All language subtitles for A And E After Dark - 1x03_track3_eng

PHONE RINGS

Hello, A&E resus.

After dark
and while most of us sleep,

A&E departments across
the UK work through the night.

Jack, do you know where you are?

With unprecedented access
to the night shift

at one of Britain
major trauma centres...

Argh, it hurts!

...this series reveals
a working environment

that's not for the faint-hearted.

What you doing? You idiot.

Ow! Argh, get off! All right.

They deserve a medal, what these
people have to put up with.

And at night, road traffic
collisions are more serious...

I think you got hit by a motorbike.
Do you remember that?

...and both drug...

Can you open your eyes for me?

...and alcohol- related
admissions increase.

You rascal, you.

We follow the incredible staff
of Hull Royal Infirmary.

Morning, sir. Welcome to Hull.

It's a job like no other.

Things affect you more on a night.
The job gets to you...

...but it's because you care.

Oh, no, no.

Are you on... Are you on nights?

It's the start of the night shift
at Hull Royal Infirmary...

Yeah, that's it.

So it all depends on
what your health status is.

...and all is calm.

Shooting straight down there and
right up me arm and I can't grip.

But that can quickly change.

A man suspected
of taking a drugs overdose

has been brought
into hospital by police.

You don't spit at police officers.

You don't spit at anybody.
It's disgusting.

Yes, you did. It's on body camera.
Yes, you did.

The patient has also been aggressive
towards two police officers

and a paramedic.

He was violent towards us.

He wouldn't...
Didn't want to come with us

and he had to be arrested
for his own safety.

Do you want a glass of water?

I'm not telling ya,
I'm asking if you want a drink?

Nurse Jen Whiting is looking
after the patient.

Sometimes with a greater police
presence, it's more of a challenge.

Sometimes it helps with
a female voice or a calmer voice.

But in this case,
he wasn't my biggest fan.

So...you can
only do what you can do.

I did think I was going to get spit
in my face but thankfully, I didn't.

I don't know if he's completely
aware of what's going on anyway,

so try and reassure him.

Do you want a cup of tea?

Just go back and sit back.

A toxicology test will determine

if the patient has taken
any harmful drugs.

Going to get this blood done,
all right?

That's working.

We're not cruel. We're here
to help you. Don't shout.

You need to lay back down pal.

We're trying to help you
and you're not helping yourself.

If he's medically fit,
he's coming with us to custody.

If he's not, he's
going to have to stay here.

It must be packed in the unit, then?

I just feel tired.

Just feel like, really tired
more than anything.

My head hurts though,
not going to lie.

It's just so painful.

Victoria Ashton, please?

It's not just the walking wounded
the night shift treat.

Nearly half their admissions
are brought in by ambulance.

Can you keep still, darling, for me?

Paramedics have
brought in 39-year-old Ricky

with a serious head wound.

Ricky? Hello.

My name is Zac,
I'm one of the doctors.

Let's have a look and see
what's going on with your head.

As soon as the patient arrives
with a head injury,

first thing you check - have
they got any significant injuries

that are causing
them to haemorrhage?

Could I get a bit of forceps,
please?

And have they got bleeding that
needs to be stopped

immediately before we even commence
the sort of assessment?

Actually, you just need to keep your
finger here, where my finger is.

Just that finger there.
You just can get...

So it's unlikely arterial.

It's probably venous.
And if I press from the top...

Ricky, I'm just going to put some
monitoring equipment on you, OK?

I absolutely love my job.

I love looking after people.

If I can make that one person
feel better on that shift,

if it's just one person,

then that makes my job worthwhile.

Ricky, are you all right?

What's the matter?

If we need to use anything
like that, we'll tell you first,

so stop panicking,
we'll sort it out.

You'll get a lot of men that
come in that are needle phobic,

but they'll be six-foot men
with tattoos everywhere

and then they won't like this
tiny little needle.

But then I've had children

that we've had to take blood
from repeatedly

that are running around,
they don't mind.

They'll sit very still,
just waiting to get a sticker.

But then some of the
men will end up on the floor.

Ricky?

Ricky?

Sorry, buddy.

Because you've put
your head through a window,

you've got a few cuts on your head.

Yeah.

So, one of them is
bleeding quite a bit,

so I might have to do
something about it.

And, uh, there are two things
I can do.

Now, please don't panic.

One - I can suture it.
Two - I can put a staple in it.

Which one would you prefer?

You'll feel a bit of sharpness,
but that's it.

OK.

OK, Kat, I need two of your hands.

So, I need pressure here, OK.

So, continue like that.

With Ricky refusing stitches...

...the resus team are growing more

concerned about the amount
of blood he's losing.

You've lost quite
a lot of blood, though.

And you're covered in it, as well.

When you're looking after a patient

and they're losing a lot of blood,
it can be very worrying.

It can be quite horrific to see.

Are you all right, Ricky?

Ricky? Ricky?

Ricky?

Ricky?

In Majors, four police are guarding
a violent patient

while they wait for
his toxicology test results.

Selena?

I am.

If the results show
he's clear of narcotics,

the patient will
be taken into custody.

He went to the toilet
and he took that opportunity to try

to spit at me. Hence the reason
why he had to be restrained.

A spit guard is used to
protect police and the medical team.

It does take up a lot of staff,
a lot of resources,

if we have to just focus on
one patient that's being aggressive.

The other patients
don't get the care they need.

My family do worry, probably,
that I'm at work in A&E.

I think it's just the reputation,
especially on the weekend.

Were just waiting on your blood
test results, aren't we?

That we took earlier.

That's where your training comes in,
you've got to be professional

and take into account
why they're here.

If they've taken anything, why have
they taken it, you know?

Are they in pain, are they scared?

What's going on?
You can't judge on what you see.

Ricky, do you know why were applying
this pressure to your head?

OK, so you've got quite a nasty
cut on your head

and it's bleeding quite a lot

so we're having to do this
to stop the bleed, OK?

Matron Kat Henry is struggling

to keep her patient's bleeding
under control.

What was it, a window?

What, and you just put head
through it?

Do you not like needles?

With a phobia of needles,
treating him is proving difficult.

Yeah, it's just there.
just, one second.

Oh, it's bleeding.

No, Wendy's not, no.

I told... Trust...
Listen to me, trust me,

I'm going to tell you

as soon as we're going to need
to use a needle, right? Trust me.

I'm not lying to you.

Zac, the doctor's back now.

So we're going to have a look at it

and we'll let you know what
we're going to do, OK?

So we promise you, if we use a
needle, we won't show you it. Ready.

And when you have copious amounts
of bleeding from the wound,

if it's arterial,
so it's coming from the artery,

you have to control
this as soon as possible

because even the smallest artery can
bleed quite profusely.

I think we should put just a bit
of non-adhesive dressing on it

and then head bandage and then CT.

Yeah. First, we're going
to make sure there's no glass

and then we'lljust need
to clean it up.

So, what we're
going to have to do is

we're going to have to
scan your head, Ricky.

Yeah, just to make sure
everything's all right inside.

Yeah.

Right, Ricky, just move your
head first. Perfect.

What kind of window was it?

Was it double glazed, triple glazed?

So, Ricky, do you have
any medical problems at all

that I need to be aware of?

Do you take any medications?

OK.

Your heart rate is a bit fast.

I just wanted to make sure
we cover all the basics.

Right.

So, what I'll need to do is,
because you've lost quite

a bit of blood, I'll need to check
to see what your blood count is. OK?

For that, I'll need to pop a small
needle into your vein here

and take some blood.

Well, I'll need that for...

OK.

OK.

OK, that's fine.

Um, we'll keep an eye on you.

Obviously, if you show any
further signs that you've lost quite

a bit of blood, I'll have
a chat with you again, all right?

You sure? OK.

How about you just rest
your head back

and we'll get the scan organised?

Shall we take your top off,
sweetheart?

Don't rip it.

Ricky!

Don't rip it.

We're there for the patients.

It's about having that relatable
interaction with patients.

No, l'lljust pull it up.

I'll pull it over your head.
You've just ruined your T-shirt.

I'd of washed that.

It's about how you
say things to them...

It's all right.

...which will result in what
their behaviour will be towards you.

A CT scan is the only way the team
will know for sure

if any glass
is buried in Ricky's scalp.

Glass itself can harbour bacteria

and that's why
glass has to be taken out

before the wound
can be cleaned and closed.

I was, like, licking me lips
and I can taste blood,

somethings just not fucking right.

The senior nurse on the ward told me
you have had the second most

serious operation there is
next to open-heart surgery.

I've had 72 sutures.

I mean, I'm only four foot nine.

It could have been lethal,
it could have fucking put me

in here, which it has done.

Are you there, love? Are you there?

She's not listening.

No, she's gone. Anyway, I'm next.

Thank goodness.

It's like a 40 quid T-shirt.

It's a fucking...

It's a Ralph Lauren.

Another patient has
been rushed in by paramedics

after a suspected overdose.

Hello.

The patient is in resus,
struggling to breathe...

Hello?

Open your eyes.

...and drifting in and out
of consciousness.

My names Maddie,
I'm one of the staff nurses.

Can you tell me where you are?

Need to pop you on a bit of oxygen.

Right, so a mask
going on to your head.

Take some big, deep breaths for me.

Over half of suspected drug
overdoses are admitted at night.

He was OK in the ambulance
initially, fully awake

and now he's become
a lot more drowsy.

So we're giving some fluids,
I'm trying some naloxone

and see whether we can
get his breathing bit faster.

Can you just check this for me?
I will.

So, we've got naloxone, 400.

And it expires 20/22. Mm-hm.

It is quite, quite quick.

The trauma team now wait to
see if the antidote takes effect.

All right, Ricky?

You got any pain at the minute?

OK.

Have you had pain relief?

Ricky's been joined by his partner.

Two hours ago, he arrived in resus
with lacerations to his head

after falling into a window.

CT scan results will indicate

whether he needs the
attention of a plastic surgeon.

Ricky is stable. We've managed
to control his bleeding

with just a bit of pressure.

His laceration is here.

So you can actually see the dressing

and there's something here.
This might be a bit of glass here.

Because if it is, we'll need
to call the maxillofacial surgeons

to see if we can fish it out and,
obviously, close his wound for us.

What you doing?

You're not, you're getting back
in that bed.

Ricky's fear of needles
becomes too much.

He decides to discharge himself.

Get in there now.

The patients do
have a right to say no.

You're getting back in that bed now.

It's incredibly frustrating

because as a doctor you're
always trained to help, fix, cure.

Get in that bed now.

Coming back in?

Come back in.

Get in there now.

Get in there now.

Get in there now.

Get in there.

Can you come back in?
I ain't got time for...

I've got sick people
to look after.

No, you need to come in.

You need to get your head
sorted out. Get in there!

You are not going home.

Get in there now. Get in there.

Get in there. No, you can't go home.

Get in there now.
Get in there now.

Get in there now!

It's a head injury so...

In there, now.

OFFICER:

Come on, now.

When a patient's refusing treatment,
it is frustrating

when it's obvious that
the patient needs the treatment.

Yeah, exactly.

So, get your arse back in there now.

Now!

Right, Ricky, come on.

Stay in here, mate,
and get seen to. All right?

After earlier refusing treatment
for deep lacerations to his head

and face, Ricky reluctantly
returns to A&E.

Come on.

HE RETCH ES

Do you want to swap it?

It'll all be from your head.

Your nose looks
like it's been bleeding.

But just try and concentrate
on your breathing.

That's it, just
concentrate on your breathing.

Ricky?

Brain looks OK. OK?

Skull's all right.

You had a CT scan, man.

Yeah.

How did you manage to do all this
to yourself? I don't know.

Cos he's a lunatic.

Usually, you need to get some help
from someone to do it for you.

It's usually someone who
doesn't like you very much.

Well, it looks
like just vomit for now.

Obviously, let's see, if you're
going to start vomiting blood,

we'll have to do something about it.

Ricky must now wait for further
treatment from plastic surgeons

before he can return home.

The CT scan has confirmed
that he has got a foreign body

in his wound which is most likely
glass from him hitting the window.

So that wound will need to be
explored

to get that foreign body out.

And obviously, Ricky is not
particularly keen on needles

and he doesn't really
want to have anything done

under local anaesthetic, so the
maxillofacial surgeon's just going

to speak with a senior to see if
they need to admit him to take him

to theatre and have this
done under general anaesthetic.

In resus, the team are still trying
to get their overdose patient

to regain consciousness.

Can you open your eyes for me?

I'm just going to
shine a light into your eyes.

He's been given an antidote,
but concerns are rising

that there may be another
reason why he's not yet responding.

Um, apparently, he had a knife

and I think he was threatening
some self-harm.

He has got previous self-harm.

I saw him on Wednesday,
he originally presented on Tuesday,

with laceration to his right arm

but there's no injuries, apparently.

Do you want to do
a top-to-toe at all,

just because he did have
a knife on scene?

I know there's no obvious signs
of any bleeding,

but I'm just thinking any other
injuries, really.

I think the most worrying thing
about a patient who's unconscious

is not knowing what's going on.

You just have to be like medical
Sherlock Holmes and start searching.

No signs of head injury or anything.

And there's always that pressure of
will I find the answer in time?

Will I be able to do enough to keep
them safe while I find the answer?

PATIENT COUGHS

Hello.

Are you all right? Sit up.

You're OK. Sit up.

There you are.

Have you got a spittoon?

There we go.

There you go. Spit it out.

That's it.

There you go. Wipe your mouth,
that's it. Spit it all out.

I'm Audrey by the way.
I'm one of the A&E doctors, hello.

Can you open your eyes now for us?

You're in hospital.

Do you remember what happened today?

No.

Have you just been taking
tablets all in one go today?

Quite a lot of them?
Do you remember that?

Yeah? Have you taken
or had anything else at all?

Smells like you've had some alcohol?

Yeah.

There was also a knife
found with you.

Now, I know this one
was from earlier this week.

Have you hurt yourself
at all with the knife today?

No? Were you planning to?

Right, OK.

Well, who rang an ambulance?
Was that you? Yeah.

So you'll need to stay here for now.

All right.

I'm just going
to take this mask off.

The patient will be kept
in overnight for observation.

Dr Fox's concern now
centres on providing the patient

with access to
the mental health team.

Yeah, hi, it's Audrey.

I have an adult
patient to refer to you.

He's a bit of a regular attender
in the department.

When I see a patient who comes in
with mental health problems,

I do tend to feel
very sorry for them

because I know
it's a difficult road.

It's a very long road to try
and get somewhere.

Depression is difficult
for other people to understand.

Like, if you break your leg,
you walk around in a cast,

then everybody understands,
you'll get lots of sympathy.

You all right there?

Whereas with mental health,
it's invisible

so people get less sympathy
from people around them.

In Majors, the aggressive patient

is waiting for his
toxicology test results.

Right, your bloods
are all hunky-dory, OK?

The police officers
will take you to custody

and you can sort your business out
there, all right?

The test results show the patient
is clear of drugs,

allowing the police to
finally take him into custody.

PHONE RINGS

Resus.

The red phone rings
signalling a blue light emergency.

No idea of speed?

OK, see you soon.
All right, thank you. Bye.

A teenager has
rolled his car four times

after swerving to avoid a deer.

Right, this is 19-year-old Ryan.

Ryan has been the single driver
of a medium-sized car

down a country lane in the dark

A deer has pulled out
in front of him.

So, he's reared to the left

and his car's rolled,
probably about four times.

He believes there hasn't
been a loss of consciousness.

When we got there,
he was face down in the car.

Extracted him using the spine board.

He's complained
of C-spine tenderness.

Just found a radial pulse.

It's 1:30am.

An ambulance has rushed in
another patient with a head injury.

Shut your eyes.
Lay back and shut your eyes.

It just hurts.

I know, just... just lay back.

56-year-old Colette
is with her husband, Tony.

The cut, it hurts.

It just hurts.

Chill out, will ya?

Yes.

Here.

I believe so, yeah.

Oh, stupid. Slipped on pizza
on the laminate flooring.

Pizza.
On the floor.

My husband decided
to have a piece of pizza

and threw the crusts
on the floor to the dog.

I didn't see it.

He went to bed, I took a walk on
the wooden floor,

went flying, hit me head
on the table.

Yeah.

About midnight-ish.

Yeah, I managed to grab me phone
cos Tony had already gone to bed.

And, uh, I rang 999.

I heard you shouting though
from upstairs.

I was just on the verge
of going over and I thought,

"Who's that shouting?"

Well, who else would it be
apart from your wife? Idiot. Well...

And eventually, he heard me and
come down to let the paramedics in.

Yeah, it's...

Yeah.

Have you found it?

Thank you very much.

You're a star.
Thank you. Bye-bye.

No more... Argh! ..pizza.

You'll be in the doghouse
for months.

I quite like diamonds.

We'll make it right.
I'll make it right.

Chill out, will ya?

We're going to keep your head still
until we know it's fine.

Whilst that's going on,
nurse is getting the pain relief.

So, if we can get some
more morphine, that'd be great.

Emma's going to get that line in.

I'll speak to scan.

After rolling his car four times,
19-year-old Ryan urgently needs

a CT scan to check
for any internal injuries.

That's all good. Scanner ready.

Might as well take him round.

Let's go.

Right, so we're just
going to drag you across.

You're still on a board.
OK, on you. Yep.

We'll be back in in a minute.

Keep an eye on his obs,

cos his saturations
did drop down to 93% there,

which I can't work out.

But just be aware we've
obviously taken him off the oxygen.

The CT findings can range
from being quite catastrophic

and life-threatening

to, hopefully,
no injuries identified.

If anything comes screaming out,

we need to get the neurosurgeon
down straight away.

Colette is being treated
for a deep gash to her head

after slipping
on a pizza slice at home.

My husband owes me a spa.

That's the last time he's feeding
the dogs pizza in my front room.

Yeah, that's fine.

OK.

I'll try not to.

I trust you, you're a doctor.

Ooh, aye, aye.

No, no, that was fine.

Thank you very much.
And you was very gentle.

You was very gentle.

Obviously.

Thank you.
You're a gentleman.

I will.
Thanks very much. Thank you.

You can come in now, sweetheart,
it's all done.

Do you not want your
dressing gown off? No.

I've got no
clothes on under it, no.

You all right there?
Yeah, thank you. Good.

I think your girlfriend's outside.
Are you happy for her to come in?

Yes, that's fine.
OK, I shalljust go and get her.

Ryan is waiting for
the results of his CT scan

after rolling his car,
leaving him trapped upside down.

You Ryan's partner?
Partner's mum?

Do you want to come through
and see him?

Have you been told what's happened
so far?

Cos he's had a car crash,
we've got a collar on him.

His heads tied down,
he's on a board,

it all looks really serious, so...

His girlfriend, Jasmin, has arrived
with her mum for support.

And I shall leave you be.

Don't worry.

I think it was a little deer,
I'm not sure, but something ran out.

I only did, like,
a quarter-turn of the wheel,

but then I hit the grass and then it
just rolled and rolled and rolled.

And here I am.

I was upside down. Three cars went
past and didn't stop.

I had my hazards on
and I kept beeping my horn,

so they knew there was
someone in there.

The ambulance? Yeah.

Then someone else stopped
and pulled over.

I'm sure if I end
up in a wheelchair,

you'll push me around, won't you?

Part of the job of being a doctor
is communicating with patients.

As good as it would be to always
give a really positive outlook,

you know, sometimes we do need to
be very honest, uh, and explain,

you know, these injuries are
life-threatening or life-changing.

Got the scan results. Cool.

Absolutely fine. Good.

Your brain's fine, your neck's fine,
your back's fine,

your tummy's fine, your chest
is fine, your pelvis is fine.

What we can do is start taking
some of these contraptions off.

Now everything's starting
to settle in

I'm just... I feel like... Well,
I feel like I've been hit by a bus.

I feel really achy and...

Keep your head nice and still
just for the time being.

I still need to
check your bones out.

The CT's fine,
but we just want to be 100% sure.

OK. Sore?

Really sore but not,
you know, like... Yeah.

I feel so much better.

Now, do you want the bad news? Yeah.

Usually after
these sort of incidents

what happens is, you can seize up.

Usually, it's about
48 hours afterwards,

when it gets to its worst. Yeah.

So we do warn you of that now,

but we'll get you off
this hardboard, as well,

and get things moving and get you up
and about.

Excellent, thank you.
All right, won't be long.

My back.

That's fantastic. At the end of the
day, the patient's had a near miss.

No injuries sustained
which is ideal.

Oh, oh, that's sore.

Oh, Jesus Christ, that hurts.

I feel good.

I'm in a fortuitous position
that when patients come to me

in pain, I'm able
to make that difference.

Yeah, slow. I'm all right.

Sure? just give it a minute or two.

If that was a member
of my family or someone I knew,

I know what I would want happening

and I try to do that day-to-day
for the patients that I see.

All right, no problems,
all the best.

Cheers. That's all right.

God, they put this on hard,
didn't they?

Just relax your arm for me.

You all right? Uh-huh.

Three hours ago,

this patient attempted to
take his own life with an overdose.

He's now conscious,

but the trauma team continue
to closely monitor him.

You keep going a bit light-headed
when you're sitting up, aren't you?

So, there's no point even attempting
to go outside.

I'm funny? Why am I funny?

I am a happy individual.

Is there not?

Is that a good thing, then?

Oh, well you're
not doing that tonight.

So, can I just have a quick look?

Well, I'm not going to touch
the actual wound,

I'm just going to clean the area.

It's going to be,
cos you've gone out and...

I think there are people who
basically just want attention.

So the classic cry for help,
so people who don't actually want

to die who just want someone to take
them seriously, to listen to them.

People who do overdoses, it does
seem to happen more in the evening.

I don't know whether that is because
people feel, maybe, more alone

or it's dark and it makes you feel
even more depressed. I'm not sure.

No.

You need your hands.
Use your hands for everything.

So, what we're going to do now is
going to pop you some antiseptic on.

I sometimes find
myself looking at patients

and thinking what's really
the different between them and me?

What really sets me apart from them?

Is it just a roll of the dice,
it's just luck of the draw?

So, that makes you sometimes
more appreciative of the people

in your life who do support you

and the chances you've had,
lsuppose.

Get in there now.

Oh, Jesus Christ, that hurts.

Is there not?

You was very gentle.

Next time...

Do you think you can get us
some help for CPR?

When it comes to cardiac arrest,

you are trying to bring them
back to life.

There is a pulse,
I can feel a pulse.

Shut the fuck up.

I don't give a fuck.
What you doing?

So, it's a visitor,
not a patient? Absolutely, yup.

You can't be smoking in here.

Cos you could have blown everybody
up in this hospital.

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