[Music] one ambulance rigged with cameras for the first time ever to show you what goes on behind closed doors body mounted cameras record everything oh it's going to be another two-hour session of wearing the man bra hello are you okay not turned on apparently it's going to be a fish oily lens on us i'm going to make your face look even fatter than it is where's the button jamie it's there we'll reveal what it's really like so where are you hurting to be a paramedic hello there lawrence we're with the west midlands ambulance service we get life to get death we have a bit of everything as they deal with three 000 emergency calls each day [Music] taking you right to the heart of the action you can't all right that's the worst bit over all right [Music] he's got budgies in the back of the in the boot of the car oh where else are you gonna put them they're in a cage yeah but mommy's going on holiday and you want someone to look after him actually that's not safe not safe what if he falls off his perch well i think she can fly [Music] i was on an arrest once i've not been in the service long and i've got my phone in my front pocket and i'd had i'd had itunes on in the car and i've not locked it oh no and as i was doing compressions i must have just pressed caught my phone and i was doing compressions in time with them all about the base you could see the family looking around where is that music coming from i didn't want to stop my compressions to turn it off so i'll just have to carry on [Music] how else are you going to transport budgies hey would you get them home from the shop maybe just bought them hold on what are these pigeons doing look we had bitching on the bonnet pigeons red one two pigeons down [Music] if birds can balance on telegraph wires and blooming pylons i'm sure they can manage in the back of a bmw it just doesn't seem right [Music] when crews are on shift and waiting for an emergency call they often park at the fire station it's close to town so they're in a good location to respond to calls quickly dan edwards and shane jones are racing to a gp surgery where a doctor has requested an emergency ambulance for a patient sepsis or blood poisoning is a potentially life-threatening condition without quick treatment it can lead to multiple organ failure so dan puts his foot down [Music] i love these new sirens [Music] [Music] it's just five minutes since the call came in shane goes to get a briefing from the gp who called 999. and dan gets the patient straight inside the ambulance [Music] so what's going on then dave what could have throwing up shaking well the doctors put you down as having a nice temperature so there we go nice little chat with the doctor been unwell recently bit of a stomach bug have you you think it was something you've eaten yes i do how do you feel today it's shaky how long has that been going on david is a retired roofer and although he's been ill for six days he doesn't like to bother his gp whenever sit on this bed your heart's a bit quick so i'd rather you be lying down let's see [Music] it's knackering you out isn't it i'm gonna put some stickers on your chest all right yeah just because your art's going a bit quick i'd rather just get an ecg done just to make sure there's nothing there do you wanna talk david has a heart rate of 160 a normal rate is between 60 and 100. he's also struggling with a bad cough have you got any breathing conditions normally copd i'm going to see him no no no 30 90. at 39.2 david's also running a temperature all these readings can point to sepsis dave's typical of the generation who no matter how hard it gets it can always get worse so they often put off calling us until it's really severe he may have looked okay but he was acutely unwell inside so he was in a life-threatening condition at that point [Music] is this skin colour normal for you like a tinge which you got like this is that a mottle isn't it right just like nice and still for me all right mottled skin is another of the symptoms for sepsis and david's oxygen levels are still low leveled out to 94. sepsis alert i'm quite unwell to be fair you've got a good infection going on but your body's struggling to shift i've got a 61 year old male triggering sepsis resps of 32 pulsar 150 temper 39.2 eta is probably gonna be about five minutes what made your daughter decide for you to get to the doctors was she just worried or was it the fact that he hadn't shifted well you know what you're gonna get now don't you yeah i told you sorry [Music] mean he wasn't expecting all this watch yes just expecting a simple walk into the surgery told you you told your daughter's worrying and that's it that's it a specialist team is standing by in a and e ready to treat david as soon as he arrives yeah it was proper septic because his oxygen saturations are so low his heart's working twice yeah so i wouldn't do if you've got the start of the chest infection queen with that car it's not his immune system took it by surprise and it's just i suppose it only takes one one drop in your immune system for it to trigger into that big gigantic inflammatory response which is [Music] sepsis [Music] tuesday afternoon paramedic gas clerk and trainee mike arrowsmith started at seven o'clock this morning they did the same shift yesterday then gaz went home and had a curry [Music] he brought it down the bar has been locked actually open your window i think uh relationships with crew mates a is probably one of the most vital things of the job really you can go to a heart frog job and you need someone to talk to get through the day using hume really don't we yeah and when you can get one over on your mate no one's about there's no patience there at all and that it's it's useful it's urgent rsa academy bilstein road tipton 15 year old patient has query fractured collarbone whilst playing football nine nine nine [Music] activities they arrive at the school 12 minutes after receiving the call the teenager has made it off the football field and into the building one of his teachers is with him what's your name hi mike this is gaz what's happening today i was playing football and i was on one on one and then i was so sorry and then i got knocked over and i just landed on my shoulder and how did you get from the field to here did you walk yourself yeah can you feel your fingers anything yeah can you move your fingers on yourself if kieran experiences numbness or pins and needles it could mean he has nerve damage so we'll take this off how attached are you to this top if it's causing too much pain we'll cut it until he sees it mike won't know how severe the injury is the bone may have broken through the skin so you landed on this shoulder yeah yeah all right so you didn't have your arm extended out at all no was it land that way or was it more towards the far front or back i landed like i was running and i just landed on my shoulders straight up all right while the collarbone hasn't broken kieran's skin it's well out of place he may need surgery to realign it if you have to score the pain out to 10 send me in the worst pain on earth one being slight what number would you put on it now nine is it a 10 on movement yeah all right it could be dislocated but then again it could be fresh we wouldn't like to say about an x-ray right river your good end this is gasoline have you ever had it before nice deep breaths it's a pain relief it'll make you laugh maybe quite giddy it only works once you breathe it in that's that noise we want to hear nice deep breaths every time and then we'll get that pain score down to a zero and it's going to be a trip to hospital all right gassing is normally used as a muscle relaxant then you relax the tension so it eases the pain i think kieran enjoyed the laughing afternoon the young people tend to uh tend to be giggling off and laughing and funny where the elderly just tends to be more sort of a zoned out being seventeen you're not legally late to drinks you never do but that's about about eight to ten times okay eight to ten it's like having one pain for me i know i've been like waiting here is that working what number would you put on it now four a four [Music] yeah and put a leg in his sleeve i just don't want it on that shoulder keep sucking on that oh yeah believe me you've got the a-team here today slings it's not really my forte i don't think i used to be really good at them but it's uh i'd say it's a lack of practice really doing this thing while the gas and air is working kieran's still in substantial pain we can pop a little needle in your arm and give you some more pain relief would you be happier with that yeah yeah it's safer for you we're gonna be driving around and we're gonna be going over potholes and bumps in the road so we're just getting pain-free right i'm gonna give you some good drugs now okay you might feel a bit warm and a bit light-headed are you right-handed i'll still be able to do work excellent after half an hour of pain relief kieran informs them he can't feel anything time to get him to hospital where gaz will need to give a full [Music] sometimes your body protects yourself by numbing pain first then afterwards it slowly starts to come back and that then goes out deserves at the end of that you broken though it's gonna work a bit into he's still floating good stuff not gonna stay off school everywhere they normally suggest at least the uh the first day in that you know have a bit of time off just to get used to the partial backslab and also not disturbing how they've set it kieran's collarbone will be x-rayed before it's manipulated back into position if the bones still don't line up properly doctors may decide to operate and fix the brake with a plate and [Music] screws [Music] i had a stabbing when i was a trainee tech technician and this guy who's in a gang another guy from again caught behind him and just he slowed missed his carotid artery and everything yeah but his throat was open you could see only strakia in the middle a knife mark they've gone across this cartilage abbey was still alive i don't know but it missed all his vitals so we put stuck up because we're only around the corner from the across it took a big bandage on it made him do this to like self-close the wind the blood and guts ones never bother me like if someone said to me what's the what's the worst job you've been to in terms of emotional it would be holding the hand of an old lady you've got cancer till she died family couldn't get there in time so i said to i said to control on i'm going to stay with her so she's at least got someone that was that [Music] they're we'll head towards the scene but if we get any suspicion we'll just drive past an update if you're happy with that received [Music] it's a very loose term isn't it stabbing i was stabbed with a paper clip versus stabbed with a machete turn the silence off now and the lights and well we'll just go and have a peek yeah it could be kids putting them out couldn't they just be a mess around [Music] he's got a little cut on his head the man is drunk and abusive he's fallen off a bench and cut his eyebrow he doesn't need any treatment so dan and shane move on to their next job so he was wasted we get that adrenaline rush don't we you get that oh this could be a proper job it could be what i'm trying to do and he could be like whoa what am i going into it's the man on the bench [Music] mercy simon and michelle have just dropped off a patient at the hospital but their next emergency call has come in straight away 91 year old ken query stroke after a head injury [Music] that's about as much off-road as that vehicle michelle and simon's body cameras will record everything [Music] 91 year old ken has collapsed he lives on his own hello ken how are you doing so what's happened yesterday ken had a fall and this morning his family found him in bed unwell yeah walked into here like the best record yeah because he wanted the toilet okay and then he sort of just went up like that okay my dad called natalie when asked was nancy yeah somebody just straight away simon does a basic test to see if ken has had a stroke can you stick your tongue out that's it oh he's smiling anyway has he been talking to him ken has two children six grandchildren and six great grandchildren keep your arms still ken i was gonna call your granddad then yeah has he been poorly or anything recently yesterday i mean he's not been too bad ken blood test on your finger all right sharp scratch 4.2 probably do with a sugary tea or something oh yeah he had a history of urine infections so we were wondering whether the fall was from that because urine infections can cause you to become confused unsteady on your feet especially in the elderly especially in the elderly all right ken i'm over here we're going to set you up okay yeah we will if you can do that all right young man bend in the middle oh where's it going ken ken where's that hurting where's your body your neck your neck here here yeah there is it there yeah ken can you lift your head lift your head put your chin to your chest and your whole head move forward like that no no okay it could have been caused by some sort of spinal damage we had to prepare for the worst in that situation simon and michelle have requested a second crew to help immobilize him before taking him to hospital all right ken what we're gonna do is we're gonna pop a collar around your neck to keep your neck nice and still then we're gonna put a board underneath here so we can get you down the stairs and then off to the hospital to see the doctor yeah sorry for stepping over here it has a lovely smile she's going to be uncomfortable hands in don't move okay we're going to lift you up all right ken ready steady got it keep your arms in ken up the ill grandad ken's had a few falls recently but has never had to go to hospital it's okay give us your honest give me your hand grandma ken i'll stop calling your granddad soon i promise okay ken oh that's my face ken's daughter jane is coming with him to hospital he's a bit slow with his responses um could be just dementia definitely needs to go to hospital for observation all right there's complaining of pain at the back of his neck as well so that's obviously concerning us i think the falls might be related to an infection as well because his temperature's slightly elevated [Music] sixty are you receiving yes go ahead yeah just giving you an update we've extracted patient onto the ambulance i think we're gonna give him some pain relief before we take off the hospital okay ken i'm gonna pop this tight thing on your arm okay how was he married uh 65 years he would have been married well how long has she passed away for nearly five years and i'd just been married 60 years i was having a big deal and she passed away and has he cooked all right since well we never thought he'd go get this far five years because he sell me staff obviously he's done well yeah he's had a lot of problems and stuff but he survived every time yeah call me uncanny [Music] all right ken we're going to the hospital [Music] okay where are we going hospital you seem a bit more confused to you than normal there's a or yeah yeah it can be quite bad at times with confusion but on the whole yeah manage is okay i've not heard you talk that bad before like your arms [Music] few bumps can granddad can that's the hardest thing to find about dementia patients is you never really know what hurts how much it hurts yeah he was very calm in the house but obviously the second put him on the board and got another size he kind of became a bit agitated but that's quite natural i think we did the best thing for him [Music] oh i hate dealing with babies that doesn't bother me they can't talk t can we i know i know they can't talk to you but at least you can tell where they're in genuine pain or not they're not gonna say that the pains are seven out of ten no no you can tell when the kid's in pain it's hard when you can't assess the miley you don't know where the pain is was just ignoring genuine stuff i think blokes tend to try and ignore it more than women yeah i think women get sicker than men die quicker and then so i'll manage all copper women are willing to accept the help more yeah absolutely [Music] i'd rather deal with an old person than a baby somebody said they're very similar they are they both need looking after a lot more it's midnight and dan smith and jamie cashmore have another hour to go till their shift is over i love them today depends i've had some really bad ones i've had some really bad ones i remember i went to a club in manchester and i had them on tap ah and they were disgusting i bought um mojito in a bottle yeah and it was like drinking listerine it was vile their next call comes through a 37 year old man with an ankle injury he's injured his anklet is painful and swollen just sort of walking home from the pub time isn't it i was just thinking at this time of night how do you do something like that unless it's just stumbled up with care or something really it's gonna be really silly isn't it but why is he walking at this time of night they arrive at the scene 14 minutes after receiving the call hello how are you doing mate you're right is it mark is it all right mark what's happened tonight [Music] is it like kind of a weak ankle kind of thing it's just got more and more painful more more painful and guessing it's not normally that swollen can i just have a look where's most of the pain just around there is it all right i'll just take your sock off is that all right what's that from it's only come up in the last couple of weeks we'll get you onto the bed get you onto the ambulance mark and kevin had been traveling home from a job in london when mark couldn't walk any further he had quite a significant ulcer on his foot and around the side of his ankle the ulcers could have made his you know his foot that little bit weaker so he may have sustained an injury on top of the altar right let's now we're in the light a little bit let's have a good look at this just turn your foot over for so long you had that three weeks about three weeks have you ever injured your foot sometimes you get problems with swelling my neck my feet [Music] yeah do you use any drugs or anything what do you use injector smoke can used to inject smoke okay where did you used to ingest where did you used to inject in your groin five years if you had any any problems with really bad circulation in your legs or anything i've got another leg you've got a leg ulcer there leg ulcers are a side effect of intravenous drug use they're often open and painful and can take several weeks to heal they can also lead to swollen aching ankles so you're walking along and all of a sudden bang you had the pain yeah what's probably not helping is there is an obvious ulcer in that foot and whether that's got infected and that's going to be causing the issue and obviously if the circulation isn't great it's not going to heal so you've had that about three weeks yeah and i bet this one on the side about three months is that better than it was all right okay get it x-rayed anyway at the hospital and then see how we go from there if an ulcer becomes infected it can develop into an abscess or gangrene it can require amputation of part of the foot or toes uh nearly nine years best job in the world yeah i absolutely love it yeah what's the worst thing sim sorry one of the worst things i've seen where i felt physically sick was a guy that had gone under a train a couple of hours later we've been cleaning the trying to win all hold on there's a bit of blood here sounds like a cheery story to get halfway day i know yeah didn't seem to take too long home time knowing that once they've handed mark over to a e staff it's 1 30 in the morning half an hour after their shift was due to end those are an interesting pair work mate quite quickly i was like drug user he's got to be there's no other reason why he'd have an ulcerated foot to be honest he was he was open with it as soon as yeah he used drugs he was quite open with it which is nice because a lot of people try to hide it which makes it so much harder to yeah to sort of assess them properly i think as well like this seemed nice enough probably just made a few crappy decisions in life from there yeah that's that's sort of how they've ended up where they have this is the first properly nice day of the year supposed to be up to sort of nearly 20 degrees the weekend so i heard on the weather yeah i've heard that admittedly i heard it from a man in the shop he was telling the counter assistant very colorful jumper jumper i know that's it sun's out tops down [Music] 99 [Music] since michelle joined the ambulance service a year ago as a technician she's done most of her shifts with simon [Music] see i'm lucky because obviously you're so chatty and you want to be lucky to have you man look at it let me get the vom bowl out i feel bad for spreading all the bad rumors about you now she picks her nose in the cab down the stairs you know she farted in front of a patient or something yeah yeah they're a bit rubbish you need you need to find through those things activated right in this [Music] [Music] [Applause] [Music] [Applause] [Music] i'm sorry they've been called to a 71 year old woman who has cancer valerie she's complaining of abdominal flank pain and she is a ca patient apparently she's been vomiting people matter waiting for them our twin sisters valerie and pam is it you we're here to say yeah what can i call you hell valve my name's simon and this is shel i'm michelle you okay yeah how are we feeling val was diagnosed with cancer three years ago all your cancers oh yeah what's the wound cancer but now it's gone to the bone how often are you vomiting i have just my lungs gone and your bowel motions zero just ain't working i think it's blocked again and that's why they said i've got to go in to get that tube put down me now okay val's tumor has got so advanced that she's already had to have the unblocking procedure four times are they planning on doing anything else now i'm okay now just flatter the time now okay what's your problem as in have you got a time uh he's not coming with us no no he's going back okay obviously i'm sorry yeah yeah um if that's anything i can do to make you feel more comfortable obviously knowing that someone is going to pass away very soon and knowing that i've got plans past that point in my life i i don't know how what humbles you he does yeah we're really tugs on your heart strings a little bit well so you've had no pain relief yeah you're a soldier aren't you i'm not sure uh what sort of pain is it how would you how would you describe it real bad pain val lives by herself but she and pam speak at least four times a day she was telling us about her 70th birthday party that they'd had together and the bond between her and her sister was just it was immense wasn't it very very strong what did you do for your birthday then yeah the road i mean it was nighttime it was brilliant yeah so dr fernandez is okay you know if he's 70. but today val is going to need to go to hospital how are you on your feet do you need a hand at all make yourself as comfortable as you can obviously forget you're both very smartly dressed as so the well is ten out of ten it can't be more than ten all right twenty i've got ocd and it can't be more than ten all right all right let's have a little look at here [Music] yeah i do think you've got a blockage so i can't hear anything yeah there everywhere else is active pam's been with val throughout her treatment they've never spent a day apart shall scratch this before i should we have a bit of air control all right so like i said it's just normal paracetamol going straight into your veins which makes it a bit more effective what's like growing up as twins man you know we could go downtown or a card and it's exactly the same and we're not with our children so close pam and val have two other sisters pam is the only one who's not had cancer as our strongest willpower now what you've gone through about nothing else you can do in snake just got a little meat yes exactly i must choose that yeah but now we need it you're feeling sorry for yourself it's three years you've got this have you got plans yeah plans we've gone to the seaside which one uh western i have a drive yeah and then we wanted to go to birmingham on a good shot because we had a good job for years and now what's it doing we don't sing songs and then when i go i'll have my ashes here because barry said we came in the world together we go out in the world together that's nice you're gonna make me cry but not yet not yet no because you've got after your new three-piece suite oh you've got to have whatever you want is that pain reduced at all did you what number was a 10 eight i'll give it a few more minutes but i can give you some more feed into your vein if you felt here there's nothing wrong with that received have you enjoyed your stay could you think of anywhere better to be right now exactly [Music] a few bums val brace yourself such a lovely lady such as a sad thing to see really i always find it hard when you're leaving someone like that when you know what's going to happen because whenever i leave a patient i always say okay see you later um you know take care you know and stuff and i hope you get sorted but what do you say to somebody who's going through that who knows that they haven't got long left you just don't know what to say it doesn't matter how strong you are or how you look in the job jobs do affect you and do make you emotional david turned out not to have sepsis or food poisoning he was instead diagnosed with pneumonia he spent 10 days in hospital on intravenous antibiotics he's now made a full recovery [Music] an x-ray showed kieran's collarbone was indeed broken doctors left it to move back into position itself as the swelling went down kieran is devastated he can't play football but his recovery is going well and val was kept in hospital for three days with a tube down her throat to clear the blockage she's been given a box of medication to manage the extreme pain when the end is near she calls it her waiting for god box val and pam have made their trip to the seaside at western super mario they now want to visit landino [Music] you