:23Go on
00:43:24Put it through, Rich
00:43:25That's it
00:43:26Go for it
00:43:27Push it on
00:43:28Okay, it's about to start
00:43:32Okay
00:43:32Lucas device fitted
00:43:36Mitch can now move the man to the ambulance
00:43:38Right
00:43:41What we'll do, guys
00:43:43We're going to lift either side
00:43:45Watch everybody's toes
00:43:46Just feed the trolley in
00:43:48Would you mind grabbing the foot end of the stretcher
00:43:50Rich
00:43:51Yeah
00:43:52And myself
00:43:53We're lifting the stretcher
00:43:54On three
00:43:55One
00:43:55Two
00:43:56Three
00:43:56Dan push
00:43:58Okay
00:43:59Push
00:44:00Sit
00:44:02George
00:44:03George
00:44:04Get the patient on the truck for me, please
00:44:06Okay, ready?
00:44:11Okay
00:44:12Watch your back
00:44:12Okay, that's for you
00:44:15Charge and shock that, yeah
00:44:16Everyone clear?
00:44:18Shocking
00:44:19Before they move, Mitch gives the man another shock
00:44:24To try and get his heart back into a normal rhythm
00:44:27Six-two
00:44:28Six-two, right, Mitch
00:44:29Mitch calls the critical care desk
00:44:34Who will update the nearest cardiac unit on the situation
00:44:37So, male
00:44:4030s to 40s
00:44:42Currently, Lucas
00:44:45He's had nine shots
00:44:46And he's in VF
00:44:48He was found rather than witnessed
00:44:51Um, he's saved
00:44:52Nice one, Mitch
00:44:57Just nice and steady
00:44:57Nine minutes later
00:45:00Mitch delivers the man to hospital
00:45:02With the Lucas device still maintaining blood flow
00:45:06Round his body
00:45:07Yeah, you're happy there
00:45:09Oh, slowly, slowly
00:45:10Yeah, it's all right
00:45:11Okay, got it
00:45:12Oh
00:45:13Come on, you spin
00:45:14All right, cheers
00:45:16His heart was in a disorganised rhythm throughout
00:45:20And it needs shocking all the time
00:45:23Or special drugs
00:45:24So we brought him here
00:45:25Where we can sort of take that a little bit further
00:45:28And unfortunately, he's quite cold today
00:45:30And whether that's been a factor to what's happened
00:45:34We don't know
00:45:35Ambulance service
00:45:48Is the patient breathing?
00:45:49No, he's not breathing
00:45:50How old's the patient?
00:45:52Four, God
00:45:53Male or female?
00:45:54Male
00:45:55Is there a defibrillator nearby?
00:45:58No
00:45:58Okay, so I'm going to tell you how to give life support
00:46:01I need you to lay the individual on the back
00:46:04Can you do that for me?
00:46:05Yes
00:46:06I need you to kneel by his side
00:46:08Put one hand flat in the centre of his chest, okay?
00:46:12Put the other hand on top
00:46:13And lock your fingers together
00:46:15I need you to push down hard and fast
00:46:18So one, two, three
00:46:20Push, push, push, push, push
00:46:23Push, push, push, push, push
00:46:26We've got some help arranged, okay?
00:46:28A person who has stopped breathing has only minutes to live
00:46:35Just a few miles away, critical care paramedic Ash Mullinder
00:46:40Dr. Hadassah Eilenfeldt and trainee Dan Reid are immediately dispatched to the scene
00:46:46We are going to somebody who's been classified as a cardiac arrest
00:46:57A 40-year-old in a block of flats
00:46:59That is all we know at the moment
00:47:01But at the age of 40
00:47:02The general thing that's running through your head is
00:47:04Have they got a cardiac problem?
00:47:06Are there any sort of drugs on board?
00:47:08Have they got a clot that's causing the problem?
00:47:10Or is there some trauma involved that nobody's seen?
00:47:14Dan, do you want to, when we first go in, do a quick airway?
00:47:16Are they breathing?
00:47:17Have they got a pulse?
00:47:18Yeah, I think they have
00:47:19I suggest, given the flat number
00:47:22We just take up our equipment anyway
00:47:24It's going to be easier to lug it all back down
00:47:26Than to run up and down several times
00:47:28You have reached your destination
00:47:31The patient is 14 floors up a tower block
00:47:37Making the logistics of the job more challenging
00:47:39Oh you're right, there's a member of the book
00:47:56They're getting out of here
00:47:57Thank you
00:47:59Bene.
00:48:13Va bene l'abbiamo in presenta.
00:48:15Questa è finalmente arrivato 15 minuti da 999.
00:48:22Sì, io l'ho necessaria che prendere dell'Italia per un secondo.
00:48:25Il testo è un compagno in Remagno ad impagno.
00:48:28Paramedics suspect a drug overdose.
00:48:31So you come off the sofa and off the floor?
00:48:33Yeah.
00:48:34I've given one Narcan item.
00:48:36Yeah.
00:48:37We're loading up a second dose now.
00:48:39OK.
00:48:40The man's been given Narcan,
00:48:42a medicine which reverses the effects of opioids.
00:48:45Sats are about 20% on here, respirator 8,
00:48:48and we've been back with it.
00:48:50The patient is not in cardiac arrest as previously thought,
00:48:54but his breathing is perilously slow and weak.
00:48:57Excuse me, are you his friend?
00:48:59I live here.
00:49:00OK.
00:49:00Has he taken some this morning?
00:49:02No point, yeah.
00:49:04He's having a description for methadone.
00:49:06Yeah.
00:49:06Drugs deaths in the West Midlands
00:49:08have reached their highest ever level,
00:49:10with more than 200 fatalities a year.
00:49:13The patient's friend denies he took anything before collapsing,
00:49:17but paraphernalia around the flat suggests otherwise.
00:49:20It's managed at the most how we're breathing,
00:49:22so he's definitely making some effort.
00:49:23Paramedics are using a ventilation bag
00:49:27to pump air into the man's lungs
00:49:29and assist his respiration.
00:49:31Since he's quite big,
00:49:32we need to wrap his shoulders up a little bit more.
00:49:34So if I lift his shoulders forward,
00:49:35can you just pump the end?
00:49:36I wonder whether that beanbag might be useful,
00:49:38might get him into a really good position.
00:49:40It's just as a thought that the big beanbag behind...
00:49:42I'm just thinking to get him as upright as possible,
00:49:45just because he's got quite a bit of weight on his chest.
00:49:47If you want to lift, I'll slide in behind you.
00:49:50Dr Hadassah hopes changing the man's position
00:49:52will help to open up his airway.
00:49:55You need to just come out and stay out for us.
00:49:57OK, then, buddy.
00:49:58If the man's breathing doesn't improve soon,
00:50:01his body will start to be deprived of oxygen
00:50:03and his heart could stop.
00:50:06On, left. Ready to set, left.
00:50:08OK, I'm going to don just so I can give you another pair of hands.
00:50:17What is the story with him?
00:50:18He's felt a bit giddy, collapsed,
00:50:21insufficient respiration.
00:50:22He's known to smoke heroin.
00:50:24He's just had a second dose of Narcan
00:50:25and a bit of supported respiration.
00:50:28It's thought the man has overdosed on drugs.
00:50:32I know everyone already has,
00:50:33but obviously just be mindful where you're kneeling.
00:50:35We have got some used needles.
00:50:39The patient's been given Narcan,
00:50:41a drug which reverses the effects of opioids,
00:50:44but he still hasn't regained consciousness.
00:50:47Are you getting any resistance on the back?
00:50:49No, we've got any resistance.
00:50:49There's no gurgling.
00:50:52Once in COVID PPE,
00:50:54Dr Hadassah is able to help paramedics
00:50:57assist the man's breathing with a ventilation bag.
00:51:00So we've got good misting.
00:51:02We've got good chest rise.
00:51:03We've got good CO2.
00:51:04and we've got good CO2.
00:51:06So as a two-person hold
00:51:07and a one-person bag,
00:51:08it is working.
00:51:09Is he coming round more with that Narcan?
00:51:10Is he more responsive?
00:51:11Yes.
00:51:12Okay.
00:51:13So and which Narcan
00:51:14are we going to try and get through
00:51:15to try and...
00:51:16We've got three lots so far.
00:51:18Three lots.
00:51:19Dr Hadassah and Ash
00:51:20want to get the man into an ambulance
00:51:22as quickly as possible,
00:51:23but it won't be easy.
00:51:26He's a big chap.
00:51:27So my proposal for expression,
00:51:28please, someone share it to me if you disagree.
00:51:30Striker, strap him in on the striker,
00:51:32so if he does wake up and start kicking off,
00:51:33he's strapped in.
00:51:35Use the back of the striker
00:51:36where the handle is
00:51:36just to strap his head to it.
00:51:38Sounds like a good place to be out.
00:51:39Anyone disagree with that?
00:51:40No, no, no.
00:51:41Are you happy?
00:51:42The man weighs roughly 20 stone.
00:51:45The plan is to get him into a carriage chair
00:51:47and lift him downstairs,
00:51:49conscious or not.
00:51:52Oh, there we go.
00:51:53Hello.
00:51:55Hello, buddy.
00:51:57Yeah.
00:51:57How are you feeling?
00:51:59I'm fine.
00:52:01The Narcan is working
00:52:02and the man is finally coming around.
00:52:05Have we still got a cannulation pouch somewhere?
00:52:08Yes.
00:52:08I'm going to try and get some IV access
00:52:10before he wakes up too much,
00:52:11and then at least we've got something
00:52:12other than IO for the route.
00:52:14Dr. Hadassah wants to cannulate him
00:52:16to make it easier to administer drugs or fluids
00:52:19while he's moved to the ambulance.
00:52:21Stay still for us, buddy.
00:52:22All right.
00:52:23You're just with the paramedics, mate.
00:52:25All right, you're OK.
00:52:26Just stay nice and still for us.
00:52:27You're OK.
00:52:27All right.
00:52:28You're just in your mate's house.
00:52:30Nice and still for me, buddy.
00:52:31Sharp scratch coming in your arm.
00:52:35Well done.
00:52:37I think what we're going to do
00:52:38is make him sit up.
00:52:41You're up to your mate's house.
00:52:42All right.
00:52:42You've had a bit of an overdose.
00:52:45Buddy, look at me.
00:52:46My name's Hadassah.
00:52:47I'm one of the doctors.
00:52:49Now, you've had a bit of an overdose.
00:52:50You took a little bit too much
00:52:51and you stopped breathing.
00:52:53So we've had to do the breathing for you.
00:52:55And we're going to get you sat up a little bit
00:52:57and you'll feel a bit less confused afterwards, OK?
00:53:00As well as helping him to get his bearings,
00:53:03sitting the man up will make it much easier
00:53:05to get him into the carry chair.
00:53:06If we help you, do you reckon you can sit up for us?
00:53:11Yeah?
00:53:11We're going to give you a hand to come and sit up
00:53:13because you're going to feel a bit better sat up.
00:53:16We're going to stop there for a second
00:53:17because your blood pressure's quite low.
00:53:19You did collapse.
00:53:20I know you're feeling quite sleepy and confused.
00:53:26That's normal, OK?
00:53:28You're safe.
00:53:28We're going to look after you, all right?
00:53:30Moving the man too quickly
00:53:31could cause him to pass out again.
00:53:34But Dr Hadassah wants to get him out of the flat
00:53:36before the latest dose of Narcan wears off.
00:53:40We're going to pop you up
00:53:41and get you on this chair, mate.
00:53:42All right.
00:53:43So we're going to need you to stand up, OK?
00:53:46Pop your hand behind my arm there, mate.
00:53:48One, two...
00:53:50Still semi-conscious,
00:53:52the man has little power in his legs.
00:53:55One, two...
00:53:57That's it.
00:54:00Pop yourself down.
00:54:04Keep your seatbelts on.
00:54:06Rob, will you put that one in on your side?
00:54:08Have you been on one of these before?
00:54:09Yeah, spot on.
00:54:11or monitoring, oxygen off
00:54:13just for the purpose of getting down
00:54:14because it's going to be easier.
00:54:15Pop this off your mind, mate.
00:54:16Yeah.
00:54:17What's happened?
00:54:19What's happened?
00:54:20I think you've took some of it, mate,
00:54:22and you've took a bit too much.
00:54:24Has that happened before to you?
00:54:25No.
00:54:26No.
00:54:26Do you know what you've took today?
00:54:28No.
00:54:28OK, mate.
00:54:30Are you too happy at the foot end
00:54:31just to get over the lip on that metal bar?
00:54:33Yeah, yeah.
00:54:33Over there?
00:54:33Yeah, yeah, yeah.
00:54:34Is that all right?
00:54:34OK, just to be aware,
00:54:36we do have reducing GCS,
00:54:37smaller pupil sizes,
00:54:39and we are sweating.
00:54:39so if we can go,
00:54:40now is our opportunity.
00:54:42OK.
00:54:42Let's all go.
00:54:43There are now signs
00:54:44the Narcan is wearing off
00:54:46and the drugs the man's taken
00:54:48are once again overpowering him.
00:54:50Put your hands close together
00:54:51so you don't bang your elbows
00:54:52off the door frames.
00:54:54Get your hands together, mate.
00:54:56Squeeze and squeeze and breathe.
00:54:57Ready, set, next.
00:55:00OK.
00:55:01Down.
00:55:02So then bars away?
00:55:03Yeah, bars away.
00:55:04Spot on.
00:55:05Paramedics accompany the patient
00:55:07in the lift
00:55:08while the critical care team
00:55:10take the stairs.
00:55:17The antidote doesn't work
00:55:18for as long as heroin lasts for.
00:55:20So at some point,
00:55:21that's going to wear off
00:55:21and he's probably going to
00:55:22land back in the same situation.
00:55:24So he'll need to go to hospital
00:55:25for a period of monitoring
00:55:27and potentially repeated doses
00:55:28of this medication.
00:55:29The patient will be taken
00:55:33to nearby Heartland's hospital
00:55:34where medics will be able
00:55:36to closely monitor his recovery
00:55:38and provide any further medication
00:55:40he needs.
00:55:41He can go to, you know,
00:55:43heroin overdoses quite a lot.
00:55:45So it is a massive impact
00:55:46on the ambulance service.
00:55:50But what's the answer?
00:55:52He's not taken that specific amount
00:55:54for the purpose of stopping himself
00:55:55breathing or killing himself.
00:55:56He's not taken it for that.
00:55:57You know, he's taken it
00:55:59because unfortunately
00:55:59that's his addiction.
00:56:01You know, he's still a patient.
00:56:03So, you know,
00:56:04we'll turn up every time.
00:56:06We'll do our bit every time.
00:56:09It's all kind of part
00:56:09and parcel of the job,
00:56:10isn't it, really?
00:56:16Ambulance service.
00:56:16Is the patient freezing?
00:56:18I'm addicted.
00:56:19I've seen a just accident
00:56:21on the way the marks
00:56:22before the roundabout.
00:56:24OK, and how many vehicles
00:56:25are involved?
00:56:26Just only one vehicle.
00:56:28Is there someone in there as well?
00:56:30Is the person breathing?
00:56:31One second.
00:56:32Hello?
00:56:32Hello.
00:56:33Is the patient breathing
00:56:34and conscious?
00:56:35No.
00:56:36There's one patient.
00:56:38He's grunting.
00:56:39His hands are cold.
00:56:41Is he awaiting?
00:56:42No.
00:56:42No.
00:56:43OK.
00:56:43No responses.
00:56:44Is somebody starting CPR?
00:56:47Yes.
00:56:47Is he trapped within the car?
00:56:49I'll figure you'll need
00:56:50to have a roof off to you, man.
00:56:52We're coming on blue lights
00:56:53and sirens as quick as we can.
00:56:55OK?
00:56:58No, no, no, no.
00:56:58Thank you.
00:57:00Police, fire brigade
00:57:01and the ambulance service
00:57:02are all en route to the scene.
00:57:05But with a man's life in danger,
00:57:07Mark and Colin are also needed.
00:57:10Never good.
00:57:10Never good.
00:57:11It's unclear if the driver
00:57:24has suffered a cardiac arrest
00:57:25and crashed his car
00:57:27or his injuries are so severe
00:57:29that he has lost consciousness.
00:57:31Either way,
00:57:32he needs urgent critical care.
00:57:34I'm in the immediate place
00:57:35and boys, while I'll take you.
00:57:39I'm in panic.
00:57:41As the other emergency services
00:57:49converge on scene,
00:57:50Mark and Colin must brace themselves
00:57:52for what they will find.
00:57:559-8-1-C.
00:57:59So there are cars
00:58:03in front of this thing
00:58:04just beware there's people there.
00:58:06Yeah.
00:58:11arriving at the crash site
00:58:14they discover the ambulance crew
00:58:15have managed to get the man
00:58:17out of the badly wrecked car.
00:58:18The dashboard is completely crushed
00:58:22and the horn still blaring.
00:58:24Guys, do you want to give us some space
00:58:26so we can work with it, yeah?
00:58:27A large group of passers-by have gathered.
00:58:29It's mine across the car
00:58:32two sets of trees.
00:58:33It's 100% mass.
00:58:33So we've ripped tonight.
00:58:34No, it's good.
00:58:35It's got a massive heading.
00:58:36Right, OK.
00:58:37Yeah.
00:58:39OK, cool.
00:58:42The 38-year-old man
00:58:43was driving back
00:58:44from seeing a friend
00:58:45when his car left the road
00:58:47and hit a wall.
00:58:48No, no, no, no, no, no, no, no, no, no, no.
00:58:50Thanks for your help, guys.
00:58:51Just move that way.
00:58:52He is completely unresponsive.
00:58:55He has a hole in his skull
00:58:56and his brain is exposed.
00:58:59Don't worry about the collar, guys.
00:59:00We're going to put a tube down in
00:59:02and go from there.
00:59:03Cool.
00:59:03Do you want to do it after the drugs?
00:59:04Yeah, cool.
00:59:05The man's breathing is so faint
00:59:07his heart could stop at any moment.
00:59:10Mark's only option
00:59:11to try and stabilise him
00:59:12is to put him into an induced coma
00:59:15so he can take over his breathing.
00:59:17Mary.
00:59:18From our point of view,
00:59:19we can do it here.
00:59:20I think we've got enough space here.
00:59:21as they prepare to perform
00:59:29this major life-saving intervention...
00:59:31Guys, is there...
00:59:32I know he's got the wound
00:59:33on the one side of his head,
00:59:34but there's nothing on the other side,
00:59:35is there?
00:59:37Mark, they nearly got him strapped on
00:59:39so we might as well just lift him up onto there.
00:59:42Mark and Colin know
00:59:43it's down to them and the crew
00:59:44to get him to hospital alive.
00:59:47Colin's going to be on the right-hand side
00:59:49of all the airway kit.
00:59:50What we're trying to do,
00:59:50as we can do,
00:59:51is we'll just move the monitor down
00:59:52to be long-sighted.
00:59:53Is that OK?
00:59:53Does it make sense?
00:59:54Yeah?
00:59:54Cool.
00:59:55So I'm going to do...
00:59:56I'm going to do ketamine,
00:59:57sucks,
00:59:58and some rock afterwards,
01:00:01and then we can go from there.
01:00:02And he's pretty fast at the moment.
01:00:03We're going to be literally
01:00:04going straight up there,
01:00:05and then we're going to put a tube down him
01:00:07and go from there.
01:00:08The patient could die at any moment.
01:00:10So Mark,
01:00:11a consultant anaesthetist
01:00:13at University Hospital North Midlands,
01:00:16is going to place him
01:00:17in a medically-induced coma
01:00:19so they can control his breathing
01:00:21and protect the vital supply of oxygen
01:00:23to his brain and organs.
01:00:25Colin,
01:00:25you've got your...
01:00:26You've got the VL?
01:00:27Yeah, it's all ready.
01:00:29I'm just going to do a mental...
01:00:30Check through his scotoscope, yeah?
01:00:31Tube,
01:00:31you've got a bit of gel in it?
01:00:33Oh, just a bit of syringe in there.
01:00:34There's the K-Y.
01:00:38Suximethonium and rocuronium
01:00:40are two fast-acting muscle relaxants
01:00:42that will temporarily paralyse
01:00:44the man's muscles.
01:00:46A mechanical ventilator
01:00:47will then breathe for him.
01:00:50Just pop them on his chest for now.
01:00:51We don't need them taped in.
01:00:53Are you ready to lift and come onto here?
01:00:55Just come round and spin round
01:00:57your head there.
01:01:00With the help of one of the bystanders,
01:01:02an off-duty paramedic,
01:01:03the crew lift the man
01:01:04onto the stretcher
01:01:05to carry out the procedure
01:01:07which is normally performed
01:01:08in a hospital.
01:01:11Hold on.
01:01:11Do a take.
01:01:12Do a take.
01:01:12Left foot.
01:01:14You happy at the top end?
01:01:15Yeah.
01:01:16Good.
01:01:16Put a blanket over his chest
01:01:18if we can.
01:01:19Have we got access yet?
01:01:21We need two lots of IV access then.
01:01:24Let's have a look at his eyes.
01:01:26In the dark,
01:01:27by the side of the road,
01:01:28Mark can't afford
01:01:29to make any mistakes.
01:01:31So before he administers
01:01:32the powerful drugs,
01:01:33he checks to see
01:01:34if there's been any change
01:01:36in his condition.
01:01:37Stephanie eyes is one,
01:01:38verbal one,
01:01:40and then it's just motor is varying.
01:01:41As if anything,
01:01:42he's doing abnormal flexion,
01:01:43isn't he?
01:01:44Right, monitor eyes.
01:01:45Just want to look at the monitor.
01:01:47So let's run back on.
01:01:48So we've got ECG on.
01:01:49I'm glad to try and do blood pressure again
01:01:51because we've not really seen one at all.
01:01:52He's a bit cold, isn't he, unfortunately?
01:01:54Just doing a blood pressure at the moment.
01:01:55Is he fighting on that arm
01:01:59or is it just...
01:01:59Yeah, he's trying to take the mask off,
01:02:01I think.
01:02:01No, just think about the blood pressure,
01:02:02why it's going...
01:02:03The man's condition is deteriorating.
01:02:07He has an irregular heartbeat
01:02:08and low blood pressure.
01:02:10I think we're going to have to work pragmatically
01:02:11on what we've got, Cole.
01:02:12Right, it's struggling with the erratic rate.
01:02:15He's going to do something very strange
01:02:17with us in a minute, Cole.
01:02:17Yeah.
01:02:18He could go into cardiac arrest
01:02:20at any moment.
01:02:22They need to act fast.
01:02:25Guys, for those of you
01:02:26who haven't seen him before,
01:02:27in a minute he's going to have
01:02:27a bit of a twitch
01:02:28as the paralysis kicks in.
01:02:29I'm going to pop the tube down.
01:02:31Okay.
01:02:32Right, ready.
01:02:34Time check.
01:02:36You happy, Cole?
01:02:36Yeah.
01:02:37Yep.
01:02:38Yeah, I think everything's very cold.
01:02:41It's a hot...
01:02:41Right, I'm going to...
01:02:42This is going to be a token 50.
01:02:50Okay, and the sucks is going through now.
01:02:54The dose of sucks
01:02:55will take a minute to take effect.
01:02:59It's quite, um...
01:03:01It's quite strong, isn't it?
01:03:02Let me know when you're ready to...
01:03:03Yeah, that's the drug kicking in.
01:03:04Quite a slow circulation, right, actually.
01:03:07As the drugs kick in,
01:03:08the muscles in the man's arms convulse.
01:03:11He is now completely paralysed,
01:03:13unable to even breathe for himself.
01:03:16Okay, Cole, all yours.
01:03:17Colin now has five minutes
01:03:19to get the breathing tube in place
01:03:21and start ventilating him,
01:03:23otherwise he will die.
01:03:26It's epiglottis, grade one.
01:03:31Yeah.
01:03:32Are you ready?
01:03:32Yeah, he's got just a large epiglottis.
01:03:39Okay, Bougie's through.
01:03:41Ready for the tube?
01:03:43The effect of the paralysing drugs
01:03:45lasts for less than 30 minutes,
01:03:47so it will need constant monitoring
01:03:49to avoid any conflict
01:03:50between his body's natural breathing
01:03:52and the ventilator.
01:03:55Just hold the tube for me, mate.
01:03:57We'll go with 820 at the tube.
01:04:00Okay, got the tube.
01:04:02Yep, tube.
01:04:03Bridge here.
01:04:05Right, you're still nice and strong.
01:04:07Okay, right.
01:04:08There you go.
01:04:09Yep, got good movement.
01:04:10Okay, I'm cramming up with the cricoid.
01:04:11I'm going to give him some rock
01:04:11because I can feel him moving already.
01:04:15Colin will squeeze air into his lungs manually
01:04:18until he can be attached to the ventilator.
01:04:24The rock's in.
01:04:25Okay, happy?
01:04:26Yeah.
01:04:26If we can start wrapping him up.
01:04:29So have your fluids at the top there, aren't you?
01:04:30Yeah.
01:04:31Let's start keeping the warmth in if we can do.
01:04:33and Sachsen can come away.
01:04:36Right, happy there, Colin?
01:04:37Yeah.
01:04:38Thank you.
01:04:39Yeah, thank you.
01:04:41Guys, anyone seen anything we've missed?
01:04:43So we're happy that airway's secure.
01:04:44We're breathing nicely.
01:04:46We are.
01:04:46Okay, Sachs are still very erratic.
01:04:48I don't think we can make any comments on that from the moment.
01:04:50It's too cold.
01:04:51Right, we'll get him on the ventilator
01:04:52as soon as he's in the back of the ambulance then.
01:04:54You ready?
01:04:58How far is it to carry from here?
01:05:0120 minutes.
01:05:01Mark and Colin will travel with the patient
01:05:07to provide critical care throughout the journey.
01:05:12So, male, unclear of the mechanism.
01:05:16There seems to be cars involved.
01:05:18Mark updates control so they can alert the hospital.
01:05:21He has, it looks like an open brain injury.
01:05:24As far as we can see, there's an injury to his back of his head,
01:05:26which definitely was a flap of skin,
01:05:29and so he's got a traumatic brain injury.
01:05:31So we have to presume he's bleeding in his brain.
01:05:33So he's now been on our side.
01:05:35ETN, I think we're going for, shall we, 15 minutes?
01:05:37We'll take 15 minutes.
01:05:4015 minutes out,
01:05:41Mark administers another dose of the muscle relaxant
01:05:44combined with a sedative.
01:05:45At this moment in time,
01:05:48we don't want him to be straining against any of what we're doing.
01:05:51We just want to keep it nice and steady and flat.
01:05:53The numbers we've got on the screen are perfect for us at the moment,
01:05:55and so if we can keep him just the way he is
01:05:57when we get to the hospital,
01:05:58then that's better for us,
01:05:59better for the patient.
01:06:01They can then reassess.
01:06:03Once they've got the scan,
01:06:03they can make a decision what they're going to do after that.
01:06:05Arriving at hospital,
01:06:10time is critical.
01:06:11The man is taken directly to the emergency doctors.
01:06:16That patient there,
01:06:19the longer he went without his airway being protected
01:06:22and us controlling the oxygen and the carbon dioxide levels,
01:06:25the more damage that potential could happen to his brain,
01:06:28and what we hope is that by doing that early intervention,
01:06:31a good, you know,
01:06:3245 minutes before he got to hospital,
01:06:34we hopefully help stabilise him a bit and made a difference.
01:06:38And that is our bread and butter,
01:06:39to go to the sick patients,
01:06:41work with the crews on infrequent events for them,
01:06:44but frequent for us.
Consigliato
0:15
|
Prossimi video
1:48:49
1:34:24
1:27:59
10:16
15:46
1:10
1:55
4:08
4:17
5:39
7:09
8:42
3:47
Commenta prima di tutti