999 - On the front line S11E08 (23rd June 2024)
999 - On the front line S11E08 (23rd June 2024)
Transcript
00:00Ambulance service, is the patient breathing?
00:03We don't know if he's breathing and he's not waking up.
00:07I've just been stung by a wasp on my lips.
00:10My mouth's been swollen up.
00:12They can't get him up. His whole body is shaking.
00:17RTC!
00:20This is a typical 12-hour shift with West Midlands Ambulance Service.
00:24It's not like a normal job.
00:26Nice and steady.
00:27What's happened then?
00:29In that time... Stop, stop, stop!
00:31..it receives over 2,000 calls for help.
00:34Does she still have the knife on her?
00:36I'm staying right here with you until we get the ambulance there, OK?
00:39From a population of 5.6 million...
00:43You are with people for the best and worst moments of their lives.
00:47Can you lift this leg for me?
00:49Anything like this happened to you before?
00:51You might have broken it, you might have dislocated it.
00:53..filming simultaneously with seven paramedic crews...
00:56Oh, sounds nasty. Yeah, roger, but on the way.
00:58Don't be afraid to call us, please.
01:01This is life...
01:03..on the front line.
01:04I'm back.
01:05If we don't get to a patient on time, it can cost lives.
01:15..with the sun up and most people still in bed,
01:18the paramedics of West Midlands Ambulance Service clock on.
01:22Lovely morning.
01:24It is. It's a very lovely morning.
01:26Right then, I think it might be time to start our day,
01:29so shall we see what's in store in the West Midlands?
01:31Let's go.
01:35Out on the road, the crews will spend 12 hours together,
01:39but for some, that's nothing
01:41compared to how long they spend with their mobiles.
01:44How much time do you reckon you spend on your phone a day?
01:47Oh, I don't know.
01:49Probably not as much as what you'd think.
01:52I probably spend more time on my phone.
01:54You do? It's the marketplace.
01:56I like a bargain, me. Yeah.
01:58Bargain hunter. That's why you've got me. I'm a bargain.
02:01And after a long day at work,
02:03there's nothing better than kicking back and watching cat videos.
02:07To be fair, I think we actually spend more time...
02:10We watch them together. ..together.
02:12Like, watching the phone and being like,
02:14oh, that's a nice video.
02:15Genuinely, I think I'm on my phone about 14 hours of the day.
02:1913, 14 hours of the day.
02:21Are you joking? No, no, see? I'm not joking.
02:24I also use it for learning Spanish as well.
02:27Learning Spanish?
02:33I'll have two chickens in the building. Two chickens!
02:44I've got to get the air con going.
02:46Ooh, I see the top of my bum.
02:51Oh, yeah, my seat's hot as well, you know.
02:54Oh, God, let's get some air.
02:56I want to sit in the sun, but then I can't.
02:58I love the heat, but not in this uniform.
03:00I think wearing uniform in hot weather
03:02and carrying all the equipment
03:04has to be up there with one of the worst things going.
03:07Yeah, it gets tiring. Tiring, sweaty. Uncomfortable.
03:10And it's just not a good thing, is it?
03:13Oh, it's just so warm. Now I'm sweating.
03:16If it was this heat and you were off work,
03:18that would be absolutely perfect.
03:20Top tier. Yes, can do.
03:23If I'm not at work on a nice hot summer's day,
03:26I think the perfect way to relax and unwind
03:29is to go in the garden, sunbathe, listen to some music.
03:32And lots of ice cream.
03:34Followed by an ice cream, that's key.
03:41Ambulance service, is the patient breathing?
03:43Yeah, the patient's breathing.
03:46I'm on Bilston Market and I'm with a lady, a gentleman,
03:49and he's been feeling really good.
03:52So is he, like, dizzy? Has he got weakness in his legs?
03:55What kind of symptoms?
03:59Has he ever had a stroke in the past?
04:06OK, we're off to the Bilston Market.
04:09So the patient's in the outdoor market.
04:11He's got weakness in the leg.
04:13The stroke or TA in the past,
04:15he's going to be potential neurological or stroke.
04:20So we'll see what's going on.
04:25This sounded like a potentially serious case
04:27and with it being in the market,
04:29it was going to make this job a lot harder.
04:31MUSIC
04:41It's quite busy, isn't it?
04:43Hello. Hello. Hello.
04:45Morning, Alan.
04:47So, Alan, Dan and Ellie, nice to meet you anyway.
04:49Nice to meet you, sweet.
04:51I won't keep you here too long, being in public.
04:53Twice I've been in the hospital.
04:55Oh, have you? OK. Oh, dear.
04:57They've said that...
05:00..they're having trouble with my heart. Yeah.
05:03It's not pumping right on the left hand side.
05:06Right, I've got you.
05:0877-year-old retired bricklayer Alan
05:11was out shopping with his partner Marilyn
05:14when he started to feel unwell and unsteady on his feet.
05:17My first impression when seeing Alan
05:19was that he was sitting on a chair and he was quite chatty.
05:22However, he was quite pale.
05:23Just give me your hands real quick.
05:25We're just going to do what's called a FAST test
05:27just to check your strength.
05:30Oh, that's good strength.
05:31And then hold them up here. Squeeze my hands.
05:34Dan checks for nerve damage.
05:36He also carries out what's called the FAST test,
05:39a series of simple tasks designed to show if Alan is having a stroke.
05:43Give us a big smile. Show me your teeth.
05:46Lovely stuff. That's fine.
05:48Does this feel the same as this?
05:50Yeah. And that? With that?
05:53Lovely. And your vision, is that OK?
05:55Yeah. No headache? No.
05:57That's fine. Not a problem.
05:59We'll get you into the back of the ambulance
06:01just so I can do some more tests. Are you OK getting up?
06:03Alan was actually FAST negative,
06:05which although means that there was no immediate indication of a stroke,
06:09he did have a significant history of previous strokes,
06:12so we were suspecting something neurological had happened with Alan.
06:16If you just pop yourself on here.
06:19Lovely.
06:28What are you doing food-wise? What have you got?
06:30Pasta, mozzarella and pesto.
06:32Are you making it yourself? Yes.
06:35It takes two seconds to do that.
06:38Do you put a load of, like, grease and fat in it
06:40like you do with your chips in the fryer,
06:42the healthy air fryer that you make unhealthy? Right.
06:44Your lunches are far too healthy.
06:46What, pesto, pasta and mozzarella? Yeah, too, right?
06:48There's lots of long words there I don't understand.
06:50It's a tongue twister as well.
06:52To be fair, I think your lunches are pretty healthy.
06:54I do try. You do try.
06:56But then you ruin it with a big burger from a fast food joint somewhere.
07:00Yeah.
07:06Ambulance service, is the patient breathing?
07:08Yes, he's breathing. He's unconscious.
07:10Is he fighting for breath?
07:12Yeah, he is.
07:14Yeah, he is panting, yes.
07:16He went with a cropper, he did.
07:18They can't get him up.
07:20His whole body's shaking, they've just said.
07:22So now he's having a seizure?
07:24Yes.
07:28Right, Amelia, we've got a Category 1 male.
07:31He's fallen in the garden.
07:33The patient's fitting,
07:35so obviously potential for traumatic brain injury here
07:38if they have hit their head quite badly.
07:41If someone's hit their head on something hard,
07:44there's risk for traumatic brain injury, skull fractures,
07:47neck and spinal injuries, amongst other injuries as well.
07:55Hello, my mate. Right, first things first, mate.
07:58Let me have a feel of your wrist quickly.
08:00What's your name? David.
08:02David.
08:0463-year-old David was in his garden when he felt dizzy and collapsed.
08:09A worried neighbour saw him across the fence and called 999.
08:13Keep your head nice and still for me.
08:15Have you bashed your head at all? No.
08:17Any pain down your neck here, mate? No.
08:19All right. Any pain anywhere at all? No.
08:21Did you collapse or did you fall over or...?
08:24I can't remember. You can't remember?
08:26Well, I was a bit concerned as to why he couldn't remember.
08:29Had he fallen and knocked himself out?
08:31Has he had a seizure while standing and then fallen?
08:34What is the cause of that memory loss?
08:36Why can't he remember what's happened?
08:38That's an important piece of the puzzle for me,
08:40to work out what injuries you might have,
08:42what assessments I need to do, where I need to go from there.
08:45Let's have a feel of your hips quickly. Any pain in your hips here?
08:48No. Any pain in this leg?
08:50It's just a bit when I start shaking.
08:53OK. Do me a favour. Can you bend this knee for me?
08:56Good man. And what about this leg?
08:59Can you lift this leg for me?
09:03If you can't, you can't.
09:05Can you normally lift this leg up?
09:07Yeah. Yeah? OK.
09:09Is that painful where I'm touching there?
09:11Open your eyes, sweetheart. Open your eyes.
09:13It was worrying when David didn't, you know, respond,
09:16because it could be due to a number of things,
09:19whether it be neurological, respiratory...
09:21Yeah, definitely. ..cardiac.
09:23It was definitely worrying that he'd been talking to us fairly well
09:26up until that point and then all of a sudden it was just stopped.
09:29Open your eyes for me, mate.
09:31Right. Look at me a second. Look to your right.
09:34Just keep your eyes open. I'm just going to shine this light in your eyes.
09:37OK.
09:39Have you got any headaches at all? No.
09:41No. Do you still feel dizzy at the moment?
09:43Just a bit. Just a bit?
09:45I was concerned that David could have been having a stroke
09:48and one of the tests we carry out to rule a stroke in or out
09:51is a fast test. We look at their face, their arms, their speech,
09:54to rule out if there is some sort of stroke going on.
09:57Do me a favour. I don't get everyone to do this,
10:00but I like you. Poke your tongue out at me.
10:03Poke your tongue all the way out.
10:05Literally... Look at me. Look at me. All the way out.
10:08That's it. Can you move it to the left for me?
10:10And the right.
10:12Can you move it to the right?
10:14OK. And relax. Relax.
10:16If David can't control the movement of his tongue,
10:19it could suggest he's had a stroke.
10:22Did you feel unwell when you fell?
10:24I felt dizzy.
10:26Felt dizzy? OK.
10:28Excuse me. Hello.
10:30Do you know roughly what time he fell?
10:33It was over an hour ago. Over an hour ago.
10:35I said, are you all right, David? Yeah.
10:37Next minute, he fell. OK.
10:39And when he was on the floor, was he talking to you straight away?
10:42No! How long was he sort of not talking to you?
10:4520 minutes. All right.
10:47I think we need a trip to the hospital, OK?
10:49So I'm a little bit worried as to how weak you are
10:51on this leg on this side, all right?
10:53And with the dizziness, I can't rule out there's something going on
10:56neurologically in your brain.
10:58Have you ever had seizures before or anything?
11:04Can we have a look on your doctor's notes?
11:06Yeah. Yeah? Cool.
11:09Ah, so you've got seizure disorder.
11:13David's records show he has a complicated medical history,
11:17including seizures.
11:19So the big issue we had with David was that his medical records were vague,
11:24so we couldn't give him the medication which we carry for seizures
11:27because his medical records had a very vague allergy to epilepsy medication,
11:32so it really left us in a conundrum as to what to do, how to treat him,
11:35because we don't know what he's allergic to.
11:38Let's get you off the floor and out of this heat,
11:40cos it's absolutely sweltering out here.
11:42Ready, steady, roll.
11:46There we go. Steady, lift.
11:48I'll see you, Dave. You'll get better.
11:50OK, thank you, Doreen.
11:52He said thanks, Doreen.
11:54Yeah, I like it.
11:55Couple of bumps, mate.
11:58Is anywhere hurting now we've moved you?
12:00Just the bottom of my back.
12:01The bottom of your back?
12:03Is it cos of the... Is it since you've been on this hard board?
12:05I don't know.
12:06Right, well, we're going to just log roll you.
12:08OK, sweetheart.
12:09Ready, steady, roll.
12:12Is that hurting? Yeah.
12:14Yeah.
12:15So we got David onto the back of the ambulance.
12:17He was complaining of lower back pain,
12:19so we just rolled him over to check to see where that pain was.
12:21He was complaining that it was on his spine,
12:23so at that point we were concerned for a spinal injury.
12:25David, what I'm going to do, mate,
12:27we're going to have to leave you on this really hard board.
12:29I'm sorry.
12:30Cos where that pain is, right in the centre of your spine,
12:32so you're going to need a scan to rule out any damage to your back.
12:34OK, so are you happy if I pop a needle into your hand or arm?
12:37We'll give you some pain relief.
12:39Not very good with needles.
12:41You can hold my hand if you want, sweetheart.
12:46This is the paracetamol I'm about to start now, OK?
12:49Hopefully this will start helping with the pain.
12:52Nigel gives David liquid paracetamol intravenously.
12:56This should help relieve his pain.
13:03Along with a suspected spinal injury,
13:06there's a risk David could have another seizure.
13:09Amelia and Nigel need to get him to hospital fast.
13:13How do you feel?
13:15A bit drowsy. A bit drowsy.
13:17How's that pain in your back?
13:19Is it better since I've given you that paracetamol?
13:22Yeah. Good.
13:25How long have you lived there for?
13:2912 years. 12 years.
13:31You've got a good set of neighbours, haven't you? Yeah.
13:33You're lucky you've got good neighbours looking out for you.
13:38You OK, David?
13:41David?
13:44David?
13:49David?
13:52Amelia, slow down a second.
13:54Suddenly, David begins to choke.
13:56Spit it out. Spit it out. Spit it out. Spit it out.
13:59What are we doing? Nigel, do you need me to stop?
14:02I need you in the back, mate. Stop. Stop, stop, stop, stop.
14:05Stop, stop, stop.
14:10I need you in the back. OK, I'm coming.
14:16Can you cut that top strap off?
14:18Oh, the bottom strap, sorry.
14:20To the south-east of Stoke,
14:22paramedics Amelia and Nigel are with David, who's started choking.
14:26Talk to us. Can you get the pads on for me, mate? Yeah.
14:30It's quite rare to have a seizure like this.
14:33It's quite rare to have a seizure like this.
14:35It's quite rare to have a seizure like this.
14:38It's quite rare to stop an ambulance on the way to hospital
14:42to support your colleague in the back.
14:45We were concerned that his airway might be compromised.
14:48Let's roll you back onto your back, David.
14:51He's getting quite brady, though, that was the problem.
14:54Brady, or bradycardia, means David's heart rate is slow.
14:58His heart rate did start to drop, which was a concern.
15:01When your heart starts to get very slow,
15:03it struggles to pump the blood round the body
15:06and it can cause... become dizzy, it can cause you to pass out,
15:09and ultimately, if your heart gets that slow,
15:11you will go into cardiac arrest.
15:1387, can we have red backup to our location, please?
15:18Yes, that's all received, thank you. I'll get you a crew.
15:21Amelia and Nigel urgently need help from another paramedic crew.
15:26It's called a red backup.
15:28Coming hypotensive. Let's get some fluids running.
15:32Still got a red.
15:35Her patient's suddenly deteriorated
15:37and we need two pairs of hands for airway management.
15:40Right, we're on pads. Blood pressure at the moment's failing.
15:44Open your eyes for me. Well done.
15:46That's it, good, ma'am. Keep your eyes open. Are you OK?
15:49Have you got any chest pain, David?
15:52I wonder if this is what's happened today.
15:54I wonder if he's had a seizure, fallen,
15:56and that's why they've then phoned us.
15:58And why he's been unresponsive.
16:0120 minutes. Yeah, cancer will go.
16:06The backup crew will take too long to reach Amelia and Nigel.
16:10They need to head to hospital now.
16:15His blood pressure was coming up, his heart rate was coming up
16:18and we could actually get going to hospital,
16:20which is where we needed to be because we couldn't get to the bottom
16:23of why this was happening or what was causing it.
16:25Are you OK?
16:28OK, mate, don't worry too much. We're nearing the hospital now.
16:32Just three minutes later,
16:34Amelia and Nigel arrive at Queen's Hospital in Burton-on-Trent.
16:39You OK, David? Yeah.
16:45You OK, David? We're just at the hospital now, mate, it's all right.
16:48Neurologists will want to run scans to try to find out
16:51why David collapsed today
16:53and what can be done to bring his seizures under control.
17:02It turned very quickly, didn't it?
17:04Yeah, I was going to say, it looks like it's going to turn for the worse, really.
17:07Doesn't it? Because he went downhill quite quick.
17:10Very, very, very quickly. On route to hospital, didn't he?
17:12And that choking was strange.
17:14I wonder if they'll get to the bottom of it at the hospital.
17:16He's in the right hands now.
17:19Pop your... Yeah, do you want me to help with your legs up?
17:22No, I'm all right. Lovely. Right, then.
17:26To the south of Wolverhampton,
17:28paramedic Dan and student paramedic Ellie are with Alan.
17:31He felt unwell while out shopping and may have had a stroke.
17:38It's a nice day, though, isn't it?
17:40You've got the sun out and everything, yeah.
17:42Right, a bit of a bump up on here, then.
17:49We're in. Perfect. We're just going to continue with our checks.
17:52I'm going to shine this light in your eyes real quick, all right?
17:55Lovely. So no change in your vision, no?
17:57I'm registered blind. You're registered blind anyway.
18:00OK. Did you witness what happened?
18:03Yeah, he couldn't walk.
18:05So he's just all funny?
18:07Alan's partner Marilyn is with him.
18:09Do you feel as if the symptoms have resolved?
18:12Do your legs still feel a bit funny, or would you say that...?
18:15My legs still feel a bit funny.
18:17OK. When was the last time you had a stroke?
18:20I think it was round about January.
18:22January this year. And was it a mini-stroke, a TAA,
18:25or was it, like, a big...?
18:27When I was drinking, the water was coming back down my nose.
18:31Given that Alan had a history of mini-strokes,
18:34he was at a significant risk of having another stroke.
18:37And what did you say about your heart?
18:39She mentioned something about you had...?
18:41The heart, I said that it's only pumping.
18:46It's not pumping very well.
18:48As, like, efficiently? I'm sorry.
18:50Okey-dokey. Not pumping very well. OK.
18:52And you've been taking your medications as you should? Yeah.
18:55Just based on his symptoms and what he's presenting with,
18:58obviously he's had a few TAAs in the past,
19:00which are obviously mini-strokes.
19:02There is the potential that another mini-stroke may have happened,
19:05given the symptoms have kind of resolved.
19:07So I'm going to call the stroke nurse at New Cross Hospital
19:10and see what she wants us to do.
19:12Either way, just based on your symptoms and what's happened,
19:15I would really recommend that we do pop you back up
19:17to New Cross Hospital today,
19:19just to make sure that there's nothing more significant going on,
19:22given the risk factors and his past medical history of strokes.
19:26So is that going to be OK with you, Alan? Yeah, of course.
19:29Costa del New Cross.
19:31Hi there, it's a paramedic on Wiskilema 4919,
19:35just with a patient at the moment.
19:37The time window for a stroke is four hours.
19:40From the point that these symptoms start
19:42to the point of getting to hospital
19:44will determine how well the patient recovers.
19:47She said that she's also in agreeance
19:49and would like you to get seen to in the local A&E,
19:52which would be New Cross anyway. Lovely.
19:54Are you going to go on your own? Do you want to come with him?
19:57I'll have to come with him. You'll come in? That's fine.
20:01Cool, we're ready, guys. Ready.
20:04People all run to us on the market.
20:07They're brilliant, aren't they?
20:09And they come to help you this morning.
20:11It's good that there's still good people around, that will help.
20:14It kind of restores your faith a little bit.
20:17He's a ladies' man.
20:19He's a ladies' man. Do you like the women, then?
20:21He likes the women.
20:23Even though you've got a partner sat right next to you,
20:25be careful what you say.
20:27I find that when you speak to people more on their level,
20:31they do open up more, it makes it a little bit more enjoyable,
20:34which, for the patient in their worst time of need, arguably,
20:38it does just help.
20:40Have you been together long, then, or...?
20:4225 years. 25 years? Wow.
20:45You've never made it official and got married?
20:48No. No. I won't speak twice, shall I?
20:53Alan and Marilyn arrive at New Cross Hospital in Wolverhampton.
20:58All right, we're all strapped in.
21:01Here, Alan will be assessed by the neurology and cardiology teams
21:05to get to the bottom of why he felt so weak today.
21:18The partner, she was like, he loves the women,
21:20and they were just having a bit of a laugh and a joke about...
21:23Oh, that's nice.
21:25..about, like, flirting with other people.
21:27I was like, how long have you been together?
21:29Cos they were, like, partners, they're not, like, married or anything.
21:32Oh, OK. And they're, like, 25 years.
21:34Some people just don't want to get married, do they?
21:36No, no, which is fair enough. You know what I think's crazy?
21:39Marriage, originally, it was so the men could have control, wasn't it?
21:42Yeah, yeah, it was, wasn't it? Like, power and stuff, yeah, yeah.
21:45When you think of the meaning, it's, like, very weird. Yeah.
21:56Oh, look at the sun setting.
21:58The trouble is, it's behind us.
22:00We had a really lovely, like, it was all orangey over here
22:03the other morning, our last night shift.
22:07It was pretty. It was pretty.
22:10Fetty. Do you remember that programme?
22:13Mm-hm. Some mothers do, haven't they? Mm-hm.
22:15Fetty. I was sort of...
22:18Fetty.
22:20Fetty.
22:22Fetty.
22:24Sort of 10, 11, maybe 12.
22:26So you're trying to say that I'm old?
22:28I only know it because of my dad, right? I am young.
22:31Oh, he's got that in there. I am young.
22:34I am. I only just turned 32.
22:36So I can't be that old for the programme.
22:39Are you saying that I look old?
22:41No, I would never say that you look young.
22:46You would never say that I look young?
22:49No, I said you would look young. Oh.
22:52Have you called me old?
22:54He might have. That's taken out of context.
22:56That's never... You probably do call me old.
22:59You should never ask a lady her age anyway.
23:01I'm a man-woman.
23:03So never ask me my age again, Tony. I'm a lady.
23:08No, I'm probably not.
23:12PHONE RINGS
23:14Ambulance service. Hello, police.
23:16Can we have your assistance, please, to an unresponsive male?
23:20So we're not sure if he's breathing unconscious?
23:22Yeah, that's right. OK.
23:24He's outside in the doorway.
23:27They don't know if he's breathing and he's not waking up.
23:344716.
23:39Yeah, no, that's all received. Thank you.
23:42So we've been tasked to a Category 1 call
23:46for a patient outside, querying cardiac arrest.
23:51A Category 1 call is given the highest priority,
23:54meaning there's an immediate threat to life.
23:57We've got no known age, just that it's a male.
24:00But they're in the doorway of a cafe, so...
24:05When we get that original information that it's a Cat 1,
24:08especially outside, you immediately start thinking,
24:11is it going to be chaos? Is there going to be people around?
24:14Is there going to be traffic?
24:16And am I driving safe enough to get there in a quick enough time
24:19to potentially save a life?
24:23Who knows how long they've been there?
24:25If a patient's in cardiac arrest,
24:27if CPR's not being done and a defib's not available,
24:30the chances of survival are almost zero.
24:34In the West Midlands,
24:36we're following seven paramedic crews simultaneously
24:39as they work a typical 12-hour shift.
24:46It's a fine girl on the bus stop here. Yeah, I think so.
24:50In Stoke, paramedics Linda and Tony are responding to a man
24:54reported to be in cardiac arrest.
24:57He's in the hospital.
24:59Paramedics Linda and Tony are responding to a man
25:02reported to be in cardiac arrest.
25:04They're met by the woman who rang 999.
25:08Hello. Is it that young man?
25:13OK.
25:15I'm just going to go and have a quick wander, then.
25:19Hello.
25:21Can we just step off this road, sweetheart? Let's get you safe.
25:24What's going on? Have you been asleep?
25:30Do you need an ambulance?
25:32You don't want us?
25:36It's always a relief when we arrive on scene
25:38and find that the patient isn't in cardiac arrest.
25:40It means that we can take a breath,
25:42we can take our time and try and help the patient.
25:46Just an update on scene, mate.
25:48The cat one patient is up and about walking.
25:50We believe he's an homeless chap.
25:52Linda's just having a chat with him at the side of the road,
25:55so all is safe and no other resources needed.
25:58Every patient that I go to,
26:00I try my utmost best to treat everybody the same.
26:02I don't know why a person is homeless.
26:04I don't understand their dark day.
26:06So we need to treat everybody the same,
26:08regardless of living requirements, sexuality.
26:10Everybody's the same.
26:12You all get the same respect and the same treatment.
26:16I genuinely don't think we have at the minute.
26:18I'm ever so sorry.
26:20You sure you don't want anything?
26:22Yeah?
26:24Where are you going to head to?
26:26You going up that way?
26:28You absolutely certain?
26:30Yeah.
26:32Take care.
26:34Doesn't want us.
26:38Yeah, I mean, he's up and walking about.
26:40He's obviously asked for a blanket,
26:42but we haven't really got any at the minute, unfortunately.
26:44Is there any on the bed?
26:46Just go the other side of the railings.
26:48There's more often than not a social aspect
26:51that we feel we want to help them with,
26:54and we know that everybody's stretched.
26:56Ourselves, hospitals, social services.
26:58And you just...
27:00You want to be able to do more.
27:02It's not really our forte, though, either.
27:04No.
27:06If it's emergency care, that's what we specialise in.
27:08With social care, we're good.
27:10But it's a lot of past experiences, isn't it?
27:12Yeah.
27:14We're just so limited.
27:18Go down that side, mate.
27:20I don't want you to get run over.
27:22It's going to be a bad day, won't it?
27:24All right, mate. All the best, dude.
27:30Let me have a look, see if there's one.
27:32See if I can get a blanket, see if we've got one.
27:34Ah, there is one.
27:36We're seeing more people being homeless now
27:38because they can't afford the bills at home.
27:40And it's a bit heart-wrenching
27:42when they've asked for the ambulance service for help
27:44and there's nothing I can do.
27:46And sometimes you will have to just shake their hand,
27:48give them a blanket and watch them walk away.
27:50It was fibbing.
27:52We found one for you.
27:54Do you want some water as well?
27:56You sure?
27:58Get yourself wrapped up in this.
28:00You OK?
28:02You sure?
28:04Last chance?
28:06Take care.
28:14Don't you always feel like you should just do more?
28:16Yeah.
28:18I always feel so sorry
28:20for the homeless people.
28:22Like, we've got no idea
28:24why they are in that situation
28:26and they get such
28:28a bad reputation.
28:30Like, he was a lovely gentleman.
28:32And not every
28:34person in the street is there
28:36because of drugs or alcohol.
28:38No, exactly.
28:40Some of them have had really bad upbringings
28:42of abuse
28:44and all the other demons that you can think of.
28:46I think we do appreciate as well sometimes, like,
28:48what is it they said?
28:50We're all two pay packets away
28:52from being homeless.
28:54Yeah.
28:56I think sometimes we do just need to remember that.
29:04From homelessness
29:06to heart attacks,
29:08West Midlands Ambulance Service
29:10receives all manner of calls.
29:12Has she had any blood loss?
29:14Listen, listen, just stop talking
29:16and listen to me.
29:18In the control room,
29:20call assessors are on shift around the clock
29:22making split-second decisions
29:24on who should get help.
29:26I love how important this job is
29:28because we are on the first line.
29:30Like, before anybody
29:32wants to speak to the emergency
29:34service, they speak to us
29:36first.
29:38Ambulance service,
29:40is the patient breathing?
29:42Is she conscious and away?
29:44OK, it's a car accident, is it?
29:46Yeah.
29:48OK, is the patient conscious and away?
29:50She is, yeah.
29:52Are you able to put the patient on the phone?
29:54Yeah.
29:56Hello, this is the ambulance service
29:58and you said you've got head pain
30:00and neck pain, is that correct?
30:02Yeah, I know.
30:04Have you lost any blood?
30:06No, no.
30:08No, OK. Is there any multiple swellings
30:10I can't see it.
30:12OK.
30:14Hiya.
30:16Hello, this is the ambulance service.
30:18Who am I speaking to?
30:20It's the husband.
30:22I'm trying to go for an assessment with your wife.
30:24All right.
30:26Are you able to put her back on the phone?
30:28Yeah.
30:30OK, please stay in the line with me
30:32so I can get you some help, OK?
30:34Yeah, that's fine.
30:36These questions might seem irrelevant
30:38usually, but to us,
30:40every question we ask,
30:42there's a reason for it.
30:44We need to ensure
30:46that we're going to get you the right help.
30:48Right, I've arranged you some help.
30:50But today,
30:52the pressure on the service is considerable.
30:54Mate, I have 60 minutes
30:56before an ambulance arrives, OK?
30:5860 minutes?
31:00We will be there as soon as possible,
31:02though, OK?
31:04So a clinician from our service may give you a call back
31:06just to discuss the most appropriate course of action.
31:08So please ensure to keep the phone line clear.
31:10OK, I will.
31:12Lovely.
31:14When I'm telling our callers
31:16that it could take up to an hour
31:18for an ambulance
31:20to arrive, it does
31:22make me feel sad, but what I've got to remember
31:24is I've ruled out
31:26anything life-threatening.
31:28And it's not actually one hour,
31:30it's up to one hour.
31:32They also may get a call back from a clinician.
31:35Just get to a safe place, OK?
31:37So if there's any new symptoms, anything changes,
31:39worsens, you've got any other concerns,
31:41call us back on 999.
31:44Although under significant pressure,
31:46it took just seven minutes
31:48for an ambulance crew to reach the patient.
31:54PHONE RINGS
31:56Are you calling about yourself or someone else today?
31:58Er, me.
32:00And what's the reason for the call today?
32:02Er, I'm out of breath.
32:04I'm panting.
32:06It's a bit of a pain in my chest.
32:08I've got a bad heart, anyway. I feel horrible.
32:10Do you have a heart condition?
32:12Yeah, I had a heart attack.
32:14Do you have the chest pain now, as we're speaking?
32:16Yeah. It's like a nagging.
32:18It just won't go away.
32:22So, Nive,
32:24we've got a 66-year-old
32:26male. He's out of breath,
32:28panting, he's had some chest pain
32:30and previously had a heart attack.
32:32When we're sent to someone who's had a heart attack previously,
32:34we're looking to see if they've
32:36got problems with their heart again.
32:38We are looking for symptoms such as
32:40the patient being sweaty and clammy,
32:42having central crushing chest pain,
32:44pain radiating into his neck
32:46or down his left arm.
32:50Hello there, sweet. Are we here for you?
32:52Yeah. What's your name, poppet?
32:54Michael. Michael, I'm Amelia
32:56and this is Nigel. Have a feel of your pool,
32:58sweetheart.
33:00What can we do you for? What's going on?
33:02Poppet items.
33:04I've got a bad heart.
33:0666-year-old retired baker
33:08Michael had a heart attack
33:10five years ago. How long has this been
33:12going on for? About six
33:14this morning.
33:16My shoulder hurts. Is that
33:18pain from your chest into your shoulder
33:20or is it a different type of pain?
33:22I've had a bad back since Sunday.
33:24Can I do some observations
33:26on your chest? You might as well.
33:28Can I nick an arm, please?
33:30Michael was sitting comfortably,
33:32not clutching his chest, which was a nice sign.
33:34However, we can't completely rule out that
33:36he's not having a heart attack without
33:38completing the relevant assessments.
33:40So, the pain in your chest,
33:42point to it for me, where is it?
33:44And what does it feel like?
33:46An aching pain.
33:54Oh, can you do me a favour?
33:56What? Can you get my
33:58lash brush out of there?
34:00Are you going to say it in your bag?
34:02Yes.
34:04We've been together now
34:06for...
34:1217 months.
34:14Where is it? Whereabouts did you drop it?
34:16Was it Love at First Sight?
34:18Probably not, no.
34:20I'm not sure.
34:22Probably not, no.
34:24Is he one of those that
34:26has to grow on you? Absolutely.
34:28Oh, God, here we go.
34:30No bloody doubt.
34:32Like a bad smell, I just keep lingering.
34:34Pretty much, yeah. There you go.
34:38This guy here, innit?
34:44Ambulance services, patient breathing.
34:46Yes, the patient's
34:48breathing, it's me. I've just
34:50been stung by a wasp, and I've just
34:52injected myself with a
34:54needle, and where the wasp
34:56stung me, it's on my lips, so my mouth's
34:58been swelling up. OK, all right.
35:00Do you feel like you're improving at all after
35:02giving the injection? I don't think I'm going
35:04down worse, but I certainly feel my
35:06lips
35:08swelling up. Yeah, so you're not getting any better?
35:10No.
35:12So, we're going
35:14to a 66-year-old
35:16male, who's
35:18had a wasp sting, a suspected
35:20allergic reaction.
35:22There's no notes available,
35:24it just says rapid swelling of the
35:26lips, so it could be
35:28a potential anaphylaxis, this one.
35:30Anaphylaxis can be
35:32a very, very life-threatening situation,
35:34and if we don't get there in time,
35:36we can make the difference between life
35:38and death. I've actually been stung by
35:40a wasp, twice.
35:42First time I was stung by a wasp,
35:44I was on a school bus. On a school bus?
35:46School bus.
35:48Well, obviously, actually, I was on a school bus.
35:50I got stung right underneath my nail bed.
35:52My whole hand swelled.
35:54No, no, no!
35:58Let's find a way in.
36:00Hi, guys, come on in.
36:02Hiya. OK.
36:04I'm Shawnee, this is Ian behind me.
36:0866-year-old retired builder
36:10Michael rang for help when a wasp sting
36:12caused his mouth to swell up.
36:14His wife Eileen is with him.
36:16I'm just going to have a feel of your wrist, buddy, OK?
36:18Yep. When I first arrived,
36:20I could see that his
36:22lips and his face were quite swollen,
36:24so at this point I was concerned about
36:26his airway. With anaphylaxis,
36:28things can change quite rapidly.
36:30So, tell me what's happened today.
36:32Well, I was enjoying a scone with cream and jam,
36:34and I was joined by a wasp.
36:36Oh, God. And the wasp thought,
36:38I'll have some of that. She didn't realise.
36:40Went up in my mouth and obviously
36:42bit me on the lip there.
36:44I had one exactly the same time,
36:46four years ago, in the summer,
36:48in the back garden with a bottle of beer.
36:50And that's when I knew I had to have a...
36:52I said, you need to have
36:54one of these EpiPens.
36:56Was it an anaphylaxis reaction?
37:08OK, open your mouth nice and wide for me.
37:10On the outskirts of Wolverhampton,
37:12paramedic Ian and technician
37:14Shaunie are treating Michael.
37:16He's had an anaphylactic reaction
37:18to a wasp sting.
37:20How does your breathing feel?
37:22Feels fine.
37:24It feels fine, OK? You don't feel tight or anything like that?
37:26No, no, I'm just slobbering at the mouth, that's all.
37:28OK, bless you.
37:30Did he sting you on the inside of your mouth, did he?
37:32No, all I know, it's there somewhere.
37:34It's there somewhere. Somewhere. Where is it? I don't know.
37:36While he's popping the Aesop's on,
37:38am I OK to just have a quick listen to your chest?
37:40Is that OK?
37:42No talking, nice deep breaths for me.
37:44Things we're looking for
37:46with an anaphylactic reaction
37:48is swelling of the mouth and throat.
37:50We're also looking for
37:52somebody's breathing rate
37:54and how their breathing sounds.
37:56Sounds nice and clear.
37:58I can't hear any wheezes or anything,
38:00so I'm quite happy with that.
38:02Have you had any Piriton or anything like that since?
38:04No, no, the only thing I did was the old...
38:06Yeah. ..EpiPen.
38:08Michael injected himself with adrenaline
38:10from an EpiPen.
38:12The drug works by relaxing the muscles in the airway,
38:14making breathing easier.
38:16The last time, it was worse than that,
38:18but I think because of the EpiPen...
38:20I think the reaction of that EpiPen
38:22has reduced it greatly.
38:24Done its job, hasn't it?
38:26Michael's fast reactions in using his EpiPen
38:28potentially did save his life.
38:30I've been indoctrinated by this lady here.
38:32Well, I wasn't here, and he says I've been stung
38:34and I've given him my EpiPen.
38:36I said, right, ring 999.
38:38Have you got any Piriton?
38:40I'll go and have a check.
38:42And this is why I'm terrified of wasps.
38:44I really, really hate wasps.
38:46I am so, so terrified of them.
38:48It is unreal.
38:50I've never been stung before in my life, touch wood,
38:52and I am terrified that I would be
38:54the type of person that would have a wasp sting
38:56and have an anaphylactic reaction to it.
38:58So, post-EpiPen,
39:00post-adrenaline that's been given, OK,
39:02you are meant to be monitored for 12 hours.
39:04Right.
39:06So, I think it's going to be a case of
39:08we will probably advise hospital,
39:10but, but,
39:12you've got capacity to make the decision.
39:14I'm happier to stay.
39:16I will just get you to sign the board
39:18to say that you are going against our advice,
39:20and you're going to be stopping with him as well,
39:22so, obviously, if there's any problems or concerns,
39:24just give us a call back straight away.
39:26I tell you what, that is a view and a half
39:28to sit there with a nice bottle of red wine.
39:30I'm catching myself there all day.
39:32Oh, good in this weather.
39:34Was that where you were sat when you were...
39:36Just sitting on there.
39:38..on there with your cream tea?
39:40Absolutely.
39:42The question is, was it clotted cream first,
39:44then jam, or jam, then clotted cream?
39:46Jam, then cream.
39:48Oh, no.
39:50That's correct.
39:52For me, I'd say clotted cream, then jam.
39:54I can give or take scares,
39:56but if I'm going to have one,
39:58if it was, it was nice until after he was.
40:00Yeah, oh, bless you.
40:02I'd be really upset if it spoilt mine, too.
40:06Wife Eileen brings Michael some antihistamine tablets
40:08to help reduce the swelling.
40:10Take one now, see you again.
40:12Hopefully the swelling should start to come down.
40:14If it's coming down and goes, then don't take any more.
40:16OK.
40:18Yeah, and certainly don't take more than stated,
40:20because you'll put yourself to sleep.
40:22Do you guys want drinks? I know you're busy.
40:24No, no, no, I'm good, thank you.
40:26No, we haven't.
40:28Does it come with a free wasp?
40:30Thank you, pal.
40:32All right, then, you're very welcome.
40:34All the best, take care.
40:44Oh, they were lovely, weren't they?
40:46That was nice, very nice.
40:48Beautiful house.
40:50Lovely couple, lovely house.
40:52Now, this is why I'm terrified of wasps,
40:54because they have full-blown anaphylaxis.
40:56That's all right, we can treat it.
40:58Yeah, but still.
41:00Depends where you are at the time.
41:02If you're miles away from an ambulance, then...
41:04Oh, in that case,
41:06I'll just carry a shovel with me at all times.
41:08A shovel? Oh, that's not nice.
41:10Don't dig my grave.
41:12I was there just to fight the wasps away,
41:14not for any other reason.
41:16Oh, my hero.
41:18Have you had anything?
41:20Something like that.
41:22I took some aspirin, too.
41:24How many of those aspirin tablets did you take?
41:26Two. Two? OK.
41:28To the north of Birmingham and Cannock,
41:30Amelia and Nigel are with Michael,
41:32who's complaining of chest pain.
41:34What were you doing
41:36when this pain started, Michael?
41:38Watching TV just as you are.
41:40Do you suffer with angina at all?
41:42You do?
41:44Thank you, sweet.
41:46Angina is chest pain
41:48caused by reduced blood flow to the heart muscles.
41:50Right.
41:52Do you mind if I bob these on you?
41:54It's not usually life-threatening,
41:56but it's a warning sign
41:58that Michael could be at risk
42:00of a heart attack or stroke.
42:02Right. I'm sure you know the drill,
42:04but just keep nice and still,
42:06no movement, no talking.
42:08I'm just going to do your heart tracing.
42:10Looks all right to me.
42:12Are you taking all your medications?
42:14Are you taking all your medications
42:16as you should do?
42:18Yeah, you're not missing doses or anything like that?
42:20No? Brilliant.
42:22Yeah, Nigel, I'm happy.
42:24Well, considering you've had an heart attack before,
42:26your ECG ain't too shabby.
42:28This chest pain, obviously,
42:30we can't completely rule out that it's not cardiac.
42:32Even though your ECG's showing
42:34that it's absolutely tickly-boo,
42:36we've still got to bob you up to hospital if that's OK.
42:38Yeah? Perfect.
42:40Just before we do it,
42:42this little bit might give you a really bad headache.
42:44All right.
42:46But hopefully it'll take that pain away.
42:48Tongue to roof of your mouth for me.
42:50Tongue to roof of your mouth.
42:52That's it. Sorry.
42:54This spray is designed to widen Michael's blood vessels,
42:56reducing the risk of a heart attack.
42:58Got a big old transport collection here, haven't you?
43:00Oh, I've got nearly 1,000.
43:02Really?
43:04I thought it was quite an impressive collection of trucks in his house, to be fair.
43:06It was, and he had loads.
43:08He had a lot.
43:10They were in pretty much every role, weren't they?
43:12Yeah.
43:14Are these all second-hand, then?
43:16I don't know.
43:18Pretty cool.
43:20How's that pain doing now, mate?
43:22Eased a bit.
43:24What have you just got out of ten now?
43:26A six.
43:28At least we're coming down the right direction.
43:30I hope the rest of that aspirin will kick in.
43:32You all right, then?
43:34Let's hit the road.
43:36It's difficult outside of hospital to 100% determine
43:38if it's your heart.
43:40They have to do a blood test that looks for a protein in your blood,
43:42which would indicate your heart's under stress,
43:44which we can't do outside of hospital.
43:46Once again,
43:48Michael is attached to an ECG machine
43:50so Amelia can monitor his heart
43:52on the journey to hospital.
43:56Right, are you comfortable?
43:58As much as you can be, anyway.
44:00We're ready to go!
44:02Hopefully,
44:04your bloods will come back
44:06nice and clear
44:08and then you can get your send back home.
44:14Michael arrives at New Cross Hospital
44:16in Wolverhampton.
44:18Right, let's unclip you.
44:22Here, doctors will want to run further ECGs
44:24and blood tests
44:26to look for any signs of a heart attack.
44:28But he was a lovely chap, wasn't he?
44:30Yeah, he's not a chap,
44:32and all those models as well were pretty cool.
44:34Apparently, he's been collecting them since the age of four.
44:36Since the age of four?
44:38Since the age of four, that's what he said.
44:40Wow. I don't think I've got the commitment
44:42to go that long to collect anything.
44:44No.
44:46Just collect a few more years every time we go along.
44:48I only collect consistently.
44:50So, Michael,
44:52you've been collecting for a long time.
44:54Yeah.
44:56I only collect consistently.
45:04In hospital,
45:06Michael's blood tests showed
45:08he hadn't had another heart attack.
45:10Cardiologists thought the episode
45:12could be stress-related.
45:14Five hours later, he was back home.
45:16Alan, who felt unwell,
45:18hadn't suffered a stroke.
45:20With his heart not working
45:22as effectively as it should,
45:24doctors thought that might be why
45:26he nearly passed out.
45:30And David, who collapsed in his garden,
45:32was in hospital for seven days.
45:34Blood tests, scans
45:36and X-rays were unable to identify
45:38the exact cause of his seizure.
45:46In this series...
45:48It's the ambulance here. Are you OK?
45:50..we followed seven paramedic crews
45:52as they responded to medical emergencies
45:54across the West Midlands.
45:58But life on the front line
46:02does have its lighter moments.
46:04Action.
46:10Rock, paper, scissors, shoot.
46:12Rock, paper, scissors, shoot.
46:14I'm going to literally shove you off the chair
46:16in a minute.
46:18SHE LAUGHS
46:20Oh, my arse is so sore on this chair.
46:24Take 152.
46:26Happy birthday!
46:28SHE BELCHES
46:30You have a stroke!
46:32SHE LAUGHS
46:34I completely forgot the question. I'm sorry.
46:48MUSIC CONTINUES