Episode 2 Ambulance

Ambulance Service. Is the patient breathing?

This programme contains some strong language

and scenes which some viewers may find upsetting.

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.

CPR in progress.

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, Dom?

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

The head's here. The head's here, nearly. Yep.

-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.

Oh, God.

-Oh, my God.

-What was he doing?

All right. 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.

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.

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, nee-naw.

Get out the way. I'm driving.

SIREN SOUNDS

Ambulance Service. Is the patient breathing?

Right, so black fluid is coming out of her mouth.

So she's not conscious, then?

It's very important...

Listen...

BLEEP

OK, this isn't going to help if you carry on like this.

One hour into the Friday late shift,

and the control room is taking its first cardiac arrest call

of the night.

Do you want any...?

Put yourself vertically above her and make sure your hands

are in the centre of the chest.

Keep your arms nice and straight.

Press down at least five or six centimetres, OK?

Don't be afraid to push too hard.

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

One and two and three.

Faster.

That's it.

Till we get there.

Press harder, OK?

Can you still hear me?

Hello?

Hello, operator.

The call has ended abruptly.

An ambulance is two minutes away, but until they arrive,

the control room must continue giving medical assistance over the phone.

It's engaged.

It's engaged.

Has he come back through to us?

Ambulance Service. Is the patient breathing?

Listen, try and stay calm for me.

The help is already arranged on the first call.

Listen, we need to try and help her.

Right...

Just go straight to CPR.

Listen to me. Is she on the floor?

Is she on the floor?

Right, go to her now. Can you take the phone to her?

All right, so what I want you to do, kneel right next to her.

Right, you're not.

You're talking to me.

So go to her.

We're in. All clear.

The thing was we were giving him CPR advice but he just wasn't

having any of it.

You can completely understand in that situation

because it's his wife.

Sometimes it just doesn't work.

Rich, stay safe. 2393.

Can you put a call out?

2393.

The crew have gone out to a patient that's fitting.

They have got there within 30 seconds of pressing her emergency button.

Controller Richard is despatching ambulances in Birmingham tonight.

As an outsider, if you walked into that room, the emotion in there,

you can feel it.

Because you check back on the case

and the crew confirm when they get there the patient is deceased...

..and you do think about it, but you've got to stay detached.

It is tough because some of them do get to you.

And it's hard to just erase that emotion.

Is he still breathing?

You've got that shooting, but patient deceased.

Just looking after the wife.

4055 are covered in faeces.

They are going back to get changed.

-OK.

-Friday night in Birmingham South means busy.

A lot of trauma, possibly stabbings, got strokes,

people that have been unconscious.

So there's a good mixture so far.

With a couple of RTCs.

The weather's not so good out there

so there's been a couple of crashes today.

Birmingham and the Black Country covers 100 square miles,

with a population of 2.2 million.

Tonight, there are 113 ambulances,

five rapid response vehicles and a specialist trauma team all on duty.

Ambulance Service. Is the patient breathing?

What's the address of the emergency?

Ambulance Service. Do you need an ambulance?

Just stay where you are so we can find you when we get there.

No, it won't be Disney World.

In Cradley Heath, an elderly patient has alerted his emergency care service,

who are calling 999 on his behalf.

We'll be there for him as soon as we can.

Ambulance crew Natalie and Nat have just arrived on scene.

Hello.

Hello?

Hello, John.

We'll just find out what happened.

Have you just gone to the toilet and you can't get up?

Get me off here, will you?

-John.

-John, honey. I need to know what's happened.

Can you get me off here?

It's hurting me.

OK. John, you haven't fallen, have you?

No.

No. So you've just gone to the toilet and you can't get up?

John, listen.

John, we're not going to take you to hospital.

-OK?

-Please, get me up.

Can you push up off your chair?

You push up off this chair.

-There you are.

-Oh, thank God.

-Keep going, keep going.

-Legs nice and straight.

I've got you, John. Hold my hand. That's it.

-OK.

-Which chair are you going to, John?

Your blue one? Is this how you normally walk, John?

I can't hear, see.

LOUDER: Is this how you normally walk?

Oh, John.

-Thank you for coming.

-You're welcome.

That's OK.

I'm deaf and all.

I've got wax in me ears.

How's that?

Going down, look.

How are you feeling now, John?

-How are you feeling now?

-All right now.

-All right now?

-Yeah.

-Yeah.

You want me to make you a cup of tea?

OK.

Whilst we put the kettle on, can I just check your blood pressure?

-OK.

-OK.

So you live here on your own?

-Yeah.

-Any family?

Diabetes?

-Did she?

-Yeah.

I'm sorry. And you've lived on your own ever since?

40 years ago, that was.

-40?

-Yeah.

You've been on your own for 40 years?

-Yeah.

-How old was she?

-I think when she died, she was about 46, I was about 50.

-Oh!

Your blood pressure is all right, John.

We fixed you.

That's that, then.

Can you get me some, what do you call it, spaghetti?

Now?

It's in that cupboard round the corner. Round the corner.

That's a nice cup of tea, love.

Nice bit of supper and a cup of tea.

That's all right.

How's that? Check it's not too hot.

He's tucking right in there.

John has been prescribed blood-thinning tablets

after a recent stay in hospital.

Natalie and Nat are struggling to find his medication.

We're worried you've got no tablets.

You've got no tablets, John.

There is some somewhere.

They've all gone.

Is there some on the side over there?

No.

There is an empty box.

There's an empty box.

Nobody has been and got you any more warfarin.

I'll let my doctor know tomorrow.

It's Saturday tomorrow, it's closed.

So that worries me.

There is risks to you not having your medication.

Yeah. Well, call again tomorrow.

Where from?

I don't know.

I'm going to phone 111 to see if they can do an emergency prescription.

OK.

Yeah, I'm a paramedic with West Midlands Ambulance Service.

John was discharged out of hospital on warfarin.

He had his last one on Wednesday.

At the moment he has got no warfarin whatsoever.

Our concern is that obviously, by the time he gets in touch with somebody

on Monday,

it's going to be Tuesday or Wednesday and that's a week without warfarin.

Thanks very much. That's great.

Thank you.

They're going to see if they can sort your prescription out.

Nat must now join the Friday night queue for a call-back

from an out-of-hours doctor.

Over the past hour, there have been 126 emergency calls

to the control room.

There is currently just one ambulance available across

Birmingham and the Black Country.

Is the patient breathing?

Do you know him?

How much blood do you think he might have lost?

OK.

Darren and Mel are the closest available

ambulance to the stabbing.

OK, Darren, 28-year-old male, stabbing, bleeding wounds.

Five stab wounds, two in back of head,

two in back and one in groin.

Five stab wounds.

Straight over at the roundabout, dude.

Darren and Mel are seven minutes away from the stabbing.

The control room have also dispatched the Merit car,

a specialist trauma unit with two doctors and a critical care paramedic on board.

A paramedic officer is also on his way to coordinate the scene.

Listen, is the blood spraying or spurting out anywhere?

OK. Have you got the wounds covered by anything

at the moment?

-Right, we're coming as quick as we can for you, OK?

-OK.

4449 on channel eight.

VOICEOVER: If it's a Friday or Saturday night

and everyone has been out on the pop,

a lot of people have a red mist.

And if you ask someone what happened during a fight they won't remember.

I think the stabbings are getting a lot worse.

A lot worse.

Hiya.

-Hello. What's his name?

-Dominic.

OK. I'm going to have a good look at him.

Keep the pressure on his head.

-Right, hang on.

-How are you feeling, mate?

-Tired.

-Yeah?

-What's your vision like?

-I can't see.

You can't see. What I want you to do, mate, is keep talking to us, OK?

This needs to come round him.

-Got it?

-Yeah.

-Right round there.

I heard screaming and it was her screaming my name

so I've come to the door and he's just there covered in blood like this.

Is he normally fit and well?

-Yeah.

-No medical problems?

-No.

-Dom, can you talk to us?

-Yeah.

-Good man.

-Dom,

do you know if you've been stabbed on your legs at all?

-No, I don't think so.

-You don't think so.

We're trying to help you.

The Merit car and the paramedic officer are now on scene.

He's really...

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

He's also been stabbed middle back and at the bottom to the right-hand

side, sort of renal area.

Can I have a drink of water, please?

Let them get you in the ambulance.

Do us a favour, mate. Just chuck it on the back of the ambulance.

Let's get you out of here, mate.

-We'll get you some water in a bit.

-One, two, three.

Stand up for us.

VOICEOVER: I used to be in the RAF when I was about 20.

We always had the golden hour. Stem the bleeding if you can,

get some fluids into them.

Just get them gone.

Being out in Afghanistan, you were in a high-pressure environment.

You never knew what you were going to,

you never knew what you were going to step on,

where you were going to tread. I guess when you come to a job like this

you've got to thrive off that kind of situation.

If you can't, then obviously you're not in the right job.

Once the patient is in the ambulance,

the team must check he has no further injuries.

Dom, I'm going to be cutting your trousers off now, mate, all right?

Dom, they are torn anyway, mate.

-They are torn anyway.

-So he has two stab wounds middle of his back and

down here to the right-hand side by his kidney region.

I put this on to try and put pressure.

It's not working. It's not great but it's stopping the bleeding.

You will do, mate.

You happy to go?

Dom, they're just having to pack your wounds.

I'm giving you some pain relief now, mate.

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

No. All right, mate.

At least you got your fancy pants on for it.

Nice. It's not Thursday, though, mate.

It's not Thursday.

Well, that's good to hear.

And what's this scar from here, mate?

The patient, Dom, has been brought to the Queen Elizabeth Hospital.

He's the fourth stab victim the Ambulance Service has treated tonight.

Sorry about your shirt.

11 miles west in Cradley Heath,

Natalie and Nat have been waiting to hear from the on-call doctor

for more than 30 minutes.

PHONE RINGS

Yay!

Hello.

Yes, hello, it's Natalie, yeah.

Hiya. Hello.

So I'm just a bit concerned, really,

because this gentleman has got no warfarin.

There's nobody that can go and get any for him.

He hasn't had any for two days.

So I just wondered could there be an emergency prescription done and

possibly delivered to this gentleman?

OK. All right.

Thanks very much. Thank you.

Bye-bye.

John? I've just spoken to the doctor.

They are going to come within the next six hours

to get you a prescription.

They are going to let themselves in with the key code.

They are going to let themselves in.

Do they know the key code?

Yeah, I've told them. OK?

OK.

So don't be alarmed if somebody comes walking in, OK?

Yeah. Thanks for looking after me.

You're welcome. You're welcome.

OK.

-Bye, John.

-Bye-bye, John.

Turn the light out. See if that fire is on.

It's on, the fire's on, John.

OK. Night-night.

Yeah.

Yeah. Night-night, John.

-Out, love.

-OK.

Bless him!

Click.

It's cold.

-It's a shame for John, isn't it?

-Yeah.

It's horrible he's got no family.

Who else has that gentleman got but us?

I like people like John.

I like John.

Ambulance Service. How can I help?

RTC.

What's the location?

Could that come under Olton as well?

Receiving.

Yeah. Straight on a job in Solihull, please.

RTC.

One male trapped and bleeding heavily.

A car is reported to have overturned in Solihull,

nine miles east of Birmingham city centre.

The control room immediately dispatch a paramedic officer

and the specialist trauma team.

Darren and Mel have just become available.

RTC entrapment, guys. There is one male bleeding from the mouth.

The vehicle is on the roof and the male is trapped inside bleeding

-heavily.

-Oh, my God.

Yeah, all received. Thank you.

Olton. I hope I don't know him.

All my friends live round there.

Paramedic officer James is sent to major trauma incidents to manage

the multiple crews on scene.

He's just behind Darren and Mel.

Cars are moving.

Old Warwick Road.

Darren and Mel have arrived at the reported address,

but there is no sign of the overturned car.

Old Warwick Road.

We're on the Warwick Road now.

Let me put it in my phone.

We can't locate this at the moment.

We can just see the fire and police turning up so we will turn round and

try and follow them. Over.

Treble 4-9. That's all received by Control.

Echo November 5-5.

Received, over.

5-5, that's all received.

We probably need to ask for a better location in

regards to where we are for this call.

No sign at present.

Yeah, we're on convoy now between fire,

ASO and police. So hopefully we'll be able to locate this, over.

Treble 4-9, that is all received.

Thank you. Just keep us updated on the location if and when found.

Received, over.

Because the patient is reported to be trapped in his vehicle,

the Fire Service has been called.

But they're also struggling to locate the incident.

Morning. How are you?

RTC reported.

Yeah. Trapped. Old Warwick Road, Olton.

I'm just going to get them to re-plot it to make sure

-we're right.

-Yeah, well, this is Old Warwick Road.

-Yeah, yeah.

-The only other thing is,

you've got Old Warwick Road which carries on on the other side as well.

It's only a small little cul-de-sac, isn't it?

-Yeah, it is.

-Let's pull up so they can...

Is it in there?

Echo November 5-5 Whisky Romeo.

Go ahead, over.

Thanks. Warwick Road, Old Warwick Road have all been checked.

There is no sign. We are currently standing by as per Old Warwick Road

with fire and my crew.

Call back and see if we can get some further info

or confirm the location, please.

5-5, yes, of course.

The initial call has come to us via police.

I do have the caller's telephone number.

Leave it with me, over.

You've come from Solihull, haven't you?

They are just trying to verify the call as well because we've got

Old Warwick Road, Olton,

and there is Old Warwick Road, Lapworth as well.

We'll verify the call for us anyway and then I'll let you know.

It has come from police to us.

Shall we flip around?

No, get out at the end.

PHONE RINGS

Hello, it's the Ambulance Service here.

Did you contact police regarding a traffic accident on the Old Warwick Road in Olton?

OK, our crews are with police

and fire on scene and there is no sign of anything

at all. Are you still there?

McLaren and Rolls-Royce garage.

It's the road between Lapworth and Hockley Heath.

Near the McLaren garage.

Yeah, roger that.

That's a little bit of a run from here.

But you may find them near a crew.

We'll get it re-plotted and just have a look,

see if there is anybody closer.

Do you know where you're going?

Motorway driving.

SIREN WAILS

It's 13 minutes since Darren and Mel

were dispatched to this job

and they're still eight miles away.

Besides the three vehicles currently assigned,

the control room has now dispatched a volunteer doctor in a car.

But controller Richard has spotted an ambulance that is closer

to the incident.

Sorry to bother you, I think you might come across an RTC now

on the Old Warwick Road.

I literally think you are going to drive through Hockley Heath

and see it. So there's vehicles on the way.

I believe car to be overturned.

Male trapped inside bleeding heavily.

We are losing minutes now. If he is losing blood and he's trapped in the

vehicle, we need to get there ASAP.

Hang on. Careful, careful.

How good is that? Look at that!

Go on, Darren. Tank it.

You do get a bit stressed with it because you are thinking, "God,

"where are they?" They could be potentially dying or someone could be lying

in a ditch and you can't find them.

Everything is just running through your head by the time you get there

because you don't know what that scene's going to be like.

Echo November 5-5, in attendance.

25 minutes after the 999 call came in, James arrives at the incident.

So it's single occupant, guys, we believe?

Is he talking to us?

Hello, mate, you all right?

Normally fit and well?

-Yeah.

-Good man.

Just keep your head nice and still for us.

-No worries.

-Probably...

..open the door, just get the stretcher in.

And then pop him out, yeah.

Happy with that? Is that all right?

-Yeah, go for that.

-OK, brilliant.

30 seconds later, Darren and Mel arrive.

They are the fourth vehicle on scene.

-Hi. All right, Carl.

-Hiya.

Oh, it's not on its roof.

Can one of you guys put a helmet on and take over from the police officer?

Please, thank you.

As soon as he is out, we'll just help him out onto the stretcher,

let's go over to where the light is.

Then we can sort him out from there.

Keep your head still.

BANG

We need feet first, thank you very much.

I think that needs to go at a bit more of an angle, mate.

Keep him as still as we can.

On ready, steady, move, OK?

Ready, steady, move.

Let's get him over.

-We in the right position?

-Yeah.

Yeah. OK, on your say, Carl.

I'm going to lower him down. On move.

Ready, steady, move.

There you go.

Thanks. Just some notes for the log.

The patient is now extricated from the vehicle.

Still remains stable.

How much have you had to drink, my darling?

You've had quite a bit to drink.

OK.

What is the last thing you remember?

You don't know. Do you know who we are?

Yeah. So you've had a bit of a crash in your car, we think.

The emergency doctor on scene must check the patient for injuries that

require immediate attention before the crew can make their way

to hospital.

And you. Thank you.

He finds nothing of concern.

-You happy?

-Yes.

Don't move your head.

Keep it nice and still.

Have you ever been in an ambulance before?

What was that for?

A little bit ironic, really, at the moment.

Yeah.

You thought it would be a good idea to take your dad's car out?

Did you crash it?

Did you lose your licence?

How long for?

How long have you had your licence back for?

Didn't learn from that experience?

So when you crashed your dad's car before, drink-driving,

I bet your dad was fuming.

We're here now.

The 24-year-old patient will be scanned

to check for broken bones and internal injuries.

You know that RTC that the crew went

-on, the roll-over?

-Yeah, yeah.

So he was drink-driving.

-Was he?

-Yeah. The roof was absolutely caved in.

In the crew's words,

the only injury he's had was his pride was dented.

-And his car was dented, not just his pride.

-Yeah.

But he could have killed himself or somebody else.

I don't know what planet they're living on, really.

At Heartlands Hospital,

the drunk driver has refused medical treatment and, 24 minutes after

arriving, he's been spotted leaving the building with his father.

His dad has just walked in and they've removed him.

Where have they gone?

They must have gone down this way.

We've advised him he needs to stay.

Can you see them?

We have said that you might arrest him.

They're there.

He's there.

Here.

-No.

-If you walk out of hospital you're fine to do a breath test.

-Come with me. Thank you very much.

-No problem.

If he stays in hospital he can get checked.

I was always the kid that no-one thought I was going to amount to anything

or do something with my life.

I just got up one morning and decided to join the RAF.

I think it'd be good for loads of people to go and join the military

and just get a bit of experience and get a bit of authority in their life,

because it kicked me up the arse.

It's Wednesday morning and Team Three is back in for the day shift.

-Good morning!

-Is it her first baby?

Second baby.

And you think she's taken an overdose.

OK.

She's got the sirens on full blast.

Listen out for the sirens. Can you hear them?

At this time in the morning, we do get a lot of falls.

You've got carers going into addresses early hours, six,

seven o'clock in the morning.

You normally get a pattern on calls.

-INTERVIEWER:

-How many ambulances have you got?

Currently we've got...20.

Is that a good number?

It's a good number for the moment.

Whether that's a good number later on today I'm not sure.

We'll soon find out when...

..everybody starts calling treble nine.

Ambulance Service. Is the patient breathing?

What is the reason for the call?

A young family in distress is the first call of the day

for Darren and his partner today, John.

26 weeks preggers.

Husband is with patient now.

ON PHONE: From there, then, where would we go to find you?

You're on the canal path?

-Which way do you want to go?

-I'll ask control.

They must know which way they are,

because there's no point us walking the whole way down that way.

Shall we go that way?

Maybe we can borrow the barge.

Can you take us up, please?

Hi, Alison.

What's gone on, then?

-There we are.

-Oh, right.

Is it all round here?

Yeah, it's a bit swollen there, isn't it?

-Can you move your foot?

-I can wiggle my toes.

You can wiggle your toes. That's a good thing.

Looking good. We'll get you to pop your coat back on as well.

Just try and keep you warm. I think stretcher is going to be the best bet.

How are you going to get a stretcher here, mate?

Alison may have fractured her ankle

and with the ambulance a quarter of a mile up the towpath,

the crew face the challenge of transporting her.

Here we are. We've got this, it's going to be very bumpy.

They've offered that we could use the barge.

-Have they?

-Chair onto there.

Yeah, and then lift on.

-Yeah.

-Right, we'll guide you towards the edge.

I was going to say, we will warn Darren where the...

Where the puddles are. One, two, three.

There we are.

Smashing.

Darren, you still all right?

Right, wheels are on.

-There we are.

-That's the hard bit done.

-See you later, John.

-See you.

John will take the ambulance and meet Darren

at a road bridge further up the canal.

Shall we do the sound effects? Nee-naw, nee-naw, nee-naw...!

-Thank you very much.

-Take a plate.

-Bacon sandwich!

I have had a bacon sandwich and everything.

I've had a great morning.

Alison can now be transported to hospital for X-rays.

Nine miles east of the canal in Bartley Green,

a new 999 call is in progress.

ON PHONE: Ambulance Service. Is the patient breathing?

Is the patient conscious?

OK, what's the reason for the call?

So what has he had for the last four weeks?

5-1, thank you. Confirming update for case, please.

ON RADIO: I've got a 42-year-old male, alcoholic, intoxicated, has had a fall.

He's got a chest injury, a shoulder injury, elbow and rib injury.

Thank you. We'll give you an early update.

That's all received. Thank you. Standing by.

He's lovely, he is.

-Is he?

-Yeah.

-SIRENS BLARE

Paramedics Maya and Lawrence are the closest crew to the job.

It's category four, so it's not deemed as...

-Life-threatening.

-No.

Trauma.

Category four jobs are the lowest priority,

and the Ambulance Service has a target of 90 minutes to respond.

But because there are currently crews to spare in Birmingham South,

this patient gets immediate attention.

Morning. You all right?

-You're his partner?

-Yeah.

-What's actually happened today?

-I've come back from dropping the kids at

school this morning and found him at the bottom of my stairs

-with the vacuum, knocked off the stairs into the hallway.

-Yeah.

-He's been up most of the night falling over.

-Yeah.

Yeah? How many cans have you had, say, today?

-About six?

-All night.

OK. Would you normally have six a day, though?

Because for some people, six is not a lot for them.

So is that...?

-About 20.

-Oh, so that is less.

There's a good chance that's why you're fitting.

If he normally has about 20.

Do you drink from the second you wake up every morning?

Yeah? Right up until you go to bed?

Yeah.

You fell over the other day.

Is there any pain anywhere at the minute, Mark?

Your ribs that are hurting.

Mark, can you sit up for me?

Can I have a little feel of your neck and your back?

And then we'll take it from there.

Let me know if there is any pain.

Any pain? No.

-Any pain?

-No.

Any problems with ulcers, as far as you know?

Yeah, we can get that looked at.

What kind of fits does he have?

-They're called absence.

-Oh, OK.

He loses his speech and he can't move his legs.

Becomes quite vacant.

-Yeah.

-Do you know how many he's been having a day?

About three or four.

-About three or four.

-That's why I phoned the ambulance last time,

-because he was fitting.

-Three or four a day at the minute?

-Yeah.

BEEPING

So far, your physical observations are OK, but that's not what we're

concerned about, really.

We're concerned about your drinking, Mark.

And we're concerned about the fact that you're having fits every day.

Because it only takes one fit...

to go on for a bit too long and that's it then, you've had it.

So what I'd probably recommend

is if you come up to the hospital with us...

But you don't look well.

You don't. You're covered in bruises and scratches.

You're going to end up hurting yourself.

What's going to happen if you have a fit for too long

and you stop breathing?

How are we going to overcome this together?

Let them give you a quick MOT. A full MOT.

OK.

Maya and Lawrence have been on scene with Mark for 20 minutes.

In that time, a further 82 999 calls have been made.

Ambulance Service. Is the patient breathing?

Is the patient breathing?

OK, is that the reason for your call? Is it the breathing?

Have you brought up any blood?

You've been sick?

Ambulance Service. Is the patient breathing?

You're the patient? Do you suffer with any breathing conditions?

Asthma.

In Kings Norton, a 54-year-old man is having breathing difficulties.

Have you ever been diagnosed with a heart attack before?

A month ago you had one?

OK.

Ambulance crew Bex and Donna have been dispatched.

Getting out of puff. And how long have you felt like that for?

Two days?

Don't talk for a minute, Phillip. I'm just listening to your chest.

OK. So you've felt short of breath for two days.

Do you normally have difficulty breathing?

No. Do you have problems with your lungs at all?

What do you suffer with normally?

Asthma. So you do have a problem with your lungs.

OK. Have you used your inhaler today?

OK. Does it hurt to breathe?

Where does it hurt? In your chest.

So you've got chest pain.

Nice and still.

MACHINE BEEPS

That looks fine. OK.

Everything we've checked is OK, at the moment, but obviously something

is causing you this discomfort in your chest, so we will pop you up to A&E.

When did you last go into hospital?

What was that for?

You took an overdose? Of what?

And when was the last time before that?

You've been in twice?

Both for overdoses?

OK. Have you taken an overdose today?

OK.

Go steady.

You're going to that person at their lowest point.

Get yourself on there.

And often people phone with one thing, but actually they want help with something else.

You sometimes have to do a bit of digging to find out

exactly what they need help with.

You put your medication in that bag, didn't you?

Yeah?

What's the main problem now?

Are you worried?

Yeah. What are you worried about?

You're worried about having another heart attack.

All right. Everything we've checked was OK, all right?

OK? And if you were having another heart attack,

we're going to look after you. OK? So don't worry.

Because worrying's going to make it worse, isn't it?

Yeah? I need you to stay nice and calm and relaxed for me, OK?

Yeah?

I know.

-We'll look after you, I promise.

-OK.

-OK?

So you've definitely not taken an overdose this morning.

And you took one on Saturday and one on Sunday?

Sunday and Monday. What did you take on Sunday?

What did they do with you in the hospital?

Nothing? Did you go to hospital?

You did. And then on Monday, you took an overdose of antibiotics?

What made you take the overdoses?

Why?

You don't see your family.

Where are they?

Why not?

You don't know.

When did you last speak to your family?

Six months ago.

Did something happen six months ago?

What for?

Oh. What did you do?

Your wife? You hit your wife?

Is she all right?

OK. So you got arrested for assault.

And now none of your family will speak to you?

No? Have you got children?

And do you not see any of them?

Because of this assault?

On their mum. Was that their mum?

Right.

Have you ever taken an overdose

before the two you took this weekend?

You have? How many times?

Pardon?

-16 times?

-Yeah.

Over what period?

What time period?

And you've not had any help with those?

Is it to take an overdose to end your life or to get some help?

OK.

This is Phillip's ninth call to the Ambulance Service in the past month.

In Bartley Green, Maya and Lawrence's patient, Mark,

is more reluctant to go to hospital.

Ambulance crews aim to be on the move after 20 minutes,

but they've now been on scene for 60.

Are you going to just come with us, please?

Can you get me a can, all right?

We do need to take you up to hospital to see someone.

Please. Just go and get checked over.

I think your partner would rather...

Yeah, we've got two young kids as well.

-Four- and six-year-old.

-So your kids need you, don't they?

They don't want to see you like this.

And a 16 and a 17 and a 19.

-Has he got five kids?

-Five girls.

-Five girls.

What about when the kids come back home from school?

And you still can't walk or stand?

It's not fair on the kids.

No, it's not, Mark.

VOICEOVER: Addiction, in general, I think it makes people incredibly selfish.

I think people in the grip of addiction aren't able to realise the effect it

has on the rest of their family.

My birth mother had issues with drugs.

So I've been on the receiving end of that.

Careful, Mark. Mark.

Wait, Mark.

No, Mark. Mark, no.

No alcohol, Mark.

Mark. No.

Mark...

I know, but, Mark, you can't drink.

Mark.

-You can't.

-You can't have a can.

VOICEOVER: I grew up thinking it was normal to be called a slut and a slag.

And to be told that I was hated.

That was normal.

We lived in numerous hostels, we lived in safe houses.

I've lost count of how many schools that we went to.

Growing up around addiction quite often felt like there was no hope.

It is so close to home.

It's like walking into my childhood quite often.

And it's really difficult, really difficult to deal with.

Mark, Sarah doesn't want you here, so you can't stay here anyway.

So you're going to have to leave.

So why don't you just come with us before...?

I want you to go to the hospital and go and get checked out.

-You're not right.

-Would you want to get the police?

Thank you very much. Could we get police to us on this job, please?

Patient lacks capacity and is refusing to be conveyed to hospital,

so we need their assistance, please. Received.

ON RADIO: That's fine, thank you. I'll give them a shout, get them away for you.

-PHONE RINGING

-001. Thank you.

We've got a case in Bartley Green.

We've got a 42-year-old male that lacks capacity.

The Ambulance Service has a specialist mental health car

which is ten minutes from Mark's location.

It has medical staff and a police officer on board,

who Richard hopes might persuade Mark to go to hospital.

All received. Thank you very much.

So the triage team there, they can't assist at the current time.

They are now going on a separate case for the police.

So they can't assist at the moment.

So currently we're at a stalemate.

With the clock ticking,

Richard decides to call the police direct for assistance.

He's an alcoholic. He had a fall,

he had a chest injury, so we need to take him to hospital.

He's got no capacity, but obviously we can't get him out,

but he needs to go.

No, no, because we can't force him out, you see?

We haven't got the power.

All right. Thanks a lot. Bye-bye.

-4451.

-ON RADIO: So I've spoke to the triage car.

They're currently busy on a further case in Northfield.

They're happy to assist but at the current time, they're dealing with a

case that they've just got to scene on.

So they're going to be some time.

I've also spoke to the police directly and they're saying they

can't force anybody out of the property. They can only ask.

If we could get some assistance soon that would be great.

I know it's not your fault.

But currently...

..they're not sending anyone.

I know we've been here hours and I wish I could say the police

were on their way, but they're still not on their way just yet.

Unfortunately there's not a quick solution at the minute,

but hopefully the police will be coming soon. Hopefully.

VOICEOVER: We do have to rely on other agencies.

And it can be difficult, because I think we feel as if maybe the police

don't want to attend.

However, it's not that they don't want to, they can't.

There's not enough funding, there's not enough staff,

but the service demand is increasing more and more.

That's all received, thank you. If you can return, please, over.

I just need you to keep checking his breathing regularly for me until the

ambulance crew arrives, OK?

-INTERVIEWER:

-How is it looking on your patch?

-Very busy.

Extremely busy.

No crews and we've got nine outstanding jobs at the moment.

Get in the chair. You can take your can with you.

Maya and Lawrence have been on scene for over 2.5 hours.

Mark's partner, Sarah,

has called in his mum and sister to try and persuade him to go to hospital.

Mark, sit on here. Have your fag on here, then.

Come on.

-Please.

-Mark, come on, son.

Don't be so bloody stubborn.

-I'm not being stubborn.

-Go and get checked over. Get checked over.

-Come on, please. In the chair, there.

-Can you give me that?

-In the chair.

-In the chair, then, please, come on. Come and get into the chair.

-Give me it.

I can't. Come and get into the chair.

You can have it. Come on, bab, please.

-I'm not.

-You are. You can have your can once you get in there.

-Move out me way, man!

-No!

Come on, babs. I've got to go and get the kids in a bit.

It's not fair on the kids.

They was up all night listening to you falling over.

It's not fair on them.

Where are you going? Where are you going?

Come and sit in this chair.

-I can't...

-This is what happened last time.

We need the police.

ON RADIO: Go ahead, over.

Hi, I just wondered, do you have an ETA for the police?

We're just still waiting.

-Roger. Over.

-Thanks.

We shouldn't be in this position.

-No, we shouldn't.

-Three hours later,

with relatives having to turn up and call the police,

so they can get some support.

VOICEOVER: I am able to separate the selfish behaviour from the actual person,

because I do believe addiction is an illness.

If someone had cancer you wouldn't discriminate against them, would you?

You wouldn't say, "Oh, well,

"I'm not going to help you because you're a horrible person."

You'd still try.

Mark. Mark. Please go to hospital.

-Please.

-Please, Mark, for your mum.

She's in tears there.

Come on, son. I can't lose you.

I think unless you've been through an experience,

I don't think you can ever truly relate to it.

So you can read as many books as you want,

however, until you've been there and been let down that many times...

..I don't think you'll ever truly understand.

The only person who can ever beat the addiction is the person themselves,

but they can only beat it when they're ready.

Look how much your mum is hurting, Mark.

Your mum has just told you that she's scared you're going to die.

She's just said she doesn't want to lose you

like she's lost her husband.

-Yes, you are going to die.

-Listen to what your mum is saying, Mark.

You will eventually, yes.

Yes, you will, eventually.

Yeah, it could be next week.

Don't be so sarcastic, son.

You need to go to the hospital, you need to sort yourself out.

4451, what she's saying is...

..they've called police, we've called police, they won't go.

And they've been sat there nearly three-and-a-half hours waiting for police.

I'll get Alison to ring the police direct from her side as well, then.

Alison is the team manager

and Rich hopes a call from her to the police can unlock the situation.

The police are saying they've got no-one to attend now.

-He's going to have to go, I think, isn't he?

-Yeah, yeah.

Because the crew and the patient's partner has phoned the police

themselves as well. Yeah, yeah.

Because they want him removed. All right?

Within a few minutes, two officers arrive on scene.

Thank you.

These folk, they don't feel that leaving you here is an option, OK?

So what we need to do is we need to get your shoes on,

we need to get you on the back of the ambo.

The quicker we get up there, the quicker you can get back.

OK, well, at the moment, mate, that's not an option. OK?

No more, Mark. Mark.

You can have it when you get back.

-I understand that, but at the moment...

-You've had some.

Nearly four hours after the ambulance arrived,

Mark is finally on his way to hospital.

Do you want to get sober, Mark?

You do. I really want you to start thinking... What's stopping you?

You don't know.

You know that feeling at the minute that you've got?

Nightmare. It probably is, to be fair.

# Lights are shining all round this world

# You'd want them all But what you want is this girl

# So you can stick those rules They're just second-best

# They'll give you so much But you'll end up with less... #

I felt very angry towards my mother for a very long time.

I don't any more, because I'm able to accept

there must have been a reason.

People say it, don't they?

Hurt people hurt people.

If certain people hadn't stopped to help me and gone that extra mile for

me, I wouldn't be where I am.

So that's why, you know, I think I have to give back.

I have to.

# ..Bruised black and blue

# Too many words are hard but true

# And we'll all wise up like we... we knew we'd do

# Bruised black and blue. #

Next on Ambulance...

I've got the baby in my hands.

-Is he breathing?

-No! I don't know!

You need to put your mouth completely over the baby's mouth and nose.

-Do it now.

-I am!