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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.
03:37aaapillas.ict
03:44Ambulance
03:45service is the patient breathing. Yes it's
03:47my father. He's had
03:49a really bad nose bleeds, bleeding for the last half an hour and he can't stop it. Would
03:54you say
03:54that it's heavy blood loss. Is it gushing?
03:57It's heavy non stop.
04:00What have we got then?
04:02Trio's not possible.
04:03remote observer but there's heavy blood loss that's all we have i kind of want to see where's
04:12this bleeding coming from when we go to a patient that's got heavy blood loss we're trying to think
04:17where's the blood coming from how much blood have they actually lost and do they need any
04:22further treatment to help stop the bleeding hello he's in the bathroom he hasn't come out
04:34the hospital with the bleed on the brain is he on blood thinners no no no he's just had a
04:38bleed on
04:38the brain okay i just come up to the toilet and i just i did blow me now as it
04:44started to learn
04:45and i knew straight away it was one of these bless you oh yeah yeah there's a clot in that
04:51one
04:52then try not to rub it if you can lean over the sink though while you're doing it 77 year
04:57old
04:57robert recently had surgery to treat a bleed on his brain tonight after bleeding heavily from his nose
05:04his son called 999. what i've had it happen before it's usually stopped within you know 10 minutes
05:1210 minutes but it's been half an hour yeah it's good how much blood would you say that you've
05:17estimated a lot yeah let me just pop that on there any headache no any blurred vision no no just
05:28the
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
05:45supposed to clamp can you feel that pressure yeah it's gone it's not very tight though no let me try
05:54a bit higher up oh never get trying this and trying in school oh there we go right keep that
06:02there for
06:02a bit i think it's doing its job it's stopped bleeding now it's stopped dripping down there we go
06:08fixture can you breathe through your mouth okay yeah yeah you're not feeling anything oh no it's still
06:13dripping i was quite worried at this point because we had no other option to stop the nosebleed apart
06:20from him applying pressure himself and i was really worried about the amount of blood loss what we'll
06:26do we're just going to contacting our team we've got a drug that's a blood clotting drug yeah the fact
06:30that it's still going after half an hour and yet it is losing quite a bit i'm thinking that that
06:36might be
06:37a go ahead if i'm honest just to see if that stops the bleeding all right as robert has recently
06:45undergone brain surgery amy needs to speak with a senior clinician before she can give blood clotting
06:50drugs amy i'm just waiting for a response mate no worries it's just my reasoning is the fact that it's
06:57been continuous for over half an hour now and it's still yeah going quite yes yeah i'm going to take
07:04this off because it really isn't doing nothing is it if you try and pinch a little bit more up
07:10here as
07:11well if you can that normally stops it a bit how's your walking like is that all okay yeah before
07:17i went
07:17to the hospital i could hardly walk and i was dripping up and falling over but uh since i had
07:23the operation
07:23to come out of the hospital i've been fine i only took the uh dressing office order wow ah i
07:30see it
07:31it's healed really really well yeah do some fresh ones there we go oh oh god that is a big
07:39clot
07:40oh that that was massive yeah was that in your nose or was it in your throat or was it
07:47when it
07:47it come from my nose into my throat that come out of my throat that did okay i'll just spit
07:53that out
07:54when i saw the blood clot it was rather grim it was large he's just had brain surgery we needed
08:00to
08:00get him to hospital fast well uh definitely think about going
08:18um i feel a little bit sick so do i you told us to get this much i saw a
08:24train i thought i've never
08:25had a train in my life we saw the ice cream van didn't we and i'm pretty sure we drove
08:28past it
08:29and then went back i think if there's an opportunity to have ice cream you're gonna take it aren't you
08:34ice cream yeah do i have chocolate all around my mouth no have that see your tongue out your tongue's
08:39blue
08:39it hurts morgan and daisy come to the end of their break and are ready for the next call
08:54ambulance service is the patient breathing yes and what's the reason for the ambulance the gentleman's
09:01had a fall but he can't wait there and every time he's moving he's crying out in pain and how
09:08old is he
09:09he's 92. we've got 92 year old male um presses care line leg injury fall injuries unknown okay
09:23you could have a neck of female fracture yeah hip hip hip if we're looking at the leg i think
09:31when you
09:31get called to a 92 year old that's fallen we are thinking is he going to have broken something
09:37and they're going to have broken his hip generally it's something that happens isn't it when they're
09:42older yeah and a bit more frail and it's not it's not nice it's not a nice break
09:53hello what's what's going on here i'm going to take these blankets off your sweet all right so i can
10:03have a look at you i know i know i know keep still sweet i know he's bent over and
10:11then fell and where
10:13was he when he fell here yeah okay yeah he's helping me retired cabbie ron fell over while trying to
10:20switch on his electric blanket daughter karen rushed over when she heard her dad was hurt
10:27i'm sorry Ron we need to just try and straighten you up a little bit this might be a bit
10:31very
10:31uncomfortable i'm really sorry is it just in your hip my hip
10:43here yeah our main concern was figuring out where this pain was why he was in pain and getting this
10:52under control, we did suspect that he may have broke his hip.
10:58I'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
11:20his nose and then come out his mouth.
11:21Right, bear with me, sorry, we've just had a clot probably about three centimetres by
11:24three centimetres round just come out 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, you OK?
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, OK?
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.
12:21In 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,
12:30you know what I mean?
12:36You have arrived at your destination.
12:40It has slowed down.
12:41Oh, don't pick it.
12:44At Russell's Hall Hospital in Dudley, doctors will investigate why Robert's nose won't stop
12:49bleeding.
12:50They'll also want to see if it's related to his recent brain surgery.
13:04Oh, it came down my leg here.
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,
13:14who's in 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, because 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 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.
13:54If 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.
14:20Yes.
14:21Oh, yeah.
14:22When Ron said that he didn't want to be alive anymore, it was quite upsetting, and it was
14:27clearly because he was in so much pain.
14:30So we just wanted to make him more comfortable, try and get him feeling back to himself.
14:35All right, I'm going to give you some paracetamol through that vein, OK?
14:40Oh!
14:42Just by the leg.
14:44Was it shooting?
14:46Up and down your leg?
14:49Oh, Ron.
14:54Daisy and Morgan give Ron liquid paracetamol intravenously, but it's having little effect.
15:02What, 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, if I'm honest.
15:09I agree.
15:11Ron had very clearly hurt himself.
15:12We do believe that he had broken his hip, so in order to move him, we knew we were going
15:18to need to give him some strong pain relief, just to try and keep him as comfortable as
15:21we 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.
15:34Don'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, but it was
16:12just 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 on?
16:26Gas and air, yeah.
16:29Right, so if you pop this in your mouth, if you suck it in...
16:32You got it?
16:34Go steady.
16:37Ron.
16:39Ron.
16:40If you suck that in, it should ease the pain, but 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, because this might be quite painful.
17:01I'm going to move your legs, OK?
17:04I don't.
17:05I'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, because we're not going to get you out.
17:23Put this in your mouth.
17:25Keep breathing on it.
17:26It's good.
17:27There 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?
17:36Yeah.
17:37With the pain medication starting to take effect, Morgan and Daisy can finally move
17:43Ron.
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, yeah.
17:57All right.
18:05Oh.
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 clearly in 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.
19:21So, 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.
19:44It'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.
19:57You 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.
20:44Yeah, Roger, thanks.
20:46We'll get you what we can do.
20:48Well, look at the time the call came in.
20:51She's woken up with chest pain.
20:52That can be quite concerning.
20:54She's never a good sign.
20:56We're only nine minutes away.
20:58Hmm, a bit tight.
21:01It's scary, isn't it, some 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 it is, and the
21:14amount of time it would take to get there.
21:15Yeah, the location of her property was up a really long, narrow road, which just made it extra hard to
21:22get to her.
21:26So what's been going on, then?
21:29Well, I've got a heart valve problem, and, you know, waiting to have it done, but, ooh, tonight it really
21:37got me.
21:38I woke up, and I 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?
21:58How little time did you wake up with the chest pain?
22:00About three o'clock.
22:01About three o'clock.
22:01Yeah, you're going to go.
22:02Do you have an irregular heartbeat, by any chance?
22:05Not normally, I don't think, no.
22:07I 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.
22:24It effectively means the heart has to work a little bit harder.
22:28So have you got palpitations in your chest at the minute, sweetheart?
22:30Not at the moment.
22:31No, did 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.
22:46Nice and 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 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 pretty fast
23:29at over 160 beats per minute,
23:31but it was also showing us that she was actively having what we call a STEMI, which is a heart
23:36attack.
23:45As the West Midlands sleeps, we're on board with eight paramedic crews working the night shift until 6.30 in
23:52the morning.
23:58We are going to be taken 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 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, reducing the strain on her heart.
24:24We're going to look and see if we can give her aspirin.
24:27Yeah.
24:27And we're going to look at giving her a needle in her arm as well.
24:30I'm just going to pop in your hall and make a phone call, OK?
24:32OK.
24:34Colleen calls the hospital to let them know they'll be arriving soon with a patient who's having a heart attack.
24:40So I did the right thing calling.
24:42Oh, yeah.
24:42I don't like to think I'm wasting anybody's time, you know.
24:45Nope, 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.
24:52Which A&E?
24:54Stoke.
24:54Rosalie has to go to hospital because she's actively having a heart attack.
24:58She needs further treatment that we cannot provide her.
25:00It's imperative that we get her there pretty quickly to 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, they'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.
25:22Oh, 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.
25:42You'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.
25:53So, 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, but unfortunately we need to do it in a way that the patient understands
26:13so they have all the information they need.
26:16Hello, resource.
26:18It's Adam, one of the paramedics.
26:19Can I put a medical standby in, please?
26:21OK, and we'll see you in about 20 minutes.
26:24We're going to be waiting for you.
26:26So, we'll go straight in, straight to see someone, hopefully.
26:31I feel a bit of a fraud going in like this.
26:34Honestly, you're really not.
26:36Really?
26:37Yeah.
26:38With your heart rate being as it is, you ain't no fraud.
26:45Right then, sweet.
26:46Couple 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.
27:06Don't think she wanted to bother us.
27:08She absolutely needed to, though.
27:09No, didn't she?
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.
27:16It 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.
27:22Way 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?
27:44Yes.
27:46Every minute of every day, the call assessors of West Midlands Ambulance Service are working hard 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.
28:10It's the ambulance service.
28:12Is the patient breathing?
28:14Is she breathing?
28:16Yes, she's breathing.
28:17Yes, yes, sort of, yes.
28:18Okay.
28:19Are they conscious?
28:19Are they awake?
28:20She's panting.
28:21She's ready breathing.
28:22Okay.
28:23I just need to know if they're conscious.
28:24Are they responding to you?
28:26Is she responding to it?
28:28No, I don't think she is.
28:30Okay.
28:31Is her breathing noisy or abnormal?
28:34It's like gargling, heavy.
28:36It's gargling.
28:37Okay.
28:38Is she responding to you?
28:39Is she making any effort to move?
28:42Yeah, she's, sort of.
28:45Okay.
28:46Right.
28:47Okay.
28:48Okay, caller, listen to me.
28:50It's really important that you follow my instructions, okay?
28:52I need you to have a look at her breathing.
28:54Is she breathing normally?
28:56Is she breathing normally?
28:59No, not really.
29:00As soon as I hear the words that they're not conscious and not breathing,
29:03it's almost like a wall comes down around me
29:07and I'm completely locked in on that call.
29:10Nothing else around me matters.
29:13Okay, we've got some help arranged.
29:15I need you to listen to my instructions, okay?
29:17Are you within easy reach of her?
29:20Yeah, somebody's on the roof.
29:22She's on a roof.
29:24She's on a what, sorry?
29:26She's on, like, a roof ledge.
29:28She's on a roof ledge.
29:30Yeah.
29:32When I heard the patient was on the roof,
29:35I think I was genuinely really confused,
29:37but it just changed things in the moment then.
29:40It meant that I needed to then think about
29:42how we were going to get the caller
29:43to the patient safely to do CPR.
29:46So when you say she's on a roof ledge, what do you mean?
29:51It's like a ledge.
29:52It's like a ledge.
29:53Is it a ledge on top of the house?
29:56Is it like a balcony out there?
29:57Yeah, yeah, like a roof.
30:00Can you see the ambulance?
30:03Caller, are the paramedics there?
30:05One on your left.
30:06One on your left.
30:06The door on your left.
30:09Hello, caller?
30:12Yeah.
30:12Is that the crew with you?
30:14Yeah.
30:14OK, I'll leave you with them.
30:19Even though we get calls quite often for people
30:23in unconventional places,
30:24it's not often that you get somebody that's on a roof,
30:27unconscious, not breathing, needing CPR,
30:32and trying to figure out how we're going to get to that patient.
30:36Minutes later, control has informed
30:39the woman was trying to take her own life.
30:42We've got some updates on that case.
30:45So, she's alive.
30:48They've now got her off the roof,
30:50fire, were there as well.
30:52I assume that's to help get her down off the roof.
30:54Yeah, because they weren't quite sure
30:55how they were going to get her down, to be fair.
30:57I just couldn't get my head around it.
31:00No.
31:00It just didn't make sense as to why she would be on the roof.
31:02She's on the back of the ambulance,
31:04so hopefully she'll be OK.
31:05Yes.
31:22Are you sweet rather than savoury, then?
31:24If I have a tub of ice cream,
31:27there's no, like, scooping it out and putting it in a bowl.
31:31I just eat all of it.
31:32Do you know what really annoys me, though,
31:34about, say, if you've got ice cream
31:35and you get it out of the freezer
31:36and you've got to wait for it to defrost a bit
31:39and your spoon just bends because it's the ice...
31:40I put it in the microwave.
31:41You put it in the microwave.
31:43I microwave it for about 10, 15, 20 seconds, depending.
31:46There has been a few mishaps on a couple of occasions
31:49where it has been too soft.
31:53So then, do I eat it or do I put it back in the freezer
31:58to freeze it up a little bit more,
32:00but then am I going to be starting back at the same point
32:03where I'm going to have to put it in the microwave?
32:05This is too much for my head.
32:06It's a science. It's a science.
32:08I do like ice cream when it's all runny, though.
32:10I'll purposely mix it until it goes to my soup.
32:11I used to do that when I was little.
32:13As a kid, yeah.
32:13I don't want it sloppy now.
32:16I want it just nice.
32:26Category 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?
32:43Yeah, yeah.
32:46Diverticulitis is a condition in the bowel
32:48which can cause bleeding and discomfort
32:50and sometimes a lot of pain.
32:52We knew this lady had been bleeding
32:54and so it was quite important
32:56that we found out what was going on.
33:07Hello.
33:08What's been going on, sweetheart?
33:10I've been having bleeds.
33:11I've got diverticulitis.
33:13OK.
33:13I'm used to having...
33:14Yeah.
33:15...small bleeds.
33:17I had to do a run into the bathroom.
33:19Mm-hmm.
33:21I had a massive bleed.
33:23You can go look in the little upstairs.
33:25Right, OK.
33:2874-year-old Maddie has lived with chronic inflammation
33:31of the bowel for 30 years
33:33but tonight, after experiencing heavy bleeding,
33:37she called for help.
33:39Are you getting any pain?
33:41Yeah.
33:41Is the pain different to normal diverticulitis pain?
33:45Yeah.
33:46It's across a year.
33:47Let's do your blood pressure, Ducky.
33:50Right.
33:51So, would you say the amount of blood that you've lost
33:54and, like, tonight and that is...
33:57Over a lot of blood.
33:58Do you find it's getting worse?
34:00Oh, yeah.
34:01Yeah.
34:01With the amount of blood Maddie was losing,
34:04I was concerned, as things can get quite serious quite fast.
34:08Oh, right, OK.
34:10So it's definitely red pressure.
34:11Yeah.
34:12Yeah.
34:28Oh, goodness.
34:29Tired, Bob?
34:30I 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,
34:39it's not really like working together
34:40because we're quite good friends anyway.
34:42Yeah, yeah, definitely.
34:44If you have a laugh with someone,
34:45time goes so fast.
34:46Yeah, it does.
34:47And you bring loads of snacks,
34:49so that definitely helps.
34:49That's also very true.
34:50That's very true.
34:51Can't wait for a cup of tea in bed tomorrow morning.
35:00I'm being in service.
35:01Is the patient breathing?
35:03Yes.
35:03He's laying in his own throw-up.
35:05Is the patient conscious?
35:07No, he's not.
35:08He's laying there on the street.
35:10Is the breathing noisy or abnormal?
35:14It's abnormal.
35:15I've got to go outside.
35:16The guy's not going.
35:20We've got a cat one.
35:23So we have arrest-peri-arrest
35:26exposed to the elements
35:29five minutes away.
35:31When a patient's heart is highly unstable
35:34but is still beating,
35:35it's called peri-arrest.
35:37It's the stage before a full cardiac arrest.
35:42Onwards and upwards,
35:43let's go see.
35:45So it's unconscious,
35:47noisy breathing.
35:49Obviously, you've done route over.
35:51Yeah, unconscious, noisy breathing.
35:53So, I mean, Sunday morning,
35:57it'd be a good guess
35:58to say that he might have been out
35:59the night before.
36:00It was at the good night.
36:00It was at the good night before.
36:03Hello.
36:05What's happened?
36:06Just found.
36:09He's breathing.
36:11Oh, yeah, yeah.
36:12I can detect my injuries.
36:13He's laying there,
36:13so I'll throw up, so...
36:14Hiya, mate.
36:15Can you wake up for us?
36:18Can you wake up?
36:19Definitely had a good night.
36:22We'll get the stretcher
36:23and get him on the ambulance.
36:24Good night.
36:27A doorman called 999
36:29after finding the man
36:30lying unconscious
36:31on the pavement.
36:32When we arrived on scene,
36:34we came across
36:35a man covered in vomit.
36:37We both took a good guess
36:38that he'd been on a night out
36:39the night before
36:40and he was just
36:41taking a sleep
36:42on the side of the road.
36:43Right, mate.
36:45It's time to get
36:46on this stretcher.
36:48Let's set you up.
36:50You've definitely
36:51had a good night.
36:54Shall we get your legs round?
36:58You able to pull him up
36:59from that way?
37:00Yes, mate.
37:01Oh, he's wet himself as well.
37:02Yeah.
37:04Hello.
37:05All right?
37:06Good for you.
37:07Good.
37:08Should I get you
37:08to stand at work?
37:08We've got to get you
37:09on this stretcher.
37:13It's out there again.
37:15Oh, no, we are worried
37:16about you with the ambulance.
37:19You're in the street.
37:20You've been sick.
37:22OK.
37:23When he sat up
37:25and came round a bit,
37:26it was very difficult
37:27to talk to him.
37:28He didn't want to speak to us
37:29and we very quickly
37:30got that vibe,
37:31but also there was a part of us
37:32that wanted to make sure
37:33he was OK.
37:35You can't stay here, though.
37:36You're going to have someone
37:36else phone an ambulance for you.
37:38No, I'm not.
37:39You're not?
37:40There's no ambulance for me.
37:40I should have gone mad, you know.
37:42What's that?
37:44Yeah, someone's found an ambulance
37:45for you.
37:46I don't know, mate.
37:47Why?
37:47Why not?
37:49Because you're not waking up.
37:50You're sleeping on the street.
37:51I do want one, man.
37:53OK.
37:54Where's home?
37:56You tell me.
37:57I don't know.
37:58Do you have a house?
37:59Fuck off.
38:00Don't ask me where I'm at home.
38:01I ain't got fucking no home.
38:04When he was coming round
38:05and he was talking to us,
38:07he was very defensive
38:09and aggressive
38:11in his answers.
38:12And at these moments,
38:13you just sigh and just think,
38:15what can I do?
38:16Is there any other way
38:17we can help you?
38:25Let me just do your blood sugar, sweetheart.
38:300.4.
38:32In Stoke,
38:33paramedics Nick and Kyra
38:34are with Maddie.
38:35She has diverticulitis,
38:38a condition that causes
38:39severe inflammation of the bowel.
38:42Do you take any pain relief for it?
38:44Does anything work?
38:45No, I don't bother.
38:47Yeah, I know.
38:48I think it's got to do
38:50with the...
38:51Down reticulitis.
38:52There's not a lot I can do.
38:54No, that's the problem with that.
38:56Your arms are OK.
39:00But someone like yourself
39:01that has got this ongoing issue,
39:06for you to be worried
39:07and be ringing people,
39:09that's a concern in itself.
39:12Because something's not normal for you.
39:15I think we need more
39:17more thorough tests done.
39:19Right.
39:19More than what I can do
39:20with this thing.
39:21So that's giving me,
39:23like, yeah, let's take you.
39:24The reason we wanted
39:26to take Maddie to hospital
39:27is due to our concern
39:28about the amount of blood
39:30she was losing,
39:31where she was losing it from.
39:33Therefore, we had to find out
39:35what was going on
39:36so we could get her treated.
39:37I don't want that.
39:38I was folding this up.
39:40Oh, God.
39:41To bring one of your
39:41nice patched ones.
39:42Can I have a look at it?
39:43Yeah, well, she can't
39:44just rip it open.
39:47While Maddie gets ready
39:48to go to hospital,
39:49Nick and Kyra
39:51admire her homemade quilt.
39:53That would look lovely
39:54in my bedroom, that would.
39:55Oh.
39:56I'd put an order in.
39:57Look how perfect it is.
39:59I've got loads of UFOs.
40:02UFOs?
40:03UFOs?
40:03Unfinished objects.
40:05Oh.
40:07Don't get her started
40:08on space and stuff.
40:09She loves it.
40:10I'm obsessed.
40:12Handmade quilts
40:13with UFOs on.
40:14The thought of having one
40:16would be absolutely amazing.
40:18It would take pride
40:19of place on my bed.
40:20I would love it.
40:24Ready when you are,
40:25thank you.
40:28I always say
40:29the human body,
40:31it's a marvellous thing,
40:33but it can really go wrong
40:34in some dramatic ways.
40:36People,
40:37unless they've got
40:38something like this,
40:38they don't understand
40:39at all how debilitating
40:41this is.
40:51At Royal Stoke University
40:53Hospital,
40:54medical staff
40:55will try to find out
40:56why Maddie's blood loss
40:58has been so heavy tonight.
41:04Is there any other way
41:05we can help you
41:06as an ambulance?
41:07Oh, is there any other way
41:08we can take you?
41:10In Birmingham city centre,
41:13paramedic Sian
41:14and technician Brogan
41:15are with a man
41:16who was found
41:16lying unconscious
41:17in the street.
41:19Have you been drinking alcohol?
41:21Yes.
41:21Yeah.
41:24I'm done with this
41:25swearing and abuse now.
41:27Let's go.
41:28I guess that's it then, mate.
41:31Yeah, that's it.
41:33Trying to get you some help?
41:36Well, we've been trying,
41:38but you're not being very nice,
41:39so...
41:41Well, okay.
41:43We decided to leave him there
41:45because,
41:46despite offering him
41:47help multiple times
41:48and him initially rejecting it,
41:51we can't force him
41:52to accept the help
41:53that we offer.
42:01No, you were breathing,
42:02but you're unconscious
42:03on the floor.
42:04You're hard to wake up.
42:05That's why we were called
42:06and we're worried about you,
42:08but you're not being
42:09all that nice.
42:10Make sure you don't fall over.
42:12Because I've been drinking, bro.
42:13Yeah, yeah, I get it.
42:14You're going to help me, bro.
42:16You just said no.
42:17You're going to help me, bro.
42:18Well, what do you want help with?
42:19You just told us to go away
42:20and leave you alone.
42:21Do you want us to make sure
42:22you're okay?
42:23If I was sat there,
42:24yeah, we're sick, yeah?
42:25What are you meant to do?
42:26Look, I'm not having an argument.
42:28Do you want your checks done?
42:30I was really frustrated
42:31with this man
42:31because anything I was offering
42:33or Brogan was offering,
42:35it just wasn't good enough.
42:36He just wanted an argument
42:38or a fight
42:39or something similar to that
42:40and you just can't help them people.
42:42Do you want your checks done?
42:43No, listen.
42:44Two minutes, bro.
42:45No, honestly,
42:45I don't have time for this.
42:47Do you want...
42:48Do you want to be real?
42:48Do you want your checks done or not?
42:50All right, am I in a mental state for you?
42:51Do you want your checks done?
42:52It doesn't matter, bro.
42:54Don't fucking start shouting at me, bro.
42:56What are you going to do?
42:57Let me walk away.
42:58Yeah, if you want.
42:59You're more than welcome to.
43:00Don't wait for me.
43:01Don't wait for me.
43:02Bro, go that way.
43:03I'll touch you, man.
43:04Bro, what are you going to do, bro?
43:06My concern when he stood up
43:08and he started shouting
43:09and getting aggressive
43:11was that he was getting close to the ambulance
43:13and he could have assaulted me
43:15and I think it would have turned worse
43:17if we'd have stayed there.
43:18So I think it was a good decision
43:19for us to leave at that point.
43:21I think we should just go.
43:22Yeah, let's just...
43:23Yeah, let's go.
43:29No, step away.
43:31Please step away.
43:32Please step away.
43:37Having to deal with aggressive patients like this
43:40is not uncommon.
43:42At West Midlands Ambulance Service,
43:44nine incidents of physical or verbal abuse
43:47are carried out against the staff every single day.
43:50Well, that was a bit scary, wasn't it?
43:54Escalated quite quickly, that job.
43:56Yeah.
43:57It was really threatening.
43:58It was quite scary.
43:59And as far as I'm concerned,
44:00when he says,
44:02can you really leave me in this state?
44:04Yes, I can.
44:04I mean, you're not in much of a state
44:06when you're able to stand up
44:07and verbally abuse us.
44:10Yeah.
44:10I mean, sometimes we get sent to people
44:13that don't want our help
44:15and are vile to us
44:16and then there's some people out there
44:17who just can't get our help
44:19and they're in a waiting...
44:20They're in a queue for 999
44:22and they're waiting for jobs
44:23where we're wasting our time
44:25with people who would just verbally assault us.
44:33Ron, who fell and was in agony,
44:35hadn't broken his hip.
44:37X-rays showed a plate in his hip had come loose.
44:40He spent four hours in surgery,
44:42having it screwed back in place.
44:47Rosalie, who was having a heart attack,
44:49was admitted to the cardiology ward.
44:52Here she received treatment
44:54for blocked coronary arteries.
44:58Robert, whose nose was bleeding heavily,
45:01spent six hours in hospital.
45:03The bleeding was stopped
45:04and he was prescribed a nasal cream
45:06to treat any possible infection.
45:09And Maddie, who had rectal bleeding,
45:12spent three days in hospital.
45:14She may require surgery
45:16to repair her intestines.
45:18We went straight through
45:20to see a consultant
45:22who was brilliant.
45:24So hopefully,
45:26he's going to have some answers for me
45:28to help me
45:30get my life back.
45:35Next time...
45:36Yeah, you're really wheezy, 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
45:45day to day.
45:46When you're unwell,
45:48it 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
45:58whilst we were with her.
46:00This can't keep happening.
46:01It's dangerous.
46:02What have you done?
46:03And a patient falls,
46:05badly cutting her head.
46:07When I looked at her injury,
46:09I could see that it was down to her skull.
46:11It needed some serious stitching.
46:13MUSIC PLAYS
46:13MUSIC FADES
46:16MUSIC FADES
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