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As night falls, ambulance crews race on blue lights and sirens to respond to a patient attacked by an XL bully dog, before discovering that a second patient has also become a victim and is critically injured. With the bites causing major blood loss, London’s Air Ambulance, advanced paramedic Dave and incident response officer Nikki are dispatched to support Liz and Alex, the ambulance crew closest to the scene.

Dispatcher Liam scours the area for another crew to send in support whilst Liz and Alex selflessly risk their safety to enter the volatile scene to provide life-saving treatment to the patient, who has suffered a catastrophic haemorrhage.

In control, Liam and Colin are dispatching teams across Westminster and Brent, including Keelan and James, Lolly and Emma, and Dave – the only advanced paramedic caring for the most unwell patients in London. As target response times are missed, delays for ambulances take their toll on patients.

Advanced paramedic Dave leads treatment on scene at the dangerous dog attack for the first patient, who has been bitten on the face. Her mother is the second victim, who is pre-alerted to the closest major trauma hospital whilst Dave does his best to reassure the juvenile patient, who is petrified about what has happened to her mother.

Debriefing post-incident, the crews reflect on managing a dangerous and hostile scene. Their conversation is cut short as HEMS are alerted to another serious incident, following reports of a shooting.

In control, with a new 999 call being answered every 13 seconds, dispatcher Liam despairs as he struggles to organise help for a patient with colon cancer who has been waiting for nine hours.

As the delays continue to build, Keelan and James are sent to Judith, who has been waiting for three and a half hours and can’t walk following a knee injury. Apologising for the delay, they find her waiting outside on a stairwell, where they administer gas and air before moving her into the ambulance and taking her to hospital for further assessment.

Liam receives an update from the crew who were eventually dispatched to help the patient with colon cancer, who has now been waiting for nearly ten hours. Liam learns he is gravely unwell and confides to his colleague Colin that hearing the update has made his stomach turn.

With the service continuing to face high demand, James and Keelan are sent to help 95-year-old Marcello who has suspected multiple fractures and has been waiting for five hours after a fall. Meeting Marcello and his concerned relatives, James and Keelan get to know him and his family and learn about his Italian heritage, his artwork and his lifelong love for his Yorkshire-born wife.

As a new night shift begins, dispatchers Liam and Colin are again responsible for the 39 resources covering Brent and Westminster. Also working is advanced paramedic Dave, who travels to the most appropriate standby point in central London to ensure he is best placed to respond to emergencies. En route, he stumbles across an intoxicated male threatening to throw himself in front of a passing car, who he decides needs care.

Brent-based crew Lolly and Emma make the 14-minute journey to Rohit, a patient suffering from a serious blood pressure condition, following a non-traumatic spinal cord injury in 2022. It left him fully paralysed and unable to leave his bed. Lolly and Emma hear his story before taking Rohit on the five-mile journey to Northwick Park hospital.

Updating dispatch, Rohit’s struggles strike a personal chord with dispatcher Liam, who lives with spina bifida, a condition that means he uses a wheelchair. Liam speaks about his journey with the NHS and how he is grateful that it has always been there for him.

James and Keelan are dispatched to Denise, who has dementia and is complaining of excruciating leg pain. Living on her own, the pair suggest she might need some help, but the price of carers is too much for Denise to afford. After preparing a hot chocolate for Denise and making her bed, James and Keelan decide that hospital is the next step for her.

This episode shines a light on the extraordinary pressure faced by London Ambulance Service as staff try their best to attend the most critically unwell, while also being there to care for the wider community who call on their services. When delays and unprecedented wait times build up, the paramedics continue to devote themselves to the job, knowing patients’ needs are often time-critical.

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