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00:00In the heart of Yorkshire
00:05A team like no other
00:09Busy, busy
00:11Fight to save lives
00:12Open your eyes for me
00:13Do you know where you are?
00:14You're in Barnsley
00:15No A&E department
00:16Charging
00:17Awww
00:2024 hours a day
00:21Wow
00:22Seven days a week
00:24Whoa
00:25Nail it
00:26Feel like a wet dishcloth
00:30Serving their community
00:31Looks like you have broken it
00:33Ooooo
00:35I don't think I'm going to love
00:37I'm dreaming of your gin and tonic
00:40Helping those most in need
00:43Love you
00:44I'm trying
00:45No
00:46There's nothing to be frightened of
00:47These girls will sort her out
00:49They care for
00:50For anyone
00:51I think I've messed your hair up, haven't I?
00:53And everyone
00:54Looking more like himself
00:55Thanks to Barnsley
00:57Working together to make people's lives
01:00Better
01:03You know, I just love to look at them
01:05I love to make a difference
01:07This is Barnsley Casualty 2015
01:10For some
01:11I must not be entering the beauty contest
01:15On shift tonight
01:18Sister
01:20Jane
01:21There's the world's biggest crew in here
01:22For triage
01:23Have you seen that?
01:24There's 19 waiting
01:25Have you seen all this?
01:28Advanced clinical practitioners
01:30Sean
01:31Open your eyes
01:32You okay?
01:33Sean
01:34Open your eyes
01:35You okay?
01:35Run
01:38And just that hair there
01:40A bit
01:41A bit
01:42A bit
01:43And advanced clinical practitioner Gemma
01:44We'll do that boxing
01:45Because I do that
01:46You don't box with your feet
01:47Do you?
01:48You
01:50Have you been in before?
01:51Been in a lot of times
01:52A repeat offender then?
01:54Yeah
01:55So
01:56Get ready to share a shift
01:57It's a 24 hour service
01:587 days a week
01:59It's a 24 hour service
02:007 days a week
02:00With the team at Barnsley Casualty
02:05It's 7 a.m.
02:09It's 7 a.m.
02:10And at Barnsley Casualty
02:11Sister Jane is running the hub
02:13Tracey
02:15You see it's only Jane
02:16I need a female
02:17Surgical bed love
02:18Yeah
02:19I'll be right back
02:20I'm Rand down here
02:24She's taking over for
02:25From a very busy night shift
02:27We just need to get them out
02:30And get some space
02:33We're always taking patience
02:35By ambulance
02:36Or walking
02:37Or the police
02:38Bring them in
02:39And it's difficult
02:41Because the department
02:42Becomes gridlocked
02:43Redlocked.
02:48Unfortunately, we're reliant on other areas helping us out to clear the department.
02:53A&E has quite a...
02:58Reputation of just speed and pace.
03:01A lot of people can be...
03:03Frightened by it, it's a daunting place to come and do a shift.
03:08We're coming to two ambulances waiting to come in.
03:11Right.
03:13Have they said that they're keeping you in?
03:15Right, I'm going to send you down Surgical S-Deck just...
03:18to get you out of here.
03:19All right, love.
03:21I hope it's only Jane down in A&E.
03:23This lady, Tracy's aware of her, she needs to come down to you.
03:26All right, darling.
03:28All right, love.
03:28Bye.
03:29Right, she can get to us today.
03:33Mr. Jane moves one patient on, but as one leaves, another arrives.
03:48A.D. Bonslake.
03:53A 53-year-old man has collapsed at home.
03:58Following multiple seizures.
03:59A.D. Bonslake.
04:00A.D. Bonslake.
04:01A.D. Bonslake.
04:02A.D. Bonslake.
04:03A.D. Bonslake.
04:04A.D. Bonslake.
04:05A.D. Bonslake.
04:06This gentleman had a stroke at the end of September.
04:10And since then he's been having non-athletic seizures.
04:15A.D. Bonslake.
04:16A.D. Bonslake.
04:17A.D. Bonslake.
04:18A.D. Bonslake.
04:19A.D. Bonslake.
04:20A.D. Bonslake.
04:21Sean, open your eyes for me, open your eyes.
04:26Hello, Sean, do you know where you are?
04:29No, you're in Barnsley A&ED.
04:31Have you got any pain anywhere?
04:34No.
04:35Yeah.
04:36This one?
04:37Did you fall onto your arm?
04:41No.
04:42You don't know?
04:43Have you had chest pain today?
04:46Whereabouts in your chest?
04:51No.
04:52No.
04:53No.
04:54No.
04:55No.
04:56I need to get these answers from Sean quickly, but it's quite difficult.
05:01With his condition.
05:02Sean was found on the floor by his wife Sam.
05:06Did he lose consciousness?
05:07When I came down he was speaking to me.
05:08Did he lose consciousness?
05:09When I came down he was speaking to me.
05:11I'm really glad his wife's here.
05:12So we can get these answers and then I can get to the bottom of what's going off.
05:16And did you not hear a crash or anything or a nothing?
05:18No.
05:19Just about?
05:20I just went to the fastest thing on Tuesday.
05:21Help!
05:22Help!
05:23Right.
05:24Okay.
05:25Am I in, right?
05:26I just went downstairs.
05:26He was on the floor.
05:27Yeah.
05:28And then he was mourning his right arm.
05:29We were hurting him.
05:30We were there.
05:31We were like, it's really hurting.
05:32It hurts.
05:33And then all of a sudden you were like, his fingers have gone numb.
05:36On his right side.
05:37Yeah.
05:38On his right side.
05:39But it's his stroke.
05:40It's his right side dirt.
05:41It's been affected.
05:42It's been affected.
05:43Yeah.
05:44How many seizures did you often have?
05:45Like every.
05:46Every day.
05:47And he's ever about eight, ten.
05:51Eight to ten a day.
05:52Eight to ten a day?
05:53Yeah.
05:54Does it get like a warning sign or anything?
05:55Yeah, normally it's fixed.
05:56It has switched and they'll start going like this with his head.
06:01It's huge.
06:01are becoming more frequent and she's quite concerned so that's the reason she's brought him to us.
06:06We'll take an ECG, pop a cannula into some blood and then we'll see what we find. Is that okay?
06:11Does it hurt there? No.
06:16What about there? It hurts there. Is that where the pain's been coming from? What about over here?
06:21Mmm. It's tender there.
06:23Sean is flipping it in and out.
06:26Of consciousness, but he is also complaining of chest pain. So my job, um,
06:31at that moment in time is to figure out if this chest pain is contributing to his conscious level as well.
06:36So it's quite important for me to establish that pain and where it's coming from.
06:41Mouse twitching, I fucking might have a seizure.
06:45Mmm.
06:46Sean.
06:47Sean.
06:48Sean.
06:49Sean.
06:50Sean.
06:51Open your eyes.
06:52Sean.
06:53Open your eyes.
06:54Sean.
06:55Open your eyes.
06:56Sean.
06:57Sean.
07:01Sean.
07:02Sean.
07:06Put your eyes, sweetheart.
07:08Open your eyes.
07:09Open your eyes.
07:10Boom.
07:11Ow.
07:11In Resus, Sean is having...
07:16multiple seizures.
07:18Sean, open your eyes.
07:21Are you okay?
07:23Sean.
07:24Advanced Clinical Practitioner Chantel...
07:26needs to determine the cause.
07:28Sean, open your eyes for me.
07:31Sean, open your eyes. Hello, how are you feeling?
07:36Not good?
07:38How do you feel?
07:40Good.
07:41Sean, tell me, how do you feel?
07:44Terrible.
07:45You feel terrible?
07:46Does he normally talk after his seizures?
07:48Yeah.
07:49No.
07:51He's a little straight out of him and he's just normal.
07:54Okay.
07:55Why some...
07:56Sean has been Sean's main carer since his seizure started following a recent stroke.
08:01Sean, open your eyes.
08:02He's a good person.
08:03I love him.
08:04He's a good person.
08:05He's a good person.
08:06I love him.
08:06I love him.
08:07He'll have one for about, five seconds.
08:08He'll stop.
08:09Yeah.
08:10Then he'll go back into one.
08:11and then it does that for about six or eight times and then I'll come around and I'll...
08:16Yeah, yeah.
08:17But it's just continuing.
08:19This is continuous.
08:21It's really more prone to them when he's unwell.
08:22When he gets hot.
08:23When he gets hot.
08:24I've noticed when he gets hot, yes, that's enough.
08:27Sean.
08:28Sean.
08:29Sean.
08:31Open your eyes for me.
08:33Open your eyes.
08:36Hello.
08:37Sean.
08:38How are you feeling?
08:40How are you feeling?
08:42No, I'm good.
08:43You're not feeling good?
08:45There's many...
08:47Sean.
08:48Sean.
08:49These seizures, can you just stop them normally like that?
08:52You can stop the seizure.
08:53And then it'll come again.
08:54And then it comes again.
08:55And then it comes again.
08:56There's epileptic seizures and then there's non-epileptic and there's a whole host of other types of seizures.
09:01So you can control these seizures?
09:03Not half that time.
09:04But do you think you can do it now?
09:07Try.
09:08You try and do it?
09:09Are you alerting away?
09:11When they're happening?
09:12So what's really important is establishing what's normal for Sean.
09:16And what's abnormal.
09:17When you're like talking to him, it'd be alright as soon as you watch.
09:21When he cut out the room, it set off.
09:23Mmm.
09:24And then a nurse came back in and he talked.
09:25It stopped.
09:26And then she'd go off and he'd start again.
09:29It's like if somebody keeps in...
09:31Talking or whatever.
09:32It seems to be alright.
09:33Something to walk away.
09:34Yeah.
09:35Which is not classic.
09:36It's not a classic.
09:36Seizure.
09:37Yeah.
09:38Because I wouldn't be able to bring him out of it.
09:41And he wouldn't be able to talk to me straight away.
09:43The increase in Sean's seizures could be the...
09:46The result of an infection.
09:48So this lung sounds quite crackly.
09:51So I'm gonna get an x-ray of his chest.
09:53You said he's had a cough.
09:54How long for?
09:56About four days.
09:57They're gonna come and do you an x-ray on your chest soon.
10:00Okay.
10:01Okay.
10:02You need to...
10:03You need to be a little bit alert and sat up for it.
10:05Okay.
10:06So I can...
10:06See if there's any infection.
10:07Alright.
10:11I'm gonna have to sit here and stroke his arm.
10:13So you can keep him calm.
10:14And then he didn't have a seizure.
10:16Yeah.
10:17That's your job, Sam.
10:18You're doing it as well.
10:21You're in a good spot.
10:22There you go.
10:23Nice and camp.
10:24There you go.
10:25Nice and camp.
10:26But it's been in and out that many times.
10:29It's like it's the norm now.
10:31But this has been the worst.
10:33He ended a stroke about eight weeks ago.
10:36Two weeks in.
10:37It started with seizures.
10:40He's got...
10:41He's got to go for like load of electrodes on his head to see what's happening.
10:46So we are going through tests to find out exactly what kind of disease.
10:51He just feels useless now because he was always on the go.
10:55He never...
10:56He just starts around doing some gardening, building, and now it's...
11:01He can't.
11:02He can't.
11:03John!
11:07Hello, Mom.
11:08Hiya, you alright?
11:09Hello.
11:11Hello, Sean.
11:12My name's Rachel.
11:13I've got Lewis here as well.
11:14Hello, Sean.
11:15My name's Rachel, I've got Lewis here as well.
11:16We've come to do an x-ray on your chest, love, alright?
11:19Radiology have come to do x-rays.
11:21Right, Sean, we're going to sit you forward and pop the board behind your back, alright?
11:26Hello.
11:27If the x-ray reveals a chest infection, Sean will need...
11:31urgent treatment.
11:41Over in the paediatric department...
11:46I've got these things to put up for the children, and they're going to be like little sticks...
11:51puppets.
11:52There's a little road out here, so that they can use them to drive along the road.
11:56It's like a little activity to do while they're waiting to see the doctor.
11:59Play leader Olivia is...
12:01creating an interactive display about road safety.
12:04So this is going to be like...
12:06like the crossroads for Barnsley Hospital.
12:08There's going to be like a little lollipop man...
12:11stick here...
12:12and then when the cars kind of come across...
12:14we're going to let the kids go fast.
12:17I love my job.
12:18Every day is so fun.
12:19They're just amazing, the kids that come here.
12:21They're so lovely and so friendly.
12:27Right, so we're going with that lady.
12:29Come on, sweetheart.
12:30Come on, sweetheart.
12:31One girl in paediatrics today is eight-year-old...
12:35Harriet, who has a suspected broken toe.
12:39Harriet, my name...
12:40My name's Gemma.
12:41Are you all right walking down, yeah?
12:42Yeah.
12:43Come this way then.
12:45Treating casualties younger patients today...
12:48is advanced clinical practitioner Gemma.
12:50You okay?
12:51Yeah.
12:52Yeah?
12:53Who have you brought with you?
12:54Mum and...
12:55We're all good.
12:56We're all good.
12:57We're all there.
13:00We're all good.
13:01If you'll pop up on the bed.
13:02There you go.
13:03Perfect.
13:04So my name's Gemma.
13:05Watch...
13:05Emma.
13:06Emma.
13:07She's jumped off Seti and she's banged a foot.
13:10On the footstool.
13:12It was sticking right out.
13:14It was all red and...
13:15she was crying.
13:16If that was my toy, it just went boom and then it hit it.
13:20right there.
13:21But it also hurt here and then it just went like that and it was like that.
13:25the whole time.
13:26And when it was sticking out, did you do anything?
13:29I did.
13:30I didn't touch it.
13:31Have you tried to move it or anything?
13:33No.
13:34No.
13:35Just a little bit swollen.
13:35That into the sweetheart.
13:36Can I have a little look at you?
13:37Is that okay?
13:38Does that hurt there?
13:39Yeah.
13:40Sorry.
13:41And just that hurt there.
13:42A bit.
13:43A bit.
13:44A bit.
13:45Okay.
13:46Let's have a little look.
13:47Compare it to the other side.
13:50So it is sticking out.
13:53So normally I would say...
13:55would just strap it.
13:56Yeah.
13:57The fact that you've said it was sticking out that way and it is a little bit.
14:00what I call angulated.
14:03I think we might...
14:05I just need to make sure it's not like a fracture type dislocation.
14:08Okay.
14:09So...
14:10I think we will get an x-ray.
14:11So give me two minutes.
14:12Okay.
14:13And then we'll get you round.
14:14Okay?
14:15Thanks.
14:16You alright?
14:17Yeah.
14:18You alright?
14:19Yeah.
14:20You've never really had any injuries before have you?
14:23I've never broken up...
14:25John.
14:26John, do you follow me and I'll show you where to go?
14:28You okay?
14:29You okay walk you round?
14:30Good one then.
14:30Yeah.
14:31If Harriet's x-ray reveals that her toe is dislocated...
14:35it will need to be manipulated back into position.
14:40Is that...
14:41That's just the next thing.
14:42Is that...
14:43That's just the next thing.
14:44I love when somebody fires me down.
14:48Yeah, we're dying.
14:4933 have got no beds at the moment and I've
14:54got this neck of femur who they do know
14:55about and there's potentially another
14:57neck of femur that's coming
14:59in the hub the pressure is not letting
15:02up for sister Jane casual
15:04is still jam-packed from a busy night
15:06shift
15:09at the moment for 63 patients in the
15:12departments at the minute
15:1411 o'clock in the morning it's not great
15:16some of these patients have been here
15:18full of
15:1915 16 hours so it's not really very good
15:21we're not a ward
15:24and we need to move patients out to get
15:26more patients in it's just a vicious
15:28circle rail
15:29it's just never ending
15:30you still have a duty of care towards
15:34those patients to ensure that they're
15:35safe they've come to a hospital to be
15:38treated for their
15:39illness and they need to be safe and
15:41sometimes it's just difficult
15:44we've been in there all morning
15:47nobody wants them in here for 12 hours
15:49because they're on trolleys
15:50but everybody's doing the best
15:54day sheen
15:55payout love
15:59A patient with a history of heart attacks has arrived.
16:0479-year-old Tommy is taken straight to the ambulance bay.
16:09So, a granddaughter is born today because he's a work with no moon.
16:15Okay, fine.
16:17Granddaughter Lauren called the ambulance.
16:19You had a bit of a chest pain again, didn't you?
16:21Oh, a chest pain, yeah.
16:22Yeah, yeah.
16:23I had a bit of chest pain again.
16:25I've not been very good for a long time.
16:29He's all too familiar with Barnsley Casualty.
16:31I've been with him a few times.
16:33You had a gas.
16:34It's on your back of your head, didn't you?
16:35Oh dear?
16:36You fell.
16:37Is that when I fell down the stairs?
16:38Yeah, and you cut your head up.
16:39Yeah.
16:40Yeah.
16:41So, you had to have it gone.
16:42Great, good job.
16:43No.
16:44Always a good job in there.
16:45Always good.
16:47Hey, Tommy.
16:48My name is Jess.
16:49Am I okay to have a look to see if I can get a cannula in to take a test?
16:52Yeah, yeah.
16:53I'm what you're allergic to.
16:54Yeah.
16:55You're allergic to.
16:56Yeah.
16:57I used to be allergic to the sun.
16:58The sun.
16:59The sun.
16:59You're not going to get that much of that now, eh?
17:01Come on.
17:02I'll zoom in here.
17:03Good.
17:05A week and a half ago, I think.
17:06No, it was two weeks, was it?
17:07Yeah.
17:09I was just going to go and get you shopping for you before you decided to feel unwell again.
17:15I've been staying with him for a few days.
17:17We take it in turns.
17:18Because he's on.
17:19He's on his own now since he lost his wife, my mama.
17:24Since then, he's gone downhill, so he's got a lot worse.
17:29So, he's got 21 grandchildren.
17:34And 16 great-grandchildren.
17:35And 16 great-grandchildren.
17:36And 16 great-grandchildren.
17:39So, we all take it in turns, don't we, granddad?
17:41Ha, ha, ha.
17:42I'll come with that and stick with it.
17:44Ha, ha, ha, ha, ha.
17:45Ha, ha, ha, ha, ha.
17:46Ha, ha, ha, ha, ha.
17:47You got to a seat doctor now.
17:48No, I'm not.
17:49Okay.
17:51Thank you, Tommy.
17:52Thank you very much.
17:53You're welcome.
17:54Tommy must wait for the blood test results to find out if he's had a heart attack.
17:59If he has, he will need to stay in for observations.
18:04No, I'm not.
18:07Thank you very much.
18:09Ellie's coming in at two and then they put a message on for any band threes they have sent me somebody down from the
18:14ward but only this morning in the hub sister Jane not only has a jam-packed
18:19casualty she's now two nurses down
18:24I've had some sick colds today
18:27my staff are tired
18:29acceptable to catching illnesses
18:31so we all struggle really
18:34pretty rubbish
18:39we're not going to close the department for no staff
18:44it's a 24 hour service seven days a week so you just have to
18:49plow on
18:54we're not going to close the department for no staff
18:59in resource Sean is still having seizures
19:03advanced
19:04clinical practitioner Chantel has the results of his chest x-ray
19:09infection markers are up a little bit
19:10yeah
19:11but there's no pneumonia on his chest x-ray which is good
19:13so I'm going to
19:14give him some antibiotics to clear that chest x-ray infection
19:17so I have told
19:19the doctors upstairs about him
19:20yeah
19:21and they're happy for him to go upstairs when there's a bed
19:23yeah
19:24do you think the infection's caused?
19:26sometimes yeah
19:27sometimes if he's been a bit unwell
19:29and a bit feverish
19:30it can upset him a little bit
19:32and
19:33antibiotics
19:34and
19:35and
19:37if he's ok tomorrow they might convert them to
19:39oral tablets and then you can take them at home.
19:41Right, I'll leave you with him.
19:43Okay.
19:44It's awfully good, get the antibiotics in.
19:49Hopefully get him back home and get back to, well, normal as possible.
19:54Sean spent the night on the ward and was released.
19:59The next day, he's still undergoing investigation for his seizures.
20:09There is no let-up for advanced clinical practitioners.
20:14As one patient leaves, another.
20:19Paramedics are bringing to Rhesus a 94-year-old.
20:24woman with a high heart rate and dangerously low oxygen levels.
20:29woman with a high heart rate and dangerously low oxygen levels.
20:34woman with a high heart rate and dangerously low oxygen levels.
20:39Thank you, thank you.
20:40It's just beautiful.
20:41It's just beautiful.
20:42Right, we're going over.
20:44And to here, okay, so a little ride.
20:46Are you ready?
20:47Yeah.
20:48Ready?
20:49Steady.
20:49It's light.
20:50Oh, you're light as a feather.
20:52Paramedic Marcus.
20:54All right, Margaret.
20:55What?
20:56Any other medical history?
20:57So, Alzheimer's...
20:59And osteoporosis as well.
21:04How are you feeling at the minute?
21:05It's fine.
21:06You feel a little bit frightened?
21:09Our priority in emergency medicine is to find out the emergency, but it's really important.
21:14To try and make a patient, regardless of age, not be scared of frightened, especially when
21:18they're confused as well.
21:19So, Margaret, do you know where you are at the minute?
21:21Yeah, I think I've been with Paul.
21:24Look.
21:25This is...
21:26This area...
21:27Look.
21:28Look.
21:29Catch me.
21:30I've never...
21:31I have been before.
21:34I do like to give comfort with touch.
21:36Do you want me to remind you?
21:39Yeah.
21:40So, you're in Barnsley Hospital at the minute?
21:41Yep.
21:42Can you remember now?
21:43Yeah, I remember.
21:44I don't know.
21:45Don't worry.
21:46You're fine.
21:47And you're in the A&E department?
21:49You don't feel frightened at the minute?
21:50I'm not frightened.
21:51Good.
21:52We'll sleep in our sleep.
21:54Mm-hmm.
21:55Did you?
21:56And you had your two little boys over there?
21:57Yeah.
21:58Are they still over there?
21:59Are they...
21:59They come back?
22:00You know, I don't even know where they are.
22:02Oh!
22:04All the best.
22:05All right.
22:06All the best.
22:07All right.
22:09All right.
22:10So, your son's gonna come up, okay?
22:11Oh!
22:12So, your son's coming up, and he's gonna come...
22:14I'll see you.
22:15All right.
22:16Take care.
22:17Bye-bye.
22:18See?
22:19You son's around.
22:19Not in Australia.
22:20Not in Australia.
22:21No.
22:25Can I have a listen to your heart and your lungs?
22:27Is that okay?
22:28Thanks.
22:29Can I take some blood tests as well?
22:31Yeah.
22:33Patient...
22:34If you're not reassured, the next job is to find out what's causing Margaret's dangerously
22:38low oxygen.
22:39That's very close.
22:40Just wait.
22:41worse situation levels.
22:42receesterol
22:52That's pretty scary.
22:53Ask breakfast if you're gonna need coffee.
22:56Better go down Chemoivareas.
22:57If that is okay, why will you joinLAN folks?
22:59Happy to meet me.
23:00We'll be seeing you soon, sir.
23:02We took a patient list, go down and go down extra and pick up.
23:04As we're coordinating with you, we've got ready fro Hakuna relations with you.
23:06I wow, they'll be Vermeous, one-harte towels� German.
23:08Kelly Kelly there is just nobody else that I can send down there I don't know what to do
23:13he's walking there's 19 waiting to
23:18be seen with an hour and 15 minute wait but it just makes it bad for this afternoon because
23:23we're going to continue to come in it makes me want to go out
23:28we all rely on a certain number of nurses to get work and jobs done
23:33and obviously if you haven't got that nurse there if you want down then it falls on another
23:38nurse or two nurses to share that responsibility so it does make it difficult
23:43Tom in rapid or Lisa in resource take it
23:48but let me know you can do rapid with me have you seen how many there is to a set
23:53walk at this
23:55oh you are kidding me
23:58thank you
24:03thank you
24:08you okay
24:09yeah
24:10right sweetheart
24:12you
24:13can I have this arm just to take some blood
24:15in resource advanced clinical
24:18practitioner Chantel needs to find the cause of Margaret's dangerously low oxygen
24:23levels
24:25you
24:26you
24:28They're not very good.
24:30They're not very good?
24:31Oh, we'll see what I can do.
24:34I'm quite good, you know.
24:36I'll not be good now, I've said that.
24:38I can't imagine.
24:39You're a little girl.
24:40I can't see you a little girl.
24:42Awww.
24:44You can see I'm a good girl.
24:46I can't see.
24:47I'm a good girl.
24:48I can't see you a little girl.
24:49I can't see you a little girl.
24:52Right.
24:53Are we ready?
24:54Yeah.
24:55Oh, ow, ow, ow, ow, ow.
24:58I can't see you again.
24:59Don't worry.
25:01There we go.
25:02There's no needling.
25:03I can't see you again now.
25:04It's all done.
25:05It's just, I'm getting the blood out.
25:08Not bad at all.
25:09Not bad?
25:10Are you sure?
25:11Are you sure?
25:12Are you sure?
25:13I thought I hurt you then.
25:14It's good, alright.
25:15I might wanna...
25:18I feel alright though.
25:19It's a nice cup of tea.
25:20I...
25:21I promised you a nice cup of tea then.
25:23Aren't I after this?
25:24Oh.
25:25As your little treat.
25:26Yeah.
25:27In...
25:28sensitive emotional situations.
25:30I still like to be a little bit light hearted.
25:33and make the patient feel more comfortable.
25:38Do you want anything to eat?
25:39I don't have a biscuit.
25:40Do you want a biscuit?
25:41Do you want a biscuit?
25:42Do you want a biscuit?
25:43We've got some biscuits.
25:44I try and be as human and normal as possible.
25:48Because that's what I would want as a patient.
25:49I'd want someone to be just really normal and nice and...
25:53light hearted with me.
25:54I'll see what I can find.
25:58I'll rummage around.
25:59I'm sure you'll find one.
26:01I will.
26:02I will.
26:03Margaret's sons join her as she heads for an x-ray.
26:13Have a seat.
26:14I'm already shot.
26:15Brill.
26:17Not yet.
26:18They're gonna tell us when they're ready.
26:19Also in radio...
26:23In radiology, 8-year-old Harriet is waiting for an x-ray to find out if she has disliked
26:28the gate at her little toe.
26:29I want to go.
26:30I want to go.
26:31I want to go.
26:33I don't.
26:34Well, you'll be going no matter what I might not be.
26:37Yeah.
26:38That's why I wish I was you.
26:40Isaac.
26:41But plus I get up.
26:43All the sympathy from you.
26:48why not?
26:49What should I do?
26:50What's she do?
26:51toda auto
26:58No, where we came from, yep.
27:03Transclinical practitioner Gemma looks at the X-ray.
27:08We've definitely crafted it.
27:09If you look at these ones, we look for nice, smooth, smooth lines.
27:13And on this one, she's got a little bit of a step there, but she's also got a bit of a bend.
27:18And here, that's what we're looking for.
27:21It's not nice and smooth, so it looks like she's...
27:23Yeah, she's fractured it.
27:25All right, I'm going to chat with her.
27:28Hello.
27:32Hi.
27:33So, just had a little look at your X-ray.
27:36Looks like you have broken it.
27:38Okay, but it's not out of line, so it's not what we call dislocated.
27:43So, what we need to do is just strap it together.
27:45What about, like, PE and can she do...
27:48And I don't want to do it, I don't want to do it.
27:50You don't want to do PE.
27:53I would, um, avoid it for a few weeks.
27:57Okay.
27:58Um, healing.
27:59And then there's one other question.
28:01What about boxing?
28:02Because I do that.
28:03You don't box with your feet, do you?
28:07No.
28:07As long as you...
28:08If you're not in pain, then you should be fine.
28:10Yeah.
28:11Happy?
28:12Yeah.
28:12Any more questions?
28:13No.
28:14Okay.
28:15Thank you very much.
28:17Bye-bye.
28:17Good day, guys.
28:18I told you it was broken.
28:19I told you it was broken.
28:23I told you it was broken.
28:26Bye-bye.
28:27Bye-bye.
28:27Bye-bye.
28:28Also on shift is volunteer Jane, who's heard there's a familiar face in Cuba.
28:33You've been in before.
28:39A repeat offender then?
28:41Yeah.
28:42Now...
28:43When we say a repeat offender, we don't necessarily mean it in a bad way.
28:48Actually, sometimes it's nice to keep seeing them.
28:51And Tommy was one of them.
28:53It was a nice repeat offender.
28:55Repeat offender Tommy is here with his granddaughter.
28:58Lauren, after suffering chest pains.
29:00Yeah, it always causes trouble, that's what it is.
29:03Y'all should remember them that caused trouble.
29:05Y'all should then.
29:07I'd say nice to-
29:08It's never nice to see you back in here.
29:10No.
29:11Is it?
29:12But then again...
29:13That's it, isn't it?
29:14Yeah.
29:15It's like meet and greet, isn't it?
29:16It's like these airports about to start and-
29:18We're charged now, isn't it?
29:19Every time you come through the door.
29:20See you later, look anyway.
29:21See ya.
29:22Ta-ra, love.
29:23Dr. Hong Tet has come to us.
29:28Hello, Thomas.
29:29Hello, Thomas.
29:30Hello, Thomas.
29:33I just understand that you came in with the chest pain.
29:35Yeah.
29:36What was the character of the pain?
29:37Is that-
29:38Sharp or-
29:39It was a sharp pain because you bent over the teeth.
29:42Yeah.
29:43Look.
29:44Are you in pain now?
29:45No, no.
29:46Any surgery to the heart or-
29:48No.
29:49He's got about 16 cents in his heart.
29:50Because he's had quite a few heart tags.
29:53I'm sorry to hear that.
29:54I was only a week ago.
29:55I'll review your blood test and then I'll let you know the-
29:58Okay.
29:59Okay.
30:00It is good to know that you're pain free now.
30:03The blood test will show if Tommy has had another heart attack.
30:08While he waits for the verdict,
30:1394-year-old Margaret is on her way back from radiology.
30:18Yeah.
30:19We'll start it.
30:20We'll let him know.
30:21When we're out there, you want to pull the teeth.
30:23Good.
30:24Advanced clinical practitioner Chantel assesses Margaret's x-ray.
30:28Ah, she's got a lovely big pneumonia sat there and that's what-
30:33That's causing her to be quite unwell.
30:34Hello?
30:35Hi.
30:36Hi.
30:37Hi.
30:38Are you okay? How are you feeling? You look tired.
30:42I'm tired.
30:43You look tired.
30:48You've got a big infection down there.
30:51What's that, Mel?
30:53What's that mean?
30:54Yeah.
30:55It means we need to give you some antibiotics.
30:58Are you just kidding me?
31:01No.
31:02No!
31:03You've got a chest infection, but quite a big one at the bottom of your...
31:08Right lung.
31:09That's the only thing I need to do.
31:11Pardon?
31:12It's a good job I'm getting.
31:13It's a good job you're getting looked after and it's a good job you're here.
31:17Yeah.
31:18There you go.
31:19There you go.
31:21There you go.
31:24Hey, that's better.
31:25Yeah.
31:26Hey.
31:27Hot.
31:28Is it hot?
31:28Hot.
31:29Just take your time with it.
31:30Alright.
31:31Any questions?
31:32I don't.
31:33I don't.
31:34So I'm a good girl.
31:35You are a good girl.
31:36You are.
31:37Yeah.
31:38I'm a good girl.
31:39Okay.
31:41I know she's in good hands.
31:43Excellent.
31:44Fantastic service.
31:45Fantastic.
31:48Are you happy for her to go to the ward once she's had...
31:51Once she's had all the treatment and...
31:53Niamh's happy with her from a nursing point of view.
31:55Yeah?
31:56She'd kind of go up.
31:57Bye Margaret.
31:58Bye Margaret.
31:59Margaret was transferred to a ward.
32:02Where she was treated for pneumonia.
32:05She returned to her...
32:07Care home.
32:08With regular visits from her two sons.
32:18Have you had your dinners down there?
32:20Just do me a favor and just...
32:22Go and see CDU.
32:23Make sure they've had the dinner.
32:24Because they were told to take each other off.
32:25I just want to make sure that they...
32:27In the hub, Sister Jane has a casualty full of patients and...
32:32Needs to keep check on the welfare of her skeleton staff.
32:37Are you two going for your break?
32:39Where's your Amelia?
32:40She's gone for her dinner.
32:41Lovely.
32:43Do you want to go for your lunch sweetheart?
32:45Do you want to go for your lunch sweetheart?
32:47Do you want to send Stella?
32:48For her dinner?
32:49Do you want to send Stella?
32:50Do you want to send Stella?
32:51For her dinner?
32:52Has she gone?
32:53Yeah.
32:54Oh, look at you.
32:55You're on the ball, aren't you?
32:56Look.
32:57You're a superstar.
32:58You're a superstar.
33:02Do you want to join Stella?
33:03Yes, Eitherا.
33:04You can do yourself.
33:05Hmmm...
33:06Oh my God...
33:07In the minor injury unit, emergency nurse practitioners
33:12of Becky's next patient is 17-year-old Caden, who's here with Mum Janet.
33:17Start curtain.
33:22What have you been doing?
33:25Why have you come to see us?
33:27I saw racing yesterday at Farmer John's.
33:29Racing on a bike, a car, a mountain bike.
33:32Okie doke.
33:33So were it like off-road?
33:34Yeah.
33:35Ok, and what happened?
33:36Erm, I came down.
33:37I went into woods.
33:38Yeah.
33:39And I went straight into a tree at some speed.
33:41Ok.
33:42What thinking speed-wise?
33:43Fifteen, twenty miles per hour straight into a tree.
33:45Ok.
33:46Straight into a tree and then obviously...
33:47Stopped impact?
33:48Yeah.
33:49Fell off the bike?
33:50Yeah.
33:51Ok.
33:52Did you get back on the bike or not?
33:52I like fell off and then I started screaming me leg, me leg.
33:55Okie doke.
33:56And did you get pain?
33:57You got pain straight away then when you fell off?
33:58Yeah.
33:59I got pain and then...
34:00And pain all the way back?
34:01And pain all the way back.
34:02Did you have to take pain colours or anything when you got home or...?
34:04No, I've just took something in my jigs.
34:07I just took some ibuprofen.
34:08Thingamajigs.
34:09Yeah.
34:10Iprofen today.
34:11Yeah.
34:12Yeah, has that helped?
34:12Not or not?
34:13It's just stuff robbing.
34:14Right, let's have you on this couch.
34:17So...
34:18So...
34:21So...
34:22Any pain...
34:23In your hips?
34:25That they are.
34:27Right, you were just pissing it then.
34:29There they are.
34:30In here?
34:31Yeah, I can feel it there.
34:32Sorry in there.
34:33Can you lift up and touch my arm?
34:37Straight as you can.
34:38That's as far as.
34:39Okay, and back down.
34:40So you're definitely sawing your...
34:42Yeah.
34:43That's saw.
34:44Yeah.
34:45What about here?
34:46Saw there.
34:47It's...
34:48I think your hips are alright.
34:49It's your famer, isn't it?
34:50Yeah.
34:51Well, get a quick extra...
34:52And then it might be that we have to get a doctor to have a look at you, just to be sure.
34:56So you'll get yourself...
34:57Self-dressed.
34:58And then we'll take it from there.
34:59Is that okay?
35:00.
35:02Follow these blue dots to x-ray.
35:05Yeah.
35:06Alright, flowers.
35:09.
35:10.
35:11.
35:12If you're looking at 15 mile an hour...
35:16.
35:17.
35:18.
35:19.
35:20.
35:21.
35:22.
35:23.
35:24.
35:25.
35:26.
35:27.
35:28.
35:29.
35:30.
35:31.
35:32.
35:33.
35:34.
35:35.
35:36.
35:37.
35:38.
35:39.
35:40.
35:57.
36:00.
36:02.
36:03.
36:04.
36:05.
36:06.
36:07on the ball with casualty full and a staff working non-stop
36:12sister jane brings out the emergency medication
36:17you
36:19you
36:22Kimberley, they've brought you chocolates ready.
36:27Yeah, I'm putting them in the drawer for everyone.
36:32Kenny's sugar here is good.
36:36We have our sweet.
36:37Which is generally always full, and if it's not, then there's...
36:42Words to be had.
36:44Specialities come down and take our sweets, and that's not fair.
36:47How is that?
36:48Chocolate.
36:49Chocolate.
36:50Yeah.
36:5110 o'clock.
36:52We are renowned in the hospital for the sweet drawer.
36:58Is it good?
36:59Yeah, it's good.
37:05In cubicle 10...
37:07Tommy is hoping to go home, but Dr. Tett has the result.
37:12The results of his blood test.
37:15I would like to keep him in.
37:17Why?
37:19Because he has got a chance to...
37:22The first pain, and the first heart attack is...
37:27Rez.
37:28Rez.
37:29I'm just worried that the heart attack is packed.
37:32When you get back home, and then you need to come back home.
37:35Okay?
37:36The thing...
37:37He is best recommended to keep you...
37:38Stay in England.
37:39He said this morning it would just...
37:42the pain, but obviously it won't.
37:43They're thinking it might have been an heart attack.
37:45It might have been an heart attack.
37:47So his granddaddy here, weren't even going to come in.
37:52I didn't know what it was.
37:54I just had a bit of pain.
37:55I've had pain before.
37:56But we also...
37:57Because he's had that many heart attacks.
37:59He's got 16 stents.
38:02In his heart.
38:03Because he's had that many heart attacks.
38:05So...
38:06You look...
38:07Don't let no help bother you, bless you.
38:08He doesn't look as though.
38:09He's just had an heart attack, does he?
38:12I want to get...
38:13I want to get...
38:17Back home.
38:18You're going to stay, aren't you, granddad?
38:19Yeah.
38:20Yeah.
38:21Yeah.
38:22I just don't want to snuff for long.
38:25Tommy spent the night in hospital...
38:27Todd is now back at home being cared for by his family.
38:39And i've been 52 months old.
38:53That's a real path.
38:55I lived with two of them yesterday, so they're trying to give me an eye to tap and they fell off three times.
39:00Yeah, it's just part of the sport, really.
39:05All right.
39:10Consultant Dr. Andrew Snell has Caden's results.
39:15We do see a lot of sports related injuries, ones that are the highest risk.
39:20Certainly, speed is related.
39:23I've had a look at the x-ray.
39:25There's no fracture on the x-rays.
39:27It's nice and clean all the way down, down to the knee.
39:30This is from Sidon, and there's your knee itself.
39:34So that's good news, but...
39:35Of course, it's not only the bones that are, you know, at risk.
39:38So we need to have a quick look at it.
39:40The general function.
39:41You have to pop up on the bed.
39:46How long have we been racing for?
39:48I started this year.
39:49Oh, did you?
39:50Yeah.
39:50But are you serious stuff, or is it...?
39:53Serious.
39:54Is it?
39:55Yeah.
39:55Very good.
39:56My lad's getting into it all now.
39:57He just started with BMX, but he's starting to get into some of them all.
40:00Stunson wants to do the downhill stuff.
40:02I think, historically, we haven't been necessarily as...
40:05as good as we should be at encouraging physical activity.
40:08So, when we do see...
40:10cases of sports and exercise related injury, I think it's really...
40:15important.
40:16We congratulate them for being active.
40:18Lift his leg straight off the bed.
40:20Just as far as I can get.
40:21Where's the pain there?
40:22All in that.
40:23Using the...
40:24Bending the...
40:25knee lifted as high as you can.
40:26Right.
40:27So, with the knee bent, it's alright.
40:28Yeah.
40:29Bit tight, but...
40:30not as hard as with the knee straight.
40:31Mm.
40:32Okay.
40:33Back down.
40:34And now...
40:35You're not going to stay on the leg at all.
40:36No.
40:37Feels normal both sides.
40:38Pull the leg back on, and you can get...
40:40your shoes back on.
40:41When's your next race?
40:42October.
40:43Oh.
40:44Okay.
40:45And what do you do for work?
40:46Build motor homes.
40:47Oh.
40:48Good.
40:50Brilliant.
40:51Works really bad.
40:52That's great.
40:54Busy lads.
40:55I don't think there's anything we need to do.
40:58Maybe for the first 48 hours...
41:00A bit of frequent icing will help...
41:02Yeah.
41:02To bring the swelling down.
41:05so all in order all right nice to meet you both and good luck with it all
41:10including the motor homes yeah back to it tomorrow yeah yeah
41:15you've been told yeah all right take care bye-bye
41:20Caden was absolutely right to be concerned and we were concerned
41:25but thankfully it looks like this time it's going to be what we call kind of soft tissue injury that will
41:30do all the time and his body will do all the healing as things heal and he feels ready and safe
41:35to ride there's there's no reason I'm very keen for him to get back to riding very good news
41:40big sigh of relief yeah can go out back out and buy it now
41:45later after a few weeks of taking it easy Caden is
41:50back doing what he loves best and he's trying hard to avoid the trees
41:55long-term care
41:59you
42:00Hello, is it Harriet?
42:05Paediatrics, charge nurse Johnny is treating 8-year-old Harriet.
42:10Did it hurt?
42:11Yeah.
42:12Yeah, but it did.
42:13I cried and then I told...
42:15I told my mum and then she said that she'd call...
42:20...and then she went into a meeting for half an hour.
42:22Oh, so she weren't even your first priority?
42:25Oh, God.
42:27Mumma ear.
42:29Right, there you go.
42:30Alright.
42:31Any problems, just come back.
42:33Bill, thank you so much.
42:35You're welcome.
42:36Bye-bye.
42:37Bye.
42:38Bye.
42:40I'm feeling a little bit guilty that it's actually broken and I left it for half an hour.
42:45But yeah, everyone's been really nice, it's been really quick.
42:50So yeah, happy that she's sorted.
42:55Bye.
42:56Bye.
42:57Bye.
42:58Bye.
42:59Bye.
43:00Bye.
43:01Bye.
43:00Bye.
43:01Bye.
43:02Bye.
43:03Bye.
43:04Bye.
43:05Bye.
43:05Bye.
43:06Bye.
43:07Bye.
43:08Bye.
43:09Bye.
43:10Bye.
43:11Bye.
43:12Bye.
43:14Bye.
43:15Bye.
43:16Bye.
43:17Bye.
43:19Bye.
43:20Bye.
43:22Bye.
43:23Bye.
43:24Bye.
43:25Bye.
43:30Bye.
43:35Bye.
43:36Bye.
43:40Bye.
43:41Bye.
43:42Bye.
43:43Bye.
43:44Bye.
43:45Bye.
43:46Bye.
43:47Bye.
43:48Bye.
43:50Bye.
43:51Bye.
43:52Bye.
43:53Bye.
43:54Bye.
43:55Bye.
43:57Bye.
43:58Bye.
43:59Bye.
44:00Bye.
44:02Bye.
44:03Bye.
44:04Bye.
44:05Bye.
44:07Bye.
44:08Bye.
44:09Bye.
44:10Bye.
44:12Bye.
44:13Bye.
44:14Bye.
44:15Bye.
44:16Bye.
44:17Bye.
44:18Bye.
44:19Bye.
44:20Bye.
44:21Bye.
44:22Bye.
44:23Bye.
44:24Bye.
44:25Bye.
44:26Bye.
44:27Bye.
44:28Bye.
44:30Bye.
44:31Bye.
44:32Bye.
44:33Bye.
44:34Bye.
44:35Bye.
44:36Bye.
44:37Bye.
44:38Bye.
44:39Bye.
44:40Bye.
44:42Bye.
44:43Bye.
44:45Bye.
44:50Bye.
44:55Bye.
45:00Bye.
45:05Bye.
45:10Bye.
45:15Bye.
45:20Bye.
45:21Bye.
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