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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.
10:47Seizure.
10:47Have the seizure.
10:48That's a seizure.
10:50Wire down flat.
10:57Seizure.
10:58Reassers, please.
11:08in Dublin third-year student Aoife and paramedic Rory are dealing with a critical emergency as
11:15they arrive at hospital with a 67 year old patient seizure resource please when somebody
11:23is seizing none of the muscles are coordinating or operating properly and they all kind of lock
11:28up even though the respiratory all your your ribs everything locks up there so essentially the
11:32patient has stopped breathing for the length of time that they are seizing let's go let's go get
11:36the machine in you go let's go I think that call was a prime example of how quick things can
11:45change
11:46that lady was widely stable but then like a drop of a hat she was actually seasoned generally seizures
11:54last about a minute two minutes at most if they don't resolve after that kind of time the patient
12:00isn't breathing for two minutes so can be very dangerous difficult calls like this one are all
12:07part of the job for experienced paramedics but it can be a tough baptism for students having to deal
12:13with critical calls on a daily basis for the first time so when you see somebody seizing for the
12:28first time and everybody looks at you in the room they go you're here to help you you literally feel
12:34really small and you suddenly have to realize remember all of your training and deal with the
12:39situation Aoife 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 after I called I felt
12:50slightly overwhelmed clearly due to the fact that I've never worked with Roy before I never worked in
12:56that station before and I feel like I had a lot of pressure on myself to kind of perform to
13:02kind of
13:03impress for Rory but I think after the call then I think speaking about it to Matty I was getting
13:10that bit of reassurance often I could see that Aoife was was going to get upset or she was getting
13:16upset when she was at the ambulance and it was the first time she'd seen seen a seizure and I
13:21did
13:21have a chat with Aoife and reassure her how well she was doing it's just shit like the last chapter
13:27I'm good the last two days I didn't I started like a bleeding club I didn't do it and I'm
13:34not I'm
13:34doing it right honestly what have I done what have I done that was good nothing we were told when
13:39we
13:39came out as interns like you're gonna have good days and bad days you're gonna have you're gonna
13:43do a call that you've probably seen ten times before and you know it to a tee and then you
13:48get a
13:48call like possibly like the one now with seizure that I've never seen before so then after that then
13:53my confidence was in the gore you're doing great I'll tell you straight out if you're not okay
13:58I'm fairly straight talking you are doing great you're great with the patients you can talk with
14:02I didn't make any interventions in that fault because I didn't think I had because everything
14:06looked okay and I did say to her at one stage she was she was like a raw diamond that
14:11we were picking
14:11up and we just needed a to polish up and to make her the the the medic that she wanted
14:18to be
14:19and you could see all the qualities in her and 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
14:27that I can be having that relationship with your crewmates is just absolutely vital because at the
14:33end of the day if you're going to major traumas or you're going to traumatic calls like it's so nice
14:39having that 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 job so much in thingless third-year student Deirdre is
14:53bringing 100 year old Alice to hospital after she had a fall at home I don't think there's any point
15:02even saying we ever in an ambulance before she's hardly ever been to the GPs never mind an ambulance
15:07he only photographs the good-looking ones Alice probably did remind me a little of my mom my mom
15:18was a tough cookie you know like Alice they don't make them like that anymore despite her pain Alice is
15:26reluctant to change the habit of a 100 year old lifetime you know when women have babies they get
15:33the gas and air yeah we're going to give you some of that no I can't make you take any
15:42medicine what
15:43I'm saying is this is here if you want right if you want no that's your choice I couldn't get
15:53over
15:54how Alice had gotten to the age of a hundred and didn't take any medication daily and didn't have
16:01any past medical history there is very few patients that I have gone to over the years who are not
16:07on
16:08at least one medication a day it was just so fascinating I've never come across a patient like
16:14her since now you keep those hands in I can see where I grab her some calls you remember
16:23over others and this is one and bringing her in to hospital we brought her in and and the
16:32handover I think was this is Alice this is the amazing Alice Alice is 100 years old look at her
16:50so nine days ago Alice had an unwitnessed fall okay so we're not sure if it was Sunday night or
16:56Monday
16:57morning okay and so possibly 12 hours or 14 hours on the floor found by the carer are you ready
17:03for her
17:04past medical history okay nothing what are you ready for her list of medications daily okay nothing
17:12wow that's hundred what are we doing wrong so yeah isn't she fabulous yes she is give me your secret
17:22that's what I said I'm coming to live with her
18:09in Wexford town
18:11second-year student Nathan and advanced paramedic Fergus have arrived at the home of DIY enthusiast Ron
18:18who has fallen off a ladder earlier in the day my name is Nathan I'm a paramedic with the ambulance
18:24I can
18:26talk louder if you want okay it's when the call came in as a elderly gentleman fall off a ladder
18:32you're
18:33expecting to find somebody lying on the ground with a ladder on top of them or a distance away from
18:38the
18:38ladder so when we got there and we found a man sitting on the corner of his bed or on
18:43the edge of
18:44his bed it was okay this isn't this isn't what it initially came in as I was outside painting today
18:52okay I
18:53saw there was a nail and I got up to hammer it in
18:58right I'd have been back but I'm in great pain I did it a little bit of a number to
19:07your back anyway
19:09being a paramedic requires a little bit of detective work sometimes and from just having a chat with with the
19:15patient and him telling us what had happened that he had been outside painting and laddered literally just fell back
19:22he fell back he fell back
19:23back landed on a big stone out in his garden then got himself up and he went
19:28about his kind of day with quite substantial injuries that we found out
19:33afterwards. You've possibly cracked a couple of ribs. We realized that there
19:38was a chance he had broken a few ribs he definitely had a head injury and he had
19:43quite a bit of a bump and some some marks and grazes to his head and he
19:48needed to go wasn't the case that we just wanted him to go he really needed to
19:51go to hospital. We have some medications that we can give you for pain can we
19:56have a wheelchair outside can we pop you on that? Don't put me in a wheelchair I'll never get out.
20:01It can be very easy to take somebody's independence away Ronald was very
20:05insistent of keeping of keeping that bit of independence and kind of walking out
20:11to the ambulance and while the injuries that he had kind of dictated that he
20:15probably shouldn't be walking the reality kind of had to set in that well he had
20:19been walking around all day at home with these injuries he had gone about making
20:22his food. Made sure he had the house in order before kind of calling us the ladder
20:27been put away the paint been put away. We're gonna swing your legs around first.
20:33Don't get too drunk on that now. It does. What did you work at Ron?
20:40I was a London cabbie. What part of London? Me? I was in a place called Dagenham.
20:45Dagenham. I lived in Wimbledon. Did you? I did. I knew Wimbledon very well. Lovely place.
20:52Wimbledon and Clapham. Once you get into an ambulance it's just chatting with people and
20:56it. Conversation can be a great pain reliever. It can also be a really good
21:01distractant. If nothing else you're calming them down.
21:08I said I lived alone but I don't. I have someone in every room. Did you know that?
21:16And who are they? Put a mirror in every room. And no matter what room we go into there's
21:22another guy in there. And we got out famously. Yeah? Oh yeah.
21:2810, 20 years ago in Ireland loneliness wasn't a huge thing. Society has changed. Loneliness
21:35with older people is probably one of the biggest things we deal with as kind of 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
21:47and forth kind of crack with people. Especially in Ireland I think that's a huge part of our
21:52job now is being that kind of middle ground of there's somebody to talk to.
22:15Should I do my wave? Sure.
22:18But I do have a job.
22:20All right.
22:20Let's go.
22:34We're going to get out of your house.
22:36We're going to get out of your house.
22:51In Dublin, first-year student Rebecca is on her 15-week placement, out of the college
22:57classroom and into the ambulance. Today she's on shift with Deirdre, a third-year student
23:02who 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
23:10without a plan? Without a plan, yeah.
23:11And then it just happened, wasn't it, that week, and that's where we're recruiting?
23:15Yeah, it was very strange. I'm so lucky, you know, that it just didn't happen, wasn't
23:20it? Yeah, it was timing. It's like a lot of things in life, it's timing and luck.
23:25Yeah. I'm really looking forward to working with my mum today, it'll be really enjoyable,
23:30we'll have to kind of find the balance of her giving out to me, and me taking feedback,
23:35and us not fighting, I 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 Abby O'Doone is complaining
23:46of severe chest pain.
23:47What would you give the pain out of 10?
23:50Nine.
23:51Nine out of 10.
23:51People are really, really concerned when they feel pain in their chest. They might have been
23:56having 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?
24:08Nothing. Just your blood pressure.
24:10Brilliant.
24:11Do you want more pressure there to you?
24:12Yeah.
24:16It is different when you're out with a student who's third person, and sometimes you can let
24:23them carry on with the call. But with the call we were at this time, I was leading the
24:29call, I was getting Rebecca to do the ob's, because I didn't want anything that was relevant
24:34past medical history to be missed.
24:37So what we're going to do is we're going to give you a little spray under the tongue, right?
24:42Okay?
24:44Might make you feel a little light-headed, might give you a bit of a headache, but it'll help
24:47with this pain, hopefully.
24:49GTN is a spray that is used really commonly, you'll see it in people's homes a lot of the
24:54time for angina. In simple terms, it kind of dilates things and allows blood to flow
25:01smoother if there is something blocking it, if that makes sense. It kind of opens things
25:06up.
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.
25:19Would have been the first call I have been on with Rebecca. It was really strange, you
25:25know, you're trying to remember back to what you were like at that stage in your career.
25:32I suppose one of my strengths has been able to talk to people, and I definitely see the
25:37same in Rebecca. She 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...
25:46button heads, or it made no difference. It didn't feel like I was working with my
25:53mum. It just felt like I was working with somebody who I knew really well, and it made
25:58the 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
26:08in the back of the ambulance with her own patients. Please God, in January when she is on her
26:13internship 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.
26:33No pins and needles in the fingers or anything.
26:34With each new emergency call testing their skills.
26:38Have you gone to the top?
26:39Yeah, that'll 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 Ballinuslaw one last time.
26:59Where are we there now?
27:00We'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.
27:17Two 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 competent 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.
27:40See and see.
27:41Brings back so many memories.
27:46The exit interview is really important for them to see how I've grown over the year.
27:51What I've learnt and how 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 it when that, 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 have, than we were in
28:20the college.
28:21This is almost like the final hurdle.
28:23I could fall at the fence.
28:24But hopefully that won't happen.
28:41In Wexford, second year student Nathan and advanced paramedic Dave were en route to a call.
28:48But they've been diverted to a higher priority patient with a history of epilepsy.
28:53So we were en route to a call and we got stood down off that call to a female actively
28:59seizing query author 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.
29:20Nothing's actually coming up.
29:21They didn't notice initially they thought it was to do with her epilepsy because she was fainting.
29:26Seem to be episodes and we have 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.
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? What happened?
29:51There 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 is 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, we're all here, all 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'll 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 the
30:51hospital as a priority.
30:57Okay, so look, I'm going to have a chat with my colleague and see what he thinks and then we
31:02will decide if we're going to do anything else, all right?
31:06Yeah, that's fine.
31:08So temperature is good, blood sugars are good, blood pressure is good.
31:14What would you treat?
31:15The anxiety and if the seizure comes back and we can treat with anandastron for the sickness.
31:24So cytosine has the longer term effect.
31:29There you go, if you hold this.
31:31You 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?
31:44Oh, I got into one.
31:46You're having a seizure, are you?
31:47Yeah, you're not.
31:49When 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.
32:05Cool.
32:16In 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 recognised the patient.
32:36I've attended to that address numerous times before.
32:41I chose not to pass that information on to Nathan because sometimes that can cloud their judgement into thinking, well,
32:51this 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.
33:19So her heart rate remains the same, her oxygen levels remain the same, her breathing rate all stay the same.
33:26If 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.
33:55While she might not be having genuine seizures, she is having some form of a crisis.
34:01And who am I, as a paramedic, who am I as a paramedic to decide that there's nothing wrong with
34:05this patient?
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 that you know needs help.
34:27But sometimes the ambulance service isn't the most appropriate help for them, and by attending this person, that you may
34:35not be there to help another person that may need you.
34:45It'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.
34:51And 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 be, to call an
35:03ambulance?
35:06I'm just at the hospital, I'm just at the hospital now.
35:10Oh, I'm vomiting and it's just, I'm not breathing right still.
35:16Sometimes 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, and the only thing sometimes that's on offer to them at the time.
35:37It can be conflicting and it can be difficult, but I think for any paramedic going out there, we always
35:45should try to remember that for them right now, it is an emergency or it is a crisis that they
35:53just 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. It was only two minutes away from where
36:36we started off initially, so quite quick to get to that call.
36:48We didn't get a key code, did we?
36:50I don't want to blow on that.
36:51There's like no other.
36:54We knocked on the door. There was no answer. So we kind of waited. We were looking around, are we
37:00at the, you know, is this the right street? This is the number, this kind of thing. And a gentleman
37:04opened the door and said hello.
37:06Hello. Hello. Hello. How are you? Not too bad. I'm Aoife, this is Quiva. Did you call for us? Did
37:16you call for us, yeah? No, come in anyway.
37:19Automatically, I was thinking, okay, well, someone around here needs us, like, so we better move on. But he insisted
37:25on inviting us in. I was a little bit, I was a little bit taken back. It was a bit
37:29strange. What's going on?
37:30So obviously we went in to him and he sat down and started to chat away to us. House was
37:36lovely. Lots of character in it. You're kind of looking around. You realise he's on his own.
37:40You didn't call the ambulance, did you not? Sit down there anyway. Just close that door and sit down there.
37:47Sandra's coming over. My daughter.
37:49When we first got on scene and we knocked on the door, we weren't even sure whether he had actually
37:53called the ambulance or not or else he was just some friendly old man that was letting the paramedic crew
37:56in.
37:56Because I think even himself, he wasn't sure as to why we were there. But we soon realised then why
38:02we were and what was the reason we were called for.
38:07What's your name? Tony. So did you call us or your daughter? Daughter, yeah. Your daughter called.
38:12I was in the bed there and I felt I couldn't get up for you. Yeah? I'm just going to
38:16do 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?
38:21I have a shakes, you know. See the shakes, yeah. I have a shakes.
38:24And you didn't, did you injure yourself at all or any of the falls?
38:28Well, just there. Did you, yeah?
38:30Was it your hand? Yeah, yeah. It's not bad now, you know. It's okay now.
38:34Can you do this to me? Yeah. Yeah.
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? Sandra, is it? Sandra.
38:46And is she looking to come and meet us, is it, before you go to the...
38:49Well, she usually needs me home to the pub, you know?
38:51Oh, lovely. And why do you think Sandra called the ambulance?
38:56Oh, don't worry about it. Worried about you.
38:58I think one of the main signs and symptoms that we noticed in the patient was that he was very
39:04shaky
39:05and his fingertips were quite red and he was slightly confused at times.
39:10So this is where myself and Eva tag teamed. So she's leading the course, she's going to stay with the
39:15patient.
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.
39:24What's your concerns at the moment?
39:29Grant. Okay. Okay.
39:31And this is all over the last few days, kind of, is it? A bit of this kind of decline
39:35yesterday and today.
39:36Okay. Her concerns were, you know, memory, not being too good, just concerned for him.
39:44There was nothing, um, 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. Do you head down to the pub every day?
39:56Oh, no.
39:57No. Just every now and again.
39:59Only one, one day.
40:00Okay. All right. Which one do you go to?
40:03The KCR over the south side and the shamrock.
40:07Oh, yeah, yeah, yeah. Yeah, I wouldn't know. I know the shamrock now. I wouldn't know the other one.
40:12And you sing, do you?
40:13Yeah.
40:14Oh, very good.
40:15Oh, I'm just singing.
40:16Brilliant. Trad music or what kind of?
40:20Oh, no, no. Just, uh, Dickie Rock, you know?
40:23Oh, yeah.
40:24We'll walk the road and life again.
40:26What's Dickie Rock? Do you not know who Dickie Rock is?
40:28No.
40:29Sing 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, did Dickie Rock do that one?
40:39No, I'll do that one, Dale.
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, love it.
40:56Brilliant, Anto.
40:57He gave us a couple of bars of a Dickie 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 singing on the ambulance gave us a positive sign that
41:13he's got everything that's 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'll be, what'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.
42:55Are 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.
43:20Getting 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.
43:28It'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.
43:37So 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,
43:55yeah, it's okay, I deserve to wear this uniform.
44:05There'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.
44:41www.virginmediatelevision.ie forward slash helplines.
44:43www.virginmediatelevision.ie forward slash helplines.
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