A&E After Dark

A+E Departments are seeing alcohol abuse on the rise and in Rotherham an alcohol-dependent patient arrives at the rapid assessment unit after faceplanting onto concrete. The patient is agitated but Dr Alex's primary concern is spinal damage and brain injury. They transfer the patient to resus just in time to intercept a seizure. Time is critical but this patient's behaviour is getting in the way of a life-saving brain scan.

214 miles south in Tunbridge Wells, a rider has fallen off her horse while at a gallop. This is a serious trauma, and tingling down her right side means she needs thorough diagnostic tests. However, this patient has a crippling needle phobia which she must overcome to receive urgent care.

In the waiting room, 67-year-old Royce is concerned that a wound he sustained during a bathroom renovation has become infected. Doctor Chukwudi is worried about this smelly cut so inspects it for sepsis and infection.

In North Middlesex Hospital, Dr Jack is looking after a patient with a complex medical history. Frank called paramedics after waking in the night unable to breathe. With a history of pneumonia and previous heart surgery it's not looking good. Frank rapidly needs more oxygen in his blood, so the ITU team is called for more invasive treatment.

Over in Majors, patient Rico has damaged his hand at an arcade. Turns out Rico was too strong for the punching bag and Nurse Sheena is concerned about loss of sensation in his hand.

Back in Rotherham, a young man was getting dressed when he heard a pop in his shoulder. With a strong suspicion it's dislocated, and the x-ray to confirm it, this patient is in a world of pain. Putting it into place is even worse and his reaction to the pain medication is a shock.

A&E in London's North Middlesex University Hospital is heating up thanks to an aggressive male who claims he has been attacked. Language is a barrier but by a stroke of luck, Advanced Clinical Practitioner Albena translates. The patient is incoherent, threatening, and is a risk to others, so security stand close until his suspected psychosis can be managed.

In Rotherham, children's Nurse Kiera is pulling out all the stops for an 11-year-old girl who stepped on glass and sliced her foot open. As feet contain thousands of nerve endings, it isn't a fun evening for this poppet, made worse by the amount of blood continuing to pour out.

An ambulance crew has rushed 77-year-old Susan into Tunbridge Wells A&E with a dislocated knee. What was supposed to be a lovely dog walk has quickly turned into a painful procedure. It's vital Dr Paul uses gentle hands to work Susan's knee back into place and avoid further damage.

Back in London, a young man is waiting to have his hand seen to after punching a pub window. Eighteen-year-old Lenny is convinced his hand is broken and unfortunately Nurse Emmanuel agrees. Although he can't feel much now, when the alcohol wears off Lenny might painfully regret the evening's events.

Nurse Sophie is on triage in Rotherham tonight as pensioner Graham comes in with his son. His gums haven't stopped bleeding days after a tooth extraction. As Graham is on blood thinners this launches him into the high-risk category.

And an unresponsive patient comes into resus in London after being found unconscious on the pavement. As the patient can't respond to any questions, it's vital that the team proceed with the worst-case scenario in mind.