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00:01Ambulance service, is the patient breathing?
00:04Every time he's moving, he's crying out in pain.
00:08He's had a really bad nosebleed. I can't stop it.
00:11It'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?
00:41Water variability of how we met.
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 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.
01:43Pinch, 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...
02:04Was it 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.
02:51There's some lists that they sent a male stripper to a care home.
02:54No way.
02:55The care home asked like...
02:56That is class.
02:57What would you like?
02:58And they had this male stripper come round.
03:01Love it.
03:02And they said that the ladies absolutely loved it.
03:05Oh bless them.
03:06And they asked if he was coming for Knitter Natter next week.
03:09Oh fantastic.
03:10Why not?
03:11I bet the 999 calls would increase after that though.
03:15Palpitations.
03:15Palpitations 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 so well.
03:30We could be talking about the weather in Turkey.
03:32The one minute next week we're having stripper grams in care homes.
03:41BEEP.
03:42BEEP.
03:44Ambulance service is the patient breathing?
03:47Yes.
03:47It's my father.
03:49He's had a really bad nose bleed.
03:51Bleeding for the last half an hour.
03:52And he can't stop it.
03:53Would you say that it's heavy blood loss?
03:56Is it gushing?
03:57It's heavy non-stop.
04:00What have we got then?
04:02Trio's not possible.
04:03Remote observer.
04:05but there's heavy blood loss that's all we have I kind of want to see where's this bleeding coming
04:13from when we go to a patient that's got heavy blood loss we're trying to think where's the
04:18blood coming from how much blood have that she lost and did I need any further treatment to
04:23help stop the bleeding hello he's in the bathroom he hasn't come out the hospital
04:34with the bleed on the brain he's on blood thinners oh no no he's just had a bleed on the
04:38brain okay
04:39I'll just come up to the toilet and I just I did blow me now as it started going and
04:45I knew straight
04:46away it was one of these bless you oh yeah yeah there's a clot in that one there try not
04:52to rub
04:53it if you can lean over the sink now while you're doing it 77 year old Robert recently had surgery
04:59to treat a bleed on his brain tonight after bleeding heavily from his nose his son called 999
05:1210 minutes but it's been half an hour yeah how much blood would you say that you've estimated
05:18drop it a lot yeah let me just pop that on there any headache no any blurred vision no no
05:27just the
05:28nosebleed Robert was in quite a mess when we first arrived on scene my major concern was the amount of
05:34blood loss and to make sure that his airway was clear well we'll see what we do we've got like
05:39this
05:39little clip that we can pop on your nose that can try and stop yeah the bleeding all right right
05:44this is supposed to clamp can you feel that pressure yeah it's gone it's not very tight
05:53no no let me try a bit higher up never get trying this and trying in school oh there we
05:59go right keep
06:01that there for a bit I think it's doing its job it stopped bleeding now it stopped dripping down there
06:07we go fixture can you breathe through your mouth okay yeah yeah you're not feeling anything oh no it's
06:13still dripping I was quite worried at this point because we had no other option to stop the
06:19nosebleed apart from him applying pressure himself and I was really worried about the amount of blood
06:24loss what we'll do we're just going to contact in our team we've got a drug that's a blood clotting
06:29drug yeah the fact that it's still going after half an hour and yet it is losing quite a bit
06:35I'm
06:36thinking that that might be a go ahead if I'm honest just to see if that stops the bleeding all
06:41right
06:43as Robert has recently undergone brain surgery Amy needs to speak with a senior clinician before she
06:49can give blood clotting drugs I mean I'm just waiting for a response might no worries it's just my
06:56reasoning is the fact that it's been continuous for over half an hour now and it's still yeah going
07:01quite yes yeah I'm going to take this off because it really isn't doing nothing is it if you try
07:09and
07:09pinch a little bit more up here as well if you can that normally stops it a bit how's your
07:14walking like
07:15is that all okay yeah before I went to the hospital I could hardly walk and I was dripping up
07:20and falling
07:21over but since I had the operation and come out of the hospital I've been fine I only took the
07:27dressing
07:27of the disorder wow ah I see it it's healed really really well yeah do some fresh ones there we
07:37go oh
07:38oh god that is a big clot oh that that was massive yeah was that in your nose or was
07:45it in your throat or
07:46was it when it come from my nose into my throat that come out my throat that did okay I'll
07:52just spit
07:53there dad when I saw the blood clot it was rather grim it was large he's just had brain surgery
07:59we
07:59needed to get him to hospital fast we'll definitely think about going
08:18hmm I feel a little bit sick so do I told us to get this much I saw a train
08:24I thought I've never had a
08:25train in my life we saw the ice cream van didn't we and I'm pretty sure we drove past it
08:29and then went
08:30back I think if there's an opportunity to have ice cream you're going to take it on ice cream yeah
08:34do you want chocolate all around my mouth no have that see to that tongue's blue
08:43Morgan and Daisy come to the end of their break and are ready for the next call
08:53ambulance service is the patient breathing yes and what's the reason for the ambulance
08:59the gentleman's had a fall he can't wait there and every time he's moving he's crying out in pain
09:07and how old is he he's 92
09:14you've got 92 year old male and presses Caroline leg injury fall injuries unknown okay I have a neck of
09:26female fracture yeah I think when you get called to a 92 year old that's fallen we are thinking is
09:36he
09:36Are they going to have broken something? Are they going to have broken his hip?
09:39Generally, it's something that happens, isn't it, when they're older?
09:42Yeah. And a bit more frail.
09:44And it's not nice. It's not a nice break.
09:53Hello. What's... What's going on here?
09:55I fell straight over at this side. I know.
09:57The pain's there. It's retarded.
10:00I'm going to take these blankets off you, sweetheart,
10:02so I can have a look at you.
10:04I know, I know, I know.
10:06Hi, and keep still, sweet.
10:08I know.
10:10He's bent over and then fell.
10:12And where was he when he fell? Here.
10:14Here. OK. Yeah, it's happening there.
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.
10:41I thought it was over here.
10:43I thought it was over here.
10:43I thought it was over here.
10:44Here? Yeah.
10:45Uh-huh.
10:46Our main concern was figuring out where this pain was,
10:50why he was in pain and getting this under control.
10:53We did suspect that he may have broke his hip.
10:58I'm not going to, I'm not going to touch you.
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 up his nose
11:20and then come out his mouth.
11:21Right, bear with me, sorry. We've just had a clot probably about three centimetre by three centimetres round just come
11:27out of his mouth.
11:28He 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, sure.
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 to get him there
12:08fast.
12:10Let's put some straps on you.
12:13And again, just checking no headache, no dizziness.
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, do you know what
12:30I mean?
12:36You have arrived at your destination.
12:39Hmm, it 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.
13:08It's like shooting.
13:09To the south of Birmingham, paramedic Daisy and student paramedic Morgan are with Ron, who's in agony after a fall.
13:18Dizz, I'm not sure if we're going to get this stretcher in, do 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.
13:26I 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 give him treatment here first.
13:35Yeah, 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?
14:06Oh, Ron, let's not say things like that.
14:09What about your daughter?
14:13No, you're not. She loves you.
14:17Well, you gave up a lot of time when she were a baby.
14:20Yes.
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,
14:32try and get him feeling back to himself.
14:35Right, I'm going to give you some paracetamol through that vein, OK?
14:44Was it shooting up and down your leg?
14:49Oh, Ron?
14:54Daisy and Morgan give Ron liquid paracetamol intravenously,
14:59but it's having little effect.
15:02Right, you need to give him something stronger, you know.
15:04I don't know.
15:06I don't think we're going to move him without giving him something stronger,
15:09if I'm honest.
15:10I agree.
15:11Ron had very clearly hurt himself.
15:12We do believe that he had broken his hip,
15:15so in order to move him,
15:17we knew we were going to need to give him some strong pain relief,
15:19just to try and keep him as comfortable as we can during the process.
15:24Is it all right if we give you some morphine?
15:27Carry on, please.
15:28Please.
15:29We're just going to grab it and we're going to grab our stretcher, OK?
15:33Yes, thank you.
15:34Don't move whilst we're gone, all right?
15:36No.
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,
16:09which 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.
16:19I'm feeling so sorry.
16:20Why are you sorry?
16:22This is our job.
16:23Do you want to try some gas and air, Ron?
16:26Gas and air, yeah.
16:27OK.
16:29Right, so if you pop this in your mouth,
16:31if you suck it in...
16:32You got it?
16:33Oh!
16:34Go steady.
16:37Ron.
16:39Ron.
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,
16:59because 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.
17:14Deep breath 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.
17:20We can.
17:21We've got to, sweet, because we're not going to get you out.
17:24Put this in your mouth.
17:25Keep breathing on it.
17:26It's there.
17:26There we go.
17:27Yvonne.
17:28Yvonne, 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?
17:37Yeah.
17:37There we go.
17:38With 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, yeah.
17:57All right.
18:05Whoa.
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.
18:27Good.
18:31At Queen Elizabeth Hospital in Birmingham, Ron will have x-rays to see if he has broken his hip.
18:51He was clearly in a lot of pain.
18:53He was not having a good time.
18:55Oh, 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.
19:19But...
19:20Right then.
19:21So, what European country has the longest coastline?
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.
19:45It'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.
19:57You know I'm going to look at that on the map now, right?
20:00Yeah, Google 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.
20:36007?
20:38007?
20:39007, you've got a 33-year-old female from chest pain.
20:42Is there a station that has a heart valve problem?
20:45Yeah, right, thanks. We'll get you what we can do.
20:48Well, that's how the call came in.
20:50If she's woken up with chest pain, that can be quite concerning.
20:54She's never a good sign.
20:56We're only nine minutes away.
20:59Bit tight.
21:01It's scary, isn't it, some of the rural communities
21:03and how isolated and vulnerable they actually are.
21:08This was potentially quite a serious case,
21:11just given her age, given the location of where it is
21:14and the amount of time it would take to get there.
21:16Yeah, the location of a property was up a really long, narrow road.
21:20Which just made it extra hard to get to her.
21:26So what's been going on then?
21:29Well, I've got a heart valve problem.
21:32And, you know, waiting to have it done.
21:34But, ooh, tonight it really got me.
21:38I woke up and I got this real pain.
21:41And my heart was racing.
21:46When racehorse breeder Rosalie was woken in the night
21:49with 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?
21:58How long did you wake up with the chest pain?
22:00At 3 o'clock.
22:01At 3 o'clock.
22:02Do you have an irregular heartbeat by any chance?
22:05Not normally, I don't think.
22:06I can see they've put it in.
22:09She's got aortic valve stenosis.
22:11Rosalie was experiencing some chest pain,
22:13which could be caused by her pre-existing heart condition.
22:17Aortic valve stenosis is the narrowing of a valve within a heart,
22:21which affects the blood flow into the arteries.
22:24It effectively means the heart has to work a little bit harder.
22:27So have you got palpitations in your chest at the minute, sweetheart?
22:30No.
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,
22:40how 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, we'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 is about 160.
23:02Yeah.
23:03It should be ideally between sort of 60 and 100.
23:07That's very fast, basically.
23:08I knew something was 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, so we're going to have to ring.
23:21Yeah, we'll give him a buzz.
23:22Once we completed a heart tracing on Rosalie,
23:25it showed us that not only was her heart beating pretty fast
23:29at over 160 beats per minute,
23:31but it was also showing us that she was actively having
23:34what we call a STEMI, which is a heart attack.
23:45As the West Midlands sleeps, we're on board with eight paramedic crews
23:49working the night shift until 6.30 in the morning.
23:57We are going to be taken to hospital,
23:59and we are probably going to be going quite quickly.
24:03On the outskirts of Stoke, paramedics Colleen and Adam are with Rosalie,
24:08who they suspect is having a heart attack.
24:11I'm just going to give you a spray under 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,
24:21reducing the strain on her heart.
24:24We're going to look and see if we can give her an aspirin.
24:27Yeah.
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
24:37with a patient who's having 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, you know.
24:45No, you have definitely done the right thing by calling.
24:48They said go to A&E initially, but give resource a quarter 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
25:03to get the treatment she needs as fast as 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, I 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.
25:22Oh, 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.
25:41You'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?
25:59OK.
26:00So, we need to get you there sooner rather than later.
26:07Breaking bad news is never fun, but 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.
26:23We'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.
26:38Well, your heart rate, being as it is, you ain't no fraud.
26:45Right then, sweet, couple of bumps.
26:47I'm a pro, don't worry.
26:49Yes, you are.
26:51At 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.
27:07She absolutely needed to, though.
27:09No, didn't she just?
27:10As soon as I seen that ECG.
27:12Yeah.
27:12I was like, hmm, that's not right.
27:14Not right at all.
27:16It 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.
27:22They weren't more chilled than I'd be.
27:24Bless 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
27:51hard to save lives.
27:53There 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.
28:11It's the Ambulance Service.
28:12Is the patient breathing?
28:14Is she breathing?
28:15Is she breathing?
28:16Yes, she's breathing.
28:17Yes, yes, sort of, yes.
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.
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.
28:37OK.
28:37Is 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.
28:49Call her, listen to me.
28:50It's really important that you follow my instructions, OK?
28:52Yeah.
28:52I need you to have a look at her breathing.
28:54Is she breathing normally?
28:57Is 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,
29:03it's almost like a wall comes down around me and I'm completely locked in on that call.
29:10Nothing else around me matters.
29:13OK.
29:13We've got some help arranged.
29:15I need you to listen to my instructions, OK?
29:17Are you within easy reach of her?
29:19Yeah.
29:20Somebody's on the roof.
29:21She'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.
29:31Yeah.
29:32When I heard the patient was on the roof, I 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 how we were going to get the caller to the patient
29:45safely to do CPR.
29:46So when you say she's on a roof ledge, what do you mean?
29:50It'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?
30:03Caller, are the paramedics there?
30:05One 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 in unconventional places, it's not often that you get somebody that's
30:26on a roof, unconscious, not breathing, needing CPR and trying to figure out how we're going to get to that
30:35patient.
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 by her.
30:51We're 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.
31:02And she's on the back of the ambulance, so hopefully she'll be OK.
31:22Are you sweet rather than savoury, then?
31:25If 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?
31:43I 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 ex.
32:06It's a science. It's a science.
32:08I do like ice cream when it's all runny, though. I'll purposely mix it until it goes to my soup.
32:11I used to do that when I was little. As a kid, yeah.
32:13I don't want it sloppy now. I want it just nice.
32:25Category 2, 70s lady with something very unfortunate. She has rectal bleeding.
32:35She's got diverticulitis as well. Right, OK.
32:38So that could be a factor.
32:42A lot of people struggle with that, don't they, diverticulitis? Yeah, yeah.
32:46Diverticulitis is a condition in the bowel which can cause bleeding and discomfort
32:50and sometimes a lot of pain.
32:52We knew this lady had been bleeding and so it was quite important that we found out what was going
32:57on.
33:07Hello. What's been going on, sweetheart?
33:10I've been having bleeds. I've got diverticulitis.
33:13OK. I'm used to having small bleeds.
33:17I had to do a runner to the bathroom.
33:19Mm-hm.
33:21I had a massive bleed. You 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.
33:39Are you getting any pain? Yeah.
33:41Is the pain different to normal diverticulitis pain?
33:45Yeah, it's across a year.
33:47Let's do your blood pressure, Ducky.
33:50Right.
33:50So, would you say the amount of blood that you've lost, lights and ice and that, is...
33:57Over a couple of months.
33:58Do you find it's getting worse?
34:00Yeah.
34:01Yeah.
34:01With the amount of blood Maddie was losing, I was concerned as things can get quite serious quite fast.
34:08Oh, right, OK.
34:09So, it's definitely red, fresh...
34:11Yeah.
34:24That's...
34:28Oh, goodness.
34:29Tired, Pap?
34:30I am tired, yeah.
34:31I definitely prefer the day shifts. What 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.
34:43Definitely.
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.
35:00Ambulance service, is the patient breathing?
35:02Yes.
35:03He's laying in his own show-up.
35:05Is the patient conscious?
35:07No, he's not.
35:08He's laying there, on the street.
35:11Is the breathing noisy or abnormal?
35:14It's abnormal.
35:15I've got to go outside because the guy can't throw up.
35:20We've got a cat one.
35:23So we have arrest peri-arrest exposed to the elements five minutes away when a patient's
35:32heart is highly unstable but is still beating it's called peri-arrest it's the stage before
35:38a full cardiac arrest onwards and upwards let's go see
35:53so I mean Sunday morning it'd be a good guess to say that he might have been out
36:04hello what's happened just found
36:14hiya mate can you wake up for us can you wake up definitely had a good night
36:22we'll get the stretcher and get him on the ambulance yeah
36:27a doorman called 999 after finding the man lying unconscious on the pavement when we arrived on
36:34scene we came across a man covered in vomit we both took a good guess that he'd been on a
36:38night
36:39out the night before and he was just taking a sleep on the side of the road right mate it's
36:45time to
36:46get on this stretcher let's set you up you've definitely had a good night shall we get your
36:55legs round oh you're able to pull him up from that way yes mate oh he's wet himself as well
37:02yeah
37:04hello all right go for you she's good get you to send it we're gonna get you on this stretcher
37:10don't worry about me it's not there again don't worry about me it's not there again oh no we are
37:16worried about you with the ambulance you're in the street you've been sick okay when he sat up and
37:25came round a bit it was very difficult to talk to him he didn't want to speak to us and
37:30we very
37:30quickly got that vibe but also there was a part of us that wanted to make sure he was okay
37:33you can't
37:35stay here though you're gonna have someone else phone an ambulance for you no I'm not you're not
37:42what's that yeah someone's found an ambulance for you why why not because you're you're not waking
37:50up you're sleeping on the street okay where's home you tell me I don't know do you have a house
38:03when he was coming round and he was talking to us he was very defensive and aggressive in his answers
38:12and at these moments you just sigh and just think what can I do is there any other way we
38:17can help
38:25you let me just do your blood sugar sweetheart no point for in stoke paramedics Nick and Kyra with
38:35Maddy she has diverticulitis a condition that causes severe inflammation of the bowel do you take any pain
38:43relief for it does anything work no I don't bother yeah I know what I think it's got to do
38:49with the
38:50down reticulitis there's not a lot I can you know that's the problem with that your arms are okay but
39:00someone like yourself that has got this ongoing issue for you to be worried and be ringing people
39:08yeah that's a concern in itself because something something's not normal for you I think we need
39:16more more thorough tests done right more than what I can do with this thing and so that's giving me
39:23like yeah let's take you the reason we wanted to take Maddy to hospital is due to our concern about
39:29the amount of blood she was losing where she was losing it from therefore we had to find out what
39:35was going on so we could get her treated I was folding it up yeah to bring one of your
39:41nice patch ones
39:42can I look at it yeah she can just rip it open while Maddy gets ready to go to hospital
39:49Nick and
39:50Kyra admire her homemade quilt that would look lovely in my bedroom that would I put an order in
39:57look how perfect it is I've got loads of UFOs UFOs unfinished objects oh don't get her started on space
40:08and
40:09stuff she loves it I'm obsessed handmade quilts with UFOs on the thought of having one would be
40:17absolutely amazing it would take pride of place on my bed I would love it ready when you are thank
40:25you
40:28I always say the human body it's a marvelous thing but it can really go wrong in some dramatic ways
40:36people unless they've got something like this they don't understand it at all how debilitating it says
40:52at Royal Stoke University Hospital medical staff will try to find out why Maddy's blood loss has
40:58been so heavy tonight is there any other way we can help you as an ambulance there's only a way
41:08we can
41:10take you in Birmingham city centre paramedic Sean and technician Brogan are with a man who was found
41:16lying unconscious in the street have you been drinking alcohol yeah I'm done with this swearing and abuse
41:26now let's go I guess that's it then mate yeah that's it we've been trying but you're not being very
41:38nice so
41:42well okay we decided to leave him there because despite offering him help multiple times and him
41:49initially rejecting it we can't force him to accept the help that we offer
41:58what was I just not breathing then no you were breathing but you're unconscious on the floor you're
42:04hard to wake up that's why we were called and we're worried about you but you're not being all
42:09that nice make sure you don't fall over yeah yeah I get it you just said no you're gonna help
42:17me
42:18well what do you want help with you just told us to go away and leave you alone do you
42:21want us to
42:22make sure you're okay if I was sat there yeah we're sick yeah that's what you meant to do look
42:27I'm not
42:27having an argument you want you want your checks done I was really frustrated with this man because
42:31anything I was offering or Brogan was offering um it just wasn't good enough he just wanted an
42:38argument or a fight or something similar to that and you just can't help them people do you want your
42:43checkston no honestly I don't have time for this do you want to be real don't do you want your
42:49checkston or not yeah if you want you're more than welcome to my concern when he stood up and he
43:08started shouting and getting aggressive was that he was getting close to the ambulance and he could
43:14have assaulted me and I think it would have turned worse if we'd have stayed there so I think it
43:19was a
43:19good decision for us to leave at that point I think we should just go yeah yeah let's go
43:29no step away please step away please step away having to deal with aggressive patients like this is
43:40not uncommon at West Midlands Ambulance Service nine incidents of physical or verbal abuse are carried
43:48out against the staff every single day that was a bit scary wasn't it escalated quite quickly that job
43:56yeah it was really threatening it is quite scary and as far as I'm concerned when he says
44:02can you really leave me in this state yes I mean you're not in much of a state when you're
44:06able to
44:07stand up and verbally abuse us yeah I mean sometimes we get sent to people that don't want our help
44:15and are vile to
44:16us and then there's some people out there who just can't get our help and they're in a waiting like
44:21they're in a queue for 999 and they're waiting for jobs where we're wasting our time with people who
44:25would just verbally assault us Ron who fell and was in agony hadn't broken his hip x-rays showed a
44:38plate in
44:38his hip had come loose he 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 here she received treatment
44:54for blocked coronary arteries Robert whose nose was bleeding heavily spent six hours in hospital the
45:03bleeding was stopped and he was prescribed a nasal cream to treat any possible infection and maddie who
45:11had rectal bleeding spent three days in hospital she may require surgery to repair her intestines we
45:19went straight through to see a consultant who was brilliant so hopefully he's going to have some answers
45:27for me to help me get my life back next time yeah you're really wheezy aren't you darling a man
45:39is
45:39struggling to breathe right let's pop this on you COPD is like breathing through a straw day to day when
45:47you're unwell it can get even worse a young woman has multiple seizures she'd been having a seizure
45:56every day she'd had more than one whilst we were with her this can't keep happening it's dangerous what
46:02have you done and a patient falls badly cutting her head when i looked at her injury i could see
46:10that
46:10it was down to a skull it needed some serious stitching
46:14so
46:40a
46:40a
46:41a
46:42a
46:43a
46:45a
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