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This episode offers an unparalleled insight into how the staff in the control room and ambulance crews on the ground help patients from across Greater Manchester as they race to answer the hundreds of calls that come in every hour. These calls can be anything from a child reported lying face down in a paddling pool to a suicide attempt on the motorway.

Specialist HEMS crew Simon and Laura are despatched to a category one emergency - an urgent road traffic incident. Despite their best effort they are unable to save the life of the young woman who has been the victim of a hit-and-run. Simon, an experienced A&E doctor, reassures the emergency team that they did everything they could to save their patient and reflects on the fragility of life.

Call handler Joe is starting his first night shift. After 12 weeks of training, he is thrown straight into the deep end with a difficult call. Joe's first job was at McDonalds and he thought that was the path he was bound to follow for the rest of his life until one day he witnessed a fatal RTC which convinced him to change direction.

Paramedic crew Bex and Kym are allocated to a job where someone is threatening to jump off a car park. With the police at the scene, they decide a quiet and calm approach is best and convince the patient to get into the ambulance, where she reveals that she has taken an overdose of paracetamol. Bex says that sometimes the last person you would ever expect is actually suffering mental health issues - and she once unexpectedly lost a friend to suicide.

Back in the control room, Joe is taking another difficult call from a mental health patient who is calling about the spiders in his room and supervisor Kath comes to Joe's aid. He reflects on how 'his journey in life has so far been sheltered' and admits he is finding his new job as a call handler 'a lot more stressful than McDonalds, but a lot more rewarding.'

Ambulance crew Kayleigh and Hannah are despatched to a 94-year-old patient with explosive diarrhoea. Upon arrival, they find a very cross patient, angry at her husband for calling out an ambulance when she felt she did not need one. The cause of the illness is put down to a packet of sugar-free butterscotch sweets but unfortunately a trip to the hospital is unavoidable. Leaving the husband behind, Kayleigh puts in a good word for him as a bit of on-the-spot relationship counselling. The night shift is not over despite dawn breaking.

Joe grows in confidence as the night shift continues and takes a very difficult call concerning a patient who has jumped out of a window. He is able to remain calm and successfully reassures the distressed caller until the ambulance crew arrive.

Bex and Kym are then despatched to a 10-year-old who has suffered a seizure whilst he was on the toilet. A child having a seizure is a category one emergency, the highest possible, and Bex and Kym are six minutes away from the patient. When they arrive, the patient's mother reveals the many health problems with her son. His complex needs require him to go to hospital, but in the back of the truck he seems most upset about missing his chance to make a speech to become head boy at school that morning.

At the end of a long and eventful night shift, Joe receives a positive update on the patient who jumped out of the window, and reveals that he has decided to stay in the ambulance service.

This episode takes the viewers behind the sounds of the sirens to discover the hugely diverse range of call outs North West Ambulance Service has to deal with, and the pressures the staff and crews at all levels face as they come to the aid of patients in need.