- 9 hours ago
Casualty 24 7 Every Second Counts S10E05
Category
📺
TVTranscript
00:01in the heart of Yorkshire just a busy day everybody's decided to come today an
00:11unbeatable team have you given it a clean or did you just slide hard at work 24
00:20hours a day sorry you've got the booby fries you've got me seven days a week
00:30saving lives helping loved ones well this is shocking they're actually broken bones making
00:39the community they serve better as well as everybody's safe that's all that matters a
00:45health service treating anyone strain your temperature jane and everyone in and out keep
00:52going a team doing anything and everything for each other the staff have been amazing
00:58they've not been able to do enough for us this is Barnsley casualty 24 7 it brings me faith in
01:07the
01:07the staff and NHS definitely on shift tonight dr. Emma Farragut 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
01:32booking in and dr. Kitty price I think we need a little bit more than a plaster for that one
01:39so
01:41get ready to share a shift lucky to be alive really with the team at Barnsley casualty
01:59it'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 I've got patients that have been here 14 hours and 15 minutes and we're
02:18still waiting on bed so 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 months
02:33I do enjoy being a sister hello ed sister you need to make sure that all your patients are safe
02:39it is
02:40really challenging especially being a sister and like managing the department and casualties doors
02:48are open 24 7 patients are sat in waiting room that have been here an hour and 20 minutes and
02:54not
02:54been 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 92 patients in department we've got a two
03:14hour three minute doctor wait it is a bit like a puzzle we've got to move staff about to help
03:21in the
03:21areas that are more demanding but yeah we're just very busy as always and it's only an hour
03:31into her shift to add to the pressure paramedics are rushing in a patient who's had a serious
03:42accident dr. Kitty price is already in resource so we've got an 85 year old male trauma at pre alert
03:50and he's coming in having four and six foot forwards off a ladder and hit its head on the ground
03:56the team prepare for his arrival
04:1485 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 in his garage the paramedics
04:40hand over to dr. john shepherd and the team the ladders have slid away from him he's gone forward
04:47he's hit his chest and his head on the ladders as they've collapsed on the floor
04:55colleagues were quite keen to demonstrate how worried they were as well which always piques your interest
05:00and it's important to try and bear their concern in mind and compare that with the patient you've got in
05:07notable injuries about one inch laceration to the right side of his head and left clavicle about here
05:18tender he's got potentially two different places that are causing him trouble and it's trying to
05:24unpick how much is one how much is the other and how much we need to be worried about both
05:29of those together
05:31dr. price takes charge she needs to assess which injuries need to be prioritized first
05:37hi john my name's kitty i'm going to doctors we're gonna have to cut your top off just so we
05:42can have a good look at you and a good look into your chest
05:55john's wife muriel has been with him since she called the ambulance
06:08what were you doing
06:18after such a high fall john's showing signs he may have broken his back
06:25and then i said i've got the wall and put it okay
06:27but on this side
06:29never got that never got right there
06:31saw here
06:32both sides i thought saw that
06:36and have a squeeze of your hips okay i want you to tell me if there's any pain in anywhere
06:42where's that pain
06:43shoulder
06:46oh no i'm not going to check your temperature my lovely i'm going to go this side because i know
06:51you've got the cut on the other side don't you
06:55have you got pain
06:56yeah yeah there just directly under there oh yeah okay
07:02how 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 here
07:13there you come up
07:15it's not gone
07:16perfect i'm sorry
07:18i have to have a good look so i know what's going on
07:21okay
07:22all right that arm on that side just to get some bloods all right
07:25i know we're coming at you from all angles
07:29i'm just going to pinch this arm to take some blood is that right
07:32oh
07:33john has multiple injuries so dr price puts together a thorough treatment plan
07:42what we're going to do is we're going to order you some scans and get you some pain relief
07:46we're going to send these bloods off going to scan this area you scan your head because you've got
07:50a bump to your head as well it looks like you've got a bit of a a gash here that
07:56we need to have a look at but what we're worried about is whether there's any bleeding in your head
07:59as well okay
08:07we're gonna have a look on this side as well
08:09we're gonna have a look on this side as well
08:10i'm not straightening your arm
08:12no
08:14try again there
08:16is that better
08:18see you next week
08:23with the risk john has internal bleeding or a brain injury
08:26he gets taken down for his ct scan
08:31if he has a bleed on the brain he will need emergency surgery
08:48in casualty sister georgia is only a couple of hours into running the department
08:54lisa would you be able to go down to walk-ins because i think there's like nine to assess for
08:58you about an hour wait is that okay
09:01walk-in patients haven't stopped coming through the doors and the triage team can't keep up
09:07we've sent more staff down though to try and get up with work so we've got an hour and twenty
09:13minute triage wait
09:15just seems busy on triage this afternoon on walk-ins
09:19when we're overflowing with walk-in patients it's really really stressful you've got a long wait
09:25you don't know what they've come in with really until you triage them
09:30we should see them really within a 15 minute window when they're walking in
09:34it's just in flux we've had a lot in over period short period of time
09:40hopefully we get back on top
09:43while sister georgia tries to keep the department on track
09:5285 year old john is having an urgent ct scan on his head and spine after he fell off a
09:58ladder in his garage
10:07now back in resus daughter beverly comes to visit her dad
10:13in the garage
10:17yeah so you knew then you'd done something
10:27i knew i had to get open you know
10:29yes
10:34i just couldn't move
10:36at the time i just couldn't move
10:38have you had any morphine or old
10:41No, I didn't want them. I'm not in pain. I won at first, but it's eased off, this pain.
10:47Oh, that's good, then. It's eased off a lot.
10:50After assessing John's results, Dr. Price heads to see him.
10:54John, how are you doing? All right.
10:56Yeah, how's your pain? It's gone a bit.
10:59OK, so we're going to give you some pain relief, some more pain relief.
11:03So we've got a bit more to do before that. All right.
11:06So, first things first, from your scan that you've had done, you've fractured your clavicle here.
11:12I've spoken to the bone doctors who want to have an x-ray of that specific area
11:17so that they can see how bad it is and what they're going to have to do about it.
11:22The scan of your head didn't show any bleeding inside your brain.
11:26It just shows that we know about this.
11:28OK, we're waiting for the rest of the scan to be reported from your clavicle downwards.
11:34OK, this has started seeping through a bit, this cut, so I need to have a look at it.
11:38All right, I'm moving out of the way.
11:39All right.
11:41I'm just going to have a good look at it, all right.
11:45Cowards.
11:47Cowards.
11:48That's going all right now.
11:50Yeah.
11:51Well, it can't be going all right now.
11:52Just put a plaster on it.
11:54I think we need a little bit more than a plaster for that one.
11:57Oh, sure.
11:58I know. We need some pain relief, don't we?
12:00Is it broke?
12:01Yeah, it's broke, that.
12:02I think likelihood is, is we can close it with a bit of glue.
12:08At the minute, it doesn't look like you've caused much damage other than that clavicle.
12:12Here.
12:14It's not good, yeah.
12:16All right, keep that head still for me, just whilst we wait that glue.
12:23Any questions for me?
12:24No.
12:26John's now got to wait for the final scan results before he can be moved out of Rhesus.
12:32But there's still a chance he could have badly broken his back.
12:45Paramedics are bringing in another patient who will be going straight into Rhesus.
12:5658-year-old Jane has come in with a severe headache, high temperature, confusion and vomiting.
13:05Dr. Emma Farragher is in charge of her care.
13:09Jane?
13:09Here I'll be using them.
13:10What would it have?
13:11We need to steal a little bit more blood just to see if there's any bugs in it.
13:15Is that OK?
13:18People coming in with textbook things is very rare.
13:21If everyone did that, we wouldn't have a job because the computer would do it.
13:27Jane has a rare condition called Addison's disease.
13:31If an Addison's patient's coming in, I'd be concerned that they're going to be quite sick.
13:36They can get quite sick quite quickly.
13:37So they need to have steroids because their bodies won't produce their own steroids to counteract them being sick.
13:46Jane is prone to serious infections.
13:50If we give you some morphine, will you be OK?
13:54Shall we try that?
13:56I love problem solving.
13:58I always loved learning.
14:00It's one of those industries where you always learn.
14:03It's always advancing.
14:05There's always something new.
14:08With Rhesus filling up, Nurse Olivia has been drafted in to help Dr. Farragher.
14:15My first day in Rhesus.
14:17I've only just qualified.
14:20But I've been in A&E two years now.
14:23Every shift is different.
14:25You don't always work in the same place.
14:27Rhesus is one of the ones that everybody fights to go in because it's adrenaline-packed.
14:35I'm just going to take some blood, darling.
14:36I don't care.
14:37I'm going to take it.
14:40It's a big learning curve in Rhesus.
14:43There's lots of things to learn, new cases that we find that I've never come across.
14:52I'm just going to pop your blood pressure cuff on as well.
14:56OK.
14:58Jane's daughter Melanie has arrived.
15:02Hello, Trouble.
15:05You're causing chaos, are we, hey?
15:08You're tired?
15:10I love you.
15:11You're tired?
15:12I love you, I love you.
15:16I'm not surprised.
15:18Still not with her, are you?
15:20Still not with her, are you?
15:22She's looking very hot and clammy, very pale, very lethargic.
15:27She seems to be a little bit confused as well, very weak, just not herself at all.
15:33We think she's got some sort of infection somewhere.
15:37You're warm enough, you're shaking a little.
15:45Dr Farragher and the team need to monitor Jane closely, in case her vital organs start to shut down.
16:02Back in the hub, patients are piling through the doors.
16:06Are you all right down there?
16:07Because I know it's really busy, isn't it?
16:09Faster than sister Georgia and the team can treat them.
16:12Is there any spare cubicles for somebody to assess or not?
16:16We've only got two triage rooms.
16:18We've got doctor's rooms as well, but then obviously doctors need to go in there and see patients in there
16:23as well, so it's hard.
16:25Otherwise, there'd be no patients getting seen by doctors if we used all rooms.
16:35In paediatrics, they have eight dedicated rooms for poorly children, and when it's as busy as today, the staff know
16:43the importance of pulling together.
16:46Teamwork here at Barnsley is incredible, especially in our emergency department.
16:53It becomes like a little family that you have around you, and that's important.
16:58I wouldn't change that for the world.
17:02And advanced clinical practitioner Liam might need to call on his colleagues for help with his next patient.
17:13energetic three-year-old Leo has been brought in by his mum, Jess, and dad, Craig.
17:19I don't know if he just constantly lives off adrenaline, but nothing fazes him at all.
17:28But yes, very active.
17:32He might not look poorly, but this morning, Leo burnt his hand while his mum was ironing.
17:43Hello there.
17:44Hiya.
17:44Hiya.
17:45Is this Leo?
17:45Yes, it is.
17:46I've seen you running up and down.
17:49And who are you guys?
17:50Mum and Dad.
17:51Fantastic.
17:52So, tell me what brings you into A&E today.
17:55So, I wore ironing uniform this morning, and then, just as I've gone to put the iron down
18:00onto the T-shirt, his arm slid up, and the iron's touched the corner of his hand here.
18:05Okey-dokey.
18:05I ran it underwater, and it just kind of looked red, so it didn't look bad.
18:10So, I've gone to school, and in that time, it's, like, blistered up.
18:14Okey-dokey.
18:15And how long did you run it underneath the water for?
18:18About 10, 15 minutes.
18:20About 10, 15 minutes.
18:21Fab.
18:22Leo, do you want to just sit on mummy's knee over there for me,
18:24so that I can take a look?
18:25Hello.
18:26Oh, nice juice bottle.
18:29So.
18:32And you say he didn't have any medical conditions, so no eczema or anything like that.
18:36Oh, it's okay.
18:37Just taking a quick look at it.
18:40It's okay, I'm not going to touch it.
18:42So, it's just a bit of aeryfema around this bit here.
18:46Yeah.
18:46It's not gone round.
18:47Can I just see the bottom of his hand, if that's all right?
18:49Is it?
18:49Can I just show him a minute?
18:50The position of a burn is really important.
18:55The burn itself can cause constriction of the skin,
18:58which then could pretend to cause issues for circulation,
19:03nerve sensation and stuff like that.
19:05So, it's quite important to check exactly where that burn is.
19:09No, it's just that one, and we're reaching for the chocolate spoon.
19:12I'm literally just going to press on it a second, so it might not like me, unfortunately.
19:17It's all right.
19:17It's okay.
19:18It's okay, buddy.
19:21It's okay.
19:23One, two, three, four, five.
19:25Good stuff.
19:26Okay.
19:28Good boy.
19:29Fantastic.
19:33So, a couple of really positive points inside that.
19:36It's one, you've done exactly what you should have done,
19:37in terms of running it underneath the water.
19:40Yeah.
19:41He's just wanting to run up and down, bless him.
19:43Get done.
19:44The other good thing is that it's not around any of his fingers,
19:48and it's not on what we call flexor bits.
19:50So, the bits that bend down and get less.
19:54Okay, so, it's not going to constrict that muscle there.
19:57The fact that it's on the top is actually better.
20:04He's very active, isn't he?
20:07Bye-bye, mister.
20:09Bye.
20:11Thank you, lesson.
20:15Leo's had a lucky escape.
20:17His blister could be much worse.
20:20But he would still have to endure the painful procedure of having it burst.
20:33In Rhesus, nurse Olivia is caring for Jane, who came in with Addison's disease.
20:40Addison's disease is where the body doesn't produce enough of hormones,
20:45such as steroids and adrenaline, which makes it hard for the patient to fight off any illness.
20:54Jane's now been stabilised, and he's been moved out of Rhesus.
21:01So, she wasn't as poorly as we'd feared, so she was suitable to be in HTC rather than Rhesus,
21:07which is just a slightly lower level of monitoring.
21:10She's taken round to a high-dependency cubicle.
21:14You've had a very bad headache, haven't you?
21:20Her daughter, Melanie, has been with her since she came in.
21:25Yeah?
21:26I've only gone home.
21:28You can't go home.
21:30I'm sorry.
21:32Not well enough.
21:35Well, I missed it.
21:36I missed it.
21:37You're quite poorly, yeah.
21:41Not very well.
21:43Dr Farragher has come to check in on Jane.
21:46Can I borrow this arm for a blood test?
21:50A few more bloods from you.
21:54You are very, very warm.
22:01No, you're very poorly, Jane.
22:03You can't go home.
22:04We need to keep you.
22:06I don't think you're going to do very well if you go home.
22:09Sorry.
22:09I think we've fluctuated because I thought that we'd had a bit of a breakthrough.
22:14She's had the hard cut, so it just seemed a bit more lucid.
22:16Yeah.
22:17And then she's kind of gone again.
22:20I'm going to check whether her sugars have dropped or anything like that.
22:22She looks worse from the end of the bed than she did earlier.
22:25And her GCS, so her consciousness level, is a little bit lower.
22:30And that's just a bit concerning for other things, not just Addison's,
22:34that there might be something going on inside her brain
22:36that we need to make sure is OK.
22:39Because Jane has deteriorated so rapidly,
22:42Dr. Farragher has ordered a scan of her head.
22:46Where am I going now?
22:49You're having a scan on your head because it's been quite sore.
22:55I don't want to.
22:56I don't know.
22:58It's got to.
22:59We'll find out what's going on.
23:05I know you want to go home, but you can't.
23:08Not yet.
23:14That's what we're trying to find out.
23:20This is a particularly bad bit of a confusion.
23:24Erm, there's only one time it's been slightly worse than this
23:28where it's been unconsciousness.
23:31But this is a particularly bad episode.
23:42Mum, there's your pain.
23:45Jane's rapid decline could indicate a much more serious condition
23:50than originally thought.
23:52Oh, sure.
24:09It's 4.30pm and Sister Georgia hasn't stopped since she clocked on.
24:14Oh, Lacey, are you?
24:16And even with 92 patients in the department,
24:20she's embracing the challenge.
24:22I do enjoy being a sister and I'm glad that I went for this job role.
24:26I do feel like I'm ready for the next chapter in my career
24:29and the next step.
24:31When Adam gets back,
24:34obviously if there's no-one else that comes in here,
24:36you can go back onto walk-ins if that's all right.
24:40You're managing all the staff.
24:42You're managing, like, the department when you're in charge.
24:44You need to make sure all your staff are happy
24:46and then it's really good teamwork then when you've got a good team.
24:52So, Lisa, a walking nurse that I sent down to help on walk-ins,
24:56but we've got a patient in resus now,
24:58so I've had to swap her because Adam's on his break,
25:01so she's going to cover resus,
25:03so we're still a nurse short on walk-ins now,
25:06so we're going to have to wait for Adam to get back
25:08and then we can swap again.
25:09Oh, no.
25:10So...
25:21In resus,
25:23John came in after falling from a ladder.
25:27He's with wife Muriel
25:29and daughter Beverly.
25:31I'm taking a photo of that bad boy.
25:45Oh, I got married in there with minors
25:49because it used to be august holidays.
25:52August holidays for minors.
25:54We got the double wages in there for two weeks.
25:56And we used to go to the doctors and get a seat note, right?
26:01And get two more weeks of a seat note and all.
26:03And that was the only time you could afford to get married.
26:06And that's when we got married, when we were 20.
26:09It's true, that.
26:10It's true, isn't it?
26:12When I come out of church,
26:14I stood on the steps, down on this lane there,
26:17on the steps outside.
26:19And she took that.
26:22Wedding's the stiffened care.
26:23Wedding's the straight out of me
26:24and she slashed it straight out of me
26:25and when I got out of the door.
26:26I don't think you've seen it since.
26:28And I've never seen it since.
26:29I think, good deal.
26:30I don't.
26:32Dr Price, who's been caring for John,
26:34has his final scan results.
26:37Sounds like we're having a good time in here.
26:40I've just gone quiet.
26:41You've gone quiet?
26:42I'm feeling a bit tired.
26:43Are you in pain?
26:45No.
26:45Right, we've got you some pain relief coming.
26:47Good.
26:48Now, a bit of an update
26:49from the rest of the scan that we've had done.
26:51Yeah.
26:52Okay.
26:53It shows that you've got some fractures in your spine.
26:56New fractures.
26:58So they've been reported.
26:59We know about the fracture here,
27:01but with the fractures being new in your back,
27:03we have to keep you on your back.
27:05Okay?
27:06And we have to get you into hospital.
27:08Okay?
27:08I can't get out of it.
27:09I've got to stop him building my area.
27:11At the moment, until we've had the full report
27:13and it's been looked into by detail
27:14by the orthopaedic doctors.
27:16Yeah.
27:17So, unfortunately,
27:18we're going to have to keep you flat on your back for the minute.
27:20But we're going to clean this up,
27:21give you a fresh pillow,
27:22and get you comfortable,
27:23and you can have a nap.
27:24I think you're quite a strong cookie.
27:26I'm not sure ever.
27:28All right.
27:28No problem.
27:29All right, thank you very much.
27:31No problem.
27:33John was taken up to the orthopaedic ward
27:36and stayed in hospital for eight weeks.
27:44Back in the paediatric department,
27:47three-year-old Leo is waiting to have the burn on his hand treated
27:51after he caught it on the iron at home.
27:54He's with his mum, Jess,
27:56and dad, Craig.
28:00Charge nurse Greg is ready to treat him.
28:04I think we're going to have some tears on this,
28:05to be honest, guys.
28:06Yeah.
28:07Hello, dude.
28:09I'm surprised you're not tired,
28:10but they might have you been running up and down.
28:12He's never been...
28:12He just needs to hold his hand still.
28:14Right.
28:14It might be one of you that gives him a hug.
28:17If they're really young
28:18and you're there,
28:19obviously, trying to have a look at the wound,
28:21trying to clean it, poke around,
28:22obviously, it's causing them pain.
28:23One, two, three,
28:26done.
28:34You need to be kind and compassionate.
28:36You need to be understanding.
28:38Because if you're medical,
28:39to you,
28:40that's just a standard, ordinary day for you.
28:42But to that child,
28:43it could be one of the worst days you've ever, ever had.
28:45So you've got to put yourself in other people's shoes, I think.
28:48So if you hold him at his elbow,
28:49mum, if that's all right, like that.
28:52That's big.
28:57All sorted,
28:58Leo heads home with mum and dad.
29:01He's soon recovered
29:02and hasn't touched the iron since.
29:10It's late afternoon in Barnsley Casualty
29:13and it's still chock-a-block.
29:16Sarah, has Cube 13 gone?
29:18To 36?
29:20She's gone.
29:22So she's gone.
29:23I'll take her off.
29:27Sometimes you might come on to shift
29:28and have like 20 patients waiting for beds,
29:31but there's no beds in the hospital.
29:33So it's like,
29:33where do these patients go?
29:35We haven't got no beds, have we?
29:37We were on a minus seven in AMU,
29:39but there were nine beds, which...
29:41Nine.
29:44So it's a case of waiting for discharges on the ward
29:47for us to be able to move out of AMU
29:49and that's what makes AMU so crowded
29:51because there's no beds in the hospital.
29:53We're going to try and move some of the patients
29:58back across from medical.
30:02You just need to make sure
30:04that them patients are safe,
30:06they've had all the treatments, medications,
30:08make sure that they're clean,
30:10make sure that they've been fed,
30:12get them a drink.
30:13Just look after them, really.
30:24Over in radiology,
30:25Jane is having an urgent CT scan of her head.
30:29The team are worried her confusion
30:31is being caused by an abnormality in her brain.
30:40Because she's deteriorated so rapidly,
30:43the team are sending her back to Reesos
30:45so they can keep a closer eye on her.
30:48Right, darling, I'm just going to pop them stickers on.
30:51Jane?
30:52Hello, sweetheart.
30:54I'm back again.
30:56It's all right.
30:56You're just back with me and Olivia now, OK?
30:59Newly qualified nurse Olivia
31:01and nurse Adam take over.
31:04Where's your pain, Jane?
31:09All over.
31:11Dr. Farragher has the results from Jane's CT scan.
31:15Hi.
31:18I think we're going to give you some different antibiotics
31:21because you've got this headache
31:23and you've been feeling sick
31:25and you're a bit confused.
31:28We're a bit worried you might have an infection in your head.
31:31Oh, my head?
31:32Yeah.
31:34Because you're a lot sicker than I would expect you to be
31:38from all your results.
31:40Because of her fever and how unwell she's been
31:42and how confused she is,
31:44we're going to cover her for an infection in the brain
31:47called encephalitis.
31:49We don't know for sure that she's got this.
31:51It's just that with her presentation, this is a concern
31:55and it's really important to cover for it.
31:59Daughter Melanie is back by her mum's side.
32:04Do we know what the cause for, like,
32:07if there's an infection in the brain,
32:09what can cause that?
32:10I don't really know the report of what's come back from her scan.
32:13I know they're just thinking it's infection on the brain.
32:18Main thing is we're going to get it sorted.
32:22We'll get you sorted.
32:23You're not a nuisance.
32:25Won't be sat here if you're a nuisance.
32:29You're all right.
32:32We're going to take you to the ward now, Jane.
32:34Is that all right?
32:36I'm going to the way, honey.
32:39AMU.
32:40Jane was taken to the acute medical unit
32:43where she stayed for two days.
32:45She's now back at home, fully recovered.
32:55The next walk-in patient to be seen is 59-year-old Maxine.
33:01I've come in because I had a really bad acute pain overnight
33:05in my, um, between my shoulder blades
33:08and it was radiating down both arms and legs
33:11and I tried to see my GP but couldn't.
33:14So they suggested I had to come to weigh in.
33:18Advanced clinical practitioner Chantel takes over her care.
33:23Maxine, my name's Chantel.
33:25I'm one of ACPs in A&E.
33:27So, Maxine, tell me about you.
33:29Tell me what's been going on.
33:30I started with a, um, some onset pain.
33:33It started Friday.
33:34Yeah.
33:35I worked Friday and as the afternoon went on
33:37I was getting more and more pain in my left shoulder.
33:39And then last night it just started
33:42but it was central, like, between your shoulders.
33:46But then it's actually been my legs as well.
33:49With this pain, any shortness of breath?
33:52Not specifically unless I got, if I was lying flat, yeah.
33:55But so long as I'd kept propped up on a couple of killers.
33:58What about when you're walking around?
33:59Er, I do get a bit breathless anyway.
34:01My initial thoughts with Maxine is
34:04could this be a chest infection?
34:05So she's come in breathless, she's got an oxygen requirement,
34:08she's got a pain to her back.
34:12Any other medical history?
34:14Er, yeah, I've got, um, I've got the sarcoidosis.
34:18Yeah.
34:18High blood pressure.
34:20Erm, I'm on medication for.
34:22Yeah.
34:22I've just, like I said, a couple of weeks ago,
34:25I've got tipped over into type 2 diabetes.
34:28OK.
34:29Which I'm not surprised at.
34:32Maxine's got a complicated health history,
34:34so it's harder to get to the root cause of her pain.
34:39Let me have a listen to the back of your lungs first.
34:42So nice, big, deep breaths.
34:45Let me just have a feel down your spine
34:46and tell me if there's any pain or anything.
34:49Oh, it's a lot of airs.
34:50OK.
34:51And what about here?
34:52Yeah.
34:53Sorry, I'm really sorry.
34:55And have you noticed this pain before?
34:57Um, no, nothing intense like that, no.
34:59OK.
35:00Let's get you some strong painkillers,
35:02get a chest x-ray as well,
35:04and Steve sent your bloods off.
35:05Yeah.
35:05The parter will take you round, OK?
35:08It's OK.
35:09The chest x-ray will hopefully give
35:11advanced clinical practitioner Chantel
35:13more of an idea of what's causing Maxine's pain.
35:17And she's trying to stay as positive as she can.
35:20I'm hoping that they say,
35:22yes, you've pulled a muscle and let me go home.
35:25That's what I'm hoping for.
35:30Sister Georgia is 10 hours into her 12-hour shift.
35:35I mean, we've got 73 patients at the department at minute.
35:39We're on a three-hour, 11-minute doctorate.
35:42Beds are coming up slowly but surely.
35:47Sometimes you do feel like
35:49you want to just, like, stop patients coming in
35:51but obviously that's not anything
35:53that you can ever do in an emergency department.
35:55You can never close the doors and just say,
35:58oh, we're not taking any more patients.
36:01It's always a 24-hour service.
36:08And a new patient is on their way in.
36:1665-year-old Ken has a large wound on his head.
36:19After a serious car crash.
36:24He's taken straight to an ambulance bay.
36:26It's just been driving on from work
36:28since he can't really remember what happened.
36:31Paramedic Jack hands over.
36:33It's gone through a concrete fence
36:35and down about, I'd say, about a three- or four-foot ditch.
36:39There's nobody else involved.
36:42So these are the pictures of the actual RTC.
36:49There's the wall that has come down.
36:51He's done three of those concrete posts.
36:57He's climbed through from the driver's side.
36:59He climbed out the passenger side.
37:00I was slightly worried about the car.
37:03I feel the old mind.
37:04I thought, if time's gone, it'll be petrol or not.
37:09That's why I wanted to get out of the car.
37:12Yeah, I didn't want to get up to the line.
37:15Dr. Heather White comes to do an initial assessment
37:18on Ken's injuries.
37:19So you've been in a car crash?
37:21Yeah.
37:22What's happened?
37:23Just took you through it.
37:23There's like a gap in there, hadn't there?
37:26I was driving along, and I don't know.
37:29Next thing I know, I've been thrown all over.
37:32And do you remember before the crash, if that makes sense?
37:35No, just before the crash, no.
37:38If you saw a picture of the car, I'd be quite lucky, really.
37:42Have you been sick at all?
37:43No.
37:44No.
37:44Any pain anywhere?
37:46No, just...
37:48I'm just going to turn a light in your eye, if that's OK.
37:51Yeah.
37:54And then I'll just press on your neck.
37:56Any pain there?
37:58No.
37:59Obviously, someone will see you a bit more thoroughly.
38:01And go over what happened before.
38:04It might have worked out before,
38:06but I think there's nothing that's worrying me right now.
38:09It seems on the surface, Ken has had a lucky escape.
38:13But he can't go anywhere
38:15until the team investigate what has caused his memory loss.
38:19No.
38:32Hiya, it's Sister in Edie.
38:33I'm just wondering if you're ready for a mail.
38:36In casualty, Sister Georgia is in the last hour of her shift
38:41and, finally, making progress.
38:43We've got 67 patients in the department.
38:45We've got an hour and seven-minute doctor wait,
38:47which is better than what it was earlier.
38:50Assessment time's looking better.
38:51So, it's a 33-minute wait for assessment nurse.
38:57So, yeah, it's looking better to hand over to 19.
39:05Over in cubicle 12...
39:07There's a button there, if you need it, and I'll pay.
39:09...Ken is waiting for another assessment
39:11after he crashed his car into some concrete posts.
39:14I'm lucky to be alive, really.
39:19I mean, I don't know if you're going to black out or what.
39:23Dr. Fenula Sherbert comes to investigate further
39:27what caused him to crash.
39:30So, you don't remember what happened pre-axing the car?
39:33No.
39:33Have you ever had a blackout before?
39:36No.
39:37Any problems with your heart?
39:39Er, no, not that I'm aware of.
39:41No.
39:42And when you were in the car, did you have any chest pain?
39:46No.
39:47We just wanted to make sure that there wasn't anything
39:49related to your heart that caused it.
39:52I'm going to get some glue to see if we can just glue that up.
39:55Yeah.
40:01That's the worst bit.
40:07An artist will work.
40:09We're going to get a scan of your head
40:11to make sure that there's not a reason that you can't remember it.
40:15We want to see if something's happened before the crash
40:17or if the reason you can't remember it
40:19is because you've popped up to your head.
40:21Yeah.
40:21No.
40:22And then I will come back to him
40:24and I'll let him know what the report says
40:27and then I will go from there.
40:29OK.
40:29Sounds good to me.
40:32Dr. Sherbert wants to find out
40:33if Ken's memory loss is due to a bleed on the brain,
40:37so sends him down to have a CT scan.
40:47Already in radiology is Maxine.
40:50Maxine, breathe in.
40:52Hold your breath.
40:54Breathe normally.
40:57She's just had a chest X-ray
40:58after coming in with pain in her shoulder and legs.
41:05Hi, I'm back.
41:07Advanced Clinical Practitioner Chantel
41:09comes to give her the results.
41:12So, let me tell you the plan.
41:17So, we're going to keep you in hospital.
41:19So, the blood clot test that we do,
41:22it's not specific for a blood clot,
41:23but it could signify a blood clot.
41:25It's come back a little bit raised.
41:27So, we need to keep you in
41:28and do a scan of your lungs.
41:31Something's going off
41:32and you're not a simple patient as well.
41:34You're on a lot of medication and special ones too.
41:37Sinful and special.
41:38So, when patients come in
41:40and they either present with lots of weird and wonderful symptoms
41:44or they have a long medical history,
41:48generally, it can be quite difficult
41:49to sieve out certain symptoms
41:51and get to the root emergency.
41:53Any questions?
41:55No, I think you're fairly comprehensive.
41:57I understand why you've got to keep me in.
41:59Right, just come and get me if you need me,
42:01actually, you know, okay?
42:03And then you'll be going up
42:04onto the acute medical unit,
42:05which is Ward 2728.
42:06Yeah, okay.
42:10It's always a little bit difficult
42:11because of my underlying health conditions
42:14and all of them together
42:16sort of complicate a lot of things.
42:18So, yeah, I'm not happy about it,
42:20but it is what it is that I've got to stay in.
42:23They're really good on the wards,
42:24so I can't quibble.
42:26Maxine spent eight days in hospital
42:28where she learnt she had a compressed fractured vertebrae.
42:32Now, back at home, she's on the mend.
42:37Back in radiology,
42:39Ken is having a CT scan
42:41to rule out a bleed on the brain.
42:43All right, what you do,
42:43keep your head still, all right?
42:55So, send your results to your doctor, okay?
42:59Armed with the new information,
43:00Dr. Sherbert updates him.
43:03Good news.
43:04No bleeding.
43:05I just thought that I'm worried about.
43:07So, the inside is fine.
43:08So, we couldn't see any reason
43:09from a brain point of view
43:11why you had the loss of consciousness.
43:13So, you're okay to leave the hospital today,
43:16but I'd like you to come back into medical aesthetic.
43:18You shouldn't drive
43:20until you've had that appointment.
43:21Have you got any questions about anything?
43:23No, no, it makes sense.
43:24All right?
43:24Yeah.
43:25Okay.
43:29Ken's still not driving.
43:30And he's undergoing tests
43:32to find out if he blacked out.
43:39It's home time for Sister Georgia.
43:43We had a busy afternoon,
43:44but we got it back,
43:46and we've left it quite a nice hot night.
43:50Let's go.
43:52Going home and just relaxing
43:53and sticking telly on,
43:56having your tea,
43:57and being with your family,
43:58like,
43:59just chills you out.
44:00And although each shift
44:02brings a new challenge...
44:04I just...
44:04I don't know where else
44:05I'd want to work.
44:07Yeah, I do enjoy it.
44:08I love it.
44:10She goes home happy
44:11and ready to do it all again
44:13the next day.
44:31And brand-new Casualty 24-7
44:34continues next Thursday at 8.
44:36If you or someone you know
44:38has been affected
44:38by any of the issues
44:40raised in this programme,
44:41please go to
44:41channel5.com
44:42slash helplines
44:43for information and support.
44:45Next, can Alex Polizzi
44:47help a 24-year-old landlord
44:48who's never even pulled a pint
44:50in the hotel inspector
44:51new after the break?
Comments