- 8 hours ago
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, um, 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, so I can have a look at
10:03you.
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.
10:38Argh!
10:41A voice over here.
10:43Over here, back here.
10:44Here?
10:44Yeah.
10:45Uh-huh.
10:46Our main concern was figuring out where this pain was, why he was in pain
10:51and getting us under control.
10:53We did suspect that he may have broke his hip.
10:57Argh!
10:58I'm not going to, I'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 that's gone up his nose
11:20and 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 just 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.
11:32Then it's come in his throat and coughed it and it's about that big.
11:34Let's just get going then.
11:37To the west of Birmingham, paramedics Mark and Amy are with Robert.
11:41Having recently undergone brain surgery, they're concerned his severe nosebleed won't stop.
11:49There we go.
11:50Right then.
11:51You okay?
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, okay?
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, so we needed to get him there
12:08fast.
12:10Just put some straps on you.
12:13And again, just checking no headache, no dizziness.
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, but there's different circumstances with yours, do you know what
12:30I mean?
12:36You have arrived at your destination.
12:39Hmm.
12:40It has slowed down.
12:41Does it?
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.
13:16Yeah.
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?
13:52Really still whilst we do this heart tracing?
13:54Stay still?
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.
14:17Well, you gave up a lot of time when she were a baby.
14:22When Ron said that he didn't want to be alive anymore, it was quite upsetting.
14:26And it was clearly because he was in so much pain.
14:29So we just wanted to make him more comfortable, try and get him feeling back to himself.
14:35Right, 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?
14:51Oh, no!
14:53Oh, no!
14:54Daisy and Morgan give Ron liquid paracetamol intravenously.
14:58But it's having little effect.
15:02Right, you need to give him something stronger, you know?
15:04I 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.
15:10Ron 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,
16:11but it was just a short-term solution.
16:13Until we got him sorted.
16:16I'm going to give you some morphine.
16:18I'm sorry.
16:19I feel like we're so sorry.
16:20Why are you sorry?
16:22This is our job.
16:23Do you want to try some gas and air, Ron?
16:26Gas and air, yeah.
16:28Right, so if you pop this in your mouth, if you suck it in...
16:33You got it?
16:33Oh!
16:34Go steady.
16:37Ron.
16:39Ron.
16:40What?
16:40If you suck that in, it should ease the pain.
16:43But 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.
17:09There we go.
17:10There we go.
17:11There we go.
17:12There we go.
17:12Put it in your mouth.
17:13Here we go.
17:14Take deep breaths on this.
17:15That'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.
17:25Keep breathing on it.
17:26There we go.
17:27You're on.
17:28You're on the chair now.
17:29You're on.
17:30Keep breathing on it.
17:32Ron, keep breathing on it.
17:33There we go.
17:34There we go.
17:35You OK?
17:37Yeah.
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.
17:52Got 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.
18:23How was that pain?
18:25Is 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.
18:51He was clearly in a lot of pain.
18:53He was not having a good time.
18:55Oh, well, at least we've got him to hospital.
18:57I know, bless it.
18:58We've got him in, didn't we?
18:59Yeah.
18:59We'll get him sorted.
19:00Heads.
19:15Heads.
19:16You 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.
19:20So, what European country has the longest coastline?
19:27Oh, geography.
19:27The longest coastline?
19:28Yes.
19:29Oh, God.
19:31Italy?
19:32I have no idea.
19:34Yeah.
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?
19:53Yep.
19:54Believe it or not, Norway has the longest coastline in Europe.
19:58You know I'm going to look at that on the map now, right?
20:00Yeah.
20:00Google it.
20:08Ambulance service, is the patient breathing?
20:11Yes, it's me.
20:12I've got something wrong with my heart valve, and I'm supposed to have it operated on.
20:18What symptoms do you have, my love?
20:21It's painful, and my heart's racing.
20:24And can you feel the pain right now?
20:27Yes.
20:28I think I'm having a heart attack.
20:36007.
20:38007.
20:39I'm using a 83-year-old maintenance of the plane.
20:42It does specially have a halter valve problem.
20:44Yeah, Roger, thanks, we'll tell you what we can do.
20:48Oh, look at town 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.
20:58Mm, a 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 a property was up a really long, narrow road,
21:19which just made it extra hard to get to her.
21:26So what's been going on, then?
21:29Well, I've got a heart valve 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,
21:41and my heart was racing.
21:46When racehorse breeder Rosalie was woken in the night
21:49with pains in her chest,
21:50she rang 999.
21:53Husband Peter is with her.
21:55What time did she wake up with the chest pain, though?
21:58How little time do you wake up with the chest pain?
22:00At 3 o'clock.
22:01At 3 o'clock.
22:01Yeah, you're going to go.
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.
22:28So have you got palpitations in your chest at the minute, sweetheart?
22:30No.
22:31No, did you have?
22:32Yes.
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 last and still, a second.
22:49Adam carries out an ECG
22:51to 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 of about 160.
23:01Yeah.
23:03It should be ideally between sort of 60 and 100.
23:07It's very fast, basically.
23:08I knew something was wrong anyway.
23:10I've been getting shorter breath.
23:12Have you?
23:13I'm not surprised with a heart rate like that.
23:16So it's saying STEMI.
23:19Yep, so we're going to have to ring.
23:21Yeah, we'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,
23:36which is a heart attack.
23:45As the West Midlands sleeps,
23:47we're on board with eight paramedic crews working the night shift
23:50until 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,
24:21reducing the strain on her heart.
24:24We're going to look and see if we can give her 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
24:36they'll be arriving soon with a patient who's having a heart attack.
24:40So, I did the right thing calling you.
24:42Oh, yeah.
24:43I don't like to think I'm wasting anybody's time, you know.
24:45Nope, you have definitely done the right thing by calling you.
24:48They said go to A&E initially,
24:50but give resource a call to go there.
24:52Which A&E?
24:53Stoke.
24:54Rosalie has to go to hospital
24:55because she's actively having a heart attack.
24:58She needs further treatment that we cannot 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, that's all.
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, you'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.
25:41I'm just going to have to do that.
25:43No, you can'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.
25:54So, like we said,
25:54we will be going in with the blues and twos, OK?
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
26:11in 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.
26:26So, we'll go straight in,
26:28straight 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.
26:38With your heart rate being as it is,
26:39you 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.
27:06I don't think she wanted to bother us.
27:08She absolutely needed to, though.
27:09No, didn't she?
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.
27:20She was really chilled.
27:21Yeah, that's what I mean.
27:22Way 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, the call assessors of West Midlands Ambulance Service are working hard to save lives.
27:54There is always something that is completely out of the box and you're not expecting it and I think that's
28:02what 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.
28:18Okay, are they conscious, are they awake?
28:20She's panting, she's heavy breathing.
28:22Okay, I just need to know if they're conscious, are they responding to you?
28:26Is she responding to it?
28:28No, I don't think she is.
28:30Okay, is her breathing noisy or abnormal?
28:34It's like gargling heavy.
28:36It's gargling, okay.
28:38Is she responding to you?
28:39Is she making any effort to move?
28:42Yeah, she's sort of.
28:45Okay.
28:46Right, okay.
28:47Okay, call her, listen to me.
28:50It's really important that you follow my instructions, okay?
28:52I need you to have a look at her breathing.
28:54Is she breathing normally?
28:56Is she breathing normally?
28:59No, not really.
29:00As soon as I hear the words that they're not conscious and not breathing, it's almost like a wall comes
29:06down around me and I'm completely locked in on that call.
29:10Nothing else around me matters.
29:13Okay, we've got some help arranged.
29:15I need you to listen to my instructions, okay?
29:17Are you within easy reach of her?
29:20Yeah, somebody's on the roof.
29:21She'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, I think I was genuinely really confused, but it just changed
29:39things in the moment then.
29:40It meant that I needed to then think about how we were going to get the caller to the patient
29:45safely to do CPR.
29:47So, when you say she's on a roof ledge, what do you mean?
29:51It's like a ledge, like a ledge.
29:53Is it a ledge on top of the house? Is it like a balcony out there?
29:57Yeah, yeah, like a roof.
30:00Can you see the ambulance?
30:03Paula, are the paramedics there?
30:05One on your back, one on your left, the door on your left.
30:09Hello, caller?
30:11Yeah.
30:12Is that the crew with you?
30:14Yeah.
30:14OK, I'll leave you with them.
30:19Even though we get calls quite often for people in unconventional places, it's not often that you get somebody that's
30:26on a roof, unconscious, not breathing, needing CPR, and trying to figure out how we're going to get to that
30:35patient.
30:36Minutes later, control has informed the 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 via...we'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, to 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, so hopefully she'll be OK.
31:05Yes.
31:05Oh, God.
31:07Oh, God.
31:22Are you sweet rather than savoury, then?
31:24If I have a tub of ice cream, there'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 and you get it out
31:36of the freezer,
31:37and you've got to wait for it to defrost a bit, and your spoon just bends because it's the ice...
31:41I'd put it in the microwave.
31:41You put it in the microwave?
31:43I'd microwave it for about 10, 15, 20 seconds, depending.
31:45There has been a few mishaps on a couple of occasions where it has been too soft.
31:53So then, do I eat it, or do I put it back in the freezer to freeze it up a
31:59little bit more,
32:00but then am I going to be starting back at the same point where I'm going to have to put
32:04it in the microwave?
32:05This is too much for my head.
32:06It's a science.
32:07It'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.
32:32She 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?
32:43Yeah, yeah.
32:46Diverticulitis is a condition in the bowel which can cause bleeding and discomfort and sometimes a lot of pain.
32:52We knew this lady had been bleeding and so it was quite important that we found out what was going
32:57on.
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 small bleeds.
33:17I had to do a runner to the bathroom.
33:21I had a massive bleed.
33:23You can go look in the loops.
33:25Right, OK.
33:26OK.
33:2874-year-old Maddy has lived with chronic inflammation of the bowel for 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.
33:47Well, let's do your blood pressure, Ducky.
33:50Right.
33:51So, would you say the amount of blood that you've lost, like tonight and that, is fine?
33:58It's getting worse.
34:00Oh, yeah.
34:01With the amount of blood Maddy was losing, I was concerned, as things can get quite serious
34:07quite fast.
34:08Oh, right, OK.
34:10So, it's definitely red, fresh.
34:11Yeah.
34:12That's...
34:28Oh, goodness.
34:29Tired, bub?
34:30I 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, it's not really like working together because we're
34:41quite good friends anyway.
34:42Yeah, yeah.
34:43Definitely.
34:44If you have a laugh with someone, time 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.
34:51Can't wait for a cup of tea in bed tomorrow morning.
35:00Ambulance service.
35:01Is the patient breathing?
35:03Yes.
35:03He's laying in his own throw up.
35:05Is the patient conscious?
35:07No, he's not.
35:08He's laying there on the street.
35:10Is the breathing noisy or abnormal?
35:13It's abnormal.
35:15I've got to go outside.
35:16The guy can't go up.
35:19Voice exit.
35:21We've got a cat one.
35:23So, we have arrest, peri-arrest, exposed to the elements, five minutes away.
35:31When a patient's heart is highly unstable but is still beating, it's called peri-arrest.
35:37It's the stage before a full cardiac arrest.
35:41Onwards and upwards, let's go see.
35:45So, he's unconscious noisy breathing.
35:49Obviously, you've done route over.
35:51Yeah, unconscious noisy breathing.
35:53So, I mean, Sunday morning, it'd be a good guess to say that he might have been out the
36:00night before.
36:10Was that a good night?
36:14Hiya, mate.
36:15Can you wake up for us?
36:18Can you wake up?
36:19Definitely had a good night.
36:22We'll get the stretcher and get him on the ambulance.
36:24Good night.
36:24Yeah.
36:27A doorman called 999 after finding the man lying unconscious on the pavement.
36:32When we arrived on scene, we came across a man covered in vomit.
36:37We both took a good guess that he'd been on a night out the night before and he was just
36:41taking a sleep on the side of the road.
36:43Right, mate.
36:45It's time to get on this stretcher.
36:48Let's set you up.
36:50You've definitely had a good night.
36:54Shall we get your legs round?
36:58You able to pull him up from that way?
37:00Yes, mate.
37:01Oh, he's wet himself as well.
37:02Yeah.
37:04Hello.
37:05All right?
37:06I can find you.
37:07Good.
37:08We've got to get you on this stretcher.
37:11Don't worry about me.
37:12Don't worry about myself.
37:13What's that again?
37:14Don't worry about me.
37:15Don't worry about myself.
37:15Oh, no, we are worried about you with the ambulance.
37:17Don't worry about me.
37:18I'm all right.
37:19You're in the street.
37:20You've been sick.
37:20I do what I want, man.
37:22OK.
37:23When he sat up and came round a bit, it was very difficult to talk to him.
37:28He didn't want to speak to us and we very quickly got that vibe.
37:31But also there was a part of us that wanted to make sure he was OK.
37:34You can't stay here, though.
37:36You're going to have someone else phone an ambulance for you.
37:38No, I'm not.
37:39You're not?
37:40No, I'm not.
37:41You're not?
37:42What's that?
37:44Yeah, someone's phone an ambulance for you.
37:46I'm not mad.
37:46Why?
37:48Why not?
37:49Because you're not waking up.
37:50You're sleeping on the street.
37:51I do what I want, man.
37:53OK.
37:54Where's home?
37:56You tell me.
37:57I don't know.
37:58Do you have a house?
37:59Fuck off.
38:00Don't ask me where home is.
38:01I ain't got fucking no home.
38:04When he was coming round and he was talking to us, he was very defensive and aggressive in his answers.
38:12And 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.
38:300.4.
38:32In Stoke, paramedics Nick and Kyra are with Maddy.
38:35She has diverticulitis, a condition that causes severe inflammation of the bowel.
38:42Do you take any pain relief for it?
38:44Does anything work?
38:45No, I don't bother.
38:47Yeah, I know.
38:48I think it's got to do with the diverticulitis.
38:52There's not a lot I can do with it.
38:54No, that's the problem with that.
38:56Your arms are OK.
38:59But for someone like yourself that has got this ongoing issue, for you to be worried and be ringing people,
39:09that's a concern in itself.
39:11Because something's not normal for you.
39:15I think we need more thorough tests done.
39:19Right.
39:19More than what I can do with this thing.
39:21And so that's giving me, like, yeah, let's take you.
39:24The reason we wanted to take Maddy to hospital is due to our concern about the amount of blood she
39:30was 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 want that.
39:38I was folding this up.
39:40Yeah.
39:40Oh, God.
39:41To bring one of your nice patched ones.
39:42Can I have a look at it?
39:43Yeah.
39:44Well, she can just rip it open.
39:47While Maddy gets ready to go to hospital, Nick and Kyra admire her homemade quilt.
39:53That would look lovely in my bedroom, that one.
39:55Oh.
39:56Yeah.
39:56I'd put an order in.
39:57Look how perfect it is.
39:59I've got loads of UFOs.
40:02UFOs?
40:03UFOs?
40:03Unfinished objects.
40:05Oh.
40:07Don't get her started on space and stuff.
40:09She loves it.
40:10I'm obsessed.
40:12Handmade quilts with UFOs on.
40:14The thought of having one would be absolutely amazing.
40:18It would take pride of place on my bed.
40:20I would love it.
40:24Ready when you are, thank you.
40:28I always say the human body, it's a marvellous thing,
40:33but it can really go wrong in some dramatic ways.
40:36People, unless they've got something like this,
40:38they don't understand at all how debilitating this is.
40:51At Royal Stoke University Hospital,
40:54medical staff will try to find out why Maddy's blood loss has been so heavy tonight.
41:04Is there any other way we can help you as an ambulance?
41:07Oh, is there any way we can take you?
41:10In Birmingham city centre,
41:13paramedic Sian and technician Brogan are with a man who was found lying unconscious in the street.
41:19Have you been drinking alcohol?
41:21Unless...
41:21Yeah.
41:23Right, I'm done with this swearing and abuse now.
41:26Let's go.
41:28I guess that's it then, mate.
41:30Fine.
41:31Yeah.
41:32That's it.
41:33That's what we can really do.
41:34Trying to get you some help?
41:36Well, we've been trying, but you're not being very nice, so...
41:41Well, OK.
41:43We decided to leave him there because,
41:45despite offering him help multiple times and him initially rejecting it,
41:51we can't force him to accept the help that we offer.
41:54Aye, Lee Steech.
41:55Aye.
41:56Right there.
41:57Come here.
41:58What?
41:58Was I just not breathing then?
42:01No, you were breathing, but you're unconscious.
42:03On the floor, you're hard to wake up.
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.
42:12Because I've been drinking, bro.
42:13Yeah, yeah, I get it.
42:14You're going to help me or not?
42:16You just said no.
42:17You're going to help me or not?
42:18Well, what do you want help with?
42:19You've just told us to go away and leave you alone.
42:21Do you want us to make sure you're OK?
42:23If I was sat there, yeah, I'd be sick.
42:25Yeah?
42:25What are you meant to do?
42:26Look, I'm not having an argument.
42:28Do you want your Chexton?
42:30I was really frustrated with this man because anything I was offering or Brogan was offering,
42:35it just wasn't good enough.
42:36He just wanted an argument or a fight or something similar to that and you just can't help them
42:41people.
42:42Do you want your Chexton?
42:43No, listen.
42:44Two minutes for you.
42:44No, honestly.
42:46I don't have time for this.
42:47Do you want to be real?
42:48Do you want your Chexton or not?
42:50Aye, am I in a mental state for you?
42:51Do you want your Chexton or not?
42:53It doesn't matter, Bro.
42:54Don't fucking start shouting at me, Bro.
42:56What are you going to do?
42:57Let me walk away?
42:58Yeah, if you want.
42:59You're more than welcome to.
43:00Don't wait for me.
43:01Don't wait for me.
43:02Bro, go that way.
43:03I'll touch you, man.
43:04Bro, what are you going to do, Bro?
43:06My concern when he stood up and he started shouting and getting aggressive was that
43:11he was getting close to the ambulance and he could have assaulted me.
43:15And I think it would have turned worse if we'd have stayed there.
43:18So I think it was a good decision for us to leave at that point.
43:21I think we should just go.
43:22Yeah, this is just...
43:23Yeah, let's just...
43:23Let's go.
43:29No, step away.
43:31Please step away.
43:32Please step away.
43:37Having to deal with aggressive patients like this is not uncommon.
43:42At West Midlands Ambulance Service, nine incidents of physical or verbal abuse
43:47are carried out against the staff every single day.
43:50Well, that was a bit scary, wasn't it?
43:54Escalated quite quickly, that job.
43:56Yeah.
43:57It was really threatening.
43:58It was quite scary.
43:59And as far as I'm concerned, when he says,
44:02can you really leave me in this state?
44:04Yes, I can.
44:04I mean, you're not in much of a state when you're able to stand up
44:07and verbally abuse us.
44:09Yeah.
44:10I mean, sometimes we get sent to people that don't want our help
44:15and are vile to us, and then there's some people out there
44:17who just can't get our help.
44:19And they're in a waiting, like, they're in a queue for 999
44:22and they're waiting for jobs where we're wasting our time
44:25with people who would just verbally assault us.
44:33Ron, who fell and was in agony, hadn't broken his hip.
44:37X-rays showed a plate in his hip had come 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.
44:52Here she received treatment for blocked coronary arteries.
44:58Robert, whose nose was bleeding heavily, spent six hours in hospital.
45:03The bleeding was stopped and he was prescribed a nasal cream
45:06to treat any possible infection.
45:09And Maddie, who had rectal bleeding, spent three days in hospital.
45:14She may require surgery to repair her intestines.
45:18We went straight through to see a consultant who was brilliant.
45:24So hopefully he's going to have some answers for me to help me get my life back.
45:35Next time...
45:36Yeah, you're really wheezy, aren't you, darling?
45:39A man is struggling to breathe.
45:41Right, let's pop this on you.
45:43COPD is like breathing through a straw day to day.
45:46When you're unwell, it can get even worse.
45:49Yeah, she's going into one.
45:52A young woman has multiple seizures.
45:55She'd been having a seizure every day.
45:57She'd had more than one whilst we were with her.
46:00This can't keep happening, it's dangerous.
46:02What have you done?
46:03And a patient falls, badly cutting her head.
46:07When I looked at her injury, I could see that it was down to her skull.
46:11It needed some serious stature.
46:41My mother was on a accident, and she'd been to the police then.
46:43You're supposed to be a miserable pill in her.
46:44So I'm not a victim.
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