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999: On the Front Line - Season 14 - Episode 04
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00:01Ambulance service, is the patient breathing?
00:04Every time he's moving, he's crying out in pain.
00:08He's had a really bad nosebleed. I can't stop it.
00:11It's painful and my heart's racing.
00:14I think I'm having a heart attack.
00:17Righty-ho, let's get them bad boys on.
00:20West Midlands Ambulance Service looks after almost six million people.
00:24I love the fact that not just every shift's different,
00:28every job's different.
00:29Do you remember everything that's happened?
00:32It looks like you're having a heart attack.
00:35Saving lives and making a difference every call out.
00:38Is she breathing normally?
00:41Water variability of how we met.
00:44Embedded with eight emergency crews.
00:47Could be anything, couldn't it?
00:49Okay, okay.
00:51Filming simultaneously across the region.
00:54Time is everything in our job.
00:56Just relax, relax for me.
00:57Can you open your mouth as wide as you can?
01:01Capturing life.
01:02How's your vision?
01:03You got it?
01:05On the front line.
01:06I go to work every day and I make a difference.
01:20What did you have for dinner?
01:21McDonald's.
01:21Oh, good.
01:22Yeah.
01:23Absolutely.
01:24Thank you, thank you.
01:25Do you know what I feel like I need?
01:27Go on.
01:28A little break away.
01:28You need to get a camper van, don't you?
01:30I'd love to.
01:30I'm trying to talk the other half into it.
01:32I just love seeing, you know when there's like them pictures online and it's like people
01:36wake up in the morning, open the back doors and there's a stunning view.
01:40I just need a bit of that in my life.
01:44Pinch, punch, first of the month.
01:47Oh God, we've got a job.
01:56What's the first band you ever went to see?
01:58I think it was Girls Aloud, you know.
02:00Was it?
02:02Yeah, in like...
02:04Was it like 2007?
02:06I'm a big fan of a band called The Wonder Stuff.
02:08I've seen them about 200 times.
02:11That's a lot.
02:12I want one of their songs at my funeral.
02:14Bit premature, innit?
02:15Not really, not at my age.
02:18You've got to think of the future.
02:20Or lack of it.
02:22It's a bit far ahead.
02:24It was the circus tour.
02:28Take that.
02:29Oh my God.
02:29With my mum and my neighbour.
02:32Yeah.
02:32It was great.
02:33Are you like 90?
02:34You wish you saw take that.
02:35No, I don't.
02:36Yeah, you do.
02:37Excuse me.
02:51Listen to this, they sent the Mousetripper to a care home.
02:54No way.
02:55The care home asked like...
02:56That is class.
02:57What would you like?
02:58And they had this Mousetripper come round.
03:01Love it.
03:02And they said that the ladies absolutely loved it.
03:05Oh, bless them.
03:06And they asked if he was coming for Knitter Natter next week.
03:09Oh, fantastic.
03:10Why not?
03:11I bet the 999 calls would increase after that though.
03:14Palpitations.
03:15Palpitations and sweating.
03:17Palpitations.
03:17I love the idea of a stripper visiting a care home.
03:22Magic Mike Monday.
03:24Stripper Sundays.
03:26Tassel Tuesdays.
03:28That's why we get on so well.
03:30We could be talking about the weather in Turkey.
03:32The one minute makes me run on the stripper grams in care homes.
03:46What have we got then?
04:02Trio's not possible.
04:03Remote Observer.
04:05But there's heavy blood loss.
04:09That's all we have.
04:10I kind of want to see where's this bleeding coming from.
04:14When we go to a patient that's got heavy blood loss, we're trying to think where's the blood
04:18coming from?
04:19How much blood have they actually lost?
04:21And did I need any further treatment to help stop the bleeding?
04:30Hello.
04:31Is he in the bathroom?
04:32He hasn't come out of the hospital with the bleed on the brain.
04:36Is he on blood thinners?
04:37No.
04:37No, he's just had a bleed on the brain.
04:39Okay.
04:39I just come up to the toilet and I just, I did blow my nose as it started to burn.
04:45And I knew straight away it was one of these.
04:48Bless you.
04:49Oh yeah.
04:50Yeah.
04:51There's a clot in that one then.
04:52Try not to rub it if you can.
04:53Lean over the sink now while you do this.
04:5677 year old Robert recently had surgery to treat a bleed on his brain.
05:01Tonight, after bleeding heavily from his nose, his son called 999.
05:07What I've had it happen before, it's usually stopped within, you know, ten minutes or so.
05:13Ten minutes, but it's been half an hour.
05:14Yeah, it's been a good hour.
05:16How much blood would you say that you've estimated?
05:18Well, a lot.
05:20A lot.
05:20A lot.
05:21Yeah.
05:21Let me just pop that on there.
05:24Any headache?
05:25No.
05:25Any blurred vision?
05:27No.
05:27No, just the nosebleed.
05:29Robert was in quite a mess when we first arrived on scene.
05:32My major concern was the amount of blood loss and to make sure that his airway was clear.
05:38Well, we'll see what we'll do.
05:39We've got like this little clip that we can pop on your nose that can try and stop the bleeding
05:43all right.
05:44Yeah.
05:45This is supposed to clamp.
05:48Can you feel that pressure?
05:50Yeah, it's not very tight though, isn't it?
05:53No.
05:53Let me try a bit higher up.
05:54Oh.
05:56Never get trying this and trying in school.
05:59Oh, there we go.
06:01Right, keep that there for a bit.
06:02I think it's doing its job.
06:04It's stopped bleeding now.
06:05It's stopped dripping down.
06:07There we go.
06:08Fixture.
06:09Can you breathe through your mouth okay?
06:11Yeah, yeah.
06:12You're not feeling anything?
06:13Oh no, it's still dripping.
06:14I was quite worried at this point because we had no other option to stop the nosebleed apart from him
06:20applying pressure himself.
06:22And I was really worried about the amount of blood loss.
06:25What we'll do, we're just contacting our team.
06:28We've got a drug that's a blood clotting drug.
06:29Yeah.
06:30The fact that it's still going after half an hour and yet it is losing quite a bit.
06:35I'm thinking that that might be a go ahead if I'm honest.
06:38Yeah.
06:38Just to see if that stops the bleeding all right.
06:43As Robert has recently undergone brain surgery, Amy needs to speak with a senior clinician before she can give blood
06:50clotting drugs.
06:52Amy, I'm just waiting for a response, mate.
06:54No worries.
06:55It's just my reasoning is the fact that it's been continuous for over half an hour now and it's still...
07:00Yeah.
07:01...going quite...
07:02Yeah, still...
07:03Yeah.
07:03I'm going to take this off because it really isn't doing nothing, is it?
07:08If you just try and pinch a little bit more up here as well if you can, that normally stops
07:13it a bit.
07:14How's your walking like?
07:15Is that all okay?
07:17Yeah.
07:17Before I went to the hospital I could hardly walk and I was tripping up and falling over but since
07:23I had the operation and come out of the hospital I've been fine.
07:26I only took the dressing off this morning.
07:28Wow.
07:29Ah, I see it.
07:31It's healed really, really well.
07:32Yeah.
07:34Do some fresh ones.
07:36There we go.
07:37Oh!
07:38Oh God, that is a big clot.
07:40Oh, that...
07:41That was massive.
07:43Yeah.
07:44Was that in your nose or was it in your throat or was it when...?
07:47It come from my nose into my throat, that come out of my throat, that did.
07:51Okay.
07:52I'll just spit that out.
07:54When I saw the blood clot, it was rather grim.
07:57It was large.
07:58He's just had brain surgery.
07:59We needed to get him to hospital fast.
08:02We'll definitely think about going.
08:18Mmm.
08:19I feel a little bit sick.
08:21So do I.
08:22You told us to get this much.
08:23I saw a train, I thought, I've never had a train in my life.
08:26We saw the ice cream van, didn't we?
08:27And I'm pretty sure we drove past it and then went back.
08:30I think if there's an opportunity to have ice cream, I'm going to have an ice cream.
08:33You're going to take it, aren't you?
08:34Yeah.
08:35Do I have chocolate all around my mouth?
08:37No, have I.
08:38Just take your tongue out.
08:39Your tongue's blue.
08:43Morgan and Daisy come to the end of their break and are ready for the next call.
08:54The ambulance service, is the patient breathing?
08:57Yes.
08:58And what's the reason for the ambulance?
09:00The gentleman's had a fall, but he can't wait there.
09:04Right.
09:04And every time he's moving, he's crying out in pain.
09:08Right.
09:08And how old is he?
09:09He's 92.
09:14We've got a 92-year-old male, and presses care line, leg injury, fall injuries unknown.
09:23OK.
09:23We could have a neck of fema fracture.
09:28Yeah.
09:28If we're looking at the leg.
09:30I think when you get cold to a 92-year-old that's fallen, we are thinking, is he going
09:36to have broken something?
09:38Is he going to have broken his hip?
09:39Generally, it's something that happens, isn't it, when they're older?
09:42Yeah.
09:43And a bit more frail.
09:44And it's not nice.
09:46It's not a nice break.
09:51Hello.
09:53What's...
09:54What's going on?
09:55I fell straight over at this side, at the pains there.
09:59I know.
10:00I'm going to take these blankets off you, sweet, all right?
10:02So I can have a look at you.
10:03I know, I know, I know, I know.
10:06Crying kids still, sweet.
10:08I know.
10:10He's bent over and then fell.
10:12And where was he when he fell?
10:14Here.
10:14Here.
10:15Yeah, his head was there.
10:18Retired cabbie Ron fell over while trying to switch on his electric blanket.
10:22Daughter Karen rushed over when she heard her dad was hurt.
10:27Ron, we need to just try and straighten you up a little bit.
10:30This might be a bit very uncomfortable.
10:33I'm really sorry.
10:35Is it just in your hip?
10:37My hip.
10:41A voice over here.
10:43Over here, back here.
10:44Here?
10:44Yeah.
10:46Our main concern was figuring out where this pain was,
10:49why he was in pain and getting this under control.
10:53We did suspect that he may have broke his hip.
10:58I'm not going to touch you.
11:00I'm not touching you.
11:16He's just had a massive clot about this big just come out from his mouth
11:19that's gone up his nose and then come out his mouth.
11:21Right, bear with me, sorry.
11:22We've just had a clot probably about three centimetres by three centimetres round
11:26just come out of his mouth.
11:28He said it was up his nose.
11:29It was up his nose and then he felt like it's gone into the throat and spat it out.
11:32And it's about that big.
11:34Let's just get going then.
11:37To the west of Birmingham,
11:39paramedics Mark and Amy are with Robert.
11:41Having recently undergone brain surgery,
11:44they're concerned his severe nosebleed won't stop.
11:49There we go.
11:50Right then.
11:51You OK?
11:52Yeah.
11:52Don't feel dizzy at all?
11:53No, I should.
11:54Let's get going then.
11:56Just nice and steady down the stairs, OK?
11:59Robert needed to go to hospital as he had had recent brain surgery.
12:03Nosebleeds can be a symptom if something's gone wrong with the brain surgery
12:07so we needed to get him there fast.
12:10Let's put some straps on you.
12:13And again, just checking no headache, no dizziness.
12:15No.
12:21In the future, just phone 999, don't worry about anything.
12:24We'd rather come to something like this.
12:26A lot of people say, oh, it's only a nosebleed,
12:27but there's different circumstances with yours, you know what I mean?
12:36You have arrived at your destination.
12:40Hmm, it has slowed down.
12:41Oh, don't pick it.
12:44At Russell's Hall Hospital in Dudley, doctors will investigate why Robert's nose won't stop bleeding.
12:51They'll also want to see if it's related to his recent brain surgery.
13:03Oh, it came down my leg.
13:06It came down your leg?
13:07Yeah.
13:08Right.
13:09To the south of Birmingham, paramedic Daisy and student paramedic Morgan are with Ron, who's in agony after a fall.
13:18Dizz, I'm not sure if we're going to get this stretcher in, do you know what I mean?
13:21Do you want to try?
13:22Or do you...?
13:23Cos I just don't think we're going to get him on carry chair.
13:25I don't think we are.
13:26I think putting him in even more pain just to get him out, I think we need to try other
13:30ways first.
13:32Yeah.
13:34We're going to give him treatment here first.
13:36Yeah, I don't want to move him.
13:38Ron has very clearly hurt himself.
13:40We think he might have broken his hip, so he needs to go to hospital.
13:44Now we need to figure out how we're going to get him there.
13:47Ron?
13:48What?
13:48Can you stay really, really still for me?
13:51Yeah.
13:52Really still whilst we do this heart tracing?
13:54Still?
13:55Yeah.
13:56Before attempting to move Ron, Morgan runs an ECG to check the state of his heart.
14:02Really still.
14:05He's always dead.
14:06Oh, Ron, let's not say things like that.
14:09What about your daughter?
14:13No, you're not. She loves you.
14:14She gave up a lot of time, didn't he?
14:17Well, you gave up a lot of time when she were a baby.
14:20Yeah.
14:22When Ron said that he didn't want to be alive anymore, it was quite upsetting.
14:27And it was clearly because he was in so much pain.
14:30So we just wanted to make him more comfortable, try and get him feeling back to himself.
14:36Right, I'm going to give you some paracetamol through that vein, OK?
14:40Oh!
14:42It was by the leg.
14:44Was it shooting?
14:46Up and down your leg?
14:49Or Ron?
14:54Daisy and Morgan give Ron liquid paracetamol intravenously.
14:58But it's having little effect.
15:02What, you need to give him something stronger, you know?
15:04I don't know.
15:06I don't think we're going to move him without getting him so much stronger, if I'm honest.
15:10I agree.
15:11Ron had very clearly hurt himself.
15:13We do believe that he had broken his hip.
15:15So, in order to move him, we knew we were going to need to give him some strong pain relief.
15:19Just to try and keep him as comfortable as we can during the process.
15:24Is it all right if we give you some morphine?
15:27Carry on, please.
15:28Please.
15:29We're just going to grab it and we're going to grab our stretcher, OK?
15:33Yes, thank you.
15:34Don't move whilst we're gone, all right?
15:36No.
15:36Stay still.
15:42We ain't got a prayer, mate.
15:45No.
15:47Moving on.
15:51There's not really any other way to get him out other than on a chair.
15:55It was quite difficult to figure out a way to extricate Ron.
16:00We couldn't fit the stretcher through the door.
16:03We couldn't use a spinal board.
16:05The only other option that we had was a chair, which was quite uncomfortable, but it was just a short
16:13-term solution until we got him sorted.
16:16I'm going to give you some morphine.
16:18I'm sorry. I'm feeling so sorry.
16:20Why are you sorry? This is our job.
16:23Do you want to try some gas and air, Ron?
16:26Gas and air, yeah.
16:29Right, so if you pop this in your mouth, if you suck it in...
16:33You got it?
16:34Go steady.
16:37Ron.
16:39Ron.
16:40What?
16:40If you suck that in, it should ease the pain, but you've got to keep sucking on it, OK?
16:46OK.
16:46So, breathe as normal with it.
16:49Daisy and Morgan have now given Ron all the pain relief available to them.
16:54Right, Ron, we're going to move you, OK?
16:57Keep sucking on that whilst we move you, cos this might be quite painful.
17:01I'm going to move your legs, OK?
17:04I'm going to sit you up.
17:06Ready?
17:08That's it, sweet.
17:09Here we go, here we go, here we go, here we go.
17:12Put it in your mouth. Here we go.
17:14Take deep breaths on this, that's it.
17:17We need you to try and sit up on the edge of the bed.
17:20We can't.
17:21We can.
17:21We've got to, sweet, cos we're not going to get you out.
17:24Put this in your mouth, keep breathing on it.
17:26There we go.
17:27Yvonne, you're on the chair now.
17:30Keep breathing on it.
17:32Ron, keep breathing on it, there we go.
17:34There we go.
17:35You OK? Yeah.
17:37With the pain medication starting to take effect,
17:41Morgan and Daisy can finally move Ron.
17:43If he has broken his hip, he's not alone.
17:4770,000 people break their neck of femur every year.
17:51There you go. Got it?
17:53Right, we're going to take you into the hospital now, OK?
17:56OK.
17:56All right.
18:07Keep having that gas and air for me.
18:10I've just gone over a few bumps.
18:22All right, my darling. How was that pain? Is it any better?
18:27Good.
18:31At Queen Elizabeth Hospital in Birmingham, Ron will have x-rays to see if he has broken his hip.
18:37HE CONTINUES
18:43HE CONTINUES
18:44HE CONTINUES
18:47HE CONTINUES
18:48HE CONTINUES
18:50HE CONTINUES
18:50Put her on. He was clearly in a lot of pain.
18:53He was not having a good time.
18:55Well, at least we've got him to hospital.
18:57I know. Bless it.
18:58We got him in, didn't we?
18:59Yeah.
18:59We'll get him sorted.
19:12HE CONTINUES
19:15You like a pub quiz, don't you?
19:17I don't mind a pub quiz.
19:18I'm not saying I'm great at it, but...
19:20Right then.
19:21So, what European country has the longest coastline?
19:27The longest coastline?
19:28Yes.
19:29Oh, God.
19:31Italy?
19:32I have no idea.
19:34I think geography is important in our job, so you know which direction, roughly, to travel.
19:39That's what we sat-nav's for.
19:40That's why you are no good at geography, because you rely on your sat-nav.
19:44It's a country that potentially had Vikings there.
19:50Sweden?
19:51No.
19:52Norway?
19:53Yeah.
19:54Believe it or not, Norway has the longest coastline in Europe.
19:57You know I'm going to look at that on the map now, right?
20:00Yeah.
20:00Google it.
20:01Beall...
20:07No.
20:12No.
20:21Yeah.
20:28He's not going to get all the information...
20:35.
20:36.
20:36007.
20:38007.
20:42Yeah, Roger, thanks, we'll get you what we can do.
20:48Well, look at the time the call came in.
20:51She's woken up with chest pain, that can be quite concerning.
20:54She's never a good sign.
20:56We're only nine minutes away.
20:58Hmm, bit tight.
21:01It's scary, isn't it, some of the rural communities
21:03and how isolated and vulnerable they actually are.
21:08This was potentially quite a serious case,
21:11just given her age, given the location of where it is
21:13and the amount of time it would take to get there.
21:16Yeah, the location of her property was up a really long, narrow road,
21:20which just made it extra hard to get to her.
21:26So what's been going on, then?
21:28Well, I've got a heart-vowel problem
21:31and, you know, waiting to have it done.
21:34But, ooh, tonight, it really got me.
21:38I woke up and I got this real pain, and my heart was racing.
21:46When racehorse breeder Rosalie was woken in the night
21:49with pains in her chest, she rang 999.
21:53Husband Peter is with her.
21:55What time did she wake up with the chest pain, though?
21:57How little time do you want to go for the chest pain?
22:00No. At 3 o'clock.
22:01At 3 o'clock.
22:02Do you have an irregular heartbeat, by any chance?
22:05Not normally, I don't think, no.
22:07I can see they've put it in.
22:09She's got aortic valve stenosis.
22:11Rosalie was experiencing some chest pain,
22:13which could be caused by her pre-existing heart condition.
22:17Aortic valve stenosis is the narrowing of a valve within a heart,
22:21which affects the blood flow into the arteries.
22:24It effectively means the heart has to work a little bit harder.
22:27So, have you got palpitations in your chest at the minute, sweetheart?
22:30No.
22:31Did you have?
22:32No.
22:33OK.
22:34The longer I spent with Rosalie, the more concerned I got.
22:37She was telling me about needing a heart operation,
22:40how she's now got chest pains and palpitations.
22:42So, the longer I was there, the more concerned I was becoming for her.
22:46My license is still a second.
22:49Adam carries out an ECG to check the electrical activity of Rosalie's heart.
22:54Yep, we'll be going.
22:56You're going to hospital, sweetheart.
22:57Is it all right, or is it...?
22:59You've got a heart rate at the minute is about 160.
23:02Yeah.
23:03It should be ideally between sort of 60 and 100.
23:07That's very fast, basically.
23:08I knew something was wrong anyway.
23:10I've been getting short of breath.
23:12Have you?
23:13I'm not surprised with a heart rate like that.
23:16So, it's saying STEMI.
23:19Yep.
23:20So, we're going to have to ring.
23:21Yeah.
23:21We'll give him a buzz.
23:22Once we completed a heart tracing on Rosalie,
23:25it showed us that not only was her heart beating pretty fast,
23:29at over 160 beats per minute,
23:31but it was also showing us that she was actively having what we call a STEMI,
23:35which is a heart attack.
23:45As the West Midlands sleeps, we're on board with eight paramedic crews
23:49working the night shift until 6.30 in the morning.
23:57We are going to be taken to hospital,
23:59and we are probably going to be going quite quickly.
24:03On the outskirts of Stoke,
24:05paramedics Colleen and Adam are with Rosalie,
24:08who they suspect is having a heart attack.
24:11I'm just going to give you a spray under your tongue if I can.
24:13Yeah.
24:13This will hopefully take some of the chest pain away.
24:16Adam gives Rosalie a spray under her tongue.
24:19This opens up her blood vessels,
24:21producing the strain on her heart.
24:24We're going to look and see if we can give her an aspirin.
24:27Yeah.
24:27Then we're going to look at giving her a needle in her arm as well.
24:30I'm just going to pop in your hall and make a phone call, OK?
24:32OK.
24:34Colleen calls the hospital to let them know they'll be arriving soon
24:37with a patient who's having a heart attack.
24:40So, I did the right thing calling.
24:42Oh, yeah.
24:43I don't like to think I'm wasting anybody's time, you know.
24:45No, you have definitely done the right thing by calling.
24:48They said go to A&E initially,
24:50but give resource a quarter to go there.
24:52Which A&E?
24:54Stoke.
24:54Rosalie has to go to hospital
24:55because she's actively having a heart attack.
24:58She needs further treatment that we can not provide her.
25:00It's imperative that we get her there pretty quickly
25:03to get the treatment she needs as fast as she can.
25:05We're going in on blue lights.
25:06We're going to be going quite quickly.
25:08She is unwell.
25:09So, it's up to you what you choose to do.
25:11But if you do...
25:12No, you're doing your job anyway.
25:14They'll look after me, I know that.
25:16We'll get you on to the ambulance
25:17and we'll get you to Stoke as quick as we can, OK?
25:19I can't walk, I think.
25:21No.
25:21No, absolutely not.
25:22Oh, all right.
25:23Absolutely not.
25:25All right.
25:25Your heart rate's already going to 160.
25:27Try and get you up and about.
25:28You'll be on the floor.
25:30I find with the older generation,
25:32they don't want to make a fuss.
25:33They just want to get on with things.
25:35But when something like this is happening,
25:36you really should make a fuss about it.
25:41You shouldn't have thought to have to do that.
25:43No, you couldn't.
25:43You're not walking anywhere, Doug.
25:45Not with your heart rate like that.
25:47Well, you know your job.
25:50Indeed.
25:51How are you feeling?
25:52Not too bad.
25:53So, like we said, we will be going in with the blues and twos, OK?
25:59OK.
25:59OK.
26:00So, we need to get you there sooner rather than later.
26:07Breaking bad news is never fun,
26:09but unfortunately we need to do it in a way that the patient understands
26:13so they have all the information they need.
26:16Hello, resource.
26:18It's Adam, one of the paramedics.
26:19Can I put a medical standby in, please?
26:21OK, and we'll see you in about 20 minutes.
26:24We're going to be waiting for you.
26:25Yeah.
26:26So, we'll go straight in, straight to see someone, hopefully.
26:31I feel a bit of a fraud going in like this.
26:34Honestly, you're really not.
26:36Really?
26:37Yeah.
26:38Well, your heart rate, being as it is, you ain't no fraud.
26:45Right then, sweet.
26:46Couple of bumps.
26:47I'm a pro, don't worry.
26:49Yes, you are.
26:51At Royal Stoke University Hospital,
26:53the cardiac team are ready and waiting to treat Rosalie.
27:03Rosalie was lovely, wasn't she?
27:05Yeah.
27:06Don't think she wanted to bother us.
27:08She absolutely needed to, though.
27:09No, didn't she just?
27:10Like, as soon as I seen that ECG.
27:11Yeah.
27:12I was like, hmm, that's not right.
27:14Not right at all.
27:16It would not shock me.
27:18But she didn't seem particularly bothered about it.
27:19She was really chilled.
27:21Yeah, that's what I mean.
27:22They weren't more chilled than I'd be.
27:24Bless her.
27:24They don't make them like her anymore, do they?
27:26Oh, definitely don't.
27:27Absolute trooper.
27:40So, is he able to respond to you at all and speak to you?
27:43Is she awake at the moment?
27:46Every minute of every day,
27:48the call assessors of West Midlands Ambulance Service
27:51are working hard to save lives.
27:53There is always something that is completely out of the box
28:00and you're not expecting it.
28:01And I think that's what makes this job so interesting.
28:05Ambulance Service, is the patient breathing?
28:09Ambulance, please.
28:10It's the Ambulance Service.
28:12Is the patient breathing?
28:14Is she breathing?
28:15Yes, she's breathing.
28:17Yes, yes, sort of, yes.
28:18OK.
28:18Are they conscious?
28:19Are they awake?
28:20She's panting.
28:21She's heavy breathing.
28:22OK.
28:23I just need to know if they're conscious.
28:24Are they responding to you?
28:26Is she responding to it?
28:28No.
28:28No, I don't think she is.
28:30OK.
28:31Is her breathing noisy or abnormal?
28:34It's, like, gargling heavy.
28:36It's gargling.
28:37OK.
28:37OK.
28:37Is she responding to you?
28:39Is she making any effort to move?
28:42Yeah, she's sort of.
28:45OK.
28:46Right.
28:47OK.
28:48OK.
28:49Call her, listen to me.
28:50It's really important that you follow my instructions, OK?
28:52Yeah.
28:52I need you to have a look at her breathing.
28:54Is she breathing normally?
28:57Is she breathing normally?
28:58Not really.
28:59No, not really.
29:00As soon as I hear the words that they're not conscious
29:02and not breathing, it's almost like a wall comes down
29:06around me and I'm completely locked in on that call.
29:10Nothing else around me matters.
29:13OK.
29:13We've got some help arranged.
29:15I need you to listen to my instructions, OK?
29:17Are you within easy reach of her?
29:20Yeah, somebody's on the roof.
29:22She's on a roof.
29:24She's on a what, sorry?
29:26She's on, like, a roof ledge.
29:28She's on a roof ledge?
29:30Yeah.
29:32When I heard the patient was on the roof,
29:35I think I was genuinely really confused,
29:37but it just changed things in the moment then.
29:40It meant that I needed to then think about
29:42how we were going to get the caller
29:43to the patient safely to do CPR.
29:46So when you say she's on a roof ledge,
29:48what do you mean?
29:51It's like a ledge.
29:52It's like a ledge.
29:53Is it a ledge on top of the house?
29:56Is it like a balcony out there?
29:57Yeah, yeah, like a roof.
30:00Can you see the ambulance?
30:03Caller, are the paramedics there?
30:05One on your left.
30:06One on your left.
30:06The door on your left.
30:09Hello, caller?
30:11Yeah.
30:12Is that the crew with you?
30:14Yeah.
30:15OK, I'll leave you with them.
30:19Even though we get calls quite often for people
30:23in unconventional places,
30:24it's not often that you get somebody that's on a roof,
30:27unconscious, not breathing, needing CPR,
30:31and trying to figure out how we're going to get to that patient.
30:36Minutes later, control has informed
30:39the woman was trying to take her own life.
30:42We've got some updates on that case.
30:45So, she's alive.
30:48They've now got her off the roof by her.
30:51We're there as well.
30:52I assume that's to help get her down off the roof.
30:54Yeah, because they weren't quite sure how they were going to get her down,
30:56to be fair.
30:57I just couldn't get my head around it.
30:59No.
31:00It just didn't make sense as to why she would be on the roof.
31:02She's on the back of the ambulance,
31:03so hopefully she'll be OK.
31:22Are you sweet rather than savoury, then?
31:25If I have a tub of ice cream,
31:27there's no, like, scooping it out and putting it in a bowl.
31:31I just eat all of it.
31:32Do you know what really annoys me, though, about, say, if you've got ice cream
31:35and you get it out of the freezer
31:36and you've got to wait for it to defrost a bit
31:39and your spoon just bends because of the ice...
31:41You put it in the microwave?
31:43I put it in the microwave for about 10, 15, 20 seconds, depending.
31:46There has been a few mishaps on a couple of occasions
31:49where it has been too soft.
31:53So then do I eat it or do I put it back in the freezer
31:58to freeze it up a little bit more,
32:00but then am I going to be starting back at the same point
32:03where I'm going to have to put it in the microwave?
32:05This is too much for my head.
32:06It's a science. It's a science.
32:08I do like ice cream when it's all runny, though.
32:10I'll purposely mix it until it goes safe.
32:11I used to do that when I was little.
32:13As a kid, yeah.
32:13I don't want it sloppy now.
32:16I want it just nice.
32:26Category 2, 70s lady with something very unfortunate.
32:33She has rectal bleeding.
32:35She's got diverticulitis as well.
32:37Right, OK.
32:38So that could be a factor.
32:42A lot of people struggle with that, don't they?
32:44Yeah, yeah.
32:46Diverticulitis is a condition in the bowel
32:48which can cause bleeding and discomfort
32:50and sometimes a lot of pain.
32:52We knew this lady had been bleeding
32:54and so it was quite important that we found out what was going on.
33:07Hello.
33:08What's been going on, sweetheart?
33:10I've been having bleeds.
33:11I've got diverticulitis.
33:13OK.
33:13I'm used to having...
33:14Yeah.
33:15..shall bleeds.
33:17I had to do a runner to the bathroom.
33:19Mm-hm.
33:21I had a massive bleed.
33:23You can go look in the loops there.
33:25Right, OK.
33:2874-year-old Maddy has lived with chronic inflammation of the bowel
33:31for 30 years.
33:33But tonight, after experiencing heavy bleeding, she called for help.
33:39And are you getting any pain?
33:40Yeah.
33:41Is the pain different to normal diverticulitis pain?
33:45Yeah.
33:46It's a cross, yeah.
33:47Yeah.
33:47Let's do your blood pressure ducky.
33:50Right.
33:51So, would you say the amount of blood that you've lost,
33:55and, like, tonight and that, is...
33:57Oh, I've got blood.
33:58Do you find it's getting worse?
34:00Yeah.
34:01Yeah.
34:01With the amount of blood Maddy was losing,
34:04I was concerned, as things can get quite serious quite fast.
34:08Oh, right, OK.
34:10So, it's definitely red, fresh.
34:11Yeah.
34:12That's...
34:28Oh, my goodness.
34:29Tired, Bob?
34:29I am tired, yeah.
34:31I definitely prefer the day shifts.
34:33What do you prefer?
34:33Day shifts, 100%.
34:35It's always better when you're working with a friend.
34:37So, when me and Sean work together,
34:39it's not really like working together,
34:40because we're quite good friends anyway.
34:42Yeah, yeah.
34:43Definitely.
34:44If you have a laugh with someone,
34:45time goes so fast.
34:46Yeah, it does.
34:47And you bring loads of snacks, so that definitely helps.
34:49That's also very true.
34:50That's very true.
34:52Can't wait for a cup of tea in bed tomorrow morning.
34:57Do you have a beer?
35:04Do you have a beer?
35:05No, no, no.
35:08It feels like I am a singer.
35:08No, no.
35:10I am.
35:11Do you have a beer?
35:11If you're breathing?
35:11noisy or abnormal it's abnormal um i gotta go outside the guy can't go up
35:19voice exit we've got a cat one
35:23so we have arrest peri-arrest exposed to the elements five minutes away when a patient's
35:32heart is highly unstable but is still beating it's called peri-arrest it's the stage before
35:38a full cardiac arrest onwards and upwards let's go see
35:4530 unconscious noisy breathing obviously you've done right over yeah unconscious noisy breathing
35:53so i mean sunday morning um it'd be a good guess to say that he might have been out
35:59the good night hello what's happened just found
36:09he's breathing oh yeah yeah i can detect my injuries he's letting us all throw up so hi
36:14yeah mate can you wake up for us can you wake up definitely had a good night
36:22we'll get the stretcher and get him on the ambulance yeah a doorman called 999 after
36:29finding the man lying unconscious on the pavement when we arrived on scene we came across a man
36:35covered in vomit we both took a good guess that he'd been on a night out the night before
36:40and he was just taking a sleep on the side of the road right mate it's time to get on
36:46this stretcher
36:48let's set you up you've definitely had a good night
36:54shall we get your legs round oh you're able to pull him up from that way yes mate oh he's
37:01wet himself
37:02as well yeah hello all right good for you she's going to get you on this stretcher
37:13sat there again oh no we are worried about you with the ambulance
37:19you're in the street you've been sick okay when he sat up and came round a bit it was very
37:27difficult
37:27to talk to him he didn't want to speak to us and we very quickly got that vibe but also
37:31there was a part of us that wanted to make sure he was okay you can't stay here though you're
37:36going
37:36to have someone else phone an ambulance for you no i'm not you're not what's that yeah someone's
37:45found an ambulance for you why not because you you're not waking up you're sleeping on the street
37:54okay where's home i don't know do you have a house
37:59fuck off so asking me where home is going to fucking go home
38:04when he was coming round and he was talking to us he was very defensive and aggressive
38:11in his answers and at these moments you just sigh and just think what can i do
38:16is there any other way we can help you
38:25let me just do your blood sugar sweetheart
38:30not point four in stoke paramedics nick and kyra are with maddie she has diverticulitis a condition
38:38that causes severe inflammation of the bowel
38:42so you take any pain relief for it does anything work no i don't bother yeah i know what i
38:48think it's
38:49got to do with the down reticulitis so there's not a lot i can do no that's the problem with
38:55that
38:55your arms are okay but someone like yourself that has got this ongoing issue for you to be worried and
39:08be ringing people yeah that's a concern in itself because something's something's not normal for you
39:16i think we need more more thorough testing right more than what i can do with this thing
39:21and so that's giving me like yeah let's take you the reason we wanted to take maddie to hospital
39:27is due to our concern about the amount of blood she was losing where she was losing it from
39:33therefore we had to find out what was going on so we could get her treated
39:37i don't know i was folding this up oh god to bring one of your nice patched ones can i
39:43have a look at
39:43it yeah she can just rip it open while maddie gets ready to go to hospital nick and kyra admire
39:51her homemade quilt that would look lovely in my bedroom that would oh i'll put an order in
39:57look how perfect it is i've got loads of ufos ufos unfinished objects oh don't get her started on
40:08space and stuff she loves it i'm obsessed handmade quilts with ufos on the thought of having one would
40:17be absolutely amazing it would take pride of place on my bed i would love it ready when you are
40:25thank you
40:28i always say the human body it's a marvelous thing but it can really go wrong in some dramatic ways
40:36people unless they've got something like this they don't understand at all how debilitating it is
40:51at royal stoke university hospital medical staff will try to find out why
40:57maddie's blood loss has been so heavy tonight
40:59is there any other way we can help you as an ambulance there's only a way we can take you
41:10in birmingham city center paramedic sean and technician brogan are with a man who was found lying
41:17unconscious in the street have you been drinking alcohol yes yeah i'm doing that too right i'm done with
41:25this swearing and abuse now let's go i guess that's it then mate
41:31yeah that's it that's what we can really do trying to get you some help
41:36well we've been trying but you're not being very nice so
41:41well okay we decided to leave him there because despite offering him help multiple times and him
41:49initially rejecting it um we can't force him to accept the help that we offer
42:05that's why we were called and we're worried about you but you're not being all that nice
42:10make sure you don't fall over because we've been drinking bro yeah yeah i get it
42:16you just said no you're gonna help me well what do you want help with you just told us to
42:20go away
42:20and leave you alone do you want us to make sure you're okay if i was sat there yeah we're
42:24sick
42:25yeah that's what are you meant to do look i'm not having an argument do you want your checks done
42:29i was really frustrated with this man because anything i was offering or brogan was offering
42:35it just wasn't good enough he just wanted an argument or a fight or something similar to
42:40that and you just can't help them people do you want your checks done no honestly i don't have time
42:46for this do you want to be real so do you want your checks done or not all right am
42:50i in the mental
42:51state for you do you want to check us at all it doesn't matter bro don't fucking start shouting at
42:56me bro what are you going to do let me walk away yeah if you want you're more than welcome
43:00to
43:06my concern when he stood up and he started shouting and getting aggressive was that he was
43:12getting close to the ambulance and he could have assaulted me and i think it would have turned
43:16worse if we'd have stayed there so i think it was a good decision for us to leave at that
43:20point
43:21i think we should just go yeah let's go no step away please step away please step away
43:37having to deal with aggressive patients like this is not uncommon at west midlands ambulance service
43:44nine incidents of physical or verbal abuse are carried out against the staff every single day
43:51but that was a bit scary wasn't it escalated quite quickly that job yeah it was really
43:58threatening it is quite scary and as far as i'm concerned when he says can you really leave me in
44:03this state yes i mean you're not in much of a state when you're able to stand up and verbally
44:09abuse us
44:09yeah i mean sometimes we get sent to people that don't want our help and are vile to us and
44:16then
44:16there's some people out there who just can't get our help and they're in a waiting like they're in
44:21a queue for 999 and they're waiting for jobs where we're wasting our time with people who would just
44:26verbally assault us
44:33ron who fell and was in agony hadn't broken his hip x-rays showed a plate in his hip had
44:39come loose
44:40he spent four hours in surgery having it screwed back in place
44:47rosalie who was having a heart attack was admitted to the cardiology ward here she received treatment
44:54for blocked coronary arteries
44:57robert whose nose was bleeding heavily spent six hours in hospital the bleeding was stopped and he was
45:05prescribed a nasal cream to treat any possible infection and maddie who had rectal bleeding
45:12spent three days in hospital she may require surgery to repair her intestines we went straight through
45:20to see a consultant who was brilliant so hopefully he's going to have some answers for me to help me
45:29get my life back
45:35next time
45:36yeah you're really wheezy aren't you darling
45:38a man is struggling to breathe
45:40right let's pop this on you
45:42COPD is like breathing through a straw day to day
45:46when you're unwell it can get even worse
45:52a young woman has multiple seizures
45:54she'd been having a seizure every day she'd had more than one whilst we were with her
45:59this can't keep happening it's dangerous
46:02what have you done
46:03and a patient falls badly cutting her head
46:06when i looked at her injury i could see that it was down to her skull it needed some serious
46:12stitching
46:24so
46:30so
46:31so
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