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Casualty 24 7 Every Second Counts S10E07
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00:02in the heart of Yorkshire an unbeatable team busy busy busy hard at work open
00:12your eyes for me do you know where you are you're in Barnsley A&E department 24
00:20hours a day seven days a week nearly feel like a wet dish club saving lives looks
00:31like you have broken it I don't think I'm going to love I'm dreaming of your gin and tonic helping
00:40loved ones love you I'm trying there's nothing to be frightened of these girls will sort her out a
00:49health service treating anyone and everyone working more like himself thanks to Barnsley a team doing
00:58anything and everything for each other you know I just love to look I love to make a difference
01:07this is Barnsley casualty 24-7 has to not be entering the beauty contest
01:15on shift tonight Dr George Beattie the bone could be going through the skin yeah and if that's the
01:22case we need to give you antibiotics yeah that's fine resident Dr Katie Quirk even sat at this angle
01:30do you feel like you're gasping a little bit for breath because I can notice the change from when
01:33you sat in the chair and sisters Vicky what do you think my job is to look after you yeah
01:41that's
01:42right and Jay it'll be quicker cubicle eight thanks honey so get ready to share a shift
01:51but it's dead it slide oh there we go with the team at Barnsley casualty
02:11morning morning lovely it's so lovely to have you back the day shift has just started morning darling are you
02:21all right I am love thank you
02:26hi it's Jane sister Jane is running the hub yes not bad Tom yourself good and every bed in the
02:37hospital is taken
02:41there's just no beds there's never any beds there's 13 patients waiting for beds that have been here 13
02:48hours it's not good is it it's flu season and sister Jane needs to keep her team protected so
02:57Jess has just rung up to say that the flu people are on the way around for injections and we've
03:04got
03:04to encourage as many people to go and get them people come in with infections all the time and
03:09everybody can pick up a cold so infection control nurses go round to all the hospitals offering the flu
03:16vaccination sister Jane is joined by sister Vicki yes who today is looking after ambulance arrivals we
03:28come on shift we have to make sure that we log on we see how many ambulances are inbound we
03:34go round
03:34and check what empty cubicles we've got what space we've got in resource just in case obviously we've got
03:41ambulances up back corridor and we've got no capacity in department and no capacity to move off then
03:45unfortunately there's nothing that we can do we just have to make sure that there's patients to say
03:49staff is safe as well
04:01sister Vicki's first emergency patient is on the way paramedics are bringing in care home manager
04:06Kirstie who's fallen over at a petrol station and landed badly on her arm that we've been tumbling
04:14don't wait I have been tumbling
04:23I think I've done both bones and it's potentially poking through the skin I believe
04:31I haven't seen it I don't want to look at it but I did break it in May this year
04:36as well so it's
04:37the same arm gone roughly in the same place have you fallen in town I actually fell in Hemsworth oh
04:49in Hemsworth but I live in Rotherham so I persuaded them to bring me here so you come to at
04:55best but I
04:57knew it as soon as I hit the floor it's very painful painful and so on paramedic Paul hands over
05:06to
05:06sister Vicki and the team you've got a split lip there you've got it you've got no seeds
05:10benefiting this and chest okay when you're taking a deep breath coughing all those things okay and
05:14anything to your left arm it's all this right arm is that all right all right forearm what are you
05:18allergic to tramadone it's a very strong pain to let's describe I'll put you for an x-ray and then
05:24we'll get you around to our recess area to get looked at okay she's in a lot of pain so
05:34what
05:35we're going to do she's around to x-ray first so we're going to give her a penthroxinella which
05:40is a good pain relief and then once we're moving from x-ray she'll go into resource and then we
05:44can
05:45give her some morphine and settle her a bit better so yeah it's quite painful but obviously we need this
05:49x-ray as soon as possible to find out what the damage is really so should we get you around
05:55for x-ray
05:56yeah I'll come with you but kirsty is not the only patient with a potentially broken arm
06:07it's just a dressing just to cover it in paediatrics is 15 year old leighton brought
06:13in by stepmom jody that flap were literally folded back grim so many some stitches definitely
06:34leighton injured his arm on his school break I just walked in the house and his dad phoned me and
06:40said
06:40can you go get leighton he thinks he's broke his arm I've caught my uh my arm in astrogate and
06:46it's
06:46ripped open all across there and I think I might have broken it too where astroturf is there's all
06:52metal gates surrounding it and he's smashed it in a gate have you broken for you all right have you
07:02got a drink or do you need one
07:03uh can i get one blood thank you yeah my bones cup sauce cup yeah i can't move it whatsoever
07:12and the bones popping out as well yeah it's bad
07:26i'm
07:26i'm telling you practitioners we all right come up with your hand then let's yeah so how do you do
07:31it
07:31i'm messing my mate and um i've trapped chasing him and he's he shut the gate but my arm got
07:38trapped in it
07:39right you should break the skin off emergency nurse practitioner tony will be in charge of leighton's care
07:46so apart from the court is anything else in your hands i feel like it could be broken
07:51i can't move it whatsoever if leighton is correct and his arm is broken he may need emergency surgery
08:00hands it take deep breaths later do you know what it means it will do love do you but i
08:04don't know
08:05what to do to help you i'm really sorry there's a big nasty open wound what we don't want is
08:11a
08:12an open wound with a fraction because then it becomes an open fracture and there's a a high risk of
08:17infection in the bone
08:29you
08:35right folks let's uh
08:39in the hub sister jane is struggling with a shortage of beds in the hospital
08:45from a nurse and healthcare point of view we are a little bit short from a bed point of view
08:51we are
08:51minus six on amu medicine have got three empty four definites with a further 20 potentials which we're
09:00going to need it'll be nice we've got quite a lot of patients in obviously we're going to start having
09:04issues but some of our bed issues in the fact that we've got patients to move around with many of
09:10the beds
09:10the hospital is occupied by flu patients the hospital is taking steps to protect the team
09:16i've been asked to ask everybody to go for the flu jabs
09:19um obviously it's personal choice but this is flu season so the flu ladies are in the seminar room for
09:28you to all go and get your flu jabs please we have emails come through every winter period about flu
09:36and
09:37covid vaccines that are offered within the nhs to nhs staff because we're quite a big department they
09:43like to come down and do a mop up and make sure that people who want them and can go
09:49and get them
09:49it is nice to think if you're coming into hospital that staff members are vaccinated against it but it
09:56is entirely up to the staff if they choose to in radiology 48 year old kirstie is having an x
10:14-ray
10:14you're doing really well we'll get around teresa then
10:29i know it's unstable because as soon as i try and moved or anything like that you can feel bones
10:35moving
10:40that's right dr george beattie takes over kirstie's care both those bones are broken in the middle of
10:47your forearm i have broke this arm before in may this year okay whereabouts did you break it exactly
10:53the same spot the same spot right so you're familiar with the orthopedic doctors yes kirstie broke
11:00one of the bones in her forearm a few months ago now that's significant because it's going to make
11:06it more difficult for the surgeons to repair a break through bone that was already broken
11:13um and it's going to leave her with a weak spot there have you got to manipulate it i think
11:20we
11:20should try to manipulate it yeah that's not a long-term fix no i know it's not but that's going
11:25to protect
11:25the blood vessels because there's a cut near the middle of your arm yeah the bone could be going
11:31through the skin yeah and if that's the case we need to give you antibiotics yeah that's fine so i
11:36need to have a quick peek under myself is that all right yeah it's got a little um scratch over
11:49a
11:49swelling in the middle of her arm if it has gone through to the bone then it's a sitting duck
11:56for
11:56a serious infection
12:09got some melon
12:13hey up joe it's only jane you've pulled that patient apparently they're going to make her an
12:18appointment in 48 hours because they want to see how she is in 48 hours there's a bed
12:24shortage in the hub and many patients have flu so sister jane and the team are taking preventative
12:31measures everyone's just gone for dinner so it's going to get your little job so if it was
12:35flu jab lease while sister vicky embraces a constant stream of ambulance arrivals
12:46i'm vicky nice to meet you i'm going to be taking hand over off these chaps okay
12:54she's fine i'm sure she is i'm working diet love so
13:11you're not allergic to anything janet are you i'm spring in the last class right are you already
13:18going to be doing that jess do you want a flu jab
13:29cheese a lemon melon yeah but i've opened it from one end so just let's
13:34refrain from opening every end shall we you can have the milk the honeydew if you want
13:39but i'll eat this and have that after
13:48in paediatrics leighton is heading for an x-ray to see if he has broken his arm
13:53do we know about eating and stuff okay has it got to wait hold off for now he's accompanied by
14:00stepmom jody
14:05did it bleed a lot yeah until they started it all dripping down me was it yeah it's really bad
14:13you know you're gonna have to have stitches don't you yeah i've never had them before
14:17well you'll not want them again when you've finished everything he's done
14:21i don't think they're numb you're either here really
14:24you're not going to get on
14:30play tune please
14:36are we all right just to slide your arm out of that sling yeah
14:41and then we just need your wrist flat on that door so as long as it's on it that's it
14:45perfect
14:48the team are trying to rule out an open fracture
14:56oh
14:56hold on
14:59leighton now heads back to paediatrics to wait for the results
15:05can't play on my xbox yeah oh leighton that's typical of kids in it oh god i hope it's not
15:14brought because i'll not be able to play on my xbox well what else you need to do well don't
15:17you use
15:18that hand how do you i don't know well he's both hands oh yeah you definitely can't play on
15:23you'll have to read books
15:30another patient to rise by ambulance 67 year old bridget is taken to high dependency cubicle one
15:37i didn't feel very well so i've got in the bath to calm down and then i got chest pain
15:44and i was
15:44panting so now i've come in for the test bridget's heart rate was monitored in the ambulance
15:50it went up to 167 apparently i didn't see it but that's what they said
15:56i've been to boundary hospital a lot for other things and i know that that they'll look after me
16:02nurse lillian has come to check on bridget
16:06you're going to be sick of that beeping
16:09right time you get out of here is that from the all of these things yeah it's because your heart
16:14rate's
16:14quite high so it's just obviously alerting us
16:22so we're going to do some goods on you and i've discussed with our consultant and i've put you
16:27as a triage too so you'll get seen a bit quicker and we can find out what's happening okay thanks
16:33very
16:35much healthcare assistant jess needs to take some bloods
16:44you need either a baby or a newborn needle because they have real problems getting blood out
16:52it's probably a smaller one what you've done to yourself do you have it you have it
17:00yeah everything yesterday
17:03i think you're mad healthcare assistant jess isn't having any look
17:10see what i mean i used to give blood around the whiteman
17:24She wants to try Bridget's thumb.
17:38The quicker health care assistant Jess can get a blood sample, the quicker Bridget's heart can be stabilised.
17:50SISTERS Jane and Vicky are four hours into their shift, as one tries to protect her staff from flu...
17:56Are you going for your flu jab, love?
17:59..the other evaluates new ambulance patients.
18:03Do you know where you are? In the seminar room where you have handover. Flu jabs, flu jabs.
18:10I've had mine yesterday. Flu jab.
18:12I've got to have my photograph taken. What's that got to do with your flu jabs?
18:22When he comes out, can you remind him that if he DTAs a patient on Careflow, he has to do
18:28it on teletracking.
18:31What do you think my job is?
18:33You look after me. To look after you, yeah, that's right.
18:38I've worked with Vicky now for ten years, plus, probably.
18:43She is one of my closest friends.
18:48Oh, you've just put me off now.
18:50We're holes apart from each other, personality-wise, but I do absolutely adore her, yeah.
18:59Are you at home, do you think, or are you in hospital?
19:03I'm at home.
19:04You're at home, OK.
19:07Hospital taxi.
19:09It's going to take him in a car 25 minutes, yeah?
19:12OK.
19:14Can you just do me a quick CT?
19:17I've got your CT head escort.
19:20It'll be quicker.
19:21Cubicle eight.
19:22Thanks, honey.
19:32Kirsty is in recess with her husband, Gary.
19:36Take this down and just have a quick...
19:45Sorry.
19:46No, you're OK.
19:47Sorry, sorry, sorry, sorry, sorry.
19:52Yeah, it's open.
19:53Eh?
19:54It's open.
19:56Yeah?
19:56It's the first open fracture I've ever had.
19:59Will you stop messing about with it?
20:00No, because I'm trying to get it in a more comfy position.
20:03What do you need?
20:04If I move it, I have to move it myself.
20:07Yeah, but if you pick it up and move it, I can...
20:09You can feel bones grating as I'm doing it.
20:13Oh, my love.
20:15What are you going to do with you?
20:22I'm going to give me ketamine and put it into a better position,
20:26pot it, and then potentially surgery.
20:30So, because at the moment, there's nothing connecting my forearm to my upper arm,
20:34because the bones are completely shattered.
20:42You can ask him for some cotton wool for your phone.
20:45What?
20:46You thought?
20:46Yeah, I don't know his fault.
20:48Oh, he's fault.
20:48He had his toe operated on last week.
20:52And we've been trying to get some cotton wool bandage just to protect stitches.
20:56And can you get it anywhere?
20:57There you go.
20:58Oh, brilliant.
20:59Do you want your toes on?
21:00There you go, love.
21:01Oh, thank you.
21:06Kirsty's got an open fracture of her forearm.
21:10What we're really trying to avoid is any damage to the nerves or blood vessels.
21:15So the best thing to do for Kirsty right now is to get her arm back into a straight position.
21:20And to do that, we're going to need to give her some sedation.
21:24And then I'm going to ask my orthopaedic colleagues to come and help us plaster it into the right position.
21:31So I'm George.
21:31I'll be doing the sedation.
21:33And I'm Kirsty, patient.
21:34You start feeling a little bit funny, then we'll give you a top up.
21:37Whoa.
21:39Yeah.
21:40Yeah.
21:41Oh, yes.
21:43Kirsty is given ketamine to keep her sedated throughout the procedure.
21:47Oh, wow.
21:50Feel as though I'm floating.
21:51Yeah.
21:52And when's your next holiday?
21:55Er...
21:59I haven't planned anything for next week.
22:02Kirsty is sufficiently sedated.
22:06Now the manipulation can begin.
22:09How are we doing?
22:10Take a little breath for us.
22:14There we go.
22:38It's really hard to see any patient shouting in pain.
22:43But she's not fully aware of what's going on.
22:46And it's emergency treatment.
22:49We need to get her arm back into a straight position.
22:52Otherwise, she could have permanent nerve or permanent blood vessel damage to her hand.
22:58And the consequence of that could be that she could not be able to use her hand any more.
23:02So we've got to get that arm straight.
23:25You're in rapid two this afternoon.
23:28Rapid two.
23:31You are ambulances.
23:35Sister Jane is halfway through a shift of battling high patient flu levels.
23:39I've got a patient still waiting for her bed from 10 to 6 this morning.
23:43So if I'm hot ready to move, she's in the queue.
23:46Is that all right?
23:4772 patients at midday.
23:49So it's not bad.
23:51It'll be over 100 again after lunch, I would imagine.
23:56I've got about a million screens open to enable me to just even manage the job.
24:03It's just hard going at the minute.
24:07Things are not running smoothly for Sister Vicky in the ambulance hub either.
24:12I think your doors are broken.
24:14My doors are broken.
24:15Yeah.
24:16Front doors.
24:17Front doors?
24:18Not opening properly.
24:20If the doors can't open for paramedics, patient flow is at a risk of becoming even slower.
24:28In play.
24:29Ambulance doors are not opening.
24:31Yeah, you know, main doors for ambulance doors.
24:35The team makes some calls to find an engineer who can get them working again.
24:41Fingers crossed.
24:43Fingers crossed.
24:43I'm not holding any hope out, but fingers crossed.
24:53In Rhesus, mother of two Kirstie is under sedation.
25:01Dr. Beattie is overseeing a manipulation of Kirstie's broken bones to stop them protruding
25:07through the skin and becoming infected.
25:15I know it sounds horrible when she makes those sounds, but she won't remember.
25:20She'll be in like a dream, a dream state.
25:25Kirstie's arm is secured in a cast.
25:29Just relax.
25:33What are you doing?
25:40All done.
25:40We've done it.
25:41And you've crossed with it.
25:42Yeah.
25:43Yeah.
25:45You're welcome.
25:47Did you feel the moving it?
25:49Yeah.
25:50No.
25:52Very good.
25:55She'll go for an x-ray just to make sure that the bones are all in the right place.
25:58And then from there, she'll be staying on the orthopaedic ward because she will need
26:01surgery for this just because of how unstable it is.
26:04The bones aren't going to knit together properly with just a cast.
26:13Speak to your daughter.
26:15Oh.
26:16Hello, daughter.
26:20Better now it's in a pot.
26:22Yeah, it's not flopping about.
26:24Because that's what it was doing.
26:25It weren't connected by anything.
26:27It was unstable.
26:29It looked like Harry Potter after fucking watching the call.
26:31Apparently it looked like Harry Potter after Chamber of Secrets, you know, when the repair
26:35is on.
26:35Yeah.
26:36Kirstie's arm was operated on the following day.
26:39She returned to work just four days later.
26:42I've got my boxing gloves at home.
26:44I'm ready for round two.
26:59Health care assistant Paul is making a cup of tea for a new patient in casualty.
27:05You're cheers the best.
27:07Definitely.
27:12I've got this nice pack of chocolate biscuits and a nice cup of tea for you.
27:15Yeah, they're gentlemen.
27:16If you need help, I'll pop it up in that department to let me know.
27:19All right.
27:20See you later.
27:21Father of two, Keith, has been in and out of hospital over the last few months.
27:26I've been bleeding.
27:27I mean, from my story, it all started with that.
27:30I had to have a transfusion, I'd lost that much blood.
27:33I've had two lots of iron, and the second lot, I haven't felt well at all.
27:42Resident Dr. Katie Quirk is going to try and get to the bottom of what's making Keith
27:47feel unwell.
27:48If you could just tell me why you've come to A&E today.
27:50Today, it's because of my breathing.
27:52It was shocking.
27:53Yeah.
27:54Terrible.
27:55When did you first notice that?
27:56This morning.
27:57I had to get up, because while I was laid down, I couldn't get my breath in.
28:02Right.
28:03Difficulty breathing.
28:04And this cough as well, has this come on as well?
28:06Mm-hmm.
28:08Is it better when you're sat up?
28:10Yes.
28:11I look better.
28:11What I have noticed yesterday, I was going to walk.
28:14I walk my dog every day.
28:16Yes.
28:17And I have to hold on to get up road.
28:19That's not me.
28:19So how far can you walk usually?
28:21Oh, I do an hour.
28:22An hour?
28:23And yesterday, it was?
28:25Top of the road.
28:26Top of the road.
28:26Wow.
28:27I didn't feel well.
28:28I'm a foundation doctor.
28:30So at the moment, I'm rotating around different specialties to kind of get a feel for different
28:34things and different types of patients.
28:37All right.
28:37So I think because of some of the symptoms you've come in with, obviously, I want to have a little
28:41listen to your lungs.
28:42I also just want to have a little listen to your heart as well.
28:45Right.
28:46And then just check your calves and things as well.
28:48Give you a bit of a once-over.
28:50Is it all right if you jump on the bed?
28:52Of course it is.
28:54You've got a bit of a tan.
28:55Have you been sat out in the sun?
28:56Yeah.
28:57Yeah.
28:57I like me gardening.
28:59I'm a bit jealous, really.
29:00We spend too much time inside here.
29:05Even sat at this angle, do you feel like you're gasping a little bit for breath?
29:08Yeah.
29:08Because I can notice a change from when you sat in the chair.
29:10Yeah.
29:11Weird, isn't it?
29:15And I'll just have a little look at these calves, if that's OK.
29:17They've been swollen.
29:19Have they?
29:19My ankles have, for some reason.
29:21Both of them?
29:22Both.
29:23When patients come in with shortness of breath, we look at different things that could be causing
29:28that.
29:28So it could be to do with the lungs themselves or the heart.
29:32One thing that could indicate it's the heart is that patients have excess fluid.
29:37What that means is the heart isn't pumping as it should and is causing heart failure.
29:44Dr Quirk wants Keith to have an X-ray on his chest.
29:47So I want to make sure that your heart's pumping enough, especially because it's worse when you're
29:51lying flat.
29:52Sometimes that's because, you know, you're not upright, you've not got gravity on your
29:56side to help with that heart pressure as well.
30:02Keith heads to radiology.
30:06But in the hub, things have not calmed down.
30:09I'll take the rope, but...
30:10Sorry, I ain't got anything.
30:13And the ambulance arrival doors are yet to be fixed.
30:17We've tried a lot of different codes on that door and it's not happening.
30:19What's the engineer said?
30:20Are they coming out?
30:22Ambulance doors don't open and the ambulances can't get in.
30:26And it's just something else we have to deal with during the day.
30:30It just becomes...
30:33..tiresome.
30:36Lisa has called for engineers and I've told her to put it as a priority task.
30:40We might need a receptionist stood there then because they're coming straight door.
30:44She's just a back pain.
30:46Why is she going on a trolley?
30:56We found out that pumpkin's good for it, you know, like a pumpkin resin.
31:01Well, I've got dash hounds, little dash hounds.
31:05Vicky's got a dog, a little sausage dog, a little dash hound.
31:10She was never having a dog when I first started working with her.
31:15She couldn't think of anything worse.
31:16That dog comes before everybody.
31:18Her husband's on the couch whenever the dog's around.
31:22She costs me a fortune sometimes.
31:24She's worth it, though.
31:34At least you get half a day out of school and a McDonald's.
31:39Layton has badly injured his arm at school.
31:41Emergency nurse practitioner Tony is reviewing the X-ray.
31:46All looks fine.
31:48His wound's roughly there, but there's nothing obviously broken.
31:53And we should be able to close out with sutures.
31:56All be well.
31:59This is going to be the worst part, stitching.
32:03I'll put you some local anaesthetic in anyway.
32:06I know, but...
32:07It's thought of it, innit?
32:09Yeah.
32:09Just ask for...
32:10I know, but it'll still look.
32:11It'll also feel something.
32:13No, you wouldn't do...
32:14Once it's injected with local, it'll be your head.
32:16You'll think about it in your head.
32:18It'll not actually hurt there.
32:20It'll just feel like it...
32:21You'll feel tugging.
32:23Yeah.
32:23That's all.
32:25Fine.
32:27Right.
32:28Do you want to come up this way, let's go to a different room?
32:30Layton needs to have his wound stitched.
32:37Do you want to pop up there for us?
32:39Yep.
32:40Oh, your mum's phoning.
32:42We're just in the room now, so he's literally, he's got to have it stitched, so the doctor's
32:49just about to inject him to numb it, and he's having it stitched, and then we'll be on his way,
32:55but it's not broke.
32:56Oh, gosh, it's good news it's not broke, though, eh?
32:59Yeah, it's a little better.
33:00Yeah.
33:01Yeah.
33:01Yeah.
33:01You'll be fine.
33:02Are you glittered that you're not going to have time off school?
33:06That's what I said, Layla.
33:08I said, oh, you could have done it to your right hand, at least you'd have made some time off
33:11school.
33:12They're just numbing it now for him, Layla.
33:15Thank you so much, Jodie, for getting there.
33:17Don't worry.
33:17Just couldn't get there.
33:18We're going to have McDonald's anyway, so he's got half day off school and a McDonald's after it.
33:23Ah, nice one.
33:24Is it all right?
33:25Yeah.
33:25All right, darling, well, listen, I hope that he's in a bit of pain, Layla, sorry.
33:32Yeah, they're injecting him as you're talking.
33:34Using local anaesthetic, it is painful to inject, and we do quite often say to him it's going to be
33:39a little bit of a sting,
33:40a little bit of a scratch, something like that, but it's...
33:43It's a tricky one because we wouldn't be able to do the procedure without the local anaesthetic,
33:48so it's a balance of try to use as little as we need to achieve local anaesthesia
33:53and make it numb enough for us to stitch it up.
33:57All right, all right, darling, well, just call me when you can, all right, I love you.
34:02We'll phone you when we're out, Layla.
34:04All right, darling, thank you.
34:05All right, love, bye, bye.
34:09Before the procedure, emergency nurse practitioner Tony
34:12checks if the anaesthetic has completely numbed the trauma site.
34:17Why don't you watch some TikToks on your phone or something like that?
34:23I was thinking to keep him a bit occupied.
34:26So, I'm going to start testing it, see how it feels.
34:29Can you feel that?
34:32I feel pressing.
34:34Does it feel painful?
34:35No.
34:36There?
34:37No.
34:38OK, and then just there?
34:40No.
34:41The anaesthetic has worked.
34:43Layton is now ready for his wound to be stitched.
34:52Bridget is in high-dependency cubicle one with an unstable heart rate.
34:58It's been a plant.
34:59Beeping.
35:00Yeah, you'd have to be in the same room as it all about.
35:03You'd be surprised how fine you can hear that beep.
35:06Health care assistant Jess has been trying to take a blood sample from Bridget's thumb.
35:13Yay!
35:15I'm bleeding well there.
35:19That's big, isn't it?
35:22Sorry.
35:23Better mess.
35:23Oh, that's OK.
35:26The blood just came everywhere, but we both knew that it was going to be more painful
35:31because of it going into my thumb.
35:34But at least you managed to get the blood out quickly.
35:38Here you go.
35:41Thank you, Bridget.
35:43You're welcome.
35:46Bridget will now be taken to Rhesus, where her heart rate will be monitored.
35:51I'm worrying so you're taking me to Rhesus, but apparently I'm not going to need Rhesus,
35:56baby.
35:57Any way to go?
36:01See you, Lillian.
36:03Bye.
36:04Keep your hands in sight.
36:06If her heart is still beating too fast, she may need an emergency procedure to slow it down.
36:32The ambulance arrival doors are still broken, but Sister Jane is doing everything she can
36:38to take control of her shift before it ends.
36:41Can I borrow your student?
36:42Where's your student going?
36:45He can go to 20.
36:47Are the beds ready for him?
36:48Okay.
36:50The lady in Rhesus C, is she ready to go to the ward?
36:5915-year-old Leighton has lacerated his arm at school.
37:02While step-mum Jodie watches on, emergency nurse practitioner Tony will attempt to close
37:08the wound with stitches.
37:10Want to make a start then?
37:11Is that all right?
37:12Yeah.
37:12Yeah.
37:14That's my scissors.
37:15Yeah, it's tongs on scissors.
37:18It doesn't hurt, but I can feel...
37:19It's really pulling.
37:20Yeah.
37:21No, I can feel it going through.
37:24I've actually had stitches myself under local anaesthetic, and it does hurt when it
37:28goes in.
37:29It does feel a bit like a bee sting.
37:30But then after that, you can't actually feel any pain.
37:33You can just feel like somebody's pulling at your skin, and it's a very strange sensation.
37:47That's just the tape coming off.
37:50Is it pulling on your hairs?
37:51Yeah.
37:52I thought you were just plucking my hairs off.
37:55Is that someone worth them all?
37:57That's the worst one.
37:58Yeah, but I actually hurt more than getting my stitching.
38:02Do you all want to have a look before I finish it off?
38:06Oh, yeah.
38:07It looks like that.
38:08Oh, yeah.
38:08It's looking better, to be fair.
38:10It does, it does.
38:10So what I'm going to do is put some strips on as well.
38:13Probably when we put stitches in, you've got a risk of scars where the stitch goes in
38:16as well.
38:17Yeah, yeah.
38:17So we can support it with, say, strips and it takes some of the pressure off as well.
38:21I'm not really fussed about scars.
38:23I'll say it's something good, sir.
38:24Yeah.
38:25He'll think it's cool.
38:26He's a teenage lad.
38:27They'll think it's cool.
38:28They'll be happy with it.
38:30Looks a lot better, that love.
38:31You've done right well.
38:32Proud of you.
38:34He did really well.
38:35It was quite painful to start with.
38:37He was good all the way through having that injection.
38:39Once the injection kicked in and it was numb, he was fine with it.
38:42He was absolutely fine.
38:42He was good.
38:44So how long will the numbness last for?
38:49Up to about eight hours, give or take.
38:51Because he wants to know if he can go on his bike, don't you?
38:53I would avoid the bike.
38:56Normal movements is one thing.
38:57Going on bike and sports, I think it's probably a bit out of the risk.
39:02Yeah.
39:02If he doesn't go careful or don't go steady on it, then there's a chance it could open up again.
39:07I mean, with the first question he asked, could he go on his bike?
39:09That's a big no-no for the time being while he's got them sutures.
39:12Thank you so much.
39:14Lovely.
39:15That's it, then.
39:16Any worries, we're always here.
39:22Layton had a McChicken sandwich on his way home.
39:24His arm healed with just a small scar.
39:35I was hoping I'd get away from this blinking alarm.
39:39Sadly not. Not yet.
39:41Retired charity executive Bridget is in recess because her heart is beating twice as fast as it should.
39:48Oh, oh.
39:49You've got another bed then.
39:52Hello, Bridget.
39:54Nurse Emma and sister Jess give Bridget some medication to try and stabilise her heart rate.
40:00I've got some of the magnesium to go up for you now and then there's a little tablet coming as
40:04well.
40:05OK.
40:06It's on this side on my thumb.
40:09Perfect.
40:11So I've just got some bars off along.
40:13Tiny little tablet.
40:15And what does it do?
40:16So it's a beta blocker so it should hopefully bring your heart rate down a little bit and stabilise it
40:20a bit.
40:25While she waits to see if the medication works, Bridget calls her husband John.
40:31Well, put them in a bag in case.
40:32Yeah.
40:33And we've got pants.
40:34I think they're down here probably.
40:35No, they're in the left hand drawer.
40:37OK, battery charger.
40:39You've got a lot of beeping going on up there.
40:41Yeah, that's because my heart rate is above 100.
40:46Hello, are you taking it to the ward?
40:48Yeah.
40:48We are.
40:49OK, bye-bye.
40:52They're just taking me up to the ward so I'll ring you back again in a bit.
40:56The team decide that it's not safe to let Bridget go home today.
41:00I thought I'd just be in and out in two or three hours.
41:03But it looks like I'll be here overnight.
41:07Hi, folks.
41:10Bridget was discharged the following day.
41:13She was fitted with a heart monitor and diagnosed with atrial fibrillation, an irregular heartbeat.
41:25In a second, I'll ask you to breathe in and to hold your breath.
41:3171-year-old Keith is having an x-ray on his lungs to try and get to the bottom of
41:36his shortness of breath.
41:39Breathe normally.
41:42We are a bit concerned there could be a blood clot.
41:44Because he's got a valve in his heart that was replaced, that can mean that you're more likely to develop
41:51blood clots.
41:53And so one thing we just want to make sure of is that because he had some bleeding a couple
41:57of weeks ago, that in that time he's not developed a blood clot near his heart.
42:02Dr Quirk has sent Keith's x-ray results.
42:06I'm trying to look for any kind of areas where it's a bit too white.
42:11So we like the lungs to look nice and clear.
42:14But can you see there's some fluffy kind of patches?
42:18That could suggest a little bit of fluid that's built up in the lungs.
42:22And then it's quite white in this corner as well.
42:25So all of that makes me a little bit concerned.
42:30One of the things that we're a bit worried about is that you could have a bit too much fluid
42:33in your lungs because your heart's not pumping quite right.
42:36We were just going to give you these.
42:39I gave Keith some furizumide, which is a type of tablet which helps remove the excess water by making people
42:45go for a wee.
42:47It stops putting too much pressure on the heart and then that should stop there being any water in Keith's
42:52lungs.
42:53All they'll do is they'll just make sure that you've not got any excess fluid and that you might go
42:59for a wee a bit more.
43:00That's the only thing that might happen. Is that all right?
43:03For now, Keith will remain in hospital under observation.
43:07Can't be helped. Meet best players.
43:11Test showed that there was indeed water on Keith's lungs, which was reducing his oxygen levels.
43:17Since being prescribed the furizumide, his breathing has improved and he's back to taking his dog for long walks.
43:25Cheers, Paul.
43:35Your patient in cubicle three, no, in high dependency two, can go home.
43:41The day shift is coming to a close and the ambulance arrival doors have finally been repaired.
43:47The doors are fine now, as far as I know it is. I've been dealing with them.
43:50But yeah, they were broken at one point. Couldn't get any crews in.
43:54So I've had to phone engineers, phone site matron, and now they're working.
44:00So, all back up and running.
44:04Sister Vicky and team are able to hand over a fully functioning ambulance hub.
44:10Right, I'll see you later.
44:13And Sister Jane is not far behind.
44:16See you in a bit, darling. Bye, love.
44:18Discharge by then.
44:20It's been a busy shift, as always, but we are coming into winter pressures.
44:25It's just to be expected. It is the normal.
44:28Help yourself to Madeline if you want some.
44:33Barnsley casualty is running smoothly once again.
44:44And if you or someone you know has been affected by the issues covered tonight,
44:49find information and support at channel5.com slash helplines.
44:54Get a feel for the pressure Royal Stokes consultants are under
44:57when the acclaimed 999 Critical Condition returns for a new series next Tuesday at 8.
45:02And the gripping conclusion of Number One Fan is next.
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