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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.
21:16Yeah, the location of a property was up a really long, narrow road, which just made it extra
21:21hard to get to her.
21:26So what's been going on then?
21:28Well, I've got a heart-bowel problem and, you know, I'm waiting to have it done, but, oh, tonight it
21:36really got me.
21:38I woke up and I got this real pain and my heart was racing.
21:46When racehorse breeder Rosalie was woken in the night with pains in her chest, she rang 999.
21:53Husband Peter is with her.
21:55What time did she wake up with the chest pain, though?
21:57How little time did you wake up with the chest pain?
21:59About three o'clock.
22:01Do you have an irregular heartbeat by any chance?
22:05Not normally.
22:06I can see they've put it in.
22:09She'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 the arteries.
22:25It effectively means the heart has to work a little bit harder.
22:28So have you got palpitations in your chest at the minute, sweetheart?
22:30No.
22:31No.
22:31Did you have?
22:32No.
22:33OK.
22:34The longer I spent with Rosalie, the more concerned I got.
22:37She was telling me about needing a heart operation, how she's now got chest pains and palpitations.
22:42So the longer I was there, the more concerned I was becoming for her.
22:46My license is still a second.
22:49Adam carries out an ECG to check the electrical activity of Rosalie's heart.
22:54Yep.
22:55We'll be going.
22:56You're going to hospital, sweetheart.
22:57Is it all right or is it?
22:59You've got a heart rate at the minute of about 160.
23:02Yeah.
23:03It should be ideally between sort of 60 and 100.
23:06It's very fast, basically.
23:08I knew something wrong anyway.
23:10I've been getting short of breath.
23:12Have you?
23:13I'm not surprised with a heart rate like that.
23:16So it's saying STEMI.
23:19Yep.
23:20So we're going to have to ring.
23:21Yeah.
23:21We'll give him a buzz.
23:22Once we completed a heart tracing on Rosalie, it showed us that not only was her heart beating
23:28pretty fast at over 160 beats per minute, but it was also showing us that she was actively
23:34having what we call a STEMI, which is 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 her to hospital and we are probably going to be going quite quickly.
24:04On the outskirts of Stoke, paramedics Colleen and Adam are with Rosalie, who they suspect
24:09is having a heart attack.
24:11I'm just going to give you a spray on your tongue if I can.
24:13Yeah.
24:13This 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 aspirin.
24:27Then 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
24:39having a heart attack.
24:40So I did the right thing calling.
24:42Oh, yeah.
24:43I don't like to think I'm wasting anybody's time.
24:45Nope, you have definitely done the right thing by calling.
24:48They said go to A&E initially, but give resource a call to go there.
24:53Which 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.
25:11But 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't walk, I think.
25:21No.
25:21No, absolutely not.
25:22No, all right.
25:23Absolutely not.
25:25All 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.
25:42You're 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?
25:58OK.
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.
26:17Hello, 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.
26:37With your heart rate being as it is, you ain't no fraud.
26:45Right then, sweet.
26:46Couple of bumps.
26:47I'm a pro, don't worry.
26:49Yes, you are.
26:50At Royal Stoke University Hospital, the 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.
27:12Yeah.
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.
27:23Bless her.
27:24They don't make them like her anymore, 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, the call assessors of West Midlands Ambulance Service are working hard to save lives.
27:54There is always something that is completely out of the box and 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, yes.
28:18OK, are they conscious?
28:19Are they awake?
28:20She's panting.
28:21She's heavy breathing.
28:22OK, I 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.
28:31Is 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 short on.
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?
28:58Not really.
28:59No, not really.
29:00As soon as I hear the words that they're not conscious and not breathing, it's almost like
29:04a wall comes down around me and I'm completely locked in on that call, nothing else around
29:11me 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, I think I was genuinely really confused, but
29:38it just changed things in the moment then.
29:40It meant that I needed to then think about how we were going to get the caller to the
29:44patient 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.
30:06The door on your left.
30:09Hello, Paula?
30:11Yeah.
30:12Is that the crew with you?
30:14Yeah.
30:14Okay, I'll leave you with them.
30:19Even though we get calls quite often for people in unconventional places, it's not often that
30:25you get somebody that's on a roof, unconscious, not breathing, needing CPR and trying to figure
30:33out how we're going to get to that patient.
30:36Minutes later, control has informed the 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, fire, 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 how 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 as to why she would be on the roof.
31:02She's on the back of the ambulance, so hopefully she'll be okay.
31:22Are you sweet rather than savoury, then?
31:24If I have a tub of ice cream, there's no, like, scooping it out and putting it in a bowl.
31:31I just eat all of it.
31:32Do you know what really annoys me, though, about, say, if you've got ice cream and you
31:35get it out of the freezer and you've got to wait for it to defrost a bit and your spoon
31:39just bends because it's the ice cream.
31:41You put it in the microwave?
31:43You put it in the microwave for about 10, 15, 20 seconds, depending.
31:46There has been a few mishaps on a couple of occasions where it has been too soft.
31:53So then, do I eat it or do I put it back in the freezer to freeze it up a
31:59little bit more?
32:00But then am I going to be starting back at the same point where I'm going to have to put
32:04it in the microwave?
32:05This is too much for my head.
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.
32:13Yeah.
32:14I don't want it sloppy now.
32:16I want it just nice.
32:23999.
32:26Category 2, 70s lady with 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?
32:44Diperticulitis.
32:44Yeah, yeah.
32:46Diperticulitis is a condition in the bowel which can cause bleeding and discomfort and
32:50sometimes a lot of pain.
32:52We knew this lady had been bleeding and so it was quite important that we found out what
32:56was going on.
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 runner to the bathroom.
33:19Mm-hmm.
33:21I had a massive bleed.
33:23You can go look in the loo upstairs.
33:25Right, OK.
33:2874-year-old Maddie has lived with chronic inflammation of the bowel for 30 years.
33:33But tonight, after experiencing heavy bleeding, she called for help.
33:39And are you getting any pain?
33:40Yeah.
33:41Is the pain different to your normal diverticulitis pain?
33:45Yeah.
33:46It's a cross, yeah.
33:47Let's do your blood pressure, ducky.
33:50Right.
33:51So, would you say the amount of blood that you've lost, like tonight and that, is fine?
33:59It's getting worse?
34:00Oh, yeah.
34:00Yeah.
34:01With the amount of blood Maddie was losing, I was concerned, as things can get quite serious
34:07quite fast.
34:08Oh, right, OK.
34:10So, it's definitely red, fresh.
34:11Yeah.
34:16Oh, goodness.
34:29Tired, Bob?
34:29I am tired, yeah.
34:31I definitely prefer the day shifts.
34:33What do you prefer?
34:33Day shifts, 100%.
34:35It's always better when you're working with a friend.
34:38So, when me and Sean work together, it's not really like working together because we're
34:41quite good friends anyway.
34:42Yeah, yeah, definitely.
34:44If you have a laugh with someone, time goes so fast.
34:46Yeah, it does.
34:47And you bring loads of snacks, so that definitely helps.
34:49That's also very true.
34:50That's very true.
34:52Can't wait for a cup of tea in bed tomorrow morning.
34:59I'm going to get in.
35:02Yeah.
35:06I'm going to get in.
35:08I'm going to get in.
35:12I'm going to get in.
35:23So, we have arrest peri-arrest, exposed to the elements, five minutes away.
35:31When a patient's heart is highly unstable but is still beating, it's called peri-arrest.
35:37It's the stage before a full cardiac arrest.
35:41Onwards and upwards, let's go see.
35:45So, this is unconscious, noisy breathing.
35:49Obviously, you've done route over.
35:51Yeah, unconscious, noisy breathing.
35:53So, I mean, Sunday morning.
35:56So, it'd be a good guess to say that he might have been out the night before.
36:03Hello. What's happened? Just found.
36:09He's breathing. Oh, yeah, yeah.
36:11I can detect my injuries.
36:12He's letting us all throw up, so...
36:14Hiya, mate. Can you wake up for us?
36:18Can you wake up?
36:19Definitely had a good night.
36:22We'll get the stretcher and get him on the ambulance.
36:24Good night. Yeah.
36:27A doorman called 999 after finding the man lying unconscious on the pavement.
36:33When we arrived on scene, we came across a man covered in vomit.
36:37We both took a good guess that he'd been on a night out the night before
36:40and he was just taking a sleep on the side of the road.
36:43Right, mate.
36:45It's time to get on this stretcher.
36:48Let's set you up.
36:50You've definitely had a good night.
36:54Shall we get your legs round?
36:58You able to pull him up from that way?
36:59Yes, mate.
37:01Oh, he's wet himself as well.
37:02Yeah.
37:04Hello.
37:05All right?
37:06Good.
37:07Should we get you to stand up?
37:08We've got to get you on this stretcher.
37:13It's out there again.
37:15Oh, no, we are worried about you with the ambulance.
37:19You're in the street. You've been sick.
37:20I do what I want, man.
37:22OK.
37:23When he sat up and came round a bit, it was very difficult to talk to him.
37:28He didn't want to speak to us and we very quickly got that vibe
37:31but also there was a part of us that wanted to make sure he was OK.
37:35You can't stay here, though.
37:36Are you going to have someone else throwing an ambulance for you?
37:38No, I'm not.
37:39You're not?
37:39If you're throwing an ambulance for me, I shall go mad, you know.
37:42What's that?
37:44Yeah, someone's throwing 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. Do you have a house?
37:59Fuck off.
38:00Don't ask me where home is.
38:01I ain't fucking no home.
38:04When he was coming round and he was talking to us,
38:07he was very defensive and aggressive in his answers
38:12and at these moments, you just sigh and just think,
38:15what can I do?
38:16Is there any other way we can help you?
38:25Let me just do your blood sugar, sweetheart.
38:300.4.
38:32In Stoke, paramedics Nick and Kyra are with Maddie.
38:35She has diverticulitis, a condition that causes severe inflammation of the bowel.
38:42Do you take any pain relief for it? Does anything work?
38:45No, I don't bother.
38:47Yeah.
38:48Yeah, I know.
38:48I think it's got to do with the...
38:51Down reticulitis.
38:52Mm.
38:52There's not a lot I can do.
38:54No, that's the problem with that.
38:56Your arms are OK.
38:59But someone like yourself that has got this ongoing issue,
39:06for you to be worried and be ringing people...
39:09Yeah.
39:10..that's a concern in itself.
39:12Because something's not normal for you.
39:15I think we need more thorough tests done.
39:19Right.
39:19More than what I can do with this thing.
39:21And so that's giving me, like, yeah, let's take you.
39:24The reason we wanted to take Maddie to hospital
39:27is due to our concern about the amount of blood she was losing,
39:31where she was losing it from.
39:33Therefore, we had to find out what was going on
39:36so we could get her treated.
39:37I don't want that.
39:38I was folding this up.
39:40Oh, God.
39:41I had to bring one of your nice patched ones.
39:42Can I have a look at it?
39:43Yeah.
39:44Well, she can and just rip it open.
39:47While Maddie gets ready to go to hospital,
39:50Nick and Kyra admire her homemade quilt.
39:53That would look lovely in my bedroom, that would.
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 and stuff.
40:09She loves it.
40:10I'm obsessed.
40:12Handmade quilts with UFOs on.
40:14The thought of having one would be absolutely amazing.
40:18It would take pride of place on my bed.
40:20I would love it.
40:24Ready when you are, thank you.
40:28I always say the human body, it's a marvellous thing,
40:33but it can really go wrong in some dramatic ways.
40:36People, unless they've got something like this,
40:38they don't understand at all how debilitating this is.
40:51At Royal Stoke University Hospital, medical staff will try to find out why Maddie's blood loss has been so heavy
40:59tonight.
41:04Is there any other way we can help you as an ambulance?
41:07Is there any other way we can take you?
41:10In Birmingham city centre, paramedic Sian and technician Brogan are with a man who was found lying unconscious in the
41:18street.
41:18Have you been drinking alcohol?
41:21Yes.
41:22Right, I'm done with this swearing 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, but you're not being very nice, so...
41:41Well, OK.
41:43We decided to leave him there because, despite offering him help multiple times and him initially rejecting it,
41:51we can't force him to accept the help that we offer.
41:54Hey, Lestitch. Hey.
41:57What?
41:59No, you were breathing, but you're unconscious on the floor, you're hard to wake up.
42:05That's why we were called and we're worried about you, but you're not being all that nice.
42:10Make sure you don't fall over.
42:13Yeah, yeah, I get it.
42:16You just said no.
42:18Well, what do you want help with?
42:19You just told us to go away and leave you alone.
42:21Do you want us to make sure you're OK?
42:26Look, I'm not having an argument.
42:28Do you want your checks done?
42:29I was really frustrated with this man because anything I was offering or Brogan was offering,
42:35it just wasn't good enough, he just wanted an argument or a fight or something similar to that
42:40and you just can't help them people.
42:42Do you want your checks done?
42:43No, honestly, I don't have time for this.
42:47Do you want to be real?
42:48Do you want your checks done or not?
42:50Do you want your checks done or not?
42:53It doesn't matter, bro!
42:54Don't fucking start shouting at me, bro.
42:56What are you going to do? Let me walk away?
42:58Yeah, if you want. You're more than welcome to.
43:00Don't wait for me.
43:01Don't wait for me. Bro, go that way.
43:04What are you going to do, bro?
43:06My concern when he stood up and he started shouting and getting aggressive
43:11was that he was getting close to the ambulance and he could have assaulted me
43:15and I think it would have turned worse if we'd have stayed there
43:18so I think it was a good decision for us to leave at that point.
43:21I think we should just go.
43:22Yeah, this is just...
43:23Yeah, let's go.
43:29No, step away. Please step away. Please step away.
43:37Having to deal with aggressive patients like this is not uncommon.
43:42At West Midlands Ambulance Service, nine incidents of physical or verbal abuse
43:47are carried out against the staff every single day.
43:50Well, that was a bit scary, wasn't it?
43:53It escalated quite quickly, that job.
43:56Yeah.
43:57It was really threatening.
43:58It was quite scary.
43:59And as far as I'm concerned, when 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 when you're able to stand up
44:07and verbally abuse us.
44:09Yeah.
44:10I mean, sometimes we get sent to people that don't want our help
44:15and are vile to us.
44:16And then there's some people out there who just can't get our help
44:19and they're in a waiting, like they're in a queue for 999
44:22and they're waiting for jobs where we're wasting our time
44:25with people who would just verbally assault us.
44:33Ron, who fell and was in agony, hadn't broken his hip.
44:36X-rays showed a plate in his hip had come loose.
44:40He spent four hours in surgery, having it screwed back in place.
44:47Rosalie, who was having a heart attack, was admitted to the cardiology ward.
44:52Here she received treatment for blocked coronary arteries.
44:58Robert, whose nose was bleeding heavily, spent six hours in hospital.
45:02The bleeding was stopped and he was prescribed a nasal cream
45:06to treat any possible infection.
45:09And Maddie, who had rectal bleeding, spent three days in hospital.
45:14She may require surgery to repair her intestines.
45:18We went straight through to see a consultant who was brilliant.
45:24So, hopefully, he's going to have some answers for me
45:28to help me get my life back.
45:35Next time...
45:36Yeah, you're really wheezy, aren't you, darling?
45:39..a man is struggling to breathe.
45:41Right, let's pop this on you.
45:43COPD is like breathing through a straw day to day.
45:46When you're unwell, it can get even worse.
45:50She's got a 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 whilst we were with her.
46:00This can't keep happening, it's dangerous.
46:02What have you done?
46:03And a patient falls, badly cutting her head.
46:07When I looked at her injury, I could see that it was down to her skull.
46:11It needed some serious stature.
46:42He has been his first stroke of an injury,
46:43and he's been her first leg of an injury.
46:43And he was feeling
46:44like you're doing the right these times.
46:44Awesome.
46:45Let's take a break tacks,
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