In a year when the NHS has been under immense pressure, >> I want you to let me know if you get any pain. >> I look great. >> How much do you sell these for >> in the heart of Yorkshire? >> You see, he's got a little mouth. Are you all right here? >> A dedicated team is working around the clock. >> Nice deep breaths really well. >> You can have a look in your ears. See if we've got any treasure in there. >> Let us know when you're ready. >> I think we're ready. They're with us for our most vulnerable moments. >> It's very, very painful now. >> She's really struggling. I need you to stay still, darling. >> Like I'm in labor. >> Facing life and death, trauma and tears, supporting each other through the toughest shifts. >> Be all right though. You've done really well. Keep going. M. Keep talking or singing out the stress. I've heard my singing. It's enough stress for anybody. >> How would you feel if I said you could go home? [music] >> I'd be alleged. >> I want to go home. >> This is casualty 247. >> An absolutely wonderful at hospital >> on shift tonight. >> Sister Bonita, >> just to update, you've had [music] 25 booking in the last hour. Consultant Dr. Julian Humphrey. Nice to meet you. >> All of this here is blood clot. A bit like black pudding. >> Junior Dr. Tom Fish. >> I look like I'm wearing pajamas as well, don't I? So, we're matching. >> And consultant Dr. Joe B. >> Driving your car, Lor's come and hit your [music] side of the car. >> So, get ready to share a shift. Do >> you want to go back or >> at Barnsley Casualty? >> [sighs] [screaming] >> It's shift change at Barnesley Hospital. >> Sister Bonita is coordinating the casualty department which frequently sees over 300 patients a day. >> Look, let's send these bloods off. So, it's [music] um got really busy. >> When you walk on to a shift, I guess you don't really have time to think about how it's going to go. >> That's a mental health. That's a guide. So, we're probably getting that referred on. >> You hit the ground running and [music] you crack on. >> There's still about seven ambulances, I think, waiting on back corridor. [laughter] >> Thank you. Okay. See you. Peace out. The casualty department is already close to capacity. >> I'll do a walk around and find out who's where. >> And there's a queue of ambulances outside. >> Mommy, your name, lovely. Trying to work out where everybody is. Too many people. >> In charge of ambulance admissions is consultant Dr. Joe Bian. >> None of my family were ever doctors. Um, my nan was a hospital cleaner and I'm really proud of my nan. Being rushed in is 32year-old Owen whose car was hit by a 20 ton bin lorry head on stein and lower back pain. >> Over 900 people in South Yorkshire were seriously injured in car crashes last year. >> It's crucial the team get as much information as possible about what happened. Hello. Hi, my name is Dr. Bean. I'm one of the consultants. So, >> driving your car, Lor's come in front of you. Yeah. And hit your side of the car. >> Yeah. Okay. Can you remember it all happening? >> Yeah. >> You weren't knocked out at all. >> No, I don't think so. No. Basically, I was uh driving towards my place of work and a bin lorry pulled across the front of me uh in between two wagons. So, I didn't see it coming and uh basically I've hit that hit that wagon in my car head on. >> If you're in a car and you're traveling at speed and the car does something fairly dramatic, then that would just make me think that they may have significant injuries. [music] And it was your neck straight away. >> Yeah. Yeah. Not long after about a minute if that. >> Okay. >> The top of the neck. Just at the bottom of the back of the stroke. >> Okay. >> But my back's supposed to be a lot more pain now. >> Okay. >> Very bottom. I mean, it's it's very very painful now. >> Right. So, what I think we need to do now is get you off this board, but we're going to need to keep your neck still. Yeah. And then we'll just get you sent round for some neck x-rays and some back x-rays. >> If I hold if I do neck >> Oh, sorry. You didn't tell me that. >> I had surgery. >> Oh, okay. Right. >> What have you just had done? >> Uh, a lift of a cheekbone. >> Oh gosh. >> It was fractured in three places. >> Yeah. Right. So, if you help out by just keeping your head really, really still then. All right. Yeah. >> I tell you what, your cheek looks pretty good, doesn't it? It's not that swollen, is it? >> I just had the stitches out today. >> Yeah. You're having a great year then, are you? >> No, it's uh it's not been going so well. >> Yeah. >> Already looking out first. >> This one side. >> Yeah. >> Nice to study. >> He's had a a fairly significant impact. >> Yeah. Yeah. Yeah. He's hit something that's considerably bigger than him. But the instant pain makes me worry a little bit more. >> She is likely to need a bed as well. Actively bleeding when they were seeing her. >> In the hub, Sister Bonita has gathered the casualty team together for an urgent update. >> Yeah, lovely. 40 beds. Yeah, 14 beds in medicine with 16 potential discharges. So, not cracking surgery. There's three >> goggles back. Yeah, it's Bonita. We've got a fire alarm going off down here. >> Unless they discover what's triggered the alarm, Sister Bonita will need to prepare casualty for a full evacuation. Advance a casualty. The shift hasn't got off to the best start. Alice, >> yeah, it's been we've got a fire alarm going off down here. It's saying basement. >> Paramedics are trying to hand over their patients. And now casualty might have to be evacuated. >> Can you hear it? It's horrendous. We've got about seven or eight ambulance to it cuz there's no room for anybody. And now we've got some alarm going off. >> Sister Bonita is ready to evacuate the department. Thank you. Yeah, they get security on it. >> Are you all okay? Are you all right? So, >> security confirm it's a false alarm so the team can get back to work. >> Starting with Owen in ambulance assessments, who's waiting for an X-ray to find out if his damage is spine following a head-on car crash with a 20 [music] ton bin Lori. >> Where is he pitted all your back? >> But lower back. Yeah. And like the top of my right shoulder >> if he's got trousers on cuz I'm doing a C-spine, a lumbar spine. So, he's probably going to need undressed in for his X-ray. >> Dr. Bean has asked the nurses to give Owen some pain medication. >> We're going to give you some of the good stuff. >> Oh, good. I read it. >> It's all chem. It can make you feel a little bit drunk and a bit weird. So, can make you more comfortable while we're getting into that >> G. Yeah. >> Right. Pop it in your mouth. >> Penthrox is [music] a really useful drug actually. It helps patients that have come in a lot of [music] pain and discomfort. >> All right. Now you look like a proper patient now. >> Although in a positive way, it helps them. They're like they go a bit crazy on it. [laughter] Yeah. >> Okay. >> It's like one of >> you to show you now. [snorts] >> Their behavior on it is a little bit funny sometimes. >> How much do you sell these for? [laughter] >> Oh my gosh. Ow. It's painful. But >> okay, >> you're going to go another scan and you're going to go up next day and then hopefully if those are okay then we'll be able to take this contraption up around your head and then you'll be able to move. We'll be able to sit you up there then I can't see you because >> I've had some of this and you feel real far away. >> You do? Yeah. >> Can you come closer? >> What you going to do? >> No, nothing. I just need to hold somebody a second. [laughter] >> Thank you. You got a nice >> Oh, thanks. >> Yeah, it is sometimes hard with what people come out with to remain a [music] professional. [laughter] >> With Owen now a lot more comfortable. >> Do you? [laughter] >> He's taken to X-ray to discover the extent of any spinal injuries. >> He's a porter, isn't he? He's a good He's the backbone of >> If it weren't for him, >> if it weren't for him, people like me wouldn't be getting to where we [music] need to. Do you want to go blast or not? >> Trust me, bro. You'll get to your [music] next job quicker than you'll ever imagine. I'm honestly >> not tell me. >> Don't tell me. >> Large numbers of patients are arriving in casualty and Sister Bonita has to find cubicles for them. >> Alison, [music] you've had 25 in the last hour. >> Ambulance patients queue, but emergencies are prioritized. 71year-old an is next to be seen. Her dog collided into a leg over a week ago, rupturing a blood vessel, but the wound has got much worse. >> Just give me a date of birth, please. >> Sister Joe wants consultant Dr. Julian Humphrey to take a look immediately. >> I'm one of the doctors here, Dr. Humphrey. So, I've seen some pictures of your leg that the dog What did the dog do to your leg? >> She look down and she went straight into me leg. Okay. >> And b straight up. >> And what sort of dog is it? >> It's a jug. Jack Russell P. And she'd been running up there like a maniac and the back of me and that were all eight. But then she started in front of me. She run straight into me leg balanced off back into the room. Oh, I'm playing [snorts] out here. I don't want like that. And before I knew where I was, she went great mess. >> Can we have a little look at it then? >> Let me just go and get something to put underneath. on your own at home, sweetheart. >> No, I'm married. >> Is that all? >> So, just relax your leg. It's all right cuz you've got this stuff here all uh don't stick to it. So, it should lift off quite easily. >> All of this here is is blood clot. A bit like black pudding. All right. And really, it needs to be got rid of. >> Okay. the skin over the top here, that's all dead because it's been separated off and it's it's that's why it's just come away with that bandage. This clot will potentially become infected very quickly if it's left any longer and that will cause then a septasemia and a systemic infection if it's not treated, which will be potentially pretty serious in someone of her age. What I think we need to try and do is put a little knife along here and just split the skin and then try and milk some of this clot off. Okay, >> that clot starting to smell a bit now is is just going to cause an infection if it stays there. >> With the risk of infection so high, Dr. Humphrey will need to operate straight away. >> Right. >> In the hub, the onslaught of ambulances is never ending. Is there any that I can take hand over for in there like sat in a chair? >> But as soon as the team clears one, another arrives, this time bringing in 80-year-old Christy, who has come in suffering from severe stomach pain. It's physicians associate Wayne's job to take the medical history before consulting with the lead doctor. >> So, I understand you've had some tummy pains. >> Yes, that's right. >> Okay. So, tell me what's been happening. So, it started about 6:00. >> Mhm. >> Last night, right across there, coming in waves all the time. >> Right. >> That went on through the night, but it was too painful to sleep. >> Mhm. >> Are you okay on your feet transferring up, getting up here? >> Oh, yeah. >> Yep. >> I think so. >> Okie dokie. >> Stomach pains in elderly patients can be a sign of a more serious condition. So, it's important to establish the [music] root of the problem as quickly as possible. Just take your time. We're up. Fabulous. So, [music] whereabouts in your tummy does this pain, you're getting the bulk of it. >> So, sort of straight in the right in the middle there. Okay. Okay. If we did your your >> Yeah, sure. >> your dressing gown there and have a >> So, this is just a big hernia, is it? >> Yes. >> Right. And how long's that been? >> Since I had my hyderectomy. >> Since Right. Okay. So that >> So that would be about eight years ago. >> About eight years ago. >> Yeah. >> So you're getting the pain mainly across there. >> Yeah. >> Okay. So I'm just going to press gently on your tummy and you just let me know if it hurts anywhere. Okay. >> So it's not particularly tight. So that hurts a little bit down there. >> Feels like it's deep inside. >> Feels like it's right down inside. >> Right. I shall uh leave you in peace for a for a short while and I'll go and have a look at these these blood results. Okay. Right. Thank you very much. >> After his examination, physicians associate Wayne discusses the case with Dr. Bey. I >> saw that like absolutely huge her one that I need to have a chat with Julian about. >> Christine will be added to Dr. Humphrey's list. But first, he needs to perform a surgical procedure on an who was rushed into casualty after colliding with her dog. >> What they call your dog then? Lucy. >> Lucy. [music] >> He's pulling and looking at me. I said, "Look at her." >> You falling, aren't you? >> Yeah. Bless her. She doesn't know what she's done. >> It's just one of them things, ain't it? >> There you go. Wait for doctor coming back in and uh >> uh right. Okay. >> Dr. Humphrey wants to remove the clots immediately. I'm not going to chop it up, are you? >> No, I am not going to chop it off. I'm going to tidy it up best I can. >> That just a pain killer. >> When a doctor tells you that he's going to take a knife to your leg in this cubicle right now, that's quite [music] intimidating. Right. What I want you to do is I want you to tell me if um you feel any pain. All right. You feeling anything? No, I think it's the answer to that. Right. This is the uh moment of truth. Right. >> Sorry. >> Ever so well. Just keep taking nice deep breaths on that. Okay. Okay. I feel amazing. [music] All right. >> Nearly finished. >> Two kids. [music] >> Yeah. >> Six grandchildren. 18 great grandchildren. >> Wow. [music] >> Keep reading on that stuff. We're nearly finished. >> Do you remember all the birthdays as well? >> No. >> No. I think I've got that many. >> You want to just dress it now? You've done absolutely amazing. >> She has. She's been a legend. >> Definitely. >> I'm not going to play with that anymore. Now, >> I can go for that. >> Big mess. Why? >> Is a mess. Is a mess. >> You're doing a good job on it, >> Batman. >> Good job. All of this area here will heal up, but it may need to have a skin graft put on it. Because this is a very bad area for healing in the body, that shin, you just relax. [music] >> You deserve one. >> At Barnsley Hospital, a large number of patients arriving by ambulance has led to an increase in waiting time, [music] putting the casualty team under pressure. Helping to clear the backlog is advanced nurse practitioner Dave. Thank you. >> Next is 88-year-old Harold. He should have been going on holiday today, but has been rushed in with severe chest pains. Right then, sir. So, when someone comes into the emergency department with chest pain, there's a number of things that are going to happen. Um, you're going to get an ECG when you come through the door. And that's look at the electrical activity in the heart. So, my name's Dave. If I can just get to your arm, what I'll do, I'll take some blood while we're having a chat if that's okay. >> You can also have a normal ECG and still have had a heart attack. Um, it's not 100%. So, we also do some blood tests as well. >> How would you describe the pain? What would you give it out of 10? 10 being the worst when it first came on. >> Sharp scratch. >> But it's worst at all. I thought it was about a nine and a half. >> Nine and a half. Out of 10. So, getting there. >> I've had it. I've had it so many times. >> Have you? >> But this time it was very severe. >> So I'll send those bloods off in a minute and just do some routine test. But I'll do some things looking at your heart as well. >> So can you point to me exactly where the pain has been the worst there? Can I just put a little bit of uh quick feel? Usually when something's that sore because I'm pressing on it, it's it's generally good because it's usually muscular sceal. So, it's sort of the the muscles and the many times >> and the tendons and the if it is muscular, it's probably because there's some inflammation around the rib or around the costrial joint there. I'll get an X-ray as well just to make sure we're not missing anything. I'll get these blood sent off. Are you okay on your feet? Before experiencing chest pains, Harold was packing to go on holiday. >> Where are you off to? >> Yorkshire Dales. We've been going there ever since we were >> Come on, Tim. and we've been married 66 years. >> I want to get this man on his holiday, [music] but I need to make sure that it's safe to do so. >> So, has this potentially scuppered your plans? >> I hope not. >> Yeah, I hope not as well. If I uh if I can discharge you, will that be you off on your way then? >> Yes, but we haven't been anywhere for such a long time. >> We are keeping out of that blood test. All right. >> Thank you for >> You're welcome. If Harold's chest pains are the result of a heart attack, his holiday in the Dales will have to wait. Barnsley Casualty is struggling to find beds for the large influx of patients arriving by ambulance. >> Is there any chance I can have an [music] ambul and I've got another another one new one to come in? >> Harold had chest pains this morning. He's waiting to find out if he's had a heart attack. Nurse Dave's got his results. >> Hello again, sir. >> So, I've now got your second sample and that's come back at 101. So, I'm very happy that there's been no no problems with your heart there. That X-ray looks absolutely fine. So, I'm happy that there's nothing more serious going off today. So, >> I think uh I think you'll be okay to get off on your holiday. >> Yeah, I'm good. >> Just charge, sir. All right. Enjoy yourself. >> Thank you. >> Take care. >> Thank you. >> You're very welcome. Giving Harold uh the good news that everything's come back okay and you can go on your holiday, sir. It's fantastic. >> You want to >> I just hope he's getting his packing finished nice and quickly. >> Harold is picked up by his daughter to be whisked away on his holiday in the Yorkshire Dales. >> Been absolutely wonderful at B hospital. >> Amazing. >> Bye. >> [snorts] >> Can we keep these notes together? I've got a gazillion front sheets on their own. >> To keep the department moving, it's crucial that everyone keeps on top of their paperwork. >> God forbid, Michael, that you get up and have a look. >> I guess some parts of the job feel like you are mumming um some of the staff, some more than others. Please code doctors, please. >> I'd like to think [music] that I'm my managerial skills are okay. I'm not too bad at or demanding, but yeah, you can have your mom moments where that [music] bit of anger gets the better of you. [laughter] >> Oh no. Who does that? >> That's lanky, isn't it? >> Owen, who's been involved [music] in a car crash, is awaiting his X-ray results. He updates his girlfriend Gemma. >> What's going on? >> Uh, I was just still I'm still in my neck brace and stuff. So, we're going to put a canula in for my pain relief. >> How are you feeling now? >> Rubbish. Really painful. >> I've had some of this, but it's run out. >> I'll find out. >> Not yet. I don't think I'm not like >> I think I'm still in the E section. I don't know. >> Yes, you are. >> Oh, yeah. >> Right, babe. I'm going to go cuz nurses. Ah. >> Oh, babe. [snorts] >> That's not his neck. That's pulling a piece of tape off. >> That was just tape. [laughter] That was just tape. >> Oh my god. Do you think you brought your back? >> Right. I got go. I got go. >> Love you. >> You better. We all be a bath. >> I love you. >> I love you. Bye. >> Bye. >> Owen's case has been taken over by consultant Dr. John Raina, who's been assessing his X-rays and is ready to deliver his findings. Is it Owen? >> Yeah. >> My name's John. Hello. >> One of the doctors working here today. >> X-rays look okay. >> Oh, >> Owen's X-rays reveal no fractures or other injuries from his car crash. It's safe to remove his neck brace. >> So, what I'm I'm not going to sit you right away. Okay. That'll be very fair. You seem to be very sore. >> I'm going to take the side bits off >> and then we'll get you some tablets to take for the pain into paracetimal if you not had any this morning. >> Right. And then we'll see what you're like after a bit of bit of rest. In a better position than you're in. Okay. I'm going to ease the color off ever so slightly again. All right. >> But you don't need to move. I'm just going to move the trolley a little bit. All right. >> Just going to be a couple of degrees. Okay. >> How's that? >> Oh, yeah. >> Not bad. >> Yeah. >> We'll get you some tablets to take. All right. And then when they start to kick in, we'll come and move you a little bit more. Okay. >> All right. >> Right. You call us off. So, I'm going to put this on your face. All right. >> Okay. [music] There you go. >> Can't see me scing either. >> Right. >> You can't take that home. By the way, >> in cubicle 3, Dr. Humphrey and sister Joe have finished removing a massive blood clots from Anne's leg. >> I thought she tolerated that very well. What did you think? >> Amazing, didn't she? She's so brave. >> What about the dressing? Is it all sorted? Wasn't It's not bleeding too much. It won't I don't think it will bleed. >> Bleeding. I've just put some trauma dressing on and some uh some gauze and bandaged it. Yeah, she's a tough woman, won't she? >> Since I've done that, does it feel a lot better? >> Yeah, since you moved that >> right now. That probably needs uh dressing again probably in 24 48 hours >> because of course you can go home. Yes. I think you should take some antibiotics uh just to make sure that that doesn't become infected. All right. It looks a little bit red around there. And it was a bit smelly when we took all that clot out. >> Okay. >> Yeah. >> Perfect. >> Okay. >> You can stand up for me, but be really careful. Obviously, your leg will be a little bit uh [music] a bit sore. >> It's a bit >> bit high. Shorter. [laughter] >> Me, too. And then there you go. >> After leaving Barza Hospital, Anne was referred to plastic surgeons in Sheffield to assess if she needs a skin graft. >> They've run out of beds. Love. They're trying to sort out upstairs. It's manic. So he's breached a weight in um a bed. >> Sister Bonita has been trying to tackle the constant stream of ambulances coming into casualty. >> Right. Lovely. Thank you. Bye. back. >> The knock-on effect is that she doesn't have enough beds for the number of patients in the department. >> You guys bed at all a trolley. Anyway, >> Owen, who was involved in a car crash, has escaped with no injuries. He can now update his girlfriend with the good news that he just needs to rest. >> Yeah, I'm a bit sat up now. They're going to try [music] and stand me up. Make sure that I can wait there properly with my back. >> Is it not broken or anything? >> No. Nothing. Nothing's showing up in X-rays and that. So, you've been crying. You have >> no stressed. >> Why? >> Well, cuz I didn't know what were going to happen. I didn't know what happened. >> Right. I'll get Bell in a bit. All right. >> Got to keep you informed. >> Okay. >> Love you. Love you. Bye. >> In the hub, physicians associate Wayne is trying to discover the source of Christine's stomach pain. He asked Dr. Humphrey for advice. Got a lady. I'd like to have a chat with you about it if I could, please. Um so this is an 80 year old lady hyerectomy eight 10 years ago uh which left her with a small hernia which has now turned into a a very sizable um an incisional hernia. >> The reason she's attended today >> is a sudden onset upper abdominal pain >> crampy collicky in nature occurring nonspecific abdominal pain. It's >> a very non-specific abdominal pain um >> in an elderly woman. Let me go and have a little look at her with you. Where is she? >> She's in number three. >> Okay. >> Are we okay to come in? >> Hello. >> I'm Dr. Humphrey. I'm one of the consultants. Incisional hernas can be [music] quite common after abdominal surgery and they can vary in size. Can I have a little feel of your tummy and we'll talk while we're having a little look. Is that okay? If they're small, they don't normally cause any trouble. But [music] if they're really big, a lot of the bowel can come out into them, and that can cause trouble. From what I understand, you had an operation once, and now you've got this this large hernia. Is that correct? >> Yeah, that's correct. >> Right. Is the hernia any different to what it normally feels like? >> Uh, no, not really. >> Not really. It's completely the same. This is the same as it was last week, two months ago. Exactly the same. Once they get really big, there is a chance that [music] bowels, the guts can come out and then cause a problem because they twist on themselves and block and that will cause [music] a blockage of the bowel which is a surgical emergency. Now, one of the things we would be a little bit worried about with this being the size it is is possibly a bit of twisted bowel in there. >> Okay. So, what we would need to do first is do an X-ray of this. All right. And then we get a better idea of what's going on. >> Yeah. We don't like people in their 80s coming with abdominal pain because it's normally quite serious. Cuz you don't like coming to hospital, you lot, do you? >> No. >> Christine will need an urgent X-ray to determine if she requires emergency surgery. >> Wendy, >> where are you? Sister Bonita is battling high ambulance admissions with a casualty department at capacity. >> I don't feel like I'm um coordinating right now. >> I feel like I just want to go home. >> Do you want to swing your legs around first? >> Okay. Yeah. >> It's been an hour since Owen was given the all clear. He can now go as long as he can walk out unaded. >> Oh yeah. >> Didn't realize how tall you were. [laughter] Yeah. >> While reactions are back, >> it's definitely a a rewarding part of the job. Someone that came into the department immobilized on a stretcher to thankfully be able to discharge them home. >> So, is that it? Buffy books. Go. >> Yeah, I think so. >> Is definitely a nice part of the job. >> Thank you very much for everything. See you later. >> A lot more relief than anything that there's nothing serious that's gone on. To have run into a a bin wagon is not not the kind of day anybody wants really. >> With large numbers of ambulances queuing to get into casualty, the team need to find cubicles to treat them. I'm struggling. Struggling. I'm struggling. I'm struggling. I'm struggling. Uh you got any cubicles free? We got three ambulances coming. >> Is this Alison? >> It's Alison. Yeah. >> Just admitted it's 44 year old Allison who's been brought into casualty with a suspected stroke. >> She started to feel nauseous and dizzy and then her whole upper body started shaking. She's on tablets for anemia. She was put on them about a month ago. >> Yeah. >> How you feeling now, love? >> Just exhausted. But what we'll do, Jenny's going to just pop a needle in your arm and take some bloods from you. And they've done an ECG, so I'll just get doctors to have a look at that. Make sure that's okay for you. >> Junior Dr. Tom Fish needs to assess her quickly. >> Oh, look. How can I help today? What's happened? >> Oh no. Uh, I was in the car. I knew my husband was driving. Uh, I haven't been very well with [music] the eye. I'll be really >> Yeah, I've just been reading about that on your nose. something to do with driving and I thought I'll just have a little drive out with him. >> But all my body just went really hot, shaky, dizzy, felt sick. >> And what scared me cuz I couldn't move. >> And so your husband was driving. What what did he say that he he saw? >> Over and then he ran 99. He asked me to to talk and try and say stuff and I think he said I did, but I was slurring. My speech was slurring. >> And did he notice you uh jerking at all? It says I was shaking. >> Okay. Was that kind of like Do you think it was more kind of a shivering shaking or a really violent kind of shaking? >> Just the top of my body was shaking. >> You had an episode like this happen before to you? >> No, never. Never. >> And no day is the same in A&E. One day uh I can be dealing with a really sick kid and the next day it can be a trauma. And that's what's really drawn me to it. >> The concern is that Allison may be having a stroke. >> Listen to your chest. Listen to your heart. >> Ready for the occasion? >> What are you doing? I have the pajamas on. >> Oh, that's all right. >> I already have them on. >> I look like I'm wearing pajamas as well, don't I? So, we're matching. I'm going to ask you to remove your mask just for [music] this bit of a test if that's okay. I'll do it for you and then we'll pop back on in a second. Um, if I can just get you to raise your eyebrows, open your mouth, give me nice big smile, and then put your tongue out for me. Fantastic. And just relax back to normal. And then close your eyes for me. I'm going to touch on your face. Want to say yes if you can feel me. Okay. >> Yes. Okay, lovely. Put them back on. >> Okay, so you've had a peculiar episode. Few things go through our heads and probably gone through the amal's head when you described a few things to them. So, first thing that might sound a bit concerning is the fact you had a bit of slurred speech. Um, other things that you you were trembling all over. So, things we start to think about is this been a a mini stroke and it now it doesn't doesn't sound necessarily classical for that. Um, you've not had any, um, drooping of your face, change your face, not had any kind of weakness to your arm. >> I'm just going to wait for the blood tests, have a chat to my boss, and we'll go from there. Is that all right? >> No worries. All right. See you in a bit. >> Allison's symptoms remain a mystery. She'll have to wait for the blood tests to find out what caused her shaking episode. All shift, the Barnsley Emergency Department has been swamped with high ambulance numbers. Allison was rushed in after suffering from a suspected stroke. >> She's had an episode lasting a couple of minutes where she's felt like she's not being able to move. Felt very weak. Her husband's pulled over. She's looked very pale. He was concerned her speech was a bit slurred. >> After discussing the case with consultant Dr. Dave Walker, Dr. Fish is now ready to deliver his findings. >> No. Hello. How you doing? >> Come to tell you about your blood results. Hi. >> Um, so we've done a range of blood tests. Look at your blood count. That was normal. Your bioc was back to normal with us today. Had a look at your kidneys. They were fine. Your liver as well. That was okay. Um, one of the blood tests we do is to look at a level of a marker called white cell, which is one of the infection markers. That was very, there was kind of slightly raised in you. Now, that can be very non-specific without any kind of infective features for me to go there's an infection [music] here. The test we've done today, it seems unlikely that anything serious is going on. Anything serious has happened. >> So, what's that actually happened in the car? Do you think that's just been >> Yeah. So, so we're unfortunately one of those situations where we in the A&E we can't always get a diagnosis. Um, and it's not always our remit to find the exact diagnosis and [music] therefore though I can't fully explain it. I can have a guess that it's caused by what's going on with the bit of um the low low blood clamp previously [music] stress or or some vi viral infection um and I can say that the likelihood of something more serious happening is is quite low. >> Thank you. >> Fantastic. I'll get one of my nursing colleagues to come and take that. No souvenirs. Yeah. No souvenirs. All right. And all the best. All right. Perfect. Thank you. >> Allison was discharged into the care of her GP. >> It's an hour until the end of the shift and there's still no let up in the ambulance arrivals. >> Currently 53 in department with a 1 hour 18 doctor wait. >> The Tuesday afternoon rush hour >> to try to tackle the everinccreasing numbers. Sister Bonita goes to help [music] out on ambulance admissions. >> The next patient is 87year-old Richard. >> No loss of consciousness, >> but he hasn't been sick. >> He's taken a tumble while out walking his daughter's dogs. >> His jaws all right. Teeth, mouth, and things fine. >> Okay. Take care. Let's get better. Get that sorted out. Then get back home. >> Thank you. >> Have a drink. Okay then. Good take care. >> It looks nasty, doesn't it? Ah, and that I thought, "Oh, I've got tis in you." >> We'll clean you up. What's happened? >> Well, been to Tesco. >> Yeah. >> And uh there's a boat doing something with his car. He left his gate on and we got level with dog. This big dog run out. >> Oh, cracky. >> And he knocked me right. He took me road and I landed on me nose. First time I've been in hospital. got to 87 and gone through life and spitted a few. >> I'll take that off and just check you've not done any other damage. >> You've scratched his glasses. >> I've scraped that road. It's under a nose. >> I know it's all right. Rose, right? Crack. >> Bless you. >> Yeah, you know your fingers. Okay. >> F is a sitting back on. without your chat up. >> Like no, I want to speak the shy guy. They want me happy married life. >> They lovely children. >> All got jobs. >> A just >> No. I'll clean your face up and then you can bob a mask back on. >> It's me n >> It looks a little bit less. So, I'm sorry if this hurts a little bit. She's got a bit of dry blood on there. >> It's been breathing all day from 11:00 went back to the time. >> So, it happened really early on today, didn't it? >> Before about half 11. >> Oh, me neca. That's ages, isn't it? We're very busy today. >> It's awful. Bear with me. 2 minutes. I'm in demand and I should come and I'll bring you a couple back and I'll fix your finger. >> Okay. Right. Let's have a little look at this. So, um, >> in the main hub, Christine's X-rays have come back and are being reviewed. >> So, um, certainly no evidence of the small bowel being obstructed. I think I would just [music] ask the surgeons to have a little look at it and see what they, uh, they think in terms of the hernia itself and what needs to be done about it. frame. Everything else looks all right. So, um yeah, go ahead with the plan as we discussed. Y >> all good. >> Certainly. Thank you very much. >> Right. >> Hello again. >> I'm back. >> So, we've just been having a look at your your X-ray [music] >> and the good news is um as far as we can see in the X-ray, it doesn't look like you've got a sort of blockage in there, an obstruction in there, which was something we're worried about. But obviously with with a hernia of that sort of size that's causing [music] you problems, it's sensible that somebody has a look at it. >> So I've spoken to our surgical [music] team and they've agreed to see you. >> Okay. >> So is why are these pain? >> Well, it could just be that this is [music] is just a tummy bug. >> Yeah. >> But we need to be sure that it it isn't it isn't something more serious. >> Is that today? >> So that's [music] today. We'll get you upstairs and let the specialists do their do their thing. >> Okay. Right. >> Thank you very much. >> Not a problem. All the best. >> Take care. Thank you. Bye-bye. >> Christine went to the surgical ward where more investigation revealed a small blockage. She was treated for 10 days before being discharged. >> Me and all love. Me and all. After battling high ambulance admissions all shift, >> Sister Bonita is finally starting to make headway. [music] >> I think there's a there's just one ambulance left now. So, it's h it's caught up a little bit. >> In cubicle six is Richard, who fell while walking his daughter's dogs. >> This man, [music] he's basically been out with two dogs today and he's fallen. So, I'm going to make him a cuper as well just to um cuz he's not I don't to eat all drinks. I said I've come through the back way. So, [music] I'm going to just bobby this on for a little while. >> Can you do what you want and put wound tissue on and not bother me? >> Right. I've handed you over to one of the girls out here. They'll come in, have a look at these wounds, tidy them up properly, and then I expect you'll probably go home. >> All right. >> Hi, Amanda. >> Sometimes [music] we just need a cup of tea and just being there sometimes is is just enough. And it's really rewarding actually and [music] I guess gets taken for granted a lot. >> What What little dog's okay? >> Okay, we'll see. You're very thoughtful, aren't you? >> After being seen by a doctor, Richard was given the allclear and sent home. >> Let's think in that first one. >> Thank you very much. >> You're welcome. >> The shift at Barza Hospital has finally come to an end. >> Oh, folks, I'm so sorry. And for Sister Bonita and the team, it's time to clock off and hand over to the next crew of doctors and nurses. >> Resource has been chocker [music] all day. There's five in there. We're fighting to get some out to get some in. I have days when they're really tough and I go home and I question why I [music] ever considered a a nursing career. There's three beds just come up and we've got [music] 18 waiting. But you then remember the small bits of care that you've delivered to somebody, the difference that you've [music] made to another patient. >> It's just a massive backlog and has been all afternoon. It's been relentless. Which you [music] reflect on and think, well, actually, I did do good today. And then you you go to [music] bed and you wake up and you do it all again.