- 20/05/2025
999 - On the front line S12E02 (11th May 2025)
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00:00Ambulance service, is the patient breathing?
00:04I've fallen in the night.
00:06I'm now finding it really difficult to move cos it's so painful.
00:11She's struggling to breathe at the moment.
00:13Seems like it's deteriorating.
00:15He's a diabetic and I can't get into him.
00:17I've got the key and I can't get in.
00:19He's got the chain on.
00:21It starts in the morning, eh? I know.
00:25We're on board with the paramedics of West Midlands Ambulance Service.
00:30This job changes every day.
00:35Can we get fire or police? Somebody with bolt cutters.
00:41Saving lives and making a difference every day.
00:44You say the patient's been stabbed?
00:46In a medical emergency, six million people rely on them.
00:51You can go to people giving birth,
00:54they're in their most traumatic time of their life.
00:56You could be having a bleed on your brain.
00:58OK, mate, move in.
01:00Filming simultaneously with seven paramedic crews.
01:03He's got loads of things going on.
01:05Take steady breaths for me.
01:07Capturing life...
01:09..on the front line.
01:11There's no price you can put on saving somebody's life.
01:15Oh, God, my trousers are a bit tight today!
01:20It's 6.30am and the paramedics are suited and booted
01:23for another 12-hour shift.
01:27Right, I've got all the radios.
01:29Yeah. Supposed to be up today, innit?
01:31Yeah. Might have to take my coat off.
01:33I'm moving out.
01:35I'm moving out.
01:37I'm moving out.
01:39I'm moving out.
01:41I'm moving out.
01:43I'm moving out.
01:45Right, OK.
01:57As the skies brighten over the West Midlands,
02:00thoughts drift to sunnier climes.
02:03What's the worst holiday you've ever been on?
02:05I was in Zante and I was in an earthquake.
02:086.8 on the Richter scale.
02:10We all just got food poisoning.
02:12Literally every single person was just thrown up and shitted everywhere.
02:16Oh, no.
02:17Well, the last time, me mum ran me dad over.
02:20Literally in the car.
02:22Deliberately, or...?
02:24I went to Mallorca once and was there for two weeks
02:27and it rained for, like, 12 days.
02:30That's where I'm going!
02:40MUSIC PLAYS
02:47Paul, Abdul, action. Snap.
02:50I worked at the safari park.
02:52Mm.
02:53And it was my job the one day to jet wash the lion enclosure.
02:57Obviously, before the lions were let out.
02:59Yeah.
03:00I had a man watching me with his gun and everything.
03:03Yeah, yeah.
03:04Well, anyway, my protector in the Jeep
03:07decides that he needs to use the facilities.
03:09The person in the tow-hub sees the Jeep...
03:11Yeah.
03:12..leaving sight.
03:13I think, so, it's all clear.
03:15Yeah.
03:16It's absolutely fine, it's nearly time to open.
03:19I'll let the lions out.
03:20Well, I happened to just turn around and glance over my shoulder.
03:23Right.
03:24There's five lionesses charging towards me.
03:27Full pelt.
03:29So, were you scared, mate, when you had these lions running towards you?
03:32I'd be lying if I said I wasn't scared.
03:34Yeah.
03:35The old survival kicked in.
03:39HE CHUCKLES
03:40That's to say, my legs moved very quick.
03:43I'm impressed you managed to move that quick.
03:45Because I can move quicker than I want to.
03:47Mate, Usain Bolt has got nothing on me.
03:55PHONE RINGS
03:57Ambulance services, patient breathing.
04:00It is, but we can't make any sense out of him.
04:03He's a diabetic and I can't get into him.
04:05I've got the key and I can't get in.
04:07He's got the chain on.
04:08Tell me! Tell me!
04:10Can you open the door?
04:14We're off to a patient presenting with slurred speech.
04:17The patient's diabetic.
04:18The brother-in-law is not sure what is happening.
04:22It could be a hypo.
04:24When we saw this was a diabetic hypo, it's a concern,
04:29because if your blood sugar's dropped too low,
04:31your heart can potentially stop and have a cardiac arrest.
04:35Can I get in the property? Chain on door.
04:37Oh, well, the door's getting kicked in, mate.
04:41So, right in here?
04:43That red door there? Yeah.
04:48You all right, mate?
04:49Yeah, we've got slurred speech.
04:50What's that, buddy?
04:52Well, he won't open the door to anybody.
04:54I don't know if he's stuck down the bottom yet,
04:56but we can't get in cos I can unlock it,
04:58but it's got a chain on and everything.
05:02It's ambulance, matey!
05:05Tony!
05:07When 78-year-old Tony was unable to answer the door,
05:11his brother-in-law Mick called 999.
05:17Is he talking like he normally talks?
05:19What's the matter, mate?
05:20He's not talking like he normally talks.
05:22He's diabetic.
05:23Yeah, put the door in, mate.
05:26With Tony unable to speak clearly or move,
05:29it's likely he's having a diabetic hypo.
05:32It's a time-critical emergency.
05:36Tony, where are you?
05:38He's stuck behind the door.
05:40Is there another door in, Mick? No.
05:42No back door?
05:43Tony, can you move away from the door?
05:45He's at the bottom of the stairs, mate.
05:49You're on the right-hand wall.
05:51Is it painted clean or is there marks on it?
05:55Could be blood, mate. Yeah, that's blood.
05:57He's come down the stairs. Yeah.
06:00Tony, have you moved?
06:02I opened the letterbox and I thought, that looks like blood.
06:05You're thinking, well, where's this blood come from? Yeah.
06:08He's obviously at the bottom of the stairs.
06:10Has he gone top to bottom to the stairs?
06:12What kind of injuries has he got? Where's the blood coming from?
06:15I'm going to take a photo. I'm going to try.
06:20He's very confused.
06:21He's very confused. His pupils are fully dilated.
06:25He's not making much sense.
06:27Heart rate is 44.
06:31Yeah, can we get fire or police?
06:33Somebody with bolt cutters for a chain.
06:36Tony lives in a first-floor flat, so has no back door.
06:40To get out, he has to come down a steep flight of stairs
06:43to the front door.
06:45There is blood on the wall, we can see through the letterbox,
06:48so we're querying trauma top to bottom of the stairs.
06:50Are you hurt?
06:51Yeah, fire attendant, he checked three minutes before he received.
06:54Yeah, Roger.
06:55Paul, three minutes. OK.
06:58So, potentially, he's got an injury on top of having low blood sugar.
07:02How long has he been on the floor? Has he been there all night?
07:06So there's a variety of things you've got to consider,
07:09but the first thing is, we need to get access to him.
07:12We need to get to Tony quickly.
07:15Tony, don't go to sleep, mate.
07:17Keep talking to me. Fire engines will be here shortly.
07:34I would say that all kind of nice-tasting food and drink
07:39is generally bad for you.
07:41Cos when you think about it, I'd be quite happy to eat chips
07:45and chocolate and drink beer all day.
07:49It's bad for you, isn't it?
07:51Would you like to eat just chips and beer, Neil?
07:54Oh, I do, I do. And live longer?
07:58Why does junk food taste so nice?
08:00Probably cos of the salt content.
08:03Yeah, more salt. You always want more salt on it, don't you?
08:06And fat. I always think fat tastes quite nice, don't you?
08:09I always think, if it's the other way around with veg and fruit,
08:14if you ate that like it was junk food,
08:16I bet you that would be really bad for you.
08:18They'd say, you must eat some chocolate,
08:20you just haven't got enough sugar in your diet.
08:29Ambulance service, is the patient breathing?
08:32She's struggling to breathe at the moment.
08:34She's got COPD and she's been in bed for two weeks.
08:39Seems like it's deteriorating.
08:45Female in her 60s, difficult in breathing.
08:49And that's all we've got.
08:51You know when you get a sixth sense about a job?
08:54You think this woman's going to be really ill? Yeah.
08:59We do get a sixth sense sometimes going to jobs.
09:02And nine times out of ten, we're right.
09:05It's hard to explain.
09:07You just read the job and you think, I think this is a proper job.
09:11That one, that one at the end there, isn't it?
09:20Hello there. What's your name?
09:22How can we help you?
09:24We've got difficulty in breathing.
09:27COPD?
09:29Pop your finger in here while we're talking.
09:3165-year-old Linda has an incurable lung disease called COPD.
09:36When she was struggling to breathe,
09:38her son called 999.
09:40Daughter-in-law Hayley is with her.
09:42Can we try and sit you up a bit more in bed?
09:44Yeah. You'd better sit right up.
09:46Because your oxygen levels are on the lower side.
09:49Your heart rate's up, OK, and your sat on air is 72%,
09:53which is way low to what we want.
09:55Oxygen levels at 72% essentially mean that your brain
10:00and all of your organs are being starved.
10:02Ultimately, that can lead to, you know,
10:05death of tissue.
10:06Yeah, I tell you what, stick that on.
10:08That's it, just... All right, all right, just calm it down.
10:11Calm it down.
10:12So when did your breathing start to get bad, then?
10:15I woke up at four in the morning.
10:17Yeah.
10:18And then...
10:19Oh...
10:25Oh, please help me, Lord.
10:27You can't help but feel slightly panicked yourself
10:30when someone's saying, please help me.
10:32But it certainly, as a paramedic,
10:34it certainly focuses the mind on what you're doing
10:37and what you're going to do for this person.
10:39Can I have your arm a minute?
10:41I know we're attacking you from all angles, aren't we?
10:44Right, sharp scratch on your arm, OK?
10:46Here we go.
10:47Come on.
10:49Oh, dear, please help me.
11:03Keep talking to me, Tony.
11:06In Dudley, paramedic Abdul and student paramedic Paul
11:10are trying to reach Tony.
11:12They suspect he's having a diabetic hypo
11:14and is trapped behind his front door.
11:17He's fallen.
11:18We don't know whether it's top to bottom of the stairs,
11:20so it might be best going up from the back and down the stairs
11:23so we can assist him properly.
11:24With blood seen on the wall,
11:26it looks like Tony has fallen down a flight of stairs,
11:29badly hitting his head.
11:31The fire service has been called.
11:34That's the door, that's his foot.
11:36And there's only a small landing at the bottom of the stairs.
11:38We can't get to the train either now cos he's moved his foot.
11:41OK, no worries.
11:42If we can get around that...
11:44We'll be in in a minute, mate.
11:46Fire Brigade are here, OK?
11:49Tony?
11:50I can't hear you.
11:52Do you want a third speech?
11:54Yeah, he's got a third speech.
11:56With Tony's condition worsening,
11:58firefighters search for a way to get into his flat.
12:06Are you happy for me to use your ladder to go in?
12:08Yeah, I can do that.
12:09Yeah, that's fine.
12:11All good?
12:12OK, mate.
12:13With no other way of reaching Tony,
12:16Abdul follows the firefighters' lead.
12:22I'm surprised, mate.
12:24Yep.
12:26Coming!
12:27Coming!
12:28Coming, mate.
12:30Wonderful.
12:31Cheers, mate.
12:33You all right, Tony?
12:34All right.
12:37Got any pain in your neck?
12:40You got any pain in your back?
12:42No?
12:44Don't know?
12:46OK.
12:47Just going to do your blood triggers, mate, OK?
12:50Where's all the blood come from?
12:54He's got a big lump on the top of his head as well.
12:57There was blood.
12:58He was lying on top of his walker.
13:00There was blood on the walls.
13:02He felt very cold as well.
13:04His blood sugars were low.
13:05We need to get him out of there quickly.
13:07It is awkward because he's in front of the door,
13:09so all equipment had to be brought around the property,
13:12up the ladder, then down the stairs.
13:15Sharp scratch.
13:18Pass us the cannulation kit, mate.
13:20Yeah, OK.
13:21Can we get this chain cut off, mate?
13:24His blood sugar's at 0.9.
13:26I need some glucose.
13:27Your blood sugars are too low.
13:30Paul! Yo!
13:31Get them the spinal board head blocks.
13:33Yeah.
13:34Basically, all this, mate, all this needs to go up.
13:38As well as critically low blood sugar levels,
13:41Abdul suspects Tony may have injured his back when he fell.
13:45To avoid any further damage,
13:47he'll need to be brought out on a spinal board.
13:49Nice one, mate. Thank you.
13:51I'm just trying to get a vein.
13:52The light down here isn't the best.
13:55Right, sharp scratch, mate.
13:58Well, that didn't work.
14:00Tony was very cold when he was at the bottom of the stairs.
14:04Obviously, your veins retreat into your body
14:07because they try and keep you warm.
14:10So I couldn't feel any veins, I couldn't see any veins,
14:13so it was very difficult to cannulate.
14:15I had a few goes and, in the end, I decided just to leave it
14:19and we'll just get him out before having a look on the ambulance.
14:23I've done some glucagel for now.
14:25Got it?
14:26Yeah, I've got it, mate.
14:27Right, mate, I'm going to pop this in your mouth.
14:30The priority is to increase Tony's blood sugars,
14:33but with no access to a vein,
14:35Abdul places a sugar gel in his mouth.
14:38Rub it round your gums, OK?
14:40That's it, just get it in your gums.
14:42Good man.
14:44This was the last one before.
14:46Yeah, same, mate.
14:47I got a defibber wind, I tell you.
14:49You got it, mate?
14:50As Abdul is going to need help moving Tony,
14:53Paul also heads up the ladder.
14:57There's that lump on the top of his head.
14:59I'm not happy about that.
15:08You've had nebulisers before, I take it?
15:11Only in hospital.
15:13To the north of Worcester,
15:15paramedic Neil and technician George are with Linda.
15:19She has COPD and dangerously low blood oxygen levels.
15:25I'm just going to take it off for a minute.
15:28George gives Linda a nebuliser.
15:30This contains a drug that she can inhale,
15:33which should help open her airways.
15:40That's it, just try and slow it down a bit.
15:43Having experienced shortness of breath myself,
15:46it's extremely scary.
15:48No matter what anyone says to you,
15:51just breathe, it sounds so simple,
15:54but in those moments it's not.
15:57So I'm just mixing this drug up,
15:59it's what we call hydrocortisone, OK?
16:01And it will reduce inflammation in your lungs,
16:03hopefully help you out a bit.
16:05Right, so that's that.
16:08You have to do it fairly slowly, all right?
16:12As well as the nebuliser,
16:14Neil gives Linda a steroid drug intravenously.
16:17Together, they should start to ease her breathing.
16:24I don't know what we do about you people.
16:27Well, what can we say?
16:29You feel a bit easier? Yeah.
16:31Yeah, all right, OK.
16:33I panic a lot, that's what I do.
16:35Yeah, well, I'd be panicking as well if I were you.
16:38I'm just glad I stopped smoking, really.
16:40When did you stop smoking?
16:42When did you stop smoking?
16:46Did you work?
16:47What industry were you in?
16:50Oh, really? Oh, OK.
16:54Yeah, yeah, yeah.
16:56Two of the most common causes of COPD
16:59are smoking and air pollution,
17:01and Linda has been exposed to both.
17:04It's quite often we see people with COPD
17:07that have had jobs in industrial environments
17:10with chemicals and that, isn't it?
17:12Industrial environments, yeah.
17:14What did you do for a living?
17:16I mean, at the time, you don't realise
17:18how it's going to affect you in later life, do you?
17:20No.
17:21Got colour on your face now. There you go.
17:23You've still got to go to hospital, though.
17:25Your work of breathing is still a bit too high, really,
17:28but we're not expecting to wave a wand and cure you here.
17:32I'll put you on just a little bit of oxygen, I think.
17:35All right, I'll just give you a little bit of a trickle.
17:38Looks like they seem to come right down again.
17:40This was a life-threatening condition.
17:42Linda needed to be in hospital as soon as possible.
17:45Her SATs were dangerously low.
17:47We knew we needed to get her out of the house very quickly
17:50and travel on blue lights to hospital.
17:53Oh, I can't breathe. I can't breathe.
17:55Sit there, then, for a minute.
17:57SHE COUGHS
17:58You'll be all right. She panics.
18:00Sorry for all this. It's all right.
18:02When Linda gets anxious, it stops her taking deep breaths,
18:05making it difficult to move her.
18:08Yeah, I know. Yeah.
18:11Shall we try it one last time? Yeah?
18:14I'll tell you what, let's think outside the box a little bit.
18:18Grab that pillow off there.
18:20What I'm thinking, that in there like that.
18:23Listen, we do this every day, OK?
18:26OK.
18:28Getting Linda out of the property was a challenge,
18:31bearing in mind she's very short of breath.
18:34Trying to get her to sit and somewhat relax on a chair
18:37while we carry her down the stairs sounds easier than it is done.
18:42Can we sit you right up? Oh, God, I can't do this.
18:45That's it, you're all right. You're doing really well.
18:48Just ringing in an alert to you.
18:51Exacerbation of COPD.
18:53SATs on oxygen, 91%.
18:56We have a heart rate of 120.
18:59OK, George, let's get moving then.
19:02In the UK, COPD affects around three million people like Linda,
19:07making it the second biggest cause of hospital admissions.
19:11So I've obviously contacted the hospital, OK,
19:14and they're going to see you straight away, OK?
19:21The journey to Worcestershire Royal Hospital takes 35 minutes.
19:26So, do you feel a bit better?
19:31Oh, brilliant.
19:32We were a bit worried about you.
19:35In A&E, doctors will stabilise Linda's oxygen levels
19:39and look at how to manage her COPD better.
19:49Well, like you said, we had a sixth sense with that job.
19:52Isn't it weird how you can tell?
19:54Yeah, I don't know, I get, like, a bit of a gut feeling before you get there.
19:57She felt a lot better than she did by the time we got here,
20:00so we've done something right.
20:02Yeah.
20:09Chuck the head blocks, please.
20:11Have we got the scoop up here as well?
20:13Yeah, yeah.
20:15In Dudley, Abdul and Paul are trying to move Tony.
20:19He's having a diabetic hypo and needs to go to hospital.
20:22We'll get the scoop under him. Yep.
20:24We'll slide him up the scoop.
20:26We're going to have to support his head and then bring him up.
20:29All right. Move this leg.
20:31We're going to put you on a plastic board.
20:33You've got the scoop there. OK?
20:35Do you want to come here? Yeah.
20:37You straddle him as well.
20:39So we'll get the two-fire at the top here.
20:41You grab his head, then I'll grab his torso.
20:43That's it, yeah. Yeah, straddle him.
20:45We have to be really careful.
20:47We have to be really careful how we moved him
20:49because you can't tell what's going on.
20:51No, and you've got to assume the worst.
20:53The slightest wrong movement from us
20:55could have quite a detrimental effect on the rest of Tony's life.
20:59Everybody ready? Yeah.
21:01Right. On slide. Ready, steady, slide.
21:06It's all right, mate. It's OK.
21:08We need to slide him up here.
21:10This isn't going to be nice.
21:12On three. One, two, three.
21:15That's better. Right.
21:17Head goes there, that slides on either side.
21:20Once Tony is safely on the board,
21:23Abdul and Paul can move him to the ambulance.
21:29Right, we good?
21:31Hey, come on.
21:33Can you open the back of the truck?
21:35Right, guys, thank you. Thanks, guys.
21:37Right, Tony, we need to pop this on your face, matey, OK?
21:41Your veins are shocking, mate.
21:43Sharp scratch.
21:45Hello, mate, I've got a silver trauma for you.
21:48After more than an hour extracting Tony,
21:51Paul lets the hospital know they have an elderly trauma patient.
21:55He dropped 13 stairs, four flight of stairs.
21:59Patient is diabetic.
22:01His BM levels have risen with blue catarrh.
22:05I can't get a lane in, mate. Yeah, just get going, then.
22:08Yeah, no worries.
22:10OK, mate, move in. That's fine, go for it.
22:14Tony needed to go to hospital because his blood sugars were low.
22:18We did manage to bring them up with some glucose gel.
22:21It only acts for a short period,
22:23so we needed to get him out for all the quickly.
22:27All right, pop this in. Open your mouth for me.
22:30Right round your gums.
22:32With no access to Tony's veins,
22:34Abdul continues to give him liquid glucose in the form of a gel.
22:39On blue lights, it's a five-minute journey
22:42to Russell's Hall Hospital in Dudley.
22:45Bring that down a bit, buddy.
22:47There we go.
22:49Here, Tony's spine will be x-rayed, his head wound closed
22:53and his blood sugar levels stabilised.
22:57What are you having for breakfast?
22:59I've got a protein shake.
23:01Oh, it's just down there, but I've only had a little bit of it.
23:04I think we'd definitely get through a 12-hour shift,
23:07mainly because we're so close to the hospital.
23:10I've got the blood sugar levels.
23:12You're on a diet.
23:14Yeah, I am.
23:15I've got a protein shake.
23:17I've got a protein shake.
23:19I'm going to have a protein shake.
23:21I'm going to have a protein shake.
23:23I think we definitely get through a 12-hour shift mainly through
23:26our utter random conversations. Yeah.
23:28And... Schnicks. And the schnicks. Schnicks.
23:31We always have a bag of schnicks. Yeah.
23:33I think it's just never going to stop.
23:34We just bring snacks in for each other, don't we? We do, yeah.
23:37It's great.
23:38I've got my waffles in my bag, I just haven't quite toasted them yet.
23:42They're going to be a dusty mess in an hour, aren't they?
23:46All my food just gets crushed in my bag and then I forget about it
23:49and then just have piles of crushed-up food.
23:53PHONE RINGS
23:59Oh, you're calling about yourself or somebody else today?
24:02I've fallen in the night and I'm now finding it really difficult
24:07to move because it's so painful.
24:09It's in the area of my right kidney.
24:11I think I was sleepwalking.
24:16Jeanette.
24:17We've got 80-year-old Jeanette.
24:19She's fallen in the night and hurt her back.
24:22She's on the floor. It gives that impression.
24:25We often go to people that fall at night-time, don't we?
24:28Mm. It's really quite common.
24:30I just find it a bit strange that there wasn't a call sooner.
24:33Yeah. I mean, it's quite common, isn't it, though,
24:36that that generation tend to wait quite a while?
24:40They do. Often, don't they?
24:50Hello, Jeanette. It's the ambulance.
24:54Oh, there you are.
24:56My name's Lisa. This is Danny coming in.
24:59Who have we got here as well?
25:01That's my husband. He's not well either.
25:03Is he not well? Oh, bless you.
25:06Eight-year-old Jeanette looks after her husband, Bill,
25:09but after falling in the night, she's the one who needs help.
25:13You're quite warm as well.
25:15And I banged my back... Mm.
25:19..in the area of my right kidney.
25:21I think I must have been sleepwalking.
25:23So you were able to get yourself up off the floor?
25:26I did, yes. Not too bad?
25:28Just that with my husband not well. Yeah.
25:31I can't do anything for him at the moment.
25:33I think Jeanette, bless her, she was more concerned about her husband,
25:37so I think maybe that's why she didn't initially call straight away.
25:40She didn't want to leave him.
25:42Give us a shout at any pain.
25:44It's just in the kidney area.
25:47That side? Not there, no, no.
25:50HE GASPS
25:51Just there? That's where it is, that's where it is.
25:54I think there's a few considerations, really, isn't there?
25:57Are we safe to stay home?
25:59Should we see how we are standing and walking?
26:03Could you put your hand over where the pain is?
26:06Here? No, no, no. Under ribs on there.
26:09Yeah, there you see, that's where the pain is.
26:12The other consideration is whether we've injured our kidney.
26:16We wanted Jeanette to walk to the bathroom
26:19because she wasn't keen to go to hospital.
26:21We had to make sure that she was safe,
26:23so you have to be able to maintain your own dignity,
26:27go to the bathroom, do the basic kind of tasks,
26:30if you're to stay at home.
26:32Oh, God. Oh, God.
26:35Oh...
26:43Across the West Midlands,
26:45we're following seven paramedic crews simultaneously
26:49as they work a typical 12-hour day shift.
26:53So there's a chair right behind you, Jeanette.
26:55There you go. Yeah, there's a chair.
26:57In Malvern, paramedics Lisa and Danny
27:00are treating retired schoolteacher Jeanette.
27:03She fell on her back and now the pain is so bad she can hardly move.
27:07I think if we can't even get to the bathroom,
27:09I think we're really going to struggle just to get up and down the stairs.
27:12This week has just been the absolute end of the line, really.
27:16And to do this, to hurt my back like this...
27:20It all needs me so much.
27:23Jeanette felt quite a responsibility
27:25that she wanted to stay at home and look after Bill.
27:28There was quite a lot going on for both of them.
27:31It must have been really stressful.
27:34Do you know, if we were to go to hospital,
27:37they might be quite satisfied that it's soft tissue,
27:40but then they'll be able to prescribe you more pain relief, really.
27:44OK.
27:45Unable to cope with the pain,
27:47Jeanette agrees to go with Lisa and Danny to the hospital.
27:51So it looks like we're going to have to take your lady into hospital.
27:56Right.
27:57So our issue now is what we're going to do with you.
28:00I'll be all right. I'm just tired at the moment.
28:03You're tired? I'm a bit dazed here.
28:06I felt quite concerned when we had to leave Bill at home,
28:09but bless him, he was quite adamant that he was OK
28:12and that he would manage while Jeanette was being checked out at the hospital.
28:16Satisfied that Bill will be OK on his own...
28:19Oh, well done.
28:21..Lisa and Danny help Jeanette down the stairs.
28:24Bye, sweetheart. Bye. Bye.
28:26Ring somebody if you need help, OK?
28:28OK, thank you. You're welcome. Take care.
28:31Ready, steady, lift.
28:35Try and get yourself into the most comfortable position
28:38that you've got there.
28:49OK.
28:52You don't need to take it out of your mouth at all.
28:55Lisa gives Jeanette gas and air to inhale.
28:58This should help ease her pain on the 30-mile journey
29:01to the Alexandra Hospital in Redwich.
29:05Right, ready? Yeah.
29:07Here, doctors will investigate
29:09what's causing the severe pain in Jeanette's back.
29:25Every day, West Midlands Ambulance Service
29:28receives over 4,000 calls for help.
29:31Is she conscious?
29:32Have you lost enough red blood to fill a mug?
29:35Most callers are worried and scared, but still polite.
29:39However, some callers are less understanding.
29:42You need to be able to take control of the situation
29:46and navigate it to build that rapport
29:49and get the caller to listen to you
29:51so they can trust you to help them.
29:56Ambulance Service, is the patient breathing?
30:00Yes, I'm in the square, Lee.
30:02OK, bear with me. Are you the patient or somebody else?
30:09What's the address of the emergency? Where exactly are you?
30:14OK, you say in the square, but we cover all off the West Midlands,
30:17so is there any shops that you're outside of, anything like that?
30:22OK, listen, listen.
30:24We can't just send an ambulance out to everybody.
30:27We have to go through details first.
30:29How are we?
30:31I feel well. I just feel cold and fucking...
30:35I just don't feel well, Lee.
30:37Have you got pain somewhere? Have you got breathing?
30:40What exactly don't you feel well with?
30:43I just don't feel well, lovely.
30:46It can be very frustrating when the caller won't give you
30:50an exact reason for the ambulance.
30:52We're not there, so we need all the information
30:55that they can give us.
30:57I can't do anything, mate.
30:59I can't fucking breathe properly, mate.
31:02OK, so you feel like it's harder for you to breathe at the moment
31:05whilst you're not doing anything?
31:07OK, so we've got some help organised for you.
31:10I do need to make you aware that at the moment,
31:13the ambulance service is under significant pressure,
31:16and it may be several hours before an ambulance may become available.
31:21Is there any way at all that you can safely get your own ambulance?
31:25Is there any way to the local hospital emergency department?
31:33Pardon?
31:36OK, there's no need to start swearing now, is there?
31:38I'm just trying to get some help organised for you.
31:41Getting sweared at and verbally abused down the phone
31:45for things that are out of my control is never nice to deal with,
31:50and it's something that we shouldn't have to deal with.
31:55OK, obviously I appreciate it's not ideal waiting a few hours
31:58for an ambulance, but that is unfortunately the situation
32:01that the ambulance service is in at the moment.
32:13Oh, I can smell that. Bit of silage, innit?
32:15Yeah. Oh, lovely.
32:17That'll wake you up in the morning.
32:19I like the smell of it. Not that smell.
32:22Oh, yeah. It's lovely.
32:24I'll tell you what does smell bad, chicken poo.
32:27Have you ever been past the field and saw chicken poo?
32:29No, no. Oh, my God.
32:31Is there a difference between cow poo and chicken poo?
32:34I don't know if...
32:36I'd say chicken poo's a lot more acrid.
32:38It kind of gets to the back of your throat.
32:40Brings a tear to your eye.
32:42Yeah, something like that. Yeah.
32:44I'd rather not smell either, to be honest.
32:48Clear your nose out.
32:50Smell of the country, so you'd...
32:55PHONE RINGS
32:57Ambulance service, is the patient breathing?
32:59Yes.
33:01My husband's saying he can't stand.
33:05I've just got this terrible pain
33:08and I don't seem to be able to breathe.
33:15Right, we've got a 70-year-old male
33:17with abdominal pains, shortness of breath,
33:21unable to talk and unable to move.
33:24So, with abdomen pain,
33:26we could be looking at an aneurysm within the tummy,
33:29which, if that bursts, that can be fatal.
33:32Nausea and vomiting, unable to go to the toilet.
33:35Sounds like he's got...
33:37he's got loads of things going on.
33:46Hello, Salamat's crew.
33:48Hello, Salamat's crew.
33:50I just feel your pulse always telling me what's happening.
34:06Yeah, OK.
34:0770-year-old Mike has been in pain for three days.
34:11When his condition worsened, his wife Susan called 999.
34:16So, the abdominal pain, how bad is that pain?
34:19It goes from ten down to about six.
34:22Right. You don't normally suffer
34:24with any stomach problems or bowel problems?
34:26No, I'm pretty regular.
34:29I mean, I had this bad tummy two days ago
34:33and I went to bed all right.
34:35But then at three o'clock, bang!
34:39With the abdominal pains is really what woke you up?
34:42Yeah, so you felt sick as well with it?
34:44Yeah. Yeah, it's OK.
34:46So, the concern that this pain has woken Mike up so suddenly
34:51would suggest that it's potentially something serious,
34:54that we need to identify what that is.
34:5637.8.
34:57Yeah, your temperature's up a little bit.
34:59His bowels have always been a little bit...
35:01Would you say they've been off recently?
35:03Well, I've just stopped going now.
35:05I usually go about four times a day.
35:07If you've got abdominal pain and you can't go to the toilet,
35:10it's always on our mind, is it a blockage or not?
35:13Bowel blockages can be extremely serious
35:16to the point it can be fatal.
35:27Can we use KFC, something big with the Asian community?
35:30I think we just eat a lot of chicken.
35:32So I used to do the shopping for the care home.
35:35A lot of our staff was Asian staff.
35:37And there was always Marilyn, because I'd do a Sunday lunch,
35:40but they could never have it because it was normal chicken.
35:42Yeah.
35:43So I started paying a bit extra, so halal chicken,
35:45so they could have it, and that was what happened.
35:47What's your secret recipe?
35:49Have you got 12 herbs and spices that you rub on?
35:52No, mate, it's not 12 herbs and spices.
35:55A bit of salt and pepper and banging it in the oven sort of thing.
35:58No masala? No, no masala.
36:00No spice, no heat?
36:02No turmeric, no masala. Nothing?
36:04No.
36:05No spice on a Sunday lunch, man.
36:07Traditional Sunday lunch.
36:09Add some spice on that, then.
36:11Rub some funk on that.
36:12Otherwise, very bland.
36:14My Sunday lunches are not bland.
36:23Is the call about yourself or somebody else?
36:26Yeah, it's myself.
36:27I'm six months pregnant.
36:29I have a pain in my tummy.
36:31There is a drop of blood in my edistral tube.
36:411-8.
36:42Cat 1 for a 25-year-old who is six months pregnant.
36:46She's actually got pain in her abdomen
36:48and she's got some bloody discharge.
36:51All received and mobile, thank you.
36:55Possible miscarriage.
36:57Six months? Six months.
37:01Paul looks up the latest guidance on premature births.
37:0524 weeks. I think pre-term's classed as 22 weeks.
37:09If a baby is born at 24 weeks, they do need advanced care.
37:14Having them born at home is not ideal.
37:17So you would potentially just try and get them on the ambulance
37:21and get them to the hospital.
37:25I don't know what we're going to find.
37:28Grab them a turnkey pad, mate.
37:40In West Bromwich, Abdel and Paul have been sent to a woman
37:44who's pregnant and complaining of abdominal pain.
37:48What's happened?
37:51All right, OK. So you've had some bleeding today as well?
37:53Yeah. Any clots? No.
37:55How far pregnant are you? Six months.
37:57Six months. All right. Any other problems?
38:00Just the bleeding. Just the bleeding.
38:02So this started this morning, spotting blood?
38:05Last night. Last night? OK.
38:07This is 25-year-old Simran Jeet's first baby.
38:11Husband Harjeet is with her.
38:14Do you want to do a blood pressure and stuff, mate?
38:16What colour's the blood, though? Is it dark? Is it bright?
38:19Er, light. So we've got fresh blood.
38:23First, Abdel checks Simran Jeet's blood sugar levels.
38:283.5, mate. When's the last time you had something to eat?
38:31Er, morning.
38:33Your sugar's below what you're used to?
38:35Morning. Your sugar's below what it should be?
38:37Your sugar should be at least 4, yours is 3.5.
38:40Grab one of them, eat that down.
38:43So this patient's blood sugars were low,
38:45regardless of whether she's pregnant or not.
38:48A patient's blood sugar being low
38:50needs dealing with straight away, anyway.
38:53So offering high-carb food and sugary food
38:56is the best thing to do, just to bring it up naturally.
38:59Do you want to stand up for me? I'll just do your blood pressure.
39:02Now keep this arm nice and straight, just down by your side.
39:05Wonderful. Is everything normal?
39:07Yeah, yeah, your blood pressure's brilliant.
39:09Your heart's going a little bit quick. You're probably a bit anxious.
39:12Although Simran Jeet's observations are normal,
39:15Abdel and Paul still don't know what's causing her pain.
39:19Are you in any pain at the minute, sweetheart?
39:21Any pain?
39:24Whereabouts? Tummy? Yeah?
39:27Spreading straight across?
39:29Yeah. How much pain?
39:31If nought was no pain, ten was terrible pain.
39:34How much?
39:49It is handy being able to speak Punjabi,
39:52just in case there isn't anybody there to translate.
39:56At times, I am the translator as well as being the paramedic.
40:01Do you have a hand there? Yeah?
40:04We'll go sit.
40:06So it's OK when she's sitting and then every so often it'll just bang.
40:09So Simran Jeet did need to go to hospital because she was bleeding.
40:12It can be normal in pregnancy, but it wasn't normal for her,
40:16so she needed to be examined at hospital.
40:20OK, darling.
40:22OK.
40:25OK, I'm just going to have a quick listen to your tummy.
40:30OK, sweetie.
40:32So I'm not concerned at the moment.
40:35I can't hear anything wrong.
40:37All good? Yeah, good, thank you.
40:4730 minutes later, Simran Jeet arrives
40:50at Birmingham City Hospital's maternity department.
40:54We're there now.
40:56Here, medics will run tests to look for the cause of her pain
41:00and to make sure that she and her baby are healthy.
41:12I was expecting... A lot worse? Somewhat worse.
41:16Yeah, that's the problem, I think.
41:18It comes through and you think, you expect the worst?
41:21Well, I'm glad it wasn't.
41:23Glad it wasn't? Yeah.
41:34Do you mind me exposing your abdomen?
41:37In Evesham, Neil and George are with Mike,
41:40who has severe abdominal pain.
41:45I've had a listen.
41:47It does sound a little reduced movement in there.
41:51So what I'd like to do now is have a feel of your tummy.
41:54Is that OK? Yeah.
42:00Tell me if it's hurting. Is it hurting there?
42:02It looks like... Yeah.
42:04Yeah, that makes me feel like I've got a puke.
42:07Yeah. OK.
42:09If everyone can stay quiet, I'm going to give your tummy a tap.
42:13The reason I tapped Mike's abdomen
42:16is to listen for high or low sounds
42:19when tapping.
42:20This could suggest fluid or air in the abdominal cavity.
42:24It's more of that one than any of them. Yeah.
42:28That's what we call hyper-resonance there. Yeah.
42:31OK, so it would suggest kind of almost trapped air.
42:34Your bowel sounds, they're slower than what I would expect
42:37as a normal bowel sound.
42:39They're there, which is a good thing.
42:41So your tummy's generally tender all over.
42:44And then when I've given you a bit of a tap over your tummy there,
42:47we've got hyper-resonance here. Yeah.
42:50We're going to recommend hospital
42:52and we're going to offer you pain relief in the form of probably morphine.
42:56So Mike needs to go to hospital because he did show signs of infection.
43:02Now, this could be that his bowel is perforated from the blockage
43:06and we're starting to see infection in the abdominal cavity.
43:10I don't know. I'd rather be safe.
43:12From what you're saying, yeah, it's not quite normal for Mike.
43:16It's not what I want, it's what my wife wants. That's it.
43:19Happy wife, happy life, that's a saying.
43:22Is it OK if I put a little cannula in your arm, yeah? Yeah.
43:26Mike was clearly in a lot of pain.
43:28He'd already had paracetamol, but this wasn't going to touch it.
43:32So morphine is one of the best drugs we can give to help his pain
43:37and will make him more comfortable en route to hospital.
43:40So we're just going to go with the morphine just now.
43:44One thing is just sit on the edge of the bed first.
43:48That's it, boy. Hold on there a minute, just get your bearings.
43:53With the help of wife Susan, Mike is able to walk to the ambulance.
43:58I know you're in safe hands, so why not?
44:01That's it. Yeah, I've been doing it 21 years.
44:04Well, long enough. I think I've got the hang of it.
44:09How's the pain?
44:11Probably zonked. Zonked? Yeah, no problem.
44:15With the morphine starting to take effect,
44:18Neil and George head for A&E.
44:21I won't keep nattering to you, I'll keep an eye on you
44:24and do a bit of paperwork, all right?
44:29After a 16-mile drive, Mike arrives at Worcestershire Royal Hospital.
44:35At least it's not raining, that's the main thing.
44:38Here, medical staff will investigate
44:40what's causing Mike's sudden and severe abdominal pain.
44:52Tests were unable to pinpoint the exact cause of Mike's pain.
44:56After five hours of investigations, he was allowed home.
45:01Simranjeet, who was pregnant and had abdominal pain,
45:04was diagnosed with a urinary tract infection.
45:08Four months later, she gave birth to a healthy baby girl called Jepchi.
45:13Jeanette, who fell and hurt her back,
45:16had X-rays to rule out damage to her kidneys.
45:19After eight hours, she was allowed home to look after her husband, Bill.
45:24Linda, who was struggling to breathe, had an MRI, antibiotics and a drip.
45:30It took several hours to regulate her oxygen levels.
45:33And Tony, who had low blood sugar levels and fell down a flight of stairs,
45:38was diagnosed with a broken neck, ribs and toe.
45:41It was five weeks before he was well enough to be discharged.
45:47Next time...
45:48What were you getting with reading the heart rate?
45:50131, 125.
45:52..a patient in police custody has a dangerously fast heart rate.
45:56In such a young person, to have such an elevated heart rate
45:59and blood pressure can be quite a challenge.
46:02High blood pressure can mean that there's a significant cardiac event happening.
46:06A woman who's struggling to breathe refuses to go to hospital.
46:10Right now, you're poorly.
46:12But if we leave you here, you're going to be very, very poorly.
46:16It is hard when patients refuse to go to hospital,
46:19when you know that they really do need to be seen by somebody else
46:22and get the treatment that's required.
46:24And paramedics struggle to treat a suspected drug overdose.
46:28OK, everyone, if you please get off the ambulance,
46:31It can be quite scary when there's people banging on the side of the ambulance.
46:34You don't know what they want,
46:36if they're going to actually get onto the ambulance.
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