- 4 days ago
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00:00Say, Lindlaker, I knew somebody at university with the same surname. It's quite unusual, isn't it?
00:06What's this?
00:06I tested myself. I came into contact with a strep A patient.
00:09Let's just say for a second you're this kid's dad. You have a right to know.
00:13I'm Teddy, by the way.
00:14Pacey Sullivan.
00:16Ashley.
00:17Come on, Claude, mate. You can't stay there.
00:19Claude?
00:20Can I get some hair for you, please?
00:23It's broken.
00:25Whole BED is broken.
00:27Look into it, please. I'm begging you.
00:30Flynn.
00:45Flynn.
00:49Flynn.
00:53This better be important, Ken.
00:57There you are.
00:58Where is she?
00:59In your office.
01:00Okay.
01:00Why has he fallen off?
01:01Oh, because I ran out of battery and I couldn't find a charger.
01:04You need to shave.
01:05Yeah, but I've been awake for 60 seconds. Give me a chance, would you?
01:08The state of this place. Sorry.
01:10It's a six-car pilot and a factory pilot. I guess things got backed up, Shaul.
01:14That's what I deal, isn't it?
01:15Well...
01:16Shhh.
01:17I said, don't get the chance.
01:18I can't eat, right?
01:20I can't eat, right?
01:21I can't smile.
01:25She's not going to eat there. Come on, where is she?
01:28Okay, let's laugh around, let's laugh around.
01:30Does this look okay?
01:30Go, go, go, go.
01:31Sure.
01:32Hi.
01:33I'm so sorry to keep you. I was with the patient. Flynn Byron, clinical lead.
01:37Kerry Malin, CQC.
01:40Kettle's boiled if anyone wants tea, coffee.
01:42I'm really sorry. Somebody should have offered.
01:44Don't be silly. I can see how busy you all are.
01:46Yeah, and to be honest, we weren't expecting a visit from CQC.
01:51Concerns have been raised.
01:52I understand another patient died in your waiting room.
01:58I'm here to do a spot inspection.
02:01Make sure you're safe to stay open.
02:04Right.
02:04Bye.
02:22Just give you a seat.
02:34I'm sorry. It's not normally this messy.
02:36I'm trialling a new filing system.
02:38And it's my daughter's birthday.
02:42How old is she?
02:45Very good.
02:46Miss Malin, um, Kerry, if I may.
02:55What happened with Claude Thompson was obviously regrettable,
02:59but totally different circumstances to what happened with Gloria Scott.
03:03So, a full spot inspection.
03:05It's not a full inspection.
03:07The focus is purely on patient safety.
03:10The incident happened on the first day of your new residence rotation.
03:14Uh, yes, it did.
03:16But, um, to be clear, neither resident was at fault.
03:21We have an extremely robust mentorship programme.
03:24They are shadowed by a senior member of staff every second of the day.
03:29I have no wider concerns about patient safety
03:32and certainly no concerns about my new residence.
03:35OK, good.
03:37Sounds like it's going to be very straightforward.
03:41OK, good.
03:44Yeah, yeah, she's cool.
03:48She's a little bit intense.
03:50She asks loads of questions.
03:51Where I grew up, about my family.
03:54Um, OK, OK.
03:55So, Mr. Gowan, where were you on the night of the 15th?
03:59She just doesn't need to know everything yet, though, does she?
04:02You know, we have only just met.
04:03But, like, haven't you seen her, like, three times this week?
04:07I mean, yeah, I'm actually fine.
04:12You know, it looks like things are moving pretty quick.
04:13That's all I'm saying, right?
04:17All right, this mental health call out,
04:18what's the house number again?
04:21Uh, it's number 26, Brian Lee Henderson.
04:23Control 3006.
04:25We've got a cat one near you,
04:26standing you down now and devoting you.
04:29It's a major incident at Wyvern Lake.
04:31Over.
04:31Copy that.
04:36No!
04:37No!
04:38Please, my mum, my mum!
04:39Mate, sorry, mate.
04:40We've got an emergency, mate.
04:41Sorry.
04:41Stop, please!
04:43Whoa, whoa, whoa!
04:43OK, go, go.
04:44I'll take control.
04:47Mate!
04:49Hey!
04:49You OK?
04:50Control, we're going to have to divert from that cat one.
04:53I'm fine, I'm fine.
04:55I'm just...
04:55I don't want...
04:57It's all right, mate, all right.
05:00What's your name?
05:02God!
05:03Kyle?
05:04OK, Kyle, I'm Jacob.
05:06OK, um...
05:06Please, please, come on.
05:08All right, all right, all right.
05:09Just try and relax.
05:10Try and relax.
05:10Try and relax.
05:11OK, we're here.
05:12OK, all right.
05:13Deep breaths, deep breaths.
05:14Try and relax.
05:15Let me have a look at this knee, OK?
05:19Do you want to go home?
05:21I was going to ask you.
05:23This shouldn't be happening.
05:24I called back, I told them it was a mistake.
05:26They all seem married.
05:29I can fix this.
05:30Good, for real.
05:31Uh, I don't want to keep everybody for long,
05:33but I wanted to introduce Kerry Mayland from the CQC.
05:37She's here to carry out a spot safety inspection.
05:40I'm sure you've all done one before.
05:42There's nothing to worry about.
05:43She'll be moving through the department, observing,
05:47maybe asking some questions,
05:49and, um, other than that, it's business as usual.
05:52Please.
05:53Promise I'll try not to get in your way.
05:54Um, where would you like to begin?
05:58Resource.
05:58Uh, I'll take you.
06:00Thank you, really.
06:03Guys, guys, huddle here.
06:05Listen, focus on clearing the corridors, OK?
06:07And unloading the ambulance crew as quick as possible.
06:10Come, can you bring the bed floor team, please?
06:12And tell them what's happening.
06:14Maybe they'll take pity on us, OK?
06:16Let's get on top of things, please.
06:19All right, calm down a little bit.
06:20Don't freak everybody out.
06:21She's a suit ticking boxes.
06:23I mean, we can handle that, can't we?
06:24Uh, if you've got me into a CQC inspection,
06:27we've got to go.
06:27It's not quite like that.
06:28Yeah, she's more than just a suit.
06:29She was, like, managing clinical director of major trauma
06:31until 2022.
06:33Really?
06:33Yeah, it's not misworded, but gets me going.
06:36What she's doing at the CQC is anyone's guess.
06:38Whatever she's told you, this is not a box-ticking exercise, OK?
06:42The outcome can affect the funding, trauma centre status.
06:45Well, you know, provision of any service.
06:48Which means job losses,
06:49the ability to carry her as a teaching hospital.
06:51We need to take it seriously.
06:52OK, OK, I'm taking it seriously.
06:54Good.
06:55Dr Byron, Dr Byron, anything I can do.
06:57Anything at all?
06:59Uh, yeah, thank you.
07:00You're going to be in research with Dr Keogh today.
07:02He's going to be mentoring.
07:02No, no, no, no.
07:03I don't know.
07:03I just told them how good the mentoring programme was,
07:05so make it convincing, please.
07:08You two, can you take the ambulance crew,
07:11and I'm going to take the corridor.
07:13I'll take the crew.
07:19We have an injured 15-year-old
07:20with a suspected fracture of patella
07:21and a possible head injury.
07:22Over.
07:23Police said they couldn't do anything.
07:25She's not in a public place.
07:26OK, mate.
07:28Nice deep breaths on that, all right?
07:30It might make you feel a bit giddy,
07:31but it'll help with the pain, OK?
07:33So I take it she's been sectioned before?
07:36Three times.
07:40If anything happened this morning,
07:41that might have set her off.
07:42She was like it when I woke up.
07:44She got all worked up about the school being closed.
07:47Ah!
07:49The roof fell in.
07:52See you at Holby Grandma?
07:52You're having a bit of a week, aren't you?
07:55Don't tell her I'm hurt.
07:56She'll freak out!
07:57All right.
07:58I'm going to have a check on her for you.
08:00No, um...
08:01Why don't we try and get her outside
08:03and I'll radio in
08:03and make sure we get police back up.
08:06Sounds good.
08:07OK.
08:08All right.
08:09All right, mate.
08:10Let's get this foot on you.
08:12All right.
08:12OK.
08:13OK.
08:14Bryony?
08:25Bryony?
08:28I'm so sorry.
08:29I didn't mean to scare you.
08:30My name's Teddy.
08:31If you look, I'm a paramedic.
08:33I'm a bit busy right now.
08:35I can see.
08:40So, um...
08:41What is it you're up to?
08:42Bake sale.
08:43To raise money for the school roof.
08:45We've got to get it fixed.
08:46The kids are never going back.
08:48Kyle!
08:49Where is he?
08:50Did you hear what happened?
08:52Yeah.
08:53Awful.
08:54Yeah, I heard.
08:54All kids.
08:55Poor teachers.
08:58Oh.
08:58Oh, you OK?
08:59Yeah, yeah, yeah.
09:00Yeah, I'm fine.
09:01I just, er...
09:02I've been on the go up all night.
09:04Cash and carry.
09:05Party supply store and then supermarket.
09:07Well, why don't you take a break?
09:09Come outside and I could check you over.
09:11No, no, no, no time.
09:12All right.
09:13Bryony.
09:13What?
09:14What?
09:14What do you want?
09:15I said I'm busy.
09:17I'm really sorry.
09:18I just want to help.
09:20You want to help?
09:21You want to help?
09:22Yeah.
09:23Then find me the icing sugar.
09:29No, no.
09:30Stop one.
09:30It'd be just, like, too weird.
09:31Well, it's quite weird at the moment.
09:33Yeah, but, you know, for you.
09:35But, you know, for me, I'm finally getting a grip on mine.
09:37I think she's responding to my tough love approach.
09:39OK, well, yeah.
09:40Mine's not quite as resolved.
09:41You know the Strep A test that he took in the staff room?
09:44Well, I might have taken that and sent it for a DNA.
09:47So I'm going to put the results back any minute.
09:48Give me a sec.
09:50Thanks.
09:52You stole the kid's DNA.
09:55You're out of frigging mind.
09:57Are you going to swap with me?
09:58No, no thanks.
09:59OK, so cubicle sevens, query, neck of femur, but the x-ray's not back.
10:07I'm sorry, am I keeping you from something?
10:11No.
10:11Sorry.
10:12OK, less focus on phone, more focus on patients.
10:15Steph, are we going?
10:17Are we able to get them off?
10:18Yeah, I don't know.
10:18I don't know.
10:18I don't know.
10:18I don't know.
10:18I don't know.
10:18I don't know.
10:18I don't know.
10:18I don't know.
10:21I complain of testing before collapsing about 40 minutes ago.
10:26GCS 14 on arrival, up to nine on route, but he's tolerating.
10:29Superclassic Airway, ECG showing ischemic changes, please, radio at 42.
10:35Pay for, please.
10:36BP is 88 over 60.
10:37Careful!
10:39400 micrograms of GTN, 300 milligrams of aspirin, that's the second 200.
10:43In the pool, a sort of fluid going through.
10:45OK, sorry, who's this?
10:47Oh, it's Kelsey.
10:48It's Courtney.
10:49Courtney.
10:50Hello, Courtney.
10:52This is what it appears to be, is it?
10:53It is exactly what it looks like, yeah.
10:56OK, sorry, do we have the keys for these?
10:58No, I lost it.
10:59When he was...
11:01OK, so we need to get these off, don't we?
11:04We need bolt cutters or something similar, because, yeah, maybe, Matty, can you go and
11:08find those for me?
11:10Me?
11:10Why me?
11:11Sorry, so the patient's peri-arrest, right?
11:14If we shock him with those on, we're going to electrocute her, aren't we?
11:16So...
11:16What?
11:17Don't worry, he's going to find bolt cutters or something similar, yeah?
11:20Please?
11:20I don't know where to...
11:21Dr. Keogh, come on now.
11:22Surely you can show some initiative, Dr. Lynn Laker.
11:24No, Paul.
11:24OK, is it the F...
11:25No, no, no, no.
11:27Come on.
11:27No, no, no, no.
11:28Right, let's get rid of the bed then.
11:30India, you're right on the airway.
11:31Yep.
11:31Can you get on the chest, please, Jodie, and let's stand by with adrenaline and amyotone,
11:35please?
11:36Dr. Keogh, please.
11:37I don't even...
11:37I don't know.
11:37Try the...
11:38Try the second floor.
11:39Try facilities on the second floor.
11:40Now, now.
11:41We will.
11:41Just as soon as we get the...
11:42Where's the rest of the...
11:57OK, um, just hang on a minute, yeah?
12:01Hi.
12:02Hi.
12:03Um, so, we're kind of dealing with an acute mental health crisis, so, um, I just feel it
12:10said something more...
12:12Mmm...
12:13...experienced.
12:15Well, you've got me.
12:17And just so you know, she does sound very erratic.
12:22Yeah, I've got it.
12:23OK.
12:24Hiya.
12:25I'm PC Sullivan.
12:27Are you Kyle?
12:29Oh, that looks nasty.
12:31Wouldn't have happened if you'd just come when I rang.
12:34I'm really sorry that no one came, but I'm here now.
12:37Do you know how many people it took to take her in last time?
12:40I'm hoping it won't get to that this time.
12:43Then you can stay together.
12:46If that's what you want.
12:50Hmm?
12:51Yeah.
12:55It is.
12:59You've done really well, Kyle.
13:02You can relax now.
13:04We're gonna take care of both of you, right?
13:07But, as you know, we need to get her outside first.
13:11OK?
13:20Put your back into it!
13:21Look, if it's your meds that are making you feel sick, you can try on some new ones, you know?
13:32Bryony?
13:39What's the look?
13:40You on your own?
13:42You working hard?
13:42I'm trying to get through to her.
13:44It's not working.
13:45It's not working.
13:46I know this.
13:47Talk room's coming up, so I'd section her.
13:48Then I can get her help.
13:51Do you think she's safe to see it?
13:54Who are you?
13:55It's OK. This is...
13:56Hi, Bryony. I'm PC Sullivan.
13:57You're not arresting me?
13:58No, no. I'm not arresting you.
13:59I've got to sell all these cakes.
14:01She's raising money for the school roof.
14:03Oh.
14:05Can I buy one of these?
14:07Yeah.
14:08A pound each.
14:10Only a pound?
14:11Yeah.
14:12I'll give you two.
14:13It's for a good cause.
14:15Can I just take any of these?
14:16Yeah.
14:18Wow, they just... they look amazing!
14:20Sorry!
14:21Why are you here?
14:22In my house?
14:23I don't understand.
14:26Is Carl all right?
14:27Is he in trouble?
14:28No, no, no. He's not in trouble. He's just outside.
14:33Look, he's really worried about you.
14:35Oh.
14:36He worries too much.
14:39I can see how much you love him.
14:41Going to all these lengths to help him.
14:44He's had a lot to deal with.
14:45Mm.
14:48He's a lovely lad.
14:50You've done a really good job of bringing him up.
14:58I've forgotten what I'm doing next.
15:04Well, why don't you pop some shoes on and we'll go outside so that Kyle knows you're OK.
15:11And we can make a plan together.
15:14Yeah?
15:16Yeah.
15:17Yeah.
15:18OK.
15:19That was amazing!
15:24That was amazing!
15:26Mm.
15:27Am I still seeing you later?
15:28Yeah, of course.
15:29All right.
15:31I've never seen a dead body before.
15:32Not dead yet. We're still treating him.
15:34But what if he does die and I'm still...
15:36Can you not do that, please?
15:38What is taking so long?
15:39Um, you know, it's a relatively unusual set of circumstances.
15:41We don't tend to have bolt cutters in the department.
15:44Oh, do we have bird next to kid details?
15:45Yeah, his wife is on the way in.
15:47I've never thought about having a wife!
15:49The amount of money I've taken off him over the years.
15:51I actually have never thought of him as a real person until now.
15:53Is that bad?
15:54I've got him!
15:55All right, let's get these off then.
15:56Quickly if we can, please.
16:01Oh, thank you!
16:02Oh, my God!
16:03Thank you!
16:07Shall we...?
16:08Yeah.
16:09Yeah.
16:10So, charge to 150, please.
16:14Defend charging...
16:16Everybody clear?
16:17Yeah, clear.
16:18Yeah.
16:19Clear.
16:20Shocking?
16:21The pulse check, please, Jodie.
16:25Yeah, pulse.
16:26Really?
16:27Yeah.
16:28OK, so we've got Ross, but he's not out of the woods yet.
16:29Let's return those to wherever they belong.
16:32Um, we should repeat the ECG then, and let's prep for an RSI as well.
16:37Where did you find them?
16:39Oh, er... site maintenance.
16:41Was there not a porter who could have gone?
16:44It's a shame you missed participating in an arrest scenario.
16:47I would have thought that was a good training opportunity.
16:49I... I volunteered.
16:51I thought it'd be quicker.
16:52Perhaps you can tick rapid sequence intubation off your list on the staff room wall instead.
17:02Hey, we need to get him in the van.
17:03Ashley's calmed her down, but they're coming out in a sec.
17:05Mate, I'm a bit worried.
17:06His VP's dropping and his heart rate in the rest of us.
17:08Kyle, where are you?
17:09Kyle!
17:10Oh, my God, Kyle!
17:11Kyle, just wait for me!
17:12What?
17:13Kyle, what's happening?
17:14Hi, Bryony.
17:15I'm Jacob.
17:16I'm looking after Kyle.
17:17Kyle, I'm so sorry.
17:18What's happening?
17:19Mom!
17:20No!
17:21They can't it stay!
17:22They can't, they can't, they can't stay with me!
17:23OK, Mrs. Carl.
17:24Right, this one's going to be yours?
17:25Yeah, he's going with you guys.
17:26I don't know whether you know this Matty, but Kerry here wrote the book on emergency airway
17:34Yeah, he's going with you guys.
17:36So, I don't know whether you know this, uh, Matty,
17:39but Kerry here wrote the book on emergency airway management.
17:43In fact, you wrote two, didn't you?
17:46Yeah, so, no pressure.
17:48Right, let's get that BVM off and the eye gel out, please.
17:53Here we go.
18:00OK.
18:04There's no light. The batteries should be...
18:07No.
18:08Got to open it.
18:09There you go.
18:15Nice and easy.
18:16So, we're remembering to lift rather than tilt.
18:19No, no, no, you're tilting.
18:21Right, OK, so, get lower in the hips.
18:23Yeah.
18:24That's it, right.
18:25And if you pick a spot on the ceiling up there, say,
18:28and just aim at that, that's it.
18:29And you lift towards that.
18:31There you go.
18:32There you go, that's it.
18:33That's it, that's it.
18:34Yeah.
18:35Can you see the vocal folds?
18:36Er...
18:37Yeah.
18:38OK, so, it's time for the...
18:39Bougie.
18:40The Bougie, that's it.
18:43Nice and smooth, I'll do the tube.
18:46I've got the Bougie.
18:47I've got the tube.
18:48Bougie out.
18:49OK.
18:50Attach to the VM, please, Jodie.
18:51And inflate the cuff, please, Dr Keo.
18:52I will do that.
18:53OK, that is the cuff inflated.
18:54Yeah.
18:55Yeah.
18:56Yeah.
18:57No end tidal waveform.
18:58Er...
18:59Yeah.
19:00Yeah.
19:01Yeah.
19:02Yeah.
19:03Yeah.
19:04Yeah.
19:05Yeah.
19:06Yeah.
19:07Yeah, yeah, OK.
19:08We're...
19:09Yeah, we've got into the esophagus.
19:10Yeah, no end tidal waveform
19:23Yeah, yeah, okay. Well, yeah, we've got into this office. Okay, we're just we're just blowing air into the stomach
19:29Okay, let's extubate them, please deflating the cuff
19:35Jody can you maintain the airway for me, please? Did you feel the clicks?
19:40On the larynx as you go through now, you should fit feel the clicks from the the the tracheal cartilage when you know
19:46No, okay. Never mind. Never mind. I tell you what let's do it again. I'll do it. I'll do it
19:51Fine, so can I have the laryngoscope, please find okay? I'm gonna get her somewhere safe
20:09Why is she not responding? I'm gonna try and find her. Okay, I'll come with you
20:13Okay, I'll come with you
20:15Okay, I'll come with you
20:17Ashley!
20:40Ashley!
20:42Rainey!
20:46Ashley!
20:53Okay, Chris Banfield.
20:55Yes.
20:56Cool.
20:57Come with me.
21:02Yeah, that's it, guys.
21:03Follow me.
21:04Hi.
21:05Hi.
21:06Sorry.
21:07Are you a doctor?
21:08One of them has swallowed a battery.
21:10You know those little button ones?
21:12Okay.
21:13Which one?
21:15I don't know.
21:22Ashley!
21:27Ashley!
21:36Ashley!
21:37Ashley!
21:38Ashley!
21:39Ashley!
21:40Ashley!
21:41Ashley!
21:42Ashley!
21:43Ashley!
21:44Oh my God, what happened?
21:45I tripped!
21:46I tripped!
21:47All right, all right, it's all right, let me have a look.
21:52All right, all right, all right.
21:54All right, all right, all right, all right.
21:55All right, all right, all right.
21:56Come here, come here.
21:57Let me see it properly.
22:01All right, I'm gonna need to put pressure on it.
22:03I know, I know, I know, I know, I know, I know, I'm sorry, I'm sorry.
22:04Jacob, Jacob, I found it.
22:05We're in his underpass.
22:06It's a woodlands pass.
22:07He's got a penetrating chest injury.
22:08I need the back I didn't bring it.
22:17Okay, hold on, I'll find it.
22:19All right?
22:20I'll just grab the ammo.
22:21Oh, my God.
22:24It's a woodlands pass.
22:26I need the back.
22:29I didn't bring it.
22:30It'll find it.
22:32All right?
22:33I'll just grab the ammo.
22:34Oh, my God.
22:36I
22:44I'm gonna need to heal it somehow
22:55Actually, it's very important. I need you to push pressure. Yeah, I'm gonna take a complete horn
23:06All right
23:10All right, all right
23:12Put this on. There we go. I know, I know, I know
23:15Well done. All right. You know what we are gonna do as soon as this is over
23:22We are gonna bake a cake. Yeah, how does that sound?
23:27Okay, that's on all right
23:30Jacob, Jacob, Jacob, please worry, please
23:34All right, I've got you
23:36I
23:40When did she notice it was missing? About 30 minutes ago, right? Okay, which means you've got
23:4690 minutes, two hours tops. Where are they now? In the relatives room. There's toys in there. No, no, but they don't need toys
23:51They they they need x-rays. Yes, but I thought I'd better check because five of them. That means unnecessary radiation
23:57No, no, no, but it's not unnecessary Kim. Okay, unless you want to see which one dies first with a hole burned in its esophagus
24:03No, no, no, I didn't think so
24:04Okay, look
24:05I've got a pre-alert. Can you go get them x-rayed
24:07Contact surgery make sure they're ready to do an endoscopy and it's time critical sort of move
24:12Would you be nice? No, we don't have time to be nice. That's an emergency
24:15Come on, the CQC want to see positive mental mentee relationships, please
24:19Yeah, well stevie nash wants her mentee to be resilient stevie be nice
24:24Yes, with pleasure
24:25This is kyle linderson 15 fell down some stairs brace lift
24:30Okay, heart rate's 120 open 98
24:33vp dropped to 94 over 60 sacks and 99 on o2 gcs is 15
24:39Giving him nitrous oxide a gram of a v5c tomorrow two and a half milligrams of morphine
24:43Okay, great. Thank you very much. I'm sure will you keep us up speed if there's anything that we missed in the meantime
24:48Let's split the primary survey reader. Can you take the chest Matthew? Why don't you do the update for me? Yep?
24:52Okay, I'll see if I can find out what's going on with your mom. Okay, try not to worry love
25:05Okay, yeah some firmness in the upper right quadrant. Okay, so in this involve possible internal bleeding
25:11Right, so we need to get hold of radiology book a full trauma ct as soon as we can please
25:15If you manage to get hold of mum, will you let me know if social services need to be alerted?
25:20Yeah, yeah, yeah poor kid
25:29Ken, why is the patient in cubicle 1 still here? I thought there was a simple laceration. He is. I'm just waiting for the x-ray before I stitch it
25:37What's going on with radiology today? They're taking an age to upload everything. Look if you want to take a look we might not need it
25:43Okay, Siobhan, do you mind cubicle 1? Uh, yeah, I'll be within two minutes. Thanks. Hey, listen what I got you
25:49Kerry is looking for that paperwork for the CCTV cameras we ordered for reception. I can't find it anywhere
25:53We have to put it out to tender first look at the responses are on your desk if you look at them now
25:59I will sort it. Thank you. Okay, right
26:03Cam, can I have a few? Yep
26:05Yeah
26:23Sorry Kyle, some technical difficulties here, mate. Won't be a minute
26:26Good luck
26:45What's going on here? I don't know
26:56Hey, look, Stevie, I need someone. Yeah, still in the UK, can we take this? Yeah, yeah, yeah
27:19This is Ashley Sullivan, 26, right? Penetrating injuries to the right anterior chest resulting in a sucking chest wound
27:25Temporarily sealed at the scene
27:28Now covered with a proper chest seal. She's tacky at 130, BP's 98 over 64, resp's 32, SAT's 92 on high flow
27:36She's had a gram of IV paracetamol, gram of TXA and five milligrams of morphine. It's all right. We're here now, yeah
27:40Right, lift on three. One, two, three
27:44Thank you, Teddy Whitfield. Are you okay to start primary survey?
27:47Jodie, can you get the monitoring on, please? And Hazel, let's activate the major hemorrhage protocol
27:51Uh, can we get a first shot pack down? And yeah, Alistair, can you get the rapid infusion, please? And uh, yeah, get an ultrasound in here, please, thank you
27:59All right, we're here now, okay
28:01I'm going to look after you
28:02Come on
28:07I'm still here, I'm still here
28:08Is there a next of kin we call?
28:11She's my girlfriend
28:12Okay, okay, okay
28:14Teddy, we need to keep it
28:18I know, but I can't
28:21Teddy, it's fine, we'll look after her, you go, okay
28:25All right, okay
28:29I'll be back as soon as I can
28:30All right
28:30Uh, did you get the x-ray?
28:41No, they were allowed to and then they said the system went down
28:45Shall I take them to St James?
28:47Who, who wants a ride in a taxi?
28:49Me!
28:50Me!
28:51Oh, and maybe even an ambulance
28:53Me!
28:54Me!
28:55Yes!
28:56I'll take you mum, I've got an idea
28:58I mean, that's there in the ED
29:00Okay, I'll see you
29:08Hi, um, do you know what?
29:09Could I just email you this paperwork?
29:11I, I...
29:12Oh, that's fine
29:13What's your contingency plan?
29:15Um, for, um
29:18You haven't heard about radiology?
29:23Uh
29:23Hey, hey, have you seen Dr Keogh?
29:29Can't find him anywhere
29:29I can't get this to work
29:31What is it?
29:31Metal detector, I got it from security
29:33Well, what do you need the metal detector for?
29:37There you go, no batteries
29:38See
29:39Oh, this isn't happening
29:40Now, I need to find out which one of those kids followed a button battery
29:43This was my last hope
29:45Oh, yeah, radiology's out
29:47Yeah, yeah, okay, okay, um
29:49Um, I know where we can get one from
29:51Come on
29:53Like, I don't even know what's going on in my own department
29:55Okay, I was on my way to tell you
29:57Do we even have a contingency plan for this?
29:59Only for a complete system failure
30:01This sounds like it's going to be down for a few hours
30:03There is no point in evacuating everybody
30:05Okay, okay, what do we do?
30:06What is the fix?
30:08Um, okay, we divert the ambulances till we're back online
30:12And we manage
30:14That is my M.O.T failed
30:17Great
30:18I'll leave that one till tomorrow
30:19Yeah, please
30:20Yeah
30:21Flynn, look
30:23We've got this, okay
30:25We keep calm
30:26And we carry on
30:27We still need a shave
30:33No, sats are still, Lou
30:34Still hypotensive and tacky, okay
30:37There's hardly any blood going through this
30:39And it's, uh
30:40Yeah, it's not swinging
30:43Maybe the drain's being located incorrectly
30:45Yeah, well, we can't know for sure without an x-ray
30:47Yeah, well, good luck getting one of those anytime soon
30:49Okay, um, yeah
30:51So, what are you thinking?
30:54Well, I'm thinking she's got a massive haemothorax
30:56But, uh, the drain's not working properly
30:59Also, possible tensioning
31:00Okay, let's, um, let's reset the drain
31:02Okay
31:06I know, I know it's uncomfortable
31:07Just squeeze my hand
31:08That's it, that's it
31:09Oh, thanks, Jodie
31:10Doing really well
31:11That's great
31:11Great, thank you
31:20There we go
31:22Oh, great, you were right
31:24Right, okay, thank you
31:27Doing all right
31:28Okay, drain going again
31:30Um, Hazel, when they've gone through
31:32Can you get two more units up, please
31:33And, Jodie, can you contact Cardiothoracics for me?
31:35Yeah
31:36Thank you
31:37Right, sets are coming back up
31:39Good call
31:40Yeah
31:40If only our good lady inspector was around to see that one
31:45Thank you
31:46No worries
31:46Uh, Dr. Kehoe, I was just looking for you
31:50Are you okay?
31:50Yeah
31:51Yeah
31:51Yeah
31:52Have you heard about radiology?
31:53Yeah
31:54No
31:54I don't know
31:55Well, paediatrics had rather stayed in resource until, uh, until they got his imaging
31:59But the fat scan is out of action, so
32:02Really?
32:03His heart rate's crept up
32:04His sats are dropping
32:04He's drowsy
32:05There's definitely something going on
32:07What do you want to do?
32:09Dylan
32:10Um, uh, yeah, sorry
32:13Could you find an ultrasound machine, please?
32:15Really?
32:15Uh, I guess I could get one from
32:17Literally anywhere
32:19Well, I could go
32:20If you
32:20No, no, no
32:20I need you with me
32:21Please
32:24Okay, so we need to
32:26We need to start from the top
32:27Full systemic assessment
32:29Try and work out where we
32:30Well, what I missed
32:32We need to start from the top
32:33Okay
32:37I'll be higher
32:38All that does go
32:39I'll be higher
32:42Right, uh, does anyone else need a wee?
32:44No
32:44No
32:49Anything?
32:50I've checked them all and there's no sign of it
32:52Are you sure one of them definitely swallowed it?
32:54Well, I mean
32:57Where is that, Obie?
33:01I thought he was with you
33:02No
33:04Oh gosh
33:06Do you mind?
33:07Yeah, thank you
33:09Albie!
33:09Albie!
33:11Albie!
33:13Hey, wait, wait, wait, wait
33:15Have you seen a little boy come through here?
33:16We think he swallowed a battery?
33:18No
33:21Miss Manon
33:22Do you need a hand?
33:23Do you need a hand?
33:29Sorry, it takes so long
33:30Obviously the one time we need it
33:32Everyone and their aunty wants to get their hands on it
33:35Okay, BP's crushing up those increasingly tense and now peritonitic
33:38Yeah, that sounds like a mesenteric tab
33:40Should we just see if Peter will take him?
33:43Uh, they won't take a 15 year old boy without confirmation
33:45I don't know if I can do this
33:56Of course you can
33:56Messentery too, you've got this
33:58Yeah, that's not quite what I meant
34:02But
34:18Anything?
34:18No one saw him leave but security are checking the car park
34:21No
34:23He was choking and then he went all floppy so I just picked him up and ran
34:27Let's get into the yourselves
34:28All right, this one
34:29Sure, it's all right, Albie
34:31It's okay
34:33It's okay, we're quite well done
34:34Dr Byron
34:38Hey, what's happening? What have we got?
34:39He's swallowed a battery
34:40When I found him, he was being sick and then he started choking
34:43I think he's a respiratorist
34:45It's okay, Albie
34:46I'm here
34:46It's okay, it's okay, it's okay
34:49Don't worry, you're doing so good
34:57Well, well done
35:00Dr Byron, I can't feel a pulse
35:03Start CPR, please
35:04Uh, Kerry
35:04In the emergency airway shortly over there
35:06You'll find a laryngoscope and Pete McGill's
35:08Please
35:18Why is the light not working?
35:24Come on
35:25Someone's taking the battery out
35:26I can't sleep right
35:27Keep going, see if I can
35:28Ah, Kerry, um
35:29Can you find me another one, please?
35:30Obviously, we're concentrating on the upper right quadrant
35:41And you can see there
35:42That, that, that, that forward
35:43Excuse me
35:44Do you have a
35:44Sorry, what?
35:45Do we have what?
35:45Do we have five minutes?
35:46Do we look like we have any time at all?
35:48What would really improve
35:50Patient safety would be not having people barge in every five minutes
35:54You know, not having people breathing down our necks
35:56While we're trying to treat patients
35:58Can you please go and bother somebody else?
35:59I was just going to say
36:01Do you have a Mach 1 blade and a laryngoscope in here?
36:05Dr Byron needs one with a working light
36:07Thank you
36:19Oh, yeah, okay
36:20So there, there's the, um
36:22The mesoteric bleed is confirmed
36:24I'll let Theatre know he's on his way
36:37Okay, yeah, I think I can see it
36:51Got it
36:51Got it
36:54Albie
36:55Hey, little man
36:56Yeah, I'm right here
36:57Everything's okay
36:59I thought I'd do, we're having, eh?
37:01Dr Chang, can you, uh
37:02Fast bleep ENT, please?
37:04He's going to need an exploratory endoscopy
37:06In case it's leaked
37:07Marie, can you get a line in, please?
37:09I'll get this oxygen on him
37:11I'll leave you to it
37:24Look, I know we haven't exactly covered ourselves in glory
37:28But today's been an atypical day, yeah
37:32Is there any other kind in an emergency department?
37:35This is not how I wanted today to go
37:39I understand the pressures you're facing, I really do
37:43But patients still need a safe place to seek treatment
37:47Somewhere with working equipment
37:48Where doctors don't bite each other's heads off when they're stressed
37:51Yeah, yeah, you're right
37:53Can you honestly say if something truly unexpected happened, you'd be prepared to handle it?
37:58I don't think you would
37:59I'm triggering a full inspection
38:02I'll email you my report with recommendations
38:06And in 30 days I'll be back to see if things have improved
38:09And, um, if they haven't
38:15Let's hope it doesn't come to that
38:17Let's hope it doesn't come to that
38:19Hey
38:23How are you feeling?
38:25Thank you so much, Teddy
38:29No, no
38:30Don't be silly
38:32Erm
38:33I've been wondering
38:35I'm sorry if it's not the right time
38:37But, do you still have my loyalty card for the coffee van?
38:45There was a free latte on that
38:48I'm sorry about that
38:50It's alright
38:51You can owe me a coffee, I suppose
38:54I was pretty out of it when we first came in here
38:57But, I've got a vague recollection of, um, you calling me your girlfriend
39:06Sorry, it was just a situation
39:09You wanna take it back?
39:12Do you want me to?
39:15Not really
39:16Okay
39:17I won't
39:20Okay
39:27Thanks, Oscar
39:34Kyle
39:35Kyle, love
39:36Yeah, I've, er
39:37Got news on your mum
39:38She's at the police station
39:39She's okay
39:40She's fine
39:41They are gonna move us somewhere more appropriate
39:44They will look after her
39:46They
39:48She's all I've got
39:51Of course they will, love
39:52This is Liv
39:53She's a social worker
39:54She's going to find us somewhere to stay
39:58Hi
39:59Alvy's parents have arrived on the children's ward, so
40:02Great
40:03Yeah, I, er
40:04I just wanted to say thank you before I went
40:07Where are the rest of your dugglings?
40:08Oh, er
40:09They've all been collected
40:11I've found it hard enough for two
40:13Honestly, I don't know how you manage
40:14Not very well, it turns out
40:20I don't think that's true
40:21I mean, you were so calm
40:24Most people would be freaking out
40:26That I was freaking him
40:28I, I still am
40:29I, I thought this job was like
40:33Like sticking and gluing and playing
40:37You know, what's the time, Mr Wolf?
40:39But, erm
40:43He, he could have died
40:45And it would have been my fault
40:47And I
40:47He couldn't die
40:48And it wasn't your fault
40:50Nobody can keep an eye on that many kids every second of the day
40:53Yeah, but that doesn't matter
40:55I, I was
40:58Responsible for looking after him
41:00And
41:01I
41:03I, I let him down
41:08I think you're being a bit harsh on yourself
41:13Anyway, er
41:13Thanks again
41:15Thanks again
41:16Well, you were amazing
41:18Well, judging from the look on everybody's faces
41:30I'm guessing you've all heard the outcome of the spot inspection
41:33Mm-hmm
41:34Yeah
41:36News of a setback like that was bound to travel fast, wasn't it?
41:40Did they say specifically what we failed for?
41:43No, they didn't
41:43Er, well
41:44I mean, it wasn't just one thing
41:46Erm
41:49But listen
41:51I know it might be hard to believe this
41:52But I want you to know that this is not a reflection on you
41:57You were all, without exception, caring, hardworking, outstanding professionals
42:04Well, it's not done much good, has it?
42:06Well, in 30 days' time, we're going to show them what we're made of, Nicole
42:10I'm confident about that
42:13And I want you all to know that in the meantime
42:14Your jobs, your training placements, your hours
42:18Absolutely none of that is at risk
42:20You can't guarantee that, though, can you?
42:23Yes, I can
42:24Because whatever the outcome of this process, it is on me
42:27Okay?
42:29I mean, they won't even need to fire me
42:30I will hand in my resignation
42:33That is how confident I am that we are going to sail through this
42:37Well, so you're offering to be a human shield for the whole department?
42:39Yeah
42:41Yeah, that's exactly what I'm offering
42:44Okay
42:51Okay, look, it's been a really long day
42:53Let's all just go home, regroup
42:56Come in and start fresh tomorrow
42:59Thank you
43:14Yeah, hey
43:26Better get off if you're going to make Poppy's birthday
43:29No, no, no, come on
43:30I'm going to stay
43:33I'll make it up to her
43:34The CQC want me to focus on residence training, on contingency planning
43:38I've got to focus on safety in the reception
43:40And all of the CCTV cameras as well
43:43If I can find the damn paperwork you said you left out for me
43:46And I've got to make a start on the training plan
43:47There you go
43:48I will stay and do it
43:49Hey, no
43:50Shiv, come on
43:51I meant what I just said in there, okay?
43:52I'm going to take care of this
43:54It's on me
43:56End of
43:57It's on both of us, isn't it?
43:58We're a team, aren't we?
44:00Go on
44:00Go and have a nice big piece of cake for me
44:05I mean it
44:05There's no point in both of us staying, is there?
44:07Go
44:07Really?
44:08You sure?
44:09Yes
44:09You sure?
44:11Go on
44:12Thank you
44:13Hey, take this
44:1420 quid, come on, take it
44:15No, no, no, no, get a cab
44:17Please, it's the least I can do
44:18You don't have your car, it's going to be late
44:20Just take it, get a test
44:20Okay, if you insist
44:23Okay, take that ridiculously oversized unicorn with you
44:26You reckon it's big enough?
44:27Yeah, go
44:29Flynn?
44:30Yeah?
44:31We've got this, okay?
44:33Look at me
44:35Okay
44:35Thank you
44:41Oh, Shiv
44:48Can I ask a figure, please?
44:50Yeah, yeah, what do you need?
44:51Would it be okay if I finished a bit early tomorrow afternoon?
44:54It's just, you know, there's an appointment for a dating scan at 4.30
44:59Or the next one's in two weeks
45:00And if I don't, if I don't get tomorrow's two weeks, could take away my options a bit
45:04Yeah, yeah, of course
45:05Thank you
45:06Yeah, how did Ian take it?
45:07Er, yeah, I haven't told him
45:11Oh, well, love, come on
45:12I know it's complicated, but he's got a right to know
45:16I know, I know
45:17But imagine how he's going to feel if he finds out and he didn't even know you were pregnant
45:22Rip the plaster off, best way
45:24It's not your fault
45:51It is, though
45:55See you tomorrow
45:55Dylan
45:57Yeah
45:59Any word on the result?
46:01Yeah
46:03And?
46:05Um, it indicates a very likely chance of paternity, about 99.9%
46:13Okay, well, that's pretty conclusive
46:15Mm-hmm
46:18So what are you going to do?
46:19Er, now I go home
46:20Okay, but don't be on your own
46:23No, I think I will
46:25It's a disaster, Steve
46:26It's a catastrophe
46:27Tick to the house
46:29Ah, that's very nice
46:34Tick to the house
46:46No, it's a disaster
46:48It's a disaster
46:51It's a disaster
46:52Yeah
46:52It's a disaster
46:53It's a disaster
46:53It's a disaster
46:54Yeah, hello, it's me. It's okay, you don't have to bring me back. I just wanted to let
47:14you know that I've pulled a few strings and someone's calling tomorrow to fit the new
47:19CCTV. I know, I know, I'm a miracle worker. Everything's going to be on your desk. I've
47:26left it there with a sticky note saying CCTV, okay, you can't miss it. And I made a start
47:33on those training plans, so they'll be on the shared drive. Anyway, I hope Poppy had a
47:39wonderful birthday and I'll see you tomorrow. Yeah, bright and early.
47:49Ah!
48:08Details of organisations offering support with domestic abuse, eating disorders or sexual
48:14violence available on the Action Line pages of the BBC website.
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