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00:00Today, road rage and alcohol lead to clashes.
00:05He's been spitting blood, flicking blood and not letting the crew do any ops.
00:10A man sustained severe injuries after collapsing in the street.
00:13It's possible he'd broken his jaw.
00:16And in Dudley, Ste hands out more than just medical help.
00:19Is that okay?
00:20Yes, thank you.
00:21Is that okay?
00:22That's beautiful, thank you.
00:23Can you put on the tape?
00:24You can't predict, really.
00:27You can not go to one or hear of one for a long, long time.
00:31And then there'll be four in quick succession.
00:34And they can range from being minor to being life-threatening.
00:47I'm working with a lovely Dr Dave tonight.
00:50I've known Dave for a long time.
00:51He was a doctor when I first started.
01:04We've just had a call to a...
01:05Somebody's been spitting in the abdomen.
01:08We don't know much else so far.
01:09The only person at the scene is an off-duty police officer.
01:13I see the main things we're worried about is bleeding.
01:26It's the most life-threatening problem with the abdomen.
01:31And from a safety point of view, we will be concerned
01:34because we don't know who the alleged assailant is
01:38and whether they're still around.
01:39You're obviously going to be driving past.
01:41Anyway, that proves to be down.
01:42If you're happy to, proceed with the previous duties
01:45and you can carry on in the direction, you're going.
01:48Take third exit at roundabout.
01:52As soon as we're here.
01:56Everything's all right.
01:57Wait there!
02:02OK, you just need to wait, OK?
02:04Just hang on. Just wait there a second.
02:07So when we arrived, there was lots of traffic
02:09because it had been a roadway incident.
02:12So there was one car certainly that was stationary,
02:14not going anywhere.
02:15People weren't really understanding what was going on
02:17so they were trying to move around that car,
02:19past the ambulance,
02:21put in police who were on scene in danger.
02:23there was blue lights going off everywhere.
02:25Do we know how, what he was talking about and stuff?
02:27It was just, we were just getting through that.
02:28Oh, was it like a slash more than a slash?
02:31Sorry.
02:32All right, so there's a relative of somebody involved.
02:35There's a relative of somebody involved
02:36who's just turned up here.
02:37It's in quite a state.
02:38I've told her just to wait there.
02:39If you can look after a while, we have good information.
02:41Yeah, yeah. Right.
02:42Cheers.
02:43There was police trying to manage the scene
02:45and also questioning people who saw the incident
02:47because it was on a busy road.
02:49This lady's a relative of somebody involved, yeah?
02:53This is the doctor.
02:56This is Dave, OK?
02:57Here we see.
02:59Hi there.
02:59I'm Dave and I'm a doctor with the ambulance service.
03:02How are you getting on?
03:03Paramedic crew, they'd done some observations
03:05and they'd covered the wound
03:06and they'd got some IV access into the vein
03:08in case they needed to give him any fluids or pain relief.
03:13How old are you, darling?
03:16We've got quite an extensive laceration.
03:19He thinks he's been slashed rather than...
03:20My first impression was that he was sitting up talking.
03:24He was fully conscious, fully aware of what was going on.
03:26That's always a good sign.
03:27Right, hospital there as you go in.
03:29So they'll be on standby when you get there
03:31to have a look at you.
03:32All right.
03:33All the best.
03:34Once the crew had handed over to us,
03:36we were quite happy that they could proceed with his care
03:38and move off quickly to hospital.
03:40Mick, I've told them eight minutes from now.
03:42Can I assist you with something, maybe?
03:44The person that...
03:46The offender has stabbed the guy's tyre before...
03:49Oh, OK.
03:50The hole in the tyre is an inch wide,
03:53so the blade is an inch wide.
03:55Well, it's quite a large wound there, isn't it?
03:59It's probably a bit wide.
04:00Yeah, two inches wide, isn't it?
04:02OK, lovely.
04:03Sometimes you don't know what your patient's been stuck with
04:06and that makes it even more difficult to assess.
04:08but if you've got a blade in front of you,
04:10you can see potentially how far that knife's gone in.
04:13The patient had been in his vehicle
04:15and the assailant had got out of the car,
04:18had slashed the patient's tyre
04:20and then put the same weapon into the patient's abdomen.
04:25Can we move these cars here so the ambulance can get through?
04:28You just reverse up a couple of feet,
04:30don't bash our car,
04:31it'll just make it easier for the ambulance to get out, yeah?
04:33So the situation is the patient's gone with the ambulance
04:36to hospital,
04:36it'll take them about four minutes to get there.
04:39There's nothing that we're going to do that will change anything.
04:41The best thing we can do is really not delay his onward journey.
04:45We're going to head back to the place.
04:46Yeah.
04:47So we've just been sent to another standing.
05:08We don't know any more details at the moment.
05:10The patient's flicking blood around,
05:24so it's not a very nice situation for anybody, really.
05:29The patient's flicking blood around,
05:38so it's not a very nice situation for anybody, really.
05:43who's going to have a good deal?
05:44Yeah, all right.
05:45Thank you.
05:45Thank you.
05:49Hi, there.
05:50Hi.
05:51Hi.
05:51Hi.
05:53Hi.
05:54Hi.
05:54Hi.
05:54Hi.
05:55Hi.
05:55Hi.
05:55Hi.
05:56Hi.
05:56Hi.
05:57Hi.
05:58Hi.
05:58Hi.
05:59I'm the official at the moment.
06:00Non è idea di cosa succederebbe?
06:02No.
06:03No.
06:04Presumente che non hai avuto il sete opzioni.
06:09No.
06:10È un'imagine, è stato un'aggressive, quindi...
06:14Se abbiamo risponduto a un incidente o un assozi,
06:18ha un controllo che ci sarà sempre che ci sono in attenzione prima di arrivare.
06:23Ci sono state, ci sono state, ci sono un priorità.
06:26I'm guessing he's BPO 292.
06:28You didn't get anything.
06:30That's reasonable.
06:32Don't tell me to hold me down when I don't want to stay here.
06:36This is the wrong look at my head.
06:39Are they going to arrest him?
06:40That's probably the best bet.
06:42We've got to think about the safety of ourselves,
06:45so trying to treat him when he's in his state
06:47is just not an acceptable thing to do, really.
06:50Listen, listen, you're knocking all of me down, yeah?
06:53You're knocking all of me down.
06:55All we know, as he had a drink, we're suspecting alcohol.
06:58He's got a laceration on his head and maybe a hand injury,
07:02but he's not been cooperating at all.
07:06He's been spitting blood, flicking blood,
07:08and not letting the crew do any haunts.
07:11So he's well, he's alert, he's orientated.
07:14We're not worried about him, but he does need to go to hospital
07:16to just have that stitched up.
07:18What's going to be the plan? Are you going to...?
07:19We're going to just go straight.
07:20Just go.
07:21Do you want me to let Heartlands know?
07:23Yeah, just let them know, yeah.
07:25I can let them know. What's your ETA going to be,
07:26and I'll let them know.
07:27Say, like, ten minutes.
07:28Five, ten minutes, yeah, yeah.
07:29Five, ten minutes, all right.
07:30I'll explain everything that's going on
07:31just so they can expect them to maybe get a room aside for you.
07:33We'll just go up on lights as well, okay.
07:35Yeah, all right, all right.
07:36I'll let everyone know then, all right.
07:38Okay, let's shut this door, yeah?
07:40Who's driving?
07:41Me.
07:42Are you standing in the back or are you getting out?
07:43Okay, good luck.
07:44I need to shut that door, I think.
07:45He saw a way out and tried to escape.
07:46Oh, actually, bear with.
07:47I'll go up at the ramp.
07:48What if you're going to drive away?
07:49You all right for me to do that?
07:51Ooh.
07:52Don't tell me too.
07:53Bro.
07:54Stay there.
07:55止.
07:56계속 toanca car, bars.
07:57Any other assistance, or what?
07:59Yeah?
08:00Don't, just jump on and take känp often
08:02and put some gloves, yeah.
08:03just jump on and put some gloves.
08:05Stay there.
08:06Stay there!
08:08Stay there!
08:09Hey!
08:10Super nice.
08:11Man from here.
08:12You just jump on.
08:13Get back and ha kyla.
08:14They're gonna get some gloves then, man.
08:15Stay there!
08:16Go ahead, they're gonna get one creep.
08:17Sorry, father, bailiOa, stop.
08:20I'm going to have to put this ramp up then, ok?
08:27It is frustrating because he's got several units of police here
08:31and actually we don't know what's gone on
08:33but he's actually the victim here at the minute.
08:38If he was to sit in a chair, let us look at his injuries,
08:41bandage him up, do some ops and take him to hospital
08:43then all these resources could go off and do what they need to do.
08:46There's no need really for this
08:48and this is what's frustrating for us, I think, really.
08:50And he's being aggressive to the crews who are trying to help him
08:53and that's also a big thing and it's unnecessary.
08:57He's being restrained by the police.
08:59There is a lot of blood but the wounds are, as stated, relatively minor.
09:04But obviously we just want them to know
09:05because there's going to be lots of noise when they get there, have I?
09:09Yeah, I'll let them know, no worries.
09:12Thank you. If you put them in in the next eight to ten minutes, have I?
09:16Useful contribution to the evening so far, some wipes.
09:20Right then, thank you.
09:21Bye. Always a pleasure.
09:22Always a pleasure, never a chore.
09:23See you later.
09:25If he'd have just let us help him, well then none of that would have happened.
09:29But unfortunately he's going under restraint now,
09:31under arrest for probably breaching the peace
09:34and being intoxicated, which is a shame really.
09:37So yeah, we're not needed anyway, which is a good thing,
09:39so minor injuries.
09:41He'll live another day.
09:42Might have a headache tomorrow.
09:43Thank you, sir.
10:02Basics is the British Association for Immediate Care Schemes
10:05and its prime focus is to provide advanced care in the pre-hospital field.
10:10Right, and we've got the major hemorrhage stuff,
10:12so we've got some swabs and some sell-ups gauze.
10:14Basics doctors train medical students
10:16and assist paramedics out on the road.
10:19Paramedics are trained to deliver excellent care,
10:23but there are limits to what they're allowed to do.
10:25Doctors can do procedures that their paramedics
10:28would otherwise be not able to do.
10:29So we've just got a call.
10:40We're on our way to a male who's having a fit.
10:44So there's a chap who is apparently outside,
10:47and he's also got reports of a head injury,
10:49so he might have fallen, sustained a head injury
10:52and is now seizing,
10:54or he might be that he's having a fit
10:58and has bumped his head on the way down.
10:59down here.
11:18Hello there.
11:19Oh yeah, is it all right?
11:20Can I pop on?
11:21Come on, yeah.
11:22Thank you very much.
11:23Just got here.
11:24Hello, sir.
11:24Hello, are you all right?
11:25I'm a medical student.
11:25My name's Mike.
11:26I'm one of the doctors with the ambulance service.
11:27What's your name, sir?
11:28Wayne.
11:29What have you found out so far?
11:31We're a diabetic.
11:32Diabetic chap.
11:33Right.
11:34Do you know what happens, Wayne?
11:37Do you know what happened to you?
11:38I was just starting to feel funny.
11:40I knew my blood sugar was low.
11:42I was just getting burnt into the ice pack
11:45with that sort of cake or something.
11:47Yeah.
11:47Just getting that confused,
11:49like, and I've come outside
11:50and met her in a bit before.
11:52I'm type 1 diabetic.
11:55I've gone into town.
11:56My blood sugar's gone low.
11:59Started getting confused.
12:01I've ended up tripping over,
12:03knocking myself out.
12:05Do you have this a lot,
12:06where you, when you have a hypo,
12:08you get a low blood sugar?
12:09Not like that, no.
12:11Not like that?
12:11It just suddenly collapsed
12:13and then banged your head on the way down.
12:14It's just a bit swollen.
12:15Wayne's low blood sugar levels
12:17have caused him to have
12:18a hypoglycemic incident known as a hypo.
12:22Mind if I just have a little look at you?
12:23Is that all right?
12:24When we first met Wayne,
12:26he was awake and talking,
12:28but he was still finding difficulty
12:31and finding the right words.
12:32He was slurring his speech a little bit.
12:34Can you still see all right, Wayne?
12:38Yeah, it's just a bit swollen, isn't it?
12:40And you could think that he was drunk.
12:42These are all possible consequences
12:43of having a low blood sugar.
12:45You were going to get up
12:46and walk into the ambulance, did you?
12:47Yeah.
12:48OK.
12:48If the brain's not getting enough food,
12:50it's not working fast enough,
12:51and people can seem slow and slurred,
12:55and that's why they go off balance
12:56in the first place and fall over.
12:58You hurt your wrist as well, have you?
12:59Here.
13:00This one's obviously sore here, isn't it?
13:02It's possible he'd broken his jaw,
13:05but he certainly caused some wounds
13:06that were gaping open,
13:08and we're going to need some stitches.
13:09It looks impressive.
13:10Have you taken a selfie yet?
13:12No.
13:12No.
13:13Fair enough.
13:14The problem with having a low blood sugar
13:17or falling to the ground
13:18or having a seizure
13:19is you can easily sustain a head injury,
13:21and your brain can become injured
13:24just by impacting with the pavement.
13:26The wound itself has got a small laceration
13:28just next to the eye.
13:29It's actually involved in the eyelid.
13:30It's gone through the layers of the skin,
13:32so it probably needs a couple of little fine sutures
13:35just to stitch it up,
13:36just something that you probably need to go to A&E for.
13:38We're going to just check your blood sugar,
13:40see what it's like now.
13:41What was it like before
13:42when you knew you had to get something?
13:43I haven't tested it.
13:45You're not tested.
13:45You just felt like you're having a hypo.
13:48Can you still see all right, Wayne?
13:521.1.
13:541.1?
13:55Wow.
13:56Okey-dokey.
13:56There we are.
13:57Yeah, I started to look at that twice.
13:58That's pretty low.
13:59Right then.
14:00I'm going to give this a little clean as well.
14:011.1 is really low.
14:03It should normally be over 4,
14:05so it's no surprise that he's felt unwell.
14:08Just don't cheat in your mouth.
14:10In Wayne's case, we gave him some gel,
14:12but ideally, you'd eat something.
14:14I've got some food in his bag.
14:15I'm just wondering.
14:16I know, yeah.
14:16It might be a bit better.
14:18Yeah.
14:18Shall we do both?
14:19Because 1.1 is pretty low, isn't it?
14:21Yeah.
14:22I'm going to post up with some biscuits.
14:24It would be a good start.
14:26Is this a chocolate bar?
14:27A chocolate bar.
14:28That's a good start, isn't it?
14:29There you are.
14:31Yeah.
14:31He'd just been to the shops
14:33and had got a carrier bag full of chocolate bars.
14:35He tried to eat it,
14:36but unfortunately,
14:37the wound that he'd got made it difficult to eat.
14:39So we gave him another lot of the sugar gel,
14:44and then they could sort him out more at hospital
14:47with a bit more pain relief.
14:49Right.
14:49Well, I think there are incapable hands here.
14:52Bless you.
14:53Right.
14:54It's a day-to-day battle for people with diabetes,
14:58and they're always at a risk of having
14:59either a high or low blood sugar,
15:02and there are problems with both.
15:03OK.
15:05There you go, buddy.
15:05Come on.
15:06Crack on with your chocolate bar.
15:09Mine?
15:10No.
15:10I know it's sore.
15:11You get some more chocolate into you.
15:13Get your sugars up.
15:15The stuff that you've had out of the tube
15:16only lasts a little while.
15:18It was a shock I was still up and walking about.
15:21So I can understand why now
15:23I was so confused and acting the way I was.
15:27Thanks, chaps.
15:29Nice to meet you.
15:30Yeah, nice to meet you as well.
15:31Thank you.
15:31Thank you very much.
15:32Cheers.
15:33Thanks, Wayne.
15:34All right.
15:34All right.
15:35Yeah.
15:36Thanks very much.
15:37OK, cheers, Wayne.
15:39I'd expect Wayne to make a full recovery,
15:42and he just needs to live with his diabetes
15:45and work with his GP
15:48to find the regime of medications that works for him.
15:53I'm from South Wales.
16:10I currently live in a British ponty pool
16:12with wife and children and the dogs
16:16and literally ended up coming up to here for work.
16:20I travel up there.
16:21It takes me just over an hour every shift.
16:25The best thing about being a paramedic, I think,
16:26is the feeling that when you know you're making a difference,
16:29you are actually helping somebody.
16:30that person is alive because of something you've done
16:34or is getting better because of something you've done.
16:37We've just been assigned to attend a female
16:52who's had a three-day history of back pains.
16:56It doesn't say whether she's injured herself
16:57or whether they've just come on.
16:59So we've got to make an assessment.
17:01and probably, you know,
17:02it could be a long, ongoing chronic condition
17:05and the lady just can't get a doctor's appointment with her GP.
17:10We still respond on lights and sirens, obviously.
17:22Whether we need to or not,
17:23we'll obviously determine once I arrive.
17:26So until we get there and assess her,
17:29we don't know it.
17:30and attend a 3-day
17:31SANSY
17:40S став
17:45Go on in!
17:46Hello, my love!
17:48Door's going to slam!
17:50Oh!
17:51Door's just slammed!
17:51Ha-ha.
17:52Is it going to be a door?
17:53Right!
17:54What's your name then?
17:55Susanna!
17:55What's your name then?
17:56Susanna!
17:56It's what, sorry?
17:57Susanna!
17:58Susanna!
17:59What's happened today?
18:17Ok, have you taken any painkillers for us?
18:23Ok, so you're not getting any relief from taking tramadol or anything like that?
18:27It became quite apparent quite early on that lady was in quite severe pain.
18:31She was really upset.
18:33So if you had to score the pain, zero's nothing and ten's like the worst pain you've ever felt.
18:37Oh, good.
18:39It's that bad, isn't it? Bad.
18:41And I think as well she was quite depressed by it.
18:43I think it had been something that had been getting her for quite a while,
18:47just getting gradually, gradually worse.
18:49And you haven't had any pain relief at all?
18:53I just wanted to die.
18:55I just wanted the Lord to take me that morning because of the pain.
18:59I've never felt pain like it in my life. Never.
19:03Pop this on your finger for me.
19:07Perfect.
19:08And have you had any problems, like have you felt any problems with passing water or anything like that?
19:14Yes, I have the last three days.
19:16And you're having like numbness in that?
19:18Yes.
19:19Ok.
19:20It's going to be a trip to hospital then.
19:22I'm not stopping in.
19:23Well...
19:24If you're taking me to no hope, I'll be booking myself out.
19:27Right.
19:28Well, initially it'll be a trip to good hope, alright?
19:32And then we'll have to go from there like...
19:34That morning I refused because I've been that many times with it and got nowhere.
19:38Just to be told it's sciatica, it's this, it's that, it's the other, and sent home.
19:44Normally I refuse point blank to get in an ambulance. I will not get in it.
19:48Right, let's have a look at your arm for me. See if we can't give you some pain relief.
19:54You've got quite little veins haven't you?
19:58So we decided to give Susan some paracetamol in liquid form that we can administer directly into a vape.
20:05It'll work a lot better than giving it to you any other way.
20:09This is a lot faster acting than oral paracetamol.
20:13And if that hadn't worked, we could have escalated her pain relief to morphine.
20:19And if you just pop that arm under there for me.
20:23Straighten it out for me as straight as you can.
20:27There's a problem.
20:28Let's look at the back of your hand.
20:31When I first looked at Susan, she had quite thin, thready veins.
20:35That's a problem because, obviously, as you're trying to advance the tube into the vein,
20:40it's quite easy for it to not tolerate the tube and pop, if you like it,
20:44which causes the patient then, obviously, some discomfort.
20:46Just relax your hand for me.
20:48Nice and soft, all right?
20:51There's possible other risks associated with that.
20:53They get swelling.
20:55And it's not something that I'm proud when it happens.
20:59There you go. Stay nice and still for me.
21:03There we go. So we're in.
21:05Pop that one there for a second.
21:09Oh!
21:13Excellent. There we are.
21:14Not a moment of doubt, eh?
21:15Oh, the crew just arriving.
21:17Hello.
21:18Hello.
21:19Come on in, come on in.
21:21Oh!
21:23This young lady, Susan, three days ago, she felt her back go.
21:28It eased.
21:29But today, same again.
21:30She now feels like she can't straighten at all.
21:33Only concern is she's got numbness going down her legs.
21:36Do you want us to grab some entonox or anything as well?
21:38Yeah, if we have some entonox and you can grab your paracetamol.
21:41Yeah.
21:42That would be marvellous.
21:43Perfect.
21:45This is the first time this ever happened to you?
21:49You've never had a slick disc or anything before?
21:52A herniated disc or no surgeries on your back?
21:55I was diagnosed years ago with a crumbling to the bottom of the disc in the back.
22:00Crumbling.
22:01Yeah.
22:02Yeah.
22:0427 years ago, they diagnosed me with a crumbled split disc at the bottom of my spine.
22:13Then I was diagnosed later on when the pain was getting worse.
22:17It was sciatica.
22:18Then later on, a couple of years ago, they diagnosed me with crumbling of the spine.
22:24The pain is getting worse, but I've got nowhere near why.
22:30Are we still a ten out of ten season or is it easing at all?
22:34Let your hand relax, OK?
22:44After 15 minutes, the pain relief begins to work and Susan is finally able to move.
22:51Now, we'll help you whatever way you want us to.
22:55We won't be lifting you just in case it causes you any more pain.
22:59Do you understand that?
23:01Right.
23:02So, if you want to hold on to me to pull yourself up, that's fine.
23:06Just sit yourself down.
23:09That's it.
23:10Perfect.
23:11Right.
23:12Is there any way that you can sit yourself back?
23:14Shhh!
23:15Shhh!
23:17Oh!
23:18Oh!
23:19Oh!
23:20Are you able to lean back at all, sweetheart?
23:25I don't know.
23:26No?
23:27OK.
23:28Oh!
23:29Mike, the paramedic, assured me that they are going to get to the bottom of it and get me the help.
23:35Right.
23:36If we come out.
23:37And I think that's the point I actually got in the ambulance in the end.
23:42Right.
23:43A little bit of a push.
23:44Oh!
23:45Oh!
23:46Sorry.
23:47Is there your hand?
23:48Shuffle yourself in the middle.
23:49Oh!
23:50Oh!
23:51There we go.
23:52Oh!
23:53Oh!
23:54Oh!
23:55Oh!
23:56Oh!
23:57Oh!
23:58Oh!
23:59Oh!
24:00So you're more of like a sat position in the middle of the bed.
24:04The lady was in a lot of pain.
24:05She's got an ongoing lower back problem anyway, where she suffers from a crumbling disc.
24:10So, you know, she does need to be transported off to hospital and get that surgical assessment
24:15as to whether she's going to need further treatment.
24:17Hopefully, you know, it's all early enough that she'll make a full recovery.
24:20The doctors have said that there's nothing they can do for my spine.
24:32It's getting that bad that it will just get worse.
24:34When I heard that, I just wanted to give up now.
24:37But then I think back, my grandchildren, I can't give up.
24:41I've just got to carry on trying to manage it myself.
24:44So, I am coping the best I can.
25:00I don't think you could ever get bored doing this job.
25:04I always say it's like a tin of mucky soup.
25:07You never know what you're going to get till you get to the bottom of it.
25:14We've got an 81-year-old male that's on the floor, whether he's fallen or...
25:28I don't really know, but he's on the floor for some reason.
25:31And got a head injury, but we don't know anything else about him.
25:35But they want me just to go and assess and see what extra resources we need, if any.
25:40As a solo responder, I couldn't get him up off the floor, so I'm going to need somebody at some time.
25:46I'm trying to avoid these little patterns.
26:02Ooh!
26:03It's quite a big area that they're resurfacing.
26:06Let's just hope it doesn't take long to rectify it.
26:11Hello, my darling.
26:12Hello.
26:13He only came out at Russell School yesterday.
26:14Did he?
26:15Come on.
26:16Right.
26:17Hello, pussycat.
26:18Are we upstairs?
26:19No.
26:20Oh, he's here.
26:21Oh, dear.
26:22Halfway.
26:23Right.
26:24That's okay.
26:25My back's there.
26:26It's hurting.
26:27Your back's hurting.
26:28Yeah.
26:29How many stairs have you fallen down?
26:31Oh, yes.
26:32Right.
26:33So we've just come down a couple of stairs.
26:34Can you remember about everything that's happened?
26:37Oh, no.
26:38Oh, no.
26:39Oh, no.
26:40Oh, no.
26:41Oh, no.
26:42Oh, no.
26:43Oh, no.
26:44Oh, no.
26:45Oh, no.
26:46Oh, no.
26:47Oh, no.
26:48Oh, no.
26:49Oh, no.
26:50Oh, no.
26:51Oh, no.
26:52Can I tell you everything that's happened?
26:53Oh, yeah.
26:54Right.
26:55Have you got any pain in your neck at all?
26:57No.
26:58Right.
26:59Tell me whereabouts on your back that you're hurting.
27:01There?
27:02Oh.
27:03Just there, at the side.
27:05Is there nothing down the middle at all?
27:07No?
27:08Yeah, there.
27:09Bob had previously just come out of hospital, so was very weak.
27:13He'd fallen on the stairs and hit his head against a plant pot
27:16and, I believe, had banged his ribs on the stairs.
27:19So he was in quite a bit of pain.
27:21Have we got a cushion or anything for his head?
27:24And maybe a towel, because we don't want to get...
27:26A what?
27:27A towel to put over the cushion, because I don't want to get...
27:3652, thank you.
27:37I'm going to ask for a red back up.
27:38He's in a precarious position on the stairs.
27:41Over.
27:42For a solo responder, it's very difficult.
27:44You've got to try and balance your equipment on the stairs
27:47and try to assess the patient at the same time.
27:50So it is important that I get back up as quick as I can.
27:53I just need to move all these things away,
27:55so we don't hurt you even more than we need to.
27:59That's a nasty cut on your head.
28:02He's crushing on everything.
28:03Okay.
28:04Pat, no worries.
28:05Thank you, my love.
28:06Okay.
28:07Let's try and rest your head on that.
28:11Is that any better?
28:13Slightly.
28:14Slightly.
28:15When you went up the stairs, you were going up, not down.
28:18You've come backwards and fell on that side.
28:21Went on.
28:22You've fallen on that side.
28:23Yeah.
28:24Okay.
28:25But there's no pins and needles anywhere.
28:26Right.
28:27Can you move your feet a little bit?
28:29That's good.
28:30That's good.
28:31Let's just have a look at your finger.
28:33I just need to check your blood sugar.
28:36Okay.
28:40Sharp scratch.
28:41There you go.
28:46Here we are.
28:47Does it normally run high?
28:5310.2.
28:54How about that?
28:55Okay.
28:56Although Bob's blood sugar is normal,
28:58Kath notices something else that isn't as it should be.
29:01Bob.
29:02Pat?
29:03Yes?
29:04At the moment, Bob's got a bit of a temperature.
29:07Has he?
29:08Yes, yeah.
29:09So when he came out of hospital, did they give him a discharge letter?
29:13Yes.
29:14Have you got that handy?
29:15Yes.
29:16Could I have a look at it, please?
29:18Yes.
29:19Thank you.
29:21Okay.
29:22It's not a high temperature, but it is a slight one.
29:25So...
29:26Okay, my love.
29:27Do you want to come and sit down?
29:29No, we don't want two patients, do we?
29:31No.
29:32The cops are sitting here.
29:34Right.
29:35Kidney failure.
29:36Been in hospital.
29:37And he came out yesterday.
29:39He is very weak.
29:40And he's...
29:41Weak.
29:42Was that today or yesterday?
29:43Weak.
29:44Yeah.
29:45And he's fell down a couple of stairs.
29:46He's got quite a nasty head injury to the back of his head.
29:49There is...
29:50I can feel...
29:51I can't see at the moment, but I can feel quite a deep cut.
29:53So...
29:54We're just keeping him where he is until some help comes.
29:58Oh.
29:59Oh.
30:00Hi, okay.
30:01Hi.
30:02Hi, mate.
30:03Hi, love.
30:04Right.
30:05This is Bob.
30:06Kidney failure.
30:07He's come down a couple of stairs.
30:08He's got no neck pain.
30:10He's got no back pain.
30:11However, he's got pain on inspiration, ribs, all your barriers.
30:16We'd needed to move him to get him off the stairs.
30:19So we gave him pain relief initially before we moved him.
30:23We need to give him some morphine or some sort of pain relief.
30:26So we're going to give him some into a muscle in his arm.
30:29Once it's kicked in and he's got a little bit more pain relief,
30:32you should be able to sit him up.
30:34All right, my darling.
30:37Flora's going to come up to you now
30:39and we're just going to give you an injection.
30:44Well, no.
30:45We've had enough blood off, you know.
30:46I think you've given enough looking at the carpet.
30:48Eh?
30:51Some jobs you have to rush.
30:53Some jobs you need to take your time over.
30:55Obviously, Pat's very upset and anxious.
30:58So because there's three of us, just to make sure that she's OK,
31:02one of our other colleagues is just going to give her a bit of a check over.
31:07It's a bit like a buy one, get one free.
31:10Laura's going to come back down
31:12and the two of us are going to sit you up gently
31:15and put a big bandage on your head.
31:17OK.
31:18OK?
31:19I think my head's all right.
31:20Yeah.
31:22Oh, come on, try, try.
31:24Yeah, I'm not going to sit.
31:25You won't go anywhere.
31:26You're not going anywhere.
31:27Just try and sit up.
31:29Lovely?
31:30That's lovely.
31:31That's lovely.
31:32That's lovely.
31:34Oops, oops, oops.
31:35Trust me.
31:38Typical.
31:42Still no pain when I'm pressing down your neck.
31:46Going again.
31:47Ready?
31:48That's it.
31:49Well done.
31:50How about that?
31:51You taller standing up?
31:52Cool.
31:53The bed is right behind you.
31:54You need to trust us.
31:55OK?
31:56Down you go.
32:09Wow!
32:10That's better.
32:11Thank you.
32:12You're welcome.
32:13You made it.
32:14Well done.
32:15He's OK, my love.
32:16He's got a bump on the back of his head, quite a nasty one, that he needs to go and get it
32:22looked at.
32:23OK?
32:24So, he's quite...
32:25He's on the stretcher now.
32:26He's sound.
32:27OK?
32:28Very often with an emergency, you don't always have one patient.
32:33You call to the one person that's ill, but they've got loving family around them and
32:40they can get very, very anxious and make the cells ill themselves.
32:45Can you actually take me off this job, please, and send another job with a different job
32:51number to the same address as the patient's wife has been took poorly?
32:55So, while the crew are going to deal with the gentleman, I'm going to stay behind and deal
33:02with the wife.
33:03It will probably be a V&R, but we just need to double check and make sure that she's
33:07all right.
33:08Received.
33:09On this occasion, Bob's lovely wife had got herself into such a state, hyperventilating
33:15and getting very, very anxious.
33:17So, once the crew came to deal with Bob, I had to deal with his wife.
33:21OK, you take care.
33:23You're going to behave.
33:24I'm strapped down.
33:26You're strapped down.
33:27OK.
33:28That's good.
33:29I'm going to go back and make sure Pat's OK.
33:31Thank you.
33:32All right.
33:33Thanks, Laura.
33:34All right.
33:35OK.
33:36I'm feeling a bit better, thank you very much.
33:38I'm very grateful for all that they're doing for my husband and myself.
33:43Any problems, if you feel you need us through the night, please call.
33:49Thank you.
33:50All right.
33:51All right.
33:52Thank you very much.
33:53Take care and carry on looking so young.
33:56Crikey.
34:08You can deal with anxiety attacks in abundance sometimes.
34:16You can be called sort of any time of day to any location to somebody suffering anxiety
34:21attack.
34:22I think in everyday life, in modern day society, then stresses and strains of home life, work
34:29life, social life become sort of greater.
34:31So I'd say that anxiety is on the up, really.
34:35So we go to a 75-year-old lady who has breathing difficulties.
34:49I've not been given any further info.
34:51Just control settings.
34:52It was an amber face-to-face job.
34:53So no other details whatsoever at the moment.
35:07It's sort of like one of the most common calls we go out to all the time today, but yeah,
35:14particularly at night times.
35:15Patient symptoms seem to get worse at night.
35:17I met this lady before.
35:19I don't remember her being a regular caller for breathing difficulties.
35:23There's a little note on the computer to say, yeah, just to walk straight into the house.
35:28Knock, knock.
35:29Hello.
35:30Hello, sweet.
35:31What's your name?
35:32Mrs. Dorian, who's here?
35:47What's the trouble?
35:48Uh, uh-oh.
35:50I woke up with me all racing.
35:53Okay.
35:54I get a lot of panic and anxiety attacks and I don't know what this one about.
35:57Have you moved?
35:58Yeah.
35:59I thought I recognised your name when it came on the computer.
36:01How long have you been up here for?
36:04Four years.
36:05Oh, right.
36:06Some time then.
36:07Doreen is a familiar face.
36:09I've not seen her for some years.
36:10So just to recap, you've got, you suffer with anxiety and you have palpit...
36:14Very bad.
36:15Very bad.
36:16And you suffer with palpitations because of your anxiety?
36:18Yes.
36:19All right.
36:20But as soon as I stepped foot in her house and I saw her face, I knew who she was.
36:23And she was quite happy to see me, I think.
36:25So, just running past me, what's happened then?
36:27You've woken up with...
36:29Just describe the symptoms you've got.
36:31Well, my body's throbbing.
36:34Your body's throbbing, right.
36:35And, um...
36:37I can't breathe.
36:39Right.
36:40I don't suffer bad with panic and anxiety attack.
36:42All right.
36:43Knowing how you feel, does it feel like panic and anxiety?
36:46It could be, I don't.
36:47It could be.
36:48Or...
36:49Can I have a listen to your chest?
36:50Is that okay?
36:51Yes.
36:52Yeah?
36:53Okay.
36:54Take some deep, slow breaths for me.
36:57There, Ned.
36:59All right.
37:00Your chest's nice and clear.
37:02What I want to do now is do a heart tracing on you.
37:05Is that okay?
37:06No pleasure.
37:07Yeah.
37:08And have your symptoms remained the same, or have they got worse or got better?
37:12Now seeing you, I seem to...
37:14Seem to have eased off a bit.
37:15Have I got that sort of face, have I?
37:17Oh, we try our best, don't we?
37:18Right.
37:19You're a good team.
37:20Thank you.
37:21I've already been satisfied with your hospital, thank you.
37:24I want to be here today.
37:25That's lovely.
37:26Right, your ECG's, it's good, it's perfect.
37:36All right, it's not going fast, everything's where it should be, everything looks normal.
37:41So, do you think that the symptoms you have now are related to...
37:45Come on.
37:46Of course.
37:47All right.
37:48And when you suffer with your anxiety normally, what happens?
37:50Does it normally pass the return of cord?
37:53Sometimes I've got breathing exercises to do.
37:56Does that help?
37:57No.
37:58Yeah.
37:59You've tried those a little bit this morning?
38:00Yes.
38:01Has it eased it off a little bit?
38:02Looks like it, yes.
38:03Looks like it.
38:04All right.
38:05Would you say that you're feeling like you're starting to recover now?
38:08Yes.
38:09Yeah.
38:10Do you feel back to normal yet?
38:11Yes.
38:12I think sometimes when people call for help in the ambulance service, they don't need
38:17any particular clinical intervention.
38:20A couple of other little things I want to do.
38:22Is that all right?
38:23Thank you.
38:24All right.
38:25Thank you.
38:26They don't need needles.
38:27They don't need drugs.
38:28They don't even need assessment sometimes.
38:30It's going to be a little scratch, OK?
38:33I think just a kind word and passing the time of day sometimes can reassure people enough
38:40to make them feel better.
38:41Right.
38:42Everything I've checked, literally everything, is normal, OK?
38:45Your pulse rate's normal.
38:46Your ECG's normal.
38:47Your blood pressure's normal.
38:49Your oxygen saturation's normal.
38:51I don't think.
38:52All right.
38:53I don't think there'd be any reason to go to the hospital.
38:55I don't think...
38:56I don't suppose you'd want to go to the hospital, do you?
38:58No, not really.
38:59No, not really.
39:00No, not really.
39:01I'm happy with everything I've checked, if you're happy.
39:03God bless you.
39:04Do you feel at ease now?
39:06Yes, I do.
39:07Do you want a cup of tea, Doreen?
39:08I'd love one.
39:09I'd love one.
39:10Your love one.
39:11I'll sort it out.
39:13Do you take sugar?
39:14No, thank you.
39:16No, just milk, yeah?
39:18Yeah, but not too strong.
39:20Not too strong milk, no sugar.
39:22I'll sort that out.
39:24This is the first thing we got taught at training school, how to make a cup of tea.
39:31I checked Doreen over, and she's sort of calmed down somewhat.
39:34That quite happens with patients, having anxiety, just to see the uniform sometimes, I think,
39:38even before we've done anything, calms them down.
39:40I've just told Control that we're going to deal, and that we don't need a big ambulance
39:44to take to the hospital.
39:45This is proper ambulance tea.
39:49Middle of the night, jobby.
39:54The tea boy's here, Doreen.
39:57Thank you so much.
39:58All right.
39:59I've not made it too strong for you.
40:00Is that okay?
40:01Yes, thank you.
40:02Is that okay?
40:03That's beautiful, thank you.
40:04Can you put it on the table, please?
40:05Of course I can.
40:06Right.
40:07I'm going to go and get some paperwork from the car, and I'll come back and just jot
40:12a few bits and bobs down.
40:13Is that all right?
40:14Yes.
40:15I won't be a moment.
40:16All right.
40:17It means such a lot.
40:18Steve coming to visit me.
40:20Not only, you know, he's very pleasant, and he's got a nice personality, and he puts people's
40:33mind at ease.
40:34And at ease.
40:35Same day as my dad's.
40:36You're not twins, are you?
40:37How old's dad?
40:38Sixty.
40:39Oh, no.
40:40I'm older than he is.
40:41Doreen, we're going to leave you in peace now, all right?
40:42It's lovely to see you again.
40:43It's been a while, hasn't it?
40:44Yeah.
40:45Yeah.
40:46I'm glad you're okay.
40:47You feel better?
40:48Yes, thank you.
40:49Okay.
41:02Okay.
41:04Okay.
41:05You take care, Doreen.
41:08Okay, not to forgive his life.
41:10All right.
41:11Okay.
41:12Bye-bye.
41:13Bye-bye.
41:14We've assessed Doreen tonight, and it's not an acute problem.
41:18problem and the important thing is she's made a full recovery here all the
41:22observations are fine so and we made a cup of tea and she's happy to stay at
41:25home so we're clear here and we were going to move on to the next job
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