Paramedics are called to a custody suite in Birmingham to deal with a prisoner who is aggressive and abusive but may have overdosed on heroin. Paramedic Rob Moore and student paramedic Ally Shipway tread a fine line between looking after him and themselves. At the same time, across the city, paramedics Jo Hardwick and Peter Bowles are called to a man who is found unconscious at the roadside, but when they wake him his mood dramatically changes and they need to decide on the best care for him. A man is cut out of his car after crashing into another vehicle, and paramedics struggle to find a patient who hung up halfway through their 999 call.

In Warwickshire, a 19-year-old man falls from a horse and the 500kg animal then falls on him. The paramedics need to move him with extreme care to the nearest major trauma unit. At the same time in Birmingham, paramedics have to reason with a man determined to do a poo in the back of the ambulance. And an intoxicated man has overdosed on paracetamol, but would rather have another drink then go to hospital.