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00:01Ambulance service, is the patient breathing?
00:04Every time he's soothing, he's crying out in pain.
00:08He's had a really bad nosebleed and he can't stop it.
00:12It's painful and my heart's racing.
00:14I think I'm having a heart attack.
00:17Righty-ho, let's get them bad boys on.
00:20West Midlands Ambulance Service looks after almost six million people.
00:24I love the fact that not just every shift's different,
00:28every job's different.
00:29Do you remember everything that's happened?
00:32It looks like you're having a heart attack.
00:35Saving lives and making a difference every call-out.
00:38Is she breathing normally?
00:41Watch availability of Hallimuth.
00:44Embedded with eight emergency crews.
00:47Could be anything, couldn't it?
00:49Okay, okay.
00:51Filming simultaneously across the region.
00:54Time is everything in our job.
00:56Just relax, relax for me.
00:57Can you open your mouth as wide as you can?
01:01Capturing life.
01:02How's your vision?
01:03You got it?
01:05On the front line.
01:06I go to work every day and I make a difference.
01:20What did you have for dinner?
01:21McDonald's.
01:21Oh, good.
01:22Yeah.
01:23Absolutely.
01:24Thank you, thank you.
01:26Do you know what I feel like I need?
01:27Go on.
01:28A little break away.
01:28You need to get a camper van, don't you?
01:30I'd love to.
01:30I'm trying to talk the other half into it.
01:32I just love seeing, you know when there's like them pictures online and it's like people
01:36wake up in the morning, open the back doors and there's a stunning view.
01:40I just need a bit of that in my life.
01:44Pinch, punch, first of the month.
01:47Oh God, we've got a job.
01:56What's the first band you ever went to see?
01:58I think it was Girls Aloud, you know.
02:00Was it?
02:02Yeah, in like 2007.
02:06I'm a big fan of a band called The Wonder Stuff.
02:08I've seen them about 200 times.
02:11That's a lot.
02:12I want one of their songs at my funeral.
02:14Bit premature, innit?
02:15Not really, not at my age.
02:18You've got to think of the future.
02:20Or lack of it.
02:22It's a bit far ahead.
02:24It was the circus tour.
02:28Take that.
02:29Oh my God.
02:29With my mum and my neighbour.
02:32Yeah.
02:32It was great.
02:33Are you like 90?
02:34You wish you saw Take That.
02:35No I don't.
02:36Yeah you do.
02:37Excuse me.
02:54Yeah.
03:10Yeah.
03:10Yeah.
03:10Yeah.
03:13Yeah.
03:14Palpitations.
03:15Palpitations.
03:16Palpitations and sweating.
03:17Palpitations.
03:17I love the idea of a stripper visiting a care home.
03:22Magic Mike Monday.
03:24Stripper Sundays.
03:26Tassel Tuesdays.
03:28That's why we get on to work.
03:30We could be talking about the weather in Turkey.
03:32The one minute makes me run on the stripper grams in care homes.
03:47What have we got then?
04:03Trio's not possible.
04:03Remote observer.
04:05No.
04:05No.
04:05But there's heavy blood loss.
04:09That's all we have.
04:10I kind of want to see where's this bleeding coming from.
04:14When we go to a patient that's got heavy blood loss, we're trying to think where's the
04:18blood coming from?
04:19How much blood have they actually lost?
04:21And do they need any further treatment to help stop the bleeding?
04:30Hello.
04:31Is he in the bathroom?
04:32He hasn't long come out of the hospital with the bleed on the brain.
04:36Is he on blood thinners?
04:37No.
04:37No.
04:37No, he's just had a bleed on the brain.
04:39Okay.
04:39I just come up to the toilet and I just, I did blow my nose and start to run and
04:45I knew
04:46straight away it was one of these.
04:48Yeah.
04:48Bless you.
04:49Oh yeah.
04:50Yeah.
04:51There's a clot in that one there.
04:52Try not to rub it if you can.
04:53Lean over the sink now while you're doing it.
04:5677 year old Robert recently had surgery to treat a bleed on his brain.
05:00Tonight, after bleeding heavily from his nose, his son called 999.
05:07What I've had it happen before, it's usually stopped within, you know, ten minutes or so.
05:13Ten minutes, but it's been half an hour.
05:14Yeah, it's been half an hour.
05:15Yeah, it's been half an hour.
05:16How much blood would you say that you've estimated?
05:18Well, a lot.
05:20A lot.
05:20A lot?
05:21Yeah.
05:21Bless you.
05:22Let me just pop that on there.
05:24Any headache?
05:25No.
05:25Any blurred vision?
05:27No.
05:27No, just the nosebleed.
05:29Robert was in quite a mess when we first arrived on scene.
05:32My major concern was the amount of blood loss and to make sure that his airway was clear.
05:38Well, we'll see what we'll do.
05:39We've got like this little clip that we can pop on your nose that can try and stop the bleeding
05:43all right.
05:44Right.
05:45This is supposed to clamp.
05:48Can you feel that pressure?
05:50Yeah, it's gone.
05:52It's not very tight though, is it?
05:53No.
05:53Let me try a bit higher up.
05:55Oh.
05:56Never get trying this in training school.
05:59Oh, there we go.
06:01Right, keep that there for a bit.
06:02I think it's doing its job.
06:04It's stopped bleeding now.
06:05It's stopped dripping down.
06:07There we go.
06:08Fixture!
06:09Can you breathe through your mouth okay?
06:11Yeah, yeah.
06:12You're not feeling anything?
06:13Oh no, it's still dripping.
06:14I was quite worried at this point because we had no other option to stop the nosebleed
06:20apart from him applying pressure himself and I was really worried about the amount of blood loss.
06:25What we'll do, we're just contacting our team.
06:28We've got a drug that's a blood clotting drug.
06:30Yeah.
06:30The fact that it's still going after half an hour and yet it is losing quite a bit,
06:35I'm thinking that that might be a go ahead if I'm honest, just to see if that stops the bleeding
06:41all right.
06:43Yeah.
06:44As Robert has recently undergone brain surgery, Amy needs to speak with a senior clinician
06:49before she can give blood clotting drugs.
06:52Amy, I'm just waiting for a response, mate.
06:54No worries.
06:55It's just my reasoning is the fact that it's been continuous for over half an hour now and it's
06:59still going quite...
07:02Yeah.
07:02Still, yeah.
07:03I'm going to take this off because it really isn't doing nothing, is it?
07:08If you just try and pinch a little bit more up here as well if you can, that normally stops
07:13it a bit.
07:14How's your walking like? Is that all okay?
07:16Yeah.
07:17Before I went to the hospital, I could hardly walk and I was tripping up and falling over,
07:21but since I had the operation and come out of the hospital, I've been fine.
07:26I only took the dressing off this morning.
07:28Wow.
07:29Ah, I see it.
07:31It's healed really, really well.
07:32Yeah.
07:34Do some fresh ones.
07:36There we go.
07:37Oh!
07:38Oh, God, that is a big clot.
07:40Oh, that...
07:41That was massive.
07:43Yeah.
07:44Was that in your nose or was it in your throat or was it when...?
07:47It come from my nose into my throat.
07:49That come out of my throat, that did.
07:51Okay.
07:52I'll just spit that out.
07:54When I saw the blood clot, it was rather grim.
07:57It was large.
07:58He's just had brain surgery.
07:59We needed to get him to hospital fast.
08:02We'll definitely think about going.
08:18Mmm.
08:19I feel a little bit sick.
08:21So do I.
08:22You told us to get this much.
08:24I saw a train.
08:24I thought, I've never had a train in my life.
08:26We saw the ice cream van, didn't we?
08:27And I'm pretty sure we drove past it and then went back.
08:30I think if there's an opportunity to have ice cream, I'm going to have.
08:33You're going to take it, aren't you?
08:34I'm going to have an ice cream.
08:35Do I have chocolate all round my mouth?
08:37No, have that.
08:37Do you see your tongue out?
08:38Your tongue's blue.
08:40Right.
08:43Do you see your tongue out?
08:43Morgan and Daisy come to the end of their break and are ready for the next call.
08:50PHONE RINGS
08:54Ambulance service, is the patient breathing?
08:57Yes.
08:57And what's the reason for the ambulance?
09:00The gentleman's had a fall, but he can't wait there.
09:04Right.
09:04Every time he's moving, he's crying out in pain.
09:08Right.
09:08And how old is he?
09:09He's 92.
09:12PHONE RINGS
09:13We've got a 92-year-old male, presses care line, leg injury, fall injuries unknown.
09:23OK.
09:23You could have a neck of female fracture.
09:28Yeah, hip, hip, hip fracture.
09:30I think when you get called to a 92-year-old that's fallen, we are thinking,
09:35is he going to have broken something?
09:37Is he going to have broken his hip?
09:39Generally, it's something that happens, isn't it, when they're older?
09:42Yeah.
09:43And a bit more frail.
09:44And it's not nice.
09:46It's not a nice break.
09:50PHONE RINGS
09:52Hello?
09:54What's...what's going on here?
09:55I fell straight over at this side.
09:57I know.
09:57The pain's there.
09:59I'm going to take these blankets off you, sweet, all right?
10:02So I can have a look at you.
10:04I know, I know, I know, I know.
10:06Crying, keep still, sweet.
10:08I know.
10:10He's bent over and then fell.
10:12And where was he when he fell?
10:14Here.
10:15OK.
10:15Yeah, his head was weird.
10:17Retired cabbie Ron fell over while trying to switch on his electric blanket.
10:22Daughter Karen rushed over when she heard her dad was hurt.
10:27Ron, we need to just try and straighten you up a little bit.
10:30This might be a bit very uncomfortable.
10:33I'm really sorry.
10:35Is it just in your hip?
10:37My hip.
10:39Aaaaah!
10:41A voice over here, over here, back here.
10:44Here?
10:44Yeah.
10:45Uh-huh.
10:46Our main concern was figuring out where this pain was, why he was in pain and getting this
10:52under control.
10:53We did suspect that he may have broke his hip.
10:57Aaaaah!
10:58I'm not gonna, I'm not gonna touch you.
11:00Aaaaah!
11:00I'm not touching you.
11:16He's just had a massive clot about this big, just come out from his mouth that's gone
11:20up his nose and then come out his mouth.
11:21All right, bear, bear with me.
11:22Sorry.
11:22We've just had a clot probably about three centimetres by three centimetres round, just come out
11:27of his mouth.
11:27He said it was up his nose.
11:29It was up his nose and then he felt like it's gone into the throat and spat it out.
11:32And it's about that big.
11:34Let's just get going then.
11:37To the west of Birmingham, paramedics Mark and Amy are with Robert.
11:41Having recently undergone brain surgery, they're concerned his severe nosebleed won't stop.
11:49There we go.
11:50Right then.
11:51You okay?
11:52Yeah.
11:52Don't feel dizzy at all?
11:53No, I should.
11:54Let's get going then.
11:56Just nice and steady down the stairs, okay?
11:59Robert needed to go to hospital as he had had recent brain surgery.
12:03Nosebleeds can be a symptom if something's gone wrong with the brain surgery, so we needed
12:08to get him there fast.
12:10Just put some straps on you.
12:13And again, just checking, no headache, no dizziness.
12:16Right.
12:21In the future, just phone 999, don't worry about anything.
12:24We'd rather come to something like this.
12:26A lot of people say, oh, it's only a nosebleed, but there's different circumstances with yours,
12:30do you know what I mean?
12:36You have arrived at your destination.
12:39Hmm.
12:40It has slowed down.
12:41Has it?
12:41Oh, don't pick it.
12:44At Russell's Hall Hospital in Dudley, doctors will investigate why Robert's nose won't stop bleeding.
12:51They'll also want to see if it's related to his recent brain surgery.
13:03Oh, it came down my leg.
13:06It came down your leg?
13:07Yeah.
13:08Right.
13:09To the south of Birmingham, paramedic Daisy and student paramedic Morgan are with Ron, who's
13:14in agony after a fall.
13:18Dizz, I'm not sure if we're going to get this stretcher in.
13:20Do you know what I mean?
13:21Do you want to try?
13:22Or do you...?
13:23Cos I just don't think we're going to get him on carry chair.
13:25I don't think we are.
13:26Yeah.
13:26I think putting him in even more pain just to get him out, I think we need to try other
13:30ways first.
13:32Yeah.
13:34We're going to get him treatment here first.
13:36Yeah, I don't want to move him.
13:38Ron has very clearly hurt himself.
13:40We think he might have broken his hip, so he needs to go to hospital.
13:44Now we need to figure out how we're going to get him there.
13:47Ron?
13:48What?
13:48Can you stay really, really still for me?
13:52Really still whilst we do this heart tracing?
13:54Keep still.
13:55Yeah.
13:56Before attempting to move Ron, Morgan runs an ECG to check the state of his heart.
14:02Really still.
14:05He's always dead.
14:06Oh, Ron, let's not say things like that.
14:09What about your daughter?
14:11No, we're not.
14:12No, you're not.
14:14She loves you.
14:15She gave up a lot of time for me.
14:17Well, you gave up a lot of time when she were a baby.
14:20Yeah.
14:21Oh, yeah.
14:22When Ron said that he didn't want to be alive anymore, it was quite upsetting.
14:26And it was clearly because he was in so much pain.
14:29So we just wanted to make him more comfortable, try and get him feeling back to himself.
14:35Right.
14:36I'm going to give you some paracetamol through that vein, OK?
14:40Oh!
14:42Just bite the leg.
14:44Was it shooting?
14:46Up and down your leg?
14:47Oh, Ron.
14:51Oh, yeah.
14:52Oh, yeah.
14:53Oh, yeah.
14:54Oh, yeah.
15:17We knew we were going to need to give him some strong pain relief, just to try and keep him
15:21as comfortable as we can during the process.
15:24Is it all right if we give you some morphine?
15:27Carry on, please.
15:28Please.
15:30We're just going to grab it and we're going to grab our stretcher, OK?
15:33Yes, thank you.
15:33Don't move whilst we're gone, all right?
15:36Well...
15:36Stay still.
15:42We ain't got a prayer, mate.
15:45No.
15:47Moving on.
15:51There's not really any other way to get him out other than on a chair.
15:55It was quite difficult to figure out a way to extricate Ron.
16:00We couldn't fit the stretcher through the door.
16:03We couldn't use a spinal board.
16:05The only other option that we had was a chair, which was quite uncomfortable.
16:11But it was just a short-term solution until we got him sorted.
16:16I'm going to give you some morphine.
16:18I'm sorry. I'm feeling very so sorry.
16:20Why are you sorry? This is our job.
16:23Do you want to try some gas and air, Ron?
16:26Gas and air, yeah.
16:28Right, so if you pop this in your mouth, if you suck it in...
16:32You got it?
16:33Oh!
16:34Go steady.
16:37Ron.
16:39Ron.
16:40What?
16:40If you suck that in, it should ease the pain.
16:43But you've got to keep sucking on it, OK?
16:46OK.
16:46So, breathe as normal with it.
16:49Daisy and Morgan have now given Ron all the pain relief available to them.
16:54Right, Ron, we're going to move you, OK?
16:57Keep sucking on that whilst we move you, cos this might be quite painful.
17:01I'm going to move your legs, OK?
17:04I'm going to sit you up.
17:06Ready?
17:08That's it, sweet.
17:09Here we go.
17:10Here we go.
17:11Here we go.
17:12Here we go.
17:12Put it in your mouth.
17:13Here we go.
17:14Take deep breaths on this.
17:15That's it.
17:17We need you to try and sit up on the edge of the bed.
17:20We can't.
17:21We can.
17:21We've got to, sweet, cos we're not going to get you out.
17:24Put this in your mouth.
17:25Keep breathing on it.
17:26It's cold.
17:27There we go.
17:27You're on.
17:28You're on the chair now.
17:30Keep breathing on it.
17:32Ron, keep breathing on it.
17:33There we go.
17:34There we go.
17:35You OK?
17:36OK.
17:36Yeah.
17:37With the pain medication starting to take effect, Morgan and Daisy can finally move Ron.
17:43If he has broken his hip, he's not alone.
17:4770,000 people break their neck of femur every year.
17:51There you go.
17:52Got it?
17:53Right, we're going to take you into the hospital now, OK?
17:56OK.
17:56All right.
18:07Keep having that gas and air for me.
18:10I've just gone over a few bumps.
18:22All right, my darling.
18:23How was that pain?
18:25Is it any better?
18:27Good.
18:31At Queen Elizabeth Hospital in Birmingham, Ron will have x-rays to see if he has broken
18:36his hip.
18:50Poor Ron.
18:51He was killing a lot of pain.
18:53He was not having a good time.
18:54Oh, well, at least we've got him to hospital.
18:57I know.
18:57Bless it.
18:58Got him in, didn't we?
18:59Yeah.
18:59We'll get him sorted.
19:16You like a pub quiz, don't you?
19:17I don't mind a pub quiz.
19:18I'm not saying I'm great at it, but...
19:20Right then.
19:20Right then.
19:21So, what European country has the longest coastline?
19:27Oh, geography.
19:27The longest coastline?
19:28Yes.
19:29Oh, God.
19:31Italy?
19:32I have no idea.
19:34I think geography is important in our job, so you know which direction roughly to travel.
19:39That's what we sat-nav's for.
19:40That's why you are no good at geography, because you rely on your sat-nav.
19:44It's a country that potentially had Vikings there.
19:50Sweden?
19:51No.
19:52Norway?
19:53Yeah.
19:54Believe it or not, Norway has the longest coastline in Europe.
19:58You know I'm going to look at that on the map now, right?
20:00Yeah.
20:00Google it.
20:08Ambulance service, is the patient breathing?
20:11Yes, it's me.
20:12I've got something wrong with my heart valve, and I'm supposed to have it operated on.
20:18What symptoms do you have, my love?
20:21It's painful, and my heart's racing.
20:24And can you feel the pain right now?
20:26Yes.
20:28I think I'm having a heart attack.
20:35Yeah.
20:36007.
20:38007.
20:39007.
20:39007.
20:3983-year-old female from chest pain.
20:42It does say she has a heart valve problem.
20:45Yeah, Roger, thanks.
20:46We'll get you what we can do.
20:48007.
20:48007.
20:49007.
20:49007.
20:50007.
20:51007.
20:51007.
20:51007.
20:52007.
20:54007.
20:57007.
21:00007.
21:01It's scary, isn't it?
21:02Some of the rural communities, and how isolated and vulnerable they actually are.
21:08This was potentially quite a serious case, just given her age, given the location of where
21:13it is, and the amount of time it would take to get there.
21:15007.
21:18007.
21:19007.
21:20007.
21:21007.
21:22get to her. So what's been going on then? Well I've got a heart and bowel problem and you know
21:32waiting to have it done but oh tonight it really got me. I woke up and I got this real
21:40pain
21:41and my heart was racing. When racehorse breeder Rosalie was woken in the night with pains in her
21:50chest. She rang 999. Husband Peter is with her. What time did she wake up with the chest pain though?
21:58How little time did you wake up with the chest pain? About three o'clock. Do you have an irregular
22:03heartbeat by any chance? Not normally. I can see they've put it in. She's got aortic valve stenosis.
22:11Rosalie was experiencing some chest pain which could be caused by her pre-existing heart condition.
22:17Aortic valve stenosis is the narrowing of a valve within a heart which affects the blood flow into
22:23the arteries. It effectively means the heart has to work a little bit harder. So have you got
22:28palpitations in your chest at the minute sweetheart? No. No. Did you have? No. Okay. The longer I spent
22:35with Rosalie the more concerned I got. She was telling me about needing the heart operation, how
22:40she's now got chest pains and palpitations. So the longer I was there the more concerned I was
22:45for coming for her. My license is still a second. Adam carries out an ECG to check the electrical
22:52activity of Rosalie's heart. Yeah. We'll be going. You're going to hospital sweetheart? Is it all right
22:58or is it? You've got a heart rate at the minute of about 160. Yeah. It should be ideally between
23:05sort of
23:0560 and 100. It's very fast basically. I knew something was wrong anyway. I've been getting
23:11short of breath. Have you? I'm not surprised with a heart rate like that. So it's saying
23:17STEMI. Yep. So we're going to have to ring. Yeah. We'll give him a buzz. Once we completed a heart
23:24tracing on Rosalie it showed us that not only was her heart beating pretty fast at over 160 beats per
23:31minute. But it was also showing us that she was actively having what we call a STEMI, which
23:36is a heart attack.
23:45As the West Midlands sleeps, we're on board with eight paramedic crews working the night
23:50shift until 6.30 in the morning.
23:58We are going to be taken to hospital and we are probably going to be going quite quickly.
24:03On the outskirts of Stoke, paramedics Colleen and Adam are with Rosalie, who they suspect
24:09is having a heart attack. I'm just going to give you a spray under your tongue if I can.
24:13Yeah. This will hopefully take some of the chest pain away.
24:16Adam gives Rosalie a spray under her tongue.
24:19This opens up her blood vessels, reducing the strain on her heart.
24:24We're going to look and see if we can give her a aspirin.
24:27Yeah. Then we're going to look at giving her a needle in her arm as well.
24:30I'm just going to pop in your hall and make a phone call, OK?
24:32OK.
24:34Colleen calls the hospital to let them know they'll be arriving soon with a patient who's having
24:39a heart attack.
24:40So I did the right thing calling you.
24:42Oh, yeah.
24:43I don't like to think I'm wasting anybody's time, you know.
24:45Nope, you have definitely done the right thing by calling you.
24:48They said go to A&E initially, but give resource a call to go there.
24:52Which A&E?
24:54Stoke.
24:54Rosalie has to go to hospital because she's actively having a heart attack.
24:58She needs further treatment that we cannot provide her.
25:01It's imperative that we get her there pretty quickly to get the treatment she needs as fast
25:04as she can.
25:05We're going in on blue lights.
25:06We're going to be going quite quickly.
25:08She is unwell.
25:09So it's up to you what you choose to do.
25:12But if you do...
25:12No, you're doing your job anyway.
25:14They'll look after me.
25:15I know that.
25:16We'll get you on to the ambulance and we'll get you to stoke as quick as we can, OK?
25:19I can walk, I think.
25:21No.
25:21No, absolutely not.
25:22No, we're all right.
25:23Absolutely not.
25:25We're all right.
25:25Your heart rate's already going to 160.
25:27Try and get you up and about, you'll be on the floor.
25:30I find with the older generation, they don't want to make a fuss.
25:33They just want to get on with things.
25:35But when something like this is happening, you really should make a fuss about it.
25:41I'm kidding.
25:42I don't want to have to do this.
25:43No, you couldn't.
25:43I'm not walking anywhere, Doug.
25:45Not with your heart rate like that.
25:47Well, you know your job.
25:50Indeed.
25:51How are you feeling?
25:52Not too bad.
25:54So, like we said, we will be going in with the blues and twos, OK?
25:59OK.
26:00So, we need to get you there sooner rather than later.
26:07Breaking bad news is never fun.
26:09But unfortunately, we need to do it in a way that the patient understands
26:13so they have all the information they need.
26:16Hello, resource.
26:18It's Adam, one of the paramedics.
26:19Can I put a medical standby in, please?
26:21OK, and we'll see you in about 20 minutes.
26:24We're going to be waiting for you.
26:26So, we'll go straight in, straight to see someone, hopefully.
26:31I feel a bit of a fraud going in like this.
26:34Honestly, you're really not.
26:36Really?
26:37Yeah.
26:38With your heart rate being as it is, you ain't no fraud.
26:45All right then, sweet.
26:46Couple of bumps.
26:47I'm a pro, don't worry.
26:49Yes, you are.
26:51At Royal Stoke University Hospital,
26:53the cardiac team are ready and waiting to treat Rosalie.
27:03Rosalie was lovely, wasn't she?
27:05Yeah.
27:06I don't think she wanted to bother us.
27:08She absolutely needed to, though.
27:09No, didn't she, Joe?
27:10Like, as soon as I seen that ECG...
27:11Yeah.
27:12I was like, hmm, that's not right.
27:14Not right at all.
27:17It would not shock me.
27:18But she didn't seem particularly bothered about it.
27:20She was really chilled.
27:21Yeah, that's what I mean.
27:22Way more chilled than I'd be.
27:24Bless her.
27:24They don't make them like her any more, do they?
27:26Oh, definitely don't.
27:27Absolute trooper.
27:40So, is he able to respond to you at all and speak to you?
27:43Is she awake at the moment?
27:46Every minute of every day,
27:48the call assessors of West Midlands Ambulance Service
27:51are working hard to save lives.
27:53There is always something that is completely out of the box
28:00and you're not expecting it.
28:01And I think that's what makes this job so interesting.
28:05Ambulance Service, is the patient breathing?
28:09Ambulance, please.
28:10It's the ambulance service.
28:12Is the patient breathing?
28:14Is she breathing?
28:16Yes, she's breathing.
28:17Yes, yes, sort of, yeah.
28:18OK.
28:18Are they conscious?
28:19Are they awake?
28:20She's panting.
28:21She's ready breathing.
28:22OK.
28:23I just need to know if they're conscious.
28:24Are they responding to you?
28:26Is she responding to it?
28:28No, I don't think she is.
28:30OK.
28:30Is her breathing noisy or abnormal?
28:34It's like gargling, heavy.
28:36It's gargling.
28:37OK.
28:38Is she responding to you?
28:39Is she making any effort to move?
28:42Yeah, she's sort of.
28:45OK.
28:46Right.
28:47OK.
28:48OK, caller, listen to me.
28:50It's really important that you follow my instructions, OK?
28:52I need you to have a look at her breathing.
28:54Is she breathing normally?
28:56Is she breathing normally?
28:59No, not really.
29:00As soon as I hear the words that they're not conscious and not breathing,
29:03it's almost like a wall comes down around me
29:07and I'm completely locked in on that call.
29:10Nothing else around me matters.
29:13OK, we've got some help arranged.
29:15I need you to listen to my instructions, OK?
29:17Are you within easy reach of her?
29:20Yeah, somebody's on the roof.
29:22She's on a roof.
29:24She's on a what, sorry?
29:26She's on, like, a roof ledge.
29:28She's on a roof ledge.
29:30Yeah.
29:32When I heard the patient was on the roof,
29:35I think I was genuinely really confused,
29:37but it just changed things in the moment then.
29:40It meant that I needed to then think about
29:42how we were going to get the caller to the patient safely to do CPR.
29:46So when you say she's on a roof ledge, what do you mean?
29:51It's like a ledge.
29:52It's like a ledge.
29:53Is it a ledge on top of the house?
29:56Is it like a balcony out there?
29:57Yeah, yeah, like a roof.
30:00Can you see the ambulance?
30:03Paula, are the paramedics there?
30:05One on your left.
30:06One on your left.
30:06The door on your left.
30:09Hello, caller?
30:11Yeah.
30:12Is that the crew with you?
30:14Yeah.
30:15OK, I'll leave you with them.
30:19Even though we get calls quite often for people
30:23in unconventional places,
30:24it's not often that you get somebody that's on a roof,
30:27unconscious, not breathing,
30:30needing CPR
30:32and trying to figure out
30:33how we're going to get to that patient.
30:36Minutes later,
30:38control has informed
30:39the woman was trying to take her own life.
30:42We've got some updates on that case.
30:45So, she's alive.
30:48They've now got her off the roof.
30:50Fire were there as well.
30:52I assume that's to help get her down off the roof.
30:54Yeah, because they weren't quite sure
30:55how they were going to get her down, to be fair.
30:57I just couldn't get my head around it.
31:00No.
31:00It just didn't make sense
31:01as to why she would be on the roof.
31:03She's on the back of the ambulance,
31:04so hopefully she'll be OK.
31:22Are you sweet rather than savoury, then?
31:24If I have a tub of ice cream,
31:27there's no, like, scooping it out
31:29and putting it in a bowl.
31:31I just eat all of it.
31:32Do you know what really annoys me, though,
31:34about, say, if you've got ice cream
31:35and you get it out of the freezer
31:37and you've got to wait for it to defrost a bit
31:39and your spoon just bends because it's the ice...
31:41You put it in the microwave?
31:43I put it in the microwave it for about
31:4310, 15, 20 seconds, depending.
31:45There has been a few mis-ups on a couple of occasions
31:49where it has been too soft.
31:53So then, do I eat it or do I put it back in the freezer
31:58to freeze it up a little bit more,
32:00but then am I going to be starting back at the same point
32:02where I'm going to have to put it in the microwave?
32:04This is too much for my ex.
32:06It's a science.
32:07It's a science.
32:08I do like ice cream when it's all runny, though.
32:10I'll purposely mix it until it goes...
32:11I used to do that when I was little.
32:13As a kid, yeah.
32:13I don't want it sloppy now.
32:16I want it just nice.
32:23999.
32:26Category 2, 70s lady
32:30with something very unfortunate.
32:32She has rectal bleeding.
32:35She's got diverticulitis as well.
32:37Right, OK.
32:38So that could be a factor.
32:42A lot of people struggle with that, don't they?
32:44Yeah, yeah.
32:46Diverticulitis is a condition in the bowel
32:48which can cause bleeding and discomfort
32:50and sometimes a lot of pain.
32:52We knew this lady had been bleeding
32:54and so it was quite important
32:56that we found out what was going on.
33:07Hello.
33:08What's been going on, sweetheart?
33:10I've been having bleeds.
33:11I've got diverticulitis.
33:13OK.
33:13I'm used to having small bleeds.
33:17I had to do a run at the bathroom.
33:19Mm-hm.
33:21I had a massive bleed.
33:23You can go look in the loops there.
33:25Right, OK.
33:2874-year-old Maddie
33:29has lived with chronic inflammation
33:31of the bowel for 30 years
33:33but tonight,
33:34after experiencing heavy bleeding,
33:36she called for help.
33:39Are you getting any pain?
33:41Yeah.
33:41Is the pain different
33:42to normal diverticulitis pain?
33:45Yeah.
33:46It's across a year.
33:47Let's do your blood pressure,
33:49ducky.
33:50Right.
33:51So, would you say
33:52the amount of blood
33:54that you've lost
33:54and, like, tonight
33:56and that is...
33:57Over a lot of blood.
33:58Do you find it's getting worse?
34:00Oh, yeah.
34:01Yeah.
34:01With the amount of blood
34:03Maddie was losing,
34:04I was concerned
34:05as things can get
34:06quite serious
34:07quite fast.
34:08Oh, right, OK.
34:10So it's definitely
34:10red pressure.
34:11Yeah.
34:28Oh, goodness.
34:29Tired, Bob?
34:30I am tired, yeah.
34:31I definitely prefer
34:32the day shifts.
34:33What do you prefer?
34:34Day shifts, 100%.
34:35It's always better
34:36when you're working
34:37with a friend.
34:37So when me and Sean
34:38work together,
34:39it's not really
34:39like working together
34:40because we're quite
34:41good friends anyway.
34:42Yeah, yeah, definitely.
34:44If you have a laugh
34:44with someone,
34:45time goes so fast.
34:46Yeah, it does.
34:47And you bring loads of snacks,
34:48so that definitely helps.
34:49That's also very true.
34:50That's very true.
34:52Can't wait for a cup of tea
34:53in bed tomorrow morning.
35:00Handling in service.
35:01Is the patient breathing?
35:03Yes.
35:03He's laying in his own throw-up.
35:05Is the patient conscious?
35:07No, he's not.
35:08He's laying there
35:09on the street.
35:10Is the breathing noisy
35:12or abnormal?
35:13It's abnormal.
35:15I've got to go outside.
35:16The guy can't go up.
35:20We've got a cat one.
35:23So we have
35:25arrest, peri-arrest
35:26exposed to the elements
35:29five minutes away.
35:31When a patient's heart
35:32is highly unstable
35:33but it's still beating,
35:35it's called peri-arrest.
35:37It's the stage
35:38before a full cardiac arrest.
35:42Onwards and upwards,
35:43let's go see.
35:45He's unconscious,
35:47noisy breathing.
35:49Obviously, you've done
35:50route over.
35:51Yeah, unconscious,
35:52noisy breathing.
35:53So, I mean,
35:54Sunday morning,
35:57it'd be a good guess
35:58to say that
35:59he might have been out
35:59the night before.
36:03Hello.
36:05What's happened?
36:06Just found.
36:09He's breathing.
36:11Oh, yeah, yeah.
36:11I can't detect my injuries.
36:13He's laying there,
36:13so I'll throw up, so...
36:14Hiya, mate.
36:15Can you wake up for us?
36:18Can you wake up?
36:19Definitely had a good night.
36:22We'll get the stretcher
36:23and get him on the ambulance.
36:24Good night.
36:24Yeah.
36:27A doorman called 999
36:29after finding the man
36:30lying unconscious
36:31on the pavement.
36:32When we arrived on scene,
36:34we came across
36:35a man covered in vomit.
36:37We both took a good guess
36:38that he'd been on a night out
36:39the night before
36:39and he was just taken asleep
36:42on the side of the road.
36:43Right, mate.
36:45It's time to get on this stretcher.
36:47Yeah.
36:48Let's set you up.
36:50You've definitely
36:51had a good night.
36:54Shall we get your legs round?
36:58You able to pull him up
36:59from that way?
37:00Yes, mate.
37:01Oh, he's wet himself as well.
37:02Yeah.
37:04Hello.
37:05All right?
37:06Good for you.
37:07Good.
37:08Get you to stand up.
37:08We've got to get you
37:09on this stretcher.
37:11Don't worry about me.
37:11Don't worry about yourself.
37:13It's out there again.
37:14Don't worry about me.
37:15Don't worry about yourself.
37:15Oh, no, we are worried about you.
37:16You're with the ambulance.
37:17Yeah, don't worry about me.
37:18I'm all right.
37:19You're in the street.
37:20You've been sick.
37:21Do I want, man?
37:22OK.
37:23When he sat up
37:25and came round a bit,
37:26it was very difficult
37:27to talk to him.
37:28He didn't want to speak to us
37:29and we very quickly
37:30got that vibe,
37:31but also there was a part of us
37:32that wanted to make sure
37:33he was OK.
37:35You can't stay here, though.
37:36You're going to have someone else
37:37throwing an ambulance for you?
37:38No, I'm not.
37:39You're not?
37:40I'm throwing an ambulance for me.
37:40I shall go mad, you know.
37:42What's that?
37:44Yeah, someone's
37:45throwing an ambulance for you.
37:46Well, I'm mad.
37:46Why?
37:47Why not?
37:49Because you're not waking up,
37:50you're sleeping on the street.
37:51I do want one, man.
37:53OK.
37:54Where's home?
37:56You tell me.
37:57I don't know.
37:58Do you have a house?
37:59Fuck off.
38:00Just ask me where home is.
38:01I ain't got fucking no home.
38:04When he was coming round
38:05and he was talking to us,
38:07he was very defensive
38:09and aggressive
38:11in his answers
38:12and at these moments
38:13you just sigh
38:14and just think,
38:15what can I do?
38:16Is there any other way
38:17we can help you?
38:25Let me just do your blood sugar,
38:27sweetheart.
38:30Not point full.
38:32In Stoke,
38:33paramedics Nick and Kyra
38:34are with Maddie.
38:35She has diverticulitis,
38:38a condition that causes
38:39severe inflammation
38:40of the bowel.
38:42Do you take any pain relief
38:44for it?
38:44Does anything work?
38:45No, I don't bother.
38:47Yeah, I know what I think.
38:49It's got to do with
38:50the dermaticulitis
38:52so there's not a lot
38:53I can do.
38:54No, that's the problem
38:55with that.
38:56Your arms are OK
39:00but someone like yourself
39:03that's got this ongoing issue
39:06for you to be worried
39:07and be ringing people
39:10that's a concern
39:11in itself
39:11because something's
39:14not normal for you.
39:15I think we need
39:16more thorough tests done.
39:19Right.
39:19More than what I can do
39:20with this thing
39:21and so that's giving me
39:23like, yeah,
39:24let's take you.
39:24The reason we wanted
39:26to take Maddie to hospital
39:27is due to our concern
39:28about the amount of blood
39:30she was losing,
39:31where she was losing it from
39:33therefore we had to find out
39:35what was going on
39:36so we could get her treated.
39:37I don't want that.
39:38I was folding this up.
39:40Yeah, good.
39:41To bring one of your nice
39:41patched ones.
39:42Can I have a look at it?
39:43Yeah, well, she can't just
39:44rip it out of them.
39:47While Maddie gets ready
39:48to go to hospital,
39:50Nick and Kyra
39:51admire her homemade quilt.
39:53That would look lovely
39:54in my bedroom, that would.
39:55Oh.
39:56I'd put an order in.
39:57Look how perfect it is.
39:59I've got loads of UFOs.
40:02UFOs?
40:03UFOs?
40:03Unfinished objects.
40:05Oh.
40:07Don't get her started on space
40:08and stuff.
40:09She loves it.
40:10I'm obsessed.
40:11I'm obsessed.
40:12I'm obsessed.
40:12Handmade quilts with UFOs on.
40:14The thought of having one
40:16would be absolutely amazing.
40:18It would take pride of place
40:19on my bed.
40:20I would love it.
40:24Ready when you are, thank you.
40:28I always say the human body,
40:31it's a marvellous thing,
40:33but it can really go wrong
40:34in some dramatic ways.
40:36People, unless they've got
40:38something like this,
40:38they don't understand at all
40:40how debilitating it is.
40:51At Royal Stoke University Hospital,
40:54medical staff will try to find out
40:56why Maddie's blood loss
40:58has been so heavy tonight.
41:04Is there any other way
41:05we can help you as an ambulance?
41:07There's only way we can take you.
41:10In Birmingham City Centre,
41:13paramedic Sian and technician Brogan
41:15are with a man who was found
41:16lying unconscious in the street.
41:19Have you been drinking alcohol?
41:20Yes.
41:21Yeah.
41:22I'm doing that too.
41:23Right, I'm done with this
41:25swearing and abuse now.
41:26Let's go.
41:28I guess that's it then, mate.
41:31Yeah, that's it.
41:33Trying to get you some help?
41:36Well, we've been trying,
41:38but you're not being very nice,
41:39so...
41:41Well, okay.
41:43We decided to leave him there
41:45because, despite offering him
41:47help multiple times
41:48and him initially rejecting it,
41:51we can't force him to accept
41:52the help that we offer.
41:54Hey, Leastricht.
41:55Hey.
41:56What's that?
41:57What we have?
41:58What?
41:58Was I just not breathing then?
42:01No, you were breathing,
42:02but you're unconscious.
42:03On the floor,
42:04you're hard to wake up.
42:05That's why we were called
42:06and we were worried about you,
42:08but you're not being all that nice.
42:10Make sure I don't fall over.
42:12Because I've been drinking, though.
42:13Yeah, yeah, I get it.
42:14Are you going to help me?
42:16You just said no.
42:17Are you going to help me?
42:18Well, what do you want help with?
42:19You just told us to go away
42:20and leave you alone.
42:21Do you want us to make sure you're okay?
42:23If I was sat there, yeah,
42:24we'd be sick.
42:25Yeah, that's what you meant to do.
42:26Look, I'm not having an argument.
42:28Do you want your checks done?
42:29I was really frustrated with this man
42:31because anything I was offering
42:33or Brogan was offering,
42:35it just wasn't good enough.
42:36He just wanted an argument
42:38or a fight
42:39or something similar to that
42:40and you just can't help them people.
42:42Do you want your checks done?
42:43No, listen.
42:44Two minutes, bro.
42:45No, honestly,
42:45I don't have time for this.
42:47Come on.
42:47Do you want to be real?
42:48Do you want your checks done or not?
42:50I'm all in a mental state for you.
42:51Do you want your checks done?
42:52It doesn't matter, bro.
42:54Don't fucking start shouting at me, bro.
42:56What are you going to do?
42:57Let me walk away.
42:58Yeah, if you want.
42:59You're more than welcome to.
43:00Come away from me.
43:01Come away from me.
43:02Bro, go that way.
43:03I'll touch you, mate.
43:04Bro, what are you going to do, bro?
43:06My concern when he stood up
43:08and he started shouting
43:09and getting aggressive
43:11was that he was getting close
43:12to the ambulance
43:13and he could have assaulted me
43:15and I think it would have turned worse
43:17if we'd have stayed there
43:18so I think it was a good decision
43:19for us to leave at that point.
43:21I think we should have scoured.
43:22Yeah, this is just...
43:23Yeah, let's go.
43:29No, step away.
43:31Please step away.
43:32Please step away.
43:37Having to deal with aggressive patients like this
43:40is not uncommon.
43:42At West Midlands Ambulance Service,
43:44nine incidents of physical or verbal abuse
43:47are carried out against the staff
43:49every single day.
43:50Well, that was a bit scary, wasn't it?
43:54Escalated quite quickly, that job.
43:56Yeah.
43:57It was really threatening.
43:58It was quite scary.
43:59And as far as I'm concerned,
44:01when he says,
44:02can you really leave me in this state?
44:04Yes, I can.
44:04I mean, you're not in much of a state
44:06when you're able to stand up
44:07and verbally abuse us.
44:09Yeah.
44:10I mean, sometimes we get sent to people
44:13that don't want our help
44:15and are vile to us
44:16and then there's some people out there
44:17who just can't get our help
44:19and they're in a waiting...
44:20Yeah.
44:21People are in a queue for 999
44:22and they're waiting for jobs
44:23where we're wasting our time
44:25with people who would just verbally assault us.
44:33Ron, who fell and was in agony,
44:35hadn't broken his hip.
44:37X-rays showed a plate in his hip had come loose.
44:40He spent four hours in surgery,
44:42having it screwed back in place.
44:47Rosalie, who was having a heart attack,
44:49was admitted to the cardiology ward.
44:52Here she received treatment
44:54for blocked coronary arteries.
44:58Robert, whose nose was bleeding heavily,
45:00spent six hours in hospital.
45:03The bleeding was stopped
45:04and he was prescribed a nasal cream
45:06to treat any possible infection.
45:09And Maddie, who had rectal bleeding,
45:12spent three days in hospital.
45:14She may require surgery
45:16to repair her intestines.
45:18We went straight through
45:20to see a consultant
45:22who was brilliant.
45:24So hopefully,
45:26he's going to have some answers for me
45:28to help me
45:30get my life back.
45:35Next time...
45:36Yeah, you're really wheezy,
45:38aren't you, darling?
45:39A man is struggling to breathe.
45:41Right, let's pop this on you.
45:43COPD is like breathing through a straw
45:45day to day.
45:47When you're unwell,
45:48it can get even worse.
45:49She's got her need to watch.
45:52A young woman has multiple seizures.
45:55She'd been having a seizure every day.
45:57She'd had more than one
45:58whilst we were with her.
45:59This can't keep happening.
46:01It's dangerous.
46:02What have you done?
46:03And a patient falls,
46:05badly cutting her head.
46:06When I looked at her injury,
46:09I could see that it was down to her skull.
46:11It needed some serious stitching.
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