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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.
10:41OK.
10:47So, yes.
10:47At the seizure.
10:48At the 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, they
11:27all kind of lock up, even the respiratory, all your ribs and 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.
11:42I 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,
12:31you're here to help, you literally feel really small and you suddenly have to realize,
12:37remember all of your training and deal with the situation.
12:40Aoife in this case, she got caught off guard, she'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.
12:52The cure to do is the fact that I've never worked with Rory before.
12:55I 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,
13:09I suppose getting that bit of reassurance off him.
13:12I could see that Aoife was going to get upset,
13:15or she was getting upset when she was out at the 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, like, the last chapter aren't good the last two days.
13:30I didn't know, I started like a bleeding pleb, I didn't do that.
13:33You're doing great.
13:34I'm not, I haven't done that.
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,
13:40you're going to have good days and bad days,
13:42you'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,
13:47and then you get a call, like, possibly like the one now with the seizure
13:50that I've never seen before.
13:52So then after that, then, my confidence was in the gut.
13:55You're doing great.
13:56I'll tell you straight out if you're not, OK?
13:58I'm fairly straight talking.
14:00You are doing great.
14:00You're great with the patients, you can talk to me.
14:02I didn't make any interventions at all, because I didn't think I had,
14:06because everything looked OK.
14:07And I did say to her at one stage, she was like a raw diamond that we were picking up,
14:12and 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, and I want to be
14:27the best that I can be.
14:29Having that relationship with your crewmates is just absolutely vital,
14:32because at the end of the day, if you're going to major traumas, or you're going to traumatic calls,
14:38it's so nice having that person or 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.
15:08Did you take 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
15:28of a 100-year-old 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.
15:57And didn't take any medication daily.
16:00And didn't have any past medical history.
16:02There is very few patients that I have gone to over the years
16:07who are not on at least one medication 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.
16:24And this is one.
16:26And bringing her in to hospital, we brought her in.
16:30And 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.
17:03Are 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 secret.
17:22That's what I said.
17:23I'm coming to live with her.
18:09In Wexford town,
18:11second year student Nathan and advanced paramedic Fergus
18:14have arrived at the home of DIY enthusiast Ron,
18:18who has fallen off a ladder earlier in the day.
18:22My name is Nathan.
18:23I'm a paramedic with the ambulance.
18:24I can talk louder if you want me to.
18:27I've got a hearing aid.
18:28Okay.
18:29So when the call came in,
18:31as an elderly gentleman fall off a ladder,
18:33you're expecting to find somebody lying on the ground
18:35with a ladder on top of them
18:36or a distance away from the ladder.
18:38So when we got there and we found the man,
18:40sitting on the corner of his bed
18:42or on the edge of his bed,
18:44it was okay.
18:46This isn't,
18:47this isn't what it initially came in as.
18:50I was outside painting today.
18:52Okay.
18:53I saw there was a nail
18:55and I got up to hammer it in.
18:58Right.
18:58Right.
18:59And I fell back,
19:00but I'm in great pain.
19:03Oh,
19:04I don't know that you're crying.
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
19:12and from just having a chat with,
19:14with the patient and him telling us what had happened,
19:18that he had been outside painting,
19:20the ladder literally just fell back.
19:22He fell back,
19:23landed on a big stone out in his garden,
19:26then got himself up
19:27and he went about his kind of day
19:29with quite substantial injuries
19:32that we found out afterwards.
19:33You've possibly cracked a couple of ribs.
19:37We realized that there was a chance
19:38he had broken a few ribs.
19:40He definitely had a head injury
19:42and he had quite a bit of a bump
19:44and some marks and grazes to his head
19:46and he needed to go.
19:48It wasn't a case that we just wanted him to go.
19:50He 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?
19:57Oh, Jesus, don'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,
20:07of keeping that bit of independence
20:08and kind of walking out to the ambulance
20:11and while the injuries that he had
20:13kind of dictated that he probably shouldn't be walking.
20:16Well done.
20:16The reality kind of had to set in that,
20:18well, he had been walking around all day
20:20at home with these injuries.
20:21He had gone about making his food.
20:23Nice and slow.
20:23Made sure he had the house in order before,
20:26kind 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.
20:33Don't get too drunk on that now.
20:35Pickles.
20:35He does.
20:38What did you work at, Ron?
20:40I was a London cabbie.
20:41What part of London?
20:43Me?
20:43I was in a place called Dagenham.
20:45Dagenham.
20:45Dagenham.
20:46I lived in Wimbledon.
20:48Did you?
20:48I did.
20:49I knew Wimbledon very well.
20:51Lovely place.
20:52Wimbledon and Clapham.
20:53Once you get into an ambulance,
20:55it's just chatting with people.
20:58Conversation can be 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.
21:19And when I walked with me to each other, there's another guy in there.
21:24And we got off famously.
21:26Yeah?
21:27Oh, yeah.
21:28Ten, twenty 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, especially 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.
22:51In Dublin, first-year student Rebecca is on her 15-week placement, out of the college classroom and into the
22:58ambulance.
22:59Today she's on shift with Deirdre, a third-year student who is a newly qualified paramedic and also her man.
23:07Do you remember when you said you were going to leave college and I said you're not leaving without a
23:10plan?
23:11Without a plan, yeah.
23:11And then it just happened, wasn't it, that week Nass were recruiting?
23:15Yeah.
23:15It was very strange.
23:17I'm so lucky, you know, that it just didn't happen.
23:20It was timing, wasn't it?
23:20Yeah, it was timing.
23:22It's like a lot of things in life. It's timing and luck.
23:25Yeah.
23:26I'm really looking forward to working with my mom today.
23:29It'll be really enjoyable.
23:30We'll have to kind of find the balance of her giving out to me and me taking feedback and us
23:35not fighting.
23:36I don't think we will, but, yeah, I'm really looking forward to it.
23:40They've been called to an apartment complex where 44-year-old Abi O'Doone is 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 when they feel pain in their chest.
23:55They might have been having it for a while before they ring, but it's something that kind of universally people
24:01panic over.
24:02Have you taken anything else in the last 24 hours? Any drugs, alcohol, medications?
24:08No.
24:08Nothing.
24:09Just your blood pressure.
24:10Brilliant.
24:12Yeah.
24:15It is different when you're out with a student who's third person and sometimes you can let them carry on
24:24with the call, but with the call we were at this time, I was leading the call.
24:29I was getting Rebecca to do the opposite because I didn't want anything that was relevant past medical history to
24:35be missed.
24:37So what we're going to do is we're going to give you a little spray under the tongue, right? Okay?
24:44Might make you feel a little light-headed, might give you a bit of a headache, but it'll help with
24:48this pain, hopefully.
24:49GTN is a spray that is used really commonly. You'll see it in people's homes a lot of the time
24:54for angina.
24:56In simple terms, it kind of dilates things and allows blood to flow smoother if 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? What are the scars from?
25:10Gastric sleeve.
25:11Gastric sleeve. When was that?
25:13A year and a half ago.
25:15Okay, and you've been well since it?
25:16Yeah.
25:17Okay.
25:19It would have been the first call I have been on with Rebecca.
25:23It was really strange, you know, you're trying to remember back to what you were like at that stage in
25:30your career.
25:32I suppose one of my strengths has been able to talk to people and I definitely see the same in
25:38Rebecca.
25:39She has that when it comes to dealing with patients.
25:42It was really enjoyable and there was at no stage where we were kind of button heads or it made
25:48no difference.
25:49It didn't feel like I was working with my mum. It just felt like I was working with somebody who
25:55I knew really well.
25:57And it made the day so relaxed.
25:59Oh, it's not talked.
26:00Just a big deep breath in in your mouth.
26:02It was great to see how she's going on and, you know, it won't be long until she's alone in
26:08the back of the ambulance with her own patients, please God, in January when she is on her internship year.
26:24For second year interns Anne-Marie and Ryan.
26:27Hello, ambulance service.
26:29It has been a tough but rewarding year on the road in Limerick and Mayo.
26:32No pins and needles in the fingers or anything.
26:35With each new emergency call testing their skills.
26:38Have you gone to the doctor?
26:39Yeah, that will do.
26:39That's fine.
26:40Yeah, that's good for me there now.
26:44And challenging them in ways they never expected.
26:47Why did I sign up for this?
26:50Can I?
26:50Two seconds.
26:55They're returning to their old campus in Ballinasloe one last time.
26:59Where are we there now? We're here somewhere.
27:02Here we go.
27:03That's the class photo now from the grad.
27:05Jeez, we don't spoke up too bad there now.
27:09Soon they'll be taking their exit exam.
27:12If they pass, they qualify as paramedics and move into third year to complete their degree.
27:18Two tutors will ask me a series of questions about my reflection on calls that I've attended to throughout the
27:25year.
27:26They want to see that you're confident in terms of your decision making on those calls.
27:31And that you're open to criticism and that you're open to, you know, progressing yourself continuously still.
27:40Seems safe.
27:41Brings back so many memories.
27:46The exit interview is really important for them to see how I've grown over the year, what I've learnt, and
27:53how I endeavour to go forward in my career as a paramedic.
27:58I remember when I was on my last chance and walking into this room, it was literally make or break.
28:04It was like, if I had failed that one, I wasn't coming back.
28:10It's hard to think that what we did in these rooms is now what we do in the back of
28:13an ambulance, in like a quarter of the space.
28:16If you think about it, we've actually been on the road now longer than we were in the college.
28:21This is almost like the final hurdle. I could fall at the fence, but hopefully that won't happen.
28:41In Wexford, second year student Nathan and advanced paramedic Dave were en route to a call, but they've been diverted
28:49to a higher priority patient with a history of epilepsy.
28:52So we were en route to a call, and we got stood down off that call to a female, actively
28:59seizing query, altered level of consciousness.
29:02So that kind of perks your ears up, because that's a pretty serious call.
29:06You know you're going to be expecting something serious when you get there.
29:10On arrival at the house, another crew has already started observations.
29:16Nausea intermittently for the last couple of days.
29:18She feels like she wants to vomit, but she can't.
29:20She can't.
29:21Okay.
29:21They didn't notice initially the daughter was to do with her epilepsy, because she was fainting, simply episodes, and we
29:27have anxiety and depression.
29:29With Nathan fully up to speed on the complexities of the case, he takes over communications with the patient.
29:35When you have the epileptic seizures, are they the full, kind of blown, kind of shaken seizures?
29:40I don't know, no.
29:41Do you know what happens?
29:42I go out, my eyesight goes, my hearing goes, and then when I come back around, I'm like, did I
29:47just have a seizure?
29:48Where was I?
29:49Where was I?
29:50What happened?
29:50There is multiple different types of seizure.
29:53Sometimes someone can be seizing and can be just jerking an arm or a leg.
29:57Sometimes it can be just rapid eye movement.
30:00Sometimes they may not have any jerking at all, but just aren't responding to you.
30:04So there's many different types of seizure and it's impossible to be able to identify them all correctly.
30:11The safest thing that we would always say that if it looks like a seizure and you're confident that it
30:17is a seizure, then treat it as a seizure.
30:20Take a few deep breaths for me.
30:21I'm scared.
30:22That's okay.
30:23We're all here.
30:23All right.
30:24We're here to help you.
30:25All right.
30:26So look, what we're going to do is I'm going to run another blood pressure.
30:29Yeah.
30:30And then we will have a chat with the rest of the guys that are here and we figure out
30:33the best way to get you out into the ambulance.
30:35Is that okay?
30:35Yeah.
30:36All right.
30:37So it took maybe three or four minutes in the house to kind of get the patient kind of up
30:41out of bed and get her into the ambulance.
30:44With the patient telling the crew that she's been experiencing periodic epileptic seizures, they decide to transport her to hospital
30:52as a priority.
30:57Okay.
30:57So look, I'm going to have a chat with my colleague and see what he thinks and then we will
31:02decide if we're going to do anything else.
31:05Yeah.
31:05Okay.
31:06That's all right.
31:07Yeah.
31:07That's fine.
31:08Okay.
31:08So temperature is good.
31:10Blood sugars are good.
31:12Blood pressure is good.
31:13What would you treat?
31:15The anxiety and if the seizure comes back and we can treat with ondansetron for the sickness.
31:24So cytosine has the longer term effect.
31:28Yeah.
31:29There you go.
31:30If you hold this.
31:31You okay?
31:32You okay?
31:37While in the back of the ambulance then, she felt that a seizure was going to come on.
31:43Is that the pain?
31:44I got into one.
31:46You're having a seizure, are you?
31:47What?
31:48When she started the season, I kind of looked at Dave to see if we should start kind of medication
31:54treatment.
31:54And when I seen his reaction, I kind of knew that maybe this isn't what it actually is all kind
32:00of adds up to be.
32:02Relax in the bed first.
32:03Just take some deep breaths.
32:04Cool.
32:15In Wexford, second year student Nathan and advanced paramedic Dave are attending to a patient who has told them that
32:24she has been experiencing periodic epileptic seizures.
32:29Hello, can you hear me?
32:33From prior experience, I recognized the patient.
32:36I've attended to that address numerous times before.
32:41I chose not to pass that information on to Nathan.
32:46Because sometimes that can cloud their judgment into thinking, well, this isn't an emergency or they may not be seizing.
32:54Everything's all right again now, isn't it?
32:58Hello.
32:59Yeah.
32:59Welcome back.
33:00All right.
33:01It's okay.
33:03When she started the season, I kind of looked at Dave to see if we should start kind of medication
33:08treatment.
33:08When the paramedic hasn't given any medication, you kind of get an idea of what's going on.
33:14She was already on the monitor and didn't have any physiological changes on the monitor.
33:20So her heart rate remained the same, her oxygen levels remained the same, her breathing rate all stayed the same.
33:25If there's no changes in those and that she's able to respond to you on cue as such, then it's
33:32highly unlikely that she's having a seizure.
33:39I just need to make sure.
33:41All right.
33:42So is there anything else that you're on medications for?
33:45Is it just for the epilepsy?
33:48And for the anxiety.
33:49Anxiety and the epilepsy, yeah?
33:50Yes, all of them.
33:51Okay.
33:55While she might not be having genuine seizures, she is having some form of a crisis.
34:01And who am I as a paramedic to decide that there's nothing wrong with this patient?
34:13Hello.
34:15It can be a little bit disheartening when you are going out to someone who you've been called for many
34:23times in the past,
34:24that you know needs help, but sometimes the ambulance service isn't the most appropriate help for them.
34:31And by attending this person, that you may not be there to help another person that may need you.
34:44It's kind of a hard one to describe, but in reality my job is as a paramedic to treat the
34:49patient that's in front of me at the time.
34:50And that means to treat them with dignity and respect, the same as I would anybody, even if I don't
34:56think they need an ambulance.
34:57The reality is in their head, they've decided they need an ambulance.
35:00So who am I to be the one to tell them that they don't need to call an ambulance?
35:15Sometimes there is more social skills or social services that may be better equipped to deal with these types of
35:26calls.
35:27But at the time, 999 and calling for the ambulance service is the only thing that they know what to
35:33do.
35:34And the only thing sometimes that's on offer to them at the time.
35:37It can be conflicting and it can be difficult.
35:40But I think for any paramedic going out there, we always should try to remember that for them right now,
35:49it is an emergency or it is a crisis that they just can't deal with and they need help with.
36:15In Dublin, second year student Aoife is on shift with advanced paramedic Quiva.
36:23This is her 86-year-old male fall injury to hand. That's all we got.
36:29We got a call for a gentleman that had a hand injury.
36:34It was only two minutes away from where we started off initially.
36:38So quite quick to get to that call.
36:47We didn't get a key code, did we?
36:50I don't want to blow him out.
36:51There's like no other.
36:54We knocked on the door. There was no answer.
36:57So we kind of waited. We were looking around.
37:00Are we at the, you know, is this the right street?
37:01This is the number, this kind of thing.
37:03And a gentleman opened the door and said hello.
37:07Hello.
37:08Oh, hello.
37:08How are you?
37:09Not too bad.
37:11I'm Aoife, this is Quiva.
37:12Did you call for us?
37:16Did you call for us, yeah?
37:18No, come in anyway.
37:19Automatically I was thinking, okay, well someone around here needs us like, so we better move on.
37:24But he insisted on inviting us in.
37:26I was a little bit, I was a little bit taken back because it was a bit strange.
37:29What's going on?
37:30So obviously we went in to him and he sat down and started to chat away to us.
37:35House was lovely.
37:36Lots of character in it.
37:37You're kind of looking around.
37:38You realise he's on his own.
37:40You didn't call the ambulance, did you not?
37:42Sit down there anyway.
37:44Just close that door and sit down there.
37:47Sandra's coming over.
37:48My daughter.
37:49When we first got on to see him, we knocked on the door.
37:51We weren't even sure whether he had actually called the ambulance or not or else he was
37:54just some friendly old man that was letting the paramedic crew in.
37:57Because I think even himself he wasn't sure as to why we were there.
38:01But we soon realised then why we were and what was the reason we were called for.
38:07What's your name?
38:08Tony.
38:08So did you call us or your daughter?
38:10Daughter, yeah.
38:11Your daughter called.
38:12I was in the bed there and I felt I couldn't get up for you.
38:15Yeah?
38:15I'm just going to do a few checks as you're chatting, okay?
38:18And did you feel, do you feel dizzy before the fall or do you just feel like weak?
38:21Yeah.
38:21Well, the shakes, you know.
38:22To the shakes.
38:23Yeah.
38:25And you didn't, did you injure yourself at all or any of the falls?
38:28Well, just there.
38:29Did you?
38:30Was your hand?
38:32It's not bad now, you know.
38:33It's okay now.
38:34Can you do this to me?
38:36Yeah.
38:37Yeah.
38:37Do you know, he was starting to paint some sort of a picture as to why the ambulance was called
38:42but still wasn't 100%.
38:44Who's your daughter?
38:45Sandra, is it?
38:46Sandra.
38:46I don't know.
38:46And is she looking to come and meet us, is it?
38:49Before you go to the...
38:49Well, she usually needs me home to the pub, you know.
38:51Oh, lovely.
38:52I see.
38:53And why do you think Sandra called the ambulance?
38:56Oh, they're worried about you.
38:57Worried about you.
38:58Yeah.
38:59I think one of the main signs and symptoms that we noticed in the patient was that he was
39:03very shaky and his fingertips were quite red and he was slightly confused at times.
39:10So, this is where myself and Aoife tag-teamed.
39:13So, she's leading the call, so she's going to stay with the patient.
39:15And she did all the assessments she needed to do with him when I went and chatted with his daughter
39:22on the phone.
39:23What's your concerns at the moment?
39:26Yeah.
39:29Grant.
39:29Okay.
39:30Okay.
39:31And this is all over the last few days kind of, is it?
39:33A bit of this kind of decline yesterday and today.
39:36Okay.
39:37Her concerns were, you know, memory, not being too good, just concerned for him.
39:43There was nothing acutely jumping out that we needed to intervene and give any treatment.
39:50This gentleman just needs to go in for further investigation.
39:53And come here to me.
39:54Do you head down to the pub every day?
39:56Oh, no.
39:57No.
39:58Just every now and again.
39:59Only one.
40:00One day.
40:00Okay.
40:01All right.
40:02Which one do you go to?
40:03The KCR over the south side and the shamrock of the case.
40:08Oh!
40:08Oh, yeah, yeah, yeah.
40:09Yeah, I wouldn't know.
40:10I know the shamrock now.
40:11I wouldn't know the other one.
40:11Yeah.
40:12And you sing, do you?
40:13Yeah.
40:14Oh, very good.
40:17Brilliant.
40:17Trad music or what kind of?
40:20Oh, no, no.
40:21It's just Dicky Rock, you know.
40:23Oh, yeah.
40:25What's Dicky Rock?
40:26Do you not know who Dicky Rock is?
40:28No.
40:30Sing us into the matter.
40:31It's three minutes into the matter, yeah, if you want to give us an old song.
40:34We won't say no.
40:36Yeah.
40:37Mona Lisa.
40:37Did Dicky Rock do that one?
40:39No, I'll do that one.
40:40Oh, dear.
40:42We'll walk the road of life together day by day.
40:48Lovely.
40:49And I will love you every step of the way.
40:55Wow.
40:56Love it.
40:56Brilliant, Anto.
40:57He gave us a couple of bars of a Dicky Rock song.
41:00I didn't know it now, to be fair.
41:01But it was lovely.
41:02It was lovely to see.
41:03And it's great to have those little moments.
41:05And they brighten up your day when you have patients like that.
41:08I suppose, with the little bit of singling the ambulance gave us a positive sign that he's
41:14got everything going to be okay with the patient.
41:35At the Talla campus, both Anne-Marie and Ryan are gearing up for their exit exam.
41:43I'm trying not to think now, at this stage, what it'll be, what it'll be.
41:48They're waiting to kill you, though.
41:51I feel okay.
41:52I'm not as nervous as I thought I would be.
41:54I feel okay.
41:56All I have to do is be honest, really, about my experience during the year and just kind
42:00of recall things and remember things.
42:05But, yeah, hopefully just being myself will be enough.
42:09The exit interviews is done by our educational team and operations.
42:14We don't do them.
42:16We don't be involved in them.
42:17They do look for our feedback.
42:19And not everybody is successful.
42:27If you become qualified, it doesn't mean you've stopped learning.
42:31It doesn't mean the journey's over.
42:32The journey continues.
42:36So, just because they change the colours on their shoulder from blue to navy,
42:40they still build on the knowledge that they have, their exposure,
42:45how they do things on a daily basis.
42:47And you'll continue to build that confidence as you go on.
42:54This is going to go. Are you ready?
43:08I still ask myself why I did it, but I love the fact that I can help people.
43:13A job like this, whether it be paramedics, guards, nursing, that'll mature you exponentially.
43:19Getting my paramedic qualification will be probably one of the biggest goals I've ever had in my life.
43:25I absolutely love being a paramedic. It's probably one of my favourite things about myself.
43:30I love telling people I'm a paramedic.
43:32There is a huge difference between, you know, learning in college and then being out in the ambulance.
43:36So, you kind of have to adapt and enjoy it as well.
43:40You know, I highly enjoyed it and I think that's an important part of the job as well.
43:45There was a long time where every time you got dressed you thought you were an imposter.
43:49But there's been a couple of times where I've had really big calls and really good outcomes that I go,
43:55So, yeah, it's okay. I deserve to wear this uniform.
44:04There's nothing like the snap of pink rubber gloves to mean business.
44:08Tonight the team tackle a rental refurb in Cork while there's dumping drama in Dublin.
44:12New series Cleaning Up Ireland continues Sunday at half eight on Virgin Media Play and Virgin Media One.
44:36If you've been affected by any of the issues raised in this programme, please visit our support page, virginmediatelevision.ie
44:43forward slash helplines.
44:44I have to make a little reasons.
44:45How to make the carbon warto cuts.
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