- 2 weeks ago
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00:00In the heart of Yorkshire
00:05A team like no other
00:10Busy, busy, busy
00:11Fight to save lives
00:13Open your eyes for me
00:14Do you know where you are?
00:15Do you in Bandsl A&E department?
00:17Carging
00:18Ohhhh
00:2024 hours a day
00:22Wow
00:237 days a week
00:24Hello
00:25Nail it
00:26I feel like a wet dishcloth
00:30Serving their community
00:32Looks like you have broken it
00:35I don't think I'm going to look
00:37Are you dreaming of your gin and tonic?
00:40Helping those most in need
00:44Love you
00:45I'm trying
00:46No
00:47There's nothing to be frightened of
00:48These girls will sort her out
00:50I care for anyone
00:51I think I've messed your hair up, haven't I?
00:53And everyone
00:55Like himself
00:56Thanks to Bandsl A&E
00:58Working together to make people's lives
01:00Better
01:01You know I just love to look
01:05I love to make a difference
01:07This is Bandsl A casualty
01:1024-7
01:11I must not be entering the beauty contest
01:15On shift tonight
01:20They're all just piling in
01:22Old Bandsl A&E's woken up
01:24Operational Supply
01:25Port Manager
01:26Antonia
01:27We're running out of space
01:28We've got at least a little
01:30Even patients waiting for beds
01:31Actually seeing what your heartmate is doing
01:36Resident Doctor Charlotte Underwood
01:38The heartmate is going
01:40It's far too high to be safe
01:45Mmm
01:46Like a shedded piece of skin, aren't ya?
01:49Mmm
01:50And emergency nurse practitioner Claire
01:52The issue with that is
01:54It's like you've cheated
01:55It's like you've cheated
01:56That piece of skin
01:57So
01:58Get ready to share a shit
02:00Some days you get up
02:01And you don't know what's going to happen, do you?
02:05Team at Barnsley Casualty
02:07Woo!
02:10Team at Barnsley Casualty
02:12Team at Barnsley Casualty
02:13Team at Barnsley Casualty
02:15Team at Barnsley Casualty
02:18Team at Barnsley Casualty
02:19Team at Barnsley Casualty
02:20Team at Barnsley Casualty
02:21Team at Barnsley Casualty
02:22Team at Barnsley Casualty
02:23Team at Barnsley Casualty
02:24Team at Barnsley Casualty
02:25Team at Barnsley Casualty
02:26Team at Barnsley Casualty
02:27Team at Barnsley Casualty
02:29Team at Barnsley Casualty
02:31Team at Barnsley Casualty
02:32Team at Barnsley Casualty
02:33Team at Barnsley Casualty
02:34Team at Barnsley Casualty
02:35Team at Barnsley Casualty
02:36Team at Barnsley Casualty
02:37Team at Barnsley Casualty
02:38Team at Barnsley Casualty
02:3977 year old male.
02:40Less than five minutes for that.
02:43Yeah, thank you.
02:44Cubicles are full, we've got...
02:49All these ambulances coming in as well.
02:52Yeah.
02:53A new...
02:54The rule that ambulance crews must hand over patients within 45 minutes is...
02:59...creating extra pressure.
03:01We've had seven ambulances just arrive.
03:04Over the past 40 minutes, but we've only got the two cubicles to take hand over in there.
03:08So...
03:09Manager Antonia joins the floor to support the team.
03:15We're running out of space.
03:17HTC to full.
03:18We've got...
03:19We've got at least 11 patients waiting for beds down here.
03:21We've got wards that we're having to keep down here because there's no...
03:24...no beds here.
03:26My role is to support the department itself.
03:29To support the patients, the staff.
03:31I love the fast-paced environment here.
03:33No day's ever the same.
03:34I never know what I'm going to come into work to.
03:36I can sit down in the morning, have a cup of tea.
03:39And then it's straight up down here, thrown into the mix.
03:44I think they're all just piling in.
03:49Oh, Barnsley's woken up.
03:54Yeah.
03:55Yeah.
03:56Yeah.
03:57Yeah.
03:58Yeah.
03:59Yeah.
04:02As the red phone keeps ringing...
04:04paramedics are rushing in a woman with suspected sepsis.
04:09Dr Underwood will be in charge.
04:14Dr Underwood will be in charge of her care.
04:19Dr Underwood will take care of her care.
04:24overwhelmed by the infection it needs to really
04:29high heart rate and basically all the different organs start to knock
04:34work as well
04:37heart rate is going
04:39at a rate that is far too high to be safe
04:44the blood pressure means that she's quite unstable
04:49so we've just got to try and get on top of things quite quickly
04:54is it diane?
04:59yeah but we've got three my love
05:01one, two, three
05:03oh
05:0467 year old diane was rushed in from her gp surgery
05:09one, two, three
05:11well done
05:13ready, study
05:14let's just see what your heart rate is doing
05:19how are you cleaning now?
05:24150's
05:26that's really fast
05:27that's really fast
05:29let's take a look at you and see what's going on
05:32have you had anything like this before?
05:34no
05:35no nothing like this
05:36okay
05:37yeah at the moment your heart's going
05:39much faster than we would expect
05:41okay
05:42so it sounds to me like from the beginning
05:44of the gp that you had a cough
05:47have you been coughing up phlegm?
05:49yeah
05:50has that been for a couple of days?
05:51yeah
05:52yeah
05:53and have you coughed up some blood today?
05:54yeah
05:54yes
05:55well yeah
05:56and you're even feverish
05:57you said you felt sweaty
05:58yeah
05:59and has that been for a couple of days as well?
06:01yeah
06:02yeah
06:03okay
06:04oh god
06:05yeah
06:06i'm a wet girl
06:07oh really
06:08just
06:09i'm gonna have a quick listen to your chest if that's alright
06:14i'm going to get an excellent
06:19to your chest
06:20so i can hear some crackles kind of on both sides
06:24sometimes we get a diagnosis that is really easy
06:29but actually with most patients
06:31it's about rolling in or out
06:34the most serious things
06:37and if you're doing that and you're
06:39treating that
06:40then you're making the correct style for the patient
06:45we'll get that x-ray
06:46we'll get the blood sent off
06:49we've got the fluids going in
06:51we'll get started
06:52we've got the fluids going in
06:53we'll get started
06:54we'll get some antibiotics
06:55and once we've given you that treatment
06:57i'm hoping your heart
06:59right
07:00will start to settle
07:02doctor underwood
07:03must work
07:04first
07:05census is
07:07really serious
07:08we know the net
07:09unfortunately
07:10can
07:11lead to death
07:12it's something
07:14that we aim to identify
07:15within an hour
07:16of a patient
07:17arriving
07:19and
07:20to
07:21to
07:22to
07:23to
07:24to
07:26to
07:29to
07:31to
07:32to
07:33to
07:34to
07:36to
07:37to
07:38to
07:39to
07:41to
07:42to
07:43to
07:44to
07:45to
07:46to
07:47to
07:48to
07:49to
07:50to
07:51to
07:52to
07:53in
07:54resus
07:54diane has suspected sepsis
07:57can you point me
07:59in
07:59exactly
08:00where that pain is
08:01doctor underwood
08:02thinks the sepsis could be the
08:04reason
08:04the
08:05result of a chest infection
08:06I
08:07saw that
08:08mmm
08:09a
08:11a
08:12a
08:13a
08:14a
08:15a
08:16a
08:17a
08:18a
08:19a
08:21a
08:22a
08:23a
08:24a
08:25a
08:26Oh, my God.
08:31Hey everybody
08:36Well done that's it we done
08:38Thank you
08:41That's really brutal
08:43If I have science hook
08:45I know about hazy
08:46This side is probably worse
08:48When she's got
08:50What we call kind of hazy
08:51Easiness on both sides
08:53Definitely worse on the right side
08:55Which is where I could hear
08:56The crackles on her chest
08:58Here and here
09:00So usually all the lungs
09:01Looks more like this
09:05To me it looks like
09:06You've probably got a bit of a chest infection
09:08Just want to see what your blood pressure is
09:11Doing
09:15And what
09:16Pressure's dropped a little bit more
09:18So I want to give her more fluid
09:20It's likely she's pretty decent
09:21Rehydrated
09:22That happens with an infection
09:23So we're just going to give her
09:25A
09:26A shot of fluid quite quickly in the antibiotics
09:28And then just some more background fluid
09:31Unless Diane's body starts responding to treatment
09:35Her condition
09:36Condition
09:37Could become critical
09:41So
09:43That's
09:44That's
09:45That's
09:46We've stopped close
09:48Aren't we
09:49We're cold
09:51In the hub
09:52The pressure is mounting
09:54Have we got any spare cubes now
09:55Have we got any spare cubes now
09:56With four more ambulances
10:00With four more ambulances
10:01Arriving
10:02Operational Support Manager
10:03Antonia
10:04Is joined by emergency
10:06Department service manager
10:07Lindsay
10:08Is it really 121
10:10Is it really 121
10:11As bats
10:12Five or six
10:13Gone
10:14It is quite stressful
10:15But
10:16I think we're all here to help each other out
10:18It's nice
10:19To be part of a team
10:20And have the people there around
10:21You
10:22We need to all work together
10:23To have that joint approach to everything
10:26Is really imperative
10:27And needy
10:28We're just very very busy waiting
10:31For bed
10:32So all the cubicles are blocked now
10:33But with in-patients waiting to go up
10:36We've got a lot of ambulances coming
10:40We've got a lot of ambulances coming
10:41Not much space
10:42Not much space
10:46It's a matter of keep calm and carry on
10:48Is there any more on room
10:50Is there any more on room
10:51Two
10:52Two
10:53Inbound
10:56Inbound
10:57Inbound
10:58Inbound
10:59Inbound
11:00Inbound
11:01Took that arm in the path
11:03There we are
11:05Next to arrive is
11:0681-year-old Pat who has multiple injuries following her second fall in a
11:11week you're on this bed pad to keep your leg elevated
11:16last time it was her right leg this time it's her left leg and
11:21both arms
11:24why don't you this is
11:26the fall and just a picture of a bad look
11:31pat is in the hands of sister georgia
11:36and advanced clinical practitioner Maddy
11:39what's happened?
11:41well I was taking some I knew they'd just been back
11:44recycling coming this morning
11:46instead of just taking a couple of things I took four
11:51slippers and to stick on the step
11:53and it threw me that way
11:57hello hello
11:58hello
11:59hello
12:00hiya
12:01hiya
12:02you're right
12:01Pat is joined by daughter-in-law Jill
12:04can I just have a quick look
12:06can you lift his leg straight up off the bed for me?
12:10perfect
12:11yeah
12:12that hurts more than anything
12:14that hurts more than anything
12:16for the moment we'll just leave that alone
12:19for the moment we'll just leave that alone
12:20yeah
12:21it might be at a later date we need to sort of drain that
12:24can you feel me touching there?
12:26yeah
12:26is that the same on both sides?
12:27yeah
12:28yeah
12:29yeah
12:30can you do
12:31okay
12:34well you've done a good job
12:35yeah
12:36yeah
12:37yeah
12:38yeah
12:39sorry
12:40yeah
12:41it doesn't hurt
12:42no pain
12:43no pain
12:44no pain
12:45I'm sorry
12:46I know
12:47I know
12:48I didn't change it all
12:49okay
12:50I know
12:51I'm sorry
12:52thank you
12:51because it's not as bad as what my leg was
12:53I just want to make sure it doesn't stick that
12:56so
12:57yeah
12:58yeah
12:59no
13:00do you need any more pain dealers?
13:01no
13:02no
13:03but you should
13:01you up
13:02are you just being brave?
13:03I'm being brave
13:04ha ha
13:05I'm not getting any better
13:06medals for that you know
13:07no
13:08we'll get you sorted out my love
13:09alright
13:10yeah
13:11the doctor's wounds need dressing
13:13and she'll need x-rays to check for broken bones
13:16I wish I'd never gone to put that rubbish
13:19yeah
13:20no
13:21no
13:22no
13:23no
13:24no
13:25no
13:26no
13:27no
13:28no
13:29no
13:30no
13:31no
13:32no
13:33no
13:34no
13:35no
13:36no
13:37no
13:38no
13:39no
13:40no
13:41no
13:42no
13:43no
13:44nine year old Archie has hurt his ankle playing in his garden
13:48are we having a bet
13:49long it takes five pound for a second
13:54no it's like five, one day, three hours long
13:59yeah that's mine
14:01he's with mum Belinda
14:02that's broken
14:04then you can't go until you've got a proper pot on
14:08Hi Achi, I'm Jo
14:09I'm Gemma one at Nurse Practitioner
14:11Advanced Clinical Practitioner Gemma assesses the injury
14:14okay
14:15tell me what's happened
14:17when I've gone up the
14:19ladders
14:20I tried my mind going down the slides
14:22I went back down
14:23I tried
14:24I ripped it that way and I fell on it
14:26okay
14:27and when did this happen?
14:28this morning?
14:29yesterday?
14:29yesterday
14:30yesterday, okay
14:31and how's it been since?
14:33back
14:34been able to walk on it
14:36I've done done it but I can't
14:39walk
14:40okay
14:41is he normally fit and well mum?
14:42any medical conditions?
14:44just asma
14:45just asma
14:46it is artistic as well
14:47artistic
14:48so I'm assuming it's this one with asma
14:49without your crock on
14:50is that okay?
14:51can we take this one off
14:52just so I can compare them
14:53is that alright?
14:54no
14:54sorry mate
14:56good job you haven't got smelly feet
14:57today
14:59I'm sorry
15:00I'm sorry
15:01tell me if you got any pain anywhere
15:04I'm doing amazing
15:06I'm doing amazing
15:07and I pay them when I'm pressing here
15:09yeah
15:10there
15:11can you close your eyes
15:13I'm just going to ask
15:14ask you if you can feel me touching
15:16you can't
15:19you feel underneath?
15:20no
15:21but I'm tickling
15:22you're ticklish
15:23so you can feel it then
15:24that's fine
15:25you can open your eyes sweetheart
15:26can you wiggle your toes for me?
15:28when dealing with
15:29children with autism
15:30there's a lot of things that can affect how they behave
15:34and how they respond
15:35can you try and point your foot upwards?
15:37a lot of the time
15:38they can display
15:39pain in different ways
15:40sometimes it's hard for them to verbalise the pain
15:43so you
15:44that's the one thing you've got to be careful with
15:46right
15:47I know you said that you're struggling to walk
15:48but I just need to see
15:49if we can put some weight on
15:50is that okay?
15:51yes
15:52so if you'll put your foot up
15:53weight on you good
15:54that's it
15:55like we did this morning remember?
15:56do you want to hold my hands?
15:58don't hold my
15:59yeah
16:00tell mums
16:01see if we can take a few steps
16:04and they might not like to be touched
16:06so you have to try and adapt
16:07to other ways
16:08that's where parents
16:09can help
16:10because that's their familiar person
16:11you're out
16:12that's fine
16:13don't have to squeeze my tool
16:14too tight
16:15yeah don't squeeze mum too tight
16:16there we go
16:17there you go
16:18okay
16:19so I think we'll get an ankle x-ray
16:21yeah
16:22so I'll just go and get it requested
16:23and then I'll come and show you
16:24where to go
16:25okay?
16:26give me two minutes
16:27mum can you give me some food?
16:28I'm hungry
16:29you're always hungry
16:30when you come to us pick up
16:33right at you
16:34okay let's show you where to go
16:38I'm pretty confident
16:39it's a bit of a sprain
16:40but it's worth getting an x-ray
16:41just to rule out a fracture first
16:43and then
16:44make a plan from there
16:45okay that way
16:46that way
16:47that way
16:48that way
16:49weeeee
16:52as Archie
16:54heads to radiology
16:59I was at pain now
17:02I was at pain now
17:04come in and go in
17:05pardon?
17:06come in and go in
17:07okay we'll keep an eye
17:08cause we can give you some more
17:09fear of not
17:10okay
17:11over in Rhesus
17:12Dr Underwood is battling to get
17:14Diane's symptoms under control
17:18I'm giving a fluence
17:19and then antibiotics as well
17:21but both those things
17:22just haven't done the job
17:25it's a really common cause of death
17:26in this country
17:27yeah sepsis
17:28does kill
17:29so at this point
17:31so at this point
17:32I need to go and get a senior
17:33yes
17:34to get some advice
17:35about what to do next
17:36cause I've given
17:37a fair amount of treatment
17:39and it hasn't improved things
17:41yet
17:42it's fine
17:43it's fine
17:44yeah
17:45Dr Underwood refers to consultant
17:48Dr Rob
17:49Jones
17:52my concern is
17:53given
17:54women's antibiotics
17:55we're only probably on our second litre at the moment
17:59but it's historic
18:00it's just still hovering below 90
18:02a rate of
18:03a rate of
18:04this
18:05yeah
18:06150 bang on
18:07which fits with flutter
18:08shouldn't cause
18:09hypertension
18:10to that degree
18:11she's already had
18:12as much fluid
18:13as he would
18:14yeah
18:15thank you
18:16thank you
18:17thank you
18:18thank you
18:19we've just gone into something called septic shock
18:21where
18:22your body has become
18:23so
18:24over
18:24overwhelmed
18:25that actually it can't even maintain its own blood pressure
18:27she's at risk of organ
18:29damage
18:31but the critical care team
18:33are
18:34especially with doctors
18:35that look after people
18:36with conditions like yours
18:37where
18:38the infection is having a really big
18:39impact on your body
18:40and
18:41so we're gonna give them a call
18:42ha
18:43ha
18:44this is charlotte
18:45i'm one of the emergency doctors
18:46is this the ITU registrar
18:49because it's such a serious condition
18:52people have to be
18:53monitored
18:54much more regularly
18:55than they would be on a ward
18:56they would be on a ward
18:57they would be on a ward
18:58they would be on a ward
18:59and
19:01Diane is on the middle
19:02she's going with my clubbers
19:04Yeah.
19:05Are you ready?
19:06Yeah.
19:07Yeah.
19:08Are you ready?
19:09Yeah.
19:09Yeah.
19:10Yeah.
19:11Yeah.
19:12Yeah.
19:13Bye.
19:14Bye.
19:15See you later.
19:16Bye.
19:17Bye.
19:18Bye.
19:19Bye.
19:20Bye.
19:21Bye.
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22:21I've been healed of it.
22:23Brian has had surgery in the past.
22:26For cancer of the oesophagus.
22:29So obviously your oesophagus are...
22:31About 10 years ago.
22:33So if it's not a crude question.
22:35What do you have...
22:36The oesophagus if they lengthen to stomach or...
22:39And they've reshaped.
22:41Then made it into a cheese.
22:44Yeah.
22:44And then brought it back.
22:46So we'll keep an eye on you.
22:50And then...
22:51We'll decide what we're going to do.
22:53I'm going to get a chest x-ray.
22:54Because I think we need to...
22:56To see what's going on in your chest.
22:58If that's alright.
22:59Yeah.
22:59Yeah?
23:00Okay.
23:00Cool.
23:01You just sit forward for me.
23:03Is that okay?
23:06With the cause of Brian's irregular heartbeat unknown.
23:09Dr. Liz must work quickly.
23:11Make a diagnosis.
23:16BELL RINGS
23:17BELL RINGS
23:18BUG
23:2615, 17 is going 60.
23:31That's him fit to sit.
23:34In the hub.
23:36The new 45-minute policy means manager Antonia is working against the club.
23:41They're locked to find spaces for patients who've arrived by ambulance.
23:4645 minutes, the crews have to hand over to our nursing staff.
23:52We're getting really tight at the moment just because we've got no space to hand over these
23:55patients.
23:56We've got one at 27 minutes at the minute, so they're doing everything they can to.
24:01It's going to prevent the crews having to leave that patient.
24:06That's what I wanted to love.
24:08Yeah.
24:08You too.
24:09Right, love.
24:10That takes us all.
24:11I'm ready to move now with a cubicle
24:16cleared for one new patient, the team now need to find space for the rest.
24:21I'm ready to go, I'm ready to go.
24:26I'm ready to go, I'm ready to go.
24:31How are we doing, Brian? You alright?
24:33I felt a lot worse earlier.
24:35Yeah, I bet.
24:36At least we're heading in the right direction.
24:38Yep.
24:39In Rhesus, Brian has an irregular...
24:41a heartbeat following open heart surgery.
24:44The doctor just asked me just to do...
24:46a quick x-ray of your chest.
24:47Is that alright?
24:48Sure.
24:50Ooh, that's...
24:51I'm sure it is.
24:55Bye bye.
24:56That's not good.
24:59Right, Brian, just breathe in for me.
25:01Hold it there.
25:03And breathe normally.
25:06There we go.
25:07Rest back.
25:08Hopefully a bit more.
25:11That's not bad.
25:12Yes.
25:13Right, Brian, I'll leave you be.
25:16It doesn't actually look that different from the last one.
25:22Dr. Liz checks Brian's x-ray.
25:24Apart from you've got some extra bits of wire...
25:26I am a new chest man.
25:27Yeah.
25:28Just what you need.
25:29Yeah.
25:31His irregular heartbeat could be the result of an infection.
25:36To me, it does look like there is a little bit of some fluffiness.
25:41Stand at the right side, which could represent infection.
25:46So I would be inclined just to give you an antibiotic.
25:51Because you've just been in hospital.
25:53And unfortunately, hospitals...
25:56You've got three bugs on you.
25:57It's quite easy to pick up some sort of chest infection.
26:00I'll put you out.
26:01You're absolutely sick of being stabbed with needles, aren't you?
26:04Yeah.
26:05Yeah.
26:06Simple answer.
26:07Simple answer.
26:08Not going to chop it up.
26:09Nope, I haven't cut it.
26:11It's huge.
26:14If the antibiotics don't stabilize brain...
26:16Brian's heartbeat...
26:17His life remains at risk.
26:21While Dr. Liz is on duty in recess...
26:26Over in May...
26:31...for ages...
26:34You're taking your skin off, aren't you?
26:35Yeah.
26:36I'm just going to give that skin tear a quick clean.
26:38See if I can pull the skin back off her.
26:41Nurse Amelia is treating Pat, who sustained multiple injuries...
26:46...when she fell, taking out her rubbish.
26:49Okay, I'm just going to see.
26:50Okay, I'm just going to see.
26:51If I can pull the skin back just a little bit.
26:57I'll shoot one eye.
26:59I'll shoot them both.
27:01Yeah, keep your eyes shut.
27:06You know, I didn't even know I'd done that.
27:08Only my leg hurt me.
27:11There's only the slightest bit that I've been able to get.
27:15It's no good sticking.
27:16Because it just pulls open.
27:18Yeah, and it's delicate as well.
27:20It's better.
27:21I think that's as good as we're going to get.
27:26I think that's it!
27:29I think that's nice.
27:31Bless you. Thank you.
27:36Pat has had a run of bad luck. Only a few days ago, she had...
27:41...hurt her other leg.
27:43This injury...
27:46I was on my bed and I wasn't sleepy so I picked my DS game up to play on it.
27:51I love the Mario games. It's a big screen one.
27:56And I dropped it on my shin and it blew up for a storm.
28:02Hello. Hello.
28:03Alright. Hiya.
28:04Hiya.
28:05With the possibility that...
28:06...that Pat's left leg is broken...
28:08...Portum Matthew takes her for an X-ray.
28:11Let's go.
28:17Hello, Patricia.
28:18Hello.
28:19My name's Emma. I'll be taking your X-rays.
28:20Hello.
28:21Hiya.
28:22Hiya.
28:23What was it that happened to your leg?
28:24I felt I was taking some...
28:26...instantly just...
28:27...spinna fell off the back step.
28:28Oh, bless you.
28:29There's only one but I fell off it.
28:31So I'm just going to take two pictures of your leg, okay?
28:35Yes.
28:36I fell off...
28:37You were having fun after it went home.
28:38I hear a little...
28:40You, I hear.
28:41yeah lovely all finished so we'll get you back round
28:46you're going to eat something to that don't you? yeah
28:51fortunately Pat has no broken bones but the team need to
28:56find out why she keeps falling
29:02lovely yeah
29:04good
29:06good
29:11We've only got two ambulance cubicles available for handover.
29:16They are full.
29:17In the hub, manager Antonia and sister Christy.
29:21are battling to find space for waiting ambulance patients.
29:26Six is not far off, we're going to have to get two.
29:31Someone out of a cubicle, that's it.
29:32Well, with ten ambulance crews now on...
29:36In sight, the pressure is on.
29:41And even more are arriving.
29:46We're going to have to go to the hospital.
29:48We're going to have to go to the hospital.
29:51We're going to have to go to the hospital.
29:54We're going to have to go to the hospital.
29:56We're going to have to go to the hospital.
29:59We're going to have to go to the hospital.
30:01We're going to have to go to the hospital.
30:02We're going to have to go to the hospital.
30:06Practitioner Claire's next patient is 31-year-old Jake.
30:11Jake, what's happened today?
30:12I drew an accident at work, tucks my skin off front of my thumb.
30:16Drilled into it?
30:17No, not quite. Piece of metal's cut it.
30:19Right, okey-dokey.
30:21A lot of the injuries that come into A&E are work-related injuries.
30:26What is your job?
30:27A mechanic.
30:29Right then, have a seat on there.
30:31I'll get some gear and we'll have a look.
30:34It is hopefully reassuring.
30:36To the patient if you're friendly and chatty.
30:38We were saying there's been three cars on...
30:41...the roofs this week round Barnsley.
30:43Have you seen them on news?
30:44I've seen one tipped over, yeah.
30:46Oh, that's happened.
30:47Then they feel at ease before you start doing an intervention.
30:51with them that's potentially going to be painful.
30:53What's going on there then?
30:54They're driving round corners.
30:56It's too fast.
30:57It's got to be speeding.
30:58It can't really be too bad a weather can it?
30:59It's not there yet.
31:00No, it's not been raining.
31:01It's been raining this week.
31:04Like a sh...
31:06...shedded piece of skin, ain't ya?
31:08Mmm.
31:09I'm not squeamish in the slightest.
31:11I like wounds.
31:12And the bigger the better.
31:16Mmm.
31:17The issue with that is it's like you've cheese grated that piece of skin.
31:21But it's quite dirty.
31:22Is that the cleanliness of your hands or will it come cleaner?
31:26Yeah.
31:26It will come cleaner.
31:27Yeah.
31:28If you go to the sink and give it a...
31:31...as good and clean as you can.
31:32Then I'll try to stir and strip it back across it so that we can try and let it...
31:36...recover.
31:37You don't want to cut it off?
31:38No.
31:39I don't want to cut it off because...
31:41...it leaves that area prone to infection but it might drop off.
31:46...when the undersurface of the wound is healed.
31:48Yeah.
31:49Alright.
31:50So give it a good wash in there Whistle.
31:51...with the soap and water and hopefully we can get it cleaner than that.
31:56Oh, it's a do-
31:57No.
31:58I'm not.
31:59It's just that, it's just got...
32:00... olives.
32:01Mechanics have always got ingredients...
32:01dance absolutely do you want me to get you some sugar do you know
32:06warmly wash it with sugar I'll go take a picture and get some yeah
32:11tricks of the tread this
32:14sugar
32:16and washing up liquid are you feeling funny no but it's soft
32:21don't wash underneath it just wash on top
32:26thank you
32:27yeah it's all
32:31some people use even cold water it doesn't dissolve so it stays as a grain
32:36which gets in the skin and it gets all dirt out
32:40that's good
32:41is it nice
32:43good as new look
32:44yeah somewhat
32:46I'll just get some steady strips
32:48right then my love
32:51pop your hand on here
32:53I'm going to steady strip that little bit of skin back on
32:56it's more of a protection thing but we don't want it to be dirty
32:59and you can bend your thoughts
33:01I'm all right everything's all right
33:03cheers
33:06cheers
33:08cheers
33:09cheers
33:10cheers
33:11just keep it on for a couple of days and then you can take this off and change
33:14it to just a waterproof dressing which I'll give
33:16you a few spares
33:17so that's done and I'll just get you some spares
33:21wear dressings and then you can be on your way
33:24nice clean hands as well
33:26yeah
33:26they're not so bad
33:27there you go
33:29all good
33:30fantastic
33:31good to go
33:32thanks very much
33:33take care of love
33:34bye bye
33:35great guys thank you
33:36bye
33:36Jake went straight back to work
33:39he still uses sugar to wash it
33:41peace hands
33:46I'm gonna give you a little bit
33:51a bit of a soprallol
33:52so you've had 1.25 this morning
33:54I'm gonna give you a little bit more now to see
33:56if that controls your rates
33:58if your heart rates
33:59ok
34:00so they're gonna keep them here not Sunday
34:01over in resource
34:02Dr. Liz's patient Brian is still not responding to treatment
34:06you ok
34:07yeah it's just me sending that off the bed
34:10get tight
34:11having had open heart surgery
34:15Brian was
34:16was only discharged from hospital yesterday
34:18well
34:20yeah
34:21this part of the human hospital is getting out
34:24do you need some painkillers?
34:26are you just tired
34:27I'm tired
34:28you're tired
34:29yeah
34:30I can't see you going
34:31we're in home at the moment
34:32I think you're probably gonna have to stay at least for 24 hours for us to get this heart rate
34:36that's fine
34:37yeah
34:38fingers crossed
34:40fingers crossed
34:41that you're not here for very long
34:42over the weekend
34:43cool
34:44alright
34:46I was really looking forward to
34:49I was really looking forward to
34:51my first day of freedom today
34:54only to find them back where I was
34:56starting
34:57yeah
34:58it's hard
34:59but never mind
35:00if it is just
35:01a day or two
35:02and then I'm gonna be out again
35:04that night
35:05yeah
35:06snow cold
35:07it's
35:08it's
35:09it's
35:11it's
35:12it's
35:13it's
35:14it's
35:15it's
35:16it's
35:17it's
35:18it's
35:19it's
35:20it's
35:21it's
35:22it's
35:23it's
35:24it's
35:25it's
35:26it's
35:27it's
35:28it's
35:29it's
35:30it's
35:31it's
35:32it's
35:33it's
35:34it's
35:35it's
35:36it's
35:37it's
35:38it's
35:39it's
35:40Twice.
35:41Twice.
35:42Yes.
35:43Elbows.
35:44Can you keep your...
35:45Toes right up there for me.
35:47That's it.
35:48Nice and still.
35:49Nice and still.
35:50Nice and still arching.
35:55I just hope it's not broken.
35:58Nice.
35:59Nice.
36:00I don't like that if it is.
36:01Okay.
36:02Well done Archie.
36:03Well done love.
36:05Does it work?
36:06Can you tell me now?
36:10Let them decide.
36:11Okay.
36:12Let them decide.
36:13So I don't want to go to school.
36:15How many days?
36:16No.
36:17So go to school.
36:18No.
36:19Telling you that.
36:20Wee.
36:21Don't touch your light self.
36:23It's another ride back to the...
36:25Pediatric department.
36:26To find out if Archie's ankle is broken.
36:29Boy.
36:30Good.
36:31Good.
36:32Good.
36:33Good.
36:34Good.
36:35Good.
36:35Beep. Beep. Beep. Beep. Beep.
36:40Beep. Beep.
36:45Beep. Beep.
36:47Beep.
36:49Beep.
36:50Beep.
36:51Beep.
36:52Beep.
36:53Beep.
36:54Beep.
36:55Beep.
36:56Beep.
36:57Beep.
36:58Beep.
36:59Beep.
37:00Beep.
37:01Beep.
37:02Beep.
37:03Beep.
37:04Beep.
37:05Beep.
37:06Beep.
37:07Beep.
37:08Beep.
37:09Beep.
37:10Beep.
37:11Beep.
37:12Beep.
37:13Beep.
37:14Beep.
37:15Beep.
37:16Beep.
37:17Beep.
37:18Beep.
37:19Beep.
36:55is stretching casualties resources to the limit.
37:00I'll meet you from the emergency department to see what we can borrow a couple of trolleys.
37:05Yeah, yeah, because we're just running out of trolleys.
37:08All right, yeah, no worries.
37:10All right, bye.
37:12We've run out of trolleys, so we're trying to...
37:15Some other areas that are closing shortly to try and borrow some of theirs to put us on.
37:18Each cubicle should have a trolleys.
37:20Oh, thank you.
37:21Good job.
37:22Bye.
37:23The rope's going to get two.
37:25We're all out.
37:30Bye.
37:31Bye.
37:32Bye.
37:35Bye.
37:36Bye.
37:37Bye.
37:38Bye.
37:39Bye.
37:40Bye.
37:41Bye.
37:42Bye.
37:43Bye.
37:44Bye.
37:45Bye.
37:45Bye.
37:46Bye.
37:47Bye.
37:48Bye.
37:49Bye.
37:50Bye.
37:52Bye.
37:53Bye.
37:54Bye.
37:55Bye.
37:56Bye.
37:57Bye.
37:58Bye.
37:59Bye.
38:00Bye.
38:01Bye.
38:02Bye.
38:03Bye.
38:04Bye.
38:05Bye.
38:07Bye.
38:08Bye.
38:09Bye.
38:10Bye.
38:12Bye.
38:13Bye.
38:14Bye.
38:15Bye.
38:17Bye.
38:18Bye.
38:19Bye.
38:20Bye.
38:22Bye.
38:23Bye.
38:24Bye.
38:25Bye.
38:26Bye.
38:27Bye.
38:28Bye.
38:29Bye.
38:30Bye.
38:31Bye.
38:32Bye.
38:33Bye.
38:34Bye.
38:35Bye.
38:36Bye.
38:37Bye.
38:38Bye.
38:39Bye.
38:40Bye.
38:41Bye.
38:42Bye.
38:43Bye.
38:44Bye.
38:45Bye.
38:46Bye.
38:47Bye.
38:48Bye.
38:49Bye.
38:50Bye.
38:51Bye.
38:52Bye.
38:53Bye.
38:54Bye.
38:30There's a little devil sat on my shoulder, knocking me over.
38:35Hello, we've come from the therapy team.
38:40Occupational therapist, Kate, and physiotherapist, Annabelle.
38:45Assess whether Pat's is safe to go home.
38:48So you mentioned you lived in a bungalow.
38:50Yes, a two-bedroom bungalow.
38:51Okay.
38:52And you manage quite well by yourself.
38:55Oh, yes.
38:55Yeah, okay.
38:58Do you have a key safe box?
39:00Patricia, do you have a false alarm?
39:03No.
39:03I'm going to look into her.
39:05Yeah, they're really good.
39:07Do you have some help with cleaning?
39:09Yeah.
39:10My brother-in-law does it all.
39:11There we go.
39:12His wife takes me to Bingle out of his...
39:15He says, I'm a bit pussy, he says.
39:17He says, I'll do your cleaning if you're not there.
39:20That sounds like a deal.
39:23So what we'll do now is...
39:25We're going to get you up, get you walking.
39:27So if you can just get yourself out, but just...
39:30Take it steady.
39:32Take it steady because you've had some...
39:35A nasty fall.
39:36Push up from the bed.
39:37How do you feel?
39:38Do you feel okay?
39:40Do you want to start taking a few steps?
39:45How's that left leg feeling?
39:47All right.
39:49I can work on...
39:50Does this walking feel like you're normal walking?
39:53I'm slow.
39:55That's fine.
39:55I think you're a bit faster than that.
39:57You're normally a bit faster.
39:59Yeah.
40:00She's managed to get in and on and off the trolley,
40:02which suggests she'll be able to get in and out of bed at home as normal.
40:05Looks like she's more of a normal, functional level.
40:08Do you want...
40:10Do you want to get your legs back into bed?
40:12Yeah, I work hard.
40:13I mean, you just don't...
40:14That leg is...
40:15Perfect.
40:16Done that all yourself?
40:17Yes.
40:18Take that off your finger now.
40:20With Pat giving the all clear...
40:23We'll be back.
40:23Nice to meet you.
40:25She can look forward to an evening in her own home.
40:28I'll watch telly tonight.
40:30I like action films.
40:34Jesus did.
40:35I like to get them out of sports radio and still own.
40:39All of them kind.
40:40People are alive.
40:41I feel right back.
40:42Thank you too much.
40:45Which way do we go?
40:46Straight up here.
40:47Oh, well, there you.
40:50Thank you very much.
40:51That made a full recovery while watching action films and playing comp-
40:55computer games.
40:56.
41:00.
41:02.
41:03.
41:05.
41:06The only thing I'm looking at is this here.
41:09.
41:10In the paediatric department, advanced clinical practitioner Gemma has the result
41:15.
41:15of Archie's ankle X-ray.
41:17When we're looking at X-rays we're looking for all areas to be-
41:20.
41:20nice and smooth it's just when I get to this bit here which is actually where
41:25is tender it just sort of nicks up but that could be normal
41:30for him because his bones are still growing still developing
41:35I'm gonna go have a chat with me consultant about that one
41:40I can't see a function
41:45it don't even extend up does it
41:50I think that's normal growth
41:52yeah that's fine
41:55hello
42:00hi
42:00so they're a little bit I just needed to go have a chat with my consultant about because where is
42:05tender they were just a little bit of just that are a bit suspicious of but actually that's just
42:10your normal bone your normal what we call growth plate developing so it's just
42:15looks like a sprain
42:17not broken then
42:18no not broken
42:19aww
42:20why do you want it to be broken
42:21so I can't go to school
42:22you can still go to school with a break anyway
42:25so what we need to do is see if we can get you up walking
42:28yeah
42:29oh no
42:30no
42:31so we try again
42:32so just one one to hold that and then I hold this one
42:35I know her
42:36oh okay
42:37um
42:38what
42:39what
42:40that's it
42:42doing really well
42:43it's gonna hurt it's a sprain mister
42:45the do sprains do hurt
42:47well done
42:48well done
42:49so it's probably
42:50best resting it at home today
42:52paracetamol and ibuprofen probably
42:55that's a regular for next day or so
42:57can we take these off once I get back
42:59no we can't take them off
43:00come on we don't have any left
43:01you gotta start walking dude
43:02gotta start walking
43:03no no no
43:04free to go
43:05go get some
43:05tweet
43:06all right
43:07you take care
43:10come on
43:11come on
43:12come on
43:13Archie had a day of school and is now full
43:15fully recovered
43:16you
43:17you
43:21You
43:31It's 7pm and the day shift are handing over to the night shift.
43:36It's as busy as people before that I feel a bit more in control.
43:41We're getting there fully.
43:46We have got a wide variation of staff.
43:51In here we've all got different skills.
43:54We work as a team together to...
43:56..to deliver the care for Barnsley.
44:00It's...
44:01..time for the team to get some rest.
44:03See you later.
44:04See you later.
44:05See you later.
44:06Before returning tomorrow to once again care for the people of Barnsley.
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