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00:03After dark, while the nation sleeps, the A&E night shift begins.
00:10It can be very dangerous.
00:13We deal with a lot of aggressive patients.
00:17Things can escalate.
00:18It can be quite scary when it's just you and one violent patient.
00:24Across the UK, we join the staff of three of the most challenged emergency departments.
00:29It's always busy, it's always under pressure.
00:31Time is of the essence.
00:34And the medics who face danger each shift.
00:37Most shifts, I see more place than nurses.
00:40With the amount of drugs and alcohol admissions rising.
00:43Have you been drinking today?
00:44The risk of violence and abuse looms large every night.
00:48Please don't swear like them.
00:50They try to attack and stuff.
00:52Calm yourself down.
00:54People can become aggressive.
00:57You've been punched, kicked.
00:59You see the good, bad and the ugly?
01:01I am done.
01:02Yeah, we'll get security.
01:03The emergency department is like a battlefield.
01:05It's like organised chaos.
01:20Every night, staff and patients in A&E waiting rooms across the UK are subjected to the abusive behaviour of
01:26intoxicated patients.
01:30It's estimated that up to 15% of A&E attendances are alcohol related.
01:35Do you understand the reason why you're arrested?
01:37We always have disruptive patients or aggression.
01:40There's been times where I have felt frightened.
01:43You don't know what to do in that exact moment.
01:45There's nothing you can do other than hope you don't get really hurt.
01:49Can I already get out of this cubicle?
01:50And at weekends after dark, that percentage can rocket to a massive 70%.
01:55There's a gentleman who was assaulted outside of pub today.
01:59High numbers coming through.
02:01A lot of them obviously under the influence of drugs, alcohol.
02:03Every single shift, there will be somebody arrested.
02:20In Belfast, Royal Victoria A&E, the security team are attending a disturbance in the waiting room.
02:27I've been born and raised in this country and I can't get triggered.
02:33You're a lot drunker when you first came in to me, you are.
02:36Now you're allowed as well.
02:37We can give up.
02:39We can give up.
02:40This is crazy.
02:41No.
02:43You can have it back afterwards.
02:45I'm not drinking it anyway.
02:48That's mine.
02:50With the woman clearly under the influence of alcohol,
02:53Deputy Sister Rebecca and the security team are worried about her upsetting the rest of the patients.
02:59What can we get treated?
03:00What we're dealing with?
03:01Can we alcohol or anything?
03:02No.
03:03No.
03:03What the f***ing call?
03:05This is disgusting.
03:07This is disgusting.
03:09Could you use your...
03:10No.
03:13Yes.
03:13No.
03:14Yes.
03:15She was shouting all around the place.
03:17She made a few racist comments to many people in the waiting room
03:21and was very loud and aggressive about it.
03:25This is absolutely f***ing.
03:28You're not a f***ing.
03:30No.
03:31Do you know what?
03:31Give me a f***er.
03:32Have a better respect.
03:34No.
03:34Do the f***ing f***ing.
03:35I mean, you get a better respect for everybody.
03:38Everybody else.
03:40No.
03:40No.
03:42No.
03:44No.
03:44No.
03:45No.
03:45No.
03:47No.
03:48No.
03:50No.
03:52No.
03:55What are you throwing going down?
03:57The fight nearly broke out, but they've been separated.
04:00And we've removed the alcohol.
04:02And we have explained her that we'll give it back to her
04:05whenever she leaves any.
04:08The woman can only stay and be seen by a doctor
04:10if she gives up her alcohol.
04:12but she's already asking for it back explain like if you're willing to sit
04:17here and behave yourself you know we will see you and get you seen by doctor but you know we
04:22can't
04:22tolerate that kind of behavior so um one more chance really and then it's just to be removed okay
04:50also in belfast 21-year-old roberta has been rushed in by her father and sister
04:55after a high-impact fall at home no slow slow deep breaths they said hey that's not a cigarette
05:05she's already been x-rayed and given a penthox inhaler for the pain
05:12that's not working ah should we get another one of those probably not in the waiting room but let
05:19me check i need some now hello the penthox inhaler needs to be used constantly if it runs out the
05:30painkilling effects wear off quickly oh please please there's nothing to do absolutely nothing i can
05:42do i'm sorry it won't be long it won't be too much longer
05:52dr dara has been alerted that roberta's extreme pain has returned and needs immediate attention
05:57what we're gonna do is give you some good pain relief okay okay we're gonna get you nice and
06:01relaxed give a go putting this back in place okay please please
06:06right sweet kids let's go
06:09dr mike will be working with dr dara and has just received the images of roberta's shoulder
06:15looking at the x-ray here this this big bone her humerus should be within the joint here it's quite
06:23clearly out of position and so we need to try and get that back in the joint sooner rather than
06:29later
06:32oh all right so next step is we're going to get mike and he's going to get the the green
06:37whistle again okay i'm going to try and settle you down and relax you a bit okay have you checked
06:41the skull yeah is it okay so just showing your your shoulders dislocated okay so the the ball the of
06:48the of the humerus bone has just popped out okay so what we're gonna do is just try and put
06:53it back
06:54in place okay and you see the most important thing is see if you can keep really relaxed after you're
06:58in a lot of pain then we're gonna try and relax you but the more relaxed you are the easier
07:01it is for
07:01us to do okay just take some deep breaths okay i'm gonna try and make it easier to calm all
07:06right
07:08there's a lot of ligaments in that joint that are being stretched and in the wrong position the longer
07:13the joint is out of socket the longer it is very very painful roberta fell over four hours ago if
07:22the shoulder is not put back into position soon there's a risk of permanent nerve damage and ongoing
07:39severe pain
07:49police are an almost permanent fixture in a andes up and down the uk
07:55i do not have an issue ringing 999 to try get police and i expect my concerns that i have
08:01staff
08:01to look out for i have myself to look out for and i have other vulnerable patients to look out
08:06for as
08:06well officers spend an estimated 800 000 hours in the department every year just stay nice and calm
08:16thank you i think an ed often feels like a bit of a police station normally in recess it is
08:22quite
08:22chaotic anyway add police add nurses add radiologists add all of this into the mix and yeah it does get
08:29quite chocker
08:43in belfast deputy sister rebecca has given a drunken disruptive patient one more chance to behave before
08:50she's removed i do love my job but like there's easier ways to make money i'm just like what am
08:58i
08:58doing with my life but no it doesn't really kind of limit to just the weekends anymore it's all of
09:06the
09:06time really monday to sunday every night of the week is just the same alcohol drugs and then oh there's
09:14something happening out here sorry excuse me
09:31i want your name i want your name i want your british name i came here for treatment and you
09:38put me in the second class no no no no i want names you do you know what you're saying
09:46to me
09:46it's disgusting well you're standing in a waiting room to stress and other people there's a full
09:51waiting room here of people who are afraid right come on let's talk outside no patients who are being
09:59fairly aggressive we'll have to approach them in a calm manner explaining to them why they can't behave
10:03like that you know it is obviously putting other patients at risk scaring the staff there's been
10:09times where i have felt a bit frightened recently i was assaulted you don't know what to do in that
10:15exact moment that is quite frightening you're being very verbally aggressive to everybody in this
10:20waiting room okay you're frightening other patients right we can't have that in this department
10:29we're not we're treating everybody here the same okay we're not going to be able to let you back
10:33in whenever you're behaving like that's okay all right that's fine you don't want that's okay
10:40right yeah that's okay do my thing right we're going around circles here she's not really looking
10:46to listen to what i have to say right he's happy enough to support art yeah yeah thank you
10:55the intoxicated woman will have to leave the hospital untreated due to her behavior
10:59i always like to give people a chance however there is a line and you can't cross it we just
11:08can't allow that kind of behavior you know patients are leaving our department to go home because they
11:13can't bear to watch what's going on anymore they feel threatened they feel unsafe so therefore they leave
11:18these are normally the people who actually need to be there and treated for something really wrong and
11:24then they go home and deteriorate which is not ideal at all
11:48in newham a and e i want to be one a midwife has been taken seriously ill in the hospital
11:54at the end of her evening shift
11:55so she had some right um illia fossa pain this morning with a bit of vomiting in the past hour
12:00she's now 10 out of 10 pain in the right illia fossa we've done the bloods but they're not back
12:05yet
12:07dr carl is trying to help 33 year old agnes who has had extreme stomach pain for over 12 hours
12:13i think there is a mentality of still coming to work even when you're feeling unwell
12:17within the nhs unfortunately push yourself too hard and then you end up here
12:23obviously you're in a lot of pain when you came in and the first things we did is we just
12:26got some
12:27blood tests from you okay and we're giving you some fluids and some painkillers as well i've already
12:33spoken to the radiologist to get you a scan so they're going to scan your tummy and down into
12:38pelvis i'm a bit worried that your appendix might either burst or be very very angry at the moment
12:55i thought i could manage my shift and then go home so that i could some pink elizabeth i realized
13:03i
13:03couldn't then my colleagues put me here i've not experienced this kind of thing before
13:11my biggest concern for agnes right now is that she might have a ruptured appendix
13:15but we can't rule out other causes and in young females you always need to think about things like
13:20ectopic pregnancies or ovarian torsion or ruptured ovarian cysts so the next step is to wait for the
13:27blood to come back and to get her into the ct scanner to see if we can find what's going
13:31on and to see
13:32whether or not it's the appendix that's causing this problem the longer it takes to diagnose the source of
13:38agnes's pain the higher the risk of life-threatening complications like peritonitis and sepsis
13:44how bad is the pain out of 10 however you grade it
13:51so can i have it look at your tummy please surgeon mr shazad has come to assess agnes before her
13:59scan
14:00as she may require surgery is it sore here is it sore here no sore here no it's okay if
14:12you make a big
14:13cough for me please it hurts when you make a cough just slightly okay that's fine
14:23on examination she's tender in righty leg fossa with a little bit of guarding let's see what ct shows
14:30so if it's appendicitis we'll apply it on her with surgeon mr shazad unsure a ct scan may be the
14:39only
14:39way to know if agnes's appendix or an ovarian cyst has ruptured and her life is in jeopardy
14:45i was six if you've been before i don't know what it was
15:02it's six in recess at the moment and one is going to itu four and intoxicated i'll assess it when
15:08it
15:10arrives in newham resus a man is arriving who fell while intoxicated causing a head wound you can come
15:17to this bed well done he was found unresponsive members of the public tried to wake him so he's
15:23got that's the way um to his head there okay clearly happened with his hat on yeah he's still
15:29got a bit of blood in there um unknown to any members of the public um no one knows where
15:34he's
15:34come from they've just literally found him lying on the floor we don't know much about this gentleman
15:39his last historic case was at the beginning of january where he had a fall downstairs sustaining a
15:46head injury and that was after being intoxicated again okay do you know where we are at the minute
15:55no we're in the hospital do you know what day it is today
16:02no do you think you might have had a few drinks yeah what how much would you drink normally what
16:09do you think you might have drunk today just one yeah one beer okay all right nothing else
16:18you got any pain anywhere
16:22no pain
16:25normal all right because what you've done is you've got a bang on your head there you've
16:29been bleeding a bit on your head did you not notice that so you don't remember falling over
16:35no nothing like that you don't remember okay housing
16:44so there's a problem with the housing okay he's drunk quite a lot tonight he's already explained that
16:52he's having some trouble paying his rent for next month and now he's also telling my colleague that um
16:58he's also been fired from work so it starts to make sense why he's here in the middle of the
17:03night very heavily intoxicated and having fallen over and injured himself i'm going to get a ct of
17:09his head would you mind just to clean up the wound and see right side of the head just a
17:14little bit
17:15see if it needs a drop of glue we're going to get a scan of your head to make sure
17:18everything is okay
17:19all right with the patient under the influence of alcohol dr sarah requests a ct scan to make sure
17:27his behavior isn't related to a brain injury so we're going to clean up your head a bit all right
17:32i'm going to come back and see you after you've had your scan okay okay
17:49uh she's screaming the place down here
17:54dr mike and dr dara are about to attempt to get 21 year old roberta's painfully dislocated shoulder
17:59back into its socket please give me something
18:04i think we can maybe get you onto this bed no i need something please
18:09did you have any pain relief before this just is an absolute nightmare
18:13the problem with it is once it kicks in you'll be
18:17very relaxed and i'll see if i'll get you onto the bed first
18:21oh i mean no i can't it took me 20 minutes to get into the car again
18:27does she need to be on the bed before she can have that ideally yes because the problem is
18:31we're going to do that we're going to get on the bed
18:34sorry we'll go slow we'll go at your pace but the quicker you get on here the quicker you can
18:39have
18:39that pain relief okay listen to me listen to me listen to me hey come on too much pain medication
18:44within 24 hours carries a risk of kidney and liver damage so roberta's last dose is being
18:50reserved for manipulating the bone back into its joint
19:01take your feet off this
19:06one two three stand up stand up that's it that's it you're up you're up pull it away pull it
19:12away
19:14you're doing it that's what she's great there you go back on it just like the car
19:23you're okay
19:27see me and lie back i'll take your legs come on i can't lie
19:30you'll be okay you'll be fine
19:36now in position she can be prepped for the arm to be manipulated into its socket
19:41but this will be even more painful do you think you can release this hand because it's best that
19:47you're in control of this no i can use my teeth as i've done before she did after a couple
19:52of
19:52breaths the first time she had in her hand but she was like she was smoking it after about two
19:57or
19:57three puffs she was fine the penthox inhaler is a fast-acting pain medication that can be self-administered
20:04nice big deep breaths first and we'll get you as comfortable as possible
20:09robert your job now is just to keep taking that green whistle for me lovely slow big deep breath
20:15we see a lot of patients with shoulder dislocations and it is very very painful the muscles that are
20:22used to usually keep it in the socket essentially are in high tension and high force and are keeping
20:28it now out of socket because the pain and is causing the patient to be so tense
20:35where's the sleep on you one bourbon do you like it
20:42gonna lie a little bit flatter you keep taking nice deep breath
20:46keep taking it bro keep taking that roberta keep taking it love keep taking the muscle
20:50roberta needs consistent pain relief to ensure her muscles are as relaxed as possible
20:55keep puffing keep going keep going big deep breath
21:02come on big break even with the inhaler working it will only dull the pain
21:07so the doctors need to work quickly to slip the arm back into position
21:13stop you're okay you're okay
21:18oh oh oh oh come on it's going in that sector good girl well done keep going
21:25roberta's arm has been out of its socket for four hours and the shoulder muscles have become
21:30incredibly tense keep breathing love
21:36big deep breath where the joint has been out for longer can be sometimes a bit trickier
21:40and often that's because the muscle has maybe gone into spasm and the patient's in a lot more pain
21:45we don't get it under control until we've got that joint back in place
21:49we're nearly there okay nearly there just another wee bit love you'll be okay hold on to me
21:57let's go
22:10he was collapsed and was in cardiac arrest over two and a half million people attend a and e at
22:17night
22:17every year
22:21which is particularly challenging for the reduced night shift staff
22:27yeah we'll get security
22:37how are you doing donning how are you feeling
22:40an intoxicated patient has just returned from the ct scanner after being found unresponsive on the
22:46floor with a gash on his head we had we did we got the ct result was okay all right
22:51we did a ct of your head
22:54do you remember no you don't remember we might have to wait until he's sober enough to go
23:01when he arrived the man explained he's been having money trouble after losing his job
23:05can you just turn over so i can see your head again just to see to see if we cleaned
23:09it up all
23:10right it's really unfortunate that it's it's a bit of a downward spiral isn't it that you know
23:14that you're having problems then you drink then you hurt yourself and it goes round and around
23:18we can step him out and then i think we just keep him somewhere until he's awake enough to go
23:23home
23:23yeah i'm gonna take you to a room there and clean the wounds okay is that all right
23:34we need to keep him safe and so we're going to keep him in the department really until he's sober
23:38enough to go home safely because at the minute he's not really remembering everything that's going
23:42on and things so we just want to keep him safe here for until probably till the morning now
23:46you want to sit up a bit yeah sit up i need to clean this side yeah when you're working
23:53in the
23:54night the problem is that no one else is working in the night and so we don't get much support
23:58from
23:58other services that's a real bit of a gap really that we're just doing a bit of patching up and
24:02then
24:02sending people home without really giving any long-term solutions anything and everything is what a
24:23a stands for
24:25doctors mike and dara are struggling to manipulate 21 year old roberta's arm back into its shoulder
24:30socket sit back at you good girl despite being medicated with strong pain relief
24:38the muscles in her shoulder remain tight making it incredibly hard to move the bones into the
24:43correct position sometimes when reductions are particularly tricky then we have to apply counter
24:48traction just by attraction horizontally this is essentially where we use a sheet
24:56um to apply a force in the opposite direction and that just gives us greater force in order to try
25:03and get the shoulder into joint stay still stay still that's when you're getting into brute force
25:09territory you don't really want that you want them relaxed come on i know i know i know the counter
25:16traction should allow the doctors to pull the ball at the end of the arm bone around the edge of
25:21the joint
25:21and back into position come on breathe but they're fighting against extremely strong tense muscles in
25:28the shoulder oh help stop stop everyone stop stay still stay still the key is you keep taking this
25:34medication for us keep taking a big deep breath big deep breaths come on stop your head moving stop your
25:44head
25:44you're doing super put your leg down put your leg down put your leg down some more big deep breaths
25:51come on come on breathe it in the longer it takes to get roberta's shoulder joint back into position
25:58the more chance she has of permanent nerve damage and potential corrective surgery come on
26:05roberta ah breathe breathe breathe in come on roberta breathe in breathe it's up on this come on
26:17oh that's it that's it that's it that's it that's it that's it that's it pop you see the problem
26:24i heard it so we'll just need to get it in a sling and get another x-ray okay
26:29and then we'll take it from there no problem no problem absolutely no problem there good girl well
26:37done proud of you yes yeah thank you it's incredibly satisfying when a joint just falls into joint and
26:45you get a nice satisfying clunk you probably have to take that off you know you've had your fun
26:51don't upset her don't be upset now okay can i have one more one last puff because it's it's really
26:58sore isn't it that's why you're taking one more puff then that's it away
27:04while roberta's shoulder appears to be now in the correct position there's no way of knowing without
27:09a follow-up x-ray she will have to go back around the action then i can go home yeah
27:13if you're if you're
27:15past if the joint isn't in the correct position you take it easy okay yes mom it could be causing
27:21further damage to her shoulder or become dislocated again it's hard it's hard to watch your child
27:27you know in pain um and it's you feel sorry for her and really really your heart goes out to
27:33them
27:34just gotta just gotta take it off this move that is what it is
27:40this is where humerus was this is where we are back in joint we had to use a little bit
27:46more force
27:47than we had hoped we would uh but thankfully it did work the joint is perfectly back where it should
27:54be and patients get to go home how do you feel now you feel a lot better it just feels
27:59a wee bit like
28:01it's normal okay and you'll be followed up in the fracture clinic obviously if it you hear pop or
28:07it seems to go back out of place obviously come back to any hopefully that won't happen okay all right
28:11yeah thank you very much no worries at all there we go let's get you home
28:32in newham resus a patient who is on a fancy dress night out has arrived after collapsing at a train
28:37station this is celeste she's 27 years old she was on her way out tonight dressed up um she had
28:45a
28:45passion fruit alcoholic drink 13 minutes later she started feeling a very dry throat but then
28:50progressively got more itchy and then she felt like it started swelling
28:55passion fruit is an allergen and can trigger a serious allergic response
29:01heart attack my throat suddenly felt like very dry and like my tongue like my mouth area felt very dry
29:07and then i started having trouble breathing and like that freaked me out my breathing was like
29:13like that and i couldn't it felt like i couldn't get enough like air in um they gave me the
29:20injection
29:20when i was on like the floor and i was able to kind of like sit up a bit more
29:24after that and they were able
29:25to like move me you know i don't think so with adrenaline administered at the scene to combat the
29:32immediate reaction dr mohammed needs to make sure celeste's breathing and heart rate are back under
29:37control so your heart will get down with time normally if you had an adrenaline you should have six hours
29:46of
29:46monitoring either celeste's fast pulse is because of the adrenaline she was given
29:53or the allergic reaction so she still might be in serious danger
30:02okay let's have a look got her attached to our monitoring over here typically for an allergic
30:08reaction anaphylaxis you monitor them for a period of like six hours just to see if there's lack of
30:14reaction fingers crossed it's terrifying like to to not be able to like breathe properly or like
30:22because you start getting lightheaded and you start feeling like you're gonna like pass out
30:26or like something's really wrong and it's just it's really scary
30:32i was like am i gonna die here on the g platform
30:43accidental emergency good evening how can i help 64 year old male with a high high bm
30:50also in newham midwife agnes is being taken for an emergency ct scan after having severe abdominal
30:57pain while on shift don't worry it's a quick scan won't take too long yeah doctors need to establish
31:04if her appendix if her appendix has burst which could be deadly keep your both hands above your head
31:11like that get same over here there you go more like that like the mission is going to say breathe
31:17in
31:17and hold your breath okay
31:24david is still
31:30sit hold down
31:32i'm gonna sit you up now yeah
31:36as part of her scan radiographer jan has given agnes an injection of contrast to help show her appendix
31:43when patient comes we tend to say is like they feel a hot flush going through their body
31:48uh a metallic taste in their mouth and you might feel like you're going to vomit yourself
31:53can you feel the hot flush yeah it's normal don't worry don't worry the vomiting could be due to the
31:58contrast but it's also a symptom of a burst appendix you have to explain to the patients
32:03why this is happening and these symptoms so that they are aware of it and a bit more calmer
32:09so surgeon mr suzad has been monitoring agnes's case and reviewing her scans so we had a ct scan
32:18it showed that your appendix is normal okay so it means you don't need surgery
32:26so there was a concern whether you have some infection of your kidneys on ct scan
32:32but it's not very clear so what we'll do we'll give you some antibiotics tonight
32:41agnes is out of danger but her suspected infection is still extremely painful
32:48we will keep her overnight and we'll recess in the morning with our consultant on call team and
32:54we'll discuss how to scan with our own radiologist and so that we can have some more clarity about our
33:03kidneys
33:14yeah sorry i've lost you i think oh hi yeah sorry can i just confirm gcs
33:19that's what yes please
33:2566 year old terry has come into a and e after crashing his motorbike things happen so quickly
33:31and uh i'm not exactly sure what happened but a deer came from the left hand side and crossed my
33:37path
33:38i then hit it and uh i was away you know i was flying his daughter jessica and her partner
33:46daniel
33:46rushed into a and e when they heard about the collision do you feel dizzy or nauseous at all
33:51no not really but that feels the least of my problems my head this this wrist is painful
33:59dr eniola is treating terry after his accident he was riding a bike and a deer popped up
34:06from the view he hits the deer he fell down off the bike the ideas around the area so and
34:13they pop
34:14up from time to time deer are more common at night and early morning and headlights cause a freeze
34:21reaction making them deadly obstacles any headaches now no headaches any hand pain any foot yeah yeah
34:29this is quite painful okay and that too is quite painful we're trying to look out for other injuries
34:36that may be marked by the more obvious one so it could be a broken bone but there could be
34:43an abdominal
34:44injury it could be a fracture in the chest in the ribs any head pain anywhere no no can you
34:54open your
34:54mouth bring about your tongue okay so we try to make sure that we don't miss out on any other
35:01um injuries which may be potentially life threatening
35:12some abdominal injury but it doesn't look worrying because his observations are also fine
35:18but he sustained some injuries on the right wrist and on the left toe as well
35:26being reassured by terry's vital signs his abdomen is likely okay dr eniola turns his attention to
35:32potential broken bones so if i can just get you to face that wall there um and then you roll
35:39up your
35:39galaxy like that you're fine that's it perfect
35:46okay if you hold still there
35:50over half of the bones in the human body are in the hands and feet combined
35:55so you're just going to bend his leg me because you want to slap like that making them incredibly
35:59vulnerable to breaks
36:02and one more for your toes the worst case scenario if it's untreated the patient could have crippling pain
36:09chronic pain throughout the years if that area isn't treated on time yeah
36:17i won't be sleeping on that side tonight though
36:39any north for norwich medical trauma
36:43dr eniola is treating 66 year old terry who crashed his motorbike into a deer
36:51he's been x-rayed as there are suspected breaks in his hands and feet
36:55the big toe yeah you can see there's a fracture and it's fractured in two places oh bloody hell
37:03i don't understand that big milk with both boots the wrist looks fine the wrist looks fine oh my goodness
37:13even though there seems to be no breaks in terry's hand he could still have a fracture of the scaphoid
37:18a collection of small bones in his wrist it can be easy to miss things on the x-ray there
37:24are some
37:24fractures that are a bit small and subtle so physical examinations are quite important
37:31the x-ray can only show so much of course really show everything so well because of the bruising
37:38yeah i'm suspecting there may be a little bone break if dr eniola doesn't find all the fractures
37:46there's a chance he could heal in the incorrect position which could lead to chronic pain for the
37:50rest of terry's life any pain as a touch yeah a little bit painful yeah that appears that there's
37:57a fracture here yeah there's a fracture yeah there's a fracture okay dr eniola has spotted a scaphoid
38:07fracture not clear on the x-ray but for this where i put a strap around here yeah sure the
38:14fracture heals
38:15yeah same thing with this okay in about two to three weeks time we'll do a repeat x-ray okay
38:21that everything is okay yeah
38:27before terry can go home his breaks will need to be given temporary orthopedic support
38:32to help them heal oh i'm a little bit surprised that i've got a a slight fracture of the toe
38:40and uh this section of the thumb it could have been a lot worse so yeah i'm pretty lucky really
38:46i think and been really good service tonight i've been really looked after i can tell people have been
38:52on a skiing holiday this is your fashionable shoes it's doing okay considering the mechanism of the injury
39:02okay i expected um something a bit more drastic the purpose sir is to immobilize your thumb keep it
39:10still keep it still keep it still so it will reduce the swelling reduce the pain uh recovering time for
39:17him considering his age it may be between about six weeks to ten weeks thank you much appreciated terry
39:26will need to return to the fracture clinic in the day once the hospital is completely open
39:31for permanent treatment it's really could have been a lot worse so i think that he's quite a lucky
39:38chap yeah not too bad hello this was in newham 27 year old celeste is being closely monitored
39:56to see if she'll have any further potentially lethal anaphylactic reactions
40:01you'll take off the wires on your chest um going here is going to take you somewhere near the main
40:08waiting with the hospital needing to free up space and her condition remaining stable she's moved to an observation area
40:16but i don't know where they put my phone on the way to the fancy dress party when she had
40:35her reaction
40:36and her airway started to close isn't like athletic shock like can it kill you i guess depends how much
40:43after it closes you can google it it's a severe potentially life-threatening allergic reaction that
40:49requires immediate emergency treatment
41:02the heart rate um last time i checked it was 19 which is which is good one of the most
41:10concerning
41:10thing about anaphylaxis is um your airway is closed so you've been suffocated basically but she was quite
41:18lucky the ambulance found there early what you need to know is you need to go home with epipen okay
41:25so
41:25epipen have um adrenaline on it if you have um symptoms that you think your your throat is closing
41:33you can't talk in full sentences you're very wheezy you're unwell you're about to collapse yeah this is
41:39a red flag that you're looking for before you're injecting yourself okay with that epipens are essential
41:46as 2.4 million people have food allergies in the uk and could die of fatal reactions can you swing
41:54okay you that's not that's real you actually have to like you swing and push it oh snap well that
42:02was
42:02like i've only ever seen that like um movies and stuff like that any questions did i almost die from
42:10this
42:10like you you have reaction okay you yeah you're lucky um and the ambulance found you in a good time
42:20they were very fast they were so fast yeah yeah they saved your life basically today
42:25with no further signs of anaphylaxis and equipped with an epipen celeste can go home taxi taxi taxi
42:34we can take the train we're happy to get you seen by a doctor but we can't have that behavior
42:47here
42:48here so you're
42:49you would think desiccating the shoulder wouldn't be as sore oh it's sort of
43:10and they're putting it back in it's going to be even shorter
43:36so have you been built out have you only got to the hospital
43:53but luckily i'm retired so i don't have to go to work i'll just do a bit more reading i
43:57suppose
44:12so
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