at the end of the road to home always you can follow the course of the road until I give you additional instructions yeah so you sat on that part now yes that's right it's all changed when I were alive [Music] [Laughter] I'm gonna eat more of these skills I'll try not to watch [Laughter] when I were allowed we didn't have any of these 3D Holograms where you followed the uh a construct where you go in or you are Google Maps and it was two-dimensional so you should listen to me like a video game and there'd be an hour yeah and sat navs will be like Ultimate Reality so you know you've got Pokemon going AP in real world yeah we love um you love SAT navs but it'll be the Mario Kart so you've got to run over things in the road yeah foreign it's coming up to nine o'clock in the evening and paramedics Laura Hickman and Lee Farley are beginning to see light at the end of their 12-hour shift five hours left oh getting tired now got a job it's a category 2 Patient collapsed at unconscious but breathing normally you'll be pleased to know because I collapsed are they unconscious 54 year old Dalton's family have rung 999 after he collapsed in the kitchen by the time Laura and Lee arrive on his Road word comes through that Dalton is no longer unconscious but he's still in a bad way straight through the houses are you okay daughter thank you luckily a neighbor is an off-duty A and E doctor okay what's happened today it was quite slow so I uh let him lay down yeah any health problems normally no no these otherwise healthy normally so your entry is equal breathing normally but he was wretching Dalton may be conscious but he's having real trouble communicating as he spoke to anybody yet he's not responding at all no he's he was just holding his arm up and it's just gone down now mate at this stage Lee and Laura don't know what's happened to Dalton but they do know it's something serious and that he desperately needs a thorough medical assessment so he's all going to be obviously taking him off to hospital are you coming with us check his temperature 34.7 goal turn we need to look after you sir okay we're gonna look after you family are here okay all right we're gonna look after you promise you all right Lee carries out an electrocardiogram check on Dalton's heart known as an ECG it turns up something worrying uh he's got his television yeah okey-doke St elevation means Dalton's heart is showing an abnormality that's a concern for us as that's quite an indicator for a heart attack or a myocardial infarction meaning that the patients need to be treated quickly and got to the most appropriate place for that to be dealt with because the longer we leave it the worse it gets as they attempt to get him to the andalton to take okay trying to be safe yeah okay let it come that's it spit it out we've got some tissue paper please [Music] wait if you like you let them while we really pull right darling Dalton's a youth worker he's been married to wife Wendy for 27 years but they've never had a day like this once inside the ambulance he seems to come round it's all turned hello I'm okay I know you are but we're still having to go to hospital okay [Music] you've had you've spent quite a while on the floor unconscious so we're going to take you to the hospital and get checked what's happened all right let's have this hand okay that's fine no don't worry we've got some don't worry there's worse things anybody to stick on the floor at the minis well it was quite worrying that Dalton couldn't communicate to us um he put his thumb up to us and that that was a that was all we could we could get out of him really was it the hard cause in the reduced Consciousness level or was there other things going on that we couldn't find and that we couldn't pick up so my concern was purely just getting him into hospital as fast as fast as we could really vomiting can be a symptom of a heart attack Laura and Lee set about getting Dalton a cannula so if needs be they can give him medicine and fluids intravenously they also give him oxygen at the same time Lee quizzes wife Wendy about exactly what's happened 10 15 minutes class and then he got off he walked out to the garden [Music] just then Dalton appears to pass out so is that oh no okay first thing you said open your eyes open your eyes open your eyes Dalton squeeze my hand squares my hand so he's obeying command so it was one for verbal yeah um event command so six at seven and always um is trying to respond to voice isn't there he's trying to open them isn't he he's kind of flickering his eyes with everything now in place it's time to get Dalton to hospital Dalton Dalton can you talk to me so are you any pain at all no pain foreign so we've got some some changes on his ECG okay um that could be heart related okay but obviously because we can't have that communication with him we don't know we don't know if he's got any pains if it's going anywhere either way his heart rate's a little low um and uh we can't give him the medication for that because he's too cold so there's there's a few things that are hampering this treatment you see so the best place for him at the moment is in the hospital okay Dalton Dalton look at me over here hello okay we're on our way to the hospital just because you've collapsed so when we get there we'll take you straight in there's going to be lots of doctors and nurses around I just need to speak to them another check of Dalton's heart shows the abnormality is still there with a heart attack a very real possibility Lee needs to have doctors on standby at the hospital the second they get there four nine just to make you aware it is a hospital alert patients showing some changes in uh St elevation on his ECG we're just pulling up that new cross now so I'll give you further details when we've cleared the result less than 10 minutes after leaving Dalton's house they arrive at the hospital we're docked right then watch your feet Wendy's get the ramp down for you it's all turn just relax keep this hand out the way all right sweet right I'm living on the monitors then all right yeah I'm happy with that Dalton will be taken straight for assessment by a d doctors to see if he is having or has had a heart attack [Music] I think that's an interesting thing this one piece will make 52 layers watch on mobile devices or the big screen all for free no subscription required download really now you're ready oh [Music] it's just gone half past five and paramedic Hannah Simpkins and technician Michelle McNulty are working a very sunny afternoon shift why haven't we got any this there we go [Music] throw a lot of feel the benefit now yeah it feels better it's pointing right to my armpit is quite nice these ventilation holes what we've got but their brief moment of chill is soon interrupted when a call comes through it is a male in his 60s that has a Cutie's leg on a piece of water that was sticking out and and he's currently got quite a lot of blood loss from it so we're going to it's okay we're going to um like a hole in his leg apparently the man Jeffrey has cut his leg on an overgrown Bush his neighbors have rung 999 concerned at how much blood he's losing just a few minutes later Hannah and Michelle arrive at the house Extreme Caution hello where are we going today I can already see the trail it's like following a trailer breakfast yeah right what's your name Young One Jeffrey what's been happening well I've had children again stones yeah so you've had problems before is it the same same leg same vein Jeff had got um varicose veins which basically means obviously that the veins that are in your leg come right to the surface and they're very um fragile so the slightest little cut will open up that vein and whereas normally you'd stop bleeding within I don't know a normal person a couple of minutes or something like that Jeff's would actually bleed quite profusely unless you put pressure on it and elevate it and do the appropriate thing to stop it so we had lost a relative amount of blood a little blur is going to always look a lot worse and I think if it's coming out of you it's probably quite you know frightening felt it shortly yeah whereabouts sister just on there okay was it like pretty flea free-flowing yes Hannah's less worried about the blood than the wound itself which she wants to get access to put your sock off first then yeah so I don't need any Footwear no I think that one's for the beginning Hannah's concerned that when she does take the dressing off with his veins the way they are the wound could spurt probably won't make more sense of oil that and if it's going to come out this way can you do that just in case we have a spirit ual help yeah now while this is Jeff because it's warm today and pretty short so yeah yeah I think advantages but the blood has cluttered nicely all right pour a bit of water on your leg yeah it does give it a bit of a clean up so I can see where it's going from it's a little bit cold Jeff sorry with the leg washed the wound is finally visible and Hannah can see where all that blood has come from well you heal noticing quickly Jeff that's always a bonus um well on the plus side Jeff it stopped which is always good it started to heal over slowly you can see where the Skin's starting to re-knit back together there my only concern is that it looks quite um it's quite Jagged so it's not necessarily going to hit knit together completely and I've got a feeling that as soon as you put your leg down and put any weight on it it's going to start going again and so I think it's probably going to need a bit of a glue a bit of a stitch or something like that a hospital also the other thing is because of what you've knocked it on I want them to make sure that there's definitely no um foreign bodies or anything in there and that means a trip to A and E for Jeff you tell us if you need any help it's good man do you want us to give you a lift that's it shuffle your bum back and then we'll give you loads of swinger right it's gonna be a little bit bumpy Jeff all right just over these uh a few doorways Jeff lives with his brother it turns out his varicose veins are a result of an accident at work that required several operations and has left him with poor circulation his blood also struggles to clot which means even a small cut can result in heavy blood loss foreign [Music] once in the ambulance Hannah gets the chance to find out a bit more about Jeff and what's happened to his leg so you didn't fall or anything today Jeff you just literally walked past and it grabbed you as you went [Music] you know I've only got two yards and it was pulling out it was going everywhere okay there we go I'm lucky whenever you are mate and Jeff's leg isn't his only issue oh you're feeling no drifting yourself a bit weird yeah [Music] moments later they arrive at the hospital [Music] foreign [Music] [Music] Jeff will be taken off for assessment in A and E to clean his wound properly and check it hasn't been infected [Music] hey golly gosh trikes crumbs oh crikey I think golly gosh is my favorite non-swear electricians and watch babies swear [Music] it's probably gonna have your smack when you get over this one another microwave Burger yeah I found that was perfect last night just just enough to stop in bed hungry but not too much did it stop me going to bed yeah thank you [Music] it's past midnight on a warm Summer's night in the West Midlands and on shift again our paramedics Lee Farley and Laura Hickman it's an RTC keep going straight bro all right I'm on it they've been called to a car crash in the oldbury area [Music] so we're going to in a taxi that was being chased by police taxi has crashed and it's an unknown Mile in their 40s so why was the taxi being chased by the police do we think [Music] it might have been stolen the crew are at the scene just a few minutes later there's three cars involved one at the other end as well what's happened mate is this one here the taxi driver is in fact innocent he's been hit head-on by a car traveling at high speed that was being pursued by police how many patients with this lady he's had an incredibly lucky Escape walking away from the wreckage that's left of his car but the crew need to check he's not got any hidden injuries hello boss all right um you're a driver are you yeah where's he come out of the side road does he yeah okay what's your first name what do we call you CJ okay CJ my name's Lee and this is Laura a couple of checks that we need to do are you wearing your seat belt at the time you were okay can I just have a feel any any pain then you're back at all yes okay keep keep nice and still while I'm examining you okay I mean here or to the sides straight down the middle okay when someone complains of pain down the center of their neck um it can be indicative of spinal fracture especially on the neck and if they're fractured then that can cause paralysis even though he was walking around and up and about the adrenaline you know when that wears off then there are injuries that come to the surface any problems with your chest at all any pain in your chest any problems with your breathing okay I saw you up and walking around yeah your legs all feel good yeah just painful okay the crew need to get CJ onto a stretcher to find out just how severe his injuries are okay come on then CJ nice and slowly my friend all right [Music] well you're taller than I saw what you were come on pop your bottom there okay I'll just keep your head there for a second we're just going to pop a little collar around you they're not very comfortable okay they're just designed to stop you from moving your head the crew are concerned the impact of the crash was so severe CJ could be suffering spinal injuries sorry chap like so they're not designed to be comfortable so they need to immobilize his neck you want somebody I just take his weight okay just let yourself go I'm just gonna grab your ankles okay one two three and then just ease yourself down okay that's it perfect right we're just going to put a couple of straps on you all right CJ it's just because Lee's driving is terrible he'd never make a taxi man would you mind if you're driving with CJ brayston safely strapped to a stretcher bit of a bump CJ the crew move him into the ambulance to do a more thorough examination we're off thank you [Applause] can have this arm where's the worst pain at the moment what part of the body in your neck okay any pain here it's tender coming down the leg Yeah tender and on this side very bad it appears CJ hasn't just sustained injuries to his upper body he also has pain in his legs do you want some pain relief yeah so would you mind if I popped a little needle in your arm and I could give you some paracetamol that way okay is that okay just because if you take on the tablets then we're in bigger trouble aren't we all right sharp scratching your arm CJ okay what would you say your pain is now [Music] moving off fantastic all right mate fortunately the hospital isn't far but they need to take it easy bumps in the road could make CJ's injuries worse if you need anything just tell me and hopefully at the hospital they'll be able to take you off this board as soon as they can alright but we have to protect the neck because it's quite fragile your neck is so that's what this color is for all right moments later they arrive at the hospital the painkiller has kicked in but CJ still needs urgent medical attention is that pain any better now better than a five or still a five still a five we've gone from an eight to a five so okay he will now go to A and E for a full assessment of his injuries all right mate [Music] so that was our last job of the night it was interesting circumstances I can't believe though he was wearing a seat belt because quite classically taxi drivers don't have to wear the seat belt when they've got passengers yeah so I've really got passengers he would have not been wearing a seat belt that type of impact he'd have most certainly hit that windscreen at Force yeah it could have been a fatal yeah in all honesty yeah [Music] it's coming up to half ten in the morning for paramedic Joe Wilson and student paramedic Sam Grosvenor when their latest job comes in oh I'm going to Quarry bonds now [Music] Kevin has called in saying his 76 year old father Raymond has fallen over and is still lying collapsed on his bedroom floor [Music] he has been there all night Joe and Sam head to his house oh lovely okay is it the way Raymond lives on his own his son Kev is five minutes away and visits every day but this morning he's come round to find his dad on the floor hello Raymond how are you feeling mate absolutely terrible oh yeah how long have you been on the floor before Oh Lord why me how'd you get down there we go she's thinking about a roll down onto it you had previous thoughts in the past you've never falling um it wasn't no stand on his feet yesterday right um it was in hospital last week for um shortness of rest um low blood count and yes lymphoma okay lymphoma is a form of cancer which Raymond has lived with [Music] but his shortness of breath is a more pressing worry for Joe and Sam they start their observations to see what might be causing it they're taking four 38.4 yeah you're quite warm mate a healthy temperature would be no more than a little over 37 degrees how to say a chest infection yeah that's just infection oh I'm gonna get a cushion I'm going to try and get him up off the floor with a cushion so you can't be comfy down there can he Joe goes to get the inflatable cushion designed to help move people who have fallen like this it gives him a chance to compare notes with Sam it's um he's rasping at 32. he's tacky it between 1 30 and 140. uh wow there's a new sepsis tall there is a new one yeah I've got it here sepsis is where an infection in the body no longer becomes localized to that area and it starts to spread around the body and this is caused by the body trying to fight it off on its own by elevating its temperature its heart rate and really trying to burn it off but that doesn't work it just makes it worse and it's really important for us to treat it as fast as we can and convey the patient Hospital you see above three yes is a history of infectious energy yeah greater than 130 per minute one of them red Subs yes GCS time critical media actions required Aquarian sets this with you just to let you know um basically his chest infection is no longer localized just in that area so starting to go around the blood tree so we need to treat him with that okay but before they can get him to hospital they need to get him up and onto a carry chair what we could do Raymond we're gonna get you onto your bum now okay so we'll roll you up onto your right hand side okay keep your feet out that way those legs around a bit more okay I'm just going to slide you across a bit more there we go the inflatable lifting cushion will raise rain so he's high enough for Joe and Sam to get him onto the carry chair well then Raymond Drew into this seat now okay okay a proudly independent father and grandfather the last place Raymond wants to be going is hospital but right now there's no other option Sun Kev will follow separately [Music] with Raymond safely on board Joe wants to start treating the sepsis right away Ray I just need to pop a needle in you is that okay yeah just need to try and dilute what infection we think you've got he wants to give him a saline drip I know you feel cold but your body temperature is really elevated that's why we've not covered you up entirely all right your temperature it was 38.4 as well that's higher oh it's our dishes Joe tries to put the cannula in for the saline drip but Raymond shaking is making it difficult Sam do me a favor I ain't gonna be able to do it because she's shaking that much just pull that needle up for me so I'll get this cup on that oh that was a good shot that was mate okay yeah with a possible sepsis patient they need to have doctors standing by as soon as they arrive at A and E so Joe radios ahead to the hospital yeah I've got a 76 year old I came out yes online you okay there yeah you're all right Raymond is clearly very unwell Joe doesn't want to waste his energy so keeps conversation to a minimum and with good reason there are around 123 000 cases of sepsis a year in England and of those some 37 000 die as a result that's nearly a third you just straighten the arm a little bit for me this one just like that see I just want to get all this fluid running into you properly and moments later they arrive Hospital it's quite a walk because he might have sepsis doctors will already be waiting to assess and treat Raymond if it's confirmed he'll be put on antibiotics and intravenous fluids as soon as possible [Music] thank you [Music] did you know why it's called the black Country Queen Victoria came what do you think Victoria I'm sure it was Queen Victoria came for a visit and saw all the black smog because of the Industrial Revolution and how industrialized the black country area was and there was like almost a black smog over the area so she she named it the Black Country [Music] it's 3 30 p.m on a warm afternoon in the West Midlands there's some fun we find in Birmingham friends Michael anslow and Dimitri Holloway are on the day shift they're a lot and they've just got their latest emergency call 49 [Music] [Music] thank you foreign Barbara has had a fall while walking her nine-year-old Greyhound Sandy and she needs urgent medical help I can see I can see her outside the house yeah when Michael and Dimitri arrive Barbara's husband Morris is waiting with her hello you're right what's happened darling I was walking the dog yes and you see there where is an even yes here yes I just caught my foot over a wind uh-huh fell on my face but I can't feel the bottom of mine did you fall face first yeah so what would you most in a case like this when a patient loses feeling in a limb there's a strong chance it's broken but Barbara's fall was so bad she could have broken her arm in more than one place and where is the worst of your pain if you point to it okay it's have you got any pain anywhere else no face is a bit a little bit sore okay I'll have a little feel down your neck and your back okay because simply he's out of all that that way Barbara's not just injured her arm she's got a nasty cut on her face where she hit the pavement but the crew are concerned she could also have hidden injuries to her neck back or spine keep your head nice and still for me yeah any pain where I'm pressing no wonderful any pain in your hips yeah for real no nothing at all about the rest yeah unfortunately the dog twice strikes again so just your arm is your main concern bless you she said that it fell to though her upper arm and her lower arm were disconnected immediately that decides that there's a potential fracture to the Bone and we have to make sure that Barbara's circulation and movement isn't affected or compromised so where's it here on the inner side and you landed flat on it did you what movement have you got have you got are you able to do a bicep curl like you're at the gym or if you're not don't lift it at all it's as if that part isn't telling that isn't as if it's not connected Barbara needs to go to hospital she's going to need an x-ray and some pain relief have a go with your with your good hand well it is clearly a trip down to the hospital so I'm afraid I haven't got x-ray vision just yet yeah is that okay the boys get Barbara's arm into a sling to stabilize it for the journey and then it's on to A and E you have a little Shuffle to it there and pop try and pop your bum at the top of this little crease there lovely Friday afternoon never do do you as well [Music] fortunately Barbara hasn't lost her sense of humor no chance you could be pregnant I'll be in the Guinness booklet Morris joins them for the journey to a d the pain at the moment Dimitri tries to keep Barbara's mind off her injuries how long to need to be married and how did you meet so what did you have planned with your grandson what are you gonna do we got him for the weekend so we're going to the safari park tomorrow oh nice [Music] 10 minutes later they arrive at a d couple of bumps as we go down we'll try and do it as smooth as possible Barbara is taken off for an x-ray to check the extent of the damage [Music] [Music] at hospital Dalton had heart and brain scans which came back clear he still doesn't know what caused his episode but wife Wendy suspects it might be due to exhaustion and dehydration he's waiting to have an MRI to see if that can shed any light foreign [Music] with suspected sepsis Raymond was actually diagnosed with pneumonia and was in hospital for three weeks he spent time in a care home while he got his Mobility back but has now recovered he still sees his son Kev every day CJ was found to be clear of breaks or fractures but was found to have severe Whiplash and has had to be signed off work the driver of the other car was charged with offensors including dangerous and drunk driving he was sentenced to 12 months in prison and banned from driving for three and a half years Jeff's leg healed so well that he didn't need any more treatment once he got to hospital and after checks was allowed home unfortunately he has since cut the same leg again Barbara was found to have fractured her upper arm in two places she had a brace put on it and is due to have another x-ray soon to see how it's healing [Music] thank you foreign