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00:00I was raped.
00:01Siobhan.
00:02I was walking home on my own.
00:04Stop! Stay where you are, please, sir!
00:06What?
00:06You'll be entertained for the purpose of a search.
00:08Actually, it's me. It's me. Take it.
00:10Take a step back!
00:11You said to me that you want to make it in the ED?
00:13Yes, I do.
00:14Right, then I need you to work on growing a thicker skin.
00:16So what is it? What have I done?
00:18It's me!
00:19I'm your dad. I've got a dad. Thanks.
00:21Patients still need a safe place to seek treatment.
00:24I'm triggering a full inspection.
00:26And in 30 days, I'll be back to see if things have improved.
00:32All I'm saying is that you really have to make a complaint.
00:34I know you're upset, but so is she.
00:36Yeah, people tend to be upset when they get in trouble.
00:38Couldn't do anything wrong. She'd have reason to suspect him.
00:41She's obviously not racist.
00:43Well, I'm sorry, but what you do?
00:44You know what it's like on a job.
00:46You have to make a split-second decision.
00:54Hiya, mate. You the one that called us?
00:55I don't know if I'm being, like, well, dramatic,
00:57but I deliver here every day.
00:58Okay.
00:59Then yesterday, nothing. Today, nothing.
01:02Well, it's nice that you came, anyway.
01:03I'll pass the food through the window when Neil and I chat, you know?
01:09Neil? Can you hear me? It's paramedics.
01:11Lads at work have a bet why he's so private.
01:13Because I've never actually seen his face.
01:16Okay, could he have just gone out?
01:17Neil, can you hear me?
01:18It's paramedics. We're checking to see if you're all right.
01:20I've delivered here for, like, a year.
01:21Even on Christmas Day.
01:22Something's happened.
01:25Okay.
01:26Um, Control, this is 3006.
01:28Uh, we're going to force entry.
01:30Can you get the police running?
01:32Live status on none.
01:34Receive that. Over.
01:47Receive that. Over.
01:51Be careful.
02:30Neil?
02:32Neil?
03:01No, no, no.
03:02Hold on, we were told that somebody was coming today.
03:06Well, then would you mind putting somebody on the phone who does know what's going on?
03:10I'd appreciate it.
03:12Should have phoned them earlier.
03:13Thanks, Stevie, that's helpful.
03:15Yeah, well, you know, I've been polite today, so I'm fresh out of nice.
03:22Wow, what's wrong with you?
03:23You're a bit.
03:27Yeah, yeah, I'm here.
03:30Well, then why has nobody turned up?
03:32Yeah, I'll hold.
03:56Me, I don't know when the CTC arrived, but don't tell me anything, mate.
03:59I don't know when the CTC arrived.
04:15I don't know when the CTC arrived.
04:18I don't know when the CTC arrived.
04:37I don't know when the CTC arrived.
04:40I don't know when the CTC arrived.
04:54I don't know.
04:56I don't know when the CTC arrived.
05:23I don't know.
05:32I don't know when the CTC arrived.
05:51I don't know when the CTC arrived.
05:53I don't know when the CTC arrived.
05:55I don't know when the CTC arrived.
05:56People will see me.
05:57I'm sorry, but we need to see what we're doing.
06:03It's all right.
06:04It's all right.
06:05It's all right.
06:06It's all right.
06:30It's all right.
06:58Is this your mum?
07:02The pizza guy told me that you lost her last year.
07:06I'm really sorry.
07:09Ooh, and who's this handsome couple?
07:14It's me and my girlfriend.
07:18Ex-girlfriend.
07:20Here, give me a mood.
07:25Control to 3-0-0-6.
07:27You still need a second truck.
07:28Over.
07:303-0-0-6 to control.
07:31Well, we're going to need P2 back up from another crew.
07:37I haven't always been this bad, you know.
07:43My ex left me, but when I started putting on weight, she said I had bigger tits than her.
07:50But so what?
07:54Mum was ill.
07:54You sure that's necessary?
07:56I nursed her for ten years.
07:58No.
07:59I couldn't just leave her on her own.
08:03Just hands on.
08:07How long have you had these sores?
08:11A few months.
08:12Is there anybody else who can help you?
08:15Family?
08:16Friends?
08:18No.
08:18No.
08:21Not now.
08:21Mum's gone.
08:24OK.
08:25Thanks for the insistence.
08:32OK.
08:32Back up is on the way.
08:34My guess is that they're going to bring a winch.
08:37A winch?
08:39No.
08:40No, I can't.
08:41I can't.
08:43You can't make me.
08:44Just give me some insulin.
08:47Leave me alone.
08:50This is Debbie, 33 years old.
08:53She's dragged underneath the car.
08:54Ten litres at 18 and 20.
08:55Matty, listen up, please.
08:57She's got left arm degloving from her wrist to her elbow.
09:00Bruising around her umbilical region.
09:01Bed three, please.
09:02Heart rate's 145.
09:04BP's 77 over 40.
09:06Sats 99% on 10 litres.
09:08Rest at 24.
09:09GCS is 10.
09:10She's had a gram of ibm and paracetamol.
09:12Four milligrams of ondansetrant.
09:14A gram of TXA.
09:16500 mills of saline.
09:18Seven and a half milligrams of morphine.
09:20And 1.2 grams of coimoxiclub.
09:22OK.
09:23On lift, please.
09:24Ready.
09:24Brace.
09:25Lift.
09:26Slide.
09:28So she's deteriorating, isn't she?
09:30So, Matty, do you want to take the primary survey?
09:32Yeah.
09:32She's hypertensive, presumably hypervolemic,
09:35so we need to find out where that bleed's coming from, don't we?
09:37Yeah.
09:37Yeah.
09:38Let's activate the major hemorrhage protocol then, please.
09:40Siobhan, could you set up the rapid infuser?
09:42As soon as you can.
09:43Kim, blood from the fridge, please.
09:45Two units FFP.
09:46Two units O'Neck.
09:47So, in time, we'll need to do CT for the trauma, obviously,
09:50and angiography on the arm.
09:52Let's do a fos...
09:52Oh, you're doing a fos...
09:54Siobhan, can we check these pills?
09:55Mm-hmm.
09:56OK.
09:57Absent lungs slide in a lung point.
09:59She has a pneumothorax.
10:01OK.
10:01So, good spot.
10:02What are we going to do?
10:03Chest drain.
10:04Yes.
10:04Let's set up for that, then, please.
10:08Sorry I snapped.
10:08Good work, Matty.
10:10Wasn't it good, Dr Keogh?
10:12Yeah.
10:13Perfectly adequate.
10:18The backup is here, Neil, and believe me, everybody wants to help you.
10:24We can bring the stretcher in and go.
10:27No.
10:28This is reversible with the right treatment, you know.
10:31Neil, you need proper electrolyte monitoring and insulin infusion,
10:36neither of which we can do in this living room.
10:37I know.
10:39From what you've told me, your mum would not want you wasting your life
10:45wearing this dark green, would she?
10:51You really want to help me?
10:54Take out my rubbish.
10:57OK, look, Neil.
11:00High blood sugar is dangerous.
11:02Low blood sugar is dangerous.
11:04DKA?
11:05Fatal.
11:07Now, if we walk out of here, which we're probably going to have to because you do have capacity,
11:11then you are going to die.
11:14So the question is, Neil, do you want to live or do you want to die?
11:18It's really that simple.
11:21Come on, Neil.
11:23Should we go?
11:38I, um, had a word with orthopedics and the boy in resus two should be fit to be moved in
11:43about ten minutes.
11:44Right, OK, thank you.
11:46Um, look, stop worrying about the CQC.
11:47They'll come tomorrow.
11:48Just go, get some sleep.
11:50Stevie, you're in danger of being nice.
11:52Yeah, I'm really not, though.
11:53This is Siobhan.
11:55Who is it?
11:59D.I. Hughes.
12:05Shouldn't be too much longer, apparently.
12:07I don't know why I'm even here.
12:09It's stopped bleeding.
12:15So, is the nursery painted?
12:17Is it all finished?
12:18Yeah, yeah, it's all done.
12:19We've just got the court to build, but the kids want to help with it, so.
12:22As brilliant as it is showing with your best mates, I honestly don't know how I'll be able to afford
12:25a place on my own.
12:26Might be all right, though, for a doctor.
12:28Not this doctor.
12:29I'm still renting.
12:33OK.
12:34You all right?
12:34You should head home as well.
12:36I haven't made an arrest.
12:37OK.
12:38Somebody's recognised the ear fit and his DNA's on my uniform.
12:42Are you kidding me?
12:42This is good news, right?
12:44Well, I mean, sorry, it obviously didn't change anything that happened.
12:47No, no, it's great news.
12:48He's off the street.
12:49He's going to face justice.
12:50OK.
12:51Hey, hey, hey, that's because of you.
12:53OK.
12:54No, don't.
12:55It's a CQC.
12:58You're kidding me.
12:59I just sent everybody home.
13:00It's OK.
13:00We can do it.
13:01OK.
13:01You've got this, OK?
13:02Just keep going.
13:03Kerry, welcome back.
13:05It's good to be back.
13:07I hope.
13:15Pizza guy's still there?
13:17Yeah.
13:19OK.
13:19Nice and easy, guys.
13:22Nice and easy, guys.
13:23Nice and easy, guys.
13:23Nice and easy.
13:26Still here, Neil.
13:36Hey, it's OK.
13:38It's OK.
13:40Everyone ready?
13:40Yeah.
13:41Let's go.
13:42OK.
13:43Push.
13:44Neil.
13:46I knew it.
13:48Neil, mate.
13:49I don't think there's a blanket big enough.
13:51Keep going.
13:52Keep going.
13:53Keep going.
13:54When you get back, Chubster, let's go down to two large pizzas, shall we?
13:57And only one portion of wings.
14:00I'm so sorry.
14:01I'm really, really sorry.
14:03Hey.
14:04Hey.
14:05Back off.
14:05Jacob.
14:06Jacob.
14:06It's not worth it.
14:08Wait until everyone sees this.
14:10No, no, no.
14:15Can you feel this?
14:18Yeah.
14:21It's OK.
14:22It's OK.
14:22It's OK, love.
14:22It's OK.
14:23Focus on me.
14:24Plastics will be down soon.
14:26That man did a real number on you, I'm afraid.
14:28He had such hatred in his eyes.
14:31I mean, everyone hates traffic wardens, but he just lost it.
14:36Because he gave him a ticket?
14:38I know people think we're busybodies, but the rules keep us all safe.
14:42I couldn't agree with him more.
14:45Problem is, some people think the rules don't apply to them.
14:48Don't they?
14:50Siobhan?
14:52Yeah, that's good.
14:53They'll do the rest in the theatre.
14:56How was the scan?
14:58Like Dr. Keir thought, grade four splenic lack, and blood in the peritoneal cavity.
15:03Shall I chase upstairs, see how quickly they can take her?
15:06I'll go and speak for surgery.
15:10Can I call somebody for you?
15:12My parents are away. I don't want to worry her.
15:15OK.
15:16Kim, could you give me a hand?
15:17We'll get you more comfy.
15:18OK?
15:19Can you lift her up, please?
15:23Thank you. That's it.
15:24Are you OK?
15:26We don't all hate traffic wardens.
15:42Hiya. This is our pre-alert Neil. He's 43, is an insulin dependent diabetic and presented in DKA after multiple
15:49missed insulin doses. His first CBG was 29.4. His ketones were 6.2. We've given him fluids as per
15:55DKA guidance.
15:57Don't touch me. They're here to help you.
16:00OK. Neil, my name is Dr. Byron. We have everything we need ready. This is Jodie. She's just going to
16:04check your blood glucose and your ketone levels, OK? Nothing to worry about.
16:08Nicole, can you get another line in? Bloods and gas and, um, I'm a little bit concerned about clotting, so
16:14let's get some blood thinners on hand as well.
16:15Yeah.
16:17Hiya, Neil.
16:18Have you got to set your hand?
16:19Yeah.
16:20It's all right. It's OK.
16:21That's it. Thank you.
16:25See you later, mate. Thank you. It's all right. Thank you, guys.
16:34Just give me that on, and then I can have a look for a vein.
16:39I did not think we were going to get him out of there at one point. I'm kind of glad
16:43you did the bad cop routine now.
16:45I'm going to smash that fool's phone.
16:47Me too.
16:48We did really good with her. What did I mean?
16:56I was thinking that maybe we could team up for the rest of the shift. And with the CQC, we
17:03need to be on it, right?
17:04Sound, yeah. Great idea.
17:11Tara Miller?
17:15Hiya. I'm Dr. Lynn Laker. This is Dr. Chang. If you'd like to follow us, please.
17:23Why don't you go? You've done your ditty.
17:26She's not your mum?
17:27No.
17:28We just work for the same soul-sucking corporate hellhole.
17:33Are we just going to go over into cubicle three?
17:37Our boss made her come because she had finished her shift.
17:42Just hop onto the bed for me.
17:44Obviously, we've made changes in all the areas you identified.
17:47And you've also worked with the inpatient teams on Flo?
17:51We have. I think you're going to find that things are running pretty smoothly.
17:54Ow!
17:55Sorry. Sorry.
18:00Okay.
18:02Yeah, how did you do this?
18:04There was too many people in the kitchen at work.
18:07Mm-hmm.
18:07Got distracted.
18:09Was bashed by a cupboard door.
18:11Glued to her phone.
18:13Any loss of consciousness? Any vomiting?
18:16She's not been quite with it and she's been sick twice.
18:19My whole head hurts. And my neck.
18:21I think we should CT, just to be on the safe side.
18:24Agreed.
18:25Might be a bit of a wait, I'm afraid.
18:30Young people don't do headphones, do they?
18:34Have you had any paracetamol in the last four hours?
18:37No.
18:38Okay.
18:39Excuse me.
18:40Can we get one gram of paracetamol, please?
18:43Thank you, Phoebe.
18:44And I'll put a CT request in with the system.
18:47I suppose I could stay a bit longer and finish telling you about when I went to Croatia.
19:07Try not to get it wet.
19:08You can use a plastic bag when you need to go on the shower, alright?
19:19I'll have to look at his name.
19:21Okay.
19:22Yeah, sure.
19:23Oh, D.I. Hughes.
19:26What are you doing here?
19:28I just needed to check your records.
19:30The man we arrested.
19:33Chris Banfield.
19:34He's saying he was a patient here.
19:36Oh, I'm sorry.
19:39I'm sorry.
19:39I'm sorry.
19:39I'm sorry.
19:49How come everyone else can do it?
19:52Do what?
19:53Lose weight?
19:53All of it.
19:55Eat a normal amount.
19:57Go to a job.
19:58Have friends.
20:00Can everyone else do it?
20:02I mean, yeah, I've got a job and I eat a normal amount.
20:06Whatever that is.
20:07But sometimes I drink too much.
20:11And I make an idiot of myself that way.
20:15I lost my mum last year.
20:19I never went to a funeral.
20:24I thought people looking at me, pointing, laughing.
20:31I just couldn't do it.
20:35I didn't say goodbye.
20:38I let her down.
20:40No.
20:42You were grieving.
20:45You...
20:47You can't keep beating yourself up for that.
20:50Yeah.
20:51Your mum would understand.
20:57But she's not here anymore, Neil.
21:03And you are the only one that can get yourself healthy.
21:07You're the only one that can choose life.
21:10You're the only one that can choose life.
21:36I would have made a gift with Miss Mackenzie.
21:38No.
21:38Absolutely not.
21:39I would have remembered him.
21:41Cam.
21:44Imaging was down.
21:46And I needed someone seeing his advice.
21:47I needed Shaborn's advice.
21:50Remember?
21:50He was going on about his mate.
21:52His mate left a nail in the woods.
21:57Would you have touched him?
22:00Yeah.
22:01That doesn't excuse it, does it?
22:03If anything, that makes it make more sense
22:05because now it's not a random thing.
22:07He's, like, followed you home. Do you know what I mean?
22:09He says Siobhan treating him is how his DNA got in her uniform.
22:16I need you to prepare yourself
22:18in case the CPS won't take it any further.
22:21What do you mean?
22:24Go on, spit it out.
22:27He reckons he's a young, attractive man
22:29and that if he needed sex, he'd go on the apps.
22:32Why would he need to rape someone?
22:35Especially someone so much older.
22:44Look, you know, rape is not about sex, OK?
22:46It's about power and violence.
22:49Yeah, and believe me, it turns my stomach.
22:52Look, I just wanted to be honest with you.
22:57Let me show you how.
22:59Anything I can do, Siobhan.
23:01Anything at all.
23:02Please, just call me.
23:11We're thinking of walking the Camino de Santiago,
23:13but I'm not sure about the hostels, you see.
23:18OK, Tara.
23:19Hiya.
23:20Your CT was normal.
23:22No fractures, no bleeding, just the cut of the head, OK?
23:25So...
23:26It's killing me.
23:27I'm not someone who moans a lot.
23:30Have you got pain anywhere else?
23:32Like I said, my neck.
23:35Can you, er, can you put your chin to your chest?
23:40Hmm.
23:43Any more nausea?
23:45Yeah.
23:46A lot.
23:52Do you tend to bash into things?
23:55Not really, no.
23:58I think I was feeling a bit dizzy.
24:01So the injury isn't the problem?
24:02It's what caused you to sustain the injury, that is?
24:04Well, what has caused it?
24:06You should develop and manage, isn't it?
24:09Just give us a minute, yeah?
24:13OK, OK, er...
24:16Maybe she had a small bleed, the CT didn't pick up, a SAR.
24:20We should do a lumbar puncture.
24:21We'll check for xanthochromia.
24:23It's not 12 hours since the fall.
24:25You can do it after six, right?
24:28We can't leave her.
24:29She'll make her sepsis or brain damage.
24:34Is Dr. Byron around to supervise?
24:43We don't need Dr. Byron.
24:45For a lumbar puncture.
24:47You know what he's like?
24:47He won't thank us for interrupting him.
24:50OK, call Dr. Keir then.
24:52No.
24:53I'm not calling him.
24:55OK, if you want to call somebody, call Dr. Nash.
24:58Yeah, I didn't think so.
25:00Look, we have trained for this.
25:03Plus, I've done one, supervised.
25:06OK, you supervise me this time.
25:10Come on.
25:11We're a good team.
25:28I shouldn't be here.
25:29I promise you, he does not want any ag either, all right?
25:33I can just apologise and everything's going to go away.
25:36This is gay defense.
25:37Come on, man.
25:37You've got the first round.
25:38No, I'm not doing that.
25:43Right.
25:44I'll see you in the pub.
25:46You all right, mate?
25:50Jacob, I owe you an apology.
25:53You and Blake.
25:56I was just trying to do my job, but I should have listened to you when you told me he
26:00had nothing to do with it.
26:01I tried to tell you that Blake had mental health issues.
26:03I know.
26:04I'm sorry.
26:07I'm sorry.
26:09I am sorry.
26:16OK.
26:18Apology accepted.
26:24That's great.
26:33We're going out in a bit if you fancy coming with us.
26:37Nah, sorry.
26:37I've got to catch up with Ian, so.
26:40I've got to finish this as well.
26:42See you in a bit.
26:43Yeah.
26:55No worries.
27:01When do you think you'll call the station?
27:06What?
27:08Mate, I'm not retracting a complaint.
27:12Look, her saying something makes things easier, but the problem's systemic.
27:16An apology's not going to change that.
27:30OK, Tara.
27:31Just checking that you're still OK for us to perform the procedure to check if there's any blood in your
27:34spinal fluid.
27:35Yeah.
27:36Yeah?
27:40I identify the L3 to L4 or L4 to L5 interspace by palpating the posterior superior iliac crests and move
27:50your fingers medially towards the spine.
27:52And that's it.
27:56Now, move up into the L3 to L4 space and mark this space with your finger.
28:01You could have let her stay.
28:03One of her stories might have been a distraction.
28:06You thought you might have wanted some privacy?
28:09Don't worry.
28:09She'll be back in a minute.
28:11She was telling me in great detail about all the trips she's been on.
28:18She's been all over the place.
28:24Mm-mm.
28:25It doesn't feel right.
28:26It's not going in.
28:28You're in the right space.
28:30But it's just not going in.
28:35I'm going to go higher.
28:37I'm allowed to do that, right?
28:38Everything all right?
28:40Yeah, yeah.
28:40Everything's fine.
28:41Not much higher.
28:43How much higher?
28:46I can go one space above, right?
28:48L2, L3?
28:54Kim?
28:56Kim?
28:59Yeah.
29:01Sure?
29:02Yes.
29:05Yeah.
29:08There we go.
29:12Okay.
29:15Okay, yeah.
29:18That's much easier, eh?
29:21Okay, we'll get this sorted for you and then we'll, er, look at your friend back in a minute.
29:37Told you we could do it.
29:39Mm-hmm.
29:39Okay, let's go.
30:14please please don't make me do the baby reader pretty please actually why don't you take angry
30:22drunk man instead wow that's like super mean don't worry don't worry we'll come back to you
30:29when we got the results no there's something wrong she's saying she can't feel her legs
30:47all right Ted yeah you're right you're right
30:54um Jacob yeah Ashley is really really sorry about what happened and we thought we thought
31:02you accepted it so I'm not understanding why we can't move on
31:09right I will get you a drink no I'm all right no I'll get you a drink I'm sitting here
31:14listening
31:14to you two fighting you're never fighting man look Teddy I need to protect my son but you don't have
31:23to make an example of my girlfriend doing that do you know that Blake hasn't left the house since
31:26your girlfriend arrested him look how far he's come and now he's terrified that this may happen again
31:33maybe in front of Carter next time look how she treated that white woman yeah you know the one
31:39with the mental health issues the moment she was compassionate she was patient but with Blake she
31:44was different and she was even more scared when I spoke up I don't believe that why are you still
31:49defending it do you know I am so sick and tired of trying not to look angry off set trying
32:02not to give
32:02them the room to call me the angry black man I know I get that do you yeah Teddy you
32:09were raised by a white
32:10family so I don't know if you do ready for to get it well make your mixed race you're more
32:18palatable
32:20than me and Blake and do you think people see me and think half white because Jacob Jacob I am
32:26telling
32:26you now I'm telling you they see a black person now you're like family to me and you know that
32:34I'm just
32:36saying that sometimes in situations like this you and Blake don't walk in the same shoes it's not the
32:42same if you don't challenge the system then how do you expect it to change I'm not retracting the
32:50complaint and if you don't get it now then I hope someday you will
33:03you'll be back in a sec tell me exactly how it feels strange tingling I can't move Tara try not
33:23to
33:23panic okay we'll run some more tests and I'm sure everything will be fine just try and relax
33:32let me tell you about all the other places I've been to last year part of this group you see
33:37divorce women
33:42I don't see how I could have done something wrong I did exactly what you said
33:45it says you can't go as far as L2 to L3
33:51wait you said that I could
33:56guys you okay
34:04we were worried about a leaking cerebral aneurysm and a small subreddit no bleed not visible on the
34:10CT enough please okay um so Tara we I'm gonna know anything for sure until we get the results back
34:16okay but the first step is to just stay calm I'm going to take a look if that's okay
34:21thank you
34:27you feel that
34:32no
34:36okay how about this
34:50how about that
34:54no no I can't feel any of it
35:05what's going on um can you call Dylan and Stevie back please thank you okay I understand how frightening this
35:12must be for you
35:15am I ever going to be able to walk again I'm going to need to take a CT of your
35:19head and an MRI of your spine but hopefully this is just temporary okay
35:24it might not be
35:26it might be permanent
35:27it's because they put that needle in her isn't it
35:29um well it might
35:31it might be a result of the lumbar puncture that Dr. Chang and Dr. Lynn Laker performed yes
35:36I'm sorry I'm so sorry
35:39you two in my office now
35:41go please hurry up thank you
35:43um I'm gonna I'm gonna send a nurse over we're gonna get you upstairs for that CT
35:48and um yeah I'm gonna I'm gonna send somebody straight over okay
35:58I'm so sorry
36:00I know this is a very difficult moment
36:04but would you mind if I asked you some questions
36:14it was my fault I misread the instructions I told him to go too high
36:20no it was my fault
36:22Kim didn't even want to do it
36:25and I've done one before
36:27with supervision
36:28I thought I could do it
36:30you've done one before with supervision
36:31I thought I could do it
36:34see one do one right
36:36see one do one that's the motto around here
36:39and and and you were busy with the CQC
36:41so why didn't you call Dr. Keo
36:44Dr. Nash wants me to stand on my own feet
36:48obviously that doesn't mean not asking for help when you have a legitimate need
36:52when a patient has a legitimate need
36:54so is that it?
36:56a young woman might never walk again
36:58because you didn't want to call Stevie in case she was a little bit sarcastic
37:01is that it?
37:02is that what you're telling me?
37:04why didn't you come to me?
37:06I would have helped you
37:07well why would we come to you after that stupid game you played that training?
37:12you let me think I was gonna die
37:14hey I
37:17how could we trust you after that?
37:22you two had better hope and pray
37:23than how paralysis is temporary
37:28I strongly advise you both
37:31not to pass any further comment
37:34just be quiet okay?
37:45I'm sorry I had to tell them the truth
37:47I know
37:48I know
37:49I know
37:52Siobhan
37:52listen if you er
37:54if you need anyone to speak to
37:55no I'm fine Cam
37:58Siobhan
38:02I really want to be there for you
38:04look Cam I know you do love
38:06and that means a lot
38:07but we've got the CQC to focus on
38:09so come on
38:10look sharp
38:15where are we going?
38:17we're going upstairs
38:18your bed's ready remember
38:19Kim?
38:20Kim?
38:21do you mind coming up with us?
38:22he was fine for
38:24Neil?
38:25I don't feel
38:26Neil?
38:27I don't feel right
38:28all right Neil
38:29Dylan Dylan
38:30I need you
38:30er
38:31ok ok ok ok
38:33what have you got?
38:34this is Neil
38:3440's
38:35inch and independent diabetic
38:36he's been on the ZPA protocol
38:38for about 3 hours
38:39and his blood sugar's coming down quickly
38:41he's having a seizure isn't he
38:42so he's probably hyperdice in it
38:43ok ok
38:43so when was his blood glucose last month?
38:46er
38:46it was 20 minutes ago 7
38:487
38:49alright
38:49it's beginning to subside I think
38:51yeah
38:51alright so let's get him to resus I think
38:54stand by with dextrose and verazepam as well
38:57ok
39:01oh wait wait
39:01stop this for the board
39:02ok stop
39:03he's struggling to breathe as well
39:04erm
39:05oh Kerry could you help
39:06would you would you give us a draw for us here?
39:09I'm just here to observe
39:11well ok
39:11you can observe him suffocate
39:12or you can lend a hand
39:16do we know where that's coming from?
39:18thank you
39:30ok so that's all
39:31beginning to stabilise aren't we?
39:33fine
39:33so as I said
39:34through to resus
39:35and let's stand by without dextrose
39:36please
39:37I'm sorry I didn't mean to bark
39:39it's ok
39:44you sure she's going to want to see this?
39:46we need to rebuild a trust in the medical profession
39:50and that begins with all of us holding our hands up
39:54Stevie
39:54you ready?
39:55yep
39:56right Kim
40:02hiya Tara
40:03my name's Dr Nash
40:04I'm one of the consultants here in the ED
40:07we have your results back
40:09and I'm really sorry to have to tell you that you have developed an epidural hematoma
40:15which is a very rare but recognised complication from a lumbar puncture
40:21so basically what's happened is that a clot is formed
40:24and that's putting pressure on the spinal cord
40:26which is
40:27which is why you can't feel your legs
40:28is it permanent?
40:30look we've ordered an urgent referral to neurosurgery
40:32so they're going to operate
40:33they will remove the clot
40:34they'll try and relieve the pressure
40:37yeah full recovery is possible
40:39but I want to be
40:39very clear here
40:41that it's not a guarantee
40:43so we could be looking at a permanent injury
40:47it was just a little cat
40:50I'm so sorry
40:51I really
40:52GET OUT
40:55I'm sorry
40:58look let me assure you that you're in the best possible hands upstairs
41:01we'll get you ready
41:03I'm going to contact Euro, okay?
41:11thank you
41:12I know I have no right to ask
41:14you've been here for hours
41:17but can you please stay a little longer?
41:20tell me another one of your stories
41:24I'm not going anywhere
41:27and you can talk about whatever you want
41:29or not talk
41:31it's your call
41:39it's your call
41:40obviously this is a massive thing to have happened
41:44and on my watch
41:48but it is just one thing
41:50that's what you said last time
41:56we fixed the problems that you identified
41:58we are hitting our target
42:00and this training exercise of yours
42:03you still think that was responsible?
42:06yes
42:07yep
42:08they have to learn to operate under pressure
42:11why don't you have more consultant cover at night?
42:17we can't afford it
42:21you know the money only goes so far
42:23both times I've been here I've had to step in
42:26and that's not because your teams aren't good
42:29Dr Keogh
42:31despite his manner
42:32is clearly an excellent doctor
42:35but if the consultants aren't on duty overnight
42:38and the residents won't ask for help
42:41your patients still aren't safe
42:51I can't stop seeing Tara's face
42:56when she realised
42:57me too
43:07how could you read that wrong?
43:10how?
43:12I mean you're a proper brain box
43:14I'm surprised you even use your phone anyway
43:17no blame
43:18obviously
43:21but you know
43:23what happened?
43:27anyone can make mistakes
43:33especially under this kind of pressure
43:52I'll be just checking on the patient
43:54yeah yeah of course heading in the right direction I think
43:57thank you
43:58not a problem
44:00I'm going this way too
44:03I'm sorry if I put you on the spot
44:06no you didn't
44:08it's just
44:10I haven't practised in a while
44:11that's all
44:132020
44:16okay but
44:17yeah
44:17that was
44:19that was tough on all of us I think
44:20and certainly if my experience was anything to go about
44:23you should try therapy
44:25Dr. Keogh
44:26I'm here to assess you
44:27not the other way around
44:36goodbye mum
44:39I do miss you
44:45I don't know any prayers or anything
44:47with him
44:48yeah I don't either actually
44:50erm
44:51I mean maybe I could make one up
44:58actually
45:01can I go outside
45:06I don't know
45:28wait
45:29hey guys
45:33I'm afraid tonight's inspection didn't go as we would have hoped.
45:38The inspectors witnessed the result of an incorrectly performed lumbar puncture.
45:45Who was it?
45:48It doesn't...
45:49We're not going to start pointing fingers, Nicole.
45:52Well, it wasn't me.
45:54And Stevie and Dylan weren't here, so...
45:56OK, look, there were a number of reasons, OK?
45:58A resident distrust of senior staff.
46:04Lack of consultant cover at night.
46:07The training exercise that I thought was a good idea recently.
46:12All of it came in for criticism, OK?
46:15Fine.
46:16Just spit it out.
46:17What are they going to do?
46:21We are no longer open to major trauma at night.
46:30From when?
46:32From right now.
46:34This is going to affect our reputation, which in turn will affect our funding.
46:37And what about our jobs?
46:39Yeah.
46:40Our jobs are on the line and most importantly, our patients will now have to go to St James,
46:44which we all know will take longer, so...
46:47To be indelicate about it, lives are going to be lost.
46:51So that's it?
46:53Well, I mean, if we can meet strict staffing, safety, leadership and quality standards,
47:00we can invite the CQC back to reassess.
47:05Yeah.
47:06Tonight, that's it.
47:09Yeah.
47:13Yeah.
47:14Yeah.
47:17Yeah.
47:19Yeah.
47:21Yeah.
47:22Go, go, go, go.
47:23Go, go, go, go.
47:47Go, go, go.
47:53You know, when I first came here, I really thought I could fix this place.
48:03I've made it worse.
48:05You haven't.
48:09I have to resign.
48:10What?
48:11You can't.
48:13No.
48:14No, we need you.
48:17Leaving's a coward's way out, anyway.
48:22We'll fix it.
48:24I have to.
48:56We'll see you next time.
49:24We'll see you next time.
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