- 12 hours ago
Ambulance - Season 16 - Episode 04: Down the Ditch
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00:00New Incident, Category 1.
00:02Put you on an RTC, two cars head on.
00:07This lady has been on the floor since 5am.
00:10It's a two-year-old who's been stabbed over.
00:14Every day across Yorkshire, more than 3,000 people call 999.
00:19He's just not breathing.
00:20He's pregnant.
00:22Right, he's pregnant.
00:23He's trying to pull petrol over gases.
00:25The ambulance service must decide who gets help.
00:30We're going to look after you, mate.
00:31We've got you.
00:33Can I get you covered up? Lovely, jubbly.
00:35And who must wait?
00:3734 jobs waiting for an ambulance now in Leeds alone.
00:40As the pressure on the NHS refuses to relent...
00:44We're creating the waiting room for a waiting room.
00:47..the paramedics on the ground navigate England's largest county.
00:51Welcome to our office.
00:53All right, kid, well done.
00:55From the busiest cities...
00:56Chaos tonight.
00:58We'll need to get out of Leeds now.
01:00..to the remotest villages.
01:02We're in the forest, in the middle of nowhere.
01:04..where each call is a crisis.
01:07Got a five-year-old found wandering in the street.
01:10Naked, malnourished.
01:11God, it breaks your heart.
01:12It's awful.
01:13..and every decision critical.
01:15Hello!
01:16Where are we going?
01:16You're all right.
01:17Please, let the kids out of here.
01:19Where are they going to land in the middle of Bratford?
01:22We go beyond the flashing blue lights...
01:25Oh, well, well, well!
01:26..to reveal the human stories behind every siren.
01:30You're still waiting for me to do it.
01:31Absolutely.
01:32Thank you for coming.
01:34You don't have to thank us.
01:35You do.
01:36You've got manners, you do.
01:38Are we all ready to set sail?
01:40Get her going!
01:41Get her going!
01:42Ha, ha, ha, ha!
01:52Fondular service, is the patient breathing?
01:55Yes, they are.
01:57It's a two-car crash.
01:59It looks like one of them's unconscious in the car.
02:02One's unconscious?
02:03The car's almost on its side.
02:06It's struggling to get one of the guys out.
02:12Hi, Matt.
02:12You've got a two-car RTC reports
02:15of one patient being unconscious.
02:18Roger, that's great.
02:19Thanks very much, Trevor.
02:21Matt is one of six critical care paramedics
02:24covering Yorkshire this morning.
02:26His specialist skills mean he is able to give advanced care
02:29to the most seriously ill and injured patients.
02:34Hello, please.
02:36Hello, we need your assistant.
02:38It's an RTC, one vehicle.
02:42The driver's twerved and hit a dry stone wall.
02:46He's now trapped in the vehicle.
02:49Two RTCs in the space of two minutes.
02:52Who would have guessed it?
02:53In dispatch, Becky and Helen are responsible
02:56for coordinating 30 ambulances across Halifax and Bradford.
03:01Good morning, 1692.
03:03Can we get you keyed on relatively quickly?
03:05Because I've got an RTC that I need a crew for quite urgently?
03:10The vehicle is on its side.
03:13We have the patient wedged against the roof by his seat.
03:18Fire amputee through, so I'm worried.
03:221692, Chris and Canada are dispatched to a second RTC,
03:26four miles from Halifax Ambulance Station.
03:31Watch out, pigeon!
03:32Ah!
03:33I thought we were going to kill a pigeon, then.
03:35We nearly had a pigeon RTC.
03:43Tom, there's another RTC.
03:45Tom, there's another RTC 4453, free car going up banking into trees.
03:49Oh!
03:49The 1671 have got there, ready to sign on.
03:52Get them on, we've got another one.
03:56In the last eight minutes, the service has received three calls for road traffic collisions.
04:02Four ambulances, three incident commanders and two critical care paramedics have been dispatched,
04:08depleting available critical care resources by almost half.
04:16An ambulance crew have arrived at the first RTC in Doncaster.
04:20On scene, Matt will be responsible for providing enhanced treatment and pain relief to injured patients,
04:27as well as leading the team on the ground.
04:30So, I think he's just doing a set of abs on that one there.
04:32They was in that car.
04:33He's not lost consciousness with us.
04:35OK.
04:36But obviously, he's trapped.
04:37He's got C-spine tenderness.
04:39OK, so he's got C-spine tenderness where he is.
04:42Has he been unconscious at any point?
04:44They said he has, yeah, but only for a few seconds.
04:47OK, no worries.
04:48So, he's really our only clinical priority at this point.
04:51Fire service are here, good.
04:53Morning, guys, you all right?
04:54So, our only clinical concern is the driver of this guy here who has some neck pain.
04:58So, what we're going to do is get a collar on him.
05:00Danny will stay down there looking after him for now,
05:02but once we're in position to safely get him out under his own steam,
05:06that'll be the plan.
05:07Is that all right?
05:13Are we able to spring that door back further
05:16so you can get people either side of him to help him come up and out?
05:21Come up to us.
05:23Yeah, no problem.
05:24Come up to me, kid.
05:25Come on.
05:26Nice one.
05:27You've done really well there, Neil.
05:29All right.
05:29My head's going to explode.
05:30I know.
05:30We're going to come have a seat with you,
05:31and I'm going to sort you out of some pain relief soon, mate.
05:33My head's going to explode.
05:34I know, pal.
05:34Honestly, my head's going to explode.
05:36Oh, my head.
05:37Okay.
05:38Okay, we're going to stay set up.
05:40Can we get a scoop out, please?
05:41Oh, my head.
05:42I know, I'm going to keep you set up,
05:43and we're going to sort your head, okay?
05:44Whereabouts in your head is it hurting?
05:46Front, back, middle.
05:46Back.
05:47All right.
05:48I am just going to go get my drugs,
05:52because I think some ketamine might be indicated here.
05:54Are you guys all right getting them inside?
06:0454 miles away in Halifax,
06:06Chris and Canada have arrived on scene
06:08at the second RTC,
06:10where the patient is trapped.
06:13What do we know?
06:14Are you still trapped?
06:15He's got to work.
06:16We're getting out now.
06:17Go on, Dave.
06:17Dave, yeah.
06:21All right, mate?
06:22It's just cutting.
06:22It's just a roof rack at the other side of the head.
06:25All right?
06:26Oh!
06:27Hello.
06:28I'm Chris.
06:28I'm a paramedic.
06:29I'm doing service.
06:30What caused you to crash this morning?
06:32Someone jumped over the wall from the right-hand side.
06:35Right.
06:35And me being a dick, and I swirved up left.
06:37Okay.
06:37I don't know whether I hit it.
06:39Have you lost consciousness at all?
06:41No.
06:42You've not.
06:42Have you got any pain, anyway?
06:43My neck's feeling sore.
06:45Okay.
06:45Before we can get to that,
06:47we need these guys to obviously remove this roof and everything, okay?
06:50So you just have to bear with?
06:51Yeah.
06:52All right, buddy.
07:00There's going to be a few bangs and pops, Davey.
07:03All right, but I'm with you, all right?
07:06You okay, mate?
07:07Yeah.
07:08All right.
07:08Where were you off, Davey, this morning?
07:11We found we picked up on this track about half a mile up.
07:14Right.
07:14What, are you going to let cattle out?
07:15I've only got a Highland bull calf.
07:18Yeah.
07:18A donkey, four foony-fony pigs.
07:21Yeah.
07:21We've got some chickens.
07:23Oh, nice.
07:23This is my little farm vehicle.
07:25All right, okay.
07:26We've tried to enjoy this.
07:2824-year-old, but I love it.
07:30Oh, loved it.
07:35Oh, is he asked about birthday?
07:37Well, I said to him, like, about something with that dog.
07:40Yeah, yeah.
07:41I've just said it.
07:42It'll be his car and his dog.
07:46On three, one, two, three.
07:50Well done, mate.
07:51Well done.
07:52You've been really well.
07:53One, two, three, move.
07:55That's it.
07:56Yeah.
07:58You're doing really well, mate.
08:03Good to meet you, love.
08:07It's a bump.
08:08I would clip you in.
08:20We're probably going to cut half of your clothes off
08:23to give you a full checkover.
08:24Don't cut my trousers.
08:25Don't cut your trousers.
08:26You might have to, dear.
08:27No.
08:28Look at her with the scissors.
08:29I'm ready.
08:30I'm ready to chop.
08:31You're just going to loosen your belt foot beginning with.
08:33Oh, that's me elbow.
08:35I know.
08:36Don't move it.
08:39Any pain where I'm touching, Dave?
08:40No.
08:42Just a little bit sore.
08:43Which...
08:44Ah!
08:45Where's that hurting, mate?
08:46The elbow.
08:46The elbow, is it?
08:48Oh, sorry, mate.
08:49I know it's going to be a little bit sore, but I'm just going to wipe this
08:51just so I can have a look at it.
08:52Jeez.
08:54I'm just going to put something over it, all right?
08:57No outdoor.
08:58There's no long balls.
08:59No pelvis.
09:00The only injuries that we've got is neck and right elbow at the moment.
09:03Yeah, okay.
09:04What's special about these trousers anyway, Dave?
09:07They're new.
09:08Oh!
09:09They're a bit mucky.
09:11I was pressure washing yesterday, but they are new.
09:13Are they expensive?
09:14About 50-odd quid.
09:20Are you trying to find a vein?
09:21Yeah.
09:22Oh, good luck with that one.
09:24Oh!
09:24I'm a Yorkshireman.
09:25I don't like giving out all my eyes, that's right.
09:28Do you like your trousers?
09:29Yeah.
09:31Do you want to have a quick look at him before we do it?
09:32Yes, please.
09:32That's all right.
09:32I'll give him his phone back as well so he can ring us.
09:34All right.
09:35Just take it off.
09:36Oh!
09:37Silly thing.
09:41So we're going to start hurting out.
09:44It's fine?
09:44Yeah, he's a bit frightened, he's shaking.
09:46He hit the windscreen.
09:48Oh, did he?
09:49And then me.
09:49Oh!
09:50Then he just sat and just was shaking.
09:53Is he all right?
09:54I'm going to ask Leah to have him.
09:55I'm going to let him out.
09:56Adam's going to go get his car so we can go to Lee's, innit?
09:59Yeah.
10:00All right.
10:00Lovely.
10:01Okay, we're going to come to Lee's.
10:02Dad, I'll see you there.
10:03Yeah, I'll see you in a bit.
10:05Okay.
10:06Right, do you want anything else from me?
10:10Just give us a shake when we're ten minutes, right?
10:11Yeah, we'll do.
10:18Happy, Chris?
10:19Yeah, happy, yeah.
10:27Dave will be taken to Lee's General Infirmary 30 minutes away, where he can be scanned and
10:33his injuries assessed.
10:42So what we need to do, Neil, we just need to get to your arms and your chest, all right?
10:45Are we okay to cut all these clothes off?
10:47Yeah, yeah.
10:47Good, man.
10:48I'm going to get a little needle in your arm and give you some medicine.
10:50Have you had morphine before, Chris?
10:52No.
10:53We'll get you some of that on.
10:56Hello, Northern General Reese.
10:57This is Matt, one of the crit care paramedics.
10:59So we've got a 55-year-old male involved in an RTC with head and neck pain scoring 9 out
11:04of 10, with both retrograde and anterograde amnesia.
11:08We're unable to lay him down because of significant pain in his head.
11:11So I'm as convinced as I can be.
11:12This gentleman has a neck injury and he also has potentially a head injury.
11:20Nice.
11:21Let's go, go on.
11:22Happy.
11:24Neil will be taken to the nearest major trauma centre in Sheffield, 31 miles away.
11:29I have no idea, Paul, what's going on.
11:32You've had a car accident this morning.
11:36Which way were I facing?
11:37You were facing up towards Stainforth, going back up towards Donny.
11:43That's totally opposite way to what I would have turned in to drive this morning.
11:48How?
11:49I don't know.
11:49I think you've had a collision with another car.
11:53How's the pain feeling now?
11:58About 8 or 9 down back in my neck.
11:59About an 8 or 9 down back in my neck.
12:01All right.
12:02I'm going to give you a little bit more pain killing.
12:06Why am I thinking I've gone to work and gone back out to do something?
12:10I don't know, kid.
12:12What does he do at work?
12:14Tractor driver, machine driver.
12:16One of those general people who make farms work?
12:19Yeah, yeah.
12:20Good man.
12:22Thank you all.
12:27Steady as we go.
12:28Good lad.
12:30That's brilliant there.
12:31Well done.
12:34See you later, guys.
12:39Hi, Matt.
12:40What's just a new vehicle from that RTC.
12:44Yeah, Roger that, mate.
12:46So this gentleman's been involved in a two-car RTC.
12:49The mechanism's unclear, but he appears to have spun his car and then ended up in a ditch after being
12:55hit by a second car.
12:57Thankfully, colleague had got down into the ditch before my arrival, so I didn't need to slide down a muddy
13:01bank.
13:02Fire service was superb at helping him get out of the car, but then just got very agitated with significant
13:08head and neck pain once we tried to lay him down and secure him on the scoop.
13:12So you, based on that, made the decision to come to the major trauma centre, whatever.
13:16Yeah, sounds like a complex job.
13:17It's been RTC's madness throughout Yorkshire this morning, if I'm honest.
13:23Thanks for attending, Matt, and return to base.
13:26Roger, we'll head back to Doncaster. Thanks, mate.
13:32Every time I put on my uniform, I'm genuinely proud of what I do.
13:37But when I'm not in uniform, I'm also a son and a dad and a brother and a husband and
13:44a bloke who likes a pint.
13:47And all of those things, that whole wealth of human experience, builds you as a clinician.
13:52I'm better at managing parents because I'm a parent myself.
13:56I'm better at managing older people because I've looked after my dad.
14:02What people really want when they're in a difficult place is a human.
14:12Ryan, have you seen this assault on 5638?
14:15Open call, open call.
14:17If any crews are around, please, for Cat 1 detail at Greengate.
14:21Or someone in a canal.
14:23I'm beginning to stack now.
14:26It's four hours into the shift.
14:28An ambulance is going to be responding as soon as we can.
14:31Let me know when they're with you, when they're inside.
14:33And Yorkshire Ambulance Service are currently receiving a new call every 23 seconds.
14:39What is going on, Helen?
14:41I don't know.
14:43Is there a patient breathing?
14:45No.
14:47Not breathing, not to the address of the emergency?
14:49No.
14:50No, the ladies don't say.
14:51What's happened?
14:52What's happened?
14:56Another cat won't come in here.
15:00In the last hour, the service has received over 160 new calls.
15:0567 patients are still waiting for an ambulance to be dispatched to them.
15:09The ambulance is with the patient breathing.
15:11She's off the roof and I think she broke both her ankles.
15:15Get out, Liz!
15:18She's one and a half years old, six and blue, and she's just constantly ready to go.
15:24She's closing her eyes like she's all popped out.
15:28Scooter.
15:29You want to walk on her back?
15:32The ambulance is on the way.
15:33Yeah, we've got ambulance to arrange as an emergency, OK.
15:381692.
15:38I've got your next job for you.
15:41It is a 62-year-old female.
15:43It states that she's come off an electric scooter.
15:47Now, my brain says it's probably a mobility scooter.
15:59Chris and Canada are eight minutes from the patient in Elland,
16:03a market town four miles south of Halifax.
16:07She is conscious and breathing and it is still active.
16:11They've just rung in for an ETA.
16:13The Category 2 patient has been waiting for 36 minutes,
16:17double the target response time.
16:24There she is.
16:36What's she called?
16:37Jane.
16:38All right, guys, I'm going off to have a firefighter.
16:41She's insulated on the floor, conscious breathing.
16:43She's come downhill.
16:44She's passed her by and they've lifted her up.
16:47Hello, sweetheart.
16:48Is it Jane?
16:49My name's Canada and this is Chris.
16:52I'm just going to do some checks on you, sweetheart,
16:54and then we'll get you up off the floor.
16:56Is that all right?
16:56I'd love to get up off.
16:57Have you fallen and hit your head all in this mud?
17:01Yes.
17:01It was like a soft landing.
17:03All right, Jane, nice to meet you.
17:05I'm sorry I'm making this way.
17:06Jane, can I just ask you a couple of questions?
17:08Have you got any pain?
17:10No more than normal.
17:12So there's nothing new?
17:13No.
17:14You've not lost consciousness?
17:15No.
17:16Can I have a quick feel of your neck?
17:17No.
17:18Any pain here?
17:20No.
17:21Anything around the back of your head?
17:23Should we wait for firefighters, eh?
17:26Eh!
17:27Sorry.
17:28What's wrong with us?
17:29Is Chris not good enough for you?
17:31Oh, no!
17:32No!
17:33I'll leave you then, shall I?
17:41Right, this is going to feel a little bit funny.
17:43All right, it's just a big air cushion
17:44and it's going to come up in stages.
17:47OK?
17:48So as we get you a little bit higher,
17:49we'll support you to sit up.
17:51OK?
17:52Right.
17:53Right, are we ready?
17:54I think we'll be best sitting up first
17:55and why she's just going to...
17:58That's it.
17:58As we go up, we'll go.
18:00Try not to push off of the cushion.
18:02You've got a little bruise on your eye.
18:05Is that from this fall, do you think?
18:06I didn't have one before.
18:08Possibly, then.
18:09It's comfortable enough for you.
18:10Can I have one of these from my house?
18:14Right.
18:14You just stay there, OK?
18:16Could you just all...
18:17Yeah, I've got to be there.
18:18Are you sure?
18:18Right, I'll grab stretcher.
18:29You're welcome.
18:29Let's drop this dressing gown
18:31and freeze some of them hands up.
18:32Yeah.
18:32Right, so on three.
18:34One, two, three.
18:36Brilliant.
18:36Right, get your bearings.
18:37Nice and steady.
18:38Nice and steady.
18:40Ready?
18:41One, two, three.
18:43There we go.
18:44Perfect.
18:45Look at that.
18:45Give you that glove so I don't...
18:46Hey, Jane, I'm out of here.
18:48I'm going to get my kids.
18:49Thank you so much.
18:50All right, guys.
18:51That's all right.
18:52No worries.
19:00Right, just a bit of a bump
19:01while we go up here, OK?
19:02Two bumps all right.
19:03Ready?
19:08There we go.
19:10Is Paul your partner?
19:11Is Paul your partner?
19:12Yes.
19:13Are you jumping on, Paul?
19:14Do you want to jump on?
19:15Is that all right?
19:16Of course it is.
19:17Not a problem.
19:17How are we looking?
19:18Just got a bit of a black eye, haven't you?
19:21You have.
19:23You want to see it?
19:24Have a look in this camera.
19:28You've got a bruised baby.
19:29You're joking.
19:33Yep.
19:33You've given it a good whack, haven't you?
19:36Bloody hell.
19:38It'll go down.
19:40Good bump on grass, I think.
19:42You've got mud in your hair as well.
19:44I thought you were out of dinner, Sarah.
19:46I feel guilty.
19:48Who were it up front?
19:49I tried to catch you, didn't I?
19:50Oh, did you, Heath?
19:51Put it on three wheels.
19:52Because your scooter just died, didn't it?
19:54So the scooter could be turned around.
19:56It was just rough.
19:58Go on.
19:59It must have been about 20, 25 miles an hour.
20:03Next time you'll have put your all-weather tyres on, I think,
20:06instead of your socks.
20:12Right, I'm just going to have a quick feel around your face.
20:15Any pain where I'm touching?
20:17Any pain in your jaw?
20:19No.
20:20Can you open it nice and wide?
20:22Close.
20:22Bite.
20:23Any pain?
20:25No.
20:26There's nothing around your neck?
20:28No.
20:29OK.
20:30Do you live on your own?
20:33No.
20:34With Paul?
20:35Yeah.
20:37My sister lives next door.
20:38That's even better then, isn't it?
20:40Yeah.
20:41She's on standby for you.
20:42She is.
20:43She does a lot for her.
20:45What's your thoughts of going to hospital today?
20:49Can I be honest?
20:50Yeah.
20:50I'd rather not go if I didn't have to.
20:53OK.
20:53But I've spent so much time in them places.
20:56You've got a little bruise to your eye.
20:59Other than that, everything else is OK.
21:01So ultimately, yeah, it's down to you what you'd like to do.
21:04Well, I think I could probably feel a lot more at ease and more comfortable if I could go home.
21:11We can't kidnap you, Jane.
21:13I'll get the scum around.
21:14OK.
21:15Are you all right there, Paul?
21:16Yeah.
21:17Are you sure?
21:18Yeah, he'll meet you at home.
21:26Where were you going today?
21:28Were you going to go anywhere interesting?
21:30I was supposed to go in to my mates.
21:33It was nice of that firefighter, wasn't it, for him?
21:36It's so lovely.
21:37Yes.
21:46Once we've got you sat on the sofa, I'll make you a brew if you want.
21:53This is a posh little station, this.
21:55Would you like me to just let your sister know next door?
21:58Oh, please.
21:59If you want, Mary.
21:59Wonderful.
22:00I'll just bob round then, all right?
22:01She makes a belting cup for our Canada.
22:04I bet she does.
22:05Yeah.
22:06It should be part of job description.
22:09You put a sweetener in.
22:11I put a beer in after.
22:12I've got a little sweet too.
22:14But at least I stay away from sugar.
22:17At least it's sweetener and not sugar.
22:19That's it.
22:20So that's sweeteners.
22:22Put that under there.
22:26Do you want anything else?
22:28No.
22:29No, you're sure.
22:30You'd be so good, thank you.
22:33Hello, that didn't last so long, did it?
22:36No.
22:37You'll throw your sin down again?
22:38Oh, dearie be.
22:39I know.
22:41I'm doing all right.
22:42Don't you?
22:43I'm all right.
22:46I would have thought that I'd have had a lot more, Mum.
22:49Are you lucky?
22:50And you're still probably running on a little bit of adrenaline.
22:53So once all that wears off and you've settled down in a little bit, you might actually think,
22:56do you know what?
22:57I'm sore.
22:58Or you might feel something that you don't feel at the moment.
23:01So you can ring us back at any point.
23:03It's been lovely to meet you.
23:04Yeah, OK.
23:05Take care, everybody.
23:06Take care.
23:07See you later, darling.
23:16Ambulance, sir.
23:17Have the patient breathing?
23:19Yes, it is.
23:20But I've just been sick and you've been coughing today, my uncle.
23:24OK, so reassuring that that helps being arranged?
23:27No problem.
23:31New incident, category two.
23:34It is a 91-year-old male complaining of breathing problems.
23:38He is coughing up phlegm.
23:40Over.
23:41Oh, bless him.
23:42Yeah, we'll see what we find when we get there.
23:44Thanks for that.
23:46Halifax crew 1671, Siobhan and Ellie, are seven miles away from their sixth patient of the shift.
23:5491, bless him.
23:56He's coughing up phlegm.
23:59Yeah.
24:00I feel like he might be a regular.
24:02You're clear left.
24:04I'm pretty, pretty certain this guy's a regular.
24:07He's in a hospital bed in his living room.
24:11He's a poorly man.
24:13In 110 yards, turn right.
24:23Hello.
24:24Hiya.
24:27Hello, Terry.
24:28Hello.
24:32Terry.
24:33Hello, my love.
24:34Did you know that we'd been called?
24:38Oh, we're from the ambulance service, Terry.
24:41I've met you before.
24:42I came last time and he'd fallen out of bed.
24:45Can I have a quick listen to your chest, Terry?
24:47Is that all right, my love?
24:55Does he have any end-of-life medication in place?
24:58These are the medication that he's brought.
25:00Does he have, like, a yellow folder with him?
25:02Oh.
25:03For the nurses?
25:04For the nurses.
25:05For the nurses.
25:06Let's have a look.
25:07Yeah.
25:10Tell her, thank you.
25:13Yeah, these pink forms.
25:15Yeah.
25:16Do you know where these are, these drugs?
25:20So it's the hyacinbutyl bromide.
25:24Yeah.
25:24That's okay.
25:25All right.
25:26All right.
25:28All right.
25:29All right.
25:43So his respect form says that he's not for Huddersfield Hospital,
25:46but he would go to Calderdale for reversible causes.
25:51Terry, if you had the option, would you rather stay at home?
25:55Yeah?
25:56Okay.
26:00We're going to speak with the nursing team
26:02and we'll see what we can do to make sure that you're nice and sick,
26:04because you've got to stay safe at home, don't you?
26:08Hey?
26:10A cup of tea?
26:12We can do that for you.
26:14How do you have your tea?
26:17Oh, it's the one on there.
26:18I'll pass it to you.
26:20You've got cake.
26:21Would you like some cake?
26:23No.
26:24Okay.
26:25Let us bring your tea to you.
26:29Let me help you.
26:40Nice, Miss, did it.
26:49Thank you for calling the Calderdale District nursing team.
26:56Hello, it's Siobhan from the ambulance service.
26:59So, Alan goes by Terry, so if I call him Terry, that's why.
27:04Alan has been having some fairly significant respiratory secretions.
27:10He's got a respect form in place that's wishing not to go to hospital, if possible.
27:15But are you happy for Terry to stay at home?
27:17I mean, I can't really make that decision, because I'm not a qualified nurse, I'm just here to take the
27:23calls.
27:24Go on.
27:24Can't do it, it'll start till seven.
27:26What time do you finish?
27:27Are you on duty all night?
27:29No, we finish around half past six.
27:32So...
27:33Oh, right.
27:34Right.
27:35It's fine.
27:36It is, yeah.
27:37I tell you what, I'm going to have a chat with one of our band sixes and see that they're
27:42happy with that.
27:44Sorry, Terry, we're still just figuring out a plan for you.
27:58The most valuable job that I go to is an end-of-life job.
28:05They require a level of care and calm and cup of tea-making.
28:13A hospital is not the place for everybody.
28:16Sometimes when we go to a patient who is dying, you have to be that patient's advocate,
28:23following somebody's wishes and keeping them comfortable and happy,
28:29no matter how difficult that is.
28:33Naomi, hello, it's Siobhan.
28:35We've had the conversation with Terry, he doesn't want to go to hospital.
28:38Well, no care button can be pressed to get help.
28:42There it is.
28:42Oh, yeah.
28:45Can you add one of these so we can check you can buzz for someone if you need anything?
28:52I'm happy with that.
28:53We're going to be quite aware and happy that he just needs to press his buzzer
28:56and we'll come straight back out.
28:57Yeah.
28:58I'm happy with that.
28:59Right.
29:00Super.
29:01Thanks so much for that, Naomi.
29:03No worries.
29:04Take care.
29:04Cheers, love.
29:05Bye.
29:06So, we're planning to leave you at home.
29:09Are you OK with that?
29:11Yeah.
29:11Terry, you know, if you were panicking and you were poorly, would you press that?
29:17No, really.
29:18How would you ring us then?
29:21He won't.
29:22Even when he's been on the floor before, he's not pressed the K-line pendant.
29:25You willingly choose not to press that pendant, don't you?
29:29You don't press it even if you need help.
29:32Why?
29:33No.
29:34You just do.
29:35Terry, the medication that we've given you today, that's for when you're dying, OK?
29:44And it may not be now and it might just be that you needed that little bit of medication
29:47to help you along a little bit with your breathing.
29:52But I just want you to know that if you feel rubbish, please call us.
29:58We'll more than happily come out and see you, Terry, and we can keep you nice and comfortable.
30:04Don't laugh at me.
30:05I'm being nice.
30:09Oh, Terry.
30:12Promise me, if you need us, press that button.
30:17All right, my love?
30:38So I've met Terry before.
30:42And the Terry that we went into, we're so different.
30:46But I don't think that there's no more that we...
30:48No.
30:49I was just going to say, I think we've done the right thing by him there.
30:51He didn't want to go to hospital.
30:53Yeah.
30:53And, you know, when someone's on palliative care, you know, is it the right thing to do
30:58to take him out of the nice, warm home, what they used to?
31:01Yeah.
31:02Oh, bless him.
31:07Hi, 1671.
31:08Thank you for running on that.
31:09I appreciate the fact that it's made you overrun a little bit.
31:12You know, they're all worth it, but sometimes they're extra worth it.
31:16And this sounds like one.
31:18So you two, enjoy your evening.
31:20And I will speak to you soon.
31:22Bye-bye.
31:24Cheers, Jake.
31:24Speak to you tomorrow.
31:27Let's go home now.
31:29Let's.
31:29Super.
31:43Morning, morning.
31:45Morning, Charlie.
31:46How's your night been?
31:47Nice and steady, to be fair.
31:48Oh, good stuff.
31:50It's the start of a new day shift for Yorkshire Ambulance Service.
31:54Morning, Emily.
31:55Morning, y'all.
31:56Morning.
31:59Back for another 12-hour shift are Halifax crew, Siobhan and Ellie.
32:05Morning, 1671.
32:07We're not looking too busy at the moment.
32:11Do you want to go and grab a quick cuppa?
32:15She's saying bold things.
32:17Yep, that sounds about right.
32:18We'll go grab a cuppa, thank you.
32:20It's going to be a mild morning.
32:23Oh, shush.
32:24She's jinxed it now.
32:25Shush, you.
32:25She's fully jinxed it.
32:27And Canada and Chris.
32:31Good morning, 1692.
32:33How are we this Sunday morning?
32:35We're OK on this dark, gloomy morning.
32:38I will hopefully not have anyone falling off any mobility scooters today for you.
32:43That's perfect.
32:48And the young service is the patient breathing?
32:51Yes.
32:52Yes.
32:52Is the patient awake?
32:54Er, no.
32:56OK, tell me, Jack, what's happened?
32:59She's on end-of-life care.
33:01We've come down this morning and she's following right off.
33:03But me and my husband are able to pick her up and put her back to me to bed.
33:08How long are you staying here?
33:09She's 96.
33:11OK.
33:1412.79.
33:16Yeah, 12.79.
33:17It's on.
33:17I've got a 96-year-old female, end-of-life patient who's fallen out of bed.
33:22She's currently conscious but some difficulty breathing.
33:25There is a crew that's seven minutes behind you of her.
33:29Roger that, mate.
33:29All we're safe.
33:34Heading up critical care again today is Matt.
33:37He's the closest specialist paramedic to the patient.
33:53Hello.
33:54My name's Matt.
33:55What's been happening?
33:57The munch is on end-of-life.
33:58OK.
33:59Have we got her end-of-life paperwork just for me to have a look at?
34:02Hello, sweetheart.
34:03What do we call her?
34:03Sylvia.
34:04Hello, Sylvia.
34:05So we come down.
34:06She's got herself wedged.
34:07So she's gently laid it at the floor.
34:11Yeah.
34:11But because of how she is, when you try to move her, she starts screaming because her legs
34:18hurt and everything hurts.
34:19Is that normal for her?
34:20Well, it is.
34:21It is in the last two days.
34:23OK.
34:24Clearly that form is quite clear.
34:26Yes.
34:27Are we happy that the right thing for us to do is just to get Sylvia back to bed and
34:30make
34:30her as comfortable as possible?
34:31Yes.
34:31Yes.
34:31Oh, no.
34:32All right, Sylvia, love, we're going to get you up off the floor as soon as we can, darling,
34:36OK?
34:36Yeah.
34:37Who's your mum?
34:38Yeah, it's my mum.
34:39Your mum.
34:39What we're going to do, I'm going to give your mum another dose of Oxycodone, just to get
34:44her some pain relief in before we get up off the floor.
34:46Is that OK?
34:47Yeah, it is, thank you.
34:51Hiya, guys.
34:52This is Sylvia.
34:54Sylvia is on end-of-life care, has fallen out of bed in the night.
34:59Family have done great jobs, as we often find with these things, to wedge her in with mattresses
35:03and Sylvia still somehow managed to negotiate her way around that.
35:06So she's on the floor down here, in quite a lot of pain whenever we're trying to move,
35:10so what I was going to do was just get her some Oxycodone, give that a couple of minutes
35:13to work, and then we'll get her up.
35:14I think it's going to be sore however we do it.
35:16Yeah, you'll see.
35:19Sylvia, darling, I'm going to give you an injection in your leg.
35:21I know, darling, I know.
35:23I'm going to give you an injection in your leg, and then we're going to get you up off
35:25the floor, darling, OK?
35:28A little sharp scratch in your leg, darling.
35:35Sylvia, love, we need to get you up off the floor, darling, OK?
35:38Ready?
35:39Up we go.
35:41There we go, darling.
35:43That's it, sweetheart.
35:44That's better, isn't it, love, eh?
35:46That's it, sweetheart.
35:50That's better, isn't it?
35:59Hello.
36:01Michael.
36:02It's over here.
36:04No, I don't, yes.
36:06Now she's back in bed.
36:07She's nice and subtle.
36:08Thank you, Michelle.
36:09It's all right, sir.
36:10Sorry.
36:10Is there anything else I can tell you, anything else we can do?
36:12No, no, no.
36:14Just keep it open at all.
36:15Absolutely.
36:16It's all right.
36:17It's awful.
36:24It's funny looking after your own parents, I mean, when they've looked after you for
36:27so long.
36:28Yeah.
36:28Yeah.
36:29But this is the idea.
36:36I'll tell you what, she's got her constitution.
36:39She's fighting.
36:41Fighting to the end.
36:42She is glad to say.
36:43Nothing as tough as little old ladies.
36:45Nothing as tough as little old ladies.
36:47I agree there.
36:48I really do.
36:48Having had a very similar experience with my own dad, we talk a lot about end-of-life
36:55care, but of course we can't predict when it's going to be, and it's a marathon, not
37:00a sprint.
37:00Yeah.
37:02And looking after yourselves, to be able to manage all of that is important.
37:07Are we okay, Sylvia, love?
37:12It's a massive privilege to be able to look after your parents when they need it the most.
37:17I would say the last two weeks of my dad's life were physically some of the most challenging
37:22I've ever had, but mentally were exhausting as well.
37:26Thank you very much.
37:27Is it Matt?
37:29Matt, yeah.
37:30Well, thank you.
37:31It's an absolute pleasure.
37:46The worst I think I've ever felt was coming downstairs in the night because he'd fallen out of bed
37:53and seeing my dad in a heap on the floor looking up at me just terrified.
38:06I think that's informed my practice about how can I work in such a way that it takes some of
38:12that burden off that family,
38:14even if it's just for a short period of time.
38:15How can I give them a little breather in this unremittingly challenging time?
38:27Yeah, Oslund desk, mate.
38:29You've got a nail in cardiac arrest.
38:31CPR in progress.
38:33And we've got a crew that's two minutes away,
38:35second crew 14,
38:36and you're showing four minutes behind them over.
38:40Roger.
38:40Thanks, mate.
38:58So, he was disconnecting something.
39:04What was he disconnecting?
39:07OK.
39:07They are travelling as quickly as they can.
39:12Demand on the service is increasing.
39:14In the last hour, the number of calls have doubled.
39:20Oh, we've got a few jobs coming in.
39:22I think this is the car before the storm.
39:23It's beginning to pick up.
39:24You can feel it.
39:27And then...
39:28It's the patient breathing.
39:29Yeah, it's me.
39:31I'm just laying back.
39:32Tell me exactly what's happened.
39:35I'm a label of...
39:37..my contractions are acting for its bar.
39:40I'm a real contractions.
39:43We heard a screamer and we've all just looked over a wall
39:46and there's literally an eight-foot wall blown over with the wind
39:49and landed on somebody who walked underneath it.
39:51Is the screwdriver still in his eye?
39:54Someone get police, please, if they're free.
40:001671.
40:01I have a further job for you.
40:03It is a tattoo for a 70-year-old female in Ellen.
40:08Siobhan and Ellie are the closest available resource to the patient.
40:13She has COPD.
40:16There's lower crackles on her lungs.
40:18Sats are dropping to 85.
40:20We'll go see what we can do for her.
40:23Lovely. Thank you.
40:43Hello, is it Sheila?
40:45Hello.
40:48So, tell us what's been happening a little bit, if you don't mind.
40:51I've just been a bit light-headed.
40:54Your sister says me mouth and me tongue will bloom.
40:58So, it came down, Sheila.
41:00Have you rang 111?
41:02My daughter must have.
41:04So, it said something about lower crackles.
41:06What's your daughter? Is she nurse?
41:08Oh, so frankly.
41:10What else feels not normal to you, Sheila?
41:14My mouth talking.
41:17In what sense?
41:19I don't talk right.
41:21So, how long have you felt like your mouth doesn't feel normal?
41:25Hello.
41:26Hello, hello. Is it Deborah?
41:28It is, yeah.
41:28Hiya, Deborah.
41:28Hiya.
41:29Siobhan, this is Ellie.
41:30Debbie, have you seen your mum today, then?
41:32Yeah, I came down early.
41:33She was trying to roll herself a cigarette,
41:35but we're talking about 20 minutes to do.
41:38So, how have you felt over the last couple of dates?
41:42Tired.
41:42Yeah?
41:43Yeah.
41:44Headachy?
41:46Yes, I've been waking up with headaches.
41:48Any family history of strokes?
41:50Her dad.
41:51Her dad.
41:53Okey-dokey.
41:58Right.
41:59Give my hands a big squeeze.
42:02Nice and strong.
42:04Brilliant.
42:05Then I want you to push my hand away with your leg.
42:08Brilliant.
42:12Great.
42:12Ugh.
42:14I think it's probably worth taking you down to hospital.
42:17Let's rule out that there's maybe not been potentially a mini-stroke.
42:24I'm less worried about the crackles at the bases of your lungs.
42:28I'm less worried about your oxygen levels, which are dropped,
42:31whereas these things that you've told me about are slightly more significant.
42:37I know nobody wants to go to hospital, but sometimes I think it's for the best.
42:44Yes.
42:45I agree.
42:46Let's get your coat on.
42:49Will you feed me cats, please?
42:51Do you want to feed them before we go?
42:53If they're fed, they'll make a run for the door when it opens.
42:57If they're not fed, they'll stay here till they get there.
42:59Because they know it's tea time soon.
43:00Yeah.
43:01I see.
43:02They'll follow me.
43:03They know the system, don't they?
43:04Are you a bit Scottish?
43:07No.
43:08Oh.
43:09She just sounded like you had a Scottish accent.
43:11It's probably because my mouth's not belonging to me.
43:13Maybe.
43:14Maybe.
43:18So, were you a nurse, Sheila?
43:19Is Debbie following in your footsteps?
43:21No, no.
43:22I worked in mill.
43:24In mill?
43:24Yes.
43:25Right.
43:26Let's get you on to Calderdale and let's get you checked over.
43:29Would you like my arm?
43:33No.
43:34Go on, then.
43:35I think it's a good idea.
43:44Right, nice and steady up here for me.
43:47Do you want to take your jacket off before you get on to bed?
43:50Because it's like a massive duvet, is that?
43:52It is.
43:53It's lovely.
44:00Scutch a bit further over for me.
44:04There you go.
44:04That'll do.
44:05Super.
44:12We'll go in.
44:13Cheers, Jake.
44:15Sheila will be taken to Calderdale Royal Hospital three miles away,
44:19where she will be treated by stroke specialists.
44:22How long have you lived in that house, Sheila?
44:24Oh, about ten years, I think.
44:27Have you always been from Elland?
44:28Yes.
44:29Yeah.
44:30So, is that what you used to do then?
44:31You used to work in the mills?
44:33I did, yeah.
44:34Did you like it?
44:35I did.
44:37I loved it.
44:38How long ago has it been since you retired?
44:42I retired because of my arthritis at Fort Depp.
44:46Oh, crikey.
44:47How do you enjoy your retirement then?
44:50With my animals.
44:51Are you just cats and dogs?
44:54No, there's a tortoise running around the house.
44:57No, there wasn't.
44:59Oh, no, as if we left.
45:01Yeah.
45:02What's your tortoise called?
45:04Michelle.
45:06It's Michelle.
45:11Oh, do you pick it up?
45:13Oh, yeah, we sit and watch telly at night together.
45:16You still do it, do you?
45:17Yeah.
45:19That's lovely.
45:20I like that.
45:20Sit to me, love me, Jess.
45:21I can't watch telly.
45:26Right, feet on that one, and then we'll get you inside.
45:37How was that detail?
45:39Over.
45:40So, the findings of Sheila were different to what we were alerted to with regards to a COPD.
45:46So, she's been taken into Calderdale with a suspected mini-stroke.
45:51Oh, bless her.
45:52And probably quite a good job it was coded as a cat, too, over.
45:55Yeah, so, my dad had had a stroke just a week ago, which Ellie had gone to my dad for.
46:00So, I'm a little bit more aware of it and maybe, I don't know, a bit cautious around that one.
46:07So, I think that's probably more why we've come down that route just in case.
46:11I think that's very sensible.
46:13Are you okay, though?
46:14Over.
46:16Oh, yeah, I'm good.
46:18My dad's good.
46:18But, yeah, life experience adds to the job all the time, doesn't it?
46:23Brilliant.
46:23I'm glad to hear that you and your dad are both doing well.
46:27Oh, you're a superstar.
46:28Thank you so much.
46:29And we'll chat to you soon, I'm sure.
46:57You will see we've diverted you onto a Cat 1, 91-year-old male.
47:03It's coming through a short-of-breath breathing problems.
47:07No worries, that's absolutely fine.
47:09It doesn't look like we're too far away anyway.
47:12So, once we get there and get eyes on, we'll give you an update.
47:19Chris and Canada are four minutes away from the Category 1 patient in Halifax.
47:33It's three, twenty-five, right door.
47:41Hello.
47:42What do we call this gentleman?
47:43Alan.
47:44Hello, Alan.
47:44How are you feeling?
47:46I walked in and the way he was breathing sounds like he's got a load of stuff.
47:51Rattle it.
47:51He's stuck and it sounds like he's drowning in it.
47:53Oh, bless him.
47:55I think you guys did come out last night from what we've been told.
47:58What's his respect?
47:59Forms said to stay at home.
48:01I don't want admission to Huddersfield, but would accept Calderdale for a treatment for reversible causes.
48:07That's it.
48:08I'm back again.
48:09OK, do you want any help?
48:11No, we're all right.
48:12Super.
48:13So, he will travel to Halifax?
48:15He will travel to Halifax.
48:17Do you want to have a look at him?
48:18Yeah.
48:20Are you guys happy if I sit this up?
48:22Yeah.
48:24Bend his knees at the same time.
48:30I don't know if he's got right-sided facial droopy now.
48:37How many times have you seen Alan?
48:39I have met him before.
48:41Right, so you know what he normally looks like?
48:43Yeah.
48:43Will you just have a quick look at Alan's face for me?
48:46Would you say that's normal for him?
48:48It is a little bit, though, isn't it, now you say it?
48:51Do you know if he's had any previous strokes or TIAs or anything like that?
48:57He is on Cocky Dog Roll.
48:59In that one.
49:00And that one.
49:03Have you got any pain, Alan?
49:05Can you nod your head for me if you have?
49:07You have?
49:09No.
49:09Super.
49:10I think there'll be a trip in.
49:12And whether maybe he's had something go on neurologically or chest, that would be Calderdale.
49:19And he is happy to travel to Calderdale for reversible causes.
49:23Yeah.
49:23Is that all right?
49:24You happy with that?
49:26Yeah.
49:30You're off on your jollies, Alan.
49:31We're taking you up to hospital.
49:43Do you have a bag that we can just put maybe some clean pyjamas in?
49:54Could you just hold that chair for me so it doesn't slip out?
50:00Let's get you in it that way.
50:07You're OK, sweetheart.
50:10We'll go get you checked out.
50:17Alan will be urgently assessed for a suspected stroke at Calderdale Royal Hospital.
50:37There is a window for strokes for the treatment and the thrombolysis, so it's important that
50:41we got him there as fast as we could.
50:45Hopefully he'll get the right treatment at hospital and he'll be home in no time.
50:50It would have been nice to keep him at home.
50:52His respect for him was all about trying to keep him at home, keep him comfortable.
51:0346 miles away in Doncaster, a crew have requested critical care backup for an end-of-life patient
51:10in severe pain.
51:18She has had a left-sided hip dislocation.
51:22It is swollen out here.
51:25The GP has given her a new respect for home, which clearly says no hospital admission.
51:30It's all right.
51:31It's OK.
51:32I don't want to take the hospital.
51:33Now, but I do think at this moment in time, it is our only sort of option.
51:41I suppose it's difficult to gauge, isn't it?
51:44It's a rock and a hard place.
51:45You know her better than us.
51:47What do you want to happen today?
51:49You want her to be pain-free?
51:51OK.
51:52So I think what we'll start with, we're going to give her an injection of morphine into her arm.
51:55If that settles her, we'll think then about what we're going to do.
52:00Yeah.
52:04I'm actually happier with the plan of, we give this, and the working plan is, if it wears
52:10off, we come back again and give some more.
52:12Of course, if this doesn't work, we then have no other option but to take her through to
52:15a hospital.
52:16At least you try in.
52:16But I think if we can do that and leave her here, I think it's a better experience for
52:21Rita.
52:21Definitely.
52:27And I'd rather us come out again, do another quick dose of morphine with everything in
52:32place that we'll put in place for her, than I think her being down in the hospital.
52:36Is that OK?
52:37Yeah.
52:37That sounds right.
52:38Yeah.
52:38OK, Rita, look.
52:41Relax back.
52:42I think it is.
52:43There we go.
52:43You've got to get it right, haven't we?
52:45There we go, darling.
52:46It's all right.
52:46Look at that.
52:47You have a cuddle with Matt?
52:48Hey.
52:50You just wanted a cuddle, aren't you?
52:52It's all right, darling.
52:53Can you have a cuddle with me?
52:54Oh.
52:55I know.
52:58My experience with my dad really does underline that when the patient isn't just their pain
53:03or their symptoms.
53:06The patient is a whole person who has lived a full and interesting life.
53:20You have to understand the patient's wishes, the family's wishes.
53:25And very often when you get to that point of saying, if this was my mum or my dad, this
53:30is what I'd do, you see the relief on the family's face that a decision has been reached
53:36that they can be at peace with.
53:40OK, the sheet's soaking as well.
53:42I think we're going to have to have a brief transfer onto trolley just to get a bed changed
53:47and get her back into a clean, dry bed.
53:49What do you like, eh, trouble?
53:53Right, my darling.
54:01Everyone happy?
54:02Ready, steady and move.
54:04Look at that.
54:04That's a good move, guys.
54:06Well done.
54:11Right, my darling.
54:13So I want to try and get her back into bed as she is, because I think she'll be a
54:16lot
54:16more comfortable if she's not propping herself up.
54:20Ready, steady and move.
54:22There we go, darling.
54:25We no longer need big lights on so they can come off.
54:33How long's Rita lived here?
54:35Since September.
54:37Was she at home before then?
54:38Yeah.
54:39Well, you've done well there.
54:41Was she having some problems with kind of memory loss and stuff before she came in?
54:45Yeah, I think we were masking it a lot as a company because of you.
54:49Well, you do your best, don't you, brother?
54:50There comes a point where you can't do any more.
54:52No, no.
54:54But then a week after she came and he said,
54:57her brother collapsed and died on it lately.
55:01Blimey.
55:02That's...
55:02It's been our time for you, hasn't it?
55:05Oh.
55:07Oh, sorry.
55:08It's OK, don't worry.
55:10It's been a really tough time for you.
55:12It's been a really tough time for you.
55:15Well, she doesn't know because she doesn't know.
55:17Well, of course.
55:18It makes it hard, I don't know.
55:26I think as we are now, I'm happy now she's asleep.
55:31That she can stay at home.
55:32Are you comfortable with that?
55:35I've written some notes.
55:36I'll have a chat with the care staff.
55:38Basically, the instruction is, if anything changes, call 999.
55:42Is there anything else we can do for you while we are?
55:44No.
55:45All right, you take care, guys.
55:47No problem.
55:48You take care.
55:48Thank you, guys.
56:06My feelings very strongly that culturally we don't talk enough around death.
56:10It's the one thing you can guarantee.
56:13Hopefully, it comes to us after a long and happy life.
56:16That doesn't make it easy.
56:18It's never easy.
56:19Honey, it's been a long time coming.
56:28We're home.
56:30Home, James.
56:32And then it's done now.
56:36There is such a thing as a good death.
56:38For me, a good death is pain-free, in a place of your choosing, surrounded by your loved ones.
56:47Our job is doing the best we can to help with that.
56:50And then I looked up at the sun, and I could see...
56:54Careful.
56:55Careful.
56:57I just wanted to say, I think you most definitely have made a difference today without a shadow of a
57:02doubt.
57:03You're welcome.
57:04Beautiful, girl.
57:04You're welcome.
57:06Ultimately, if we can't save a life, how do we allow that patient to die with maximum dignity, in the
57:13most peaceful possible way, that's in line with their wishes?
57:20Can you hear my heart beating?
57:25Oh, do you hear that sound?
57:34Yes, I can't help crying, and I won't look down.
58:01Details of organisations offering information and support with end-of-life care, elderly care or stroke are available on the
58:08Action Line pages of the BBC website.
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