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00:07It's one of the most pressurized jobs in the world.
00:15Becoming a paramedic is not for the faint-hearted.
00:18So it's going to 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 welcomes
00:29around 90 new hopefuls to their campuses in Dublin, Ballinusloe, Tullamore and Cork.
00:34These people here are going to be your absolute backup over the next three years.
00:40But not everyone makes it true.
00:42I don't think I'm going to do this anymore.
00:44It's just shit.
00:46I'll go to that in two days.
00:48Because this is no ordinary degree course.
00:51We're going to go.
00:52It'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.
01:08It's over there.
01:11With every shift a crash course in courage.
01:14It doesn't get any harder than this.
01:17Resilience.
01:17Lift.
01:18And critical decision making.
01:20We have a device that brings the bones back into place.
01:22But it's going to cause them to scream.
01:24Big deep breath for me.
01:25The exams on this course aren't just a pass or fail.
01:30Why did I sign up for this?
01:32They're a potential matter of life.
01:34Are you going to wake up for me?
01:35Or death.
01:36We're not breathing.
01:55In Mayo, second year student Ryan and colleague Tommy are responding to a call outside Castle Bar.
02:0221 minutes.
02:05Where a woman is struggling to breathe.
02:10Obviously, the ambulance service is called to critically ill patients every day of the week.
02:15And that comes with responsibility from us to perform to the best capabilities that we can on the day.
02:23Second year students are classed as interns.
02:26Rostered on shift for 52 weeks with an experienced paramedic.
02:31And they are expected to step up their learning on every call.
02:35You're kind of like a duck on water.
02:37When you get on scene, you're going to look confident and come across that you know what you're doing.
02:41But inside your heart is racing.
02:43Keep going up.
02:45Keep going up.
02:47Keep going up.
02:47And you're going to sit there.
02:50This one?
02:51Yeah.
02:52Jeez, look at that for a house.
02:58On arrival at scene, we were met by some family members and we were directed into the bedroom where Roberta
03:04was struggling quite hard.
03:09How are you doing?
03:10How are you keeping?
03:11Ryan is my name.
03:12I get the machine.
03:13Do a few checks.
03:14Yeah.
03:16Initially we were carrying out the assessment and I just identified, right, she's going to need something else.
03:20So I went out to the ambulance to grab and nebulise her.
03:24So is it general deterioration today?
03:27Like what would her kind of general condition be?
03:29Well normally what would that pin be?
03:30When I came back in, there was no sign of Ryan.
03:33Sorry.
03:34I was just having a chat with this lady.
03:37Right, come in there.
03:39It's a bit of a haze.
03:40When Tane chatted with the patient, I went to the next to kin to get details and I think I
03:46kind of zoned in a bit too much on actually trying to get details.
03:50Any rigors or, you know, shaking as if she's a temperature?
03:55No, no.
03:55No temperature.
03:57Ryan got focused on paperwork.
03:59He was trying to get next to kin details rather than identifying that Roberta was struggling fairly hard to try
04:06and get her breath in.
04:08What was the sets?
04:10ATA, which is very wheezy, very lethargic.
04:13More important to this now than to get paperwork.
04:15I know, but like one person can do one job and the other person can guess what the story is.
04:20Like one of the things that used to be always said to me, is this patient sick or are they
04:23big sick?
04:24And she was heading towards the big sick.
04:25She was struggling.
04:27Now, we have a chair here and we're going to get you onto our chair and get you out to
04:31the ambulance.
04:31Is that okay?
04:33So I'm going to put my arms underneath you and lift you over onto the chair.
04:38I think I was in reverse gear, to be honest with you, going in the door while Tommy was in
04:42fifth gear.
04:44Okay, ready?
04:45One, two, three.
04:49I love him.
04:50Can we get the blanket down under there?
04:55It wasn't really until I got out of the ambulance or thereabouts when we were transferring the patient
05:01that I kind of got the hint that Tommy wasn't too impressed.
05:04Do you remember when you told me don't be asking questions?
05:07I'll ask all the questions I need.
05:09I was taking a history and then I was disturbed.
05:11Oh, I know, I know.
05:15We're going to head for Castlebar Hospital, so we are.
05:19Good to go?
05:19Yeah.
05:21Seatbells on?
05:22They'll be on now in two seconds.
05:24You'll be under pressure, Tommy.
05:26Good.
05:26I'm glad the last call put you under pressure.
05:28Oh, yeah, this is morbid now so it is.
05:32Now, Roberta.
05:33Lamblings can be bumpy enough at times, alright?
05:37I suppose having that trust that I could let him do it,
05:40but there's no point me doing all the big calls and him not getting the experience from it.
05:44He needs to experience that patient that's sick in front of him.
05:491644.
05:521644, go ahead there.
05:54Susan, how's it going?
05:56Could I just put in a pre-alert there for recess for Castlebar?
05:59Over.
06:00You can, indeed.
06:00Give me two minutes, sir.
06:02Thanks, Ian.
06:07With Roberta safely delivered to the emergency department for further examination and treatment,
06:13Tommy is debriefing with Ryan.
06:15I had one look at her.
06:16You could see she was lethargic.
06:17The eyes were going.
06:18You could hear the bubbling.
06:21Like she was struggling.
06:23I went for the machine.
06:24I came back.
06:25You were gone.
06:26There was no one there.
06:26The room empty, patient on her own.
06:28And then I had to run out because I knew she needed a nib without even having to listen to
06:32her chest.
06:33So I was doing that.
06:34Yeah.
06:34Like there was nearly a shout going across.
06:37Yeah, yeah.
06:37Where the fuck are you going, Tommy?
06:39Do you know what I mean?
06:40Yeah.
06:41And then there was one or two other.
06:42I just said, out until I get this sorted.
06:44So once I had the nib on, I was trying to help her and open it up.
06:47The airways for her.
06:49Getting her out, fair enough.
06:49Look, we worked well getting her out and all that.
06:51Chair was the handiest thing.
06:53I went for the chair as well.
06:55Yeah.
06:55Where were you?
06:57Probably.
06:57Were you in the room back at that stage?
06:58No.
06:59At that stage I was doing the BGL in the town.
07:01Okay.
07:01Sam.
07:02But no, I completely agree.
07:04You know what I mean?
07:04Do you know where I come from?
07:05No, I completely agree with you.
07:06Can't be all sunshine and butterflies as you said.
07:09And sure it never is.
07:09It never is.
07:10No, I completely agree with you.
07:12I shouldn't have left the room.
07:13At the end of the day, we're going through the internship for a reason.
07:17So that when we do qualify, we don't make those mistakes.
07:21And as long as you learn from those experiences and not just disregard the experience, I think that's very important.
07:32All right.
07:33Look at that.
07:33It's been a long road.
07:36Sorry.
07:40Can I have two seconds?
07:44It's been a long road.
07:46It's been a long road.
07:46And I think anyone in the class...
07:50Sorry.
07:50The emotions of that call is just getting to me.
07:56Excuse me.
07:57It's been a long two years and there's been a lot of ups and downs as far as here.
08:02And it's definitely...
08:04I don't know why I'm crying.
08:06But yeah, it's been a long two years.
08:10So it has.
08:12I don't know why I'm crying.
08:15It was a combination of the factors to be honest with you.
08:19I had some nasty calls.
08:23Calls that were fatalities and of minors as well.
08:26Pissed off at myself is what I am.
08:29It's only two, three minutes of the call.
08:31I know.
08:31That's it.
08:32That's it.
08:33Everything else was fine.
08:34One tiny little minuscule piece of the call.
08:39Yeah.
08:40Never mind you.
08:41Yeah.
08:41This is the...
08:42Yeah, yeah.
08:43You're brushing off.
08:44Yeah, yeah.
08:44Do you know what I mean?
08:45I know.
08:45So don't be under any illusion.
08:47You're well able to do the job.
08:49Look it.
08:49Tommy came into the back of the wagon and we hugged it out and chatted and all was well.
08:55But you have to like, it's...
08:57You need that.
08:58You need that camaraderie in the service as well.
09:01So you do.
09:01And you need that wingman.
09:03Ah, come here.
09:06Get up.
09:07I don't think it's even...
09:08Get up.
09:09Fuckin' ass.
09:10Yeah.
09:11Fuck.
09:12I don't think it's even this call.
09:14It's not.
09:16It's all the...
09:17All the stuff that builds up.
09:18Yeah.
09:19Yeah?
09:19And all the emotions you have to deal with.
09:22Do you remember what I said to you before?
09:24It's all there and then the next thing it just bursts out in you for no reason.
09:29Jeremy, you're well able to do the job.
09:30And I know that you're saying it's not this call.
09:35Your soundbuck.
09:37Get it out of ya.
09:38Yeah.
09:39That's what I need.
09:41Good cry.
09:43Yeah.
09:45Why did I sign up for this?
09:47Number 4 1 2!!!
09:565 2 over.
09:582 Lima 5 2 go ahead.
10:01We're good to go there, Gary, we're just moving off if we get for coffee well and good.
10:05There was a call there, a turn on to us over.
10:11Where are we going for coffee? Anywhere.
10:13Going for the dock road? Yeah, I don't mind, yeah.
10:18In Limerick, Anne-Marie, who is also midway through her intern year,
10:22is out on the road with experienced paramedic Jim.
10:28We were grabbing a coffee while we had the chance
10:31because we don't always get the chance.
10:34And, lo and behold, a call came through.
10:37I'll see what it is, I'll see what it is.
10:38I remember the start of that call.
10:41We literally had literally got into the queue for coffee and the radio.
10:46The radio went off and Marie stayed in the queue
10:48and I ran out to the ambulance.
10:52It was a purple call, so it meant there was a life threat.
10:56Yeah, we better go. It's cardiac.
10:58And he said that we had to go quick because it was a cardiac arrest,
11:01that it was a young girl.
11:05We better go.
11:07As the crew rushed to the scene, more information comes through
11:11that a young girl has attempted to take her own life.
11:14We weren't too far away from the call.
11:16We were about five minutes away.
11:19On the way to this call, there was a mix of emotions.
11:23Your adrenaline is going.
11:25You're trying to recall everything in your head that you need to remember.
11:32Organising what I needed to organise before I had time to organise.
11:36It was almost robotic, in a way.
11:38But I was definitely feeling nervous.
11:44If you grab the Lucas, I'm grabbing the defence.
11:48We made our way into the house and there was a first responder volunteer
11:52that was already there.
11:55Where are we?
11:56Where are we, lads?
11:57Are we upstairs, downstairs? Where are we?
11:58Those flashcards, downstairs.
12:06Them are clear.
12:07Clear lads.
12:08More!
12:09Dhh, fill up!
12:11In Limerick, multiple crews are in attendance at the address
12:15where a young girl has attempted to take her own life.
12:19Second year student Anne Marie is leading the call.
12:23At Neil, how long are we doing this?
12:32When you go to a call and a person is in cardiac arrest and there's family members around,
12:39it's very distressing for the family.
12:45Anne-Marie was the one who took charge.
12:48So her goal then wasn't to actually do CPR, her goal wasn't to insert an airway,
12:54her goal wasn't to assess anything, her goal was to make sure that everybody else was doing what they were
12:59supposed to do.
13:05You're trying to be as professional as you can and attend to the patient
13:09and give that patient the best chance that you can, but you're also trying to be sensitive towards the family.
13:20We continued as per what our guidelines tell us to do, to continue oxygenating her
13:26and to continue checking her rhythm of her heart and her pulse and to also keep doing compressions.
13:43That was a really, really tough situation because as the call was going on, there were, at that stage,
13:50two ambulances outside the door, there was a doctor's car and there was a community first responders car.
13:55Yeah, if you can get the second BBM with the oxygen to take over this one in a second.
14:01Yeah, right.
14:02One second now.
14:03Just stand here, like, shocker voice.
14:05Yeah.
14:06Clear?
14:07Yeah.
14:08There was nothing there at her hand now?
14:10Yeah.
14:11No.
14:12There it goes, Henry.
14:14Reanalyzing my rhythm in 40 seconds.
14:18Because it was a young girl, we tried literally, we try everything anyway, but you keep on going,
14:23trying and hoping that you get some kind of a response and you get some kickback from her heart,
14:30but it didn't happen.
14:39What time is it?
14:4111.
14:42Are you okay?
14:42Yeah.
14:45Oh, God.
14:47No, no, no, no, no, no.
14:52They're tough calls for somebody because they're high pressure situations, you know,
14:57and no training room, no syndicate room in the college would prepare you for the reactions
15:02of the family.
15:06We tried to present her in the most dignified manner that we could where she was so that
15:12her family members could come in and see her.
15:16Please, please.
15:19It was quite a hard and emotional call to be attending.
15:23I dealt with it okay.
15:24I think my paramedic hat was on when it needed to be on.
15:28I was clinical and my medical knowledge, everything that I'd learnt and experienced before,
15:33all came into play at that moment.
15:34But I also had my empathy hat on as well.
15:38Thank you very much.
15:39Given the traumatic nature of the call, educational training officer Donna is keen that the entire
15:44team take a break.
15:46I think we may be going back down to the dock road for a cup of coffee in a minute.
15:49I think we need to finish off.
15:50Yeah.
15:51Just for our own sake, we'll stand down for a few minutes.
15:53I definitely felt very, very sorry for the family.
15:58I think what got me more was because this patient was a young patient.
16:02She was a young girl.
16:03I remember when I was that age, going through depression and growing through self-doubt and
16:09having moments where I could have had the same outcome as her.
16:15And thinking that my family could have been in that position at one time.
16:20And that really got me that another family were having to deal with that.
16:27Yeah, it was sad.
16:50After some stressful calls that have tested relationships.
16:54Now Tommy, I want to see a nice steady pace here now.
16:57No tearing off like a lunatic.
17:00Tommy has persuaded intern paramedic Ryan to take some time away from the ambulance.
17:05Are you keeping up with me?
17:07I can't.
17:08Are you knackered?
17:09I'm nearly out already.
17:11And we haven't even met the Statue of Mary yet.
17:15Tommy had always been hounding me.
17:17We had a cardiac arrest on my third assessment up Crowpatrick.
17:22And I was absolutely puffed out of it by the time I got up the mountain.
17:26So he'd been slagging me since about it.
17:28So I said, come on, we'll go and climb it.
17:32Bless yourself now with this fella.
17:35Well...
17:36Well, I don't know.
17:38Do you know something?
17:38I thought it was Statue of Mary that was here all the time.
17:42Did you not know that?
17:43I thought it was the Statue of Mary, sure.
17:45I was saying, Patrick's Mountain, Mary's at the bottom.
17:49Genuinely, I always thought that it was Statue of Mary there.
17:57We had four seasons in one day, so I had, but halfway up the view, even halfway, is just absolutely
18:03unbelievable.
18:04And I suppose when you're local somewhere, you don't really appreciate that view either.
18:09Well, it was a good shot anyways climbing, I think.
18:12It's good to get out and about, like.
18:13So thanks for asking to come.
18:15No, you're welcome.
18:16It's good to get out in nature and stand back and I suppose just take time to analyse where you
18:26are in life.
18:26That's for sure.
18:27Like, we see a lot in work and we probably don't do it enough, decompressing outside of the job from
18:32it, like.
18:33You probably do it at work, but I suppose you process it, but then you're straight into the next call
18:39again.
18:40And I know we didn't come up here today and we weren't talking about work and that's the whole point.
18:43Yeah.
18:43That you don't really talk about work, that you talk about everything else and the fresh air, meeting people.
18:50Something different.
18:51Yeah.
18:57Working with Ryan over the Alice couple of shifts has been, it's been fantastic.
19:01He's a good communicator, he's able to have the laugh, which is all important, but he's well able to deal
19:07with patients.
19:08He's very compassionate towards them and deals in that way.
19:13You feel, have you progressed with your confidence in dealing with your, your confidence definitely builds with,
19:19the exposure you have to different calls and that kind of thing over the course of the year.
19:25But it doesn't matter whether I was in the internship or whether I'm going on to be qualified,
19:29like, I'll still be learning every day, every day is a school day, like, so.
19:33Because there's still calls that I haven't come across, like, types of calls.
19:40Something that he needs to work on, and it's hard for a young person, is, is the emotion.
19:46Um, he, he holds a lot in, um, and when he's dealing with certain stuff, just how to deal with
19:53that.
19:53But that all comes with experience.
19:55Um, he's going to see calls that are, he, he's going to have to learn to deal with.
19:59And he's also going to do calls that his skills are going to be pushed further.
20:03Well, wasn't it worth it?
20:06That's for sure.
20:07See all the good places I do take you?
20:09I'm telling you, some view in fairness, like.
20:13Now, we'll sing the green and red of mayo, will we?
20:17I haven't a notion.
20:19Oh, the green and red of mayo.
20:22A job like this, whether it be paramedics, guards, nursing, you know, anything that deals with life and death moments,
20:29I suppose you could, you could argue.
20:32That'll mature you exponentially, um, dealing with those emotions, um, because it gives you a different perspective on life.
20:49In Dublin, third-year student Deirdre is starting her shift with colleague Stephen.
20:5875-year-old.
20:59Tripped, fallen, query to arm.
21:01Conscious and breathing.
21:04999, mood activated.
21:07We were called to an elderly lady who had had a fall in her garden.
21:15So, we followed the directions of the sat-nav and it brought us to the back of houses where there
21:22was no patient.
21:23But another, a neighbour flagged us down.
21:26Oh, she's waving us?
21:27Aww.
21:29Oh, guess it's a granny.
21:32Okay.
21:32Is she on the ground?
21:33She's on the ground, yeah.
21:34You can come through my house, yeah.
21:37Shuffled us all through her house and brought us out to the front garden where we found Margaret.
21:43What's going on?
21:45I stumbled.
21:46Right.
21:46And my arm went over the wall.
21:48Okay.
21:49And she came over my head with that.
21:51And I couldn't feel my hand.
21:55Oh, okay.
21:56Right.
21:57Okay.
21:58You normally fitting well or do you take medication?
22:00I'm diabetic.
22:01Okay.
22:02Dee, I'm going to pull the almonds.
22:03I don't think so.
22:04Yeah.
22:04Is there anything I can do for you?
22:05Yeah, I think maybe bring me over a Pentrox.
22:07A Pentrox, yeah.
22:08Yeah, because I reckon the shoulders, Margaret thinks her shoulder's gone and probably her forearm.
22:12And the forearm as well, yeah.
22:13So, yeah.
22:14Yeah, we get a sling as well for that, yeah.
22:15Yeah, no bother, yeah.
22:16So, zero been no pain and ten been the worst pain you've ever felt in your life.
22:20What are you at now?
22:21Nine.
22:22Nine.
22:22That's okay.
22:23Despite being in, the pain she was in, she was super.
22:28Can I ask a few silly questions before I give you this drug?
22:30Yeah.
22:31Do you know what month it is?
22:33March.
22:34Do you know what year it is?
22:3625.
22:36And do you know who the President of Ireland is?
22:39The little man.
22:40The little man.
22:41That'll do.
22:42The little man.
22:43That's what everyone calls him and that's the answer we accept.
22:46The little fella.
22:47Yeah.
22:47So, with this medication, right?
22:50It doesn't taste great for the first one but it'll be fine after.
22:53Where it's going to take you is to a very special place.
22:55Yeah, right.
22:56Right?
22:57You're just loading.
22:59Okay.
22:59Right.
23:00We got Margaret Pentrox, which is our magic whistle.
23:04The first breath in it might catch you because it's quite a potent thing.
23:08Breathe in and breathe out through the whistle.
23:11And blow out through the whistle.
23:12That's it.
23:13In and out.
23:15So, with Margaret initially she didn't think she was too injured, you know, and she thought
23:19she'd be fine but as we moved her we could see the displacement of the shoulder and any
23:24kind of movement was just causing her excruciating pain.
23:28A few bubbles on you?
23:29No.
23:30Where's that catching?
23:32Oh!
23:33Where's that catching?
23:34This side.
23:35Oh!
23:36Over here?
23:36Yeah.
23:37That's alright.
23:38We'll do all the work.
23:40Oh!
23:41Oh!
23:41She thinks the...
23:42Oh!
23:43You are alright.
23:43You're okay.
23:44You're okay.
23:45Keep going on this.
23:46Keep going on this.
23:46So we decided we'd get her into a sling because it would immobilise the arm and reduce the
23:53pain.
23:54You'll be singing Irish ballads now in a couple of minutes.
23:57And in the jig.
23:59That's it.
24:00Keep going.
24:01Well done.
24:02That's it.
24:02We have a lot of drugs in our ambulance for pain relief but the one thing we also use
24:07is the slinging and reduces the pain just by keeping the arm straight.
24:14So keep going.
24:15Well done.
24:16Well done.
24:16Well done.
24:19I'm sorry.
24:20No, don't be apologising.
24:21What are you apologising for?
24:23You're keeping us in a job.
24:25Keeping us busy.
24:25Yeah, they don't be calling her.
24:26She was typical older generation.
24:29I don't need an ambulance.
24:30I'm fine.
24:31She clearly wasn't fine.
24:32She was clearly badly injured.
24:34So what we're going to do is we're going to get you standing up, okay?
24:36So after three, you're going to push up as well and we're going to help you up as
24:40well, okay?
24:41One, two, three.
24:42One, two, three.
24:43I can't.
24:44I can't.
24:45Sorry.
24:46You're doing great.
24:47There you go.
24:48I'm up.
24:49I'm ground when I'm up.
24:50You're ground when you're up?
24:51Yeah.
24:52Any new pains anywhere?
24:53No.
24:54Any pains gone away?
24:55Everything's much the same, is it?
24:57No.
24:58Oh.
24:58So can you take a few steps towards your house?
25:00Back towards me.
25:02Back towards me.
25:02Yeah, I'll tell you when.
25:03Keep coming towards me.
25:04Where's that sword?
25:05The arm again?
25:05Keep coming towards me.
25:09Now, there's a bed right behind you.
25:11You're not going anywhere.
25:12Right?
25:13The brakes are on it.
25:15How's that?
25:16Now it's just going forward.
25:17Where's that whistle?
25:18It's just on the wall.
25:19Yeah.
25:30In Dublin, third year student Deirdre is treating 75 year old Margaret.
25:36After she tripped and fell in her garden, suffering a suspected broken shoulder.
25:42I'm so sorry.
25:43What are you sorry for?
25:44You feel like you need something more?
25:47A bit stronger?
25:48Yeah.
25:49You're quite severe, aren't you?
25:50That's all right.
25:50Yeah, that's no problem, Talia.
25:53I've often said to my colleagues, if I could only go to calls to people over the age of 65,
26:00I would.
26:01I love them.
26:02I could sit and talk to them all day.
26:10That morphine should be kicking in.
26:12Has it helped at all?
26:14A little.
26:15Okay.
26:17For a long time, I looked after my mom.
26:19She was in the back of many an ambulance, and I saw the care she got from paramedics,
26:25and the difference it made to her in that first few minutes, that reassurance that she
26:31was okay, and just the kindness that they showed her.
26:35Yeah, we rang ahead, and they're expecting us.
26:38Told them there's a VIP on the way.
26:42You're the VIP.
26:43Oh, you must be joking.
26:46Yeah.
26:47Oh, God.
26:53Does he have to go around corners?
26:56Yeah.
26:56There isn't a straight route.
26:58Only if we'd have gone in a helicopter would we have been able to get straight there.
27:06We are just here.
27:08Yeah.
27:12And you can bring your whistle in with you.
27:16What's the whistle?
27:17Your green whistle.
27:20Green.
27:22I need a doctor.
27:23Have you a welcoming party here?
27:26Have you?
27:27Because I don't-
27:28My daughter, my daughter.
27:30Is it yours?
27:31She's been causing awful trouble.
27:33I haven't.
27:35They know I wouldn't.
27:37No, you wouldn't.
27:39I've put you here for a reason.
27:42I've put you here for a reason.
27:42Oh, you-
27:42Sorry, sorry, sorry.
27:43You are someone looking after you.
27:45So, so close to you.
27:47While we had Margaret in the ambulance, she started revealing a few little things to us, aside
27:54from her injuries, and that was that she had a special gift.
28:00She's not long gone.
28:03But she's so proud of you.
28:05She said something to me about, I've someone here who's not long passed.
28:09And I'm like, okay.
28:10My mom hadn't passed away that long before that.
28:13She'd only passed a year before that.
28:16Do you have a gift?
28:17Yeah.
28:18Aww.
28:18Do you?
28:19Yeah.
28:20Oh, well.
28:21I don't use it.
28:22Is she looking out for me?
28:24You let her down you were to do something three weeks ago, and you didn't do it.
28:28I don't think so.
28:30Would you have time to do it?
28:31Have I?
28:32Oh, God.
28:32Yeah.
28:34Post it.
28:35And it was so funny, because Margaret was talking as if she could hear voices.
28:38And I'm like, this Pentrox might be a bit too strong for Margaret.
28:42She was like, no, no.
28:44And she was giving out about you.
28:46She's saying, you've forgotten about something.
28:49Letters.
28:50And there was two letters on the back seat of my car that have been there for about eight
28:55weeks that I just hadn't got around to posting.
28:59Use some four sheets on your email.
29:01There's two letters on the back seat of my car that I was meant to post three weeks ago.
29:04Do it.
29:05Okay, I will.
29:07I'd like to believe some of those things can be true.
29:11Maybe it was a bit of the green whistle, but I think she knew a bit too much to be
29:16just
29:17Pentrox induced.
29:21Now, just a little one.
29:25Sorry, sorry, sorry.
29:27Margaret was fantastic, and I do hope that she does have the gift.
29:32And if she wants to get in touch with me, she can with the lotto numbers.
29:37That would be great.
29:38They're doing things.
29:39They're doing things.
29:49Deirdre's daughter, Rebecca, is also training to be a paramedic.
29:53And she's halfway through her first year.
29:57alongside classroom learning and exams there's another skill first-year students must learn in
30:02order to advance emergency service driving head on whenever you're ready today rebecca is heading
30:10out for a lesson with instructor pj and her classmates it was very kind of nerve-wracking
30:19at the start when you're beginning to get your c1 and you're starting your driving course everything
30:24is kind of such a big deal throughout the year you know because you need that to move on to
30:30the
30:30next stage we're going to take the next exit you can go on to level three whenever you want then
30:34okay so for this you have to put your you actually have to put your hand on it don't you
30:42blue light driving you're driving as if you're responding to an emergency but you're not
30:47responding to an emergency you're with your driving instructor so you have that safety net
30:51and they'll give you advice and techniques and ways to safely get through traffic and
30:59it's so interesting like when they'll say to do something and then
31:02you get the reaction that you want from other drivers
31:15the first time i put the blue lights on i was so nervous but then within two minutes i had
31:23calmed
31:23down because i realized the more nervous you are the less you're giving yourself time to think about
31:29things and to react to things so once you relax it becomes so much easier good safety space there
31:36so you're anticipating that he's going to have to move out because of our house so we're giving
31:41loads of room so even if he does we still have a safe gap yeah the driving is a lot
31:47of the job you
31:48know it's kind of half the time you are driving so they don't just want to let anybody out behind
31:54the wheel driving on blue lights to emergency situations it's a really important part to just
31:59kind of get through the year without any blips as much as possible and to pass everything as you go
32:07if you've learned nothing else today just learned that she always gets green lights
32:10she seems to excuse me i've gone through plenty of reds you've had more green lights than anyone
32:17ever i'm just so good at like assessing the traffic that i know when to predict them you know
32:25it will be a while before rebecca is driving on real emergency calls but as a first year
32:31she's being mentored by experienced crew greg and cuiva
32:38today they are responding to a call where a patient who has a tracheostomy is experiencing shortness of breath
32:47rebecca yeah look up your cpg for tracking care will you yeah
32:54i asked rebecca to look over the cpg so our clinical practice guideline
32:57and but it will lead you in the right direction or maybe just refresh your memory of
33:03whatever kind of care that that requires that's different to normal care
33:09you stay back you come back where are you going maybe i can't hear you geez
33:14all right we've arrived i'll turn it while you go okay
33:22i'm rebecca this is greg as well has this been going on for a while or this is just this
33:28morning
33:29just this morning okay have you had any infections recently when we arrived into the house and one of
33:36the main things they teach you in college especially about trekkies is that if the patient has been
33:43managing this tracking for a while they are the absolute experts how long have you had
33:50that yeah what's it going up good good good he was a lovely man he was non-verbal
33:58so rebecca again this is where you can we talk about language barrier but this is someone who can't
34:04speak at all speak at all to her so he took to um he had like a board with a
34:08marker and he was writing
34:10down that way so a lot of patience was involved
34:14esophagus cancer that's what you have okay can i have a little listen to your chest
34:21she also had to learn how to reword her questions to give shorter answers he knew himself what was
34:27wrong you know he just he needed that support of us telling him like yeah you know it looks a
34:32bit
34:33infected so we're going to get you in and we'll explain that to to the staff in the hospital you
34:37changed that 20 minutes ago do you have a suction you use to clear it have you been using that
34:42yeah
34:43and that's not giving it any relief quite gunky it's yellow yeah let's change 20 minutes ago we're
34:48quite full let's get a listen in yeah sound congested and there is a wheeze there on the the left
34:56hand
34:56side we've got a good reading there though when we're up at 99 i think it's more the congestion
35:04your sacerations are quite good which is good but you're short the breath so most likely you're
35:08gunked up or you've an infection you know this better than anyone don't you i can walk are you
35:14sure yeah yeah i'm gonna have to get in the chair for you we won't hang around right once we
35:20disconnect
35:20you we're gonna walk to the ambulance we'll set you up out there okay yeah are you sure are you
35:24happy
35:24with that yeah grant we had initially got him a wheelchair to bring him out to the ambulance but
35:30he wanted to walk take your time we're not in any rush okay we want to wrap them up in
35:35cotton wool
35:35and you know look after them but promoting their independence is also really important to do
35:48in dublin first year student rebecca is helping to transport 64 year old damien to hospital
35:54after he reported difficulty breathing disaster this is everybody happy to move yeah you're happy
36:04great so we are quite congested rebecca yeah and kind of global congestion we can hear the the mucus
36:12yeah yeah and is it more diminished or no it's it's loud and it's global yeah
36:20because of his tracheostomy damien is non-verbal and communicates via a whiteboard
36:27ah right your older brother is a retired ambulance man very good and your father how come you never
36:33got roped into doing it you're a chef very nice so what you're saying is when we come back next
36:41week
36:41you'll have a lovely meal prepared for us to say thank you yes i'll accept that
36:46with some students that's that's something they have to learn learn how to communicate
36:51with a patient with rebecca i feel like it's actually just quite a natural talent and i don't
36:56know if it's from working in a shop and probably having all sorts of customers all sorts of walks of
37:02life and everything she's a quite sociable person she's got great communication skills your team are
37:09worried about pneumonia okay and you were with them yesterday yeah yeah so they'll obviously they'll
37:16have a better look at it today you look like you've a bit of an infection like a sinus as
37:22well
37:23you've a bit of secretions coming out of your nose as well yeah you have to be careful yeah we're
37:30just
37:30here now anyway now damon we've arrived here okay we're going to take all the bits and bobs off
37:37you and we'll head inside to your favorite place i definitely have things to learn and i think that's
37:43like a a really big part of the job is that you can kind of you can keep finding new
37:49things to discover
37:50new calls up until you're 10 20 years into the job because people will come up with these new
37:56weird and wonderful ways to ring an ambulance so um i think it's just it's sitting in that place of
38:02you know there's still lots to learn but you're at a stage where you're you're competent enough to
38:09handle the big the bigger calls you know the more common calls
38:16it's the start of a new shift in wexford second year student nathan is on with advanced paramedic dave
38:24and the emergency calls never stop
38:27so he's pouring boiling water into a container container broke boiling water landed scottling
38:36upper thigh and drawing area red nested skin is broken patient who fights suit appearing oh jesus
38:41we got a call for it was an elderly lady who was at home and had filled a very cold
38:48glass with boiling
38:49hot water um and the glass shattered and completely burned her ties on both sides for an intern paramedic
38:59like nathan every call is a test of the skills he's learned so far so what's first priority so abc's
39:07and
39:07dealing with if there is checking her temperature and make sure that she's not hypothermic but mainly abc's
39:15to make sure it's not affecting her breathing in any way abc's pain relief so she's unlikely to be
39:20hypothermic so abc's pain relief pain relief pain relief would you prefer to go um with an ib pain
39:28relief or we go with pentrox and see how that works what's quickest all right so we go with pentrox
39:33and
39:33see how that works hello there anna hello how are you you had an argument with the the kettle did
39:43you
39:44my name's nathan i'm one of the paramedics you have dave coming in there as well okay
39:47she was sat on her bed and you could see that the um skulls were getting quite kind of um
39:54aggressive
39:54with blisters and stuff on both sides both sides of your legs here is it that's okay anywhere down
40:00further on your legs no there was a little bit there a little bit down here i see it and
40:04did i hear you
40:05put pseudo cream on it i did yeah did i do wrong so just if it ever happens again and
40:10you get burnt don't
40:10put anything like pseudo cream on it just put cold water on it until we get here sometimes part of
40:15our job is
40:16educating patients about what not to do there's a lot of old wives tales out there about burn
40:21injuries when we burn ourselves our skin is still technically cooking so we don't use oil-based
40:27products to to to treat that burn because all that the oil-based products is doing is it's trapping
40:31the heat in and still cooking the skin effectively so what i'm going to do is we're going to pop
40:37some dressings on your leg just where the burns are on your it is so this this one is called
40:42a burn gel
40:42okay so it's a little it's going to be a little bit cold yeah all right we're going to put
40:46this
40:46on and some cling film just to wrap it all up is that okay yeah with this particular patient she
40:52had
40:53areas of superficial burn but also areas of partial thickness burns where the top layer of skin had
40:59been burned away and the pseudo cream had been rubbed into these areas of the burns because it's a foreign
41:05object it can introduce infection as well as insulation the burn and can cause more harm than good so the
41:11first things that we had to do that day was try and cleanse the burn as best we could without
41:16causing any further damage to it there's blisters there there is yeah and no i don't don't worry i
41:22won't break the blisters there's one broke there that that'll be very sore it might get a little bit
41:28scaldy but we'll get some pain relief onto you first okay this one that we're going to give you is
41:33called pentrox okay might make you feel a little bit drunk have you ever been drunk before
41:40that's it well done given the level of injury to her leg that day she was in great spirits
41:50you should go in and get those burns checked out anyway and because of the fact that they've blistered
41:55up like that it's worth going in and getting it checked out burns have the risk of getting infected
41:59sometimes especially the one that's open there so they might want to give you some antibiotics as
42:03a just in case the best thing to do if you ever burn ourselves is treat the burn with water
42:09a cool
42:09compress and make sure that it's cold and even put the towel down and gently pour cold water onto that
42:15it work it'll work quite well and don't be afraid to call us if it ever happens don't wait until
42:19everybody else gets here before you call us we're only a few minutes down the road as well
42:24i didn't know you does this of course we do that's what else would we be doing
42:30nathan done quite well on this call considering we don't see
42:33many burns especially burns of this type and this nature he had his priorities right
42:38you won't be keeping me though will you i don't know i can't tell you that
42:43unfortunately i'm i'm good at a lot of things but i'm not going to tell in the future my dear
42:45i'd love to be keep doing that all the time as much as you want even in the ambulance even
42:52in the
43:21amulet
43:23have you taken anything else in the last 24 hours any drugs alcohol medications
43:38breathing new life into dated spaces and all on a budget
43:41catch the complete series of the salvage squad streaming right now on virgin media play
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