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00:00live in the heart of Yorkshire a team like no other busy busy busy fight to
00:11save lives open your eyes for me do you know where you are you in bands like any
00:15department 24 hours a day Wow seven days a week whoa nail it feel like a wet
00:27dishcloth serving their community looks like you have broken it I don't think I'm going to look
00:36you're dreaming of your gin and tonic helping those most in need love you there's nothing to
00:46be frightened of these girls will sort it out they care for anyone and everyone like himself
00:54thanks to Barnsley working together to make people's lives better you know I just love to look I love to
01:05make a difference this is Barnsley casualty 24-7 let's not be entering a beauty contest on shift tonight
01:17Dr. Heather Soudan it looks painful than it was before no it still hurts okay consultant Dr. Dave Walker
01:28is that it well yeah I'm doing some one you might need three and have you got her ready as I know
01:38it's ready sister Jane so Primrose is ready to move so get ready to share a shift you know when you're
01:49used to doing receipts at supermarket with the team at Barnsley casualty it's the start of the early
02:04shift and sister Jane is running the hub I went to Turkey last year fifth of October and two days of
02:19rain out of me week but rain is the least of sister Jane's worries today the hospital is moving to a new
02:29patient and port a tracking system just got to get on where's job yeah it went smoothly it's meant to
02:39cut out a lot of waiting time because they know where the beds are when they're empty when they're
02:46clean and when we can put a new patient in there but this is in an alphabetical order the system will
02:56track the movements of patients in real time and in charge of implementing it is service manager Lindsay
03:02so this is one of the badges so when a patient is going to be admitted to the ward they will have
03:10one of these badges placed what this does is then track the journey throughout the hospital oh my god I
03:18have no idea what I've just done well could cast chaos to add to the chaos ED Barnsley there's now an
03:32emergency on the way eight month old boy dr. Sowden heads to recess to prepare the paediatric bay so
03:41the ambulance crew have just phoned us and told us they are bringing in an eight-month-old boy who
03:48is really struggling with the breathing and mom and dad are concerned that he's not as responsive as
03:52they would like him to be
03:53paramedics arrive in recess with eight-month-old Noah he's accompanied by 18-year-old mum Maddy and 20-year-old
04:13dad Kieran you could assess Noah as he was coming in the door because you could hear him breathe could
04:33see was working really hard he was pulling in between his ribs he was clearly struggling with
04:38his breathing I said any of you said I'm to part at medicine to call Paul I've been open or anything
04:44like that okay okay I'm pencil in about I passed come on dad you want to come up the top end yeah
04:54just so I can see you so when did you start making the noises
05:01Kieran has taken the day off work to be with his son right it's it was really really bad we've
05:17noticed that he was really bad when we breathe in yeah he's trying to cough couldn't cough until
05:25he's choking and then no he's gasping for her problem it his heart's going like the clappers
05:33because he's hot so it's what kids do so when they've got a temperature the heart goes like
05:36the clappers and they breathe faster he's having to work a bit harder so he's sucking in under his
05:42ribs no so he'll be breathing a lot faster because he's hot no was born prematurely and he spent most of
05:53his life in and out of hospital just leaves him more susceptible than all the kids of his age to
06:00chest infections and when he gets them he might not deal with them as well as other kids and he
06:06actually weighed less than a kilo when he was born I can't imagine how small that is but we're just
06:12trying to convince ourselves that we can rely on tell what his option levels are oh buddy I'm sorry
06:21you're so hot all right thank you I'm just gonna do a bit of an assessment is that all right yeah
06:27as dr. Sowden continues her assessment she notices another cause for concern these old spots that I
06:47have known about so these you've not seen these before okay thank you so that's a birthmark yeah
06:59but these are these are new I noticed some spots on his back and I asked mom and dad have these been
07:07there before have you seen them before and when they say no you go okay it's a new rash do I need
07:12to worry about the rash so some of the spots go away when I press and some don't so we're gonna
07:17cover him with some strong antibiotics we're just waiting for his hands your hands and feet go cold
07:22when you've got temperature so we're just waiting for him to warm up and then we're gonna put a drip
07:26in and do some bloods and then we can give him some strong antibiotics to do as well we were told that
07:31non-blanching spots are meningitis until proven otherwise but none of us are brave enough to say we can
07:37be relaxed about these spots yet infection of the brain that's meningitis and leave kids with brain
07:46damage the team must work quickly before his condition deteriorates
07:51in the hub sister Jane is just one hour into her shift somebody's pulled back that green at 10 41 but
08:15not put it in here it's the team's first day using a brand new porter and patient tracking system
08:21yeah this and Tony's trying to log in on her own loving way because there's some apps they put it on
08:26as an app as well at the end of the day it's for the patient's safety it's for their safety and to
08:32make their journey in hospital better but there are teething problems oh that's fine we just move
08:39her off and we put her in right there but I need to make sure she's going to my bed right but that's
08:47your problem love isn't it not mine it is right that's all right but none of the auto partering
08:54seems to have sent a party yet okay how do you complete it
08:59over in resource baby Noah is still struggling to breathe
09:17Dr. Sowden has spotted a rash on his back which could be meningitis she's called pediatric registrar
09:35Dr. Myles Whitfield for a specialist opinion but mom and dad said they weren't there of course
09:47Noah has been in and out of hospital since birth
09:54it was 26 weeks and two days so he came three and a half months early and then yeah very scary
10:05uh suspected uh stepsis which is blood poisoning which were very very like very worrying
10:15so then uh that's put a breathing tube in him for well not for a few of them for like a few weeks
10:22weren't it
10:22got a good trace now
10:25it's nice now though let's have a listen for a bit
10:28noah's premature birth means he's vulnerable to infections
10:39the team need to find a vein so they can start to treat him with ivy antibiotics
10:44we're just gonna put a drip in his uh foot so it won't it won't be our friends just to warn you he
10:54will get upset with us we have praise for gas juice so where i'm looking at is just here so if you
11:00bring it up a little bit for me down slightly just about where my hand is just to here a little bit
11:05perfect thank you we just know that it's better to give ivy antibiotics if you're worried about a
11:14serious infection over tablet antibiotics and if someone can't swallow you want to get fluids in
11:19you want to do it through a drip finding a vein can be difficult
11:39newborns really slim skin lovely veins and then over three you get nice veins in the middle you've got
11:47chunks and they're just full of nice doughy chewy skin that's nice and snugly but oh i might might get
11:56lining
12:10eventually the team find one of noah's veins
12:17noah is given fast-acting antibiotics his parents must now wait to see if his condition improves
12:38over in minor injuries janet has come in with a suspected broken wrist
12:43it's her 60th birthday today getting ready to go take the dog for a walk went to the dustbin
12:51came back slipped straight down on the ice she's now under the care of emergency nurse practitioner
12:58claire i'm claire hi claire so you've been already for an x-ray yes and the x-ray shows that you've broken
13:04your wrist okay so it's in a not a great position so we'll need to put some anesthetic into it and make
13:11it all nice and numb and then make it a lot straighter for you i know the injection is going
13:17to work because it's into your wrist and i know injections into your wrist are painful
13:21so i'm not looking forward to this
13:29decided looking at the x-ray on the screen it looked perfectly okay oh really yeah well you'll
13:34be a lot happier when i've strained it up janet's wrist needs to be numbed before emergency nurse
13:40practitioner claire can manipulate it back into place oh there's where the fracture site is okay
13:48so that's where i'm going to go into all right i don't think i'm going to look so i'm not going to
13:53lie to you it does sting yeah hopefully we'll get straight in that's your word that's going to really
14:00hurt yeah remember to breathe okay you ready yeah yeah
14:10you all right yeah i can lie you're doing brilliant
14:29that's it we're spit over thank you right then so you'll just rest it like that now
14:36all right until it works until okay
14:43oh no no they were just running just i don't know why i cry but only happy things
14:50i can cry every i think i do cry at sad things as well i think i have got an emotion just yeah
14:55but i don't cry at happy things yeah i'll pass you that back you can finish off thank you
15:01it's all right can it's my gin and tonic yeah can't wait for mine
15:10in the hub the new patient and portrait tracking system is still causing problems
15:17so i bet primrose is ready to move because she's fit to see it i need to know if primrose is ready to
15:23move have you got her ready as i know it's ready so primrose is ready to move
15:32service manager lindsay is overseeing the change
15:36i mean it's never never an easy time to roll out a new system in the emergency department because
15:41patients don't stop booking in so we we're always busy so if you click on the pending screen there
15:46somebody's put a bed request in to move her why have they put wheelchair so she's ordered the porter
15:54so should she do that or not it should be auto-portering some of the patient location information
15:59isn't coming through you know when you're used to doing receipts at supermarket
16:06so we're just working on that we're just waiting for it support to come in there
16:09do some tweaking for us this is very slow if you've got trolley breaches coming up
16:23whether the system works or not new patients keep arriving
16:32the next to be brought in by ambulance is 78 year old kathleen who's fallen over on her doorstep
16:39oh dear i will really pull on her door oh that's better just a minute ready mum's right now
16:50paramedic tracy hands over to sister beth so we've got kathleen she's gonna have to get her milk off the
16:58doorstep come back in tripped over the lip of the dark way and face planted straight down she's got
17:08um a large hematoma and she's got like a skin tear underneath the eye and on the top of the eyelid as
17:17well hello hello my name's beth nice to meet you sister beth will be looking after kathleen first she
17:26needs to assess her injuries
17:41is it bad that's a that's not me entering the beauty contest
17:46do you live on your own yeah i'm sorry i'm just trying to get this skin right
17:55i think my husband's in the home he's got alzheimer's
18:00what did you do i used to be a dinner lady at school did you i was
18:08my grand eldest grandson and my granddaughter used to go to the same school
18:13they all all pupils like me because i gave them extra puddin
18:18as kathleen has a nasty skin tear sister beth wants to consult with a colleague
18:23i need i need to look at this eye before i address it she's got a hematoma here a skin
18:31tear here skin tear on her eyelid and a massive one here we're gonna have to get a scan of your
18:35head my love because you because you've banged your head and your pupils are different
18:40and that could be a sign that there might be a bleed inside your brain okay
18:45if the scan does show a bleed on the brain kathleen will need an emergency operation
18:50i just told me don't find out serious
19:03a new patient is rushed from the high dependency unit into recess
19:0955 year old mother of two joanne has atrial fibrillation
19:13an irregular heartbeat her heart is beating more than twice as fast as it should
19:20register dr alice morgan heads straight to see her hello hello how we feeling i feel as i'm having
19:29palpitations okay all right rapid heart rhythms create blood clots which can lead to strokes because
19:38her palpitations or atrial fibrillation started within the last two hours she was a good candidate
19:44for what we call dc cardioversion so a synchronized shock using the defibrillator to try and basically
19:50shock the heart back into a normal rhythm you look like you've got fairly good veins there so let's just
19:55have a little look oh i like socks very jazzy
20:00so what we basically do is we put the pads on for the defibrillator i give you some medication
20:12through this drip to make you feel nice and relaxed nice and settled okay and when i'm happy that you're
20:17at a point that you're really really relaxed we administer one shock and we check what rhythm you're in
20:24and then theory you should be back in a normal rhythm
20:31the team are planning to put a strong electrical shock through joanne's body a little scratch
20:41we'll pop some extra monitoring on in a second so it's a little bit of oxygen
20:45blood pressure heart rate um and co2 monitoring so that just measures your breathing the actual
20:50procedure takes seconds it's the it's the build up yeah it's all right don't worry do you want to
20:57keep your glasses on or do you want them off for a bit yeah i'll look after them we'll put the pads
21:02on and then liz my colleague so she's one of the consultants will come in and she'll be the one
21:07that um that does the machine part i'll be the the doctor that's doing the sleepy part
21:12so she's got joanne is given defibrillator pads to place under her clothes which will deliver the
21:24shock to her heart are you happy for us to start i'll do a little bit of talking um probably mainly
21:31to you all right we'll just have a chat and then when you stop answering we know we're all right okay
21:36all right i'll give you a little bit of the painkiller um all right let's see how we we get on
21:44to keep joanne calm the team used some distraction techniques do you have like a tipple of choice if
21:50you were out having a drink my favorite drinks malibu okay so be like having a couple of malibu
21:55that sounds like a plan do you have it with coke yeah or pineapple oh nice is it okay that's making
22:07me think of caribbean tropical yeah yeah it's just like barnesley we sort of gauge based on how chatty
22:14they are and they become a bit less chatty um as the drugs kick in how we feel him yeah the
22:21little bit of sleep yeah don't worry that'll pass it's just those malibus kicking him
22:31if the electric shock doesn't reset her heart joanne will still be at risk of a stroke
22:38we're getting there i think
22:51i'm not sure if she i think she's learning or she wishes no i'm sure she is
23:07the team are implementing a new system that will track patients around the hospital in real time
23:13so are they just meant to look at this screen and think oh because they are on there just have
23:18a look cubicle eight to x-ray lovey cubicle eight to x-ray yeah please where's the badges
23:28service manager lindsay is rolling out a badge system which will track the journey of the patients
23:33around the hospital hoping it goes well because if it works as it's intended
23:40we'll get much faster access to beds on the ward so if they start off on amu and then go to 33
23:46you know that that's where they are because of the badging system so it should speed up
23:51the process of discharge and thus provide us with beds earlier in the day do you know i just think if
23:57they can do without badging now for the next week which is going to be we need to just drop that all
24:01together we still can't budge yeah
24:11in resus joanne's heart is beating at twice the normal rate putting her at risk of a stroke
24:22once joanne is fully sedated dr morgan and the team will try to shock her heart into a safe rhythm
24:31how are we feeling joanne yeah yeah okay
24:39i want me to arrive back there sounds good
24:45joanne is sufficiently anesthetized now the team will administer an electric shock to her heart
24:50so i'm gonna charge so can we take the oxygen away please thank you very charging
25:06doing really well joanne okay delivering shot now stand back please
25:09oh wow
25:3074 oh well done well done joanne we'll let you have a little rest
25:35joanne's heart rate has come down by more than half her risk of having a stroke has been immediately
25:43reduced
25:47well it provisionally looks like it but we just need to keep an eye on you for a bit longer because
25:51sometimes you go back into the other rhythm um but touch wood it's looking good
25:58so ups are good so ups are good breathing's good we'll just let that medication just go through your
26:06system all right soon joanne is alert again
26:14you want something to eat yes please what do you answer um just some hospital toast please
26:21hospital toast hospital toast is always nice does your heart feel slower than it did before it does
26:28feel slower good yeah so it's at a nice rhythm now so it's 89 beats before it was 100 and uh 190
26:36ouch do you remember anything from the sedation i remember talking to you about
26:41fine but that's it perfect there you go it's worked yeah excellent so it's really quick uh it's a two
26:47second two second procedure to get her back into a normal rhythm it's uh it's just the setting up
26:52and the safety measures that take the the longest time um but she's had a good outcome so hopefully
26:57we don't see her back in there okay stop thank you joanne recovered the same day and is now on
27:05medication to regulate her heart rate thank you bye-bye kathleen had a fall at home and banged her head
27:21she's in cubicle one waiting for a ct scan can you come home yet sorry i said can you come home yet
27:30i've i've seen the doctor yeah her daughter tracy has arrived i've been long gone down no no well i
27:40don't know how big it was before well it was as big as a golf ball the second well not quite as big as
27:46a golf ball now maybe grandson thomas might know hi thomas who've you been fighting with now um
27:54um well it went tight so i can tell you that it was blooming milk i went flat on my face do we need to
28:05uh start bringing your milk for you or something maybe if the milkman delivers to our house and we
28:10take it down don't call any towers then on your way back and have a biscuit jacket potato with cheese
28:17oh it's not a restaurant it is waiting on mars about
28:28in the hub the new patient tracking system is still causing problems so badging's still not
28:36working we've not we've not sent one budget patient yet just stop there's been a few teething problems
28:43um so the badging hasn't worked as yet they're just trying to work with it now but the system is
28:50up and running we've gone live just with a few elements of it not fully switched on yet so hopefully
28:57that shouldn't be too long so far not too bad we're about 70 percent there so how will that work then if
29:04we're not bad you now do you know who's where sister jane wants to go back to basics there's a phone
29:12there can you not have that phone oh yeah so we're going to give you this phone so that the coordinator
29:19can bring it to 7117 7117 yeah oh i need a drink and i don't drink i've got a drink
29:34in recess baby noah is being treated for a serious infection which has left him struggling to breathe
29:45his temperature's cooled down a lot he's more like more aware and uh seems more like his normal self to
29:51be fair having finally shown signs of improvement noah is moved from recess to the increased observation
29:59cubicle he's chewing on his fingers yeah he's working more like himself thankfully thanks to barnsley
30:14the treatments have worked he's breathing to settle down is a lot better there'll be a period of
30:18observation so that when the medicines we give him wear off we just check that he doesn't go back to
30:23being as poorly as he was when he came in and depending on whether his symptoms recur or whether he
30:28remains stable he'll be off home just got to stay another night do some observations and see how
30:34he is and i'll have to be back home tomorrow very stressful yeah good especially with everything
30:41that has been through so far you want to do a last set of numbers okay and then they're going to transfer
30:46you up to the children's ward yeah that's fine that's going to fall back into normal limits now
30:50that's good to hear so we think noah had croup which is a virus um me and you get croup and because
31:01our air was a bit bigger a little bit of swelling we wouldn't even notice it no we've been so small
31:06and being a history of prematurity that's probably why he needed to come into any and get some drugs to
31:11help him noah spent the night in the children's ward and has now made a full recovery
31:30and will it show it without them allocating the porter or have you got to allocate the porter for
31:34it to show up the porters are still not all connected to the new real-time tracking system
31:44so at the minute it's going a bit chaotic we're having a few issues but some of us are on
31:48some of us are not i'm absolutely rubbish on things like this technical and made of mine crash when
31:55it's time to get dumped in your life you know you're my age is there any things here for dinosaurs like
32:06it's making it a bit hard and a bit stressful but at minute i'm keeping my stress levels down
32:11in cubicle four emergency nurse practitioner claire has pain relief for janet's broken wrist
32:30so i'm going to give you this to breathe on as well now to help you okay makes you feel a bit
32:35woozy a bit relaxed helps with the pain okay dr sowden has been called from recess to have a look at
32:44janet's x-ray hello i'm Heather nice to meet you i'm going to be with the doctors i'm not looking
32:52forward to this why not i can move my fingers where i was struggling to move them but they're going
32:59numb they're starting to go numb good and your wrist if you did that is it any better i can't really do that
33:05no is it less painful than it was before no it still hurts okay and i'm not usually a baby but it
33:11still hurts oh yeah okay fine oh you're definitely allowed to be upset yes all right you've done a
33:18good job that bit's pointing the wrong way i didn't think it looked that bad actually i mean it's still
33:25attached but i'm not a doctor it's still attached it could be worse
33:31dr souden and emergency nurse practitioner claire are going to attempt to manipulate janet's wrist
33:38back into place
33:42so nice breaths on that if you can for us
33:44try and relax your hand for me and try to not hold on to me if you can so that it doesn't tense
33:54the bones up yeah all right hmm you're dreaming of your gin and tonic yeah okay
34:04so you're starting off with someone who is in pain because something is broken and all the tissues
34:10around the break will be swollen and every time that break moves it's gonna hurt
34:17breathe in and out for me
34:22all right
34:31now that janet's wrist has been repositioned a cast is fitted quickly to hold the bones in place
34:40so that's the pot for now we're gonna see what it looks like now on another x-ray right but it's very
35:03unstable while janet heads to x-ray kathleen is taken for her ct scan
35:14she's being looked after by healthcare assistant lisa
35:19oh what you've been doing i've only fixed milking i went to try and shut down and i just went
35:27so i have to stop drinking i could do but i don't drink i'm allergic to alcohol oh bless you
35:35i will go into york today
35:39can you change it to another day it'll have to do well i don't think they'll let me go this afternoon
35:45oh no they'll not let you go so what were you going to be doing in york today then well um
35:52because it was my birthday they were buying me a birthday present so you're going to betty's
35:58betty's what's that it's it's a restaurant
36:03you'll have to do it another day when you're feeling a bit better
36:07i feel all right you might get it for free if you're showing me bruise might take pity on you
36:12do you think so you might get your d and cake for now lass the ct scan will show if kathleen
36:21has a bleed on the brain
36:22so i'll have to sit well off well done all right and i'll get you when you're done
36:38and i'll get you when you're going to get your dta on care flow and then you would click that button
36:51and the patient and porter tracking system is now almost fully operational if you want to admit
37:01a patient you do your dta on care flow and then you would click that button so if you click on
37:05clinical operations it's very futuristic the porter is automatically dispatched to come and collect them
37:22in radiology grandma kathleen has just had a ct scan to see if she's had a bleed on her brain
37:34following her fall
37:37consultant dr dave walker is reviewing the results ct head's fine um she's got a large swelling big
37:45bruise big hematoma on her forehead which is this lump here in front of her head
37:50um but otherwise her brain's fine so
37:56healthcare assistant emma is taking over kathleen's care
38:02walk this way
38:04am we all right to take some bloods off you some more have you had you've not had any done
38:09here though have you no if you'd have said i could have brought some up a kitchen floor
38:15you've made a bit of a mess of that eye haven't you it looks like it
38:20you live on your own oh have you got a button or out to press
38:25well what do i want one of them for in case this happens
38:30here you last what are you doing
38:34oh sorry sweetheart that's what they all said but they still stick it in
38:38i stick it in then i say sorry it's time for dr walker to examine kathleen's wound
38:47it's not gonna be right comfy i'm afraid
38:48so you just keep saying that until somebody lets you go is that the plan yeah
39:03fine you do think about your either your elderly relatives when you're treating a patient of this
39:08age i mean i think i was always told to subscribe to the sort of grandma rule and say you know how
39:13would you treat your grandma and that's how you should treat your patients so i'll just peel that off
39:17we'll try not to take this game with you
39:21sorry so this should be wet i'm told oh god i meant it right yeah
39:29okay
39:35dr walker is going to stitch up kathleen's wounds
39:41first he needs to apply an anesthetic
39:43i've had injections in me other eye but they numb it well when you've had injections actually into
39:52your eyeball well in me eye i don't know i can't see what they're doing no well right
40:02the one's asked me do you know i says i don't know i'm really asleep
40:13it might sting a wee bit as it goes in
40:25you okay yeah you can blink it's just yeah that's where it's good to sit around the eye is difficult
40:31the lid uh is really tricky to get right and if you get that wrong obviously if you can't close
40:37your eye that will damage your eye pull that together there it's like a little
40:43jigsaw puzzle
40:49okay is that it well yeah i've done one you might need three we shall see
40:58with a lot of older patients their skin is quite fragile and quite tears quite easily
41:03so you have to be really gentle with elderly skin
41:06you're very gentle are they dissolving ones yes they are
41:15i thought i were only having one yeah it needed more it's just the very top of your lid just above
41:22your lid so just close your eye i know what boxes feel like now
41:28right you're i'm afraid you're still a bit all bruised but the skin's back together
41:37all right so yeah so there's this bit that was the main concern below our eye
41:41i thought i was only having one stitch about five it looks a lot better
41:52i'm shattered it's been a long day for kathleen but she's now ready to go home home sweet home
42:10home the jacket potato was waiting for her and her face healed after a few weeks rest
42:18very good on your feet aren't you
42:22birthday girl janet is spending the day at barnesley casualty after she badly broke her wrist
42:33hello i'm back again another x-ray please you forgot to wish me happy birthday though
42:40is it your birthday i've had to cancel all my birthday plans to come here
42:44an x-ray will show if the team have managed to successfully manipulate it back into position
42:54party plans have cancelled now
43:01emergency nurse practitioner claire can see the x-ray immediately right then honey okay
43:08so this was the before picture yes so you can see this big chunk fragment there
43:14and this is the ap view and that's how it is now so it's in a lot better position yourself and other
43:21yeah however it's still really unstable
43:28janet came back to barnesley hospital for surgery on her wrist and has now made a full recovery
43:34the team's first shift using the new patient and porter tracking system is coming to a close
43:50it's gone okay really i suppose apparently badging is now live let's go and give it a go
43:59portering is now operational so we're using the new system for portering it's okay it's okay it time
44:06will tell
44:09as the shift ends see you later lovely sister jane and the team head home but the doors to barnesley
44:16the casualty remain open 24 7.
44:33new casualty 24 7 every second counts is back next wednesday at eight
44:38if you or someone you know has been affected by any of the issues raised in this program
44:43please go to channel5.com slash helplines for information and support next it's a matter of
44:50life or death as surgeons perform a delicate operation with huge risks new after the break
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