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St John’s Wood crews Omar and Kez and Tanya and Kelsey are two of just 26 ambulance crews on shift who are responsible for caring for patients in central London today.

As they battle their way through the capital’s notorious traffic, a new life-threatening category 1 emergency comes in for a patient who has collapsed and stopped breathing outside Buckingham Palace. Fortunately, a passing member of the public reacts immediately to provide life-support to the patient, Ron, as seven resources are dispatched to the famous landmark to give the patient the best chance of survival. As Omar and Kez arrive on scene, the team confirm that CPR has helped Ron’s heart to start beating again within the time window that means he might survive. Nevertheless, his condition is still critical, so Omar and Kez must immediately take him on blue lights and sirens to hospital. Advanced paramedic Rory travels in the back of the ambulance with Ron’s wife, where he confirms that the stranger who helped treat him on scene has undoubtedly saved her husband’s life.

Meanwhile, in the Tactical Operations Centre, the team receives reports of a serious collision involving a bus and a police van at a busy junction outside Oval tube station. Tactical response paramedic Abi, four ambulances and three specialist resources are dispatched to support the teams already at the scene, who have confirmed that amongst the multiple casualties are five police officers. Abi prioritises making the scene safe, before leading care for the most seriously injured patient, Paul, a police community support officer who was in the police van when it collided with the bus. Abi suspects Paul, who is still trapped in the van, has suffered spinal injuries which carry a risk of paralysis. She directs the fire brigade on how to safely extricate him before he is taken to the closest major trauma hospital for further investigation.

As the service grapples with pressures of providing emergency care to the capital city, the programme goes behind the landmarks and bright lights of tourist London, to reveal the realities for the people who live and work in the capital city.

Towards the end of their shift, Kelsey and Tanya are dispatched to help 93-year-old Ronald, whose doctor suspects he may have suffered a stroke. On arrival, they discover that despite his recent ill health, Ronald is still fiercely independent, and he enjoys reminiscing with the crew on stories from his long life, including his career as a chauffeur and his childhood memories of the war. Tanya enjoys hearing Ronald’s views on how much London has changed as he is taken to hospital for more tests.

As a new day shift begins, a caller rings 999 and confesses that they have killed someone before abruptly hanging up the phone. As control try to reconnect to the caller, paramedic Abi is dispatched to the location of the call. Alongside her are two ambulances, an incident response officer, police and London’s air ambulance, HEMS. Arriving on scene, Abi discovers that it is a false alarm and the call is a hoax, invented by a distressed child. Although they are relieved there is nothing sinister to investigate, it is a frustrating waste of valuable resources that could have been used to help other patients in need.

Elsewhere, Tanya and Kelsey are dispatched to Kensington to help Steven, who is suffering from chest pain. On arrival, the crew is bewildered by Steven’s long list of medical problems. They decide to take him to hospital for blood tests - but not before getting to know Jimmy, his trusty four-legged friend.

Omar and Kez, and advanced paramedic Barry are dispatched to London Victoria underground station to help a 53-year-old woman who has fallen down the stairs and badly dislocated her ankle. On scene, they learn that what was meant to be a lovely day out to the Victoria and Albert Museum has ended in disaster for Rebecca and her daughter Clementine. With Rebecca in severe pain, Barry decides he needs to give treatment on the spot rather than take her straight to hospital, so he administers ketamine before manipulating Rebecca’s ankle back into place. Once her condition stabilises, Rebecca is taken to St Thomas’ Hospital for an x-ray.

In control, another category 1 call comes in - this time for a man who has been found unconscious by his neighbour and his granddaughter, Amber. As paramedic Abi travels to scene alongside an ambulance and a first responder, call handler Louis gently instructs the caller on how to give life support. When Abi arrives, she finds Amber distraught as she tries to talk through the events that have led to finding her grandad unresponsive. Abi does what she can to calm her down while ensuring that there is no delay in taking Lenny to the hospital, as he is very unwell.