0:00:02 > 0:00:05SIREN WAILS Racing to treat a patient in need of critical care.
0:00:05 > 0:00:06Can I have a crew, please?
0:00:06 > 0:00:09This is the West Midlands Ambulance Service.
0:00:09 > 0:00:12This could have been a fatal incident, 100%.
0:00:12 > 0:00:14A dedicated team of doctors and paramedics.
0:00:14 > 0:00:17- Hi there, ambulance. - I don't like it when they cry.
0:00:17 > 0:00:20They respond to 1 million 999 calls every year.
0:00:22 > 0:00:24Fighting to save lives.
0:00:24 > 0:00:27Went straight up in the air, crashing down.
0:00:27 > 0:00:29Because some emergencies are so severe...
0:00:29 > 0:00:31He has fractured his femur.
0:00:31 > 0:00:33..treatment must begin...
0:00:33 > 0:00:35- Take a deep breath. - ..out on the road.
0:00:35 > 0:00:39I am grateful to every paramedic. If I could give them a medal, I would.
0:00:47 > 0:00:51Today, paramedics treat a man hit by a lorry on the motorway.
0:00:51 > 0:00:53He was lying on the floor rolling round when I got here.
0:00:53 > 0:00:56This could have been a fatal incident, 100%.
0:00:56 > 0:00:59A driver in pain fears for his life.
0:00:59 > 0:01:01Whereabouts is it in your chest?
0:01:01 > 0:01:06I laid down in the van and I thought my time had come.
0:01:06 > 0:01:09And Cameron helps a young girl in excruciating pain.
0:01:09 > 0:01:11If you could score the pain out of ten, ten being the worst pain
0:01:11 > 0:01:14- you've ever experienced, how would you score it at the moment?- Ten.
0:01:22 > 0:01:24The West Midlands Ambulance Service
0:01:24 > 0:01:26is one of the biggest in the country,
0:01:26 > 0:01:31looking after over 5.5 million people in a 500 square mile area.
0:01:31 > 0:01:35Its staff respond to over 3,000 999 calls each day.
0:01:37 > 0:01:39And in the most serious cases
0:01:39 > 0:01:41the West Midlands Ambulance Service
0:01:41 > 0:01:45has its own mobile trauma unit known as MERIT.
0:01:45 > 0:01:49MERIT stands for Medical Emergency Response Instant Team.
0:01:49 > 0:01:52It's a team of two,
0:01:52 > 0:01:53consisting of a senior doctor
0:01:53 > 0:01:55from an emergency medicine background
0:01:55 > 0:01:56or an anaesthetic background,
0:01:56 > 0:01:59teamed together with a critical care paramedic.
0:01:59 > 0:02:01Our remit is to respond to major trauma.
0:02:01 > 0:02:04So major trauma could be lorry versus car,
0:02:04 > 0:02:06road traffic accident on the motorway
0:02:06 > 0:02:09or knife attack, machete attacks, gunshot wounds,
0:02:09 > 0:02:14basically anything that is causing someone to have a severe injury
0:02:14 > 0:02:17it's more likely than not we will be called to go and respond to it.
0:02:19 > 0:02:22Tonight, the MERIT team of Greg Ambler and Nick Crombie
0:02:22 > 0:02:26are on their way to a crash on the M6.
0:02:26 > 0:02:32I would say between 30 and 50% of our work are road traffic accidents,
0:02:32 > 0:02:34and that can include all manner of road traffic accidents.
0:02:34 > 0:02:36Motor cyclists versus cars,
0:02:36 > 0:02:40cyclists versus cars and pedestrians versus all manner of vehicles.
0:02:50 > 0:02:55We are going to reports of a pedestrian versus a lorry
0:02:55 > 0:02:57on the active carriageway of the M6
0:02:57 > 0:02:59just north of Birmingham.
0:02:59 > 0:03:02It's somewhere around junction nine or ten,
0:03:02 > 0:03:06so as we get to that area we will obviously start to come upon
0:03:06 > 0:03:08standing traffic and probably police.
0:03:08 > 0:03:12When we get reports of a person hit by a lorry on a motorway
0:03:12 > 0:03:14the immediate... hairs on your back go up.
0:03:14 > 0:03:17The feeling is that it's a 60mph speed limit,
0:03:17 > 0:03:20lorries obviously carry quite a lot of force.
0:03:20 > 0:03:23Unfortunately they generally tend to be fatal incidents.
0:03:29 > 0:03:30On the scene.
0:03:33 > 0:03:37Surprisingly, the casualty is sitting up on the road talking.
0:03:37 > 0:03:41It looks like, as you can see, a young chap, apparently intoxicated,
0:03:41 > 0:03:43- walked into the road. He was hit by a lorry.- OK.
0:03:43 > 0:03:45He has got a head injury.
0:03:46 > 0:03:48His breathing is OK.
0:03:48 > 0:03:49His chest sounds clear.
0:03:49 > 0:03:51When we arrived, the gentleman was seated in an
0:03:51 > 0:03:54upright position with a couple of policemen around him.
0:03:54 > 0:03:58His conscious level was fantastic, he was talking,
0:03:58 > 0:04:01he was orientated and aware to sort of time and place.
0:04:01 > 0:04:04We were very, very surprised that he was not more seriously injured.
0:04:04 > 0:04:07Especially when we spoke to the driver of the vehicle
0:04:07 > 0:04:09who stated that he was doing 40mph
0:04:09 > 0:04:11when he hit the gentleman and he saw him fly
0:04:11 > 0:04:14through the air and land on the ground.
0:04:14 > 0:04:16I'm a doctor. I am going to have a little look at you, OK?
0:04:18 > 0:04:20I am a doctor. I'm just going to have a look.
0:04:21 > 0:04:22OK, in a minute.
0:04:23 > 0:04:28- D you know what hit him?- That lorry there.- That one there?- Yeah.
0:04:28 > 0:04:32He was just lying on the floor rolling around when I got here.
0:04:32 > 0:04:33Have you got any pain?
0:04:33 > 0:04:35Does it hurt? Sore?
0:04:35 > 0:04:36Ow?
0:04:40 > 0:04:44What we're looking for at first is to see if there is any external
0:04:44 > 0:04:46catastrophic haemorrhage,
0:04:46 > 0:04:50to see if there is any obvious significant bleeding points.
0:04:50 > 0:04:52We have a look to see if they've got an airway
0:04:52 > 0:04:54and generally if they are talking, we are in a good place.
0:04:54 > 0:04:55OK.
0:04:57 > 0:05:01No limbs, no long bones, chest, abdo, neck, OK.
0:05:01 > 0:05:02If you've got his legs,
0:05:02 > 0:05:05I'm just going to sit up and he might be a bit more compliant.
0:05:05 > 0:05:07OK.
0:05:07 > 0:05:09Stop! Stop, stop!
0:05:09 > 0:05:10Well done. Well done, mate.
0:05:10 > 0:05:13- Relax, OK?- The gentleman was obviously intoxicated.
0:05:13 > 0:05:15He just wanted to go home.
0:05:15 > 0:05:18He didn't realise that he had actually crossed the motorway.
0:05:18 > 0:05:23He just thought it was a busy road and he misjudged the fact that the
0:05:23 > 0:05:25vehicles were going at the speed they were
0:05:25 > 0:05:28and he just wanted to get to the other side of the motorway to go home.
0:05:30 > 0:05:33OK, that's all right. It's OK.
0:05:33 > 0:05:35You're OK.
0:05:35 > 0:05:43Where is home? Where home?
0:05:43 > 0:05:45Where is home?
0:05:48 > 0:05:49You're a rigger?
0:05:49 > 0:05:51Has he got any ID on him at all?
0:05:52 > 0:05:55Nick checks the man's pelvis and spine for fractures.
0:05:59 > 0:06:01- Nothing's hurting. - Well done, mate. Well done.
0:06:05 > 0:06:06Listen...
0:06:06 > 0:06:08You are OK. You are OK.
0:06:09 > 0:06:14Even though he is presenting really well you still need to do a thorough
0:06:14 > 0:06:17top to toe check, so we go from the head to the feet,
0:06:17 > 0:06:19have a good feel of all his bones,
0:06:19 > 0:06:21and we make sure that we, for example
0:06:21 > 0:06:23the gentleman's moving all four limbs
0:06:23 > 0:06:29with no pain, that they have no sort of serious spinal injuries
0:06:29 > 0:06:31or spinal problems.
0:06:31 > 0:06:32We also have a look at their chest,
0:06:32 > 0:06:36so we are making sure that they are breathing well for themselves,
0:06:36 > 0:06:39if it does not cause any extra pain.
0:06:39 > 0:06:41We have a good poke and prod at their belly, etc.
0:06:47 > 0:06:51More than 1,700 people were killed on the roads last year.
0:06:51 > 0:06:53This man's had a lucky escape.
0:06:54 > 0:06:57If you think about it, a 7.5-12.5 tonne vehicle
0:06:57 > 0:07:00moving 40mph and you are a person,
0:07:00 > 0:07:04so that force hits you and all your internal organs move,
0:07:04 > 0:07:06so it's going to get this wave of movement.
0:07:06 > 0:07:08That's his primary injury.
0:07:08 > 0:07:10His secondary injury then happens
0:07:10 > 0:07:15is he then falls backwards onto the motorway, so this massive mechanism
0:07:15 > 0:07:18goes ten foot and then hits the ground.
0:07:18 > 0:07:20That is where he gets his secondary injury.
0:07:20 > 0:07:23So the index of suspicion's massive, really.
0:07:24 > 0:07:28But miraculously, the man doesn't appear to have any serious injuries.
0:07:28 > 0:07:33Upon checking things like his heart rate,
0:07:33 > 0:07:37how well he was moving oxygen around the body, his blood pressure,
0:07:37 > 0:07:40having looked at a picture of his heart,
0:07:40 > 0:07:45we felt quite confident that he was in quite a stable state, really.
0:07:45 > 0:07:46I know.
0:07:46 > 0:07:51I'm English. I don't speak Russian.
0:07:54 > 0:07:59He's done some miraculous dance move to be in the position where he was.
0:07:59 > 0:08:01We were both, as a crew, myself and Nick
0:08:01 > 0:08:04were incredibly surprised that he was in the state he was.
0:08:04 > 0:08:06This could have been a fatal incident, 100%.
0:08:06 > 0:08:10If this lorry was doing 60mph, as it's allowed to do,
0:08:10 > 0:08:14and hit that gentleman at 60mph, he would have died.
0:08:14 > 0:08:16We are going to go into the ambulance now.
0:08:17 > 0:08:18Have you been briefed?
0:08:18 > 0:08:20Only what I've heard on the radio.
0:08:20 > 0:08:22This guy we believe is Russian.
0:08:22 > 0:08:24- OK.- He was intoxicated.
0:08:24 > 0:08:27He's been crossing the carriageway and got hit by the lorry.
0:08:28 > 0:08:31That one? That one that's there, the red one. Speed - don't know.
0:08:31 > 0:08:34It's almost like a glancing blow and he's spun but obviously he's been
0:08:34 > 0:08:37thrown forward by where he landed where the lorry is.
0:08:37 > 0:08:42He's got a bleeding lump to the back of his head but no haematoma,
0:08:42 > 0:08:44it's not boggy, it's a graze.
0:08:45 > 0:08:50All of his limbs are absolutely fine, pelvis, abdomen, chest area,
0:08:50 > 0:08:53BP is good, stats are good on air.
0:08:53 > 0:08:55Drunk and very, very lucky as far as I can tell.
0:08:55 > 0:08:56Let's have a clean of your eye.
0:08:56 > 0:08:58We're going to give you a clean, OK?
0:08:58 > 0:09:00He might have a fractured cheekbone.
0:09:00 > 0:09:05He did have a fracture to his eye socket, he did not require any
0:09:05 > 0:09:07immediate definitive care
0:09:07 > 0:09:11and fortunately he didn't have a time critical head injury either.
0:09:11 > 0:09:13He just had a slight concussion.
0:09:14 > 0:09:16The man was taken to hospital
0:09:16 > 0:09:20where a CT scan confirmed he had no internal injuries.
0:09:20 > 0:09:24We did actually call because we were so surprised that he was
0:09:24 > 0:09:29quite well and so we did call the hospital later in the evening.
0:09:29 > 0:09:33The gentleman was staying in overnight just as a precaution
0:09:33 > 0:09:35but he had no time critical injuries.
0:09:35 > 0:09:40He just had the fracture which we suspected to his left eye socket,
0:09:40 > 0:09:42but it wasn't time critical.
0:09:42 > 0:09:45And didn't require any surgical intervention at that time.
0:09:45 > 0:09:49I am incredibly surprised that the gentleman did not have any more
0:09:49 > 0:09:50significant injuries.
0:09:58 > 0:10:01The West Midlands Ambulance Service
0:10:01 > 0:10:05has recruited more than 430 paramedics in the last three years.
0:10:06 > 0:10:11One of these recent recruits is 25-year-old Cameron McVittie.
0:10:11 > 0:10:14It's Saturday afternoon and he's been called to a woman who's
0:10:14 > 0:10:16suffering from extreme pains.
0:10:18 > 0:10:20This is one of the most rewarding jobs in the world.
0:10:20 > 0:10:23It's the old cliche that, yeah, I'm here to help people.
0:10:23 > 0:10:27And I like, you know, delivering that bit of extra compassion
0:10:27 > 0:10:28and I care for people.
0:10:28 > 0:10:31But it's also a bit of a personal challenge to work under pressure
0:10:31 > 0:10:37and use such a kind of unique set of skills to deliver, in some cases,
0:10:38 > 0:10:40you know, that life-saving, life-saving techniques.
0:10:40 > 0:10:44You're pushed to your limit in work in this area, I think.
0:10:44 > 0:10:46The volume of cases, or the volume of calls
0:10:46 > 0:10:47that we get on a daily basis,
0:10:47 > 0:10:52it's quite high and we're all under a lot of pressure to....
0:10:52 > 0:10:53to deliver.
0:11:08 > 0:11:11- Hello.- She's in the loft. That's the problem.- She's what?
0:11:11 > 0:11:14In the loft? What we doing in the loft?
0:11:14 > 0:11:16I hope I don't have to carry her down!
0:11:18 > 0:11:19Now, is it Chelsea?
0:11:20 > 0:11:23Yeah? Now, then, how can I help you today?
0:11:25 > 0:11:28Talk to me. Let me know what the problem is and I can help you.
0:11:28 > 0:11:31Got pains all in the stomach and they're shooting down the legs.
0:11:31 > 0:11:33She was heavily bleeding yesterday with period.
0:11:33 > 0:11:35It was going straight through her but...
0:11:35 > 0:11:36Is it that time of the month?
0:11:36 > 0:11:39Yes. But she's suffers with endometriosis.
0:11:39 > 0:11:45Endometriosis is a disease where tissue that normally grows inside the womb is growing outside the womb
0:11:45 > 0:11:47and can cause ladies significant problems
0:11:47 > 0:11:49and significant amounts of pain.
0:11:49 > 0:11:51Pop your finger in there for me, Chelsea.
0:11:51 > 0:11:53So you've been sick this morning as well?
0:11:53 > 0:11:54- Yes.- Yeah.
0:11:56 > 0:11:58And where exactly is the pain at the moment?
0:12:00 > 0:12:02And if you could score the pain out of ten.
0:12:02 > 0:12:04Ten being like the worst pain you've ever experienced,
0:12:04 > 0:12:07how would you score at the moment? Is it ten out of ten?
0:12:07 > 0:12:10All right. Well, we'll get that pain sorted for you shortly. OK?
0:12:10 > 0:12:12It's hard to see anybody in an amount of pain,
0:12:12 > 0:12:16but when they've got clear distress and you can see that look in their
0:12:16 > 0:12:17eyes, that look of help me,
0:12:17 > 0:12:21you act a little bit quicker and you always try and go the extra mile for
0:12:21 > 0:12:24those people that really, really want you to help them.
0:12:24 > 0:12:27So have you ever been to hospital before with your endometriosis pain?
0:12:27 > 0:12:29- Yeah.- When was the last time?
0:12:29 > 0:12:30Was it recent?
0:12:32 > 0:12:34You've been in and out the last two years, isn't it?
0:12:34 > 0:12:39I've had endometriosis and I've had it since I was 13 years old.
0:12:39 > 0:12:41It's something that's always there.
0:12:41 > 0:12:42You know when it's coming.
0:12:44 > 0:12:47You don't know when it's going to go or when the pain's going to stop.
0:12:48 > 0:12:51When womb tissue grows outside the womb,
0:12:51 > 0:12:55for example in the bowel or bladder, it bleeds with menstruation.
0:12:55 > 0:12:58This causes pain and inflammation.
0:12:58 > 0:13:00Your belly bloats and you're sick.
0:13:00 > 0:13:02You're passing out.
0:13:02 > 0:13:05It stops you from doing everyday things.
0:13:05 > 0:13:08Especially working, you can't make it to work.
0:13:08 > 0:13:11I can't drive when my stomach's bad.
0:13:11 > 0:13:12Even moving or getting out of bed.
0:13:13 > 0:13:15You just can't do it.
0:13:15 > 0:13:19Now then, with one finger, tell me where it hurts the most?
0:13:19 > 0:13:22There. OK. I'm just going to have a little press of your tummy now,
0:13:22 > 0:13:24all right? Any problems going to the toilet at all?
0:13:24 > 0:13:25- No.- No.
0:13:25 > 0:13:27OK, just a light press now.
0:13:27 > 0:13:28Just relax. OK?
0:13:28 > 0:13:29Is that sore?
0:13:29 > 0:13:32- Yes.- Sore here?
0:13:32 > 0:13:35And when I press here, where does it hurt?
0:13:35 > 0:13:36In the middle.
0:13:36 > 0:13:39Does it hurt when I let go or worse when I press?
0:13:39 > 0:13:41When I let go.
0:13:41 > 0:13:42I just need to lift this leg up.
0:13:42 > 0:13:44Can you just relax it a minute?
0:13:44 > 0:13:45I'll lift it up.
0:13:45 > 0:13:47OK? Ready. So that's floppy leg.
0:13:47 > 0:13:49Just relax your leg.
0:13:49 > 0:13:51That's better. Just relax your knee.
0:13:51 > 0:13:52Completely relax.
0:13:52 > 0:13:54Does that make the pain worse or better?
0:13:55 > 0:13:58Or just the same? Just the same.
0:13:58 > 0:14:00As a paramedic, it's quite important that we not only focus
0:14:00 > 0:14:03on the problem that we're presented with,
0:14:03 > 0:14:06but we try and rule out other problems that may arise.
0:14:06 > 0:14:10The reason I was moving her leg around was it was one of the tests for appendicitis.
0:14:10 > 0:14:13And once I could rule that out, as that test was negative,
0:14:13 > 0:14:15it was clear that the problem,
0:14:15 > 0:14:19the chronic problem that she has was causing that acute flare-up of her
0:14:19 > 0:14:20pain and not something more sinister.
0:14:20 > 0:14:22So we can get you some pain relief sorted.
0:14:22 > 0:14:24Have you taken any paracetamol or anything this morning?
0:14:26 > 0:14:28You threw it all back up.
0:14:28 > 0:14:30- And when you take paracetamol, how many do you take?- Two.
0:14:30 > 0:14:31You take two.
0:14:31 > 0:14:32And when you go to the hospital,
0:14:32 > 0:14:34what pain relief do they normally give you?
0:14:34 > 0:14:36Oramorph?
0:14:36 > 0:14:37OK, and does that normally help you?
0:14:37 > 0:14:39- Yeah. I've actually got some. - Do you?
0:14:39 > 0:14:43Would you like to take some of your own? That might help you. Yeah?
0:14:43 > 0:14:44How much do you normally have?
0:14:45 > 0:14:47Just one spoon. All right.
0:14:47 > 0:14:51Do you want to sit yourself up a little and I'll get some of this for you.
0:14:51 > 0:14:53All right. Do you want this, then? Here it comes.
0:14:53 > 0:14:54Ready.
0:14:57 > 0:15:00OK. All right. Do you want a little drink of water to flush it down?
0:15:00 > 0:15:01Yeah.
0:15:01 > 0:15:02113.
0:15:02 > 0:15:04Can you send an ambulance backup, please?
0:15:06 > 0:15:08While Cameron waits for the ambulance to arrive,
0:15:08 > 0:15:11he prepares Chelsea for the trip to hospital.
0:15:11 > 0:15:13You need to keep it straight.
0:15:16 > 0:15:18OK, just stay really still.
0:15:18 > 0:15:19All right? OK.
0:15:19 > 0:15:20It will be a little scratch.
0:15:20 > 0:15:22Just wriggle your fingers a little tiny bit.
0:15:22 > 0:15:24Keep going.
0:15:26 > 0:15:28Very good. It's all sorted.
0:15:28 > 0:15:31So what we're doing at the moment is we've just popped a little plastic
0:15:31 > 0:15:34tube or a cannula into Chelsea's hand,
0:15:34 > 0:15:36just in case we need to give her any further pain relief.
0:15:36 > 0:15:39Obviously she's taken her own pain relief, which is great.
0:15:39 > 0:15:42But you know, she says that the pain gets worse on movement.
0:15:42 > 0:15:44So if we need to give any further medication, ie,
0:15:44 > 0:15:47any paracetamol through the vein or anything like that,
0:15:47 > 0:15:50then we can do that much more simply now.
0:15:50 > 0:15:52OK. Are you comfortable there for a second?
0:15:54 > 0:15:55Negotiate the steps.
0:15:55 > 0:15:57All right?
0:15:57 > 0:15:59- Hello.- This is Chelsea.
0:15:59 > 0:16:01OK, Chelsea's 18 years old.
0:16:01 > 0:16:03Unfortunately Chelsea suffers with endometriosis.
0:16:03 > 0:16:06She, unfortunately, this morning,
0:16:06 > 0:16:08about 10am, experienced a sudden,
0:16:08 > 0:16:10very intense super pubic abdominal pain.
0:16:11 > 0:16:13That's kind of where we are.
0:16:13 > 0:16:16The only way she can safely come down is literally by walking.
0:16:18 > 0:16:20There's no way that we could extricate someone through here.
0:16:20 > 0:16:24It's too dangerous to use the carry chair and the extrication equipment.
0:16:24 > 0:16:27Obviously if the patient deteriorates or was unconscious,
0:16:27 > 0:16:30it would be a different scenario, but she's going to
0:16:30 > 0:16:32make her way very slowly down the stairs.
0:16:34 > 0:16:36OK, put your bum there.
0:16:37 > 0:16:38What is your name again?
0:16:39 > 0:16:41Hi there, Chelsea.
0:16:41 > 0:16:44Now, you've been having the entonox and you've had your own Oramorph.
0:16:44 > 0:16:48Legs up. If you had to score that out of ten, ten being the worst one,
0:16:48 > 0:16:51where would you put it now?
0:16:51 > 0:16:52It's about a five. OK.
0:16:52 > 0:16:55All right, sweetheart?
0:16:55 > 0:16:57Is it easier with that pain relief?
0:16:57 > 0:16:59Yeah. You have some morphine now.
0:16:59 > 0:17:01- OK?- I don't remember much.
0:17:01 > 0:17:03I don't even remember getting to the hospital or anything.
0:17:03 > 0:17:05I was, I knew they were putting the morphine in my hand
0:17:05 > 0:17:09when I was in the ambulance. And that was it then, I was gone.
0:17:09 > 0:17:11I was out of it.
0:17:11 > 0:17:15It's yet another visit to the hospital for Chelsea and her boyfriend, Ben.
0:17:16 > 0:17:19It's horrible knowing I can't really do anything about it.
0:17:19 > 0:17:22Anyway I can help, like, I can go into hospital appointments and that,
0:17:22 > 0:17:25but I look at her and I see her and I can't do anything about it.
0:17:25 > 0:17:26So it's upsetting, to say the least.
0:17:28 > 0:17:29OK, Chels, they'll look after you.
0:17:29 > 0:17:30All right? All the best.
0:17:30 > 0:17:31See you later.
0:17:34 > 0:17:37Been to see many ladies unfortunately who suffer with this medical problem.
0:17:37 > 0:17:39Again, every single one I have seen,
0:17:39 > 0:17:41the common factor is they are in excruciating pain.
0:17:41 > 0:17:44And the only thing that I can do, you know, is provide that really
0:17:44 > 0:17:46good level of pain relief to try and get it under control.
0:17:46 > 0:17:49I hope she'll make a good recovery. Hopefully she'll be assessed
0:17:49 > 0:17:52and I know she's awaiting some scan results, so fingers crossed for her.
0:17:52 > 0:17:53I wish her all the best.
0:17:55 > 0:17:56Following her visit to hospital,
0:17:56 > 0:18:01Chelsea underwent surgery to treat her endometriosis.
0:18:01 > 0:18:05They just said that they would laser it away, that was keyhole surgery.
0:18:05 > 0:18:06And after I had that done,
0:18:06 > 0:18:09everything was a lot better for about a few weeks.
0:18:09 > 0:18:13I went back to work for a few months and ended up in hospital again with
0:18:13 > 0:18:16the same pain. And they told me that it'd all grown back.
0:18:16 > 0:18:20I've tried everything now and there's nothing else that I can try.
0:18:20 > 0:18:24So I know that it's something I'll have forever and it won't get cured.
0:18:24 > 0:18:27It's just something I have to learn to deal with.
0:18:35 > 0:18:37The West Midlands Ambulance Service
0:18:37 > 0:18:40employs thousands of front-line emergency staff.
0:18:40 > 0:18:41Is that hurting there?
0:18:41 > 0:18:43Can you bend it at all?
0:18:45 > 0:18:48They also make use of volunteers.
0:18:48 > 0:18:52BASICS is a charity that covers the whole of the UK.
0:18:54 > 0:18:57In North Staffordshire, it's made up of six doctors who give their time
0:18:57 > 0:19:00freely to provide that extra care
0:19:00 > 0:19:04that can't be delivered by the roadside paramedics.
0:19:04 > 0:19:06Right. Got the major haemorrhage stuff,
0:19:06 > 0:19:08got some swabs and some set-up scores.
0:19:08 > 0:19:13We can mobilise to anything that where the Ambulance Service think that we can make a difference,
0:19:13 > 0:19:14so it's often trauma.
0:19:15 > 0:19:18Motorcycle, car accidents, plane crashes.
0:19:18 > 0:19:22But it could just as simply be somebody who's struggling medically
0:19:22 > 0:19:25with difficulty breathing or another medical problem.
0:19:30 > 0:19:33Today, Mike and medical student Jonathan Charles
0:19:33 > 0:19:37are en route to a man who has suffered a suspected heart attack.
0:19:47 > 0:19:49Yes. A red van. Thank you.
0:19:59 > 0:20:01We're about three minutes away.
0:20:01 > 0:20:05He could be having a heart attack, so we'll get there, assess him,
0:20:05 > 0:20:08do an ECG and take it from there.
0:20:09 > 0:20:13An ambulance backup crew has been dispatched to assist the doctors.
0:20:15 > 0:20:17When we're sent to somebody who's got chest pain,
0:20:17 > 0:20:21it could be a wide variety of different problems.
0:20:21 > 0:20:23From mild indigestion to a full-on heart attack
0:20:23 > 0:20:25that ends up into a cardiac arrest.
0:20:25 > 0:20:27If you've got somebody who's in cardiac arrest
0:20:27 > 0:20:30you've got a limited amount of time before brain damage sets in.
0:20:30 > 0:20:32And you really need to get in there,
0:20:32 > 0:20:35drag him out to the car and get going with CPR.
0:20:37 > 0:20:42So, it's really important that we do some very rapid assessment and find
0:20:42 > 0:20:44out how serious it is.
0:20:47 > 0:20:48Red, is it?
0:20:48 > 0:20:50Some people call them vans, don't they?
0:20:50 > 0:20:52I guess so. Could be.
0:20:52 > 0:20:53That looks like him.
0:20:55 > 0:20:57- I think someone's in there. - Are they?
0:20:59 > 0:21:00OK.
0:21:00 > 0:21:01Yeah.
0:21:03 > 0:21:04Say hello.
0:21:07 > 0:21:09Yeah. Hello, sir. Hi, there.
0:21:09 > 0:21:11Want an ambulance?
0:21:11 > 0:21:13Hi there. Are you OK at the moment?
0:21:13 > 0:21:15You've got pains in your chest.
0:21:15 > 0:21:17- And my arm.- All right. We'll just come around the other side.
0:21:17 > 0:21:19We'll have a look. Is the door unlocked?
0:21:19 > 0:21:22The fact that he was talking to us was a great sign.
0:21:22 > 0:21:24It meant that he wasn't in cardiac arrest
0:21:24 > 0:21:27and we had a few more minutes to work out what was going on.
0:21:31 > 0:21:34- And whereabouts is it in your chest? - There.
0:21:34 > 0:21:40I first realised something was wrong when the pain in my chest
0:21:40 > 0:21:42was spreading elsewhere.
0:21:42 > 0:21:45I realised it wasn't heart burn.
0:21:45 > 0:21:50This was something more considerable, something quite bad.
0:21:50 > 0:21:53So at that point I pulled over and I phoned for an ambulance.
0:21:53 > 0:21:55Is it spreading down your arms at all?
0:21:55 > 0:21:57- There.- Your left-hand side.
0:21:57 > 0:21:59- Both hands are numb. - Both hands are numb.
0:21:59 > 0:22:01OK. And when did this start?
0:22:01 > 0:22:04Five, ten minutes ago.
0:22:04 > 0:22:08I hadn't got the strength to hold the phone to my ear.
0:22:08 > 0:22:09My hands were tingly.
0:22:09 > 0:22:11I put the phone down.
0:22:11 > 0:22:14And I lay down in the van.
0:22:14 > 0:22:16And I thought, my time had come.
0:22:16 > 0:22:18I really did.
0:22:18 > 0:22:19And are you generally fit and well.
0:22:19 > 0:22:21Any medical problems at all?
0:22:23 > 0:22:25- No.- Normally, no heart problems in the past?
0:22:25 > 0:22:29My heart misses every other beat and the occasional...
0:22:29 > 0:22:30We couldn't assess him properly
0:22:30 > 0:22:32while he was laid across the car like that.
0:22:32 > 0:22:35Luckily the Ambulance Service turned up pretty much the same time as
0:22:35 > 0:22:37we did, which was really helpful.
0:22:37 > 0:22:39Because we needed to get him into an ambulance.
0:22:39 > 0:22:43Into a nice warm place that we could assess him and examine him properly.
0:22:43 > 0:22:44- What's your name, sir?- Simon.
0:22:44 > 0:22:46All right, Simon. You've got pain in that left arm?
0:22:46 > 0:22:48- Just numb.- OK.
0:22:48 > 0:22:51- What sort of pain is it? - Stabbing there.
0:22:51 > 0:22:53Right through to the back.
0:22:53 > 0:22:56Right through to the back. Have you ever had anything like this before?
0:22:56 > 0:23:01I thought it was...indigestion.
0:23:03 > 0:23:05OK. We'll get you help out the car
0:23:05 > 0:23:09- and someone will be able to give you checks. OK?- No worries.
0:23:09 > 0:23:12Simon was well enough to suggest to us that he was able to sit up and
0:23:12 > 0:23:15maybe get himself into, on to the stretcher
0:23:15 > 0:23:17and get into the ambulance.
0:23:17 > 0:23:20Right, so he's bringing the trolley round for you to climb on to.
0:23:20 > 0:23:21No worries.
0:23:22 > 0:23:24That's it. We'll lock the door for you.
0:23:27 > 0:23:29- It felt like indigestion. - Yeah.
0:23:31 > 0:23:34And it kind of wasn't going away.
0:23:34 > 0:23:38- Have a look at your chest. - And it just got worse and worse.
0:23:38 > 0:23:40Have you ever had anything like this before, Simon?
0:23:40 > 0:23:43- No.- No.- Not like that.
0:23:46 > 0:23:50- Nice and clear?- If you could rate the pain, ten being very painful,
0:23:50 > 0:23:51zero not being painful at all.
0:23:51 > 0:23:54- What would you rate it? - Escalated to a ten.
0:23:54 > 0:23:56- It's gone off now. - What would you say it is now?
0:23:56 > 0:23:58- Nothing at all.- Nothing at all.
0:23:58 > 0:24:01- Just numb. - Still got those tingly fingers?
0:24:01 > 0:24:03Tingly fingers. Yeah.
0:24:04 > 0:24:06How old did you say you were, Simon?
0:24:06 > 0:24:08- 52.- 52.
0:24:08 > 0:24:11We've been able to get him into the ambulance. A bit more private.
0:24:11 > 0:24:14A bit more secure and able to assess him properly.
0:24:14 > 0:24:15He still has had these pains
0:24:15 > 0:24:17giving him some tingling in his fingers and things.
0:24:17 > 0:24:20So we're just doing a heart tracing now to find out if there are
0:24:20 > 0:24:23any signs of it being a heart attack.
0:24:23 > 0:24:26Right, really nice and still while this is just reading for me.
0:24:26 > 0:24:30On Simon's heart tracing, there was some changes from normal.
0:24:30 > 0:24:34It wasn't quite enough to really put our finger on it and say he's having
0:24:34 > 0:24:37a big heart attack. But it was suggestive enough.
0:24:37 > 0:24:41So we made the decision to take him to the hospital for further testing.
0:24:42 > 0:24:44So, what we're going to do, Simon,
0:24:44 > 0:24:48is we're going to give you some painkillers and hopefully take the edge off the pain.
0:24:48 > 0:24:50- Yes.- But you are going to need to go into the hospital,
0:24:50 > 0:24:53to see what's happening with your heart.
0:24:53 > 0:24:56- OK.- As I say, there are some subtle changes on there.
0:24:56 > 0:24:58They might be the old ones that you are talking about,
0:24:58 > 0:25:00or they might be new ones. So, we're going to take you to A&E.
0:25:00 > 0:25:03They'll be able to do some blood tests as well, just to see
0:25:03 > 0:25:05if there's been any heart damage or anything like that.
0:25:05 > 0:25:06- OK.- Right. Thanks, Simon.
0:25:06 > 0:25:08- Thank you. - Hope you feel better soon.
0:25:08 > 0:25:10- Catch you later.- Bye-bye.
0:25:10 > 0:25:13He certainly needs more investigation to find out exactly what the
0:25:13 > 0:25:16cause of his pain is. It could easily have been a heart attack,
0:25:16 > 0:25:20just a small one. So, he'll go to the A&E,
0:25:20 > 0:25:22at the Royal Stoke University Hospital,
0:25:22 > 0:25:24and they'll be able to take things from there.
0:25:27 > 0:25:29Simon was kept in hospital overnight
0:25:29 > 0:25:32until doctors could reach a clear diagnosis.
0:25:35 > 0:25:39I had very extensive tests in hospital.
0:25:40 > 0:25:44They say it was a heart attack caused by a virus.
0:25:44 > 0:25:46Nothing wrong with my heart at all.
0:25:46 > 0:25:52The tests, the ultrasound and everything said quite a good, strong heart.
0:25:54 > 0:25:57It just makes you live every day when you wake up,
0:25:58 > 0:26:01"Wow, it's another day, it really is another day
0:26:01 > 0:26:03"and be thankful for it."
0:26:11 > 0:26:12In Wolverhampton...
0:26:13 > 0:26:18..paramedic Kathryn Davies is blue-lighting it to a teenager in distress.
0:26:18 > 0:26:22We're going to a young 14-year-old girl,
0:26:22 > 0:26:27who's suddenly started vomiting and become breathless.
0:26:27 > 0:26:30If she started vomiting first,
0:26:30 > 0:26:35people can become very breathless through the physical effort of vomiting.
0:26:36 > 0:26:40If the breathlessness come first before the vomiting, that's different.
0:26:40 > 0:26:47So, you know, it's hard to make assumptions, but at the moment, hopefully,
0:26:47 > 0:26:50it's something we can deal with on the scene.
0:26:59 > 0:27:03Her mum must be really concerned, because obviously she's rung 999.
0:27:03 > 0:27:05Like with the younger ones.
0:27:05 > 0:27:10If it's something serious, I think it affects most of us.
0:27:10 > 0:27:13Just such young lives.
0:27:13 > 0:27:15You know, you think a bit differently.
0:27:19 > 0:27:21But before she can deal with the medical problem,
0:27:21 > 0:27:25Kathryn has a logistical problem of her own to deal with.
0:27:25 > 0:27:27Houses without drives.
0:27:27 > 0:27:28You can never park.
0:27:32 > 0:27:35However, I think we're in luck.
0:27:36 > 0:27:37Somebody waving to us.
0:27:44 > 0:27:45Hello, my lovely.
0:27:46 > 0:27:48Hello. What's going on then?
0:27:48 > 0:27:49Finding it hard to breathe.
0:27:49 > 0:27:51She keeps gagging now.
0:27:51 > 0:27:52OK.
0:27:53 > 0:27:55What's happened then?
0:27:55 > 0:27:58I've just picked her up, brought her home. She's been sick.
0:27:59 > 0:28:00High temperature.
0:28:01 > 0:28:02Hard to breathe.
0:28:02 > 0:28:04So this has all happened suddenly?
0:28:04 > 0:28:06In the last 20 minutes.
0:28:06 > 0:28:07OK. Let's have a look at you.
0:28:09 > 0:28:11My name's Kathryn. What's your name?
0:28:11 > 0:28:12Jessica.
0:28:12 > 0:28:15That's lovely. Pop your finger in there.
0:28:16 > 0:28:19Nice painted nails, aren't they?
0:28:19 > 0:28:20When I hear it's somebody young,
0:28:20 > 0:28:23if she's got no previous and she's breathless,
0:28:24 > 0:28:25one of the main reasons
0:28:25 > 0:28:28is that they could have got themselves very anxious.
0:28:28 > 0:28:31That's good. So everything's working OK.
0:28:31 > 0:28:34All right. Can we take some nice deep breathes in.
0:28:34 > 0:28:38It does happen to a lot of people who don't suffer with anxiety
0:28:38 > 0:28:42and it can just happen to us for no reason at all.
0:28:42 > 0:28:46You take a deep breath in and count to two and blow out slowly.
0:28:46 > 0:28:48Go on.
0:28:48 > 0:28:50Come on, sweet heart. Come on.
0:28:50 > 0:28:52Don't get yourself upset.
0:28:52 > 0:28:55Although Jessica is conscious and communicating,
0:28:55 > 0:28:58Kathryn's concerned by how distressed she is.
0:28:58 > 0:29:00OK. Nice and steady.
0:29:00 > 0:29:02Jess, look at me.
0:29:05 > 0:29:07That's better.
0:29:07 > 0:29:11While you're doing that, I'm going to have a little listen to your chest. OK? Yeah.
0:29:14 > 0:29:16That heart's racing a bit.
0:29:16 > 0:29:17We'll slow that down.
0:29:17 > 0:29:18Nice and steady.
0:29:18 > 0:29:22I did her oxygen levels just to make sure that she wasn't
0:29:22 > 0:29:26lacking any oxygen and they were 100%.
0:29:26 > 0:29:30I listened to her chest and that was clear.
0:29:30 > 0:29:33With Jessica's heart and chest both appearing to be fine,
0:29:33 > 0:29:36Kathryn now decides to check her temperature.
0:29:37 > 0:29:40Sweetheart, I'm just going to pop this in your ear.
0:29:45 > 0:29:47Oh, yes. She's got a raging temperature.
0:29:48 > 0:29:49Is your throat sore at all?
0:29:49 > 0:29:52- Yes.- Can I have a look in your throat?
0:29:53 > 0:29:56- Open, say "ah".- Ah.
0:29:56 > 0:29:58Yeah, you've got a red throat.
0:29:58 > 0:30:01Oh, dear! Have a little feel here.
0:30:01 > 0:30:02I think the problem was, yes,
0:30:02 > 0:30:05she'd had a high temperature and she wasn't feeling too well.
0:30:05 > 0:30:08She'd probably got a viral infection.
0:30:08 > 0:30:10And being 14,
0:30:11 > 0:30:14because of this she started to get herself very anxious,
0:30:14 > 0:30:17which led to her hyperventilating, which frightened all the family,
0:30:17 > 0:30:19because it's not a nice thing to sees.
0:30:20 > 0:30:23I'll come and sit by ya. OK?
0:30:23 > 0:30:27It seems that a simple sore throat is what's caused Jessica to get
0:30:27 > 0:30:28into such a state.
0:30:28 > 0:30:32Right, Mum, she's got reddening to her throat,
0:30:32 > 0:30:35but there's no white pus on her throat at all.
0:30:35 > 0:30:39So I don't think we're at the antibiotic level at the moment.
0:30:39 > 0:30:40- No. Just viral.- Yes.
0:30:40 > 0:30:42Keep an eye on her throat.
0:30:42 > 0:30:46If there's any white pus start on it,
0:30:46 > 0:30:48that's the time to go and see your doctor.
0:30:48 > 0:30:52I think because she's feeling unwell, she's got herself upset.
0:30:52 > 0:30:55- Yes.- You know? And hyperventilating,
0:30:55 > 0:30:59it causes you have to pins and needles and feel sick,
0:30:59 > 0:31:00but we're settling down now.
0:31:00 > 0:31:02Colours going back down again.
0:31:02 > 0:31:03You still look beautiful.
0:31:03 > 0:31:05You're all right. OK?
0:31:07 > 0:31:09She's been out playing with her friends at the park
0:31:09 > 0:31:12and probably put a little bit of a brave face on.
0:31:12 > 0:31:16Got herself home and started to feel really unwell and getting really
0:31:16 > 0:31:20upset with it. Just coached her breathing, calmed her down,
0:31:20 > 0:31:22and we've suddenly got a happy little girl,
0:31:22 > 0:31:24where she was really upset before.
0:31:24 > 0:31:27But hopefully, just with a paracetamol and plenty of fluid,
0:31:27 > 0:31:29she should be feeling a lot better.
0:31:30 > 0:31:35Jessica later visited her GP and found she had a virus.
0:31:35 > 0:31:37She hasn't needed medical help since.
0:31:44 > 0:31:48I think alcohol has a huge effect on the NHS.
0:31:48 > 0:31:52We go out to so many alcohol-related problems
0:31:52 > 0:31:54and we are tied up with them
0:31:54 > 0:31:58and people who are drunk, they are difficult to assess.
0:31:59 > 0:32:03In Dudley, the ambulance team of Tracey Hawthorne and Helen Parry
0:32:03 > 0:32:06are on their way to deal with a man who has collapsed.
0:32:11 > 0:32:12'Just ahead.
0:32:12 > 0:32:13'Turn right.'
0:32:13 > 0:32:17We're going to an unknown patient at the moment,
0:32:18 > 0:32:20who's unconscious in the street, outside...
0:32:23 > 0:32:25Outside a supermarket.
0:32:27 > 0:32:31We've got no reports of any fitting, so possibly,
0:32:31 > 0:32:33possibly alcohol-related at the moment.
0:32:44 > 0:32:47Clear left.
0:32:49 > 0:32:50It's all going on in this street!
0:32:55 > 0:32:58They arrive to find the police already on scene.
0:33:03 > 0:33:04- Where's the chap?- In here.
0:33:07 > 0:33:09Hello. Hello there.
0:33:09 > 0:33:15Hello. Just been flagged down by the people there to say he's come in,
0:33:15 > 0:33:18asking for alcohol. They've refused him and he's gone to the floor.
0:33:20 > 0:33:22Semi-responsive, breathing.
0:33:22 > 0:33:23Yeah.
0:33:23 > 0:33:26- He's got his dots on. - He's still got his dots on.
0:33:26 > 0:33:29The dots, or heart monitoring pads,
0:33:29 > 0:33:32show the man was recently treated by paramedics.
0:33:32 > 0:33:33You can hear me.
0:33:33 > 0:33:35We've met before, haven't we?
0:33:35 > 0:33:37How long has he been on the floor?
0:33:37 > 0:33:40- How long has he been, fellow?- About five minutes before you arrived.
0:33:40 > 0:33:41About five minutes. OK.
0:33:41 > 0:33:44- About ten minutes. - About ten minutes.
0:33:44 > 0:33:45- Did he fall to the floor? - No.
0:33:45 > 0:33:47And he went down on the floor.
0:33:47 > 0:33:49So he just lay himself down.
0:33:49 > 0:33:52When he was lying down he was still talking, he was still wide awake then.
0:33:52 > 0:33:54OK. So he didn't fall, he didn't...
0:33:54 > 0:33:56OK. Can I have your finger.
0:33:56 > 0:33:58Let's do some obs.
0:33:58 > 0:33:59Got the ambulance crew, mate.
0:33:59 > 0:34:02So it's not very comfortable down there, is it?
0:34:02 > 0:34:04You don't want to be staying there all night.
0:34:04 > 0:34:07Just going to take your blood pressure, OK?
0:34:07 > 0:34:11Some days you will have drunk after drunk after drunk,
0:34:11 > 0:34:14all alcohol-related jobs after one another.
0:34:14 > 0:34:17We met you the other day. Do you remember us?
0:34:17 > 0:34:21You sometimes, you don't know what's took them there
0:34:21 > 0:34:25and you just see what their future is and it's not good.
0:34:25 > 0:34:27You can't stay here all night, can you?
0:34:30 > 0:34:34What I'll do is I'll go and get the stretcher, and then...
0:34:34 > 0:34:38- We'll get him onto the stretcher. - We'll get him onto the ambulance, out of the way.
0:34:38 > 0:34:40We see so many homeless people that, er,
0:34:40 > 0:34:43that drink, that have got nowhere to go.
0:34:43 > 0:34:44They've got no toilet facilities.
0:34:44 > 0:34:46They've got nowhere they can wash.
0:34:46 > 0:34:50The only safe thing we can do is take them to hospital and that's
0:34:50 > 0:34:55frustrating, as it has a huge knock-on effect with other patients
0:34:55 > 0:34:58that genuinely are sick and need treating.
0:34:58 > 0:35:01Yeah, I think it's pretty similar to what happened last time.
0:35:01 > 0:35:02I think he went into A&E.
0:35:02 > 0:35:03- OK.- And was being discharged.
0:35:06 > 0:35:08Our only option is to take him to A&E.
0:35:08 > 0:35:10- Thanks for coming out, guys. - No problem.
0:35:11 > 0:35:13Thank you.
0:35:13 > 0:35:15Thank you. This is a patient I've been to before.
0:35:15 > 0:35:17The last time we went out to him,
0:35:17 > 0:35:20he'd been discharged with some medication
0:35:20 > 0:35:22to help with his alcohol addiction.
0:35:22 > 0:35:26He's come out and tried to buy alcohol and a passer-by called,
0:35:26 > 0:35:29so it's pretty much the same as the last time.
0:35:29 > 0:35:32But at the moment he's not really safe to be left.
0:35:44 > 0:35:49On arrival at A&E, Tracey and Helen discover that the man has already
0:35:49 > 0:35:51been in hospital today, but discharged himself,
0:35:51 > 0:35:53against medical advice.
0:35:54 > 0:35:56And less than half an hour later,
0:35:56 > 0:35:58he's discharged himself again.
0:36:03 > 0:36:07People say that they are a waste of time, a waste of a resource,
0:36:07 > 0:36:10but it might be their family, we don't know.
0:36:10 > 0:36:12It might be their children.
0:36:12 > 0:36:15They're part of society that we have to keep safe, so...
0:36:16 > 0:36:17..that's what we do.
0:36:28 > 0:36:32Kathryn Davis has been a paramedic for 17 years.
0:36:32 > 0:36:35It's lovely to do your job when you know that you've really,
0:36:35 > 0:36:36really helped somebody.
0:36:36 > 0:36:40Whether it's just keeping somebody company and holding their hand,
0:36:40 > 0:36:41maybe making them a cup of tea,
0:36:41 > 0:36:45or whether it's physically, actually, saving their life.
0:36:45 > 0:36:48When I left school, I wanted to be a hairdresser and nothing else was
0:36:48 > 0:36:50going to stop me, and I did that.
0:36:50 > 0:36:53But when the children got a little bit older, I thought,
0:36:53 > 0:36:55"Right, it's time now."
0:36:55 > 0:37:00So, I joined the Ambulance Service and it's the best thing I ever did.
0:37:01 > 0:37:05It's early evening and Kathryn has been called to a hotel in Hagley,
0:37:05 > 0:37:07just outside Birmingham.
0:37:09 > 0:37:12We're going to a male in his 40s in a restaurant.
0:37:12 > 0:37:15It's come through as choking,
0:37:15 > 0:37:19but then he's actually said there is something stuck in his throat.
0:37:19 > 0:37:20I'm being backed up with a crew,
0:37:20 > 0:37:26but will probably be there first on scene, to render aid, if need be.
0:37:37 > 0:37:38Oh, that's him there.
0:37:39 > 0:37:42Richard Dawson was having dinner with his family
0:37:42 > 0:37:44when he started choking.
0:37:44 > 0:37:46What's happened then, my love?
0:37:46 > 0:37:48I swallowed a chunk of steak.
0:37:48 > 0:37:49A piece of steak?
0:37:49 > 0:37:52- It's there. - Right, you can feel it?
0:37:52 > 0:37:54- Yeah.- Can you still swallow?
0:37:56 > 0:37:58He's had a bit of water but he's brought it back up.
0:37:58 > 0:38:01Yeah. We've got an ambulance crew on the way, so we can get you on there.
0:38:01 > 0:38:05Whatever you want to do for the best, all right?
0:38:05 > 0:38:09Richard had got a piece of steak stuck at the back of his throat
0:38:09 > 0:38:12and he just couldn't relieve it in any way.
0:38:12 > 0:38:15He was starting to get anxious, which is not going to help,
0:38:15 > 0:38:18and although he was able to speak in full sentences,
0:38:18 > 0:38:20he was very uncomfortable.
0:38:20 > 0:38:23Let's just pop this on and have a little listen to your chest.
0:38:23 > 0:38:24Are you normally fit and well?
0:38:24 > 0:38:27- Yeah.- Yeah, there you go.
0:38:27 > 0:38:29That finger. There you go.
0:38:29 > 0:38:33Let's have a little listen.
0:38:33 > 0:38:34All right.
0:38:34 > 0:38:35Giving you pain?
0:38:35 > 0:38:37It comes and goes.
0:38:37 > 0:38:39I checked his oxygen levels,
0:38:39 > 0:38:45basically to see how much oxygen he was managing to get into his body,
0:38:45 > 0:38:48and I wanted to listen to his chest to make sure he'd got
0:38:48 > 0:38:51equal air entry.
0:38:51 > 0:38:53Just breathe normal, don't...
0:38:53 > 0:38:54HE WHEEZES
0:38:55 > 0:38:57OK, don't worry.
0:38:57 > 0:38:59- This is Richard.- Hiya, Richard.
0:38:59 > 0:39:01He's got sats of 98.
0:39:01 > 0:39:04He's got a piece of steak stuck and he can actually feel it.
0:39:05 > 0:39:09He has got a little bit of a wheeze at this side.
0:39:09 > 0:39:10OK, yeah.
0:39:10 > 0:39:12So, I think we just need to get him on and get it sorted.
0:39:12 > 0:39:14Is it throat or is it...?
0:39:14 > 0:39:16- No, it's here.- OK, fine.
0:39:16 > 0:39:18So, it's already gone down.
0:39:18 > 0:39:23He's had some water and he's brought it back up again, so it is blocked,
0:39:23 > 0:39:25but his sats are good and he's normally fit and well.
0:39:25 > 0:39:27All right, shall we get you onto the motor?
0:39:27 > 0:39:29Are you OK to walk, just to there?
0:39:29 > 0:39:31Yeah? Come on then.
0:39:31 > 0:39:32OK.
0:39:32 > 0:39:36If somebody's choking and their airway is completely blocked,
0:39:36 > 0:39:40they're at the danger of stopping breathing and we need to take
0:39:40 > 0:39:44immediate intervention. But if that blockage is there,
0:39:44 > 0:39:48but people are still breathing sufficiently, we leave it well alone
0:39:48 > 0:39:53because if we start intervening and we move that foreign object,
0:39:53 > 0:39:58it could be moved into a place where it completely blocks their airway,
0:39:58 > 0:39:59and then we're in trouble.
0:39:59 > 0:40:03- We don't touch anything that's not broken, OK?- Right, OK.
0:40:03 > 0:40:05So, that's why there's none of this going on,
0:40:05 > 0:40:06because it could dislodge it...
0:40:06 > 0:40:07RICHARD COUGHS LOUDLY
0:40:07 > 0:40:10..and - it's all right - it could dislodge it and cause more problems.
0:40:10 > 0:40:11OK, right.
0:40:11 > 0:40:14Instead, the team decide to give Richard a fizzy drink.
0:40:15 > 0:40:16We're going to get some Coca-Cola.
0:40:16 > 0:40:20- Right.- Because very often that helps, or a hot drink helps.
0:40:20 > 0:40:22- PARAMEDIC:- You might throw something up.
0:40:22 > 0:40:25- All right. - If you do, that's fine. That's fine.
0:40:28 > 0:40:29That's it.
0:40:29 > 0:40:30I can recheck his chest.
0:40:32 > 0:40:35Daddy is fine. Do you want to come with me and see him?
0:40:35 > 0:40:36- CHILD:- I want...- You want Mummy?
0:40:36 > 0:40:39Do you want to go with Phoebe and see Daddy?
0:40:39 > 0:40:40It's fine. What's your name?
0:40:40 > 0:40:42- Phoebe.- Phoebe.
0:40:42 > 0:40:44Phoebe, look, Daddy's fine.
0:40:44 > 0:40:46Give him a kiss.
0:40:46 > 0:40:48- PARAMEDIC:- It's all right. - That's it.
0:40:48 > 0:40:50- We'll follow Dad, shall we? - There you go.
0:40:50 > 0:40:53OK. They'll be a few minutes here anyway, so...
0:40:53 > 0:40:56Bye, girls! Bless them.
0:40:56 > 0:40:58When you've got children as well,
0:40:58 > 0:41:00you've got other patients to look after.
0:41:00 > 0:41:04You know, they're really upset, traumatised, but as well as the crew
0:41:04 > 0:41:07looking after him now, we've got to reassure the children
0:41:07 > 0:41:08that Daddy's OK.
0:41:10 > 0:41:12- Bit of Coke?- He went... He went, "That's gone."- Oh, good.
0:41:12 > 0:41:14I'm just going to assess him.
0:41:14 > 0:41:16OK, right, we've just had some good news.
0:41:16 > 0:41:18While we're waiting for the ambulance to assess the patient,
0:41:18 > 0:41:21he's been drinking this Coca-Cola to see if it'll help,
0:41:21 > 0:41:26and it has actually cleared the piece of steak that was blocked.
0:41:26 > 0:41:27He's absolutely fine now.
0:41:27 > 0:41:29A little bit shook up, but he's fine.
0:41:29 > 0:41:31- See?- Tell them to put another steak on.
0:41:31 > 0:41:32All right.
0:41:33 > 0:41:35Yes, girls, Daddy's better!
0:41:35 > 0:41:37Yeah!
0:41:37 > 0:41:39Definitely feel all right?
0:41:39 > 0:41:41- Yes.- It's definitely come up.
0:41:41 > 0:41:43You can have the bag if you like?
0:41:43 > 0:41:45- PHOEBE:- I've seen enough today. - You sure?- Yeah.
0:41:45 > 0:41:47One, two, three - wahey!
0:41:51 > 0:41:52You all right?
0:41:52 > 0:41:55- Yay.- Hopefully, we won't see you again this weekend.
0:41:55 > 0:41:56- Hopefully not.- Enjoy your weekend.
0:41:56 > 0:41:58Thank you.
0:41:58 > 0:41:59Bye-bye.
0:41:59 > 0:42:02I cut too big a piece, didn't chew it enough, swallowed and...
0:42:04 > 0:42:05Stuck.
0:42:05 > 0:42:07Straightaway, I knew I hadn't chewed it enough.
0:42:07 > 0:42:09Stuck, stuck.
0:42:10 > 0:42:14- It was stuck.- And it just... Could just feel it there, lodged.
0:42:14 > 0:42:15And, yeah, just hurt a lot
0:42:17 > 0:42:18I just feel a bit silly now.
0:42:19 > 0:42:20And hungry.
0:42:26 > 0:42:30Oh, it's lovely to get a happy ending. It really is.
0:42:30 > 0:42:31It makes the job worthwhile.
0:42:34 > 0:42:36I've always enjoyed working with people.
0:42:36 > 0:42:40It's because I'm so shy and retiring... Not!
0:42:40 > 0:42:44You know, I've always enjoyed it and I am a people person.
0:42:44 > 0:42:51Altogether, it's been 17 years I've been in the Ambulance Service now,
0:42:51 > 0:42:53and it'll see me through till I retire.
0:42:53 > 0:42:55I would want to do anything else.
0:42:55 > 0:42:59We have ups and downs, like you do in every job,
0:42:59 > 0:43:00but I do love my job.