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00:00Today, Mike fights to save the life of a man found unconscious in Birmingham city centre.
00:07Hello mate, can you give your eyes for me?
00:09It's the paramedics.
00:11Cameron helps a young girl in excruciating pain.
00:14If you could score the pain out of ten, ten being like the worst pain you've ever experienced,
00:17how would you score at the moment?
00:19Two.
00:20And a patient gets up close and personal with Kath.
00:23Hey, I'm not a recliner.
00:25Don't make yourself too comfortable.
00:30It is a job where you deal with life and death on a very regular basis,
00:40and as long as I can walk away from a job saying,
00:43well, you know, we tried our best.
00:46That's all that you can do sometimes.
00:49When I joined the service, one of the things that we were told was that you're there to help people,
01:02and it shouldn't matter who those people are, whether it be through different beliefs, different practices,
01:09or even people who are drunk and drug addicts.
01:12They still need our help, and we still turn out to them.
01:15We're currently going down to the Digbeth area of the city for a reported unconscious male.
01:29The caller stated that they can smell alcohol.
01:31It could be that he is just intoxicated and fallen.
01:34He could have been assaulted.
01:35It's quite a vague description of what's happened and then the fact he's unconscious.
01:39There's somebody lying outside on the floor.
01:41I'll come out to him.
01:42Yep.
01:43And his face is all bloody.
01:45And so then...
01:47I recognise him.
01:49Yeah?
01:50Yeah.
01:51I think I've been out to him before.
01:53When I arrived on scene and walked up to the man,
01:55I recognised him as a patient I'd previously dealt with within the city centre.
02:00He was led on the floor.
02:02He appeared unconscious.
02:04Hello, mate.
02:05Can you open your eyes for me?
02:06It's the paramedics.
02:08He tried pain stimulus by pinching his shoulder.
02:11There was no response.
02:13I was just inside working and then a customer's come in and said,
02:16can you call an ambulance for a chap outside?
02:18So I'll come out and then he's lying on the floor.
02:20He's bleeding, his nose, he's got blood over his clothes.
02:24Doesn't look good.
02:25The man's blood oxygen levels are dangerously low,
02:28which means he's not getting enough air into his lungs.
02:31Your airway is your basic, basic lifeline, if you like.
02:38If you do not have an airway, you will eventually die.
02:42There is no two ways about that.
02:44We've got an ETN crew for me, please.
02:46Oh, mate, can you hear me? Keep your eyes.
02:48It's the paramedics.
02:50He's currently not responding at all.
02:52He's just trying to work out is that because of his head injury.
02:55The problem I've got on my own,
02:56I don't want to roll him over onto his back,
02:58that's going to then cause an airway problem on my own sometimes.
03:01It's just not having enough hands.
03:02But luckily the crew's just arriving,
03:04so we'll be able to do a bit more now and see arriving.
03:07You all right, mate?
03:08You all right, mate?
03:09I've been to this gent before I recognise him.
03:11I don't know his name or anything.
03:12Found outside on the floor as he is now.
03:14Initially, quite low sats.
03:16He's got a head injury.
03:17Don't know whether he's been sort of punched or something,
03:19or whether it's just from hitting the floor.
03:21OK.
03:22A fair bit of blood.
03:23Quite low sats initially.
03:25I think we're going to have to get him up and get him on the bed
03:27and then have a look.
03:28Do you want a scoop or not?
03:29Yeah, I think we'll have to because we don't know what's happened.
03:31Yeah.
03:32The patient needed to go to hospital.
03:35Obviously, because he remained unresponsive.
03:38He couldn't maintain his own airway.
03:40If he can't maintain his own airway,
03:42he's going to need interventions to find the root cause
03:47of his unresponsiveness.
03:49It could be internal injuries, you know, brain problem,
03:54and it's important that that patient gets the best level of care
03:58that they can at the earliest opportunity.
04:00The man requires urgent treatment in hospital,
04:03so the paramedics need to act fast.
04:05That's it.
04:06Right, ready?
04:07But moving him is not going to be easy.
04:09On three.
04:10One, two, three.
04:12How are we worth sliding out?
04:16What, bring him that way and then put the board under him?
04:19Yeah.
04:20The problem is he's...
04:22He's proper out there, isn't he?
04:24Yeah.
04:25The male was quite a large, heavy-set gent
04:27without working alongside the two crew members that turned up.
04:31There's no way we would have been able to get that patient
04:34out without all working together.
04:36And that's what we trained for.
04:38I've got an idea.
04:39If we take the scoop out, a 180 roll on through the backs.
04:43Yeah.
04:44Yeah.
04:45Yeah, we'll try that one.
04:47James?
04:48See if we can pull his arm out from underneath him, James.
04:50Can we get his arm?
04:52You want it?
04:53Can you get out front of it?
04:55No, he's laying right on it.
04:57Like this, it is.
05:00In critical situations like this,
05:02the man needs all the help he can get,
05:04particularly with his breathing.
05:06Maintaining someone's airway is potentially
05:09a very, very simple process
05:11that takes you back to basic first aid.
05:14and it is literally just to tilt the chin back
05:16and open the airway.
05:19There we go.
05:22He's proper out of it.
05:24This pulls your tongue forward in your mouth
05:27and stops you, in essence, swallowing your tongue.
05:31Right.
05:33We're ready.
05:34Ready, steady, roll.
05:37You up to there, mate?
05:38Yep.
05:39I used to do it.
05:40So, on lift.
05:42Ready, close.
05:43Lift.
05:52Later, the man's condition deteriorates
05:55and Mike makes an urgent call to A&E.
05:58He's either fallen or been assaulted.
06:00We're not sure which.
06:01He was found on the floor, unconscious.
06:11I do get used to seeing people
06:13in lots of differing types of pain.
06:15You get that sense of,
06:17I know when you're in that pain.
06:19I know I can almost feel your pain.
06:22Because it's clear to see on your face
06:24and we have to deal with it in the correct way.
06:26And I will argue till the cows come over,
06:28this is one of the most rewarding jobs in the world.
06:29It's the old cliche that, yeah, I'm here to help people.
06:30And I like, you know, delivering that bit of extra,
06:33extra compassion and I care for people.
06:35But it's also a bit of a personal challenge to work under pressure,
06:38you know, and use such a kind of unique set of skills
06:41to deliver, in some cases, you know, that life-saving techniques.
06:58Hello.
07:15She's in the loft.
07:17She's what? In the loft?
07:19What are we doing in the loft?
07:21I hope I don't have to carry her now.
07:25Now then, is it Chelsea?
07:27Yeah?
07:28Now then, how can I help you today?
07:32Talk to me, let me know what the problem is,
07:34and I can help you.
07:35I've got tines all in her stomach
07:36and they're shooting down her legs.
07:38She was heavy bleeding yesterday with periods
07:40it was going straight through her, but...
07:42Is it that time of the month?
07:43Yes, but she's got suffers with endometriosis.
07:46Ah!
07:47Endometriosis is a disease where tissue
07:49that normally grows inside the womb
07:50is growing outside the womb
07:52and can cause ladies significant problems
07:54and significant amounts of pain.
07:56Pop your finger in there for me, Chelsea.
07:58So you've been sick this morning as well?
08:00Yeah.
08:03And where exactly is the pain at the moment?
08:07And if you could score the pain out of ten,
08:08ten being like the worst pain I've ever experienced,
08:10how would you score at the moment?
08:12Ten.
08:13Is it? Ten out of ten.
08:14All right.
08:15Well, we'll get that pain sorted for you shortly, OK?
08:17It's hard to see anybody in an amount of pain,
08:19but when they've got clear distress
08:21and you can see that look in their eyes,
08:22that look of help me,
08:23you act a little bit quicker
08:25and you always try and go the extra mile
08:27for those people that really, really want you to help them.
08:30So have you ever been to hospital before
08:32with your endometriosis pain?
08:33Yeah.
08:34Yeah.
08:35And when was the last time?
08:36Was it recent?
08:37It's been in and out the last three years, hasn't it?
08:40Have you really?
08:41Yeah.
08:42OK, and are you seeing your gynae specialist about it yet?
08:45And what have they said?
08:46I've seen a blood specialist.
08:48Some people don't see some of my blood.
08:50Right.
08:59I have endometriosis and I've had it since I was 13 years old.
09:03It's something that's always there.
09:05You know when it's coming.
09:07You don't know when it's going to go
09:10or when the pain's going to stop.
09:12When womb tissue grows outside the womb,
09:15for example in the bowel or bladder,
09:17it bleeds with menstruation.
09:19This causes pain and inflammation.
09:22Your belly bloats and you're sick.
09:25You're passing out.
09:26It stops you from doing everyday things,
09:29especially working.
09:31You can't make it to work.
09:33I can't drive when my stomach's bad.
09:35Even moving or getting out of bed,
09:37you just can't do it.
09:39Now then, with one finger,
09:41tell me where it hurts the most.
09:43There.
09:44OK.
09:45I'm just going to have a little press of your tummy now.
09:47OK.
09:48Any problems going to the toilet at all?
09:49No.
09:50No.
09:51OK.
09:52Just a light press now.
09:53Just relax.
09:54OK.
09:55Is that sore?
09:56Yeah.
09:57Sore here?
09:58And when I press here, where does it hurt?
09:59In the middle.
10:00In the middle.
10:01Does it hurt when I let go?
10:02Or worse when I press?
10:04When I let go.
10:05I just need to lift this leg up.
10:07Can you just relax it a little minute?
10:08All right.
10:09I'll lift it up.
10:10OK.
10:11Ready?
10:12It's a nice floppy leg.
10:13Just relax your leg.
10:14That's better.
10:15Just relax your knee.
10:16Completely relax.
10:17Does that make the pain worse or better?
10:20Or just the same?
10:21Just the same?
10:22As a paramedic, it's quite important that we not only focus on the problem that we're presented with,
10:27but we try and rule out other problems that may arise.
10:30The reason I was moving her leg around was it was one of the tests for appendicitis.
10:34And once I could rule that out as that test was negative, it was clear that the problem,
10:40the chronic problem that she has was, you know, causing that acute flare-up of her pain
10:44and not something more sinister.
10:45So we can get you some pain really sorted.
10:47Have you taken any paracetamol or anything this morning?
10:49I don't think I could just throw it all back up.
10:51You threw it all back up.
10:52And when you take paracetamol, how many do you take?
10:54You take two.
10:55And when you go to the hospital, what pain relief do they normally give you?
10:58Or a more.
10:59Or a more.
11:00OK.
11:01And does that normally help you?
11:02Yeah, I've actually got some.
11:03Do you?
11:04Would you like to take some of your own?
11:05That might help you, yeah?
11:07How much do you normally have?
11:09Two.
11:10Just one spoon.
11:11Yeah, all right.
11:12Do you want to sit yourself up a little minute?
11:14I'll get some of this for you.
11:15All right.
11:16Do you want this then?
11:17Here it comes.
11:18Ready?
11:19Yep.
11:20OK.
11:21All right.
11:22Do you want a little drink of water to flush it down?
11:24Yeah.
11:25One, one, three.
11:26Hi, sir.
11:27Yeah, thanks.
11:28And hand my back up, please.
11:29In the current climate, ANEs are extremely busy.
11:48They have long waits.
11:50If we can avoid anybody going into hospital that doesn't need to go into hospital, it's a bonus for everybody.
11:57We're going to a lady who's having problems trying to walk this morning.
12:12She's very trembling.
12:13She has got a history of having strokes, so we'll just go and do a full assessment and see what other things that we may need.
12:26Right.
12:27I think it's here.
12:28Hello.
12:29The door's open.
12:30Good morning.
12:31What's your name?
12:32Joyce.
12:33Joyce.
12:34I'm Catherine.
12:35What's the problem today?
12:36Well, when I got out of bed this morning, I haven't been able to walk very well for some time, but suddenly I got out of bed and I found that my legs were even wobbly.
12:42than usual.
12:43I'd intended to go shopping.
12:44No way could I go out.
12:45Right.
12:46I do drive.
12:47Right.
12:48So you have managed to walk from the bed to here.
12:49I could walk, but while I have been having problems walking.
12:52Yes.
12:53It was different.
12:54It was different.
12:55It was different.
12:56It was different.
12:57It was different.
12:58It was different.
12:59It was different.
13:00I'm Catherine.
13:01What's the problem today?
13:02I'm Catherine.
13:03What's the problem today?
13:04Well, when I got out of bed this morning, I haven't been able to walk very well for some time, but suddenly I got out of bed and I found that my legs were even wobblier than usual.
13:11It was different this morning.
13:13Any pain?
13:14No.
13:15I must tell you, I was diagnosed last week with spinal stenosis.
13:20Right.
13:21Okay.
13:22Spinal stenosis is a narrowing of the canal which holds the spinal cord.
13:27It can cause weakness, pain or numbness in the legs and arms.
13:31You say you were wobbly.
13:32There was no pins and needles or anything.
13:34No.
13:35Joyce said that she suffers with spinal stenosis.
13:37It's something she's had for a long, long time, which does cause her mobility problems at times.
13:43But because of her past history, she has TIAs in the past, I wanted again to do a full fast test on her to make sure that there was nothing neurological going on that I could detect.
13:56Can you lift that leg?
13:57Yes.
13:58Yeah.
13:59And lift it out?
14:00Yes.
14:01Oh.
14:02Hear your knee crack then.
14:03Right.
14:04Back again.
14:05That's it.
14:06And this one.
14:07That's lovely.
14:08And back again.
14:09Oh, my hands.
14:10Give me a good squeeze.
14:11Good.
14:12Push me away.
14:13Now pull me towards you.
14:15That's good, isn't it?
14:16Yeah.
14:17Yeah.
14:18You've got some good strengths going on there, haven't you?
14:20Thank you.
14:21Right.
14:22Let's do a few little tests.
14:30I've got a pacemaker, by the way.
14:32Okay.
14:33That's fine.
14:34Blood pressure, 150 over 71.
14:36Do you take any blood pressure medication?
14:38I've got my beer.
14:39Yeah.
14:40So, you've called us today rather than the doctor, because this has really concerned
14:45you.
14:46Is that right?
14:47Well, I was reading the little pumpers about stroke, and I thought, as I've had 3T, I'm
14:53quite better.
14:54Yeah.
14:55But as I say, there's no weakness anywhere.
14:57No.
14:58No pins and needles.
14:59It was just that you felt wobbly.
15:00Yeah.
15:01Much more wobbly than usual.
15:02Yeah.
15:03And I'm presuming you're talking like you normally do.
15:05Yes.
15:06Okay.
15:07Sounds fine.
15:08Don't worry.
15:09You're precious.
15:10Yeah.
15:11It didn't look to me like she'd had a mini stroke.
15:16All her observations were fine.
15:18I came to the conclusion that as she'd got full strength in all her body, she could coordinate
15:23well.
15:24Probably she was just sitting there very lonely and got herself very anxious.
15:28Right.
15:29Your pacemaker's working well?
15:31Okay.
15:32I'm going to pop these off you, and I just want to see, with my help, how you can stand
15:38and how you're feeling.
15:39All right.
15:40There's your stick.
15:41Don't do anything you don't think you can, but I need to make sure.
15:45I'm open.
15:46I feel all over the place.
15:50All right.
15:51Okay.
15:52Yeah.
15:53Right.
15:54So you're walking okay, but you're still feeling wobbly.
15:56Oh, better than.
15:57Let's come back here.
15:58See, I have felt wobbly for some time, but it's worse.
16:00Yes.
16:01It's worse.
16:02A little bit worse today.
16:03Have a sit down.
16:04Right.
16:05Okay.
16:06Am I just panicking, do you think?
16:07Well, all your observations that I've done are all okay, and you are walking okay.
16:13You've got no pain anywhere, but you're still feeling a little bit wobbly on your legs.
16:18Very wobbly.
16:19So we can do one of a few things, really.
16:21If you feel a bit scared to be left here, we can pop you up the A&E.
16:25They can have a look at you there, or we can get back in touch with the doctor, see what
16:30he has to say.
16:31So we can get a visit arranged for them to come out and see you a little bit later.
16:36That might be a bit better.
16:37Would that be better for you?
16:38I think that's a good idea.
16:39Right.
16:40Okay.
16:41What I want to do, Joyce, is take your blood pressure standing up.
16:43Right.
16:44To see if it drops when you stand.
16:45So just have a little...
16:46Right.
16:47Let's have a little feel.
16:48You're all right just standing.
16:50It's just when you're walking, you're just feeling a little bit jellified.
16:54Worse, yes.
16:55Yeah.
16:56That's the word, jellified.
16:57That's a good word.
16:58Jellified.
16:59Okay.
17:00You're looking well, anyway.
17:01That's what they all say.
17:02Yeah.
17:03I've washed my face, but that's all I can deep wash my face.
17:07You haven't had a wash?
17:08No.
17:09Do you, me?
17:10Dirty girl.
17:11Dirty girl.
17:12That's lovely.
17:13Have a sit down.
17:14All her observations are absolutely fine, and her blood pressure standing is fine as well,
17:19and she seems in good spirits herself.
17:21So, on this occasion, we're going to go back to the doctor.
17:24We don't want to be taking her up to A&E unnecessary, and I don't think you're keen on that idea,
17:29anyway, at the moment.
17:30You know, so as long as Joyce is safe and happy, we're going to go through to the doctors
17:34and see if we can get a home visit arranged.
17:37There you go.
17:38We don't always have to send people to hospital, and in this case, we've rung the GP up
17:44who is happy to come out and visit round about lunchtime to come and see Joyce.
17:48She's a lovely lady.
17:50She's in good spirits, and she's very, very switched on, and now she's living a good,
17:55healthy life.
17:56No carers.
17:57Does it all herself.
17:58And obviously, if she does need a little bit of help like she did this morning, we're
18:02here, and we've left her quite happy.
18:05In Birmingham, Mike is treating a man who was found unconscious outside a shop and could
18:10have a potentially life-threatening head injury.
18:12It's very sad for someone to be found in the street in that situation.
18:17Alone and almost appeared like, you know, people passing by, didn't seem bothered, you know.
18:24I don't think anybody chooses to be homeless.
18:27I know I certainly wouldn't.
18:34A big bump on the front of his head.
18:36So we're going to just try and clear up some of the blood.
18:39The male had a cut to his face, which we believe to be from where he's ended up on the floor.
18:45It did look quite bad initially.
18:46There was some blood coming from it.
18:48Plus the fact that the patient remained as unresponsive as he did, we would expect to
18:52start seeing some change, but there was absolutely nothing at all.
18:56Well, that looks quite clear, actually, mate.
19:00Mmm.
19:01Yeah.
19:02The team are particularly worried about the man's breathing.
19:06He couldn't maintain his own airway.
19:09If he can't maintain his own airway, he's going to need interventions to maintain his airway
19:17and breathing until the point that they can find out what's causing the problem.
19:22The priority was to sort out his airway, which we've now done with the use of what we call an OP airway,
19:29which basically pulls the tongue forward and stops it falling back.
19:33That we've done successfully.
19:35And as you might be able to hear now, we've not got those sort of snoring respirations.
19:39We're just trying to get a full set of OBS, hopefully trying to get some IV access.
19:44And then the plan will be to speak to our trauma team, which is based on our control room, our trauma desk,
19:50and then take the gentleman to where they think is most appropriate.
19:55Ah.
19:565154.
19:58Yeah, he's an approximately 60-year-old male unconscious.
20:02We believe he's either fallen or been assaulted.
20:05We're not sure which.
20:06He was found on the floor unconscious.
20:08No response even to a quite vigorous pain stimuli so far.
20:13He's got facial injury.
20:15BP is 145.85.
20:18Resps of 30, 3-0.
20:21Sat to 100% now on 100% O2, but he was down in the 40s on my arrival.
20:28How are we looking now with pupils?
20:30Unreactive and freeze.
20:32Unreactive completely.
20:33You shone a torch in?
20:34Yeah.
20:37QE.
20:38Cool.
20:39Ten minutes.
20:40Yeah.
20:41Yeah, all received.
20:42No problem.
20:43They'll be seen imminently.
20:44Unreactive pupils are not a good sign.
20:47They could indicate a serious brain injury.
20:50He's remained unconscious and obviously he's got quite a nasty cut across his nose
20:55and a bit of swelling to the front of his head.
20:57Potentially it could be a very serious head injury.
20:59Let's say that that's down to the scans and the doctors to make that decision.
21:20You push to your limit in work in this area, I think.
21:24The volume of cases, or the volume of calls that we get on a daily basis is quite high.
21:30You know, and we're all under a lot of pressure to deliver.
21:35But we haven't failed yet and we work hard.
21:38In Birmingham, Cameron is treating 18-year-old Chelsea who suffers from endometriosis,
21:44a disease where wound tissue grows outside the wound.
21:47You need to keep it straight.
21:50Don't worry.
21:52OK, just stay really still.
21:54All right?
21:55OK, a little scratch.
21:56Just wiggle your fingers a little tiny bit.
21:58Keep going.
22:02There you go, it's all sorted.
22:04So what we're doing at the moment is we've just popped a little plastic tube or a cannula into Chelsea's hand
22:10just in case we need to give her any further pain relief.
22:12Obviously she's taken her own pain relief, which is great.
22:15But, you know, she says that the pain gets worse on movement.
22:18So if we need to give him further medication, i.e. any paracetamol through the vein or anything like that,
22:23then we can do that. It's much more simple now.
22:26OK.
22:27Be comfortable there for a second?
22:29That's it. Negotiate the steps.
22:32All right.
22:33Hello.
22:34This is Chelsea.
22:35Chelsea's 18 years old and unfortunately, Chelsea suffers with endometriosis.
22:39She unfortunately this morning, about 10 o'clock, experienced a sudden onset of a very intense super pubic abdomen pain.
22:46She is on her period at the moment, but she's experiencing a lot more heavy bleeding than normal.
22:51I think we might be better whilst moving with just pure end knocks.
22:54She said that works quite well.
22:55And then we were kind of reassessing to see what we want to do when the truck if that's right with you.
23:00The only way she can safely come down is literally by walking.
23:03There's no way that we could extricate someone through here.
23:06It's too dangerous to use the carry chair or any extrication equipment.
23:10Obviously, if the patient deteriorates or was unconscious, then it would be a different scenario.
23:15But she's going to make her way very slowly down the stairs.
23:19Oh, we need your bump.
23:22You all right, mate?
23:23What was your name again?
23:25Chelsea.
23:26Chelsea.
23:27Now, you've been having the end to knocks and you've had your own armour.
23:30If you had to score that out of 10, 10 being the worst, one being none, where would you put that?
23:35It's about a fault if we can.
23:38How much have we got?
23:41Is it easier with that pain relief?
23:43Yeah?
23:44You're going to have some morphine now.
23:45OK.
23:46I don't remember much.
23:47I don't even remember getting to the hospital or anything.
23:49I know they put the morphine in my hand when I was in the ambulance.
23:53And that was it.
23:54Then I was gone.
23:55I was out of it.
23:56There is currently no cure for endometriosis.
23:59But there are treatments available, including surgery, to remove the affected tissue.
24:03They just said that there lies a bit away.
24:06So that was keyhole surgery.
24:07And after I had that done, everything was a lot better for about a few weeks.
24:12I went back to work for a few months and ended up in hospital again with the same pain.
24:17And they told me that it all grew back.
24:19I've tried everything now and there's nothing else that I can try.
24:22So I know that it's something I'll have forever and it won't get cured.
24:26It's just something I have to learn to deal with.
24:29Luckily, Chelsea has a lot of support from her family and her boyfriend, Ben.
24:34It's horrible knowing I can't really do anything about it.
24:38It's not any way I can out going to hospital appointments and that.
24:41But I look at her and I see her and I can't do anything about it.
24:44So it's upsetting to that at least.
24:46OK, Chas.
24:47We'll look after you all right.
24:48All the best.
24:49No problem.
24:50See you later.
24:51I've been to see many ladies who unfortunately suffer with this medical problem.
24:56Again, every single one that I've seen, the common factor is that they are in excruciating pain.
25:01And the only thing that I can do, you know, is provide that really good level of pain relief
25:04to try and get that under control.
25:06I hope she'll make a good recovery.
25:07Hopefully she'll be assessed.
25:08And I know she's awaiting some scan results.
25:10So fingers crossed and wish her all the best.
25:21Before I joined the Almond Service, I was at school.
25:30I did my GCSEs, my A-levels, and then I joined the Almond Service straight from there.
25:34So all I've known is the Almond Service.
25:44Probably since the age of six, I've always wanted to be a paramedic.
25:47I'm a big lad, but a caring side of me.
25:49I've always wanted to help people, which is the best way, really.
25:52When you're on the scene and helping someone that really needs help, it's the ultimate job, really.
25:565152.
26:16We are going through a 57-year-old gentleman.
26:18Saying he's got severe abdominal and flank pain.
26:21The daughter tells us he's got...
26:23There's a kidney dialysis patient with a defibrillator.
26:25It sounds like he's got a few issues going on with him, bless him.
26:33Hello.
26:34Hello, fella.
26:35What have we been doing?
26:36Right.
26:37We started a couple of hours ago.
26:38Right.
26:39He had a lot of pain in his groin.
26:41Yep.
26:42Oh!
26:43And it's moved.
26:44It's around the side and this side of his back now.
26:46Okey-dokey.
26:47He's a dialysis patient three times a week.
26:49Right.
26:50He's like, the pain is up there.
26:51OK, Phil.
26:52I need gasoline.
26:54OK, is that...
26:55Is it something you've had before?
26:56No, no, no.
26:57He's had a lot of attacks before.
26:58Right.
27:00He's never had anything like this.
27:01I need gasoline.
27:02The patient, Stephen, is on dialysis.
27:04A procedure to remove waste products from the blood
27:07when the kidneys, which usually do this job, aren't working properly.
27:11When we actually go into the property, he's got his own room
27:13that was actually set out for dialysis.
27:15He had his own dialysis machines.
27:17So, kind of, when you go into these places,
27:19you think, you know what you're on about.
27:21If he's saying he's in pain, and he's in pain,
27:23he instantly called out for gas in here,
27:26which is an enteroxy pain-reliefing gas.
27:28And when you know someone who's quite clued up with his health
27:31asking for that, you're getting me.
27:33All right, then.
27:37This pain, I don't know where this pain's come from.
27:39There you go, fella.
27:41So, this came on a couple of hours ago.
27:43Did it just suddenly hit you?
27:44Did it just suddenly come on in the groin?
27:46It's pain down in this groin.
27:47OK.
27:48And then it just seemed to get worse.
27:49But it moved from the groin round, well, the right side,
27:52to the left side, here, and all round that side there.
27:55It's looking up into kidneys.
27:56You haven't had kidney stones in the past, or...?
27:59No.
28:00No.
28:01Go ahead.
28:02Yeah, thanks, mate.
28:03Just have an amber back-up, please, mate.
28:05Amber back-up or receive.
28:08In the grand scheme of it, it sounds kind of kidney stone-related.
28:11No, I thought so.
28:12Especially the way you describe where it's gone.
28:14It's started down, it's gone right the way round,
28:16and it's pretty much the exact track that it takes, if you know what I mean.
28:20We thought that.
28:21Yeah.
28:22I initially thought it was kidney stone due to the location of the pain.
28:25Within the kidney area, there's not really much, no other organs really there.
28:28So when you see someone in that distress, complain of the pain in that area,
28:31it's kind of the first line that you go towards, and then try and disprove anything else really.
28:35It'll pop you up to Russell's hall and get you ticked out.
28:37All right.
28:38Hopefully he'll get you a scan or an x-ray done just to see.
28:41In terms of medication, what does he take?
28:44He changes quite often, so you have to remember one.
28:48Stephen, is that pain gone now?
28:49It's gone but it's still there.
28:50It's still there.
28:51It's gone but it's still there?
28:52Yeah, it's still there.
28:53From experience and talking to people, they are the most painful things.
29:06Some people have described it worse than labour.
29:08They are very painful, and nine times out of ten when you go to these patients,
29:12you can tell they're sweaty, they're pale, and they're just bent over,
29:15begging you for pain relief.
29:17I'll tell you what they'll do though.
29:18Slow down a bit.
29:19Just slow down taking that.
29:20Once before, could you ever feel the benefits of that if you keep taking it?
29:23He wanted to get it in his system as quick as he can, bless him.
29:26The problem you have, it contains a high level of oxygen.
29:28If you breathe it in too quick, it overwhelms the body with oxygen,
29:32and it can cause you to hyperventilate and become ill in other ways.
29:38Just try something a bit different.
29:39Instead of every breath, take every other breath with it.
29:42All right?
29:43All right.
29:44What we don't want you to do is feel too dizzy that you have to stop taking it,
29:47and then you don't get the benefit of it.
29:48Okay.
29:49Kidney stones form when crystals in the urine stick together to create hard rock-like lumps.
29:55There are treatments that can be used to basically obliterate them, so they can pass them naturally in your urine.
30:01So, yeah, that's, again, it's a hospital decision, a surgical decision.
30:04But when we deal with these cases of kidney stones on scene, it's literally solely about pain relief and management.
30:10Just all the basic tests, make sure everything's all right.
30:12We'll just wait for the crew to come, and we'll pop you up the road.
30:15If that's all right with you, yeah, we'll get you sorted.
30:18Can I have your finger, my friend?
30:21I don't know, of course.
30:22It's a sharp scratch, mate.
30:23How are you doing?
30:24Hiya.
30:25Hiya.
30:26Good day, good day.
30:27This is it, Stephen.
30:28It sounds like about 2 o'clock today, Stephen, he's had a sudden onset severe pain in his groin, penis area.
30:39That's kind of an ease of its own accord, really, but now, about 6 o'clock, he's kind of tracked right on the way around to his left kidney.
30:44Obviously, a diagnosed patient, got a sense of kidney fairly with it all.
30:50Instant event of diabetic, deep implant.
30:53As soon as I've come in, he says, I've got the gas in here, so we've put him on it, and it's kind of settled him down.
30:57He's not taken the pain away, but he's quite comfortable-ish on it, and took the edge off him.
31:02The pain now is really sort of around the back more.
31:06With this, it's around the back, left kidney, right, down there.
31:13Now, now.
31:14OK.
31:15Stephen, we're starting to look to move you, I think, now.
31:17All right, Steve.
31:18Nice and steady.
31:19We're able just to shuffle onto you, mate.
31:21I know.
31:22You'll be right up there.
31:23It's all that I said when you heard your drums.
31:26Can I put it by me?
31:27That's it.
31:28All you've got is top, mate.
31:29Just bring yourself around.
31:30I know.
31:31We've got you.
31:32You're all right.
31:33There we go.
31:34There you go, that one first.
31:36All right, Steve.
31:37Nice and steady.
31:38Can we take that off you?
31:39You don't want to let that go for love no money, do you?
31:40No.
31:41Ready?
31:42You got it?
31:43There we go.
31:44Oop-a-day.
31:45Nicely done.
31:46Well done, mate.
31:47You don't want to let that go for your legs.
31:48Well done, fella.
31:49Stephen will be taken to Russell's Hall Hospital in Dudley, where doctors will carry out a scan of his kidneys.
32:11We're getting some IV paracetamol.
32:13We're going to take it to hospital for further assessment and some treatment from then and after.
32:19Stephen's kidney stones passed naturally the following day.
32:24Unfortunately, four months later, he developed an infection and was admitted to hospital again.
32:30He died four days later with his family around him.
32:34It was called an advanced paramedic course where we could do wound closures basically to try and keep people at home and it has worked.
33:01We're used in different ways.
33:03If it's a real serious job, they will respond to us as well as an ambulance.
33:08And we are there first and assess the situation.
33:12With a job with less priority, we tend to go there first as well.
33:18And control will tend to wait on our say-so if we need any backup.
33:23We're going to a gentleman who's had a fit within the last 12 hours and he is diabetic, so he's bumped his head while he had a fit.
33:42That's as much info as what we've got at the moment.
33:44Where am I going?
33:52Down here.
33:53Right.
33:54What's happened then?
33:55I believe he's had a seizure.
33:57I can't take sure but I didn't see it happen.
33:59And he's cut his head along here and there's blood there.
34:03Yeah.
34:04He's had a seizure, fallen, cracked his head.
34:06Does he have many seizures?
34:07No, they're very well controlled.
34:09Once a month later, you can even lessen up.
34:13Hello.
34:14Yeah.
34:15How are you doing?
34:16Good.
34:17Let's have a look at this.
34:20What's your name?
34:21Norman.
34:30Was the fit witnessed by anybody?
34:32No?
34:33Did you hear it?
34:34I heard the clatter and the fall.
34:36Right.
34:37Can you remember falling over?
34:39No.
34:40You can't.
34:41OK.
34:4252, thank you.
34:43I'm going to need a crew.
34:44I'm going to ask for an Amber response.
34:46This gentleman's on the floor, unable to get up over.
34:4915, no problem.
34:51Melvin and his friend, Eric, share a flat and are looked after by support worker Sam.
34:56I was cooking the tea for Mel and I was in the kitchen and I heard him have a fall.
35:01I went to see him and he was suffering from a seizure.
35:04He's had seizures before that he hadn't really bumped his head or had cuts on his head.
35:08So when I saw he had a cut on his head, I had to phone the ambulance.
35:11You've got no pain anywhere?
35:12No.
35:13No?
35:14No pain around here?
35:16Anything down here?
35:18No.
35:19No?
35:20No.
35:21Well that's only a little scratch on your head, we can deal with that.
35:23He had got a superficial wound to the top of his head.
35:27It was only a small cut, but as an advanced paramedic that is something that I could deal with.
35:32But I decided to wait until the ambulance crew got there because I wanted to do his basic observations first of all.
35:39Right, give me this hand, bend your elbow that way, that's it, sharp scratch.
35:45Is he on insulin or tablets?
35:47No.
35:48Just diet controlled?
35:50Yes.
35:51Right.
35:52Although Melvin is epileptic, having fits, he's diabetic.
35:57With diabetes you have to be very careful with your blood sugars.
36:00If they drop too low, you can actually go in a coma.
36:04His blood sugar's fine.
36:06OK.
36:07Melvin's blood sugar at this present time was absolutely fine.
36:12So it appears that it was the epilepsy that had caused him to have a fit and have his head injury.
36:19We're just going to have to wait for an ambulance crew to come now.
36:22OK?
36:23They'll help you get up off the floor.
36:25In the meantime, I'm going to sit by you so I can be a cushion.
36:29All right?
36:30Yeah.
36:31I'm leaning on you.
36:33Yeah.
36:34I'm leaning on me, yeah?
36:35Yeah, I'm leaning on you.
36:36Hey!
36:37Hey, I'm not a recliner!
36:38Don't make yourself too comfortable!
36:41I'm looking for one in here!
36:42I'm looking for one in here!
36:43Bless him!
36:4552, thank you.
36:46Do we have an ETA of the crew, Annie?
36:48The patient's using me as a recliner at the moment.
36:52Yeah, um, I have a crew, I say, five minutes away now.
36:56We're safe.
36:57Yeah, that's lovely, thank you.
36:59They're only five minutes away, Mel.
37:01Yeah, I'm not.
37:02Oh, my.
37:03We've got Melvin.
37:04How are you, Melvin?
37:05No.
37:06He's had a fit today.
37:07Sam, who's the carer, was getting the dinner ready, and he heard a bump.
37:12And when he came in, he found Melvin on the floor, still fitting.
37:16No sign of being post-ictal at all.
37:19He's come round really well.
37:20We have just got just a tiny little graze to the head, but I can deal with that in a minute.
37:25He says he's got no pain anywhere, and his numbers are fine.
37:29But he just needs that bit of a, you know, he's quite a big lad, so I think we're going to need the Manga Elk to get him up.
37:38The Manga Elk is a lifting cushion.
37:41It's got four compartments, and it is initially very flat, which if a patient is on the floor, we can get underneath them.
37:50It's dangerous for both patient and the operator to try and get somebody up off the floor without this cushion.
37:58It could end up with more injury to the patient and injury to the paramedic as well.
38:03Right, young Melvin, I'm going to come round the front way.
38:07Hello?
38:08No.
38:09You all right?
38:10Have you ever been lifted up with one of these cushions before?
38:13No.
38:14OK.
38:15It's a cushion we're going to put underneath your bottom.
38:17Yeah.
38:18But we need you to try and have a shuffle onto it when you're ready.
38:21Can you shuffle a little bit backwards?
38:23Nothing.
38:24No, lie backwards.
38:25No.
38:26Keep shuffling.
38:27That's it.
38:28Bend your knees again.
38:29Beautiful.
38:30One more.
38:31Go on, one more for good luck.
38:32You're renting up in the world.
38:33Yeah.
38:34You can even hold my hands, all right?
38:36Yeah, pull you down.
38:37He's a monkey.
38:38He's a monkey.
38:39He's a monkey.
38:40He's a monkey.
38:41He's off the floor, that's it.
38:42That's it.
38:43Yeah.
38:44Hello?
38:45Yeah.
38:46You taller standing up?
38:47Yeah.
38:48Are we going to go on your recline?
38:49Yeah.
38:50Are we going to go on your recline?
38:51Yeah.
38:52Yeah.
38:53Yeah.
38:54Yeah.
38:55Yeah.
38:56Yeah.
38:57Yeah.
38:58Yeah.
38:59Yeah.
39:00Yeah.
39:01Yeah.
39:02Come on, mate.
39:03All right.
39:04Sit yourself up, my darling.
39:05Let me have a look at this head.
39:06Oh, yeah.
39:07Once we got Melvin up and sitting in the chair, I'd got a better vision of his head wound.
39:14I cleaned it up and realised that it was only a superficial wound.
39:17It did need closure, and on looking at it, tissue glue would have dealt with this wound perfectly.
39:29I am just going to put a little bit of tissue glue on it. It's a nice, neat cut. It is only very tiny, but it will just seal it all right.
39:34This is just going to sting a bit, matey.
39:36Yeah.
39:37But it will do the job.
39:38Yeah.
39:39Move on the finger.
39:40Melvin?
39:41Yeah.
39:42Shall we just get you up and have a little walk around and make sure you're back to your normal self?
39:47Yeah.
39:48Yeah?
39:49Yeah.
39:50Let's just stand up there, Melvin, and take a few steps.
39:52I'm leaving.
39:53Right.
39:54Just show us how you do it.
39:56Easy.
39:57Easy.
39:58Easy.
40:00What do we now?
40:01It's normal for him?
40:02I've got to hold his hands now.
40:03I've got to hold his hands now.
40:04I've got to hold his hands then.
40:05Okay.
40:06Oh, I'm up.
40:07There you go.
40:08Hey.
40:09All right.
40:10I think we know that you're all right.
40:12Yeah.
40:13All right.
40:14On the serious note now.
40:15Yeah.
40:16I bet you're ready for your tea now, aren't you?
40:17Yeah.
40:18On another serious note, are you happy to stay at home?
40:21Yeah, stay at home, yeah.
40:22So you don't want to go to hospital?
40:24No.
40:25He's in good spirits.
40:26In fact, I'd go as far as saying he's feisty.
40:28All his observations are fine.
40:30Yeah.
40:31And he's walked quite happily to the chair.
40:33Yeah.
40:34I've just cleaned his head up and he just needed a little bit of tissue glue.
40:37That's going to keep him out of hospital, which is always a plus.
40:40So we've got a happy ending all round, don't we, Melvin?
40:43Yeah.
40:44All right then, Melvin.
40:45Yeah.
40:46We've been a pleasure meeting you.
40:47Yeah.
40:48All right.
40:49OK.
40:50Behave yourself.
40:51Yeah.
40:52Bye bye.
40:53Bye bye.
40:59Bye.
41:01Bye bye.
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