24 Hours in A&E

Follow patients treated in the same 24-hour period at St George’s Hospital in south west London, which has one of the most advanced and busiest A&E departments in the world.

This week a little girl has serious injuries after being kicked in the head by a race horse.

This week’s programme is about the importance of the powerful and resilient bonds between patients and their partners, parents and children

26-year-old Lawrence is rushed to St George’s after being hit by a car while crossing the road on a night out in Eastbourne.

10-year-old Josh arrives at St George’s having severed his finger during an accident on the school playing field. Mum Jane accompanies Josh into resus, but she has a secret - Josh has no idea that his finger has actually been cut off during the accident. Doctors now face a double challenge: to work out whether they can re-attach his finger, which will require major surgery, and how and when to explain to Josh what has really happened. Meanwhile 40-year-old stonemason Guido is in minors having dropped a marble slab on his finger. His finger is wrapped up and Guido has reassured his wife Dina that it’s ‘just a little cut’. But when specialist nurse Prav unravels the bandages the extent of the injury is revealed and Dina isn’t happy. And 74-year-old Maggie, who’s partially-sighted, is brought to resus after falling over and hurting her leg. She’s come with neighbour Nathalie who lives in a housing complex for people with visual impairment. Maggie admits that she couldn’t stand Nathalie when they first met, but Nathalie persisted and they became best friends. An x-ray reveals that Maggie’s ankle is broken in two places and, as doctors fix it, Maggie talks about the challenges she faced during childhood that led her to lose trust in other people and rely on herself.

34-year-old mechanic Grant is rushed to A&E having been crushed against a brick wall by his own car while working on it. Doctors are concerned he has a serious pelvic injury and other internal injuries and work quickly to find out their severity. Grant’s mum Lynn and sister Becky race to St George’s. “I didn’t know if he would be paralysed, what sort of state he would be in,” says Lynn. “You think ‘Let it be me, not him’. I don’t know how he will deal with this if he’s not able to walk. To Grant it would be the end of the world.” Meanwhile 44-year-old Doug is rushed to A&E with severe bleeding from his head. He has a rare incurable condition that has caused a growth on his head and face that is prone to profuse bleeding that could be life threatening. Specialist nurse Terry has treated Doug before. Doug’s wife Rosemary talks about how the condition has affected him and those who care for him. And 23 year-old scaffolder Charlie has something in his eye and is treated in minors. He may be a tattooed cage-fighter, but Charlie isn’t quite how he first appears. “You shouldn’t judge a book by its cover,” he says.

5-year-old Kayla is rushed into St George’s struggling to breathe. With her is worried mum Rachel. Doctors try to find out what’s wrong and give Kayla drugs to relax her chest muscles. Rachel reveals that Kayla was diagnosed with a rare form of juvenile arthritis and she has spent months in Great Ormond St hospital under specialist care - something that’s been very difficult for both mum and daughter. Meanwhile 83-year-old Derek arrives at A&E having fallen over and he’s in a confused state. When asked what year it is, he replies “2003”. Doctors try to get to the bottom of what is going on. It’s revealed that Derek has an irregular heartbeat, but that’s not the whole story. Wife Gwyneth arrives at St George’s and recalls how she first met Derek when he was 62 and she was 39. As doctors carry out tests and a CT scan to diagnose Derek’s condition, Gwyneth reveals how he’s not quite the man he once was and helps doctors understand why he’s so confused. And 12-year-old Olivia has and been brought to A&E with a nasty cut on her leg by big sister Maddie after falling over while doing a handstand at school. Olivia has to be brave as doctors attempt to close the wound.

22-year-old motorcyclist Adam is brought to A&E after crashing into a car and being thrown thirty metres. Adam has possibly injured his neck and spine and doctors are concerned that the severity of his leg injury means that he risks losing his foot. Adam’s mum Diane was phoned at home by the police and rushes to be by his bedside. The medical team send Adam for a full body CT scan to find out how bad things are. Meanwhile 78-year-old former nurse Lina has been brought to St George’s by her husband Tony after becoming dizzy at her sewing class. Tony talks about how the couple met and their life together before Lina takes a turn for the worse and doctors worry she has had a stroke. Lina had a stroke two years ago and Tony had to become her carer. And 18-year-old Rosa is in minors with her mum Jo having fallen off her bike on her way home after a night out with friends. Jo is not impressed. ‘You smell like the floor of an old pub. Let’s not talk about it, I’m still cross,” she tells Rosa.

51-year-old builder Rod is rushed to A&E after falling eighteen feet from scaffolding onto concrete. His injuries are so serious that he’s taken straight for a CT scan of his head, neck and back. Rod’s brother Doug was at the scene of the accident and saw him fall. Doug and Rod’s wife Nicky are in shock and scans reveal that Rod has fractured some of his vertebrae and will require extensive surgery. Nicky calls their two sons to prepare them for bad news. Meanwhile 86-year-old retired policeman John is brought to St George’s having fallen off a wall while waiting for his wife Barbara and has injured his head. Doctors carry out scans and reveal that John’s broken his neck. As doctors assess the severity of the damage and treat his head wound, John talks about how his career as a policeman - including as part of the so-called ‘dirty squad’ - took over his life, so much so that he missed the birth of his son. And 19-year-old cyclist Mack is rushed to St George’s after colliding with a Porsche. He has a head injury and an agonising dislocated shoulder which consultant Manny needs specialist help to relocate. Dad Jim explains how adopting Mack and his brother changed all their lives.

84-year-old Paula has been referred to St. George’s by her GP for urgent treatment. A routine blood test has detected that Paula has a dangerously high level of potassium, or salts, in her blood. “High potassium can be quite dangerous, but you can appear very well,” says registrar Matt. “When it gets to a very high level it can be toxic to the heart and cause your heart to go into cardiac arrest.” Paula’s had tough times; she’s lost three husbands and one of her six children. Her mother treated her very badly. “If I did anything wrong, she used to pull me up the stairs by my hair and all she would feed me would be a slice of dry bread and a mug of water. When I was seventeen and I became pregnant, I was a disgrace to the street and my mother put me in the workhouse. She didn’t want to know me.” But Paula has bounced back through her good humour. “I like making people laugh, make them smile when they're a bit down,” she says. “I like helping people, it makes me feel good.” 74-year-old Derek is brought into A&E after suffering a suspected stroke. He had a sudden severe headache and his wife Mary noticed he was confused. Derek and Mary are devoted to each other. “He’s a lovely likeable guy. He reminds me of my father, old-fashioned,” says Mary. “When we met we felt like we’d known each other for years. We just hit it off straight away. I met him in September and we got engaged in November.” Derek worked as a driver on film sets and used to come home to Mary with lots of stories. “He loves Sandra Bullock,” says Mary. “She wasn’t stuck up or anything, she chatted to everyone.” A CT scan reveals that Derek’s had a bad bleed in his brain and is taken for emergency surgery. Mary is determined to help Derek recover. Meanwhile 31-year-old fireman Glenn has come in to A&E with his twin brother Dean suffering from a suspected abscess in his throat. The pair are inseparable and even finish one another’s sentences. “We’re very similar in a lot of way, but he’s brains, I’m brawn,” says Glenn. “But he’s not that brainy and I’m not that brawny.”

3-year-old Louie is airlifted to St George’s after being run over by a car while playing outside his house. Doctors are concerned that his neck seems to be stuck in one position, which could indicate damage to his neck and spine. And consultant Will is worried that he hasn’t seen Louie move his lower limbs. Meanwhile 14-year-old Josh arrives in resus having injured his ankle while riding a BMX with his dad, Simon, on the front. As doctors relieve Josh’s pain and work out how to fix his ankle, Simon talks about how his struggle to support his family led him to become involved in a risky plan to make some quick cash. Meanwhile 41-year-old Sam arrives in resus after losing control of her car and crashing into a tree. Sam has a nasty cut to her head and doctors send her for a CT scan, concerned about possible spinal and internal injuries. Husband Mark talks about how the couple met and Sam explained that she couldn’t have children because of having leukaemia as a child. Mark wasn’t going to forsake his love for Sam because they couldn’t have a family. But years later, to their amazement and delight, Sam became pregnant.

79-year-old Carole is rushed to A&E with signs of a stroke. She’s confused and undergoes tests and a CT scan so that doctors can assess what’s happened and how best to treat her. Neurologist Dr Mahinda decides to give Carole a ‘clot-busting’ drug, but it only has a one in eight chance of success. Carole and her husband Ted have been married for sixty years, but Ted talks about how things got off on the wrong foot when they first met as 14-year-olds. 77-year-old David comes to St George’s with his wife Kathy. He’s had Type 1 diabetes since he was 15. Recently his toes have become infected - two have already been removed and a third is affected. Specialist Nurse Helen checks the circulation in David’s foot. The medical team are concerned that, because of his diabetes, a lack of blood flow to his foot could result in infection and, ultimately, amputation. David and Kathy are very careful about his diet and Kathy even had to give up baking. Meanwhile 33-year-old Yvette is in minors with abrasions to her eye after having false eyelashes fitted at a salon. But it won’t stop her going back.

52-year-old retired firefighter John is rushed to A&E by helicopter after being accidently hit in the face by a golf club. The golf club hit him so hard that it snapped. John lost consciousness and is in an induced coma. With a suspected critical head injury, John is sent straight for a CT scan. John’s wife Allison is by his side. “John was in the fire brigade for 32 years. He would put his life on the line to save someone,” says Allison. “And then he goes off to play golf and ends up…” As doctors assess the seriousness of John’s head injuries, they are also concerned that his right eye isn’t reacting as it should and he’s weak down the right side of his body, which could indicate further problems. They decide to wake him from his coma. 77-year-old Joan has come to St George’s after falling down the stairs at home and hurting her leg. As she waits to be treated, Joan talks about growing up in Camberwell. “Sixteen children, my mum had. And she was the eldest of 22 children. My mum and dad just put it down to there was no television!” says Joan.

85-year-old Maura is rushed into A&E after falling over during the night at home. Her son Mark and his family found her face down on her bedroom floor when they arrived to take her out for the day. Maura has pain in her back and medics are concerned that she can’t move or feel her legs. CT scans reveal that Maura has broken bones in her spine and doctor Sarah has to inform Maura’s son and his wife Denise that her injuries could be life changing. Mark and Denise have to decide when to share the gravity of the situation with Maura and her granddaughter Meg. Meanwhile 37-year-old doctor Jim arrives in A&E after a collision with a van while cycling to work. Jim’s face is a mess and he has concussion and pain down one side, but he’s reluctant to make a fuss. Jim’s wife Nayana, a doctor at St George’s, visits to make sure he’s OK. But a CT scan shows that, despite Jim putting on a brave face, his injuries are more serious than first thought. And chef Mimi is in minors with her flat mate Ryan after cutting her thumb while chopping peppers at home. Mimi is treated by junior doctor Tom, who she immediately takes a shine to, much to Ryan’s amusement.

81-year-old cyclist Bill is brought to St George’s from Surrey after being hit by a car while crossing the road. Bill wasn’t wearing a helmet and ‘bullseyed’ the car’s windscreen. He has multiple injuries, but doctors are most worried that he may have sustained a serious head injury. Betty, Bill’s wife of fifty years, is recovering from a stroke and worries about him cycling. Bill and Betty’s eldest son Billy was knocked over and killed by a car, on the very same road Bill was hit. Meanwhile 93-year-old Amy has come into A&E after a clothes airer fell on top of her while she was hanging out the washing. She’s with her 85-year-old friend Bernie. Amy talks about her two unhappy marriages and meeting Bernie when she was seventy-five. And she recalls how her father refused to let her sign up to serve in the WRAF during the war. Instead she volunteered for ambulance service and worked through the Blitz, bringing patients to St George’s. And 78-year-old Samuel has come to St George’s after falling over some boxes and landing on his face. He is looked after by emergency nurse practitioner Craig.

59-year-old Charulata is rushed to A&E after collapsing at home with signs of a stroke. Charulata has a previous history of strokes, has diabetes and is waiting for a heart bypass. Medics send her for a CT scan to find out what has happened. While they wait for results, her husband Dilip talks about meeting his wife through family, marrying at Wandsworth Town Hall and running a corner shop together in Tooting. Dilip spent a decade away from his family in America, while Charulata was left to look after their children. 28-year-old carpenter Luke has come into A&E with his girlfriend Stacy having cut his finger at work. Stacy claims it looks like a paper cut, but Luke – who has epilepsy – is worried that it might trigger a seizure. Luke’s epilepsy began three years ago after he crashed his bicycle into a stationary car. He was treated at St George’s then too. He was given a 10% chance of survival and underwent brain surgery. Meanwhile 75-year-old Anne is in St George’s with husband Steve after falling and hurting her arm while on holiday. Anne took a couple of painkillers and continued her holiday, but an x-ray reveals that she’s broken her elbow.

77-year-old Martin is rushed to St George’s after collapsing at home. It’s not the first time that Martin has blacked out and he has two further seizures in A&E. Doctors carry out urgent tests to find out what is causing his problems. As they await the results, Martin’s wife Margaret talks about their life together. “We never had much money. It was hard to pay the rent,” says Margaret. “But I knew that he would always look after me and, as much as I could, I would look after him. There’s not much more you can hope for.” 83-year-old Harry collapsed while out shopping. He’s short of breath and has chest pains and dizziness. Harry has been widowed for 35 years and describes himself as ‘an independent old bugger’. As a younger man Harry spent time working on fairgrounds. “I was on the Waltzers, the best five and a half years of my life,” he says. Meanwhile 6-year-old Lilly has cut her head after falling off her scooter. Paediatric nurse Kelly loves working with kids. “I guess you see perks to other people’s jobs – 9 to 5 would be amazing or wearing a power suit to work and heels would be super cool – but helping people and making a difference is fantastic,” says Kelly. “I must just have been born with the caring gene!”