999 - On the front line S12E02 (11th May 2025)
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00:01Ambulance service is the patient breathing.
00:04I've fallen in the night.
00:07I'm now finding it really difficult to move
00:09because 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.
00:18I've got the key and I can't get in.
00:20He's got the chain on.
00:22Starts in the morning, eh? I know.
00:25We're on board with the paramedics
00:27of West Midlands Ambulance Service.
00:29This job changes every day.
00:35Can we get fire or police?
00:37Somebody with bolt cutters.
00:39Pay 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,
00:48six million people rely on them.
00:51You can go to people giving birth
00:54and 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.
01:04Take steady breath for me.
01:06...capturing life...
01:08Oh!
01:09...on the front line.
01:10There's no price you can put on saving somebody's life.
01:14Oh, God, my trousers are a bit tight today.
01:28It's 6.30am and the paramedics are suited and booted for another 12-hour shift.
01:35Right, I've got all the radios.
01:39Yeah.
01:40It's supposed to be up today, isn't it?
01:41Yeah.
01:42Might have to take my coat off.
01:43I'm moving out.
01:44Right, OK.
01:46Right, OK.
01:47Right.
01:48Let's go.
01:57As the skies brighten over the West Midlands, thoughts 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...?
02:23I went to Mallorca once and it was after two weeks and it rained for like 12 days.
02:30That's where I'm going!
02:32LAUGHTER
02:47Paul, Abdul, action.
02:49Snap.
02:50I worked at a safari park.
02:52Mm!
02:53And it was my job, the one day, to, uh, jet wash the lion and crowd,
02:57obviously before the lions was let out.
02:59Yeah.
03:00I had a man watching me with his gun and everything.
03:02Yeah, yeah.
03:04Well, anyway, my protector in the jeep
03:07decides that he needs to use the facilities.
03:09The person in the tower sees the jeep leave in sight.
03:13Think so. It's all clear.
03:16It's absolutely fine. It's nearly time to open.
03:19I'll let the lines out.
03:20What happens, just turn around and glance over my shoulder.
03:23Right.
03:24There's five lionesses charging towards me.
03:28Full pelt.
03:28So, were you scared, mate, when you had these lines?
03:32I'd be lying if I said I wasn't scared.
03:34Yeah.
03:35The old survival kicked in, that's to say.
03:41My legs move very quick.
03:44I'm impressed you managed to move that quick.
03:45I can move quicker than I want to.
03:48Mate, Usain Bolt has got nothing on me.
03:51Ambulance service is a patient breathing.
04:00He 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.
04:08Tony, Tony, Tony, can 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.
04:23When 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?
04:36Chain on door.
04:37Oh, well, door's getting kicked in, mate.
04:41So, right in here.
04:44That red door there?
04:45Yeah.
04:45You all right, mate?
04:49Yeah, we've got some.
04:50What's up, buddy?
04:52Well, you won't open the door to anybody.
04:54I don't know if he's stuck down the bottom here,
04:56but we can't get in, because I can unlock people.
04:59So, the chain on the net is...
05:00It'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.
05:13Is he talking like he normally talks?
05:18What's the matter, mate?
05:20He's not talking like he normally talks.
05:21He's diabetic in here, so...
05:22Yeah, put the door in, mate.
05:25With 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 down the door.
05:40Is there another door in, Mick?
05:41No.
05:42No back door?
05:43Can you move away from the door?
05:45He's at the bottom of the stairs, mate.
05:46Yeah, I can.
05:49You know on the right-hand wall?
05:50Yeah.
05:51Is it painted clean, or is there marks on it?
05:54This would be clean, right?
05:55There could be blood, mate.
05:57Yeah, that's blood.
05:58He's come down the stairs.
05:59Yeah.
06:01Tony, have you moved?
06:03I opened the letterbox, and I thought,
06:04that looks like blood.
06:05You're thinking, well, where's this blood come from?
06:07Yeah.
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?
06:13Where's the blood coming from?
06:15Are you going to take a photo?
06:16I'm going to try.
06:21He's very confused.
06:22His pupils are fully dilated.
06:25He's not making much sense.
06:27I'll break his foot if I give you a roll.
06:29Zero, go ahead.
06:30Powered.
06:31Yeah, can we get fire or police?
06:33Somebody with vault 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.
06:46We can see through the letterbox.
06:48So we're clearing trauma, top to bottom of stairs.
06:50Over.
06:50Yeah, roger.
06:56Paul, three minutes.
06:57OK.
06:58So potentially he's got an injury on top of having low blood sugar.
07:03How long has he been on the floor?
07:04Has 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.
07:18Fire engines will be here shortly.
07:34I would say that all kind of nice tasting food and drink
07:39is generally bad for you.
07:41Because when you think about it,
07:43I'd be quite happy to eat chips and chocolate
07:46and drink beer all day.
07:47It's bad for me, isn't it?
07:51Would you like to eat just chips and beer, Neil?
07:54Oh, I do.
07:55And live longer?
07:56And you'd live longer?
07:58Why does junk food taste so nice?
08:00Probably because of the salt content.
08:03Yeah.
08:03More salt.
08:04You always want more salt on it, don't you?
08:06And fat.
08:07I always think fat tastes quite the best.
08:08I 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, oh, you must eat some chocolate.
08:20You just haven't got enough sugar in your diet.
08:23Ambulance service.
08:30Is it a patient breathing?
08:32Um, she'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.
08:41Female in her 60s, difficult in breathing,
08:50and that's all we've got.
08:52You know when you get a sixth sense about a job?
08:55Mm.
08:55You think this woman's going to be really ill?
08:57Yeah.
08:59Oh, jeez.
09:00We do get a sixth sense sometimes going to jobs,
09:03and nine times out of ten we're right,
09:06and it's hard to explain.
09:08You just read the job and you think,
09:09I think this is a proper job.
09:11That one, that one at the end there, isn't it?
09:22Hello there.
09:23What's your name?
09:24How can we help you?
09:27We've got difficulty in breathing.
09:30COPD.
09:31Pop your finger in here while we're talking.
09:3465-year-old Linda has an incurable lung disease called COPD.
09:39When she was struggling to breathe,
09:40her son called 999.
09:43Daughter-in-law Hayley is with her.
09:45Can we try and sit you up a bit more in bed?
09:47You better sat right up.
09:49Because your oxygen levels are on the lower side.
09:52Your heart rate's up, OK,
09:53and your SATs on air at 72%, which is way low to what we want.
09:58Oxygen levels at 72% essentially mean that your brain and all of your organs are being starved.
10:05Ultimately, that can lead to death of tissue.
10:08Yeah, I'll tell you what, stick that on.
10:10That's it.
10:11Just, all right, all right, just calm it down.
10:14Calm it down.
10:15So when did your breathing start to get bad then?
10:17Well, I don't have to fall for a minute.
10:19Yeah.
10:20And then...
10:21Oh.
10:22Oh, please help me, Lord.
10:29You can't help but feel slightly panicked yourself when someone's saying,
10:33please help me.
10:34But it certainly, as a paramedic,
10:36it certainly focuses the mind on what you're doing
10:39and what you're going to do for this person.
10:42Can I have your arm a minute?
10:43I know we're attacking you from all angles, aren't we?
10:45I won't care.
10:47Right, sharp scratch on your arm, OK?
10:49Here we go.
10:50Go on.
10:52Ah, please help me.
11:05Keep talking to me, Tony.
11:06In Dudley, paramedic Abdul and student paramedic Paul
11:11are trying to reach Tony.
11:14They suspect he's having a diabetic hypo
11:16and is trapped behind his front door.
11:18He's fallen.
11:19We don't know whether it's top to bottom of stairs,
11:21so it might be best going up from the back and down the stairs
11:24so we can assess him properly.
11:26With blood seen on the wall,
11:28it looks like Tony has fallen down a flight of stairs,
11:30badly hitting his head.
11:32The fire service has been called.
11:34That's the door.
11:36Oh, that's his foot.
11:37And there's only a small landing at the bottom of the stairs.
11:39We can't get to the chain either now because he's moved his foot.
11:41OK, no worries.
11:42Come to my guys, if we can get around that way.
11:45We'll be in in a minute, mate.
11:47Fire brigade are here, OK?
11:50Tony?
11:51OK.
11:52He's got third speech.
11:55He has got third speech.
11:56With Tony's condition worsening,
11:59firefighters search for a way to get into his flat.
12:03Chuck, sir.
12:04Do the drive, mate.
12:05Are you happy for me to use your ladder to go in?
12:09Yeah, you happy for me to go in?
12:09Yeah, that's fine.
12:12Are we good?
12:13OK, mate.
12:14With no other way of reaching Tony,
12:17Abdul follows the firefighter's lead.
12:19No, that's where they are.
12:23Cleared all this.
12:24That's fine.
12:24Come on, let's go in.
12:25Yep.
12:27Come in.
12:28Come in, mate.
12:29I'm in.
12:30Wonderful.
12:30Cheers, mate.
12:32Are you all right, Tony?
12:34All right.
12:35OK.
12:37Got any pain in your neck?
12:38Don't know.
12:39You got any pain in your back?
12:41No, don't know.
12:42No?
12:43Don't know.
12:44Don't know?
12:45No.
12:46OK.
12:47I'm just going to do your blood sugars, mate.
12:48OK?
12:50Where's all the blood come from?
12:52He's got his head on the soil, yeah.
12:54He's got a big lump on the top of his head as well.
12:56There was blood.
12:58He was lying on top of his walker.
12:59There was blood on the walls.
13:01He felt very cold as well.
13:03His 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,
13:08so all equipment had to be brought around the property,
13:12up the ladder, then down the stairs.
13:14Sharp scratch.
13:18Passes the cannulation kit, mate.
13:19Yeah.
13:20Can we get this chain cut off, mate?
13:23His blood sugars are 0.9.
13:26I need some glucose.
13:27Your blood sugars are too low.
13:30Paul!
13:30Yo!
13:31Give him the spinal board head blocks.
13:33Yeah.
13:34Basically, all this, mate, all this needs to go up.
13:37As 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.
13:51I'm just trying to get a vein.
13:52The light down here isn't the best.
13:54Right, 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.
14:08So, I couldn't feel any veins.
14:12I couldn't see any veins.
14:13So, it was very difficult to cannulate.
14:15I had a few goes and, in the end,
14:17I decided just to leave it
14:18and we'll just get him out before having a look on the ambulance.
14:23You want some gluca gel 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.
14:44It's washed the glass on the floor.
14:45Yeah, same, mate.
14:47I've got a D for you, but we're in.
14:48There you go.
14:49You got it, mate?
14:51As Abdul is going to need help moving Tony,
14:54Paul also heads up the ladder.
14:58There's that lump on the top of his head.
15:00I'm not happy about that.
15:08You've had nebulisers before, is it, Kit?
15:12Are you in the hospital?
15:14To the north of Worcester,
15:16paramedic Neil and technician George are with Linda.
15:20She has COPD
15:21and dangerously low blood oxygen levels.
15:25Oh, I can't breathe, honestly.
15:26I'm just going to take it off for a minute.
15:29George gives Linda a nebuliser.
15:31This contains a drug that she can inhale,
15:34which should help open her airways.
15:37Oh, my God.
15:38Please don't.
15:39Oh, God.
15:41That's it.
15:41Just try and slow it down a bit.
15:44Having experienced
15:45shortness of breath myself,
15:47it's extremely scary.
15:50No matter what anyone
15:51says to you,
15:53just breathe.
15:54It sounds so simple,
15:56but in those moments, it's not.
15:59So I'm just mixing this drug up.
16:00It's what we call hydrocortisone, okay?
16:02And it will reduce inflammation in your lungs,
16:05hopefully help you out a bit.
16:06Right, so that's that.
16:09You have to do it fairly slowly.
16:11All right?
16:14As well as the nebuliser,
16:16Neil gives Linda a steroid drug intravenously.
16:19Together, they should start to ease her breathing.
16:25So that's a 92 now, right?
16:27I don't know what we do without you people.
16:29Wow, what can we say?
16:31You feel a bit easier.
16:33Yeah, all right.
16:34Okay.
16:37Well, I'd be panicking as well
16:39if I were you.
16:42When did you stop smoking?
16:46Did you work?
16:47What industry were you in?
16:51Oh, really?
16:51Oh, okay.
16:52They said it could have been chemicals,
16:54called alcohol.
16:55Yeah, 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
17:06that have had jobs in industrial environments
17:10with chemicals and that, isn't it?
17:12And dusty environments.
17:13Yeah.
17:13What did you do for a living?
17:15I mean, at the time,
17:17you don't realise how it's going to affect you
17:19in later life, do you?
17:20Got colour on your face now.
17:22There you go.
17:23You still got to go to hospital, though.
17:25You work a breathing still a bit too high, really,
17:27but we're not expecting to wave a wand
17:29and cure you here.
17:30I'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
17:49and travel on blue lights to hospital.
17:53Oh, I can't breathe.
17:54I can't breathe.
17:55Sit there, then, for a minute.
17:58You all right?
17:59She panics.
18:00Sorry for all this.
18:01It's all right.
18:02When Linda gets anxious,
18:03it stops her taking deep breaths,
18:05making it difficult to move her.
18:08I'm not doing this back, so I can't breathe.
18:09Yeah, I know.
18:10Yeah.
18:11It's funny, too.
18:12Shall we try it one last time?
18:14Yeah?
18:15Tell you what, let's think outside the box a little bit.
18:19Grab that pillow off there.
18:20What I'm thinking, that in there like that.
18:24Listen, we do this every day, OK?
18:27OK.
18:27Getting Linda out of the property was a challenge,
18:32bearing in mind she's very short of breath.
18:34Trying to get her to sit and somewhat relax on a chair
18:38while we carry her down the stairs sounds easier than it is done.
18:42And we'll sit you right up.
18:44Oh, God, I can't do this.
18:46That's it.
18:47You're all right, can't you?
18:48You're doing really well.
18:49Just ringing in an alert to you.
18:52Exacerbation of COPD sat on oxygen 91%.
18:56We have a heart rate of 120.
19:02OK, George.
19:03Let's get moving, then.
19:04In the UK, COPD affects around 3 million people like Linda,
19:10making it the second biggest cause of hospital admissions.
19:14So I've obviously contacted the hospital, OK?
19:17And they're going to see you straight away, OK?
19:23The journey to Worcestershire Royal Hospital takes 35 minutes.
19:27In A&E, doctors will stabilise Linda's oxygen levels
19:42and look at how to manage her COPD better.
19:52Well, like you said, we had a sixth sense with that job.
19:55Isn't it weird how you can tell?
19:56Yeah, I don't know, I get, like, a bit of a gut feeling
19:58before you get there.
19:59She felt a lot better, didn't she,
20:01by the time we got here, so we've done something right.
20:04Yeah.
20:10Chuck, there's the head blocks, please.
20:13Have we got the scoop up here as well?
20:15Yeah.
20:17In Dudley, Abdul and Paul are trying to move Tony.
20:21He's having a diabetic hypo and needs to go to hospital.
20:24We'll get the scoop under him.
20:26Yep.
20:27We'll slide him up the scoop.
20:28We're going to have to support his head and then bring him up.
20:31Move this leg.
20:34We're going to put you on a plastic board.
20:36You've got the scoop there.
20:36OK?
20:37Do you want to come here?
20:39Yeah.
20:39You straddle him as well.
20:40So we'll get the two fire at the top here.
20:43You grab his head then, I'll grab his torso.
20:45That's it, yeah.
20:45Yeah?
20:46Right, straddle him.
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?
21:00Yeah.
21:01Right, on slide.
21:02Ready, steady, slide.
21:03It's all right, mate.
21:07It's OK.
21:08We need to slide him up here.
21:10This isn't going to be nice.
21:12On three.
21:13One, two, three.
21:16That's better.
21:17Right.
21:18Right.
21:18Head goes there.
21:19That slides on either side.
21:21Once Tony is safely on the board,
21:24Abdul and Paul can move him to the ambulance.
21:30Right.
21:30We good?
21:32Right.
21:32Come on.
21:33You can open the back of the truck.
21:35Right, guys.
21:37Thanks, guys.
21:39Right, Tony, I need to pop this on your face, matey, OK?
21:42Your veins are shocking, mate.
21:45Sharp scratch.
21:46Hello, mate.
21:47I've got a silver trauma for you.
21:50After more than an hour extracting Tony,
21:53Paul lets the hospital know they have an elderly trauma patient.
21:57He dropped 13 stairs, four flights of stairs.
22:01Patient is diabetic.
22:02His BM levels have risen with glucose gel.
22:07No, I can't get a line in there.
22:08Yeah, just get going then.
22:10OK.
22:10Yeah, no worries.
22:12OK, mate, move in.
22:13That's fine.
22:14Go for it.
22:16Tony needed to go to hospital because his blood sugars were low.
22:20We did manage to bring them up with some glucose gel.
22:22It only acts for a short period, so we needed to get him out for all the quickly.
22:29Right, pop this in.
22:30Open your mouth for me.
22:32Right around your gums.
22:33With no access to Tony's veins, Abdul continues to give him liquid glucose in the form of a gel.
22:40Go, man.
22:40On blue lights, it's a five-minute journey to Russell's Hall Hospital in Dudley.
22:48Bring that down a bit, buddy.
22:50There we go.
22:52Here, Tony's spine will be x-rayed, his head wound closed, and his blood sugar levels stabilised.
22:58What are you having for breakfast?
23:18I've got a protein shake.
23:20Ooh.
23:21It's just down there, but I've only had a little bit of it.
23:23I think we definitely get through a 12-hour shift mainly through our utter random conversations and...
23:29Snacks.
23:30And the snacks.
23:31Snacks.
23:31We always have a bag of snacks.
23:33Yeah.
23:34Do you think it's just never going to stop?
23:35We just bring snacks in for each other, don't we?
23:36We do.
23:37Yeah.
23:37It's great.
23:39I've got my waffles in my bag.
23:41I just haven't quite toasted them yet.
23:43They'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, and then just have piles of crushed up food.
23:53Oh, you're going about yourself with somebody else today?
24:03I've fallen in the night, and I'm now finding it really difficult to move because it's so painful.
24:10It's in the area of my right kidney.
24:12I think I was sleepwalking.
24:14I've got 80-year-old Jeanette, but she's fallen in the night and hurt her back.
24:23So, she's on the floor?
24:24It gives that impression.
24:26We often go to people that fall at night time, don't we?
24:30It's really quite common.
24:31I think I just find it a bit strange that there wasn't a call sooner.
24:35Yeah.
24:35I mean, it's quite common, isn't it, though, that that generation tend to wait quite a while.
24:41They do.
24:42Often, don't they?
24:52Hello, Jeanette.
24:54It's the ambulance.
24:56Oh, there you are.
24:58My name's Lisa.
24:59This is Danny coming in.
25:01Who have we got here as well?
25:02That's my husband.
25:03He's not well either.
25:04He's not well.
25:05Oh, bless you.
25:08Eight-year-old Jeanette looks after her husband, Bill, but after falling in the night, she's the one who needs help.
25:14And I felt...
25:15It was quite warm as well.
25:16And I banged my back in the area of my right kidney.
25:22I think I must have been sleepwalking.
25:24So, you were able to get yourself up off the floor?
25:27I did, yes.
25:28Not too bad?
25:29Just that, with my husband not well.
25:31Yeah.
25:32I can't do anything for him at the moment.
25:35I think Jeanette, bless her, she was more concerned about her husband, so I think maybe that's why she didn't initially call straight away.
25:41She didn't want to leave him.
25:43Give us a shout out to any pain.
25:45It's just in the kidney area.
25:48That side?
25:49Not there, no, no.
25:51Oh, just there?
25:52That's where it is, that's where it is, that's where it is, no place.
25:54I think there's a few considerations really, isn't there?
25:57Are we safe to stay home?
26:00Should we see how we are standing and walking?
26:04Could you put your hand over where the pain is?
26:07Here?
26:07No, no, no.
26:08Under ribs on there.
26:09There, there.
26:09Yeah, there, you see, that's where the pain is.
26:12The other consideration is whether we've injured our kidney.
26:17We wanted Jeanette to walk to the bathroom because she wasn't keen to go to hospital.
26:22We had to make sure that she was safe, so you have to be able to maintain your own dignity,
26:27go to the bathroom, do the basic kind of tasks if you're to stay at home.
26:32Oh, God.
26:34Oh, God.
26:46Across the West Midlands, we're following seven paramedic crews simultaneously
26:51as they work a typical 12-hour day shift.
26:55So there's a chair right behind you tonight.
26:57There you go.
26:58Yeah, there's a chair.
26:59In Malvern, paramedics Lisa and Danny are treating retired schoolteacher Jeanette.
27:05She fell on her back, and now the pain is so bad she can hardly move.
27:10I think if we can't even get to the bathroom, I think we're really going to struggle just
27:13to even get up and down the stairs.
27:15This week has just been an absolute end of the line, really.
27:20And to do this, to hurt my back like this, when the girl needs me so much.
27:25Jeanette felt quite a responsibility that she wanted to stay at home and look after Bill.
27:31And there was quite a lot going on for both of them.
27:34It must have been really stressful.
27:37Jeanette, if we were to go to hospital, they might be quite satisfied that it's soft tissue,
27:43but then they'll be able to prescribe you more pain relief, really.
27:47OK.
27:48Unable to cope with the pain, Jeanette agrees to go with Lisa and Danny to the hospital.
27:54So it looks like we're going to have to take your lady into hospital.
27:59Right.
27:59So our issue now is what we're going to do with you.
28:02I'll be all right.
28:03I'm just tired at most.
28:05You're tired.
28:06Easy, actually.
28:07I felt quite concerned when we had to leave Bill at home, but bless him, he was quite adamant
28:12that he was OK and that he would manage while Jeanette was being checked out at the hospital.
28:18Satisfied that Bill will be OK on his own,
28:21Oh, well done.
28:22Lisa and Danny helped Jeanette down the stairs.
28:25Why should I not lie?
28:27Ring somebody if you need help, OK?
28:29OK, thank you.
28:30You're welcome.
28:30Take care.
28:32Ready, steady, lift.
28:34You can try and get yourself into the most comfortable position that 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 to the Alexandra Hospital in British.
29:04All right, ready?
29:05Yeah.
29:07Here, doctors will investigate what's causing the severe pain in Jeanette's back.
29:25Every day, West Midlands Ambulance Service receives over 4,000 calls for help.
29:30Is 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 and navigate it to build that rapport
29:49and get the caller to listen to you so they can trust you to help them.
29:57Ambulance Service, is the patient breathing?
29:59Yeah, so I'm in the square lane.
30:02OK, bear with me.
30:03Are you the patient or somebody else?
30:06No, I just don't feel well.
30:08What's the address of the emergency?
30:10Where exactly are you?
30:12Well, I'm in the square lane.
30:13OK, 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?
30:20I don't understand why it's so hard.
30:23Listen, listen, we can't just send an ambulance out to everybody.
30:27We have to go through details first.
30:30How old?
30:31I just feel just cold and fucking...
30:35I just don't feel well, like.
30:38Have you got pain somewhere?
30:39You've 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 an exact reason for the ambulance.
30:52We're not there, so we need all the information that they can give us.
30:57I can't do anything, mate.
30:59I can't fucking breathe hardly, mate.
31:03OK, so you feel like it's harder for you to breathe at the moment whilst you're not doing anything.
31:08OK, so we've got some help organised for you.
31:11I do need to make you aware that at the moment,
31:14the ambulance service is under significant pressure
31:17and it may be several hours before an ambulance may become available.
31:22Is there any way at all that you can safely get your own way
31:25to the local hospital emergency department?
31:27OK, there's no need to start swearing now, is there?
31:38I'm just trying to get some help organised for you.
31:40Getting 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.
31:52That's a totally wrong boy.
31:55OK, obviously I appreciate it's not ideal waiting a few hours for an ambulance
31:59but that is unfortunately the situation that the ambulance service is in at the moment.
32:13Oh, I can smell that. Bit of soil is in it.
32:15Yeah.
32:16Oh, lovely.
32:17I had to wake you up in the morning.
32:19I like the smell of it.
32:20Not that smell.
32:22Oh, yeah, it's lovely.
32:24I'll tell you what it does smell bad, chicken poo.
32:27Have you ever been past the field and say chicken poo poo?
32:29No, no.
32:30Oh, my God.
32:31Is there a difference between cow poo and chicken poo?
32:35I don't know if I...
32:35I'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.
32:43Yeah.
32:44I think, yeah.
32:45I'd rather not smell either, to be honest.
32:48Clear your nose out.
32:50Smell of the countryside.
32:51Ambulance service, is the patient breathing?
33:02Yes.
33:03My husband's saying he can't stand.
33:07I've just got this terrible pain,
33:10and I don't seem to be able to breathe.
33:16Right, we've got a 70-year-old male
33:18with abdominal pains.
33:21Shortness of breath.
33:23Unable to talk and unable to move.
33:26So, with abdomen pain,
33:28we could be looking at an aneurysm within the tummy,
33:32which, if that bursts, that can be fatal.
33:34Nausea and vomiting.
33:36Unable to go to the toilet.
33:38Sounds like he's got loads of things going on.
33:41Hello, salami, this crew.
33:51I just feel your pulse always telling me what's happening all.
33:54Yeah, I've got this terrible pain in my stomach,
33:58in my bowel,
33:59but I can't breathe anymore.
34:01And I've lost all my energy,
34:03because I'm quite a fit person.
34:06Yeah, OK.
34:0770-year-old Mike has been in pain for three days.
34:11When his condition worsened,
34:13his wife Susan called 999.
34:15So, the abdominal pain, how bad is that pain?
34:19It goes from ten down to about six.
34:22Right.
34:23You don't normally suffer with any stomach problems
34:25and bowel problems?
34:26No, I'm...
34:27You're...
34:28Pretty irregular.
34:29I mean, I had this bad tummy two days ago
34:33and I went to bed all right,
34:35but then it's three o'clock and bad.
34:38With the abdominal pains is really what woke you up?
34:42Yeah, so you felt sick as well with it?
34:44Yeah.
34:44Yeah, 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.
34:59Um, his bowels have always been a little bit.
35:01Would you say they've been off recently?
35:03Well, I'm just not going there.
35:05I usually go about four times a day.
35:07If you've got abdominal pain and you can't go to the toilet,
35:11it'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?
35:31I think we just eat a lot of chicken.
35:33So, I used to do the shopping for the care room
35:34and a lot of our staff was Asian staff
35:37and there was always moaning because I'd do a Sunday lunch
35:39but I could never have it because it was normal chicken.
35:42Yeah.
35:43So, I started paying a bit extra.
35:44So, halal chicken, so that I could have it
35:46and there was what happened.
35:47Yeah.
35:48What's your secret recipe?
35:49Have you got 12 herbs and spices that you rub on?
35:52No, mate.
35:52It's not 12 herbs and spices.
35:55A bit of salt and pepper and bang it in the oven sort of thing.
35:58No masala?
35:59No, no masala.
36:00No, no spice, no heat.
36:02No turmeric, no masala.
36:03Nothing?
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.
36:13My 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.
36:28I have a pain in my tummy.
36:31There is a drop of blood in my distrails too.
36:41What night?
36:42At one, for a 25-year-old who is six months pregnant.
36:47If she's actually got pain in the abdomen
36:48and she's got some bloody discharge.
36:52All received in my bar, thank you.
36:55Possible miscarriage.
36:57Six months?
36:58Six months.
37:01Paul looks up the latest guidance on premature births.
37:0524 weeks.
37:06I think pre-terms class is 22 weeks.
37:09If a baby is born at 24 weeks, they do need advanced care.
37:13Having them born at home is not ideal, so you would potentially just try and get them on the ambulance and get them to the hospital.
37:23I don't know what we're going to find.
37:26I don't know what we're going to find.
37:28Grab the maternity pack, mate.
37:30In West Bromwich, Abdul and Paul have been sent to a woman who's pregnant and complaining of abdominal pain.
37:49What's happened?
37:50What's happened?
37:50I'm just bleeding.
37:52All right, okay.
37:54So you've got some bleeding today as well?
37:55Yeah.
37:55Any clots?
37:56No.
37:56How far pregnant are you?
37:58Six months.
37:59Six months.
38:00All right.
38:00Any other problems?
38:01Just the bleeding.
38:03Just the bleeding.
38:03So this started this morning, spotting blood?
38:06Last night.
38:07Last night?
38:08Okay.
38:10This is 25-year-old Simranjeet's first baby.
38:14Husband Harjeet is with her.
38:17Do blood pressure and stuff, mate.
38:18What colour is the blood, though?
38:20Is it dark or is it bright?
38:22Light.
38:23So we've got fresh blood.
38:26First, Abdul checks Simranjeet's blood sugar levels.
38:303.5, mate.
38:32When's the last time you had something to eat?
38:34Oh, good morning.
38:36Your sugar's below what it should be.
38:37Your sugar should be at least four.
38:39Yours is 3.5.
38:40Grab one of them.
38:41Eat that, Dalton.
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,
38:58just to bring it up naturally.
38:59Do you want to stand up for me?
39:00I'll just do your blood pressure.
39:02Okay.
39:02Now keep this arm nice and straight,
39:04just down by your side.
39:05Okay.
39:06Wonderful.
39:07Is everything normal?
39:08Yeah, yeah, the blood pressure's brilliant.
39:10Your heart's going a little bit quick.
39:11You're probably a bit anxious.
39:12Although Simranjeet's observations are normal,
39:15Abdul and Paul still don't know what's causing her pain.
39:18Are you in any pain at the minute, sweetheart?
39:22Any pain?
39:23Any pain?
39:25Whereabouts?
39:26Tummy?
39:27Yeah?
39:28Spreading straight across.
39:29Yeah.
39:30How much pain?
39:31If naught was no pain,
39:3310 was terrible pain.
39:35How much?
39:35It is handy being able to speak Punjabi,
39:52just in case there isn't anybody there to translate.
39:55At times, I am the translator,
39:58as well as being the paramedic.
40:00Do you have any pain at the time?
40:02Do you have any pain at the time?
40:02Yeah?
40:03Hmm.
40:03Yeah?
40:04We'll go for seven.
40:06So it's okay when she's sitting,
40:07and then every so often it'll just bang, it's up.
40:09So Simranjeet did need to go to the hospital
40:11because she was bleeding.
40:13It can be normal in pregnancy,
40:15but it wasn't normal for her,
40:17so she needed to be examined at the hospital.
40:19Okay, darling.
40:23Okay.
40:25Okay, I'm just going to have a quick listen to your tummy.
40:30Okay, sweetie.
40:32So I'm not concerned at the moment.
40:35I can't hear anything wrong.
40:37All good?
40:38Yeah, good, thank you.
40:39I can't hear anything wrong.
41:09I was expecting a lot worse.
41:15Some worse.
41:16Yeah, that's the problem, I think.
41:18It comes through and you think,
41:19you expect the worse.
41:22Well, I'm glad it wasn't.
41:24I'm glad it wasn't.
41:25Yeah.
41:34Do you mind me exposing your abdomen?
41:37In Evesham,
41:38Neil 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.
41:51Yeah.
41:51So what I'd like to do now
41:53is I have a feel of your tummy.
41:55Is that okay?
41:55Yeah.
42:00Tell me if it's hurting.
42:02Is it hurting there?
42:02Yeah.
42:03It looks like, yeah.
42:04Yeah, that makes me feel like I've got a puke.
42:08Yeah.
42:08Okay.
42:09If everyone can stay quiet,
42:11I'm going to kind of give your tummy a tap, okay?
42:14The reason I tapped Mike's abdomen
42:17is to listen for high or low sounds when tapping.
42:21This could suggest fluid or air in the abdominal cavity.
42:25It hurts more than any of them.
42:29That's what we call hyper-resonance there.
42:31Yeah.
42:32Okay.
42:32So it would suggest kind of almost trapped air.
42:35Your bowel sounds,
42:37they're slower than what I would expect
42:38as a normal bowel sounds.
42:41They're there,
42:41which is a good thing.
42:43So your tummy's generally tender all over.
42:45And then when I've given you a bit of a tap
42:47over your tummy there,
42:48we've got hyper-resonance here.
42:51Yeah.
42:52We're going to recommend hospital
42:53and we're going to offer you pain relief
42:56in the form of probably morphine.
42:58So Mike needs to get hospital
42:59because he did show signs of infection.
43:04Now this could be that his bowel
43:05is perforated from the blockage
43:07and we're starting to see infection
43:10in the abdominal cavity.
43:12I don't know.
43:13I'd rather be safe.
43:14From what you're saying,
43:15yeah, it's not quite normal for you.
43:17It's not what I want.
43:17It's what my wife wants.
43:18That's it.
43:19So what do you want?
43:19Happy wife, happy life, that's the same.
43:22Is it okay for putting a little cannula in your arm, yeah?
43:25Yeah.
43:26Mike was clearly in a lot of pain.
43:29He'd already had paracetamol
43:30but this wasn't going to touch it.
43:33So morphine is one of the best drugs we can give
43:36to 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.
43:49That's it.
43:50Right, hold on there a minute.
43:51Just get your bearings.
43:52With the help of wife Susan,
43:55Mike is able to walk to the ambulance.
43:59I know you're in safe hands,
44:00so why not be with you?
44:01That's it.
44:02Yeah, I've been doing it 21 years.
44:04Oh, well, long enough.
44:05I think I've got the hang of it.
44:10How's the pain?
44:11Probably zonked.
44:13Zonked, yeah, no problem.
44:14With the morphine starting to take effect,
44:18Neil and George head for A&E.
44:21I won't keep nattering to you.
44:23I'll keep an eye on you and do a bit of paperwork, all right?
44:29After a 16-mile drive,
44:32Mike arrives at Worcestershire Royal Hospital.
44:36At least it's not raining.
44:37That's the main thing.
44:38Here, medical staff will investigate
44:41what's causing Mike's sudden and severe abdominal pain.
44:53Tests were unable to pinpoint the exact cause of Mike's pain.
44:57After five hours of investigations,
45:00he was allowed home.
45:02Simranjeet, who was pregnant and had abdominal pain,
45:05was diagnosed with a urinary tract infection.
45:08Four months later,
45:09she gave birth to a healthy baby girl called Jepji.
45:14Jeanette, who fell and hurt her back,
45:16had x-rays to rule out damage to her kidneys.
45:19After eight hours,
45:21she was allowed home to look after her husband, Bill.
45:24Linda, who was struggling to breathe,
45:27had an MRI, antibiotics, and a drip.
45:30It took several hours to regulate her oxygen levels.
45:34And Tony, who had low blood sugar levels
45:37and fell down a flight of stairs,
45:40was diagnosed with a broken neck, ribs, and toe.
45:43It was five weeks before he was well enough to be discharged.
45:49Next time...
45:50What were you getting with reading the heart rate?
45:521.31, 1.25.
45:54A patient in police custody
45:55has a dangerously fast heart rate.
45:58In such a young person,
45:59to have such an elevated heart rate and blood pressure
46:02can mean that there's a significant cardiac event happening.
46:05A woman who's struggling to breathe refuses to go to hospital.
46:09Right now, you're poorly.
46:11But if we leave you here, you're going to be very, very poorly.
46:15It is hard when patients refuse to go to hospital
46:18when you know that they really do need to be seen by somebody else
46:21and get the treatment that's required.
46:23And paramedics struggle to treat a suspected drug overdose.
46:26OK, everyone, if you please get off the ambulance,
46:29we need to start some treatment.
46:31It can be quite scary when there's people banging on the side of the ambulance.
46:35You don't know what they want,
46:36if they're going to actually get onto the ambulance.
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