Jaw-dropping Joints Operation Ouch!

He's Dr Chris.

He's Dr Xand.

Yes, he's still got his beard.

And we're still identical twins.

Did you know your body is brilliant?

And we're going to show you how in this brand-new series.

We go head-to-head in more Operation Takeover challenges.

-That's embarrassing.

-This is very, very hard.

-BOTH:

-Man overboard!

Ouch And About hits the wards.

That might be the squishiest nose I've ever seen.

You told us you wanted more first-aid tips, so we've got some.

-So, we do need to get Xand to hospital.

-Let's go.

We meet more Ouch Patients.

Hello.

And we're back in the lab...

..where our experiments...

That is amazing.

..will blow your mind!

That's an amazing view.

So, are you ready to join us?

You're crazy.

I can't see a thing.

-Coming up today on...

-..Operation Ouch!...

BOTH: Three, two, one.

Drop!

Meet new Ouch Patient Maisie...

Hello.

..and prepare for take-off.

But first...

OK, Chris. You start.

-Are you sure?

-Absolutely, Chris. This is yours for the taking.

-Go ahead. You start, kick it off.

-OK.

-In the A&E department...

-There's a new case just through the door,

and it's not for the squeamish!

Over in Sheffield accident and emergency department,

15-year-old Abdul is waiting with his mum.

Now, that's what you call a bandage. It's a whopper!

I slipped and banged my head.

How did he do that?

It was lunchtime at Abdul's school.

BELL

Mmm, lunchtime! Was it fish and chips?

No idea.

Abdul was actually playing five-a-side football with his mates.

Yes, but does he want salt and vinegar?

-WHISTLE

-Xand, concentrate.

Everyone knows there's no food allowed in the sports hall.

Hmm, good point.

Now, Abdul is the star striker.

He had the goal in his sights.

He reached for the ball...

Nothing can stop this lad from scoring!

Well, nothing except sliding headfirst into a door!

BOTH: Ouch!

How are you feeling now, Abdul?

My forehead has opened.

Opened? That doesn't sound good.

Get Dr Clare O'Connell in here, quick.

First, Dr Clare takes a look at that bonce.

Here comes a gross alert.

BOTH: Whoa!

You've got quite an impressive cut on your head.

A big bump to the head always needs to be checked by a doctor,

because it could cause concussion...

Keep looking at my finger.

..which is a minor brain injury.

-Am I going to get stitches?

-Probably.

Tough luck, Abdul.

Nurse Emma gets to work with anaesthetic gel

to numb the whole area.

I'm just going to use some water, just to clean it a little bit. OK?

Get ready again...

No, I mean it - if you're squeamish,

you won't want to see what's coming next.

-Is that skull?!

-Yep.

You've actually cracked the bone on the front of your head.

What we're going to need to do is a special scanner, called a CT scan.

The CT scan takes detailed 3D images of Abdul's head.

Find out what the results are later on.

Did you know, babies are born without proper kneecaps?

The hard bone on your knees grows as you get older.

Cool!

Talking of knees, now to our lab.

It's time for some big body experiments...

..some of them gory...

This is not for the squeamish.

..some extreme.

It's freezing!

So, are you ready?

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

Today, we're looking at your joints.

So if you want to find out why we're doing this...

Keep watching.

What are you up to, Xand?

I'm trying to crack my knuckles, but they won't make a sound.

-Can you do it?

-No, I've never been able to do it.

You know, it would be really good if we had someone here

-who could crack their knuckles.

-Hang on...

Sirak, come on out.

-Hi, Sirak.

-Hi.

-What's with the sling?

-I broke my elbow.

-How did you do that?

-I was running on a wall in Spain.

-Were you in trouble for that?

-No.

-Don't run on walls in Spain.

Anyway, why don't you show us how you crack your knuckles, OK?

CRACKING

That was a lovely crunchy noise.

What's happening is that, inside each of the joints of your hand,

Sirak, there is a special liquid called synovial fluid.

and, I tell you what,

do you both want to see what's happening inside your hands?

BOTH: No way!

Look, I'm not going to actually cut your hands open.

I'm just going to show you using this syringe.

BOTH: Phew!

Now, the water in this syringe represents the synovial fluid

in Sirak's joints. And when he cracks them,

what he's actually doing is temporarily reducing the pressure.

I can simulate that in the syringe.

It's sealed at the end and no gas can get in,

so if I pull it and reduce the pressure, bubbles form,

and that's because there's gas dissolved in the fluid.

When you reduce the pressure, it comes out of solution,

a bit like when you open the lid on a fizzy drink.

And if you pull the plunger back and then release it suddenly,

you get a pop when the bubbles collapse.

That's called cavitation

and we think that that's what's causing the noise

in Sirak's joints when he pops them.

Well, Sirak, you have been a brilliant knuckle cracker today,

so thank you very much.

Go on, off you go, back to the cupboard.

Fine. I have things to do anyway.

All right, fine. Bye!

Bye.

So, synovial fluid might be great for making a popping sound

and it probably doesn't do the joints of your hand any harm,

but they can be extremely annoying,

so don't do it if someone asks you to stop.

Unless you want to annoy someone.

But the real purpose of synovial fluid is to lubricate and protect

all the moving joints in your body.

And, in fact, it can handle a huge amount of force.

So much force that we are unable

to demonstrate it inside the laboratory.

We are going to have to take it outside.

Come on, Xand, chop chop.

Now, when you do something as simple as running for a bus,

your knees have to absorb a force equivalent to eight times your own

body weight. Now, that might sound like a lot but, of course,

the synovial fluid in the knee absorbs the force,

spreads it evenly and protects the joint.

Come on, Xand.

I'm coming! I can't wait to see what you're going to show me.

My absolute favourite thing about synovial fluid...

Wait a minute, Chris, is that a crane?

-Yes.

-Is that a weight attached to it?

-Yes.

-You don't mean...

-Yes.

-You're not going to...

-Yes.

-Wow!

Your synovial fluid is amazing at dispersing huge amounts of force.

It's like a cushion that softens the impact on joints, like your knees.

And that's lucky, because when a gymnast lands...

I THOUGHT I saw a gymnast back there.

Yes, this is youth Olympic champion Tyesha Matias,

who said she'd show us a few moves to help with our experiment.

So, when Tyesha lands,

up to 12 times her own body weight goes through her knees.

And we're going to show you what that kind of force looks like

by dropping a weight onto this car.

Now, the weight and the distance of the car

have been specially calculated to exactly represent

the force that goes through Tyesha's knees.

But unlike Tyesha, this car has no synovial fluid.

-Are you ready, Xand?

-I was born ready!

This is all in the name of science.

Scientific synovial fluid experiment, go!

BOTH: Three, two, one, drop!

Look at this!

It's completely caved in the metal roof of the car.

And that is the kind of force that your knees are protected from

by the synovial fluid.

But I tell you what -

I'd be very interested to know the kind of forces involved

if the gymnast was built, you know, more like me.

Well, that's easy to do, Xand.

We just need to raise the weight higher to see the greater force

that would go through the knees of someone heavier.

-You ready?

-Ready.

BOTH: Three, two,

one -

drop!

XAND GIGGLES

Xand, if you look at this broken glass,

that is what the cartilage in your knees would look like

if you didn't have synovial fluid and you did gymnastics.

So, we've shown you that knuckle cracking makes a popping noise

because bubbles from your synovial fluid burst

as you flex your fingers.

And we've shown you that the synovial fluid

has a much more important job than fun popping sounds.

It helps your joints withstand the huge amounts of force

you put on them every day.

Well, I must say, Chris, that was absolutely excellent,

and that car is completely ruined.

Now, how about I give us a lift back to the lab?

UNLOCKING BEEP

CAR ALARM

Chris? Chris?!

Meet Kaden, Maisie, Olu and Millie.

We'll be following them across the series as they let us know

what it's like to be a regular hospital outpatient.

They invite us into their lives at home and as they undergo treatment.

Meet 11-year-old Maisie.

Hello.

Maisie lives with her mum, dad, brother and dog Poppy.

She has coeliac disease.

It means that you can't have gluten,

which is wheat, barley, rye, malt and oats.

And, as a result, Maisie is unable to eat everyday foods

such as bread, pasta and pizza.

If I eat gluten, I end up getting the runs, I get sharp stomach pains,

I feel sick and I just basically want to lie in bed and go to sleep.

Maisie is so sensitive to gluten

that everything food-related has to be separated

to avoid her coming into contact with it.

So, I have my own ketchup and butter to make sure

that no cross-contamination goes on there.

We've started doing a lot more home cooking and baking

since I've been coeliac.

So we make gluten-free chicken nuggets.

We grated frozen gluten-free loaf

and then we put it onto the chicken.

It's lots of fun.

Luckily for Maisie, there are also special gluten-free versions

of some of her favourite takeaway foods.

So, we're watching a film

and I've got a gluten-free pizza

and Jess has a normal pizza, because she's normal.

So we're enjoying our sleepover.

Find out how I get on next time.

Bye!

Back in the emergency department,

Abdul is waiting for news of his CT scan.

Come on, Chris. Let's see how he's getting on.

Earlier, Abdul arrived in the emergency department with...

..a deep cut and skull fracture.

Super-striker Abdul was playing footie with his mates

but rather than hitting the back of the net...

..he hit a door, headfirst.

-BOTH:

-Ouch!

Abdul has had a 3D CT scan of his skull and brain.

The results are in.

You've broken your skull at the front, here.

Because of that, it's likely that you'll probably have to

stay in hospital tonight.

With any head injury,

it's always possible that something will develop.

And because he's got the fracture, the neurosurgeons need to

observe him closely to make sure he doesn't deteriorate.

Time to hand over to doctor Hasan Siddiqui, AKA the Superstitcher.

Once the anaesthetic kicks in, Dr Hasan has this all sewn up.

Ready for some blood?

He starts with some dissolvable stitches in the deep tissue.

He then sews up the middle layer, before finishing with finer thread

on the surface, which will need to be removed in a week.

It's a lot of stitches. What's the score?

Wow! And he's as cool as a cucumber.

It was a long procedure and he's relaxed and staying still.

-Quite impressive.

-It's not hurting as it was before.

I think I can handle it.

Abdul heads up to the ward for an overnight stay.

It's a new day.

How are you feeling, Abdul?

Yeah, I'm feeling better than yesterday.

Yesterday I had a little bit of a headache and that,

but it got better and better.

Does this mean he can go home, Doc?

Abdul is OK to be discharged home.

But he will need to take a rest from activities

for a period of about three months.

Three months?! That's ages, but it will give Abdul's skull fracture

time to heal under the wound.

Maybe rest up on the headers, Abdul.

BOTH: Bye!

Still to come...

Why are you dressed as a witch?

Bwah-ha-ha-ha!

..and meet Ouch Patient Kaden.

Hello.

Amazing people do lots of important jobs inside and outside hospitals

that help to keep you safe.

But what will happen when we have a go?

I feel a bit silly.

This is Operation Takeover.

Can you guess who today's hero is?

Well, I'll give you a clue.

They may use one of these to bring you food and drink.

Wait, did somebody say food and drink?

Ooh, I'll have some juice and a cheese sandwich, please.

Certainly, sir. What kind of cheese would you...?

-Wait a minute, Xand, this isn't a real flight!

-Isn't it?!

If you do require any assistance,

please don't hesitate to contact a member of the cabin crew.

Did you guess it?

We're about to take over the job of today's high-flying hero,

British Airways cabin-crew trainer, Chris.

The pilots might be flying the planes, but it's the cabin crew

who are there to keep you safe in an emergency.

The way most of us meet cabin crew is because you guys

serve us food and drink,

but that's not the main reason you're on the plane, is it?

No. In the very rare instances that may happen,

we need to ensure that we are capable and able to deal with

any situation, whether it is a medical situation

or something that might be wrong with the aircraft.

-Can you show us the safety demonstration?

-Absolutely.

The safety briefing is the most important information

given to passengers before take-off.

And Chris runs us through it.

Your safety card is in your seat pocket.

Please take it out and study it.

-PA:

-Passengers should keep their seat belt fastened at all times.

It is fastened,

adjusted and released as shown.

If the cabin air supply fails,

oxygen masks will fall from the panel above you.

Pull a mask over your nose and mouth, and breathe normally.

Life jackets are located under your seat.

Inflate it by pulling on this toggle or blowing into this tube.

Finally, all passengers should note the location

of their nearest emergency exit.

All cabin crew have intensive training

and are able to deal with medical emergencies.

Every year, we refresh our knowledge.

We are, throughout the year, expected to have that knowledge

at a set level, because we need to act on it at any time.

And they do. Cabin crew assist with around 44,000 in-flight

medical emergencies worldwide every year.

We've seen just how important the work of cabin crew

is in keeping you safe in the air.

But in our time as cabin crew,

will we be high-flyers or will we never get off the ground?

It's time for us to go head-to-head as cabin crew.

I want to see how well you deliver that safety demonstration.

I want to see how well you deal with medical scenarios.

And thirdly, I want to see how well you cope under pressure.

-Are you ready?

-We're ready.

-We're ready.

-Where did you get that?

-You've got to do the...

Tie a nice tight knot and then you just pull the cord.

Xand's up first.

No pressure. The flight looks full today.

There is the safety card in your seat pocket.

It describes the brace position, your seat belt.

And if you have any questions about it,

you can ask a member of the crew.

Off to a flying start, Xand.

Now it's my turn.

In the unlikely event of cabin depressurisation,

oxygen masks will fall from the ceiling.

Life jackets are located in and around your seat.

I think we're breezing through it, Chris.

The exits weren't pointed out, so no-one knows where those exits are.

..everyone, fasten your seat belts...

Oh, dear.

With the safety briefing over...

Can I get you anything to drink?

..the next test should be more up our street.

Oh, excuse me, I've really hurt my shoulder.

Do you mind letting this lady out?

Ooh, moving the passenger, Chris. Is that a good idea?

Ideally, I'd sit you down.

There'd normally be a little crew seat.

Can I have some water, please, with ice and lemon?

I'm looking after this patient. I can't deal with that man's request,

so I am going to ignore it for the time being.

I hope you're not cracking, Chris.

OK. I wasn't expecting to have to use a sling.

I can see that!

When was the last time you put a sling on someone, Chris?

It's not really holding my arm up.

It might have been a while ago, Xand.

How are you going to deal with the situation, then?

Why don't you sit there, try and support your arm

with your other arm, and I'm going to get the medical kit.

It's really hurting, can you hurry up?

Hop to it, your patient's waiting.

-Excuse me...

-So, what I'm going to do...

-Excuse me.

I'm just helping this lady, I'm sorry.

Good prioritisation skills there.

The most important thing,

I think if we keep it still, that will help the pain.

-Feeling a bit more comfortable now?

-Yes, that's a bit better, thank you.

-PA:

-Cabin crew, prepare for landing. The challenge is over.

I'm so glad that's over.

I could use a cup of tea.

It's time for the verdict.

How did we do, Chris?

So, the first area was the safety demo.

With that, you both didn't point out the exits.

Really, really important.

How did we not do that?

Secondly, the medical incident.

Surely we've got this in the bag?

Our lady, she'd broken her arm.

One of you dealt with the situation in the cabin, another took her away.

Moving her will hurt her even more.

After all, Chris, you are on a moving aircraft.

Thirdly, staying calm under pressure.

Dr Chris, I think you were a little bit flustered during the challenge.

Dr Xand, I got the impression that you were in control

and there was an air of calmness going on.

So, Chris, what's the verdict?

Well, it was very close.

-Dr Xand.

-Yes!

You know, Xand, I think what we've really learned today

is how important cabin crew are for keeping you safe in the air,

and that it is most definitely a job best left to the professionals.

-Let's hand our blazers back.

-Chris, thanks very much.

-Thank you.

-Right, Chris, we've landed.

Let's go and get our luggage. I wonder where we are?

Meet ten-year-old Kaden.

-Hello.

-Hello!

Kaden really likes dogs.

I've got a dog there, a dog there.

Told you.

I've got a real dog, and his name's Bandit.

-Hello, Bandit! DOG VOICE:

-Hello!

Kaden has cystic fibrosis.

Cystic fibrosis is something that affects your lungs.

Kaden's body produces thick, sticky mucus,

which can make it hard to breathe and lead to infections.

To help break up this mucus, Kaden has to do lots of physio exercises.

If I weren't to do it,

I'd either get really sick or there'd be a lot of mucus.

If I did get really sick, I might be in the hospital for a long time.

So, this is my bubble PEP.

Pep stands for...

When Kaden blows into this straw, it creates pressure in his lungs,

which helps to move the mucus.

It starts overflowing.

It makes me a bit messy, and it's fun if it's messy.

This is my acappella.

I blow into it.

It vibrates and it makes a funny noise.

WHIRRING

The acappella does a simpler job to the bubble PEP,

and gets the mucus moving.

As soon as I do six blows on this, I have to do a huff, huff, cough.

That's like this.

HUFF, HUFF

COUGH

Another piece of Kaden's kit is the I-neb.

This delivers an antibiotic directly into his lungs

to fight off any infection.

It makes a big beep when it's finished, and that's how you know.

And it also makes a smiley face.

We'll get to see more of Kaden and his treatments next time.

Goodbye.

IN SCREECHY VOICE: I will have no-one else surpass me in my beauty!

Bwah-ha-ha-ha-ha!

Every year, Xand gets very excited about his role in our local play.

And this year, he's playing the part of the Wicked Queen in Snow White.

Why are you dressed as a witch?

Bwah-ha-ha-ha!

Ahem.

Anyway, every play can be full...of danger!

Aargh!

If you don't have your evil fake teeth properly fitted,

-you could choke on them.

-Evil teeth?

But these are my REAL teeth.

If your costume's too long, you could trip on it and bang your head.

And no, my dress is tailor-made to my exact specifications.

And you should always take regular breaks from practising your lines,

because you wouldn't want to lose your voice before the big day.

Bwah-ha-ha...ugh... COUGHS

OK. I think it is time you took a break, Xand.

What a shame. We're just about to get my favourite bit,

with the poisoned apples.

Ooh, apples, I love apples.

Wait. Are these the poisoned apples?

-Yes!

-Oh, no! Help me, quickly!

Injury alert!

So what should you do if you think

someone has swallowed something poisonous?

..that makes everything OK.

..and keep them calm.

The answer is B.

Find out what they've swallowed, when and how much,

then call 999 and keep them calm.

Let's see what this lot do without any advice at all.

-Are you ready?

-Yes!

Off we go.

Mirabel and Abid are both pretending

that they've swallowed something poisonous.

Quick guys, they need your help.

-What's wrong?

-She can't speak.

Both teams get straight to work.

-What happened?

-Drink some water.

Owww!

He did not seem to react very well to the water.

-She's choking!

-She looks like she's very ill.

-We'll call 999.

-Yeah!

999!

So, they were correct to call 999 quite quickly,

but they still haven't figured out what Mirabel has eaten.

And there's lots of poisonous stuff on that table.

Good point, Chris.

This lot didn't do quite the right thing in this situation.

I think we should have picked it up quicker

that the water was making it worse.

That's right, Korrianne.

Now it's time to show you how it should be done.

Oh, ugh!

Remember, we're showing you what to do in an emergency,

but it's always best to get an adult.

Oh, my tummy.

You all right, Chris?

Oh, no, I feel really sick, my tummy hurts, I feel really ill.

-OK. Have a seat.

-OK.

Have you eaten any of this?

Yeah, I did, I ate one of these. I thought it was a sweet.

This is a dishwasher tablet, Chris, this could be quite poisonous.

-When did you eat it?

-About 20 minutes ago.

So I'm going to call the ambulance and get you some help, OK?

-Thanks, Xand.

-I need an ambulance,

I've got a guy here who's eaten one dishwasher tablet.

He ate it about 20 minutes ago.

-Can I have some water?

-No, they say you shouldn't have any water.

-Should I make myself vomit?

-No, they say don't make yourself vomit.

Just sit and stay calm and the ambulance is on its way.

Are you all ready to have another go at it?

Yes!

So if you see someone who's swallowed something poisonous,

you must...

What did you take?

Don't panic.

Remember, this is an exercise.

You should never play with poisonous substances.

That is fantastic, they've done it all correctly.

Quick, Xand, use my phone to call 999.

What on Earth for?

Because I've eaten one of the poisoned apples.

Those aren't poisoned apples.

They are nice, normal apples that I'm using as props.

Oh. Well, why didn't you just say so?

Plays aren't dangerous.

Now, I'm going over here to rehearse.

Waaaah!

CRASH!

Our next patient ended up in the emergency department

after watching rugby.

It's been a bit of a TRYING day!

Oh, Xand.

This is eight-year-old Gracie,

in the emergency department with her mum.

Why are you here, Gracie?

They fell and slammed my foot.

Anything else?

I was wearing my Chewbacca onesie.

A Chewbacca onesie? We need to see this.

Gracie was watching a rugby match at her local club with her mum and dad.

Nice selfies.

It was a chilly afternoon, so she was wrapped up warm

-in her bunny slippers and...

-..her Chewbacca onesie!

So cool, Gracie.

It was an under-20s international, Wales versus Ireland,

and you couldn't take your eyes off the action-packed drama.

Well, apart from the fact that poor Gracie couldn't see a thing.

So she climbed up onto the seat for a better view.

But it flipped up, trapping Gracie, and her foot slammed into the floor.

-BOTH:

-Ouch!

A Chewbacca onesie is amazing.

Thank you.

Is me borrowing it totally out of the question?

Yes, of course it is.

Gracie needs a Jedi knight in shining armour.

But we'll settle for Dr Joe Howard.

Dr Joe takes extra-special care

because Gracie was born with a foot condition called talipes,

which means the movement in her ankles and toes is limited.

-It hurts there.

-That's where it hurts, OK.

I think it's probably worth us getting an X-ray of that foot.

-I like X-rays.

-You like X-rays!

Who doesn't love an X-ray?

Where's the X-rays?

YODA VOICE: Behind you, it is.

-What are you doing, Xand?

-I'm being Yoda, obviously.

Roll your socks and left shoe off for me?

-YODA VOICE: Shoes and socks, remove you must.

-Oh, dear.

Get ready for your close-up, Gracie.

The X-ray results, we know not.

Enough with the Yoda impressions, Xand, bring the doc in.

-No breaks.

-Yay!

We don't need to do anything, just the usual -

painkillers if it's sore, take it easy. OK.

Any message for that pesky seat, Gracie?

You told it! Bye, Gracie.

See you soon.

Bye, Gracie. And may the Force be with you.

Next time on Operation Ouch!...

..there's a loud bang on the lab roof...

Aargh!

..Xand opens wide...

..and Grace has a special canine companion.

Oh, hello!

So we'll see you next time for more Operation Ouch!

Chris! Chris!

I missed the ending! Chris!

I'm not going to cut your hands open,

I can demonstrate using this syringe.

-Phew!

-Oops, I forgot to do that.

No, that's just... We'll just do it again.

What are you doing? What?

Are you going to go that way?

Why don't you push a bit harder? You're doing it really badly.

Operation Ouch!