0:00:03 > 0:00:05Racing to treat a patient in need of critical care.
0:00:05 > 0:00:07Yeah, 52, can I have a crew, please?
0:00:07 > 0:00:10This is the West Midlands Ambulance Service.
0:00:10 > 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 > 0:00:16Hi, there. Ambulance.
0:00:16 > 0:00:17I don't like it when they cry.
0:00:17 > 0:00:21They respond to a million 999 calls every year.
0:00:21 > 0:00:23Fighting to save lives.
0:00:23 > 0:00:27Basically went straight up in the air, crashing down.
0:00:27 > 0:00:29Because some emergencies are so severe...
0:00:29 > 0:00:31He's fractured his femur.
0:00:31 > 0:00:35..treatment must begin out on the road.
0:00:35 > 0:00:37I am grateful to every paramedic.
0:00:37 > 0:00:39If I could give them a medal, I would.
0:00:48 > 0:00:52Today, doctors race to treat a young stab victim.
0:00:53 > 0:00:54Hello, matey.
0:00:55 > 0:00:58- Hi.- Left side, lumbar region, stab wound.
0:00:58 > 0:01:01A factory worker takes a hard fall.
0:01:01 > 0:01:04It looks like you've potentially dislocated or fractured your elbow.
0:01:04 > 0:01:06Maybe this bone here as well.
0:01:06 > 0:01:08And a diabetic man sustained serious injuries
0:01:08 > 0:01:10after collapsing in the street.
0:01:10 > 0:01:13I'm type one diabetic. My blood sugar has gone low.
0:01:13 > 0:01:16I have ended up tripping over, knocking myself out.
0:01:25 > 0:01:29Every year, thousands of victims are hospitalised
0:01:29 > 0:01:30from knife attacks in the UK.
0:01:33 > 0:01:35And numbers are on the rise.
0:01:38 > 0:01:40Generally, I think over the past few years,
0:01:40 > 0:01:41there's been a slow increase
0:01:41 > 0:01:44in the number of stabbings being reported
0:01:44 > 0:01:46and that we're responding to.
0:01:46 > 0:01:49The patient has an isolated stab wound
0:01:49 > 0:01:52- to the cardiac box, anteriorly. Over.- 'Roger.'
0:01:52 > 0:01:56Typically now, we're seeing teenagers around school age
0:01:56 > 0:01:58being involved in knife crime.
0:01:58 > 0:02:00How many times were you stabbed?
0:02:00 > 0:02:02It does shock you to see that people
0:02:02 > 0:02:06are prepared to, you know, commit a crime and take someone's life.
0:02:06 > 0:02:09To increase the patient's chances of survival,
0:02:09 > 0:02:13a unique team of frontline staff are kept on stand-by.
0:02:13 > 0:02:16The Merit team is a group of individuals
0:02:16 > 0:02:18who have specialist training.
0:02:18 > 0:02:22A trauma doctor, together with a critical care practitioner
0:02:22 > 0:02:25who's had specialist training to work together as a team.
0:02:25 > 0:02:29We can deliver advanced surgical skills.
0:02:29 > 0:02:33We can deliver the advanced trauma care that the patient requires
0:02:33 > 0:02:36in that first hour after they're critically injured,
0:02:36 > 0:02:39which could make the difference between life and death.
0:02:40 > 0:02:44Tonight, the Merit team of Neil Abeysinghe and Ryan James
0:02:44 > 0:02:47are on their way to treat a stabbing victim.
0:02:47 > 0:02:52'In 500 yards, take the third exit off the roundabout...'
0:02:52 > 0:02:56We've just been tasked to a male who allegedly has been assaulted.
0:02:56 > 0:02:58We believe that he has a head injury
0:02:58 > 0:03:01and he's been stabbed multiple times.
0:03:01 > 0:03:05It can be anything from a penknife all the way through to a machete.
0:03:05 > 0:03:10Those injuries can be quite minor, from a razor cut,
0:03:10 > 0:03:15all the way through to fatal injuries involving multiple organs.
0:03:26 > 0:03:29There you go, look. There are the blue lights.
0:03:31 > 0:03:34- Do you want to take the bag?- Yeah.
0:03:34 > 0:03:37First, they have to decide if the injuries are serious enough
0:03:37 > 0:03:39to treat the patient on scene,
0:03:39 > 0:03:43or to stabilise him before taking him to A&E.
0:03:43 > 0:03:47- Hiya.- Left side, lumbar region, stab wound.
0:03:47 > 0:03:49I don't know what was used.
0:03:49 > 0:03:51- Yeah.- We've got a sledgehammer.
0:03:51 > 0:03:53He has been hit to left-hand side forehead.
0:03:53 > 0:03:55- Yeah.- My name is Ryan and this is Neil.
0:03:55 > 0:03:58We've just come to assist the crew here
0:03:58 > 0:04:02- to make sure you are all right. OK? Are you normally fit and well?- Yeah.
0:04:02 > 0:04:03So when we arrived,
0:04:03 > 0:04:06the patient was already being attended by a paramedic crew.
0:04:06 > 0:04:09They've already made an initial assessment,
0:04:09 > 0:04:12and they'd identified he'd got a wound to his head.
0:04:12 > 0:04:15Dealing with head wounds is really challenging.
0:04:15 > 0:04:18It's difficult to know how serious that head wound is
0:04:18 > 0:04:20without the benefit of a scan.
0:04:20 > 0:04:22All we're going to do is just ask a few more questions
0:04:22 > 0:04:24to what the crew already has.
0:04:24 > 0:04:28Just to make sure that everything's been done that needs to be done.
0:04:28 > 0:04:29OK?
0:04:29 > 0:04:32The worst-case scenario is the bleeding compresses the brain,
0:04:32 > 0:04:35and, given sufficient amount of time,
0:04:35 > 0:04:37that pressure will build to the point
0:04:37 > 0:04:39that eventually they'll stop breathing and their heart may stop.
0:04:39 > 0:04:43So where are your injuries? Where have you been stabbed, do you think?
0:04:44 > 0:04:46Did you feel anything at all?
0:04:47 > 0:04:50OK, you just felt your head, did you?
0:04:50 > 0:04:51Anything else?
0:04:51 > 0:04:54Stabbing victims will often focus in
0:04:54 > 0:05:00on the area of their body that has been most severely injured,
0:05:00 > 0:05:03but they can have injuries elsewhere.
0:05:03 > 0:05:04Were you knocked out, do you know?
0:05:04 > 0:05:06I don't know.
0:05:06 > 0:05:09So it's important that we examine the patient fully,
0:05:09 > 0:05:12to identify if there are any life-threatening wounds
0:05:12 > 0:05:14that the patient hasn't identified themselves.
0:05:14 > 0:05:17OK, as you lie there, mate, where is your pain?
0:05:17 > 0:05:21- In my head.- Where else?- I don't know.- OK, can I get you to sit up?
0:05:21 > 0:05:22Is that OK?
0:05:22 > 0:05:25Sit forward. Sit forward, sit forward, sit forward.
0:05:25 > 0:05:27Well done, buddy.
0:05:28 > 0:05:30OK. The back is clear. Lift your arms up, matey.
0:05:30 > 0:05:32OK, armpit. On the other side, please.
0:05:34 > 0:05:35OK. All clear. Right.
0:05:35 > 0:05:38The man has a small stab wound in his back.
0:05:38 > 0:05:41Ryan now has to find out what damage has been done.
0:05:42 > 0:05:45You've not got any pain in your buttocks,
0:05:45 > 0:05:47or the tops of your legs or anything?
0:05:47 > 0:05:49You definitely got no problems around here?
0:05:49 > 0:05:51All right.
0:05:51 > 0:05:52OK.
0:05:52 > 0:05:54Roll over to your left.
0:05:56 > 0:05:58- Any pain here?- Mm.- OK.
0:05:58 > 0:05:59Any pain there?
0:05:59 > 0:06:01All right, OK.
0:06:01 > 0:06:04At the time it was unclear what object had been used
0:06:04 > 0:06:05to stab the victim.
0:06:05 > 0:06:10For us, it's really important to try and identify the object if we can,
0:06:10 > 0:06:12because that will give us an idea about the depth
0:06:12 > 0:06:15that has penetrated the body,
0:06:15 > 0:06:18and the types of body organs that has involved.
0:06:18 > 0:06:22Key for me was to try and get to hospital as quickly as possible,
0:06:22 > 0:06:26to try and give him that greatest chance of survival.
0:06:26 > 0:06:29I'm just going to put this fluid in your arm, mate, all right?
0:06:29 > 0:06:33Just in case you have any large amounts of bleeding.
0:06:33 > 0:06:35This is just going to help you.
0:06:35 > 0:06:39He has a penetrating stab wound
0:06:39 > 0:06:43to the right lower lumbar.
0:06:43 > 0:06:46As a doctor we try and stay as objective as we can.
0:06:46 > 0:06:50I think personally the younger the patient is,
0:06:50 > 0:06:52I think that's the harder to deal with.
0:06:57 > 0:06:59Much to the relief of the Merit team,
0:06:59 > 0:07:02the stab victim had been extremely lucky.
0:07:02 > 0:07:06His wounds were treated in hospital, and he was discharged the next day.
0:07:16 > 0:07:20Ste Hill has been a paramedic in his hometown of Stourbridge
0:07:20 > 0:07:21for the past 14 years.
0:07:24 > 0:07:28I think the profession paramedic is all about helping people.
0:07:28 > 0:07:29Being valuable in your community,
0:07:29 > 0:07:32particularly where I work in Stourbridge, it's where I grew up.
0:07:32 > 0:07:35It's nice to give something back to the community
0:07:35 > 0:07:37that I've always been a part of.
0:07:37 > 0:07:41He's responding to a call from a man who's had a suspected heart attack.
0:07:41 > 0:07:45We're on the way to a male patient who's 28 years of age.
0:07:45 > 0:07:46He's in a public place.
0:07:46 > 0:07:50The job's come through that he's having chest pain and palpitations.
0:07:50 > 0:07:52Quite limited information at this time.
0:08:02 > 0:08:05The man was driving when he felt chest pains,
0:08:05 > 0:08:09so pulled into a car park and asked a passer-by for help.
0:08:09 > 0:08:13I was driving down the road and he just flagged me down.
0:08:13 > 0:08:16Asked if I could call an ambulance for him.
0:08:16 > 0:08:18Hello there, mate. Is it Dave?
0:08:18 > 0:08:20- Yes, yes.- All right, mate, OK. Hello.
0:08:20 > 0:08:23Do you want to come and have a seat, just on the back of the car
0:08:23 > 0:08:24- and we'll have a chat?- All right.
0:08:26 > 0:08:28OK, so what's been happening?
0:08:28 > 0:08:31I've started getting these flutters in my chest, my heart.
0:08:31 > 0:08:34- Right.- And it keeps making me want to cough.
0:08:34 > 0:08:36- OK.- Expel my air.
0:08:36 > 0:08:39And I can feel it, like, speeding up and then thumping.
0:08:39 > 0:08:42It's making me feel like it's going to stop.
0:08:42 > 0:08:45And I keep coughing like that.
0:08:45 > 0:08:47So the pain you had, how would you describe it?
0:08:47 > 0:08:50- It was quite sharp. - A sharp pain, all right.
0:08:50 > 0:08:53- Yeah.- Has that passed now? - Yeah, it has.
0:08:53 > 0:08:56- But my heart just keeps, like, it doesn't feel right.- All right.
0:08:56 > 0:08:58What I want to do, with the symptoms that you've explained,
0:08:58 > 0:09:02- an ECG is the foremost thing. We'll have a look at your heart.- OK.
0:09:02 > 0:09:05We'll have a look at the heart rhythm and see what's going on.
0:09:05 > 0:09:08- Is that OK?- Yeah. I knew something was pretty serious at that moment.
0:09:08 > 0:09:12And I needed to get help as soon as possible.
0:09:12 > 0:09:14Pop your finger in there, mate.
0:09:14 > 0:09:17I was very worried with my two children in the car,
0:09:17 > 0:09:21for their safety as well, because I was driving the vehicle at the time.
0:09:21 > 0:09:24If I were to have passed out or anything,
0:09:24 > 0:09:26and the car was moving,
0:09:26 > 0:09:29I could have caused a lot of injury to myself and my children,
0:09:29 > 0:09:31let alone to the public.
0:09:31 > 0:09:33- OK.- Do you suffer with anxiety?
0:09:33 > 0:09:35Um, I have had anxiety, yes.
0:09:35 > 0:09:37But I've never had it on this scale.
0:09:37 > 0:09:40- Never.- Does this feel like anxiety but worse?
0:09:40 > 0:09:44- Yeah, yeah.- It does.- Just my heart doesn't feel right.- OK.
0:09:44 > 0:09:48Dave is complaining of symptoms suggestive of sort of palpitations,
0:09:48 > 0:09:51so potentially a cardiac problem.
0:09:51 > 0:09:53There's four sticky dots, one on each ankle and one on each wrist.
0:09:53 > 0:09:56And there's six sticky ones on your chest as well.
0:09:56 > 0:09:58- Yeah.- So we're going to do an ECG.
0:09:58 > 0:10:00Have a look at the electrical activity in his heart.
0:10:00 > 0:10:02See if everything is where it should be.
0:10:02 > 0:10:03We'll take it from there.
0:10:03 > 0:10:06Having a feel of his wrist, his pulse does feel fast.
0:10:06 > 0:10:09Not excessively fast, but faster than what we would expect as normal.
0:10:09 > 0:10:11Just let this settle down a moment.
0:10:11 > 0:10:13He said he suffers with anxiety, he has done in the past.
0:10:13 > 0:10:16So it may be something along the lines of that.
0:10:16 > 0:10:19We'll have a further investigation and we'll see what's going on.
0:10:22 > 0:10:24Your ECG is OK.
0:10:24 > 0:10:26- All right.- There's nothing abnormal,
0:10:26 > 0:10:28apart from it's ever so slightly fast.
0:10:28 > 0:10:30What sort of pain did you have yesterday?
0:10:30 > 0:10:32It was when I was lying down in bed.
0:10:32 > 0:10:34I was getting a bit of sharp chest pain.
0:10:34 > 0:10:39- It was sort of radiating around the centre of my chest.- Yeah.
0:10:39 > 0:10:43I'm thinking, after looking at his ECG, his ECG looks OK.
0:10:43 > 0:10:46Cardiac pain, we wouldn't expect it to pass on its own.
0:10:46 > 0:10:48Somebody would have to intervene and do something.
0:10:48 > 0:10:50So, everything's looking OK at the moment,
0:10:50 > 0:10:52but I think there's an element of anxiety,
0:10:52 > 0:10:54so we'll calm him and put his mind at rest.
0:10:54 > 0:10:57Right, your chest sounds nice and clear.
0:10:57 > 0:10:59Now, your heart rate has reduced a little bit.
0:10:59 > 0:11:02It's not quite as fast as it was. All right. And your ECG is fine.
0:11:02 > 0:11:05With everything we've checked, and what we've found, or not found,
0:11:05 > 0:11:08- I don't think there's any reason for you to go to the hospital.- OK.
0:11:08 > 0:11:11- That peace of mind for you? - Yeah, yeah, it is. Thank you.
0:11:11 > 0:11:16Ste, the paramedic, he was a very calm, relaxed...
0:11:16 > 0:11:18Knows what he's doing.
0:11:18 > 0:11:21That, to me, picking up those vibes, you know,
0:11:21 > 0:11:25was kind of telling me that he wasn't too concerned.
0:11:26 > 0:11:30I think in everyday life, in modern-day society,
0:11:30 > 0:11:33stresses and strains of home life, work life, social life,
0:11:33 > 0:11:35become sort of greater.
0:11:35 > 0:11:39I'd say that anxiety is on the up, really.
0:11:39 > 0:11:43We can associate fast heart rate and palpitations with anxiety symptoms.
0:11:43 > 0:11:45You know, they're one of the observations
0:11:45 > 0:11:48- that we tend to see with anxiety. - OK.
0:11:48 > 0:11:52- All right. You do seem quite anxious as well.- I am a little bit.
0:11:52 > 0:11:54Just worried. I had my two boys in the car.
0:11:54 > 0:11:56Are they still there now?
0:11:56 > 0:12:00- Yeah. They're eating food. - Did your boys know what's happening?
0:12:00 > 0:12:02They... I'll explain to them later.
0:12:02 > 0:12:04I think they think it's pretty cool,
0:12:04 > 0:12:07because obviously kids and ambulances and fire fighters and...
0:12:09 > 0:12:11I feel a lot better now.
0:12:11 > 0:12:17And obviously, the gentleman said anxiety and that,
0:12:17 > 0:12:21so I'm going to go to the GP and talk to him, really,
0:12:21 > 0:12:24and see what they can do for me, and that.
0:12:24 > 0:12:28Because I've never had that sort of episode before.
0:12:28 > 0:12:30Do you want me to follow you back, or...?
0:12:30 > 0:12:33- I'll be OK.- Are you sure? - Yeah, yeah.- OK.
0:12:33 > 0:12:36As well as calling 999, good Samaritan Anthony
0:12:36 > 0:12:38has been keeping an eye on the kids.
0:12:38 > 0:12:40You can tell when someone's not feeling good,
0:12:40 > 0:12:42so he didn't look too well.
0:12:42 > 0:12:45So, you're not going to keep driving, are you?
0:12:45 > 0:12:47You are going to stop and help somebody out.
0:12:47 > 0:12:48It's what you have to do.
0:12:48 > 0:12:50Touch wood, everything's all right.
0:12:50 > 0:12:53They've given him the all-clear. Good news at the end of the day.
0:12:55 > 0:12:57Anybody with chest tightness and palpitations,
0:12:57 > 0:12:59they do need to get it checked out.
0:12:59 > 0:13:01Anxiety isn't the only cause for them.
0:13:01 > 0:13:03You can obviously have an underlying heart condition.
0:13:03 > 0:13:08If those symptoms do occur, then it is always important to have an ECG.
0:13:08 > 0:13:11You know, or see your GP or, you know, the Ambulance Service,
0:13:11 > 0:13:14so the guy has done the right thing in getting checked over.
0:13:14 > 0:13:16You know, to rule out anything more serious.
0:13:16 > 0:13:20But, yeah, we are quite happy that he's sort of like... He's OK.
0:13:23 > 0:13:25They started to listen with my chest,
0:13:25 > 0:13:31and that's when they picked up on something that was abnormal
0:13:31 > 0:13:33with my heart rate.
0:13:33 > 0:13:37And that's when they told me that it was a diastolic murmur.
0:13:37 > 0:13:39From what I believe,
0:13:39 > 0:13:43a diastolic murmur can be a result of
0:13:43 > 0:13:46your valves in your heart being faulty.
0:13:46 > 0:13:50Basically, I've got to go and see a cardiologist.
0:13:50 > 0:13:55Currently at the moment, I'm wearing a heart monitor.
0:13:55 > 0:13:59Ste, that night when he advised me to go to my GP,
0:13:59 > 0:14:02it's almost like a bit of a blessing in disguise,
0:14:02 > 0:14:06that that happened and, you know, kind of it was fate
0:14:06 > 0:14:09for this to happen and for him to be there.
0:14:09 > 0:14:12Because otherwise, I may have not ever found out.
0:14:33 > 0:14:36Front-line staff are under increasing pressure
0:14:36 > 0:14:39to meet eight-minute emergency response times.
0:14:39 > 0:14:42You really do have to kind of be on top of your game.
0:14:42 > 0:14:45You're pushed to your limit.
0:14:45 > 0:14:47You are put under a lot of pressure.
0:14:47 > 0:14:51Personally, I feel like I thrive under pressure
0:14:51 > 0:14:54and enjoy that kind of, a little bit of a stressful situation.
0:15:02 > 0:15:03Yeah, understood. Thanks a lot.
0:15:03 > 0:15:06Paramedic Cameron McVittie is en route to a factory
0:15:06 > 0:15:09just outside Birmingham city centre.
0:15:09 > 0:15:10So it's come through,
0:15:10 > 0:15:14a 41-year-old male who has injured his arm somehow at work,
0:15:14 > 0:15:18and now there's reports that he has difficulty in breathing.
0:15:18 > 0:15:20Could be some significant trauma...
0:15:22 > 0:15:25..if he's trapped his arm in a machine, or something like that.
0:15:35 > 0:15:37Hello, mate. How are you? Are you all right?
0:15:37 > 0:15:40- What do we think has happened?- He climbed onto a paper roll...- Yeah.
0:15:40 > 0:15:43..to put a ladle onto a larger roll...
0:15:43 > 0:15:45- OK.- Slipped, fell backwards...
0:15:45 > 0:15:49- Yeah.- His arm is under his body. - Underneath him? OK, fine.
0:15:49 > 0:15:51All right, let's have a look.
0:15:54 > 0:15:55Hello, mate.
0:15:55 > 0:15:57His name is Hassan.
0:15:57 > 0:15:58Hello, Hassan.
0:15:58 > 0:16:01Need to do some very, very quick observations on you.
0:16:01 > 0:16:03Can I just cut the length of this arm?
0:16:03 > 0:16:05Is that OK? The jumper? Yeah?
0:16:06 > 0:16:08When I looked at his elbow,
0:16:08 > 0:16:11straightaway it was obvious to me that it wasn't in the right place.
0:16:11 > 0:16:16He had loads of pain and all of his muscularity around his elbow,
0:16:16 > 0:16:18it was all in like a spasm.
0:16:18 > 0:16:21He was holding his elbow so tight.
0:16:21 > 0:16:24It looks like you've potentially dislocated and fractured your elbow.
0:16:24 > 0:16:26OK? Maybe this bone here as well.
0:16:26 > 0:16:29All right? What I'm going to go and do
0:16:29 > 0:16:33is get you some gas and air to try and take the edge of the pain away.
0:16:33 > 0:16:36The speed of the gas and air is one of the biggest reasons
0:16:36 > 0:16:39why we give people with fractures or other injuries -
0:16:39 > 0:16:42they're in quite a lot of distress with - we give it to them first.
0:16:42 > 0:16:44Have you ever had Entonox before?
0:16:44 > 0:16:46This gas and air?
0:16:46 > 0:16:50- A long time ago.- A long time ago. You can control this yourself, OK?
0:16:50 > 0:16:53So I'm going to give this to your other hand.
0:16:53 > 0:16:54You simply put this in your mouth.
0:16:54 > 0:16:57Make a tight seal around, and just breathe normally.
0:16:57 > 0:17:01OK? When you breathe this in, I want it to make this noise...
0:17:01 > 0:17:03RUSHING AIR
0:17:03 > 0:17:07OK? It will start to work after a couple of minutes, all right?
0:17:09 > 0:17:12Has the pain gone away a little bit? Taken the edge off?
0:17:13 > 0:17:15- Still the pain.- Still the pain.
0:17:16 > 0:17:18When I asked for the crew to arrive, they came,
0:17:18 > 0:17:22and they brought the most vital piece of equipment at that job,
0:17:22 > 0:17:23which was the vacuum splint.
0:17:23 > 0:17:27Something that I don't carry on my own as a responder in a car.
0:17:27 > 0:17:29What we need to try and do is get you sat up, OK,
0:17:29 > 0:17:31so we can have a good look at this elbow.
0:17:31 > 0:17:33We want to vac splint it.
0:17:33 > 0:17:35The vacuum splint is a great piece of equipment
0:17:35 > 0:17:39that allows us to immobilise a limb, the whole length of the limb.
0:17:39 > 0:17:43Basically, it's filled with beans, and we withdraw all the air
0:17:43 > 0:17:44away from that mattress
0:17:44 > 0:17:47so that the beans become tightly compacted together,
0:17:47 > 0:17:51not allowing anyone to move the limb that it's wrapped around.
0:17:51 > 0:17:52So, just deep breaths.
0:17:52 > 0:17:55Deep breaths. You're doing really well.
0:17:55 > 0:17:57Keep your arm still.
0:17:57 > 0:18:00What it will do is just suck the air out, OK?
0:18:02 > 0:18:05- Might feel a little bit strange. - It does.
0:18:05 > 0:18:07Can you feel it getting tighter?
0:18:07 > 0:18:11Yeah? You won't be able to move your arm now.
0:18:11 > 0:18:14- OK?- It's coming out there.
0:18:16 > 0:18:18So, to stand, I want you to try and bend your knees,
0:18:18 > 0:18:20with your feet on the floor.
0:18:20 > 0:18:23That's it. We're just going to stand up.
0:18:23 > 0:18:25- Are you ready?- Yes.- After three.
0:18:25 > 0:18:26One, two, three.
0:18:28 > 0:18:30Brilliant. Well done. OK?
0:18:30 > 0:18:32- Relax.- Have a sit down on here.
0:18:32 > 0:18:34All the best, Hassan. I'll see you soon, mate.
0:18:36 > 0:18:39It might sound a crazy question, score out of ten.
0:18:39 > 0:18:42If you imagined ten being the worst pain ever,
0:18:42 > 0:18:44what would you rate it right now?
0:18:44 > 0:18:45- Ten.- Ten. I thought that was it.
0:18:45 > 0:18:48Hassan, can I have a look at this arm?
0:18:48 > 0:18:50I'm going to try and give you some better pain relief.
0:18:50 > 0:18:52OK, just relax now.
0:18:52 > 0:18:53Little scratch, OK?
0:18:53 > 0:18:56Intravenous paracetamol is a great drug
0:18:56 > 0:18:58that we can give people for significant pain.
0:18:58 > 0:19:00The drug gets into the system quite quickly.
0:19:00 > 0:19:02We're skipping the whole digestive system
0:19:02 > 0:19:05and entering the bloodstream straightaway.
0:19:05 > 0:19:06- Hassan?- What?
0:19:06 > 0:19:09Good luck to you. Any problems, Craig is your man.
0:19:09 > 0:19:11- All right? See you later. - Yeah, cheers.- All the best.
0:19:11 > 0:19:12See you later. Bye-bye.
0:19:12 > 0:19:16An X-ray revealed Hassan had dislocated his elbow
0:19:16 > 0:19:18and broken two bones.
0:19:18 > 0:19:21After an operation and physiotherapy, he's back at work.
0:19:21 > 0:19:24It happens, we're humans, we make mistakes.
0:19:24 > 0:19:26We have accidents.
0:19:26 > 0:19:28It's just fortunate that we were there to help him out
0:19:28 > 0:19:30when he had his accident.
0:19:39 > 0:19:43The West Midlands is one of the most diverse areas in the UK.
0:19:43 > 0:19:45From inner-city Birmingham
0:19:45 > 0:19:49to the sprawling countryside of Staffordshire,
0:19:49 > 0:19:53hundreds of front-line staff are employed
0:19:53 > 0:19:56to cover its 5,000-square-miles patch.
0:19:56 > 0:19:58West Midlands is absolutely huge.
0:19:58 > 0:20:01Can be lonely working in the car if you let it be,
0:20:01 > 0:20:03but we just do so many miles
0:20:03 > 0:20:07that we don't get chance to be lonely.
0:20:07 > 0:20:08We're just so busy.
0:20:10 > 0:20:13Paramedic Kathryn Davies is on her way to a job in Stourbridge,
0:20:13 > 0:20:15just outside Birmingham.
0:20:15 > 0:20:18We're going to a 71-year-old male, generally unwell.
0:20:18 > 0:20:20Feeling very weak in his legs.
0:20:20 > 0:20:23And he feels like his lips are numb.
0:20:23 > 0:20:27So we'll go and check him over, give the control a quick update.
0:20:27 > 0:20:30And see if we need a crew or not.
0:20:42 > 0:20:43Hello.
0:20:44 > 0:20:47- My name's Kathryn, what's yours? - David.
0:20:47 > 0:20:50David. What's going on, David?
0:20:50 > 0:20:53I don't know. I took the dogs for a walk and when I was coming back,
0:20:53 > 0:20:57I felt very funny, my legs just went when I got to the gate.
0:20:57 > 0:20:59Your legs buckled. Did you fall onto the floor?
0:20:59 > 0:21:01No, I was hanging onto the gate.
0:21:01 > 0:21:04- You just felt very weak?- Yes.
0:21:04 > 0:21:06Nothing wrong with your heart or anything?
0:21:06 > 0:21:10No, the last thing I had, the heart thing, they said it was fine.
0:21:10 > 0:21:13That's all clear. Right. OK, that's good.
0:21:13 > 0:21:15Can we take your arm out of this?
0:21:15 > 0:21:18Yeah? Nice and steady.
0:21:19 > 0:21:20Okey-doke.
0:21:20 > 0:21:23I had taken the dogs out for a walk
0:21:23 > 0:21:28and just when I was coming back, there's a gate up in the field.
0:21:28 > 0:21:31And my legs just seemed to go.
0:21:31 > 0:21:35And I had to stand there for about five, six minutes.
0:21:35 > 0:21:37I just didn't feel well at all.
0:21:37 > 0:21:39My head started spinning a bit.
0:21:39 > 0:21:44My wife Liz phoned up, you know, the ambulance.
0:21:44 > 0:21:49Basically because, you know, she knows usually how fit I am.
0:21:49 > 0:21:51And...
0:21:51 > 0:21:54I think it worried her an awful lot.
0:21:54 > 0:21:56Are you feeling sick at all?
0:21:56 > 0:21:58- No...- No?
0:22:06 > 0:22:10David described his symptoms of feeling weak
0:22:10 > 0:22:13and having numbness in his fingers and his toes.
0:22:13 > 0:22:17That could be a sign of a TIA - a mini stroke.
0:22:17 > 0:22:19So that did cause a worry.
0:22:19 > 0:22:22David, can you raise this leg for me?
0:22:22 > 0:22:23Go on, push against me.
0:22:23 > 0:22:26OK. A bit shaky, aren't you?
0:22:26 > 0:22:29Give me a smile.
0:22:29 > 0:22:31Bob your tongue out at me. There's a reason for it!
0:22:31 > 0:22:34Shut your eyes. Put your tongue away now.
0:22:34 > 0:22:36Can you feel me touching your face?
0:22:36 > 0:22:40- Yes.- And that side?- Yes. - Does it feel the same both sides?
0:22:40 > 0:22:42- Yes.- All right. - David, open your eyes?
0:22:42 > 0:22:46Now, now! Can you open your eyes?
0:22:46 > 0:22:48This finger, put it on your nose.
0:22:48 > 0:22:50There, OK.
0:22:50 > 0:22:53And just see if you can go away and come back.
0:22:53 > 0:22:56To your nose. All right. Put it back to your nose.
0:22:56 > 0:22:58And again. Away.
0:22:58 > 0:23:00Back to your nose.
0:23:00 > 0:23:02OK, that's fine.
0:23:02 > 0:23:04It's just to check their senses.
0:23:04 > 0:23:06If anybody's got a brain injury,
0:23:06 > 0:23:09or if there's anything going on like a bleed,
0:23:09 > 0:23:12sometimes these senses won't be precise.
0:23:12 > 0:23:17And it does give us a good indication of what may be going on.
0:23:17 > 0:23:20Can you sit yourself right up now, David?
0:23:20 > 0:23:22Thank you. That's it.
0:23:22 > 0:23:24That's it, OK.
0:23:24 > 0:23:25What I want you to do...
0:23:25 > 0:23:27Hang on. Hang on.
0:23:27 > 0:23:28Oh, sorry.
0:23:28 > 0:23:31Fold your arms, have a bit of a cough.
0:23:31 > 0:23:33Right. And sit yourself forward so I can...
0:23:33 > 0:23:36Good. Good, so I can have a good listen.
0:23:36 > 0:23:38Nice, steady, deep breaths in.
0:23:38 > 0:23:39And out.
0:23:40 > 0:23:42OK.
0:23:42 > 0:23:44Right, I'm just going to do the front now.
0:23:44 > 0:23:45Hold on, I feel a bit...
0:23:45 > 0:23:48It's all them deep breaths in and out.
0:23:48 > 0:23:50- Shall we have a rest?- Yes.
0:23:53 > 0:23:56Yeah, I'll just have a little listen to the front.
0:23:56 > 0:23:58No, no, no, that's fine.
0:24:03 > 0:24:06Pardon? I missed that. What did you say?
0:24:08 > 0:24:09No, you're all right.
0:24:09 > 0:24:13I'd like you to go to hospital and have some further tests.
0:24:13 > 0:24:14Is that fine by you?
0:24:18 > 0:24:20You're not wasting nobody's time.
0:24:20 > 0:24:23All right? All his observations are absolutely fine.
0:24:23 > 0:24:26David has got a lot of ongoing problems at the moment.
0:24:26 > 0:24:28He is waiting for a CT scan.
0:24:28 > 0:24:31But he's almost collapsed on the way back
0:24:31 > 0:24:34from walking his dog, which is unusual.
0:24:34 > 0:24:37Enough for him to ask for an ambulance,
0:24:37 > 0:24:38because he's not that sort of fella.
0:24:38 > 0:24:42So, although everything is looking right here,
0:24:42 > 0:24:45A&E may be not exactly the right pathway but it's...
0:24:45 > 0:24:48At the moment, we will take him in,
0:24:48 > 0:24:51and just see if they pick anything else up.
0:24:54 > 0:24:56Well, we'll see, shall we?
0:24:56 > 0:25:00I knew deep down I needed to go to hospital
0:25:00 > 0:25:04because nothing like this had ever happened before.
0:25:11 > 0:25:15It's a case that there's something going on,
0:25:15 > 0:25:17there's nothing hitting us in the face.
0:25:17 > 0:25:20But sometimes you've just got to go with your gut instinct.
0:25:21 > 0:25:23Gut feeling says send him in.
0:25:29 > 0:25:33In hospital, David underwent a series of tests.
0:25:33 > 0:25:35I had to go and have an X-ray.
0:25:35 > 0:25:39And it was actually through that they found out I had lung cancer.
0:25:40 > 0:25:43It was only about a week, a week and a half after that
0:25:43 > 0:25:46that they wanted me in for a Pet scan,
0:25:46 > 0:25:50which gives a better view of your stomach and your lungs and that.
0:25:50 > 0:25:52And they said...
0:25:54 > 0:25:56..we believe you've got a tumour...
0:25:58 > 0:25:59..on your diaphragm.
0:25:59 > 0:26:01It's life-changing.
0:26:01 > 0:26:05Life-changing, finding out that you've got, you know,
0:26:05 > 0:26:08lung cancer and then a tumour.
0:26:08 > 0:26:10It is frightening
0:26:10 > 0:26:13because you hear about other people that have got tumours
0:26:13 > 0:26:16and you know, they ain't got long to live and you think,
0:26:16 > 0:26:18that can happen to me.
0:26:19 > 0:26:23If I hadn't gone up to Russells Hall with my legs...
0:26:26 > 0:26:29..I don't think they would have found out
0:26:29 > 0:26:32about the tumour or the lung cancer.
0:26:34 > 0:26:38David is now undergoing treatment for both conditions.
0:26:47 > 0:26:51Some sticky dots, just to keep a look at your heart, all right?
0:26:51 > 0:26:53Doctors across Britain volunteer their time
0:26:53 > 0:26:57to help the Ambulance Service through the charity Basics.
0:26:57 > 0:27:01Basics is the British Association for Immediate Care schemes.
0:27:01 > 0:27:04And its prime focus is to provide advanced care
0:27:04 > 0:27:06in the prehospital field.
0:27:06 > 0:27:10We've got the major haemorrhage stuff, some swabs and some gauze.
0:27:10 > 0:27:14Basics doctors train medical students and assist paramedics
0:27:14 > 0:27:15out on the road.
0:27:15 > 0:27:19Paramedics are trained to deliver excellent care,
0:27:19 > 0:27:22but there are limits to what they are allowed to do.
0:27:22 > 0:27:25Doctors can do procedures that paramedics would not be able to do.
0:27:25 > 0:27:31We've just got a call, we're on our way to a male who's having a fit.
0:27:31 > 0:27:35And we've also got reports of a head injury, so he might have fallen,
0:27:35 > 0:27:38sustained a head injury, and is now seizing.
0:27:38 > 0:27:42Or he might be that he's having a fit and has bumped his head
0:27:42 > 0:27:44on the way down.
0:27:55 > 0:27:58- Hello there. Hiya. All right? Shall I pop on?- Come on, yeah.
0:27:58 > 0:28:00Thank you very much. Hello, sir.
0:28:00 > 0:28:03All right? I'm Mike, I'm one of the doctors with the Ambulance Service.
0:28:03 > 0:28:05- What's your name, sir?- Wayne.
0:28:05 > 0:28:07What have you found out so far?
0:28:07 > 0:28:09- Diabetic.- Diabetic chap.
0:28:09 > 0:28:12Right. Do you know what happened, Wayne?
0:28:13 > 0:28:15Do you know what happened to you?
0:28:30 > 0:28:31I'm type one diabetic.
0:28:31 > 0:28:35I'd gone into town. My blood sugar has gone low.
0:28:35 > 0:28:37Started getting confused.
0:28:37 > 0:28:40I ended up tripping over, knocking myself out.
0:28:41 > 0:28:45Do you have this a lot when you have a hypo, the low blood sugar?
0:28:45 > 0:28:47- Not like that.- Not like that.
0:28:47 > 0:28:51You just suddenly collapsed and banged your head on the way down.
0:28:51 > 0:28:54Wayne's low blood sugar levels have caused him
0:28:54 > 0:28:57to have a hypoglycaemic incident, known as a hypo.
0:28:58 > 0:29:01When we first met Wayne, he was awake and talking,
0:29:01 > 0:29:05but he was still finding difficulty in finding the right words.
0:29:05 > 0:29:07He was slurring his speech a little bit.
0:29:07 > 0:29:09Can you still see all right, Wayne?
0:29:09 > 0:29:11Yes, it's just...
0:29:11 > 0:29:13It's just a bit swollen, isn't it?
0:29:13 > 0:29:15And you could think that he was drunk.
0:29:15 > 0:29:18These are all possible consequences of having a low blood sugar.
0:29:18 > 0:29:20Did you manage to get up and walk into the ambulance, did you?
0:29:20 > 0:29:21- Yeah.- OK.
0:29:21 > 0:29:24If the brain is not getting enough food, it's not working fast enough,
0:29:24 > 0:29:27and people can seem slow and slurred
0:29:27 > 0:29:31and that's why they go off balance in the first place and fall over.
0:29:31 > 0:29:36You hurt your wrist as well? Here? This is obviously sore here.
0:29:36 > 0:29:38It is possible he's broken his jaw
0:29:38 > 0:29:41but he certainly caused some wounds, which are gaping open,
0:29:41 > 0:29:42and were going to need stitches.
0:29:42 > 0:29:46The wound itself has got a small laceration next to the eye,
0:29:46 > 0:29:49involving the eyelid, it's gone through the layers of the skin,
0:29:49 > 0:29:52it probably needs a couple of fine sutures to stitch it up,
0:29:52 > 0:29:55something he'd probably need to get to A&E for.
0:29:55 > 0:29:58Can we just check your blood sugar, see what it's like now?
0:29:58 > 0:30:01What was it like before, when you knew you had to get something?
0:30:01 > 0:30:04- I haven't tested it.- Not tested it, just felt like it was a hypo.
0:30:06 > 0:30:07Can you still see all right, Wayne?
0:30:09 > 0:30:11- 1.1.- 1.1?
0:30:11 > 0:30:13- Yup.- Wow!
0:30:13 > 0:30:15Okey-dokey. There we are. That's pretty low.
0:30:15 > 0:30:181.1 is really low.
0:30:18 > 0:30:20It should normally be four.
0:30:20 > 0:30:23It's no surprise that he felt unwell.
0:30:25 > 0:30:29In Wayne's case we gave him some gel but ideally he would eat something.
0:30:29 > 0:30:32He'd just been to the shops and had a carrier bag of chocolate bars.
0:30:32 > 0:30:34He tried to eat it, but the wounds that he had got
0:30:34 > 0:30:36made it difficult to eat.
0:30:36 > 0:30:39They could sort him out more at hospital with more pain relief.
0:30:39 > 0:30:42Right, well, I think you're in capable hands here.
0:30:42 > 0:30:45It is a day-to-day battle for people with diabetes
0:30:45 > 0:30:49and they're always at risk of having either a high or low blood sugar,
0:30:49 > 0:30:51and there are problems with both.
0:30:51 > 0:30:52Thanks, Wayne.
0:30:52 > 0:30:53- All right?- All right.
0:30:53 > 0:30:55- Yup, thanks very much.- Cheers.
0:30:57 > 0:31:00I'd expect Wayne to make a full recovery
0:31:00 > 0:31:03and he just needs to live with his diabetes
0:31:03 > 0:31:09and work with his GP to find the medication that works for him.
0:31:09 > 0:31:12At hospital, Wayne received treatment for his wrist
0:31:12 > 0:31:15and head injuries, before being discharged.
0:31:21 > 0:31:24The hardest thing about being a paramedic
0:31:24 > 0:31:27is the suffering you deal with.
0:31:27 > 0:31:30From experience, you know when people aren't coping.
0:31:30 > 0:31:34Sometimes it takes a stranger to come and say,
0:31:34 > 0:31:35"You're tired.
0:31:35 > 0:31:37"You can't keep dealing with this.
0:31:37 > 0:31:40"Let's put something in place to help you."
0:31:42 > 0:31:45Paramedic John Cobb is on the late shift,
0:31:45 > 0:31:49en route to treat an elderly lady with Parkinson's,
0:31:49 > 0:31:51in pain from an infected pressure sore.
0:32:01 > 0:32:03- Hello, sir.- Hello. - Where are we heading?
0:32:05 > 0:32:07When we arrived at the address,
0:32:07 > 0:32:09the house was full of family, neighbours,
0:32:09 > 0:32:14everyone basically trying to sort the house out, moving beds -
0:32:14 > 0:32:18it was evident she'd got so much support, they're a lovely family.
0:32:20 > 0:32:24- Hello! What's been happening? - She's gone off her legs.
0:32:24 > 0:32:27- Right.- She suffers with Parkinson. - Okey-dokey.
0:32:27 > 0:32:32Parkinson's is a debilitating degenerative brain condition.
0:32:32 > 0:32:36The typical symptom is the shaking, but it's more of the mobility aspect
0:32:36 > 0:32:38of it that we end up being called for.
0:32:38 > 0:32:41- Other than Parkinson's, does she suffer from anything else?- No.
0:32:41 > 0:32:43How are you in yourself?
0:32:43 > 0:32:47Do you feel bad in yourself?
0:32:47 > 0:32:52- Just don't feel right. - That's a good answer.
0:32:52 > 0:32:54I'll get down to you. Have you got any pains anywhere?
0:32:54 > 0:32:58Lower back. I've read about pressure sores.
0:32:58 > 0:33:01Has that developed quite quickly?
0:33:01 > 0:33:05- Yes, over the last three or four weeks.- Okey-dokey.
0:33:05 > 0:33:09- Quite a big one as well.- I'm going to pop this in your ear. All right?
0:33:12 > 0:33:14There we go. 38.2.
0:33:14 > 0:33:16Can we have a look at your back?
0:33:16 > 0:33:18If we just sit you forward slightly.
0:33:18 > 0:33:21See how far we can get without up-heaving you.
0:33:22 > 0:33:24Is that all right, sweetheart?
0:33:24 > 0:33:25Come on, darling.
0:33:25 > 0:33:29Just come forward a little bit, and let's move your packing...
0:33:29 > 0:33:30Bless you.
0:33:30 > 0:33:32Pressure sores are sore by their nature,
0:33:32 > 0:33:36and some people, it is absolute agony for them.
0:33:36 > 0:33:40She probably got this due to her reduced mobility and Parkinson's,
0:33:40 > 0:33:44and if she's not able to get about,
0:33:44 > 0:33:47these sores then can generate issues.
0:33:47 > 0:33:49Has she lost complete use of her legs?
0:33:49 > 0:33:52Is she able to do any weight-bearing at all?
0:33:52 > 0:33:58It's like she tries, but it's as if she's trying,
0:33:58 > 0:34:02she wants to, but it's not happening.
0:34:02 > 0:34:05Her feet, it's just not happening.
0:34:05 > 0:34:10All of her tests are fine. Her temperature is up slightly, 38.2,
0:34:10 > 0:34:14it is classed as a high temperature, but not significantly high.
0:34:14 > 0:34:17I'm thinking that if we get her into hospital tonight
0:34:17 > 0:34:19and get a full assessment,
0:34:19 > 0:34:24make sure that wound isn't causing any long-term infection,
0:34:24 > 0:34:29we'll arrange for an ambulance to come and we'll get it sorted.
0:34:29 > 0:34:34She's been gradually going off her legs over the last few weeks
0:34:34 > 0:34:39and today, she just was hardly able to move at all.
0:34:40 > 0:34:45So I decided to call for professional help.
0:34:46 > 0:34:50For your mum to come back out, we can make sure there's a package
0:34:50 > 0:34:53of care put in place, so Mum's safe here, and you are safe as well.
0:34:53 > 0:34:56I know the bed's coming down and that's a good start,
0:34:56 > 0:34:58but she's not really safe.
0:34:59 > 0:35:01Without sounding horrible, you are your age,
0:35:01 > 0:35:04you're going to do yourself some harm, really.
0:35:04 > 0:35:07You've got to be careful that the husbands and wives
0:35:07 > 0:35:10that are caring for their family members
0:35:10 > 0:35:13don't become ill themselves due to the fact they're caring for them.
0:35:13 > 0:35:17When that happens, we need to take a step back
0:35:17 > 0:35:19and put something in place to help them.
0:35:19 > 0:35:23Why wear yourself out doing something you don't need to do?
0:35:23 > 0:35:25You haven't got to go very far now.
0:35:25 > 0:35:26It is a difficult decision for the family
0:35:26 > 0:35:29because they're acknowledging that they cannot cope.
0:35:29 > 0:35:33As good as family are, they're not here 24 hours a day.
0:35:33 > 0:35:36We'll get her assessed at the hospital, get some bloods done.
0:35:36 > 0:35:38If it's an infection we can treat it,
0:35:38 > 0:35:41and if it's not, then we can get her back home
0:35:41 > 0:35:43with a package of care in place.
0:35:43 > 0:35:47It's just there... It helps John, it helps the family.
0:35:47 > 0:35:50Just keeping a bit of normality, really.
0:35:50 > 0:35:54When we mentioned it to John, he sighed a bit of relief, deep down.
0:35:54 > 0:35:56Whether he's been fighting this, I don't know.
0:36:02 > 0:36:04A few little bumps on the way out.
0:36:04 > 0:36:06We go to the right.
0:36:12 > 0:36:15Well, hopefully they can just stabilise her.
0:36:15 > 0:36:19Parkinson's is a progressive disease anyway,
0:36:19 > 0:36:21so there's nothing they can do about that,
0:36:21 > 0:36:24it will just have to run its course
0:36:24 > 0:36:27till the other bits and pieces that need sorting.
0:36:29 > 0:36:32So, just hope for the best.
0:36:34 > 0:36:36There you go.
0:36:36 > 0:36:38Just get you to shuffle along this way.
0:36:43 > 0:36:47Melva spent the night in hospital before returning home,
0:36:47 > 0:36:51but five weeks later she was moved into a care home.
0:36:51 > 0:36:53The news that Melva's now gone into a care home
0:36:53 > 0:36:57is kind of proof that her husband was struggling,
0:36:57 > 0:36:59and the family were struggling.
0:36:59 > 0:37:01To see them doing what they were doing -
0:37:01 > 0:37:03trying to get the house ready - was lovely to see,
0:37:03 > 0:37:06and they were doing everything they can to make sure she was safe.
0:37:06 > 0:37:10It also shows that the package of care put in place
0:37:10 > 0:37:13still wasn't good enough for her needs,
0:37:13 > 0:37:17and that a care home is suitable,
0:37:17 > 0:37:20and that it would be the best course of action for her.
0:37:31 > 0:37:33It's the early hours of the morning.
0:37:34 > 0:37:39Paramedic Ste Hill is blue-lighting it to get to an OAP in distress.
0:37:39 > 0:37:43We're going to a 75-year-old lady who has breathing difficulties.
0:37:43 > 0:37:45We've not been given any further info,
0:37:45 > 0:37:48just Control saying it was an amber face-to-face job.
0:37:48 > 0:37:49No other details at the moment.
0:37:51 > 0:37:53Having breathing difficulties is sort of like,
0:37:53 > 0:37:56one of the most common calls we go out to.
0:37:56 > 0:37:59At all times of the day, but particularly at night times.
0:37:59 > 0:38:02Patients' symptoms seem to get worse at night.
0:38:02 > 0:38:04I've met this lady before,
0:38:04 > 0:38:06and I don't remember her being a regular caller
0:38:06 > 0:38:08for breathing difficulties.
0:38:17 > 0:38:20Hello, sweet. What's the trouble?
0:38:25 > 0:38:26OK.
0:38:29 > 0:38:32Doreen is a familiar face. I've not seen her for some years.
0:38:32 > 0:38:35So just to recap, you suffer with anxiety...
0:38:35 > 0:38:37- Very bad.- Very bad.
0:38:37 > 0:38:40- And you suffer with palpitations because of your anxiety?- Yes.
0:38:40 > 0:38:43As soon as I stepped foot in her house, and I saw her face,
0:38:43 > 0:38:47I knew who she was. She was quite happy to see me, I think.
0:38:47 > 0:38:48Just describe the symptoms you've got?
0:38:51 > 0:38:53Your body's throbbing, right.
0:39:00 > 0:39:04Knowing how you feel, does it feel like panic and anxiety?
0:39:04 > 0:39:08It could be. Can I have a listen to your chest, is that OK?
0:39:08 > 0:39:11- Yes.- Yeah? OK.
0:39:11 > 0:39:13Take some deep, slow breaths for me.
0:39:15 > 0:39:16And out.
0:39:18 > 0:39:19Your chest's nice and clear.
0:39:19 > 0:39:23- What I want to do now is do a heart tracing on you, is that OK?- Yes.
0:39:23 > 0:39:27And have your symptoms remained the same,
0:39:27 > 0:39:29or have they got worse or got better?
0:39:29 > 0:39:32Seemed to have eased off a bit.
0:39:32 > 0:39:34Have I got that sort of face, have I?
0:39:34 > 0:39:36We try our best, don't we?
0:39:42 > 0:39:45Your ECG's good, it's perfect.
0:39:45 > 0:39:48All right? It's not going fast, everything's where it should be.
0:39:48 > 0:39:50Everything looks normal.
0:39:50 > 0:39:52When you suffer with anxiety normally, what happens?
0:39:52 > 0:39:55Does it normally pass of its own accord?
0:39:59 > 0:40:00- Does that help?- Yeah.
0:40:00 > 0:40:03You've tried those a little bit this morning?
0:40:03 > 0:40:05- Yes.- Has it eased it off a little bit?
0:40:05 > 0:40:07Looks like it, all right.
0:40:07 > 0:40:10Would you say that you're feeling like you're starting to recover now?
0:40:10 > 0:40:14- Yes.- Yeah. Do you feel back to normal yet?- Yes.
0:40:14 > 0:40:17I think sometimes when people call for help
0:40:17 > 0:40:19from the Ambulance Service,
0:40:19 > 0:40:23they don't need any particular clinical intervention.
0:40:23 > 0:40:25A couple of other things I want to do -
0:40:25 > 0:40:27your temperature and your blood sugars, is that all right?
0:40:27 > 0:40:29All right, thank you.
0:40:29 > 0:40:31They don't need needles or drugs.
0:40:31 > 0:40:33They don't even need assessment, sometimes.
0:40:33 > 0:40:36It's just going to be a little scratch, OK?
0:40:36 > 0:40:40I think just a kind word and passing the time of day sometimes
0:40:40 > 0:40:43can reassure people enough to make them feel better.
0:40:43 > 0:40:47Right, everything I've checked, literally everything, is normal, OK?
0:40:47 > 0:40:50I don't think there's any reason to go to the hospital,
0:40:50 > 0:40:52I don't suppose you want to go to the hospital, do you?
0:40:54 > 0:40:58No, not really. I'm happy with everything, if you're happy?
0:40:58 > 0:41:00- God bless you. - Do you feel at ease now?
0:41:00 > 0:41:03- Yes, I do. - Do you want a cup of tea, Doreen?
0:41:03 > 0:41:05- I'd love one.- You'd love one.
0:41:05 > 0:41:08This is the first thing we got taught at training school,
0:41:08 > 0:41:10how to make a cup of tea.
0:41:13 > 0:41:15I checked Doreen over, she's calmed down somewhat.
0:41:15 > 0:41:18That quite happens with patients who have anxiety,
0:41:18 > 0:41:21just to see the uniform, sometimes I think, before we've done anything,
0:41:21 > 0:41:22it calms them down.
0:41:22 > 0:41:25I just told Control that we're going to deal and we don't need a big
0:41:25 > 0:41:27ambulance to take her to hospital.
0:41:27 > 0:41:29This is proper ambulance tea.
0:41:30 > 0:41:32Middle-of-the-night jobby.
0:41:35 > 0:41:37The tea boy's here, Doreen.
0:41:39 > 0:41:42All right. I've not made it too strong for you, that OK?
0:41:42 > 0:41:43- Yes, thank you.- That's OK?
0:41:43 > 0:41:47Beautiful, thank you. Can you put it on the table, please?
0:41:47 > 0:41:48Of course I can. Right.
0:41:48 > 0:41:52I'm going to get some paperwork from the car
0:41:52 > 0:41:55and I'll come back and just jot a few bits and bobs down.
0:41:55 > 0:41:56- Is that all right?- Yes.
0:41:56 > 0:41:58All right, I won't be a moment, all right?
0:41:59 > 0:42:02It means such a lot, Ste coming to visit me.
0:42:02 > 0:42:04He's very pleasant
0:42:04 > 0:42:07and he's got a nice personality.
0:42:07 > 0:42:10And he puts people's mind at ease.
0:42:14 > 0:42:16Same day as my dad's.
0:42:18 > 0:42:20Not twins, are you?
0:42:20 > 0:42:23- How old's dad?- 60.
0:42:26 > 0:42:30Doreen, we're going to leave you in peace now.
0:42:30 > 0:42:33All right? Lovely to see you again - it's been a while, hasn't it?
0:42:33 > 0:42:37- Yeah.- Yeah? I'm glad you're OK. You feel better?- Yes, thank you.
0:42:39 > 0:42:41- OK.- OK.
0:42:41 > 0:42:43You take care, Doreen.
0:42:43 > 0:42:46All right, OK, bye-bye.
0:42:46 > 0:42:49- Bye-bye, take care.- Bye-bye.
0:42:49 > 0:42:52We've assessed Doreen tonight, and it's not an acute problem.
0:42:52 > 0:42:55The important thing is she's made a full recovery,
0:42:55 > 0:42:57all of our observations are fine.
0:42:57 > 0:42:59We've made her a cup of tea and she's happy to stay at home,
0:42:59 > 0:43:04so we're clear here and we're going to move on to the next job.