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00:02in the heart of Yorkshire
00:07just a busy day everybody's decided to come today an unbeatable team have you given it a clean or
00:15did you just I wouldn't let my wife anywhere near it slide hard at work 24 hours a day sorry
00:23you've
00:24got the booby prize you've got me seven days a week saving lives helping loved ones well this is
00:37shocking they're actually broken bone making the community they serve better as well as everybody's
00:43safe that's all that matters a health service treating anyone strain your temperature Jane and
00:50everyone keep going a team doing anything and everything for each other the staff have been
00:58amazing they've not been able to do enough for us this is Barnsley casualty 24 7 it brings me faith
01:07in
01:07the staff and NHS definitely on shift tonight dr. Emma Farragher we're a bit worried you might have
01:23an infection in your head sister Georgia we should see him really within a 15 minute window when the
01:32looking in and dr. Kitty price I think we need a little bit more than a plaster for that one
01:40so
01:42get ready to share a shift lucky to be alive really with the team at Barnsley casualty
02:00it's a hectic start to the afternoon shift sister Georgia is in charge just a busy day everybody's
02:10decided to come today so we've got patients that have been here 14 hours and 50 minutes and we're
02:18still waiting on beds not good we're trying as best though but getting to grips with running the
02:26department is an exciting new challenge I've only actually been doing my sister role a couple of
02:33months I do enjoy being a sister hello you do sister you need to make sure that all your patients
02:39are safe
02:40it is really challenging especially being a sister and like managing the department and casualties
02:48doors open 24 7 patients are sat in waiting room that have been here an hour and 20 minutes and
02:55not
02:55being triaged yet so obviously it's patient safety that we need to maintain sometimes like you walk in
03:01patients are actually the sickest patients in the department so if there's a long triage wait down
03:06there you've got to prioritize getting them seen so we've got nine to two patients in department we've
03:14got a two-hour three-minute doctor wait it is a bit like a puzzle we've got to move staff
03:20about to
03:21help in the areas that are more demanding but yeah we're just very busy as always and it's only an
03:31hour
03:31into her shift to add to the pressure paramedics are rushing in a patient who's had a serious accident
03:43dr. Kitty price is already in resource so we've got an 85 year old male trauma at pre-alert and
03:51he's
03:52coming in having fun six foot forwards off a ladder and hit his head on the ground the team prepare
03:58for
04:13his arrival 85 year old John has a severe head injury and pain in his back
04:28so about 10 45 this morning John has been approximately two meters up some ladders
04:36in his garage the paramedics hand over to dr. john shepherd and the team the ladders have slid away
04:45from him he's gone forward he's hit his chest and his head on the ladders as they've collapsed on the
04:53floor colleagues were quite keen to demonstrate how worried they were as well which always piques your
05:00interest and it's important to try and bear their concern in mind and compare that with the patient
05:06that you've got in front of you notable injuries about one inch laceration to the right side upper his
05:15head and left clavicle about here tender he's got potentially two different places that are causing
05:23him trouble and it's trying to unpick how much is one how much is the other and how much we
05:28need to be
05:29worried about both of those together dr. price takes charge she needs to assess which injuries
05:35need to be prioritized first John's wife Muriel has been with him since she called the
06:00ambulance
06:08yeah what were you doing
06:19after such a high fall John's showing signs he may have broken his back
06:25and then he said I've got the wall and I thought okay never gone right there
06:31saw here
06:32both sides I thought saw her there
06:34can I have a squeeze of your hips okay I want you to see if there's any pain in anywhere
06:42where's that pain shoulder
06:47I'm gonna check your temperature my lovely I'm gonna go this side so they've got the cuts on the other
06:53side
06:56yeah
06:57yeah
06:58yeah
06:58yeah
06:59there just directly under there
07:00oh yeah
07:01okay
07:03how have you been with moving this hand
07:05all right
07:07any pain in your shoulder joint here
07:11or is it only where I was pressing it in
07:13there you come up
07:16enough
07:17perfect
07:18I'm sorry
07:19I have to have a good look so I know what's going on
07:21okay
07:22oh sorry
07:23all right that arm on that side just to get some blood's all right
07:25I know we're coming at you from all ankles
07:27I don't want to hear that
07:29I'm just gonna pinch this arm to take some blood is that all right
07:32yeah
07:33I love you
07:33John has multiple injuries so Dr Price puts together a thorough treatment plan
07:40yeah
07:43what we're gonna do is we're gonna order you some scans and get you some pain relief
07:46we're gonna send these bloods off
07:48we're gonna scan this area
07:49we're gonna scan your head because you've got a bump to your head as well
07:52it looks like you've got a bit of a gash here that we need to have a look at
07:56but what we're worried about is whether there's any bleeding in your head as well
08:00yeah
08:00okay
08:01so we're gonna have a look on this side as well
08:09no
08:10I'm not straightening your arm
08:12no
08:15try again there
08:16is that better?
08:18see you next week
08:19yeah
08:19yeah
08:20yeah
08:20yeah
08:23with the wrist John has internal bleeding or a brain injury
08:27he gets taken down for his CT scan
08:31if he has a bleed on the brain he will need emergency surgery
08:45in casualty sister Georgia is only a couple of hours into running the department
08:50Lisa would you be able to go down to walk-ins?
08:53because I think there's like nine to assess for you about an hour
08:56wait is that okay?
08:58walk-in patients haven't stopped coming through the doors
09:01and the triage team can't keep up
09:04we've sent more staff down though to try and get up with work
09:08because we've got an hour and 20 minute triage wait
09:12just seems busy on triage this afternoon on walk-ins
09:16when we're overflowing with walk-in patients it's really really stressful
09:20you've got a long wait
09:22you don't know what they've come in with really until you triage them
09:27we should see them really within a 15 minute window when they're booking in
09:31it's just in flux we've had a lot in over a short period of time
09:37hopefully we get back on top
09:39while sister Georgia tries to keep the department on track
09:4985 year old John is having an urgent CT scan on his head and spine
09:54after he fell off a ladder in his garage
10:04now back in Reesos daughter Beverly comes to visit her dad
10:10I'm a lad in garage here for an hour before I couldn't move
10:16couldn't move
10:18when I turned round there was a lot of blood up right side
10:21yeah
10:22so you knew then you'd done something
10:24I knew I had to get open you know
10:25yeah yeah
10:27but I felt somewhere go you know I'd click
10:32I just couldn't move at the time I just couldn't move
10:36have you had any morphine or out?
10:38no I didn't want them I'm not in pain
10:40I was at first but it seized off this pain
10:43oh that's good then
10:44it seized off a lot
10:46after assessing John's results
10:49Dr Price heads to see him
10:51John how you doing?
10:53alright
10:53yeah how's your pain?
10:54it's gone a bit
10:55ok so we're going to give you some pain relief
10:58some more pain relief
10:59send me on
10:59so we've got a bit more to do before that
11:01alright
11:03so
11:03first things first
11:05from your scan that you've had done
11:06you've fractured your clavicle here
11:08I've done done done done
11:09I've spoken to the bone doctors
11:10who want to have an x-ray of that specific area
11:14so that they can see how bad it is
11:16and what they're going to have to do about it
11:18the scan of your head didn't show any bleeding inside your brain
11:22it just shows that we know about this
11:25ok
11:26we're waiting for the rest of the scan to be reported from your clavicle downwards
11:30ok
11:32this has started seeping through a bit this cut
11:34so I need to have a look at it
11:35alright
11:35I'm moving out of the way
11:36alright
11:37I'm just going to have a good look at it
11:39alright
11:41cowards
11:42just
11:44cowards
11:45that's going alright now
11:46yeah
11:47well it can't be going alright
11:49just put a plaster on it
11:51I think we need a little bit more than a plaster for that one
11:54sure
11:55I know
11:55we need some pain relief don't we
11:57is it broke?
11:58yeah it's broke that
11:59I think likelihood is
12:01is we can close it with a bit of glue
12:05at the minute it doesn't look like you've caused much damage other than that clavicle
12:09here
12:10it's not good that
12:12wow
12:13alright keep that head still for me
12:15just whilst we wait that glue
12:19any questions for me?
12:21no
12:23John's now got to wait for the final scan results
12:26before he can be moved out of Rhesus
12:28but there's still a chance he could have badly broken his back
12:42paramedics are bringing in another patient who will be going straight into Rhesus
12:5358 year old Jane has come in with a severe headache, high temperature, confusion and vomiting
13:02Dr Emma Farragher is in charge of her care
13:06Jane
13:08we need to steal a little bit more blood just to see if there's any bugs in it
13:12is that okay?
13:15people coming in with textbook things is very rare
13:17if everyone did that we wouldn't have a job
13:20because the computer would do it
13:24Jane has a rare condition called Addison's disease
13:28if an Addison's patient is coming in
13:30they'd be concerned that they're going to be quite sick
13:32they can get quite sick quite quickly
13:34so they need to have steroids
13:36because their bodies won't produce their own steroids
13:39to counteract them being sick
13:42Jane is prone to serious infections
13:47if we give you some morphine will you be okay?
13:51should we try that?
13:53I love problem solving
13:55I always loved learning
13:56it's one of those industries where
13:59you always learn
14:00it's always advancing
14:01there's always something new
14:05With Rhesus filling up
14:07Nurse Olivia has been drafted in to help Dr Farragher
14:12My first day in Rhesus
14:14I've only just qualified
14:16but I've been in A&E two years now
14:20every shift is different
14:21you don't always work in the same place
14:23Rhesus is one of the ones that everybody fights to go in
14:27because it's adrenaline packed
14:32I'm just going to take some blood darling
14:33okay?
14:37It's a big learning curve in Rhesus
14:40there's lots of things to learn
14:41new cases that we find
14:43that I've never come across
14:49I'm just going to pop your blood pressure cuff on as well
14:52okay?
14:55Jane's daughter Melanie has arrived
14:59Hello trouble
15:01you causing chaos are we?
15:03hey?
15:05you tired?
15:07you tired?
15:09I am
15:12I am
15:13not surprised
15:15still not with her here
15:16still not with her here
15:19she is looking very hot and clammy
15:21very pale, very lethargic
15:24she seems to be a little bit confused as well
15:26very weak
15:28just not herself at all
15:30we think she's got some sort of infection somewhere
15:33you warm enough?
15:35you shaking a little?
15:42Dr Farragher and the team need to monitor Jane closely
15:45in case her vital organs start to shut down
15:58Back in the hub, patients are piling through the doors
16:03are you alright down there?
16:04because I know it's really busy in terms
16:06faster than sister Georgia and the team can treat them
16:09is there any spare cubicles for somebody to assess or not?
16:13we've only got two triage rooms
16:15we've got doctor's rooms as well
16:16but then obviously doctors need to go in there and see patients in there as well
16:20so it's hard
16:22otherwise there'd be no patients getting seen by doctors if we used our rooms
16:32in paediatrics they have eight dedicated rooms for poorly children
16:37and when it's as busy as today
16:39the staff know the importance of pulling together
16:43Teamwork here at Barnsley is incredible
16:45especially in our emergency department
16:48it becomes like a little family that you have around you
16:53and that's important
16:55I wouldn't change that for the world
16:59and advanced clinical practitioner Liam might need to call on his colleagues for help
17:06with his next patient
17:10energetic three-year-old Leo has been brought in by his mum Jess and Dad Craig
17:16I don't know if he just constantly lives off adrenaline but it's nothing phases him at all
17:25but yes very active
17:28he might not look poorly
17:30but this morning Leo burnt his hand while his mum was ironing
17:40he's been brought in by his mum
17:40Hello there
17:41Hiya
17:41Hiya
17:41Is this Leo?
17:42Yes, he's me
17:43I've seen you running up and down
17:46and who are you guys?
17:47Mum and Dad
17:48Fantastic
17:49so tell me what brings you into A&E today
17:51so I wore ironing uniform this morning
17:54and then just as I've gone to put the iron down onto the t-shirt
17:57his arm slid up and the irons touch the corner of his hand
18:01Okie dokie
18:02I ran it underwater and it just kind of looked red so it didn't look bad
18:07so I've gone to school and in that time it's like blistered up
18:11Okie dokie
18:12How long did you run it underneath the water for?
18:15About 10-15 minutes
18:16About 10-15 minutes
18:18Leo, do you want to just sit on mummy's knee over there for me so that I can take a
18:22look?
18:22Hello
18:24Nice juice bottle
18:26So
18:29And you say he didn't have any medical conditions
18:31No
18:32So no eczema or anything like that
18:33Oh, it's ok, just taking a quick look at it
18:37It's ok, I'm not going to touch it
18:39So, it's just a bit of erythema around this bit here
18:42Yeah
18:43It's not gone round
18:44Can I just see the bottom of his hand if that's alright?
18:48The position of a burn is really important
18:51The burn itself can cause constriction of the skin
18:55Which then could potentially cause issues for circulation
18:59Erm, nerve sensation and stuff like that
19:02So, it's quite important to check exactly where that burn is
19:06No, it's just that one under
19:08Okay
19:08We're reaching for chocolates
19:09I'm literally just going to press on it a second
19:12So, it might not like me unfortunately
19:13Exactly
19:14It's ok
19:15It's ok buddy
19:17It's ok
19:20One, two, three, four, five
19:22Good stuff
19:23Ok
19:24Good boy
19:25Good boy
19:26Fantastic
19:27Thank you
19:30So, a couple of really positive points inside that
19:32Is one, you've done exactly what you should have done
19:34In terms of running it underneath the water
19:38He's just wanting to run up and down, blessing
19:41The other good thing is that it's not around any of his fingers
19:45And it's not on what we call flexor bits
19:47Right
19:47So the bits that bend down and get less
19:51Ok, so it's not going to constrict that muscle there
19:54The fact that it's on the top is actually better
20:01He's very active innit
20:03Bye bye mister
20:06Bye
20:08Thank you, that's it
20:12Leo's had a lucky escape
20:14His blister could be much worse
20:17But he would still have to endure the painful procedure
20:20Of having it burst
20:30In recess, nurse Olivia is caring for Jane, who came in with Addison's disease
20:37Addison's disease is where the body doesn't produce enough of hormones such as steroids and adrenaline
20:45Which makes it hard for the patient to fight off any illness
20:51Jane's now been stabilised, and is being moved out of recess
20:58So, she wasn't as poorly as we'd feared
21:00So she was suitable to be in HTC rather than recess, which is just a slightly lower level of monitoring
21:07She's taken round to a high dependency cubicle
21:11She's had a really bad headache, haven't you?
21:17Her daughter Melanie has been with her since she came in
21:22Yeah?
21:23Can we go home?
21:25You can't go home
21:26I'm sorry
21:29Not well enough
21:31Well, I missed it
21:33I missed it
21:34You're quite poorly, yeah
21:37Not very well
21:39Dr Farragher has come to check in on Jane
21:43Can I borrow this arm for a blood test?
21:46A few more bloods from you
21:51You are very, very warm
21:56Can we go home?
21:58No, you're very poorly Jane, you can't go home
22:01We need to keep you
22:03I don't think you're going to do very well if you go home
22:06Sorry
22:06I think we've fluctuated because I thought that we'd had a bit of a breakthrough
22:10If she had the headquarters, it would just seem a bit more lucid
22:13Yeah
22:14And then she's kind of gone again
22:16Check whether her sugars have dropped or anything like that
22:18She looks worse from the end of the bed than she did earlier
22:22And her GCS, so her consciousness level, is a little bit lower
22:26And that's just a bit concerning for other things, not just her Addison's
22:31That there might be something going on inside her brain that we need to make sure is okay
22:36Because Jane has deteriorated so rapidly, Dr Farragher has ordered a scan of her head
22:42Where am I going now?
22:46You're having a scan on your head because it's been quite sore
22:51I don't want to scan
22:54It's got to, find out what's going on
23:01I know you want to go home, but you can't
23:05Not yet
23:11That's what we're trying to find out
23:17This is a particularly bad bit of a confusion
23:21Erm
23:23There's only one time it's been slightly worse than this where it's been unconsciousness
23:27But this is a particularly bad episode
23:32Oh
23:39Mum
23:40Lose your pain
23:42Jane's rapid decline
23:44Could indicate a much more serious condition than originally thought
23:48Oh sure
23:52Oh
24:02It's 4.30pm and Sister Georgia hasn't stopped since she clocked on
24:07Oh Lisa you're here
24:10And even with 92 patients in the department, she's embracing the challenge
24:15I do enjoy being a sister and I'm glad that I went for this job role
24:20I do feel like I'm ready for the next chapter in my career and the next step
24:25When Adam gets back, erm, obviously if there's no one else that comes in here
24:29You can go back onto walk-ins if that's alright
24:32Thank you
24:33You're managing all the staff, you're managing like the department when you're in charge
24:37You need to make sure all your staff are happy and erm, then it's really good teamwork then
24:43When you've got a good team
24:46So Lisa, erm, walking nurse that I sent down to help on walk-ins
24:50But we've got a patient in resus now
24:51So I've had to swap her because Adam's on his break
24:55So she's going to cover resus
24:57So we're still a nurse short on walk-ins now
24:59So we're going to have to wait for Adam to get back
25:01And then we can swap again
25:02We're doing something
25:15In resus Jon came in after falling from a ladder
25:21He's with wife Muriel and daughter Beverely
25:24I'm not taking a photo of that bad boy
25:39Oh, I got married in there with minors, because it used to be augustologies, augustologies
25:46for minors, we got the double wages in there for two weeks, and we used to go to the doctors
25:51and get a sick note, right, and get two more weeks sick note and all, and that was the
25:57only time you could afford to get married, and that's when we got married when we were
26:02twenty. It's true, that. It's true, isn't it? When I come out of church, I stood on the
26:09steps, down on this lane there, on the steps outside, and she took that.
26:15Weddings to stiffen your head.
26:16Weddings to stiffen your head.
26:17Street out of my hand, she slashed it straight out of my hand when I got out of the door.
26:20I don't think you've seen it since.
26:21And I've never seen it since. I've been, bloody hell.
26:25Dr Price, who's been caring for John, has his final scan results.
26:31Sounds like we're having a good time in here.
26:33I've just gone quiet.
26:34You've gone quiet?
26:36I'm feeling a bit tired, yeah.
26:37Are you in pain?
26:38No.
26:39Right, we've got you some pain relief coming.
26:41Good.
26:42Now, a bit of an update from the rest of the scan that we've had done.
26:45Yeah.
26:45Okay.
26:47It shows that you've got some fractures in your spine. New fractures.
26:51So they've been reported. We know about the fracture here.
26:54Yeah.
26:55But with the fractures being new in your back, we have to keep you on your back.
26:59Mm.
26:59Okay.
26:59And we have to get you into hospital.
27:01Okay.
27:02I mean, I can't get out of bed. I've got to stop in bed right here.
27:04Yeah.
27:04At the moment, until we've had the full report, and it's been looked into by detail by the
27:08orthopaedic doctors.
27:10Yeah.
27:10So, unfortunately, we're going to have to keep you flat on your back for the minute.
27:14But we're going to clean this up, give you a fresh pillow, and get you comfortable,
27:17and you can have a nap.
27:18I think you're quite a strong cookie.
27:20I'm not.
27:21Never.
27:21All right.
27:23All right.
27:23Thank you very much.
27:27John was taken up to the orthopaedic ward and stayed in hospital for eight weeks.
27:38Back in the paediatric department, three-year-old Leo is waiting to have the burn on his hand
27:44treated after he caught it on the iron at home.
27:48He's with his mum, Jess, and dad, Craig.
27:54Charge nurse, Greg, is ready to treat him.
27:57I think we're going to have some tears on this, to be honest, guys.
28:00Yeah.
28:01Hello, dude.
28:03I'm surprised you're not tired with him, how you've been running up and down.
28:05He doesn't need to hold his hand still.
28:08Right.
28:08So, it might be one of you that gives him a hug.
28:10If they're really young, and you're there, obviously, trying to have a look at the wound,
28:14trying to clean it, poke around, obviously, it's causing them pain.
28:17Three, two, three.
28:20Done.
28:21Yeah.
28:22Oh, hey!
28:24Woo!
28:25Yeah!
28:27Go!
28:27You need to be kind and compassionate.
28:30You need to be understanding, because if you're medical, to you, that's just a standard,
28:34ordinary day for you.
28:36But to that child, it could be one of the worst days you've ever, ever had.
28:38So, you've got to put yourself in other people's shoes, I think.
28:42So, if you hold him at his elbow, Mum, if that's alright, like that.
28:45Yeah!
28:45Last bit.
28:50All sorted, Leo heads home with Mum and Dad.
28:55He's soon recovered, and hasn't touched the iron since.
29:04It's late afternoon in Barnsley Casualty, and it's still chock-a-block.
29:09Sarah, has Q13 gone?
29:12To 36?
29:14She's gone.
29:14She's gone.
29:16So, she's gone.
29:17I'll take her off.
29:20Sometimes you might come on to shift and have, like, 20 patients waiting for beds,
29:25but there's no beds in the hospital, so it's like, where do these patients go?
29:29We haven't got no beds, have we?
29:30What have you got?
29:30We were on a minus seven in A&E, but there were nine beds, which...
29:34Nine.
29:38So, it's a case of waiting for discharges on the ward for us to be able to move out of
29:42A&E,
29:42and that's what makes A&E so crowded, because there's no beds in the hospital.
29:47They're going to try and move some of the patients back across from medical.
29:56You just need to make sure that them patients are safe,
29:59they've had all the treatments, medications, make sure that they're clean,
30:04make sure that they've been fed, get them a drink, just look after them, really.
30:17Over in radiology, Jane is having an urgent CT scan of her head.
30:23The team are worried her confusion is being caused by an abnormality in her brain.
30:27The other day is obviously not sucking, doesn't it?
30:34Because she's deteriorated so rapidly, the team are sending her back to Rhesus,
30:39so they can keep a closer eye on her.
30:41Right, darling, I'm just going to pop them stickers on.
30:45Jane?
30:45Yeah?
30:46Hello, sweetheart.
30:48I'm back again.
30:49It's all right, you're back with me and Olivia now, OK?
30:53Newly qualified nurse Olivia and nurse Adam take over.
30:57Where's your pain, Jane?
31:02All over.
31:05Dr Farragher has the results from Jane's CT scan.
31:09Hi.
31:12I think we're going to give you some different antibiotics
31:15because you've got this headache and you've been feeling sick
31:18and you're a bit confused.
31:21We're a bit worried you might have an infection in your head.
31:25Oh, my head?
31:26Yeah.
31:27Because you're a lot sicker than I would expect you to be
31:31from all your results.
31:34Because of her fever and how unwell she's been
31:36and how confused she is,
31:38we're going to cover her for an infection in the brain
31:41called encephalitis.
31:43We don't know for sure that she's got this,
31:45it's just that with her presentation this is a concern
31:48and it's really important to cover for it.
31:53Do you know what the cause for, like, if there's an infection in the brain, what can cause that?
32:04I don't really know the report of what's come back from her scan.
32:07I know they're just thinking it's infection on the brain.
32:11The main thing is we're going to get it sorted.
32:16We'll get you sorted.
32:17You're not a nuisance.
32:19You won't be sat here if you were a nuisance.
32:21You're so kind.
32:23You're all right.
32:25We're going to take you to the ward now, Jane.
32:28Is that all right?
32:30I'm going to AMU.
32:32AMU.
32:34Jane was taken to the acute medical unit,
32:36where she stayed for two days.
32:39She's now back at home, fully recovered.
32:49The next walking patient to be seen is 59-year-old Maxine.
32:55I've come in because I had a really bad acute pain overnight in my, between my shoulder blades
33:01and it was radiating down both arms and legs.
33:05And I tried to see my GP but couldn't.
33:07So they suggested I had to come to Wayne in.
33:12Advanced Clinical Practitioner Chantel takes over her care.
33:17Maxine, my name is Chantel. I'm one of the ACPs in A&E.
33:21So Maxine, tell me about you. Tell me what's been going on.
33:24I started with a sudden onset pain.
33:26It started Friday.
33:28I worked Friday and as the afternoon went on I was getting more and more pain in my left shoulder.
33:33And then last night it just started but it was central, like between your shoulders.
33:39But then it's actually been my legs as well.
33:42With this pain, any shortness of breath?
33:45Not specifically unless I got, if I was lying flat, yes.
33:49But so long as I'd kept propped up on a couple of killers.
33:51What about when you're walking around?
33:53I do get a bit breathless anyway.
33:55My initial thoughts with Maxine is could this be a chest infection?
33:59So she's come in breathless, she's got an oxygen requirement, she's got a pain to her back.
34:05Any other medical history?
34:08Yeah, I've got the sarcoidosis, high blood pressure, I'm on medication for.
34:16I've just, like I said, a couple of weeks ago got tipped over into type 2 diabetes.
34:21Okay.
34:22Which I'm not surprised at.
34:25Maxine's got a complicated health history, so it's harder to get to the root cause of her pain.
34:33Let me have a listen to the back of your lungs first.
34:36So nice, big deep breaths.
34:39Let me just have a feel down your spine and tell me if there's any pain.
34:42Or anything.
34:43Oh, it's sore there.
34:44Okay.
34:45And what about here?
34:46Yeah.
34:47Sorry, I'm really sorry.
34:48And have you noticed this pain before?
34:51No, nothing intense like that, no.
34:53Okay.
34:54Let's get you some strong painkillers, get a chest x-ray as well, and Steve sent your bloods off.
34:59Yeah.
34:59The part will take you round, okay?
35:02It's okay.
35:03The chest x-ray will hopefully give advanced clinical practitioner Chantelle more of an idea of what's causing Maxine's pain.
35:11And she's trying to stay as positive as she can.
35:14I'm hoping that they say, yes, you've pulled a muscle and let me go home.
35:19That's what I'm hoping for.
35:24Sister Georgia is 10 hours into her 12-hour shift.
35:28I mean, we've got 73 patients in the department at minute.
35:32We're on a 3-hour, 11-minute doctor wait.
35:36Beds are coming up slowly but surely.
35:41Sometimes you do feel like you want to just, like, stop patients coming in, but obviously that's not anything that
35:47you can ever do in an emergency department.
35:49You can never close the doors and just say, oh, we're not taking any more patients.
35:55It's always a 24-hour service.
36:01And a new patient is on their way in.
36:0965-year-old Ken has a large wound on his head after a serious car crash.
36:17He's taken straight to an ambulance bay.
36:20He's just been driving on from work since he can't really remember what happened.
36:25Paramedic Jack hands over.
36:27He's gone through a concrete fence and down about, I'd say, about a three- or four-foot ditch.
36:33There was nobody else involved.
36:35So these are the pictures of the actual RTC.
36:43There's the wall that has come down.
36:45There's the wall that has come down.
36:45He's done three of those concrete posts.
36:51He's climbed through from the driver's side.
36:53I climbed out the passenger side.
36:54I was slightly worried about the car like that.
36:57I filled the open light.
36:58I thought, if time's gone, it'll be petrol all over.
37:02That's why I wanted to get out of the car.
37:06Yeah, I didn't want to get burnt away.
37:08Dr Heather White comes to do an initial assessment on Ken's injuries.
37:12So you've been in a car crash?
37:15Yeah.
37:15What's happened?
37:16Just walking through it.
37:17There's like a gap in me, hadn't there?
37:19I was driving along and, I don't know, the next thing I know, I've been thrown all over.
37:25And do you remember before the crash, if that makes sense?
37:29No, just before the crash, no.
37:32I've been quite lucky, really.
37:35Have you been sick at all?
37:37No.
37:38Any pain anywhere?
37:40No, just...
37:41I'm just going to let channel light in your eye, if that's okay.
37:44Yeah.
37:48And then I'll just press on your neck.
37:50Any pain there?
37:52No.
37:52Obviously, someone will see you a bit more thoroughly.
37:55Yeah.
37:55And go over what happened before.
37:58It might have blacked out before, but I think there's nothing that's worrying me right here.
38:03It seems on the surface, Ken has had a lucky escape.
38:07But he can't go anywhere until the team investigate what has caused his memory loss.
38:22Hiya, it's Sister in Edie. I'm just wondering if you're ready for a mail.
38:25No.
38:26In casualty, Sister Georgia is in the last hour of her shift.
38:31And finally, making progress.
38:33We've got 67 patients in department.
38:35We've got an hour and seven minute doctor wait, which is better than what it was earlier.
38:40Assessment time's looking better.
38:41So, it's a 33 minute wait for assessment nurse.
38:47So, yeah, it's looking better to hand over to the night team.
38:55Over in cubicle 12...
38:57There's a bottom there if you need, is it okay?
38:59...Ken is waiting for another assessment after he crashed his car into some concrete posts.
39:05I'm lucky to be alive, really.
39:09I mean, I don't know if it'll black out or what.
39:14Dr Fenula Sherbert comes to investigate further what caused him to crash.
39:20So, you don't remember what happened pre-axing the car?
39:23No.
39:23Have you ever had a blackout before?
39:26No.
39:27Any problems with your heart?
39:29Er, no. Not that I'm aware of.
39:32And when you were in the car, did you have any chest pain?
39:36No.
39:37We just wanted to make sure that there wasn't anything related to your heart that caused it.
39:42I'm going to get some glue to see if we can just glue that up.
39:51That's the worst bit.
39:57An artist at work.
39:59We're going to get a scan of your head to make sure that there's not a reason that you can't
40:04remember it.
40:04We need to see if something's happened before the crash.
40:08Or if the reason you can't remember it is because you've bubbled your head.
40:11Down.
40:11Crash.
40:12And then I will come back to him and I'll let him know what the report says and then we'll
40:18go from there.
40:19OK. Sounds good to me.
40:22Dr Sherbert wants to find out if Ken's memory loss is due to a bleed on the brain.
40:27So sends him down to have a CT scan.
40:37Already in radiology is Maxine.
40:40Maxine, breathe in.
40:42Hold your breath.
40:44Breathe normally.
40:47She's just had a chest x-ray after coming in with pain in her shoulder and legs.
40:55Hi, I'm back.
40:57Advanced clinical practitioner Chantel comes to give her the results.
41:01Erm, so let me tell you the plan.
41:07So, we're going to keep you in hospital.
41:09So, the blood clot test that we do, it's not specific for a blood clot, but it could signify a
41:15blood clot has come back a little bit raised.
41:17Yeah.
41:17So we need to keep you in and do a scan of your lungs.
41:21Yeah.
41:21Something's going off and you're not a simple patient as well and you're on a lot of medication and special
41:26ones too.
41:27Not simple, I'm special.
41:29So when patients come in and they've got, they either present with lots of weird and wonderful symptoms or they
41:34have a long medical history, generally it can be quite difficult to sieve out certain symptoms and get to the
41:42root emergency.
41:43Any questions?
41:45No, I think you're fairly comprehensive.
41:47I understand why you've got to keep me in.
41:49Right.
41:50Just come and get me if you need me, actually, you know, okay.
41:52Yeah.
41:53And then you'll be going up onto the acute medical unit, which is Ward 2728.
41:56Yeah.
41:57Okay.
42:00It's always a little bit difficult because of my underlying health conditions and all of them together sort of complicate
42:07a lot of things.
42:08So, yeah, I'm not happy about it, but it is what it is that I've got to stay in.
42:12They're really good on the wards, so I can't quibble.
42:16Maxine spent eight days in hospital, where she learnt she had a compressed fractured vertebrae.
42:22Now back at home, she's on the mend.
42:27Back in radiology, Ken is having a CT scan to rule out a bleed on the brain.
42:33All right, what you do is keep your head still, all right?
42:45So, send your results to your doctor, okay?
42:49Armed with the new information, Dr. Sherbert updates him.
42:53Good news.
42:54No bleeding, which is what we're worried about.
42:57The inside is fine, so we couldn't see any reason from a brain point of view why you had the
43:02loss of consciousness.
43:02So, you're okay to leave the hospital today, but I'd like you to come back into medical aesthetic.
43:09You shouldn't drive until you've had that appointment.
43:11Have you got any questions about anything?
43:13No, no, it makes sense.
43:14All right?
43:14Yeah.
43:19Ken's still not driving, and he's undergoing tests to find out if he blacked out.
43:29It's home time for Sister Georgia.
43:33We had a busy afternoon, but we got it back, and we've left it quite a nice fat night.
43:40Let's go.
43:42Going home and just relaxing and sticking telly on, having your tea, and being with your family, like, just chills
43:50you out.
43:51And although each shift brings a new challenge...
43:54I just, I don't know where else I'd want to work.
43:57Yeah, I do enjoy it. I love it.
44:00She goes home happy and ready to do it all again the next day.
44:12Have a great day.
44:14Bye.
44:19Bye.
44:22Bye.
44:31Bye.
44:33Bye.
44:35Bye.
44:36Bye.
44:48Transcription by CastingWords
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