Awesome Oxygen Operation Ouch! Hospital Takeover

'He's Dr Chris.'

'And he's Dr Xand.'

BOTH: And we're identical twins.

Well, we were until you grew your beard.

In this series, we're taking over

one of the biggest children's hospitals in Europe -

the amazing Alder Hey in Liverpool.

We'll go head-to-head as we take on

some of our hospital's most important jobs.

This isn't going well.

Ouch & About hits the wards for more medical mysteries.

-That is a hole going inside your stomach.

-Yes.

And we'll be meeting our brilliant Ouch! patients

who come in for regular treatment.

Hi!

We've hidden our lab in a top-secret location...

And our experiments just got...

HE BELCHES

..bigger!

Argh!

You guys are crazy!

So, are you ready to join us?

I have to change my cape.

-Coming up today on "Operation...

-Ouch!"

We're all revved up over new technology.

Wow.

In a 999 panic.

My friend is unconscious!

And feeling explosive.

-Argh!

-HE LAUGHS

But first...

A&E is the hospital department of surprise.

ELEVATOR DINGS

And there's nothing more surprising than this case.

In Alder Hey's emergency department,

nine-year-old Oliver is waiting with his mum and dad.

Oh, he's got lots of gory grazes.

It hurts around there and my wrist and then my knees.

And he can't talk properly with that bust lip.

How did it happen?

Oliver's just passed his cycling proficiency test.

Well done, Oliver.

He celebrated by going on a bike ride with his dad to the park.

-It's a nice day for it, Chris.

-Yes.

-This all seems very pleasant.

-Where's this story going?

-I'm about to tell you!

Oliver was following his dad around the park when he hit a bump,

-fell off his bike and knocked his knees!

-Ouch!

-And hurt his hands!

-Double ouch!

-And he banged his bonce! BOTH:

-Triple ouch!

It stings.

-Does it?

-There.

-Yeah.

Best get that bruised body seen to...

..by nurse practitioner Sarah Jackson.

So how fast were you going on your bike?

-Quite fast.

-Did you have a helmet on?

-Yes.

-Good. That'll have helped.

Oliver's had a big fall, so every bit of his body needs checking.

Head, neck, mouth, tummy...

We just always have to be careful with bikes,

-cos handlebars can end up in the stomach sometimes.

-Yeah.

The list is endless.

-Ow.

-Is that sore?

-Yeah, there.

-The left arm is sore, so he'll need an X-ray.

His right side, he's going to need an X-ray of that.

His right leg is tender on his kneecap,

so he'll need an X-ray of that.

Crikey, Chris - it'd be quicker to mention where Oliver's NOT hurt!

-Ooh.

-Let's get to X-ray and make it snappy.

Nice and still, OK? No wiggling, no giggling, OK?

BEEPING

This sounds like a supermarket checkout!

Find out later if any of those banged bones are broken.

In hospital, it's not just the doctors and nurses

who help to get you fixed.

There are lots of other heroes working behind the scenes.

-Yes!

-What will happen when we have a go at their amazing jobs?

Welcome to The Dr Chris Show.

Useless.

This is Operation Takeover.

Today's hospital heroes are 999 call handlers Laura and Fiona

from the East Midlands Ambulance Service.

They're part of a team that sends out over 600,000 ambulances

every year, saving lives every hour of every day.

Wow, let's get ready for a 999 boot camp.

How many calls do you get in a typical day?

That can vary and every day is very different.

Today, for instance, it's now nearly eight o'clock

and we've taken 1,537 calls.

-Wow.

-And out of that,

86% of those have been picked up within five seconds.

-Five seconds?

-Five seconds.

-Wow.

What I find amazing about being in this room

is that it is a very calm, quite relaxed environment,

and yet I know that almost everyone on the phone in this room

is having a phone call with someone who's having a terrible day.

Yes, even though it could be their 40th, 50th call of the day,

the person they're speaking to,

chances are it's the first time and maybe only time

they will ever make this 999 call.

Our call handlers have to make sure that they keep them calm

and help them through it.

One person who knows just what it's like

to be on the other end of the phone is seven-year-old Hannah,

who dialled 999 to help her sister Aimee.

And this is nurse Chris and call handler Lisa

who helped her through it.

-CALL RECORDING:

-'Ambulance service. Tell me exactly what's happened.'

-HANNAH:

-'Well, my sister has gone funny.

'She can't see anything. She's gone really pale.'

'I'm going to pass you through to one of our clinicians, all right?'

'Hannah, it's Chris.

'I'm a nurse at the ambulance service

'and I would like you to ask Mummy to lie your sister down on the floor

'with her feet up on something.'

'She needs to lie flat with her feet up on something.

'She's going a bit red.'

'Good. Well, the ambulance are there now to help make your sister better,

'all right? How old are you, sweetheart?'

-'I'm seven.'

-'Well done.'

It turned out Aimee had a virus and she made a total recovery.

Wow. What an amazing call!

Was it difficult, making the phone call?

Yeah. I was really scared and I was literally standing there

-and shaking like mad.

-You didn't sound nervous at all.

Chris, were you very surprised when you found out

that Hannah was seven years old?

Absolutely amazed, because she was actually, to be honest,

a lot better than a lot of the adults that we speak to!

What do you think, Aimee?

I don't think anyone would have done as good as she did.

If you ever need to make a 999 call like Hannah,

here are the things you need to do.

Number one, know your address or where you are.

Number two, clearly describe what happened.

And number three, keep calm and listen.

We've seen how the professionals do it.

Time for us to take over as 999 call handlers.

Our mission is to handle a major emergency.

Well, Xand, it's a fake call with Fiona and her mate Doris,

-who's a dummy.

-Ooh, hello, Doris!

I'm just trying to get in the right frame of mind for this challenge

and just practise my calm, reassuring voice.

Ambulance! I don't know exactly what's happening!

Xand, Xand, you're doing this all wrong.

Let me do it. You've got to stay calm, OK? Watch this.

SHRIEKING: Ambulance! Ambulance!

-That sounded pretty good, actually.

-That sounded better.

I feel relaxed. I feel good.

-I feel good about that.

-I think we're ready.

'To help us, we have the 999 protocol book.

'This contains all the rules for giving medical help over the phone.'

But what can possibly go wrong?

Remember, never call 999 unless you have a genuine emergency.

Ambulance, tell me exactly what happened.

My friend is unconscious! She's not awake!

She's not awake.

What is the address of the emergency?

-Swan Street.

-Swan Street. OK, thank you very much.

Can you see if her chest is moving

-or can you put your hand over her mouth?

-My hand over her mouth?

'Er, not sure that's going to help, Xand.'

OK, so I just need you to answer a few more questions.

Erm...

'Time-wasting, Chris!'

Place the heel of your hand on the breastbone

and pump the chest hard and fast 30 times, twice per second.

'Feeling the pressure, Xand?'

Now I want you to place your hand on her forehead

and put your other hand under his neck.

My friend is a girl!

-Sorry.

-'Poor Doris!'

There's an ambulance on the way.

-You're doing a really good...

-It's not working!

-She's not waking up, help me!

-'This is a nightmare!'

Stay calm and just focus on doing this properly.

'That's the best thing you can do for your friend at the moment.'

Nothing's happening, she's not waking up!

'Please make the ambulance arrive!'

Keep giving the breaths and keep giving the 30 pumps.

The ambulance is here!

I'll go and let them in.

OK, hand over the patient... LINE GOES DEAD

Oh, they've hung up.

Oh, she's hung up on me.

So that was extremely stressful.

I've all the instructions written down,

I know it's Fiona in the other room,

I know it's not a real patient,

and I made what I think was basically a complete mess of that.

What an amazing job.

Let's get the verdict.

I need to lie down.

Three, two, one, vote.

-What?

-WOMEN LAUGH

-Sorry.

-So what clinched it for Xand?

He got to CPR instructions much faster.

-Right.

-I mean, I still took possibly a fatally long time.

Well, both of you had quite big pauses within the call.

In their, you know, moment of need, gaps are not good.

I think it's best that we leave handling the 999 calls

-up to you guys.

-Thank you.

-Thank you.

-Thanks a lot.

-Thank you.

BEEPING

I'm hitting the wards with my Ouch bleeper.

BLEEPING

Because we've brought Ouch & About inside the hospital.

Wow!

-Dr Xand!

-Oh!

And I'm hitting the streets to answer your medical mysteries.

'In the hospital, Chris has his first call.'

BLEEPING Oh! A question!

'It's from Jessica, who has had an operation on her hip.'

Hi, Jessica, how are you?

-Hello.

-I got a message on my bleeper saying you had a question for me.

Yes, what's it like operating on children?

'What's the diagnosis, Doc?'

Sounds like a case of "what's it like operating on children"-itis.

'I couldn't have put it better myself.'

Where did your question come from?

Well, because I've been operated on quite a few times.

I was wondering, like, what it's like for the doctors.

Do they get, like, worked up before they do it,

just in case anything goes wrong and it's their fault?

-So do surgeons get nervous before operations?

-Yeah.

OK, well, I can answer that a bit,

because I trained as a surgeon for two years

and the kind of surgeons that operate on you don't get nervous

before big operations, because they're so experienced

and good that, for them, as weird as it sounds,

it is just another day in the office,

and, usually, there's more than one surgeon in the room.

-Yeah, cos I had two consultants.

-You had two consultants?

-Yeah.

OK. Surgeons are part of a really big team of people,

all of whom are working very hard

to make sure that everything goes right.

I think you have earned yourself an "Operation Ouch!" sticker.

APPLAUSE Can I put this on your hip?

-Yeah.

-Let's put it on like that.

Thank you, Dr Chris.

'I'm Ouch & About on the street, waiting for the next question.'

Dr Xand, Dr Xand!

How do people get double joints?

-Are you double-jointed?

-No.

Have you got friends who are double-jointed?

My friend, she can twist her hand all the way round.

OK, so your joints are held together by ligaments,

and ligaments connect bones to bones.

Ligaments are made of a very tough tissue called collagen.

It's the stretchy, elastic bit of your body

that allows you to sort of be a bit rubbery,

the way that humans are,

and, basically, people have different kinds of collagen.

'If you've got very tough collagen

'that holds your joints tightly together,

'you won't be double-jointed or very flexible,

'and if you have got very stretchy collagen,

'you'll be more likely to be double-jointed.'

-Does that make sense?

-Yes.

-Oh, good stuff.

-All right.

-Thanks, Dr Xand.

-That's all right, Maram.

'Back in the hospital, I've had a question from Connor.'

Connor, hi, my bleeper went off. What's your question?

Have you ever treated anyone with septic arthritis?

-That is a great question.

-'What's the diagnosis, Doc?'

It sounds like you have a case of

"I want to know if Dr Chris has ever treated anyone

"with septic arthritis"...itis.

'That's quite a mouthful!'

So, the answer is yes, because I'm an infection doctor,

when I'm not presenting "Operation Ouch!".

So is that what you had?

-Yes.

-So what did the doctors and surgeons here do?

They gave me two operations and washed out my bone.

That's right, because, unlike lots of other bits of your body,

your joints aren't very good at getting rid of infections.

The inside of your joints should always be sterile

and if there are bacteria in there, they have to be washed out.

So, did you get a big scar from the operation?

-Yeah.

-Go on, let's have a look.

Oh, wow, and has your leg healed up fully now?

-Yes.

-What can you now do?

-I can do Brazilian jujitsu.

-He can do Brazilian jujitsu.

Do you want to show me what you can do?

-Hi-yah!

-Argh!

-'I'm out of here!'

-'Not so fast!'

But one thing - you need your sticker.

-Bye!

-Bye-bye, Dr Chris.

Job done for today. Clinic closed.

Earlier, we met Oliver, who'd had a bike accident.

Let's head back to accident and emergency.

What? I said back, not backwards!

What are you doing?

Nine-year-old Oliver was battered and bruised after a bike accident.

Oliver was following dad around the park when he hit a bump

and fell off, knocking his knees,

hurting his hands and banging his bonce.

Oliver is waiting to find out if he's got any broken bones.

Cue nurse practitioner Sarah.

Right, the good news is,

-I can't see any fractures at all on any of those X-rays.

-Great.

I had a really good look at them,

so his wrist, his hand and his leg are fine.

He's been very, very lucky,

and obviously having that helmet on has obviously protected his head.

Oliver's cuts need cleaning, which could sting,

so he's given some gas and air to help relieve the pain.

Nurse Karen gives those wounds a good wipe

to get rid of all the dirt...

..then he's bandaged up and on the mend.

How are you feeling, Oliver?

It feels easier to talk now and not as stiff on my face.

That's good news, so everything's better now?

No, cos I can't stay off school.

LAUGHTER

I said, "If there's any breaks in those X-rays, a day off school."

There's no breaks, kiddo.

Back to school.

Too bad, fella!

-Hop along.

-That's right, on your bike.

Hmm, maybe not.

BOTH: Bye!

Still to come...

our lab's banging...

-Argh!

-LAUGHTER

..there's a twist in a wrist...

It really hurts down there.

..and it's full speed ahead to improve patients' lives.

It'll be great for the future.

But first...

That's a really bad idea, Xand.

Well, the answer is B,

you can only survive without oxygen for up to three minutes,

because it's vital for almost every chemical reaction

happening in every cell in your body at every moment of the day.

'And now to our lab, but this time,

'we've hidden it in a top-secret location.

'So secret, in fact, that even Xand doesn't know where it is.'

It's time for some amazing experiments.

Just don't try anything you see here at home.

Today, we're looking at oxygen.

Xand, have you seen my stethoscope?

I've been looking for it everywhere.

-Xand!

-Oh, hello, Chris!

I borrowed your stethoscope.

I can see that, but why?

I'm counting the number of breaths I'm taking

so that I can find out how much oxygen my body can extract

from the air in a day.

So far I'm at 8,229.

8,230!

By my calculations, by the end of today,

I'll have taken 19,000 breaths.

That's pretty amazing, isn't it?

That is amazing, but, Xand, if you really want to know

how much oxygen you can get out of the air we breathe...

-I do! I do!

-..you're going to need to use

a breath by breath gas analysis system.

Oh. Well, if only we had one of those.

-I do, it's over here.

-What?!

'This machine will show us how much oxygen Xand breathes in from the air

'and how much his body actually absorbs in one minute.'

OK, Xand, you can take the mask off and stop breathing.

So your breathing frequency is 20, ventilation 9.5 and CO2 is 0.3.

All clear?

No. I don't understand what any of that means!

OK, perhaps I'd better explain this in terms of cans of air.

Come over here, Xand.

Now, the machine told us that in one minute,

you breathed 9.5 litres of air.

That's the equivalent of these 27 cans.

Brilliant! I've always wanted 27 cans of air!

So I get to keep all these cans?

Uh-uh-uh, no, Xand. Air is only 20% oxygen.

The rest is made up of other gases like nitrogen and carbon dioxide.

So, in fact, of the 27 cans, only these six have oxygen in them,

so I'll just take these ones away.

Great! So I get to keep six cans of oxygen.

No, because your body can't soak up oxygen that quickly.

The machine shows that in one minute,

you only absorbed one can's worth.

One lousy can?!

Well, this is completely useless!

What am I meant to do with one little can of oxygen?

Well, actually, Xand, you would be amazed at what your body can do with

one can's worth of oxygen.

Come on, Xand, I'll show you.

'Oxygen is used in chemical reactions in your body

'to create energy.

'You need energy for everything you do - walking, eating...'

'And skipping!'

'Er, yes, Xand.

'So, do you want to see how oxygen helps to make energy?'

'Yes, please!'

'Good. Let's blow stuff up.

'Firstly, I've filled this balloon with hydrogen,

'because it's a gas that burns well in air without extra oxygen,

'so you can see the difference later.'

-Oh!

-Ooh!

What did you think of that, Xand?

That was really good.

It was... It was really good.

Look, I don't want to hurt your feelings, but it wasn't great.

Well, that, Xand,

is because I didn't add your little can of oxygen.

Do you really think this little can of oxygen would make a difference?

Yes. At the moment, the hydrogen can only burn

using the oxygen in the air around the balloon.

If we put that can of oxygen inside the balloon,

everything will happen a lot quicker.

OK, in three, two, one...

Oh! That was great!

That's amazing!

Just from adding that tiny amount of oxygen.

In your body, of course, you don't have an explosion,

but the fact that you do have lots of oxygen in your cells

means that all the reactions happen very efficiently and quickly,

-and release lots of energy.

-You know what this means, Chris?

-What, Xand?

-We should add a lot more oxygen, like, ten minutes' worth!

-Are you ready?

-I'm ready!

Three, two, one...

Argh!

-That's amazing.

-That's really good, isn't it?

I feel like my whole face has been slapped.

Very, very powerful shock wave.

So, we've shown you how much oxygen your body absorbs from the air,

and even though it's only a small percentage,

that oxygen is vital

to making reactions in your body happen efficiently.

You know, this oxygen stuff is amazing.

I'm going to try and get me some more of it.

HE BREATHES DEEPLY

Our next patient today was turned upside down

when they had an unusual accident.

Well, let's meet them.

Waiting to be seen by the doctor is ten-year-old Isla, with her mum.

I've hurt my wrist, yeah, and it's really sore.

She's doing a great job of elevating her hand with that hoodie.

I wonder where she got that from.

I was watching a few episodes of Operation Ouch,

and I saw it, so I tried it and it worked.

Excellent work! You could be a doctor at this rate.

But how did it happen?

Isla was on holiday with her family in Sherwood Forest.

-Ooh, home of Robin Hood!

-That's right, Xand.

I can picture it now...

# Robin Hood, Robin Hood riding through the glen... #

Actually, Xand, Isla was playing hide and seek.

# Robin Hood, Robin Hood with his band of men... #

No, Xand, she was with her friends, and there were no horses.

She was at a leisure centre in the forest

when, all of a sudden, she jumped onto a stool and fell off.

-Oh.

-And look - she's landed on her wrist.

-BOTH:

-Ouch!

It's straight down to X-ray

for Isla to get some pics of that jarred joint.

OK, Isla, all finished.

With the X-rays out of the way,

here to look at her hurt hand is Dr Daniel Murray.

Let's have a look. Let's roll that sleeve right up, OK?

Dr Daniel checks to see where Isla is most sore.

Did you win at hide and seek?

-No.

-No.

That adds insult to injury.

Make a fist for me, tight as you can.

-It really hurts down there.

-Hurts down there. OK.

Straighten it out.

Is that hurting a wee bit?

OK. Very good. OK.

-And I understand you've been round for an X-ray?

-Yeah.

Well, I'll look at your X-ray,

-and I'll pop back and have a chat with you and Mum, OK?

-OK.

-All right.

So what's the diagnosis, Doc?

Just round about here, is where she was tender,

and that looks completely normal, OK?

If you look down there

to see if there's any sort of steps or breaks in the bone,

and I can't see anything obvious there.

To me, it looks like a normal, normal X-ray.

So she's most likely just sprained her wrist when she's fallen on it.

There are 13 bones in your wrist.

Between these bones are ligaments.

They're like strong elastic bands which connect bones to one another.

When too much pressure is put on a part of your body,

like falling on your wrist,

these ligaments can get stretched, twisted or torn.

It's called a sprain, and this is what happened to Isla.

Just giving it some rest, OK?

And regular painkillers.

Do you do sports at school?

-Yeah, we do PE.

-You do PE, OK.

I'd probably give that a miss for the week.

OK? Just to give it a chance to rest.

Isla doesn't look overly happy about that, Xand.

I'm sad I'm not allowed to do dancing, erm, sports.

And have we learned any lessons from this?

Don't jump on a chair.

We'll bear that in mind.

-BOTH:

-Bye, Isla!

Come on. Temperature!

Temperature! I need my temperature!

Xand, what are you doing?

I'm trying to get this little car to take my temperature.

I can see that, but why?

Haven't you heard? It's this whole new system.

Patients are using Formula One car technology

-to monitor their vital signs.

-Yes, Xand, I HAVE heard of this,

and it IS true, patients are getting their vital signs monitored

by Formula One race car technology -

but this is obviously not how it works.

You're right! I need a real car.

Sounds like a case for Investigation Ouch.

It seems totally bizarre,

but taking a patient's vital signs could be helped by a car.

So, I'm heading off in the fast lane to meet the motors.

And I'm starting off with a pit stop on the wards to meet Matt,

who's just had a heart operation.

You've got a lot of different monitoring

going on here at the moment.

Can we see how many wires are on your chest?

Matt is wired up to a monitor to check his vital signs.

Vital signs are important bits of information about a patient,

such as oxygen levels and heart rate.

Are you allowed to unplug yourself at all?

What I have to do is I have to get my nurse. They'll take this off...

Doctors and nurses write down Matt's vitals by hand on a chart.

This system's time consuming for the staff

and, more importantly, uncomfortable for Matt.

So at the moment, for you, basically,

leaving the bed is a real hassle.

Yes.

Chris, this is where the cars come in!

In Formula One, monitoring systems have gone up a gear.

This is Dr Adam Hill.

He is the chief medical officer at McLaren,

and works out how Formula One technology can be used in hospitals.

What a cool job.

So how much is a Formula One car like a human being?

Well, Formula One cars are incredibly complex devices.

They have an engine, a bit like our hearts.

They have a need to breathe, a bit like our lungs,

and they're incredibly intelligent.

Just like me! And the healthier the car...

..the faster it goes.

So, just like a patient, its vital signs are monitored.

We use little gadgets like this

that collect information at up to 960,000 times every single second,

from a single sensor.

Wow! That is amazing.

The F1 system is wireless...

efficient and fast.

If only the hospital had something like this!

Well, Dr Adam has worked with Birmingham Children's Hospital

to create a new system. It's a world first.

It's brand-new, and I'm going to try it out.

-Alex, that's it, now.

-Yes, that's it now.

-It's flashing.

-It's flashing.

-It's sending the signal to the monitor.

-Yeah.

It has one sensor doing the same job

as the six that Matt is hooked up to.

The results are instantly available on a computer monitor.

Bye-bye, charts!

Plus, it's wireless - I can walk anywhere.

Even do a few press ups, if I like.

You're doing very well, Chris.

All this time, it's recording my vital signs.

Perfect.

And then I can download my results when I get back -

even though I was jumping at the other end of the hospital,

the computer knows what I've been up to.

The hope is that children will be able to go home with this system

and they will be able to take one of these tablets with them,

so we can log on from the hospital

and see what's happening in their homes.

This would be life-changing for patients like Matt.

How much easier with you find it

if you could just wear that new monitor?

A lot - seriously, I would lose a lot of these wires.

It's small, compact,

and that monitor takes 60 seconds to monitor your heart.

The other one monitors that every second.

I think it would be great for the future.

And then, hopefully, other kids will find it a lot easier in hospital.

Thanks, Matt -

who would have thought hospitals could learn stuff from a car?

Next time on Operation Ouch, Hospital Takeover...

we learn a bit about spit.

-BOTH:

-Wow!

That's amazing!

It's hectic on the helipad...

I fell on my neck.

..and we flush a few things out.

Oh, no!

So, that's it till next time, from Operation...

Ouch!

So we...

HE COUGHS

So...

So we've seen just how important and how difficult

the work of the emer...emergency...

Right...

I don't know if I can do it!

Operation Ouch!