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00:02in the heart of Yorkshire a team like no other busy busy busy fight to save lives
00:12open your eyes for me do you know where you are you're in bands like any department
00:1924 hours a day wow seven days a week whoa nearly feel like a wet dish club
00:29serving their community looks like you have broken it
00:35i don't think i'm going to love you dreaming of your gin and tonic helping those most in need
00:43love you i'm dry there's nothing to be frightened of these girls will sort it out they care for
00:50anyone i think i've used your hair up haven't i and everyone looking more like himself thanks to
00:55barnesley working together to make people's lives better you know i just love to look i love to make
01:05a difference this is barnesley casualty 24 7. i should not be entering the beauty contest
01:15on shift tonight advanced clinical practitioner chantelle it could be that you fractured her hair
01:22oh dr heather souden do you like type food enough to break your ankle and your foot flop
01:30and sister vicky barbara's gone to ward
01:36so get ready to share a shift i love my job today i think it's amazing with the team at
01:43barnesley casualty
01:49the early shift has begun hey need your sister can help today sister vicky is running the hub
01:58so what do we know no i know it's my last long day is it but there's a problem
02:08i don't think messages are feeding through to epma now operational support manager antonia has become
02:15aware of a disruption to the hospital network the tracking system's down the internet's down
02:22i'm just trying to get older id for an update as well because it's affected quite a lot of things
02:33but before the team can work out the scale of their connection problems the first ambulance arrives
02:42jeannie has been brought into casualty for the second time this week
02:47paramedic andy hands over her care to advanced clinical practitioner chantelle
02:52jeannie had a full attended bars of district a and e on sunday night gp then referred patient to
03:01a crisis response team found to be abnormal at that time physio rang 999 immediately and still on
03:10scene when we arrived she does have a pacemaker there you go everything straight like i say has become
03:18quite irregular okay and we'll leave jean in your care thank you thank you okay love bye you all right
03:27jean i'm chantelle i'm coming to see you genius son stephen and daughter-in-law carol are with her
03:37right jim you're 92 year old yeah you don't look it thank you so tell me in your own words
03:43what
03:43happened on the third when you fell i've had a little read i was just walking through the kitchen
03:49and i just fell i think i tripped and how did you go down on the floor forward this whole
03:57face straight
03:57on the floor yeah since you've fallen and hit your face have you felt sick not like nauseous vomited
04:05no not been coughing any blood off no good and are you taking your painkillers yes are you taking
04:12them yeah oh yeah everyone always says yes and they never do so i always check
04:18and you're worried about anything because you know your own body apart from your face
04:34you've broken your ribs yes take a big breath in and it hurts why is the pain
04:43across the chest across the top okay
04:50breathing difficulties like genie's can cause serious illness when it comes to chest injuries
04:56but there's not much we do unless it's a big trauma yeah the problems with a chest injury is if
05:03frailty is not on your side when you get older but then if you're not taking good breaths
05:07and being able to cough and clear you're just going to be at risk of getting a pneumonia so we
05:10have to try
05:10and keep you moving breathing coughing comfortable because when you shallow breathe you get infections
05:19down there okay if you can't breathe properly you're higher risk of getting a chest infection or a
05:24pneumonia especially in the older population because they don't move around as much so that's my priority
05:29with genie
05:34elsewhere in the hospital an alarm has been triggered
05:38so the doctors are very much the correct
05:40from radiology where he collapsed during a ct scan
05:46to recess
05:53oh it really hard to have a cannula put in
05:59apparently i'm difficult to cannulate
06:02and my head was really felt like it was getting really hot
06:07At the worst it's been, all of a sudden it was like a big heavy circus, right?
06:12There's a paper around me and swapping me on to the bed and putting me on the oxygen mask and
06:19so on.
06:21And they bust me down here, I don't know.
06:24I think I'm in positivity, I believe, I'm not sure.
06:28Oh, God.
06:31The CT scan was to check how Graham's body has responded to treatment for cancer.
06:37I got a little bit of cancer on the oncologist.
06:46I think the last time of chemo was about June time.
06:53And then he's going to decide whether they need to go back on chemo or just monitor it for a
07:01while.
07:02Trainee advanced clinical practitioner Jess...
07:05How are you feeling?
07:06..is looking after Graham.
07:09So what I'm going to do, if it's OK with you, is I'm going to just try and take some
07:12blood from that cannula.
07:14Oh, from the cannula?
07:15Yeah, I'm going to see if I can manage it. I know you've had contrast to it.
07:18It's not the greatest, but with how anxious you've been, I'm going to see if we can just get a
07:21little bit off that, all right?
07:23Primarily, I want to check that your calcium's OK, all right?
07:27So when you've got a cancer diagnosis, background of cancer, we like to check your calcium, because if you're feeling
07:33a bit off it and we're not entirely sure why, that can sort of answer a lot of questions, all
07:37right?
07:38Sometimes you can have low calcium or high calcium, and in a cancer patient, that needs to be treated as
07:43a medical emergency, so that would mean that he's brought in for treatment and an infusion to reduce that or
07:49to bring his calcium levels up.
07:50So we like to say that if you've got bones, moans and groans, so if you've got bone pain or
07:55you've just got general aches and pains, that can sometimes be attributed to calcium levels that aren't normal.
08:03If Graeme's calcium levels have become too high, he will need immediate treatment.
08:09Oh.
08:20In the hub, Sister Vicky is just half an hour into her shift.
08:25I can't.
08:26It's just messaging that's not coming in an outlet system.
08:29I'm not going to be able to act that.
08:30So you're telling me I have to do this for a patient?
08:32I'm just going to say, I'm going to report it.
08:34So today we haven't got the tools that we generally have, and our patient tracking system is down, so we
08:39can't see the plotting of the patient's arrivals.
08:42It's going to be one of them, do you?
08:43Yes.
08:44So currently we're having a few issues, because I do believe all the internet's down throughout the hospital,
08:49and it's national as well as what I've found out, so we're having to do it manually and verbally between
08:55members of staff.
08:56So on top of one problem and then another issue arises.
09:02But if the server problems were not enough, casualty is now quickly filling up with patients.
09:09What was your cubicle for? Barbara?
09:11I put a pretty nice.
09:14Barbara's gone to what?
09:15Yes, you've gone.
09:16Right, it's just so I can tick her off this list.
09:18So currently we've got 25 patients in the department, so then it gets a little bit empty when I need
09:24to have staff moving and things.
09:30Right, close your eyes for me.
09:32Can you feel me touching you?
09:33Yeah.
09:3492-year-old Jeannie has fallen at home.
09:37Advanced clinical practitioner Chantel is assessing her injuries.
09:41Good stuff.
09:42And pop your arms out.
09:43Jeannie's son, Stephen, and daughter-in-law, Carol, are by her side.
09:47Can I have a look at your lip?
09:49Oh, it's healing nicely, that.
09:50Yeah.
09:51You heal well.
09:53Yeah.
09:54Okay, can I pop your glasses off?
09:56I'm just going to have just a little look.
09:58Look straight forward.
10:00So it's important to do another thorough history on Jeannie.
10:03She might have injured something else that we didn't initially pick up on.
10:05That can be quite common.
10:06So I did a really thorough workup, a good examination of it, just to make sure that there's nothing else
10:12underlying anything broken that we've missed the first time.
10:16Can you just follow my pen torch?
10:18It can make you feel a bit dizzy sometimes, this.
10:21Down there.
10:22Okay.
10:23Can you move your eyebrows?
10:25Close your eyes really tight.
10:26Nice and tight.
10:27Okay, open your eyes.
10:28Can you puff them cheeks out?
10:32And smile for me.
10:34Can you bite down?
10:35And can you bite your teeth together?
10:37Good stuff.
10:38Okay.
10:40He's laughing at you.
10:41No, we're just saying.
10:42It's our wedding anniversary today.
10:44It's your wedding anniversary.
10:46It's just what we know, I'll forget.
10:48I've described my bedside manner as quite lighthearted.
10:52I'm really sorry, Gina, but you didn't tell me it was a wedding anniversary.
10:56I like to just be myself.
10:59Patients coming to A&E can be quite scary, especially if you're older.
11:03There's a bit of a notion where we like to keep patients in and that can be quite worrying for
11:07them.
11:10They've put me off now, Jeannie.
11:12Some people get scared thinking they're not going to end up going home.
11:16If they're coming to hospital and they're scared of dying in hospital.
11:19So I try and keep it as lighthearted as possible and reassure them that my job is to try and
11:24get them back home.
11:25Can I have a listen to your lungs?
11:27Yes.
11:28Let me feel your pacemaker.
11:30Is it there?
11:30Yes.
11:31How long has this pacemaker been in for?
11:34Two years.
11:37She had it checked on in May.
11:39Did she?
11:40Yeah.
11:40Here.
11:41It will help me.
11:43Sorry.
11:44Is this painful?
11:45Yes.
11:48Is it painful around there?
11:49Yeah.
11:50I find it difficult seeing anybody in pain, but seeing older patients in pain can be quite upsetting.
11:56It's hard to try and find out if they're in pain because a lot of older patients are quite stoical,
12:01especially from Barnsley as well.
12:03They don't want to admit any weakness.
12:05Sorry.
12:07Is that where it's really painful?
12:08Yes.
12:12I'm here.
12:15Oh!
12:17It could be that you've fractured a rib.
12:19Oh!
12:21Okay.
12:23Right, let's have a listen down there.
12:26Big breath in.
12:28I know.
12:30Can you sit forward for me?
12:37Are you all right?
12:38Yeah.
12:38Are you sure?
12:39Yeah.
12:43Just have a good look at your back.
12:45My job is to try and figure out where the pain is, to try and encourage them to be honest
12:50about the pain,
12:51because it helps me diagnose pain.
12:53And if it were my own grandparents, that would really upset me.
13:03You're quite crackly down there at the bottom, so I might send you for an x-ray just to make
13:07sure
13:07there's no fluid or anything.
13:09Right.
13:09Okay.
13:10Yes.
13:10You have got a rib that's extremely tender, so it might be that you've cracked that rib.
13:14Yeah.
13:21Chest x-ray, I'll have a chat with the pacemaker team, and then we'll go from there.
13:26Is that okay?
13:42It's been an interesting IT day today so far.
13:46In the hub, sister Vicky and the team have called an emergency meeting to address the global internet outage.
13:53If you require any porters for any movements for x-ray CTs, just come to the coordinator.
13:59We've been writing them down and allocating porters when we see them.
14:03We've only got two female AMU beds.
14:06Male's full.
14:09Medicine's full with five definites and 13 potentials.
14:11Surgery only had one bed.
14:13Ortho were full.
14:14Guiry tool beds.
14:19In recess, advanced clinical practitioner Jess is trying to find out what caused cancer patient Graham to collapse.
14:29Once we've done this, we're going to give you some fluids, just because your blood pressure's a little bit low.
14:33All right.
14:35The blood pressure's always been a bit low.
14:37It's a little bit too low, this one.
14:40It's a bit surprising considering my weight.
14:42Well, that's what I'm thinking.
14:43You're quite a large chap.
14:46So, a blood pressure like that is fairly low.
14:52Advanced clinical practitioner Jess takes some bloods.
14:56There'll be a little bit of me shimmy in this about, all right, so just bear with me.
15:00I know you're not a fan of it.
15:02Graham has a fear of medical procedures.
15:06Oh, bless you.
15:07We were getting so worked up, weren't you?
15:10I don't think that helped today, has it?
15:12You're getting so stressed about this.
15:15You're obviously feeling generous today.
15:18You're giving me plenty of the good stuff.
15:22You know what, sweetheart?
15:23All done.
15:24Less stress, I hope.
15:25I'm going to pop this side up and then I don't lose you.
15:27You're off this side at bed.
15:29I'll be back with you shortly.
15:30Okay, Molly.
15:31There you go.
15:35I'm basically just giving him a bit of an MOT.
15:37See if we can figure out if it is just a basic, what we call, phase vagal.
15:41So, just a passing out episode that is experienced today.
15:44He said he was quite anxious before having it done because he knows it's quite tricky to get blood from.
15:50So, I think that might have played a part.
15:53So, we just want to make sure that all the scaries are ruled out, which is essentially our job in
15:56Aene.
15:57Graham must now wait for the results of his blood tests.
16:01I think there's a vampire farm somewhere around here.
16:04He's a man to my blood there, probably.
16:12With no intranet in the hub, Sister Vicky is having to go old school.
16:18We're having to revert back to the old ways as contacted site matrix for beds and obviously escalated to different
16:24wards.
16:25As portals, we've got no log for as portals anymore.
16:28So, I'm going to have to do it written, handwritten and obviously as well as doctors if needed.
16:35I love my job today. I think it's amazing.
16:37Today, we had to revert back to pieces of paper, which is really old school.
16:41And then just give those to the person and then do the portering jobs.
16:46So, what are we doing for extra reason?
16:47You're telling me and I'm writing them down and they're coming and ticking them off.
16:52But while the network has slowed to a halt, the patients have not.
16:58Everybody's slipping down and breaking bones.
17:01Lots of plasters, lots of manipulations.
17:04Busy, busy, busy.
17:0836-year-old Louise has slipped over and fractured her ankle.
17:13Should have been going out for a meal for Thai food with my mum.
17:18And I don't really want to go.
17:22And I started walking down the street, around the corner, slipped, bang.
17:27And I knew, I just knew that I'd done something.
17:32It's quite a nasty ankle.
17:36Louise has had an x-ray, so emergency nurse practitioner Claire can now prepare her for the next steps.
17:44I'm going to take it into resource.
17:46Yeah.
17:46OK.
17:46We need to get that into a cast.
17:48Yes.
17:48With that medication and pain relief.
17:51Yeah.
17:52And then once we've done that, then we'll get orthopedics to see you.
17:56Right.
17:56OK.
17:57Yeah.
17:57Welcome.
17:58Dr. Heather Soudan is called to come and assess Louise.
18:03There's a patient that's just moved into resource that's got a fractured edification ankle.
18:07Ooh.
18:08It's a bit complicated because it's second metatarsal.
18:10Yeah.
18:10It's fractured edification.
18:11So you don't fall with a horse?
18:13No.
18:13No, we can't, actually.
18:15No.
18:18I've seen older people who fall on one side and maybe break a hip and maybe break a shoulder or
18:25a forearm.
18:25But I've not seen a young person do two places on the same leg.
18:34It's really hard, though.
18:35Slipping is something you just can't protect yourself for.
18:38It's not the forces are.
18:39The joints are used to.
18:43It looks sore on the x-ray.
18:46Fine.
18:47I'm going to go have another nosey at them.
18:49So, ideally, there'll be someone popping you off to sleep.
18:52There'll be someone putting your ankle back in place.
18:55And then there'll be someone doing the potting.
18:57So I need two more friends.
18:58Do you mind your favourite look at the x-ray?
18:59Yeah, of course you can.
19:04So, that's the bone that everything's sitting on.
19:07Yeah.
19:07This one, your shin bone's pushed forward, so we need to push that back a bit.
19:10Okay.
19:11Because that's your ankle joint.
19:12So it needs to be equal space all around.
19:15So we're doing a squeeze and a push back.
19:17And hopefully, it'll go clunk.
19:18Okay.
19:20Your mum's got a lot to count for today, inviting you out for food.
19:23Do you know what food it were, though?
19:25Fish and chips.
19:25Thai.
19:27Thai food.
19:28Do you like Thai food?
19:29Enough to break your ankle and your foot foot.
19:32No.
19:33Louisa's leg needs correcting quickly to restore her blood flow
19:37and reduce the risk of permanent injury.
19:44The internet may be down, but the ambulances don't stop arriving.
19:50Paramedics Mark and Shay have picked up a Barnsley resident
19:53who has had a bad fall.
19:58You're a cutie.
20:00Let's lift this out.
20:01Have a moment.
20:02Let's relax that arm, Bonnie.
20:06Put this on your finger.
20:07Let's get some numbers on you.
20:09Illustrate it here.
20:10I'm sure you'll shine the light in your eyes, if that's okay.
20:14Lovely.
20:15Give me a good smile.
20:16Show me to you.
20:17Please, stick your tongue out.
20:19Lovely.
20:19And thank you.
20:21Can you sign this before my bachelor decides to call it a day?
20:25June was in a chair and has fallen forward.
20:28Unfortunately, she's hit the table, haven't you, June?
20:31Must have.
20:32You must have, because you've broken the leg on the table, haven't you?
20:35Eh?
20:35I broke my leg.
20:37Not your leg, the table leg.
20:41June's injury is unfortunate.
20:42She's got a very large skin tear across her, top of her chest here.
20:48Possibly cut underneath her chin, one to her elbow, and extensive bruising to her face.
20:55Just fill them down.
20:58I'm not busy.
21:00I'm not like my head is full.
21:04June goes for a CT scan to check what internal damage has been caused by her fall.
21:11The scan will find any bone fractures, internal bleeding, or organ damage.
21:30The team in casualty are halfway through a difficult shift.
21:34So, all systems have gone down.
21:36Oh, OK.
21:38And I mean every single one of them.
21:39A global internet outage means that Sister Vicky has no digital record of where any of
21:46her patients are.
21:47So, the system's still down.
21:49The porting system's still down.
21:50The tracking system's still down.
21:52So, we're able to still do everything on paper.
21:56I can't see any systems getting fixed any time soon, because obviously it started last night
22:01and there's still nothing being solved.
22:03So, you're going to go for your dinner, aren't you?
22:05No.
22:05Yes, please.
22:06If the internet problems were not enough, casualty has a higher number of patients than usual.
22:12So, the team are having to pull together.
22:15Jack of all trades.
22:17Master of none.
22:21In recess, advanced clinical practitioner Jess has an update for Graham after his collapse.
22:27So, I mentioned earlier, didn't I, that it looks like the nodule that they've noted on
22:31your left side of your lung has got bigger.
22:34Oh, right.
22:35I didn't know about that.
22:37Yeah, so, that's the report of your scan today, so they've been pretty speedy.
22:41I suspect your little funny-do around there has probably sped things up a little bit,
22:46getting a report done.
22:47Um, it may be that this is what's causing the change of breathing.
22:52All right.
22:52So, like I said, just waiting for them bloods to come back.
22:55Make sure there's no added infection on top of everything else that you've got going on.
22:59Graham was diagnosed with cancer four years ago.
23:03I started off in my bowel, and that was all successfully removed in 21.
23:10And they monitor you for five years.
23:13And they find it in my lungs.
23:18I'm just seeing more of the hospital than I would like.
23:22But it's just what comes with old age, I suppose.
23:28Considering what's gone off today, I want to play it safe and bring you in for tonight,
23:32at least, for a medical team to review you.
23:34I'd love to say that I want to be really brave and get you home.
23:37But I think because you've got so many things going off, I think it's the ample opportunity to just touch
23:43base with you.
23:44And they'll be able to touch base with the CHESS team as well about your results of your scan.
23:47Okay.
23:48So it may be a quick turnaround, and they may say, I don't know why Amy's kept you in,
23:53but I'd rather do all that and be safe than send you home.
23:55So I'd like to be in tonight.
24:00We've got such a brilliant health service here, and they don't let you go if they've got a few queries
24:07about you.
24:10The doctors found that a blood clot was reducing Graham's oxygen levels.
24:14His battle with cancer is still ongoing.
24:20In cubicle three, June is back from radiology, where a scan revealed no internal injuries from her form.
24:27Sister Benita will now treat her skin wounds.
24:30Oh, chicken.
24:32I'm Benita.
24:34I'm one of the nurses.
24:36What's some stuff?
24:37So we can give you a bit of a clean-up.
24:39All right.
24:43Yeah, it's a bit of warm water.
24:45All right.
24:46I'm sorry.
24:47I'm sorry.
24:49Can I give you a bit of a cup?
24:50I'm not.
24:51June has a skin tear across the top of her chest.
24:56All done.
24:56There you go.
24:58There you go.
24:58There you go.
24:59All done.
25:01Yeah.
25:02Because she's sustained multiple wounds and her skin's so fragile.
25:06I wouldn't say it's life-threatening or anything like that, but it'll just prolong her stay.
25:11And she's so thin and not got much meat on her bone, she's going to need managing in terms of
25:18making sure that she gets back on her feet properly.
25:21Right, the plan for this is to give it a bit of pain and the reason it hurts is because
25:30underneath you skipped it is exposed and that's why it's making it sore.
25:36So if I can clean it as quick as I can, try and see if it's coming back, then her's
25:42at the heel, not first.
25:44Can I just have a little look and see if you've got some on your legs as well?
25:50She's full of fluid downwards and she looks like she's got some little areas that are being dressed in the
26:04community.
26:04But because of circulation is so poor, it just starts to cause a lot of other problems.
26:11Sister Bernita brings June some painkillers.
26:15Are you okay swallowing these, them like that?
26:19I'm very good.
26:20I don't know.
26:21You tend to find that fairly stoic Barnsley folk, they don't come forward quick enough in terms of painkillers.
26:31And it'll be so painful when they're exposed to air, it's...
26:37Have you lived in Barnsley all your life?
26:39More or less.
26:41More or less.
26:42What did you do work-wise?
26:45Did you work?
26:46And what did it sell?
26:50Pork pies.
26:51Pork pies.
26:52People in Barnsley like pork pies though, don't they?
26:57It's actually really nice to have those conversations about her life and what she's done.
27:03And I always find in older people, they've been through so much and you learn such a lot from them.
27:09Did you have children?
27:11Yeah.
27:12How many children did you have?
27:15Two.
27:16Two boys.
27:17Two boys.
27:19My two eldest, they're 16 and 30.
27:24Well, he's just turned 17 actually.
27:25It was his birthday over the weekend.
27:27And they're at a point now where they're actually beginning to get on with each other.
27:36Sister Benita starts to treat June's wounds.
27:40Right.
27:40Are you ready?
27:44Here.
27:45Hold me.
27:52I'm sorry, I know.
28:00Right.
28:01I'm going to leave that for 20 seconds.
28:03I'm just going to go and get some tweezers.
28:08In the hub, there's no sign of things slowing down.
28:12What are them two waiting for?
28:14Them two aren't waiting for that.
28:15Yes, we'll bring you a good day.
28:16A bit to say, right.
28:18So, um...
28:19I'm just ringing for a little bit of advice about a patient's pacemaker.
28:25I'm plodding on through here.
28:26I'm not entirely sure what's happening with the system yet.
28:30That's for an update, so...
28:32I am not giving up my holidays.
28:35On you off, too?
28:37Next, on Saturday.
28:39Saturday.
28:40Have you lost any of your weight?
28:42Have I yet?
28:44I've even started calorie counting now on an NHS app, but it just...
28:49It says it can't do much for me because my BMI is perfect.
28:53My hips don't say that it's perfect.
28:55Yeah.
28:59Jeannie is having an X-ray to see what internal injuries she's sustained in her form.
29:06Lovely.
29:07Breathe away.
29:08Super.
29:09That's it.
29:10We're all very soon.
29:13Right.
29:14You've had an ECG before, I'm guessing.
29:16Yes.
29:17Yes.
29:17So, I'm going to have a walk across to cardiology and let them have a look at this ECG and
29:26see
29:26if they're happy with it.
29:27I don't have my grandparents anymore, but I've seen my grandparents in pain, so I empathise
29:32a lot with older patients that I see in the hospital.
29:34I do think they're very proud of me, and, um...
29:39Oh, gosh.
29:40I know my grand...
29:41I can't...
29:41I can't...
29:43After this, I'm going to get the nurses to do a blood pressure while you're laying down
29:47and standing up, and I'll check your X-ray, and then if everything's okay and you've
29:52passed the tests, you can go home.
29:56I know she's really proud of me, and I know my family are proud of me.
30:04And I do know I'm good at my job, so...
30:07Anyway, you've got me crying.
30:11Ready for the finale?
30:14So, this is your X-ray.
30:16Have you seen your pacemaking like this before?
30:19No.
30:19No?
30:20OK.
30:20So it's absolutely fine, and you'll be good to know that I can't see any rib fractures
30:24either.
30:24I think you've just injured and got a bit of bruising around your muscles of your chest
30:29wall, and it's a bit bruised.
30:31Yeah.
30:32OK?
30:32Your blood pressure's OK as well, so I'm happy for you to go after your painkillers.
30:36Right.
30:37Who's taking you home?
30:38Me!
30:40You've got a little chariot.
30:42After one week's rest, Jeannie's breathing pain completely went away.
30:49Get him out.
30:50Doze your toes.
30:52Now, there's a new arrival in paediatrics.
30:55I've got everyone messaging, checking you're all right.
30:58Eight-year-old Henry, with mum, Stephanie.
31:03I got a phone call at one o'clock from school, and he's fallen at height on the playground.
31:09I was playing on a climbing plane, I was kind of low to the floor, and then someone jumped
31:17on, I fell, smashed, and then I was, like, bleeding like this, and then there was one
31:27on the wall.
31:29He's smashed basically three front teeth, so he's broke his two adult teeth and the one
31:35next to it, blood pouring everywhere.
31:37He's all swollen, and he got a deep cut to his lip.
31:41He was a bit hysterical, just really, really upset.
31:44He thought he was going to be mad because he's knocked his teeth out, bless him.
31:49Nurse Ella will be assessing Henry's injuries.
31:53He hit the actual wood, the big log part of the side.
31:57Yeah, it came down head first.
32:00How long ago was this?
32:02I got phone call at about one o'clock.
32:06Do you have any medicine or anything since?
32:07No.
32:08No.
32:08He's just complained to you, obviously.
32:10He's having a bit of a headache, hasn't he?
32:12But then he's just, he's just, like, off the teeth.
32:15Fine.
32:15No vomiting or anything since?
32:17No, no.
32:17No, fine.
32:19Can we pop this on your thumb?
32:21Is that okay?
32:21It's just a sticker, so it's going to show us your heart rate and your oxygen levels.
32:25Is that okay?
32:25Okay, if my heart is not beating, and I'm still...
32:30Well, I think, as soon as you're chatting to us, I think it will be.
32:34Yeah?
32:35Mr. Dramatic Heart, yeah.
32:37Is that my heartbeat?
32:38So, this one is your heart rate and this one's your oxygen levels.
32:43Oh!
32:43But it's not quite picking you up properly yet.
32:46Do you see this all, it's all wiggly.
32:49So, we need this finger to stay...
32:51Yeah.
32:52Does that mean almost dead?
32:54No, no, quite.
32:56Sometimes, if you get a bit excited or a bit scared, your heart rate jumps up and down.
32:59So, keep that finger nice and still for us, and then we'll get some real numbers, yeah?
33:03Yeah.
33:04Can we do your temperature while we wait?
33:06Which here would you like?
33:08This one?
33:09Which one?
33:12Sorry.
33:12Sorry.
33:13Perfect.
33:16Ready?
33:17We're all done.
33:19So, I'm going to pop your waiting room now for now, Mum, we'll get it when we're not just travelling.
33:23Is that OK?
33:24Yeah, that's fine.
33:25Thank you very much.
33:26Come on, then.
33:29Henry will need to wait to find out if he's broken his jaw.
33:32We've got all your numbers, yeah?
33:33Now we've got to go wait for a doctor.
33:35Go back in that waiting room.
33:39There, the teeth.
33:41I think it might have to have a cap by the dentist.
33:44They might have to cap, cap and both, unless they can glue.
33:54In recess, factory worker Louise has badly broken her ankle.
33:59I'm just pinching your potting trolley, Claire.
34:02All right, Nick.
34:03Dr. Sowden is joined by a team who will work together to move Louise's leg back into position.
34:10We've got everything ready.
34:12We're good to go.
34:14First, Louise is sedated with an anaesthetic.
34:17Just see how she responds to you, playing around with her ankle.
34:21You're holding the whole leg or no?
34:22Yeah, I've got it.
34:23Louise has broken and dislocated her ankle, so this is not a simple procedure.
34:29For some joint dislocations, you also need the muscles to relax to be able to effectively get the joint back
34:37in.
34:40The drugs we need to give to relax can also affect your ability to breathe safely.
34:46So we do a surgical sedation, whereby we try and get enough drugs into the person that they are still
34:53breathing for themselves.
34:55Their heart rate, their blood pressure is stable.
34:57But, yeah, in their head, they haven't got a clue what they were doing to them, and they shouldn't be
35:02feeling any pain.
35:03You're holding?
35:04Mm-hmm.
35:08I don't know if this is the idiot.
35:13Louise's ankle is manipulated back into position and placed in a cast.
35:24Thank you so much for coming and giving us a hand.
35:41Louise now needs another X-ray to see if her ankle is back in the correct position, and if not,
35:47she will need emergency surgery.
36:03Today has been a busy shift in casualty.
36:08I bet you have to pay extra for one of them 80-page passports.
36:12Do you?
36:13She's not quite a tough thing.
36:14The hospital's computer network has gone down, so Sister Vicky has spent her shift resorting to old-school communication methods.
36:23So has anybody took anybody around from CDU?
36:27Operational support manager Antonia has been working to get Barnsley back online.
36:33Probably it's a global issue that's happened, so that's all been reset now, so we're slowly getting them back up.
36:40And the system should hopefully be back up and running in a bit half an hour, so we can start
36:45using it again.
36:46To be honest, I'd rather be in here than sorting the IT.
36:51Modern day, June.
36:54Bet you didn't have this in your shop, did you?
36:56IT issues.
36:58You know that diet, Darren, my calorie counting?
37:01It's coming out of the window.
37:02Well, no, you're counting.
37:04You're counting a lot.
37:05You're counting higher.
37:07How high can you go?
37:09How high can you go?
37:16Louise is having an x-ray to see if her broken ankle is back in position.
37:27Yeah, a lot better.
37:28A lot better.
37:30No, no, but you've got that back on there.
37:32The fellowship is gone.
37:33Yeah.
37:34Dr. Soudan and the team conclude that the manipulation has been a success.
37:42Louise's leg will remain in this position until it can be operated on.
37:50They need to do a CT before they operate, just to get a better picture.
37:53Yeah.
37:53So, are you okay going home?
37:56Yeah.
37:56Okay.
37:57If we need to wait till morning to kick you out in daylight, that's an option.
38:00That's all I'm thinking.
38:02But if you think you can safely get from the taxi to the house, yeah?
38:06Yeah.
38:06I'd rather be in my own bed if nothing was going to happen over the weekend.
38:09Yeah.
38:09Pain-wise, what's it like?
38:11It's throbbing.
38:12Okay.
38:14Like, I want to move it like that.
38:17Okay.
38:18It's throbbing, annoying throbbing rather than painful throbbing.
38:21Yeah, it's like it's stuck.
38:23Yeah.
38:23But it is.
38:24We've put a pot on.
38:27I look forward to coming to work and wondering who I'm going to meet and what kind of problem
38:34they're going to have.
38:35And even if I'm tired and grumpy, I try and remember what a privilege it is for people
38:40to kind of let me in on what's going on for them.
38:43How long have you been a nurse?
38:45Me?
38:46Um, never.
38:50I'm a doctor.
38:51How long have you been a doctor?
38:53About 15 years.
38:55You like it?
38:56Love it.
38:56Is it the best job in the world?
38:57It's the best job in the world.
38:59And I hope at the end of, like, them seeing me that we've got them in a better position
39:05than when they came in.
39:07Do you need some painkillers from me?
39:08Yes, please.
39:09Yeah.
39:09Okay, that's fine.
39:10And then taxi home?
39:11Yeah.
39:16I'm excited to go home, yes.
39:20Your uncle could be dead.
39:24I'll not be going out for Thai food again.
39:28Louise came back for surgery after two weeks, where she was fitted with two plates and 11
39:33screws.
39:34She returned to work six months later.
39:43In cubicle three, sister Benita has almost finished cleaning June's wounds.
39:49You've got a bit of it left, but I think you've lost a bit of skin as well.
39:58But we've managed to cover a little bit of it up.
40:01All right.
40:03Are you okay pain-wise?
40:04Are you okay?
40:05Yeah.
40:06Yeah.
40:07Have you fallen a bit recently?
40:10My fist.
40:14My fist.
40:16Yeah.
40:17I feel like you're falling a bit more.
40:19I'm really used to fall.
40:22What makes you fall?
40:23What makes you fall?
40:23I don't know.
40:25Don't feel funny and fall?
40:27No, I don't know.
40:29Do your legs just give way?
40:30I'm just thinking, when you're being a bit full of fluid, I wonder if they just feel like
40:38you're a bit full.
40:40And then when I get my grip, that's all you'll say.
40:46The medical team will have a look at her and establish what it is that's making her fall.
40:52Because although she's sustained all of those injuries, she's done that as a result of falling.
40:57And that seems to be the recurring problem with her.
41:00Will you be glad to get rid of me?
41:02No.
41:04No, I'm not.
41:07Right.
41:08Is that okay?
41:10Yes.
41:10I'm going to just quickly go and write some bits up and then we'll get you upstairs.
41:14You have a lot better there.
41:17Good.
41:19Oh, are you taking her?
41:22Yeah, very good.
41:24June moved out of casualty to the acute medical unit.
41:28She remained in hospital for two weeks before returning home to be looked after by her family.
41:36In paediatrics, eight-year-old Henry has fallen off a climbing frame and shattered his front
41:42teeth.
41:42Come and have a seat.
41:44Emergency nurse practitioner Tony now needs to check if Henry has broken anything else.
41:50All right, let's have a look then.
41:53Let me use this bright torch.
41:55It's going to work today.
41:56Oh, my God.
41:57Look up to the ceiling.
41:57Open your mouth right wide.
41:59Two.
42:01Yeah, it says that one next to it.
42:03Sorry.
42:03Sorry, dude.
42:04All right.
42:06A little bit wobbly, isn't it?
42:08Sorry, I'm just going to have to lift your lip up a little bit so I can see.
42:11He's gone with a right bang.
42:13Bless him.
42:14Let's look at this side as well.
42:16Our main concern is, is there anything else going on in the mouth or the jaw?
42:20And open your mouth really, really wide.
42:22Wide just gone.
42:23Perfect.
42:23And you can see he broke his mouth really, really well and his jaw was okay.
42:27It's a little bit bruised, but it feels nice and hard under there, so I don't think
42:31there's anything broken.
42:32It is a tough one, and especially at his age, he's going to be conscious about his teeth.
42:36He's going to be all worried about them.
42:39That other tooth at top's a little bit wobbly, but it's still quite well fastened in, so it's
42:43not, I don't think he's going to come out anytime soon.
42:46You do need to see a dentist, obviously, about them first, too.
42:49There's not really anything we can do with them.
42:51So, I'm going to let you go home, okay?
42:54Yay, finally.
42:56We'd only had a conversation the week before saying, like, you've got to look after
42:59your teeth.
43:01And then he goes and does that today.
43:04He does the falling and silly things.
43:05Right, we'll let you get it going then, mate.
43:07Right, thank you very much.
43:08There he is.
43:09Hopefully the dentist will see him quite quickly.
43:11He'll get them two sorted, put a cap off, some fixing on temporarily probably until he's
43:16a little bit older, and then we'll have some more work done on it.
43:20We'll be back smiling before in no time.
43:34Henry had two new front teeth built by his dentist, and he's now back to running around on the
43:39school playground.
43:48The day shift is almost at an end, and operational support manager Antonia has finally been able
43:55to connect to the hospital network.
43:57It looks as if it's slowly feeding back through now.
44:02It's almost time for Sister Vicky to clock off, with her holiday just around the corner.
44:08So where's this one to?
44:10What are you going to?
44:11Turkey.
44:11Turkey.
44:12Have I not shown you a picture of what it looks like?
44:17So it's like, and then there's like all over water bungalows and stuff, and it's very posh.
44:24Too posh for me.
44:26We managed to get all the patients back on the system, the system up and running, everything
44:30was how it should be.
44:33Relief.
44:35It was at quarter to five.
44:37With the network now back online.
44:40It looks a bit, it looks a bit, it's all right now.
44:43Barnsley Casualty is running at full force once again.
45:19Transcription by CastingWords
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