Episode 1 Ambulance

This programme contains some strong language.

Ambulance Service. Is the patient breathing?

Every year in Britain,

12 million people dial 999 for an emergency ambulance,

more than 3,000 a day in the West Midlands.

Right. Stop screaming and listen to me, listen,

don't be afraid to push too hard.

One and two and three.

-One and two...

-CPR in progress.

SIREN WAILS

Everyone clear?

Each call tells the story of a person in desperate need.

Can you upgrade it to a red, please? He's been badly beaten.

Do you know what it was you were stabbed with, Don?

And with call numbers doubling in the last decade...

Keep going! His hair! The head's here, the head's here, nearly. Yeah.

-I can't!

-You can.

..for our public services, a situation that is now critical.

They've got to find somewhere for him,

they can't just say there's no beds.

Is this literally what you've got? What you're standing up in?

You've got nothing else?

-OK.

-The failure of the system.

-AMBULANCE SIREN

-Oh, God.

-Oh...

-Oh, my God.

What was he doing?

All right, guys. Just, just one minute.

Cameras follow cases as they unfold, minute by minute.

Two ambulances, please, if possible.

OK, yeah. As long as you're all right,

I'll get everybody to you as quick as I can.

In the control room...

Confirmed life extinct.

-LOW TONE

-Oh, man.

..and on the ground...

Sorry for your loss.

..as the West Midlands Ambulance Service race to save lives.

They are coming to you, blue lights and sirens,

as fast as they possibly can.

SIREN WAILS

Is he breathing?

Can you see the helicopter?

You're no trouble, honestly.

Everybody needs help sometimes, don't they?

This is the story behind the sirens.

-Nee-naw...

-Nee-naw, nee-naw...

Get out the way, I'm driving.

SIREN STARTS

Ambulance Service. Is the patient breathing?

Can you get any response from him at all?

All right. Can you say the word "now" for me

every time he takes a breath?

And the next one.

INDISTINCT VOICE

Has he taken another one?

Listen to me, then.

Pull him onto the floor for me. It's really important.

He's a big man...

Listen, put the phone to one side and go and help him.

It's an hour and a half into the Saturday night shift.

The CPR call in progress is a category one,

the most life-threatening.

Put the heel of your hand in the centre of his chest

and the other hand on top of it.

Press down on his chest at least two inches

while you keep your arms straight.

And don't be afraid to push too hard.

It's one of 193 999 calls

the West Midlands Ambulance Service is currently dealing with.

Do it at the rate of one and two and three.

And one and two and three.

Five miles away, crewmates Katie and Sarah have just become free.

FAINT BEEPING

-Rowley Regis.

-Unconscious, not breathing.

CPR in progress.

And just a bit quicker for me.

One and two and three.

That's it. Can you count out loud so I can hear you doing it?

You're doing really well. We're coming as quickly as we can.

I haven't done an OS for ages.

I can't even remember the last one I did.

This is the first one I've done since I've been back on the road.

-CALLER:

-We need, please, somebody to come, because nothing's happening!

-We are coming as quickly as we can.

-There's nothing happening.

Keep going, though.

One, two, three.

-You've got your steth in your pocket, haven't you?

-Yeah.

If you take your steth, I'll grab...

-..the suction...

-I'll grab...

-..and take in the ALS bag.

-Yeah.

-IN VOICEOVER:

-I get nervous.

I try and keep it under wraps, but deep down, you know,

this person's life is in your hands

and it's your responsibility not to get it wrong.

Katie and Sarah are nine minutes from the patient's house.

With the patient's heart stopped,

two crews are needed for the best chance of survival,

so a second ambulance is on its way.

Is he breathing?

Have a look if he's breathing. Look at his chest.

Nothing at all? Keep going with the chest compressions.

That's it. Keep going. We're coming as quickly as we can.

Do NOT try and walk out.

Jesus Christ.

I think he actually thought we were going to let him go.

-CALLER:

-Come on, Terry. Come on.

-Keep going.

Keep going. Don't stop until I tell you to.

The other crew arrives first.

-CALLER:

-..three. One, two, three.

I won't leave you until I can hear them in the room, OK?

The patient's wife has been doing CPR for eight and a half minutes.

What's his name?

Has he ever had any cardiac events or anything?

That's it, Terry.

What's your name, sweetheart?

Are you Terry's wife, Joan?

-Can you charge that, mate?

-Yeah.

-Charged.

-OK. Everyone clear.

Shocking.

So first shock. Has anyone got a time?

-IN VOICEOVER:

-Programmes on TV and reality are quite different things.

People will get their hopes up because of what they've seen on TV,

where their loved one has CPR performed

and they're back to life and it's all happy.

But the chances of that happening are quite slim.

I've been to 15 cardiac arrests,

only two survived long enough to be discharged home.

-Sarah, if you get the flush out, I'll just swap over.

-Yeah.

-OK. Ready?

-Yeah.

OK. Charging again.

Everyone clear?

Yeah? Back on chest.

Check pulse.

Back on chest.

-IN VOICEOVER:

-All your adrenaline is going because this is it.

It's now or never.

You have got to do absolutely everything you can

because as time goes on, the chance of survival decreases.

OK. Adrenaline just going in now.

We've not got nothing, have we?

It's 26 minutes since Terry first went into cardiac arrest.

OK, everyone clear.

Yeah, press it. Yeah.

-I've got a pulse.

-Got a pulse?

-Yeah.

-He's making a good effort now.

-OK. Cool.

Right, let's get ready.

Yeah. Someone will go in...

There's two ambulances going, so one can go in the one at the back,

OK, cos we obviously need quite...

Yeah, that's absolutely fine.

We need quite a lot of space. At the moment, he has got a pulse,

but things can change, all right, sweetheart?

I don't want to get your hopes up, all right?

We'll get him straight to the hospital now, all right?

That's it, Terry. That's the ambulance.

We're going to get you to the hospital now, sweetheart.

You're doing really well.

Right then. On three. One, two, three...

OK, we're going to have two go up.

Can you support that arm?

That's it, we're through.

Right. OK.

Right, let's reassess.

SHE EXHALES

Let's have your arm, Terry. That's it.

He's gagging now as well.

Is he?

He's definitely got a pulse.

Just going to put a mask on your face.

We've got a blink there as well.

Well done, Terry. Well done.

Doing really well, Terry.

I'm going to take this ambulance, they're going to take Terry.

You can both come. That's not a problem. All right?

I'm just going to shut your doors now, all right, chuck?

All right, then, my lovely. If you two have a seat there.

OK?

At this point...

It's difficult to know.

He is making a really, really good effort at the moment.

A really good effort.

Yeah. And I can see that.

He is fighting.

All right?

Aw, bless him.

Well, we'll do our best for him and we'll get him there

as quickly as we can, all right, my love?

All right, ladies.

I'll take you inside. Don't worry.

They'll have taken him straight through to the resus area.

It may just be for the first sort of five or ten minutes,

they may just need you to wait.

Go ahead, over.

In the control room,

team three are four hours into their Saturday night shift.

All right, mate. I'll speak to you in a bit, OK? Give us an update.

Give us an update.

Controllers Glennis and Richard are responsible

for sending all ambulances across Birmingham tonight.

The patient's 41 weeks' pregnant and she's urging to push.

So I'll try and get you a second vehicle,

and I'll get you another update shortly, over.

News of Katie and Sarah's ROSC - getting a patient's pulse back -

is filtering through.

4449 went out to the cardiac arrest to the 75-year-old patient.

The crew got there, got an output, and it's a ROSC.

-Oh, nice one.

-Which means...he's alive.

A ROSC is awesome for ourselves and for the staff,

but it's just maintaining that then

and seeing how we get on with the patient's ambition.

The next few hours will be crucial.

My very first cardiac arrest, we got a ROSC

and she was discharged from hospital two weeks later.

-Really?

-Yeah.

-I've never known any of mine...

-Yeah.

In fact...

..he's probably the best ROSC I've ever had.

-Really?

-Mm.

-Normally...

-It was good.

..I get a ROSC and they go, and doctors call it in resus.

I whispered to you, "We need to turn the telly off."

I think we just happened to glance at the telly at the same point

and all I saw was an ambulance

and I just thought, "Oh, my God. Casualty's on. How inappropriate."

SHE LAUGHS

COMPUTER CHIMES

New job. A 32-year-old female with left-hand-side lower-back pain.

Just getting a few jobs in now. It's getting busy now.

There are 51 ambulances on shift in Birmingham at the moment,

but all of them are tied up with patients.

So we've got three... four outstanding.

We've got RTCs we can't cover.

Um, I've got a middle-back injury from an RTC.

That's another job.

Every person that rings for an ambulance, it's their emergency,

but I have to take on everybody's tragedy.

It's all right in an ideal world -

when you've got lots of ambulances, it's fine.

But when you haven't, you're having to prioritise.

Right, we've got a 33-year-old kicked in the knee.

He needs to just wait.

Wait for the ambulance because that won't be coming any time soon.

That's awesome, thank you. I'll book you clear.

If you can just stand by for the moment,

cos we are stacking a few nines, over.

As pubs begin to close, the 999 calls pour in.

Ambulance Service. Is the patient breathing?

OK, what's he done?

LOW TONE

What's the reason for the call?

LOW TONE

Oh, right. OK. What's the address of the emergency?

You called to say you've injured your knee and can't walk.

Can I ask whereabouts you are, please?

You're in an alleyway?

In an alleyway in a cul-de-sac?

-Yeah.

-OK, let me just have a little look on the map,

where my ambulance crew are.

So I can try and locate you.

Are you able to shuffle on your bottom

so you're visible from the street for me at all?

I know you can't stand up.

I'm going to tell the crew to put the lights and sirens on, all right,

and see if he can hear them.

Can you put your lights and sirens on, just quickly,

to see if the patient can hear them?

Ungie and Maria are near to where the patient says he is.

-SIREN WAILS

-Yeah, they're on.

Yeah.

Farnhurst Road, yeah?

Where, sorry?

-Farnhurst Road.

-Farnhurst, I've got you now.

They're not in right place. They need to go down Farnhurst Road.

Apparently you need to go down Farnhurst Road.

Is he on Farnhurst Road then?

I don't know where he is.

I don't think he knows where he is.

Can you see the ambulance yet?

No.

They're being as quick as they can.

I bet it is cold on the floor.

We'll get you in the nice, warm ambulance in a bit.

We just need to get the crew to you.

It does look like a bit of a rabbit warren there.

Is it lots of little alleyways?

Hello?

Maurice!

-Maurice!

-Maurice!

Is there anyone down there with you?

Maurice!

I know that, sweetheart. I know that.

And I know you're uncomfortable. We're being as quick as we can.

Can you hear any voices?

No.

Whilst on the phone to Maurice, 48 new 999 calls come in,

including several fights.

If all crews can be aware of High Street in Dudley

and surrounding streets.

I believe there is a fight in progress.

There's several fights ongoing the moment.

I don't know what's happening,

but I know it's quite tense in the city centre at the moment.

There might be.

Crikey.

OK. I take it you're en route?

Crikey, that's going to be...

I'm in an alleyway.

I...

I know you're in the alleyway.

But you know when you walked into the cul-de-sac...

Have you seen this RTC, Julia?

This is a big fight going on.

Right, warn the crew.

There's a fight in progress.

No, there's a fight in progress and somebody's been hit by a car.

Tell them not to approach until we've got police there.

There's a fight in progress and a person's been hit by a car.

Police are en route. Just stand by, safe distance.

Yeah, thank you.

Mark and Jacob are three miles from the fight.

Paramedic manager James is also en route,

to coordinate the scene with the other emergency services.

His is a BMW X5.

There's no way I'm going to be able to beat him in this thing.

I'm going to be expecting a lot of people around, though.

Yeah, it could be a bit carnage.

They arrive in seven minutes.

There's a few cop shop vehicles about.

-OK.

-We'll have a look.

-All right, fella.

All right, let's have a look at this arm.

It's just gone through the top.

I couldn't tell you, to be honest, mate.

There is a further casualty.

-Is there?

-Query, baseball bat.

Yeah, yeah. I'll go and check him.

While Jacob stays with the man with suspected stab wounds,

Mark and James prioritise the more seriously injured man,

who they think's been attacked with a baseball bat.

Hello.

We're just going to get you sorted out now, all right?

Can I just have a quick listen to your breathing, OK?

You weren't knocked out, where you?

OK.

You feel sick?

HE RETCHES

Try and keep your neck still, if you can.

-Upgraded to a Red.

-Breathe nice, slow, deep breaths.

A second ambulance has been requested.

But worried about the man's neck

and how long it will take to arrive on a busy Saturday night,

James contacts Control.

This gentleman needs to be immobilised -

he's been battered with a baseball bat.

He's conscious and breathing but looks pasty.

So I'd prefer them not to be diverted.

Yeah, roger. I'll get it sorted. Stand by.

Case 14. Can you upgrade it to a Red, please?

He's been badly beaten.

14. Ta, mate.

The fight victim is the highest priority patient currently

in Birmingham. He takes Glennis's last ambulance.

Seven other patients in the city will now be left waiting

until a new crew becomes free.

It's going to be a horrible night tonight. Really horrible.

We know it's going to be horrible now.

So I'm going to have to come under this shoulder as well.

I'm going to support your neck. Keep nice and still.

We are going to lower you to the floor, onto this board. All right?

On "lower", then. Ready? Set. Lower.

Well done, mate. Keep nice and still.

-HE GROANS

-All right. Relax back.

Good lad. Well done.

All right, all right.

Perfect.

-IN VOICEOVER:

-If someone's severely beaten,

especially around the head and neck, it's going to cause serious damage

to the point where they might not walk again.

Keep nice and still for me, mate, OK?

In reality, it's going to affect, not just the person that's injured,

but the family. And then the repercussions from that

sort of escalate out. It's like a ripple effect.

-OK.

-Shall we slide him?

Yeah.

-PATIENT GROANS

-All right, mate.

Doing really well.

I am surprised what people will do to each other.

It's almost like it's out of a film.

One, two, three.

But in the film, people will take a knife wound,

but get up and still carry on fighting.

When, in reality, that doesn't happen.

Well done, mate.

Go.

-ON RADIO:

-Approximately 20-year-old male,

been assaulted with a baseball bat,

with numerous external injuries.

He's immobilised. Pain relief en route.

Off scene now for Heartlands.

ETA - 08 minutes.

Well done, mate.

-Are you happy for us to go, James, yeah?

-Yeah.

Blues and twos, mate, all the way in.

How's your pain at the moment, mate?

Right, I'm going to use paracetamol, OK?

Intravenously. I'm going to look after you, bud.

So do you remember what happened, then?

Yeah.

Right, OK.

Yeah.

OK. Do you remember what the incident was all about?

Why it all started?

-IN VOICEOVER:

-I'd expect fights to be over important things.

Being chivalrous, protecting your family.

Your loved ones.

But it ends up being over really silly, petty things,

when really we should just be nice to each other and get along.

It would make my job ten times easier.

Right, we're just pulling in to the hospital now. All right?

There's going to be doctors asking you questions

and prodding and poking you. All right?

Completely normal. You've seen it on Casualty a million times.

Aren't you?

Well, you're doing all right, mate. You're doing all right.

What we'll do is we'll just get you to sit outside for a second

while we get you handed over to the doctors.

We'll get you in all right.

Just two miles away, Ungie and Maria have been searching

for their patient, Maurice, for nearly half an hour.

We've had a look down those ones, and we couldn't see him down there.

-OVER RADIO:

-Have you got your sirens on now?

Put your sirens on.

SIREN WAILS

All right, say that to me again?

Cos I'm sure that's different to what you told me first.

You'd come to the bottom of Farnhurst Road, and what did you do?

-First left.

-Left?

-Left. First right.

-Left and then right?

Right, OK. I think we're going to have to start again.

Can you go again to the bottom of Asholme Close and turn right?

-They're on the way.

-And there's a cul-de-sac,

and I've got a young man who is going to flag them down.

In York Drive, there's a cul-de-sac.

The ambulance crew should be coming round the corner,

so hopefully we'll be there with you in a minute.

Oh, there you go.

Straight down there, yeah? Cheers.

-I'm not going to get...

-There he is.

-Yeah, there he is, OK.

Thank you for that, guys.

-Hello. Is it Maurice?

-That's right.

How you doing, buddy? My name's Ungie.

Sorry we took so long to get to you.

We were trying to find where you were.

-Thanks for that. Cheers.

-What have you done, buddy?

Oh, dear.

Let's have a quick feel of your wrists there.

So what happened, you just tripped over and went down?

-Yeah.

-OK. Have you hurt your neck at all?

-No.

-Nothing where I'm pressing here at all?

-That's all right.

-OK.

Did you land full-force just on that one knee there?

Just fell down and that was it.

-You weren't knocked out? You didn't lose consciousness or anything?

-No.

OK. We'll get the stretcher out of the ambulance

and we'll get you on that,

get you into the warmth and we'll have a good look at you in there,

so you're off the floor.

-Who do you live with?

-I lost me parents.

OK. Are you living on your own at the minute?

Mum and Dad...

OK. Has it been a long time since they've gone?

-Too long.

-OK.

Let's get a proper splint on it.

We'll just pop a little splint on this leg

to support it and keep it still. All right?

And then we'll get you up onto the stretcher.

-Sound like a plan?

-Yeah.

-Bless you. How old are you?

-62.

-62.

I'll be 63 in April, with a bit of luck. Touch wood.

-We'll support you.

-Just be wary of this leg.

Try not to catch it on the stretcher as you bring it up.

-OK.

-On three, Maurice.

-Ready?

On three, Maurice. Push up on this good leg and we'll pull you up.

-I won't...

-You will.

-On three.

-One, two, three. Push up on your good leg.

HE SCREAMS

-I've got your leg.

-Hold that one up as well, buddy.

-Hang on.

-We've got it.

Let's cover you up. Keep you warm.

At least you're off the floor now.

-In we go, buddy.

-Ready?

Little bump.

Let's just shut the doors, too.

All right, we'll get the heaters on to keep you warm.

Other than the pain in your knee, any pain anywhere else at all?

-No.

-OK. Can you wiggle your toes on this foot?

So obviously, we don't know what you've done to that knee,

cos we can't see into it.

It doesn't look too badly deformed or anything like that.

We'll pop you down to the hospital and get them to have a look at it,

see what's going on. You got any other family that are around?

Any brothers, sisters, partner?

-Children?

-No.

-Nothing at all?

-Do you live alone?

I live alone but with a cat.

What's your cat called?

-Libby.

-Debbie?

-Libby.

-Libby.

How are you coping at home?

All right.

Do you need any more support or help?

I've got a support worker in.

Yeah. Just pulling into the hospital now, Maurice.

-You're tired, aren't you?

-Yeah.

-What time do you finish?

-Seven in the morning.

Blimey.

I know.

Long day, ain't it?

Another six hours, 15 minutes to go.

Then you have a day off?

Er, no, I'm back in tonight.

Do it all again.

-Bonkers.

-Somebody's got to do it.

-Ready, steady, go.

-Go.

A couple of bumps.

There we go.

-ON PHONE:

-Ambulance Service.

OK, I need to know, are they breathing?

OK, are they still fighting?

Hang on one second. I'll just have a look.

Yeah.

OK. So he was punched and knocked out?

What do you mean, he's gone?

Hang on, hang on. Is the patient breathing?

Right, OK. How did it happen?

Yeah, roger, will do. Thank you.

Standing by.

We've got 13 outstanding jobs.

It's three o'clock in the morning.

They're all bleeding, alcohol-related.

Overdoses. Assaults.

Drink related. Then they're having a fight and then they feel sick.

Oh, we've just had a call from police

to say this patient's been glassed and we are required.

But I still haven't got anybody.

-IN VOICEOVER:

-I've been doing this job now 20 years.

When I first started, if you had a stabbing it was like,

"Oh, my God, I've got a stabbing!"

But now it's matter-of-fact.

It's like the weapons they use - glasses, hammers, knives...

You name it, they'll use it. It worries me.

I don't like going to pubs and things if I don't know people

cos I'm thinking, "Oh, my God, I hope nothing happens."

So that's the way the job affects me.

Bear with us, my love, OK?

We're exceptionally busy across the area with life-threatening cases,

but we are getting to patients as fast as we can.

On this Saturday night,

the Ambulance Service has dealt with nearly 1,500 patients,

20% up on a weeknight.

I need a nice, extra large coffee.

I might even have two.

One of their first patients of the shift, Terry,

who was in cardiac arrest, has survived through till morning.

-Morning.

-Morning, morning.

It's the start of a new shift for Team Three.

4453, roger, thank you. Good morning.

I'll get you booked on. I hope you have a good shift.

# Sun is shining.

# The weather is... #

This a day makes me happy.

94 ambulance crews are on duty today across Birmingham

and the Black Country.

-OVER RADIO:

-Good morning. I'll get you booked on. Have a good shift.

It's a lovely sunny day.

Ooh, you've said it now.

The sunny part, I hope it remains sunny. I've got my Ray-Bans on,

so I'm all set for the day, over.

-We good to go?

-Yeah, absolutely.

I can definitely take my coat off now.

LOW TONE

Ambulance Services. Is the patient breathing?

Yes, my wife is nine months pregnant.

Right, so is she an labour, do we think?

I think so, but I don't understand why it's bleeding.

Has she got a bleeding from her vagina right now?

-I don't know.

-No, we need to know now.

Can you ask her right now if she losing blood?

Er... Yes.

If you touch her stomach, does that hurt her?

If you touch it gently on the stomach?

-Yes.

-It does hurt there if you touch it?

-Yes.

Oh, here we go.

Natalie and Nat are nearest to the maternity call.

-ON RADIO:

-It's a 25-year-old female, 40 weeks pregnant, that's bleeding.

It does say that the patient's got an urge to push.

If you could give us an early update, that would be great.

Oh, gosh, we will do.

Yeah, we'll let you know when we're there, over.

-Roger. Thank you, standing by.

-This could be happening for me.

-With you.

-It's a baby, a baby, a baby.

I've not been to one on the road.

In the four and a half years, I have never been to one.

I'm just going to stand at the bottom.

Ah, it'll be fine.

-It's not good, though, with blood, bird.

-Hm?

It's not good if it's red, fresh blood.

-40 weeks.

-Has she got the placenta previa, though?

Or the placenta abruption?

-We don't want that. Let's not have...

-I know.

I know, but what's she bleeding for at 40 weeks?

-Suspected placenta abruption.

-Oh, sh...sugar.

-Advanced labour.

Patient in bath now.

This one?

-ON PHONE:

-Just go and get the door open for us

and I'll stay on the line here with you.

Hello.

Is it your first baby?

No? OK.

Any problems with your pregnancy, my darling?

No. Has your blood pressure been OK?

Sometimes more, sometimes high.

OK. And what baby is this?

Baby number...?

Three.

Oh, I'm sorry.

-This one. Do you know what this one is?

-It's a boy.

Little boy? Lovely!

Lovely. OK, then.

Right. So, if we get you some gas and air, darling.

All right? To help you with the pain.

Are you having another contraction now?

-No.

-No?

-Only the pain.

-You've just got constant pain?

-Yes.

-It's there all the time?

OK. All right, my darling.

Was your last baby stillborn?

OK, my darling.

-So, Nat, this lady is on her third pregnancy.

-Uh-huh.

Full term?

Yeah.

It's not so much a contraction any more, it's severe lower pain.

-There was some blood in the toilet.

-OK.

-Red fresh blood.

Are you consultant led?

-Yeah.

-She's consultant led.

Because of previous.

So previously they didn't find out what the cause was? No?

-What was your due date, darling?

-13th.

-A couple of days early.

He wanted to come meet you.

-Yeah.

-Come and say hi.

With signs of bleeding, and having lost a baby already,

Natalie and Nat want to get mother Ionela to hospital

as quickly as possible.

Is this the bag that she's packed for the hospital?

-Yes.

-OK. Perfect.

Lovely. OK, you are going to need to put a couple of those in

for the little baby.

SHE SOBS

-Do you feel the urge to push?

-Yes.

-All right, darling.

-OK, OK.

-Calm, calm.

-Deep breaths, my darling.

OK, try your gas.

Just a little...

-Slow, slow.

-Slow.

-OK.

-Look at me, look at me.

Breathe through your mouth, darling.

-Is it happening again?

-Yes.

All right, darling.

SHE SOBS

-Is it just the contractions now?

-Yes.

-Yeah? OK.

-All right.

I can feel, like, down, the baby.

-It's coming down.

-OK.

SHE SCREAMS

All right, my darling.

SHE CONTINUES SCREAMING

Do you feel you need to push?

Yeah, OK.

All right, darling. Use the gas, my darling.

Big breaths.

No, we can't.

Ionela's contractions are speeding up, and despite her history,

there is no choice - the baby will need to be delivered at home.

-Nothing we can do about it.

-Yeah, I know.

They'll need a second crew to help in case of complications.

52, thanks.

Yeah, we are going to have another crew after all

cos I don't think we're going to get the chance to...

move with this patient, so I think we are going to need another crew,

please. Over.

RADIO CHATTER

Lovely, thank you.

So when you contract,

your body will tell you when it's time to push.

When you need to push, tell us that you need to push

-and you need to push, OK?

-OK.

-IN VOICEOVER:

-I think it's one of the hardest things,

when a patient tells you they've lost a child.

Delivering a baby at home doesn't come without risks

and, as a paramedic, we know our capabilities are somewhat limited.

We haven't got a doctor on scene,

we haven't got a theatre for an emergency Caesarean.

So it's a massive responsibility.

Massive.

Well done.

They've asked for Amber backup, then,

and the crew are showing about nine minutes away.

With a second ambulance urgently needed at the maternity call,

there are now just three emergency ambulances available

to cover the 2.2 million people of Birmingham and the Black Country.

Three new 999 calls are coming in every minute.

Ambulance Service. Is the patient breathing?

Right, OK, what's the problem?

Don't swear at me.

LOW TONE

Is the patient breathing?

Not breathing.

LOW TONE

Give him a light shake on his shoulder,

call his name and tell me exactly what he's doing.

LOW TONE

Is he conscious?

Right, get him out the pond.

Have you just got him out the pond, just this second?

And he's definitely not breathing?

You can't see any signs of him breathing?

What's the address?

It looks like Thailand's out the window for me.

-Why?

-Because these flights are just ridiculous.

Darren and Mel are two miles from the pond and have just become free.

I'm not going to pay, like, 550 quid for ten days,

and the flights are going to be, like, what?

-Two days long.

-Yeah, 20 hours or something.

We've got a job. Pavilion, Heath Road.

Drowning?

-RADIO:

-49, thank you. Cardiac arrest, please.

Patient had been fishing.

They've fallen into the pond.

Now I believe pulled out and not breathing.

Second crew responding.

ETA eight minutes away.

Okey dokey. Thanks a lot.

What I need you to do is gently tilt his head back

and lift his chin upwards and pinch his nostrils together.

I need someone to put their lips around his mouth and blow steadily

-into the mouth to make the chest rise.

-OK.

Have you got the ambulance on its way?

We've got some help on its way to you.

We're going to get this guy back.

We've got a crew that have just said they're nearly there.

Is someone looking for them?

Yes. They're nearly there.

I'll get somebody up to the car park and look for them now,

OK, love?

Right, we'll stay on the line with you until they get there.

OK, then.

Have you seen them yet?

Huh? I can't see anyone waving.

-The police went that way.

-Yeah.

It looks as though he's getting a bit of breath now.

Is he taking regular breaths, though?

-It's the ambulance men.

-The ambulance are there.

-Is he conscious?

-Conscious, yeah.

-He is conscious?

Hello, sweetheart. We're going to roll you over.

Has he had an epileptic fit and then gone in?

-We don't know.

-That's all we've heard.

With no obvious explanation for the accident,

Darren and Mel are keen to get the man into a warm ambulance

as quickly as possible.

-HE GROANS LOUDLY

-Let's get him over.

All right, sweetheart. All right?

Yeah.

That's his mobility? So he's...straight in?

I would imagine his scooter into there and gone into there.

-Driven his scooter in?

-Yeah, his scooter's still in there.

-He's bitten his tongue.

-He's had some sort of fit.

Paramedic officer Chris has been dispatched

to manage the scene so the crews can focus on the patient.

Patient query driven scooter into a lake.

Query seizure at time.

I don't know whether he's actually still mid-seizure

or whether it's just shock.

We're getting him in the warm first - he's freezing.

One, two, three.

All right, lovely. What we're going to do, if you just dry him,

let's whip these off and get the dry ones on him.

So he's just trundling, trundling, and all of the sudden...

-Yuugh!

-Just goes in.

-Who dragged him out?

Some members of the public.

Some members of the public dragged him out.

-Pulled him out.

-As he was or...?

As you've seen him. I don't think he was breathing,

or he wasn't responsive at first when they got him out.

So unresponsive to start with?

-And then he's gone to this level, and that's it.

-Yeah.

I'm just trying to work it out. He's not...

Basically, he could have had a fit before he's gone in.

He could have had a fit as he was going in. I don't know.

Any ID that you found?

Does anybody here know him?

OK.

All right.

Cheers, mate. We're going to have the second crew travel on this one.

Not happy with patient's presentation.

Can't rule out whether he's had a stroke or anything beforehand,

judging the way he's gone at the moment.

So, yeah, they're going to travel. One person's going to go in,

one person's going to take the vehicle afterwards, all right?

Yeah, that's all received. Thanks very much. Over.

One of the crew has travelled on 49.

They're driving the second truck up,

but the first person has travelled to treat him on the back of that,

on the drowning. They've been on scene for 17 minutes and we've gone.

So we've took him straight in.

The crew are not messing around, really.

Rather than sort of treat and delay anything,

we're getting him straight to hospital.

PATIENT GROANS LOUDLY

OK, mate. All right.

At the moment, we've got no details,

we've got not medical history, no name, no age.

All we know is what passers-by have told us.

He was on his own, so we don't know anything else at the moment.

It's hard in circumstances like that

because obviously we've got no indication, nothing to call him,

and I don't like not knowing patient's names.

Cos I think you should always try and call them...

..by their name, even if they are unconscious or reduced GCS,

to make them more of a person.

I don't think it's right to not know somebody's name.

I think it's quite difficult. We've literally...

Man unknown is all we've got.

He could have a wife at home who has no idea.

So I just hope he was found in time.

Poor chappie.

-IONELA SCREAMS

-Push.

-OK, keep pushing.

-Nice.

-Off the gas.

-Take it off the gas.

Off the gas. Push. OK?

It's been 16 minutes since Natalie and Nat decided it wouldn't be safe

to transfer Ionela to hospital...

Pushing, that's it.

..and they'd have had to deliver the baby themselves.

-SHE SCREAMS

-OK, push.

-OK, keep pushing.

Nice and quiet. Perfect. Good girl, that's it.

That's OK.

They're worried mother and baby are getting into difficulty.

52, sorry.

Yeah, we need that other crew ASAP, please. Over.

-RADIO:

-10-4, 52. Thank you, they are on the way.

They're less than a minute now.

OK. That's it. In through your mouth.

Nice, slow breaths.

You're doing really well.

Another one.

-Hello.

-Hello.

We got here about 40 minutes ago, I think.

We've tried to move once - it weren't happening.

Obviously, we've got no way of monitoring baby, have we?

And that's the thing, you see.

Pushing. Got to push.

Breath. Air down, air down.

Hold your breath. Good girl. You've got to push. Keep pushing.

I know it's going to hurt, sweetie. I know.

SHE GROANS

-IN VOICEOVER:

-They have to push the baby over a dip in the birth canal.

And it's getting them through that dip that's the hardest work.

So if a mum tires and she can't do it,

then you start to worry about baby becoming distressed.

Hold on to me, hold on to me. That's it. Good girl. That's it.

Listen, listen to me.

Listen to me. To get this baby out, you need to push it out, yeah?

-Yeah.

-Every time you get these contractions

and you feel that urge to push, you've got to really, really push.

-IN VOICEOVER:

-I know how horribly wrong they can go.

My first two births were fine, absolutely fine.

Jessica's wasn't good.

I had a ruptured uterus.

Subsequently, Jessica's severely disabled

and has been starved of oxygen.

She's 15. She's tube fed, she can't walk, she can't talk.

So I know what starvation of oxygen can do.

I know we've only got that ten-minute window.

OK? Ready.

Give it everything you've got, yeah? Each time.

Yeah, if we can... Yeah, absolutely.

Hold my hand, darling. Hold Natalie's hand.

Well done. Go ahead, darling.

That's it. Well done. Well done.

We just need one good push over that birth canal.

-Keep pushing in your bottom. Right in your bottom.

-I can't!

You can. You can.

-I can't...

-You can, you can.

It means we're nearly there when you feel like that.

OK? I know, darling.

-It does. It does.

-Ow...

We either need to really go for it here or move.

So, it's up... You know, we can't...

We don't know what's happening with baby.

When we get that contraction and when you want to push,

you've got to really push, all right?

So we're going to come off this.

We can. How else is he going to come out?

-I can't.

-You can!

-No.

We want to meet him. We want to meet him.

Right, up we get. Up high.

Got to push, got to push.

-I can't.

-You can!

Eight miles away, Darren and Mel

have finished handing over the drowning victim to A&E staff.

-What would you think? Epileptic?

-Seizure.

-Seizure. Bleed on his...

-Wow, I was thinking... Yeah, his tongue's been bitten.

-Yeah.

As we've handed him over to the doctor,

he spoke for the first time, and he goes, "Let me die."

-And I was just like, "Ooh..."

-What?

"I don't want to live any more."

Has he got any family?

No. I asked him, "Do you have any family?"

And he was like, "No, got no family."

I said, "Have you done this on purpose today

"and gone and drove into the pond?"

And he goes, "Yes. Let me die. I don't want to live any more.

"I hate life. I want to die."

-88 years old.

-That's so sad.

So he's just...

drove himself into the pond on his mobility scooter.

88, yeah.

-No kids, no family. That's what he said.

-What a shame.

Mm. It is.

-RADIO BEEPS

-Go ahead.

49, thanks.

Have you got an ETC?

Yeah, I was talking to Mel about that job.

We're ready to go. You can clear us.

-Joan?

-Yeah?

I've got another update on that.

-On what?

-The drowning.

-Oh, yeah?

-He died at hospital.

-Did he really?

-Yeah.

-Really?

-Yeah.

Oh, man.

Oh, man.

-Really?

-Yeah.

How quick did we get there?

We got there quick enough, didn't we? But... Oh, shit...

What has he died of?

Secondary drowning.

Oh, really? So he's got to have been under for a while, then.

-Yeah, he's died.

-Really?

-We just found out he died in hospital.

-Oh, man.

Oh, I thought you'd found out it was a suicide attempt.

I didn't see that coming at all.

-Secondary drowning?

-Yeah.

Oh, man.

People do die and we know they die,

but you're not normal if it doesn't affect you.

I've dealt with thousands and thousands and thousands of jobs,

but there are probably four or five that I still think about,

and he will remember that job, probably, now,

like I remember my jobs.

But you do have to think,

"You have done your best to get to somebody."

SHE SCREAMS

-Please push.

-You've got to push. You've got to push.

-Push.

-She needs to push.

-Push.

Push this baby out.

We're getting to the stage now where we either need to have the baby

or we need to go to... We don't know what baby is doing in there.

We can't monitor baby.

We can feel him kicking and moving and having a lovely wriggle.

-You've got to...

-SHE WHIMPERS

I know.

Good, good.

Just like that. Good girl.

Up we go, up we go.

Push, push, push, push.

-Push hard. Push. Come on. You can do this. Come on.

-I can't.

-But you can.

You can. You are nearly there. You can. Come on. Push.

-HE SPEAKS IN HIS LANGUAGE

-Push. Push.

Keep going, keep going.

Keep going. His hair! The head's here.

The head's here, nearly, yeah.

-Keep going, keep going.

-Push, push.

-Push.

-He's there. The head's there.

-Good girl.

-OK, my darling.

Well done.

Stop when she tells you to.

Let's meet this little boy.

Good girl. Good. There we go.

-All right, Nat?

-Yeah, we're all good.

Awesome. Push, push, push.

Keep pushing, keep pushing.

-He's just there.

-Ooh, hello, little baby.

Oh, gosh. Here he is.

You see, Dad? He's coming.

-His hair.

-Awesome, awesome.

There he is! Hello!

Catch your breath and push.

OK. I've got his head.

One more push.

Yeah, it's turning, it's turning.

-I've got him.

-Yay!

Keep going, keep going.

keep pushing, my darling. Hello, hello!

-Hello!

-You did it! Well done.

-Good girl, good girl.

-BABY CRIES

Good girl.

-Hello!

-Hello, young man.

-Hello, beautiful.

OK, darling. Here he is. There he is!

Well done. Well done.

Oh, Nat...

We've got a beautiful little baby boy. Time - 11.02.

As far as babies go, this one's pretty cute. Over.

52, that is wonderful.

Congratulations to all there.

Glad everything is all right.

Thank you ever so much for that update. Over.

Thanks, sweetheart.

-So we got an update on the baby case.

-OK.

Baby boy, born at 11.02.

Aw. Oh, that's good news.

Good news. Bless her.

I do, I like the jobs like this.

# Don't play that song for me

# Cos it brings back memories... #

What a privilege.

-I mean, I was the first person that held that baby.

-Yeah.

And that is an amazing feeling.

To pass a baby to their mum is just lovely.

It's like, "Here, this beautiful, beautiful baby boy."

Who's that?

-Who was it?

-I don't know.

# Cos I remember just what he said

# He said, "Darlin'..." #

-ON RADIO:

-Go ahead.

I've just got a bit of an update for you regarding case 885.

Patient now deceased. Confirmed by ED.

So that guy has died?!

-I can't believe that.

-Of what?

I think it's secondary drowning.

The chest was clear.

The doctors assessed it, I assessed it.

I'm really shocked.

There was nothing more we could have done, was there?

All you can do is listen and see if there's any bubbling.

But even if you did think he had fluid on his lungs,

-what could you do? There's nothing you can give him.

-That poor bloke.

# I remember on our first date

# He kissed me and he walked away... #

It's a privilege, my job.

Sometimes between life and death stands a paramedic.

I'll never forget, a lady said to me once, "This can't be happening.

"Ten minutes ago, he was drinking a hot chocolate."

And that is the reality.

People's lives can change within ten minutes,

and we're there through the whole time.

Then you get back to the station, you put your keys in the cupboard,

you put your drugs away and you pick your child up from Brownies

on the way home. Because life goes on.

# Oh, don't let him play it

# Oh, no

-# It fills my heart with pain

-It hurts

# Please stop it right away

# Cos I remember just what he said

-# He said, "Darlin', I

-Darlin', I

# "I know that I lied... #

Next on Ambulance...

-Is the patient breathing?

-Yeah, he's breathing.

He's been stabbed. There's about five different stab wounds.

He's got stab wounds twice to his head here.

What I want you to do, mate, is keep talking to us. OK?

We're trying to help you.