24 Hours in A&E

10-year-old Ashleigh is rushed to St George’s by ambulance after an accident playing football where she twisted her leg awkwardly. X-rays reveal that Ashleigh’s femur is broken and will need surgery. It’s not Ashleigh’s first time at St George’s, her dad was treated there for Leukaemia. He died when she was just seven. 3-year-old Lola is visiting A&E with her dad Quin after having a seizure earlier today. She suffers from febrile convulsions, a condition that causes her to fit intermittently. “Naturally when you see this sort of thing you go through all the worst case scenarios,” says Quin. “You think ‘What if this happens when we’re not with her?’ In that moment there’s nothing I can do, that’s the scary thing.” Meanwhile 91-year-old Betty is brought to St George’s with severe chest pain. Doctors need to do a blood test to confirm if she is having a heart attack and she faces life-saving surgery. Betty’s niece Anne talks about her aunt’s long and eventful life. “She was a telegraph operator to the North Atlantic convoys,” says Anne. “After that she did what she really, really wanted to do, which is to travel. She went to South Africa, India, Singapore, Hong Kong, Australia, New Zealand and Canada. She was ahead of her time, a trailblazer.”

37-year-old IT project manager Robert was travelling to work on his motorbike when he collided with a car. Robert is confused and has injuries to his face and head, he’s taken straight for a CT scan to assess their severity. Initial results show that Robert has a bleed on the brain, a broken jaw and two missing teeth. Dr Mevan has to break the news to Robert’s partner Izabela when she arrives in A&E with the couple’s 3-year-old daughter. Robert’s injuries could be life-changing and he faces extensive surgery. 54-year-old legal secretary Mary collapsed in the street on the way to work and has hit her head, her heart rate was so low it nearly stopped. Registrar Mevan needs to establish if it is simple fainting or something more sinister is to blame. Tests reveal that Mary has problems with the electrical signals to her heart and will need to have a pacemaker fitted. Meanwhile 27-year-old Jessica has come to St George’s. Two months ago she was diagnosed with breast cancer and had a lumpectomy to remove tissue, but part of the wound won’t heal. She’s treated by Emergency Nurse Practitioner Craig, whose time being treated in intensive care gave him a huge insight into how patients feel.

5-year-old Isa is rushed to A&E after being hit by car and trapped underneath it. Witnesses had to lift the car so he could be treated by paramedics. Doctors send Isa for scans, suspecting that the impact may have caused serious internal damage, as well as significant head injuries. They discover he has a collapsed lung that urgently needs to be drained and may have a small bleed on his brain. Dad Siddiq, who travelled to hospital with Isa, worried about telling his pregnant wife Tawra. She’s concerned about what the injuries could mean. 26-year-old Tom is brought to St George’s after slicing through his leg with a circular saw. Doctors fear that the blade has cut so deeply into the muscle tissue that it could starve Tom’s leg of blood. While he’s scanned to check the severity of his injuries, Tom talks about his parents’ tough decision to sell their farm in Colombia to come to the UK in search of a better life for their family. Meanwhile 85-year-old retired actor Donald comes into A&E complaining of pain in his bladder. He has a catheter and consultant Faheem suspects there may be an infection. Donald talks about starting in theatre during the war and working in musicals.

75-year-old Gerry is rushed to A&E with a dangerously high heart rate of over 250 bpm. Doctors aren’t able to slow Gerry’s heart rate down with drugs and their only option is to try to return his heart to a normal rhythm with an electric shock. They suspect the problem has been caused by an underlying chest infection that will need to be brought under control. Gerry’s wife Julie talks about meeting Gerry after first husband died from cancer, giving her a second chance for happiness. 92-year-old Margaret has come to St George’s after falling over and hitting her head. The cut may be small, but doctor Tom wants to carry out a series of tests to make sure there’s no underlying cause for her falling. They discover that she too has a dangerously high heart rate. Margaret is not your average 92-year-old. She lives alone and looks after herself as well as spending time with younger friend Yvette. Margaret talks about losing her husband to Alzheimer’s and her daughter to cancer. Meanwhile 6-year-old Daniel has an infected blister on his foot and has come to A&E to get it sorted out, accompanied by his mum and three siblings. But Daniel needs some reassurance and distraction, as well as gas and air, so that the medics can make him better.

13-year-old Tom is rushed to St George’s after crashing his bike headfirst into a parked car while racing a friend. Half of Tom’s face is badly swollen and doctors are concerned that the impact could have caused internal injuries. They order a CT scan to assess if he’s suffered life-changing injuries including a bleed on the brain, while specialists decide whether he will need emergency surgery to his face. Tom’s mum Fiona talks about his dramatic early birth shortly after her own mother died from Parkinson’s. 26-year-old Andy arrives at A&E after injuring his knee during a game of Frisbee with best friend Sam. Andy had a challenging time growing up and has struggled with anxiety and depression for over a decade. He lived with Sam’s family for a year. Meanwhile 51-year-old Jason comes to St George’s with best friend Matthew after suffering from blurred vision for two days. He’s referred to an eye specialist. The pair met at school and Matthew supported Jason after both of his parents were murdered.

78-year-old Barrie is rushed to St George’s with breathing difficulties. His wife Irene is with him. She reveals Barrie has been in A&E a few times in recent months with chest problems and is also suffering from dementia, “He couldn’t remember things,” says Irene. “He forgot my birthday, but I didn’t want to broach the subject.” While doctors carry out further tests, Irene talks about how as newly weds they desperately wanted children together, but found they couldn’t. They adopted two children, but a few years later Irene started feeling tired and went to the doctors. It turned out she was pregnant and gave birth to a son on Barrie’s 44th birthday. Irene was offended when people said ‘you must be pleased to have one of your own’. “We never thought of our two adopted children as not our own,” she says. In resus, Barrie’s condition worsens. Tests reveal he has fluid on his lungs and faces serious medical treatment meaning Irene has to come to terms with a difficult conversation. 75-year-old David is also in A&E having fallen down a flight of stairs. He was staying with his wife Jane at her sister’s house when he woke in the middle of the night to go to the toilet, but “mistook the top of the stairs for the bathroom door.” Jane is worried about his injuries, but admits “It was funny...he didn’t have anything on!” David, a former teacher, occasionally has restless nights where he dreams of fighting. Wife Jane explains, “We will be cuddled up fast to sleep...and he will kick me really hard. So I’d wake up and kick him back and we’ll end up kicking each other.” As doctors carry out further tests, David explains how as a young boy he was sent to live with his Aunt and Uncle, a situation that David says led him “to grow up believing I was bad…I became quite hard…I look back now with regret that I didn’t shown my aunt and uncle more affection. They would do anything for me.” Years later David’s uncle suffered from dementia and came to live with them giving David the opportunity to repay their kindness. “I remember with gratitude that I could nurse him in his final years,” he says. Meanwhile 82-year-old Bob has come into majors after a DIY accident at home. His wife, daughter in law and grandson are with him. Due to previous accidents, Bob has been banned from using ladders and grandson Robbie suggests they might have to cut off the electricity to the shed to stop him using power tools too.

48-year-old train driver Andy is rushed to A&E after falling twelve feet from a tree while cutting branches. Andy landed on his feet and has badly fractured both ankles. He doesn’t have any sensation in his feet and doctors are concerned that the damage may have caused life-changing damage to critical nerves and blood vessels in his feet and legs. Medics decide to cut the skin on his calves to relieve dangerous swelling and Andy will need major surgery. 59-year-old Angela has come to St George’s with her husband Antoni. She has a history of heart disease and her heart has been beating at over 150 bpm for eight hours, risking stroke and other complications. Cardiologist Dr Arun’s attempts to bring down Angela's pulse using a powerful drug aren’t successful, so he decides to electrically shock her heart to reset it. Meanwhile 3-year-old Shane has come to A&E after falling off a trampoline at his grandma Marion’s house. His sister Milly thinks Shane is faking it, but it turns out Shane has broken his leg and it will need to be put in a cast.

43-year-old cyclist John is brought to A&E after crashing face first into a car. His injuries are so severe that he was put in an induced coma at the scene. Doctors send John for scans, suspecting that the impact may have caused serious damage to his brain and spine. They discover that John has multiple fractures to his face and spine and a bleed on his brain. John’s wife Suki rushes to hospital to be with him, she’s worried about what his injuries will mean for John and their three children. 68-year-old Pat comes to St George’s with her son Michael and grandson Darius after injuring her leg while on a family holiday. While they await the results of an X-ray, Pat talks about how the family pulled together after the loss of her husband. Meanwhile 89-year-old Adrian arrives at A&E complaining of chest pain. While he and his wife Anne wait for the results of an ECG and blood test, Adrian reminisces about his former career as governor of Pentonville prison.

31-year-old Liam is rushed to St George’s after collapsing at home during an epileptic seizure. It was his fourth seizure of the day and he experiences another at the hospital. He’s given an anti-seizure drug to stabilise his condition. Liam’s wife Alice and mum Kimberley talk about the effect his seizures have on them all. “I dread that phone call one day from Alice,” says Kimberley. “Maybe he’s not gonna pull through. It’s a worry every day.” Kimberley was still at school and was starting to get into trouble when she became pregnant with Liam. “He was just like a God send,” she says. “I had to grow up very quickly… you get this natural instinct of I’ve got to look after this. Your whole world is focused on this baby.” 89-year-old Mair is brought to A&E suffering from severe chest pain and difficulty breathing. Doctors take blood samples to test whether her symptoms are due to pneumonia. While she’s treated, Mair’s daughter Janet talks about her mum, who ran a corner shop with her husband. “My mom and dad were very good providers, always had a lovely home,” says Janet. “It was a nice childhood. First kids in the road to have a television. First kids in the road to have a car.” Mair is keen to see her upcoming 90th birthday, but as she has existing heart problems, doctor Tom has to discuss whether she wants to be resuscitated if her heart stops. Meanwhile 12-year-old Lauren arrives by ambulance after breaking her leg while scoring a try in a rugby match. An x-ray shows the extent of her injury and Lauren will need extensive surgery to give her the best chance of walking normally again. “Lauren is a tom boy. She would always be the one up a tree…always kicking a ball around with the boys,” says mum Rachel. “So at the moment I don’t have that kind of relationship where we can go out doing the girlie things. She doesn’t want her nails painted or for me to plait her hair.”

39-year-old Stephan is rushed to St George’s with internal bleeding from his femoral artery. “When someone comes in and they’re bleeding from their femoral artery, you need to act quickly,” says registrar Sophie. “You need to stop that bleeding otherwise the consequences could be very serious.” Stephan has a condition called Sudden Arrhythmic Death Syndrome and the bleed was caused by complications following an angiogram he had the day before. Doctors are concerned that the drop in blood pressure and sudden blood loss could be putting Stephan’s heart under potentially fatal strain. Stephan had to have a device fitted to restart his heart and his cardiologist encouraged him to ‘live a little’ – so he’s in training for his first Iron Man event. Stephan’s wife Fiona talks about how the couple met in their twenties, but things didn’t work out and they cut all ties for three years before deciding to meet up to give it another try. “He pulled up the driveway, I took one look at him and I said ‘I have to be with this guy!’,” says Fiona. “There's not a day that goes by that he doesn't do something magical for me. He just treats me like a princess. I could not imagine my life without Stephan.” 19-year-old Emmanuel Junior comes to A&E after suffering an acute attack of sickle cell disease. It’s a chronic condition that causes infections, severe pain and can lead to early death. Emmanuel Junior’s sister died from the condition. “Sickle cell, it's not anything that can be controlled,” says Emmanuel Junior’s mum, Elizabeth. “The blood cells sickle and then it starts a whole extreme painful episode. And you don't know when it's going to end.” Meanwhile 40-year-old Fernanda has come into St George’s with abdominal pain. The mum of five is with her 3-year-old twins and their dad Jorge. Doctors take blood and urine samples to find out what's causing Fernanda’s pain. But the test results reveal a surprising reason for her discomfort.

50-year-old motorcyclist Michelle is rushed to A&E after crashing head first into a lamppost. Michelle was riding back from a rally on the Isle of Man with her husband Rik when the crash happened. She was taken to a local hospital, but her injuries were so severe that she’s had to be transferred to St George’s. Scans reveal that Michelle has broken bones in her neck, arm, ribs and shoulder. She’ll need emergency surgery to fix her shoulder and the medical team won’t know until afterwards if she will regain full use of her arm and hand. “I’m split between never wanting her to step on a motorbike again, to ever go near one,” says Michelle’s daughter Alex. “But then I think if it makes her happy, you just got to let her get on and do it.” 69-year-old Timothy comes to St George’s after riding his bicycle into the back of a parked ambulance. He has plenty of bruises and needs stitches for a cut finger, plus a flat tyre. Timothy was training for a 100-mile charity bike ride at the time of the accident. He cycled around Europe as a young man; that trip ended with him crashing into a kilometre stone near Venice. “I’ve been bicycling in London since I was ten. I used to bicycle up to Trafalgar Square and back, but there wasn’t much traffic then,” says Timothy. “As I got older, instead of being the quickest on the road I became the slowest… I always wanted to do a hundred miles when I was 70, and maybe once I’d done it I won’t want to do it again.” Meanwhile 33-year-old Eleanor is in A&E after cutting her thumb at home on a meat cleaver. She needs stitches. “It can’t be worse than childbirth!” says Eleanor, who’s heavily pregnant and the baby is due in a week.

68-year-old Beth is rushed to A&E after falling down a flight of stairs and breaking her ankle – her foot is hanging off and the bone is sticking out. Beth, who’s originally from Canada, lives on her own after her husband died recently. “I remember losing my balance. I just remember going down, and when I landed thinking, 'Oh God! I've lost my foot',” says Beth. “I was scared, because I'm on my own. I'm not quite used to that yet.” Dr Ashley is concerned that Beth may have sustained other internal injuries. Doctors manipulate her ankle back into place and she faces emergency surgery and intensive physiotherapy. But Beth is determined to walk again. “I've got things to do and places to go. I'm not ready to lay down and die yet!” she says. 67-year-old Leigh has head injuries after being knocked off his bicycle in a hit and run incident. He was travelling at speed and wasn’t wearing a helmet. Medics are worried that he has suffered a severe trauma to his head and may have further injuries to his neck and spine. “A car came out of a side road, and he obviously didn't see me, because I hit him before I could even touch the brakes,” says Leigh. “It was a horrible feeling. I just knew I was gonna crash.” Leigh was born in Southern Rhodesia, which became Zimbabwe, and doesn’t have any family in the UK. He talks about how life changed in the country as pressure for independence grew and why he had to leave at short notice after being threatened with arrest for treason. Meanwhile 26-year-old Luke comes to A&E after an accident at work involving an electric saw. He’s accompanied by his twin brother, Dan. They were always close until Dan moved away and had a son with his girlfriend. Luke had a couple of run ins with the police, but now wants to find the right girl and settle down.

22-year-old cyclist Athar is rushed to St George’s after a collision with a car on his way to work. Athar wasn’t wearing a helmet and ‘bullseyed’ the car’s rear window; he can’t remember anything about the crash. Doctors send him for a CT scan to assess whether he has sustained a serious head injury, as well as damage to his neck, spine or internal organs that could be life-changing. Athar faces major surgery and a period of recovery. His cousin Musawar talks about the close bond between the two young men and the challenges Athar faced when he moved to the UK from Germany with his family. 91-year-old Peter has come to A&E after suffering a fall three nights previously while at home with his wife. As well as carrying out x-rays, medical staff test for any underlying health problems that may have caused Peter's fall. Peter was born in India before being sent away to a boarding school in England at the age of seven. “I was extremely happy, in a lovely house in Lahore in the Punjab with a beautiful garden and two nice Scottie dogs,” he says. “You couldn't have a more sort of luxurious, very comfortable life.” Peter served as a dispatch rider for the Home Guard during the war before heading back to India to work as a shipping agent where he met his wife Marlene, who he now cares for. “She can't do very much at all, because her balance is so bad. So I'm the one that needs two feet because I have to do everything,” he says. Meanwhile 26-year-old Emma is in hospital with mum Tracey and dad Stuart. She cut her head open after suffering an epileptic seizure. Emma also has a form of cerebral palsy called hemiplegia that leads to stroke-like symptoms. It’s the ninth time this year she’s needed treatment. Tracey talks about how Emma’s conditions affect her and the family. “You do try and have as normal a life as possible,” she says. “It is hard, sometimes it is hard. In day-to-day life you get a protective shell…because that’s how you survive. You don't know what's in the future, so you try and cram as much in as you can.”

11-year-old Jack is rushed to A&E after being hit by a motorbike while walking to his first day at secondary school. Jack managed to push his friend out of the way, but he was thrown up in the air and banged his head, fracturing his skull. He was taken to a local hospital, but his injuries are so severe that he’s been transferred to St George’s. A CT scan reveals that Jack has a bleed on his brain caused by the fracture and doctors are also worried that he may have internal bleeding. He’s taken to intensive care. “I think when it's a head injury. Cause you can't see it you don't know what's happening,” says Jack’s mum Lynda. “I just felt so helpless because I just couldn't do anything for him.” Consultant Will feels huge empathy for Jack’s parents. “When it's your child lying on a trolley I think parents are completely overwhelmed. It's completely alien to anything else they've ever been involved in before,” he says. “All they can see is their son there and worrying about exactly what is happening.” 24-year-old Jake arrives in A&E after being involved in a head-on collision with another car and he ‘bullseyed’ the windscreen. He was driving past his ex-girlfriend at the time. Jake has a seven inch injury on his head, but fortunately no sign of brain injury. He admits he’s accident prone. “I’ve had broken hands and fingers, big slashes on my legs,” says Jake. “I’ve got ‘You Only Live Once’ tattooed on my arm. If you have something tattooed on you and then you don't live by it you're an idiot if you ask me.” Meanwhile 32-year-old Saumeel has come to hospital with his brother Rishin after cutting his hand badly on a washing machine. Student doctor Uzair, who’s just started at St George’s, is looking after Saumeel, but he needs some specialist help to stitch the wound.

12-year-old Tulsi is airlifted to St George's after falling from a cliff near her home in Hastings, seventy miles away. She has a head injury and is designated as a ‘Code Red’, meaning she’s bleeding badly. Emergency doctors have put her into an induced coma. Clinical director Phil orders urgent CT scans as soon as Tulsi arrives so he can assess the extent of her injuries. They reveal that she has a subdural haematoma – a clot of blood within the head which is expanding, putting pressure on her brain. Tulsi needs emergency brain surgery. “If that pressure builds up and the brain is squashed, it can stop the patient breathing,” says Dr Phil. “Your worry is that, even if you do get the clot out and the child survives, that she may have residual brain dysfunction or injury.” 39-year-old bus driver Adam is rushed to A&E after his motorbike collided with a car in south west London on his way home from work. Adam has a very obvious and painful leg injury, but consultant Rhys is concerned that there might be something less visible, but more life-threatening. “Coming off a motorbike at high speed, they could be injured anywhere,” says Dr Rhys. “Sometimes it's not the leg that I'm most worried about, it's the things like, inside his chest or is there anything going on in his abdomen or his pelvis or his head?” CT scans reveal that Adam has fractured his wrist and some of the bones in his spine. He also has bruised lungs and an injury to his kidney. And he faces lengthy emergency surgery to fix his badly broken leg and a long period of rehabilitation. Meanwhile 70-year-old retired mechanic Ron has come to St George’s after getting his hand caught between two vehicles while helping a friends fix their car. He’s been brought in by his girlfriend, bus driver Jackie. Doctors suspect he may have broken some bones. “We went to bed that night and didn't think much of it,” says Jackie. “When we got up in the morning, looked like someone had got hold of a rubber glove and blown it up!”

71-year-old Tony is rushed to St George’s by air ambulance after falling head first onto a tiled floor while doing some DIY in his kitchen. He was talking when the ambulance crew arrived, but soon became unresponsive. Scans reveal that Tony has a severe bleed on his brain and requires immediate life-saving surgery. While his family wait on tenterhooks for news, Tony’s wife Sue talks about the challenges life with her husband, who worked on helicopters for the RAF. “When I married Tony I knew what the military life was, I didn't enter it blind,” says Sue. “We moved around, we've had to mould together as a family, you have to rely on each other. He missed the family dreadfully when he was away.” 23-year-old Charlie has come to A&E with facial injuries after being assaulted on his way home from a night out. Doctors suspect he may have a broken jaw and send him for x rays. “Charlie as a little boy, he was very adventurous and fearless I'd say,” says dad Mark. “From the time he was probably five or six, Charlie would generally be in the wrong place at the wrong time. He was just really inquisitive.” “We’ve had a really up and down journey. Lots of times when I wondered if he would come out the other side and just not be there one day,” says Mark. “That didn't really change until he met his partner. And then having a child made him realise that he needed to grow up.” Meanwhile 10-year-old Lucy is in A&E after having seizures for the past 48 hours. Her parents first realised something wasn’t quite right when she was four or five and they haven’t been able to find out what is wrong with her. “There has never been a week where she's been completely seizure free,” says Lucy’s mum Zoe. “It's just devastating, because I just want to be able to take it away and everything be all right, but we still don't know what's wrong.”