Episode 2 A&E on the Road

Racing to treat a patient in need of critical care.

Can I have a crew, please?

This is the West Midlands Ambulance Service.

This could have been a fatal accident, 100%.

A dedicated team of doctors and paramedics...

-Hi, there. Want an ambulance?

-Don't like it when they cry.

..they responded to a million 999 calls every year.

Fighting to save lives.

Basically went straight up in the air, crashing down.

Because some emergencies are so severe...

He's fractured his femur...

..treatment must begin...

-Now take a deep breath in, mate.

-..out on the road.

I am grateful to every paramedic.

If I could give them a medal, I would.

Today, paramedics battle to help an injured motorcyclist.

Right, it looks like your big bone at the top of your leg,

-the femur, it looks like that's been broken.

-Oh, dear.

-OK?

A lady collapses while out shopping...

I says, "Jean, are you all right?"

She says no. After that, she passed out.

And Tracey and Dan rush a woman with a severe kidney infection to hospital.

What's the matter?

SHE MOANS AND SOBS

Short, sharp breaths, like we said.

There is always a burden on the Ambulance Service from call volume.

We are expected to respond to anything, anywhere at any time.

I quite enjoy working on my own.

I find that what I'm doing,

it's my decisions and I know what I'm doing and I feel I have got my

confidence and capabilities to be able to do the best for people.

It's early evening,

and rapid response paramedic Ste Hill

is blue-lighting it to the scene of a motorbike crash.

We are on the way to a road traffic collision on the bypass in Lye.

We are only a couple of minutes away.

It's come through as the patient's come off his motorbike

and he's been seen to be flung in the air.

So there is a crew on the way.

Obviously the job is outside.

Motorbike, there is a risk of any sort of injury.

Particularly if he's hit anything -

pavements or a lamp post or something.

It's a serious smash.

But thankfully the biker is conscious and responding to the paramedics.

Talk to me, Les, what happened today?

I just run off the road, basically.

Talk to me, Les. Were you knocked out at all?

-No.

-Where is hurting at the moment?

-The leg.

I'd finished work for the day.

And headed back home.

Round the ring road. Actually to the lights.

And that's it.

I can remember maybe about 150 yards of that ride across there

and I can't remember anything else.

Les has lost control of his bike and been flung 50 yards into an

electrical cabinet on the roadside.

What we're going to do, Les,

we're going to have a good look at you.

We will get you off the floor and keep you nice and still.

And then we'll get you in the back of the ambulance

-and we'll have a closer look at you, all right?

-Take a deep breath in.

OK. Right, it looks like the big bone at the top of your leg,

-the femur, that's been broken.

-Oh, dear.

-OK?

Is there any pain there, mate?

-No, mate.

-Any pain up here?

Right, I'm just going to pop your boot off, mate. All right?

Les has had a road traffic collision.

He's come off his motorbike. We guess he's been thrown 50 yards down the road.

Injuries at the moment - he's got a leg injury, upper leg injury.

We reckon he has fractured his femur.

Also suspecting some sort of abdominal injuries.

We have been treating him with pain relief, some fluids.

And we're going to mobilise him and he'll be off to hospital -

all being well, very quickly.

I suppose in the back of my mind...

..you've always got that little doubt of the danger.

Motorcyclists account for 21% of road deaths,

despite making up just 1% of road traffic.

Any early indications as to condition, whether it is

going to be threatening or life-changing?

Potentially, if he's got internal injuries,

we'll treat it as life-threatening.

For now. He's got an obvious fracture to his left leg,

his upper left leg,

we are suspecting he has got some sort of abdominal injury,

because his blood pressure is quite low.

How are you feeling, Les?

-Sore.

-Sore? We're going to get you something for the pain.

Now we've stabilised your blood pressure,

we're going to get you something for the pain, all right?

Just have a feel of the pulse in your foot, mate, all right?

Can you feel this OK?

Can you feel me touching your foot?

-I can feel it, yeah.

-OK, mate, good lad.

The impact has forced Les's shinbone through the sole of his foot.

Right, what we're going to do now,

while Laura's holding your head, have you seen these hard collars

-that wrap around there like that?

-Yeah, I've seen them before.

All right, we're going to pop one on you.

What we're going to do with Les - and there's no easy way to do this -

we're going to have to move him because he's wedged up against here.

What we're going to do is roll him slightly to his left.

He's got a nasty fracture to his thigh bone.

One of the bones in his lower leg

-has come through the bottom of his foot.

-OK.

If you just sort of steady as best you can, mate, all right?

Les, keep your arms crossed as tight as you can, mate.

Tight as you can, good lad.

Out of all motorists, motorcyclists tend to sustain the worst injuries.

The nature of riding a bike with no protection around you,

no airbags or seat belts, when you come off,

you're going to hit something hard

which is going to cause serious injury.

I wouldn't want any of my family or loved ones to ride a motorbike,

through what I've seen and the injuries that can be sustained.

Ready, steady, roll.

OK, yeah, I think we've got that.

Just bear with us a minute, mate,

we'll try and readjust this on the ambulance, all right?

You're strapped in, you're not going to have much movement in your head.

Just try and keep it as still as you can.

We're detached from everything, aren't we?

On three, mate. One, two, three.

-That's the tubing, isn't it?

-Yeah.

Potential nature of quite serious injuries to this gentleman.

We're guessing a sort of pelvic and abdomen injury as well.

So if that's the case, it could be life-threatening.

Crew are on the way to Queen Elizabeth,

they've just liaised with the major trauma desk in the control room.

They've passed on an alert so they will be there in about 15 minutes.

So, three people on the crew, we are not needed, so we will withdraw.

We will go back and prepare for the next case.

Five months after the incident, Les is faced with a difficult decision.

It's been very traumatic.

My left foot is totally shattered, to the point

where surgeons have said that the healing time is going to be

such a long process and that I could still end up losing the foot.

So I have made the decision of

actually having it amputated at this point.

I think I was lucky that day to come away from the scene with my life.

I haven't met the paramedic that helped me.

But thank you.

You do a fantastic job.

Getting emotional now.

I can't thank you enough. I really can't.

Er...

It's...

I wouldn't be here without 'em, I don't think.

So from the bottom of my heart, thank you.

Sorry.

I've been in the Ambulance Service about 18 months now.

I started off in training school, came out on the road,

fresh, and then picked up Tracey

after about five months of being on the road.

I became his surrogate work mum.

I look after him.

Yeah, she does look after me.

I do think she's one of the best paras at Dudley ambulance station.

By far.

Just the way she is calm on jobs.

That's definitely rubbed off on me.

Dan has picked things up really quickly.

So I have taught him well.

She has taught me well, yeah.

It's early evening and Tracey and Dan are en route

to a woman in extreme pain.

33-year-old female who has rang 111 this evening

because she's got stomach pain.

She's got a bit of back pain as well.

She's got a headache...

..and that's all we know at the minute.

You all right, darling?

Right, let's have a talk about what's going on this evening, then.

What's the matter?

It started Sunday evening, just severe pain in my left

side of my stomach.

Just under my rib. And that just gradually got worse.

I was still able to function as normal yesterday,

just every now and then doubling up in pain.

And then last night I developed a severe headache and back pain.

I couldn't sleep at all with it all night.

-OK.

-It's just got worse and worse.

I had been feeling unwell for a number of days

but then suddenly that day it became so intense

and it was hurting to breathe and hurting if I tried to walk.

And I just knew I needed to get medical attention.

So what prompted the call, because the pain just got too much...?

It just got my so bad and my headache and my back

and I couldn't even move.

OK.

Is it all right if I do a few obs on you?

Are you all right to sit up?

-It's really painful if I sit up.

-You'd rather lie down there?

Right, I'll see if I can get to you.

-Have you done your temperature or anything like that?

-No.

-OK.

Let's have a look.

There you go. You've got an infection somewhere.

Right, show me where this pain is.

-This area here.

-OK, all right.

I was developing intense pain in the sort of mid,

lower back either side of my spine.

Just underneath where your ribs end.

It was very, very tense,

and when I tried to take a breath in,

it felt like someone was squeezing

something inside of me really, really tight.

Which was very, very painful.

In terms of what's going on, the way you describe the pain,

you've got a bit of a temperature, you've got a headache, you don't feel like eating.

It seems like it may possibly be a bit of a kidney infection you've got.

When people get kidney infections they can be quite painful.

Sometimes they've had a water infection that's not been treated

and it's just got worse.

You know, you need to see a doctor.

And probably get some antibiotics sorted out for you

before it gets any worse.

Are you happy to pop up to A&E?

OK.

But before they can move her, Tracey and Dan need to get Melissa's

pain under control.

Try some Entonox.

Hopefully it will take the edge off.

All right? You've had it before, so just grip it with your teeth.

Then it might make you a bit dry, it might make you a bit woozy.

It wasn't helping it at all, was it, really?

She was in quite a bit of pain.

I'll go first.

SHE MOANS

All right, darling. Sick bag's there.

As I said, I know it's not the best

but obviously it's the best we've got for the minute, all right, OK?

We will go to New Cross.

Happy, Trace? All right.

As my colleague said, looking like a kidney infection.

With the kidneys, you have to be careful.

We don't know how long she has had it or what is going on underneath.

She is clearly in a lot of pain.

She has clearly got quite a high pain threshold.

Obviously she had the paracetamol so we can't give her anything stronger.

She needs a few further tests, basically, that we can't do.

-So we will see what happens there.

-SHE CRIES

What's the matter?

What's the matter, darling? What's the matter?

Mm? What's the matter?

It just suddenly got worse.

Short, sharp breaths, like we said.

Tracey and Dan, the paramedics, were really good.

Lovely people, very patient,

very calm, and I think you need that.

When you're in a lot of pain,

it can make you a bit panicked or flustered.

And you need someone who is staying calm, is reassuring,

and I think it's always good as well when they talk to you and try

and distract you a little from your pain.

All right, here we are.

Yeah.

OK?

Right.

She is feeling cold and trying to snuggle up,

so I think there is definitely some sort of infection there.

So hopefully... I don't know whether they will scan her or treat her

with antibiotics and send her home.

But, yeah, job done.

Melissa reached hospital just in time.

Doctors diagnosed her with kidney stones and a kidney infection.

She was given antibiotics to treat the infection and passed

the kidney stones six weeks later.

A high proportion of the patients we tend are elderly.

And what they're complaining of

might be down to a chronic condition.

For example, they might be having chest pain through to chronic high

cholesterol and blood pressure.

So we're dealing with the end result of sort of long-term conditions.

More than half of people treated by the West Midlands Ambulance Service

are over the age of 65.

Ste is in Stourbridge, on his way to help an OAP in trouble.

We are responding to a lady in her 70s who has collapsed outside

Costa coffee in an indoor shopping precinct in Stourbridge town centre.

Pulling up at the address now.

Hello there, is it Jean?

Hello there, my name is Ste.

I'm one of the paramedics. What's happened?

-I don't know.

-You don't know.

What I want to do is check you over quickly and then we'll decide what we're going to do.

Have you got any pain anywhere?

We shop in Stourbridge every Friday morning.

And we'd done the shopping, we were just going for coffee.

And she bought me coffee to the table and I said, "I don't feel very well."

I says, "Jean, are you all right?"

She says no,

and after she said that, she was violently sick

and then she passed out.

It appears your pulse is a bit slow in the wrists

so it might be that your blood pressure is sort of a bit low.

So I'm going to lie you on the floor, is that OK?

Right, lie yourself down for me.

Sit down, sit down.

OK. Jean, I'm going to lift your legs up.

We'll see if you start to feel any better like that.

-OK?

-OK.

One of the big things with low blood pressure is literally the pressure

is that low that the blood doesn't get to your vital organs -

ie your brain, you heart and your lungs.

Five-two, can I have a crew, please?

Can you back me up with an amber response?

I've got a lady passed out with low blood pressure.

If the blood supply to the brain is reduced,

the easiest thing you can do is get the blood back there by lifting her legs off the floor.

And it just causes, through gravity, blood to run back to the brain.

-Do you feel any easier now?

-Yeah.

She is starting to feel a little bit better,

but she looks quite pale and clammy, so we are going to do a routine set of observations.

We've asked for an ambulance to come

and then we'll check her over more in depth on the back.

Do you have any medical problems normally?

-Yes.

-What do you suffer with normally?

-My heart.

-Your heart?

-And diabetes.

-OK.

Jean has been diabetic for eight years.

Diabetes is basically when your body can't regulate blood sugar levels.

First and foremost, it would be high, as an undiagnosed diabetic.

Quite often people who suffer from diabetes,

it can cause their sugars to go low and that can cause them to have funny turns.

Jean, the next test I want to do is take a spot of blood from the tip of your finger. Is that OK?

-Yeah.

-Do you test your own blood sugars?

-Yeah.

-You do. Do you know what number it normally is?

-About seven.

About a seven.

A normal reading for a blood glucose, a BM, would be between five and eight.

-A little scratch on your finger, is that all right?

-Yeah.

OK, just squeeze that on your finger for me. Thank you.

All right. Your blood sugars are 15. Is that quite high for you?

-Yeah.

-It is. Her blood sugars are quite high.

They're 15. She's a diabetic, that's a lot higher than normal.

Can you give my hands a really good squeeze with both hands, OK?

Close your eyes for me. I want you to hold your arms up in the air.

OK, that's lovely, pop them down.

We've done a quick survey of her neurological function,

which has proved OK.

So we're not suspecting a stroke at this time.

As soon as the ambulance gets here,

we will do more in-depth ECG and we'll have a look at her heart.

This isn't the first time Jean has collapsed.

Last September was the last one she had.

And it happened in Debenhams at Merry Hill.

Exactly the same thing, passing out.

This was the first time that I'd been there when it did happen.

And it was very frightening to see how ill she was.

If we sit you up, the chances are

you're probably going to go dizzy again. All right?

Would you have any objections to me popping a little needle into your arm? Or your hand?

We're going to give you some fluid, is that OK?

Just relax your hand.

We've given the lady some sodium chloride, basically salty water.

Fluid replacement, should bring the blood pressure up.

Hiya, are you all right?

-Hello.

-Right, this is Jean.

She is fully aware of what went on.

No pains. Obviously I haven't done a 12 lead where we are.

-I've discussed with her that we will do one in the back the ambulance.

-OK.

-All right?

-Yeah.

Give me your hand, my darling, nice and steady.

-OK?

-That's it, just have a breather a moment.

That's it, OK?

In the ambulance, the paramedics check Jean's blood pressure again.

Looks all right. Have a sit down.

29, 70, perfect.

-That's me.

-Have a sit down, Jean.

You were lying flat for a good 25 minutes, weren't you?

-Yeah.

-Yeah. And your blood pressure remained really low,

that's why we give you some fluid.

But as it is now, your blood pressure is quite stable.

But from what we've seen today, we would advise a trip to the hospital.

-Waste of time.

-If it is that you don't want to go...

No, it's not that. I don't mind hospitals.

No, obviously our advice would be to get it checked out.

If you don't want to go, that's fine.

Jean has made quite a good recovery

with the fluids we have given her. She responded quite well to it.

Her blood pressure has stabilised now.

We advised her to go to the hospital because low blood pressure

has caused her to have a collapse in a public place.

She has experienced it before and the experience she's had is she

doesn't want to receive any further treatment at hospital. This time she doesn't want to go.

Our advice would be to attend and the fact she doesn't want to travel with us,

we'll get her to sign our electronic paper device to state that she's

not going with us at this time.

But after passing out in the coffee shop,

Jean's condition deteriorated.

I couldn't get over it.

When I got home, I knew it was something different.

My sisters had to come down.

They took it in turns to look after me.

Eventually, Jean collapsed again.

I passed out at home.

I was unconscious for two hours.

When I come round, I phoned my son up.

And, obviously, an ambulance had to come.

They took me to hospital.

Where I was for two weeks while they did a load of tests to find out

what's the matter with me.

After weeks of uncertainty, Jean was told she had a faulty heart valve.

He says, well, you're going to have to have your heart done.

He says, because that is causing you to black out.

I ended up in Wolverhampton...

..to have my heart done.

Which they did.

Jean had a successful aortic valve operation.

But the tests discovered another life-threatening condition.

It turns out I've got cancer.

Which I don't mind having since you've got to die of something, for Christ's sake.

He says he's got to take most of my pancreas out,

some of the stomach, some of the bowel.

It is about five things he's got to take out.

And then just stitch it all together and I'll be fine.

Jean is putting on a brave face.

But it's been a difficult time for her.

Luckily, her best friend Joan has been with her throughout.

-Oh, thanks, darling.

-Nice cup of tea.

-Thank you.

-Nice cup of coffee.

Look at these photos here.

46 years ago, they were taken.

-Never.

-Stuart was two there and he's 48 now.

And you and I are lovely and slim and beautiful.

Joan is my family.

She's always been like my family.

She has been my best friend for 50 years.

And we've had an awful lot of laughter.

And happiness.

There's one particular night we went out and she was drunk

and she couldn't stop vomiting.

And she'd got a few false teeth.

So she took them out and I washed her false teeth under the tap.

That's what good friends are.

That's friendship, that is.

We've been very concerned about Jean because she's been quite poorly.

And I just hope that everything will turn out all right for her.

I think it's going to take a long, long time for her to get better.

But she's a very brave lady.

Very brave indeed.

My friend in there, she keeps saying I'm brave. I says, I'm not brave.

I'm just getting on with life.

Jean will soon have to undergo another operation.

Luckily, Joan will be by her side.

She always knows, I tell her where I am.

If you want me, I'm here.

50 years is a hell of a long time to be friends.

And we are very fond of each other.

-Very fond.

-It's important for anybody to have a friend.

You've got to have somebody you can talk to.

Or else you'd go barmy. Everybody should have a Joan.

Last year, nearly 12 million working days were lost due to anxiety,

depression and stress-related illnesses.

Try and calm yourself down, just concentrate on your breathing.

There is no one reason why anxiety and stress

is more common these days.

Stressful lives, financial difficulties,

lifestyle, can all contribute negatively to someone's health.

Dr Mike Greenway and medical student Jonathan Charles are on their way

to treat a woman who is struggling to breathe.

When we get there we will have to see what is going on.

It sounds as though she is unwell.

I'm not sure how old she is but she has a breathing problem.

It could be anything from anxiety to pneumonia or to asthma.

A flare-up of COPD or anything,

so we will have to see when we get there.

The patient has collapsed at work and is being treated by first aiders.

Hello. My name is Mike,

I'm one of the doctors with the Ambulance Service.

-Have you had these sort of things before?

-No.

-No?

OK. Did you suddenly feel all panicky,

tight-chested and tingling in your hands and all those sort of things?

-Yeah. I've gone dizzy. Every time I stand-up I feel I'm just going to drop.

-Right, OK.

You say you've not had it before?

Can I just borrow your hand, is that all right?

You're ever so cold and shut down, aren't you, there?

When we first saw Hannah, she was sat on the floor looking distressed.

She was breathing very fast and not really able to make eye contact

and speak to us properly.

This led us quickly to think this might be what is called a panic attack.

What I need you to do is to try to just settle your breathing for me.

That's going to be the important part.

OK? Just slow your breathing right down,

concentrate on taking slow and small breaths.

I felt sick, I felt dizzy,

I felt like my chest went so tight, I couldn't breathe.

And I think it was making me panic more

because I didn't know what was happening.

One of the problems is when you breathe fast it makes the

symptoms worse.

I was having some stresses at home and at work.

I think that might have possibly triggered my panic attack.

You all right? Just slowly take your breaths, that's it.

We'll just do a few observations, just check your blood pressure

and just see what's going on.

Cool, so you've got your monitory stuff?

The treatment for a panic attack

is to allow her to take control of her breathing.

So, when you take a breath in,

lift your shoulders right up, near your ears.

So take a breath in,

lift your shoulders right up near your ears.

Squash your ears with your shoulders.

And then breathe out and let your shoulders go down. Right down.

At the moment, we're allowing one person to do the talking

and helping her to calm down.

One, two, three.

It was scary, I couldn't breathe.

And I wanted to know why I couldn't breathe.

I sort of felt I was trapped in a hole.

In a weird way.

How is that tingling in your hands doing?

Yeah? Yeah.

Is it any better or any worse?

I don't know.

We needed to get her onto the back of the ambulance,

away from the eyes of her work colleagues.

So that she could feel in a safe environment and not feel judged,

able to calm down in her own time.

And just stand there for a minute... OK?

You feel like your legs are all jelly...?

Once Hannah was on the back of the ambulance,

she was really able to calm down fully.

Looking better already.

Are you feeling your fingers coming back a little bit more now?

They can stay numb for a while, but, yeah, you look less tense.

Have you felt yourself unfolding a little bit?

-Yeah, a little bit.

-Yeah, that's good.

It didn't take that long, about ten to 15 minutes.

But that was all she needed to really sort of get control.

How's that feeling now?

Are you feeling quite tired?

-I feel like my head's just not attached to my body.

-Dreamy.

-My head feels like... Yeah.

-It will come back slowly.

-So, now am I OK?

-It is a panic attack.

It's probably worse than you ever thought they could be.

Yeah, I've never had one.

In about half an hour, you'll be back to normal.

When I was in the ambulance and I was coming round and I started talking more

and I started looking a little bit better than I was,

they said that I have suffered a panic attack.

So is my heart beating OK?

Well, it's beating fine. Your blood pressure is better than mine is.

Your oxygen saturation is, not surprisingly, 100%.

100%.

Can't get any better than that.

For someone your age, fit and healthy, that's fine.

Hannah has done really well in being able to calm down.

She was coaxed through it by

our ambulance colleagues who did a great job.

She was able to avoid going to hospital.

Two weeks on and Hannah is back on her feet.

Since the first panic attack that I've had, I've not had a second one.

But, considering the first one was quite bad and scary,

it does make me more aware of - they can come on at sort of any time.

Hannah is a lot better now, she doesn't seem stressed.

She is calmer and she looks a lot more healthier now.

I think she's let everything all build up

and it just all got too much for her.

Right, where are we going?

The panic attacks were horrible.

I hope that I don't ever have one again.

But if I do, I sort of know

when it is coming and how to control it myself.

I think the doctors and the paramedics did a fantastic job that day.

They looked after my little girl, made sure she was better.

I am very grateful of what they did on that day.

It felt like they saved my life.

Right, so you're walking OK, but you're still feeling wobbly?

-Oh, very.

-Let's come back here.

I get called out to a lot of elderly people on their own.

Ranging from just a general safe and well check

right to the other end of the spectrum.

Can I have a look at your wrist?

Let's have a look.

We get called to a lot of falls with elderly, as well,

and again you just have to treat them with tender loving care.

It is early evening, and paramedic Kathryn Davies is en route

to a pensioner who has fallen in his garden.

Right, we've got an elderly gentleman

who has fallen on the floor.

Don't know if it's a mechanical fall or if he's had some sort of faint,

we don't know yet. He is unable to get off the floor.

It is reported that he's got some sort of back injury.

She's only few miles away,

but the traffic is causing problems for Kath

and an ambulance on a different job.

See, it's difficult at traffic lights when they're on red.

Because you don't want to push cars over

into the path of an oncoming car, but now they are green,

the cars still remain where they are

instead of just going to let us through.

They stop and you have to weave through them.

But people do panic when they hear blue lights and sirens behind them.

At the man's house, Kath is met by his daughter.

Where are we? Oh, we're here!

Hello, my darling.

What are you doing down there?

-You tell me.

-Malcolm was actually on the floor.

He had had a fall, no initial injuries.

But, again, he just could not get his self up off the floor.

Can you move this leg at all?

-Yes.

-Yeah? Can you bend it at all?

Good. Is that hurting?

No, it's just there, that's all it was.

-And you've got no pain at the bottom of your back?

-No.

I normally go at night, about half past five, to water the garden.

And I sat on the seat on the patio.

I've got this condition where I just fall asleep.

Fell off the seat.

I took a seat with me under the table

and knocked the table on top of me,

and all the plants. I couldn't get rid of it all, I couldn't turn over.

I panicked then because I thought, well...

And then I remembered I've got the house phone in my pocket.

He's been on the floor possibly three quarters of an hour.

Because these young ladies weren't in the house at the time.

They've come and found him.

Unable to lift Malcolm on her own, Kath radios for assistance.

I'm going to ask for an amber response because the patient is outside in the garden.

And he is quite cold, so amber response.

And we are going to need a crew with a manga ELK, please.

When we have elderly people on the floor, we have to look at ways

of getting them upright safely.

All the ambulances now carry a piece of equipment called a manga ELK.

It's a big lifting cushion and it's the only way now to safely lift

somebody up off the floor.

Have you done all these flowers?

-Yes.

-How fabulous is that?

It's beautiful. Did you used to be a butcher?

-Yes.

-You look like a butcher.

-You know why?

-Why?

-I've just seen your bike.

-Oh, I see.

-Yeah, I thought so.

-Hello.

-Hi, folks.

-Hello, are you all right?

Right, before we do anything, just look at this wonderful view.

-It's very nice.

-It is, it is.

We're going to try to get this cushion underneath your bottom.

-OK.

-OK? And then once it's underneath your bottom,

we're going to roll you onto your back so you are onto it.

-Yes.

-Then we are going to try and sit you up.

-OK.

-OK?

-Thank you.

Right. If you can just try and roll, nice and steady,

and we'll move the cushions with you.

-Keep going. You're safe, you're safe.

-Right, OK?

Nice and steady.

You're better sitting up.

OK?

How do you feel?

Right. What we'll do, we'll just try and stand you up.

If you can't get up, the seat is right behind you again.

All right? Do you want to try?

-Yes. OK.

-Shall we go after three?

-Yes.

-One, two, three.

Push, push.

Fabulous.

Right. OK?

We've got you, you're not going anywhere.

That's it.

Because of his age, we are going to take him up the A&E.

Mainly just for the daughter's sake as well,

because she's really concerned about him, says how pale he looks.

I mean, she knows her dad better than anybody.

He's just sitting there now, he is settling down.

But I'm happier with him going into hospital as well.

Yeah!

Be even better if you had had your pendant on you, wouldn't it?

-Yes.

-Eh?

-Consider yourself told off.

-Yes.

A lot of elderly people have an alarm in the house

and they also have either a bracelet

to wear with a big red button to press,

or one that's round the neck.

The amount of times we go to elderly people on the floor who have got

these alarms and they are hanging up on a picture,

or they are on the bedside table...

As far as you can, just lean back into the chair.

Put your arms on your lap...

Luckily he had brought his mobile phone out with him.

I had a phone call when I was driving home saying he had fallen.

So I came here and he was, he was out and he was shaking.

Very cold. And he said his hip was hurting.

Couldn't get him up, so we phoned the ambulance.

Right. OK?

-Thank you, Kathryn.

-You're welcome.

He knows he's supposed to wear his fob, but he doesn't like wearing it.

But if he hadn't got his phone, he would have been out here all by himself all night.

Malcolm was later given the all-clear in hospital,

and now wears his pendant all of the time.

Yes, I make sure I wear it now,

because I suppose they're life-savers, aren't they?

I mean, the week before my daughter was in Portugal,

so what would I have done?

They are life-savers without a doubt.

I love gardening, so I try to do as much as I can.

People used to say I was odd because I used to garden in the dark.

It worries my daughter what I do.

But she knows it's what I enjoy.

My son is the same, he worries about me.

I'm a bit stubborn.

I do it my way, they call me Frank Sinatra.

We cover a lot more distances than we used to.

And obviously people's expectations

have got greater. So it doesn't matter if it's a weekend,

it doesn't matter if it's the week, it is just as busy.

Paramedic Simone Armfield has been called to attend to a man who has

collapsed at home.

All right, we're off to Norton in Stourbridge.

And it is to a 64-year-old.

He is unconscious but we have been told he's newly diagnosed diabetic.

So obviously it might be a hypoglycaemic incident

where his blood sugars are low.

Hello. Where are we?

-Where is he?

-I'll show you.

Aw. Hello.

Was this young man's name?

Adrian.

I started to feel, well, just shaky and I kept falling over.

Oh, right.

Earlier in the day, I'd felt as if I've got quite a bad headache.

I felt quite lethargic.

Are you newly diagnosed diabetic?

You're an old professional, so you've been a diabetic for a while?

Let me just take your blood. Have you took your blood sugars yourself?

-No.

-No. So, in yourself, have you felt strange?

-Have you had any headaches?

-I have today.

-You have today.

-All day today?

-Yes.

The sensation was very strange on that day.

I'd never felt like it before.

When I have had a dip in my blood sugars,

I always know when that's happening

because my legs tend to start to get a little bit like jelly.

But on this occasion, it didn't feel like that.

So have you been sick at all?

No, no. I just feel tired.

And do you suffer with anything else other than your diabetes?

I don't know why but you took two antidepressants, haven't you?

What are these depression tablets that you're taking, then?

Are they something you've been taking for a long time?

-Yeah.

-OK. And you haven't taken more than you should today?

-No.

That day it was quite complex with Adrian,

because I know he did suffer from depression.

It was quite worrying for him and quite scary for him and his family.

because it seemed a neurological...

There was something neurological going on.

Have you ever been in hospital for anything at all?

How long ago was this?

So it's all been quite close?

And then it never happened again until today?

-Yeah.

-What are we going to do with you, then?

When you're a paramedic and you've got something acute,

it's quite easy to deal with because you know what you're going to do.

But when it's quite vague, it's like being a detective.

Unsure of what might be causing Adrian's symptoms,

Simone takes an ECG of his heart.

Well, that says you are normal.

-It's a waste of time.

-It isn't, not when you're not feeling right.

-DOORBELL RINGS

-That'll probably be the crew.

It's all right, there's an ambulance that came as well.

Why?

Hello!

-It's a reunion.

-Hello, sir.

Right, then. This is Adrian.

He's not with it, are you? It's the only thing that we can say.

He knows that he's a bit unsteady on his feet.

We were suspecting that maybe Adrian might have had a mini stroke, a TIA.

He might have a bit of dysphasia, where you confuse speech,

or he might have a weakness to a limb, or some slurred speech.

But it actually corrects itself within 24 hours.

And that was what we were querying.

When you woke up, you were feeling fine then?

-Yeah.

-Other than you felt a bit stressed, that's why you took your tablets.

When you took the sertraline, what time did you take it?

-About half past nine.

-And when did you start feeling bad?

Well, I didn't feel bad, I just felt a bit stumbly and sleepy.

And when was that?

So he started to feel unwell before he took the sertraline.

So he can't say it's the sertraline that's done it.

With the antidepressants ruled out as a possible cause,

and the team suspecting a mini stroke, Adrian must go to hospital.

We're going to pop you to the... I won't,

these lovely people will take you.

A trip up the hospital, get you checked out.

-Do some blood tests, like.

-Bit of peace of mind.

Adrian had to go in that day,

because even though his observations were fine,

there was obviously something abnormal

that needed more scans, more tests.

There's no sort of signs of a stroke at the moment.

He'll just be going at normal speed to A&E,

and obviously they can check him.

Whether he's going to have further tests afterwards,

whether he'll have some repeat scans, CT scans,

and obviously just some blood tests to make sure there's nothing else going on.

Three months later, Adrian is back home,

feeling optimistic about the future.

I've had various tests.

They've assured me that there's nothing serious that's shown up

on the tests as I've had up to now.

To get that news was very good.

When you don't understand what's gone on, you do imagine

all sorts of things that could or couldn't be there.

And to be told that there isn't anything serious,

but two or three more tests to see the specialist in four months,

is a relief. We are back to normal now.

Well, I'm feeling back to normal, but Diane might say differently.