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00:00in the heart of Yorkshire a team like no other busy busy busy fight to save
00:11lives open your eyes for me do you know where you are you're in bands like any
00:15department 24 hours a day Wow seven days a week well nearly feel like a wet
00:27disco serving their community looks like you have broken it I don't think I'm going
00:36to love dreaming of you gin and tonic helping those most in need love you I'm
00:44tried there's nothing to be frightened of these girls will sort her out they care
00:49for anyone and everyone working more like himself thanks to Barnsley working together
00:58to make people's lives better you know I just love to look I love to make a difference this
01:07is Barnsley casualty 24-7 let's not be entering the beauty contest on shift tonight advanced
01:19clinical practitioner Chantel it could be that you've cracked her in oh dr. Heather Soudon do
01:26you like to have food enough to break your ankle and your football and sister Vicki
01:31so get ready to share a shift I love my job today I think it's amazing with the team at Barnsley
01:43casualty the early shift has begun today sister Vicki is running the hub so what do we know
01:59no no no it's my last long day is it but there's a problem I don't think messages are feeding through
02:10to EPMA now operational support manager Antonia has become aware of a disruption to the hospital
02:17network the tracking system's down at the internet's down I'm just trying to get older ID for an update as
02:24well because it's affected quite a lot of things but before the team can work out the scale of their
02:36connection problems the first ambulance arrives Jeannie has been brought into casualty for the second time
02:45this week paramedic Andy hands over her care to advanced clinical practitioner Chantel Jeannie had
02:53a full attended Barnsley District A&E on Sunday night GP then referred patient to a crisis response team
03:03found to be abnormal at that time physio rang 999 immediately and still on scene when we arrived she does
03:13have a peacemaker I say has become quite irregular okay and we'll leave Jean in your care thank you thank
03:23you okay hello bye you're all right Jean I'm Chantel I'm coming to see you Jeannie's son Stephen and
03:31daughter-in-law Carol are with her right Jim you're 92 year old yeah you don't look it thank you so tell me
03:42in your own words what happened on the third when you fell I've had a little read I'm just was just
03:48walking through the kitchen and I just fell I think I tripped and how did you go down on the floor forward
03:56this whole face straight on the floor yeah since you've fallen and hit your face have you felt sick
04:02not like nauseous vomited no not been coughing any blood oh no good and are you taking your painkillers
04:10yes are you taking them yes oh yeah everyone always says yes and they never do I always check and you
04:19worried about anything because you know your own body apart from your face when I take a deep breath or
04:29I'm more yeah makes the rings because it said the ribs were broken you've broken your ribs yes take a big
04:36breath in and it hurts yeah where's the pain helps the chest across the top okay
04:49breathing difficulties like Jeannie's can cause serious illness when it comes to chest injuries
04:56but there's not much we do unless it's a big trauma the problems with a chest injury is if frailty is not
05:04on your side when you get older but then if you're not taking good breaths and being able to cough and
05:08clear you're just gonna be at risk of getting a pneumonia so we have to try and keep you moving
05:12breathing breathing coughing comfortable because when you shallow breathe you get infections down
05:19there okay if you can't breathe properly you're higher risk of getting a chest infection or a
05:24pneumonia especially in the older population because they don't move around as much so that's my priority
05:28with Jeannie elsewhere in the hospital an alarm has been triggered medics rush Graham a 74 year old
05:40outpatient from radiology where he collapsed during a CT scan to recess
05:47I had to have a cannula put in apparently I'm difficult to cannulate and the head was really that was a bit really hot but the worst it's been all of a sudden it's about to get a circus right there's the people around me and
06:14the CT scan was to check how Graham's body has responded to treatment for cancer
06:37I got a little bit of cancer on the oncologist
06:44and then he's gonna decide whether I need to go back on to you know just monitor it for a while
07:01trainee advanced clinical practitioner Jess is looking after Graham so what I'm gonna do if it's
07:10okay with you is I'm gonna just try and take some blood from that cannula oh yeah I'm gonna see if I can
07:16manage it I know you've had contrast to it it's not the greatest but with our anxious you've been I'm gonna
07:21see if I can just get a little bit off that all right primarily I want to check that your calcium is okay all right so when you've got a cancer diagnosis
07:29background of cancer we like to check calcium because if you're feeling a bit off it and we're not entirely sure why that can sort of answer a lot of questions all right
07:38sometimes you can have low calcium or high calcium and in a cancer patient that needs to be treated as a medical emergency so that would mean
07:45that he's brought in for treatment and an infusion to to reduce that or to bring his calcium levels up so we like to say that if you've got bones
07:53moans and groans so if you've got bone pain or you've just got general aches and pains that can sometimes be attributed to calcium levels that aren't normal
08:02normal if Graeme's calcium levels have become too high he will need immediate treatment
08:20in the hub sister Vicky is just half an hour into her shift
08:24so today we haven't got the tools that we generally have and our patient tracking system is down so we can't see the plotting of the patient's
08:40arrivals
08:41it's gonna be one of them yes
08:43so currently we're having a few issues because I do believe all the internet's down throughout the hospital and it's national as well as
08:51what I've found out so we're having to do it manually and verbally between members of staff
08:56so on top of one problem and then another issue arises
09:02but if the server problems were not enough casualty is now quickly filling up with patients
09:09what was your cubicle for? Barbara?
09:12Barbara's gone to ward?
09:15Yes she's gone
09:16right it's just so I can tick her off this list
09:18so currently we've got 25 patients in the department
09:21so then it gets a little bit icky when I need to have staff moving and things
09:30right close your eyes for me
09:31can you feel me touching you?
09:33yeah
09:3492 year old Jeannie has fallen at home
09:36advanced clinical practitioner Chantelle is assessing her injuries
09:40good stuff and pop your arms out
09:43Jeannie's son Stephen and daughter-in-law Carol are by her side
09:47can I have a look at your lip?
09:49oh it's healing nicely that
09:50yeah
09:51you heal well
09:52yeah
09:53okay can I pop your glasses off?
09:55I'm just gonna have a just a little look look straight forward
09:59so it's important to do another thorough history on Jeannie
10:02she might have injured something else that we didn't initially pick up on
10:05that can be quite common
10:06so I did a really thorough work up
10:09a good examination of it just to make sure that there's nothing else underlying
10:13anything broken that we've missed the first time
10:16can you just follow my pen torch?
10:18it can make you feel a bit dizzy sometimes this
10:21down there
10:22okay
10:23can you move your eyebrows?
10:24close your eyes really tight
10:26nice and tight
10:27okay open your eyes
10:28can you puff them cheeks out?
10:31and smile for me
10:33can you bite down?
10:35and can you bite your teeth together?
10:37good stuff
10:38okay
10:39he's laughing at you
10:41we're just saying
10:42it's our wedding anniversary today
10:44it's your wedding anniversary?
10:46this is what we love
10:47okay
10:48I've described my bedside manner as quite light-hearted
10:52I'm really sorry Jeannie but it's the
10:54you didn't tell me it was a wedding anniversary
10:56I like to just be myself
10:58um
10:59patients coming to A&E can be quite scary
11:01especially if you're older
11:02there's a bit of a notion where we like to keep patients in
11:05and then that can be quite worrying for them
11:07they've put me off now Jeannie
11:12some people get scared thinking they're not going to end up going home
11:16if they're coming to hospital
11:17and they're scared of dying in hospital
11:19so I try and keep it as light-hearted as possible
11:21and reassure them that my job is to try and get them back home
11:25can I ever listen to your lungs?
11:27yes
11:28let me feel your pacemaker
11:30is it there?
11:31yes
11:32how long has pacemaker been in for?
11:34till I see you
11:36no, er
11:37she had it checked on in May
11:39did she?
11:40yeah
11:41here?
11:42it will help me
11:43sorry
11:44is this painful?
11:45yes
11:46erm
11:48is it painful around there?
11:49yeah
11:50yeah
11:51I find it difficult seeing anybody in pain
11:53but seeing older patients in pain can be quite upsetting
11:56it's hard to try and find out if they're in pain
11:59because a lot of older patients are quite stoical
12:01especially from Barnsley as well
12:03er, they don't want to admit any weakness
12:05sorry
12:06oh oh
12:07is that where it's really painful?
12:08oh
12:09yes
12:10oh
12:11oh
12:12oh
12:13oh
12:14oh
12:15oh
12:16oh
12:17it could be that you've fractured a rib
12:18oh
12:19oh
12:20oh
12:21okay
12:22right, let's have a listen down there
12:25big breath in
12:27I know
12:29can you sit forward for me?
12:37are you alright?
12:38yes
12:39sure
12:40yeah
12:41just have a good look at your back
12:45my job is to try and figure out where the pain is
12:48to try and encourage them to be honest about the pain
12:51because it helps me diagnose pain
12:53and if it were my own grandparents that would really upset me
13:03you're quite crackly down there at the bottom
13:05so I might send you for an x-ray just to make sure there's no fluid or anything
13:08right
13:09okay
13:10yes
13:11you have got a rib that's extremely tender so it might be that you've cracked that rib
13:14yeah
13:16there is also a concern that Jeannie may have damaged her pacemaker
13:20chest x-ray
13:21chest x-ray I'll have a chat with the pacemaker team and then we'll go from there, is that okay?
13:26yes
13:27right
13:28would be nice
13:29to turn you just for the right
13:32and then we'll try to change the body from here
13:33you can just force you to pursue your life
13:34so you can see the incredible pain
13:35that makes sense
13:36just for everyone
13:37that's not going to be safe
13:38the way that people will do that
13:39really is going to be happy for your life
13:40It's been an interesting IT day today so far.
13:47In the hub, Sister Vicki and the team have called an emergency meeting to address the
13:51global internet outage.
13:54If you require any porters for any movements for x-ray CTs, just come to the coordinator.
13:59We've been writing them down and allocating porters when we see them.
14:03We've only got two female AMU beds.
14:07Male's full, medicine's full with five definites and 13 potentials, surgery only had one bed,
14:13ortho were full, gynae tool beds.
14:15Anybody thought it was a wonder.
14:20In recess, advanced clinical practitioner Jess is trying to find out what caused cancer
14:25patient Graham to collapse.
14:27Once we've done this, we're going to give you some fluids, just because your blood pressure's
14:32a little bit low.
14:33All right.
14:34The blood pressure's always been a bit low.
14:37It's a little bit too low, this one.
14:39It's a bit surprising considering my weight.
14:42Well, that's what I'm thinking.
14:43You're quite a large chap.
14:44So a blood pressure like that is fairly low.
14:51Advanced clinical practitioner Jess takes some bloods.
14:55There'll be a little bit of me shimmying this about, all right.
14:59So just bear with me.
15:00I know you're not a fan of it.
15:02Graham has a fear of medical procedures.
15:05Oh, bless you.
15:06You were getting so worked up, weren't you?
15:08Mm.
15:09I don't think that helped today, has it?
15:11You were getting so stressed about this.
15:14And you're obviously feeling generous today.
15:17Give me plenty of the good stuff.
15:19You know what, sweetheart?
15:20All done.
15:21Less stress, I hope.
15:22I'm going to pop this side up and then I don't lose you off this side at bed.
15:29I'll be back with you shortly.
15:30Okay, Molly.
15:31There you go.
15:32I'm basically just giving him a bit of an MOT, see if we can figure out if it is just
15:39a basic, what we call a vasovagel, so just a passing out episode that is experienced
15:43today.
15:44He said he was quite anxious before having it done because he knows it's quite tricky
15:49to get blood from, so I think that might have played a part.
15:53So we just want to make sure that all the scaries are ruled out, which is essentially
15:56our job in Aene.
15:58Graham must now wait for the results of his blood tests.
16:01I think there's a vampire farm somewhere around there.
16:04There's a vampire blood there, father.
16:13With no intranet in the hub, Sister Vicky is having to go old school.
16:17We're having to revert back to the old ways as contact at site matron for beds, and obviously
16:23escalated to different wards.
16:25As porter, we've got no log for as porters anymore, so I'm going to have to do it written,
16:31handwritten, and obviously as we help doctors if needed.
16:35I love my job today.
16:36I think it's amazing.
16:37Today, they had to revert back to pieces of paper, which is really old school, and then
16:41just give those to the parson and then do the portering jobs.
16:45So what are we doing for x-rays now?
16:47You're telling me, and I'm writing them down, and they're coming and taking them off.
16:52But while the network has slowed to a halt, the patients have not.
16:57Everybody's slipping down and breaking bones.
17:00Lots of plasters, lots of manipulations.
17:03Busy, busy, busy.
17:0536-year-old Louise has slipped over and fractured her ankle.
17:13I should have been going out for a meal for Thai food with my mum, and I don't really want
17:19to go.
17:21And I started walking down the street, round the corner, slipped, bang, and I knew, I just
17:29knew that I'd done something.
17:32It's quite a nasty ankle.
17:35Louise has had an x-ray, so emergency nurse practitioner Claire can now prepare her for the next steps.
17:42I'm going to take you into resource.
17:44Yeah.
17:45OK.
17:46We need to get that into a cast.
17:47Yes.
17:48With that medication and pain relief.
17:50Yeah.
17:51And then once we've done that, then we'll get orthopedics to see you.
17:55Right.
17:56OK?
17:57Yeah.
17:58Dr Heather Soudan is called to come and assess Louise.
18:03There's a patient that's just moved into resource, so it's got a fractured dislocation ankle.
18:07Ooh.
18:08It's a bit complicated, because it's second metatarsal.
18:10Yeah.
18:11It's fractured dislocation.
18:12So you don't fall off a horse?
18:13No.
18:14That whole car accident?
18:15No.
18:16I've seen all the people who fall on one side and maybe break a hip and maybe break a shoulder
18:24or a forearm.
18:25But I've not seen a young person do two places on the same leg.
18:30It's really hard, though.
18:35Slipping is something you just can't protect yourself for.
18:37Yeah.
18:38It's not the forces are.
18:39The joints are used to.
18:42It looks sore on the x-ray.
18:45Fine.
18:46I'm going to have another nosey at them.
18:49So, ideally, there'll be someone popping you off to sleep, there'll be someone putting
18:54your ankle back in place, and then there'll be someone doing the potting.
18:57So I need two more friends.
18:58Do you mind if they have a look at me extra?
18:59Yeah.
19:00Once you come.
19:01So that's the bone that everything's sitting on.
19:06Yeah.
19:07This one, your shin bone's pushed forward, so we need to push that back a bit.
19:10OK.
19:11Because that's your ankle joint.
19:12Nice.
19:13So it needs to be equal space all around.
19:14So we're doing a squeeze and a push back, and hopefully it'll go clunk.
19:18OK.
19:19Your mum's got a lot to count for today, inviting you out for food.
19:23Do you know what food it were though?
19:24Fish and chips.
19:25Thai.
19:26Thai food.
19:27Do you like Thai food?
19:28Enough to break your ankle and your foot foot?
19:31No.
19:32No.
19:33Louisa's leg needs correcting quickly to restore her blood flow and reduce the risk of permanent
19:38injury.
19:40The internet may be down, but the ambulances don't stop arriving.
19:50Paramedics Mark and Shay have picked up a Barnsley resident who has had a bad fall.
19:58You're a cutie.
19:59What's wrong, guys?
20:00Just let me sound up.
20:01I don't know.
20:02Just relax that arm, Bonnie.
20:05Put this on your finger.
20:07Get some numbers on you.
20:09You look straight at me.
20:10I'm just going to shine my light in your eyes if that's OK.
20:12Lovely.
20:13Give me a good smile.
20:14Show me a teeny little place to get your tongue out.
20:18Lovely.
20:19And thank you.
20:20Can you sign this before my battery decides to call it a day?
20:24Yeah.
20:25June was in a chair and has fallen forward.
20:28Unfortunately, she's hit the table, haven't you, June?
20:31Must have.
20:32You must have, because you've broken the leg on the table, haven't you?
20:34Eh?
20:35And probably my leg.
20:37Not your leg, the table leg.
20:40Eh?
20:41June's injury is unfortunate.
20:42She's got a very large skin tear across the top of her chest here.
20:47Possibly a cut underneath her chin, one to her elbow, an extensive bruising to her face.
20:54Just fell down.
20:55I don't...
20:56I'm...
20:57I'm not busy.
20:58You're not like that.
20:59I just fall.
21:00June goes for a CT scan to check what internal damage has been caused by her fall.
21:09The scan will find any bone fractures, internal bleeding or organ damage.
21:16Beep.
21:17Beep.
21:18Beep.
21:19Beep.
21:20Beep.
21:21Beep.
21:22Beep.
21:23Beep.
21:24Beep.
21:25Beep.
21:26Beep.
21:27Beep.
21:28Hey, your sister got a help.
21:30The team in Casualty are halfway through a difficult shift.
21:34So all systems have gone down.
21:36Oh, okay.
21:37And I mean every single one of them.
21:39A global internet outage means that sister Vicki has no digital record of where any of
21:46her patients are.
21:47So the system's still down.
21:49The porturing system's still down.
21:50The tracking system's still down.
21:52So we can still do everything on paper.
21:56I can't see any systems getting fixed any time.
21:59So obviously it started last night and there's still nothing been sorted.
22:03So you're going to go for your dinner, aren't you?
22:05No.
22:06Yes, please.
22:07If the internet problems were not enough, Casualty has a higher number of patients than
22:11usual.
22:12So the team are having to pull together.
22:15Jack of all trades.
22:17Master of none.
22:21In recess, advanced clinical practitioner Jess has an update for Graham after his collapse.
22:27As I mentioned earlier, didn't Heather, it looks like the nodule that they've noted
22:30on your left side of your lung has got bigger.
22:34Oh, right.
22:35I didn't know about that.
22:36Yeah, so they've reported your scan today, so they've been pretty speeding.
22:40I suspect your little funny-do around there has probably sped things up a little bit,
22:45getting a report done.
22:47It may be that this is what's causing the change of breathing.
22:51All right.
22:52So, like I said, just waiting for them bloods to come back, make sure there's no added infection
22:56on top of everything else that you've got going on.
22:58Graham was diagnosed with cancer four years ago.
23:01I started off in my bowel, and that was all successfully removed in 21.
23:08And they monitor you for five years, and they find it in my lungs.
23:14I'm just seeing more of the hospital than I would like.
23:20So it's just what comes with old age, I suppose.
23:27Considering what's gone off today, I want to play it safe and bring you in for tonight
23:31at least for a medical team to review you.
23:34I'd love to say that I want to be really brave and get you home.
23:36Yeah.
23:37But I think because you've got so many things going off, I think it's the ample opportunity
23:41to just touch base with you, and they'll be able to touch base with the CHESS team as well
23:46about your results of your scan.
23:47Oh.
23:48OK.
23:49So it may be a quick turnaround and they may say, I don't know why your knee's kept you in,
23:53but I'd rather do that and be safe and send you warm and love another episode.
23:56So I'd like to be in tonight.
23:57Yeah.
23:58Got such a brilliant health service here, and, you know, they don't let you go
24:05if they've got a few queries about you.
24:08The doctors found that a blood clot was reducing Graham's oxygen levels.
24:14His battle with cancer is still ongoing.
24:20In cubicle three, June is back from radiology, where a scan revealed no internal injuries from
24:25her form.
24:27Sister Benita will now treat her skin wounds.
24:30Oh, Jackie.
24:32I'm Benita.
24:33I'm one of the nurses.
24:35I've got some stuff, so we can give you a bit of a clean-up.
24:38All right.
24:43There you are.
24:44Bit of warm water.
24:45All right.
24:46I'm sorry.
24:47I'm sorry.
24:48I'm sorry.
24:49Can it be one after?
24:50I like.
24:51June has a skin tear across the top of her chest.
24:54Oh, Dad.
24:55Yeah.
24:56There you go.
24:57There you go.
24:58There you go.
24:59There you go.
25:00All done.
25:01Yeah.
25:02Because she's sustained multiple wounds, and her skin's so fragile.
25:06I wouldn't say it's life-threatening or anything like that, but it'll just prolong her stay.
25:11And she's so thin and not got much meat on her bone, she's going to need managing in terms
25:17of making sure that she gets back on her feet properly.
25:21All right.
25:22The plan for this is to give it a bit of a clean-up.
25:27And the reason it hurts is because the need to get these exposed, and that's why it's making it sore.
25:36So, if I can clean it as quick as I can, I'll try and see if you spin back.
25:41Then, how's that nail not fixed?
25:44Can I just have a little look and see if you've got some on your legs?
25:48Um...
25:49She's full of fluid downwards, and she looks like she's got some...
25:55..iclarious.
25:56Um...
25:57..that are being dressed in the community, but because of circulation so far,
26:06it just starts to cause a lot of other problems.
26:11Sister Bernita brings June some painkillers.
26:15Are you okay swallowing these, them like that?
26:18I'm very good.
26:19I don't know.
26:20You tend to find that fairly stoic Barnsley folk,
26:25they don't come forward quick enough in terms of painkillers.
26:31And it'll be so painful when they're exposed to air, it's, um...
26:37Have you lived in Barnsley all your life?
26:39More or less.
26:40More or less.
26:42What did you do work-wise?
26:45Did you work?
26:46And what did it sell?
26:48Pork pies.
26:51Pork pies.
26:52People in Barnsley like pork pies, though, don't they?
26:57It's actually really nice to have those conversations about her life
27:01and what she's done, and I always find in older people,
27:05they've been through so much, and you learn such a lot from them.
27:09Did you have children?
27:10Mm-hm.
27:11Yeah.
27:12How many children did you have?
27:14Two.
27:15Two boys.
27:16Two boys.
27:17Two boys.
27:18Two boys.
27:19My two eldest, they're 16 and 30...
27:23Well, he's just turned 17, actually.
27:25It was his birthday over the weekend.
27:27Erm, and they're at a point now where they're actually beginning
27:31to get on with each other.
27:33It was his birthday over.
27:36Sister Benita starts to treat June's wounds.
27:39Right.
27:40Are you ready?
27:41Here, hold me.
27:45I'm sorry, I know.
27:50Right.
27:51I'm going to leave that for 20 seconds.
27:52I'm just going to go and get some tweezers.
28:08In the hub, there's no sign of things slowing down.
28:11What are them two are waiting for?
28:12Them two are waiting for that patient.
28:13Fit to sit.
28:14Right.
28:15So, erm...
28:16I'm just ringing for a little bit of advice about a patient's pacemaker.
28:20I'm flodding on through here, I'm not entirely sure what's happening with the system yet.
28:30That's where I'm at, so...
28:32I am not giving up my holidays.
28:34Are you off soon?
28:37Next, on... on Saturday?
28:38Saturday.
28:39Have you lost any of your weight?
28:41Have I, heck?
28:43I've even started calorie counting now on an NHS advert, it just...
28:47It says it can't do much for me because my BMI's perfect.
28:52She is now.
28:53My hips don't say that it's perfect.
28:55Yeah.
28:59Jeannie is having an x-ray to see what internal injuries she sustained in her form.
29:05Lovely, breathe away.
29:08Super.
29:09That's it, you're all loose, thank you.
29:13Right.
29:14You've had an ECG before, I'm guessing.
29:16So, I'm going to have a walk across to cardiology, and let them have a look at this ECG,
29:25and see if they're happy with it.
29:27I don't have my grandparents anymore, but I've seen my grandparents in pain,
29:31so I empathise a lot with older patients that I see in the hospital.
29:34I do think they're very proud of me, and, erm...
29:37Oh, gosh.
29:39Oh, gosh.
29:40I know my grand...
29:41I can't...
29:42I can't...
29:43After this, I'm going to get the nurses to do her blood pressure while you're laying down and standing up,
29:48and I'll check your x-ray.
29:50And then if everything's okay and you've passed the tests, you can go home.
29:55I know she's really proud of me, and I know my family are proud of me.
29:59And I don't know I'm good at my job, so...
30:05Anyway, you've got me crying.
30:08Ready for the finale?
30:12So, this is your x-ray.
30:15Have you seen your pacemaking like this before?
30:18No.
30:19No?
30:20Okay.
30:21So it's absolutely fine, and you'll be good to know that I can't see any rib fractures either.
30:24I think you've just injured and got a bit of bruising around your muscles.
30:27Oh, yeah.
30:28Of your chest wall.
30:29Huh?
30:30And it's a bit bruised.
30:31Yeah.
30:32Okay?
30:33Your blood pressure's okay as well, so I'm happy for you to go after your painkillers.
30:36Right.
30:37Who's taking you home?
30:38Me!
30:39Me!
30:40You've got a little chariot.
30:42After one week's rest, Jeannie's breathing pain completely went away.
30:49Get him out and do your tongue off.
30:51Now, there's a new arrival in paediatrics.
30:55I've got everyone messaging, checking you're all right.
30:58Eight-year-old Henry, with mum, Stephanie.
31:02I got a phone call at one o'clock from school, and he's fallen at height on the playground.
31:09I was playing on a climbing plane, I was kind of low to the floor, and then someone jumped on, I fell, smashed, and then I was like, bleeding like this.
31:26And then there was one on the wall.
31:27And then there was one on the wall.
31:28He's smashed basically three front teeth, so he's broke his two adult teeth, and the one next to it, blood pouring everywhere.
31:37He's all swollen, and he got a deep cut to his lip.
31:40He was a bit hysterical, just really, really upset.
31:43He thought he was going to be mad because he's knocked his teeth out.
31:46Bless him.
31:48Nurse Ella will be assessing Henry's injuries.
31:51He hit the actual wood.
31:54Right.
31:55The big log part of the side.
31:57Yeah, head first.
31:58It came down head first.
32:00How long ago were they?
32:01I got a phone call at about one o'clock.
32:05Is he having any medicine or anything?
32:06No.
32:07No.
32:08He's just complaining, just obviously.
32:10He's having a bit of headache, hasn't he?
32:12But then he's just, he's just like, oh, pretty.
32:14Fine.
32:15No vomiting or anything since?
32:16No, no.
32:17No.
32:18Fine.
32:19Can we pop this on your thumb?
32:20Is that okay?
32:21It's just a sticker.
32:22It's going to show us your heart rate and your oxygen levels.
32:25Is that okay?
32:26Okay.
32:27If my heart is not beating...
32:30I think, seeing as you're chatting to us, I think it will be.
32:34Yeah?
32:35Mr. Dramatic Heart Death.
32:37Is that my heartbeat?
32:39So, this one is your heart rate and this one's your oxygen levels.
32:43Oh!
32:44But it's not, it's not quite picking you up properly yet.
32:46Do you see this all, it's all wiggly.
32:48So, we need this finger to stay...
32:51Yeah.
32:52Does that mean almost dead?
32:54No, not quite.
32:55Yeah, yeah.
32:56Sometimes if you get a bit excited or a bit scared, your heart rate jumps up and down.
32:59So, keep that finger nice and still for us and then we'll get some real numbers, yeah?
33:03Yeah.
33:04Can we do your temperature while we wait?
33:06Which ear would you like?
33:07This one?
33:08This one?
33:09Which one?
33:10Sorry.
33:11Perfect.
33:12Well, ready, we're all done.
33:13So, I'm going to pop your waiting room now for now, Mum.
33:14We'll get...
33:15Right.
33:16Yeah, that's fine.
33:17Thank you very much.
33:19Come on then.
33:20Henry will need to wait to find out if he's broken his jaw.
33:23We've got all your numbers, yeah?
33:24Now we're going to go wait for a doctor.
33:25Go back in that waiting room.
33:26Yeah.
33:27There are the teeth.
33:28I think it might have to have a cap by the dentist.
33:30They might have to cap, cap and both.
33:31Unless they can glue.
33:32Unless they can glue.
33:33In recess, factory worker Louise has badly broken her ankle.
33:34I'm just pinching your pot in trolley, Claire.
33:35All right.
33:36All right.
33:37Let's go.
33:38Let's go.
33:39Let's go.
33:40Let's go.
33:41Let's go.
33:42Let's go.
33:43Let's go.
33:44Let's go.
33:45Let's go.
33:46Let's go.
33:47Let's go.
33:48Let's go.
33:49Let's go.
33:50Let's go.
33:51Let's go.
33:52Let's go.
33:55In recess, factory worker Louise has badly broken her ankle.
33:59I'm just pinching your pot in trolley, Claire.
34:01All right, Nick.
34:02Dr Sowden is joined by a team who will work together to move Louise's
34:08leg back into position.
34:10Got everything ready.
34:12We're good to go.
34:13First, Louise is sedated with an anaesthetic.
34:17Can you just see how she responds to you playing around with her
34:19ankle?
34:20You're holding the whole leg or no?
34:22Yeah, I've got it.
34:23Louise has broken and dislocated her ankle,
34:26so this is not a simple procedure.
34:29For some joint dislocations,
34:31you also need the muscles to relax
34:33to be able to effectively get the joint back in.
34:40The drugs we need to give to relax
34:42can also affect your ability to breathe safely.
34:45So we do a procedure called sedation
34:48whereby we try and get enough drugs into the person
34:52that they are still breathing for themselves,
34:55their heart rate, their blood pressure is stable,
34:57but yet, in their head,
34:59they haven't got a clue what they were doing to them
35:01and they shouldn't be feeling any pain.
35:03You're holding?
35:04Mm-hm.
35:13Louise's ankle is manipulated back into position
35:16and placed in a cast.
35:23OK?
35:24Thank you for helping.
35:25You have a great mess.
35:28In this?
35:29Yes!
35:30Oh!
35:31Hello!
35:33That was timing!
35:34Thank you so much for coming and giving us a hand.
35:41Louise now needs another X-ray
35:43to see if her ankle is back in the correct position
35:45and, if not, she will need emergency surgery.
35:49PHONE RINGS
36:04Today has been a busy shift in casualty.
36:08I bet you have to pay extra for one of them 80-page passports.
36:11Do you?
36:12She sure crashed up here.
36:14The hospital's computer network has gone down,
36:17so Sister Vicky has spent her shift resorting
36:19to old-school communication methods.
36:23So, has anybody took anybody round from CDU?
36:27Operational support manager Antonia
36:29has been working to get Barnsley back online.
36:33Apparently it's a global issue that's happened,
36:36so that's all been reset now,
36:38so we're slowly getting them back up
36:40and the system should hopefully be back up
36:42and running in maybe half an hour,
36:43so we can start using it again.
36:46To be honest, I'd rather be in here than sorting the IT.
36:51Modern day, June.
36:53I bet you didn't have this in your shop, did you?
36:55IT issues.
36:57You know that diet, Darren, my calorie counting?
37:00It's going out of the window.
37:02Well, no, you're counting.
37:04You're just counting a lot.
37:05Counting higher.
37:07How high can you go?
37:08How high can you go?
37:09How high can you go?
37:16Louise is having an X-ray
37:18to see if her broken ankle is back in position.
37:21So, what, are you going to say what?
37:26Yeah, lots better, a lot better.
37:28I'm going to get a perfect problem.
37:30No, no, but you've got that back on there.
37:32Famership is gone.
37:33Yeah.
37:34Dr Soudan and the team conclude
37:36that the manipulation has been a success.
37:42Louise's leg will remain in this position
37:44until it can be operated on.
37:46They need to do a CT before they operate
37:51just to get a better picture.
37:52Yeah.
37:53So, are you OK going home?
37:55Yeah.
37:56OK.
37:57If we need to wait till morning
37:58to kick you out in daylight,
37:59that's an option.
38:00That's all I'm thinking.
38:01No.
38:02But if you think you can safely
38:03get from the taxi to the house, yeah?
38:05Yeah.
38:06I'd rather be in my own bed
38:07if nothing was going to happen over the weekend.
38:09Yeah.
38:10Pain-wise, what's it like?
38:11It's rubbing.
38:12OK.
38:13Like, I want to move it like that.
38:17OK.
38:18It's throbbing, annoying throbbing
38:20rather than painful throbbing.
38:21Yeah.
38:22It's stuck.
38:23Yeah.
38:24But it is.
38:25We've put a pot on.
38:28I look forward to coming to work
38:30and wondering who I'm going to meet
38:32and what kind of problem they're going to have.
38:35And even if I'm tired and grumpy,
38:37I try to remember what a privilege it is
38:39for people to kind of let me in
38:41on what's going on for them.
38:43How have you been a nurse?
38:45Me?
38:46Um, never.
38:50I'm a doctor.
38:51How have you been a doctor?
38:53About 15 years.
38:55You like it?
38:56Love it.
38:57Is it the best job in the world?
38:58It's the best job in the world.
38:59And I hope at the end of, like,
39:02them seeing me,
39:03that we've got them in a better position
39:05than when they came in.
39:07Do you need some painkillers from me?
39:08Yes, please.
39:09Yeah.
39:10OK, that's fine.
39:11And then taxi home?
39:12Yeah.
39:17I'm excited to go home.
39:18Yes.
39:19Your uncle will be dead.
39:24I'll not be going out for Thai food again.
39:28Louise came back for surgery after two weeks,
39:31where she was fitted with two plates and 11 screws.
39:34She returned to work six months later.
39:43In cubicle three,
39:44Sister Benita has almost finished cleaning June's wounds.
39:49You've got a bit of it left,
39:50but I think you've lost a bit of skin as well.
39:58But we've managed to cover a little bit of it up.
40:01All right?
40:02Are you OK pain-wise?
40:04You OK?
40:05Yeah.
40:06Yeah.
40:07Have you fallen a bit recently?
40:09Yeah.
40:10I feel like you're falling a bit more.
40:11I'm really used to fall.
40:12What makes you fall?
40:13I don't know.
40:14Don't feel funny, aren't they?
40:15No, it's not.
40:16Do you?
40:17Do you feel like you're falling a bit more?
40:18I'm really used to fall.
40:22What makes you fall?
40:23I don't know.
40:26Don't feel funny in fall?
40:27No, it's not.
40:29Do your legs just give way?
40:30It does.
40:32I'm just thinking,
40:33when you're being a bit full of fluid,
40:35I wonder if you just feel like...
40:38I'm a bit full.
40:39I mean, when I get back up,
40:41The medical team will have a look at her and establish what it is that's making her fall,
40:51because although she's sustained all of those injuries, she's done that as a result of falling,
40:56and that seems to be the recurring problem with her.
40:59Will you be glad to get rid of me?
41:02No.
41:04Now I'm not looking for you.
41:06Right.
41:08Is that OK? Yes.
41:10I'm going to just quickly go and write some bits up and then we'll get you upstairs.
41:14Yes, I've got this one.
41:16Good.
41:19Oh, are you taking her?
41:22Yeah, very good.
41:24June moved out of casualty to the acute medical unit.
41:28She remained in hospital for two weeks before returning home to be looked after by her family.
41:34In paediatrics, eight-year-old Henry has fallen off a climbing frame and shattered his front teeth.
41:42Hey.
41:43Come and have a seat.
41:44Emergency nurse practitioner Tony now needs to check if Henry has broken anything else.
41:50All right, let's have a look then.
41:52Let me use this bright torch.
41:54Is it going to work today?
41:55Oh, no.
41:56Don't.
41:57Look up to the ceiling, up your mouth right wide.
41:59Do it.
42:01Yeah, it says that one next to it.
42:03Sorry.
42:04Sorry, Dune.
42:05All right.
42:06A little bit wobbly into it.
42:07So I'm just going to have to lift your lip up a little bit so I can see.
42:10He's gone with a right bang, bless him.
42:13Let's look at this side as well.
42:15Our main concern is, is there anything else going on in the mouth or the jaw?
42:19And open your mouth really, really wide.
42:21Why did you get on?
42:22Perfect.
42:23And you could see roping his mouth really, really well and his jaw was okay.
42:26So it's a little bit bruised, but it all feels nice and hard under there.
42:29So I don't think there's anything broken.
42:31It is a tough one and especially at his age, he's going to be conscious about his teeth.
42:36He's going to be all worried about them.
42:39That other tooth at top is a little bit wobbly, but it's still quite well fastened in.
42:42So it's not, I don't think he's going to come out anytime soon.
42:45Yep.
42:46You do need to see a dentist, obviously, about them first too.
42:48There's not really anything we can do with them.
42:51So, we can let you go home, okay?
42:53Yay, finally!
42:55We'd only had a conversation the week before saying like,
42:58you've got to look after your teeth.
43:01And then he goes and does that today.
43:03He does the falling and silly things.
43:05Right.
43:06We'll let you get it going then, mate.
43:07Right.
43:08Thank you very much.
43:09Hopefully the dentist will see him quite quickly.
43:10He'll get them tooth sorted, put a cap off, some fixing on temporarily probably until
43:16he's a little bit older and then we'll have some more work done on it and be back smiling
43:21before in no time.
43:22Oh, you love the dentist, don't you?
43:24Yeah.
43:25But I like the hospital more than anything.
43:27Are they going to stop you from climbing?
43:30No.
43:31Henry had two new front teeth built by his dentist and is now back to running around on the
43:39school playground.
43:40The day shift is almost at an end and operational support manager Antonia has finally been able
43:55to connect to the hospital network.
43:57It looks as if it's slowly feeding back through now.
44:02It's almost time for Sister Vicky to clock off with her holiday just around the corner.
44:08So where's this one to?
44:10Turkey.
44:11Turkey.
44:12Have I not shown you a picture of what it looks like?
44:15So that it's like...
44:18And then there's like all over water bungalows and stuff and it's very posh.
44:24Too posh for me.
44:26We managed to get all the patients back on the system, the system up and running.
44:30Everything was how it should be.
44:33Relief.
44:35It was at quarter to five.
44:37With the network now back online...
44:39It looks as if it's alright then.
44:43Barnsley Casualty is running at full force once again.
44:54We're back in Barnsley A&E, new next Wednesday at 8.
44:58And if you or someone you know has been affected by any of the issues raised in tonight's programme,
45:02please go to channel5.com slash helplines for information and support.
45:07A 47-year-old with a rare renal cancer needs the surgeon's skills.
45:11It's a matter of life or death as we join them in the operating theatre.
45:15New next.
45:16Any idea
45:19yay
45:20nitrogen
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