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00:00New Incident, Category 1.
00:03Put you on an RTC, two cars head on.
00:08This lady has been on the clock since 5am.
00:11It's a two-year-old who's been stabbed over.
00:15Every day across Yorkshire, more than 3,000 people call 999.
00:20He's just not breathing.
00:22He's pregnant.
00:23He's pregnant.
00:24He's trying to borrow petrol load gases.
00:26The ambulance service must decide who gets help.
00:30Andrew.
00:31We're going to look after you mate.
00:32We've got you.
00:34Can I get you covered up?
00:35Lovely and jubbly.
00:36And who must wait.
00:3834 jobs waiting for an ambulance now in Leeds alone.
00:42As the pressure on the NHS refuses to relent.
00:45We're creating the waiting room for a waiting room.
00:48The paramedics on the ground navigate England's largest county.
00:52Welcome to our office.
00:55Alright kid, well done.
00:56From the busiest cities.
00:57Chaos tonight.
00:59We'll need to get out of Leeds now.
01:01To the remotest villages.
01:03We're in the forest.
01:04In the middle of nowhere.
01:05Where each call is a crisis.
01:08I've got a five-year-old found wandering in the street.
01:10Naked.
01:11Malnourished.
01:12God, it breaks your heart.
01:13It's awful.
01:14And every decision critical.
01:16Hello!
01:17Where are we going?
01:18You alright?
01:18Please get the kids out of there.
01:20Where are they going to land?
01:21In the middle of Bratford.
01:24We go beyond the flashing blue lights.
01:26Whoa!
01:27Whoa, whoa, whoa!
01:27To reveal the human stories behind every siren.
01:31Just keep going.
01:32Absolutely.
01:33Thank you for coming.
01:35You don't have to thank us.
01:36You don't.
01:37If you've got manners, you don't.
01:39Are we all ready to set sail?
01:41Get her going!
01:42Get her going!
01:43Ha ha ha!
01:44Ha ha ha!
01:53I love your drive and...
01:54Is the patient grooving?
01:56Yes, they are.
01:58It's a two-car crash.
02:00It looks like one of them is unconscious in the car.
02:03One is unconscious?
02:04The car's almost on its side.
02:07It's struggling to get one of the guys out.
02:13Hi Matt, you've got two car RTC reports of one patient being unconscious.
02:19Roger, that's great. Thanks very much Trevor.
02:22Matt is one of six critical care paramedics covering Yorkshire this morning.
02:27His specialist skills mean he is able to give advanced care to the most seriously ill and injured patients.
02:35Hello please.
02:36Hi, we need an assistant. It's an RTC, one vehicle.
02:43The driver's twerved and the hair drives no more.
02:47He's now trapped in the vehicle.
02:50Two RTCs in the space of two minutes, who would have guessed it?
02:54In dispatch, Becky and Helen are responsible for coordinating 30 ambulances across Halifax and Bradford.
03:02Good morning 1692.
03:04Can we get you keyed on relatively quickly, because I've got an RTC that I need a crew for quite
03:10urgently.
03:12The vehicle is on its side. We have the patient wedged against the roof by his seat.
03:20Fire amples are also en route.
03:231692, Chris and Canada are dispatched to a second RTC, four miles from Halifax Ambulance Station.
03:32Watch out pigeon!
03:34Thought we were going to kill a pigeon then.
03:36We're nearly having a pigeon RTC.
03:44Tom, there's another RTC 4453, free car going up banking into trees.
03:50The 1671 have got, they're ready to sign on.
03:53Get them on, we've got another one.
03:57In the last eight minutes, the service has received three calls for road traffic collisions.
04:03Four ambulances, three incident commanders and two critical care paramedics have been dispatched,
04:09depleting available critical care resources by almost half.
04:16An ambulance crew have arrived at the first RTC in Doncaster.
04:21On scene, Matt will be responsible for providing enhanced treatment and pain relief to injured patients,
04:28as well as leading the team on the ground.
04:31So if he's just doing a set of abs on that one there, they was in that car.
04:34He's not lost consciousness with us.
04:36OK.
04:37But obviously he's trapped, he's got C-spine tenderness.
04:40OK, so he's got C-spine tenderness where he is at NSM.
04:43Has he been unconscious at any point?
04:45They said he has, yeah, but only for a few seconds.
04:48OK, no worries.
04:49So he's really our only clinical priority at this point.
04:52Fire service are here, good.
04:54Morning, guys, you all right?
04:55So our only clinical concern is this driver of this guy here who has some neck pain.
04:59So what we're going to do is get a collar on him.
05:01Danny will stay down there looking after him for now,
05:03but once we're in position to safely get him out under his own steam,
05:07that'll be the plan.
05:08Is that all right?
05:14Are we able to spring that door back further so you can get people,
05:18either side of him, to help him come up and out?
05:22Come up to us.
05:24Yeah, no problem.
05:25Come up to me, kid.
05:26Come on.
05:27Nice one.
05:28You've done really well there, Neil.
05:30My head's going to explode.
05:31I know, we're going to come have a seat with him
05:32and I'm going to show you how some pain relief soon, mate.
05:35My head's going to explode.
05:35I know, pal.
05:36Honestly, my head's going to explode.
05:37Oh, my head.
05:38OK.
05:39OK.
05:39OK, we're going to stay set up.
05:41Can we get a scoop out, please?
05:42Oh, my head.
05:43I know, I'm going to keep you set up
05:44and we're going to sort your head, OK?
05:45Whereabouts in your head is your hurting?
05:47Front, back, middle.
05:47Back.
05:48All right.
05:49I am just going to go get my drugs
05:53because I think some ketamine might be indicated here.
05:55Are you guys all right getting them inside?
06:0554 miles away in Halifax, Chris and Canada have arrived on scene
06:09at the second RTC where the patient is trapped.
06:14What do we know?
06:15It is so trapped, these guys.
06:16It's kind of work.
06:17They're getting out now.
06:18It's called Dave.
06:18Dave, yeah?
06:22It's all right, mate?
06:23It's just cutting.
06:24It's just a roof rack at the other side of the edge, all right?
06:28Hello.
06:29I'm Chris.
06:29I'm a paramedic.
06:30I'm doing service.
06:31What caused you to crash this morning?
06:33Someone jumped over the wall from my right-hand side.
06:36Right.
06:36And me being a dick and I swerved to the left.
06:38OK.
06:39I don't know whether I hit it.
06:41Have you lost consciousness at all?
06:42No.
06:43You've not.
06:43Have you got any pain, anyway?
06:44My neck feeling sore.
06:46OK.
06:46Before we can get to that, we need these guys
06:49to obviously remove this roof and everything, OK?
06:51So you just have to bear with?
06:53Yeah.
06:53All right, buddy.
07:01There's going to be a few bangs and pops, Davey.
07:04All right.
07:04But I'm with you, all right?
07:07You OK, mate?
07:08Yes, I do.
07:09All right.
07:10Well, are you off, Davey, this morning?
07:12My parents have picked up on this track about half a mile up.
07:15Right.
07:15What are you going with letting cattle out?
07:16I've only got a Highland bull calf.
07:19Yeah.
07:19A donkey.
07:20Four soony soony things.
07:22Yeah.
07:22We've got some chickens.
07:24Oh, nice.
07:24This is my little crown vehicle.
07:26All right, OK.
07:27I'm afraid I'd enjoy this.
07:2924-year-old, but I love it.
07:31Aw.
07:32Loved it.
07:36Oh, has he asked about birthday?
07:39Yeah.
07:42Yeah.
07:43I've just said it.
07:44It'll be his car and his dog.
07:46All right.
07:46All right.
07:47Are you ready?
07:47On three.
07:48One, two, three.
07:51Well done, mate.
07:52Well done.
07:52Well done.
07:53You've been really good, Rob.
07:54One, two, three.
07:55Move.
07:56That's it.
07:57Yeah.
07:58You're doing really well, mate.
08:01You're doing really well, mate.
08:05Good to be your love.
08:08Because of a bump, I would clip you in.
08:21Well, we're probably going to cut half of your clothes off to give you a full check-over.
08:25Don't cut my trousers.
08:26Don't cut your trousers.
08:27You might have to, Dave.
08:29Look at her with the scissors.
08:30I'm ready.
08:31I'm ready to chop.
08:32I'm just going to loosen your belt beginning with.
08:34Oh, it's my elbow.
08:36I know.
08:37Don't move it.
08:40Any pain where I'm touching, Dave?
08:42No.
08:43Just a little bit sore.
08:44Which...
08:46Where's that hurting, mate?
08:47The elbow.
08:48The elbow, is it?
08:49Oh, sorry, mate.
08:50I know it's going to be a little bit sore, but I'm just going to wipe this so I can
08:52have
08:52a look at it.
08:53Jeez.
08:55I'm just going to put something over it, all right?
08:58No, I don't.
08:59There's no long bone.
09:00No pelvis.
09:01The only injuries that we've got is going to get a look at it.
09:02We've got neck and right elbow at the moment.
09:04Yeah, okay.
09:05What's special about these trousers, anyway, Dave?
09:08They're new.
09:11They're a bit mucky.
09:12I was pressure washing yesterday, but they are new.
09:14Are they expensive?
09:15About fifty-odd quid.
09:20Are you trying to find a vein?
09:23Yeah.
09:24Good luck with that one.
09:25I'm a Yorkshireman.
09:26I don't like giving out all of those, actually.
09:29Do you like your trousers?
09:32Do you want to have a quick word in before we do it?
09:33Yes, please.
09:33If that's all right.
09:33I'll give him his phone back as well so he can ring us.
09:35All right.
09:38Silly thing.
09:42So we're going to start Burton now.
09:45He's fine?
09:45Yeah, he's a bit fine.
09:47He's shaking.
09:47He hit the windscreen.
09:49Oh, did he?
09:49And then me.
09:50Oh.
09:51Then he just sat and just was shaking.
09:54Is he all right?
09:55I'm going to ask Leah to have him.
09:56I'm going to let him out.
09:57Adam's going to go get his car so we can go to Leah and say,
10:00I'll see you in a bit.
10:01Lovely.
10:02OK, we're going to come to Leah.
10:04Dad, I'll see you in a bit.
10:04I'll see you in a bit.
10:06OK.
10:07Right.
10:07Do you want anything else from me?
10:10I want to see.
10:11Just give us a shake when we're ten minutes, eh?
10:13Yeah, we'll do.
10:19Happy, Chris?
10:20Yeah, happy.
10:20Yeah, yeah.
10:28Dave will be taken to Leeds General Infirmary 30 minutes away,
10:33where he can be scanned and his injuries assessed.
10:43So what we need to do, Neil, we just need to get to your arms and your chest.
10:46All right.
10:46Are we OK to cut all these clothes off?
10:48Yeah, yeah.
10:48Good, man.
10:49I'm going to get a little needle in your arm and give you some medicine.
10:51Have you had morphine before, kid?
10:53No.
10:54We'll get you some of that on.
10:57Hello, Northern General Rhesus.
10:58It's Matt, one of the crit care paramedics.
11:00So we've got a 55-year-old male involved in an RTC
11:03with head and neck pain scoring 9 out of 10,
11:06with both retrograde and anterograde amnesia.
11:09We're unable to lay him down because of significant pain in his head.
11:12So I'm as convinced as I can be this gentleman has a neck injury
11:15and he also has potentially a head injury.
11:22Nice, let's go, go on.
11:22Happy.
11:25Neil will be taken to the nearest major trauma centre in Sheffield,
11:2931 miles away.
11:31I've no idea, Paul, what's going on.
11:33You've had a car accident this morning.
11:37Which way were I facing?
11:38You were facing up towards Stainforth, going back up towards Donny.
11:44That's totally opposite way to what I would have turned in to drive this morning.
11:49How?
11:50I don't know.
11:50I think you've had a collision with another car.
11:54How's the pain feeling now?
11:59About an 89 down back in my neck.
12:02About an 89 down back in my neck.
12:28Steady as we go.
12:29Good lad.
12:31That's brilliant, Neil.
12:32Well done.
12:35See you later, guys.
12:41Hi, Matt.
12:41Thank you very much.
12:42Just a new clear from that RTC.
12:46Yeah, Roger that mate.
12:47So this gentleman's been involved in a two-car RTC.
12:50The mechanism's unclear, but he appears to have spun his car and then ended up in a ditch after being
12:56hit by a second car.
12:57Thankfully, colleague had got down into the ditch before my arrival, so I didn't need to slide down a muddy
13:02bank.
13:03Fire service was superb at helping him get out of the car, but then just got very agitated with significant
13:09head and neck pain once we tried to lay him down and secure him on the scoop.
13:13Based on that, I made the decision to come to the major trauma centre, however.
13:17Sounds like a complex job.
13:19It's been RTC's madness throughout Yorkshire this morning.
13:24Thanks for attending, Matt.
13:26And return to base.
13:27Roger, we'll head back to Doncaster. Thanks, mate.
13:33Every time I put on my uniform, I'm genuinely proud of what I do.
13:38But when I'm not in uniform, I'm also a son and a dad and a brother and a husband and
13:46a bloke who likes a pint.
13:48And all of those things, that whole wealth of human experience, builds you as a clinician.
13:53I'm better at managing parents because I'm a parent myself.
13:58I'm better at managing older people because I've looked after my dad.
14:03What people really want when they're in a difficult place is a human.
14:13Ryan, have you seen this assault on 5638?
14:17Open call, open call.
14:18If any crews are around, please, for cat one detail at Greengate.
14:22Or someone in a canal.
14:24I'm beginning to stack now.
14:27It's four hours into the shift.
14:29An ambulance is going to be responding as soon as we can.
14:32Let me know when they're with you, when they're inside.
14:35And Yorkshire Ambulance Service are currently receiving a new call every 23 seconds.
14:40What is going on, Helen?
14:42I don't know.
14:44Is there a patient breathing?
14:46No.
14:48Not breathing? Not for the address of the emergency?
14:50No.
14:51What happened?
14:53What happened?
14:54What happened?
14:54What happened?
14:56What happened?
14:58Another cat won't come in here.
15:01In the last hour, the service has received over 160 new calls.
15:0667 patients are still waiting for an ambulance to be dispatched to them.
15:10An ambulance for the patient breathing.
15:12She's off the roof and I think she brought both of her ankles.
15:16Get out of this!
15:19She's one and a half years old.
15:21It's blue.
15:22And she just constantly runs down.
15:25She's closing her eyes like she's all popped out.
15:29Scooter.
15:30On her back.
15:33The ambulance is on the way.
15:34Yeah.
15:35We've got ambulance to arrange as an emergency.
15:36OK.
15:391692.
15:39I've got your next job for you.
15:42It is a 62-year-old female.
15:44It states that she's come off an electric scooter.
15:48Now, my brain says it's probably a mobility scooter rather than a ride-on.
15:55Gangster.
15:56Gangster, Granny.
16:00Chris and Canada are eight minutes from the patient in Elland, a market town four miles south of Halifax.
16:08She is conscious and breathing and it is still active. They've just rung in for an ETA.
16:14The Category 2 patient has been waiting for 36 minutes, double the target response time.
16:24PHONE RINGS
16:25There she is.
16:38PHONE RINGS
16:39Jane.
16:39All right, you guys. I'm going off to a firefighter.
16:42She's insulated on the floor, conscious breathing.
16:44She's come downhill.
16:45These passerby have lifted her up.
16:48Hello, sweetheart.
16:49Is it Jade?
16:50Yes.
16:50My name's Canada and this is Chris.
16:53I'm just going to do some checks on you, sweetheart.
16:55And then we'll get you up on the floor. Is that all right?
16:57I'd love to get up on the floor.
16:58Have you fallen and hit your head all in this mud?
17:02Yes.
17:02It was like a soft landing.
17:04Nice to meet you.
17:06I'm sorry we met this way.
17:07Jade, can I just ask you a couple of questions?
17:10Have you got any pain?
17:12No more than normal.
17:13So there's nothing new?
17:14No.
17:15You've not lost consciousness?
17:16No.
17:17No.
17:17Can I have a quick feel of your neck?
17:19No.
17:19Any pain here?
17:21No.
17:22Anything around the back of your head?
17:24No, no.
17:24Should we wait for firefighters, eh?
17:28Sorry.
17:29What's wrong with us?
17:30Is Chris not good enough for you?
17:32Oh, no.
17:33No.
17:34I'll leave you then, shall I?
17:36All right.
17:42Right, this is going to feel a little bit funny.
17:44All right.
17:44It's just a big air cushion, and it's going to come up in stages.
17:48OK?
17:49So as we get you a little bit higher, we'll support you to sit up.
17:52OK?
17:53Right.
17:54Right, are we ready?
17:55I think we'll be best sitting up first and why she's just going to...
17:59That's it.
18:00As we go up, we'll go.
18:01Try not to push off of the cushion.
18:03You've got a little bruise on your eye.
18:06Is that from this fall, do you think?
18:07I didn't have one before.
18:09Possibly, then.
18:10It's comfortable enough for you.
18:11Can I have one of these from my house?
18:15Right.
18:15You just stay there, OK?
18:17Could you just all...
18:18Yeah, I've got to be there.
18:19Are you sure?
18:19Right, I'll grab a stretcher.
18:30You're welcome.
18:30Let's drop this dressing gown and freeze some of them hands up.
18:33Yeah.
18:33Right, so on three.
18:35One, two, three.
18:37Brilliant.
18:37Get your bearings.
18:38Nice and steady.
18:39Nice and steady.
18:42Ready?
18:42One, two, three.
18:44There we go.
18:45Is Paul your partner?
18:46Look at that.
18:46Give you that glove so I don't lose it.
18:48Hey, Jane, I'm out of here.
18:49I'm going to get my kids.
18:50Thank you so much.
18:52That's all right, no worries.
19:01Right, just a bit of a bump while we go up here, OK?
19:03Two bumps all right.
19:04Ready?
19:09There we go.
19:11Is Paul your partner?
19:12Yes.
19:13Yeah?
19:14Are you jumping on, Paul?
19:15Do you want to jump on?
19:16Is that all right?
19:17Of course it is.
19:18Not a problem.
19:18How are we looking?
19:19Just got a bit of a black eye, haven't you?
19:22You have.
19:24You want to see it?
19:25Have a look in this camera.
19:29You've got a bruised baby.
19:30You're joking.
19:34Yep.
19:34You've given it a good whack, haven't you?
19:37Bloody hell.
19:39It'll go down.
19:40That's a good whack.
19:41It's good inside, isn't it?
19:42Good bump on grass, I think.
19:43You've got mud in your hair as well.
19:45I thought you were out.
19:47I didn't know, sorry.
19:47I feel guilty.
19:49Who were at the front?
19:50I tried to catch it, didn't I?
19:51Oh, did you, Heath?
19:52Put it on three wheels.
19:54Because the scooter just died, didn't it?
19:55So that the scooter could be turned around.
19:58It was just rough.
19:59Go on.
20:00It must have been about 20, 25 miles an hour.
20:04Next time you'll have put your all-weather tyres on, I think,
20:07instead of your slugs.
20:12Right, I'm just going to have a quick feel around your face.
20:16Any pain where I'm touching?
20:18Any pain in your jaw?
20:20No.
20:21Can you open it nice and wide?
20:23Close.
20:23Bite.
20:24Any pain?
20:26No.
20:27There's nothing round your neck?
20:29No.
20:30OK.
20:31Do you live on your own?
20:34No.
20:35With Paul?
20:37Yeah.
20:37Yeah.
20:38My sister lives next door.
20:39That's even better then, isn't it?
20:41Yeah.
20:42She's on standby for you.
20:44She is.
20:44She does a lot for her.
20:46What's your thoughts of going to hospital today?
20:50Can I be honest?
20:51Yeah.
20:51I'd rather not go if I didn't have to.
20:54OK.
20:55I've spent so much time in them places.
20:57You've got a little bruise to your eye.
21:00Other than that, everything else is OK.
21:02So, ultimately, yeah, it's down to you what you'd like to do.
21:06Well, I think I could probably feel a lot more at ease and more comfortable if I could go home.
21:12We can't kidnap you, Jane.
21:14I'll get the scooter on.
21:15OK.
21:16Are you all right there, Paul?
21:18Are you sure?
21:19Yeah, he'll meet you at home.
21:27Where were you going today?
21:29Were you going anywhere interesting?
21:31I was supposed to be going to my mates.
21:34It was nice of that firefighter, wasn't it?
21:36It's so lovely.
21:38It's so lovely.
21:38Yes.
21:47Once we've got you sat on the sofa, I'll make you a brew if you want.
21:54This is a posh little station, this.
21:56Would you like me to just let your sister know next door?
21:59Oh, please.
22:00If you wouldn't mind.
22:00Wonderful.
22:01I'll just bob round then, all right?
22:03Yeah.
22:03She makes a belting cuppa, our Canada.
22:05I bet she does.
22:07It should be part of job description.
22:10You put a sweetener in.
22:12I put a few in after.
22:14I've got a little sweet too.
22:15But at least I stay away from sugar.
22:18At least it's sweetener and not sugar.
22:20That's it.
22:21So that's sweeteners.
22:23Put that under there.
22:27Do you want anything else?
22:29No, you're sure.
22:32You'd be so good, thank you.
22:34Hello.
22:35Hello, that didn't last so long, did it?
22:37No.
22:38You're throwing yourself out again?
22:39Oh, dearie be.
22:40I know.
22:42Oh, you're all right, don't you?
22:44Oh.
22:47I would have thought that I'd have had a lot more, Mum.
22:50Well, you're lucky.
22:51And you're still probably running on a little bit of adrenaline.
22:54So once all that wears off and you settle down a little bit,
22:57you might actually think, do you know what, I'm sore.
22:59Or you might feel something that you don't feel at the moment.
23:02So you can ring us back at any point.
23:04It's been lovely to meet you.
23:06OK.
23:06Take care, everybody.
23:07Take care.
23:08See you later, darling.
23:17Ambulance, sir.
23:18Is the patient breathing?
23:20Yes, it is.
23:21But I've just been sick and he's been coughing to name Al.
23:25OK.
23:26So reassuring that that help's been arranged?
23:28No problem.
23:32New incident, category two.
23:35It is a 91-year-old male complaining of breathing problems.
23:39He is coughing up phlegm.
23:41Over.
23:42Oh, bless him.
23:43Yeah, we'll see what we find when we get there.
23:45Thanks for that.
23:47Halifax crew 1671, Siobhan and Ellie,
23:51are seven miles away from their sixth patient of the shift.
23:5591, bless him.
23:58He's coughing up phlegm.
24:00Yeah.
24:01I feel like he might be a regular.
24:04You're clear left.
24:04I'm pretty, pretty certain this guy's a regular.
24:09He's in a hospital bed in his living room.
24:12He's a poorly man.
24:14In 110 yards, turn right.
24:24Hello.
24:26Hiya.
24:28Hello, Terry.
24:29Hello.
24:33Terry.
24:34Hello, my love.
24:35Did you know that we'd been called?
24:39Oh, we're from the ambulance service, Terry.
24:42I've met you before.
24:43I came last time and he'd fallen out of bed.
24:46Can I have a quick listen to your chest, Terry?
24:48Is that all right, my love?
24:56Does he have any end-of-life medication in place?
24:59These are the medication that he's got.
25:01Does he have, like, a yellow folder with him?
25:03Oh.
25:04For the nurses?
25:05For the nurses.
25:06For the nurses.
25:07For the nurses for you.
25:07Let's have a look.
25:08Yeah.
25:11Tell her, thank you.
25:13Mm-hm.
25:15Yeah, these pink forms.
25:16Yeah.
25:17Do you know where these are, these drugs?
25:22So it's the hyacinbutyl bromide?
25:25Yeah.
25:25Super.
25:29Terry, so this is some medication that's going to go into the top of your arm, OK?
25:34Sorry, my love.
25:36The medication that I've given you will help with that noisiness that you're feeling.
25:43So his respect form says that he's not for Huddersfield Hospital, but he would go to Calderdale for reversible causes.
25:52Terry, if you had the option, would you rather stay at home?
25:57Yeah?
25:58OK.
26:01We're going to speak with the nursing team and we'll see what we can do to make sure that you're
26:05nice and sick, because you've got to stay safe at home, don't you?
26:09Hey?
26:10One, two, three.
26:12A cup of tea?
26:13We can do that for you.
26:15How do you have your tea?
26:18Oh, it's the one on there.
26:19I'll pass it to you.
26:21You've got cake.
26:22Would you like some cake?
26:24No.
26:25OK.
26:26Let us bring your tea to you.
26:30Let me help you.
26:32Ooh.
26:41Nice and steady.
26:49Thank you for calling the Calderdale District Nursing Team.
26:57Hello, it's Siobhan from the Ambulance Service.
27:00So, Alan goes by Terry, so if I call him Terry, that's why.
27:05Alan has been having some fairly significant respiratory secretions.
27:11He's got a Respect Form in place that's wishing not to go to hospital,
27:14if possible.
27:16But are you happy for Terry to stay at home?
27:19I mean, I can't really make that decision
27:21cos I'm not a qualified nurse.
27:23I'm just here to take the calls.
27:25Go on.
27:25Can't you pay a bill to start till seven?
27:27What time do you finish? Are you on duty all night?
27:29Er, no, we finish around half past six, so...
27:34Oh, right. Right.
27:36It's fine. It is, yeah.
27:38I tell you what, I'm going to have a chat with one of our band sixes
27:41and see that they're happy with that.
27:45Sorry, Terry, we're still just figuring out a plan for you.
27:59The most valuable job that I go to is an end-of-life job.
28:06They require a level of care and calm and cup of tea-making.
28:13A hospital is not the place for everybody.
28:17Sometimes when we go to a patient who is dying,
28:20you have to be that patient's advocate,
28:23following somebody's wishes
28:25and keeping them comfortable and happy,
28:30no matter how difficult that is.
28:34Naomi, hello, it's Siobhan.
28:36We've had the conversation with Terry.
28:38He doesn't want to go to hospital.
28:42Yeah.
28:43There it is.
28:43Oh, yeah, yeah.
28:48Yeah.
28:49Can you add one of these so we can check you can buzz for someone
28:52if you need anything?
28:55Yeah.
28:58Right.
29:01Super.
29:02Thanks so much for that, Naomi.
29:04No worries.
29:05Take care.
29:05Cheers, love. Bye.
29:07So, we're planning to leave you at home.
29:10Are you OK with that?
29:12Yeah.
29:12Terry, you know, if you were panicking and you were poorly,
29:16would you press that?
29:18No, no, no.
29:19How would you ring us, then?
29:22He won't.
29:23Even when he's been on the floor before,
29:24he's not pressed the key line pendant.
29:26You willingly choose not to press that pendant, don't you?
29:30Why?
29:30You don't press it even if you need help.
29:33Why?
29:34No.
29:35You just do.
29:36Terry, the medication that we've given you today...
29:41Yeah?
29:41..that's for when you're dying, OK?
29:45And it may not be now and it might just be
29:47that you needed that little bit of medication
29:49to help you along a little bit with your breathing.
29:53But I just want you to know
29:55that if you feel rubbish, please call us.
29:59We'll more than happily come out and see you, Terry,
30:01and we can keep you nice and comfortable.
30:05Don't laugh at me, I'm being nice.
30:10Oh, Terry.
30:13Promise me, if you need us, press that button.
30:18All right, my love?
30:39So I've met Terry before.
30:42And the Terry that we went into, we're so different.
30:46But I don't think that there's no more that we...
30:49No, I was just going to say,
30:50I think we've done the right thing by him there.
30:52He didn't want to go to hospital.
30:54Yeah.
30:54And, you know, when someone's on palliative care,
30:57you know, is it the right thing to do
30:59to take them out of a nice, warm home, what they used to?
31:02Yeah.
31:03Oh, bless him.
31:08Hi, 16721.
31:09Thank you for running on that.
31:10I appreciate the fact that it's made you overrun a little bit.
31:14You know, they're all worth it,
31:15but sometimes they're extra worth it,
31:17and this sounds like one.
31:19So you two enjoy your evening.
31:21And I will speak to you soon.
31:23Bye-bye.
31:25Cheers, Jake. Speak to you tomorrow. Thank you.
31:28Let's go home now. Let's.
31:45Morning, morning.
31:46Morning, Charlie. How's your night been?
31:48Nice and steady, to be fair.
31:49Oh, good stuff.
31:51It's the start of a new day shift for Yorkshire Ambulance Service.
31:55Morning, Amy. Morning, y'all. Morning.
32:00Back for another 12-hour shift,
32:03our Halifax crew, Siobhan and Ellie.
32:06Morning, 1671.
32:08We're not looking too busy at the moment.
32:12Do you want to go and grab a quick cuppa?
32:16She's saying bold things.
32:18Yep, that sounds about right.
32:19We'll go grab a cuppa, thank you.
32:21It's going to be a mild morning.
32:23Oh, shush.
32:25She's jinxed it now.
32:26Shush, you.
32:27She's fully jinxed it.
32:29And Canada and Chris.
32:32Good morning, 1692.
32:34How are we this sunny morning?
32:36We're OK on this dark, gloomy morning.
32:39I will hopefully not have anyone falling off
32:41any mobility scooters today for you.
32:44That's perfect, thank you.
32:49I'm feeling service is the patient breathing.
32:52Yes.
32:53Yes.
32:53Is the patient awake?
32:55Er, no.
32:57OK, tell me that colour's happened.
33:00She's on end of life's hair.
33:02We've come down this morning and she's fallen right away.
33:05But me and my husband are able to pick her up
33:07and put her back to bed.
33:09How long are you staying here?
33:11She's 96.
33:11OK.
33:161279.
33:17Yeah, 1279, it's on.
33:18I've got a 96-year-old female end-of-life patient
33:21who's fallen out of bed.
33:23Er, she's currently conscious but some difficulty breathing.
33:26There is a crew that's seven minutes behind you of her.
33:29Roger that, mate. All we're safe, thank you.
33:35Heading up critical care again today is Matt.
33:38He's the closest specialist paramedic to the patient.
33:54Hello, my name's Matt.
33:56What's been happening?
33:58She's on end of life.
33:59OK, have we got her end-of-life paperwork just for me to have a look at?
34:03Hello, sweetheart, what do we call her?
34:05Sylvia.
34:05Hello, Sylvia.
34:06So we come down, she's got herself wedged.
34:08So she's gently, we've laid it at floor.
34:12Yeah.
34:12But because of how she is, when you try to move her,
34:17she starts screaming cos her legs hurt and everything hurts.
34:20Is that normal for her?
34:22Well, it is.
34:22It is in the last two days.
34:24OK.
34:25Clearly that form is quite clear.
34:27Yes.
34:28Are we happy that the right thing for us to do
34:30is just to get Sylvia back to bed and make her as comfortable as possible?
34:32Yes, yes.
34:32Oh, no.
34:33All right, Sylvia, love, we're going to get you up off the floor
34:36as soon as we can, darling, OK?
34:38How's your mum?
34:39Yeah, it's my mum.
34:40Your mum.
34:40What we're going to do, I'm going to give your mum
34:43another dose of Oxycodone,
34:45just to get her some pain relief in before we get up off the floor.
34:47Is that OK?
34:48Yeah, that is, thank you.
34:52Hiya, guys.
34:53This is Sylvia.
34:55Sylvia is on end-of-life care,
34:58has fallen out of bed in the night.
35:00Family have done great jobs, as we often find with these things,
35:03to wedge her in with mattresses,
35:04and Sylvia's still somehow managed to negotiate her way round that.
35:07So she's on the floor down here,
35:08in quite a lot of pain whenever we're trying to move her,
35:11so what I was going to do is just get her some Oxycodone,
35:13give that a couple of minutes to work,
35:14and then we'll get her up.
35:15I think it's going to be so however we do it.
35:17Yeah, yeah, so, yeah.
35:19But I think...
35:20Sylvia, darling, I'm going to give you an injection in your leg.
35:22I know, darling, I know.
35:24I'm going to give you an injection in your leg,
35:26and then we're going to get you up off the floor, darling, OK?
35:29A little sharp scratch in your leg, darling.
35:36Sylvia, love, we need to get you up off the floor, darling, OK?
35:39Ready?
35:40Up we go.
35:42There we go, darling.
35:45That's better, isn't it, love, eh?
35:47That's a sexual terror.
35:51That's better, isn't it?
36:00Hello.
36:02Michael!
36:03Somebody here.
36:05Laughter, yes.
36:07Now, she's back in bed.
36:08She's nice and subtle.
36:10Thank you, Michelle.
36:10It's all right, sir, sorry.
36:11Is there anything else I can tell you, anything else we can do?
36:13No, no, no.
36:14Yeah, that is really weird.
36:15Just keep a good look at all.
36:16Absolutely, it's all right.
36:18It's all for them.
36:25It's funny looking after your own parents,
36:27only when they've looked after you for some of them.
36:29Yeah.
36:30Yeah, but they've existed here.
36:37I'll tell you what, she's got her constitution.
36:40She's fighting.
36:42Fighting to the end.
36:43She and bless her.
36:44Nothing as tough as little old ladies.
36:46Nothing as tough as little old ladies.
36:48I do agree there.
36:50Having had a very similar experience with my own dad,
36:55we talk a lot about end-of-life care,
36:57but, of course, we can't predict when it's going to be.
37:00It's a marathon, not a sprint.
37:01Yeah.
37:03And looking after yourselves,
37:05to be able to manage all of that is important.
37:08Are we OK, Sylvia, love?
37:13It's a massive privilege to be able to look after your parents
37:15when they need it the most.
37:18I would say the last two weeks of my dad's life
37:20were physically some of the most challenging I've ever had,
37:23but mentally were exhausting as well.
37:27Thank you very much.
37:28Is it Matt?
37:30Matt?
37:31Yeah, I am.
37:31It's an absolute pleasure.
37:35Right, am I OK to leave things in your cake?
37:37Yeah, absolutely.
37:39Happy, happy, happy, happy.
37:42Thank you very much, Matt.
37:42It's an absolute pleasure, guys.
37:44You take care.
37:45Yeah, thank you, Matt.
37:48The worst I think I've ever felt
37:51was coming downstairs in the night
37:52because he'd fallen out of bed
37:54and seeing my dad in a heap on the floor
37:58looking up at me just terrified.
38:07I think that's informed my practice about
38:10how can I work in such a way
38:12that it takes some of that burden off that family?
38:15Even if it's just for a short period of time,
38:17how can I give them a little breather
38:19in this unremittingly challenging time?
38:28Yeah, I was on the desk, mate.
38:30You've got a nail in cardiac arrest.
38:32CPR in progress
38:33and we've got a crew that's two minutes away,
38:36second crew 14,
38:37and you're showing four minutes behind them, over.
38:41Roger, thanks, mate.
39:02So, he was disconnecting something.
39:05What was he disconnecting?
39:08OK.
39:08They are travelling as quickly as they can.
39:13Demand on the service is increasing.
39:16In the last hour, the number of calls have doubled.
39:21Oh, we've got a few jobs coming in.
39:23I think this is the car before the storm.
39:24It's beginning to pick up.
39:26You can feel it.
39:29It's the patient breathing.
39:30Yeah, it's me.
39:32I'm a layman.
39:34Tell me exactly what's happened.
39:36I'm a layman of it.
39:38My contacts are at two minutes left.
39:44We heard a scream and we've all just looked over a wall
39:47and there's literally an eight-foot wall blown over with the wind
39:50and landed on somebody who walked underneath it.
39:52Is the screwdriver still in his eye?
39:55Someone get police, please, if they're free.
40:021671.
40:02I have a further job for you.
40:04It is a tattoo for a 70-year-old female in Ellen.
40:09Siobhan and Ellie are the closest available resource to the patient.
40:14She has COPD.
40:17There's lower crackles on her lungs.
40:19Sats are dropping to 85.
40:21We'll go see what we can do for her.
40:24Lovely. Thank you.
40:44Hello.
40:45Is it Sheila?
40:46Hello.
40:49So tell us what's been happening a little bit, if you don't mind.
40:53I've just been a bit light-headed.
40:55My sister says me mouth and me tongue will bloom.
40:59So it came down, Sheila.
41:01Have you rang 111?
41:03My daughter must have.
41:05So it said something about lower crackles.
41:07What's your daughter?
41:08Is she a nurse?
41:09OK.
41:12What else feels not normal to you, Sheila?
41:16My mouth talking.
41:18In what sense?
41:20I don't talk right.
41:22So how long have you felt like your mouth doesn't feel normal?
41:26Hello.
41:27Hello, hello.
41:28Is it Deborah?
41:29It is, yeah.
41:29Hiya, Deborah.
41:30Hiya, Siobhan, this is Ellie.
41:31Debbie, have you seen your mum today then?
41:33Yeah, I came down early.
41:34She was trying to roll herself a cigarette,
41:36but we've taken about 20 minutes to do.
41:39How have you felt over the last couple of dates?
41:43Tired.
41:44Yeah?
41:44Yeah.
41:45Headache?
41:47Yes, I've been waking up with headaches.
41:49Any family history of strokes?
41:51Her dad.
41:52Her dad.
41:53Okey-dokey.
41:59Right.
42:00Give my hands a big squeeze.
42:03Nice and strong.
42:05Brilliant.
42:06Then I want you to push my hand away with your leg.
42:09Brilliant.
42:13Great.
42:15I think it's probably worth taking you down to hospital.
42:18Let's rule out that there's maybe not been potentially a mini-stroke.
42:25I'm less worried about the crackles at the bases of your lungs.
42:29I'm less worried about your oxygen levels, which are dropped,
42:32whereas these things that you've told me about are slightly more significant.
42:37No.
42:38I know nobody wants to go to hospital,
42:42but sometimes I think it's for the best.
42:45Yes.
42:46I agree.
42:48Let's get your coat on.
42:50Will you feed me cats, please?
42:52Do you want to feed them before we go?
42:54If they're fed, they'll make a run for the door when it opens.
42:58If they're not fed, they'll stay here till they get fed.
43:00Because they know it's tea time soon.
43:02Yeah.
43:02I see.
43:03They'll follow me.
43:04They know the system, don't they?
43:05I see.
43:05Are you a bit Scottish?
43:08No.
43:09Oh.
43:10She just sounded like you had a Scottish accent.
43:12It's probably because my mouth's not belonging to me.
43:14Maybe.
43:15Maybe.
43:19So were you a nurse, Sheila?
43:20Is Debbie following in your footsteps?
43:22No, no.
43:23I worked imp mill.
43:25Imp mill.
43:26Right.
43:27Let's get you on to Calderdale and let's get you checked over.
43:31Would you like my arm?
43:34No, yeah.
43:35Good morning.
43:36I think it's a good idea.
43:45Right.
43:46Nice and steady up here for me.
43:48Do you want to take your jacket off before you get on to bed?
43:51Because it's like a massive duvet, is that?
43:53It is.
43:54It's lovely.
43:55It's lovely.
44:01Scutch a bit further over for me.
44:05There you go.
44:06That'll do.
44:06Super.
44:13We're going.
44:14Cheers, Jake.
44:15Sheila will be taken to Calderdale Royal Hospital three miles away, where she will be treated by stroke specialists.
44:23How long have you lived in that house, Sheila?
44:25Oh, about ten years, I think.
44:28Have you always been from Elland?
44:29Yes.
44:30Yeah.
44:31So is that what you used to do then? You used to work in the mills?
44:34I did, yeah.
44:35Did you like it?
44:36I did.
44:38I loved it.
44:39Yeah.
44:40How long ago has it been since you retired?
44:43I retired because of my arthritis that fucked it.
44:47Oh, crikey.
44:48How do you enjoy your retirement then?
44:51With my animals.
44:53Okay.
44:54Are you just cats and dogs?
44:56No, there's the tortoise running around the house.
44:58No, there wasn't.
45:00Oh, no, as if we left.
45:02Yeah.
45:03What's your tortoise called?
45:06Michelle.
45:07It's Michelle.
45:12Oh, did you pick it up?
45:14Oh, yeah, we sit and watch telly at night together.
45:17Stop it, do you?
45:18Yeah.
45:20That's lovely, I like that.
45:21Sit to me on my chest and watch telly.
45:26Right, feet on that one and then we'll get you inside.
45:38How was that detail?
45:40Over.
45:41So, the findings of Sheila were different to what we were alerted to
45:45with regards to a COPD.
45:47So, she's been taken into Calderdale with a suspected mini-stroke.
45:52Oh, bless her.
45:53Probably quite a good job.
45:54It was coded as a cat too, over.
45:56Yeah, so, my dad had had a stroke just a week ago,
46:00which Ellie had gone to my dad for.
46:01So, I'm a little bit more aware of it and maybe, I don't know,
46:06a bit cautious around that one.
46:08So, I think that's probably more why we've come down that route just in case.
46:12I think that's very sensible.
46:14Are you okay, though?
46:16Over.
46:17Oh, yeah, I'm good.
46:19My dad's good.
46:19But, yeah, life experience adds to the job all the time, doesn't it?
46:24Brilliant.
46:24I'm glad to hear that you and your dad are both doing well.
46:28Oh, you're a superstar.
46:30Thank you so much and we'll chat to you soon, I'm sure.
46:39Ambulance service, pace on breathing,
46:41I work.
46:41And we're currently caring for this man.
46:43And we've walked in and he's laid on the bed and his breathing is just not right.
46:50It sounds like he's drowning in his own phlegm.
46:59You will see we've diverted you onto a Cat 1, 91-year-old male.
47:04It's coming through a short-of-breath breathing problems.
47:08No worries, that's absolutely fine.
47:11It doesn't look like we're too far away anyway, so once we get there and get eyes on, we'll
47:16give you an update.
47:20Chris and Canada are four minutes away from the Category 1 patient in Halifax.
47:3423, 25, right door.
47:42Hello.
47:43What do we call this gentleman?
47:44Alan.
47:44Hello, Alan.
47:45How are you feeling?
47:47I walked in and the way he was breathing sounds like he's got a load of stuff stuck.
47:52Rattling.
47:53It sounds like he's drowning in it.
47:54Oh, bless him.
47:56I think you guys did come out last night from what we've been told.
47:59What's his respect for him, sir, to stay at home?
48:02Er, don't want admission to Huddersfield but would accept Calderdale for a treatment for
48:07reversible causes.
48:08That's it.
48:09I'm back again.
48:10OK, do you want any help?
48:12No, we're all right.
48:14Super.
48:14So he will travel to Halifax?
48:16He will travel to Halifax.
48:18Do you want to have a look at him?
48:19Yeah.
48:21Are you guys happy if I sit this up?
48:23Yeah.
48:25And his knees at the same time.
48:31I don't know if he's got right-sided facial droopy now.
48:38How many times have you seen Alan?
48:40First.
48:41I have met him before.
48:42You have.
48:42Right, so you know what he normally looks like?
48:44Yeah.
48:44Will you just have a quick look at Alan's face for me?
48:47Would you say that's normal for him?
48:49It is a little bit, though, isn't it, now you say it?
48:52Do you know if he's had any previous strokes or TIAs or anything like that?
48:58He is on cocky dog roll.
49:00In that one?
49:01In that one.
49:04Have you got any pain, Alan?
49:06Can you nod your head for me if you have?
49:08You have?
49:10No.
49:11Super.
49:12I think there'll be a trip in, and whether maybe he's had something go on neurologically
49:17or chest, that would be Calderdale, and he is happy to travel to Calderdale for reversible
49:23causes.
49:24Yeah.
49:24Is that all right?
49:25You happy with that?
49:27Yeah.
49:28Right.
49:31You're off on your jollies, Alan.
49:32Listen.
49:32We're taking you up to hospital.
49:43Do you have a bag that we can just put maybe some clean pyjamas in?
49:55Could you just hold that chair for me so it doesn't slip out?
50:02Let's get you in it that way.
50:08OK, sweetheart.
50:11We'll go get you checked out.
50:18Alan will be urgently assessed for a suspected stroke at Calderdale Royal Hospital.
50:38There is a window for strokes for the treatment and the thrombolysis, so it's important that
50:42we got him there as fast as we could.
50:46Hopefully, he'll get the right treatment at hospital and he'll be home in no time.
50:51Yeah.
50:51It would have been nice to keep him at home.
50:53His respect for him was all about trying to keep him at home, keep him comfortable.
51:0446 miles away in Doncaster, a crew have requested critical care backup for an end-of-life patient
51:11in severe pain.
51:15Hiya, are you all right?
51:17So, this lady's 83.
51:19She has had a left-sided hip dislocation.
51:23It is swollen out here.
51:26The GP has given her a new respect for hospital, which clearly says no hospital admission.
51:31It's all right.
51:32It's OK.
51:33I don't want to take it to hospital now, but I do think at this moment in time, it is
51:38our only sort of option.
51:42I suppose it's difficult to gauge, isn't it?
51:45It's a rock and a hard place.
51:47You know her better than us, what do you want to happen today?
51:50You want her to be pain-free?
51:52OK.
51:53So, I think what we'll start with, we're going to give her an injection of morphine into
51:56her arm.
51:56If that settles her, we'll think then about what we're going to do.
52:01Yeah.
52:05I'm actually happier with the plan of, we give this, and the working plan is, if it
52:11wears off, we come back again and give some more.
52:13Of course, if this doesn't work, we then have no other option but to take her through to
52:16hospital.
52:17But I think if we can do that and leave her here, I think it's a better experience for
52:22Rita.
52:22Definitely, yeah.
52:23And that's what I'd want if she was my mum.
52:28And I'd rather us come out again, do another quick dose of morphine with everything in place
52:33that we'll put in place for her, than I think her being down at hospital.
52:37Is that OK?
52:38Yeah.
52:38That sounds right.
52:39Yeah.
52:40OK, Rita, look.
52:42Yeah.
52:42Relax back.
52:43I think it is.
52:44There we go.
52:45You've got to get it right, haven't we?
52:46There we go, darling.
52:47It's all right.
52:48Look at that.
52:48You have a cuddle with Matt?
52:49Hey.
52:51You just wanted a cuddle, aren't you?
52:53It's all right, darling.
52:54Can you have a cuddle with me?
52:55Oh.
52:56I know.
52:59My experience with my dad really does underline that.
53:02My patient isn't just their pain or their symptoms.
53:06The patient is a whole person who has lived a full and interesting life.
53:15Should I have a scratch?
53:17Well done.
53:19Well done.
53:20Well done.
53:21You have to understand the patient's wishes, the family's wishes.
53:26And very often when you get to that point of saying,
53:29if this was my mum or my dad, this is what I'd do.
53:33You see the relief on the family's face that a decision has been reached
53:37that they can be at peace with.
53:41Look at this sheet soaking as well.
53:43I think we're going to have to have a brief transfer onto trolley.
53:46OK.
53:47Just to get a bed changed and get it back into a clean dry bed.
53:51What you like, eh, trouble?
54:01Right, my darling.
54:02Everyone happy?
54:03Ready, steady and move.
54:05Look at that.
54:06That's a good move, guys.
54:07Well done.
54:12Right, my darling.
54:14So I want to try and get her back into bed as she is,
54:16cos I think she'll be a lot more comfortable if she's not propping herself up.
54:21Ready, steady and move.
54:23There we go, darling.
54:26We no longer need big lights on so they can come off.
54:34How long's Rita lived here?
54:36Since September.
54:38Was she at home before then?
54:40Well done well there.
54:42Was she having some problems with kind of memory loss and stuff before she came in?
54:46Yeah.
54:47I think we were masking it a lot as a comic or something, yeah.
54:50Yeah.
54:50Well you do your best, don't you, brother?
54:51There comes a point where you can't do any more.
54:53No.
54:54No.
54:55But then a week after she came in and he had her brother collapsed and died unexpectedly.
55:01Oh.
55:02Blimey.
55:03That's...
55:04It's been our time for you, hasn't it?
55:06Oh.
55:08Oh, sorry.
55:09It's OK, don't worry.
55:11It's been a really tough time for you.
55:13I don't know.
55:16And she doesn't know because she doesn't know.
55:18No, of course.
55:19So...
55:20It makes it hard, I don't know.
55:27I think as we are now, I'm happy now she's asleep.
55:32That she can stay at home.
55:33Are you comfortable with that?
55:36I've written some notes, I'll have a chat with the care staff.
55:39Basically the instruction is if anything changes, call 999.
55:43Is there anything else we can do for you or will you?
55:45No.
55:46Alright, you take care, guys.
55:48No problem.
55:49You take care.
55:49Thank you, guys.
56:07My feelings very strongly that culturally we don't talk enough around death.
56:11It's the one thing you can guarantee.
56:14Hopefully it comes to us after a long and happy life.
56:17That doesn't make it easy.
56:19It's never easy.
56:21Honey.
56:24It's been a long time.
56:28Coming.
56:29Well, home.
56:31Home, James.
56:32Home, James.
56:37There is such a thing as a good death.
56:39For me, a good death is pain free.
56:43In a place of your choosing.
56:46Surrounded by your loved ones.
56:48Our job is doing the best we can to help with that.
56:55Careful, careful.
56:58I just wanted to say, I think you most definitely have made a difference today without a shadow of a
57:03doubt.
57:07Ultimately, if we can't save a life, how do we allow that patient to die with maximum dignity in the
57:14most peaceful possible way that's in line with their wishes?
57:20Can you hear my heart beating?
57:28Oh, do you hear that sound?
57:35Yes, I can't help crying.
57:39And I won't look down.
57:46And I won't look down.
57:49And I won't look down.
58:09I hope so.
58:27Until then, we camped down.
58:28You're welcome.
58:28Thank you,mäßigρόこと
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