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00:04Oh, cardiac arrest coming in. Dolly mount!
00:07It's one of the most pressurised jobs in the world.
00:15Becoming a paramedic is not for the faint-hearted.
00:18So, it's gonna be a little bit of pulling and dragging.
00:20That's okay.
00:23No, it's okay.
00:25Each year, the National Ambulance Service College
00:28welcomes around 90 new hopefuls to their campuses
00:31in Dublin, Ballinasloe, Tullamore and Cork.
00:34These people here are going to be your absolute backbone
00:37over the next three years.
00:40But not everyone makes it true.
00:42I don't think I'm gonna do this anymore.
00:44It's just shit, like, do I have to go to that in two days?
00:48Because this is no ordinary degree course.
00:51Where are you gonna go? It's cardiac.
00:56These students are out in ambulances across the country.
01:00999 mode activated.
01:04Learning on real emergency calls.
01:07Here, here, here, here. It's over there.
01:11Would every shift a crash course encourage?
01:14It doesn't get any harder than this.
01:16Resilience.
01:17Lift.
01:18And critical decision-making.
01:20We have a device that brings the bones back into place,
01:22but it's gonna cause them to scream.
01:24Big deep breath for me.
01:25The exams on this course aren't just a pass or fail.
01:29Uh, why did I sign up for this?
01:32They're a potential matter of life.
01:34Are you gonna wake up for me?
01:35Or death.
01:36We're not breathing.
01:55In Dublin...
01:56Five-six.
01:57Third-year student Deirdre is on shift with paramedic Greg.
02:00Five-six, go ahead.
02:02How you doing?
02:02Do you want to try and send that call down to us again there, please?
02:04Over.
02:06Roger.
02:07We'll try now, over.
02:11You're on a spread.
02:12Chest pain.
02:13I fell last week.
02:14No chest pain.
02:16Oh, my goodness.
02:17Look what age she is.
02:21We got a call that we were going to someone who had fallen two days previous,
02:26who was a hundred years old.
02:32I don't think I've met a hundred-year-old yet.
02:35I've had a few.
02:36Have you?
02:37So what was she born?
02:391924 or 1925?
02:44Alice, what's going on with you?
02:46I called a creature over here.
02:47What?
02:48You fell?
02:49When did you fall, darling?
02:52I think it was two days ago, I think it was.
02:54Okay.
02:54I don't remember.
02:55Was anybody here when she had the fall?
02:57No.
02:58No.
02:58No.
02:58And how long was she on the fall?
02:59Was she on the ground for?
03:00How long was it before she was found?
03:02We don't really know that, because they have a car coming in, and she came and she found
03:05her.
03:06So we don't really know.
03:06Was it morning time?
03:07Morning time.
03:08Okay, so she could have possibly been there all night.
03:10I have a good heart.
03:11Well, it sounds like you have a grey heart.
03:13She can't walk any longer.
03:15She used to, like, she can't really stand up any longer.
03:17And was she walking up until the fallout?
03:19She was.
03:19No.
03:20No, she was.
03:20Our knees have been gone bad, but she is.
03:23And did you go to hospital when you had your fall?
03:25No.
03:25No, you didn't.
03:27Yeah.
03:27Where's the pain, mostly?
03:29It's all on the side.
03:31All on your left hand side.
03:32So listen, for a hundred year old, are you normally fitting well?
03:36Do I?
03:36Are you normally well?
03:38She's normally well.
03:39Yeah, it's fine.
03:40Yeah, yeah.
03:41Does she take medication every day?
03:42No, no.
03:44She's only on a morphine patch at the moment for the pain.
03:47So she doesn't take tablets for blood pressure, cholesterol?
03:50No, no, nothing, nothing.
03:51I think I haven't seen a 30-year-old who isn't on medication day off.
03:55Is she?
03:55It's unreal.
03:56Well, I want something what she lives for.
03:58I don't know.
03:58So do we.
03:59As we do with every call, we go in and we do the history taking.
04:03And you say, so, Alice, what's your past medical history?
04:06And she was like, what do you mean?
04:08And I was like, well, what would you take tablets for every day?
04:11And she, tablets?
04:12I don't take any tablets.
04:14Can I have a little look at the legs?
04:15You can do what you like.
04:16Oh my goodness.
04:17I'd move to do anything.
04:19One of the hardest things about going, I think it's to older people, is their reluctance
04:24to travel and their opinion that they're a nuisance.
04:27And there's no space in the hospital now.
04:29There's always space.
04:31My husband has stayed with her since the fall at night time.
04:35And then we got the carers that are coming in.
04:38She has four with them now.
04:40Okay.
04:40When you go out to a fall, you're trying to establish a couple of things.
04:44Was it a mechanical fall?
04:45Did they just trip over their slipper?
04:47Or was it a medical event?
04:48Did they have a little syncope?
04:50Did they have a stroke?
04:52Did they, you know, what was the reason for the fall?
04:55Would you have a little bit of toast or will you have something for me if the gang didn't make
04:59it?
04:59They're actually doing it for me.
05:01I couldn't really use it.
05:02Would you be able to have even a cup of tea with a bit of sugar in it for me?
05:05Because your sugars are low.
05:06I always suffered my low blood pressure.
05:08No, it's your sugars.
05:10You have the blood pressure of a 20-year-old athlete.
05:13Alice's sugars were a little low, so we got Alice a cup of tea and some bickies.
05:18And Alice told us about her childhood and growing up.
05:22And what do you remember?
05:23What's your earliest memory?
05:25Everything from my childhood.
05:27Do you?
05:27Yeah.
05:33When all the wars and all was on, I was alive.
05:37And do you think it's a better life now or do you think times are...
05:41Ah, much better.
05:42Do you?
05:44I often wonder if my mamma would be alive today, wouldn't she be happy?
05:48Yeah.
05:49She's never had a penny.
05:50She's from Germany.
05:51My mother's Germany.
05:52From Cologne.
05:53And where was your dad from?
05:55He was in the army.
05:58And how did your mamma and dad meet?
06:01During the war.
06:02During the war?
06:02During the war.
06:03In Cologne.
06:04Alright, okay.
06:05He was over there.
06:07Alice told us that she'd had a big party for her 100th birthday the previous May.
06:12It was a flapper-themed 1920s party and we got to see Alice in all her glory.
06:22If you're looking to see her like more, I'm going to live.
06:25You have many years left in you.
06:27Don't be worried about that.
06:28If I could make another four weeks, I'd be glad.
06:30Four weeks?
06:31What's so special in four weeks?
06:33I'd be a hundred and more.
06:34Oh my God.
06:35So tell me, did Michael D send you anything?
06:38Did you get a card last year off the President?
06:40Oh, did I what?
06:41Did you?
06:41It's in the packs for those.
06:43No, off the President.
06:44Oh yes, of course.
06:46What did he give you?
06:46I was up to see him in the pack before all this happened.
06:50Stop.
06:51He sent for me and gave me a special tea.
06:53What a day.
06:55When we are taking someone elderly or really unwell from their home, you will often see
07:01them have a look around the room.
07:04I think a lot of it is in their head.
07:07They think maybe this is the last time they're going to see their house that they've lived
07:10in for 60, 70 years.
07:12So there's so many times that we would just take a pause, leaving the house and not just
07:20rush out and maybe not block the patient's view for that last little turn leaving the
07:25sitting room and let them be able to take it all in.
07:35In SOARDS, second year student Aoife and paramedic Rory have been diverted to a high priority call.
07:42A 67-year-old woman who has collapsed at home.
07:46What happened?
07:47What happened?
07:47She was just standing there and she went to tell me something and then she just started
07:51to stutter.
07:53Beep, beep, beep, beep, beep, beep, beep, beep, beep, beep, beep, beep, beep, beep, beep,
07:54and then her whole body just started to convulse.
07:56Yeah.
07:56And then she collapsed.
07:57Yeah.
07:58There was a lot of reasons as to why she collapsed.
08:01Like, was it something as innocent as she slipped and fell?
08:05Like, we don't know.
08:05We weren't there.
08:06We can only take from what the family and the daughter-in-law had said, I'm saying.
08:10Aoife started to try and talk to the patient, but we weren't getting any response.
08:13We weren't getting coherent information back from the patient at all.
08:18She was able to follow simple commands and we managed to get her to sit up onto the couch,
08:22having found out that she didn't have any major traumas from the fall or anything like that.
08:26Has she got any medical history there?
08:28No.
08:29No?
08:29No.
08:30Yeah, a quick temperature on your pet, okay?
08:33You could nearly rule out sepsis from vitals if she had no serious markers.
08:38Like, you do a fast assessment on patients to see if she does have left or right-sided weakness.
08:43And so you can kind of narrow down in the circumstances and kind of just kind of differentiate what you
08:49think is the main prognosis.
08:53Could you sit back for me in the chair?
08:55And I just need to put a few more dots on your chest.
08:57Is that okay?
08:58Can you sit?
08:59No.
09:00Oh, no.
09:01Here, there's a little back on this.
09:02Just a little bit.
09:02There you go, lovey.
09:04Is that okay?
09:04Yeah.
09:05You're doing really, really well.
09:07There was no major things jumping out at us in terms of the obs or any of that.
09:10Obviously, she was still confused, which is a red flag, of course.
09:14But it could mean any number of things.
09:16She may have had a stroke.
09:17She may have had a bleed in the brain or something like that.
09:20We were suspecting a seizure activity.
09:22And post-seizure, people are post-ictal.
09:26So they would be very confused.
09:27So we were kind of sticking with that route initially.
09:30So our only decision we could do at that stage was to mobilise the hospital.
09:34And so we did that.
09:40I think one thing that I really had to learn while on the road is, you can only treat
09:45what you can see.
09:46You don't have to, you don't have to have it all figured out.
09:48You don't have to go to the hospital and say, this is what it is.
09:51You can go in and say, this is what I think it is.
09:53Or this is what we've treated for.
09:56But yeah, treat what you see.
09:57And then, yeah, and then if not, transport to the hospital.
10:25And then, yeah.
10:29And then, yeah.
10:29And then, yeah.
10:29And then, yeah.
10:30Yeah.
10:30I'm still quite dazed.
10:31Wasn't really interacting with myself.
10:34But then it was only when we got to the hospital, she started making quite an ematic noise.
10:46She's got the seizure.
10:48That's a seizure.
10:50Wire down flat.
10:57Seizure, resource please.
11:08In Dublin, third-year student Aoife and paramedic Rory are dealing with a critical emergency
11:14as they arrive at hospital with a 67-year-old patient.
11:19Seizure, resource please.
11:22When somebody is seizing, none of the muscles are coordinating or operating properly and
11:27they all kind of lock up, even the respiratory, all your ribs, everything locks up there.
11:32So essentially the patient will stop breathing for the length of time that they are seizing.
11:35Let's go, let's go, get the machine, in you go.
11:37Let's go.
11:41Hold on, stop.
11:42I think that call was a prime example of how quick things can change.
11:46That lady was vitally stable, but then at the drop of a hat she was actively seizing.
11:53Generally, seizures last about a minute, two minutes at most.
11:57If they don't resolve after that kind of time, the patient isn't breathing for two minutes,
12:01so it can be very dangerous.
12:05Difficult calls like this one are all part of the job for experienced paramedics.
12:10But it can be a tough baptism for students having to deal with critical calls on a daily basis for
12:15the first time.
12:26So when you see somebody seizing for the first time and everybody looks at you in the room and they
12:30go, you're here to help.
12:33You, you literally feel really small and you suddenly have to realize, remember all of your training and deal with
12:39the situation.
12:40Aoife in this case, she got caught off guard.
12:42She'd never seen a seizure before in her life.
12:44And then all of a sudden she was right beside a patient who was seizing.
12:49After I called, I felt slightly overwhelmed.
12:52Pure to due to the fact that I've never worked with Roy before.
12:54I never worked in that station before.
12:58I feel like I had a lot of pressure on myself to kind of perform, to kind of impress Rory.
13:04But I think after the call, then I think speaking about it to Matty, I was getting that bit of
13:11reassurance off him.
13:12I could see that Aoife was going to get upset, or she was getting upset when she was out at
13:17the ambulance
13:17and it was the first time she'd seen a seizure.
13:21I did have a chat with Aoife and reassure her how well she was doing.
13:25It's just shit.
13:26Like, the last chapter aren't good the last two days.
13:30I didn't, I started like a bleeding club.
13:32I didn't do that.
13:33You're doing great.
13:34I'm not, I haven't done that, mate.
13:35Honestly, what have I done?
13:36What have I done that was good?
13:37Nothing.
13:38We were told when we came out as interns, like, you're going to have good days and bad days.
13:42Like, you're going to have, you're going to do a call that you've probably seen ten times before
13:46and you know it to a T, and then you get a call, like, possibly like the one there with
13:50the seizure
13:50that I've never seen before.
13:52So, then after that, then, my confidence was in the gutter.
13:55You're doing great.
13:56I'll tell you straight out if you're not.
13:58Okay?
13:58I'm fairly straight talking.
13:59You are doing great.
14:00You're great with the patients.
14:01You can talk to them.
14:02I didn't make any interventions in that fault.
14:04Because I didn't think I had.
14:06Because everything looked okay.
14:07And I did say to her at one stage, she was like a raw diamond that we were picking up
14:11and we just needed to polish up and to make her the medic that she wanted to be.
14:19And you could see all the qualities in her, but she couldn't see them in herself.
14:23I think because I'm so passionate about my job and I love it so much,
14:26and I want to be the best that I can be, having that relationship with your crewmates
14:31is just absolutely vital because, at the end of the day, if you're going to major traumas
14:35or you're going to traumatic calls, like, it's so nice having that person
14:41or the people in the station that you know you can always turn to.
14:44That's one of the main things I love about the job so much.
14:50In Finglas, third-year student Deirdre is bringing 100-year-old Alice to hospital.
14:56You do anything for a day out.
14:57After she had a fall at home.
15:01I don't think there's any point in even saying we're ever in an ambulance before.
15:04She's hardly ever been to the GPs.
15:06Never mind an ambulance.
15:08I think he's taking photographs.
15:11He only photographs the good-looking ones.
15:14Alice probably did remind me a little of my mam.
15:17My mam was a tough cookie.
15:20You know, like Alice.
15:22They don't make them like that anymore.
15:24Despite her pain, Alice is reluctant to change the habit of a 100-year-old's lifetime.
15:30You know when women have babies?
15:32Yeah.
15:33They get the gas and air.
15:34Yeah.
15:35We're going to give you some of that.
15:36I don't care.
15:37I won't need anything like that.
15:39You will not.
15:40No, I can't make you take any medicine.
15:42What I'm saying is this is here if you want it, right?
15:46Yeah.
15:46If you want it.
15:47No.
15:48I just don't want it.
15:50That's your choice.
15:52I couldn't get over how Alice had gotten to the age of 100 and didn't take any medication daily and
16:00didn't have any past medical history.
16:02There is very few patients that I have gone to over the years who are not on at least one
16:09medication a day.
16:10It was just so fascinating.
16:12I've never come across a patient like her since.
16:15Now you keep those hands in.
16:17I can see where I grab her.
16:21There's some calls you remember over others and this is one.
16:26And bringing her in to hospital we brought her in and the handover I think was this is Alice.
16:35This is the amazing Alice.
16:38Alice is 100 years old.
16:41Hello Alice.
16:43Look at her.
16:45I have to wait six more weeks to leave the 101.
16:48101.
16:49In six weeks.
16:50So nine days ago Alice had an unwitnessed fall.
16:54Okay.
16:54So we're not sure if it was Sunday night or Monday morning.
16:58Okay.
16:58So possibly two hours or 14 hours on the floor found by the carer.
17:02Are you ready for her past medical history?
17:05Okay.
17:06Nothing.
17:06What?
17:07Are you ready for her list of medications daily?
17:10Okay.
17:11Nothing.
17:12Wow.
17:13That's 100.
17:16What are we doing wrong?
17:18So yeah.
17:19Isn't she fabulous?
17:20Yes she is.
17:21Give me your secrets.
17:22That's what I said.
17:23I'm coming to live with her.
17:48I am checking.
17:49I am getting away with her.
17:50I am getting away with you.
17:53I am beginning to live with you.
18:02In this moment, I might arrow, I start walking with my cabin.
18:09In Wexford Town, second-year student Nathan and advanced paramedic Fergus have arrived
18:15at the home of DIY enthusiast Ron, who has fallen off a ladder earlier in the day.
18:22My name is Nathan, I'm a paramedic with the ambulance.
18:24I can talk louder if you want me to.
18:27I've got a hearing aid.
18:29So when the call came in, as an elderly gentleman, fall off a ladder, you're expecting to find
18:33somebody lying on the ground with a ladder on top of them or a distance away from the
18:38ladder.
18:38So when we got there and we found a man sitting on the corner of his bed, or on the
18:43edge of
18:44his bed, it was, okay, this isn't what it initially came in as.
18:50I was outside painting today.
18:52Okay.
18:53I saw there was a nail and I got up to hammer it in.
18:58Right.
18:59And I fell back, but I'm in great pain.
19:03Oh, I don't know that you're lying.
19:06Well, you did a little bit of a number to your back anyway.
19:09Being a paramedic requires a little bit of detective work sometimes and from just having
19:14a chat with the patient and him telling us what had happened, that he had been outside
19:19painting, ladder literally just fell back.
19:22He fell back, landed on a big stone out in his garden, then got himself up.
19:27And he went about his kind of day with quite substantial injuries that we found out afterwards.
19:34You've possibly cracked a couple of ribs.
19:37We realized that there was a chance he had broken a few ribs.
19:41He definitely had a head injury and he had quite a bit of a bump and some marks and grazes
19:46to his head.
19:47And he needed to go.
19:48It wasn't the case that we just wanted him to go.
19:50So he really needed to go to the hospital.
19:52We have some medications that we can give you for pain.
19:55Can we have a wheelchair outside?
19:57Can we pop you on that?
19:57No, Jesus.
19:58Don't put me in a wheelchair.
20:00I'll never get out.
20:01It can be very easy to take somebody's independence away.
20:05Ronald was very insistent of keeping that bit of independence and kind of walking out to
20:11the ambulance and while the injuries that he had kind of dictated that he probably shouldn't be walking.
20:16Well done.
20:16The reality kind of had to set in that, well, he had been walking around all day at home with
20:21these injuries.
20:21He had gone about making his food.
20:23Nice and slow.
20:23Made sure he had the house in order before kind of calling us.
20:27The ladder had been put away.
20:28The paint had been put away.
20:29We're going to swing your legs around first.
20:31Hold up.
20:32Oh.
20:33Don't get too drunk on that now.
20:35It does.
20:36It does.
20:38What did you work at, Ron?
20:39I was a London cabbie.
20:41What part of London?
20:43Me.
20:43I was in a place called Dagenham.
20:45Dagenham.
20:46I lived in Wimbledon.
20:48Did you?
20:49I did.
20:49I knew Wimbledon very well.
20:51Lovely place.
20:52Wimbledon and Clapham.
20:53Once you get into an ambulance, it's just chatting with people and a conversation can
20:58be a great pain reliever.
21:00It can also be a really good distractant.
21:02If nothing else, you're calming them down.
21:08I felt I lived alone, but I don't.
21:11I have someone in every room.
21:14Did you know that?
21:16And who are they?
21:18Put a mirror in every room.
21:20And no matter what room we go into, there's another guy in there.
21:24And we got out famously.
21:27Oh yeah.
21:2810, 20 years ago in Ireland, loneliness wasn't a huge thing.
21:33Society has changed.
21:35Loneliness with older people is probably one of the biggest things we deal with as ambulance crews.
21:41And a lot of our job is just being able to have a chat and kind of having the bit
21:46of back and forth kind of crack with people.
21:49Especially in Ireland.
21:51I think that's a huge part of our job now is being that kind of middle ground of there's somebody
21:57to talk to.
22:15Should I do my way?
22:17Sure.
22:18One, two, three.
22:19Should I do my way?
22:20Believe me.
22:21One, two, three.
22:25Any power?
22:51In Dublin, first-year student Rebecca
22:54is on her 15-week placement,
22:56out of the college classroom
22:58and into the ambulance.
22:59Today she's on shift with Deirdre,
23:01a third-year student who is a newly qualified paramedic
23:05and also her man.
23:07Do you remember when you said you were going to leave college
23:09and I said you're not leaving without a plan?
23:11Without a plan, yeah.
23:11And then it just happened, wasn't it,
23:13that week Nass were recruiting?
23:15Yeah.
23:15It was very strange.
23:17I'm so lucky, you know, that...
23:19It was just timing, wasn't it?
23:20Yeah, it was timing.
23:22It's like a lot of things in life,
23:24it's timing and luck.
23:25Yeah.
23:26I'm really looking forward to working with my mum today.
23:29It'll be really enjoyable.
23:30We'll have to kind of find the balance
23:32of her giving out to me
23:33and me taking feedback
23:34and us not fighting.
23:36I don't think we will, but...
23:38Yeah, I'm really looking forward to it.
23:40They've been called to an apartment complex
23:42where 44-year-old Abi O'Doone
23:45is complaining of severe chest pain.
23:47What would you give the pain out of ten?
23:50Nine.
23:51Nine out of ten.
23:51People are really, really concerned
23:53when they feel pain in their chest.
23:55They might have been having it for a while
23:58before they ring,
23:59but it's something that kind of universally
24:01people panic over.
24:02Have you taken anything else in the last 24 hours?
24:05Any drugs, alcohol, medications?
24:08Nothing.
24:09Just your blood pressure.
24:10Brilliant.
24:11Doing blood pressure therapy.
24:12Yeah.
24:12I don't know what's up.
24:16It is different when you're out with a student
24:19who's third person
24:21and sometimes you can let them
24:23carry on with the call.
24:25But with the call we were at this time,
24:28I was leading the call.
24:30I was getting Rebecca to do the ops
24:31because I didn't want anything that was relevant
24:34past medical history to be missed.
24:37So what we're going to do
24:38is we're going to give you a little spray
24:40under the tongue, right?
24:42Okay?
24:44Might make you feel a little light-headed,
24:45might give you a bit of a headache,
24:47but it'll help with this pain, hopefully.
24:49GTN is a spray that is used really commonly,
24:52you'll see it in people's homes a lot of the time,
24:54for angina.
24:55In simple terms,
24:57it kind of dilates things
24:58and allows blood to flow smoother
25:01if there is something blocking it,
25:04if that makes sense.
25:05It kind of opens things up.
25:07What have we had the surgery for?
25:08What are the scars from?
25:10Gastric sleeve.
25:11Gastric sleeve.
25:12When was that?
25:13A year and a half ago.
25:15Okay, and you've been well since it?
25:16Yeah.
25:17Okay.
25:19Would have been the first call
25:21I have been on with Rebecca.
25:23It was really strange, you know,
25:25you're trying to remember back
25:27to what you were like
25:29at that stage in your career.
25:32I suppose one of my strengths
25:33has been able to talk to people
25:35and I definitely see the same in Rebecca.
25:39She has that
25:39when it comes to dealing with patients.
25:42It was really enjoyable
25:44and there was at no stage
25:45where we were kind of button heads
25:47or it made no difference.
25:49It didn't feel like I was working with my mum.
25:53It just felt like I was working with somebody
25:55who I knew really well
25:57and it made the day so relaxed.
25:59It's not talked.
26:00Just a big deep breath in in your mouth.
26:02It was great to see how she's going on
26:04and, you know, it won't be long
26:06until she's alone
26:08in the back of the ambulance
26:09with her own patients.
26:11Please God, in January
26:12when she is on her internship year.
26:24For second year interns
26:26Anne-Marie and Ryan
26:27Hello, ambulance service.
26:29It has been a tough
26:30but rewarding year
26:31on the road in Limerick and Mayo.
26:33No pins and needles
26:33in the fingers or anything.
26:35With each new emergency call
26:36testing their skills.
26:38Yeah, that'll do.
26:39That's fine.
26:40Yeah, that's good for me down there.
26:44And challenging them in ways
26:45they never expected.
26:47Why did I sign up for this?
26:49Can I have two seconds?
26:55They're returning to their old campus
26:57in Ballinus Law
26:57one last time.
26:59Where are we there now?
27:00We're here somewhere.
27:02Here we go.
27:03That's the class photo now
27:04from the grad.
27:05Jeez, we don't spoke up
27:06too bad there now.
27:09Soon they'll be taking
27:10their exit exam.
27:12If they pass
27:13they qualify as paramedics
27:15and move into third year
27:16to complete their degree.
27:18Two tutors
27:19will ask me
27:20a series of questions
27:21about my reflection
27:23on calls
27:24that I've attended to
27:25throughout the year.
27:26They want to see
27:26that you're confident
27:28in terms of your decision making
27:29on those calls
27:30and that you're open
27:32to criticism
27:33and that you're open
27:34to, you know,
27:36progressing yourself
27:37continuously still
27:40brings back
27:41so many memories.
27:46The exit interview
27:48is really important
27:49for them to see
27:49how I've grown
27:50over the year
27:51what I've learnt
27:52and how I endeavour
27:54to go forward
27:56in my career
27:57as a paramedic.
27:58I remember
27:59when I was on
27:59my last chance
28:01and walking
28:02into this room
28:02it was literally
28:03make or break.
28:04It was like
28:04if I had failed
28:06that one
28:07I wasn't coming back.
28:10It's hard to think
28:10that what we did
28:11in these rooms
28:11is now what we do
28:13in the back of an ambulance
28:14in like a quarter
28:15of the space.
28:16If you think about it
28:17we've actually been
28:18on the road now
28:18longer than we were
28:20in the college.
28:20This is almost like
28:21the final hurdle
28:22I could fall
28:23at the fence
28:24but hopefully
28:25that won't happen.
28:41In Wexford
28:43second year student
28:44Nathan
28:44and advanced paramedic
28:46Dave
28:46were en route
28:47to a call
28:48but they've been
28:49diverted to a higher
28:50priority patient
28:51with a history
28:51of epilepsy.
28:52So we were
28:53en route
28:54to a call
28:55and we got
28:56stood down
28:57off that call
28:58to a female
28:59actively seizing
29:00query
29:00altered level
29:01of consciousness
29:02so that kind of
29:03perks your ears up
29:04because that's
29:04a pretty serious call
29:05you know
29:07you're going to be
29:07expecting something
29:08serious when you get there.
29:10on arrival
29:11on arrival at the house
29:11another crew
29:12has already started
29:14observations.
29:15Nausea
29:16intermittently
29:16for the last couple
29:17of days
29:18she feels like
29:19she wants to vomit
29:19but she can't
29:20now that it's actually
29:21coming up.
29:21They didn't notice
29:22initially they thought
29:23it was to do
29:23with her epilepsy
29:23because she was
29:25fainting
29:25and simply the episodes
29:27and we have anxiety
29:28and depression.
29:29With Nathan
29:29fully up to speed
29:30on the complexities
29:31of the case
29:32he takes over
29:33communications
29:34with the patient.
29:35When you have
29:36the epileptic seizures
29:38are they the full
29:38kind of blown
29:39kind of shaken seizures
29:40I don't know
29:41do you know what happens?
29:42I go out
29:43my eyesight goes
29:44my hearing goes
29:45and then when
29:45I come back around
29:46I'm like
29:47did I just have a seizure?
29:49Where was I?
29:49What happened?
29:51There is multiple
29:51different types of seizure
29:53sometimes someone
29:54can be seizing
29:54and can be just
29:55jerking an arm or a leg
29:57sometimes it can be
29:58just rapid eye movement
29:59sometimes they
30:00may not have any
30:01jerking at all
30:02but just aren't
30:03responding to you
30:04so there is many
30:05different types
30:05of seizure
30:06and it's impossible
30:07to be able to
30:08identify them all
30:10correctly
30:12the safest thing
30:13that we would always
30:13say that if it looks
30:15like a seizure
30:16and you're confident
30:16that it is a seizure
30:17then treat it
30:18as a seizure
30:20take a few deep
30:21breaths for me
30:21I'm scared
30:22that's okay
30:23we're all here
30:23alright
30:23we're here to help you
30:24alright
30:25so look
30:26what we're gonna do
30:27is I'm gonna run
30:28another blood pressure
30:29yeah
30:30and then we will
30:31have a chat with
30:32the rest of the guys
30:32that are here
30:33and we figure out
30:33the best way to
30:34get you out
30:34into the ambulance
30:35is that okay
30:35yeah
30:36alright
30:37so it took maybe
30:38three or four minutes
30:39in the house
30:39to kind of get the patient
30:41kind of up out of bed
30:42and get her
30:42into the ambulance
30:44with the patient
30:45telling the crew
30:46that she's been
30:46experiencing
30:48periodic epileptic
30:49seizures
30:50they decide to
30:51transport her
30:51to hospital
30:52as a priority
30:57okay so look
30:58I'm gonna have a job
30:59with my colleague
31:00and see
31:00what he thinks
31:01and then we will
31:02decide if we're
31:03going to
31:04do anything
31:04yeah okay
31:05yeah that's fine
31:07so temperature is good
31:10blood sugars are good
31:11blood pressure is good
31:13what would you treat?
31:15the anxiety
31:16and if the seizure
31:18comes back
31:19and we can treat
31:20with andanztron
31:21for the sickness
31:23so cytosine
31:25has the longer term
31:27effect
31:29there you go
31:30if you hold this
31:31you okay?
31:37while in the back
31:38of the ambulance
31:38then
31:39she
31:41felt that
31:41a seizure
31:42was going to come on
31:43is that the pain
31:44I got into one
31:46you're having a seizure
31:47are you?
31:48when
31:48she started
31:50the season
31:50I kind of looked
31:51at Dave
31:52to see if we should
31:52start kind of
31:53medication treatment
31:54and when I seen
31:55his reaction
31:55I kind of knew
31:56that maybe this isn't
31:57what
31:57it actually
31:59is all
32:00kind of adds up to be
32:01relax in the bed first
32:03just take some deep breaths
32:16in Wexford
32:17second year student
32:18Nathan
32:19and advanced paramedic
32:20Dave
32:21are attending
32:22to a patient
32:23who has told them
32:24that she has been
32:25experiencing
32:25periodic epileptic
32:27seizures
32:28hello can you hear me?
32:33from prior experience
32:34I recognised
32:35the patient
32:36I've attended
32:37to that address
32:39numerous times before
32:40I chose not
32:42to pass that information
32:43on to Nathan
32:46because sometimes
32:47that can
32:48cloud their judgement
32:49into thinking
32:50well this isn't
32:51an emergency
32:52or they may not be
32:53seizing
32:54everything's all right
32:54again now isn't it?
32:58hello
32:58welcome back
33:00alright
33:00it's okay
33:03when she started
33:04the season
33:05I kind of looked
33:05at Dave
33:06to see if we should
33:07start kind of
33:07medication treatment
33:08and when the paramedic
33:09hasn't given any medication
33:10you kind of get
33:11an idea of what's going on
33:14she was already
33:15on the monitor
33:16and didn't have any
33:17physiological changes
33:18on the monitor
33:19so her heart rate
33:20remained the same
33:21her oxygen levels
33:23remained the same
33:24her breathing rate
33:24all stayed the same
33:25if there's no changes
33:27in those
33:27and that she's able
33:29to respond to you
33:30on cue as such
33:31then it's highly unlikely
33:33that she's having a seizure
33:55while she might not
33:57be having
33:57genuine seizures
33:58she is having
33:59some form of a crisis
34:00and who am I
34:02as a paramedic
34:03to decide
34:03that there's nothing
34:05wrong with this patient
34:13hello
34:15it can be
34:16a little bit
34:17disheartening
34:18when you are
34:20going out to someone
34:21who you've been
34:22called for many times
34:23in the past
34:24that you know
34:26needs help
34:27but sometimes
34:28the ambulance service
34:28isn't the most
34:29appropriate help
34:30for them
34:31and by attending
34:32this person
34:33that you may not
34:35be there
34:35to help
34:36another person
34:37that may need you
34:45it's kind of a hard
34:45one to describe
34:46but in reality
34:47my job is
34:48as a paramedic
34:49to treat the patient
34:49that's in front of me
34:50at the time
34:50and that means
34:51to treat them
34:52with dignity and respect
34:53the same as I would
34:54anybody
34:54even if
34:55I don't think
34:56they need an ambulance
34:57the reality is
34:58in their head
34:58they've decided
34:59they need an ambulance
35:00so who am I
35:00to be the one
35:01to tell them
35:01that they don't
35:02need to be
35:03they call an ambulance
35:06I'm just at the hospital
35:07I'm just at the hospital now
35:11oh I'm vomiting
35:12and it's just
35:13I'm not breathing right still
35:16sometimes there's more
35:17social skills
35:19or social services
35:20that may be
35:23better equipped
35:24to deal with these
35:26types of calls
35:27but at the time
35:29999 and calling
35:30for the ambulance service
35:31is the only thing
35:32that they know
35:33what to do
35:33and the only thing
35:34sometimes
35:35that's on offer
35:36to them at the time
35:37it can be conflicting
35:39and it can be difficult
35:40but I think
35:42for any paramedic
35:42going out there
35:44we always should
35:45try to remember
35:47that for them
35:48right now
35:49it is an emergency
35:51or it is a crisis
35:52that they just
35:53can't deal with
35:54and they need help with
36:16in Dublin
36:17second year student
36:19Aoife is on shift
36:20with advanced paramedic
36:21Cuiva
36:23this is her
36:2486 year old male
36:25fall injury to hand
36:27that's all we got
36:29we got a call
36:30for a gentleman
36:32that had a hand injury
36:33we were only 2 minutes
36:35away from where
36:36we started off
36:37initially
36:38so quite quick
36:39to get to that call
36:48we didn't get a key
36:48code did we
36:49I don't want to blow
36:51there's like no other
36:54we knocked on the door
36:55there was no answer
36:57so we kind of waited
36:59we were looking around
36:59are we at the
37:00you know
37:00is this the right street
37:01this is the number
37:02this kind of thing
37:03and a gentleman
37:04opened the door
37:05and said hello
37:07hello
37:07hello
37:08oh hello
37:08how are you
37:09not too bad
37:10I'm Aoife this is Cuiva
37:12did you call for us
37:15did you call for us
37:17yeah
37:18no come in anyway
37:19automatically I was thinking
37:20okay well someone
37:21around here
37:21needs us like
37:22so we better move on
37:24but he insisted on inviting us in
37:26but he insisted on inviting us in
37:27I was a little bit
37:27I was a little bit taken back
37:28it was a bit strange
37:29what's going on
37:30so obviously we went in to him
37:32and he sat down
37:34and started to chat away to us
37:35house was lovely
37:36lots of character in it
37:37kind of looking around
37:38you realise he's on his own
37:40you didn't call the ambulance
37:42did you not
37:42sit down there anyway
37:44just close that door
37:45and sit down there
37:47Sandra's coming over
37:48my daughter
37:49when we first got on scene
37:50and we knocked on the door
37:51we weren't even sure
37:52whether he had actually
37:53called the ambulance or not
37:53or else he was just
37:54some friendly old man
37:55that was letting the paramedic crew in
37:56because I think even himself
37:58he wasn't sure
37:59as to why we were there
38:00but we soon realised then
38:02why we were and
38:03what was the reason
38:03we were called for
38:07what's your name
38:08Tony
38:08so did you call us
38:09or your daughter
38:11your daughter called
38:12I was in the bed there
38:13and I felt I couldn't get up
38:15yeah
38:15I'm just going to do a few checks
38:16as you're chatting
38:17okay
38:18and did you feel
38:19do you feel dizzy before the fall
38:20or do you just feel like weak
38:21well the shakes
38:22you know
38:22the shakes
38:23yeah
38:24and you didn't
38:25did you injure yourself at all
38:26or any of the falls
38:27well just there
38:28did you yeah
38:30was your hand
38:31yeah
38:32it's not bad now
38:33you know
38:33it's okay now
38:34can you do this to me
38:36yeah
38:36yeah
38:37do you know
38:38he was starting to paint
38:39some sort of a picture
38:40as to why the ambulance was called
38:42but still wasn't 100%
38:44who's your daughter
38:45Sandra is it
38:46and is she looking to come
38:47and meet us is it
38:48before you go to the
38:49she usually needs me
38:50over to the pub
38:51oh lovely
38:53and why do you think
38:54Sandra called the ambulance
38:56I don't worry about
38:57worried about you
38:58I think one of the
39:00main signs of symptoms
39:01that we noticed
39:02in the patient
39:02was that
39:03he was very shaky
39:04and his fingertips
39:05were quite red
39:06and he was
39:08slightly confused
39:09at times
39:10so this is where
39:11myself and Aoife tag teamed
39:12so she's leading the course
39:14she's going to stay with the patient
39:15and she did all the assessments
39:17she needed to do with him
39:18when I went
39:19and chatted with
39:21his daughter on the phone
39:23what's your concerns
39:24at the moment
39:28Grant
39:29okay
39:29okay
39:30and this is all over
39:32the last few days
39:33kind of is it
39:33a bit of this
39:34kind of decline
39:35yesterday and today
39:36okay
39:36her concerns
39:37were you know
39:40memory
39:40not being too good
39:42just concerned for him
39:43there was nothing
39:46acutely
39:48jumping out
39:48that we needed to intervene
39:49and give any treatment
39:50this gentleman
39:51just needs to go in
39:51for further investigation
39:52and come here to me
39:54do you head down
39:54to the pub every day
39:56oh no
39:56no
39:57just every now and again
39:58only one day
40:00okay
40:01all right
40:01which one do you go to
40:03the case you are
40:04over the south side
40:05and the shamrock
40:07oh
40:08oh yeah
40:08yeah
40:08yeah
40:09I wouldn't know
40:09I know the shamrock
40:10now
40:10I wouldn't know
40:11the other one
40:11and you sing
40:12do you
40:13yeah
40:13oh very good
40:16brilliant
40:17trad music
40:19or what kind of
40:20oh no
40:20no
40:21it's just
40:22Dickie Rock
40:23you know
40:23oh yeah
40:25what's Dickie Rock
40:26do you not know
40:27who Dickie Rock is
40:27no
40:29sing us into the matter
40:31there's three minutes
40:31into the matter
40:32yeah if you want to
40:32give us an old song
40:34we won't say no
40:36Mona Lisa
40:37did Dickie Rock
40:38do that one
40:39no I'll do that one
40:40do you
40:42we'll walk the road
40:44of life together
40:47day by day
40:48lovely
40:49and I will love you
40:52every step
40:54of the way
40:55wow
40:56love it
40:56brilliant Anto
40:57he gave us a couple
40:58of bars of a Dickie Rock
41:00song
41:00I didn't know it now
41:01to be fair
41:01but it was lovely
41:02it was lovely to see
41:03and it's great to have
41:04those little moments
41:05and they brighten up
41:05your day
41:06when you have patients
41:07like that
41:08I suppose
41:09with the little bit of
41:10singling the ambulance
41:11gave us
41:11a positive sign
41:13that
41:13please God
41:14everything's going to be
41:15okay with the patient
41:35at the Tala campus
41:37both Anne-Marie and Ryan
41:39are gearing up for their exit exam
41:43I'm trying not to think
41:44now at this stage
41:45what it'll be
41:47the waiting to kill you
41:49though
41:51I feel okay
41:52I'm not as nervous
41:53as I thought I would be
41:54I feel okay
41:56all I have to do
41:57is be honest really
41:57about my experience
41:58during the year
41:59and just
42:00kind of recall
42:01things
42:02and remember things
42:05but yeah
42:06hopefully just being myself
42:07will be enough
42:09the exit interviews
42:10is done by our
42:11educational team
42:12and operations
42:13we don't
42:15we don't do them
42:16we don't be involved
42:16in them
42:17they do look for our feedback
42:19and not everybody
42:20is successful
42:27if you become qualified
42:29doesn't mean
42:30you've stopped learning
42:31doesn't mean
42:31the journey's over
42:32the journey continues
42:36so just because
42:37they change the colours
42:37on their shoulder
42:38from blue to navy
42:39they still build
42:42build on the knowledge
42:43that they have
42:44their exposure
42:44how they do things
42:46on a daily basis
42:47and you'll continue
42:49to build that confidence
42:50as you go on
42:54this is going to go
42:55you ready
43:08I still ask myself
43:10why I did it
43:11but I love the fact
43:12that I can help people
43:13a job like this
43:14whether it be
43:15paramedics, guards
43:16nursing
43:17that'll mature you
43:19exponentially
43:20getting my paramedic
43:21qualification will be
43:22probably one of the
43:23biggest goals
43:24I've ever had
43:24in my life
43:25I absolutely love
43:27being a paramedic
43:28it's probably one of my
43:29favourite things about myself
43:30I love telling people
43:31I'm a paramedic
43:32there is a huge difference
43:33between you know
43:35learning in college
43:35and then being out
43:36in the ambulance
43:36so you kind of have to
43:38adapt and enjoy it as well
43:40you know I highly enjoyed it
43:42and I think that's important
43:43part of the job as well
43:45there was a long time
43:46where every time you got
43:47dressed you thought
43:47you were an imposter
43:48but there's been a couple
43:50of times where I've had
43:51really big calls
43:52and really good outcomes
43:54that I go
43:55yeah
43:56it's okay
43:57I deserve to wear
43:58this uniform
44:04there's nothing like the snap
44:06of pink rubber gloves
44:07to mean business
44:08tonight the team tackle
44:09a rental refurb in Cork
44:10while there's dumping drama
44:12in Dublin
44:12new series
44:13Cleaning Up Ireland
44:14continues Sunday
44:15at half eight
44:15on Virgin Media Play
44:16and Virgin Media One
44:36If you've been affected
44:37by any of the issues
44:38raised in this program
44:39please visit our support page
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