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00:02in the heart of Yorkshire an unbeatable team busy busy busy hard at work open
00:12your eyes for me do you know where you are you're in Barnsley A&E department 24 hours a day
00:21Wow seven days a week nearly feel like a wet dish club saving lives looks like you have broken it
00:34I don't think I'm going to love you dreaming of your gin and tonic helping loved ones
00:43love you I'm trying there's nothing to be frightened of these girls will sort her out
00:48a health service treating anyone and everyone working more like himself thanks to Barnsley
00:57a team doing anything and everything for each other you know I just I just love to look I love
01:05to make a difference this is Barnsley casualty 24-7 that's not be entering the beauty contest
01:15on shift tonight dr. George Beatty the bone could be going through the skin yeah and if that's the
01:22case we need to give you antibiotics yeah that's fine resident dr. Katie quirk even sat at this
01:29angle do you feel like you're gasping a little bit for breath because I can notice the change from
01:33when you sat in the chair and sisters Vicky what do you think my job is to look after you
01:41yeah that's
01:42right and Jay it'll be quicker cubicle eight thanks honey so get ready to share a shift but it's dead
01:52it slide
01:53all over we come there we go with the team at Barnsley casualty
02:10morning morning lovely it's so lovely to have you back the day shift has just started morning darling
02:21are you all right I am love thank you hi it's Jane sister Jane is running the hub yes not
02:32bad Tom yourself
02:35good and every bed in the hospital is taken there's just no beds there's never any beds there's 13 patients
02:46waiting for beds that have been here 13 hours it's not good is it it's flu season and sister Jane
02:54needs
02:55to keep her team protected so jess has just rung up to say that the flu people are on the
03:01way around
03:02for injections and we've got to encourage as many people to go and get them people come in with
03:07infections all the time and everybody can pick up a cold so infection control nurses go around to all
03:14the hospitals offering the flu vaccination sister Jane is joined by sister vicky yes who today is
03:26looking after ambulance arrivals when we come on shift we have to make sure that we log on we see
03:31how many ambulances are inbound we go around and check what empty cubicles we've got what space we've got
03:37in resource just in case obviously we've got ambulance up back corridor and we've got no capacity in
03:43department and no capacity to move off then unfortunately there's nothing that we can do
03:47we just have to make sure that his patients are safe staff are safe as well
04:01sister vicky's first emergency patient is on the way paramedics are bringing in care home manager
04:06kirsty who's fallen over at a petrol station and landed badly on her arm that we've been tumbling
04:14don't wait i have been tumbling
04:18whatever you're ready
04:23swing your lens of glass thank you very much for it i think i've done both bones and it's potentially
04:29poking through the skin i believe i haven't seen it i don't want to look at it but i did
04:34break it
04:35in may this year as well so it's the same arm gone roughly in the same place
04:45have you fallen in town i actually fell in uh oh in emsworth but i live rotherham so oh yeah
04:52i persuaded them to bring me here so you're going to at best but i knew it as soon as
04:58i hit the floor
04:58it's very painful painful and so on paramedic paul hands over to sister vicky and the team
05:08you've got a split lip there you've got it no see it's been intended in this and chest okay when
05:12you're taking a deep breath coughing all those things okay and anything to your left arm it's
05:16all this right arm is that right oh my forearm and what are you allergic to tramadol yeah it's a
05:21very strong pain to describe i'll put you for an x-ray and then we'll get you around to our
05:24recess
05:33area she's in a lot of pain so what we're going to do because she needs to go around to
05:36x-ray first
05:37so we're going to give her a penthoxy nailer which is a good pain relief and then once we're moving
05:42from x-ray she'll go into resource and then we can give her some morphine and settle her a bit
05:46better
05:47so yeah it's quite painful but obviously we need this x-ray as soon as possible to find out
05:52what the damage is really so shall we get you around for x-ray yeah i'll come with you
05:58but kirstie is not the only patient with a potentially broken arm
06:07it's just a dressing just to cover it the time being in paediatrics is 15 year old leighton
06:12brought in by stepmom jody i thought you were messing with me because
06:24that flap were literally folded back
06:29it's grim it's gonna need some stitches definitely
06:34leighton injured his arm on his school break i just walked in the house and his dad phoned me
06:40and said can you go get leighton he thinks he's broke his arm i've caught my uh my arm in
06:46astrogate
06:46and it's ripped open all across there and i think i might have broken it too
06:51where astroturf is there's all metal gates surrounding it and he's smashed it in a gate
07:00i'll be broken for you all right have you got a drink or do you need one
07:03uh can i get one blood thank you my bones cup sauce cup
07:09i can't move it whatsoever and the bones popping out as well yeah it's bad
07:26hi hey i'm tony one of the practitioners
07:28we all right come up your hand then let's yeah so how do you do it i'm messing my mate
07:33and
07:34um after i've chased him and he's he's shut the gate with my arms got trapped in it
07:39branches break the skin up emergency nurse practitioner tony will be in charge of leighton's
07:45care so apart from the court is anything else in your hands i feel like it could be broken
07:51i can't move it whatsoever if leighton is correct and his arm is broken he may need emergency surgery
08:00hands it take deep breaths later do you know what it is it will do love do you but i
08:04don't know
08:05what to do to help you i'm really sorry there's a big nasty open wound what we don't want is
08:11a
08:12an open wound with a fraction because it becomes an open fracture and there's a high risk of infection in
08:18the bone
08:39in the hub sister jane is struggling with a shortage of beds in the hospital
08:45from a nurse and healthcare point of view we are a little bit short from a bed point of view
08:51we are
08:51minus six on amu medicine have got three empty four definites with a further 20 potentials which we're
09:00going to need it would be nice if we've got quite a lot of patients in obviously we're going to
09:04start
09:04having issues but some bad issues in the fact we've got patients moved around with many of the beds
09:27we have emails come through every winter period about flu and covid vaccines that are offered within
09:39the nhs to nhs staff because we're quite a big department they like to come down and do a
09:45mop up and make sure that people who want them um can go and get them it is nice to
09:51think if you're
09:51coming into hospital that staff members are vaccinated against it but it is entirely up to the staff if they
09:58choose to in radiology 48 year old kirstie is having an x-ray
10:14you're doing really well we'll get around to recess then
10:29i know it's unstable because as soon as i try and moved or anything like that you could feel bones
10:39moving dr george beattie takes over kirstie's care both those bones are broken in the middle of your
10:47forearm i have broke this arm before in may this year okay whereabouts did you break it exactly the
10:53same spot the same spot right so you're familiar with the orthopedic doctors yes kirstie broke
11:00one of the bones in her forearm a few months ago now that's significant because it's going to make
11:06it more difficult for the surgeons to repair a break through bone that was already broken
11:13um and it's going to leave her with a weak spot there have you got to manipulate it i think
11:20we should
11:20try to manipulate it yeah that's not a long-term fix no i know it's not but that's going to
11:25protect
11:25the blood vessels because there's a cut near the middle of your arm yeah the bone could be going
11:31through the skin yeah and if that's the case we need to give you antibiotics yeah that's fine so i
11:36need to have a quick peek under myself is that all right yeah it's got a little um scratch over
11:49a
11:49swelling in the middle of her arm if it has gone through to the bone then it's a sitting duck
11:55for
12:07a serious infection
12:09johnson mallet
12:13hey joe it's only jane you've pulled that patient apparently they're going to make her an appointment
12:18in 48 hours because they want to see how she is in 48 hours there's a bed shortage in the
12:25hub and
12:26many patients have flu so sister jane and the team are taking preventative measures everyone's just
12:32gone for dinner so as soon as go and get your blue jabs so if it was from it it's
12:35got any questions to ask
12:37while sister vicky embraces a constant stream of ambulance arrivals
12:46i'm vicky nice to meet you i'm going to be taking hand over off these chaps okay
12:53she's fine i'm sure she is i'm working diet so
13:02minute yeah put it steady slide over we come there we go
13:11you're not allergic to anything janet are you i've been in the last class right
13:17all right are you all right yes do you want a flu jab
13:26these are lemon melon yeah but i've opened it from one end so just let's
13:34refrain from opening every end shall we you can have the milk the honeydew if you want but i'll eat
13:40this and have that after
13:48in paediatrics leighton is heading for an x-ray to see if he has broken his arm
13:53do we know about eating and stuff okay has it got to wait hold off for now he's accompanied by
14:00stepmom jody
14:05did it bleed a lot yeah until it started to hold you down was it yeah it's really bad you
14:13know
14:13you're gonna have to have stitches don't you yeah i've never had them before well you'll not want
14:18him again when you've finished everything he's done i don't think they're numb you either here really
14:30lay tuned please
14:36are we all right just to slide your arm out of that swing yeah
14:41and then we just need your wrist flat on that door so as long as it's on me that's it
14:45perfect
14:46do it the team are trying to rule out an open fracture
14:56hold on
14:59leighton now heads back to paediatrics to wait for the results
15:05can't play on my xbox yeah oh leighton that's typical the kids in it oh god i hope it's not
15:13brought because i'll not be able to play on my xbox well don't you use that hand how do you
15:19i don't
15:19know oh yeah you definitely can't play on you you'll have to read books
15:30another patient to rise by ambulance 67 year old bridget is taken to high dependency cubicle one
15:37i didn't feel very well so i got in the bath to to calm down and then i got chest
15:43pain and i was
15:44panting so now i've come in for the test bridget's heart rate was monitored in the ambulance
15:50it went up to 167 apparently i didn't see it but that's what they said
15:56i've been to barnesley hospital a lot for other things and i know that that they'll look after me
16:22so we're going to do some goods on you and i've discussed with our consultant and i've put you
16:27as a triage too so you'll get seen a bit quicker when we can find out
16:31what's happening okay thanks very much
16:37healthcare assistant jess needs to take some bloods
16:44you'll need either a baby or a newborn needle because they have real problems getting blood out
16:52it's a tranche
16:55what have you done to yourself oh is it a new tattoo so you have to have it for the
17:00only one
17:01yeah everything yesterday
17:03i think you're mad
17:07healthcare assistant jess isn't having any look
17:09you see what i mean
17:12i used to give blood at the white man
17:15and veins are drunk
17:17yeah
17:24She wants to try Bridget's thumb.
17:38The quicker healthcare assistant Jess can get a blood sample,
17:42the quicker Bridget's heart can be stabilised.
17:50Sisters Jane and Vicky are four hours into their shift.
17:53As one tries to protect her staff from flu...
17:56Are you going for your flu jab, love?
17:59..the other evaluates new ambulance patients.
18:03Do you know where you are?
18:05In the seminar room where you have handover.
18:08Flu jabs, flu jabs.
18:10I've had mine yesterday.
18:11Flu jab.
18:12I've got to have my photograph taken.
18:14What's that got to do with your flu jab?
18:22When he comes out, can you remind him
18:24that if he DTAs a patient on CareFlow,
18:27he has to do it on teletracking.
18:31What do you think my job is?
18:33You look after me.
18:35To look after you, yeah, that's right.
18:38I've worked with Vicky now for ten years.
18:41Plus, probably.
18:43She is one of my closest friends.
18:48Oh, you've just put me off now.
18:50We're holes apart from each other, personality-wise.
18:55But I do absolutely adore her, yeah.
18:59Are you at home, do you think, or are you in hospital?
19:03I'm at home.
19:04You're at home, okay.
19:07Hospital taxi.
19:09It's going to take him in a car 25 minutes, yeah.
19:14Can you just do me a quick CT?
19:17I've got your CT head escort.
19:20It'll be quicker.
19:21Cubicle eight.
19:22Thanks, honey.
19:32Kirsty is in recess with her husband, Gary.
19:36Take this down and just have a quick look.
19:45Sorry.
19:45No, you're okay.
19:47Sorry, sorry, sorry, sorry, sorry, sorry.
19:52Yeah, it's open.
19:54It's open.
19:56Yeah.
19:56It's the best open fracture I've ever had.
19:58Will you stop messing about with it?
20:00No, because I'm trying to get it in a more comfy position.
20:03What do you need?
20:04If I move it, I have to move it myself.
20:07Yeah, but if you pick it up a little bit, I can...
20:09You can feel bones grating as I'm doing it.
20:14Oh, my love.
20:15What are we going to do with you?
20:18We're going to have to remove the wipe it.
20:22I'm going to give me ketamine and put it into a better position,
20:26pot it, and then potentially surgery.
20:30So, because at the moment,
20:31there's nothing connecting my forearm to my upper arm
20:34because the bones are completely shattered.
20:42You can ask him for some cotton wool for your foot.
20:45What?
20:46No, he's fucked.
20:48He had his toe operated on last week.
20:52And we've been trying to get some cotton wool bandage
20:54just to protect stitches.
20:56And can you get it anywhere?
20:57There you go.
20:58Oh, brilliant.
20:59There you go, love.
21:01Oh, thank you.
21:06Kirsty's got an open fracture of her forearm.
21:10What we're really trying to avoid
21:11is any damage to the nerves or blood vessels.
21:14So, the best thing to do for Kirsty right now
21:17is to get her arm back into a straight position.
21:20And to do that, we're going to need to give her some sedation.
21:24And then I'm going to ask my orthopaedic colleagues
21:26to come and help us plaster it into the right position.
21:31So, I'm George. I'll be doing the sedation.
21:33And I'm Kirsty, patient.
21:34You start feeling a little bit funny,
21:36then we'll give you a top up.
21:37Whoa.
21:39Yeah.
21:40Yeah.
21:41Oh, yes.
21:43Kirsty is given ketamine
21:44to keep her sedated throughout the procedure.
21:47Oh, wow.
21:49I feel as though I'm floating.
21:51Yeah.
21:52When's your next holiday?
21:55Er...
21:59I haven't planned anything for next week.
22:02Kirsty is sufficiently sedated.
22:06Now, the manipulation can begin.
22:09How are we doing? Take a little breath for us.
22:14There we go.
22:17There we go.
22:28There we go.
22:32There we go.
22:35There we go.
22:36There we go.
22:38There we go.
22:38It's really hard.
22:40To see any patient shouting in pain,
22:43but she's not fully aware of what's going on,
22:46and it's emergency treatment.
22:49We need to get her arm back into a straight position,
22:52otherwise she could have permanent nerve
22:55or permanent blood vessel damage to her hand.
22:58And the consequence of that could be
23:00that she could not be able to use her hand any more.
23:02So we've got to get that arm straight.
23:05WHISTLE BLOWS
23:13PHONE RINGS
23:16PHONE RINGS
23:24You're in Rapid 2 this afternoon.
23:28Rapid 2.
23:30You are ambulances.
23:34Sister Jane is halfway through a shift
23:37of battling high patient flu levels.
23:39I've got a patient still waiting for her bed
23:41from 10 to 6 this morning,
23:43so if I put ready to move, she's in the queue.
23:46Is that all right?
23:4772 patients at midday, so it's not bad.
23:51It'll be over 100 again after lunch, I would imagine.
23:55I've got about a million screens open
23:58to enable me to just even manage the job.
24:04Just hard going at the minute.
24:07Things are not running smoothly for Sister Vicky
24:09in the ambulance hub either.
24:12Do you think your doors are broken?
24:14My doors are broken?
24:15Yeah.
24:16Front doors?
24:17Front doors?
24:18Not opening properly.
24:20If the doors can't open for paramedics,
24:23patient flow is at a risk of becoming even slower.
24:28Ainsley.
24:29Ambulance doors are not opening.
24:31Yeah, you know, main doors for ambulance doors.
24:35The team makes some calls to find an engineer
24:38who can get them working again.
24:41Fingers crossed.
24:43Fingers crossed.
24:43I'm not holding any hope out, but fingers crossed.
24:53In Rhesus, Mother of 2, Kirsty is under sedation.
25:01Dr. Beatty is overseeing a manipulation of Kirsty's broken bones
25:05to stop them protruding through the skin and becoming infected.
25:15I know it sounds horrible when she makes those sounds,
25:17but she won't remember.
25:20She'll be in, like, a dream, a dream state.
25:25Kirsty's arm is secured in a cast.
25:29Just relax.
25:32Oh.
25:38What are you doing?
25:40It's all done. We've done it.
25:41And you've crafted it. Yeah.
25:43Yeah. Thank you.
25:45You're welcome.
25:47Did you feel the moving it?
25:49Yeah.
25:50No.
25:52Very good.
25:54She'll go for an x-ray just to make sure that the bones are all in the right place,
25:57and then from there she'll be staying on the orthopaedic ward
26:00because she will need surgery for this,
26:02just because of how unstable it is.
26:03The bones aren't going to knit together properly with just a cast.
26:13Speak to your daughter.
26:15Oh.
26:16Hello, daughter.
26:20Better now it's in a pot.
26:22Yeah, it's not flopping about.
26:24Because that's what it was doing.
26:25It weren't connected by anything.
26:27It was unstable.
26:29It looked like Harry Potter after fucking what do you recall?
26:31Apparently it looked like Harry Potter after Chamber of Secrets,
26:33you know, when they prepare it on.
26:35Yeah.
26:36Kirsty's arm was operated on the following day.
26:39She returned to work just four days later.
26:42I've got my boxing gloves at home, I'm ready for round two.
26:59Healthcare assistant Paul is making a cup of tea for a new patient in Casualty.
27:05Your tea is the best.
27:07Definitely.
27:12I've got this nice pack of chocolate biscuits and a nice cup of tea for you.
27:15Yeah, they're gentlemen.
27:16If you need help, I'll pot it up and out the department to let me know.
27:19All right, thank you.
27:20See you later.
27:21Father of two, Keith, has been in and out of hospital over the last few months.
27:26I've been bleeding from my store.
27:29It all started with that.
27:30I had to have a transfusion, I'd lost that much blood.
27:33I've had two lots of iron.
27:36And the second lot, I haven't felt well at all.
27:42Resident Dr Katie Quirk is going to try and get to the bottom of what's making Keith feel unwell.
27:48If you could just tell me why you've come to A&E today.
27:50Today, it's because of my breathing, it was shocking.
27:53Yeah.
27:54Terrible.
27:55When did you first notice that?
27:56This morning, I had to get up because while I was laid down, I couldn't get my breath.
28:02Right.
28:03Difficulty breathing.
28:04And this cough as well, has this come on as well?
28:06Mm.
28:07Mm.
28:08Is it better when you're sat up?
28:10Yes, a lot better.
28:11What I have noticed yesterday, I was going to walk.
28:14I walk my dog every day.
28:16Yes.
28:17And I'd have to walk on to get up road.
28:19That's not me.
28:19So, how far can you walk usually?
28:21Oh, I do an hour.
28:22An hour?
28:23Easy.
28:23And yesterday, it was?
28:25Top of the road, right?
28:26Top of the road.
28:27Wow.
28:27I didn't feel well.
28:28I'm a foundation doctor.
28:30So, at the moment, I'm rotating around different specialties to kind of get a feel for different
28:34things and different types of patients.
28:36All right.
28:38So, I think because of some of the symptoms you've come in with, obviously, I want to have
28:41a little listen to your lungs.
28:42Yeah.
28:42I also just want to have a little listen to your heart as well.
28:45Right.
28:46And then just check your calves and things as well.
28:48Give you a bit of a once over.
28:50Is it all right if you jump on the bed?
28:52Of course it is.
28:54You've got a bit of a tan.
28:55Have you been sat out in the sun?
28:56Yeah.
28:57Yeah.
28:57I like me gardening.
28:59I'm a bit jealous, really.
29:00We spend too much time inside here.
29:05Even sat at this angle, do you feel like you're gasping a little bit for breath?
29:08Because I can notice a change from when you sat in the chair.
29:10Yeah.
29:11Weird, isn't it?
29:15And I'll just have a little look at these calves, if that's okay?
29:17They've been swollen.
29:19Have they?
29:19My ankles have, for some reason.
29:21Both of them?
29:22Both.
29:23When patients come in with shortness of breath, we look at different things that could be
29:27causing that.
29:28So it could be to do with the lungs themselves or the heart.
29:33One thing that could indicate it's the heart is that patients have excess fluid.
29:37What that means is the heart isn't pumping as it should and is causing heart failure.
29:44Dr Quirk wants Keith to have an x-ray on his chest.
29:47So I want to make sure that your heart's pumping enough, especially because it's worse when you're
29:51lying flat.
29:52Sometimes that's because, you know, you're not upright, you've not got gravity on your side
29:56to help with that heart pressure as well.
30:02Keith heads to radiology.
30:06But in the hub, things have not calmed down.
30:09I'll take the rope.
30:10Sorry, I haven't got anything.
30:12And the ambulance arrival doors are yet to be fixed.
30:17We've tried a lot of different codes on that door and it's not happening.
30:19What's the engineer said?
30:20Are they coming out?
30:22Ambulance doors don't open and the ambulances can't get in.
30:27And it's just something else we have to deal with during the day.
30:30It just becomes...
30:33...tiresome.
30:36Lisa has called for engineers and I've told her to put it as a priority task.
30:40We might need a receptionist stood there then because they're coming straight door.
30:44She's just a back pain.
30:46Why is she going on a trolley?
30:56We found out that pumpkin's good for it, you know, like a pumpkin resin.
31:01Well, I've got dash hounds, lots of dash hounds.
31:05Vicky's got a dog, a little sausage dog, a little dash hound.
31:11She was never having a dog when I first started working with her.
31:14She couldn't think of anything worse.
31:16That dog comes before everybody.
31:18Her husband's on the couch whenever the dog's around.
31:22She costs me a fortune sometimes.
31:24She's worth it, though.
31:34At least you get half a day off school and a McDonald's.
31:39Layton has badly injured his arm at school.
31:42Emergency nurse practitioner Tony is reviewing the X-ray.
31:46All looks fine.
31:48His wound's roughly there, but there's nothing obviously broken and we should be able to close
31:54that with sutures.
31:56All being well.
31:59This is going to be the worst part, stitching.
32:02I'll put you some local anaesthetic in anywhere.
32:05Yeah.
32:06I know, but...
32:07It's thought of it, innit?
32:09Yeah.
32:09Just ask for it.
32:10I know, but it'll still hurt.
32:11It'll still feel something.
32:13No, you wouldn't do...
32:14Once it's injected with local, it'll be your head.
32:16You'll think about it in your head.
32:18It'll not actually hurt there.
32:20It'll just feel like...
32:21You'll feel tugging.
32:22Yeah.
32:23That's all.
32:24It's fine.
32:26LAUGHTER
32:27Right.
32:28Do you want to come up this rail?
32:28Let's go to a different room.
32:30Layton needs to have his wound stitched.
32:37Do you want to pop up there for us?
32:39Yep.
32:40Oh, your mum's phoning.
32:43We're just in the room now, so he's literally...
32:45He's got to have it stitched.
32:48So the doctor's just about to inject him to numb it,
32:52and he's having it stitched, and then we'll be on his way.
32:55But it's not broke.
32:56Oh, gosh.
32:57It's good news it's not broke, though, eh?
32:59Yeah, it's a little bit better.
33:00Yeah.
33:01Yeah.
33:01You'll be fine.
33:02Are you glitter that you're not going to be on time of school?
33:05LAUGHTER
33:06That's what I said, Layla.
33:07I said, oh, you could have done it to your right hand.
33:09At least you'd have made some time off school.
33:12They're just numbing it now for him, Layla.
33:15Thank you so much, Jodie, for getting there.
33:17Don't worry.
33:17Just couldn't get there.
33:18We're going to have McDonald's anyway,
33:20so he's got half day off school and a McDonald's after it.
33:23Ah, nice one.
33:24Is it all right?
33:25Yeah.
33:25All right, darling.
33:26Well, listen, I hope that...
33:29He's in a bit of pain, Layla, sorry.
33:31Yeah, they're injecting him as you're talking.
33:34Using local anaesthetic, it is painful to inject,
33:37and we do quite often say to him,
33:38it's going to be a little bit of a sting,
33:40a little bit of a scratch, something like that,
33:41but it's...
33:43It's a tricky one because we wouldn't be able to do the procedure
33:46without the local anaesthetic,
33:48so it's a balance of try to use as little as we need
33:51to achieve local anaesthesia
33:53and make it numb enough for us to stitch it up.
33:57All right.
33:57All right, darling.
33:58Well, just call me when you can, all right?
34:00I love you.
34:02We'll phone you when we're out, Layla.
34:04All right, darling.
34:05All right, love.
34:06Bye.
34:07Bye.
34:09Before the procedure,
34:11emergency nurse practitioner Tony
34:12checks if the anaesthetic
34:14has completely numbed the trauma site.
34:17Why don't you watch some TikToks on your phone
34:21or something like that?
34:23I was thinking to keep him a bit occupied.
34:26So, I'm going to start testing it, see how it feels.
34:29Can you feel that?
34:31Er, I can feel pressing.
34:34Does it feel painful?
34:35No.
34:36There?
34:37Er, no.
34:38OK.
34:38And then just there?
34:40No.
34:41The anaesthetic has worked.
34:43Layton is now ready for his wound to be stitched.
34:52Bridget is in high-dependency cubicle one
34:55with an unstable heart rate.
34:58It's been a blast.
34:59Yeah.
35:00You'd be surprised how fine you can hear that beep.
35:07Healthcare assistant Jess has been trying to take a blood sample
35:10from Bridget's thumb.
35:13Yay!
35:15I'm bleeding well there.
35:22Sorry.
35:23Better mess.
35:23Oh, that's OK.
35:26The blood just came everywhere.
35:28But we both knew that it was going to be more painful
35:31because of it going into my thumb.
35:33But at least you managed to get the blood out quickly.
35:38There you go.
35:41Thank you, Bridget.
35:43You're welcome.
35:46Bridget will now be taken to Rhesus, where her heart rate will be monitored.
35:51I'm worrying saying you're taking me to Rhesus.
35:54But apparently I'm not going to need Rhesus, baby.
35:57And we're ready to go.
36:01See you, Lillian.
36:03Bye, bye, bye.
36:04Keep your hands in sight.
36:06If her heart is still beating too fast, she may need an emergency procedure
36:11to slow it down.
36:25Can you do me a favour, my darling?
36:28And take me back to the pharmacy?
36:32The ambulance arrival doors are still broken.
36:35But Sister Jane is doing everything she can to take control of her shift
36:39before it ends.
36:41Can I borrow your student?
36:42Where's your student going?
36:45He can go to 20.
36:47The bed's ready for him.
36:49OK.
36:50The lady in Rhesus, see?
36:52Is she ready to go to the ward?
36:5915-year-old Layton has lacerated his arm at school.
37:02While step-mum Jodie watches on,
37:05emergency nurse practitioner Tony will attempt to close the wound with stitches.
37:10Want to make a start, then?
37:11Is that all right?
37:12Yeah.
37:14That's my scissors.
37:15Yeah, it's tongs on scissors.
37:18It doesn't hurt, but I can feel...
37:19It's really pulling.
37:20Yeah.
37:21No, I can feel it going through.
37:24I've actually had stitches myself under local anaesthetic,
37:26and it does hurt when it goes in.
37:29It does feel a bit like a bee sting.
37:30But then after that, you can't actually feel any pain.
37:33You can just feel like somebody's pulling at your skin,
37:35and it's a very strange sensation.
37:47That's just the tape coming off.
37:50Is it pulling on your hairs?
37:51Yeah.
37:52I thought you were just plucking my hairs off.
37:56That's not my work for my wife.
37:56That's my hair as well.
37:57Yeah, but it actually hurt more than getting my stitching.
38:02Do you want to have a look before I finish it off?
38:06Oh, yeah.
38:08Oh, yeah.
38:08It's looking better, to be fair.
38:10It does, it does.
38:10So, what I'm going to do is put some strips on as well.
38:13The problem when we put stitches in,
38:14you've got a risk of scars where the stitch goes in as well.
38:17Yeah, yeah.
38:17So, we can support it with, say, strips,
38:20and it takes some of the pressure off as well.
38:21I'm not really fussed about scars.
38:23So, it's something good, sir.
38:24Yeah.
38:25He'll think it's cool.
38:26He's a teenage lad.
38:27They'll think it's cool.
38:28They'll be happy with it.
38:30Looks a lot better, that, love.
38:31You've done right well.
38:32Proud of it.
38:34It did really well.
38:35It was quite painful to start with.
38:37It was good all the way through having that injection,
38:39and once the injection kicked in and it was numb,
38:41it was fine with it.
38:41It was absolutely fine.
38:42It was good.
38:44So, how long will the numbness last for?
38:47Um, up to about eight hours, give or take.
38:51Because he wants to know if he can go on his bike, don't you?
38:53I would avoid the bike.
38:56Normal movements is one thing.
38:57Going on bike and sports and things,
38:59probably a bit out of the risk.
39:02If he doesn't go careful or don't go steady on it,
39:04then there's a chance it could open up again.
39:07I mean, when the first question is asked,
39:08could he go on his bike?
39:09That's a big no-no for the time being,
39:10while he's got them sutures.
39:12Thank you so much.
39:14Lovely.
39:15That's it, then.
39:16Any worries, we're always here.
39:22Layton had a McChicken sandwich on his way home,
39:25his arm healed with just a small scar.
39:35I was hoping I'd get away from this blinking alarm.
39:39Sadly not, not yet.
39:41Retired charity executive Bridget is in recess
39:45because her heart is beating twice as fast as it should.
39:48Oh, no.
39:49You've got another bed.
39:52Hello, Bridget.
39:54Nurse Emma and sister Jess give Bridget some medication
39:57to try and stabilise her heart rate.
40:00I've got some of the magnesium to go up for you now
40:03and then there's a little tablet coming as well.
40:05OK.
40:06It's on this side on my thumb.
40:09Perfect.
40:11So I've just got some bicep along.
40:13Tiny little tablet.
40:15And what does it do?
40:16So it's a beta blocker,
40:17so it should hopefully bring your heart rate down a little bit
40:19and stabilise it a bit.
40:25While she waits to see if the medication works,
40:28Bridget calls her husband John.
40:30Well, put them in a bag in case.
40:32Yeah.
40:33And we've got pants.
40:34I think they're down here probably.
40:35No, they're in the left-hand drawer.
40:37OK.
40:38That's your charger.
40:39You've got a lot of beeping going on up there.
40:41Yeah, that's because my heart rate is above 100.
40:46Hello, are you taking it to the ward?
40:48Yeah.
40:48We are.
40:49OK, bye-bye.
40:52They're just taking me up to the ward,
40:54so I'll ring you back again in a bit.
40:56The team decide that it's not safe
40:58to let Bridget go home today.
41:00I thought I'd just be in and out in two or three hours.
41:03But it looks like I'll be here overnight.
41:07Hey, folks.
41:10Bridget was discharged the following day.
41:13She was fitted with a heart monitor
41:14and diagnosed with atrial fibrillation,
41:17an irregular heartbeat.
41:24In a second, I'll ask you to breathe in
41:27and to hold your breath.
41:3171-year-old Keith is having an X-ray on his lungs
41:34to try and get to the bottom of his shortness of breath.
41:39Breathe normally.
41:42We are a bit concerned there could be a blood clot.
41:44Because he's got a valve in his heart that was replaced,
41:49that can mean that you're more likely to develop blood clots.
41:53And so one thing we just want to make sure of
41:55is that because he had some bleeding a couple of weeks ago,
41:58that in that time he's not developed a blood clot near his heart.
42:02Dr Quirk has sent Keith's X-ray results.
42:06I'm trying to look for any kind of areas where it's a bit too white.
42:11So we like the lungs to look nice and clear.
42:14But can you see there's some fluffy kind of patches?
42:18That could suggest a little bit of fluid that's built up in the lungs.
42:22And then it's quite white in this corner as well.
42:25So all of that makes me a little bit concerned.
42:30One of the things that we're a bit worried about
42:32is that you could have a bit too much fluid in your lungs
42:35because your heart's not pumping quite right.
42:37We were just going to give you these.
42:38I gave Keith some furizumide, which is a type of tablet
42:42which helps remove the excess water by making people go for a wee.
42:47It stops putting too much pressure on the heart
42:49and then that should stop there being any water in Keith's lungs.
42:53All they'll do is they'll just make sure
42:56that you've not got any excess fluid
42:58and that you might go for a wee a bit more.
43:00That's the only thing that might happen. Is that all right?
43:03For now, Keith will remain in hospital under observation.
43:07Can't be helped.
43:09Meet best players.
43:12Tests showed that there was indeed water on Keith's lungs,
43:15which was reducing his oxygen levels.
43:17Since being prescribed the furizumide,
43:19his breathing has improved
43:21and he's back to taking his dog for long walks.
43:25Cheers, pal.
43:35Your patient in cubicle three,
43:37no, in high dependency two, can go home.
43:41The day shift is coming to a close
43:43and the ambulance arrival doors have finally been repaired.
43:47The doors are fine now, as far as my way is.
43:49I've been dealing with them,
43:50but, yeah, they were broken at one point.
43:52Couldn't get any crews in,
43:54so we've had to phone engineers,
43:57phone site matron,
43:59and now they're working,
44:00so all back up and running.
44:04Sister Vicky and team are able to hand over
44:07a fully functioning ambulance hub.
44:10Right, I'll see you later.
44:13And Sister Jane is not far behind.
44:16See you in a bit, darling.
44:17Bye, love.
44:18It's been a busy shift, as always,
44:23but we are coming into winter pressures.
44:25It's just to be expected.
44:26It is the normal.
44:28Help yourself to Madeline if you want some.
44:33Barnsley casualty is running smoothly once again.
44:44And if you or someone you know
44:46has been affected by the issues covered tonight,
44:49find information and support at
44:51channel5.com slash helplines.
44:53Get a feel for the pressure Royal Stokes consultants are under
44:57when the acclaimed 999 Critical Condition
45:00returns for a new series next Tuesday at 8.
45:03And the gripping conclusion of Number One Fan is next.
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