Spring Keeping Britain Safe 24/7

Hello. If you can hear me, but can't speak, could you tap on the phone?

64 million people, 365 days

and 31 million calls to 999.

That's the scale of the task faced by Britain's emergency teams.

And for one exceptional year,

we'll be following their front-line workers.

Not just our police, our firefighters and our paramedics,

we've been with our other critical emergency teams as well.

Teams we rely on sometimes without ever noticing.

The specialist teams that keep our railways moving

despite the dreaded leaves on the line.

Notting Hill binmen with just seven hours to clean up

after our liveliest carnival.

National Grid controllers responsible for powering

20 million homes, 24 hours a day.

The Greater Manchester Police Dog Unit,

controlling 75,000 fans at the height of the football season.

Lifeboat crews at Britain's busiest station,

with just 90 seconds to respond.

We'll show you how these specialist teams work under pressure

to protect us from danger on their most demanding days.

This is the story of one year with our emergency teams.

A year with the heroes Keeping Britain Safe.

Tonight it's spring.

Longer days and warmer weather.

But it's still a season of extremes.

Spring sees the number of accidents increase, so we are

behind the scenes of the largest trauma centre in the Midlands...

Aaargh!

..to see how they cope with this seasonal rise.

And the life-saving essential none of us can do without.

Julia investigates what it takes

to ensure that blood is always there when we need it.

What a hero! He's doing it in his lunch break.

But first...

It takes a lot of manpower to keep Britain safe,

and the odd animal too.

This is the Manchester Police Dog Unit, home to 38 German shepherds

who are used to track criminals,

find missing persons and control crowds.

These dogs are perfect for police work.

They have a phenomenal sense of smell, they are a good size,

as in they are quite imposing, and they are very agile.

They are also very noisy. Aren't you? Yes.

Across Britain, there are about 2,500 police dogs

attached to just about every police force.

And spring is one of their busiest times, mainly because of this.

The football season is reaching its climax.

The crowds are on the increase and tensions are rising.

It's April and we are in Manchester for the derby match

between Manchester United and Manchester City.

Violence between these two teams has been an issue in the past.

Last season, 145 United and 95 City fans were arrested.

For Sergeant Nicholas Forshaw and the dog unit,

policing the event is a major undertaking.

You're looking in excess of 200 police officers.

Then you've got your support units, such as the mounted

and ourselves as the dog unit.

So you've got 75,000 people plus, and 200 of you.

You seem a little short-staffed.

Yes, well, there's 75,000 people, 99 percent of them

come to watch a football game.

The minority of trouble-causers probably don't outweigh our numbers.

So, when you do come across trouble

and you know something is happening, what do you do?

We don't really want the dogs to bite.

If truth be known. They will bite.

If they get in contact with the public, they will bite.

But what we want them to do is disperse the crowds.

CHANTING

The first role of the dog unit is simply to act as a deterrent

and intimidate the crowds.

The officers park their van up with the doors open

and the dogs bark at passing crowds.

Meanwhile, the officers keep an eye on the crowd

and try to disperse any troublesome fans.

Elsewhere, the police have officers acting as spotters

observing crowd behaviour.

Above, a helicopter relays aerial pictures

to commanders on the ground.

Keep moving, mate.

Move, keep moving!

Move! Keep moving.

The dogs can do the work of 10, 20 officers

because they are so fast at what they do.

People are aware that the police dogs are there,

they can hear them barking

and in their shoes, I wouldn't want to cause any disorder.

So the best-case scenario for us today

is that we don't get the dogs out of the van.

To get them out, it would be because something serious has happened

that we need to get a grip of straightaway.

The game has finished and the City fans have the bragging rights,

beating their rivals 2-1.

But just outside the main stand, opposing fans are mixing.

Police commanders fear clashes.

Let's get the dogs through.

The dogs form a barrier to keep the two rival sets of fans apart.

Go round, please. Go round the dogs.

Just go around the dog line, mate, don't go through.

Don't go through the line of those, go around those officers, please.

Last season in England and Wales, 39 million fans turned out

to watch a football match, with only 2,456 arrests.

At Old Trafford tonight, there's been a crowd of 75,500,

but thanks to the dog unit,

the game has passed without any major incidents.

It's a high-octane situation.

The tempers got frayed and fans were trying to get towards each other,

so the dogs were deployed.

Within five minutes,

you could see that the crowds did get onto the coaches.

So to me, the dogs' tactics worked 100 percent.

In the UK, the German shepherd is the most popular breed

for this kind of police work.

Primarily because they are easy to train.

But this is a partnership.

These dogs and their handlers have to be tremendously disciplined.

Might be time to go.

So what does it take to make the grade?

Meet Jerry, a 14-month-old German shepherd dog,

and his handler Paul Jackson.

They're training to become new members of the Greater Manchester Police Dog Unit.

He's very energetic, really enjoys the work he does.

So we're learning together, really, so he's a novice dog.

A novice dog handler.

There's a lot to take on board.

You've got to get the bond from the dog, get the dog to love you,

so you've got to build the trust between yourself and the dog.

A police dog performs many different roles,

from tracking suspects to crowd control.

If successful, Paul and his dog Jerry hope to graduate together this spring.

The dog's acute sense of smell is said to be 10,000 times

better than ours.

Release the dog!

As part of a training exercise,

Jerry's nose is put to the test, tracking down a criminal.

It's the middle of a wood, found the hidden man,

barking until the handler gets there.

For the first six weeks,

we couldn't get Jerry to bark,

so what he's just done there is a massive step forward.

I'm really, really pleased with Jerry today, that was fantastic.

Ya-hay!

The police raise these dogs themselves from pups.

When a dog is paired with a police officer,

he then lives at home with his handler.

But it's raised as a working dog, not as a pet.

Paul and Jerry passed the course with flying colours.

Three months after they joined the unit,

I've come to Manchester to find out how they've both been getting on.

One of the first jobs when we turned out was an armed robbery,

where two lads had gone into a working men's club

and used an imitation firearm against the people that work there.

They then made off from there and we've attended.

On attending, I set Jerry up the track.

And he coped with it very well, he led me to an apartment block

where we've gone in and we've been able to arrest the two offenders.

From there also, Jerry has done a search on the outside

of the building where we've been able to locate the firearm. Incredible.

And with Jerry being a young dog, only 20 months old,

these two hope to have another seven years of work ahead of them.

Up and down Britain,

the NHS deals with more than a million patients every 36 hours.

Each year, there are almost 10 million operations undertaken.

It's a remarkable organisation,

but it would struggle to function without one thing,

donated by selfless volunteers -

blood.

Do you want to look the other way now? Yes.

It's not hurting too much? It's fine. You must tell me if it is.

Each year, the NHS gratefully receives almost a million

litres of blood, donated by one and a half million donors.

How does it feel, Marina, giving blood? It feels fine.

It's not something that you or your family have needed? Never.

But you never know, do you? No, absolutely not.

In Britain, there are 31 donation centres, like this one,

which is attached to Southmead Hospital in Bristol.

And across the country, additional mobile units travel

the length of the country collecting supplies.

Why do you do it? Saving lives, basically.

I can actually fit this in in my lunch breaks

and still get back to work and complete the toil, if you like.

What a hero! He's doing it in his lunch break, that is brilliant.

Donors can give blood if they're between 17 and 65

and weigh over 7 stone 12 pounds.

You can give blood every 12 weeks for men, and 16 for women.

And it only takes 10 minutes to donate.

But this is just the beginning of a massive logistical operation.

Now, the donated blood has to be screened, tested,

packaged and distributed.

But it's all got to be done quickly.

Even if it's refrigerated, blood is good for just 35 days.

And so, across Britain,

there are eight blood processing factories and five testing centres.

And the biggest of these -

in fact the largest facility of its kind in the world -

is Filton Blood Factory, here in Bristol.

Look at the size of this place.

Here, they package and process up to 850,000 blood donations in a year,

which then get distributed to hospitals up and down the country.

Operating 24 hours a day, seven days a week,

Filton supplies 100 hospitals across England and North Wales.

There's the grouping side, that's to test your blood group.

If you're an established donor we'll just run you through once, because

we've got your blood group on record.

If you've never given blood before, which is about 12

to 13% of the population, then we'll do it twice and make sure that they both match.

This is the lab where they do the testing. Vital screening for numerous viruses.

The three main viruses we test for are Hepatitis B,

Hepatitis C and HIV.

They are the three that can be transmitted by blood, and if so can cause problems to the recipient.

I think for most people, their primary concern about giving blood and receiving blood is safety,

so this is the most important lab to them. It is, it is. We can't get it wrong, it's got to be safe.

We all fall into one of four main blood groups - O, A, B or AB.

Each of these groups can either be rhesus positive or rhesus negative.

44% of people in Britain will be blood group O.

42% are A. The rarer groups are B with 10%, and blood group AB belongs to just 4% of the population.

In case there's a spike in demand, they hold reserves of each blood type.

A couple of weeks ago we had people from the MOD coming in and telling us

what an important job we are doing and how we affect the blood supply

in places like Afghanistan and Iraq, so, that felt really nice.

It is amazing to think that when we donate blood it can end up going all over the world.

But the vast majority of it is used closer to home.

In Britain, around 9,000 blood transfusions are carried out every day.

It is...fantastic, is the right word, and, um, deeply reassuring. Good.

At Southmead hospital in Bristol I'm meeting Michael Paraskiva,

whose very life depends on donor blood.

Hi, Michael. Hello. How are you doing?

Yeah, good, thanks.

So how often do you come here? Every four weeks.

And you're not giving blood, you're receiving blood. Yeah.

For a blood disorder I've got called thalassaemia.

My red blood cells don't reproduce themselves, so I need to have three units of blood every 3-4 weeks

in order to survive, basically.

Blimey. It takes about six hours.

And how long have you had the condition? All my life.

So you've been doing this your entire life? Yeah.

And you must know everybody here. Yeah, I've been coming here for 20 years.

And what would happen if you didn't get the blood? Leading up to the transfusion, when I need the blood,

I know I need it because I'm tired and achy and a bit energy-less.

And that would continue if I didn't get the blood.

So ultimately, you would die if you didn't get the blood? Yes, yeah.

I'm grateful, when I'm coming up and getting three pints of other people's blood.

And grateful to all the donors out there. Definitely, yeah.

Usually you think about blood circulating around the body,

but when you see a place like this, you consider the size and complexity of the operation,

to circulate donated blood around the country.

The blood processed at Filton is shipped around the country by a fleet of trucks.

But at weekends or in an emergency, the NHS relies on a team of volunteer motorcycle couriers.

A bike can get to its destination quickly, and this is a service that costs the NHS nothing.

In Glasgow I'm meeting up with Jason, Kenny and Sarah Jane.

They belong to a group of volunteer blood bikers on call

24 hours a day, to keep Scotland's hospitals supplied.

We're the invisible people. You know. People just assume when they go to hospital

that particular building has everything it needs, when in fact

it can be spread out over 20-30 miles,

and there's no transport infrastructure to get things from A to B.

What you've done is, you've indentified a need

and also identified the fact that bikers will go for a ride

for any reason at all.

This is just an excuse for long rides. No!

It isn't really about the bikes - the reason we all volunteer

and the reason we started this in the first place

is to benefit the NHS.

There are 20 blood bike charities in Britain with hundreds of riders

ready to respond.

It's a service that's been running for over 40 years.

This team in Glasgow is made up of 15 bikers, sharing a fleet of five motorcycles.

And there's something they recently started to deliver

that's making a big difference to many people's lives.

Donated breast milk. Some maternity nurses use it to help premature babies in their first weeks.

Because breast milk helps develop a baby's immune system,

reducing the risk of allergies and infections.

The first milk bank opened 75 years ago and there are now 17 in Britain.

As I'm a biker myself, I've signed up to help collect supplies

for Scotland's breast milk bank, located at Glasgow's Yorkhill hospital.

Debbie Barnett is the milk bank co-ordinator.

Looking at babies that are premature,

specifically, what is it about donor milk that could help them?

it's much, much easier for these babies to digest breast milk.

And there is evidence that shows that we can get these babies feeding more quickly,

we can hopefully get them home a bit more quickly.

I can only imagine that it is valuable,

otherwise you wouldn't be sending men in high-vis all over Scotland!

We've been sent to collect a supply of milk from a donor mum.

For those of you who have never ridden a motorbike, the advantages are clear. If this was an emergency

and we needed to get something vital somewhere in a hurry, I'd just be going straight through this.

Hello, you must be Lynette? Yes.

And is this Logan? It is. You are gorgeous!

Let's get some filled ones from your fridge. Yeah.

Do you want me to...

Lynette makes sure Logan has all the milk he needs

and the rest she expresses and stores in sterile bottles in the freezer.

To be a breast milk donor, your baby needs to be less than six months old when you start to donate,

your caffeine and alcohol intake has to be moderate, and you can't smoke or be on medication.

Left holding the baby, literally left holding the baby.

Do you ever think about the end user of this milk

and what it means to them?

To think about the little babies who might well be benefiting from it, yeah,

I think it's a nice thought to think that you could be helping

a little sick baby, yeah, I think that is nice.

Once we've got the milk we need, our work here is done.

Thank you so much, Lynette! Bye-bye, Logan. No problem.

If I say to my wife, "Darling, I'd just like to go out on my motorcycle for a bit,"

she won't be all that impressed.

But if I say to her, "Darling, I have to deliver milk to premature babies that need it,"

she's got to let me go!

Lynette's milk will be screen, pasteurised

and stored back at the bank until it's needed to help a premature baby somewhere in Scotland.

Babies like Rowan and Richard Hill's triplets,

they were the first babies born at Ninewells Hospital in Dundee

to receive donor breast milk.

They spent the first two weeks of their life in incubators,

and being fed through tubes and being assisted with their breathing

and on drips and everything else. It was quite emotional, really, to see it.

Seeing your babies in incubators, as tiny as they were, with all these wires and oxygen,

yeah, it's really scary.

With them being so early, my body wasn't ready for them to be here yet

so it took a while for my milk to come through.

So with having the donor milk it took all that pressure off

and I knew they were getting the right vitamins and protein that they needed.

It was amazing that we had the donor milk and we couldn't have asked for more with them.

The only thing that scares me is knowing that

I'm being trusted with three small babies!

But, uh, they'll turn out all right!

And thanks to the donor milk and the support they've received here, babies Oliver, Amelia and Joseph

are now ready to leave hospital.

Still to come, the sun is out and so are we.

Just going to lift your leg up, buddy.

We're with the Midlands Air Ambulance And Trauma Centre

as they experience a whole range of new challenges this spring.

Hello again, John.

Hello, this is the police emergency number, do you need the police?

Hello, if you can hear me but you can't speak, could you tap on the phone?

999 is the world's oldest emergency call service.

Today control centres like this one receive 31 million calls a year.

And almost half are made to the police.

We're going to get the police round to the address.

There were over 700,000 crimes in the capital last year.

And of the ten most crime-ridden postcodes in Britain,

six are here in London.

Among the worst offenders are the Westfield Shopping Centre in Shepherd's Bush

and Euston Station.

So today, across the capital's 32 boroughs, the Metropolitan Police

is launching its spring offensive.

Nice and controlled as we go in, detain anybody there.

Use of force, obviously...

Called Operation Big Wing, this is a high-profile, highly visible crackdown on crime.

The Met has over 31,000 officers and over a 24-hour period

they'll be taking part in a series of operations.

Nice and slow and easy.

Since the initiative was launched back in 2011, there have been over 6,000 arrests.

We don't want to upset too many people. We will have some PCSOs coming along afterwards,

to do some reassurance to other residents and letting them know what's going on.

This morning, over 800 operational activities are planned across London.

I'm basing myself here in Wandsworth because this is one of

the largest and one of the newest custody suites here in London.

And as Big Wing gets going, this place should be jumping.

Hello, mate, how you doing? You all right? Buzz us if you need anything.

My main role is to speak to the prisoners as they come in

I would generally book them in.

I don't get involved in any of the investigation whatsoever, my main concern is to make sure they're safe,

they're well and they're looked after correctly while they're here.

there's a microphone above your head and there's microphones all around this custody suite.

Once you're arrested, the process follows a standard protocol,

replicated in custody suites like this one up and down Britain.

I've asked Damon to take me through exactly what happens.

OK, so here I am, I've just come in,

make up a charge, what have I been doing?

Shoplifting, let's go with something simple.

OK, so I'm a shoplifter, allegedly. Yeah. I've been shoplifting.

I will ask you a whole load of questions about your health,

have you been drinking? Have you taken drugs?

All those questions come into it because we then have to

assess how we're going to care for you while you're here.

You've also got human beings across the desk.

Are you able to kind of make sense of that?

Do you look at them and make a judgment at that stage?

You know, whether you've been arrested for a very minor offence

or a very serious offence, it's still a human being in front of you.

Put me through the process. Where do I go next?

You'll go from here and my colleague would then take you off

and take your fingerprints, your photograph, your DNA.

I'm going to stick with this hand,

I'm going to do the individual fingers.

'When you're brought into custody the police have the right, without your

'permission, to take fingerprints, a DNA sample, and to photograph you.'

Cool, that's it. Can read your palm.

'This information is then stored on a vast police database,

'which they can then refer to for other investigations.'

No numbers, nothing like that?

Not the Hugh Grant...? No.

OK, erm, this is a cell here you're going to be placed in.

OK, come in. Thank you.

Right, everything in here,

there's CCTV just up there watching you all the time, OK?

You've got the toilet. So, yeah, so you'll remain here now.

Thank you very much, I think. Thank you.

Ooh.

From the outside it kind of looks chic. On the inside,

it's very bright, there's a constant whine,

there's a slight smell of something that's a cleansing fluid.

I don't like it.

All over the cell, it's got little messages to remind you

that there are ways you can make your life a bit easier.

Have your other crimes taken into consideration,

what I believe are known as ticks.

I would imagine the first time that you come in here,

it would be quite intimidating.

All you can do is think about the unknown

which is what's going to happen to you next.

You know there's a process going on out there where the

police are trying to gather enough evidence to make, you know,

a conviction stick, and you're in here and there's nothing you can do.

SHUTTER CLANKS Oh, God!

You know, even just for five minutes in there,

and I know this is an exercise and I can get out at the end of it,

but for five minutes I thought, "OK, I'm getting my head around this,"

and then suddenly the shutter went on the door and you're looking in...

Yeah. And I think to myself, "No, I am not in control here."

That's it, there's no privacy.

First-time offenders, especially young sort of children here,

you may, as you're putting them into the cell,

you explain it all to them, and then when you close the door,

you may just want to give it that little bit of a harder push

so it makes that real slam effect, it makes them

think about what they're here for.

'Many of these cells are currently unoccupied.

'But the police involved in Operation Big Wing are beginning to

'arrive at the unit with detainees.'

Should have had some general strip search to do that, yeah?

Yep, if we go straight through there please.

Erm, so, time of arrival please?

'Keeping an eagle eye on proceedings is Officer Charlotte Wall.'

What's your name, sir?

'She's in charge of what they call the Pod. It's here that she

'monitors the cells and corridors on CCTV in case of an incident.'

VOICE ON RADIO INAUDIBLE

OK, I'll open the gate, don't push it.

'And she controls access in and out of the custody suite.'

Don't push it, don't push it.

'Through their intercom, detainees can also request food and drink.

'There's a choice of tea, coffee and hot chocolate

'along with five different microwaveable meals.'

People obviously think it's the Holiday Inn in Wandsworth

cos they ask for visitors

and they ask for people to come in and see them,

and we don't do slippers or dressing gowns

but everything else is probably catered for quite nicely.

People come in with all sorts of bizarre stories.

The guy that came in, when he went to bed, we said,

"You need to go to sleep." He said, "Can I have a bedtime story?"

I was like, "I'm not reading you a bedtime story."

So we played some music for him

and then he decided to dance around the cell for about half an hour.

I mean, he wasn't a bad man.

I'm not going to read him the Three Bears but if I can play him

a little bit of disco music and he's happy with it

then that's fine. Made my night.

Could Number Two have some water please?

Right...

The offence? Attempted robbery. Commercial premises.

'At the custody desk, there's a new arrival.

A man suspected of robbing a convenience store.'

He has leant over the counter and attempted to take the till.

OK, sir, do you understand the reason

as to why you've been arrested?

You've understood everything the officer said, yeah?

I'm going to authorise your detention then for you to be

interviewed about the offence on tape.

Would you like a solicitor?

No, no, no. Any particular reason why you don't want a solicitor?

Cos I haven't done nothing. OK.

OK, left hand, same four fingers. Nothing, negative, yeah?

'Upstairs, detectives are working on the evidence.

'Detective Brian Kelleher is studying CCTV cameras

'from the shop the man's been accused of robbing.'

What we see here is the suspect enters the store,

he's got his hood up, he puts some socks on his hands

so that he's not leaving fingerprints.

He has a knife inside a carrier bag which he threatens

the staff of the shop with.

At this point, the shopkeeper locks the door,

they're throwing bottles at him, the door's locked...

which he then breaks to get out,

and then he's gone and they chase after him.

It can be picked up on the street outside.

The shop staff are throwing bottles after him.

One of them, quite a large looking one, smashes right by his feet,

and then we see the shopkeeper running after him.

If his shoes are covered in sticky stuff,

it just adds to the picture, should it go to court,

that it's definitely this person who we've arrested.

'The police aren't satisfied that there is sufficient evidence against

'the convenience shop robber,

'and he's being taken off to court to be put in front of a judge.'

So, Operation Big Wing, that we saw taking place this morning,

how do you gauge how successful or otherwise it was?

We've had a number of arrests this morning.

We've already, erm, investigated, charged,

and today now actually they're on their way to court.

It frees up those police officers to get back out there

and carry on doing stuff.

'Across the capital,

'the operation has led to 449 arrests for a range of offences,

'including burglary, robbery and possession of firearms.'

You're screaming and shouting at the officers.

As soon as you calm yourself down the handcuffs will come off.

'One of the most densely populated areas outside the capital is the

'East Midlands, home to the Queen's Medical Centre trauma unit in Nottingham.

'It's one of 22 new major trauma centres.

'This network of specialist emergency units is part of a new strategy

'for improving outcomes for the 20,000 major traumas

'that happen annually.

'And we're here for one weekend to see how a centre like this works.'

But we're not just here on any old weekend.

This is the first proper weekend of spring,

the first decent weather we've had in ages,

and that has changed the kind of cases they're seeing in there,

because people have been enjoying themselves.

And sometimes when people enjoy themselves it doesn't end well.

'The first assessment of the patient takes place

'here in the resuscitation room.

'Then right next door to resus there's a designated CT scanner.

'So within 15 minutes of a trauma coming in,

'they'll have a full body scan completed.

'The idea is to gather as much experience, expertise

'and technology in one place.

'Emergency Doctor Craig Douglas explains to me how it works.'

We'll have the general surgeons, who will be there to deal with

any major problems involving the abdomen.

We'll have the orthopaedic surgeons,

problems with the pelvis or the limbs.

We'll also have the consultant who's on for major trauma.

'Trauma cases arrive here by road and by air.

'There are two Air Ambulances serving the East Midlands,

'and last year 91 patients were airlifted to the trauma unit.

'The Lincs and Notts Air Ambulance is based at RAF Waddington

'south of Lincoln.'

PHONE RINGS Hello?

'And for the crew, it's never too long

'before the emergency phone rings.'

Jane, got a job!

'On board are a pilot and two paramedics.'

It's a scramble incident, driving, off-road scrambling,

but we're not sure exactly the extent of his injuries.

'With a maximum speed of 154mph, the Air Ambulance is the quickest way

'to get access to the casualty in an isolated Lincolnshire forest.'

The high proportion of jobs that we do

go to where a land vehicle just physically can't get.

Just going to lift your leg up, buddy.

Looks like he's got a fracture to the bottom of his leg.

I'm sure with an X-ray it'll show that it's fractured. Roll.

This is not very comfy, mate, I'm sorry. I'm very sorry.

And slide.

Perfect. Have we all got a bit of board? Yep.

'Ben is being airlifted by one of 36 Air Ambulances

'operating across Britain.

'All are run as charities, and on average

'they attend 70 serious incidents like this every day.

'Joining Ben in trauma is a number of other bikers

'who've also got into trouble.'

D'you remember if you bumped your head?

'This is James, another motocross rider with a fractured leg.'

The likelihood is that all you've done is broken your leg, OK?

'Conrad's a biker in his 60s, also with a leg fracture.'

Just one of them things.

THEY SPEAK ALL AT ONCE

Approximately 60mph...

All right, where's your main pain, my friend?

'And Chandler's come off his bike at 60mph.'

Whilst flying through the air,

you do wonder, you know, this is going to hurt.

As soon as you land, your first instinct is what's wrong now?

'Motorcyclists make up just 1% of the traffic on our roads,

'but in 2011 they accounted for 19% of deaths.

'These riders are the lucky ones.

'Their injuries will heal given time.

'For Emergency Doctor Lizzie Robinson, her next patient,

'19-year-old student Liz Tyndale,

'is the first Frisbee player she's ever had in.'

SHE SCREAMS IN PAIN

'And it's a painful one, because she's dislocated her knee.'

Ultimate Frisbee!

Not just Frisbee, Ultimate Frisbee.

And don't ask me what that is. I presume it involves Frisbees,

and a lot of running around.

SHOUT OF PAIN

It's very painful, obviously, as you can tell.

It's going to be a lot better when it's in the right position,

just like any dislocated joint.

And then we're going to pop your knee back into the right position.

SHOUT OF PAIN

All right, OK. I'll give you a little bit more. Well done.

It's OK, it's fine. Just relax.

Get me more. Get me more now.

You're doing so well. Get me more.

So we start off the game, she goes out, takes a wrong step.

Just went down screaming.

It's quite a serious injury to get for a non-contact sport.

Well done. It's all done. Just take some deep breaths for us.

Pop your head forward. You're all right.

Hopefully this won't ruin her Ultimate Frisbee career.

It's been a hectic day for Lizzie. But during her break,

we get a chance to catch up.

This weekend that we've had...

Now, bearing in mind I'm a motorcyclist... Oh, dear.

Yeah. Er, not great for me and my brethren.

No, no. Um...there have been a few motorcycle accidents.

I suppose in the springtime, it is when people,

particularly after the bad and late winter that we've had,

people are now getting out and doing things that they haven't done

for quite a long time,

and some of those things are relatively high-risk.

You do wonder sometimes

how more bad things don't happen, if you see what I mean.

Are you ever able to stop and think to yourself,

"How many lives have I saved?"

I know that sounds dramatic,

but that's the reality of what you're doing.

I think you see yourself as part of a team.

It's not just you as a person. You're part of it,

and that's a nice thing to be part of,

but I don't go home and have a little sort of star chart

of how many lives I've saved!

Predictably, perhaps, the first decent weather of spring

has delivered a clutch of biker casualties.

But here, they have to be ready for anything.

Being brought into the resuscitation room

is emergency patient 73-year-old John Litchfield.

John's heart has been going into an abnormal rhythm,

which means it isn't pumping blood around his body.

Paramedics have had to shock him to keep him alive.

they called us because he'd had a couple of fainting episodes at home

and his wife was concerned.

Four times, I had to shock him, and that's quite unusual.

Very unusual.

Hello, sir.

Hello. How are you feeling?

Looking after John is critical care doctor David.

Hello, sir.

We need to get a couple of things sorted, all right?

Your heart keeps going into a funny rhythm which makes you pass out.

As David is talking to him, John loses consciousness again.

John? John?

The team try to get John's heart beating normally once more.

Shocking.

Hello again, John. Hello.

Feeling OK again?

We've given him some medication now to try and stabilise the heart,

stop it going into the abnormal rhythm, but we haven't got

a primary cause for why it's happened and he's not in the clear.

As John lies resting, his wife and son are shown in to see him.

John? Your family are here.

John's critically unwell,

but he's fortunate at least to be here,

because at a hospital of this size

there are all the key specialists he needs.

You're doing well.

And one of the hospital's cardiologists is here

to try and discover what's causing John's illness.

Mr Litchfield, I'm Dr Al-Hinai, I'm one of the cardiology registrar.

Hi.

So you had a bit of a funny turn this morning, haven't you?

This time we got you into hospital in time,

but if this were to happen again, especially if you were alone...

Come here, come here. Ssh.

All right.

Well, you're in the right place, all right? Yeah.

We'll get there, we'll get there.

Dr Hinai has diagnosed why John's heart keeps failing.

He had actually what we call ventricular arrhythmia,

and what that means is that the bottom chambers of the heart

are essentially...the electrical mechanism in it has gone haywire,

if you like. And it's all over the place,

and as a result the heart stops pumping blood.

An abnormal heart rhythm affects over two million people in Britain,

and of those, 100,000 die each year from sudden cardiac arrest.

But if diagnosed early, 80% of fatalities could be avoided.

As John recovers in hospital, the Lincolnshire Air Ambulance

had been scrambled yet again.

This time it's a horse rider with a serious leg injury

that needs to get to hospital fast.

Take some deep breaths.

About 30 seconds on it, as big as you can.

Cos this will be sore, OK?

SHE SHOUTS IN PAIN

49-year-old Melanie has fallen from her horse.

That's it. Big deep breaths.

'OK, that's fantastic.'

Cheers, bye.

Er, fracture dislocation to ankle after falling off a horse.

She's had 15mg morphine, it's still actively bleeding from the site.

Here we go. Excellent, all done.

Everybody go a bit? Ready, steady...

lift. OK.

What's the story?

No initial pain, no loss of consciousness,

and then a gradual onset of left ankle pain.

There's a fracture, quite a nasty fracture high up in the fibula bone.

We'll need to perform a manipulation, um, tonight.

Melanie, are you aware that we're going to have to manipulate

this fracture of yours into a better position?

SHE SHOUTS IN PAIN

That's it. Well done. OK, Melanie, we're all done there. All done.

Tomorrow, Melanie will be taken to theatre,

where an orthopaedic surgeon will pin her ankle.

Spring is the season

when horse-riding accidents hit their peak.

And while you might think riding a motorcycle is dangerous,

horse-riders are hospitalised three times more often.

It's a bit like London buses in here sometimes.

Sometimes wait a long time for a trauma, and then maybe two at once.

While we're filming, another horse rider, 18-year-old Lauren Lewis,

arrives with Dr Pam Hardy.

Lauren's injuries are potentially very serious.

This young lady's 18 and she's fallen off a horse at some speed.

and hit her head on a metal gatepost.

She's been outside for a long time on the floor.

Did they get a temperature?

When we got there she wasn't consolable.

That's a sign of a brain injury.

We checked all the other obvious causes for that

and we're having to work on the diagnosis

of a potential brain injury.

Lizzie and the team complete their first checks

before Lauren is taken off to be scanned.

It's only when they get the scan results back

that they'll get a proper picture of her injuries.

Now, Dr Adam Brooks, clinical lead of the Major Trauma Centre,

has come down to look at the scans.

She's picked up a number of injuries,

a number of fractures, breaks in the bone.

There's no evidence of bleeding or swelling, which is very good news.

Lauren is sedated throughout the whole process.

When it's over, she's transferred upstairs

to the Critical Care Unit to rest.

So the plan at the moment is to stop the sedation we've been using

to keep her asleep, and see how she wakes up,

and fingers crossed she'll wake up fine

and hopefully just had a concussion rather than anything more serious.

Lauren fractured a number of bones in the fall,

but when she did eventually wake up, there was no injury to her brain

and she made a full recovery.

We filmed here at the Trauma Centre in Nottingham two days ago.

It also happened to be the first really nice spring weekend,

which meant that the bikers, the cyclists and the horse riders

were out in force. It also meant that the team here

had to deal with an increased number of sporting injuries,

so I'm back to check up on some of the patient.

My first visit is to motocross rider Ben.

Are you all right? Yes, all right, thank you very much.

How's it feeling? Sore. Sore? Yep.

And here you are. What exactly happened?

Leisurely ride out on the bikes,

couldn't see where the front wheel was, hit a rock.

Broken.

Did you know instantly that this was quite a serious injury?

Yeah. Yeah, my foot was pointing that way

and the knee was pointing that way.

So this is at the very moment, or just after it.

Yeah.

Oooh. Your foot and your knee are not going in the right direction.

It's not good, is it? No.

Let's take you to see your leg.

I'm a bit scared of the bumps, to be honest. I'll take it nice and easy!

You can see here that the tibia bone, it's got this large nail.

What do you think of your new metalwork?

I'm slightly overwhelmed, to be honest.

So that's part of you forever now.

Yeah.

Now with John Litchfield recovering from his ordeal in hospital,

I've come along to catch up with him and his wife Mary.

Hello! I'm going to say hi to you first,

and it's a pleasure to meet you. Hello, Julia. Hello, John,

good to meet you. And we might not have met! No.

I can't believe you're here after six cardiac arrests.

So you have died six times. Six times, yeah.

Can you remember much?

Just having a cup of coffee,

and I must have just, like,

fell asleep.

If he starts getting a bit awkward, I'm going to be saying,

"Just remember I saved your life!"

THEY LAUGH

Love you too!

'John needs to have a device fitted in his chest

'that will shock his heart if this happens again.

'But after that, he'll be able to live a normal life.'

'It's sobering to think how close John came to death

'just a few days ago.'

The paramedics, the nurses, the doctors here

have done an incredible job

and they've kept a very lovely couple together.