Episode 8 First Time on the Front Line

Britain's next generation of emergency service recruits,

chosen from a pool of thousands.

Rookies like former soldier Mark,

now hoping to make it as a paramedic.

I'm proper nervous. I was all right until I pulled up this morning. Phew!

And Police Special Amber, who dreams of becoming an officer full-time.

You can stretch as wide and as high as you want in the career.

It's an exciting job to have.

Harry's following a family tradition

of volunteering for the local lifeboats.

Just watching what the RNLI actually do is just amazing

and now I can help and put my time into saving lives as well.

Contact.

They've survived months of intensive training.

-Come on! Let's move!

-ALL: Get back!

-There's a child in the water. Over.

-They've been tested to their limits.

-Spray! Spray!

-It's burning. Can't see.

Stop panicking, don't worry.

All to realise their dream careers.

What we've just done could save a life.

Join them for their First Time On The Front Line.

In today's programme,

Mark is faced with a multiple sclerosis patient

whose life is on the line.

He needs to act fast.

The drugs you've been given aren't working.

-Underwater and under pressure.

-THEY SHOUT

-How's everybody? All right?

-Yes.

Lifeboat recruit Harry undergoes his first capsize.

Not the experience I was expecting. You think, "Oh, my God, I'm going to get trapped."

And life as a police special.

Amber arrests a suspect who refuses to come quietly.

-Do you understand?

-Do you understand?

-Do you understand?

If you're going to take me, take me!

-Get hold of them cos you're going to...

-BLEEP!

-They always get louder once the door's closed.

-BLEEP!

-Good morning.

-Recruitment day at West Midlands Ambulance Service.

Over 100 applicants for 47 precious jobs.

37-year-old Mark Edwards hopes to be successful today.

So you put that to 120 and then charge.

All candidates have completed two-year degrees

in paramedic science and today, their new knowledge

and skills are being tested, assessed and compared.

Their clinical expertise...

Airway, breathe in. Manage those problems on scene.

-..physical strength...

-OK, guys. Lift up as hard as you can.

..and driving abilities.

Pull up to the small cone in front of you.

Getting selected will be tough, but at least Mark is prepared.

As a former member of the Parachute Regiment

he served three years in Afghanistan,

training as a combat medic and treating wounded comrades.

When I was there, I dealt with everything from someone playing with a scorpion,

which was quite interesting, to people losing limbs.

We're there to do a job and we tried hard and we worked hard

and, you know, a majority of us come back.

Mark came home in 2009 but found it hard to adjust.

I left the Army and I got an office job and it was just mind-numbing.

It's just not me, so I applied to be a paramedic.

That decision meant two years at university and then graduation.

-Mark Anthony Edwards.

-THEY CLAP

But getting a job can be even harder than obtaining a degree

and Mark's about to find out if he's been successful.

The recruitment day is over. The results are in.

And for the applicants, the news is mixed.

-You didn't pass your interview.

-Are you serious?

-Yeah. I'm really sorry.

Congratulations, you passed everything.

-The job's yours if you want it.

-Oh, that's great.

-Well done.

Now, it's Mark's turn to get the news.

Two years of study and intense training

have all been leading to this moment.

-Well done, Mark, that's a pass.

-Oh, fantastic!

-OK. Very good patient assessment.

-Thanks a lot.

-Well done again.

Thanks a lot. Officially a paramedic, yeah.

How about that? Ace!

Mark can't wait to tell his family.

I got a job, Dad. I'm no longer a student, how about that?

Yeah, great news. Yeah. There you go, I've done it.

I've passed it. All right, mate, bye-bye. That's my dad.

Man of few words. "Well done, Son, knew you could do it. Good job."

That's it! That's it.

It's two months on and Mark's about to start his first shift

as an official paramedic.

He's been partnered with experienced colleague, Will Tansey.

-So how much sleep did you get last night?

-Four hours.

-Four hours.

You never manage to sleep before your first day shift.

I'm proper nervous. I was all right until

I pulled up this morning and now I'm a bit...

Second guessing everything but I've just got to calm down a little bit.

Will's with me, so I should be all right.

I'd better go. All right.

No paramedic ever forgets their first 999 call.

And for Mark, it arrives within minutes.

A 75-year-woman has collapsed at her home.

As her son's been unable to lift her,

she's been stranded on the bedroom floor for hours.

-Hello, my love.

-Did you hurt yourself?

-No.

The patient's name is Elizabeth.

She doesn't have the strength to get up.

If you bend your knees up and put your feet on the floor...

-Hiya.

-..and Mark will come behind you and we'll all stand up together.

There you go, you hold on to me.

That's all right, we weren't doing anything.

Elizabeth has a history of breathing difficulties

and has collapsed before.

The last time, she dislocated her shoulder.

Don't be so silly.

You can't spend the rest of the day on the floor, can you?

This time, there are no injuries and a thorough check shows that

her breathing, blood pressure and body temperature are all normal.

You don't need us to do anything, no?

You don't need us to give you any nebulisers or anything

while we're here, no? All right, OK.

Elizabeth declines the offer to go to hospital so the paramedics

make her comfortable and leave her to recover at home.

What are we going to do - a bit of paperwork, quick signature, we'll leave you to it.

For Mark, it's a straightforward start to his paramedic career,

but his first shift will soon present stiffer challenges.

In Cheshire, another emergency service rookie

is about to face a stern test of her own.

Police Special Amber-Louise Evans has already been on a drugs raid

where she cuffed a suspect for the first time.

You're under arrest concerning supply of controlled drugs.

Do you understand?

Now she's to get a taste of the notorious Friday evening shift.

Amber's Police Special journey began in summer 2013

when she completed a 20-day training course.

On the first one, just draw your baton,

we're going to go straight into the high parry... Go!

ALL: Get back!

Although Police Specials are volunteers,

they have the same powers as regular officers when on active duty.

They also face the same risks...

It's better to come from the side,

so you're not going to get kicked in the face.

..so all trainee specials are taught how to use the kit they'll need to

defend themselves if circumstances demand it,

-including pepper sprays...

-MAN: Spray! Spray!

-..Velcro straps...

-The tighter you put them on, the better.

..plastic hoods...

-This is how it goes on.

-..and, of course, hand cuffs.

Get the second cuff on, tighten them up,

check for tightness and double lock.

Amber couldn't wait to complete the course and go out

on the streets as a Special.

I think helping people is really the driving force

that has made me interested in joining the police.

Her ultimate aim - becoming a full-time officer.

There's quite a few careers that you can go into

which will help people, but with the police being so varied

and you can stretch as wide and as high as you want in the career,

the diversity of it is just something which you can add to your life.

Eight weeks later and the training is behind her.

Amber arrives at the station to prepare for duty.

It's only her second shift and it promises to be eventful.

It's a Friday night, anything can happen.

It's basically... It's just going to be jobs flying at us

and it's just going to be the complete unexpected.

Specials are assigned constable tutors

and Amber's mentor is PC Richard Whitehead - a seasoned officer.

And with experience comes a sense

of whether things will be quiet or hectic.

This week already, leading up to today,

has been a very busy week for Warrington.

Lots of arrests, lots of people in custody and today already,

you can tell by the mood on the radio, it'll be a busy evening.

Richard and Amber's first job involves the arrest of a man

suspected of shoplifting.

This is a crime that recently hit a ten-year high,

with an estimated 2.7 million offences against retailers.

You usually find people steal meat and stuff from shops

because it's quite easy to sell on easily, isn't it? For drug money.

The annual cost of retail crime in the UK is now £1.6 billion.

The officers reach his address.

If he's at home, it will be down to Amber to make the arrest.

Get my phone.

Another officer goes round the back,

just in case the suspect tries to do a runner.

Will you just stand back for us, if you don't mind.

Amber's suffering from last-minute nerves.

DOGS BARK

-I don't know what to say.

-It's all right.

Tell him you need to speak to him about something

and then just lock him up.

She needs to get the words of the caution exactly right

for it to be legally sound.

-Hello. Is he in?

-No.

-Where is he?

-What do you want him for?

-Just come to have a chat.

-What?

-Can I have a quick word with you?

What's this all about? Am I getting arrested for something?

-Yeah.

-Oh, my God!

-BLEEP!

-Don't worry about it.

-You are joking. What for now?

You're under arrest for the suspicion of theft of wine from 15th May.

-You do not have to say anything...

-15th May? When did I go to jail?

-You weren't in jail then, we've already checked.

-15th May!

You do not have to say anything but it may harm your defence

if you do not mention when questioned something you later rely on in court.

-Anything you do say may be given in evidence.

-BLEEP!

-Do you understand?

-Do you understand?

-Do you understand?

-If you're going to take me, take me...

-BLEEP!

Amber's arrest and caution were word perfect.

Despite the suspect's anger, she showed no sign of nerves.

-You won't get an Oscar for this, you know.

-I don't want an Oscar.

The suspect's probation worker was informed about his impending

arrest earlier today.

A fact that doesn't impress him.

She knew we were coming for you, but she's ...

-She could have

-BLEEP

-told me about it.

She's not going to tell you about it, is she?

Neither is he happy about the order to remove his shoes -

but they have laces and that's a suicide risk.

-You don't need them, do you?

-He's not happy with your laces.

-I'm not happy with you having laces in the van.

-Why?

They're loose laces. Just give them here.

Don't throw them on the floor. They cost me a lot of money.

You walk on the floor! What's the problem?

-Don't throw them cos you're going to scuff them...

-BLEEP!

They always get louder once the door's closed.

To the new recruit, it's already clear

that Specials face the same hostility as full-time officers.

So, how did she cope with the suspect's aggression?

I'm kind of a little bit numb to it, actually.

I think it was really like he was quite riled up at the door,

so you've just got to try and talk him down,

make sure he's listening to me whilst I cautioned him.

Obviously he was quite upset but, yeah, I think it went all right.

Quite happy about it.

Amber's shift has got off to a volatile start

and it has several hours to go.

West Midlands ambulance service receives around 3,000

999 calls every day.

In Birmingham, rookie paramedic Mark and his colleague Will

are responding to the latest.

It concerns a 78-year-old man who's complaining

of severe abdominal pains.

-How's Philip on his feet recently?

-He's slow.

He's been a little bit more unsteady than normal today.

The call has come from Philip's wife Patricia.

Not only is he in agonizing pain,

he's also suffering from advanced Alzheimer's.

-We're going to the ambulance now.

-We're going to where?

-We're going to the ambulance.

-Are you?

-You're coming with me.

-Am I?

-Yeah, you are, yeah.

-Does Pat know as well?

-Yeah, she's coming with us as well.

-Right.

-OK.

Alzheimer's Disease affects almost half a million people in the UK.

One in three people over 65 will die with some form of dementia.

Philip, lie on that stretcher for me, OK?

Swing your legs round.

There you go, don't worry about the sheets. There you go, last one.

Mark tries to find out the cause of the pain.

-First he examines Philip's stomach.

-It is distended.

It feels bloated and hard to the touch.

What did you notice about his trousers not fitting?

-They wouldn't fasten.

-Just wouldn't fasten.

-No, wouldn't fasten.

-Mark makes a disturbing discovery.

-There's a blockage somewhere.

Phillip's stomach may be enlarged due to his intestine

being blocked or twisted.

It's definitely bigger, it feels firm.

I mean, I can't hear much going on in there, to be honest.

Normally you can hear quite a lot.

-When did he eat last?

-At lunchtime.

-At lunchtime.

A blocked intestine is serious.

It can lead to tissue death

and the intestine wall rupturing, with potentially fatal consequences.

Philip needs immediate hospital care.

Will drives without the sirens on to avoid alarming Philip and his wife.

Once they arrive,

the patient's rushed in for a scan on his intestine.

The result? Mark's diagnosis is correct.

Philip's intestine is blocked. He'll now undergo emergency surgery.

I'm getting confidence in my skills.

The things I'm doing and the training I'm doing is all making sense,

which gives me confidence to go on.

I have got the training. I've just got to have faith in it, really.

The training that paramedics undergo is tough but not unique.

For lifeboat volunteers like Harry Davies,

the regime is every bit as testing.

RNLI HQ in Poole, Dorset,

and a batch of new lifeboat recruits

are receiving a week of intensive training.

They've been taught how to extinguish fires, helm a boat...

And once you're happy, you can pick up speed.

-..read charts...

-So let's have a look at putting that on here, then.

..and light flares in an emergency.

-What do we use an orange smoke flare for?

-Daytime distress.

22-year-old Harry is an electrician.

He's just joined the lifeboat service

and has many new skills to learn.

Put your hand straight up. Don't bother looking at it.

You shouldn't feel any warmth in your hand at all.

Harry's wanted to be a lifeboat man since he was a boy.

Sea rescue runs in the family.

My dad was a tractor driver.

I grew up living across the road so it's something, as a kid...

Helping out, just watching what the RNLI actually do

is just amazing and now I can help and put my time

into saving lives as well.

But in saving lives, lifeboat crews often risk their own.

One of the most dangerous events at sea is a lifeboat capsizing -

the focus of the next training session.

As soon as you lose power, the boat ends up being off, doesn't it?

And if we're in any breaking surf, you only need a wave

the height of the sponson, really, to actually roll you over.

If the engines were to fail, what do we want to get out immediately?

-Sea anchor.

-The drove or the sea anchor, absolutely.

And it should be as the helmsman's telling you,

you should be jumping out of your seat to put that in.

Harry's about to experience a controlled capsize

so he knows what to do if it happens on a call out.

There's a strict procedure to follow.

Move your left leg backwards, hands down to the handrail,

head to your hands, all the way down, like that.

Harry's part of the first group to be capsized.

The trainers will keep a close eye on the rookies to check

they follow protocols under pressure.

You grab the A-frame there. That's it. That's good.

Harry's been assigned position three on the starboard side of the boat.

So just to recap, we'll go heads to deck, the boat will go over,

I'll blow my whistle and then it's all slow time and there's plenty of

room under the boat, we can chill out and we'll sort ourselves out.

A wave machine will create sea-like conditions

and a powerful crane will tilt the boat.

OK, heads to decks, please.

When it capsizes, the rookies must shout their numbers

to confirm they're OK.

-Numbers!

-Three!

-Four!

-Good stuff.

The next stage - getting their bearings in an air pocket...

-How is everybody? All right?

-Yeah. Good.

-OK, wasn't it?

..before swimming to safety, ensuring no-one's left behind.

Harry followed the protocol perfectly.

Not the experience I was expecting.

When you're in the back seat and you're down like that,

in actual fact you think, "Oh, my God! I'm going to get trapped!"

And then you don't, you just slide out.

Your head doesn't even go underwater, the water can come up to about here

and you just sort of pull yourself round after

you've shouted out your numbers and work your way to the front.

I'd go and do it again.

It's a month on, and Harry's on call near his home town,

the Welsh coastal resort, Aberdovey.

While he waits on stand-by,

he takes some time out with fiancee Bethany.

Harry proposed to her on this cliff top just a few weeks ago.

The sun was out, there were no clouds

and it was just absolutely gorgeous

and to be honest, I wouldn't want to do it anywhere else.

The couple both grew up in the area.

They know that while the sea looks calm now, that can quickly change.

Living so close to the sea, I think it makes us understand

a little more of how harsh a sea can actually be.

It's very unpredictable.

The strength and the power of it is phenomenal.

Now Harry's about to experience that sea power close-up.

His crew has just had a call-out.

A group of holiday-makers are stranded on a sandbank

on the outskirts of the estuary.

They've been Jet Skiing and their engine has failed.

The crew needs to reach them fast -

the afternoon visibility may be good, but darkness is approaching.

Harry's spotted the Jet Skiers and the crew go to rescue them.

They were pulling an inflatable when their Jet Ski broke down.

Hi, guys. You all right?

They're lucky the strong currents swept them onto the bank

rather than out to sea.

-Ten years old, it's never ever let us down.

-First time?

The inflatable needs deflating and towing back to dry land.

The crew can't leave it here, as the heavy winds will sweep it out

to sea and it could be mistaken for a casualty needing assistance.

This will go in the boat with us. And we'll to tow this behind us.

-Do you want me to deflate this then?

-Yeah, basically, yeah, if that's OK.

But the inflatable's valve is jammed.

Harry, Harry! Have you got some pliers in the tool kit?

There you go, mate.

That's got the plug out.

Valve sorted, the inflatable can be placed on the lifeboat.

Next, the Jet Skiers' turn.

-Just drag yourself in.

-Go round here, mate.

Once on board, they're returned to dry land and safety.

The Jet Skiers took to sea without mobiles or marine radios.

They're fortunate they were spotted and rescued before nightfall.

We were trying to get as close as we could back to the rocks

over the back there, just so we could try get someone's attention.

Yeah, we were waving.

It's one of those things you don't really want to go through,

but it's nice to know there's somebody there to rescue you when you're in need.

Luckily enough, they were there today so it was good. Very good.

-Otherwise we'd still be over there.

-Otherwise we'd still be stuck.

Harry and his colleagues return to the station. Mission accomplished.

Back in Warrington, Police Special Amber and her mentor Richard are out on patrol.

Richard's spotted a familiar car - he's convinced he recently saw it

being driven suspiciously.

Were you going pretty quick over the bridge before?

I reckon it was you going the opposite way from me

by the cantilever the other day.

Yeah, I was in a plain car, a plain little Corsa

and a blue BMW like this was screwing up the other way.

Amber calls control to access the police national computer.

Can I have a vehicle check, please?

But the car and its occupants get the all-clear.

BMW 3 Series in blue - insurance is held,

MOT in order. No reports.

Done. Cheers.

Amber's radio skills are improving.

On her first shift, she struggled with her call sign.

Can I have a PNC person's check. 80573.

-Details when ready.

-What's that?

-Just say "details when ready".

Details when ready. I can't remember how to do it.

But today she's communicating like a veteran

and her observation skills are growing sharper too.

During the stop,

she spots a man throwing a package onto the roof of the carwash.

Richard wants to find out more.

He's claiming it had bread in it and he does it all the time so...

Richard's getting the ladder out to see if he can go up

and make sure he's telling the truth.

Throwing bread in a sealed bag onto a roof seems a strange story.

But the man wants to show it's not a false one.

Stop, you're not going to do it. You're going to break your neck.

He's determined to prove he's telling the truth.

He's not going to put the ladder on that!

-One second.

-No, you're going to break your neck

and I'm not going to go to hospital with you.

We've got things to do. I'll trust you for now.

As an old hand, Richard's used to the unpredictable world of policing.

For Amber, it's a totally new but enjoyable experience.

It's just so random.

It's so hilarious but at the same time, it's also one of those things

which balance out the seriousness of the role

and gives a good sense of diversity to the job.

Rookie paramedic Mark is nearing the end of his shift.

There's time for just one more job.

He and colleague Will are responding to a 999.

Ambulance service.

The case is serious and complicated.

The patient, Julie, has advanced multiple sclerosis

- a condition affecting the central nervous system.

She's struggling to breathe.

Heather, her carer, is very concerned.

-Julie developed a cold last Sunday.

-OK.

She's been on antibiotics since Tuesday.

-She's struggling to breathe.

-OK.

Cos she has progressive MS, she can't cough

so it's basically stuck there.

I'm going to listen to your chest, OK.

-Sats are 89.

-89?

The sats number relates to Julie's blood oxygen levels.

-They're worryingly low.

-I'm just going to lift your arm up.

-Does she normally have any inhalers or anything like that?

-No.

-She doesn't have any asthma on top of everything?

-No.

As expected - rattles.

A rattling chest indicates a build-up of fluid on Julie's lungs.

But because of her MS, she can't cough it up,

leading to severe breathing difficulties.

What we doing then, boss?

The antibiotics have not cleared the infection,

we've got rattles in the chest, so basically the only thing we can do

is take her to hospital.

But Julie's condition is critical.

Unless she can be stabilised now, she might not even make it to A&E.

I think you're not winning this particular fight today, are you?

-SHE GROANS

-OK.

We've going to put you on some oxygen,

just because your breathing isn't that good, OK?

Despite her difficulty in talking, Julie's fully aware what's going on.

Mark keeps her informed at every stage.

You have a high temperature, you have an infection

and the drugs you've been given aren't working, OK?

And because your airway's blocked as well,

we really do need to get you some IV antibiotics

so I'm going to put a little needle in your hand

to bring down your temperature

and take away your pain a little bit, yeah?

Administering paracetamol intravenously requires skill.

A skill Mark learned during his training.

The only side effect of it is if it's given too quickly, it can drop

your blood pressure a little bit but we're not going to give it quickly.

A case like this would be challenging

for an experienced paramedic, let alone a rookie.

-Ow!

-Sorry, love. I'm sorry, I'm sorry.

It's proving hard to find a viable vein.

It might take repeated attempts.

OK, sharp scratch on your hand, OK.

OK, sharp scratch.

But Mark's hit the target first time.

Julie can get the medicine she needs.

Give me some IV paracetamol, please.

The paracetamol will bring Julie's temperature down

but it won't help her breathing.

For that to happen, she needs urgent hospital treatment.

There we go.

Around 100,000 people in the UK have MS.

Except in rare cases, the condition isn't fatal

but complications arising from it, like pneumonia, can be.

OK, you down?

When they reach the ambulance, Will and Mark sit Julie upright.

Hopefully, the fluid in her throat will drain down,

helping her breathe.

-Are you warm enough, Julie?

-SHE GROANS

I don't want to put a blanket on and overheat you.

Yeah, she's too hot as it is.

While observing Julie's vital signs,

Mark starts to suspect she has sepsis -

potentially fatal body inflammation caused by severe infection.

He'll report his concerns to the hospital when they arrive.

Will's an expert blue light driver.

He delivers Julie to A&E within minutes.

Sepsis claims more than 37,000 lives in the UK every year

- more than breast cancer and bowel cancer combined.

It's a big killer.

Sepsis leads onto something called SARS, which is an organ failure.

If she went on to that, she has about a 10%

chance of dying an hour

and if we as paramedics can't spot the sepsis,

she won't get the treatment she needs when she gets to hospital,

which is very definitive, it's very clear.

What we've just done could save a life.

Philip's operation on his twisted intestine was successful.

He's now back at home with Patricia.

The man accused of shoplifting wine from a local supermarket,

whom Amber calmly arrested despite him losing his temper,

wasn't charged for that offence.

And Julie's now home after a lengthy stay at hospital.

Following intensive treatment, her severe infection has cleared up.

Next time, the teaching's over.

It's time for rookie firefighter Brendan to tackle a real emergency.

Hello, fire service.

The clock ticks for new paramedic Sam

and a patient needing life-saving treatment.

We're going to raise your legs up to see if we can raise the blood pressure first.

And the chase is on as Police Special Becky

tracks down a gang of suspected burglars.

See if you can get through the gap.

I'm not too sure, I might have to jump over.