This program contains scenes that some viewers might find disturbing. Viewer discretion is advised. The city of Los Angeles has the largest population of homeless people, drug addicts, and street gangs in the United States. Being a paramedic in the LA districts of South Central and Skid Row is brutally demanding, and a place where severe psychological stress is a day-to-day occurrence. Weaving an ambulance in and out of heavily congested traffic requires great skill and alertness. One of the top dangers of of our jobs is actually responding to the incidents. >> Paramedics work in extreme conditions. They are constantly at risk to contagious diseases and acts of violence from unstable patients. >> As I turned around to uh pull the gurnie into the hospital, he punched me in the face. >> In the dead of night, the stakes are heightened as events can spiral out of control in a matter of seconds. Hey. Hey. Hey. Where are you? Hero [Music] [Music] heat. The city of Los Angeles has long been a destination for people in search of the American dream. Where luxury cars cruise the high streets of the rich and famous and where the cost of a house can run into the millions. But for the people of LA living in Skidro, life couldn't be more removed. It is home to one of the largest stable populations of permanent homeless people in the United States. Population estimates range from 7 to 8,000 for this district alone. Cardboard condominiums and camping tents are used as makeshift homes. It's a place where heroin is easier to buy than a quart of milk and where crack pipes light the streets like fireflies. >> Just anxiety attack. That's what you're saying. I can't answer. >> Both substance abuse and mental illness are higher among homeless people than in the rest of the community. [Music] >> For paramedics Chris Baker and Greg Lewis, working a 24-hour shift in LA's druginfested skid row means they must put their lives on the line in order to do their job. Within a single shift, they can receive 10 to 30 calls. The minute they leave the station, they have no idea what or who awaits them. [Music] Within 15 minutes of starting their shift, Chris and Greg are dispatched to a downtown hotel that is notorious for housing drug addicts and people suffering from mental illness. Driving to the scene of an emergency is one of the most dangerous parts of their job. Maneuvering a two-tonon ambulance at high speed through intense traffic is a high-risisk activity. Chris has to pay attention to what's going on at all times. It's a really one of the top dangers of uh of our jobs is actually responding to the incidents. Um we're we're going lights and sirens down the street and we're uh relying on people to react to us appropriately and as with most things in our line of work, people don't act appropriately. Like everything else, if we can't get there, then the problem can't get resolved. [Music] As soon as they arrive at the hotel, Chris looks for the security guard who leads them toward the patient. >> Uh, yeah, that's >> watching their backs is the engine company who will step in if Chris and Greg's lives are ever put in danger. Oh, I forgot about that. >> Two nights ago, he was in the hallway. >> 655. >> The man in need of medical assistance is a known drug addict with a history of violence. [Music] As they enter the patient's room, Chris notices a strong smell wafting out, an indication that rigger mortise has already set in. The man has already been dead for at least 48 hours. In order to officially pronounce him dead, Chris has to make sure that he is not breathing or has even the faintest pulse. Chris then checks under the bed for any weapons or drugs that may give him a clue to the cause of death. Staying constantly aware of used needles that could prick him and possibly infect him with HIV or hepatitis. The city of Los Angeles has a drug death rate that's 10% above the state average. Here, overdoses are almost routine. >> Yeah, we see this pretty often actually. A lot of times people in these big buildings, they'll not see each other for a couple days and so they just do a welfare check and then they'll find somebody who's deceased. So, The guy's just out of jail. They haven't used in a while. They come down here. They get out of jail. Twin Towers are down a little ways away. Come down here, buy, shoot up, use the same amount they used to, and they overdose. And that's it. As soon as the Los Angeles Police Department arrive at the hotel, Greg hands the crime scene over to them. The police will determine if there was any foul play. >> Um, don't see any signs of trauma. Security guards in there say he's a known heroin user, but we didn't find anything around there, but we didn't really find anything trauma to him or anything like that. and he's only been a day or two. >> Just as they're about to head back to station 9, Greg gets a call from the dispatch center advising them to go to a nearby hotel. [Applause] The hotel manager placed a call stating that a woman was lying in the corridor suffering from a severe seizure and needs immediate medical attention. Yeah, he just told me where he would be >> like at the last hotel. And in order to find the patient quickly, they must get in contact with the hotel security staff who will be able to give them the specific details they need. >> She had a se like I went up there. >> Did you see her have a seizure or >> she Well, she's like this on the ground. >> You know what I She's pulling and she's doing a fish on the ground and then I'm on the phone with you guys and they're saying tell her not to move >> and so she's like >> she's quiet then there's a fight going on in another room. I go over there >> when I come back she's passing me on the stairway man like with a beer I'm like you doing up yeah beer wasn't open dropped a couple times. >> Oh okay >> but uh yeah going to 467 >> four >> 467 >> 467 >> they call her green eyes >> very very peculiar looking you know what I'm saying? Oh, okay. We'll know her when it's here. >> All right. Hey, thanks. See you out there. >> Is 467 this way? >> All right. >> Damn it. >> The sight of human suffering is something that both Chris and Greg have to endure every working day. They are constantly surrounded by legions of sick, homeless people and drug addicts inflicted with incurable illness. >> You want our help? Do you want our help? Why don't you open up the door and talk to us? >> I'm all right. >> You don't want our help? >> I'm okay. >> Are you green? Green eyes. Okay. >> Okay. >> You're cool. >> Okay. Well, what happened? >> I just had >> You had seizures? Do you have seizures? Although the woman requires immediate attention, she refuses to be taken to the hospital. >> I haven't I haven't seen a doctor yet. >> Huh? >> I haven't seen a doctor. >> Chris tries in vain to convince the woman that she needs medical attention. >> You don't want to help at all. >> The engine crew stays grouped behind him, not knowing who or what lies behind the door. >> Paramedics can never let their guard down, even when it's a routine call, as a moment of inattention can quickly turn events upside down. we're walking into places that we haven't been to before that we're walking into someone's home uh looking for them without too much information. So, as we go into their door, we we don't know what to expect or what to find and it's always potentially hazardous in the area that we work in. >> Chris continues to try and persuade the woman to let him examine her. Once again, she refuses and therefore there is little more Chris can do. One of the most frustrating parts of any paramedic's job is when a patient is in serious need of medical attention but refuses to be treated. Unfortunately, this is just one of many realities that they have to deal with on a daily basis. [Music] Los Angeles is the gang capital of the world. With 700 street gangs and 40,000 members, it's a ratio of about one police officer for every four gang members. Being a frontline paramedic working in the ganglands of South Central LA is not a job for the faint-hearted. Each year there are around 425 homicides and almost half of them are gang related. There are three firearm related deaths in Los Angeles every week. Drive-by shootings are a regular occurrence. Twothirds of all child and adolescent homicide victims in LA are victims of gang violence. Jessica Cullen and Carlos Morurell know that every time they are dispatched to a call, their lives are at risk. I think that South Central um South Los Angeles is one of the most dangerous areas in uh LA. Had just started working down here and um I had a patient that was a diabetic altered and was taking him into the hospital and as I turned around to uh pull the gurnie into the hospital, he punched me in the face. So, um it was a uh I got kind of blindsided by it, but you just you always have to be looking and uh be aware and be ready for something like that that can go on. And I went home and regrouped and came back the next day and you know, still doing my job today. But it just makes you keep eyes in the back of your head and on your toes at all times. It's Carlos and Jessica's first call of the day. A 32-year-old man is dying of AIDS and must be taken to the hospital. >> We're in St. Noah's catchment. So, yeah. Once at the location, Jessica heads into the house to check the patient while Carlos prepares the stretcher in order to quickly transfer the patient into the ambulance. >> Hi, sir. >> All right. We're going to take you to the hospital. Okay. >> Sir, can you walk? >> Can you stand up and walk? >> That's fine. >> She is saying that he's having trouble breathing. Um, it's been going on for a couple days. And, uh, this is her cousin and she called us today. probably all above. >> Yeah, we'll just set this up. >> See, >> Carlos has to be careful when carrying the man out of the house as infection can occur through a break in the skin or through the eyes. The tiniest rip or hole in his equipment can be a gateway for disease and contamination. Getting their patient to the hospital is their number one priority. Any fear of contamination has to be put aside. >> Sounds like it. >> Paramedics who work in South Central Los Angeles have to be emotionally resilient. Dealing with life and death situations is something they face daily. Uh, did you get a blood pressure, Marshall? >> Sir, your doctors are in harbor. >> We're going to take him to harbor. Okay. All right. 32 [Music] [Music] >> 7752as mas um [Music] diabetes, HIV. >> Their patient has low blood pressure, which is making it hard for Carlos and Jessica to administrate fluids. This initial procedure is necessary for easing the transfer of the patient from paramedic to doctor. [Music] Carlos takes the wheel as Jessica continues to administrate medical attention. >> At this time, we've unable to attain an IV. So, I'm going to just keep trying to get an IV on this guy because his blood pressure is really low, but he has really poor veins there. You know, the the community people get it because there's a lot of drugs or um unsafe sex, then they don't have the proper care, so they don't make it to the the hospital. Um this is sad. [Music] the the biggest thing that has changed my perspective on life and working in South Los Angeles is that I see things that most people will never see in their life. um the kind of conditions that people live in, uh that children are brought up in, the kind of sicknesses, um they don't have the money to get health care. Um so very sick people, um gangs, violence, child abuse, all sorts of things that um most people will never experience and may not even know exists. I see it on a daily basis. Once at the hospital, Jessica and Carlos rushed their patient to a waiting team of doctors and nurses. >> IV and he just keeps kind of dazing off in and out. So, >> hi As day turns to night, paramedics are still working around the clock responding to 911 calls. Each year, paramedics receive approximately 25,000 calls for assistance following acts of violence. Chris and Greg's first call of the night is in a downtown area that is known for street gangs. They're responding to a man who has multiple stab wounds. We're going to another intersection um for stabbing and it just says stabbing generalized uh central wounds doesn't give us any info on a patient. Our main concern is our safety and security not only with what we wear to protect ourselves but uh having police LAPD be on scene and secure the scene before we rush right in. When responding to a gang related call, paramedics and their engine crew stay in constant radio contact with the Los Angeles Police Department in case any violence breaks out at the scene of the emergency. >> Got one in the chest and one probably in his back. >> Okay. >> We haven't turned him yet. >> Okay. >> But he's probably >> Are you having trouble breathing? Is it Are you having trouble breathing or just hurting when Take a breath? >> Take a breath. The man sustained severe stab wounds to the chest and back. Passers by said that he was attacked and dragged up the street by two other men who then left him for dead. >> Oh, he's stabbed in the chest. >> Okay. >> Paramedics need to account for all injuries as well as hidden weapons before they decide whether they should move him to the ambulance or treat him right away on the sidewalk. Yeah, I saw those two. >> Okay. So, that's five. >> What's that? >> Okay. >> No, it's on. I don't think we need that. >> One, two, three. Put your hands up. >> Keep your hands this way. Put your hands. Put your hands here. >> The injured man has lost a considerable amount of blood. >> Greg has to administer fluids in order to stabilize him before they transport him to the hospital. >> Don't move. >> Don't move your arm. It's a stink. Don't move. We got to give you fluid. >> Hey, open up your eyes, okay? We need to know you're okay. >> Your stomach hurts you at all? >> So, we'll call you back if not. >> You been drinking today? >> Drugs? >> Yes. No. He is complaining of pain on inspiration and palpation. We have good lung sounds bilaterally. Good chest rise and fall. >> We have one which is >> once their patient is safely secured within the back of the ambulance. Greg phones ahead to a local trauma center notifying them of their patients condition. >> We have to get back to the rescue. 15 L mask O2. So they're going pretty good. Just one. Take a deep breath. [Music] [Music] An investigation into the stabbing was conducted by the LAPD. The patients attackers were never brought to justice. LA paramedics work a 24-hour shift. In that time, they can receive as many as 15 calls. [Music] Paramedics Carlos Morell and Jessica Cullen's first call of the night is to a 25-year-old woman who is suffering from severe asthma. The patient's address is situated in the ganglands of South Central Los Angeles. Even though this call is not related to any criminal activity, the area is well known for gang related homicides. Carlos and Jessica will have to stay aware of their surroundings at all times. >> Thank you. >> Hi, ma'am. real quick. >> Put it up on bed. >> Get a a room. >> She's got bilateral wheezes. >> Asthma is a chronic disease that affects the tubes that carry air in and out of the lungs. This causes symptoms like wheezing and troubled breathing, especially at night and in the early morning. >> After we get this blood pressure, >> are you 25 years young? More than 20 million people in the United States have been diagnosed with asthma. It is also responsible for claiming 5,000 lives a year. Carlos administers the medication Albutrol through an inhaler while Jessica checks out the woman's vital signs such as her heart rate, blood pressure, and breathing rate. >> Keep breathing. >> I can't do that. We might. Yeah, we might take a driver on this one just because she's been intubated a lot. >> We are not in California's catchment. So, let me contact them and see. >> Do you have a doctor at California Hospital, ma'am? >> Yeah. Yeah. Just >> until I'm holding that down so the medicine comes out. You don't have to They have a boundary. Okay. But the the way you're breathing right now, I need to get you into a hospital. Okay. >> She needs a uh mask. >> Can you hold that down so I can get another blue cap? Carlos, >> I got it. >> She can't. You got the blue cap? >> It's perfect. Perfect. That's what I want you to do. >> I need to get an IV on you. All right. Is there enough in there? >> Ma'am, >> I'm sorry. >> That's okay. You don't have to apologize. >> As best as you can, we need you to try and breathe. Slan >> 10 pounds. Patient was just discharged from your facility. yesterday. It's kind of hard. It's kind of hard to do. >> That's where she was really. >> Okay. Just a quick prick. Okay. >> Please just stop. Please. >> You need to do it. >> Okay. Please. Please don't. For real. >> Don't pull away. Okay. >> Just give me a quiet. [Music] >> Paramedics must also act as psychologists. They need to manage their patients anxieties as well as their stress levels. [Music] Thank you. No, it's okay. It's okay. >> Uh, no. We're going to give this subq or subcutaneous just under the skin. >> I can't get to it cuz where she's sitting. So, we'll just use this. We just fold in. >> Now that the woman's medical condition is beginning to stabilize, Carlos has to shift his attention from the medical to the emotional trauma of the patient. This is the last time. All right. So, it gets it off. >> This This is medicine. It's going to help your breathing. >> Keep it just like that. It's going to help your breathing. It's a really tiny needle. You can barely feel it. Okay. >> Get that off my face. >> It is important that Carlos continues his efforts to make the woman feel that she is going to be okay. Reinforcing the feeling that everything is under control. >> You're not a bad mom. Don't >> You're not a bad mother. >> Don't say that. I can't take care. >> Well, you stop, baby. >> You're sick. You can't take care of your baby if you can't take care of yourself. Okay, >> you're okay. >> I'm taking you to the hospital. You're going to get taken care of. Okay. >> Give me 50 on her. You don't have to worry about >> here. Hold my hand. >> Okay. But I can't breathe. I don't want to be intubated. >> Okay. >> Just concentrate on breathing slower. >> Yeah, exactly. >> We got you. >> Okay. >> Okay. We got you. No, you're getting We're almost there. >> We're almost there. >> You're doing this all by yourself. >> I'm so tired. He's going so slow. >> You're strong. He's not going slow. >> Okay. He's going as fast as he can. >> You guys, please don't let me die. Please. >> We're not going to. That's the last thing I want to hear from you. Okay. >> No. >> No. We're almost there. >> All right. We're going to take her off this. Just get the O2 ready so that we can pull her out. >> Stop. I'm tired. >> You are tired. You know that. >> Okay, >> I'm tired. >> You ready? >> Yeah. >> I'm tired. Don't play. >> Okay. >> Okay. >> Once at the hospital, the woman is taken to the emergency department where doctors will be able to administer the necessary treatment. She's been intubated before, which means that she's had a tube put down her throat. When she can't breathe, she says she was tired. I'm feeling tired. I'm tired. She feels like she's What's going to happen is that she won't be able to breathe for herself. So, we have to breathe for her. So, we put a tube down her throat to protect her airway and then we breathe for her and she doesn't want that to happen. There's different ways that you can breathe for people and she wants to get to this hospital so that they can do a different procedure, a procedure that we can't administer here. So, we did the best we could with what we had. We got her here. We didn't have to intubate her, but um she's more anxious because it's happened eight times already before. She has she was just released from uh a different hospital for the same condition uh yesterday. Chris and Greg arrive at station 9 for the first time in more than 6 hours. >> Trying to talk this guy into it and he gets up freaking >> sharing their experiences with their crew is all part of being a member of a battalion that faces life-threatening situations every shift. The last thing they want to do is take their stresses home with them. >> Don't put him under pressure. He's really Jack. >> Just when Chris and Greg are about to relax and sit down for a muchneeded meal, they are called out to another potential gang related incident. A young man is in need of their assistance. Dispatch tells them that he is lying unconscious in the middle of a downtown street. >> They're responding to another intersection call for a 19-year-old male, victim of an assault. The only comments say perhaps unconscious. >> Chris gets more detailed information from the dispatcher while on route to the scene. This will allow them to prepare the proper response materials for the medical attention they will need to give their patient. There we go. [Music] Anybody see it? The injured patient is unconscious, which means that they have a legal obligation to get him out of harm's way and into the ambulance so they can administer the necessary treatment. >> The patient is a 19-year-old man who is severely intoxicated and is bleeding heavily from his mouth. Things get out of control when one of his drunken friends tries to drag him away. >> What's up? Hey, where you going, man? >> Hey, hey, hey. Where are you? Hey, stay back. >> The chief fire officer calls Los Angeles Police Department for backup. >> Suspicious of the crowd that surrounds them, security steps in and acts as a buffer, enabling the paramedics to do their job. >> What's your name, man? >> What is he? >> That's my brother. >> Okay. What's his name? Check it out. >> Any one of these bystanders could be responsible for the patient's bloodied face. >> Okay. How old is that? >> Birthday. >> 86. >> How old are you? >> That's it. Do you know if he has medical problems? >> 200 what? >> What year is it right now? >> How old are you? I'm 31. How old are you? >> I've never had that happen before. >> No. Yeah. make your face and you're not answering my >> You're not answering my questions, right? >> No, you're not answering my questions, man. >> Hey. Hey. >> Hey, dude. Come here. >> Look, it's easier with me than with the cops. Why don't you come and let us check you out? All right. >> You're not all right. You're not answer, man. >> All right. You banged your face and you're not answer. We can't You're not just going to walk away. >> We right here. Stay right here. >> That's fine. But he's not he's not in any shape of mind to be leaving right now. Okay. >> Yes, I am. Yes, I am. You're not You're not talking. You won't answer the question. >> Let us take your vital signs, check all that stuff, and then you're on your way. >> You're not You're failing all the way. >> You're almost fell over now. >> We're taking it. That's it. Sorry. You fail. >> Scoot back. >> Scoot back. Scoot back. >> Scoot back. >> Scoot your bum all the way back. >> Lee, you don't have to help. >> We do have to help you. We can't leave you. You can't even take care of yourself. >> All the way back. >> Just scoot back. >> If you can't stand up by yourself, take us to the hospital, man. should be all good. >> I believe you that you think you're all right, but you're not acting like you're all right. >> Listen up for a second. >> You can't stand up on your own. We'll take care of you. No, no, no. Stay there. Don't don't no don't. Come on. >> You're making it harder on yourself. I'm not making it. We're just going to get you at the hospital. Go see what >> Come on. >> Scoot back. Scoot back. >> Hey, if you can't stand up by yourself, we can't leave you here. Too hard though. >> Okay. You're going to get up and you're going to fall over again. >> Okay. But still though, >> let them handle it. >> Jail or hospital? What do you want to do? You're 19 years old. >> Then try to do it. >> He stands up and he falls over. So, we can't just leave him that way. >> We're trying to convince him not to do the whole time thing. Chris reminds his patient that because he was found in an unconscious state that they have a legal obligation to check him out and they can't just let him walk away. >> They have to transport you to look at you cuz you're their responsibility now. And if you don't, it might make it a police matter and we don't need to make it a police matter if you just work with us so we can help you and help them do their job. That's all I'm asking you to do. You sit back, we we all go together and we're out of here and you can stay with the fire department. >> Okay? Does that sound fair? >> Not at all. >> What can I do to make you do what I'm asking you to do? >> Leave me alone and then we go home. >> Okay. We can't leave you alone right now because you have to get transported by the fire department. What else? >> What else? >> Why do I need >> Because they found you in an altered state and unconscious and they got to check on you. >> Okay. >> What else can I do? >> Okay. Well, I'm letting you know that I'm all right. I can go home. >> Okay. Do you have your ID on you? >> No, sir. >> I don't know. >> Let's Let's check it out. Let's see what you got. Let me take >> Okay. Just relax. >> No, >> the red strikes me none. >> This is going to keep talking. You keep listening to what's going on. >> He's act he's acting like like takes two steps back he goes. >> We got your ID over here going buddy. That's right. >> The patient refuses to listen to the advice of the police officer and gets up and walks away from the scene. >> A paramedic's job is not only dangerous, but it can also be thankless. >> Now you're going to be uh jaywalking. Yeah, he's refusing uh to be treated. Obviously, he's under the influence of alcohol and he's not making clear decisions and uh for our protocols and uh he's not answering questions appropriately that we can just let him go. Obviously, he can't care for himself. Uh, we're going to leave it to the police to try to restrain him and then we can take him against his will because he's not uh thinking clearly. So, >> he ran down the street >> and the cops didn't chase him. So, >> it's not our job to the >> police business. So, >> when working as a paramedic in the city of Los Angeles, the body is put under chronic stress for short intervals. This increases blood pressure and stress on the heart. that acute stress that you put on your heart. It's not when you work out, you're supposed to warm up and cool down, that kind of thing. But, you know, from a dead sleep to your max heart rate in less than five minutes is just not healthy for your heart. And it's not like you do it once a week or twice. You know, you're doing it several times a day in the middle of the night, you know, that kind of thing. sitting in the middle of a meal, calm, relaxed, and then next thing you know, boom, it's that that acute stress that gets on your that really starts to kills a lot of guys. [Music] [Music] The city of Los Angeles is the largest city in the state of California and the second most populous in the United States with just under 4 million registered residents. Los Angeles is one of the most ethnically and geographically diverse cities in the country with its residents speaking 224 different languages. Over the past 10 years, the city of Los Angeles has had over 100,000 shootings, 12,000 homicides, and locked up 450,000 youths in local jails and youth detention facilities. There are six times as many gangs and twice as many gang members as there were 10 years ago. After being called out five times throughout the night, both Carlos and Jessica eventually get back to station 57. Working day in and day out on the front lines of South Central LA can desensitize even the most experienced paramedic. They are part of a tight-knit family that relies on each other for emotional support and understanding. We do a 24-hour shift and we do a 24-hour shift every other day for three shifts and then we have a few days off. You spend about as much time here as you do at home, a little bit less than you do at home. So, this is this is our second family. We do everything. We eat, sleep, do everything at the station. And over time, you start to meet certain people. you're always tight with the family that is your home station, but then as you start working at other stations, you get familiar with other people and you learn how they work and um you become a tighter knit family. So if something happens to one of us, it happens to all of us. It's not unheard of to have uh someone who's sick and have as many firefighters as possible go visit them at home or send them something as a as a note that we're still thinking about them. >> It gets tiring, but um I think what makes it the best being down here is all the guys they get to work with. Um, [Music] >> that's us. >> That's us. >> Thank you. >> Thanks. >> Rescue OS72. >> Even though they've had little sleep and nothing to eat for almost 10 hours, both Jessica and Carlos must put their own needs aside. The husband of a pregnant woman is called for assistance as his wife has gone into premature labor. Often times uh the call may be something other than what the the caller who called 911 is. So sometimes we'll go on respiratory arrest and it'll be a seizure. Sometimes it'll be uh a shooting when we thought it was difficulty breathing. So, we're always prepared for it to be a different call than what we got on the screen. >> Carlos knows that serious complications with a pregnancy can be fatal not only to the mother, but also to the unborn child. Okay. They're bringing her out. >> Yeah. >> Okay. >> Hey, Nick. Can you do me a favor? >> Being a paramedic in the city of Los Angeles requires many skills. Speaking more than one language is not just an advantage but a necessity. [Music] No. >> Once the woman is in the ambulance and calm, Jessica and Carlos begin to get her vitals and determine the urgency of the call. >> Stabilizing her is the number one priority. So, by the time they get to the hospital, the doctors will be able to quickly diagnose her ailments. So, >> right now we're just getting the blood pressure and stuff on the patient. Um, just making sure that everything's stable before we get going to the hospital. >> 128 over 92 is her blood pressure. She has a heart rate of 98. >> It is also important that they get a medical history from the patient's family members. Jessica and Carlos need to establish if any of the medication that she is on will conflict with the treatment that they are about to administer. So, while we're getting her history, trying to figure out if this has happened before, and uh what the hospital did for it, we're getting her blood pressure, as my partner said, I'm going to start an IV on her, and then we'll put her in route to the hospital. >> Many individuals act as a unit in order to carry out a specific mission. And if it's patient care, which it often is, that requires that we each know our job, know our place on scene, and know how to carry it out. So one person may be talking to the patient, the other person may be getting the the important information that we need for our reports. Yet someone else may be checking lung sounds, another person will be putting on the blood pressure cuff. All these people need to act together at once so that we can give the best care as quickly as possible. And since time is of the essence, everybody needs to know what to do and there can't be any questions or thinking about it. We just need and that's where the training comes in. By the training that we were given, we're able to act quickly and appropriately and efficiently. Her blood glucose or how much sugar she has in her system is normal. Once at the hospital, the woman is taken into the maternity ward. 60 million people enter the United States on more than 675,000 commercial and private flights. Another 6 million come by sea and 370 million by land. In addition, 116 million vehicles cross the land borders with Mexico and Canada. The illegal drug market in the United States is one of the most profitable in the world. The US Mexico border is the primary point of entry. As such, it attracts the most ruthless, sophisticated, and aggressive drug traffickers. With this voluminous trade, drug traffickers are able to conceal cocaine, methamphetamine, marijuana, MDMA, and heroin shipments for distribution in US neighborhoods. No more so than LA's Skid Row, where class A drugs are sold on every street corner. This means that both Greg and Chris are constantly called out to drugrelated incidents. Their sixth call of the day is to a skid mission where they respond to a woman who has been taking hard drugs for over 25 years. We're responding to another mission to a 40-year-old female said heroin overdose. There are approximately 90,000 heroin overdoses in the United States each year. Within a few minutes of arriving at the mission, Greg and Chris transport the woman to their ambulance as it will be much easier for them to control her convulsions. >> Okay, I'm going to lay down flat. Okay, just stay still. Melinda, lay back. Lay back. >> Don't reach for anything. There you go. You're filming a show. Okay. >> A heroin overdose reduces the body's breathing, blood pressure, heart rate, as well as reducing the body's temperature. >> Okay. You take medication for that too or just >> the breathing slows to the point of respiratory arrest where a lack of oxygen to the brain leads to the loss of consciousness, coma, or even death. >> Sit back. Sit back. No, it's >> we couldn't even control you. >> Oh, that's right. >> Both Greg and Chris are familiar with the woman. >> What medications do you take? Do you know them? >> No. >> None of them. >> As with many people who overdose, the woman finds it hard to respond to outside stimulus. Even so, Greg continues to talk to the woman as he must try and keep her awake. The last thing he wants is for her to slip into a coma. >> You used yesterday morning or this morning? Yesterday. >> Yesterday. Sit up. Melinda. >> Here's a bag. Hold that in front of your face. >> Okay. Cuz I don't want you throwing up over the rig cuz >> I'm not going to throw up all of you guys. >> How long have you been using Melinda? >> 27 years. >> 27 years. >> My sister stuck a needle in my arm at 11. >> At 11? You're [ __ ] >> Nice. So, >> how old was she? These are uh >> rubber bands that they use. >> So use like a little tourniquet to get their uh >> get their veins to pop up. >> You can take them off. >> And a lot of times they're wrapped around the balloon ends to keep the balloons tight cuz the heroin comes in little little balloons about yay big. How much is in a balloon? >> Oh, it's a nickel. >> Huh? >> It's a nickel. >> A nickel. How much is in? So how much makes a gram? You said you used a gram. >> A gram. How many balloons is that? >> About >> How many balloons is that? >> Huh? >> About 20%. >> 20 balloons at one time? >> No. >> How much are you using a day right now? >> I suppose. >> Oh, you're using that in a day. So, she's using about 20 balloons worth of heroin a day. >> The content and purity of street drugs is always unpredictable. They're often cut with contaminants. In the past decade, quality has risen while price has dropped, increasing availability and sadly the number of overdoses. >> She's just going through a withdrawal for her. For her, the last time she used it now is a long time. >> So, she's she's going through withdrawals. She also has a condition where she fidgets like this. Not taking her medication and the heroin abuse causes her to fidget like this. I'm sure he has one. >> And so she's trying to kick it. She's trying to get in a program. She tried to go to the mission >> and they do their best to help. They can be selective sometimes and she can't sit still and it's fidgety like that. So they can't give her a bed, so they call us. She wants to go to a methodone or rehab clinic, but we don't transport to rehab clinics. We transfer to ERS >> down here. How'd you do that down here? >> Salvation Army. >> Why don't you go there? She was just being a Whenever we have a patient suspected heroin overdose, something like that, and then we bring them back, you're trying to get maybe information out of them, an ID, something like that. Instead of reaching into pockets down where we're at, where most places you can do that, you can't do that where we've had three or four guys get stuck, they reach, usually guys that don't work down there, um, they reach into a pocket cuz they're used to doing that and sure enough, there's a needle in there and they get stuck. And it's I mean there's nothing you can do. It's instant. You're you're exposed and you got to go all through all the procedures and protocols to find out if you're all right. >> Can you sit still so I can pull this out? I don't want you to fall off. Here. Here's your other shoe, too. >> Bend this leg, too, cuz I don't want your >> There you go. Yeah, we're pretty much done. Say bye. [Music] >> Hey, watch this. A lot of times we'll have heroin overdose. We give them uh Narcan which counteracts the um heroin and they immediately become out of their high or overdose and a lot of times they'll go right into withdrawals. So sometimes that'll upset people that we took away their high even though we saved their life. Paramedics rarely hear back from the patients they saved from the dead. More often than not, they have to be satisfied with their roles as unsung heroes, knowing that what they do makes a difference. [Music] [Music] [Music]