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00:01Ambulance service is patient breathing.
00:04This old gentleman, he can't walk no farther.
00:08There's a person on the floor, and that's if it's OK, but he doesn't respond.
00:13The gentleman's fallen over. We'll need a mountain rescue as well.
00:17Righty ho, let's get them bad boys on.
00:20West Midlands Ambulance Service looks after almost six million people.
00:25I love the fact that not just every shift's different, every job's different.
00:30Do 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.
00:39Is she breathing normally?
00:42What availability of HeliMed?
00:45Embedded with eight emergency crews.
00:48Could be anything, couldn't it?
00:49OK, OK.
00:51Filming simultaneously across the region.
00:55Time is everything in our job.
00:57Just relax, relax for me.
00:58Can you open your mouth as wide as you can?
01:02Capturing life.
01:03How's your vision? Got it?
01:05On the front line.
01:07I go to work every day, and I make a difference.
01:16Stand well clear. Vehicle reversing.
01:20Hey, how comes I always end up getting on a truck before you?
01:23Age before beauty.
01:25It's going to be a long shift this is, Mick.
01:33If you could master any talent, what would it be?
01:37Probably to learn every language.
01:41I'm jealous of that answer.
01:42Mine would be to be able to play the piano.
01:44I want to be able to just see a piano and just play it.
01:48In public. In a train station.
01:50Yeah. Do a little courtesy.
01:51Yeah. Thank you, everybody.
01:53That's a good talent. It is, isn't it?
01:55Yeah.
01:56Good morning. It's Scott and Law on 7-7 today, over.
02:00I'll get you both. I'm good, guys.
02:03Brill, thank you. Have a good day.
02:07What's the best compliment you've ever received at work from a patient?
02:12There was a guy that was, a patient that was a bit high,
02:16but told me I was the most beautiful person I'd ever seen.
02:21He was lying.
02:24A lady told me I'm going to marry Johnny Depp,
02:27and I was pretty complimented by that.
02:29Yeah.
02:30I like getting called a handsome young man
02:32off all the women in the 90s.
02:35That's my favourite.
02:37The ones that wear glasses and should go with their eyesight.
02:39Yeah, those ones.
02:40Yeah.
02:53Oh, God, that was a good click.
02:55That was a good crack.
02:57Click your neck.
02:58All right.
02:59Not bloody.
03:00Now.
03:01Show monkey.
03:01Actually, don't.
03:02I will get a snake.
03:05Yeah.
03:07Oh, stop it.
03:09I don't like your neck.
03:11I think there's two types of people in this world.
03:13People who are obsessively clicking themselves,
03:16and some people who are not, and that's the difference between me and you.
03:18Yeah, I crack too much all the time.
03:22Yeah, honestly, I'm not surprised you didn't come and be like,
03:24oh, I can crack my nose.
03:26Some people can.
03:27You know what?
03:27Can you crack your ear?
03:30Oh.
03:32I don't know how you do it.
03:33It makes you feel like I'm going to break my head.
03:35Yeah, it does your right.
03:44Can you talk to me?
03:44I'm doing it at service, is the patient breathing?
03:47Just to bed, this old gentleman, he can't walk no farther.
03:51Can I speak to him directly?
03:54Hello?
03:54Hello. So tell me what's the main problem?
03:58Struggling to walk.
03:59Right, what's going on with your speech, sir? You sound a little bit slurred to me.
04:04Have you ever had a stroke before?
04:07Yes, I've had a couple of little strokes.
04:13We are going to a 71-year-old male exposed to the elements.
04:19Apparently struggling to walk short of breath.
04:22He's previously had a stroke.
04:25His speech appears to have become slurred, and he is sweating.
04:29This could actually be a stroke.
04:33On the way to this job, it came through as slurred speech, didn't it?
04:36So obviously that's a stroke symptom.
04:38We've only got a very short window of opportunity that we can help treat that stroke.
04:44So time really is not on our side.
04:47Oh, look, there he is.
04:49What are you doing there?
04:51In the middle of the field.
05:00What's your name?
05:02Bill.
05:02Bill, nice to meet you, Bill. I'm Brooke, and that's Keira.
05:04Hello.
05:05So what's happened?
05:06His legs have gone completely.
05:08He was going to one side, and his legs were giving way.
05:12He just couldn't walk.
05:13When 71-year-old Bill found himself staggering while crossing this grassland, neighbours Sheila
05:21and Karen came out to help and called 999.
05:26We're living there now, especially with your story.
05:29Oh, they rescued you, did they?
05:30Yeah.
05:30That's nice of them.
05:31So what do you remember happening?
05:34Well, I couldn't walk, and she was helping me walk down.
05:39And what were you doing? Were you just on a walk or...?
05:41Yeah.
05:42Yeah.
05:42She was coming back from the shops.
05:44I think people that come out and help people like those ladies did, it's really thoughtful.
05:48It restores your faith that people actually do care about everybody, so it's nice to see
05:53that sense of community.
05:56Can I just have your hands for a second?
05:59Just give them a nice big squeeze for me.
06:01Nice and hard.
06:03Fabulous.
06:04Now lift your arms up in the air for me.
06:06Close your eyes.
06:07Keep them there.
06:08Don't let them drop.
06:10Okie dokie.
06:12Try that again.
06:13Keep them there for me.
06:15Okie dokie.
06:17You can relax them down.
06:18Now can you try and kick your foot out towards me, against my hand?
06:23Brooke carries out what's called the fast test to try and identify the telltale signs
06:29of a stroke.
06:33And then in towards my hand.
06:36Okie dokie.
06:37Fabulous.
06:38You know, when you closed your eyes then, did you feel like you were leaning to one side
06:42at all?
06:43Yeah.
06:44I did a fast test on Bill to make sure that he didn't have any weakness to one specific
06:49side to rule out the fact that he was having a stroke.
06:51He didn't, however, he was still leaning to his side significantly.
06:55We didn't know what was happening, so we needed to figure out quickly.
06:58Do you feel like you just feel a bit weak or is it like that you're...
07:02He says he's not eating.
07:17If I had my way, I would eat chicken every single day.
07:21It's just absolutely lovely.
07:22Would you have it still warm on your salad?
07:23Oh, yeah, yeah.
07:24I can eat a cold drumstick.
07:26But if I sort of cut half a chicken up, I can't eat it cold.
07:30The law is you have to have a cold drumstick, but the breast has to be warm.
07:35Especially if it's just come off the spit roast and it's juicy and you're just...
07:40Oh, yeah, they're all running on your chops.
07:41I'm hungry now.
07:51Ambulance, sir, this is a patient breathing.
07:54He is, yeah.
07:56He has a lot of bronchitis.
07:57He's been coughing, coughing, coughing.
07:59And last night, he's been in pain with his chest.
08:06Going to a 77-year-old male with chest pain, excruciating pain at onset.
08:14Right, you.
08:16Could be absolutely anything with chest pain.
08:19Cardiac, is it muscular, musculoskeletal?
08:22Have they got a cough?
08:22Cough, respiratory.
08:24Until we get there, it's that proverbial guessing game.
08:27Get your foot down and get there.
08:37Hello?
08:38Where is he?
08:39Where's he hiding?
08:41My name is Dave and this is Mick.
08:42Hi, you're right.
08:43What's going on with yourself?
08:45I'll be 25 in 2.5.
08:49I just want to cough now, I'm having a hold.
08:52Yeah, I think I might have pulled something again.
08:54We're coughing, you've hurt yourself.
08:56OK.
08:5777-year-old Bob has been struggling with a cough,
08:59and since yesterday, he's had a severe pain in his chest.
09:05So whereabouts is the pain in your chest, then?
09:07Just there.
09:08Just there, OK.
09:09Had you been coughing quite heavily prior to the change?
09:13There's pain around about here.
09:14Yeah, that's right.
09:15Well, I'm touching.
09:16I'm taking a deep breath for me.
09:18Does it hurt when you're taking a deep breath?
09:19No, no.
09:20No?
09:21OK.
09:21When I first heard Bob coughing, quite a hacking, barking cough.
09:27As he pulled the chest muscle, popped the rib from all the coughing.
09:31That was my initial...
09:32That was the initial thought.
09:33The initial thought, yes.
09:35Just have a quick listen to your chest.
09:39When I've listened to Bob's chest, it was quite noisy, isn't it?
09:42The best way to describe it, it sounded like an organ.
09:45It was wheezes, it was crackles, there was all sorts of going on.
09:48However, when I'm listening, there's a little part of me going,
09:51could this be something else?
09:54So you are quite wheezy on your chest.
09:56We'll give you something for that, just to sort that out, OK?
09:58Right, we'll pop some dots on, we'll do an ECG, OK?
10:01Yeah.
10:01We never come out for one thing, we always come out and we find something else as well.
10:05The ECG provides a snapshot of how Bob's heart is functioning.
10:10So what do you do for a job?
10:12Over the pit.
10:14Oh, that'll do it.
10:15So you've always been around dust.
10:17When Bob told us he worked down the mines,
10:19we started to think, ah, right, OK, this is what his problem is with his chest.
10:23He's got dust, he's got coal dust on there.
10:25And this is what's potentially causing him all his issues and his problems.
10:29This is a salbutamol inhaler, OK?
10:32Just clear some of that wheeze off your chest.
10:34While Mick secures the inhaler to help Bob with his breathing...
10:39Right.
10:41..Dave prepares to run the ECG on his heart.
10:45Feeling a bit of pain now.
10:47Where about is it?
10:49Just right in the middle there?
10:51Yeah. OK.
10:52It's definitely not going anywhere else.
10:54Does it feel like it's going through to your back?
10:56No.
10:57Right, nice and steady for me, OK, for 30 seconds
11:00while I do this ECG reading.
11:01You ready?
11:06You haven't had any pins and needles in your hands at all?
11:09When there's pain come, I've got pins and needles here.
11:12In there? OK.
11:21I'm going to bob that through to cardiology and get him to have a look at it.
11:28It was a bit of a woe moment.
11:30After listening to his chest and listening to his story,
11:33I was expecting it to be a respiratory, not a cardiac event.
11:38I mean, you could see the changes on that heart tracing
11:40straight off where I was sitting.
11:42Absolutely.
11:43And to me, it looked like he was having a heart attack.
11:46Game's there now.
11:59Right, so I'm going to give you an aspirin.
12:02Right.
12:03Just pop that in, OK?
12:05And just chew it.
12:06Don't swallow it, because it's an aspirin, OK?
12:09In Stoke, paramedics Mick and Dave are with Bob,
12:12who they suspect is having a heart attack.
12:17Hi, good morning. It's Mick, one of the paramedics.
12:18You OK?
12:19I'm just with a 77-year-old gentleman at the moment.
12:22Tongue up, top of your mouth.
12:23While Mick calls the cardiology department at the nearest hospital...
12:27Right, I'm just going to give you a squirt of this under your tongue as well.
12:30It'll help with that pain.
12:32Dave gives Bob GTN spray.
12:34This will help widen his blood vessels,
12:37reducing the strain on his heart.
12:40Right, it's a trip to the hospital anyway.
12:42We're just going to find out where we're taking you.
12:44There's some changes on your ECG.
12:46I'm just getting somebody to have another look at it.
12:48They know a little bit more about it than I do.
12:51I've had it confirmed by the cardiologist team
12:54that he is having a heart attack.
12:55I have now got to tell Bob.
12:57I have to be careful how I explain it to him.
12:59I don't want to frighten him,
13:01because that can put stress on the heart,
13:03and if we put any more stress on the heart that he's already under,
13:05it could be potentially fatal.
13:08It will be about 15, 20 minutes.
13:13Okay, that's great.
13:14Thanks, Em.
13:15Bye-bye.
13:16So it looks like you're having a heart attack.
13:18Okay?
13:19That's what it's looking like.
13:21Don't worry, okay?
13:22You're in the right place.
13:23We're going to get you sorted out, okay?
13:25That's what it looks like on the ECG,
13:26and that's why we just phoned the cardiology department
13:28so they can just confirm.
13:29So we're taking you directly there.
13:32All right?
13:33So don't get upset, okay?
13:35Because if you start crying,
13:36you'll get me going,
13:36you'll get me mascara running,
13:37you'll be a right mess.
13:39We're going to look after you, okay?
13:41What we don't want to do
13:42is put any more strain on your heart, all right?
13:45When I've told Bob he's having a heart attack,
13:48he was quite taken aback.
13:49He was quite shocked.
13:50To the point where I think he was getting a little bit upset,
13:53because if somebody hears heart attack,
13:55they automatically think the worst.
13:58However, I have explained to him
14:00we're going to take him to the hospital
14:02to get the right treatment.
14:04One day is me driving shoes.
14:06Your driving shoes, eh?
14:07How did he grip the steering wheel?
14:11Right.
14:12Big stand.
14:13Nice and steady.
14:14And have a sit down.
14:15Okay.
14:16That's it.
14:17There you go.
14:18Okay.
14:22Get on there.
14:23Put your feet up.
14:30So, obviously, we don't want to hang around,
14:32so we're going to pop the lights on
14:33just to get through the traffic and get you in.
14:36I've never...
14:37Even hand in through the lights.
14:39Have you not?
14:40Have you not?
14:40If you want to go faster, just scream.
14:50Right, I'm just going to do another ECG tracing, okay?
14:54Bob's heart is already struggling,
14:56so Dave needs to keep an eye on his condition
14:58in case it worsens.
15:02Shall I have a heart attack?
15:03Well, you're having one at the moment.
15:04Yeah.
15:05That's what your ECG points to.
15:08Heart attacks affect different people different ways.
15:11With Bob, I don't think he actually believed me
15:14when I told him he was having a heart attack
15:15because he was sat up, talking, and felt fine,
15:19apart from this slight discomfort.
15:26So, we're chairing up, isn't it?
15:28Where are we at now?
15:28So, we're at the back of the hospital
15:30because we're going straight up to cardiology.
15:32So, you're not going to be waiting outside the A&E.
15:35Having been alerted by Dave,
15:37the cardiology team at Royal Stoke University Hospital
15:40is standing by.
15:42Okay.
15:45Yeah.
15:52Well, I tell you what,
15:53I was not expecting that to be a cardiac issue.
15:57I wasn't either.
15:57That's all.
15:58I've had a cough.
15:59I think I pulled something.
16:00It's hurting.
16:01Yeah.
16:01I mean, I listened to his chest.
16:02It sounded awful.
16:04And then you pop the leads on,
16:06and, whoa, there we go.
16:08It just goes to show
16:09no two heart attacks present the same way.
16:12Yeah.
16:19I'm just going to roll this sleeve up.
16:21I'm going to do a blood pressure,
16:22and then what I want to do, really,
16:24is see if we can get you into the ambulance,
16:26because I don't particularly want you to be set out here for too long.
16:28In Canuck, paramedics,
16:31and I don't know if I can get you into the hospital.
16:55No.
16:56No.
16:56Your blood pressure's rather high.
16:59It's 199 over 73.
17:02Oh, my God.
17:02I can sit there.
17:04So...
17:05I can sit there for an hour.
17:06That's really high, isn't it?
17:07It's very high, yeah.
17:09Just pop your finger in here for me, Will.
17:10Oh, you just pinch that.
17:12Let's take that off, yeah?
17:14Blood pressure this high
17:15could lead to a heart attack or stroke.
17:18It's a medical emergency.
17:21What I want to see, Will,
17:23is just to see if you can stand up off that chair.
17:28Right.
17:29How does that feel?
17:31I think if I let go,
17:32you'll probably fall, wouldn't you?
17:34Right, sit yourself down, then.
17:37There's no arms on the chair,
17:38so you've just got to go straight back.
17:40That's it.
17:42When we stood Bill up,
17:44he was really unsteady on his feet,
17:46couldn't really stand up for himself
17:48without some support,
17:49so we had to use the carry chair
17:51to get him to the ambulance,
17:53which was quite difficult
17:53because he was in the middle of a field.
17:55Right, then, so this is probably
17:57going to be a bit of a bumpy ride.
18:00Might make you feel a bit travel sick.
18:03If not, might bumpy, isn't it, this?
18:07If you didn't feel sick before,
18:10you definitely do now.
18:11Right, then.
18:13What were you picking up from the shops?
18:15I was going to put a bet on.
18:18Put a bet on?
18:20Well, let's hope it checks out, eh?
18:22It might make this journey worth it.
18:29You know, when we were outside
18:30and we got you to stand up,
18:31how did you feel you were then?
18:34A bit dizzy.
18:35A bit dizzy.
18:36Shall I try and get you to just stand up
18:37where you are,
18:38and I'll do your blood pressure
18:39when you stand up
18:40to see if that changes anything?
18:43Brooke checks to see
18:44if Bill's blood pressure
18:45is still dangerously high.
18:48Fabulous.
18:48Right, just close your eyes for me.
18:55Is that when you go...
19:00That's when you're leaning, isn't it,
19:01when your eyes are closed?
19:02I don't know.
19:03Yeah.
19:04I think if you close your eyes for long enough,
19:07you'd hit the deck, to be honest.
19:10I think it might be worth
19:11a trip up to hospital today
19:13because your blood pressure's a little bit high
19:15and if your balance is off,
19:17a certain part of your brain
19:18might not be functioning properly.
19:21We obviously know his blood pressure was quite high,
19:23but we didn't really know what was going on,
19:25whether that was...
19:26His balance was off
19:27because his blood pressure was high
19:28or whether it was, like, a neurological problem.
19:30But we were very much...
19:31It was a job where we were in the dark, I think,
19:33weren't we, with what was going on?
19:34And it was...
19:35Take him to hospital for that conclusion, really.
19:39You know, at least you're still getting about
19:40and looking and...
19:42Newsies or losers.
19:44Well, exactly.
19:45Exactly.
19:46My nan told me that motto as well.
19:50Ready to go?
19:51Yeah.
19:55You're from Cunwick?
19:56Scotland.
19:57Scotland?
19:58Oh, yeah.
19:59I didn't pick up on the accent.
20:01You live on your own.
20:02Yeah.
20:03Do you feel like you need any support or not?
20:06No.
20:06You're OK?
20:10At New Cross Hospital in Wolverhampton,
20:12doctors will try to find out
20:14why Bill's blood pressure
20:15is so high and treat it.
20:29What is my most defining quality as a house, mate?
20:33Your ability to cook.
20:35That's it.
20:35That's all I bring to you, mate.
20:37Yeah.
20:38If you got a personal chef, that'd be it.
20:40I'd just be...
20:41Out on you, mate.
20:42You want an excellent cook, though.
20:45You've got to get a dishwasher.
20:46Yeah.
20:47Because you created so much mess.
20:50You don't get an artist to clean up his pain, do you?
20:53You'd make one dish, and then you'd need six bowls.
20:57I think living together definitely has its advantages,
21:00but also a few challenges.
21:02Definitely a few challenges.
21:04We squabble.
21:05Yeah, like siblings.
21:07Yeah.
21:08I'm right.
21:09You're wrong.
21:10We meet in the middle.
21:11I'm going to figure out that I'm right all along.
21:13No.
21:13Yeah.
21:14Never.
21:15See?
21:16Never, ever.
21:17If it was up to you, you'd have had a microwave curry
21:20without a microwave.
21:29I'll be looking at, sir.
21:30Is the patient breathing?
21:32Yes.
21:34Okay, what's the word?
21:35See what's happened.
21:36The gentleman's fallen over,
21:38and he's either broken an ankle or damaged soft tissue,
21:42and he can't bear weight on it.
21:44We'll need a mountain rescue as well.
21:50Oh, nice.
21:51Voice accept.
21:52Zero nine.
21:53Patient's fallen.
21:55They've got an ankle injury.
21:57Mountain rescue are on scene as well.
21:59So we're going to a 54-year-old male.
22:02He's fallen over.
22:04Injury to ankle.
22:07It's difficult terrain for a retrieving patient
22:11calling mountain rescue.
22:12Oh, nice.
22:15When we got a call saying mountain rescue were on scene,
22:18I think our first thought is, where on earth are we going?
22:20Yeah.
22:21And how are we getting there?
22:24I did anticipate that he was going to be halfway up the mountain,
22:27and we were going to have to figure out some way to get him down,
22:30because with the injury, there was no way he was going to walk.
22:32Yeah.
22:36We've made it.
22:37We've made it.
22:38I have.
22:38I saw a mountain rescue have made it.
22:40Me too.
22:42There's mountain rescue.
22:52Across the West Midlands,
22:54there are around 400 paramedic crews on the road every day.
22:59We're on board with eight of them to see the work that they do.
23:10So, Madge slipped on the top of Fort Cloud.
23:13OK.
23:14At approximately 3 o'clock,
23:16he managed to get himself down to the path.
23:18OK.
23:18Um, we've got suspected lower left ankle.
23:25Paramedic Sharni and Technician Jack have just arrived
23:28in Dovedale National Park, in the Peak District.
23:33Lovely.
23:34All yours. Lovely.
23:35Thank you very much.
23:36Thank you very much.
23:3754-year-old Madge was hiking here with his 11-year-old son, Victor,
23:42when he fell and injured his left ankle.
23:47What have you been up to?
23:48I've heard you've had a bit of it before.
23:49Found a little rock and just flipped my foot that direction.
23:52OK.
23:53So, you sort of rolled onto your ankle?
23:55Er, yeah.
23:56I rolled on it, and what I just experienced was that, you know,
24:01tissues just come and lose.
24:02You didn't hear any crunches or bone breaking or feel anything like that?
24:06No, no, no, no.
24:06It was like a soft tissue, you know, ligaments,
24:09tangents, things like this.
24:10And your pain at the minute?
24:11At the minute.
24:12It's not good.
24:13That's amazing.
24:14I expected that we were going to give significant amounts of pain relief,
24:18and when Madge told us that he was in no pain at all,
24:21it threw me off guard a little bit.
24:23I thought, how strong is he?
24:26Can I have a quick look?
24:28I'll lift your leg up.
24:29Yeah.
24:30And then we'll just come out.
24:31Grab a quick feel.
24:33Wiggle your teeth.
24:34Is that okay?
24:34Yeah, it's working.
24:35Good peel approach.
24:35I got some mobility in it, but, of course, it's swollen, so...
24:39Is this pain more this size?
24:41Yes.
24:42Because that's where it's swollen the most.
24:43Yeah, yeah, yeah.
24:43When I first had a look at Madge's leg,
24:45it looked a little bit swollen, but not significantly injured.
24:49I expected a lot worse.
24:51He was able to move his toes, and it looked okay.
24:54Normal feeling, normal sensation.
24:56Yeah, nothing like that.
24:58Perfect.
24:58What we'll do is we'll put our vacuum splint on.
25:01Right, this one's going to be the slightly nasty strap.
25:04Jack fits a vacuum splint to Madge's ankle.
25:08This uses air pressure to help immobilise his leg.
25:13Yeah.
25:15Does that feel okay?
25:16Yeah.
25:17Can't move it, can you?
25:18No.
25:19Good.
25:19Perfect.
25:24You all ready to go?
25:25Yeah, good to go.
25:26Yeah.
25:28Madge and his son, Victor, are on holiday.
25:31The hospital closest to their hotel in Meckersfield
25:34is 30 miles away.
25:37Is this your first day of the trip?
25:38Oh, no!
25:40Yeah.
25:41Should have done it on the last day.
25:42Yeah.
25:43No, it shouldn't happen at all.
25:44No, well, that would be...
25:46Yeah.
25:46That would be best.
25:47Do you enjoy the hiking as well?
25:48Yeah.
25:49You picked the right day for it.
25:51I walked up the mountain two times, and I was very tiring.
25:54You've done very well,
25:55because I don't think I could have walked up it once.
26:01Still feeling okay?
26:02No pain?
26:03Oh, I wasn't right.
26:04Okay.
26:05Yeah, I could.
26:06You're much tougher than me.
26:12Take the next ride.
26:14I think we've arrived.
26:17A walk with his son in the countryside
26:19has ended with an hour-long trip
26:22to Mecklesfield District General Hospital.
26:26Pull up on here, or me.
26:29Easy.
26:30You are.
26:31Amazing.
26:31Stella.
26:33Here, doctors will carry out x-rays
26:35to see exactly what damage has been done to Meckles' ankle.
26:50What a trooper.
26:51I've never seen someone so relaxed.
26:54Had no pain?
26:55None.
26:56Zero pain?
26:57But it's clearly swollen and...
26:59Isn't it, yeah?
27:00There's got to be something in there.
27:02Something.
27:02Is it at least a sprain, possibly a fracture?
27:05They haven't given me x-ray eyes yet.
27:07That's coming in the future.
27:08In the future.
27:10Yeah.
27:21You know what, the foot is really hurting, OK?
27:23OK, so just confirm he's conscious and awake.
27:26Madge's ankle injury was the 2,200th call today,
27:31and the team here have no idea what the next call will bring.
27:38Of course, there are certain calls that you don't want to get.
27:40Like, the majority of things to do with children.
27:43Something about them just being so little
27:44just makes it a lot more difficult.
27:46I don't know whether it's because I've got a daughter as well.
27:48Like, you can sort of put yourself in their shoes.
27:52Ambulance service.
27:53Is the patient breathing?
27:55Yes.
27:56Are they conscious and awake?
27:57Yes.
27:58What's the reason for the ambulance, please?
28:00One of our pupils has just fallen up the steps
28:02and hit her forehead off the edge of the step,
28:06and she has a large wound that we're applying pressure to.
28:09Blatter, OK.
28:10Is she bleeding at the moment?
28:12Yes.
28:13OK, has she been bleeding red blood very heavily
28:15in the last 30 minutes?
28:17Yes, it was red blood, and it's coming from the forehead.
28:20Might be a bit difficult.
28:21Can you see the bones sticking out through the skin?
28:24You can see flesh, because obviously it's on her forehead.
28:27Children are so resilient, and they're so good at bouncing back.
28:30But if something's wrong, they tend to kind of dive quite quickly,
28:34which can be incredibly scary.
28:36She's gone cold now.
28:39We've got a blanket over her.
28:41OK.
28:42Yeah, just do best to keep her comfortable, keep her safe.
28:45Is she limp or floppy at the moment?
28:47She's not limp or floppy.
28:48I think she's just shocked.
28:50Oh, yeah, I know, of course.
28:51Any new weakness or coordination problems in her arms or legs?
28:55Can you lift your arms up for me?
28:57Wave to me.
28:59And the other one, give me a wave.
29:01And can you wiggle your legs?
29:02Can you kick them?
29:03Kick, kick, kick.
29:05Yeah, she's just a bit dazed, but she's lifting her arms,
29:08and she's moving her legs, but she's quite dazed for herself.
29:11OK.
29:12If a child is quiet or more subdued,
29:15then that can be a lot more concerning.
29:17I'd much rather them be making noise.
29:19If I can hear them chatting, laughing or crying,
29:22then for me, at least I know that they're OK.
29:24I do have some help arranged for her.
29:27Sounds like you are doing all of the right things,
29:28but if the blood does soak through that pad,
29:30don't take it off, just put another pad on top of it.
29:33And we do just need to advise.
29:34Yeah, that's what we've done.
29:34We've just added, that's why it's quite thick,
29:36because onto the others we've added another section on top
29:39to apply the pressure.
29:40Was it soaking through the initial one quite quickly?
29:43It did soak quite quickly on the initial one, yeah.
29:46Right, OK.
29:46No, that's fine.
29:47And it was all going down her face.
29:50It came to light that actually,
29:52that was the second lot of dressing that they'd put on.
29:55The first lot had bled through quite quickly.
29:56So at that point, I knew, actually,
29:58this was significant blood loss,
30:00especially for someone so little.
30:02All right, and I'll have this down as a high-priority response,
30:05OK, just because of that.
30:07So I will stay on the phone with you until the crew get there
30:10and just keep her safe and comfortable where she is then.
30:16They're just coming in now.
30:18All right, then, I'll leave you guys with the crew.
30:20Bye-bye.
30:21Bye-bye.
30:26Brave little girl.
30:28Bless her.
30:30The patient was taken to the paediatric unit
30:33where she was treated for her injury.
30:52A patient thought that I was a lot, lot younger than I was,
30:55and bear in mind, this was on a fourth night shift in a row.
30:58You're not doing bad for 40, are you?
30:59You're a cheeky get.
31:00You're closer to 40 than me.
31:03Got less wrinkles, though, aren't I?
31:05Shut up.
31:07I've got really bad smile lines, though, to be fair,
31:09because I'm always smiling.
31:12Not when I'm working with you.
31:14I'm definitely not first thing in the bloody morning.
31:17Working shifts on an ambulance definitely ages you.
31:20It does.
31:20It does.
31:23Also, the company you're with sometimes ages you.
31:25Like, working with Colleen ages me about 10 years every shift.
31:28Speak for yourself.
31:31Night shifts, though, aren't they?
31:33We are polar opposites.
31:34Absolutely, which is why we work.
31:36Mm.
31:43Ambulance service, is the patient breathing?
31:49Is he able to tell you what's happened?
31:56Has he got his eyes open?
31:58I can't see because his head's on the floor.
32:07So, an unconscious in the street.
32:11I'm guessing we don't have much information.
32:13No.
32:14Going to these jobs in the streets can put you on edge,
32:18because is it something sinister, like a drugs-related thing?
32:24Is it a homeless person who's...
32:26Collapsed?
32:27Yeah.
32:28But in fairness, it could even just be someone
32:30who is generally unwelcome, aren't it?
32:32A call for someone unconscious in the street
32:34could be a thousand and one things.
32:36Have they been hit by a car?
32:39Have they collapsed?
32:40Have they intoxicated?
32:42Absolutely anything.
32:43The only way we know is by getting there.
32:46So, we need to get there quite quickly.
32:50There they are.
32:51Oh, yeah.
32:54Maybe block them so they don't get hit by a car.
32:56Let's leave that there.
32:57Yep.
32:58I'll go check it out.
33:05Wakey-wakey, buddy.
33:06You were asleep in the street.
33:08Squashed your bread.
33:09There you go.
33:11Have you fallen or just passed out?
33:15A passer-by called 999
33:17after seeing the man lying in the road unresponsive.
33:22Have you had any gear or anything, matey?
33:23We don't care if you have, by the way.
33:25We just want to make sure that you're OK.
33:27It's not every day that we come across someone on the side of the street, literally in the road, unconscious.
33:34When I first seen this patient, my first thoughts were, how on earth has he ended up in this situation?
33:39Could it be a medical episode or could it be something more like illicit drugs or alcohol?
33:44Shall we get your stuff off the road? I don't want you to lose any of it. Is that a
33:47handle? Is that yours?
33:49Some pretty serious gloves.
33:51I don't think your Milky Way is salvageable, to be honest.
33:54Have you got any medical conditions that would make you fall in the street?
33:57Yeah, that's probably not.
33:59OK, have you taken them today?
34:01And you say you don't think you've had your diazepam today?
34:05You have.
34:06The patient is known to take diazepam, a powerful sedative drug only available on prescription.
34:14Shall we get you on the bed and get you in the truck?
34:16Yeah, can we go and assess you on the truck instead, rather than on the floor?
34:20Come on, try and wake up, fella.
34:21If we help you, do you think you could stand up?
34:25When he disclosed he'd taken diazepam, that was a bit of a red flag.
34:29That would explain why potentially he was unconscious in the street.
34:33But has he taken anything else?
34:34Right, are you ready?
34:36Yeah.
34:40We're going to go assess you on the truck.
34:42I'll get a bag and I'll put your stuff in it, OK?
34:44On this way.
34:54Lift your head up a second.
34:55Do you want another look in them eyes, darling?
34:58There you go.
34:59In Stoke, paramedics Adam and Colleen are with a patient they suspect has taken an overdose.
35:06They are small, but they're not pinpoint.
35:10That's diazepam, though.
35:11Look at his eyes.
35:12How much diazepam have you had today?
35:15A lot, I'm guessing.
35:17When you look at a patient's eyes, it can tell you quite a lot.
35:21So if they've taken anything like drugs or opiates, it can make their eyes really, really small.
35:26However, some other drugs can make their pupils really, really big.
35:29So it can give you a lot of information.
35:32I'm just going to get a bit of blood from the tip of your finger, darling, OK?
35:35You're just going to feel a sharp scratch, but it'll only be for a second.
35:39There you go.
35:433.8 is hyperglycerin.
35:45As well as being sleepy due to an overdose of prescription medication, the patient has a slightly low blood sugar
35:52level.
35:55Do you think you'll be able to eat your Milky Way for me if I get it for you?
36:01It is a bit squashed.
36:04You just need your blood sugars up, OK?
36:09You don't want it?
36:10Yeah, that's what I'm going to see on you.
36:12Like you put it in your hand.
36:14It's your Milky Way.
36:15It's just a bit squashed.
36:17Gel down on that, mate.
36:18I don't think he's going to eat that.
36:20I'm going to have to put some gluca gel in your mouth because you're not going to be able to
36:23eat that by the looks of it.
36:25I'm just going to tip your head back a little bit.
36:27Now, because you can't eat this, I'm going to put this gel in your mouth, OK?
36:31It's going to taste very, very sweet.
36:34Colleen tries to give him a fast-acting glucose gel designed to bring blood sugar levels up quickly,
36:40but the patient has now become too unresponsive to take it.
36:48I think we're just not going to make, to be honest.
36:50He isn't going to have that.
36:51Let me take that off.
36:52Let's see how this goes.
36:54I'm going to squirt something up your nose, OK?
36:57I'm going to feel weird.
36:58As overdoses often involve a mix of drugs,
37:02Colleen gives the patient Narcan.
37:04If he's also taken any opioids,
37:07this will reverse the effects of the overdose.
37:11Tip your head back for us.
37:13Just want that airway open.
37:14Perfect.
37:16We gave the patient Narcan
37:17because it was apparent that he'd taken some form of drug
37:21and potentially others Narcan's given to be able to increase a patient's consciousness
37:26and make them more awake.
37:28Come on, fella.
37:29We're going to need you to wake up and stay awake for us if you can
37:31because you're not in a good place at the minute.
37:36Shall we go?
37:44Say when, mate?
37:45Yeah, ready when you are.
37:48As the patient isn't responding to Narcan
37:51and Adam and Colleen don't know exactly what he's taken,
37:55they decide to head for hospital.
37:59There you go.
38:00Rest your head down, sweetie.
38:01That's it.
38:02Perfect.
38:03I'm just going to keep hold of your head
38:04just so it stays in this position, OK?
38:10At Royal Stoke University Hospital,
38:12the patient will be monitored
38:14and may be given medication
38:16to reverse the effects of an overdose.
38:26I don't know how much of God knows what he's taken,
38:30but he's taken a lot of it.
38:31A lot of it.
38:34Probably too much of it, if I'm honest.
38:36Yep.
38:37It could be anything.
38:39It could have been a combination
38:40of a lot of different things, unfortunately, with him.
38:43Milky Way Man, that's what he is.
38:44Milky Way Man.
38:45Milky Way Man.
38:46Out of this world.
39:00If you would give yourself a different name,
39:03what would you name yourself?
39:05Oh.
39:06I'm seeing an Ellie.
39:08Really?
39:09Yeah.
39:10I think that's too girly for me.
39:11Or, like, a Sasha.
39:13Oh, no.
39:14OK.
39:14Sasha.
39:16I mean, my name is literally unisex,
39:18so mine's not girly.
39:19I don't think yours is girly at all.
39:20No.
39:21Mine's quite girly.
39:23Yeah.
39:24I don't love it.
39:25Yours is literally a flower.
39:26Yeah.
39:27It's rather feminine, isn't it?
39:30I don't even think I sit Daisy, to be fair.
39:32I think it's a bit innocent.
39:34No.
39:42Ambulance service.
39:43Is the patient breathing?
39:45It's me.
39:47I've got an infection again.
39:50It's a sign of pain, and that's what I had before.
39:53And is the pain in your stomach?
39:55Or is it anywhere else?
39:56Yeah.
39:57It's in the lungs.
40:01Oh, there we go.
40:04Bicep sex.
40:05We've got a 74-year-old male...
40:09..arbitral pain.
40:10Oh, bless him.
40:11Could be anything, couldn't it?
40:12Could be DNV.
40:14Could be.
40:15Could be UTI.
40:17DNV stands for diarrhoea and vomiting.
40:20UTI, urinary tract infection.
40:23Urinary tract infection, yeah.
40:23We don't actually know what's going on with this patient, do we?
40:26No.
40:26No, not yet.
40:30Is this the back, or is this the front?
40:36Ambulance!
40:37Hello?
40:38Oh, hello.
40:40You OK?
40:41Yeah.
40:42Have you rang for us?
40:43Yeah.
40:46I just couldn't sleep all night.
40:48Yeah.
40:48Just go through.
40:49I'm coughing, coughing, coughing.
40:51Where have you got the pain?
40:53Yeah.
40:53In your chest?
40:54Yeah.
40:54When did the pain come on?
40:57Well, last night, really.
41:00After a night of constant coughing, 74-year-old John called 999.
41:06Have you took anything for the pain?
41:08Like paracetamol?
41:09Yeah, yeah.
41:10I got some, yeah.
41:11Yeah.
41:11Who did you call this morning for us to get here?
41:15Did you call 111 or 999?
41:17999.
41:18What were you hoping for from us?
41:20Are you wanting pain relief?
41:22No, just to check me out.
41:24Just to have a chat?
41:25Yeah.
41:25OK.
41:26Because I'm diabetics as well, so you know.
41:28Right.
41:28You need to speak to your doctor so that they can sort you out a nurse that can show you
41:36how to do your checks for your diabetes.
41:39I think the story changed slightly as we were there.
41:43Once we were on scene, yeah.
41:45Went from chest pain to cough.
41:49To a woman's diabetes check-in.
41:51To the triggers checked, yeah.
41:53Just to check, you're not allergic to anything?
41:56Yeah, with me.
41:57I'm allergic to men.
41:59You're outnumbered here, unfortunately.
42:02Right, nice and still.
42:04As the pain is in John's chest, Daisy checks his heart rate.
42:12It's on the lower side, but I'm not overly concerned.
42:15No, because he's presenting well, isn't it?
42:17Yeah.
42:18Do you feel dizzy at all?
42:19I'm always dizzy.
42:21OK.
42:23Right, I'll tell you your blood sugar's...
42:284.3.
42:30It's a bit on the lower side.
42:32What have you got in to eat?
42:34A toast.
42:35Toast?
42:36Do you want me to make you some?
42:37John's blood sugar was on the lower side.
42:40The solution to this is to just get some sugar in him,
42:43whether that be a sugary cup of tea,
42:45some toast with a bit of jam on it.
42:47It's not really something that an ambulance needs to do.
42:51He could have probably done this by himself.
42:53Let's have a look.
42:54What covers the bread in?
42:55It's on top of the microwave, isn't it?
42:57Above the microwave.
43:02I'm not taking you to hospital because your heart rate's a bit low.
43:06I don't think they're going to do anything for you.
43:09It's not that low that we would treat it.
43:12There you go.
43:13You can sit up.
43:14Do you want to sit up?
43:15No.
43:16No?
43:17Do you want a cup of tea?
43:19Can you make tea?
43:20I can make tea.
43:22I can.
43:23I'm from Yorkshire.
43:24Tea is in me veins.
43:29I like your pink kettle.
43:31Did you pick that?
43:36I reckon that is a good cup of tea.
43:40Cracking.
43:43I think he looks all right, that.
43:47Yeah?
43:47Happy?
43:48I don't know, yeah.
43:49I'm excited.
43:50Should I do?
43:52You're right, please.
43:54Have you had enough?
43:56I don't eat no mud.
43:57Well, you should probably eat a bit more at some point because your blood sugars were on the lower side.
44:03John didn't need to go to hospital today.
44:05I think John just wanted a cup of tea and a little bit of company.
44:08Are you happy to stay at home?
44:09Yeah.
44:10Yeah.
44:11But you need to speak to your GP.
44:13You know where we are if you need us, all right?
44:16All right, nice to meet you, John.
44:18All right, thank you.
44:19See you later.
44:23Let's go.
44:30All we've really done for him was give him some tea and toast.
44:34Do you know what?
44:35I think he might have been a bit lonely.
44:36I think he wanted a bit of company.
44:37I think he wanted some company, didn't he?
44:45John called another ambulance crew later that same day.
44:49Like Morgan and Daisy, they advised he should take the painkillers he'd been prescribed and speak to his GP.
44:58Bob, who was having a heart attack, was found to have a blockage in one of his arteries.
45:03He had a stent fitted to widen it.
45:06Two days later, he was able to return home.
45:10Bill's blood pressure eventually returned to normal, but he may have problems with his kidneys that could require medication.
45:19And Madge, who'd fallen while hiking, had an X-ray in the fracture clinic.
45:24This confirmed he'd broken his ankle.
45:33Next time...
45:36The man is in agony.
45:38Put this in your mouth. Keep breathing on it. Open your mouth.
45:42Our main concern was figuring out where this pain was.
45:45And then getting this under control, we did suspect that he may have broke his hip.
45:50Oh, God, that is a big clot. That was massive.
45:53A patient has a severe nosebleed.
45:55When I saw the blood clot, it was rather grim.
45:58It was large. He's just had brain surgery.
46:01We needed to get him to hospital fast.
46:02I woke up and I got this real pain, and my heart was racing.
46:09And the woman is complaining of chest pain.
46:12Once we completed a heart tracer, it showed us that she was actively having what we call a STEMI, which
46:17is a heart attack.
46:18We are going to be taking her to hospital, and we are probably going to be going quite quickly.