Episode 6 Secret Life of the Hospital Bed

SIREN WAILS

Hand versus chainsaw.

That looks painful.

Our hospitals are taking care of more patients than ever...

Are you all right?

-No.

-Oh, poppet!

..with medical teams under constant pressure...

BEEPING

Can the doctor come to Resus, please?

Somebody as poorly as this little one,

we really need to treat them quickly.

..to meet our expectations.

I'm just worried about what he's going to be like afterwards.

But there's a crucial member of the team we sometimes forget...

I've never, ever been on a bed like this.

..the hospital bed.

Another ward, another story, another bed.

-Yeah.

-Agh!

In our lifetime,

we are likely to need one of them at least three times.

I've probably spent a quarter of my life on a hospital bed.

In this series, our cameras have been given unprecedented access

to beds in four very different hospitals across the country.

It's life. Life and death.

And everything that goes in between.

We'll see the world through the bed's eyes...

Hello, my love! Hiya!

..as they share the most challenging...

I don't know what to do. I don't know.

..most intimate...

-OK.

-All right.

I know.

..and most rewarding...

Happy birthday!

Ain't hospitals wonderful?

..moments of our lives.

Thank you for being here.

I wouldn't have been anywhere else.

A hospital cannot function without beds.

Beds are vital.

This is The Secret Life of the Hospital Bed.

Birmingham's Queen Elizabeth Hospital has 9,000 staff,

working around the clock to look after anyone who falls ill.

Can I have one of your beds, David?

This is the hospital day surgery unit.

It treats around 500 patients every week.

Just closing some of his stitches.

The day surgery beds are a small army of intensive shift workers

that are on duty 12 hours a day.

Today, day surgery bed 40

will be with 44-year-old Lisa O'Nions

who's here for a life-saving procedure.

ALL TALK

All right, then.

I had to get the dash in there

-cos I pronounced it wrong, so I do apologise.

-Oh, don't worry.

-You get that a lot, don't you?

-Yes, yes.

-Own-ions. Onions.

-LAUGHTER

-But I answer to O'Nions.

-I had to ask. I was like...

we weren't too sure.

Lisa has a serious heart defect and needs a pacemaker to keep her alive.

Sometimes, I do get a little bit angry with myself,

I suppose, really. Cos I think,

well, I don't drink, I don't smoke,

I exercise regularly, I eat well - healthily.

Why me? But, at the end of the day, you sort of have to deal with it.

It's there. It's not going to go away.

And, actually, it's keeping me alive now,

so just get on with it.

Today, Lisa is having the battery changed on her current pacemaker.

Do you have a list of medication?

I don't have any.

-No meds?

-I'm a good girl.

-Ooh!

Nurse MacDonald is dealing with Lisa's pre-op care.

-Just a bit about your past medical history.

-OK.

So, the reason the pacemaker was put in?

Sick sinus syndrome.

Is that from a child, or...?

Well, they found it when I was 23.

-Oh, OK. Just irregular heartbeat?

-Just irregular heartbeat.

I was just going for a routine check-up for some medication

and my GP found that I've got an irregular heartbeat.

-Oh, OK.

-And it picked up from there.

-Rhythm.

-Mm.

Only 2% of pacemakers are fitted in people under the age of 45.

If Lisa's condition hadn't been picked up by her GP,

she wouldn't be alive today.

THEY TALK

And your next of kin?

Stuart O'Nions. That's my husband.

Is he coming with you?

He's going to come up

-once I've had the procedure done.

-Yeah, yeah. That's fine.

Cos I said, "Well, you'll probably be...

-"so to speak, in the way".

-NURSE LAUGHS

I didn't know that my hubby could be here, you see.

-Yeah, yeah.

-That's why I said...

-Has he got a job where he can just nip out, then?

-Yeah, yeah.

It might keep you...

When am I scheduled to go down?

I've just got to double-check the list.

I don't know how I'm going to let him know.

Do I just let him know afterwards?

Do you want to text him now the number?

-Oh, do you mind?

-Yeah, of course.

Lisa married her husband, Stuart, 20 years ago.

She wanted him to be here.

But, for now, she's facing the operation on her own.

Can your wedding band come off, or do you want it taped?

-I'll have it taped, if that's OK.

-Yeah.

And the one on my toe as well, please, if that's OK.

-Is that a wedding band on your toe, too?

-Yeah.

-Is it?!

Is it like a special ceremony you had?

-LAUGHTER

-Is it not?

We went into the wedding ring centre in Florida

and he said, "I've never sized up somebody's toe before."

LAUGHTER

I've never seen a wedding band on a toe, I'm not going to lie.

-LAUGHTER

-It's very unusual.

Oh, that's cool.

You'll have to glitz up those toes,

-won't you, every year, every anniversary?

-I've took all...

-Yes.

-LAUGHTER

Can I pop just a little bit of tape here?

And I'm going to go towards the toe, is that all right?

LAUGHTER

LAUGHTER

I've just never seen a wedding band on a toe. Honestly!

That's it. It doesn't come off.

LAUGHTER

THEY TALK

Professor Leyva, an expert in cardiac devices,

will be carrying out the operation.

We know that, when you are not pacing, you just stop.

-Isn't it?

-That's right, yeah.

So, to be absolutely sure, we'll just put in a temporary wire.

And that just covers us

-during the process of changing the box.

-I know, when you're switching.

OK. I wondered how that was going to work, cos I thought, you know...

-Yeah. No, that's the safest way to do it.

-That explains it.

Changing a battery on a pacemaker

is an intricate procedure that can take up to an hour.

And do you know whether you'll be using the same scar?

Yeah, I'll just use the same scar.

I'll have a look.

If I need to add another one, I might have to.

-OK.

-But I'll try not to.

-OK.

-OK.

-OK?

-Thank you.

-Very good.

-See you soon.

-Very good.

-Thank you.

It's 2pm.

Husband Stuart hasn't arrived yet,

but Lisa's friend Kay, from school, works at the hospital.

ALL TALK

-THEY MURMUR

-I'll go and get it now.

-You've done this before.

-I know.

I know. Thank you. Thanks for coming to see me.

Day surgery bed 40 takes Lisa to theatre.

I think Stuart might be on his way, so...

Yeah. Yeah.

In the next hour, Lisa will have her pacemaker renewed...

..to keep her alive.

See ya.

The Royal Victoria Infirmary in the heart of Newcastle.

It's one of only five UK centres to offer emergency consultant care

24 hours a day.

These A&E beds work the hardest,

seeing more patients than any other hospital bed.

On average, ten a day.

That guy's been discharged now.

-He's got an outpatient appointment with us.

-Champion.

Eight-year-old Mason's been treated here many times

for an ongoing condition - pressure on the brain.

But today it's his dad, Lee, who's waiting to be seen.

It's not the first time he's been to A&E.

I'm a little bit accident-prone, you could say.

Operations, snapped fingers...

broken bones.

Cos I'm always doing daft things, is that right?

-Yeah.

-Aye, thought it was.

-LAUGHTER

I've got suspected broken ribs and two bite marks on my back.

It was just...

stupidity, really. Just friends being daft.

A&E bed 15 is ready for its next patient.

Mason and mum Michaela will be Lee's bedside support.

Hello. Is it Lee?

-Yeah.

-Right, come and have a seat up here.

-Yeah.

I'm Bob Jarman, one of the consultants.

Consultant Mr Jarman has 13 years' experience in emergency medicine.

He'll assess whether Lee's ribs have been broken.

-And what's your name?

-Mason.

-This is Mason.

-Mason, OK.

So, I'm going to ask your dad a few...

Is he your dad, I presume? You're not his dad?

-I am.

-You're his dad?

-Mm-hm.

-Oh, right. OK.

OK, what I'm going to do... Let's you examine you now.

-I'll just close the door.

-Yep.

-Just so nobody can see us examine you.

-I'll close the door.

-And then we'll do that. OK?

Good boy. That's right, Mason. OK, well trained.

What a helper.

So, yeah, somebody's decided to have you for supper, then, eh?

Ah, yeah, a snack.

So, let's just have a little feel.

-I'm just going to feel in the middle.

-Yeah.

-OK?

-All right down there, yeah?

-Yeah.

I'll just have a little feel here.

-LEE WINCES

-Is that sore, yeah?

-Mm-hm.

So, you can see there's a couple of bite marks

-that have pushed it over a little bit now.

-Mm-hm.

There's also some bruises there,

-where it looks as if you might have been grappled a bit.

-Mm-hm.

Let's just have a little feel on this side.

Can you just take a deep breath in for me?

-LEE INHALES DEEPLY

-Agh!

-Again.

-LEE INHALES DEEPLY

Ah, OK.

OK. Can you just rest yourself back?

Just be careful, cos it's got to be slow.

Oh, it's going to be. Oh, yeah.

Mm.

I think what I'm going to do is go and to get my little sound machine

and we're just going to check that there's no evidence

of your lung being collapsed down, or any blood down the bottom.

-Right.

-If that's OK, then that's good.

-Right.

-OK. I'll come back in a few minutes.

-No problem, thank you.

'It looks as if he has got some trauma to his chest.'

There are bite marks on one side,

some bruises and he's also tender

with bruising to the side of his chest, too.

So, the most important thing is that we need to rule out

things that may be serious, like a collapsed lung,

or bleeding around the lung itself.

And human bites can get infected with bacteria.

And they can also transmit viruses between humans, too.

To see two big bites to his chest is quite unusual, to be fair.

Between them, Lee and son Mason have been in hospital more than 30 times.

Dad, how many times have you been in this hospital?

Er...

A few times, son.

I've probably spent a quarter of my life on a hospital bed.

Try and guess how many times I've been in.

I think I've lost count.

How many was it? 200 more.

Have you ever snapped your finger?

I don't think I have. I don't think I've had a broken finger.

I'll tell you if you have.

Does any fingers look like that?

Don't think so.

-Ah, Dad, it still hurts.

-Does it?

-Aye.

-What is it?

-Look, that.

-Oh!

Lee will have to stay on A&E bed 15 for further assessment.

Next door, at the Great North Children's Hospital,

is the paediatric emergency department.

-PHONE RINGS

-Hello, PED EME.

Its nine A&E beds are smaller,

but they work around the clock to care for the under-16s.

We have nine beds in total.

We've got six cubicles

and then we've got three monitoring beds behind us here.

The monitoring beds are used as a step down from Resus,

so for sick children that need a bit more one-on-one care.

Today, paediatric A&E bed 27 is expecting a four-year-old.

-So, if I can get Theon to have a seat on the bed.

-Yeah, sure.

Parents Sarah and Mark have rushed their son, Theon,

to the emergency department with stomach pain.

Less than a month ago,

he had emergency surgery to remove a bowel blockage.

He's being assessed by Nurse McGee.

Whilst on holiday in Dubai, we thought he had a little tummy bug...

-Uh-huh.

-..which turned into something a bit more sinister.

-He actually had a intussusception in his bowel.

-Uh-huh.

-So, he's had part of his intestine removed out there.

-OK.

And everything's been doing great up until last night,

when he started getting a bit of

-loose bowel movements, with no pain.

-OK.

But today he's complained quite a lot of the pain

and on the scar tissue across.

-And has he had loose stools this morning as well?

-Yeah.

The thing is, it's a similar colour to what it was

the day before it all kicked off.

-Right.

-So, that's why we're just...

-It was quite mucusy.

So, we just want to make sure he's all right.

Can we take your jacket off, darling?

-I don't want to...

-ALL TALK

Oh, don't cry. It's OK!

Oh, listen. It's the tickly one.

-Do you remember the one you liked?

-ALL TALK

It won't hurt. I promise it won't hurt.

This one won't hurt.

Intussusception is the most common cause of bowel blockages

in young children.

If left untreated,

this condition can lead to death in less than five days.

Wow. That's OK.

-Ooh!

-MACHINE BEEPS

-HE SNIFFLES

-You've been very brave.

-Don't cry.

'We were just at the pool and it was a normal day'

on our nice holiday, and he started saying he had a bit of tummy pain

and felt a little bit sick, so, Mark took him out of the pool

and he was sick and we thought,

oh, maybe he's just had too many milkshakes.

-The hotel had a...

-Medical centre.

-It had a medical centre,

so we just went down to see them.

They didn't even check him.

They just said he needs to go to hospital straightaway,

something's not right.

We got sent to the hospital and they did ultrasound and an X-ray,

which showed that he had this blockage in his bowel.

The surgeon came out and said he needed surgery there and then,

cos the situation he was in, it was like a life-saving operation,

it was urgent surgery.

Just when you get a couple of symptoms that were very similar

-to what happened before...

-THEON SNEEZES

..when it's happened in Dubai,

-you sort of get a little bit...

-HE PLAYS AND LAUGHS

..nervous.

An X-ray is the only way of determining

four-year-old Theon's condition.

'They're doing some more images of his abdomen, you know,

'seeing if the bowel and the intestine and everything

'is working as it should be. You worry.'

You hope to God that it's not...

we're not going down the same route as before, with this obstruction.

In less than an hour,

the results will reveal if young Theon's life is at risk again.

In Birmingham's day surgery unit,

bed 40 is taking 44-year-old Lisa for her heart operation.

-Sorry.

-Yeah.

She's having a new battery fitted to her pacemaker.

Without it, she wouldn't be alive.

OK, that's good.

-You OK?

-Yeah.

-All right.

Well, we're just going to have a look at the device

and see what it's doing.

Local anaesthetic will be about three milligrams...

If you're anxious, we'll give you more.

Yeah.

-I think that might be better.

-Yeah.

-Don't worry. You'll be fine.

-OK.

-Good, excellent.

Cardiologist Professor Leyva is in charge.

Lisa will be sedated, but awake throughout.

'This lady has had a pacemaker in for quite some years, since 1998.'

And what we're trying to do

is just to change the battery.

We take out the whole pacemaker and put a new one in.

'It's less common at her age.

'It's mainly in the 60, 70, 80-year-olds,

'it's much more common to have pacemakers.

'So, we're just checking, at the moment,

'that her own heart is actually beating'

when we take the pacemaker out.

So that, when we change it, the heart just doesn't stop.

The team reduce Lisa's heart rate.

They're on standby, in case her heart stops beating.

How are you feeling there at the moment?

As long as it's not for too long.

What we'll do is we'll leave you like that just for a moment,

just to give you a bit longer to adjust,

having been at 60 beats per minute

and now you're down to 40 beats per minute.

It takes you a minute or two to adjust to that, OK?

So we'll check with you again before leaving it.

Lisa's husband, Stuart, has arrived at the hospital.

'She doesn't whinge at all.

'She just does take it in her stride. This morning'

she put the girls off to school as normal

and I went to work. I was told to...

be as normal as possible.

But, no, your mind's not at work.

Your mind's elsewhere. You're worrying.

And then, as soon as she tells me...

..you know, that there's a time for her theatre,

I just jumped ship from work and came straight here.

And then it's just a worry, then, making sure everything's OK

and you're here for her when she comes through from the operation.

All done.

All right?

Good.

'So, we didn't have to put in a temporary wire'

because, actually, her heart was beating quite well.

Although, it stopped for a little bit,

it was a very quick change of the box.

The whole point of pacemaker treatment

is to make it as...least intrusive to the patient as possible.

And the boxes now are smaller, so...

..that is much better, cosmetically.

And I'm very conscious in patients who are so young

who are going to have so many scars,

to be as atraumatic as we possibly can.

-STUART:

-'She's in good hands.

'A very good hospital. Very good surgeons.

'They've transformed her life. She couldn't breathe properly.'

Her heartbeat was sort of stopping for four to six seconds sometimes.

She needs this pacemaker.

Lisa is transferred back to day surgery on bed 40.

She'll soon be reunited with her husband, Stuart, back on the ward.

It's 3:20pm at the Royal Victoria Infirmary in Newcastle.

A&E bed 15 is with Lee,

an A&E regular, and son Mason.

I'm a doctor. I'm...

I'm going to make us look creepy.

Watch how creepy.

-What's that?

-MASON LAUGHS

-GLOVE SNAPS

-Right, Dr Mason's here to help.

Lee was admitted to A&E an hour ago,

with suspected broken ribs and human bite marks on his back.

Sorry, sorry.

-Are you almost getting squashed?

-Mm-hm.

-I don't know.

Consultant Mr Jarman is back to examine Lee's chest

with an ultrasound machine.

THEY TALK

It will detect any damage to Lee's ribs, or bleeding in his lungs,

which could seriously affect his circulation.

OK, so let's do the good side first. OK?

Take nice, deep breaths for me.

-OK, so what we've got, some ribs.

-Yeah.

-Yeah?

-Yeah. And this is the surface of your lung.

And, as you take a deep breath in and out, it moves up and down, yeah?

-Oh, aye, yeah.

-So, that means that hasn't collapsed down,

-which is good. OK, that's good. Now, you just stay where you are.

-Yeah.

I'm just going to change and look for any evidence of bleeding

-in your chest, OK?

-OK, no problem.

So, we haven't found any babies yet, Mason.

-Oh!

-No babies.

I just want a brother. I've already got a sister.

Yeah?

Mason's used to hospitals.

He's been in and out of them, due to an ongoing illness.

THEY TALK

Unsurprisingly, he's become interested in medicine.

Whoa!

HE MIMES

So, where's the ribs?

-These are all the ribs, here.

-Oh, them?

Yeah. These are all the ribs.

So...how can you tell if it's bleeding in the tummy?

I was just going to ask that.

Because what we're looking for is...

it looks like black fluid.

And we can't see any down here. This is where we get it, all down here.

But there's nothing to see, really, is there?

-And that's all very good, isn't it?

-Oh, yeah.

And, looking at it, there's nothing that looks bad. It all looks good.

-Oh, well...

-So, that's good.

-Yay!

Mr Jarman now needs to deal with the human bites.

Oh, Dad, you're bad. Your back's bad.

There is a risk that hepatitis B and tetanus

could have been transferred to Lee.

I'm presuming you haven't been vaccinated for hepatitis B.

-No.

-But we'll do it as a precaution.

-Yep, thanks.

Cos the bugs in human mouths can be quite nasty.

You're going to have a couple of injections now.

-One of them is for hepatitis B.

-Right.

-We take human bites very seriously.

-Mm-hm.

-OK?

-Look after yourself.

-You as well, mate.

And no more getting bitten, yeah?

-Thank you very much.

-No problem.

-Thank you.

-Bye-bye. Bye, Mason.

-Bye!

-THEY TALK

-Is your name Bob?

It is.

But you can call me Dr Bob.

Dr Bob.

Lee is given tetanus and hepatitis jabs.

He can now leave A&E.

Dad, how many lives you got left?

Cos I think you've got one.

-Aye.

-LAUGHTER

Hopefully, I've got more than one, like.

LAUGHTER

Lee is on and off bed 15 within an hour.

The next patient will be here soon.

Today, all 29 beds in A&E are busy.

Bed nine has being allocated to 30-year-old Emma.

Have a seat on the bed, if that's OK.

She has a numb feeling in her arms and face

and is anxious she may have had a stroke.

What's brought you in?

Dr Earl-Wright, a junior doctor in his second year of training,

needs to make a diagnosis.

Erm, for a couple of weeks, I've had pins and needles down my arm.

-Down my right arm.

-OK.

-In my fingers especially, but a kind of numbness at the top.

-Right.

I woke up with it,

so I thought I may have kind of slept on it funny...

-Yeah, laid on something.

-Yeah.

But I've woken up this morning and my face feels like I've had...

you know like a dental injection?

-Mm-hm.

-You know when it's kind of wearing off.

-All feels really numb?

Yeah, it's all just this right side.

And is it the same sort of feeling you're getting in your hands?

-Like a pins and needles feeling?

-Yeah.

And is it mainly in your fingers, the pins and needles?

-Or is it worse in your entire arm?

-It kind of...

does kind of radiate, but I've got like a numbness up here.

-Mm-hm.

-And it's my fingers that are pins and needly.

But it's more my face that's bothering me.

It's just really quite strange.

-Really strange?

-Mm-hm.

-Do you want to relax down on the bed for me?

I'll have a quick examination of your arm.

-Can you feel that on there?

-Mm-hm.

Does it feel the same on both sides?

No, it feels peculiar on this side.

Feels strange?

Yeah, it just doesn't feel as prominent on this side.

Like pinky and pinky is the same, yeah? Thumb and thumb is the same?

-Mm-hm.

-It all feels...?

I can't describe it. It just feels...bizarre.

Bizarre. Right.

The tingling could indicate a number of serious conditions,

including a stroke, or multiple sclerosis.

And nothing runs in your family, does it?

-My mum's dad died of a heart complaint when he was younger.

-OK.

No neurological problems run in the family at all?

-A few strokes.

-OK.

Right...

I think we should do some baseline blood tests, OK?

We'll check your calcium and make sure that's OK.

And a few others just to make sure there's nothing, you know,

-aberrant there that could possibly be causing this.

-OK.

'Emma has a very strange constellation of symptoms'

that basically adds up to her having numbness and paresthesia,

which is abnormal sensation,

'down her arm and the side of her face.

'It doesn't really make any sense at the moment.

'So, we're going to do some blood tests and'

once those are back,

I'm going to have a chat with one of the consultants and see whether

we can have any fresh ideas.

Cos it doesn't really quite add up yet

'to anything that makes sense.'

It's handover time, so I've been here for 12 hours,

so I will hand your case over to someone else.

-OK.

-And they'll come in and see you.

-OK.

-All right?

-We'll see whether we can get to the bottom of it.

-OK.

But it might be that it might need further investigation.

But, if that is the case, we can sort that out.

-That's fine.

-Does that sound all right?

-Yeah, that's fine.

-Do you have any questions?

-No.

-No? Good stuff. All right.

-Thank you.

You just chill out in here.

-Oh, in here?

-Yeah, you just hang out here.

-OK.

-Someone will be in soon. All right?

-OK, thank you.

-Cheers.

Emma's family history of strokes puts her at greater risk.

Dr Earl-Wright decides more tests are needed.

For now, Emma will remain on A&E bed nine.

BEEPING

Next door, in Newcastle's Great North Children's Hospital,

four-year-old Theon has left paediatric bed 27.

He is on his way to X-ray.

Wow, look! The toys!

Around a month ago,

he had life-saving surgery to fix a bowel blockage.

Mum Sarah and dad Mark fear the blockage has returned.

We've had some blood taken.

That's just to check for any infection, anything like that.

Hopefully, they'll come back soon.

And, in the meantime, we've been sent here for an X-ray

of his abdomen to check everything, all the bowels and intestines.

So, he thinks he's having a photo taken.

He quite enjoying it in here,

cos there's lots of toys and it's nice and bright for him.

We are just concerned, obviously,

until we have the X-ray done and the bloods back to know what's going on.

There's the worry about the operation

that he had done out in Dubai.

Is there some complication that has arisen since that?

Or is it something else going on?

There's still a lot of anxiety until you know.

When we were in Dubai, I was worrying then.

But now I'm sort of trying to be a little bit more hopeful

that it's nothing sinister

and hopefully we'll get those answers shortly.

-Theon?

-Ready?

Radiographer Wilson will be carrying out the X-ray.

There you go, big boy.

Right, Theon, I'm Nicola.

I'm going to take your X-ray, OK?

-Are you speaking?

-How old are you?

-How old, Theon?

-Four.

-Four!

-SARAH LAUGHS

-Right, are you ready?

-Yeah?

Ooh!

The last time Theon was on a hospital bed,

he needed a life-saving operation.

That's it. Breathe in.

-Breathing in.

-Hand out!

And just hold your breath. That's it.

The X-ray will determine

if four-year-old Theon is at risk again.

Oh, bless him.

Theon, you're all finished!

Looking at his bowel...

-He's had previous surgery. Is that correct?

-Yeah.

-Yes.

Three-and-a-half hours after being admitted,

Theon is taken back to bed 27.

Why are you moving up here, Mummy?

-To sit next to you.

-To sit next to you.

If that's OK with you.

LAUGHTER

Hm?

How beautiful are you, Theon?

LAUGHTER

How beautiful are you?

-What's the time, Mummy?

-The time?

The time is 1:10.

So we can go home now?

Not much longer now.

Hello, how are we doing?

How's your tummy?

-OK.

-Is it feeling OK?

Nurse McGee has the results.

His X-ray is all clear.

Four-year-old Theon does not have a blocked bowel.

Lovely. If you have a little seat in the waiting room.

OK? Okey dokey.

Theon and his parents can go home.

Well, that's good news. His X-ray looks absolutely normal.

Everything's healed from the previous surgery that he's just had.

His blood tests were all normal.

And it's fine for us to go home and just keep a check on him.

Things look good for the future for him, so we're happy.

And you've no more pain, have you? You're doing good.

Do you want to go home now?

-LAUGHTER

-I think he's absolutely delighted

to go home to his own bed. He can't wait.

-And neither can I.

-LAUGHTER

BEEPING

In the adult emergency department

of Newcastle's Royal Victoria Infirmary,

A&E bed nine has been with 30-year-old Emma for an hour.

She arrived with numbness in her face and arms.

I don't feel unwell.

I just feel strange, really.

Thought maybe that I'd slept on it funny

and trapped a nerve, or something.

Maybe I've been bitten by something.

That's the only thing I can think of.

The priority is to rule out a serious illness.

Despite Emma's young age, there's a concern it could be a stroke.

With a family history of the condition,

this puts Emma at greater risk.

Blood tests have been ordered to help the diagnosis.

I don't think I could do it, be a doctor or a nurse.

I struggle to decide whether I want a pair of red shoes or black shoes.

A&E bed nine will be with Emma until her results are back.

-Hiya.

-Hi.

-Hi.

Dr Seeley has just come on shift.

He's taken on Emma's case.

-I understand you met Ben before.

-Yeah.

And he's told me that you've had pain in your right arm

and then you've developed some numbness in your face

-and on your arm.

-Yeah.

-Is that right?

Kind of like pins and needles in my fingers.

And a kind of numbness at the top of my arm.

And now it's this kind of side of my face.

I feel like I've had a dental injection.

-And it's just gone a bit numb?

-Yeah.

-OK.

Just, for my peace of mind, do you mind just...

-I'm just going to examine your neurology again.

-Mm-hm.

So, squeeze my fingers.

That's lovely.

Like you're a chicken.

Don't let me push them down.

Push them down.

Great. OK. That's all fine, isn't it?

All right. The first thing to say is your blood tests

-are all completely normal, so that's great news.

-Yep.

We certainly don't need to bring you into hospital.

What we look for in A&E is anything that might be A, life-threatening.

-Yeah.

-Or B, worrying in the next couple of days,

which I don't think this is.

It was just the concern about my face, really.

Yeah, so it's a little bit of reassurance

-that it will probably sort itself out.

-Mm.

Sometimes we never get to the bottom of it.

-OK.

-But the majority do, eventually, resolve.

Things to worry about, and to come back if it changes,

-so if it starts spreading.

-Mm-hm.

So, if you get more numbness elsewhere.

If you start getting weakness, or if anyone notices

you've got a bit of a droopy face.

Anything to do with getting drowsy, or confused, or anything like that.

-OK.

-Or troubles with your balance or your speech.

-OK.

-OK?

-Yeah, that's fine.

-That all all right?

-Mm-hm.

Lovely. In that case, we can let you go home.

Is it causing you any pain? Do you need painkillers to take with you?

No, it's just a little weird.

OK. Great. All right.

-Thank you.

-In that case, thank you very much.

-Thank you.

Emma has not had a stroke.

One of the things that we're told as juniors,

when we first come into the department is,

when you first see someone, to look at them and work out

if you think they're going to need to come into hospital,

or whether it's something that we can sort out and get people home.

Obviously anyone who needs to come into hospital has to come into hospital.

If they need a bed, they need a bed.

But, if someone has got something that can be followed up

safely in the community, then it's our job to make sure

they then get plugged into the right services.

A&E bed nine is released for its next emergency patient.

BEEPING

At Newcastle's Great North Children's Hospital,

paediatric bed 27 is about to meet seven-year-old Brandon.

He's hurt his cheekbone.

'Brandon woke up this morning with a swollen eye.

'Not too bad, so I sent him to school.

'And I got a phone call at ten o'clock,

'saying that he was sobbing.

'Pain down his face and his tooth.'

Got him to dental hospital -

"It's definitely nothing to do with his teeth,

"so you're going to have to go over to the A&E".

Brandon will be assessed by trauma consultant Dr Carol.

So, what's happened to you?

I've had something smack my eye socket.

OK. Is your eye socket sore?

-Yeah.

-OK. Have you got hit by a swing? Is that the right story?

-Yeah.

-What sort of swing was it? A big wooden one, or a plastic one?

-It was plastic.

-OK. And when did that happen?

-Different colour.

-Yesterday.

-OK.

And were you knocked out, or do you remember everything that happened?

I remember everything, but I didn't get knocked out.

OK, good lad.

And do you hurt anywhere else, apart from your face?

-No, just my face.

-OK.

-I had a toothache.

-OK.

And I've got clean teeth.

-Good lad.

-"And I've got clean..."

-LAUGHTER

So have I.

Brandon has been sent to A&E by the dental hospital.

I'm going to start by looking down from the top of your head.

So, a bit swollen on the right, isn't he?

So, whereabouts is your face most sore?

That's it. This side OK?

-Yeah.

-So, the swing only hit you on that side?

How does your nose feel?

-Good.

-Good.

-And that cheekbone feels OK?

-Yeah.

Open your mouth nice and wide.

'He's clearly a clever little lad. He takes things very quickly.'

He seemed to know exactly what I was talking about and was happy

with the explanation that we've given him.

Keep it open. Don't let me push it shut.

Is that sore? Does that hurt?

It's probably the ideal environment to have him on a bed,

so you can look over the top.

It's very important to assess symmetry in facial injuries.

Just one pen over there?

-It's blurry.

-OK. And over this way?

-Still blurry.

-OK. Look up.

-Still blurry.

-Look down.

-Still blurry.

-OK.

It's very, very unusual for youngsters

to break the bones in their face.

He does have quite a bit of swelling there

and that will be affecting his vision to some extent,

cos he'll be able to see it.

And, because it's swollen up from below,

it will just change the way he sees the world through that eye.

I think it'll all go back to normal, as the swelling settles.

It might be worth trying to get an ice pack on that

for five or ten minutes this evening, just to try to reduce the swelling.

He had one on at school as well. And he's had ibuprofen.

It seems to have taken it down quite a bit.

So, I'll put another one on when he gets home.

Dr Carroll is satisfied that no further tests are needed.

The facial bones are quite well protected in children,

because there's adult dentition in the sinus cavities.

And that forms an extra layer of protection,

so you've got basically two layers of bone.

'So, it's very unusual for children to break the bones of their face.'

-All right.

-That's fab.

-I'll let you away.

-Thank you very much.

After you, sir. Thank you.

Brandon can head home.

This way.

Paediatric A&E bed 27...

-Bye!

-Bye!

..may soon be needed by someone else.

The Queen Elizabeth Hospital in Birmingham.

Bed 40 is heading back to the day surgery ward.

Its patient, 44-year-old Lisa,

has just had a new pacemaker battery fitted.

THEY TALK

You can come on in. You can come in.

Husband Stuart is by her side as she comes round from sedation.

Take care.

THEY TALK

SHE WINCES

SHE SOBS

'Lisa's a very brave, lovely woman.

'Lovely mother. Couldn't wish for a better wife, or mother.

'The children are her world.

'She looks after me and the children more than enough

'and it's our time to repay her.'

Lisa has a serious heart condition.

This is the third heart operation she's had to keep her alive.

Lisa's friend, Kay, is back to visit.

-They brought you a coffee.

-Ooh!

A woman after me own heart!

You know, don't you?

How are you?

All right. It was just the box change,

-so it was quicker than anticipated, which was good.

-Yeah.

Do you notice a big difference once they've changed the box?

Not yet. I will do...

-In a few days?

-Yeah.

Yeah.

Oh, thank you, Lisa!

Thank you ever so much, chick.

You're a star.

So, if you're feeling up to it after this,

-we'll go for a little stand and see how you're feeling.

-OK.

Lisa's pacemaker is now fully charged.

Her life can begin to return to normal.

She'll be released as soon as she can find all her belongings.

They made me take my underwear off in the theatre.

So, somewhere...

I don't know where...

-Is your...

-Undercrackers.

-There'll be some undercrackers.

They'll turn up the end of the day!

-LAUGHTER

-Oh, no!

-Normally, they're under here.

-Oh!

So, I'm just apologising to the cleaners.

-LAUGHTER

-Oh, no!

Don't worry. I can get...

-They weren't special pants, were they?

-No. I can get home...

-Anniversary pants or anything?

-LAUGHTER

I can get home commando. You're OK.

-LAUGHTER

-I know, but...

Oh, has she put them there? Has she?

Bless her. Yeah.

-LAUGHTER

-Do you recognise them?

LAUGHTER

-Anyway...

-Right, then.

I'm just going to get you up, OK?

Problem solved, Lisa is now ready to leave day surgery bed 40.

-You're very welcome.

-You've been a star.

-Thank you.

-Thank you.

-You really have, you've worked really hard.

Thank you ever so much. Thanks to all your staff as well.

-Thank you.

-OK? Bye.

-Bye.

'I can't explain the feeling.

'It's sort of like a heaviness'

that I had before and just felt, you know...

But I do feel lighter.

Rest up for a few days.

Easy exercise to begin with.

And then, gradually, build up back to my three times a week.

-She's in good hands.

-You've done it before.

-Yeah, I've done it before.

-He is quite domesticated, so...

-Yeah.

-..you'll be OK.

-Yep.

Well, we'll see if he can look after the house and the girls.

Obviously, he won't be as good as me, but I shall...

rest up for a couple of weeks and I'm sure he'll do a grand job.

Our hospital beds have given us

intimate access to the work of the NHS.

After a short stint on A&E bed 15,

the pain in Lee's chest has gone.

Theon had to go back to hospital with tummy pain,

but is now OK.

And Lisa's heart is beating well.

She's back at work and enjoying family life.

The beds are now back on their wards,

ready and waiting for their next round of patients.