- 9 hours ago
Casualty 24 7 - Season 11 - Episode 02
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00:02In the heart of Yorkshire, a team like no other, fight to save lives, 24 hours a day, 7 days
00:23a week.
00:30Serving their community.
00:31Looks like you have broken it.
00:35I don't think I'm going to look.
00:37I'm dreaming of your gin and tonic.
00:39Helping those most in need.
00:44I'm driving though.
00:45There's nothing to be frightened of.
00:47These girls will sort her out.
00:49They care for anyone.
00:51I think I've used your hair up, haven't I?
00:53And everyone.
00:54Looking more like himself, thanks to Barnsley.
00:57Working together to make people's lives better.
01:02You know, I just love to look.
01:04I love to make a difference.
01:07This is Barnsley Casualty 24-7.
01:11Has to not be entering the beauty contest.
01:16On shift tonight.
01:19Dr Heather Soudon.
01:20Is it less painful than it was before?
01:22No, it still hurts.
01:23It's okay.
01:26Consultant Dr Dave Walker.
01:29That's it.
01:30Well, yeah, I've done one.
01:32You might need three.
01:36And...
01:37Have you got her ready?
01:38I know it's ready.
01:39Sister Jane.
01:40So Primrose is ready to move.
01:45So, get ready to share a shift.
01:48You know when you're used to doing receipts at the supermarket?
01:52With the team at Barnsley Casualty.
02:02It's the start of the early shift.
02:05Morning.
02:06Morning, morning.
02:07And Sister Jane is running the hub.
02:12I went to Turkey last year.
02:175th of October and two days of rain out in a week.
02:24But rain is the least of Sister Jane's worries today.
02:27The hospital is moving to a new patient and porter tracking system.
02:32Just got to get on where's job in Port Polly.
02:36We, er...
02:37It went smaller.
02:39It's meant to cut out a lot of waiting time
02:41because they know where the beds are, when they're empty,
02:45when they're clean and when we can put a new patient in there.
02:51Put this in an alphabetical order.
02:55The system will track the movements of patients in real time.
02:59And in charge of implementing it is Service Manager Lindsay.
03:03So, this is one of the badges.
03:05So, when a patient's going to be admitted to the ward,
03:08they will have one of these badges placed.
03:12And what this does is then track the journey throughout the hospital.
03:16Oh, my God.
03:18I have no idea what I've just done.
03:22Well, could cause chaos.
03:27To add to the chaos...
03:30Edie Barnsley.
03:31..there's now an emergency on the way.
03:34Eight-month-old boy.
03:36Dr Soudan heads to Reese's to prepare the paediatric bay.
03:41So, the Emirates crew have just phoned us and told us
03:44they are bringing in an eight-month-old boy.
03:48Who is really struggling with the breathing.
03:50And Mum and Dad are concerned that he's not as responsive
03:52as they would like him to be.
04:01I'm here.
04:01Hello.
04:03Hello.
04:15Hello.
04:16Yes, this is Noah.
04:17For the past two hours, basically, his breathing's got worse.
04:19He's quite...
04:20He's quite crackling on auspultation.
04:23His leg's quite cold.
04:25His central is quite hot.
04:27Yes.
04:27You could assess Noah as he was coming in the door
04:31because you could hear him breathe.
04:32You could see he was working really hard.
04:34He was pulling in between his ribs.
04:37He was clearly struggling with his breathing.
04:39Has he had any recent medicine to call Paul
04:42out of a propping or anything like that?
04:44Yeah, just call Paul at about 12 o'clock.
04:47Okie dokie.
04:48He had pencil in at about half past two.
04:52Mum and Dad, do you want to come up the top end?
04:54Yeah.
04:56Just so I can see you.
04:58So when did you start making the noises?
05:02The only one that's on, but they weren't as bad as they were now.
05:10Kieran has taken the day off work to be with his son.
05:14Right, it was really, really bad.
05:17So we've noticed that he was really bad when he was breathing.
05:22He was trying to cough.
05:23Couldn't cough.
05:25And she was just choking.
05:27And then there was gasping for air.
05:31At one minute his heart's going like the clappers
05:33because he's hot.
05:34Oh.
05:34So that's what kids do.
05:35So when they've got a temperature,
05:36their heart goes like the clappers and they breathe faster.
05:39He's having to work a bit harder,
05:41so he's sucking in under his ribs.
05:43I'm saying because he does breathe quite faster.
05:46So he'll be breathing a lot faster because he's hot.
05:50Noah was born prematurely
05:52and he spent most of his life in and out of hospital.
05:57It just leaves him more susceptible
05:59than other kids of his age to chest infections
06:01and when he gets them he might not deal with them
06:03as well as other kids.
06:05He actually weighed less than a kilo when he was born.
06:08I can't imagine how small that is.
06:11But we're just trying to convince ourselves
06:13that we can rely and tell what his options levels are.
06:17We've got a bug trace now.
06:19Oh, buddy, I'm sorry, you're so hot.
06:22Right.
06:23Right, thank you.
06:25I'm just going to do a bit of unsettling.
06:26Is that all right?
06:27Yeah.
06:28We'll get a bug gas up this year when it feels longer.
06:30That would be lovely.
06:31Terrific, really cool.
06:32And you.
06:36Excellent.
06:37Oh, you are a baby boy.
06:39As Dr. Sowden continues her assessment,
06:42she notices another cause for concern.
06:45Hey, Mum, are these all spots that I've known about?
06:49No.
06:50So these, you've not seen these before?
06:52OK.
06:54I know he's got a few little hands there, isn't he?
06:58So that's a birth marker there?
07:00But these are, these are new?
07:01Yeah, I've got to see him in there.
07:04I noticed some spots on his back,
07:06and I asked Mum and Dad,
07:07have these been there before?
07:08Have you seen them before?
07:09And when they say no, you go,
07:11OK, it's a new rash.
07:12Do I need to worry about the rash?
07:14So some of the spots go away when I press,
07:16and some don't.
07:17Yeah.
07:17So we're going to cover him with some strong antibiotics.
07:19We're just waiting for his hands,
07:21your hands and feet go cold when you've got temperature.
07:24So we're just waiting for him to warm up,
07:25and then we're going to put a drip in and do some blitz,
07:27and then we can give him some strong antibiotics to do the drip.
07:29We were told that non-blanching spots are meningitis until proven otherwise,
07:35but none of us are brave enough to say we can be relaxed about these spots yet.
07:42Infection of the brain, that's meningitis,
07:45can leave kids with brain damage.
07:47The team must work quickly before his condition deteriorates.
08:05In the hub, Sister Jane is just one hour into her shift.
08:12Somebody's pulled back their green at 10.41, but not put it in here.
08:16It's the team's first day using a brand-new porter and patient tracking system.
08:22Yeah.
08:23And Tony's trying to walk in on her own,
08:24walk in quick.
08:25There's some apps.
08:26They put it on as an app as well.
08:27At the end of the day, it's for the patient's safety,
08:31it's for their safety, and to make their journey in hospital better.
08:36But there are teething problems.
08:38I think that's fine.
08:39We'll just move her off and we'll put her in right there,
08:41but I need to make sure I'm not sure she's going to the right bed.
08:45Right.
08:46But that's your problem, love, isn't it, not mine?
08:49It is.
08:49Right, that's all right.
08:52But none of the auto-portering seems to have sent a porter yet.
08:57OK.
08:57How do you complete it?
09:13Over in Rhesus, baby Noah is still struggling to breathe.
09:28Dr. Sowden has spotted a rash on his back,
09:30which could be meningitis.
09:33She's called paediatric registrar Dr. Myles Whitfield
09:36for a specialist opinion.
09:39But Mum and Dad said they weren't there before.
09:47Noah has been in and out of hospital since birth.
09:53It was 26 weeks and two days, so they came three and a half months early.
09:59And then, erm, yeah, that was very scary.
10:06Suspect to the stepsis, which is blood poisoning,
10:09which were very, very, like, very worrying.
10:15So then they had to put a breathing tube in him for...
10:20Well, not put a tube in him, but, like, a few weeks, weren't he?
10:22Got a good trace now.
10:25It's nice and alert.
10:27Let's have a listen for a bit.
10:35Noah's premature birth means he's vulnerable to infections.
10:39The team need to find a vein so they can start to treat him with IV antibiotics.
10:47I'm just going to put a drip in his foot.
10:50Yeah, that's fine.
10:51So it won't be our friends.
10:53Just to warn you, he will get upset with us.
10:55We have faith for the gas tubes.
10:57So, what I'm looking at is just here.
11:00So if you'd bring it up a little bit for me.
11:02Down slightly, just about where my hand is.
11:04Just to here.
11:05Further down?
11:05A little bit further.
11:06Perfect. Thank you.
11:09We just know that it's better to give IV antibiotics
11:13if you're worried about a serious infection over tablet antibiotics.
11:17And if someone can't swallow, you want to get fluids in,
11:19you want to do it through a drip.
11:23I know, darling.
11:29You're a nasty doctor, isn't it?
11:32Finding a vein can be difficult.
11:38New bonds, really slim skin, lovely veins, and then over three, you get nice veins.
11:46In the middle, you've got chunks.
11:49And they're just full of nice, doughy, chewy skin that's nice and snugly.
11:54But, oh, I might might get lining.
12:10Eventually, the team find one of Noah's veins.
12:13Well done, sweetie. We're finished now.
12:25Noor is given fast-acting antibiotics.
12:28His parents must now wait to see if his condition improves.
12:38Over in minor injuries, Janet has come in with a suspected broken wrist.
12:44It's her 60th birthday today.
12:47Getting ready to go take the dog for a walk.
12:50Went to the dustbin, came back, slipped straight down on the ice.
12:54She's now under the care of emergency nurse practitioner, Claire.
12:58I'm Claire.
12:59Hi, Claire.
13:01So, you've been all ready for an x-ray.
13:02Yes.
13:03And the x-ray shows that you've broken your wrist.
13:05Right.
13:05Okay, so it's in a not a great position.
13:08So, we'll need to put some anaesthetic into it and make it all nice and numb.
13:13And then make it a lot straighter for you.
13:16I know the injection's going to work because it's into your wrist and I know injections into your wrist are
13:21painful.
13:22So, I'm not looking forward to this.
13:29I've decided looking at the x-ray on the screen it will look perfectly okay.
13:33Oh, really?
13:34Yeah.
13:34Well, you'll be a lot happier when I've strained it up.
13:37Janet's wrist needs to be numbed before emergency nurse practitioner Claire can manipulate it back into place.
13:45So, I said, there's where the fracture site is, okay?
13:48Yeah.
13:48So, that's where I'm going to go into, alright?
13:51I don't think I'm going to look.
13:52So, I'm not going to lie to you.
13:54It does sting.
13:55Yeah.
13:56Hopefully, we'll get straight in.
13:59That's your word.
13:59That's your word for saying it's going to really hurt.
14:01Yeah.
14:02Remember to breathe.
14:05Okay?
14:06You ready?
14:06Yeah.
14:15You alright?
14:16Yeah.
14:17I can lie.
14:19You're doing brilliant.
14:25Yeah.
14:29That's it.
14:30We're going to spit over.
14:33Right then.
14:34So, you'll just rest it like that now.
14:36Right.
14:36Until it works.
14:37Until.
14:38Okay.
14:40I'm not crying.
14:41Are you crying?
14:42Are you crying?
14:42Are you crying?
14:43Oh, no.
14:44No, they were just running.
14:45Just running.
14:46I don't know why.
14:47I cry, but only happy things.
14:50I can cry at everything.
14:52I think I do cry at sad things as well.
14:53I think I have got an emotion.
14:55Yeah.
14:55But I do cry at happy things.
14:58Yeah.
14:58I'll pass you that back.
14:59You can finish off that.
15:01Oh, thank you.
15:01It's alright.
15:01Can you finish my gin and tonic?
15:02Yeah.
15:03Can't wait for mine.
15:10In the hub, the new patient and porter tracking system is still causing problems.
15:16So, I bet Primrose is ready to move because she's fit to sit.
15:20Yeah.
15:21I need to know if Primrose is ready to move.
15:24Have you got her ready?
15:26Yes, I know it's ready.
15:28So, Primrose is ready to move.
15:32Service manager Lindsay is overseeing the change.
15:37I mean, it's never an easy time to roll out a new system in the emergency department
15:40because patients don't stop booking in, so we're always busy.
15:45So, if you click on the pending screen there, somebody's put a bed request in to move her.
15:51Why have they put wheelchair?
15:52So, she's ordered the porter.
15:54So, should she do that or not?
15:55No, it should be auto-portering.
15:57Some of the patient location information isn't coming through.
16:00You know when you're used to doing receipts at supermarket.
16:05So, we're just working on that.
16:07We're just waiting for IT support to come and do some tweaking for us.
16:13This is very slow if you've got trolley breaches coming up.
16:22Whether the system works or not, new patients keep arriving.
16:32The next to be brought in by ambulance is 78-year-old Kathleen, who's fallen over on her doorstep.
16:39Oh dear, I will really call on her door.
16:43Oh, that's better.
16:44Just a minute, yeah.
16:45Ready?
16:45Mum's right now.
16:50Paramedic Tracy hands over to Sister Beth.
16:53So, we've got Kathleen.
16:56She's gone out to get her milk off the doorstep, come back in, tripped over the lip of the
17:03doorway and face planted straight down.
17:08She's got a large hematoma and she's got like a skin tear underneath the eye and on the
17:16top of the eyelid as well.
17:17Hello.
17:18Hello.
17:20My name's Beth.
17:21Nice to meet you.
17:22Sister Beth will be looking after Kathleen.
17:25First, she needs to assess her injuries.
17:41Is it bad?
17:43That's a, that's not be entering a beauty contest.
17:49Do you live on your own?
17:50Yeah.
17:53I'm sorry, I'm just trying to get this skin right.
17:56Look, my husband's in the home.
17:58He's got Alzheimer's.
18:01What did you do?
18:03I used to be a dinner lady at school.
18:05Did you?
18:08I used...
18:09My eldest grandson and my granddaughter used to go to the same school.
18:13And they all, all pupils like me because they're in a mixture puddin'.
18:17Aw.
18:18As Kathleen has a nasty skin tear, Sister Beth wants to consult with a colleague.
18:25I need, I need to look at this eye before I dress it.
18:28She's got a hematoma here, a skin tear here, a skin tear on her eyelid and a massive one here.
18:34Yeah.
18:34We're going to have to get a scan of your head, my love.
18:36It's all right.
18:37Because you, because you've banged your head and your pupils are different.
18:40Yeah.
18:40And that could be a sign that there might be a bleed inside your brain, okay?
18:44If the scan does show a bleed on the brain, Kathleen will need an emergency operation.
18:51I just told them they don't find out serious.
19:03A new patient is rushed from the high-dependency unit into rhesus.
19:0955-year-old mother of two, Joanne, has atrial fibrillation, an irregular heartbeat.
19:15Her heart is beating more than twice as fast as it should.
19:20Yeah.
19:21Register our doctor, Alice Morgan, head straight to see her.
19:24Hello.
19:26Hello.
19:27How are we feeling?
19:28I feel as I'm having palpitations.
19:31Okay, all right.
19:32Rapid heart rhythms create blood clots, which can lead to strokes.
19:37Because her palpitations, her atrial fibrillation, started within the last two hours,
19:42she was a good candidate for what we call DC cardioversion,
19:46so a synchronised shock using the defibrillator to try and basically shock the heart back into a normal rhythm.
19:52You look like you've got fairly good veins there, so let's just have a little look.
19:57Oh, I like socks.
19:59Very jazzy.
20:03So, what we basically do is we pop the pads on for the defibrillator.
20:10Right.
20:11I give you some medication through this drip to make you feel nice and relaxed, nice and settled.
20:15Okay.
20:16And when I'm happy that you're at a point that you're really, really relaxed,
20:20we administer one shock and we check what rhythm you're in,
20:24and in theory you should be back in a normal rhythm.
20:31The team are planning to put a strong electrical shock through Joanne's body.
20:36Little scratch.
20:41We'll pop some extra monitoring on in a second, so it's a little bit of oxygen,
20:45blood pressure, heart rate and CO2 monitoring, so that just measures your breathing.
20:49The actual procedure takes seconds, it's the, it's the build up.
20:54Yeah.
20:55It's all right, don't worry.
20:57Do you want to keep your glasses on or do you want them off for a bit?
20:59I'm happy to take them off.
21:00Yeah, I'll look after them.
21:01We'll put the pads on and then Liz, my colleague, so she's one of the consultants,
21:05will come in and she'll be the one that does the machine part,
21:09I'll be the doctor that's doing the sleepy part.
21:19Joanne is given defibrillator pads to place under her clothes,
21:23which will deliver the shock to her heart.
21:26Are you happy for us to start?
21:28I'll do a little bit of talking, probably mainly to you.
21:32All right, we'll just have a chat and then when you stop answering we know.
21:35I've worked there.
21:36All right, okay.
21:37All right, lovely.
21:38I'll give you a little bit of the painkiller.
21:40All right, let's see how we, we get on.
21:44To keep Joanne calm, the team used some distraction techniques.
21:49Do you have like a tipple of choice if you were out having a drink?
21:52My favourite drink is Malibu.
21:53Okay, so be like having a couple of Malibu.
21:57Sounds like a plan.
21:59Do you have it with Coke?
22:01Yeah, or pineapple.
22:02Ooh.
22:03Nice.
22:03Lovely with pineapple.
22:04Is it? Okay.
22:06That's making me think of Caribbean tropical ice.
22:09Yeah.
22:09It's just like Barnsley.
22:12We sort of gauge based on how chatty they are
22:14and they become a bit less chatty as the drugs kick in.
22:18How are we feeling?
22:20Yeah, the sea is rolling.
22:21Little bit of sleep.
22:22Yeah, don't worry, that'll pass.
22:24It's just there's Malibu's kicking him.
22:26Yeah.
22:30If the electric shock doesn't reset her heart,
22:34Joanne will still be at risk of a stroke.
22:38We're getting there, I think.
22:40just like Wee-
22:42for the electric shock.
22:43Leaping.
22:45Leaping.
22:47Leaping.
22:50Leaping.
22:59Leaping.
23:01I'm not sure if she I think she's learning and she wishes no I'm sure she is
23:07The team are implementing a new system that will track patients around the hospital in real-time
23:14So are they just meant to look at this screen?
23:19Cubicle eight to x-ray love I
23:26Where's the badges
23:27Service manager Lindsay is rolling out a badge system, which will track the journey of the patients around the hospital
23:36Hoping it goes well because if it works as it's intended
23:40We'll get much faster access to beds on the ward
23:43So if you start off on AMU and then go to 33 you know that that's where they are because
23:48of the badging system
23:49So it should speed up the process of discharge and thus provide us with beds earlier in the day
23:56You know I just think if they can do without budging now for the next week which it's gonna be
24:00we need to just drop that all together
24:02We still can't budge
24:04Yeah
24:11In resus John's heart is beating at twice the normal rate putting her at risk of a stroke
24:21Once John is fully sedated dr. Morgan and the team will try to shock her heart into a safe rhythm
24:31How are we feeling to arm yeah? Yeah, yeah, okay?
24:38I won't be able to ride back there
24:42That's good
24:44Joanne is sufficiently anaesthetized now the team will administer an electric shock to her heart
24:55All right, so I'm gonna charge so can we take the oxygen away please? Thank you
24:59Fair charging
25:03I'm doing really well Joanne
25:07Okay delivering shot now stand back please
25:14Wow
25:28What's the heart rate now is? 74
25:31Ah well done
25:32Well done Joanne
25:34We'll let you have a little rest
25:37Joanne's heart rate has come down by more than half
25:40Her risk of having a stroke has been immediately reduced
25:45So let's work first
25:46Well it provisionally looks like it but we just need to keep an eye on you for a bit longer
25:51because sometimes you go back into the other rhythm
25:54um
25:55But touch wood
25:57it's looking good
26:00So ups are good breathing's good
26:03We'll just let that medication just go through your system all right
26:09Soon Joanne is alert again
26:14You want something to eat?
26:16Yes, please
26:16What do you answer?
26:19Erm, just some hospital toast please
26:21Hospital toast?
26:23Hospital toast is always nice
26:25Does your heart feel slower than it did before?
26:27It does feel slower than it was before
26:29Good, yeah
26:29So it's at a nice rhythm now so it's 89 beats before it was 190
26:36Ouch
26:37Do you remember anything from the sedation?
26:39I remember talking to you about that
26:41Fine, but that's it
26:42Perfect, there you go
26:43It's worked
26:44Yeah, excellent
26:45So it's really quick
26:46It's a two second procedure to get her back into a normal rhythm
26:50It's just the setting up and the safety measures that take the longest time
26:55But she's had a good outcome so hopefully we don't see her back in here
26:58There you go, it's stop
27:00Thank you
27:02Joanne recovered the same day and is now on medication to regulate her heart rate
27:07Thank you, bye bye
27:17Kathleen had a fall at home and banged her head
27:21She's in cubicle one waiting for a ct scan
27:26Can you come home yet? Sorry?
27:28I said can you come home yet?
27:30I haven't seen the doctor yet
27:32You've seen the doctor?
27:33Yeah
27:34Her daughter Tracy has arrived
27:36Has my lump gone down?
27:38No, no
27:39Well, I don't know how big it was before
27:41Well, it was as big as a golf ball, I said
27:44Well, not quite as big as a golf ball now
27:48Maybe grandson Thomas might know
27:50Hi Thomas
27:51Who have you been fighting with now?
27:55Well, it weren't Tyson, I can tell you that
28:00It was bloody milk
28:02I went flat on my face
28:04Do we need to start bringing your milk for you or something?
28:08Maybe if the milkman delivers to our house and we take it down
28:11Do you want to call in the towers then on your way back and have a biscuit?
28:15A jacket potato with cheese
28:18Bloody hell, it's not a restaurant
28:20It is waiting on Mars about
28:27In the hub, the new patient tracking system is still causing problems
28:33So badging's still not working, we've not sent one badge to patient yet
28:38Just stop badging
28:41There's been a few teething problems
28:44So the badging hasn't worked as yet
28:46They're just trying to work with it now
28:49But the system is up and running, we've gone live
28:52Just with a few elements of it not fully switched on yet
28:56So hopefully that shouldn't be too long
28:58So far not too bad, we're about 70% there
29:03So how will that work then?
29:05If we're not badging now, do you know who's where?
29:08Sister Jane wants to go back to basics
29:11There's a phone there, can you not have that phone?
29:17So we're going to give you this phone
29:18So the coordinator can bring it to 7117
29:227117
29:23Oh I need a drink and I don't drink
29:26I've got a drink
29:38In recess, baby Noah is being treated for a serious infection
29:43Which has left him struggling to breathe
29:46His temperature's cooled down a lot
29:47He's more like, more aware
29:49And seems more like his normal self to be fair
29:53Having finally shown signs of improvement
29:56Noah has moved from recess to the increased observation cubicle
30:02He's chewing on his fingers
30:05Yeah, he's working more like himself
30:08Thankfully
30:10Thanks to Barnsley
30:14The treatments have worked
30:15He's breathing settled down and he's a lot better
30:17There'll be a period of observation so that when the medicines we give him wear off
30:21We just check that he doesn't go back to being as poorly as he was when he came in
30:25And depending on whether his symptoms recur or whether he remains stable
30:29He'll be off home
30:31Just got to stay another night
30:32Do some observations and just keep it to see how he is
30:35And I'll have to be back home tomorrow
30:38Very stressful
30:39Yeah, good
30:40Especially with everything that he's been from so far
30:43Do you want to do a last set of numbers?
30:45Okay, then they're going to transfer you up to the children's ward
30:47Yeah, it's fine
30:48It's going to fall back into normal limits now
30:53That's good to hear
30:55So we think Noah had croup, which is a virus
30:58And me and you get croup
31:01And because our air was a bit bigger, a little bit of swelling
31:03We wouldn't even notice it
31:05Noah being so small and being a history of prematurely
31:08That's probably why he needed to come in Swayne and get some drugs to help him
31:15Noah spent the night in the children's ward
31:17And has now made a full recovery
31:29And will it show it without them allocating the porter
31:33Or have you got to allocate the porter for it to show up?
31:38The porter's are still not all connected to the new real-time tracking system
31:44So at the minute it's going a bit chaotic
31:46We're having a few issues
31:47But some of us are on, some of us are not
31:51I'm absolutely rubbish on things like this
31:53Technical and made of
31:54Mind crash when I tend to get it up to
31:56You're like, you know, you're my age
32:00So is there any things here for dinosaurs?
32:06It's making it a bit hard and a bit stressful
32:08But at the minute I'm keeping my stress levels down
32:13Whoa, nearly
32:23In cubicle four, emergency nurse practitioner Claire has pain relief for Janet's broken wrist
32:30So I'm going to give you this to breathe on as well now to help you
32:34Okay, makes you feel a bit woozy
32:36A bit relaxed
32:38Helps with the pain
32:40Okay
32:41Dr. Sowden has been called from recess to have a look at Janet's x-ray
32:47Hello, I'm Heather, nice to meet you, I'm one of the other doctors
32:52I'm not looking forward to this
32:53Why not?
32:55I can move my fingers where I was struggling to move them
32:58All right
32:59But they're going numb
33:00They're starting to go numb
33:01Good
33:01And your wrist, if you did that, is it any better?
33:04I can't really do that
33:05No
33:05Is it less painful than it was before?
33:07No, it still hurts
33:09Okay
33:09And I'm not usually a baby, but it still hurts
33:13Oh yeah, okay, fine
33:15Oh, you're definitely allowed to be upset
33:17Yes
33:17All right
33:18You've done a good job
33:19That bit's pointing the wrong way
33:21I didn't think it looked that bad, actually
33:24I mean, it's still attached
33:26I'm not a doctor
33:26It's still attached
33:28Could be worse
33:31Dr. Sowden and emergency nurse practitioner Claire
33:34are going to attempt to manipulate Janet's wrist back into place
33:42So nice breaths on that if you can for us
33:48Try and relax your hand from it and try to not hold on to me if you can
33:53so that it doesn't tense the bones up, yeah?
33:56You all right?
33:57Mm-hmm
33:58You're dreaming of your gin and tonic?
34:00Yeah?
34:01Okay
34:04So you're starting off with someone who is in pain because something is broken
34:08and all the tissues around the break will be swollen
34:13and every time that break moves, it's going to hurt
34:17Breathe in and out for me
34:22You all right?
34:23I'll be coping
34:31Now that Janet's wrist has been repositioned
34:34a cast is fitted quickly to hold the bones in place
34:44You all right, Janet?
34:48I'll say yes
34:51Positive vibes
34:55So that's the pot for now
34:58We're going to see what it looks like now on another x-ray
35:01Right
35:02But it's very unstable
35:06While Janet heads to x-ray, Kathleen is taken for her CT scan
35:14She's been looked after by healthcare assistant Lisa
35:19Oh, what have you been doing?
35:21I'm only fetch milking
35:23I went to try and shut down and I just went
35:28So I have to stop drinking
35:31I could do but I don't drink, I'm allergic to alcohol
35:34Oh, bless you
35:36I'm going to York today
35:39Can you change it to another day?
35:41It'll have to do, won't it?
35:42I don't think they'll let me go this afternoon
35:45Oh, no, they'll not let you go
35:48So what were you going to be doing in York today then?
35:51Well, um, because it was my birthday, they were buying me a birthday present
35:56So you were doing a bit of shopping?
35:57And I'm going to Betty's
35:59Betty's, what's that?
36:00Yeah, it's a restaurant
36:02Yeah, they were
36:03You'll have to do it another day when you're feeling a bit better
36:06I feel all right now
36:07Yeah, you might get it for free if you're showing me bruise
36:10Might take pity on you
36:12Do you think so?
36:15You might get your tea and cake for now, lass
36:19The CT scan will show if Kathleen has a bleed on the brain
36:25Do I have to sit on?
36:26Well done
36:26All right, I think
36:27I'm going to get you when you're done
36:44Sister Jane and her team are nine hours into their shift
36:49There isn't a consultancy
36:51Well, they're all in hand over at the minute
36:54And the patient and porter tracking system is now almost fully operational
37:00If you want to admit a patient, you do your DTA on care flow
37:03And then you would click that button
37:05So if you click on clinical operations
37:08It's very futuristic
37:11The porter is automatically dispatched to come and collect them
37:27In radiology, Grandma Kathleen has just had a CT scan
37:31to see if she's had a bleed on her brain following her fall
37:42She's got a large swelling, big bruise, big haemoterma on her forehead
37:47Which is this lump here in front of her head
37:51Otherwise, her brain's fine
37:56Healthcare assistant Emma is taking over Kathleen's care
38:02Walk this way
38:04Are we all right to take some bloods off you?
38:06And some more
38:07Have you had, you've not had any done here though, have you?
38:10No, if you'd have said I could have brought some off a kitchen floor
38:15You've made a bit of a mess of that eye, haven't you?
38:18Yeah, it looks like it
38:19Oh, love
38:20You live on your own?
38:22Yeah
38:22Oh, have you got a button all out to press?
38:25Well, what do I want one of them for?
38:27In case this happens
38:30Hey, lass, what are you doing?
38:34Oh
38:35Sorry sweetheart
38:36Oh, that's what they all said, but they'll still stick it in
38:40I stick it in then, I say sorry
38:42It's time for Dr Walker to examine Kathleen's wound
38:46It's not going to be right comfy, I'm afraid
38:50Daughter Tracy is by her side
38:52Kathleen?
38:53Yes, I'm all right
38:57She might be, but the rest of us
38:59It's fine
38:59So you just keep saying that until somebody lets you go
39:01Is that the plan?
39:02Yeah
39:04You do think about your elderly relatives when you're treating a patient at this age
39:08I mean, I think I was always told to subscribe to the sort of grandma rule
39:12And say, you know, how would you treat your grandma?
39:14And that's how you should treat your patients
39:15So I'll just peel that off
39:17We'll try not to take the skin with you
39:21Sorry
39:23So this should be wet, I'm told
39:26Oh
39:26Come on, Ben it
39:28Ben it
39:29Yeah
39:29Okay
39:34Dr Walker is going to stitch up Kathleen's wounds
39:41First, he needs to apply an anaesthetic
39:46I've had injections in my other eye, but they numb it
39:50Well, when you've had injections actually into your eyeball
39:53Well, in my eye, I don't know
39:56I can't see what they're doing
39:57No, oh, right
40:02They once asked me, do you know
40:05I says, I don't know
40:06I'm really asleep
40:18Sting a wee bit as it goes in
40:25You okay?
40:25Yeah
40:26You can blink
40:27It's just
40:28Yeah, that's where it's good to sit
40:30Around the eye is difficult
40:31The lid
40:33It's really tricky to get right
40:35And if you get that wrong
40:36Obviously, if you can't close your eye
40:38That will damage your eye
40:41Pull that together
40:43It's like a little jigsaw puzzle
40:49Okay
40:49Is that it?
40:51Well, yeah, I've done one
40:53You might need three
40:55We shall see
40:58With a lot of older patients, their skin's quite fragile and tears quite easily
41:03So you have to be really gentle with elderly skin
41:09Be very gentle
41:11Are they dissolving ones?
41:13Yes, they are
41:15I thought I were only having one
41:18Yeah
41:19It needed more
41:20It's just the very top of your lid, just above your lid
41:23So just close your eye
41:26I know what boxes feel like now
41:33Right
41:34I'm afraid you're still a bit all bruised but the skin's back together
41:37All right
41:37So yes, it's this bit that was the main concern below her eye
41:45I thought I were only having one stitch
41:49About five
41:51It looks a lot better
42:01I'm shattered
42:03It's been a long day for Kathleen
42:05But she's now ready to go home
42:08Home sweet home
42:12The jacket potato was waiting for her
42:14And her face healed after a few weeks rest
42:18Very good on your feet, aren't you?
42:27Birthday girl Janet is spending the day at Barnsley Casualty
42:30After she badly broke her wrist
42:33Hello, I'm back again
42:36Another x-ray please
42:37You forgot to wish me happy birthday though
42:39Is it your birthday?
42:41I've had to cancel all my birthday plans to come here
42:45An x-ray will show if the team have managed to
42:48successfully manipulate it back into position
42:53Party plans have cancelled now
43:01Emergency nurse practitioner Claire can see the x-ray immediately
43:05Right then honey
43:06Okay
43:07So this was the before picture
43:11Yes
43:11So you can see this big chunk fragment there
43:14And this is the AP view
43:16And that's how it is now
43:18So it's in a lot better position
43:20So it's in a lot better position
43:21For self and other
43:21Yeah
43:21However, it's still
43:24really unstable
43:28Janet came back to Barnsley Hospital for surgery on her wrist
43:31And has now made a full recovery
43:40Picky when Chloe comes back we'll go
43:44The team's first shift using the new patient and porter tracking system is coming to a close
43:51It's gone okay
43:52It's gone okay really I suppose
43:53Apparently badging is now live
43:56Let's go and give it a go
43:57Let's look at a tag level
43:59Portering is now operational so we're using the new system for portering
44:03It's okay
44:04It's okay
44:05Time will tell
44:09As the shift ends
44:10See you later lovely
44:13Sister Jane and the team head home
44:15But the doors to Barnsley Casualty remain open 24-7
44:42Known
44:42We'll be back
44:44We'll be back
44:444
44:455
44:456
44:455
44:469
44:516
44:529
44:596
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