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00:04Oh, cardiac arrest coming in. Dolly mount!
00:07It's one of the most pressurized jobs in the world.
00:15Becoming a paramedic is not for the faint-hearted.
00:18So it's going to be a little bit of pulling and dragging.
00:20That's okay.
00:23No, it's okay.
00:25Each year, the National Ambulance Service College
00:28welcomes around 90 new hopefuls to their campuses in Dublin,
00:32Ballinasloe, Tullamore and Cork.
00:34These people here are going to be your absolute backbone
00:36over the next three years.
00:40But not everyone makes it true.
00:42I don't think I want to do this anymore.
00:44It's just shit. I'll go to that in two days.
00:48Because this is no ordinary degree course.
00:51Where are we going to go? It's cardiac.
00:56These students are out in ambulances across the country.
01:00999 mode activated.
01:04Learning on real emergency calls.
01:07Here, here, here, here. It's over there.
01:11With every shift a crash course in courage.
01:14It doesn't get any harder than this.
01:16Resilience.
01:17Lift.
01:18And critical decision making.
01:20We have a device that brings the bones back into place.
01:22But it's going to cause them to scream.
01:24Big deep breath for me.
01:25The exams on this course aren't just a pass or fail.
01:29Ugh, why did I sign up for this?
01:32They're a potential matter of life.
01:34Are you going to wake up for me?
01:35Or death.
01:36We're not breathing.
01:55In Mayo, second year student Ryan and colleague Tommy
01:59are responding to a call outside Castle Bar.
02:0221 minutes.
02:04Where a woman is struggling to breathe.
02:09Obviously, the ambulance service is called to critically ill patients
02:14every day of the week.
02:15And that comes with responsibility from us to perform
02:19to the best capabilities that we can on the day.
02:23Second year students are classed as interns.
02:26Rostered on shift for 52 weeks with an experienced paramedic.
02:30And they are expected to step up their learning on every call.
02:35You're kind of like a duck on water.
02:37When you get on scene, you're going to look confident
02:39and come across that you know what you're doing.
02:41But inside your heart is racing.
02:44Keep going up.
02:45Keep going up.
02:47And you're going to sit there.
02:50This one?
02:51Yeah.
02:51Jeez, look at that for hours.
02:58On arrival at scene, we were met by some family members
03:01and we were directed into the bedroom where Roberta
03:04was struggling quite hard.
03:09How are you doing?
03:10How are you keeping?
03:11Ryan is my name.
03:12I get the machine.
03:13Just do a few checks.
03:16Initially we were carrying out the assessment
03:17and I just identified, right,
03:18she's going to need something else.
03:19So I went out to the ambulance to grab a nebuliser.
03:23So is it general deterioration today?
03:26Like what would her kind of general condition be?
03:30When I came back in, there was no sign of Ryan.
03:33Sorry.
03:34I was just having a chat with this lady.
03:37Right.
03:37Come in there.
03:38It's a bit of a haze.
03:40When Tane chatted with the patient,
03:42I went to the next of kin to get details
03:43and I think I kind of zoned in a bit too much
03:48on actually trying to get details.
03:51Any rigors or, you know, shaking as if she's a temperature?
03:55No, no, no, no temperature.
03:56Ryan got focused on paperwork.
03:59He was trying to get next of kin details
04:00rather than identifying that Roberta was struggling
04:04fairly hard to try and get her breath in.
04:08What was the set?
04:1088.
04:10She's very wheezy, very lethargic.
04:12More important to this now then.
04:14You need to get paperwork.
04:15I know, but like one person can do one job
04:17and the other person can get what the story is.
04:20Like one of the things that used to be always said to me
04:22is this patient's sick or the big sick?
04:24And she was heading towards the big sick.
04:25She was struggling.
04:27Now, we have a chair here
04:29and we're going to get you onto our chair
04:30and get you out to the ambulance.
04:31Is that okay?
04:33So I'm going to put my arms underneath you
04:35and lift you over onto the chair.
04:37I think I was in reverse gear,
04:39to be honest with you, going in the door
04:40while Tommy was in fifth gear.
04:44Okay, ready?
04:45One, two, three.
04:49I love him.
04:50We'll get the blanket down around her there.
04:54It wasn't really until I got out of the ambulance
04:57or thereabouts when we were transferring the patient
05:00that I kind of got the hint that Tommy wasn't too impressed.
05:04Do you remember when you told me
05:05don't be asking questions?
05:07I'll ask all the questions I need.
05:09I was taking a history and then I was disturbed.
05:11Oh, I know, I know.
05:15We're going to head for Castlebar Hospital, so we are.
05:18Good to go?
05:19Yeah.
05:20Seatbelts on?
05:22They'll be on now in two seconds.
05:24Give me under pressure, Tommy.
05:25Good.
05:26I'm glad the last call put you under pressure.
05:28Oh, yeah.
05:29This is morbid now, so it is.
05:31Now, Roberta.
05:33Damblings can be bumpy enough at times, all right?
05:36I suppose having that trust that I could let him do it,
05:40there's no point me doing all the big calls
05:42and him not getting the experience from it.
05:44He needs to experience that patient that's sick in front of him.
05:491644.
05:521644.
05:53Go ahead, there.
05:54Susan, how's it going?
05:56Could I just put in a pre-alert there for recess for Castlebar?
05:58Over.
05:59You can indeed.
06:00Give me two minutes, sir.
06:02Thanks, Ian.
06:07With Roberta safely delivered to the emergency department for further examination and treatment,
06:13Tommy is debriefing with Ryan.
06:15I had one look at her.
06:16You could see she was lethargic, the eyes were going.
06:18You could hear the bubbling, like she was struggling.
06:23I went for the machine, I came back, you were gone.
06:25There was no one there.
06:26The room empty, patient on her own.
06:28And then I had to run out because I knew she needed a neb without even having to listen to
06:32her chest.
06:32So I was doing that.
06:34Yeah.
06:34There was nearly a shout going across.
06:36Yeah, yeah.
06:37Where the fuck are you going, Tom?
06:38Do you know what I mean?
06:40Yeah.
06:41And then there was one or two other, I just said out until I get this sorted.
06:44So once I had the neb on, I was trying to help her and open it up.
06:47The air was for her.
06:48Getting her out, fair enough.
06:49Look, we worked well getting her out and all that.
06:51Chair was the handiest thing.
06:53I went for the chair as well.
06:54Yeah.
06:55Where were you?
06:56Were you in the room back at that stage?
06:58Or were you still Tom?
06:58No, at that stage I was doing the BGL at the time.
07:01Okay, so.
07:02But no, I completely agree.
07:03Do you know where I come from?
07:04No, 100%.
07:04No, I completely agree with you.
07:06Can't be all sunshine and butterflies as you said.
07:09And sure, it never is.
07:09It never is.
07:10No, I completely agree with you.
07:12I shouldn't have left the room.
07:13At the end of the day, we're going through the internship for a reason.
07:17So that when we do qualify, we don't make those mistakes.
07:21And as long as you learn from those experiences and not just disregard the experience,
07:27I think that's very important.
07:32All right, look at it.
07:33It's been a long road.
07:36Sorry.
07:40Can I have two seconds?
07:44It's been a long road.
07:45And I think anyone in the class...
07:50Sorry now, the emotions of that call is just getting to me.
07:56Excuse me.
07:57It's been a long two years and there's been a lot of ups and downs on the...
08:01As far as here.
08:02And it's definitely...
08:04I don't know why I'm crying.
08:06But, yeah.
08:08It's been a long two years.
08:10So it has.
08:12I don't know why I'm crying.
08:15It was a combination of the factors, to be honest with you.
08:19I had some nasty calls.
08:23Calls that were fatalities and of minors as well.
08:26Pissed off at myself is what I am.
08:29It's only two, three minutes of the call.
08:31I know.
08:31That's it.
08:32That's it. Everything else was fine.
08:34One tiny, little, minuscule piece of the call.
08:39Yeah.
08:40Yeah, never mind you.
08:41Yeah.
08:41This is the...
08:42Yeah, yeah.
08:42You're brushing off.
08:43Yeah, yeah.
08:44Do you know what I mean?
08:45I know.
08:45So don't be under any illusion.
08:47You're well able to do the job.
08:48Look it.
08:49Tommy came into the back of the wagon and we hugged it out and chatted and all was well.
08:55But you have to, like, it's...
08:57You need that.
08:57You need that camaraderie in the service as well.
09:00So you do.
09:01And you need that wingman.
09:03Ah, come here.
09:06Get up.
09:06I don't think it's even...
09:08Get up.
09:08Shut up.
09:09Fucking ass, yeah.
09:11What the fuck?
09:12I don't think it's even this call that's dead to me.
09:15It's not.
09:16It's all the stuff that builds up.
09:18Yeah.
09:19Yeah?
09:19And all the emotions you have to deal with.
09:22Do you remember what I said to you before?
09:24It's all there and then the next thing it just bursts out in you for no reason.
09:29Jeremy, you're well able to do the job.
09:30And I know that you're saying it's not this call.
09:34Hey.
09:35Your soundbuck.
09:37Get it out of ya.
09:39That's what I need.
09:41Go cry.
09:43Yeah.
09:45Ah, why did I sign up for this?
09:56Yeah.
09:56Hello, thanks.
09:56Five two over.
09:57Two Lima, five two, go ahead.
10:01We're good to go there, Gary.
10:03We're just moving off if we get for coffee well and good.
10:05If there's a call there to unlock us over.
10:11Where have you gone for coffee?
10:12Anywhere.
10:13Go for dock road?
10:16And I don't mind, yeah.
10:17In Limerick, Anne-Marie, who is also midway through her intern year,
10:22is out on the road with experienced paramedic Jim.
10:28We were grabbing a coffee while we had the chance
10:31because we don't always get the chance.
10:33And lo and behold, a call came through.
10:36I'll see what it is. I'll see what it is.
10:38I remember the start of that call.
10:41We literally had literally got into the queue for coffee
10:44and the radio. The radio went off.
10:47Anne-Marie stayed in the queue and I ran out to the ambulance.
10:52It was a purple call, so it meant there was a life threat.
10:56Yeah, we better go. It's a cardiac.
10:58And he said that we had to go quick because it was a cardiac arrest,
11:01that it was a young girl.
11:05We better go.
11:07As the crew rushed to the scene,
11:09more information comes through
11:11that a young girl has attempted to take her own life.
11:13We weren't too far away from the call.
11:16We were about five minutes away.
11:18On the way to this call,
11:20there was a mix of emotions.
11:23Your adrenaline is going.
11:25You're trying to recall everything in your head
11:27that you need to remember.
11:30Clear.
11:32Organising what I needed to organise
11:34with what I had time to organise.
11:36It was almost robotic, in a way.
11:38But I was definitely feeling nervous.
11:43Grab the Lucas.
11:45If you grab the Lucas, I'm grabbing the defence.
11:46Yeah.
11:48We made our way into the house
11:49and there was a first responder volunteer
11:52that was already there.
11:55Where are we?
11:56Where are we, lads?
11:56Are we upstairs, downstairs?
11:58Where are we?
11:58Yes, thanks.
11:59We're there.
12:06Clear, lads.
12:08Come on.
12:09Just analysing.
12:11In Limerick,
12:12multiple crews are in attendance at the address
12:14where a young girl has attempted to take her own life.
12:18Second-year student Anne-Marie is leading the call.
12:23Anne-Marie, how long are we doing this?
12:30Five minutes ago.
12:31When you go to a call
12:33and a person is in cardiac arrest
12:36and there's family members around,
12:38it's very distressing for the family.
12:41Give your pads on, just pads on.
12:43Pads on.
12:43We need our ones on.
12:44Yes.
12:45Anne-Marie was the one who took charge.
12:48So her goal then wasn't to actually do CPR,
12:52her goal wasn't to do insert an airway,
12:54her goal wasn't to assess anything.
12:56Her goal was to make sure that everybody else
12:58was doing what they were supposed to do.
13:00Can someone get a step and listen to the gist, please?
13:04You're trying to be as professional as you can
13:06and attend to the patient
13:09and give that patient the best chance that you can,
13:12but you're also trying to be sensitive towards the family.
13:16Clear, lads.
13:20We continued, as per what our guidelines tell us to do,
13:24to continue oxygenating her
13:26and to continue checking her rhythm of her heart and her pulse
13:30and to also keep doing compressions.
13:43That was a really, really tough situation
13:46because as the call was going on,
13:48there were, at that stage, two ambulances outside the door.
13:51There was a doctor's car
13:52and there was a community first responder's car.
13:54Yeah, if you can get a second BBM with the oxygen
13:57to take over this one in a second.
14:01Yeah, right.
14:02One second now.
14:03Stand clear, lads.
14:04Shocker, lads.
14:05Yeah.
14:05Clear.
14:07Yeah.
14:08There was nothing there, her hand, no?
14:10Yeah.
14:12There was a memory.
14:14Reanalyzing my rhythm in 40 seconds.
14:18Because it was a young girl, we tried, literally,
14:20we try everything anyway,
14:22but you keep on going, trying and hoping
14:24that you get some kind of a response
14:27and you get some kickback from her heart,
14:30but it didn't happen.
14:35If you can stop now,
14:37I'm going to say it's fine.
14:39Yeah, I'm going to say, what time is it?
14:4111.22?
14:42Yeah.
14:45Oh, my God.
14:47No, no, no, no, no, no.
14:52They're tough calls for somebody
14:54because they're high-pressure situations,
14:56you know, and no training room,
14:58no syndicate room in the college
15:00will prepare you for the reactions of the family.
15:06We tried to present her
15:09in the most dignified manner that we could
15:11where she was
15:12so that her family members could come in
15:14and see her.
15:16Please, please.
15:18It was quite a hard and emotional call
15:21to be attending.
15:23I dealt with it okay.
15:24I think my paramedic hat was on
15:26when it needed to be on.
15:27I was clinical and my medical knowledge,
15:30everything that I'd learnt and experienced before,
15:33all came into play at that moment.
15:34But I also had my empathy hat on as well.
15:38Thank you very much.
15:38Given the traumatic nature of the call,
15:41educational training officer Donna
15:43is keen that the entire team take a break.
15:46I think we may be going back down to the dock road
15:47for a cup of coffee in a minute.
15:49I think we need to finish off, yeah.
15:50Just for our own sake,
15:51we'll stand down for a few minutes.
15:52I definitely felt very, very sorry for the family.
15:58I think what got me more was because this patient
16:00was a young patient.
16:02She was a young girl.
16:03I remember when I was that age,
16:05going through depression
16:06and growing through self-doubt
16:09and having moments
16:11where I could have had the same outcome as her
16:15and thinking that
16:17my family could have been in that position at one time.
16:20And that really got me
16:25that another family were having to deal with that.
16:27Yeah, it was sad.
16:50After some stressful calls
16:52that have tested relationships...
16:54Now, Tommy, I want to see a nice steady pace here now.
16:57No tearing off like a lunatic.
17:00Tommy has persuaded intern paramedic Ryan
17:03to take some time away from the ambulance.
17:05Are you keeping up with me?
17:07I can't.
17:08Are you knackered?
17:09I'm nearly out already.
17:11And we haven't even met the Statue of Mary yet.
17:15Tommy had always been hounding me.
17:17We had a cardiac arrest
17:18on my third assessment of Crowpatrick
17:21and I was absolutely puffed out of it
17:23by the time I got up the mountain.
17:26So he'd been slagging me since about it.
17:28So I said, come on, we'll go and climb it.
17:32Bless yourself now with this fella.
17:35Well...
17:36Well, I don't know.
17:37Do you know something?
17:38I thought it was the Statue of Mary that was here all the time.
17:42Did you not know that?
17:43I thought it was the Statue of Mary shirt.
17:45I was saying, Patrick's Munson.
17:46Meo, he's at the bottom.
17:49Genuinely, I always thought that it was Statue of Mary there.
17:56We had four seasons in one day, so I had, but halfway up the view,
18:01even halfway, is just absolutely unbelievable.
18:04And I suppose when you're local somewhere,
18:06you don't really appreciate that view either.
18:36Well, it was a good shot anyways climbing, I think.
18:38to the next call again.
18:40And I know we didn't come up here today,
18:41we weren't talking about work, and that's the whole point.
18:43Yeah.
18:43That you don't really talk about work,
18:45that you talk about everything else,
18:46and the fresh air, meeting people.
18:50Something different.
18:51Yeah.
18:57Working with Ryan over the last couple of shifts has been fantastic.
19:01He's a good communicator.
19:02He's able to have the laugh, which is all important.
19:05But he's well able to deal with patients.
19:07He's very compassionate towards them,
19:09and deals with them that way.
19:13You feel, have you progressed with your confidence
19:15in dealing with your confidence definitely builds
19:19with the exposure you have to different calls
19:22and that kind of thing over the course of the year.
19:25But it doesn't matter whether I was in the internship
19:27or whether I'm going on to be qualified,
19:29like, I'd still be learning every day.
19:31Every day is a school day, like, so.
19:33Because there's still calls that I haven't come across,
19:36like, types of calls.
19:40Something that he needs to work on,
19:42and it's hard for a young person, is the emotion.
19:47He holds a lot in,
19:50and when he's dealing with certain stuff,
19:51just how to deal with that.
19:53But that all comes with experience.
19:55He's going to see calls that he's going to have to learn
19:58to deal with,
19:58and he's also going to do calls that his skills
20:02are going to be pushed further.
20:03Well, wasn't it worth it?
20:06That's for sure.
20:07See all the good places I do take you?
20:09I'm telling you.
20:10Some view in fairness, like.
20:13Now, we'll sing the green and red and mayo, aren't we?
20:17I haven't a notion.
20:19Oh, the green and red and mayo.
20:22A job like this,
20:23whether it be paramedics, guards, nursing,
20:26you know, anything that deals with life and death moments,
20:29I suppose you could argue,
20:31that'll mature you exponentially,
20:34dealing with those emotions,
20:36because it gives you a different perspective on life.
20:49In Dublin, third-year student Deirdre
20:52is starting her shift with colleague Stephen.
20:5775-year-old.
20:59Catch a trip to fall and query to arm.
21:01Conscious and breathing.
21:03999 mode activated.
21:05Scoop, sure.
21:06We were called to an elderly lady
21:10who had had a fall in her garden.
21:15So we followed the directions of the sat-nav
21:18and it brought us to the back of houses
21:21where there was no patient,
21:23but another, a neighbour, flagged us down.
21:25Oh, she's waving us?
21:27Oh.
21:29Oh, guess it's a granny.
21:31Okay.
21:32Is she on the ground?
21:33She's on the ground, yeah.
21:34You can come through my house, yeah.
21:37Shuffled us all through her house
21:39and brought us out to the front garden
21:41where we found Margaret.
21:43What's going on?
21:44I stumbled.
21:45Right.
21:46My arm went over the wall.
21:48Okay.
21:49And she came over my head.
21:51I couldn't feel my hand
21:55and my shoulder's gone, definitely.
21:57Okay.
21:58You normally fitting well
21:59or do you take medication?
22:00I'm a diabetic.
22:01Okay.
22:02I'm going to pull the arm ones.
22:03I don't think so.
22:04Yeah.
22:04Is there anything I can do for you?
22:05Yeah, I think maybe bring me over a Pentrox.
22:07A Pentrox, yeah.
22:08Yeah, because I reckon the shoulders,
22:09Margaret thinks her shoulder's gone
22:11and probably her forearm.
22:12The forearm as well, yeah.
22:13So, yeah.
22:14Yeah, we'll get a sling as well for that, yeah.
22:15Yeah.
22:15Yeah, no bother, yeah.
22:16So, zero been no pain
22:17and ten been the worst pain
22:19you've ever felt in your life.
22:20What are you at now?
22:21Nine.
22:21Nine.
22:22That's okay.
22:23Despite been in,
22:24the pain she was in,
22:25she was super.
22:27Can I ask a few silly questions
22:29before I give you this drug?
22:30Yeah.
22:31Do you know what month it is?
22:33March.
22:34Do you know what year it is?
22:3525.
22:36And do you know who
22:37the President of Ireland is?
22:39The little man.
22:40The little man.
22:41That'll do.
22:41The little man.
22:42That's what everyone calls him
22:44and that's the answer we accept.
22:46The little fella.
22:47Yeah.
22:47So, with this medication, right,
22:50it doesn't taste great for the first one
22:51but it'll be fine after.
22:53Where it's going to take you
22:54is to a very special place.
22:55Yeah, right.
22:55Right?
22:57You've got to loosen it.
22:59Okay, right.
23:00We got Margaret Pentrox,
23:02which is our magic whistle.
23:04The first breath in,
23:05it might catch you
23:06because it's quite a potent thing.
23:08Breathe in and breathe out
23:09through the whistle
23:10and blow out through the whistle.
23:12That's it.
23:13In and out.
23:14So, with Margaret,
23:15initially she didn't think
23:16she was too injured,
23:18you know,
23:18and she thought she'd be fine
23:19but as we moved her,
23:21we could see the displacement
23:22of the shoulder
23:22and any kind of movement
23:24was just causing her
23:27excruciating pain.
23:28A few bubbles on you?
23:29Nope.
23:30Where's that catching?
23:33Where's that catching?
23:34This side.
23:35Over here?
23:36Yeah.
23:37That's all right.
23:38We'll do all the work.
23:41She thinks the...
23:43You're all right.
23:43You're okay.
23:44You're okay.
23:44You're okay.
23:44Here, keep going on this.
23:46Keep going on this.
23:46So we decided
23:47we'd get her into a sling
23:49because it would immobilise the arm
23:52and reduce the pain.
23:54We'll be singing Irish ballads
23:55now in a couple of minutes.
23:57And in the jig.
24:00Keep going.
24:00Well done.
24:02We have a lot of drugs
24:03in our ambulance
24:04for pain relief
24:05but the one thing
24:06we also use
24:07is the slinging
24:09and reduces the pain
24:10just by keeping
24:11the arm straight.
24:14So keep going.
24:15Well done.
24:16Well done.
24:16Well done.
24:19I'm sorry.
24:20Oh, don't be apologising.
24:21What are you apologising for?
24:22You're apologising for.
24:23You're keeping us in a job.
24:24Keeping us busy.
24:25Yeah, I'll take that big time over there.
24:26She was typical
24:27older generation.
24:29I don't need an ambulance.
24:30I'm fine.
24:31She clearly wasn't fine.
24:32She was clearly badly injured.
24:33So what we're going to do is
24:34we're going to get you standing up, okay?
24:36So after three
24:37you're going to push up as well
24:39and we're going to help you up as well, okay?
24:41One, two, three.
24:41So whenever you're ready
24:42one, two, three.
24:43I can't.
24:44I can't, sorry.
24:46You're doing great.
24:48I'm up, I'm grand and I'm up.
24:50You're grand when you're up?
24:51Yeah.
24:52Any new pains anywhere?
24:53No.
24:54Any pains gone away?
24:55Everything's much the same, is it?
24:57No.
24:58So can you take a few steps
24:59towards your house?
25:00Back towards me.
25:01Back towards me.
25:02Yeah, I'll tell you when.
25:03Keep going.
25:03Keep coming towards me.
25:04Where's that sore?
25:05The arm again?
25:05The arm.
25:05Yeah, okay.
25:06Keep coming towards me.
25:09Now, there's a bed right behind you.
25:11You're not going anywhere.
25:12Right?
25:13The brakes are on it.
25:15How's that?
25:16Now I'll skip over there.
25:16We're going to give you...
25:17Where's that whistle?
25:18It's just on the wall.
25:19Yeah.
25:29In Dublin, third-year student Deirdre is treating 75-year-old Margaret.
25:36After she tripped and fell in her garden, suffering a suspected broken shoulder.
25:42I'm so sorry.
25:43What are you sorry for?
25:44Do you feel like you need something more?
25:47A bit stronger?
25:48Yeah, you're quite severe, aren't you?
25:50Yeah, that's no problem, Tony.
25:53I've often said to my colleagues, if I could only go to calls to people over the age of 65,
25:59I would.
26:01I love them.
26:01I could sit and talk to them all day.
26:09That morphine should be kicking in.
26:11Has it helped at all?
26:14A little.
26:15Okay.
26:17For a long time, I looked after my mum.
26:19She was in the back of many an ambulance, and I saw the care she got from paramedics and the
26:25difference it made to her in that first few minutes, that reassurance that she was okay, and just the kindness
26:33that they showed her.
26:35Yeah, we rang ahead, and they're expecting us.
26:38Told them there's a VIP on the way.
26:42You're the VIP.
26:43Oh, you must be joking.
26:46Yeah.
26:53Does he have to go to our corners?
26:56Yeah, there isn't a straight route.
26:58Only if we'd have gone in a helicopter would we have been able to get straight there.
27:02My model is shut for this.
27:03That's all.
27:05We are just here.
27:07Are you here?
27:08Yeah.
27:09Stand well killed.
27:11Vehicle reversing.
27:12And you can bring your whistle in with you.
27:16What's a whistle?
27:17Your green whistle.
27:22I need a doctor.
27:23Have you a welcoming party here?
27:26Have you?
27:27Is it out?
27:27I don't mind a doctor.
27:30Is it yours?
27:31She's been causing awful trouble.
27:33I haven't.
27:35I don't mind a doctor.
27:36No, I wouldn't.
27:36No, you wouldn't.
27:39I'd put you here for a reason.
27:42Sorry, sorry.
27:43You have someone looking after you, so, so close to you.
27:47While we had Margaret in the ambulance, she started revealing a few little things to us,
27:53aside from her injuries, and that was that she had a special gift.
28:00She's not long gone.
28:03But she's so proud of you.
28:05She said something to me about, I have someone here who's not long passed.
28:09And I'm like, okay.
28:10My mum hadn't passed away that long before that.
28:13She'd only passed a year before that.
28:15Do you have a gift?
28:16Yeah.
28:17Oh, do you?
28:19Yeah.
28:20Oh, well.
28:21I don't use it.
28:22Is she looking out for me?
28:24You let her down.
28:25You were to do something three weeks ago, and you didn't do it.
28:29I don't think so.
28:30Would you have time to do it?
28:31Have I?
28:32Oh, God.
28:32Yeah.
28:34Posted.
28:34And it was so funny, because Margaret was talking as if she could hear voices.
28:39And I'm like, this Pentrox might be a bit too strong for Margaret.
28:42She was like, no, no.
28:44And she was giving out about you.
28:45She's saying, you've forgotten about something.
28:49Letters.
28:49And there was two letters on the back seat of my car that have been there for about eight
28:55weeks that I just hadn't got around to posting.
28:59You just don't post it on your email.
29:01There's two letters on the back seat of my car that I've been meant to post three weeks ago.
29:04Do it.
29:05Okay.
29:05I will.
29:07I'd like to believe some of those things can be true.
29:11Maybe it was a bit of the green whistle, but I think she knew a bit too much to be
29:16just
29:16Pentrox induced.
29:21Now, just a little one.
29:25Sorry, sorry, sorry.
29:27Margaret was fantastic.
29:28And I do hope that she does have the gift.
29:32And if she wants to get in touch with me, she can.
29:36And with the lotto numbers, that would be great.
29:49Deirdre's daughter, Rebecca, is also training to be a paramedic, and she's halfway through
29:54her first year.
29:56Alongside classroom learning and exams, there's another skill first-year students must learn
30:01in order to advance.
30:03Emergency service driving.
30:06Head on whenever you're ready.
30:08Today, Rebecca is heading out for a lesson with instructor PJ and her classmates.
30:13Signal.
30:17It was very kind of nerve-wracking at the start when you're beginning to get your C1 and you're
30:22starting your driving course.
30:24Everything is kind of such a big deal throughout the year, you know, because you need that to
30:29move on to the next stage.
30:31Great.
30:31We're going to take the next stage.
30:33You can go on to level three whenever you want then.
30:34Okay.
30:35So finish, you have to put your...
30:38You actually have to put your hand on it, don't you?
30:40Yeah.
30:41Yeah.
30:42Blue light driving.
30:43You're driving as if you're responding to an emergency, but you're not responding to
30:47an emergency.
30:48You're with your driving instructor, so you have that safety net.
30:51And they'll give you advice and techniques and ways to safely get through traffic.
30:59And it's so interesting, like, when they'll tell you to do something and then you get
31:02the reaction that you want from other drivers.
31:11Sorry.
31:12It was a little bit higher than you wanted me, that's all.
31:25Yeah.
31:37You're anticipating that you're anticipating that he's going to have to move out because
31:39of the parkhouse.
31:40Yeah.
31:40So we're giving loads of room.
31:42So even if he does, we still have a safe path.
32:13The driving is a lot of the job.
32:24It will be a while before Rebecca is driving on real emergency calls.
32:30But as a first year, she's being mentored by experienced crew Greg and Cuiva.
32:35Move, move, move.
32:37Today, they're responding to a call where a patient who has a tracheostomy is experiencing
32:43shortness of breath.
32:47Rebecca?
32:48Yeah?
32:49Look up your CPG for trache care, will you?
32:51Yeah.
32:54I asked Rebecca to look over the CPG, so our clinical practice guideline, but it will lead
32:59you in the right direction or maybe just refresh your memory of whatever kind of care that
33:04that requires that's different to normal care.
33:09You stay back.
33:10You come back.
33:11Where are you going?
33:12I can't hear you.
33:14Geez.
33:15Guys, we arrived.
33:17I'll turn it while you go.
33:18Okay.
33:22I'm Rebecca.
33:23This is Greg as well.
33:25Has this been going on for a while?
33:27Or this is just this morning?
33:29Just this morning.
33:30Okay.
33:31Have you had any infections recently?
33:34When we arrived into the house, and one of the main things they teach you in college,
33:38especially about tracheys, is that if the patient has been managing this trache for a
33:44while, they are the absolute experts.
33:47How long have you had that?
33:51Yeah.
33:53What's it going up?
33:54Good, good, good.
33:55He was a lovely man.
33:56He was non-verbal.
33:58So, Rebecca, again, this is where you come when we talk about language barrier, but this
34:02is someone who can't speak at all to her.
34:05So, he took to, he had like a board with a marker, and he was writing down that way.
34:10So, a lot of patience was involved.
34:14Esophagus cancer.
34:14That's what you have.
34:15Okay.
34:17Can I have a little listen to your chest?
34:20She also had to learn how to reword her questions to give shorter answers.
34:26He knew himself what was wrong.
34:28You know, he just, he needed that support of us telling him like, yeah, you know, it
34:32looks a bit infected, so we're going to get you in and we'll explain that to the staff
34:36in the hospital.
34:37You changed that 20 minutes ago.
34:38Do you have a suction you used to clear it?
34:41Have you been using that?
34:42Yeah.
34:43And that's not giving you any relief?
34:44It's quite gunky.
34:45It's yellow.
34:46Yeah.
34:4720 minutes ago, we're quite full.
34:48Let's get a listen in.
34:50Yeah.
34:53Sound congested, and there is a wheeze there on the left-hand side.
34:56It's definitely not congested based on the core.
34:58We've got a good reading there, though, and we're up at 99.
35:01I think it's more the congestion.
35:04Your sacerations are quite good, which is good, but you're short the breath, so most
35:08likely you're gunked up or you've an infection.
35:10You know this better than anyone, don't you?
35:11I can...
35:12Walk?
35:13Are you sure?
35:14Yeah, yeah.
35:15I'm going to have to get in the chair for you.
35:17We won't hang around.
35:18We won't hang around, right?
35:19Once we disconnect you, we're going to walk to the ambulance.
35:22We'll set you up out there, okay?
35:23Yeah.
35:23Are you sure?
35:24Are you happy with that?
35:25Yeah.
35:25Grant.
35:26We had initially got him a wheelchair to bring him out to the ambulance, but he wanted
35:30to walk.
35:31Take your time.
35:32We're not in any rush, okay?
35:33We want to wrap them up in cotton wool and, you know, look after them, but promoting their
35:38independence is also really important to do.
35:40Is that all right?
35:41Is that all right?
35:41Just the machine.
35:47In Dublin, first-year student Rebecca is helping to transport 64-year-old Damien to hospital
35:54after he reported difficulty breathing.
35:57Disaster.
35:58This is...
36:01Everybody happy to move?
36:02Yeah.
36:03You're happy?
36:04Great.
36:05So we are quite congested, Rebecca?
36:07Yeah, and kind of global congestion.
36:10We can hear the mucus.
36:12Yeah.
36:13Yeah.
36:14And...
36:14Is it more diminished?
36:16Or...
36:17No, it's loud and it's global, yeah.
36:19Sorry, let's just say...
36:20Because of his tracheostomy, Damien is non-verbal and communicates via a whiteboard.
36:27Ah, right.
36:27Your older brother is a retired ambulance man.
36:30Ah.
36:30Very good.
36:31And your father.
36:32How come you never got roped into doing it?
36:36You're a chef.
36:37Very nice.
36:39So what you're saying is when we come back next week, you'll have a lovely meal prepared
36:42for us to say thank you.
36:43Yes.
36:44I'll accept that.
36:46With some students, that's something they have to learn.
36:50Learn how to communicate with a patient.
36:52With Rebecca, I feel like it's actually just quite a natural talent.
36:56And I don't know if it's from working in a shop and probably having all sorts of customers,
37:01all sorts of walks of life and everything.
37:04She's a quite sociable person.
37:06She's got great communication skills.
37:08Your team are worried about pneumonia.
37:11Okay.
37:12And you were with them yesterday.
37:14Yeah.
37:15Yeah.
37:15So obviously they'll have a better look at it today.
37:18You look like you have a bit of an infection, like a sinus as well.
37:23You have a bit of secretions coming out of your nose as well.
37:27You have to be careful.
37:28Yeah.
37:29We're just here now anyway.
37:32Now, Damon, we've arrived here, okay?
37:35We're going to take all the bits and bobs off you and we'll head inside to your favourite place.
37:40I definitely have things to learn and I think that's like a really big part of the job is that
37:46you can kind of,
37:47you can keep finding new things to discover new cause up until you're 10, 20 years into the job.
37:54Because people will come up with these new weird and wonderful ways to ring an ambulance.
37:58So I think that it's just, it's sitting in that place of, you know, there's still lots to learn, but
38:05you're at a stage where you're competent enough to handle the big, the bigger calls, you know, the more common
38:13calls.
38:16It's the start of a new shift in Wexford.
38:19Second year student Nathan is on with advanced paramedic Dave.
38:24And the emergency calls never stop.
38:31So he's pouring boiling water into a container, container broke, boiling water landed, scottling, upper thigh and groin area, redness
38:38of skin is broken, patient applied, suit appearing, oh Jesus.
38:40We got a call for, it was an elderly lady who was at home and had filled a very cold
38:47glass with boiling hot water and the glass shattered and completely burned her thighs on both sides.
38:56For an intern paramedic like Nathan, every call is a test of the skills he's learned so far.
39:03So what's first priority?
39:04So ABCs and dealing with, if there is, checking her temperature and making sure that she's not hypothermic, but mainly
39:14ABCs to make sure it's not affecting her brain in any way.
39:18ABCs pain relief, so she's not likely to be hypothermic. So ABCs pain relief.
39:23Pain relief, would you prefer to go with an IV pain relief or would we go with Pentrox and see
39:30how that works?
39:30What's quickest?
39:32So we go with Pentrox and see how that works.
39:37Hello there Anna.
39:38Hello.
39:39How are you?
39:40Not too bad.
39:40You had an argument with the kettle, did you?
39:44My name's Nathan, I'm one of the paramedics. You have Dave coming in there as well, okay?
39:47She was sat on her bed and you could see that the skulls were getting quite kind of aggressive with
39:54blisters and stuff on both sides.
39:56Both sides of your legs here, is it?
39:58Oh, that's all, thank God.
39:59Anywhere down further on your legs?
40:00Oh, there was a little bit there.
40:02A little bit down here, I see it.
40:04And did I hear you put suitor cream on it?
40:06I did, yeah, did I do it wrong?
40:08So just, if it ever happens again and you get burnt, don't put anything like suitor cream on it.
40:12Just put cold water on it until we get here.
40:14Sometimes part of our job is educating patients about what not to do.
40:18There's a lot of old wives tales out there about burn injuries.
40:21When we burn ourselves, our skin is still technically cooking.
40:25So we don't use oil-based products to treat that burn.
40:29Because all that the oil-based product is doing is it's trapping the heat in and still cooking the skin
40:34effectively.
40:35So what I'm going to do is we're going to pop some dressings on your leg just where the burns
40:39are on your leg.
40:40It is.
40:40So this one is called a burn gel, okay?
40:43So it's going to be a little bit cold.
40:44Yeah.
40:45Alright.
40:45We're going to put this on and some cling film just to wrap it all up.
40:48Is that okay?
40:49Yeah.
40:50With this particular patient, she had areas of superficial burn but also areas of partial thickness burns.
40:57Where the top layer of skin had been burnt away and the suitor cream had been rubbed into these areas
41:03of the burns.
41:04Because it's a foreign object, it can introduce infection as well as insulating the burn and can cause more harm
41:10than good.
41:10So the first thing that we had to do that day was try and cleanse the burn as best we
41:15could without causing any further damage to it.
41:18There's blisters there.
41:19There is, yeah.
41:20I can't break them.
41:21No, don't worry.
41:22I won't break them.
41:23I won't break the blisters.
41:24There's one broke there.
41:25That'll be very sore.
41:27It might get a little bit scaldy but we'll get some pain relief onto you first, okay?
41:30This one that we're going to give you is called Pentrox, okay?
41:34I have side effects.
41:36It might make you feel a little bit drunk.
41:37Have you ever been drunk before?
41:38No.
41:39Always.
41:40That's it.
41:41Well done.
41:42Given the level of injury to her leg that day, she was in great spirits.
41:49You should go in and get those burns checked out anyway.
41:53And because of the fact that they've blistered up like that, it's worth going in and getting them checked out.
41:57Burns have the risk of getting infected sometimes, especially the one that's open there.
42:01So they might want to give you some antibiotics as a just in case.
42:04The best thing to do if we ever burn ourselves is treat the burn with water, a cool compress, and
42:10make sure that it's cold.
42:11And even put the towel down and gently pour cold water onto that.
42:15It'll work quite well.
42:17And don't be afraid to call us if it ever happens.
42:19Don't wait until everybody else gets here before you call us.
42:22We're only a few minutes down the road as well.
42:24I didn't know you said this.
42:26Of course we do.
42:27What else would we be doing?
42:30Nathan done quite well on this call considering we don't see many burns, especially burns of this type and this
42:36nature.
42:36He had his priorities right.
42:38You won't be keeping me though, will you?
42:40I don't know.
42:41I can't tell you that.
42:42Unfortunately, I'm good at a lot of things, but I'm not good at telling the future, my dear.
42:45I'd love to be.
42:47Keep doing this.
42:48Keep doing that.
42:49All the time.
42:50As much as you want.
42:51Even in the ambulance.
42:52Even in the ambulance.
42:54Alright.
43:13Next time.
43:14You know when women have babies?
43:16Yeah.
43:17They get the gas in there.
43:18I don't care.
43:19I won't need anything like that.
43:21You will not.
43:23Have you taken anything else in the last 24 hours?
43:25Any drugs, alcohol, medications?
43:27No.
43:31I haven't seen her.
43:33I haven't seen her.
43:34I haven't seen her.
43:38Breathing new life into dated spaces and all on a budget.
43:42Catch the complete series of The Salvage Squad streaming right now on Virgin Media Play.
44:10If you've been affected by any of the issues raised in this program, please visit our support page, virginmediatelevision.ie
44:17forward slash helplines.
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