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] never thought about it when you get these newer trucks it sounds like it's chain size [Music] just kind of the police they just love the reverberating noise of this uh I love it it's this one I can't stand foreign [Music] it's coming up to 5 30 in the evening and another job has come through for paramedic Michael anslow and student paramedic Dimitri Holloway uh Category 3 70 year old male who's Fallen patient is on the floor with a walking stick call Estates patients shuffling along the floor States he's had an operation and has no Toes has no toes interesting Michael and Dimitri only have a rough location for the man they also know he's white with gray hair and black clothes let's have a little walk Michael arriving at the address they head off to look for him I'll have a look down there you'll have a look down there might meet in the middle hello have you seen anybody on the floor look found him over there down there where just down here on the left grab the kit then yeah well Dimitri goes to bring the ambulance closer Michael says hello there what's your name sorry you got no toes what's your name sorry yours is Graham what's happened today then Graham I bet you're going out toes in that titties cold okay but what's made you go on to the floor can I feel your wrist a sec so have you fallen you're not quite sure what's happened have you been discharged from the hospital recently when was that just yesterday what were you in for free your feet was it okay do yourself with diabetes hello gangria it's okay Right gangrana's feet aren't something Michael has come across before Graham is not in a good way and it soon becomes clear why where'd you live hello you don't have an address in the park Graham is homeless his poor living conditions have led to the serious infection in his feet which has meant he's had to have an operation to remove his toes since his fall this morning he's been on the ground for over an hour do you feel dizzy or anything no and no pain anywhere other than your toes okay have you had all of them off on your left foot okay oh all ten so both feet right it's okay how did you fall you're not sure no I did sleep over on these cabs so you've tripped then you told me you weren't sure I ain't bothered what I told you I told you I fell over all right what do you want me to say are we uh it's the reason why we asked Graham is so we can work out what's going on medically if there's anything more than just a simple trip or right where have you come from have you come from the park to here or so where were you going I've been in there I see you've come out today okay so you've made it unfortunately uh in our role we do meet a lot of abusive patients and Graham was a difficult character to to assess and and to manage and swearing quite a lot uh vocally at us I could understand his frustrations but at the same time there was no excuse for some of his language and aggression towards us really there's no need to swear at all really it's about using communication skills to try and win the patient over to explain that we're only there to help Michael wants to get Graham to the ambulance to check him over properly but to get him up and about they're going to need to use special equipment we're going to get a cushion that goes under your bum and it inflates and then lifts you up off the floor okay um right do you think you could lift the weight off your bum enough or Shuffle onto here that's it well done the inflatable cushion will raise Graham enough to get him to his feet Graham insists he's then well enough to walk do you think you're going to be able to get to the ambulance if we give you a hand yeah you sure yeah yeah not gonna fall on us a bit wobbly Graham yeah should we opt for a stretch or do you think Graham Graham's clearly not up to walking but with no home to go to and nobody to look after him he's a tricky case for Michael and Dimitri so you say you've got no no family at all I want nobody you're on your own nice any close friends or anything like that I don't know nobody absolutely nobody all right Graham our problem is that because you you don't have a fixed address and you're very unsteady on your feet wouldn't really be safe for us to leave you here well something needs to get put in place for you because you can't live in a park despite having been discharged Only Yesterday Michael's got no choice but to take Graham back to hospital as well as the usual observations Michael needs to inspect Graham's feet are your feet have they got dressings on I take it or yeah can we have a look at them or can we leave your socks off so they don't get infected that's it they've done a neat job can you still feel sort of here and here yeah good until you feel sorry for Graham it's not a life that I would wish for anybody I did feel quite sorry for him that he's found himself in this position I think deep down I think he was still possibly a bit lonely and would benefit certainly from some social interaction and I just hope that he will accept the help that's offered to him so he can move forward and have a better quality of life with the checks done it's time to get Graham back to hospital where Michael would like to get him some extra help and support we'll express our concerns for you Graham as they head to the hospital Michael finds out more about Graham's life are you single yeah [Music] is that because you're not interested or just I don't know what you do now interesting me that's really helpful you never know you might find someone you never know what life holds but you can't inevitably stay in the park I mean I don't care well if I don't want to let me try to fall and give me a coming out that's what I'm trying to to say to you Graham to try and I'm on your side here don't need to shout how long have you been homeless for huh do you when was the last time that you had like a home though we're there on your own then any of you split up and then yeah [Music] all right too much trouble yeah moments later they arrive at the hospital I pop your your shoes and stuff in a bag and your socks yeah Graham will be taken for assessment on his walking and hopefully found some extra welfare support [Music] I feel sorry for him I know like he's obviously got nowhere to live he can't stand and walk independently unfortunately it's more of a a social issue yeah for the patient which unfortunately we can't do much about and I just wish we could do more for some people but unfortunately that's not the way the system works we'll make 50 on mobile devices or the big screen all for free no subscription required download really now [Music] Paula means very useful for when you go to the long-term debt stro yeah snapping in half but half a beach nostril and then put a couple in your mouth [Music] Simon little and Michelle McNulty have just started their shift together but Michelle has an emergency of her own to sort out her six-year-old daughter Orla has a cracked tooth and the school have phones saying she's in agony hi I'm just wondering if you've got any emergency appointments tomorrow please from a six-year-old daughter that's brilliant thank you very much what's wrong with all this too well it's um but for quite some time it's had like a break it's one of our back teeth it's all kind of breaking apart the ambulance service let Michelle go to the school to check all is okay and to give her pain relief hello all right serious catapult yeah well to stop you uh wanting to come out of school isn't it thank you right there you okay let's have a look at him outside oh yeah I was broken a lot more time oh dear oh definitely it's probably come apart it looks like it's gonna come out even is that wobbly oh he might take it out you know how much how much money do you think you'll get for that I don't know it's breaking off in pieces she's probably getting a quid at a time yeah when if it comes out give it a good open your mouth then let me see let's be nice and wide it looks like it's just going like that like a flower and just breaking did you manage to eat some lunch yeah did it hurt so it was soft jacket potato oh yeah I thought you like Dylan I love you goodbye says thank you with the call in at the school done in just five minutes they're now ready for a job sorted [Music] hello seven thank you so much for that that's really much appreciated we're now clear no what oh no oh no they've been told their next patient has cut his leg open at a horse yard Simon's terrified of horses he's going to have to leave his fears at the stable door [Music] if there's a if there's a horse right over your head no I'm not getting out push the horse away oh as they approached they realize the company address is that of a horse box manufacturer okay they might just be making horse boxes I feel a little bit more comfortable now there's no horses you don't think they need a horse to check the sizes or anything they arrive at the yard luckily for Simon there don't seem to be any horses in sight there he is there he is we found him hold on a second I'm missing 40 year old roofing supplier Steve has slashed his leg open on sheet metal is it him on the floor hello what happened oh just walk past them steel sheets and sleep down inside the local razor blade all right okay a bit of blood on the floor I hope that's lost yeah yeah and obviously so didn't you you're trying to yeah you need new trainers Steve has a painful looking deep gouge in his leg oh that's a good end you've done well there it's a good one clean it all right you're all right with blood I I assume you're not gonna like pass out or anything else as Steve's got an open wound he's now at high risk of an infection for Simon and Michelle it's unusual to see such a nasty slice cut you've done well there that is a good one hang out to many good ones do we right on the tip of your tattoo there I don't think you got anything in it yeah yeah yeah Steve's incredibly calm despite what's happened and doesn't realize how serious the cut is oh look he's even bought you the stretcher oh wall bite no you won't oh well no because you've been bleeding if you started now but everyone as soon as you put pressure on it yeah pinch it together okay as well as cleaning the wound Michelle and Simon need to dress it to make sure it doesn't become infected and cause further pain sorry if I'm pressing a bit hard on you mate I feel like you need any pain relief any kind of say tomorrow or anything you're sure just the shock of it all more than anything into it you didn't even feel it with Steve bandaged up they now need to get him inside the ambulance put this one off all right keep coming up get coming up you're up to date with all your tetanus and that yeah so how are you feeling all right yes [Music] so is this your business then yeah there we go All Aboard see on the other side on the other side as Steve needs to go to hospital he hands over the reins to his staff for the afternoon stitches [Music] might be a few as well it's quite a lengthy uh Court in it welcome to sleep no no but they might just numb it a bit all right Seventeen minutes later they arrive at hospital but Steve is adamant this won't disrupt his caravanning weekend at the seaside you know how many holidays built with you this week well from good day to the van the weekend yeah that'd be fine you can have a little paddle in to say the salt water should be good for your leg attract all them sharks yeah they're really sharp oh you could tell the kids that you're not gonna go in oh no no I know there are sharks in the world I mean oh are there any sharks down like Western Steve's cut will now be sewn up by the medical team in hospital [Music] it was a good cut wasn't it I like that it's a juicy cooked juice you can have a little scar there aren't they cool because it's very clean it'll probably be a really neat scar as well and it'll probably fade quite well yeah just goes to shower how dangerous it can be going just near a sheet metal well it's wearing shorts to work isn't it that's why we don't wear shorts to work thank you I'm stabbing [Music] you know it's been ages since I've had a banana butter [Music] interesting no fruit and bread oh I'm just gonna have myself an apple sandwich it doesn't work with the Apple banana you sicken me [Music] it's tea time in Dudley regular crewmates Jivani Gallagher and Patrick Barnes are stuck in traffic when they get another call out which abdominal flank pain in the notes it says patient has an infected gallbladder gallbladder problems can cause excruciating pain I've heard apparently it's worse than labor pain really according to my friend who's had a baby and according to everything that I've talked to nothing is worse than labor pain well nothing a mountain experience [Music] difficult Associated vomiting very severe pain rising in pain their patient is a 58 year old woman [Music] it's her third attack of the week and the pain is out of control [Music] what's happening Sylvia you've got gallstones yep infected right I've been diagnosed at the hospital has it uh MRI scan okay Sylvia was diagnosed with gallstones four months ago and has been suffering from ongoing stomach pains and nausea ever since I'll keep her in this page but it's definitely a gallstones it's exactly the same as what you've had before of course it's definitely okay the her husband Steve and Sister Yvonne called for an ambulance I'll keep them in these a textbook I've had this one since Friday how come also is okay I'm on the board test every six months okay I'm on board yeah that's cancer 14 years ago okay are you passing any blood in the urine at all nothing left usually when we have these bad attacks after I've been sick I use the ears yeah foreign okay what's the best thing to do for a silver I think is get you on the back of the vehicle is that all right and then we can sort you out with some pain relief make you feel a bit more comfortable okay do you wanna hold on to me or are you all right okay it was terrible yesterday okay what time did it start roughly today yeah I've had a friend die from cholecystitis so the pain is an indicator that something's severely wrong um so it's as much of a pain relief getting to the hospital as well as for investigations and to find out what is wrong and to do something about it take time okay it might make you feel a bit drunk hold on to it with Sylvia in the back of the ambulance Patrick and Giovanni hope some gas and air will help relax her but it means we can get everything else in place on a scale of one to ten silver pain hold on I have to ask I'll return this time over 10. and prior to today when did you have a period of this pain you could say every I have the taxes I twice a week but today is much worse yeah no longer despite the gas and air Sylvia is still in pain they decide she needs stronger pain relief so prepare some morphine the strongest painkiller they carry of your children would you say this is worth in childbirth or not it's worse but I had a section so right scratch is it painful when you press it well it's just right just pain it's just it's only belly button really okay it's about yeah it's about there Sylvia couldn't be controlled on on scene her pain was too severe we had to get into hospital because the morphine doesn't last forever you know the pain would have returned once I had worn off so getting into hospital was the best treatment plan for at that time to keep it comfortable you should have called me earlier what could you have done yeah but I was just saying he's now good yourself in the panel uh usually after I'm sick he usually use after another so we had you know she'd had quite complex medical history and she seemed like such a resilient person and I think to have to fight through all of those you know bouts of chemotherapy that she's been through and to to fight against the leukemia in the cancer and to come out strong on the other side and then to have these gallstones I think you know she's been through a hell of a lot but she's still still sort of doing her best okay for the Four Mile Journey they try and keep Sylvia as relaxed as they can [Music] yeah carry on yeah just take as much or as little as you want you know when they arrive nine minutes later Sylvia is handed over to the doctors in A and E who will try to manage her acute pain and deal with her ongoing gallbladder problems [Music] we need just some good nights out so I'm gonna have a party for my birthday at mine I'm gonna have a book [Music] I think so and then go uptown afterwards I don't know what the the menu phone call thing from the bottom who cares ladies will like it [Music] yeah it's just gone 2PM oh an ambulance sandwich [Music] it's very weird to travel in Convoy yeah paramedic Michael anslow and student paramedic Dimitri Holloway are nearly nine hours into a 12-hour shift Republic probably think that's like a major incident going on probably yeah if any of the turn into the same job though wouldn't it yeah that before we turn up and there's just another crew and the tendency like hello it's me but you're gonna sing Adele then yeah I won't be breaking out with singing voice unfortunately the mum of a toddler has dialed 999 because her child has been ill since last night welcome to Michael two-year-old with a fever and vomiting but they're not the first crew at the scene see something green fluorescent ambulance color as it's a category one call another paramedic is already there all right paramedic Stephen Cooper is working alone his vehicle can't carry patience but the toddler needs hospital treatment so it's up to Michael and Dimitri to take over we're here for this this young lad okay um he's two and a half and since I think it was about seven o'clock last night he was in bed tomorrow night is he had a short Rising his temperature okay mum poor one is extremely worried she's been looking after fate with her auntie manjeet who lives close by I think it's all there had a febrile or some type of convulsion okay oh it's just the rigors I'm not sure okay it's quite lethargic and flat position 10 39 hours okay Steve Steven thinks Fate's high temperature has caused him to have a febrile convulsion but his heart is also beating too quickly and his breathing is rapid combined these are all very worrying symptoms is this nappies and stuff being okay they've been wet regularly yeah yeah smelly it's quite smelly okay the assessment of fata was was difficult because uh there was a language barrier it was quite difficult for me to communicate with mum and also vice versa for mom to tell me about her concerns because of the the language barrier that was there and what language do you speak Punjabi okay I don't speak Punjabi sorry [Music] um could we take him to the ambulance if you come with us so you're there yeah Michael's keeping things calm so he doesn't panic the family but he's noticed fatay's showing signs of sepsis a life-threatening blood infection okay Michael yeah um is rad on the sepsis tool his respirates um 52s it's classed as severe attacking paneer when someone mentions that someone's taking bread on their sepsis scale it means that they're what we class is Big sick so we really have to step up our game we need him and his bum on here sepsis is a life-threatening emergency and if not treated can cause organ failure and ultimately death if not treated at all don't worry it's okay it's really important that we get the patient to a hospital and to definitive care as soon as we possibly can never got my cool torch look what's this smoke called torch even my cool torches not doing the trick today Michael crew need to get fat at a hospital for treatment as quickly as possible I just check their temperature if fate does have sepsis he could deteriorate very quickly Michael needs to monitor him throughout the journey Michael shot me when you're ready I'm good to just start traveling [Music] the hospital is just under three miles away [Music] but at this point every second counts [Music] you like the blue lights we're calling the hospital um just to let them know that we're coming okay and has he had a seizure yeah he has yeah a seizure uh with a condition as serious as sepsis it's critical that they get an accurate diagnosis the ambulance crew have access to translators for over 100 languages could I have a Punjabi translator English to Punjabi you're right do you want to step off for me first of all do you want me to carry or you you sure yeah okay if I carry your bag lovely the Pediatric team are standing by to assess fate if he does have sepsis he'll need urgent emergency care ten ten and four fours are my normal shifts oh dear and you want a permanent crewmate no you don't want one I want one yeah I want I want to have a permanent cremate that pop a Patty with you know I might ask oh God I'm happy to be your crewmate Tiffany's if we can I don't I don't know [Laughter] it's just gone midday and Laura Hickman and Nicole McClintock are deep into their shift when a call comes through this job is to a doctor's surgery um for a query stroke a man has been taken to his local GP by his friend who's worried that he might have suffered a stroke the previous day the GP thinks he should have specialist attention as soon as possible just three minutes later Nicole and Laura arrive at the surgery find the patient Sydney and his friend Miriam so why are you feeling I'm fine for your rest sweetheart first up Nicole needs to check for obvious signs of a stroke any headaches or anything sweetheart no no can we send this stick over okay so you take my hands oh you're cool give me a squeeze always cold and push me away and pull me in towards you okay and hold your arms out in front I'm going to let go when you keep your arms there okay [Music] touch your nose with this finger ly faster and this one all right Sydney's got no immediate stroke symptoms and puff your cheeks out but he says he woke up at 3am the previous night needing the loo and found himself unable to move it so when when you couldn't move what what part your body couldn't move just one side weakness on one side of the body is a classic sign of a stroke and I still feel the strains every day Sydney might have had one without realizing so what's your medical history in the history of any Strokes many strokes Oh my days I was out of all right after while I've been with him any blood pressure problems but Sydney does have other medical problems including angina heart and kidney diseases and prostate issues Nicole and Laura learn his blossoming friendship with Miriam has helped him to cope in the morning to make sure we're alive oh bless you hmm you're 93. oh you're 93 I still don't believe they're both here to be honest you're 83. oh my goodness you look better than me I'm 28. it may be all smiles but there's a serious side yeah the GP says because of what's happened the stroke team at the hospital wants Sydney brought into a and e as soon as possible no if you pop your bum close up to that bend as you can get it and while it's Sydney that needs medical attention it turns out Miriam has problems of her own you pop your bum on here sweetheart you don't like it okay you've got a very active diaphragm from the sounds of it on the Belch all the time oh she burps a lot of a lot and it gets classy girls and then they have to at the other end with boom that legs with and it goes if you need to fart you need to fart it goes just take your temperature Sydney all right oh I go to bed amongst the hilarity Laura and Nicole still need to stay focused on Sydney's Health [Music] Sydney can I just pinch a bit of blood out your finger is that all right I'll give it your bath I promise sharp scratch okay you're just a very gassy person really aren't you it's all that Sherry you drink on a nighttime that's what does it I don't get embarrassed oh bless you oh no a lady will put in some glasses out in the departmental stuff yeah and they're Lent over and that's a bent over right over here you should have said somebody just squashed a frog in your floor or who let the ducks in oh Deary me it's gonna be a good day today Nicole yeah I can feel it in my Waters no I've been letting you bones really simple bones just chuckle to yourself on that one okay laughs oh well if it's anything like you my darling I could feel it in my bottom couldn't I love you mine oh sorry derriere with Sydney and Miriam safely strapped in it's time for Laura to get them off to hospital are you ready near two seconds are just getting my belt on my driving's not that bad I'm about to jump in I saw right then man the rabbit's in the room Nicole takes the chance to check on Sydney have you been eating and drinking normally how many toilet and okay yes every night it drinks out I'm ready [Music] oh it's not I thought your men and princess you know what prin a prune that you eat oh you're not talking right oh Irish Northern Ireland yeah why do we get confused with Scottish just then they arrive at the hospital and it's time to break up the party foreign [Music] let's get this stuff off we're going to take lean on this bed okay we are indeed [Music] sweetheart can I get you to pop off for me first so that we aren't running you over [Music] don't fall on top of me foreign [Music] okay Sydney will be taken off for assessment by stroke specialists and Miriam will go with him [Music] um Graham who fell over and couldn't get up was taken to A and E Michael and Dimitri also put a call into Social Services to try to get him some support Michael says he's now heard Graham is in Assisted Living housing after slicing his leg on a sheet of metal at work Steve needed stitches to close the wound he's particularly grateful to A and E staff because they took Extra Care to make sure the stitches didn't ruin his wolves tattoo he's still wearing shorts to work Sylvia was in such Agony from an infected gallbladder that her family called 999 she spent five days in hospital a few weeks later she had another bad attack and this time had an operation to remove gallstones she hopes to go on holiday once she recovers [Music] two-year-old fate who was rushed to hospital showing signs of sepsis was treated by pediatric doctors who worked to bring down his temperature they discovered he didn't have sepsis but that it was a throat infection which had caused his high fever which led to him having a fit a was given antibiotics and was back to normal after a few days [Music] and Sydney who'd gone to his GP because he'd lost feeling in one side of his body had suffered a very minor stroke but the good news is he's now regained movement on his right side he continues to enjoy the time he spends with Miriam they still call each other every morning laughs [Music]