0:00:02 > 0:00:06This programme contains some strong language and some scenes which some viewers may find upsetting.
0:00:06 > 0:00:09- Emergency ambulance... - Tell me exactly what's happened.
0:00:09 > 0:00:12When the most serious emergencies strike,
0:00:12 > 0:00:15the ambulance has eight minutes to respond.
0:00:15 > 0:00:17FRANTIC VOICE ON PHONE
0:00:17 > 0:00:20I'm going to... Sir, I'm going to tell you what to do, right?
0:00:20 > 0:00:24With 999 calls doubling in London over the past ten years...
0:00:24 > 0:00:26I'm not asking if you're an atheist,
0:00:26 > 0:00:28I'm asking, do you want an ambulance?
0:00:28 > 0:00:29..in the control centre,
0:00:29 > 0:00:32every single one needs a split-second decision.
0:00:32 > 0:00:35Who needs an ambulance quickest?
0:00:35 > 0:00:37It's so critical that we try and cut him down.
0:00:37 > 0:00:40It's the only way we're going to be able to try and save his life.
0:00:40 > 0:00:42And who must wait?
0:00:43 > 0:00:46Kathleen, the ambulance will not be coming to you tonight.
0:00:48 > 0:00:51Following calls from the moment they come in...
0:00:51 > 0:00:52He's been stabbed in the stomach.
0:00:52 > 0:00:54Looking for any ambulance for
0:00:54 > 0:00:57a 16-year-old who's had her hands slashed by a machete.
0:00:57 > 0:00:58Another stabbing?!
0:00:58 > 0:01:01..as crews race to save lives.
0:01:01 > 0:01:03Seconds feel like minutes, minutes feel like hours
0:01:03 > 0:01:05when you're waiting for an ambulance.
0:01:05 > 0:01:08My name's Peter, all right? We're going to look after you.
0:01:08 > 0:01:10We're going to give you some very strong pain medicines.
0:01:10 > 0:01:12Got a 94-year-old female who's fallen.
0:01:12 > 0:01:15I need to know if he's breathing or not. It's really important.
0:01:15 > 0:01:17He's as drunk as a thousand people.
0:01:17 > 0:01:20With the NHS under unprecedented pressure...
0:01:20 > 0:01:25There was a hanging, there was a four-year-old who's fallen 20 foot,
0:01:25 > 0:01:27and now we've got another double stabbing.
0:01:27 > 0:01:31You're the Queen of England? So why have you dialled 999?
0:01:31 > 0:01:34..and with London growing by over 100,000 people a year...
0:01:34 > 0:01:37- You've overdosed, fella.- Eh? - You've overdosed.
0:01:37 > 0:01:40..ambulances are struggling to keep up.
0:01:40 > 0:01:42The situation is now critical.
0:01:42 > 0:01:45Someone's taken my Echo-231 for something else!
0:01:45 > 0:01:47Another cardiac arrest, another deceased.
0:01:47 > 0:01:49Please, God, be an ambulance. Be an ambulance.
0:01:51 > 0:01:53This is the story behind the sirens...
0:01:53 > 0:01:55FEEDBACK CRACKLES
0:01:55 > 0:01:57..through the eyes of the London Ambulance Service.
0:01:57 > 0:02:00Did you see what you were shot with? A shotgun?
0:02:02 > 0:02:06I think essentially we should say that she's gone. It's time to stop.
0:02:06 > 0:02:09Sometimes it's just not easy.
0:02:10 > 0:02:14- But you go on to your next job... - Marvellous!
0:02:14 > 0:02:16..cos there's somebody else you can help.
0:02:16 > 0:02:19Oh! London has woken up. Here we go.
0:02:19 > 0:02:22SIREN WAILS
0:02:33 > 0:02:36One, two, three, four.
0:02:36 > 0:02:40One, two, three, four.
0:02:40 > 0:02:43PERSON ON PHONE JOINS IN: One, two, three, four.
0:02:43 > 0:02:46One, two, three, four.
0:02:46 > 0:02:49OK, my love, I'm going to tell you how to give mouth-to-mouth, OK?
0:02:51 > 0:02:53Just do two breaths, and then once you've done the breaths,
0:02:53 > 0:02:55we're going to go back to the compressions, OK?
0:03:00 > 0:03:03Wednesday morning in the London Ambulance Control Centre,
0:03:03 > 0:03:05and today is a normal day.
0:03:05 > 0:03:08I believe you were having some chest tightness and coughing
0:03:08 > 0:03:11from inhaling bathroom bleach, is that correct?
0:03:11 > 0:03:16The 75-strong team on shift have been at work for two hours.
0:03:16 > 0:03:18Yeah, it's ticking over.
0:03:19 > 0:03:22You know, we get very experienced very quickly in here,
0:03:22 > 0:03:24of getting a rough gauge of
0:03:24 > 0:03:25what sort of day you're going to have.
0:03:25 > 0:03:29I need to know if he's breathing or not. It's really important.
0:03:29 > 0:03:32Across London, there's probably 50 attempted suicides,
0:03:32 > 0:03:34around 50 drug overdoses a day.
0:03:34 > 0:03:3670 road traffic collisions.
0:03:36 > 0:03:38Lots of elderly fallers.
0:03:38 > 0:03:41Cardiac arrests, average in London is 28.
0:03:41 > 0:03:43I'm organising help for you now, so just stay on the line
0:03:43 > 0:03:45and I'll tell you exactly what to do next, OK?
0:03:45 > 0:03:47Yeah. It's all...
0:03:48 > 0:03:50It's reasonable so far.
0:04:00 > 0:04:035,000 calls will come in today.
0:04:03 > 0:04:06But with only 386 crews at their disposal,
0:04:06 > 0:04:08the split-second decisions they have to make
0:04:08 > 0:04:12can have ongoing consequences across the city.
0:04:12 > 0:04:15And for the patient, mean the difference between life and death.
0:04:19 > 0:04:21BABY CRIES
0:04:26 > 0:04:28THEY LAUGH
0:04:30 > 0:04:35In the east, a Red 1, the most urgent of calls, is in progress.
0:04:45 > 0:04:48Ambulance crew Scott and Andy are closest,
0:04:48 > 0:04:50and they've just become free.
0:04:50 > 0:04:52Right. Oh, Red 1.
0:04:52 > 0:04:54Oh, Red 1. Cardiac arrest.
0:04:54 > 0:04:56'999, road, activate.'
0:04:56 > 0:04:58SIREN STARTS UP
0:05:05 > 0:05:09Every second counts when you're dealing with a cardiac arrest.
0:05:09 > 0:05:12They're not breathing, their heart's not beating.
0:05:12 > 0:05:14Their tissue and organs are starting to die.
0:05:16 > 0:05:18The quicker we start chest compressions
0:05:18 > 0:05:20and we get that blood moving round the body,
0:05:20 > 0:05:22the better chance we've got of saving his life.
0:05:26 > 0:05:29- WOMAN SHOUTS:- Wake up! Wake up!
0:05:32 > 0:05:34DOG BARKS
0:05:34 > 0:05:36Hello! Ambulance! In here?
0:05:37 > 0:05:39When did you last see him, sweetheart?
0:05:46 > 0:05:48Right.
0:05:48 > 0:05:49Let's get those pads on.
0:05:51 > 0:05:55The 62-year-old patient, Paul, lives with his sister Dawn.
0:05:55 > 0:05:56Not seen since last night.
0:05:56 > 0:05:59She found him when she came downstairs for breakfast.
0:06:01 > 0:06:04- COMPUTER:- If no signs of circulation, start CPR.
0:06:07 > 0:06:09When we do CPR, it's brutal.
0:06:09 > 0:06:11It is absolutely brutal.
0:06:11 > 0:06:14We're putting airways in and we're doing chest compressions
0:06:14 > 0:06:16and ribs are getting broke and...
0:06:16 > 0:06:18for the family, it's just raw.
0:06:18 > 0:06:21You know, the emotion that you get within a room.
0:06:21 > 0:06:23And that can be really difficult.
0:06:27 > 0:06:2928, 29, 30.
0:06:33 > 0:06:35Yeah, adrenaline.
0:06:35 > 0:06:36Ten mil, it's in date.
0:06:36 > 0:06:39- COMPUTER:- 3, 2, 1, ventilate.
0:06:40 > 0:06:42Ventilate.
0:06:43 > 0:06:44Ventilate.
0:06:46 > 0:06:4820 miles from Paul's house,
0:06:48 > 0:06:52another man is suffering a cardiac arrest at his doctor's surgery.
0:06:53 > 0:06:55Two ambulances are on scene,
0:06:55 > 0:06:59and have requested urgent backup from an advanced paramedic.
0:06:59 > 0:07:01The problem is the only one available
0:07:01 > 0:07:04is stuck in heavy traffic in Central London -
0:07:04 > 0:07:0513 miles away.
0:07:10 > 0:07:13So 51-year-old male,
0:07:13 > 0:07:15now confirmed with an ambulance on scene
0:07:15 > 0:07:17saying the patient is in cardiac arrest
0:07:17 > 0:07:19and has had one shock delivered.
0:07:19 > 0:07:20Er...
0:07:24 > 0:07:25Oh, nightmare.
0:07:25 > 0:07:28There's no other way we can go at the moment.
0:07:28 > 0:07:31In a two-year period since becoming an advanced paramedic,
0:07:31 > 0:07:35I've done approaching 250 cardiac arrests.
0:07:35 > 0:07:37The average paramedic in London
0:07:37 > 0:07:40will attend between three to five in a year.
0:07:40 > 0:07:44Dan is sent to the more complex cardiac arrests,
0:07:44 > 0:07:47where his expertise can make the difference between life...and death.
0:07:47 > 0:07:50Even if we get a pulse back...
0:07:50 > 0:07:51that's actually the most difficult period
0:07:51 > 0:07:53for cardiac arrest management.
0:07:53 > 0:07:56And that's where my strengths certainly will come in.
0:07:56 > 0:08:00Chelsea? Can you call Romeo-101 on their Bravo set
0:08:00 > 0:08:02regarding that cardiac arrest, please?
0:08:02 > 0:08:06Romeo-101, hello, it's Chelsea on the APP desk.
0:08:07 > 0:08:08Chelsea is co-ordinating
0:08:08 > 0:08:10the advanced paramedics across London today.
0:08:11 > 0:08:14Give me a sec, I'll tell you exactly where he is.
0:08:14 > 0:08:16So he's still a little bit to you, but he's making good progress.
0:08:16 > 0:08:18Cheers, bye.
0:08:18 > 0:08:21That's one of the ambulance crew that are on the scene
0:08:21 > 0:08:23of this cardiac arrest that I've sent Dan to.
0:08:23 > 0:08:26They've got a pulse back on this patient,
0:08:26 > 0:08:27but they know that he's having an MI
0:08:27 > 0:08:30and he's got a blocked artery in his heart.
0:08:33 > 0:08:36Surviving a cardiac arrest is...
0:08:36 > 0:08:39I think you've got a one in ten chance or something like that.
0:08:39 > 0:08:40So the reality of running out,
0:08:40 > 0:08:43jumping up and down on someone's chest and shocking them,
0:08:43 > 0:08:45and everyone surviving like you see on TV,
0:08:45 > 0:08:46is actually pretty rare.
0:08:46 > 0:08:50It takes Dan 36 minutes to reach the scene.
0:08:52 > 0:08:55'You are acutely aware that you've got someone's life in the balance.
0:08:55 > 0:08:59'I think you have to have... kind of like tunnel vision.
0:08:59 > 0:09:01'Without sounding too cold about it,
0:09:01 > 0:09:04'you have to look at it as disease processes in front of you,
0:09:04 > 0:09:07'and try to avoid thinking about an individual
0:09:07 > 0:09:09'as a dad, as a son, as a member of someone's family.'
0:09:09 > 0:09:11Have we got any family members here at all?
0:09:11 > 0:09:13Yeah, yeah, yeah. They were made aware.
0:09:14 > 0:09:16Earlier this morning, the patient, Saeed,
0:09:16 > 0:09:18was walking his dog when he felt chest pains.
0:09:18 > 0:09:21He went to his GP surgery, where he collapsed.
0:09:24 > 0:09:26How we doing? Just the one shock?
0:09:26 > 0:09:28- Yeah, just one shock...- OK.
0:09:28 > 0:09:31- And what's his name?- Saeed.- Saeed.
0:09:31 > 0:09:33Obviously he's in a pretty fragile state
0:09:33 > 0:09:36so we just aim to keep him as flat as we possibly can.
0:09:36 > 0:09:37Minimal movement wherever we can,
0:09:37 > 0:09:39and bear in mind that when we start to roll him around,
0:09:39 > 0:09:42there's always the possibility he might re-arrest.
0:09:42 > 0:09:45SAEED MOANS Dan must stabilise Saeed
0:09:45 > 0:09:49before it is safe to transport him to a specialist heart attack centre.
0:09:49 > 0:09:51His level of consciousness is starting to come up.
0:09:51 > 0:09:53The problem with that is the whole time that happens,
0:09:53 > 0:09:56he's going to start to put more and more pressure
0:09:56 > 0:09:57on his fragile heart muscle.
0:09:57 > 0:10:01OK, cool. Going to give him this and then we're going to get going, guys.
0:10:01 > 0:10:02So can you just timestamp on this,
0:10:02 > 0:10:06press the "event" button, then just press "morphine" for me?
0:10:06 > 0:10:08SAEED GROANS
0:10:08 > 0:10:10All right, Saeed.
0:10:11 > 0:10:14I'm just going to go and have a quick word with his family.
0:10:14 > 0:10:16Are you all right getting him out on to the trolley bed
0:10:16 > 0:10:18- and just carrying on to the ambulance from now on?- Yeah.
0:10:18 > 0:10:20Hi, there, my name's Dan.
0:10:20 > 0:10:22I've come to assist the guys here at the moment.
0:10:22 > 0:10:25It all looks quite scary, but try to kind of reassure yourself
0:10:25 > 0:10:27that we're on top of this at the moment.
0:10:27 > 0:10:29Do one of you want to come in the ambulance,
0:10:29 > 0:10:31or will you follow up separately, or...?
0:10:31 > 0:10:33- If you can take her... - Yeah, certainly.
0:10:38 > 0:10:39All right, Saeed.
0:10:42 > 0:10:45Just keep reassuring him at the top end, that's awesome.
0:10:45 > 0:10:47SIREN WAILS
0:10:54 > 0:10:5825, 26, 27, 28, 29, 30.
0:10:58 > 0:11:01- COMPUTER:- 3, 2, 1, ventilate.
0:11:05 > 0:11:06I mean, we've had nothing at all.
0:11:06 > 0:11:08- Not a bleep, not even with adrenaline.- Yeah.
0:11:08 > 0:11:11What we have had so far, just...?
0:11:11 > 0:11:12- Yeah.- Yeah.
0:11:12 > 0:11:15In East London, Scott and Andy have been trying to resuscitate
0:11:15 > 0:11:17Dawn's brother Paul for 40 minutes.
0:11:20 > 0:11:23For us, its someone we've never met, but for the family,
0:11:23 > 0:11:24it's their loved one,
0:11:24 > 0:11:27they're the most important person in their life...
0:11:27 > 0:11:29MACHINE: Three, two, one...ventilate.
0:11:29 > 0:11:33..and they think that we can perform miracles.
0:11:35 > 0:11:39There comes a point where we can't do any more and we need to
0:11:39 > 0:11:41let the person pass peacefully.
0:11:46 > 0:11:48And he's not been seen since last night.
0:11:48 > 0:11:50You know, no other reversibles.
0:11:52 > 0:11:53Yeah, yeah, will do.
0:11:53 > 0:11:57It is a really difficult decision because you know the impact
0:11:57 > 0:12:00that it's going to have on people's lives, the family...
0:12:00 > 0:12:03It doesn't look like we're going to have much success.
0:12:03 > 0:12:05Hmm.
0:12:05 > 0:12:07I just need to speak with our clinical people,
0:12:07 > 0:12:09and talk about what's going to happen next, OK?
0:12:09 > 0:12:12- Yeah.- But erm, I should imagine we'll probably stop what we're doing.
0:12:12 > 0:12:14We've done everything we can for him and at the moment...
0:12:14 > 0:12:16He's passed away?
0:12:16 > 0:12:17It does seem that way.
0:12:22 > 0:12:24After 46 minutes,
0:12:24 > 0:12:28they decide there's nothing more that can be done for Paul.
0:12:40 > 0:12:43When we have to stop a resuscitation, sometimes the hardest
0:12:43 > 0:12:46bit of the whole process is gathering the family together and
0:12:46 > 0:12:49helping them to understand what's happened.
0:12:49 > 0:12:52The ambulance driver said it was quick...
0:12:56 > 0:12:58It was quick, you know.
0:13:00 > 0:13:04It might be that we've not managed to save the patient,
0:13:04 > 0:13:08but I think sometimes probably the most important thing we do is just
0:13:08 > 0:13:11to show a little bit of humanity and a little bit of kindness to
0:13:11 > 0:13:13the people that are left behind,
0:13:13 > 0:13:16cos they're the people that have got to deal with what's left.
0:13:20 > 0:13:22We're off now, sweetheart.
0:13:22 > 0:13:24- Thank you so much. - All right.
0:13:24 > 0:13:26You've been so helpful. I really appreciate it.
0:13:26 > 0:13:29- Thank you.- You know if there's anything you need or anything,
0:13:29 > 0:13:30you can always call, you know,
0:13:30 > 0:13:32if you find yourself in a bit of a crisis.
0:13:32 > 0:13:33- OK.- All right?- Thank you so much.
0:13:33 > 0:13:36- All right? We're very sorry. - Thank you.
0:13:38 > 0:13:41Thank you. Thank you.
0:13:49 > 0:13:50All right, Saeed?
0:13:50 > 0:13:52We're at the hospital now, Saeed.
0:13:54 > 0:13:57Do you want to follow us? Yeah, you follow us through, yeah, definitely.
0:13:57 > 0:13:59Sorry, what was your name?
0:13:59 > 0:14:01- Sufi.- Sufi?
0:14:01 > 0:14:04An hour and 20 minutes after going into cardiac arrest at his
0:14:04 > 0:14:08doctor's surgery, Saeed's been brought five miles to one of
0:14:08 > 0:14:11London's specialist heart attack centres.
0:14:12 > 0:14:15Hang on, I'm just going to check the pulse.
0:14:15 > 0:14:18Just check for a pulse a second, guys.
0:14:18 > 0:14:20You got a pulse?
0:14:23 > 0:14:24Have you got a pulse?
0:14:25 > 0:14:28Hang on, let's get him out the lift.
0:14:28 > 0:14:31Just into this area here for a second.
0:14:31 > 0:14:34Just pop that down on the floor.
0:14:34 > 0:14:36Hang on.
0:14:39 > 0:14:41Yeah, he's got a good pulse.
0:14:41 > 0:14:43So just get that back onto his face and just actually hold it
0:14:43 > 0:14:45- like that, cos it's... - Hold it just like that?
0:14:45 > 0:14:48No, no, no, hold it like you had it before.
0:14:48 > 0:14:49OK, cool. Ready, brace, lift.
0:14:51 > 0:14:53Hang on, hang on.
0:14:53 > 0:14:56Just one second, cos I need to get these straps off. OK, cool.
0:14:59 > 0:15:01SAEED GROANS
0:15:03 > 0:15:06Obviously the pressure's on to get this in and get... Here we go,
0:15:06 > 0:15:08so the dye's going in now.
0:15:08 > 0:15:12Over the next hour, the cardiac surgeon will remove the blockage
0:15:12 > 0:15:15from Saeed's artery and insert a stent to keep it open.
0:15:18 > 0:15:21I think luck does play a part in people's lives.
0:15:21 > 0:15:24Having your cardiac arrest in a GP's surgery, where there's
0:15:24 > 0:15:26a defibrillator and a trained medical professional is
0:15:26 > 0:15:28probably the luckiest you're going to get.
0:15:31 > 0:15:35In the city today, the ambulance service has dealt
0:15:35 > 0:15:37with 26 cardiac arrests -
0:15:37 > 0:15:39they've saved the lives of four of them.
0:15:50 > 0:15:52Are you scared of dying?
0:15:52 > 0:15:56It's not really something I've ever given really much thought about.
0:15:56 > 0:15:58I wonder if this job changes... Because we do see
0:15:58 > 0:16:00quite a lot of death.
0:16:00 > 0:16:02I think it does.
0:16:02 > 0:16:06I know this might sound really soft...but I think because
0:16:06 > 0:16:08- I understand that, you know, life's quite fragile...- Huh-uh.
0:16:08 > 0:16:10- ..and we could go at any time... - Yeah.
0:16:10 > 0:16:12- And because my boys are sort of spread...- Uhmm.
0:16:12 > 0:16:15- ..a little bit and everything else...- Yeah.
0:16:15 > 0:16:17..every time I speak to them, I always make sure I tell 'em
0:16:17 > 0:16:18- I love 'em.- Yeah.
0:16:18 > 0:16:21- And I think that has definitely changed...- Uh-huh.
0:16:21 > 0:16:22..since I've been doing this.
0:16:22 > 0:16:25You know, with this job, at some point, you're going to see it.
0:16:25 > 0:16:28You know, if you work in an office, you know, the biggest thing
0:16:28 > 0:16:31- you've got to worry about is your pen running out.- Yeah.
0:16:38 > 0:16:42Well, I checked the ponds last night and there is not a tadpole in sight.
0:16:42 > 0:16:45- Is there not? - No, my fish have eaten them all.
0:16:45 > 0:16:46Really?
0:16:46 > 0:16:50I'm devastated. I'm not going to be a mum to frogs this year.
0:16:53 > 0:16:54How many?
0:16:59 > 0:17:00It looks like it's a care home.
0:17:00 > 0:17:02A resident has assaulted a member of staff.
0:17:02 > 0:17:05That member of staff has been stabbed and is in a bad way.
0:17:05 > 0:17:08The police have reported that one of them may be in cardiac arrest.
0:17:08 > 0:17:09They want two ambulances.
0:17:09 > 0:17:13'When we get a major trauma job, they're always quite heavily
0:17:13 > 0:17:16'resourced because we know we may have multiple patients and
0:17:16 > 0:17:19'you can deplete your resources quite quickly.
0:17:19 > 0:17:23'You suddenly find your stress level ramps up a gear.'
0:17:23 > 0:17:26Two patients at the care home are suffering major trauma and
0:17:26 > 0:17:30blood loss, and multiple crews are needed on scene.
0:17:30 > 0:17:34All available ambulances in the area are dispatched.
0:17:40 > 0:17:43Right, sorry, but I've got to cancel them.
0:17:43 > 0:17:46There's quite a lot of crews at the moment, but there's
0:17:46 > 0:17:49a larger incident, but obviously while that's going on,
0:17:49 > 0:17:51calls are still incoming for the area.
0:17:51 > 0:17:54Now I've got a red call...
0:17:55 > 0:17:5712 miles from the stabbing at the care home,
0:17:57 > 0:18:01another life-threatening emergency is in progress in East London.
0:18:06 > 0:18:08Seen it.
0:18:08 > 0:18:09Chelsea needs to quickly assesses
0:18:09 > 0:18:12whether she has an advanced paramedic available.
0:18:13 > 0:18:15HEMS as well, here we go - boom.
0:18:15 > 0:18:17DIALLING
0:18:17 > 0:18:20- AUTOMATED VOICE:- Incident updated.
0:18:20 > 0:18:23Three people have been shot, one in the leg, one in the back.
0:18:25 > 0:18:28Dan, its Chelsea. Your next job is a shooting.
0:18:28 > 0:18:30Two patients, HEMS are also attending.
0:18:30 > 0:18:33I'll confirm the RVP with you shortly.
0:18:33 > 0:18:36Yeah, roger, that's all received. It's right next to my flat.
0:18:38 > 0:18:40Dan is 12 minutes away.
0:18:40 > 0:18:42Two ambulances,
0:18:42 > 0:18:45a first-response car and the air ambulance are also en route.
0:18:57 > 0:18:59'If a bullet enters your leg, the difference between a couple
0:18:59 > 0:19:02'of millimetres either side of one of the largest vessels in your body,
0:19:02 > 0:19:04'is the difference between you living
0:19:04 > 0:19:07'and potentially bleeding to death in the back of an ambulance or
0:19:07 > 0:19:08'before an ambulance even gets to you.'
0:19:08 > 0:19:10So the clock is ticking.
0:19:28 > 0:19:31'The very nature of these calls is they tend to be pretty chaotic.
0:19:31 > 0:19:34'There's always the possibility that there's someone still running
0:19:34 > 0:19:36'around with a gun or a knife.
0:19:36 > 0:19:38'The people that are involved in this incident were all running
0:19:38 > 0:19:40'around and screaming and shouting,
0:19:40 > 0:19:43'they're massively adrenalized and scared as well.'
0:19:43 > 0:19:45Cool, how we doing?
0:19:45 > 0:19:48'I may give off a certain air of calm, but, underneath, my heart's
0:19:48 > 0:19:51'going as fast as everyone else's.'
0:19:51 > 0:19:55While the air ambulance crew deal with the man shot in the back,
0:19:55 > 0:19:57Dan, as the most senior paramedic on scene,
0:19:57 > 0:19:59takes charge of the other victim.
0:19:59 > 0:20:01How we doing?
0:20:01 > 0:20:04This guy's got, erm, shot in the leg.
0:20:04 > 0:20:06Was he shot in the car or... Do we know where it's all happened?
0:20:06 > 0:20:08No, outside the car, he got put in the car.
0:20:08 > 0:20:11- And it's...- Single gunshot wound exactly there...
0:20:11 > 0:20:13- OK.- ..and no exit wound.- No exit wound, thank you.
0:20:13 > 0:20:17Can you see the bullet anywhere near the surface, or anything like that, at all?
0:20:17 > 0:20:18I'll find it in a second.
0:20:18 > 0:20:22- And we've got no idea, at the moment, what he's been shot with? - Er, no.- OK, cool. Right...
0:20:22 > 0:20:25- That's my brother! - Yeah, well, let's get you... Listen,
0:20:25 > 0:20:28- let's get you in the ambulance first.- I want my brother!
0:20:28 > 0:20:30I know, we'll get you in the ambulance first, mate, all right?
0:20:30 > 0:20:32We've got one wound, erm, a single entry,
0:20:32 > 0:20:34no exit wound on the back of his thigh.
0:20:34 > 0:20:37No obvious underlying haematoma at all. Yeah.
0:20:37 > 0:20:39I'm not going to undress it, but I want just
0:20:39 > 0:20:40a quick look at your leg, mate.
0:20:40 > 0:20:42Right.
0:20:42 > 0:20:46I think we'll go and we'll do everything kind of en route.
0:20:46 > 0:20:47Yeah.
0:20:47 > 0:20:50So the kind of things we're kind of worrying about - where that
0:20:50 > 0:20:54wound is, cos obviously you've got a big blood vessel that kind of runs up the inside of your thigh,
0:20:54 > 0:20:57but it doesn't appear to be actively involved with that at the moment.
0:20:57 > 0:20:59Right, cool.
0:20:59 > 0:21:01No, no, no...
0:21:03 > 0:21:04What's this scar from?
0:21:07 > 0:21:09Did you?
0:21:11 > 0:21:14So you just take it nice and easy mate, yeah?
0:21:14 > 0:21:176-2...
0:21:17 > 0:21:20Yeah, Dan, go ahead with your report.
0:21:20 > 0:21:24Yeah, can I put a blue call in to the Royal London when you're read details?
0:21:24 > 0:21:27We've got a 22-year-old male, erm, with a single gunshot wound
0:21:27 > 0:21:31at the back of his... ..And rear of his right thigh.
0:21:31 > 0:21:35We've got an entry wound going in, with no exit wound seen.
0:21:35 > 0:21:38I'm about to give him some morphine for analgesia,
0:21:38 > 0:21:40but no further drugs administered... Understood?
0:21:40 > 0:21:42And we've got an ETA of approximately 15 minutes,
0:21:42 > 0:21:45this is going to be the second patient, following the HEMS patient
0:21:45 > 0:21:48- that I believe is just ahead of us. - Yeah, no worries.
0:21:48 > 0:21:51This is just a bit of morphine. You might feel a bit of cold in your arm.
0:21:51 > 0:21:54All right, I can give you more of this but obviously I can't take it away.
0:21:54 > 0:21:56So I can always keep topping it up buddy, all right?
0:21:56 > 0:21:59Listen, all your numbers that we're looking at are really good,
0:21:59 > 0:22:00so there's nothing to suggest
0:22:00 > 0:22:02you're bleeding heavily in your legs.
0:22:02 > 0:22:04I know it hurts, all right, and I'm giving you stuff
0:22:04 > 0:22:07and I can give you some more for that on the way, all right?
0:22:07 > 0:22:08I know it's really... Huh?
0:22:10 > 0:22:12I know, mate.
0:22:12 > 0:22:13Mate, don't be brave about it.
0:22:13 > 0:22:15I can give you plenty more, so that's not a problem, all right?
0:22:15 > 0:22:18I know, I know, so to start off with,
0:22:18 > 0:22:21you're going to have lots and lots of adrenaline running around you.
0:22:21 > 0:22:23But that adrenalin's going to start to wear off.
0:22:23 > 0:22:25Yeah, I know.
0:22:25 > 0:22:27Did you see what you were shot with?
0:22:27 > 0:22:29Was it a hand gun, was it?
0:22:29 > 0:22:31- I think it was a shit gun. - Right, a shotgun?
0:22:31 > 0:22:32A shit.
0:22:32 > 0:22:35Oh, shit gun, sorry, OK, yeah.
0:22:35 > 0:22:38- Was it pretty close-range, then, was it?- Yeah.- Yeah, OK.
0:22:39 > 0:22:43We're not far now, mate. Probably a couple of minutes.
0:22:43 > 0:22:44- Is the pain still there at the moment?- Yeah.
0:22:44 > 0:22:46Yeah, let me give you a little bit more, mate,
0:22:46 > 0:22:49cos obviously when that adrenaline starts to wear off...
0:23:35 > 0:23:38'It's not my concern to think about what this person has done
0:23:38 > 0:23:42'or not done to end up in the back of my ambulance.
0:23:43 > 0:23:45'I don't want to know what's happened prior to me arriving
0:23:45 > 0:23:49'and that way I can impartially treat everyone that's involved.
0:23:51 > 0:23:54'I went to the Lee Rigby job and we didn't know what had happened.
0:23:54 > 0:23:57'We thought it was just some gang thing, so we treated the two
0:23:57 > 0:24:01'that killed him and it was only when we got back that someone went,
0:24:01 > 0:24:05'"Put Sky News on," when we realised what had happened.
0:24:05 > 0:24:06'I'm glad I didn't know.'
0:24:11 > 0:24:13Lovely, all right, mate.
0:24:18 > 0:24:22The East London shooting is just one of eight major trauma cases
0:24:22 > 0:24:24currently in progress,
0:24:24 > 0:24:27all requiring multiple crews on scene.
0:24:27 > 0:24:30In the control centre, they're struggling to find ambulances
0:24:30 > 0:24:33for the new high priority calls coming in.
0:24:33 > 0:24:35If anybody can please assist us
0:24:35 > 0:24:37with any of the following emergency calls -
0:24:37 > 0:24:39chest pain in Thornton Heath,
0:24:39 > 0:24:42a chest pain in Biggin Hill,
0:24:42 > 0:24:45an unresponsive person in Croydon...
0:24:45 > 0:24:48The allocators must appeal to crews to make themselves available
0:24:48 > 0:24:51for the next patient as quickly as possible.
0:24:51 > 0:24:53I was talking to 17, 18,
0:24:53 > 0:24:56still looking for an ambulance, please, for a category four, SE1.
0:24:56 > 0:24:57I'm afraid the cupboard is bare.
0:24:57 > 0:24:59SHE EXHALES
0:24:59 > 0:25:01'There can be times it makes you nervous.'
0:25:01 > 0:25:05I was on duty on July 7th 2005 and there's always that thought
0:25:05 > 0:25:06in the back of your mind,
0:25:06 > 0:25:08"What is the next call going to be?"
0:25:21 > 0:25:25What the flipping heck is going on today?
0:25:25 > 0:25:27We've now got two people stabbed,
0:25:27 > 0:25:31an 18-year-old male in the stomach and somebody else.
0:25:31 > 0:25:36You're in your school uniform, stabbing other students, God.
0:25:37 > 0:25:42Chelsea's coordinating three advanced paramedics across London.
0:25:42 > 0:25:45Two are currently busy treating patients.
0:25:45 > 0:25:48Dan is at the hospital with the shooting victim
0:25:48 > 0:25:51and the other with a man who's in cardiac arrest
0:25:51 > 0:25:52at King's Cross Station.
0:25:54 > 0:25:57Chelsea must decide whether to commit the only other one available
0:25:57 > 0:26:02to support the regular crews at the stabbing call that's just come in.
0:26:02 > 0:26:05When you've got a limited number of vehicles
0:26:05 > 0:26:07and plenty of calls coming in,
0:26:07 > 0:26:10you have to decide, "Right, who's the sickest?
0:26:10 > 0:26:12"Who am I hedging my bets with here?"
0:26:12 > 0:26:14Tell me exactly what's happened there.
0:26:16 > 0:26:17Oh, my God, there's another hanging.
0:26:34 > 0:26:35I've just sent AP60.
0:26:36 > 0:26:40Chelsea decides to dispatch her last available advanced paramedic
0:26:40 > 0:26:42to the hanging, while an air ambulance crew
0:26:42 > 0:26:45deal with the schoolboys who've been stabbed.
0:26:48 > 0:26:50- 'I'm worried as well.'- OK.
0:26:56 > 0:26:58Er...
0:26:58 > 0:27:00At the moment, the best thing we can do for this patient
0:27:00 > 0:27:03is to cut him down, because until he's cut down,
0:27:03 > 0:27:06we can't start doing resuscitation on him.
0:27:06 > 0:27:08'I can completely understand he wouldn't want to go back in.'
0:27:08 > 0:27:10It's quite an ask for a member of the public
0:27:10 > 0:27:12who's never seen anything like that before.
0:27:17 > 0:27:20I understand, I do understand that you're worried, my love...
0:27:20 > 0:27:24You do need to do this. You have to help us until we can get to him.
0:27:24 > 0:27:26No, listen to me, sir,
0:27:26 > 0:27:28it's so critical that we try and cut him down.
0:27:28 > 0:27:31It's the only way that we're going to be able to try and save his life.
0:27:34 > 0:27:36Is the ambulance with you?
0:27:36 > 0:27:37- 'Yeah, yeah.'- Can you see them?
0:27:37 > 0:27:39- 'Yeah, yeah.'- All right, my love.
0:27:39 > 0:27:42I'll leave you with the paramedics. Thank you, bye-bye.
0:27:42 > 0:27:44SHE EXHALES
0:27:44 > 0:27:46It's gone crazy this afternoon.
0:27:48 > 0:27:50Absolutely crazy.
0:27:50 > 0:27:52- Chelsea?- Got it.
0:27:52 > 0:27:54Thank you.
0:27:54 > 0:27:56A call has come in for a man
0:27:56 > 0:27:59who's reported to have fallen from height.
0:27:59 > 0:28:01At the Royal London Hospital,
0:28:01 > 0:28:04advanced paramedic Dan has just finished handing over his patient
0:28:04 > 0:28:05who had been shot.
0:28:06 > 0:28:08Dan?
0:28:08 > 0:28:11- AP62?- Are you in a position at all to go green for a call?
0:28:11 > 0:28:14- Yeah, yeah. Yeah, yeah.- Great. - I'm listening, yeah, go on.
0:28:14 > 0:28:16A gentleman who's reported to have jumped
0:28:16 > 0:28:18from the ninth floor of a hotel.
0:28:18 > 0:28:21Great, and at the minute you're the only resource dispatched.
0:28:21 > 0:28:22Yeah, no worries, yeah. Leaving.
0:28:22 > 0:28:24The ninth floor, 600 foot.
0:28:24 > 0:28:26OK, yeah, leave me on it, mate.
0:28:26 > 0:28:28Yeah, will do. Cheers, bye-bye.
0:28:28 > 0:28:29Bye-bye, bye-bye.
0:28:29 > 0:28:31- INTERVIEWER:- What's happened?
0:28:31 > 0:28:35Er, so someone has jumped off a building from the ninth floor,
0:28:35 > 0:28:37so they're sending me at the moment.
0:28:39 > 0:28:42No other ambulances are available in the area,
0:28:42 > 0:28:45so Dan takes the two at the hospital who are just finishing up
0:28:45 > 0:28:46with the double shooting.
0:28:46 > 0:28:48HEMS are currently not available.
0:28:52 > 0:28:54He doesn't appear to be breathing, is what we've been told,
0:28:54 > 0:28:55and he's not responding.
0:28:55 > 0:28:57With a... With a head injury.
0:28:57 > 0:28:59SIREN WAILS
0:28:59 > 0:29:02'Even if something sounds hopeless, if we get there early enough,
0:29:02 > 0:29:08'there is always a minute chance that we can do something about it.'
0:29:09 > 0:29:12It's going to be down here somewhere, I'd imagine.
0:29:12 > 0:29:14'I don't want to be the person that thinks "if only.
0:29:14 > 0:29:18'"If only I'd tried, if only I'd checked for more injuries,"
0:29:18 > 0:29:21'I don't want that "if only" sort of hanging over me.'
0:29:21 > 0:29:23Is there any obvious kind of brain matter anywhere
0:29:23 > 0:29:25- that you can see, or...?- No.
0:29:27 > 0:29:30- OK. Are you happy for me to move him?- Yeah, yeah.
0:29:33 > 0:29:36I'll just put the pads on him. I think realistically...
0:29:38 > 0:29:40I mean, this is...
0:29:40 > 0:29:41He's got massive chest injuries.
0:29:48 > 0:29:51Pupils are fixed and dilated.
0:29:51 > 0:29:53We've got blood coming out of there, we've got no pulse.
0:29:53 > 0:29:54He is...he's deceased.
0:29:54 > 0:29:56We'll get a time officially off this as well.
0:29:56 > 0:29:58I take it this has literally just happened, hasn't it?
0:29:58 > 0:30:00- We're declaring at 17... - 17:12, yeah.
0:30:02 > 0:30:05Yeah, AP62, just a quick update when you're ready for details.
0:30:05 > 0:30:07Yeah, I'm ready, Dan, go ahead.
0:30:07 > 0:30:10Erm, he has got injuries incompatible with life
0:30:10 > 0:30:14and we have recognised life extinct at 17:12.
0:30:14 > 0:30:16Er, plenty of police officers on the scene.
0:30:16 > 0:30:18Yeah, roger that.
0:30:18 > 0:30:20Recognition of life extinct, 17:12.
0:30:20 > 0:30:22Injuries incompatible with life. Thanks.
0:30:22 > 0:30:25Thank you, mate, I'll call you shortly.
0:30:26 > 0:30:28Blimey, OK.
0:30:31 > 0:30:33'By the very nature of what I do,
0:30:33 > 0:30:36'there is every chance that I'm going to pronounce someone dead
0:30:36 > 0:30:37'at least once a shift.
0:30:38 > 0:30:41'It has now become the norm for me.
0:30:44 > 0:30:47'That's not to be confused with saying I'm used to it.
0:30:47 > 0:30:49'I don't think you should ever become used to it,
0:30:49 > 0:30:51'because then something's a bit broken inside you.
0:30:51 > 0:30:55'But it's important to accept that it's part of the norm for my job,
0:30:55 > 0:30:57'and you build up a level of resilience
0:30:57 > 0:31:01'that you don't become too attached to that individual
0:31:01 > 0:31:04'because the next call is inevitably going to be
0:31:04 > 0:31:07'just as critical as the one I've just attended.'
0:31:16 > 0:31:18WOMAN GROANS IN PAIN
0:31:20 > 0:31:22INDISTINCT
0:31:22 > 0:31:24It's all done.
0:31:25 > 0:31:28Monday morning and across the city,
0:31:28 > 0:31:31all 408 crews on shift are working at full capacity.
0:31:35 > 0:31:37- You all right?- Yeah.
0:31:37 > 0:31:40We don't offer brandies, I'm afraid, otherwise I'd give you one.
0:31:40 > 0:31:42He looks like he needs one, doesn't he?
0:31:42 > 0:31:43SHE CHUCKLES
0:31:43 > 0:31:46I understand that you've never done it before.
0:31:46 > 0:31:48If the baby is ready to come,
0:31:48 > 0:31:51we're going to have to help your wife.
0:31:51 > 0:31:52In the control centre,
0:31:52 > 0:31:55the past two hours have seen an unexpected spike
0:31:55 > 0:31:57in life-threatening red calls.
0:31:58 > 0:32:00Steph, can we have a report from the IRO
0:32:00 > 0:32:02on that hanging one, please, love?
0:32:02 > 0:32:05Stay on the line, I'll tell you exactly what to do next, OK?
0:32:05 > 0:32:08We've also got another one there, 87-year-old not breathing.
0:32:08 > 0:32:13You do think to yourself that absolutely every resident of London
0:32:13 > 0:32:15has picked up the phone.
0:32:15 > 0:32:19We have a whole department of people looking into trends
0:32:19 > 0:32:22and sometimes it is just everybody gets sick.
0:32:22 > 0:32:24With critical calls stacking up,
0:32:24 > 0:32:26they're running out of ambulances.
0:32:28 > 0:32:31You don't really want to see any yellow on the map.
0:32:31 > 0:32:33We've got quite a big portion of London
0:32:33 > 0:32:35that's not got any cover at the moment.
0:32:35 > 0:32:37The patient has been on the floor for 50 minutes
0:32:37 > 0:32:40waiting for an ambulance to become available.
0:32:40 > 0:32:43We just don't have enough ambulances.
0:32:44 > 0:32:47And there's still no let-up in new calls coming in.
0:33:46 > 0:33:47CALLER SOBS
0:33:55 > 0:33:59- Surge purple enhanced. - Purple enhanced.
0:33:59 > 0:34:02With a new emergency call now coming in every 12 seconds,
0:34:02 > 0:34:06they're at risk of not reaching them all in time.
0:34:06 > 0:34:10Senior clinicians decide they must escalate to a state
0:34:10 > 0:34:12known as "surge purple enhanced".
0:34:13 > 0:34:16We're struggling to provide a safe response to London.
0:34:16 > 0:34:19We have to start making sure we're getting to the sickest quickest
0:34:19 > 0:34:22and we have to say "no" or "not yet"
0:34:22 > 0:34:26to those who aren't as seriously ill or injured.
0:34:26 > 0:34:28OK, so based on the information that you've provided,
0:34:28 > 0:34:31we have assessed that an emergency ambulance is not required
0:34:31 > 0:34:34at this moment because you need a further assessment.
0:34:34 > 0:34:36We have to start being a lot more ruthless
0:34:36 > 0:34:38with the calls that we're holding.
0:34:38 > 0:34:40We refer people to the 111 service,
0:34:40 > 0:34:43we start advising people that they should be contacting their GP
0:34:43 > 0:34:46or, if they're able to do so, make their own way to an A&E department.
0:34:46 > 0:34:50..cos at the moment, we don't need to send you an emergency ambulance.
0:34:50 > 0:34:54Once you ring 111, and you give them that information,
0:34:54 > 0:34:56they will assess you and if they feel that they need
0:34:56 > 0:34:59to provide transport, they'll automatically do that for you.
0:34:59 > 0:35:04No, I understand that, OK, that's why I'm arranging this help for you
0:35:04 > 0:35:05but at the moment,
0:35:05 > 0:35:08an emergency ambulance is not required for yourself.
0:35:08 > 0:35:10Well, give...
0:35:11 > 0:35:13He's hung up on me.
0:35:13 > 0:35:16It can be really difficult telling someone,
0:35:16 > 0:35:20"No, sorry, we're not sending you an ambulance."
0:35:20 > 0:35:22OK, who's in the house with you?
0:35:22 > 0:35:25You can have people calling for help for their loved ones
0:35:25 > 0:35:28or for themselves but we haven't got the vehicles or the staff
0:35:28 > 0:35:35so that can be difficult and you do feel quite...heartless sometimes.
0:35:37 > 0:35:40Only 15 ambulances are currently available
0:35:40 > 0:35:43for the 8.5 million people of London.
0:35:48 > 0:35:50And now a life-threatening call is coming in.
0:35:50 > 0:35:53DEVICE BLARES
0:35:53 > 0:35:55Oh, I know where we're going. Cool.
0:36:01 > 0:36:04The last remaining crews in the area are dispatched.
0:36:13 > 0:36:17Is he breathing, Mo? Shall we get him down off the steps, mate?
0:36:17 > 0:36:19Just start bagging him up first
0:36:19 > 0:36:21and then we'll get him moving once the crew's here.
0:36:23 > 0:36:26Cool. So, it looks to me, opiate overdose as given.
0:36:26 > 0:36:28Yeah, we'll get him down and get him off the steps.
0:36:28 > 0:36:30Careful, everyone. Careful, careful, careful.
0:36:30 > 0:36:32OK, keep going, keep going, keep going, keep going.
0:36:32 > 0:36:33OK, that'll do.
0:36:33 > 0:36:36Mind his head, mind his head. Cool, OK, so we'll start bagging him.
0:36:36 > 0:36:37We'll need some Narcan.
0:36:37 > 0:36:39Just see what his veins are like first of all.
0:36:39 > 0:36:40They're not horrendous.
0:36:40 > 0:36:44No, they're not awful, so just be aware of sharps, guys.
0:36:46 > 0:36:50I've got some Narcan here which I'll draw up for you.
0:36:50 > 0:36:52- You happy at the top end still, guys?- Yeah.- Yeah.
0:36:52 > 0:36:54Chest ain't moving...
0:36:54 > 0:36:58Dan administers a drug, Narcan, that reverses the effects of the heroin.
0:36:59 > 0:37:02So he's had 400, I'll give him another 400 in a minute.
0:37:02 > 0:37:03I'm hearing his respiratory...
0:37:03 > 0:37:05Yeah, we've got a pulse.
0:37:05 > 0:37:07Open your eyes for us, fella. Hello, mate, how you doing?
0:37:07 > 0:37:11- MAN GROANS - Hello, mate. Just lie still for a minute, fella.
0:37:11 > 0:37:15Just lie still for a minute. Shall we just get a 100% mask?
0:37:15 > 0:37:17Just lie still for me, fella, lie still for me.
0:37:19 > 0:37:23- You've overdosed, fella.- Eh? - You've overdosed.
0:37:23 > 0:37:25Yeah?
0:37:25 > 0:37:26Yeah.
0:37:27 > 0:37:29Yeah? You're all right?
0:37:29 > 0:37:30So, my name's Dan, I'm a paramedic
0:37:30 > 0:37:34and these guys all around you are paramedics too as well, OK?
0:37:34 > 0:37:35So just relax.
0:37:35 > 0:37:37Just get them in as soon as we can, yeah?
0:37:37 > 0:37:40Do it on that arm. All right, buddy? Do it on that arm.
0:37:42 > 0:37:45Not sure. We found you up on the steps, mate,
0:37:45 > 0:37:47so we're just going to give you a little bit of oxygen.
0:37:47 > 0:37:52Just leave that one on cos that's just measuring it. All right, buddy?
0:37:52 > 0:37:53What's your name?
0:37:54 > 0:37:56OVERLAPPING CONVERSATIONS
0:37:56 > 0:37:59Emergency ambulance, what's the address of the emergency?
0:37:59 > 0:38:01We're going to be with you as soon as we can, OK?
0:38:01 > 0:38:03I do need to advise you, though, it may take up to an hour
0:38:03 > 0:38:07for an ambulance to be dispatched because we are very busy.
0:38:07 > 0:38:10No, we haven't actually got any units at the moment to send to you.
0:38:10 > 0:38:14Yeah, it may take up to an hour because we're very busy.
0:38:14 > 0:38:17It will be as soon as we can, though. It will be...
0:38:18 > 0:38:20I under...
0:38:20 > 0:38:23I understand that it's an emergency
0:38:23 > 0:38:25and we always get there as soon as we can,
0:38:25 > 0:38:28it's just because we're very busy at the moment.
0:38:30 > 0:38:34RADIO MESSAGE
0:38:34 > 0:38:38Shaney and Gary have just finished treating a patient with a bad cut...
0:38:38 > 0:38:41- SIRENS BLARE - One in, one out.
0:38:41 > 0:38:43..and already they've been dispatched to the home of
0:38:43 > 0:38:48an 88-year-old man with dementia whose condition is deteriorating.
0:38:48 > 0:38:49I think it's just right here.
0:38:49 > 0:38:53- Royal Free's now getting busy. - Is Royal Free busy as well?
0:38:53 > 0:38:55Waiting times of up to 60 minutes.
0:39:01 > 0:39:03DOGS BARK
0:39:03 > 0:39:05- Hello.- Hello.
0:39:05 > 0:39:07Have we come for you?
0:39:09 > 0:39:12We haven't done anything yet, don't be thanking us just yet.
0:39:12 > 0:39:14And what's happened today? Why...?
0:39:19 > 0:39:21He appears to be struggling a bit?
0:39:36 > 0:39:38Sir? Hello.
0:39:40 > 0:39:43- I'm fine, how are you? - Thank you.
0:39:43 > 0:39:47Your wife's very worried about you so what we're going to do is
0:39:47 > 0:39:51we're going to pop you downstairs, get you on the ambulance,
0:39:51 > 0:39:55all right, and take you to hospital, OK?
0:39:55 > 0:39:56HE COUGHS WHEEZILY
0:39:56 > 0:39:59- Oh, dear. - WOMAN SOBBING:- I don't want it...
0:39:59 > 0:40:01Oh, darling, don't worry, it's all right.
0:40:01 > 0:40:02SHE SOBS
0:40:02 > 0:40:06- Sweetheart, listen, OK?- Please...
0:40:06 > 0:40:09Listen, if he's not very well, he's not very well, is he?
0:40:09 > 0:40:13All right? You've done the right thing by calling us. OK?
0:40:17 > 0:40:20Oh, whoa, there'll be no talk of that.
0:40:20 > 0:40:23There'll be no talk of that, far too much paperwork to do.
0:40:23 > 0:40:27- No talk of that. Let's get him back up the hospital.- Yes.
0:40:27 > 0:40:29That's a nice hat and scarf.
0:40:30 > 0:40:32Is that all right?
0:40:33 > 0:40:34Not at all, my lovely.
0:40:36 > 0:40:38I know.
0:40:39 > 0:40:41(Oh, gosh.)
0:40:42 > 0:40:44He's not fat, but he's quite tall and heavy
0:40:44 > 0:40:46and that's what I'm worried about.
0:40:46 > 0:40:50- That lift's not big enough for a stretcher, is it?- No.
0:40:50 > 0:40:54..202, the patient is not weight-bearing at all.
0:40:54 > 0:40:57And we're just getting him into the chair and then onto the bed
0:40:57 > 0:40:59so it's going to be a difficult lift. Over.
0:40:59 > 0:41:03- RADIO:- Yeah, roger that. Absolutely. Don't be doing yourself an injury.
0:41:03 > 0:41:07Could you get another crew running on this call,
0:41:07 > 0:41:09preferably a double crew? Over.
0:41:09 > 0:41:12- RADIO:- Sorry, mate. Currently no.
0:41:21 > 0:41:26In East London, three crews are still with their overdose patient...
0:41:26 > 0:41:29Do you know where you are, buddy?
0:41:29 > 0:41:31Tell me where you are.
0:41:31 > 0:41:33..and Dan's drugs are working their magic.
0:41:36 > 0:41:39OK, don't worry, it's just... That's all right, you can put it back in.
0:41:39 > 0:41:42No, don't worry. We've had to give you a little bit of that already.
0:41:42 > 0:41:44You've already had some cos that's what's woken you.
0:41:44 > 0:41:46You weren't really breathing properly.
0:41:46 > 0:41:48Well, you were barely breathing at all...
0:41:48 > 0:41:50so we've got some oxygen on at the moment
0:41:50 > 0:41:52and we've obviously had to give you some of the naloxone.
0:41:54 > 0:41:57You are at the moment but obviously you know probably full well
0:41:57 > 0:42:00that the drug we've given you wears off a lot quicker.
0:42:00 > 0:42:02We're going to get you up onto our trolley bed in a minute.
0:42:02 > 0:42:05Listen, we just need to get you on the ambulance
0:42:05 > 0:42:07so we can do some checks on you.
0:42:07 > 0:42:09Yeah, well, you are at the moment but because of what we've given you,
0:42:09 > 0:42:12you know full well that wears off quicker
0:42:12 > 0:42:14than the heroin that you've taken.
0:42:15 > 0:42:18'There's always the chance that if he wanders off without our help,
0:42:18 > 0:42:21'he could go back into respiratory depression and respiratory arrest
0:42:21 > 0:42:23'so he could overdose again.'
0:42:23 > 0:42:26Let's just put some oxygen on you, buddy.
0:42:27 > 0:42:29Just sit yourself up, fella.
0:42:29 > 0:42:30There we go.
0:42:32 > 0:42:33Right.
0:42:34 > 0:42:36'They never thank you for saving their lives.
0:42:36 > 0:42:37'As soon as you start waving syringes around,
0:42:37 > 0:42:39'they know what you've done
0:42:39 > 0:42:41'and they don't want you to give them any more.'
0:42:41 > 0:42:43However they've paid for it, they got their hit
0:42:43 > 0:42:45and if you turn up and ruin it by administering the drug,
0:42:45 > 0:42:47they don't particularly like it, so...
0:42:49 > 0:42:52You understand the potential of you walking away here is that
0:42:52 > 0:42:55you could overdose again and stop breathing, you understand that?
0:42:56 > 0:42:59Yeah, I know you've no intention but you have to understand
0:42:59 > 0:43:00and you need to repeat it back to me.
0:43:02 > 0:43:03Yeah?
0:43:07 > 0:43:08Fantastic, right.
0:43:10 > 0:43:12Well, sorry, mate,
0:43:12 > 0:43:14cos we thought you were in cardiac arrest at the time.
0:43:14 > 0:43:16- I'm sorry about that. - Can you sign there?
0:43:18 > 0:43:21Cos you weren't breathing and you were blue.
0:43:21 > 0:43:23To all intents and purposes, you were dead.
0:43:25 > 0:43:28'You can become very angry and very disillusioned doing this job
0:43:28 > 0:43:31'if you got judgmental with every single patient.
0:43:32 > 0:43:36'My job is to treat what's put in front of me.
0:43:36 > 0:43:38'If I suddenly got to the point where I'm judging and deciding
0:43:38 > 0:43:41'who gets my assistance and who doesn't get my assistance,
0:43:41 > 0:43:45'you're getting into the realms of playing God a little bit there.'
0:43:45 > 0:43:46Come on, pop your jacket on.
0:43:46 > 0:43:49If you want to leave, feel free to leave now,
0:43:49 > 0:43:52otherwise stay with us and we'll take you to hospital.
0:43:52 > 0:43:53Right.
0:43:57 > 0:43:59'People aren't born onto the streets.
0:43:59 > 0:44:01'They all have a story.
0:44:01 > 0:44:03'In the time that I've been with the ambulance service,
0:44:03 > 0:44:06'homelessness has definitely gone up.
0:44:06 > 0:44:09'I've been to homeless people who went to public schools,
0:44:09 > 0:44:10'who had good jobs,
0:44:10 > 0:44:13'who were married and had children and are now living homeless.'
0:44:13 > 0:44:15Your mates are all up the top.
0:44:15 > 0:44:16With your dog.
0:44:16 > 0:44:18All right?
0:44:18 > 0:44:21OK, well, the dog that was with you, then.
0:44:21 > 0:44:25'People who are kind of living on the streets have no-one.
0:44:25 > 0:44:26'It... It's sad.'
0:44:30 > 0:44:33Yeah, well, because he's at an angle, if I hold it like this,
0:44:33 > 0:44:34it'll be...
0:44:34 > 0:44:37Cyrus's carer has arrived
0:44:37 > 0:44:40and offered to help Shaney and Gary move him down to the ambulance.
0:44:40 > 0:44:42Does he normally go to hospital with you?
0:44:44 > 0:44:47- It's not on properly, no? - No, it needs to come up.
0:44:47 > 0:44:49One, two, three...
0:44:49 > 0:44:52- Is that OK?- Yes, fine.
0:44:52 > 0:44:54Thank you so much for your help.
0:44:54 > 0:44:56No, you've saved another ambulance coming.
0:44:56 > 0:44:59- I'll give them a call. - Did you cancel it?
0:44:59 > 0:45:02Yeah, it's Echo 202. You can cancel.
0:45:02 > 0:45:05We've worked around it with the help of the carer, over.
0:45:07 > 0:45:09Of course, of course, are you ready to go?
0:45:13 > 0:45:14I'm going to get this up.
0:45:18 > 0:45:20Sweetheart, just give us a second.
0:45:20 > 0:45:22We're just going to get your husband on the bed
0:45:22 > 0:45:23and then we'll get you in, all right?
0:45:24 > 0:45:26All right, you ready?
0:45:26 > 0:45:27One, two, three...
0:45:28 > 0:45:29Perfect.
0:45:29 > 0:45:31You should get a job in the ambulance service.
0:45:31 > 0:45:32- I just said that to him. - Did you?
0:45:32 > 0:45:34THEY LAUGH
0:45:45 > 0:45:49Erm... Four.
0:45:50 > 0:45:52Not yet. Not yet!
0:45:54 > 0:45:56Where are you from?
0:45:56 > 0:45:57Oh, really?
0:45:58 > 0:46:00When did you come over here?
0:46:02 > 0:46:03Really?
0:46:05 > 0:46:06Oh, I see.
0:46:06 > 0:46:0836 years!
0:46:13 > 0:46:16Oh, honey. I know, it must have been horrific.
0:46:16 > 0:46:17How was...?
0:46:28 > 0:46:29Wow.
0:46:31 > 0:46:33Well, that's pretty horrific.
0:46:37 > 0:46:38This is your ex-husband?
0:46:41 > 0:46:43Do you still live together though?
0:46:55 > 0:46:57Wow!
0:47:03 > 0:47:05It's a good job you do love him, isn't it?
0:47:14 > 0:47:17Sorry, darling?
0:47:17 > 0:47:18Yeah, we're here.
0:47:28 > 0:47:30You all right, darling?
0:47:30 > 0:47:32Yes, of course.
0:47:32 > 0:47:33Don't rush!
0:47:38 > 0:47:40By five o'clock,
0:47:40 > 0:47:44call volume across London has fallen and normal service has resumed.
0:47:57 > 0:48:00Is there a person there that needs an ambulance?
0:48:02 > 0:48:04You don't need...
0:48:04 > 0:48:06Tell me exactly what's happened.
0:48:14 > 0:48:16Right.
0:48:16 > 0:48:17OK.
0:48:18 > 0:48:22Ambulance emergency, what is the address you need the ambulance?
0:48:26 > 0:48:27Sorry, you're the Queen?
0:48:27 > 0:48:29You're the Queen of England?
0:48:30 > 0:48:32All right. So why have you dialled 999?
0:48:33 > 0:48:37Emergency ambulance, what's the address of the emergency?
0:48:46 > 0:48:49Sir, sir, I'm going to tell you what to do, right.
0:48:49 > 0:48:51OK, is everyone safe and out of danger?
0:48:57 > 0:48:58You think he's dead?
0:49:05 > 0:49:06Right, so you...
0:49:06 > 0:49:08Yeah, OK, listen to me.
0:49:08 > 0:49:10Help is on the way. We're getting the fire brigade.
0:49:10 > 0:49:11How many now?
0:49:12 > 0:49:14Three now?
0:49:14 > 0:49:17So you've just got a third person out, yeah?
0:49:17 > 0:49:19And they're burnt as well, are they?
0:49:21 > 0:49:23IP62.
0:49:23 > 0:49:26Pete is the nearest advanced paramedic.
0:49:26 > 0:49:28Stoke Newington area, there's a fire call.
0:49:28 > 0:49:30There's lots and lots of people at the scene.
0:49:30 > 0:49:32I think there's a lot of smoke. Involving a flat.
0:49:32 > 0:49:34Some people are reporting an explosion.
0:49:34 > 0:49:37But there's one person trapped inside and there's one person
0:49:37 > 0:49:40outside that was either on fire or something to that effect.
0:49:40 > 0:49:44We had multiple calls and by multiple I mean in excess of ten.
0:49:44 > 0:49:46I will go. Be green in two seconds.
0:49:46 > 0:49:47All right, bye.
0:49:49 > 0:49:52'Multiple calls normally triggers alarm bells
0:49:52 > 0:49:57'that what you're responding to is going to be big.
0:49:57 > 0:50:01'It does make you step up a gear and focus.'
0:50:03 > 0:50:08Four ambulances, five first response cars, advanced paramedic Pete,
0:50:08 > 0:50:12the air ambulance team and the fire brigade are all en route.
0:50:12 > 0:50:15Yeah, so you've got everybody coming down there as fast as they can.
0:50:15 > 0:50:16Well, they're all on the way.
0:50:16 > 0:50:20Ambulance, police and the fire brigade. Everyone's on the way.
0:50:22 > 0:50:24They are coming as fast as they can.
0:50:26 > 0:50:29Seconds feel like minutes, minutes feel like hours,
0:50:29 > 0:50:32when you're waiting for an ambulance, don't they?
0:50:37 > 0:50:40You're doing really well though. Just keep flushing out with water.
0:50:48 > 0:50:49Yes?
0:50:49 > 0:50:51I can't talk to you at the moment.
0:50:51 > 0:50:52OK, I can't talk to you.
0:50:59 > 0:51:02The air ambulance team will deal with the patient feared dead
0:51:02 > 0:51:03inside the flat.
0:51:03 > 0:51:06Pete is responsible for the other three patients
0:51:06 > 0:51:08who are scattered across the site.
0:51:08 > 0:51:09Hello, mate.
0:51:11 > 0:51:12Yeah.
0:51:13 > 0:51:14Yeah.
0:51:15 > 0:51:16Yeah.
0:51:18 > 0:51:19Yeah.
0:51:23 > 0:51:24- OK.- OK?
0:51:24 > 0:51:27- Do we know the cause of the explosion?- We don't yet...
0:51:27 > 0:51:29All right, no worries, I'll go and start triaging.
0:51:30 > 0:51:32Yeah, hello, mate, you all right?
0:51:32 > 0:51:35- OK, so, open your mouth, stick your tongue out and say, "Ah".- Ahhh...
0:51:35 > 0:51:39And does your... Does your throat feel burnt at all?
0:51:39 > 0:51:40I'm just going to look up your nose.
0:51:40 > 0:51:44- It does feel burnt.- OK, so he's got singeing to his nose hair.
0:51:44 > 0:51:46- What happened?- I don't know, mate.
0:51:46 > 0:51:47OK, all right.
0:51:47 > 0:51:49Let's leave these on here for another ten minutes
0:51:49 > 0:51:51so the burns gels have been on for 15 minutes.
0:51:51 > 0:51:53- You're going to stay with this guy, OK, all right?- OK.
0:51:53 > 0:51:55And you guys are going to transport him.
0:52:00 > 0:52:02- Is this patient number three? - No, it's only patient number four.
0:52:02 > 0:52:03Injuries, quickly?
0:52:03 > 0:52:05- He's got quite a lot of singeing. - Got you.
0:52:05 > 0:52:09- Dude, open up your mouth and say, "Ah."- Ahhh...
0:52:09 > 0:52:11OK, so there's no soot in the airway.
0:52:11 > 0:52:13- I couldn't see anything. - No singeing.
0:52:13 > 0:52:15OK, cool. I'm happy to leave you with him.
0:52:15 > 0:52:17- OK? All right.- Yeah, no worries.
0:52:18 > 0:52:19- Hello.- Are you the LAS paramedic?
0:52:19 > 0:52:22- Yes, yeah.- We're about ready to go, he wants you to come with him.
0:52:22 > 0:52:26The explosion's happened in the middle of an Orthodox Jewish area
0:52:26 > 0:52:29and the community Hatzola ambulance has come to lend a hand.
0:52:31 > 0:52:33- GROANING MAN:- All right, all right.
0:52:33 > 0:52:35Hello, man, how are you? I'm Pete, you all right?
0:52:35 > 0:52:37How you doing? Nice to meet you, mate.
0:52:37 > 0:52:38- Injuries?- There's burns on his face.
0:52:38 > 0:52:42- His neck... His neck. His two hands, both have deformed.- OK.
0:52:42 > 0:52:44And he's got the both legs and his buttocks.
0:52:44 > 0:52:46How long have these burns gels been on?
0:52:46 > 0:52:49Have they been on for more than 15 minutes?
0:52:49 > 0:52:53- Um... Just about, yes...- OK, right. So, guys, all burns gels off.
0:52:53 > 0:52:55I want clingfilm on the burns you can see,
0:52:55 > 0:52:57don't wrap them all the way around his arms.
0:52:57 > 0:52:59Once the clingfilm's on,
0:52:59 > 0:53:01I want him completely covered to stop him getting cold.
0:53:01 > 0:53:04Sir, my name's Peter, all right? We're going to look after you.
0:53:04 > 0:53:06We're going to give you some very, very strong pain medicines.
0:53:06 > 0:53:09Does your airway, does your throat feel burnt at all or sore?
0:53:09 > 0:53:12- MAN:- Yeah. - OK. OK, right, this guy needs to go.
0:53:12 > 0:53:14OK, I'm worried about his airway.
0:53:14 > 0:53:16Just going to give you some strong painkillers, OK?
0:53:16 > 0:53:19Some really, really strong painkillers.
0:53:19 > 0:53:21Yeah, Papa 6-2, can you show me blue with Hatzola
0:53:21 > 0:53:24to the Royal London Major Trauma Centre, please?
0:53:25 > 0:53:27- OVER RADIO: - 'Blue for the London with Hatzola.'
0:53:28 > 0:53:31He has partial and full thickness burns.
0:53:31 > 0:53:36I haven't worked out a percentage yet. He does have airway burns.
0:53:38 > 0:53:42He's currently GCS 15 and talking.
0:53:42 > 0:53:46He's been given IV ketamine and our ETA to the Royal London
0:53:46 > 0:53:48is going to be 15, 1-5 minutes, over.
0:53:48 > 0:53:50'Pete, I got all of that loud and clear.'
0:53:50 > 0:53:52Thanks, I'm going to pass for you now.
0:53:54 > 0:53:57How's that pain? I gave you a really strong painkiller. How's the pain?
0:53:57 > 0:54:00Is it a little bit better? OK, cool. Right, let's go, please.
0:54:00 > 0:54:04Thanks very much. All right, all right, it's OK, it's OK.
0:54:04 > 0:54:08He's got full thickness burns to his face, hands, buttocks and both
0:54:08 > 0:54:12lower limbs, and confirmed to have airway burns, which presents a huge
0:54:12 > 0:54:15problem because it isn't long before the airways start swelling.
0:54:17 > 0:54:20Hence the need to go very, very swiftly to hospital
0:54:20 > 0:54:21with this gentleman.
0:54:22 > 0:54:27And I'm sure Pete will be watching him like a hawk the whole way there.
0:54:27 > 0:54:29Yeah, of course, yeah. No, it's fine.
0:54:32 > 0:54:35Each day can be...
0:54:35 > 0:54:38mentally, emotionally and quite physically draining.
0:54:38 > 0:54:41It takes its toll, that's for sure.
0:54:42 > 0:54:45- PHONE RINGS - 'Hi!'
0:54:45 > 0:54:47Oh, hello.
0:54:47 > 0:54:50- 'Hello, how are you?' - Yeah. More importantly, how are you?
0:54:50 > 0:54:52'Ah, yeah, good, good. I'm tired now.'
0:54:52 > 0:54:53'I bet you are.'
0:54:53 > 0:54:56I'd love to talk to you for longer but I want to go home.
0:54:56 > 0:54:57- SHE LAUGHS - 'I'll speak to you tonight.'
0:54:57 > 0:54:59- All right. Take care, sleep well. - 'Bye!'
0:54:59 > 0:55:01- Bye-bye! - 'Bye.'
0:55:01 > 0:55:02He sounds fine, you know.
0:55:02 > 0:55:04To be fair, we're all pretty resilient.
0:55:04 > 0:55:09You've got to be, otherwise, after years of doing this I think...
0:55:09 > 0:55:12- I'd probably be a jibbering wreck! - SHE LAUGHS
0:55:13 > 0:55:14# Oh, my
0:55:15 > 0:55:19# I didn't know what it means to believe
0:55:20 > 0:55:22# Mmm
0:55:22 > 0:55:24# Oh, my
0:55:25 > 0:55:28# I didn't know what it means to believe... #
0:55:28 > 0:55:31With the greatest of respect, the governing party of the UK
0:55:31 > 0:55:34isn't really relevant as to whether you need an ambulance at the moment.
0:55:34 > 0:55:36Frederick, Frederick?
0:55:36 > 0:55:39OK, Frederick, I don't think God is going to punch me on the nose today.
0:55:39 > 0:55:41Frederick, you're going to need to listen to me.
0:55:41 > 0:55:43# Oh, Lord
0:55:43 > 0:55:45# I'mma getting ready
0:55:45 > 0:55:48# To believe
0:55:50 > 0:55:52# Oh, my... #
0:55:52 > 0:55:54My sister asked me not that long ago about how many dead people
0:55:54 > 0:55:59I reckon I'd seen and I genuinely have long ago lost count.
0:55:59 > 0:56:03It's only when you talk about it or chat to relatives or friends
0:56:03 > 0:56:04who aren't involved in this,
0:56:04 > 0:56:08you realise that what we do is not entirely normal.
0:56:08 > 0:56:09HE CHUCKLES
0:56:09 > 0:56:14# But if I hold on tight is it true?
0:56:14 > 0:56:18# Would you take care of all that I do?
0:56:18 > 0:56:19# Oh, Lord... #
0:56:19 > 0:56:22- SHE GROANS - I'm pleased that day's over!
0:56:22 > 0:56:23Yeah, I bet.
0:56:23 > 0:56:26SHE LAUGHS
0:56:26 > 0:56:28It was a nice way to finish, though.
0:56:28 > 0:56:31# Then we'll be waving hands singing freely
0:56:32 > 0:56:36# Singing standing tall It's now coming easy
0:56:36 > 0:56:37# Mmm
0:56:37 > 0:56:40# No more looking down, honey Can't you see? #
0:56:41 > 0:56:43- Home, James.- Yep.
0:56:43 > 0:56:44I'm done.
0:56:45 > 0:56:48- London's had it all. - JAMES CHUCKLES
0:56:48 > 0:56:50# I'mma getting ready
0:56:50 > 0:56:52# Oh, Lord
0:56:53 > 0:56:55# I'mma getting ready
0:56:55 > 0:56:59# To believe. #
0:57:03 > 0:57:07Next time, it's the night shift.
0:57:07 > 0:57:10I need you to keep calm, keep taking the gas and air, darling.
0:57:10 > 0:57:11FEMALE WHINES WITH PAIN
0:57:11 > 0:57:14Unfortunately, we've got too many calls and not enough trucks
0:57:14 > 0:57:15and a lot of very sick people tonight.