Traumatic Cardiac Arrest - 24 Hours in A&E - S14 EP09 - Medical Documentary

foreign I don't think there's anything  that's certain in the world at the moment there's a lot that can change there's a lot  that can happen and I think that is in the back of your mind every time I'm going  into work adult trauma ETA five minutes five-year-old hit by a car drag for  three meters d-glove the right side of their scalp code red they're now saying  partial amputation a traumatic cardiac arrest make that up proper day today in it St George's London one  of Britain's busiest a e de

partments under more pressure than ever it does sometimes feel like  a battlefield and it feels like a losing battle at times as well you need to calm yourself  down I have 10 traumas and absolutely no space 25 year old jumped from a third floor  balcony this is the point where we can make a difference thank you everybody thank you a  place where life best place to make friends scariest thing in my life unfold every single day [Music] a life is not just a singular thing  things that happen to yo

u have a huge effect on the people around you as well you scared  me so much all the patience you're about to see were treated in just one 24-hour period I  see Behavior every day that reaffirms my belief in the inherent goodness of people it's all a bit  of a shock isn't there and I think I'm incredibly fortunate to work in that environment it's a  lot to take in is the love of my life [Music] he'd always had a bike was a fairly regular  cycle to work person [Music] started to own more bikes an

d go off on cross-country cycle  rides on his owner with his mates I like to conscious I he likes his surroundings  [Music] it helps him to clear his Minds particularly when he goes on his own  that's what he did his thinking [Music] he set off that morning on  a bike fit and active happy suddenly started to wonder where  he was the phone went and it was Neil I must have said what's happened  and he said I don't know they found me he found me in the road I said are  you all right and he said I d

on't know St George's recess [Music] 53 year old Neil was found unconscious by the  side of the road following a bicycle accident adult male trauma call Eta 12 minutes [Music]  um what was the story it's a trauma transfer his injuries are so severe he's  being transferred from his local hospital to the emergency  department at St George's if they are a trauma patient  with multiple injuries it is best to look after  them in a major Trauma Center people involved in these bike crashes can come  in

with head injuries they can't get problems with their neck chest problems bleeding in  the belly or in the pelvis as well [Music] a lady from the ambulance crew took the phone  off him and said can you come to the hospital I think I was still in a bit of a State  of Shock a little bit numb [Music] right who's going to give us that so this is  Nielsen a 53 year old who came off his bicycle and was found on the middle of the road we're  unsure if he's taken a trip or been hit by a car and brought

to Croydon with concerns about  the left side of his chest reduce air entry and also reduce chest wall movement a left-sided  clavicle fracture and the significant injuries are left-sided upper rib fractures and a 20  hemothorax and also pneumothorax hemothorax means there is blood filling the the chest cavity  so that there is not space for the lung to expand fully so it can cause problems with your breathing  and that can be life-threatening hello sir another one of the doctors Josh from the

Amy videos now  how is your pain at the moment whereabouts is the pain in the in the side of the chest there okay  my main concerns at the moment is that most of the stuff on this left hand side of your chest  there's evidence that you'd bled into the space between the chest and the chest wall and there's  also evidence that there's a bit of bleeding in the lung itself as well do you feel short of  breath at all you do feel short of breath okay with a hemothorax if you're continuing to  bleed in

to the chest cavity then you're losing your blood volume so that's why we  need to get a seat which will give us an in-depth look of all the things that  are going on within the chest cavity okay so from primary survey as we know got  the the chest training situ and then we'll get a repeat x-ray you don't do something about  it quickly can actually lead to a patient day I was already in the CT scan ready for scan  it's just a normal day and it took a while for me to compete with it this is quite

serious  and this is going to affect us for a long time [Music] cyclist Neil was found unconscious at the roadside  after coming off his bike he has a punctured lung and is bleeding into his chest if you've had a  significant chest trauma and you've got blood in the chest or air where it shouldn't be it is  possible that in the space between the lung and the chest wall is just getting bigger and bigger  and bigger that can then lead to a cardiac arrest or slow deep breath and we're going to mov

e you  when you exhale all right ready steady slight [Music] yes I eat it really well let's pop this  pillow in a bit further is that all right for a couple of minutes I'm so sorry love I know it's  horrible you're doing really really well yay it's pecan we would like both your hands up  above your head if you can manage see how you do is that better yeah yeah thank you Mr Right the  day we met was the end of 1984. we were at the same art college it was called Central School  of Art at the time

became Central Saint Martins who was two years above me [Music] I'd seen him  around but there was one particular occasion where he helped my flatmate to find me  well I said to her how did you find me she said oh this very nice gentleman  here and he was beaming from ear to ear I think it was the first time  I really sort of clocked him he looked like my favorite pop star at the time  so that was good the guy called Stuart Adamson he was in a band called Big Country in the last week  of my firs

t term somebody passed me a little note inviting me out to a concert by  the guy who he looked like [Music] I found herself sitting opposite each other in  the Student Union bar a couple of days later and I sent somebody else over with the note and  just said go and ask that guy if he sent the note and he tried to say it was the mate of his I knew it was him [Music] just have a  drink and then you look lost to Neil Neil's wife Kate has arrived at St George's  after traveling from their home in S

outh London it's okay that's okay that's okay sorry how long was it before he proposed to you yes  a long time nine years we'd had an argument it was his wife making up after an  argument at somebody else's wedding I said yes but I thought I'll check with him  in the morning whether he really meant it so I said you know I do remember what  you said do you remember what you said yes do you want the chance to change your mind now that's great let's do it we got married in St Paul's Cathedral not 

in the upstairs at some pools Neil's father he was an army man and he had a CBE and that  entitled him and his children to use the chapel and so we decided we would end the most of that  I can remember it as an intense thing I was quite emotional that everybody was there but the actual  point of going through that ceremony [Music] are completely zoned out from everybody  else it felt like just me and him there have been many times since then I've looked  back on that day and remembered it for th

e lovely day than it was and it's really helped me to get  over problems obstacles difficulties along the way [Music] I said stop poking it 27 year old  George has come to a e with his girlfriend cyan after injuring his eye  on his way home from a night out [Music] you were racing me why I just don't I  don't know I said why do you have to win we've had a few drinks over rather  giggly and excited to get back home and I might have instigated a slight race I was  winning I won but it was dark and

there was a branch that was going right across the path  with me right in the eye and he's just goes I kind of you go you go feeling around the  side of the Bush and he plucks out a twig Captain Gray beard you say you're competitive yes very very yeah  it's anything I do I have to always win he is like a serious Scrabble player he's the kind  of guy like he studies the two letter words he's always claimed I've never lost a game of  Scrabble I almost win 99 of the time and I say nine times at th

e time because I actually lost  the other day for the first time in a few years I thrashed him he wouldn't let me in the  face either he was shouting at the Scrabble board it's just I keep pulling these bad  tiles I know he doesn't really take it that seriously but it just makes me laugh when  he gets stuff like worked up it was Scrabble let's hope I don't get an eye patch  shaped Hamlet that would be so funny but I really want you to have an eye patch  or maybe just a consolation eye patch like

nothing's wrong but we'll give you the patch  anyway have you been a big boy yeah exactly [Music] it's in George's recess okay [Music] a 40 year old man is being  rushed to St George's after suffering severe chest pain during a game of golf  Adam's priority ETA 10 minutes [Music] the man's wife was at home at the time of the  incident and is on her way to the hospital the first guy I got in the golf club tell me Michael  got a heart attack at the cross under a whole 13. for me I think about wha

t happened  to Michael and then what happened to my kids because I'm alone  here [Music] nobody can help me if somebody has had a heart attack sometimes  you have very minimal information to go on and you need to piece together the bits that  you do have [Music] they actually been having crushing chest pain they may say that it's  radiating to their arms or into their jaw often look quite unwell with it  they'll look sweaty they'll look clammy hello into three please [Music] so this is Michael's

40 years old been playing  gold this afternoon did an onset of pins and needles down his arms and his legs and then  across his chest is always why they called us initially you get a pulse of like 60 and then  literally out of nowhere uh it's over 200. anybody with a heart rate going along as fast  as that they need to be assessed quite quickly putting monitoring on and we'll do an ECG your heart rate is going much faster than  we'd expect at the moment so around at 160 beats per minute what we

need to figure out  here is whether or not the heart rate is going fast and that's what caused you the chest pain  or whether or not you had something go wrong with your heart and that was what caused the  chest pain and now you've got a fast rhythm doctors need to carry out urgent  blood tests to find out what is causing Michael's Rapid heart rate how are  we feeling feeling very light-headed [Music] are you having chest pain now yeah or  was it a dull ache or was it like a sharp pain okay rig

ht I'm just gonna  have a little listen to your chest there are a number of causes  for such a fast heart rate one of them is a heart attack so  that's why we need to act quickly [Music] I like Chinese now I love you too crackers  duck with the roll and hoisin sauce yeah I do oh you like some drink jump in really really thank you [Music] does anybody said anything about  investigate why you might have fallen off [Music] and unconscious by the side  of the road after coming off his bike you don't

think you did not turn up [Music] doctors have received the  initial results of his CT scans yeah so he's got he's got a left hemo pneumothorax  bilateral contusions worse than the left than multiple red fractures with a fire on the left  a flail chest means that you have got multiple fractured ribs which are next to each other it  can affect how you breathe because that part of the chest wall where the fractures are will move  in a different direction to the rest of the chest we know these are

patients that can deteriorate so sometimes they will be  admitted to an intensive care unit we're all for you please Chap's name is Neil well specialist chest surgeons decide whether  Neil needs to be sent to intensive care orthopedic doctors are assessing his other  injuries try to lift your leg straight up okay well we've got two children Louis is 17  and Connie is 21. do you remember the day you found out you were pregnant yeah  he told me because I gave him the stick so he could look at it

yeah I mean before I  looked at it okay take that wait two minutes look at it tell me what it says so he  told me uh just by smiling big smile my daughter was born by an emergency C-section when I woke up he was waving her around in  front of my face it was quite funny and she had big eyes so all I was gradually coming around  and I could see these big eyes for some somebody was wafting her in front of me so he had more  to do with her in the early hours of her life than I did I was aware that w

as a nice thing  for him although I think he was in state shock okay we found it quite difficult  to adjust to being a family I don't mind saying that it wasn't easy [Music] I think we were a good couple who but  not overly dependent on each other and then all of a sudden when you  become a family you need one another I think van baby's very difficult he didn't  understand what it was like for me because I wasn't working I was a full-time parent for  a while I think we took a long time to adjust

we've had a few things we've had to deal with  that did sort of set us apart a little bit times it's been really difficult what about  your back have you got any pain in your back um not really okay no I'm fine man [Music] three there is a gap of between seven and  eight years between me and his older brothers Stephen was quite a grounding influence on him it was the sensible one it was good family man  her lovely little family good friend good Mentor Neil certainly looked up to him as did I Ne

il started running because of his brother  there was a Nottingham half marathon they would do that together I think any time they  could get together to run a race they would [Music] it was 2005. I came in from work one day there  was a message on the answer phone from Neil's dad and he was really upset it's even been running he  was running with a friend he had a heart attack when he died it was just dazed days could hardly talk to me didn't want anyone else to be around could  hardly but have

the children around [Music] you know I made myself available to talk whenever  you're ready but I think you preferred not to he was very angry perhaps I wished he would need me more I think  he did a lot of sobbing in private [Music] if you want anything else let me know I don't  know why I'm so excited to go 10 minutes I'm slowly becoming my name George is waiting to  be seen after injuring his eye on a branch around other elderly couples oaps  yeah afternoon tea on my own and it was then when

I lived to myself I thought  Jesus Christ the judge what are you doing I'd come out of a relationship but  like the year before and it taken me a while to get over it I was stuck  in a bit of a negative cycle about it I lost my confidence big time [Music] I  had a string of sites some really rough relationships a few of them of which I had  really kind of put out a lot of myself for no matter how destructive the relationship  was I think I was still trying to rectify it in the process I think I

sacrificed a  lot of my wants my needs my personality I just didn't know I didn't know what to  do to kind of enjoy life oh I had a dream I went to Legoland not for me no I think I  was being kidnapped and if that's something I didn't want to be with the people [Music] we met it's gonna be nearly two years ago I  work as a model I was on the train on the way to castings I'm reading the book on the tube Bill  Bryson can't remember exactly which one hello come through I was just like wow she's stu

nning it  was probably a little bit of the same feeling that I feel when I kind of seen like there's a  cute puppy on board it's like oh look at that you try it obviously you don't want to stare  you don't want to come across like a creep sure there wasn't weird like that but it  was kind of real like I think I glanced and then I wasn't sure if he was looking at me  and probably vice versa so it kept kind of like oh are we looking at each other is that happening  is that a thing lovely okay talk

me through what brings you in today um I got hit in the face  with the branch okay uh last night yeah yeah and it got me right in the eye um this is why  running is dangerous for you in the dark oh no I noticed he's like scribbling down like in  this notebook as I went to got off the tube I bent down to pretend to pick something  up and just said I think you dropped this and it's his phone number I slid it in my book and  you know I had a bit of a smile of I smell okay I'd like to say it was re

ally cool but my  legs were like jelly it was so nerve-wracking forgot about it until I got back home  I think like that evening open my book again and out Falls George's  number you still got to know wallet so we have a little live room which  we're going to use to basically have a little look though and see if there is anything that  we see then thank you very much get it out follow me then George hey let's pop this under your tongue first yeah Michael is in recess after collapsing  with chest

pain during a round of golf doctors are worried that he may have had a heart  attack I notice you're on lots of medications for your blood pressure yeah yeah okay have you ever  had any problems with your heart at all in the past the last similar attack was in November okay  my consultant he sent me for X-rays and ECG it all turned up clear okay Michael's wife Nora and their  baby daughter Rihanna have arrived at St George's oh yeah and who's this little  one as well hiya hello there is your da

ddy giving mummy a  newer scare yeah don't you worry I was born in Malaysia in Kuala Lumpur  my paternal grandfather was a refugee from China and started everything  from Scrooge in Malaya at that time I was brought up as a Buddhist we used to  get pocket money by helping our grandparents in the petty Fields or in the Orchards  and the back of my bedroom was actually a jungle so that's why we go chasing  cobras around our back Garden [Music] during my teens there was quite a lot of conflicts  in

that area Vietnam was still recovering from the Vietnam war in the 90s we still had Lead Mine  victims there the Malaysian Red Cross had a camp for refugees I wanted to be a doctor so  I joined them and I started my volunteer work we met a youth training camp that she was one  of the members in my unit we learned how to help people in the accident how to survive in  the jungle he's just a very nice guy funny guy very friendly especially with my family very  kind person [Music] his day second on

e oh hello we never dated on our own because she was from  a Muslim family I was always with a group of friends we went for dinner we're in for a movie  and if I remember correctly her younger sister was a chaperon for the date at that time married  [Music] the first movie we watched together I decided that there was it that  she was the one but at that time the Malaysian government gave me  a scholarship to study in the UK from then on we were thinking how are we going  to make this long distan

ce relationship work in China you shake my hand yeah all my friends from the Red Cross ah is that  Michael proposia no you're just friend are you sure yeah [Music] it's going back to Malaysia  he passed the ring to her during a training camp aign oh that's the gold ring with  the diamond six seven seven diamonds and they called me are you got the ring  yeah I got that ring so what you want to say in my country if you're a non-muslim I made it  the Muslim people you must convert to Muslim so I ju

st made it like that  because that the law in Malaysia I don't know what to do that time I just wanted  to give you all a bit of a update of what's been going on okay your heart rate is slowing down a  bit with the medication that we've given you but it is in this Rhythm this atrial fibrillation  is an irregular Rhythm we might need to give you some more medication to get that rate  down a little bit lower I don't want you worrying about yourself at all I just want you  to think about getting yo

urself better okay okay [Music] hello it's quite an interesting  story when you listen to it and she's done 40K around Richmond Park and then  outside our house fell off my back broken a wrist you're right I know not funny  not funny [Music] goodbye [Music] you're sweaty cyclist Neil and his wife Kate are waiting to find out whether Neil needs to be  transferred to intensive care let me give you more of the sponges yeah I think losing his brother let's just  start with us having to find out what

each other really really needed and wanted  from the other thank you again thank you I've come to really appreciate his softer side but he's become very supportive he's  found in a plenty of ways to to help it's usually just by listening [Music] it's taken  us a long time to understand each other [Music] together isn't it we've grown  up together and at times we felt like we were veering off but all there  were always 10 times come back together hello recess specialist chest surgeons have now 

reviewed Neil scans [Music] thank you very much [Music] hello we're going to be speaking to you  at the the cardiothoracic doctors to see how we're going to manage it we'll need to be  keeping a close eye on you for a bit because of that blood that's in the lung as well that we  need to put you up on our Intensive Care Unit okay multiple chest injuries  that can be life-threatening these patients need to be monitored in a more  High care environment I might need to have support with their breath

ing and that might  be in the form of being intubated with a tube [Music] foreign doctors are worried that Michael  may have suffered a heart attack following a series of blood tests a specialist  doctor has now been called to assess him any history of heart attacks in the family  yeah on your mum's side yeah okay exactly it's the legal requirement of Malaysia and if you  want to marry a Muslim you must become a Muslim that's not for me to push you to  convert to raise your decision in my belief

God is God whether and  Christianity or in Buddhism so I became a Muslim I'm very proud even going with the Muslim but it's a big shout out to the to Michael  family especially for the her own parents because in their family he's the oldest son so  can I have a listen to Johan you know yeah sure the big day the big reception about nearly 2  000 people turn up let's step back my father being a former member of parliament we had various  dignitaries and all that all turning up with their family t

hank you the royal families come the Big  Show doesn't know [Music] so it was special moment you're just gonna go sit and write my  notes okay yeah sure cardiologists try and get some advice about what's best to try and bring him home right down but bearing  in mind you not being happy at times doctors now have the results of  Michael's blood tests hi guys now your blood tests have come back and one  of them called you troponin is elevated now the troponin can be elevated if your heart  rate's b

een going very fast for a while yeah or it can be elevated if there's been any  damage to the heart muscle from a heart attack because you did have that episode  of a bit of chest discomfort I'd like to treat it as if it did come from the heart [Music] Michael will now be taken to a  cardiac Ward so specialist doctors can establish the cause of the problem with his heart [Music] a really heart feeling to be upset left my younger  sister and my parents behind far far away from me come here much w

hen they go first  time I saw this thing I'm very excited I think I remember the first time out are you  wearing three lace trousers five layers should we've been married now for 12 and a  half years and have two children [Music] oh she means the life to me really  she's sort of my companion my friend she's the one that's got to  Bear everything for me [Music] at the end of the day she and her children  are the love of my life really [Music] so there we go small amount one centimeter into  the l

eft lower eyelid four times a day for five days and then you discard anything else tests on  George's eye have revealed a scratch on his cornea give me five minutes or so just because I've  got to get to a logged on computer okay and then I'll just do your referral I'll let you  and give that to you so just bear with me well come on outline those  because all the sizes have linked the first joke went really well but it was the  second day I think that really stood out it was a meaty shower that

night and we basically  decided that we were gonna go and watch it went to Wimbledon common and walked right into  the middle of it when it's dark and we just lay on the ground and looked at the stars and  and sort of like shooting star went went past as you went into the middle of a comment on a  dollar we despite with someone she'd only met once I mean I I don't know that's the sort of person  she is someone's gonna come up now yep there we go find lovely so tip your head back open your eye  r

eally really wide and then it's just awesome yeah we had a lot of things in common a lot of geeky  things in common which is always nice because I've kind of I've kept the geeky side of me  repressed for a while it's so fun with them doing silly things and making thoughts  and playing with Lego which we do a lot [Music] have you grown together  we might have requests together in fact I wasn't building Forts and  playing with Lego when I met him play is so important I think  in any sort of relati

onship just to kind of Let Yourself Go really be silly  and make mistakes and joke around I think we've spoke tried to be adult with each other and  say we can't we need to be adults together too it's not always going to be a super high but  when it's good it's great and you enjoy that nice and yeah oh thank you thank you okay that's poundland go get an eye  patch for a pound we should do that and trick walls and Frosty and you come back thank you very much no worries guys  lovely to meet you ta

ke care bye-bye she means everything she's just the most  amazing person I've ever met and I want to spend time with her always is in very true sense he's my partner but don't I say forever just because I had  no control over that I see me with George now and I would love now to be forever [Music] I've got your phone yeah  what do you want to look at me oh you want the score what would your advice be for a couple who  are about to embark on a lifetime together I think manage your expectations  t

he cracks in the walls don't matter it doesn't matter if there's a few weeds in  the garden you know actually doesn't matter your numbers are stable you ready to go yeah keep smiling keep laughing don't  lose your sense of humor [Music] It won't always be fabulous  sometimes it might be rubbish and other times you know you  can't best be without each other I think as time's gone on that's I think  that's how we feel most of the time now I don't want to be without each other [Music] [Music] thank

you [Music] I'm thinking about what's  happened to Michael after this is it been okay we lie down for life in the bed [Music] Michael getting better just wait for the operation [Music] first three months afterwards I was very shaky  it's made me a little bit more cautious about how I proceed with my life and even Crossing  roads and things like that it just makes you very grateful for literally Every Breath  You Take the gate was fantastic she's my other half in in every sense of it fair to say

  without her I'd be somewhat lost and I think I caught my ear on a chair and it like ripped my  piercing and within the ball's still inside it and I said Mama are you okay and then she was  like oh oh it's like my worst night now [Music] it turned out to be a multi-organ  failure and eventually can lead to death he was asking me if mommy's gonna be  okay and I said all we have to do is pray oh [Music] [Music] [Music]