don't worry it's okay let's go with me let's go we're back on shift inside the ambulance got a job do you need me to get in the back you might have to stop with more medical emergencies I'm okay oh that's a good end and more cameras that Tyler is a little camera we're taking you back to the heart of the action just lie down for me we're from the ambulance okay there are some new faces I'm happy to be your crewmate I feel like we've bonded and some old friends I'm better driving yeah is it the fact that I'm faster and smoother than you you're driving's terrible how can I help body mounted cameras record every moment nice deep breaths going to open up smashing to show you what goes on behind closed doors we'll get you right all right you'll be on the front line with the ambulance cruise from West Midlands Ambulance Service I don't need to be a doctor I just need to know what I can do to help as they deal with 3 000 emergency calls each day we see so many people who get told that nasty c word so many people can fight it now step inside the ambulance you take care mate all right thank you thank you [Music] it is interesting though the different patients you get in it like I don't think like the Sunday Night Shift patients you get are all people that don't want to go to work on a Monday morning yep you got it it's funny I went to it I went to the Garden once he was vile he was really aggressive he threatened that he was gonna stab me and look around my like to a point where I got off the truck press the emergency button cry honestly I'm sure everyone needs to hold that man to leave the room I just thought I I ain't interested I ain't coming to listen to this that was one of the funniest things you get out when you literally literally went all bad mom news came around and went no that's enough now you need to leave I've been assaulted by dementia patients when you go to move them slide them across from one bed to the next what happened to your eye isn't it right okay [Music] it's coming up to four in the afternoon and paramedic Hannah Simpkins and technician Michelle McNulty are close to clocking off when a call comes through address some members of the public have rung 999 concerned about a man who they've found lying unconscious in the street not breathing properly right there unconscious mail in his 30s the information is confused but they also know that the collapsed man has hypodermic needles on him online well we didn't really know what we were going to we were just told that it was an unconscious person in the street and when we got there it was kind of like okay so what's happened here then yeah [Music] the condition of the man and the presence of the needles make Hannah suspect a heroin overdose the way with the patient are that is that they're very difficult to assess because you don't know any of the story that's happened before you get there you don't know what they've taken and obviously the facts that they're showing signs that they're taking something means that they can be very unpredictable with someone that's taken on overdose particularly of heroin if you've taken too much of it then you'll just stop breathing all together basically and you'll go into cardiac arrest you're right fella you're all right mate you open your eyes for us inside his bag Michelle finds documents that confirm the man is a drug user open your eyes mate hello hello mate uh come on then should we sit up Michelle and Hannah would like to get him to the ambulance but he's barely conscious that's it put yourself shut up mate there we go look good man I see all right you open your eyes come on yeah all right that's it you stand up with us come on then you're gonna have to help us mate no sit yourself back there and then lean yourself against the rail in there turn yourself around that's it come on mate talk to me we'll be taken look at my mates have a look in your eyes fixed in twos it's the answer to that question then but yes the patient's fixed pupils are a classic sign of a heroin overdose stretcher go to the hospital all right the priority for Hannah and Michelle now is to get the man treatment before he has a cardiac arrest stand up that's it mate what Hannah and Michelle do know from the man's records is that he has a history of abusive behavior and violence [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 all right what you've been doing hi where are you being what have you talk now with the man too intoxicated to help and the risk of a heart attack still real Hannah and Michelle have one final option an injection of naloxone a drug which reverses the effects of opiates such as heroin but it has to be applied with care taken too early it can cause the patient to come down too fast this will go and then do it when we pull up outside and then do it life is going to get very complicated very quickly and what I suggest to try to put some oxygen on him the mask with some oxygen all right Hannah and Michelle plan to administer the injection the moment they get to the hospital when they'll have more help around Hannah gets it ready let's go [Music] oh [Music] [Music] and five minutes later they pull in it's the Moment of Truth time for the naloxone injection but knowing what's coming the man isn't ready to come down just yet yes yes let go of may let go I will not what no no lock sound why why it's bad for you why is it bad for you having radioed ahead other paramedics are on site to help Hannah and Michelle out but he said no it does bad things to him [Music] I've wiped his arm already what's it do bad to you yeah we're gonna yeah yeah go on sorry because it's indicated because if you've got an opiates then we can use this to bring you out of it can't we don't because they find you unconscious in the street and you won't breathing properly for yourself okay and if we don't give it to you there's a chance that you'll stop breathing all together mate there we go all right okay there we go pop your feet back on the stretcher the scientist thing that he gets abusive and violent um get ready for it everybody yeah yeah just while I grab these notes he did grab hold of my hands I don't think he would have had the energy to get up off the bed and physically fight me but I think if he'd been any more alert I would have been worried into the hospital the man is taken off to A and E where he'll be closely monitored as the emergency antidote drug takes its effect [Music] [Music] Mysteries of the human bodies um baffle me sometimes because I'm on par of course carrying this lady down the stairs and she's obviously got bowel obstruction I'm at the bottom of the chair which is a rookie mistake and we're coming downstairs and we'll help with this little girl I just said Neil can we hurry up we get to like the second flight the next thing you know it just it just came in one and obviously where's your stranded it's gone all down the back of my neck all down my shirt oh my God it's horrific absolutely horrific [Music] thank you [Music] 999 mode activate it's just gone half six in the morning and paramedic Michael anslow and trainee Dimitri Holloway have just begun their day's shift when the details come through for their first job a woman has called about her husband who has a series of long-standing medical conditions he's been feeling very unwell since four o'clock that morning how old is he [Applause] [Music] reached your destination just four minutes later they arrive at the man's house [Music] on in [Music] hello hi Anthony my name's Dimitri this is Michael what's happening matey [Music] do you suffer from any existing medical problems what does he suffer with a dialysis uh-huh love platelets this is diabetic Anthony I'm just going to take a spot of your blood if that's all right just check your sugars and check them in a couple of days okay Michael Tony is clearly very sick the priority for Michael and Dimitri is to try and work out what's causing it and whether it's linked to one of his long-term conditions they start with some basic observations checking his blood sugar levels and heart rate nice slow deep breaths for us is very tacky he's going at like 200 mate a heart rate of 200 is a concern a person's nor rate would 60 and I think we know why you're feeling so rotten your heart rate's very quick at the moment Anthony okay Anthony normally suffers with a condition called atrial fibrillation abbreviated to AF it is a lifelong condition was making him vomit it was making him quite short of breath very clammy and generally weaken off his legs the body cannot sustain a heart rate of 200 beats per minute so he needed his heart rate stabilized at the emergency department which looks like faster if Michael there's no p waves as well no well you can barely see them yeah right we're going to get you a chair Anthony um and we're going to take you up to the hospital now all right AF isn't usually life-threatening but it does increase the risk of a stroke Michael's keeping calm but he wants to get Anthony Hospital treatment as soon as he can okay number three ready lift all right I'm today yeah Anthony okay as we go up it's really important to keep patients calm in the back of the ambulance with Anthony's condition we didn't want him to become more stressed increase stress can can put the patient at risk of having further arrhythmias with their heart and can also increase the risk of the patient having a stroke so we wanted to keep Anthony really calm reassure his breathing and get him to the hospital as soon as we could yeah [Music] with your breathing try and slow it down if you can for us Anthony I appreciate your Breathless it's nice and slow slow deep breaths okay [Music] because you're basically if it's breathless because your heart's going so fast so it's harder for your body to get the oxygenated blood sort of around your body which is why you feel a bit breathless and dizzy and sick [Music] just letting the hospital know we'll come in all right oh yeah can I place an alert please um I've got a 56 year old male he's currently in fastair and he's complaining of feeling breathless dizzy and nauseous and he's wretching as well and so we're about five minutes or so away we'll see you in a bit all right thank you cheers bye [Music] basically we're just letting the hospital know you're coming Anthony because we don't want your sort of we want you seen as a priority with your heart rate it's all right as Dimitri rushes to the hospital it emerges Anthony's got a very special reason to want to get well soon the big day out then it is there okay um financially because the dialysis took over the insulin what what cause is it kidney failure I take it what's caused um [Music] just then Anthony takes a turn for the worse any other medical conditions that you're aware of and so that's it hold the bucket writer hold the bucket I'm gonna be sick again thankfully they've arrived at the hospital me darling just get the ramp down first all right you hold that right up for me another bucket yeah don't worry look you've got plenty of room in there sorry okay keep hold of that for a second that'll get you foreign that's it cover your mouth with it got it for Anthony it's been a very unpleasant Journey but now he's here he can get treatment for his fast heart rate and hopefully get better in time for that wedding Michael yeah just a couple of bumps as we go down all right [Music] keep your arms in for me that's it [Music] it's half past seven on a very special Sunday morning Happy Father's Day by the way and to yourself and that kids will have a loving Father's day without just being there they will yeah Lee timbrel and gas Clark have just started their shift and they're already feeling the Heat well it's gonna be a hot one today I don't mind if I'm sitting in the garden all right updated assignment it's a very abdom pain nausea cold or plummy very severe pain with a knee pain it's all we know [Music] he has debilitating abdominal pain [Music] they reach her in just three minutes hello hello there I'm Gary and Lee's just coming in what's been going on then what about them how long have they been going on about 20 minutes there so you're okay last night when you went to bed oh Sarah has been having severe pain on and off for the last few days it got so bad this morning that her partner Luke called for an ambulance where is it if you can point with your fingers does it go around the sides at all no it's just what type of Pains of these are they a burning itching stubbing gripping she known you've been wounded nicolon Taylor is there any position that makes it easier when we turned up to see Sarah she was obviously in quite a bit of pain and quite a bit of distress she was very agitated been up all night just really couldn't sell properly quite often with a person you can tell them in Pain by the eyes the eyes are dilated holding the stomach can't stand up straight and literally just isn't in the same room as us at the same time the extra stab of pain I know is excruciating I can see that in your face how often do these stabbing pains come back so it's a sudden cramp start last for a couple of minutes and then it slowly disappears and then it can be away for a couple of minutes the difficulty in trying to ascertain what's wrong with any abdominal pain is that there are literally hundreds of conditions that affect the abdominal area all we can do is treat any symptoms that we can such as the level of pain and take them to a doctor to be assessed properly so maybe for about a year this has been actually going on in the background sure for it yeah they said that the MedStar wants could be taking the lining off my stomach how long have you been on them about a year now so since you did start taking your antidepressants you've started to have problems Sarah's Health has been suffering for the last few years ever since her baby was born prematurely and soon after when Hernan died so you suddenly lost a load of weight as well I need to press around by your kidneys at the back just just relax just relax any pain there at all why I'm pressing it doesn't cause any discomfort anyway does it hurt when I press it's just really tight monster workers yeah I can feel that yeah it feels like you've been in a hundreds of thousand punches every single day unservice case with the history that she was portraying to us the rapid weight loss abdominal pain following eating so when she's actually digesting the foods this is having some effect on her body like a condition called IBS irritable bowel syndrome so we're getting some gasoline before we move it have a little bit on that see if we can just get your liquid stable get you back on the ambo then I can examine you a bit better because you'll be in the right position right one of the things is that if your stomach muscle really tight which they are yeah then that's going to be pressing on all the internal organs the gas and air will relax the muscles have a little puff on this first settle things down in that so you know how it works the gas and air offers Sarah some temporary relief relief Luke her partner will need to stay at home with the kids have a seat on there throw your legs up when it stabs what does the pain go to at the moment yeah and you were crying in that mud okay with Sarah still in so much pain Gaz decides to try something else paracetamol straight into her vein it's early in the day for us today we started at seven o'clock thank you so your first customer no we're always happy no it's unfortunately sharp scratch okay [Music] I did wish guys a Happy Father's Day this morning yeah and I explained it's not because I see him as a father figure but more of a grandfather figure right there you are it's not bad from the first cannula ever change from oh God yeah it is yeah we'll head off then [Music] on the three mile journey to hospital Gauss takes the opportunity to get more information from Sarah there's not much of you to be honest the higher have you've lost five stars before when I had my son and then um I lost my land and everything and I'm down to I went down to seven so I was six and I went on eight so six now and now gas has got Sarah talking she gives him a vital clue as to what might have triggered this entire episode so I decided to not know some fajitas something wraps in the cheese that was on it so I think that's what did it in literally within five minutes of eating it it was drinking a paramedic because I was just I was rolling around on the floor even my friend my partner's friend there and he was scared society's Dairy then it's a case of right is it cheese is it milk you know which type of thing Martino before you slap that what he really Mark you I could barely have milky Martina since being pregnant with my youngest and he was premature as well so everything's just stem from yeah well just try try the differences by having different foods uh miss out some foods if you think there's something causing a problem but that way you're getting in control of it in your guide in the way that it is and armed with gaza's idea on her diet they take her into a and e for tests foreign much bigger and brighter do you want me to be [Music] wow and I awesome then he's always made by the way you can see it can you you watched because he'll be the idiot to pranked it into someone a net of killing a family of three or four yeah he'll walk out completely uninjured we're Brewing another family's life but regardless what an absolute idiot absolute fool put the phone Dawn [Music] [Applause] [Music] it's just gone half past two and paramedic Darren Westwood and technician Craig allsop are on the afternoon shift Bryce moving on we've got a job with 49 year old female with breathing problems um also legs are swollen 999 um she's shaking she's sore she's unable to walk and she's breathless what do you mean we're swollen like indicate um increase all power yeah could be couldn't it yeah just six minutes later Darren and Craig arrive at the woman's home all right where are we going just through there hello [Music] sweet is Nicola hello Nicola what's going on today sweet all sorts what what's the concern today why have you phoned I can't see you're struggling with your breathing Nicola Hans Craig a note which says she suffers from esophageal varices a condition which leaves the veins in her stomach at risk of rupturing she also has diabetes and arthritis but it's the breathing problems which are worrying crazy I mean obviously you coughing there have you been bringing anything up any sort of yeah yeah yeah it depends on what time and date it is to be honest in the morning it's thick and green and nasty yeah and then it gets to like different colors yellow and white and bubbly food and have you been to the doctor about it I'm supposed to go this afternoon that's fine that's fine okay we'll pop a bit of o2 and then I think I'll have a listen to your breathing then if that's all right I do need to just the last time she did see a doctor some days ago she was told she didn't have a chest infection but since then her cough and other symptoms have got considerably worse have you got any pain anywhere at the moment with it everywhere okay is it is it more that you you're more breathless when you remember so you're off legs completely off balance please oh no and what was that just did you lose balance and sort of fall into the bomb rice okay did you see anyone then when that happened he didn't [Music] but at the moment you are our priority so we need to get you right don't we so with with young children and a partner throat cancer Nicholas not had Craig's carried out a check on her heart which has reassured him that Nicholas breathlessness is not linked to any heart problems instead he thinks there's another more obvious cause for the sound of it it sounds like you've got a chest infection you've got a good temperature so I would say that we'll probably give you some paracetamol we will take you to the hospital and get you seen there all right foreign wants to get Nicola a full Hospital assessment as soon as possible so they head to the ambulance marvelous perfect that was like a job in the city what's almost as far as you can straight up there right keep yourself upright as much as you can just positioned better and then when you're ready pop your feet up and that's it lovely right we'll get off there mate Nicholas situation was that she was actually caring for a quite poorly husband who had cancer and she seemed to be the the go-to person in the family who cared after everybody else and neglected herself a little bit and every now and again the cameras need a bit of care so unfortunately she left it to this point where she got poorly if she left it any longer it could have got even more serious and those people that she cares for were about to go somewhere else for their case so we've caught her in time obviously you've got a lot on your plates I think you're looking after your partner and everything you see having some keema or anything tomorrow yeah um at the moment we think it might be dog gone door midnight okay so we're just walking through his CT scan yeah okay your breathing definitely seems a bit easier though at least if you've done something we've sorted your breathing out with Nicola appearing to be improving they arrive at the hospital right we have arrived your heart rate's calm down nicely but everything that when we first walks in is nice and relaxed now so I feel that we've at least sorted something out for you there's gonna be no moving don't worry about that so you won't be going anywhere until you're not sweating again she's just worked a load of it yeah I thought I thought she was crying but now it was sweat I'm just getting all emotional on me Nicola will go off to have a full checkup on her chest and other conditions to see what's causing her breathing problems [Music] foreign [Music] she's got quite a few things going on actually at the moment bless her I went with this one woman the other week who knows this one was it wit's end because she'd been training about 20 times she's only about in her 40s and she kept going on and on and on about you know or make my heart beat three scene I think it's a regular is it a regular I've checked my pulse I think it's irregular and then every time you glance every time you glance at the screens you go how's he looking is it irregular and she was a nurse to realize how many people have a needle phobia yeah it's normally the men that are covered in tattoos yeah that are scared of needles ironically foreign [Music] [Music] student paramedic Leon Askari are well into their 12-hour shifts yeah thank you we'll be backing up half thanks a category one is the highest priority call out a crew can get 12 year old male who's fitting the boy in question Brendan has just had a fit another ambulance team is already on the scene less than five minutes later Leon and preet arrive paramedic David leavesley is from the hazard area response team they were sent to the case as they were the closest available ambulance team we had a seizure a few weeks ago yeah and he's been investigated by their hospital he was told that there was likelihood that he was going to have a second one anyway so we've got a second one that's lasted for about two minutes now and started off slowly quite violent shaking in the next um it's quite um Dopey at the moment Dave's team are Keen to hand over to preet and Leon so they can be ready for other calls preet now needs to assess what state Brendan's in do you remember what happened sweet yeah let you know where you are you are here I am yeah who am I Sophie Brendan's mum Michelle explains Brendan also suffers from attention deficit disorder which he's on medication for he clearly needs proper hospital care but to get him that means a ride in the ambulance and there's a risk that further stress and excitement could cause another seizure I know what we might have to do because we don't know and this is quite a new condition for you might need to pop a little plastic tube in the back of your hand okay so if you do go into another seizure we can stop it yeah does that sound good to you yeah preet and Leon want to put a cannula into Brendan's hand so they can give him an instant injection if needed but Brendan hates needles and already looking nervous right darling listen I don't want you to panic I don't want you to panic you're doing really well all right right look at me look at me darling right you feel a little scratch okay but what I don't want to do is pull your hand away okay I want you to stay nice and still yeah come here come here come here come here come here Brendan is so upset at the thought of the needle preet and Leon decide against it they think it's more important to get him to hospital as quickly as possible come on I can understand why people don't like needles people don't tend to like to have needles in their arms or in their hands in you know any circumstances let alone being a child who's confused after a seizure and doesn't recognize you and you you're trying to put a needle in his hand so it's not the best situation to be in what's the last thing you can remember with Leon clearly still feeling the after effects of the seizure prete and Leon want to get him to hospital as fast as they can it's only his second ever seizure but Leon suspects it might be a sign of a more serious underlying medical condition epilepsy any type of epilepsy in the family or anything like this anything to me Brendan was behaving very typically of that of a epileptic patient a diagnosis of epilepsy can change anybody's life people have to plan their life really around the condition rather than just go um just go happy go lucky with it and as a child it can change somebody's perception on themselves they see themselves as different but there is help and medication out there that does help you wait no you're not all today he's gonna eat at school it is diagnosed in the long run as like epilepsy yeah he needs to have it needs to be a strict routine of 18 at the same time eating the same thing okay you must have three meals you have to eat at the same time medication at the same time he's a change of life it is you don't sleep enough you wouldn't throw another fish miss one dose here at risk of having a fifth okay so you it's I know it's probably not what's best for him at the moment to be in the future he may be better team moments later preet pulls into the hospital right we're here yeah we'll get you outside in a second [Music] Brendan is taken off to have his seizure assessed and to see whether there are any longer term implications [Music] the patient who collapsed after taking a heroin overdose discharged himself soon after arriving at hospital against the advice of the medical staff he's not been seen since [Music] an x-ray showed that Tony had a buildup of fluid on the lungs which made it difficult for him to breathe he was suffering from a chest infection and spent four nights in hospital on antibiotics thankfully just the next week proud father Tony was well enough to walk his daughter down the aisle on her big day Sarah who was suffering with excruciating stomach ache was given more morphine in hospital to relieve her pain she spent the night on a drip to replace the fluids she'd lost through vomiting although she's back home now she still suffers with stomach pain and is on medication to try and manage it [Music] doctors discovered that the reason Nicola was struggling to breathe was because she had a severe case of pneumonia caused by blood clots she was kept in hospital for a week and given a strong course of antibiotics to fight the pneumonia she will now need to take blood thinners for the rest of her life to make sure no more clots form Brendan who had a fit was kept in hospital under observation after tests he was diagnosed with epilepsy and given medication to control it since then he's had too many seizures while asleep but his mum thinks the medications help oh here we are home sweet home [Music] thank you