- 11 minutes 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.
22:52sister Jane is half way through a challenging shift.
22:57she's changed it here to surgical but she's not took the amu bed out i'm not sure if she i
23:02think
23:02she's learning if she wishes no i'm sure she is the team are implementing a new system that will
23:10track patients around the hospital in real time so are they just meant to look at this screen
23:16yeah oh because they are on there just have a look cubicle eight to x-ray lovey cubicle eight to
23:23x-ray
23:23yeah please where's the badges service manager lindsay is rolling out a badge system which will
23:32track the journey of the patients around the hospital hoping it goes well because if it works
23:39as it's intended we'll get much faster access to beds on the ward so if you start off on amu
23:44and
23:45then go to 33 you know that that's where they are because of the badging system so it should speed
23:50up the process of discharge and thus provide us with beds earlier in the day do you know i just
23:57think if they can do without badging now for the next week which is going to be we need to
24:01just drop
24:01that all together we still can't badge yeah in recess joanne's heart is beating at twice the normal
24:14rate putting her at risk of a stroke once joanne is fully sedated dr morgan and the team will try
24:26to
24:26shock her heart into a safe rhythm how are we feeling joanne yeah yeah okay
24:41sounds good joanne is sufficiently anaesthetized now the team will administer an electric shock to her heart
24:55so i'm going to charge so can we take the oxygen away please thank you fair charging
25:06i'm doing really well joanne okay delivering shot now stand back please
25:28joanne's heart rate has come down by more than half
25:29oh well done well done joanne we'll let you have a little rest joanne's heart rate has come down by
25:38more
25:39than half her risk of having a stroke has been immediately reduced
25:46well it provisionally looks like it but we just need to keep an eye on you for a bit longer
25:51because
25:51sometimes you go back into the other rhythm um but touch wood it's looking good
26:00so ups are good breathing's good we'll just let that medication just go through your system all right
26:08soon joanne is alert again
26:11do you want something to eat yes please what do you answer
26:18um just some hospital toast please hospital toast hospital toast is always nice
26:25does your heart feel slower than it did before it does feel slower good yeah so it's a nice rhythm
26:30now
26:31so it's 89 beats before it was 100 and uh 190
26:35ouch do you remember anything from the sedation
26:39i remember talking to you about that but that's it perfect there you go it's worked
26:44yeah excellent so it's really quick uh it's a two second two second procedure to get her back into a
26:49normal
26:49rhythm it's uh it's just the setting up and the safety measures that take the the longest time
26:54um but she's had a good outcome so hopefully we don't see her back in there
26:58there you go it's that thank you
27:02joanne recovered the same day and is now on medication to regulate her heart rate
27:07thank you bye bye
27:18kathleen had a fall at home and banged her head she's in cubicle one waiting for a ct scan
27:26can you come home yet sorry i said can you come home yet i've seen the doctor yet you've seen
27:32the doctor
27:33yeah her daughter tracy has arrived has my lump gone down no no well i don't know how big it
27:40was
27:41before well it was as big as a golf ball the second well not quite as big as a golf
27:46ball now
27:47maybe grandson thomas might know hi thomas who have you been fighting with now
27:53um well it went tight so i can tell you that it was bloody milk i went flat on my
28:03face
28:04do we need to uh start bringing your milk for you or something maybe if the milkman delivers to
28:10our house and we take it down don't call any thousand on your way back and have a biscuit
28:15a jacket potato with cheese it's not a restaurant it is waiting on mars about
28:33so badging is still not working we've not we've not sent one badge to patient yet
28:38just stop badging there's been a few teething problems um so the badging hasn't worked as yet
28:46they're just trying to work with it now but the system is up and running we've gone live
28:52just with a few elements of it not fully switched on yet so hopefully that shouldn't be too long
28:58so far not too bad we're about 70 percent there so well how will that work then if we're not
29:05bad
29:05you now do you know who's where sister jane wants to go back to basics there's a phone there can
29:13you not
29:13have that phone oh so we're going to give you this phone so that the coordinator can bring it to
29:207 117
29:217 117 yeah oh i need a drink and i don't drink i've got a drink
29:38in recess baby noah is being treated for a serious infection which has left him struggling to breathe
29:45his temperature's cooled down a lot he's more like more alert and uh seems more like his normal self to
29:51fair having finally shown signs of improvement noah is moved from recess to the increased observation
29:59cubicle he's chewing on his fingers yeah he's working more like himself thankfully thanks to barnsley
30:14the treatments have worked he's breathing to settle down is a lot better there'll be a period of
30:19observation so that when the medicines we give him wear off we just check that he doesn't go back
30:23to being as poorly as he was when he came in and depending on whether his symptoms recur or whether
30:28he remains stable he'll be off home just got to stay another night do some observations and just keep
30:34it and see how he is and i'll have to be back home tomorrow very stressful yeah good especially with
30:41everything that has been from so far you want to do a last set of numbers okay and then they're
30:45going to
30:46transfer you up to the children's ward yeah it's fine that's going to fall back into normal limits now
30:53that's good to hear so we think noah had croup which is a virus um me and you get croup
31:00and because
31:01our air was a bit bigger a little bit of swelling we wouldn't even notice it no we've been so
31:06small
31:06and being a history of prematurity that's probably why he needed to come in swaney and get some drugs to
31:11help him
31:15noah spent the night in the children's ward and has now made a full recovery
31:29and will it show it without them allocating the porter or have you got to allocate the porter for
31:34it to show up the porters are still not all connected to the new real-time tracking system
31:44so at the minute it's going a bit chaotic we're having a few issues but summoners are on summoners
31:49or not
31:51i'm absolutely rubbish on things like this technical evader mind crash when it's hard to get it up too
31:56you're like you know you're my age
32:00so is there any things here for dinosaurs like
32:06it's making me a bit hard and a bit stressful but at minute i'm keeping my stress levels down
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 okay makes you feel
32:35a bit
32:35woozy bit relaxed helps with the pain okay dr sowden has been called from recess to have a look at
32:45janet's
32:45x-ray hello i'm heather nice to meet you i'm one of the other doctors i'm not looking forward to
32:53this
32:53why not i can move my fingers where i was struggling to move them all right they're going
32:59better starting to go numb good and your wrist if you did that is it any better i can't really
33:05do
33:05that no is it less painful than it was before no it still hurts okay and i'm not usually a
33:11baby but
33:11it still hurts oh yeah okay fine oh you're definitely allowed to be upset yes all right you've done a
33:18good job that bit's pointing the wrong way i didn't think it looked that bad actually i mean it's still
33:25attached i'm not a doctor it's still attached it could be worse
33:31dr sowden and emergency nurse practitioner claire are going to attempt to manipulate janet's wrist
33:37back 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 so that
33:53it doesn't tense the
33:55bones up yeah all right you're dreaming of your gin and tonic yeah okay
34:04so you're starting off with someone who is in pain because something is broken and all the tissues
34:10around the break will be swollen and every time that break moves it's gonna hurt breathing in and out for
34:18me
34:22you're all right
34:23you're all right
34:23i'm hoping
34:31now that janet's wrist has been repositioned a cast is fitted quickly to hold the bones in place
34:55so that's the pot for now we're gonna see what it looks like now on another x-ray
35:01right but it's very unstable while 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 i've only fixed milking i went to try and shut down and i just
35:27went
35:28still have to stop drinking
35:31i could do but i don't drink i'm allergic to alcohol
35:34oh bless you i'm going to yoke today
35:39can you change it to another day it'll have to do wednesday i don't think they'll let me go this
35:44afternoon oh no they'll not let you go so 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 and i'm going to betty's
35:59betty's what's that it's it's a restaurant
36:02yeah i don't wanna you'll have to do it another day when you're feeling a bit better yeah i feel
36:07all right you might get it for free if you're showing me bruise might take pity on you
36:12you might get your d and cake for now lass
36:18the ct scan will show if kathleen has a bleed on the brain
36:25so i'll have to sit on hold on all right and i'll get you when you're done
36:45sister jane and her team are nine hours into their shift
36:49there isn't a consultancy well they're all in handover 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 and then you would click that
37:04button
37:05so if you click on clinical operations it's very futuristic the porter is automatically dispatched
37:13to come and collect them
37:18so if you want to see if you want to see if she's had a bleed on her brain following
37:35her fall
37:37consultant dr dave walker is reviewing the results
37:42ct head's fine um she's got a large swelling big bruise big hematoma on her forehead which is this
37:48lump here in front of her head um but otherwise her brain's fine so
37:56healthcare assistant emma is taking over kathleen's care
38:02walk this way this may all right to take some bloods off you and some more have you had you've
38:08not
38:08had any done here though have you no if you'd have said i could have brought some up a kitchen
38:12floor
38:15you've made a bit of a mess of that eye haven't you yeah it looks like it oh love
38:20you live on your own yeah oh have you got a button or out press oh what do i want
38:26one of them for
38:27case this happens
38:42it's time for dr walker to examine kathleen's wound it's not gonna be right comfy i'm afraid
38:50daughter tracy is by her side kathleen yes i'm all right
38:57she might be but the rest of us so you just keep saying that until somebody lets you go is
39:02that the
39:02plan yeah you do think about your you know your elderly relatives when you're treating a patient
39:08of this age i mean i think i was always told to subscribe to the sort of grandma rule and
39:12say
39:12you know how would you treat your grandma and that's how you should treat your patients so i'll just peel
39:16that off we'll try not to take the skin with you sorry so this should be wet i'm told oh
39:26god
39:35dr walker is going to stitch up kathleen's wounds
39:41first he needs to apply an anesthetic
39:46i've had injections in me other eye but they'd numb it well when you've had injections actually into
39:52your eyeball well in me i don't know i can't see what they're doing no oh right
40:02they once asked me do you know i says i don't know i'm really asleep
40:18i'm gonna sting a wee bit as it goes in
40:24you okay yeah you can blink it's just yeah that's where it's good to sit around the eye is difficult
40:31the lid uh is really tricky to get right and if you get that wrong obviously if you can't close
40:37your
40:37eye that will damage your eye pull that together there it's like a little jigsaw puzzle
40:49okay is that it well yeah i'm doing done one you might need three we'll we shall see
40:58it well with a lot of older patients their skin is quite fragile and quite tears quite easily so
41:04you have to be really gentle with elderly skin
41:09be very gentle are they dissolving one yes they are i thought i were only having one yeah
41:19it needed more it's just the very top of your lid just above your lid so just close your eye
41:26i don't know what boxes feel like now
41:33right you're i'm afraid you're still a bit all bruised but the skin's back together
41:37so yes it's this bit that was the main concern below our eye
41:45i thought it were only every one stitch about five it looks a lot better
42:03it's been a long day for kathleen but she's now ready to go home home sweet home
42:12the jacket potato was waiting for her and 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 barnesley casualty after she badly broke her wrist
42:33hello i'm back again another x-ray please you forgot to wish me happy birthday though
42:39is it your birthday i've had to cancel all my birthday plans to come here
42:45an x-ray will show if the team have managed to successfully manipulate it back into position
42:54party plans have cancelled now
43:01emergency nurse practitioner claire can see the x-ray immediately
43:05right then honey okay so this was the before picture yes so you can see this big chunk fragment
43:13there on this is the ap view and that's how it is now so it's in a lot better position
43:20yourself and other yeah however it's still really unstable
43:28janet came back to barnesley hospital for surgery on her wrist and has now made a full recovery
43:44the team's first shift using the new patient and porter tracking system is coming to a close
43:51it's gone okay really i suppose apparently badging is now live let's go and give it a go
43:57then let's talk about portering is now operational so we're using the new system for portering it's
44:04okay it's okay it time will tell
44:09as the shift ends see you later lovely sister jane and the team head home but the doors to barnesley
44:16casualty remain open 24 7.
44:30so
44:39so
44:40so
44:45so
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