24 Hours in A&E

Senior consultant Malcolm Tunnicliff and his team face a battle to save a 'Code Red' - a patient with potentially fatal injuries - brought into A&E by helicopter. Thirty-three-year-old Greek student Theodore Chatziapostolou was dragged under a bus while crossing the road at Elephant and Castle. He was trapped and literally folded in two with his 'nose touching his toes'. Hovering between life and death, he has multiple serious injuries, including a terrible pelvic injury. Tunnicliff has 15 minutes to keep him alive so he can find out what's wrong with him and work out how to save him. The same day, 13 other emergency cases were treated in Resus, including 78-year-old Tom Gibbs, who fell head-first off a ladder while painting his daughter's landing, and a confused cyclist with a severe head injury.

The second programme in the series reveals the stories of individuals who started the day with little in common, but found themselves being treated by the King's A&E team in the same 24-hour period. A day that, for many of them, would change their lives. The 'red phone' from the ambulance service rings, signalling the imminent arrival of a seriously ill patient. Thirty-one-year-old Brendan has had a head-on collision between his motorbike and a car, 'bulls-eyeing' the windscreen. Brendan's broken both his wrists, but he's most worried about injuries to his testicles: he's so bruised that his penis looks like a 'purple carrot'. And he's decided to hang up his bike keys. Teenager Alex turns up with nasty injuries to his hand after punching through a window. Will he learn a lesson once he's been patched up by the A&E staff? Meanwhile, sisters Pat and Alice are concerned about when they can get a sandwich from mobile tuck-shop operator, Pritpal. And after the Resus team struggle to revive two patients in their eighties, they discuss what they would want done for them in a similar situation.

In the third programme, eleven-year-old Kofi is rushed into Resus, critically injured after being hit by a van. His father, Wayne, sits by Kofi's bedside praying for his recovery: 'I remember when Kofi was born I counted all his fingers and toes and held him in the air'. Meanwhile, 73-year-old Roger Jackson is coming to terms with his own mortality. A member of The Tornados, the first British group to top the US chart in the Sixties, Roger confesses that, despite having cancer, he wouldn't give up his rock 'n' roll fame for his health. Back in Resus, senior consultant Chris Lacy is tested to the limit when three trauma patients arrive in quick succession: one has been shot in the face, another has been stabbed in the chest and a third has been knifed in the head. As armed police arrive and a gang gathers outside A&E, tempers flare and Chris calls for calm as Kofi fights for his life.

The Emergency Department is besieged by Saturday night drunks. Alcohol is one of the biggest causes of injury seen at King's A&E; on an average weekend, half the cases will be alcohol-related. Thirty-nine-year-old Sean has had one too many, tripped over a clothes horse, fallen and broken his neck. The medical team have attached blocks to the sides of his head to stop him from moving his neck and prevent him from paralysing himself, but it's a struggle to persuade him to leave them there. Andrew, 26, has been arrested after a day of heavy drinking. 'To be honest with you I can't remember too much about it,' he says. The police have brought him to King's because he's cut his hand putting it through a window. It takes two officers to hold him still, and, after he refuses to co-operate, three to lead him away to the police van waiting outside. And 56-year-old David is a long-term alcoholic who's collapsed in the street and bashed his head. When he was two, he survived a plane crash that killed his mother. 'That may have started it, I don't know,' he says. He drinks a bottle of brandy in the morning and another in the evening. 'Booze has ruined my life,' he adds. 'I've basically wasted my life.' Sister Claire has seen the consequences of drink. She says: 'I've looked after somebody that has drunk so much they actually bled to death in front of me.

This episode reveals what can happen when something goes wrong with the brain, including when patients suffer a stroke (or a 'brain attack'). Sixty-five-year-old cabbie Charlie Brown is making his second visit to King's in a week. Two days previously he crashed his cab and 'bulls-eyed' the window with his head. He was stitched up and discharged, but Charlie's not been the same since, reading the newspaper upside down and becoming uncharacteristically chatty. Dr Tian is concerned that this may be as a result of a brain haemorrhage caused by his accident. When a scan shows a large dark patch on the left side of Charlie's brain, his fears seem well-founded. Also in A&E is 89-year-old Peggy Pierce. Her husband Derek woke to find her slumped semi-conscious over the bed and she's been rushed into King's with a suspected stroke. This isn't the first time Derek's had to take an emergency trip to the hospital with his wife, so he's braced for the worst. King's is a specialist Stroke Centre, treating on average three cases a day, and doctors know time is of the essence. 'It's terrifying', says stroke specialist Dr Kumar. 'It's like a heart attack. It's a brain attack.' Meanwhile, in the waiting room, Sally is comforted by her ex-boyfriend Ben while she awaits treatment for a cut finger, and two boisterous friends entertain themselves with an impromptu ride around the department in a wheelchair.

Sister Jen's nightshift kick-starts as a stabbing victim, Colin Richards, who's 35, is rushed in by ambulance with injuries to his lung, arm and liver. He's accompanied by his 19-year-old girlfriend, Esther, who was lying in bed next to him when they were awoken at gunpoint. Esther lovingly watches over Colin, who admits he was no angel a few years back. 'I just felt like he just needed hugs and like smiles and me telling him he was gonna be OK,' Esther says. 'I just felt like I had to really be there for him when that happened.' Jen says: 'A lot of people don't have anybody to look after them, to love them, I think that's sad... I think everybody deserves to be looked after and loved and cared for.' While Esther cradles her boyfriend in Resus, Jen tends to Nancy Shirley, 86, who has spent her life alone and fell over at home. 'If you're happily married and got a family you know it must be very nice for people; I've always thought that,' says Nancy. 'When I would have been courting the war was on and all the men were away.' And in Minors, former international lawyer Robert Knutson is patched up after collapsing on the street, drunk. He has lost his wife and family after years of alcoholism. 'I don't have a home... the bed in the hospital is the nicest bed I've been in, in a long time... I'm sorry but that's the state of Robert Knutson,' he says. But, having been treated with care and compassion, Robert decides to make a change.

The team face a 12-hour night shift treating young men with stab wounds, as their friends gather in the A&E waiting room and tension mounts. 'For penetrating trauma to the chest, which are your stab wounds, King's is one of the busiest hospitals in Europe. The areas we serve in London are particularly high crime areas,' says Nurse Scott. 'Sometimes you're looking at two or three stabs a day so the numbers have risen; it seems that people's way of fighting has moved on from punching each other to using bats, to using knives, to using guns.' Seventeen-year-old Levi is the first stab victim to arrive after a fight on the street. His injuries aren't life-threatening, but he needs extensive stitching and an overnight stay. His mum is distraught, but Levi doesn't want to speak to the police about the attack. When two young men from different areas with stab wounds from the same fight come in, the staff know trouble is brewing and groups of their friends soon arrive. Other patients in this episode include a young woman who's been punched in the face and knocked to the ground, and a man who has had too much to drink at the House of Commons. And porters Brian and Kevin, who are responsible for moving patients, collecting bloods and taking specimens to the labs - as well as taking bodies to the mortuary - explain their passion for the job.

The medical team, patients and their families face up to the meaning of life and death. Former motorbike racer John, who's 77, has been sent to A&E with his wife Brenda after a routine health screening revealed a potentially-deadly 'Triple A' (abdominal aortic aneurism) - a dramatic swelling of the main artery that could burst at any moment, making him a 'walking timebomb'. The only option is major surgery, which could be dangerous at his age. Meanwhile, 92-year-old widow Eileen has been brought into hospital after falling and spending the night on the floor. Consultant Liz is worried Eileen may have broken her hip and wants to keep her in overnight to make sure she's fine. 'Lots of times there's nothing I can do,' says Liz. 'We are meant to grow old, we are meant to get ill and we are meant to die. I can fiddle about at the edges of that, but there's no sort of magical response in this hospital that can change that.' Among the other patients is Claire. A year ago, her boyfriend, a medical student, was killed instantly while cycling to lectures, and now she's been injured on her bike. Meanwhile, emergency medical technician Amanda and mobile catering assistant Pritpal talk about the roles they play in helping people to get better.

The medical team faces a range of sport and drink-related injuries on a busy Saturday. But things turn darker when a family party goes horribly wrong, leaving a father and son with life-threatening injuries. Every year 750,000 people are treated at A&E for injuries suffered during recreational activities, mostly at weekends. Ball games account for 300,000 of those, with football the number one culprit, closely followed by rugby. But as evening approaches, sporting injuries begin to make way for the results of another favourite British recreational pastime - drinking. It's a huge issue: there were three million alcohol-related admissions to A&E last year, with half of the patients under 25. Two 19-year-old girls are waiting for treatment after falling when the bar they were dancing on collapsed, while bricklayer Colin has been badly cut by someone trying to mug him. But the evening takes a dramatic turn when a father and son, Morris and Jamie, are rushed into A&E badly injured after being attacked by gatecrashers, one armed with a Samurai sword, at a family birthday party.

This programme focuses on accidents. 'It takes all sorts,' says Nurse Kim. 'You'll find people who think "I'm only nipping up a ladder so I'll hold a cup of tea, a drill, something round my neck, one sock on and a flip flop."' Construction worker William has been trapped under a cherry picker, breaking his leg in three places and crushing his chest. Nick has fallen from a ten-metre ladder onto concrete, landing on his head, resulting in a severe brain injury. It's a matter of life and death, and his brother, Nigel, waits nervously at his bedside. Darren has fallen through a window while trying to clean it, cutting his arm badly. It's not the first time he's been seriously injured: he had head injuries as a teenager when he was knocked over by a moped. Meanwhile, Wilfred, who lives alone after his wife died, has had a nasty accident with a mandolin while cutting vegetables. And good-natured Alex, who once dived onto a railway track to save a woman, has been headbutted by someone trying to steal his wallet and mobile phone.

Seventy-eight-year-old Reginald is dangerously ill. He woke up with severe stomach pain, and the A&E team have concluded that his condition is life-threatening. But can they save him? A retired dock worker who is now his wife's carer, Reginald suffers from diabetes. King's doctors Firas and André suspect that part of his gut may have died and that without immediate surgery he won't survive. There are risks, but, as André says: 'Compared to your risk of dying without it, that risk pales into insignificance in my view.' Firas recently qualified as a consultant at King's: 'It's a bit clichéd but, yes, I have always wanted to be a doctor - ever since I had my tonsils out at the age of five and my parents bought me a Fisher Price doctor's kit.' Reminded of his own father passing away, Firas becomes increasingly concerned about his patient. 'It is hard when you see a strong man who's suddenly become very vulnerable,' he says. Meanwhile, other patients include Richard, who has twisted his knee moon-walking in a club, and a young cyclist brought in unconscious after coming off his bike.

Eighty-eight-year-old Omar is brought in after suffering severe stomach pains and a suspected abdominal aortic aneurism, also known as a triple A. The news that Omar now only has a 50% chance of surviving the operation he urgently needs comes as a huge blow to his son, Talit, who says: 'I thought, I don't think I've ever said to my father I love you.' These 24 hours take place on a Monday: often the busiest time of the week for the department. The A&E begins to fill up with patients. The resuscitation ('resus') area is busy, ambulances are arriving all the time, and the department is stretched to its limit. Consultant Jacqui describes the tension in these periods as a 'sense of not even impending doom. It's just doom's here. It's queuing up.' Thirty-three-year-old Hanny is rushed in after attempting to take his life with a lethal cocktail of drugs. And during the hectic few hours when the A&E is inundated, staff fight to save an 18-year-old who's been stabbed in a street fight and lost a life-threatening amount of blood. King's A&E has more than 200 employees and around 60 are non-medical staff who work behind the scenes to keep the department functioning 24 hours a day. This episode also reveals what happens when the open doors of A&E lead to a department flooded with patients, and what working life is like for the porters, receptionists, cleaners and security guards who also experience the traumas and pressure alongside their medical colleagues. Ward clerk Fintan looks after everything from lost property to trolley maintenance and stationery, but also witnesses the difficult and emotional moments. He says: 'I do see what's going on in resus. I thought I'd be removed from that. But I'm not.'

Seventy-four-year-old Ted and his wife Irene are on their tenth visit to A&E this year. Ted has already been diagnosed with terminal bladder cancer, but his problems have got worse, and after getting blood test results he's been urgently sent to King's. As much as staff try to keep their emotions in check, Senior Sister Maria, who looks after Ted, finds herself profoundly affected by his situation and how he and his wife are coping. She says 'There are patients that will get to you. For Ted to have such a positive outlook, it can't but inspire you. There are a few Teds in my career that I will always remember.' Emergency medical technician Amanda is a key part of the team administering CPR to a man who's suffered cardiac arrest. She talks about the strain of trying desperately to save someone's life: 'The minute it's in the door, it affects me. You have to be professional and it is hard.' German doctor Roman is still getting used to the cultural differences between practising in Germany and the UK: 'I got the hints from nurses that you can't say "this or that" straight to a patient. You should imply a little bit more: "darling, please, would you mind?" and "unfortunately, I have to, I know it will hurt a little bit". The German way is see the problem, make it known and solve it. "Will it hurt, doctor?" "Yes".' A young man comes in with a splinter in his thumb, which he's had for a month; he is sent back to his GP. Another patient has fallen out of a tree, drunk. And a 40-year-old-man who's been kicked in the face during a football match needs stitches.

One in four of us will suffer from mental health issues at some point in our lives. The final episode of the series reveals how, alongside the usual broken bones and heart problems, the A&E team at King's deal with a population that is becoming more and more psychologically fragile. A regular patient to King's who suffers from schizophrenia is admitted after failing to take his diabetes medicine: it's his 19th visit in a year. Meanwhile a young girl seeks refuge with the mental health team. She's in crisis and struggling to cope with life. Psychiatric nurse Jenny has seen it all and reveals that the patients her team have to deal with are getting younger and younger. One patient with suicidal thoughts was just seven. Joseph, a 16-year-old schoolboy, is rushed to A&E after suffering a suspected stroke, and is joined at his bedside by his twin brother Elijah and their mother as they await the results of a brain scan. Clive, 61, a former betting shop manager, is also suspected of having a stroke. Known as the 'Memory Man' in his youth, he is now coming to terms with his diminishing mental abilities, but it may just be his anti-depressants, coupled with the years of alcoholism that are his real problem.