- 2 days ago
999 - On the front line S12E08 (22nd June 2025)
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00:01Ambulance service is patient breathing.
00:04He's in absolute agony.
00:06He's struggling to breathe now with the pain.
00:08He's not making a lot of sense.
00:11His eyes keep rolling into the back of his head.
00:15It's my granddaughter.
00:17She's only a few months old.
00:19She's not responding.
00:21Starts in the morning, eh?
00:23I 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?
00:37Somebody with bolt cutters.
00:38Pay for even when I'm pressing here.
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,
00:54then 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.
01:03It's got loads of things going on.
01:05Take a steady breath for me.
01:06Capturing life
01:07on the front line.
01:10There's no price you can put on saving somebody's life.
01:13It's 6.30pm, and while most people are heading home,
01:25the paramedics of West Midlands Ambulance Service
01:28are just starting a 12-hour night shift.
01:30All good to go?
01:35Yeah.
01:35Just change these.
01:35You need to change these.
01:37OK.
01:38I've set your iPad up for you.
01:39Have you?
01:40Have you connected to the Zoll?
01:41Yes.
01:41Have you?
01:42Winning.
01:42Are you doing the first job?
01:44Yes.
01:44It's going to be a cold one tonight.
01:47Yeah, I've noticed you wearing a T-shirt.
01:48Yeah, I've got a T-shirt on there.
01:49Oh, yeah.
01:52We're all ready, aren't we?
01:53Yeah.
01:53I've got the radios.
01:54Cool.
01:54Yeah, let's go.
01:58See where the night takes us.
02:00These crews are out on the road, rain or shine,
02:08but no matter the weather, they're always in the same uniform.
02:12What improvements would you make for our uniform?
02:15Imagine this in, like, fluorescent pink.
02:17You look like you're going to a neon party.
02:19Maybe yellow, because our high business is going on.
02:21Oh, my words.
02:22You'd look like a glove stick.
02:23Oh, my God.
02:23That'd be cool.
02:24Especially this summer, I'd rather have shorts.
02:26What was knee-length socks?
02:29Yeah.
02:30And a pair of knee pads.
02:31Yeah, because it would be socks.
02:32Oh, the knee pads as well, that'd be amazing.
02:35Yeah, I've got proper rugby player, like...
02:36You know, like a onesie, but it's all plastic ones.
02:40Well, like dungarees, like overalls.
02:42Overalls would be so good.
02:44I'd rather come rub it.
02:44I hate the police sirens, though.
02:58Come back to our house.
02:59They're really like...
03:00If I've got my eyes closed, I know which...
03:04If it's fire police or us.
03:05Yeah, I think ours are nice, because they sound like what you think sirens should sound like.
03:10Woo!
03:11Woo-woo-woo-woo-woo-woo.
03:14To get through a 12-hour shift, I think you need your friends.
03:17Especially if you're in the cab 12 hours and you don't get on with your crewmate.
03:20It's a long day.
03:21Yeah, I find that you help me get through, but also coffee and...
03:28Food.
03:28Food.
03:29Snacks.
03:29And snacks.
03:34Are you calling about yourself or someone else today?
03:37That's my wife.
03:38We've had a rare carrying problem with her back.
03:40She's in absolute agony.
03:42She's struggling to breathe now with the pain.
03:44Can I speak, then, Pat?
03:46Do you want to try and see if you can...
03:49Oh, my God.
03:50Oh, my God.
03:51Can't breathe now.
03:57So, we're going to a 51-year-old female who's got ongoing problems with her back.
04:04I wonder if, like, what's different today than if it's ongoing.
04:07I wonder what's going on.
04:10Considering we knew it was already ongoing problems with her back,
04:13we've got to know why, what's prompted this call, what's different,
04:18what's changed to today, to how it's always been.
04:22Yeah, back pain can be quite excruciating and painful.
04:26So, sort of thinking about treatment options before we get there,
04:29before we assess the scene.
04:31A live scene.
04:36Hello, sweetheart.
04:37My name's Courtney.
04:38I've got Parker with us as well.
04:40Hello, guys.
04:41What's been happening, darling?
04:42I've slipped my disc.
04:44You've slipped your disc.
04:45When did you do that?
04:46About half an hour ago.
04:47Half an hour ago.
04:48How did you do it?
04:49I didn't do anything.
04:50I just got up on the sofa.
04:52Got it really awkwardly.
04:54When 51-year-old Beverly found herself in agony and unable to move,
04:59her husband, Andrew, called for help.
05:01Sister Kerry is also here.
05:04This is about the third time that this has left her incapacitised.
05:08You could tell that she was in pain.
05:10She said that she'd got up off the sofa and hurt her back.
05:13This is, like, the third time that this has happened.
05:16So, this is quite an ongoing problem for Beverly.
05:18Can I have a little feel and look at your back?
05:21Is that OK?
05:22Can I just...
05:22It's my hip, this side.
05:26It's painful even when I'm pressing here.
05:29Oh, God, yeah.
05:31Yeah.
05:32Between each bone in Beverly's spine is a cushion of tissue known as a disc.
05:37If one of these gets pushed out of place,
05:39it's called a slipped disc and can be extremely painful.
05:42Even just me touching like this, very painful.
05:46Where's the pain originating from?
05:48Where's it starting from?
05:50It's my spine.
05:51Right in the middle.
05:52Going all to the right.
05:54Like a spasm.
05:55Beverly needed to go to hospital
05:57because it would have been unsafe to leave her at home alone.
06:01The extrication is going to be difficult
06:02as her back was constantly in spasm,
06:04so we needed to manage her pain before we moved her.
06:07Oh, my neck.
06:09Oh, no, my neck's here.
06:10I don't have a neck should have pain in the middle of my head.
06:23Oh, what's that?
06:27Rubbish.
06:28That's a bag.
06:29A bit like a...
06:29Oh, it's not just an animal.
06:31Like a muntjac.
06:32It's about to jump out like Indiana Jones.
06:34Saved.
06:37I think being on the road,
06:38we're always so aware of what's going on.
06:40I think, is something going to happen in front of us
06:42or is something going to jump out at us or...
06:44Animal.
06:45Oh, yeah.
06:46Human.
06:46We've been vets before, haven't we?
06:48We have.
06:48It's got to be prepared for every eventuality.
06:50Exactly.
06:51Ambulance service, is the patient breathing?
06:58Yes.
06:59He's not making a lot of sense.
07:01His eyes keep rolling into the back of his head.
07:04He's been complaining of a pain in the upper abdomen.
07:07Okay, is it like a question,
07:09what a severe aching pain?
07:11What's your pain like?
07:14Very severe, I would say, at the moment.
07:16So, not responding normally.
07:22We've got vascular dementia,
07:23we've got a high temperature,
07:25on antibiotics and steroids.
07:286th of August had an MI.
07:30It was a heart attack in August.
07:31What's going on?
07:32They're not having much luck, are they?
07:34No.
07:35There's a lot going on there.
07:37When you get a patient that's got lots of medical conditions,
07:41you're thinking, well, which one of them,
07:44if any of them, are causing the concern today.
07:48So, is it something that's pre-existing,
07:51or is it something new?
07:52Hmm.
07:53This sounds like a bit of a minefield.
07:55It's hard with dementia as well, isn't it?
07:56What stage of their dementia are they at?
08:04I don't know what's where he is then.
08:05He's been a serial offender.
08:07Oh, dear.
08:07We've been here before.
08:09Yeah, you probably have.
08:10This will be now the third visit in less than a month.
08:15Right.
08:17Hello.
08:1973-year-old Nick has vascular dementia
08:22and is running a high temperature.
08:25Two months ago, he had a heart attack.
08:28Tonight, his wife, Elizabeth, called 999
08:31when he was unable to respond to her.
08:33He didn't want all his dinner,
08:34and he said he didn't feel that good.
08:37OK.
08:38So, I brought him upstairs,
08:40called him at 10 o'clock for his meds,
08:42and he just started telling me, yes, he was coming.
08:45And then, eventually, about half past 10,
08:46I came up and said, what are you doing?
08:49He's still here.
08:49And then he wasn't even responding at all to me.
08:52Do you feel a bit confused?
08:54Yeah, just a touch.
08:55When we got to Nick,
08:56it was quite clear that he was a little bit muddled,
08:59a little bit confused.
09:00He even said to me that he felt a bit confused himself.
09:03So, we have to consider, like,
09:05is that the vascular dementia
09:06or is that something that's going on today?
09:0939.
09:11At 39 degrees, Nick's temperature is very high,
09:15indicating that his body is fighting an infection.
09:19It's more concerning because of his recent heart problems.
09:23Because you saw on the notes that it said about chest pain.
09:26He's complaining of the pain here.
09:27And if you touch his tummy now, he'll squeal.
09:31Do you have any pain now?
09:34I don't know.
09:35Whereabouts?
09:35Can you point?
09:36Tummy.
09:37Into your tummy.
09:38Is it all over or in one particular place?
09:40Yeah.
09:42All over?
09:43Yeah.
09:44You're normally quite confused.
09:45Not as confused as this.
09:47Right, but.
09:47It's really important to listen to Nick's wife,
09:50as she did explain that his level of confusion
09:52was worse than his normal for his dementia.
09:55So it was quite important to look at the causes for that.
09:59And in this case, most likely was an infection
10:02causing his increased confusion.
10:05If I have a feel of your tummy,
10:06let me know if you've got any pain, OK?
10:08Ow.
10:09That's painful.
10:10What about here?
10:12Bit painful all over, aren't we?
10:13Any pain back here?
10:15No.
10:16So tell me generally a little bit about how you're feeling.
10:19Rough.
10:20Rough.
10:20In what way?
10:21Rough.
10:22Just generally unwell?
10:24Mm-hmm.
10:25So, main things are, we've got a temperature,
10:28so you've got an infection somewhere.
10:30Now, where that infection is, I'm unsure.
10:33And our oxygen level, we've just dropped down to 88.
10:38Although Nick's lungs don't appear to be congested,
10:41his oxygen levels are falling.
10:43I think there's no real question
10:44whether we're going to hospital tonight.
10:47And you're feeling pretty rotten, aren't you?
10:49We're ticking a few of our concerning markers, really,
10:53for an infection that needs to be treated probably with IV antibiotics.
10:58Danny and Lisa are concerned that Nick may have sepsis.
11:02This is the body's extreme reaction to an infection
11:05and is a life-threatening emergency.
11:09It wasn't appropriate for Nick to stay at home.
11:11I think the infection had gone past the point of being treatable at home.
11:15He'd already been on his antibiotics and his steroids,
11:17and they weren't working.
11:18So he was now ticking what we call red-flag sepsis,
11:21which can be very dangerous.
11:22It can lead to multi-organ failure,
11:24and you just need treatment very quickly,
11:27as it can be fatal.
11:38Relax this arm for me.
11:40I know you're in pain.
11:41To the south of Dudley,
11:43paramedics Courtney and Parker are with Beverly,
11:46who has severe back pain.
11:49We'll start off with some paracetamol, OK?
11:51Have you ever had Entonox before?
11:53Gas and air.
11:54Yeah.
11:55Ideally, if we can get you moving with the Entonox, great.
11:58So if it sounds like your back's sort of spasming at the moment,
12:02this is a muscle relaxant, OK?
12:03So hopefully that'll ease all that.
12:06Is that in your mouth?
12:07Entonox, or gas and air,
12:10is a painkiller commonly used in childbirth.
12:12What?
12:13When's your baby coming through there?
12:14I don't know. I've never seen it before.
12:15You guys remember this?
12:17Oh, God.
12:17I bet he hopes you're not having anyone's any time soon.
12:20No babies today, please.
12:21I know. It'll be a bit of a shock.
12:22Do you reckon you could move now, now you've had that, or no?
12:26It doesn't make up my feet tingle yet.
12:29You've got the giggles.
12:31You moved your legs for me.
12:33While Beverly inhales gas and air,
12:35Courtney gives her even stronger pain relief, morphine.
12:39Sharp, scratch, sweetheart.
12:41Nice and relaxed for me.
12:42Breathe in.
12:43Nice. Have a suck on the Entonox.
12:46The gas and air was definitely working for Beverly,
12:48so she was laughing with us, interacting well with us.
12:51Couldn't be too sure if moving her,
12:53she would be in a lot more pain,
12:55so that's why we give her some intravenous morphine.
12:58How's that pain out of ten?
13:00I don't move.
13:02It's about a six or a seven.
13:03And then when you do move, what's the pain?
13:0620.
13:0620.
13:07It's the realistic pain, child.
13:13We've got a smile now.
13:14I didn't get a smile when I first come in.
13:17With the pain relief starting to take effect,
13:20Courtney and Parker prepare to move Beverly to the ambulance.
13:24Nice big puffs to control your breathing
13:26with that Entonox, OK?
13:31There we go, sweetheart.
13:32OK, OK.
13:34Right, yeah?
13:35Do you want your dressing gown on?
13:35Yeah.
13:36Yeah.
13:37That's a sweet little three.
13:40You taking a squash mellow for reassurance?
13:43Where is he?
13:44Go on in?
13:45Yeah.
13:45Yeah.
13:46Beverly loved her squash mellow, and I did too.
13:49She wanted to take it with her.
13:50She wasn't going anywhere without it,
13:52and we sort of had a bit of a laugh with her about that,
13:54and I think it helped calm her and put her at ease.
14:00That's it.
14:01Keep pushing as you puff in.
14:02That's it.
14:03Keep going.
14:04There we go.
14:04Keep puffing.
14:05That's on that one.
14:05Keep up a fin.
14:07That's it.
14:08Ready?
14:09If you hold this, I'm going to help with your legs.
14:11Ready?
14:12I'm just going to sort of manoeuvre your body around.
14:14Ready?
14:15A few big steps.
14:15One, two, three.
14:16That's it.
14:17Keep breathing that in.
14:20And I'll just follow up the hospital.
14:22All right, guys, thank you so much.
14:23Thank you for your help as well.
14:25Husband Andrew will make his own way to the hospital while Courtney monitors Beverly's pain.
14:32What are we giving the pain now?
14:34It's about a seven or one.
14:35Out of 20 or out of 10?
14:37Out of 10.
14:38Out of 10.
14:38It's still there.
14:40Let me know when you're ready, Corp.
14:43Yeah, I'm happy when you are.
14:47What sort of started it all off?
14:50Like, did you have any trauma?
14:52When I was born, you just can't take it.
14:54Does that affect any of your, like, milestones?
14:57Slower, that's all.
14:58Like, three or four before I could walk properly in the straight line without stamping my feet.
15:02I gave up work two years ago because the hips were really bad.
15:05What did you do for work?
15:06I was, I worked at the pub down the road.
15:08Okay.
15:08I was a baker originally.
15:10You're much more relaxed than when we first got to you.
15:13I really felt for Beverly this condition can be quite debilitating.
15:17It's affected her childhood, it's affected her adulthood, and it can be quite difficult to live with.
15:21After 15 minutes, Courtney and Parker arrive at Russell's Hall Hospital in Dudley.
15:30So, puff on that for as long as you need, because as soon as we go in, it's goodbye.
15:35Oh, my God.
15:37I'm going down here.
15:37This is my emergency.
15:39Emergency?
15:40I'm going to have to treat myself.
15:42You won't get them no more.
15:43They've sold out.
15:44Don't tell me that.
15:45Here, doctors will x-ray Beverly's spine to find out if she has slipped a disc in her back.
16:00She was nice.
16:01Like, when she wasn't in pain, she was so funny.
16:04I know.
16:05It's just a shame, isn't it?
16:06Like, she was saying to me, she used to work at the pub down the road, and she had to give it all up, because she said she couldn't physically work.
16:14Oh, bless her.
16:20Let's get these leggies around.
16:22Near Evesham, paramedics Danny and Lisa are treating Nick, who has dementia and a very high temperature.
16:29There we go.
16:30He's moving better than you are.
16:36Good.
16:38With Nick secure in the back of the ambulance, wife Elizabeth will make her own way to the hospital.
16:44Nick's wife was his full-time carer.
16:46We see this so, so often.
16:49Patients being looked after by their partner full-time, particularly with dementia.
16:55It must be really, really difficult.
16:57You know, it's 24 hours a day, and they get no support or little support.
17:05Bye-bye.
17:06Bye-bye.
17:08We'll probably see you in a little while.
17:11No, no, no.
17:15Good evening, Worcester.
17:17It's Lisa on 4062.
17:1973-year-old male.
17:23I think it's a sepsis alert.
17:24He's confused.
17:26He says 14.
17:28Temperature of 39.1.
17:31He's got abdominal pain as well.
17:34And a recent MI and multiple infections and respiratory failure.
17:40Danny drives on blue lights as Nick urgently needs hospital treatment.
17:48Lovely.
17:48Thank you so much.
17:49See you in a bit.
17:50Thanks.
17:50Bye-bye.
17:50Your oxygen level just keeps dropping that little bit.
17:55And because you feel a bit short of breath, I'm just going to give you a couple of weeks.
17:58Not a lot.
17:59Okay.
18:00See if it helps a little bit.
18:03On the way to hospital, I was really quite concerned about Nick.
18:05He needed some extra oxygen just to keep his levels within the normal range.
18:12When somebody's suffering with sepsis, it affects all of your organs.
18:17So it was really important that we got Nick to hospital for his treatment as quickly as we could.
18:22Any chest pain at all?
18:25A little bit.
18:26A little bit.
18:26Whereabouts?
18:29So right at the bottom here.
18:31When they press there, does that hurt?
18:34It hurts a bit now.
18:38As Danny and Lisa arrive at Worcestershire Royal Hospital, they check Nick's ECG again.
18:43Since leaving the house, there's been some worrying changes to his heart trace.
18:47There.
18:50Oh, gosh, yes.
18:52So.
18:52Something developing.
18:54Potentially.
18:55So it was a concern that Nick had recently had a heart attack.
18:59So it was really important that we completed all of our checks, including a full ECG.
19:03There wasn't any depression on the other one?
19:05Not like that.
19:07No, not like we've got now, no.
19:11Ready to go.
19:12Here, Nick's heart will be closely monitored, and if he does have an infection, he'll be given intravenous antibiotics.
19:27He's had a lot go on these last few months, hasn't he?
19:29Hasn't he been the luckiest guy?
19:31Never rains before, hasn't it?
19:33Yeah.
19:34I mean, he's had some big things go on.
19:36Hmm.
19:37Hopefully.
19:38Feeling better soon?
19:39Yeah.
19:42You're yawning away now?
19:54I'm a psychopath, but I'm not joining you.
19:57It's weird.
19:58If my dog yawns, when I yawn, and you don't yawn.
20:02I do yawn.
20:03It's a bit worrying.
20:04I do yawn.
20:05You're like a machine.
20:06I'll get you to it over when I'm tired.
20:08You can tell when each other's tired.
20:09And you sort of have to step it.
20:12It is most of the time.
20:13It was the time.
20:14So you just take turns.
20:15Yeah.
20:20Ambulance services, the patient breathing.
20:24Yes, he is, but with difficulty.
20:26And what's the main problem?
20:28It's my husband.
20:29He suffers with very, very severe COPD.
20:32He's really, really struggling to breathe.
20:38It's a very well-failed patient.
20:40He's having difficulty breathing ever.
20:43Roger.
20:44Mobile.
20:47COPD uses oxygen, nebulise, history of strokes, takes blood thinners.
20:51If the patient with COPD, he's not got enough oxygen into his body,
20:57obviously this can cause the organs to shut down.
21:00And the patient did have a past of strokes and other issues going on.
21:05This taken into account, potentially,
21:07this could be quite a life-threatening job to go to.
21:10Ended night to you the last time, so...
21:11Hello, darling.
21:18Hello.
21:18You OK, my friend?
21:19I'm Abdul.
21:20This is Paul.
21:22So, what's going on, my friend?
21:23I was getting up to bed, and I got really short of breath.
21:28Right.
21:2968-year-old retired engineer Tom is struggling to breathe.
21:34He was admitted to intensive care a week ago with similar symptoms.
21:38Wife Gwen is with him.
21:39Does he always sound so chesty?
21:43Yes, he's got...
21:45COPD, yeah.
21:46Severe.
21:46What's his oxygen levels usually, that's right, aren't you?
21:49Er...
21:5094.
21:5194.
21:5194, that's with his oxygen on.
21:54Have a quick listen to your chest, my friend.
21:56Tom has an incurable respiratory disease called COPD
22:00that makes breathing difficult.
22:04Tom did look like he was struggling to breathe.
22:06He was quite pale, fairly clammy.
22:10And he just didn't look very comfortable at all.
22:13Every breath he was taking, he was hard-working.
22:16It was quite a struggle for him.
22:18Let's have a listen to the side.
22:22We'll give him a neb.
22:23He's got a wheeze, right-sided.
22:25He's had two.
22:26He's had two.
22:27We'll give him one of ours, darling.
22:28Abdul and Paul give Tom a nebuliser containing a drug that he can inhale.
22:34This should help open his airways, making breathing easier.
22:39So, the oxygen's slightly lower than it would be normally.
22:42Let's take these off you for a bit, mate.
22:44Oh, there we are.
22:47Right.
22:48I'm just going to pop this on your finger.
22:50It's a sharp scratch.
22:52So, you've been feeling unwell or anything before this happened?
22:55I've been feeling unwell all day.
22:57Just all day?
22:58Just in general, or...?
22:59Shortness of breath.
23:01Yeah.
23:02I had a stroke of breath.
23:04Right.
23:04Has that left you with any weakness?
23:06Yeah, all down the right side.
23:07Down the right side?
23:08Some people who suffer with COPD relate to breathing efforts,
23:15like trying to breathe from a straw.
23:17Yeah, and it's quite hard if you're doing that all the time, isn't it?
23:20Yeah, do you imagine how that feels like constantly suck air from a straw?
23:25It's going to be tiring.
23:27It's not nice.
23:28No.
23:28No, not nice.
23:29I think, as you've said, you've ended up in ICU before.
23:32Probably best to take you if it's similar to the last time.
23:35We're in the mud, darling, so don't worry, OK?
23:37I've moved, darling, you need to sing the book, please.
23:40Yeah, so we'll treat what we can here, and then we'll head off.
23:43Tom needed a go because he was struggling to breathe.
23:47Sometimes with COPD, you can't effectively cough.
23:50If you can't effectively cough, the mucus can build up
23:54and you can end up with pneumonia.
23:55He did have crackles, which I heard when I listened to his chest.
23:58At the very least, he needs a scan and assessment at a hospital
24:01just to rule in or rule out any sort of chest infection.
24:05Are you able to stand by yourself, or do you usually get help,
24:09or what do we normally do?
24:10I'll help him up, unless you want your friend.
24:12Do you want your friend?
24:13Yeah.
24:14Yeah, he's nervous.
24:15He's not good at all.
24:17OK.
24:17If it's too much, we can do something else.
24:23We're going to stick the satyrone back in there.
24:25If that's desaturating, then we're going to give him something else.
24:27I don't want him to, like, overexert himself
24:30if he's going to drop his oxygen.
24:32As standing seems to be a struggle for Tom,
24:35Abdul checks his blood oxygen levels once again.
24:3987.
24:40Right, stay where you are, mate.
24:42You're not moving.
24:43Let's have another listen.
24:45A normal blood oxygen level is around 95%.
24:49At 87, Tom is no longer getting enough oxygen into his body.
24:53Do you want to just get the stretcher in, mate?
24:56We're on the night shift with the paramedics
25:09of West Midlands Ambulance Service
25:10as they respond to all kinds of medical emergencies.
25:17Just try them on four litres using that, mate.
25:19There's no wheezer.
25:21In Dudley, paramedic Abdul and student paramedic Paul
25:25are with Tom, who's been struggling to breathe.
25:28I always titrate it down if it gets too high.
25:30Tom's oxygen had dropped below what we'd consider as normal,
25:33between 88% and 92%, so it is concerning.
25:37He needs to go to hospital quickly to get that sorted out.
25:40Right, do you think you'll be able to stand, turn and sit down?
25:45Yeah. Yeah? OK.
25:47I don't want you to overexert yourself.
25:49I'm going to keep the mask on.
25:50I could do it and I'll put an hand.
25:52If you take hold of your frame...
25:54Yeah.
25:55..and then I will come from the back.
25:57One, two, three.
25:58That's it. Well done.
26:00So we literally just need you to rotate round.
26:03All right, and have a seat now.
26:04Straight down.
26:05Straight behind you. Have a seat.
26:07There we go. Well done.
26:08OK?
26:09Yeah.
26:10There we go.
26:11Slow your breathing down for me, OK?
26:14Concentrate on that breathing.
26:1691.
26:17We've desaturated our mobilisation.
26:18In the UK, there's over a million people like Tom living with COPD.
26:24Smoking and air pollution are the main causes,
26:27making it the second most common reason why patients go to A&E.
26:32When I was young, everybody smoked.
26:33It's very much a generational thing as well, isn't it?
26:36At the moment, there's a lot coming through from the older generation
26:39because they used to work in factories and smoking pumps and stuff like that.
26:43And some people still smoke.
26:45How are you feeling at the minute?
26:46Not too bad.
26:47Yeah?
26:47Yeah.
26:49How are you feeling?
26:49There's your breathing.
26:51It's getting there.
26:53It's getting there.
26:58Wife Gwen will travel to hospital by car.
27:01I think the fact that even that slight movement, the oxygen went down,
27:05it is a bit concerning.
27:07So I think we made the right choice taking you in, my friend.
27:09You all good, mate?
27:11Yeah.
27:11Go for it.
27:15So the oxygen's good at the moment, yeah?
27:17Everything else seems fine.
27:19Yeah.
27:20After 10 minutes, Tom arrives at Russell's Hall Hospital in Dudley.
27:28This is his second visit to A&E in a week.
27:31Doctors will want to investigate how his deteriorating COPD can be better managed at home.
27:37Tom's is the 5,454th call to be answered today.
27:49Could you suggest the emergency, please?
27:52Get ready to fill up a ladder onto a plant pot.
27:55Responding to people in distress is what this job is all about.
27:59But there are some calls that stay with you.
28:02Calls that I dread would be baby CPR calls, so when they've stopped breathing.
28:07And you can always tell because you can hear a lot of the screams from the parents and the family in the background.
28:13But, yeah, I would say that's one of the worst ones that you can take.
28:19Ambulance service, is the patient breathing?
28:21Yeah, it's my granddaughter.
28:24She's only a few months old and she's nervous.
28:27My heart just sank.
28:29But then, like, your training kicks in and you know that you have to get the help arranged as quickly as possible.
28:34Come on, darling.
28:35OK, so I just need to know, I know she's struggling to breathe, but is she breathing regularly?
28:42She's not.
28:43Right, OK.
28:44So I'm just going to tell you how to give basic life support.
28:47OK, so I need you to put your phone on hands for your loudspeaker now for me.
28:50OK, put her on her back for me on a flat, hard surface.
28:54Just tilt the baby's head back for me very slightly and just lift her chin.
28:57Oh, yeah, okay, she's coming back now.
29:00She's coming back now.
29:01So is she breathing regularly now?
29:03Not really, no.
29:04We need to focus on her breathing now.
29:06So I need you to get her on her back for me.
29:08I need you to tilt her head back.
29:09She still wants to pop it out of her.
29:14OK, is that her I can hear crying?
29:16Otherwise she wasn't responding.
29:18OK, is she crying now?
29:20She's just, yeah, you can hear her.
29:22She's just crying now.
29:23Just turn her onto her side for me, OK?
29:25And just monitor her breathing for me.
29:27When you can hear the baby crying, it's a relief for me, in a way, because then at least you know that they are breathing, they're conscious.
29:36But ultimately, you obviously know as well that things can change drastically again.
29:39OK, so can you see her chest rising and falling regularly?
29:43It is.
29:44OK.
29:45So just keep her on her side for me.
29:47And is she still taking regular breaths?
29:49She is.
29:50I think the paramedics are here now.
29:52Just let me know when they're in the room with her, OK?
29:54Are they there?
29:54Yeah, they're here now.
29:55OK, I'll leave you with the crew then.
29:57Take care.
29:58Oh, thank you for your help.
30:00You're welcome.
30:01Take care.
30:01Bye.
30:02Bye.
30:07In Birmingham, paramedics Courtney and Parker are more than halfway through their shift.
30:13I want a new car.
30:15Where's that come from?
30:16I won the lottery last week.
30:18They said, like, the next day, like, congratulations, you have won the lottery.
30:23I was like, oh, my God.
30:24I'm a tenner.
30:26I was gassed with a tenner like you and you have a bit of palpitation.
30:29You start thinking, oh, my God.
30:30I was like, oh, my God, I won the lottery.
30:32I'm going to have to bring my mum.
30:33What would you do if you win the lottery?
30:35I think I'd give some to my family.
30:36Buy my mum a house.
30:37Mm.
30:38Move to Australia.
30:39Give me some.
30:41Think about it.
30:46Courtney and Parker's dreams of lottery wins are interrupted by a call from control.
30:51So we're going to a category one.
30:55It's coming through as an arrest, cardiac arrest, not breathing, outside of the prison.
31:00But they originally had a call a few hours ago for the same patient.
31:05But they don't know if...
31:06Are they breathing?
31:07Who's phoned?
31:08Who's phoned it in?
31:09Who's phoned it?
31:10Who isn't breathing?
31:11It's going to be a hoax, isn't it?
31:12Yeah, but it might not be a hoax.
31:14A cardiac arrest for us is quite a time-critical incident.
31:17We need to make sure we get there as fast as we can.
31:21All right, left.
31:24As they approach the last known location of the caller, Parker spots a man by the side
31:30of the road on his phone.
31:33That's it.
31:33Hello.
31:36Are you on the phone now?
31:39Who are you on the phone to?
31:42999.
31:43Can I speak?
31:45Have you called an ambulance?
31:47Have you called 999?
31:49Yeah.
31:50Pardon?
31:51Yeah.
31:51Have you said you're dead in a cardiac arrest?
31:54Yeah.
31:54Yeah.
31:54Why?
31:56Why have you said you're in cardiac arrest?
31:58Yeah.
31:58You're breathing, you're talking to me now.
32:05You've been sick?
32:06OK, so you're not in cardiac arrest.
32:10Hiya, mate.
32:11We're outside on a road by the prison.
32:15We're just having a chat to him now, so this isn't an arrest.
32:19Roger, that's all received.
32:22With this gentleman, he was stood up talking to us,
32:25so that's the first sign that he's not in cardiac arrest.
32:27However, then that poses the question as to why the call
32:30has come through as a cardiac arrest
32:32and why the call has been made.
32:33It's a hoax.
32:34Just trying to figure out why he's phoned an ambulance.
32:38As this came through as a cardiac arrest,
32:41paramedic officer Nathan has been sent to help Courtney and Parker.
32:45This is the patient.
32:47He's called to say he's not breathing in cardiac arrest,
32:49but they've had multiple calls from him today.
32:52How can we help today?
32:53How come you've called 999?
32:55What's wrong?
32:55Why do you want to go to hospital?
33:00What can hospital do to help?
33:07Have you been drinking?
33:10Alcohol?
33:11Yeah.
33:12Yeah.
33:12How much?
33:13A lot.
33:16Shall we get you on the ambulance and have a sit down?
33:18No, no, no, no.
33:20Have a walk.
33:21Stand up.
33:2230 miles away, paramedics Danny and Lisa are heading towards Worcester.
33:30Do you not feel the pressure in your ears right now?
33:33Are we going downhill?
33:34I'm going uphill.
33:35What do you mean we're going?
33:36How are we going uphill?
33:37Now we're going uphill.
33:39That was downhill.
33:40That was uphill.
33:41Now downhill.
33:42Now it's going uphill.
33:43No, stop.
33:44That's not uphill.
33:45We're still going downhill.
33:46Oh, that's downhill to me.
33:50I'm quite happy to accept that I'm probably not right.
33:56I don't know.
33:57Because my balance has always been so appalling.
34:01This is true.
34:02You do trip over air.
34:04I do trip over air.
34:05And I think maybe, you know, my inner gimbal isn't quite right.
34:11So I'm quite happy on this occasion to accept that I'm probably not right on this one.
34:16Just this time.
34:19Just the once.
34:25Ambulance service, is the patient breathing?
34:28Yes.
34:28I'm calling from a lifeline.
34:30I've had a 79-year-old male fallen, bleeding in his mouth.
34:35Okay.
34:35How do you fall?
34:36Fell from standing, I believe.
34:40So, he's 79 years old.
34:42Patient has fallen and is bleeding from the mouth.
34:45And then he's palliative.
34:47The cancer's basically eating away at his shoulder and some of his ribs.
34:52So he must be handled really carefully.
34:55And that job is almost 12 hours.
35:00This patient had been waiting over 12 hours for an ambulance.
35:03It does make you quite angry but then upset at the same time
35:06because it's something that is out of our control and it shouldn't be happening.
35:09I just feel so much for him.
35:12It just makes me quite upset.
35:22Hiya.
35:22I'm Danny and this is Lisa.
35:25Danny and Lisa.
35:26Yes.
35:27I'm so, so sorry how long you've been waiting for an ambulance.
35:3112 hours.
35:3212 hours, I know.
35:3579-year-old Philip has terminal cancer.
35:38He's been waiting all day with his partner for the ambulance to arrive.
35:43Have you got any new pain anywhere?
35:45No.
35:45Do you remember hitting your head on here at all?
35:48Yeah.
35:49On there?
35:50No.
35:51We're just going to gather a few numbers.
35:53Blood pressure, your oxygen level, your heart rate,
35:56just to make sure we're not going to do any more harm by moving you.
36:00OK.
36:01No pain in your neck or your back?
36:03No.
36:03Do you mind if I have a little bit of a feel?
36:05Yeah.
36:06Is that OK?
36:07You stay still.
36:08You just say, ow, or yes, if there's pain.
36:12Yeah.
36:14Oh, so no pain when you move your head?
36:16No.
36:17OK.
36:17It's all gone.
36:18That's good.
36:18Any pain in your hips?
36:20No.
36:21No?
36:21And you can wiggle your toes.
36:23Oh, good.
36:24We're having a little dance.
36:25Wiggle your fingers.
36:28Probably just a bit sore from being on this floor for so long.
36:31Yeah.
36:32Can I pop some stickers on your chest to check your heart?
36:34Is that OK?
36:35And then we'll look at getting you moved.
36:37So seeing Philip on the floor was quite heartbreaking, really.
36:41You know, he's laid there for over 12 hours.
36:44It's cold.
36:45It's, you know, it's a hard floor.
36:48It can't have been very comfortable for him.
36:50Just going to have a little listen to your chest, actually,
36:52while Danny's doing that, because your chest has sounded a little bit crackly.
37:02Stand up.
37:05That's it.
37:06That's it.
37:06In Birmingham, paramedics Courtney and Parker are treating a patient who rang 999 claiming
37:12he was in cardiac arrest.
37:14Have a seat on there.
37:15He's talking and appears fine, but they still need to carry out medical checks on him.
37:21Can we take your jacket off?
37:23Do your blood pressure?
37:25City hospital.
37:27Why do you want to go to hospital?
37:29Other than drinking, is there anything else wrong today?
37:33Yeah.
37:34What's wrong?
37:36Falling down.
37:36You're falling down.
37:38But are you happy with me to go?
37:40Yeah.
37:41As there's no emergency, paramedic officer Nathan heads off, leaving Courtney and Parker to deal
37:47with this patient who seems very keen to go to City Hospital.
37:52OK.
37:53Collapse because you're feeling unwell or fall because you're drunk?
37:59Drunk.
38:00Pop this in your ear.
38:01Do your temperature.
38:01If you're telling me that you're medically OK and that you're just drunk, why do you want
38:08to go to hospital?
38:11Yeah.
38:11Did you hurt yourself when you fell?
38:16You got chest pain?
38:18How come you're telling me you got chest pain now and you never told me you had chest pain
38:22half an hour ago?
38:24Is that because I'm telling you that I'm not taking you to hospital?
38:26It was going from intoxicated to being sick, to falling over, to being dead, to then having
38:33chest pain.
38:35It was a bit suspicious in a way because every time we asked him something, it was a new
38:40answer and it was sort of like he was trying to amplify what it was to get us to take him
38:46to hospital.
38:48There's nothing wrong, is there?
38:50You just need to go to bed.
38:54Ambulances aren't taxis, mate.
38:56You've called the ambulance multiple times to say that you're not breathing and in cardiac
39:02arrest and you've been walking down this road, up and down, absolutely fine, just because
39:11you want to lift to the hospital because it's closer to your house.
39:15Can you understand that we're not a taxi service, sweetheart?
39:18We're here for emergencies.
39:21There's poorly people waiting now while we're sat here talking about this.
39:26We're an NHS ambulance.
39:28There are people that need us more now, OK?
39:31We're just going in circles, all right?
39:34He doesn't need to go.
39:36It's a waste of time.
39:37He's just going to keep doing it and doing it.
39:39Hope's callers are very frustrating.
39:41As a service, we're in very high demand.
39:43So, adding on top of that, we have hope's callers, and it can mean that people aren't being seen
39:48to as quickly as possible, and eventually that can mean that it can cost lives.
39:54We're not taking you.
39:56We're not taking you, Dylan.
39:56Come on.
39:57Come on, then.
40:01See you later.
40:02All right.
40:02With the patient out of the ambulance, Parker and Courtney keep an eye on him to make sure
40:08he doesn't injure himself.
40:10What we do is we just follow him.
40:13In the 58 minutes that Courtney and Parker are spent with this patient, West Midlands Ambulance
40:19Service has received 169 calls for help.
40:22The reality is that this guy will probably call 999 again, purely because we never took
40:28him to hospital.
40:29It's a waste of time.
40:30It's a waste of resources, and it has an impact on the ambulance service.
40:35Five minutes after Courtney and Parker left this patient, he rang 999 again.
40:47People who abuse the system like this affect those that really need it.
40:51Let's borrow that finger, and then I'm going to take your temperature.
40:56Near Evesham, paramedics Danny and Lisa are with Philip.
41:01He's been lying on the floor for 12 hours, waiting for a paramedic crew to become available.
41:07Chest is as expected, but no wheeze.
41:1136.3.
41:1236.3.
41:14So that's good.
41:15And where did you get the pass or whatever?
41:18Your ECG looks good.
41:20Nice beating heart.
41:22Nice and strong.
41:24With all Philip's observations looking good, Danny and Lisa prepared to move him off the
41:30floor.
41:30All right.
41:31Yes.
41:32Can you lift your bottom for me?
41:33Just to get...
41:33Oh.
41:36Philip.
41:37Were you a dancer?
41:40Yeah.
41:40Yeah.
41:41Very nimble with your legs.
41:43I was so shocked.
41:45How nimble he was.
41:47His legs!
41:48Is that doing the can-can?
41:49Like, you know, he's frail, isn't he?
41:52Yeah.
41:52And, you know, being so unwell and on the floor for so long, but yet, I mean, he had
41:59some fantastic moves.
42:01He did.
42:02Danny and Lisa use an inflatable cushion to move Philip slowly and safely.
42:07So bend those knees.
42:11That's it.
42:13There we go.
42:14Right.
42:15How do you feel sat there like that?
42:17I feel a bit wobbly under the cushion.
42:19Yeah.
42:20But you don't feel dizzy?
42:21Yeah.
42:22No new pain?
42:23No.
42:24Good.
42:24How do you feel about standing?
42:27Yeah, I can do that.
42:28I'm going to ask Emily to do this.
42:31What do you want me to do, baby?
42:33Oh, we've got a routine.
42:37Philip's partner, Emily, is here to help him.
42:40You ready?
42:41Yes.
42:42OK.
42:44Lovely.
42:44Look at that.
42:45There we go.
42:46Are you OK?
42:47Yeah.
42:49Get moving, then.
42:50Turn.
42:51Take a turn now.
42:52That's it.
42:53Perfect.
42:54How are you feeling now you're sat there, Philip?
42:56OK.
42:57OK.
42:58Will you just do your blood pressure again now you're off the floor?
43:01I feel a lot better.
43:02Back in bed?
43:03Yeah.
43:04Yeah?
43:05Good.
43:06I'll sit on that floor for God knows how long.
43:12It was a long time, wasn't it?
43:14Do you want food?
43:16Please.
43:16You're ready for food?
43:19Sorry.
43:20Have you got any pain at all, Philip?
43:23Yeah.
43:24OK.
43:25It's a tumour.
43:28Hmm.
43:29Press it on.
43:31He just can't go in a minute.
43:34Hmm.
43:36Philip's observations are all fine.
43:38He won't need to go to hospital tonight.
43:41We're going to go now.
43:42All right.
43:43I'll leave you to it.
43:44Are you going to have your pudding?
43:46That's all right.
43:47You're very welcome.
43:48There's your spoon.
43:49You're all good.
43:50You can join us pudding in bed.
43:53Nice.
43:53You've got a sweet tooth.
43:55Oh, no, I'm fine.
43:56Thank you so much, though.
43:59That's so kind of you, but I'm all good.
44:02Good day, you.
44:04Come on in.
44:05I know I'm fine.
44:07I'm sure I'll get enough sugar through the night time.
44:09Thank you so much.
44:10You don't need to share your pudding with me.
44:13I'll take you all myself.
44:15You enjoy it.
44:16You take care, Philip, OK?
44:18Thank you, my love.
44:19It was nice to meet you.
44:21You take care.
44:22Don't cause too much trouble.
44:23No.
44:24I'm sure you don't.
44:25You're very welcome.
44:27Take care.
44:27Take care, Philip.
44:29It's been our pleasure.
44:31Our pleasure.
44:32You enjoy your pudding?
44:33Oh, oh, bless you.
44:35You enjoy that pudding?
44:37I will.
44:38Good.
44:38Philip was just such a sweetie, wasn't he?
44:40He was.
44:41You're offering me his pudding.
44:43I think that made my night.
44:45Generosity.
44:46You know, such generosity.
44:48Give me a little peck on the cheek.
44:50Oh, he's so cute.
44:52Such a lovely man.
44:57Beverly, who was in agony, had slipped a disc in her back.
45:03She was given morphine and referred to pain management specialists.
45:07She was discharged later that day.
45:10Tom, who'd been struggling to breathe, spent a week in hospital.
45:15He was put on steroids and given a different nebulizer to help his breathing.
45:21Nick, who had abdominal pain, was diagnosed with pneumonia and COVID.
45:27He was given intravenous antibiotics and after two days went home.
45:31And Philip, who had terminal cancer, fell over again at home.
45:37He contracted sepsis and pneumonia.
45:40And two weeks later, Philip sadly died.
45:47Next time.
45:48Right, Carol.
45:49Just go back as much as you can.
45:52A woman has severe chest pain.
45:55Our main priority was getting that pain under control.
45:58She needed an x-ray and she needed doctors to be able to figure out what was causing her breathing to be so laboured.
46:03A man with multiple sclerosis has an infection.
46:07You've got a few little crackles right at the bottom of your lungs.
46:1038.3.
46:12OK, so you're a little bit hot.
46:14Andy had quite a high temperature at 38.3.
46:17Along with the crackles on his lungs, we would be inclined to think that Andy has a chest infection.
46:22And a baby is constantly choking on her feet.
46:26Oh, projectile now.
46:28When Freya began choking on her vomit, we were hoping that she might be able to clear her airway herself.
46:35But we noticed at one point that she was really struggling.
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