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The BAFTA award-winning series returns following a whole new cast of characters drawn from the staff of North West Ambulance Service in Greater Manchester.

First up we meet emergency doctor Oli as he prepares for a day on duty with the North West Air Ambulance charity. He is the only doctor leading a crew based on a helicopter available to care for the entire north west area today.

It's the start of a new shift in control, and Laura is working on the helicopter dispatch desk. She is responsible for deciding where to send the valuable doctor-led resource.

Multiple 999 calls are in progress, all ringing for a patient who has been struck by a car. Laura decides she must send Dr Oli and the team as it is the most life-threatening incident. Unfortunately the helicopter is grounded by freezing conditions and the scene is 45 minutes away by car.

At the same time, ambulance crew Cassie and Ray are dispatched to a priority call for a patient who is short of breath. When they arrive they find the patient with her daughter, who explains that the patient is suffering with a tumour and COPD. The crew fear that the patient may have sepsis, which they know they must treat with emergency antibiotics at hospital, but it is also clear that the patient is nearing the end of her life. There is a dilemma about what is the best course of treatment.

Meanwhile, Dr Oli has arrived at scene of the patient struck by a car. Laura, who is co-ordinating the job in control, is visibly distressed to hear the news that the patient on scene with Dr Oli has been pronounced dead.

Temperatures have plummeted across Greater Manchester and snow is beginning to cause problems for the team in control at the start of the next day shift.

Advanced paramedic Jon responds to an urgent call for a homeless man who has spent the night in a van and has no discernible pulse.

Rob is in charge of the helicopter dispatch desk today. He decides where to send Dr Matt, the doctor on duty for the next twelve hours. Freezing conditions have grounded the helicopter for a second day, leaving them to respond by car. Their first call of the day is for a hanging, but it isn鈥檛 long before Rob is forced to decide between other jobs that all need a doctor.

Meanwhile, there is a flurry of 999 calls. Crewmates Jenny and Ellis are dispatched to an 80-year-old patient who has fallen outside in the snow. Once they manage to settle the patient inside at home, the crew grow increasingly concerned about the condition of his wife and whether both are coping together at home.

Dr Matt is on scene with a patient who has had a cardiac arrest whilst at the gym. With the patient stable, he makes the potentially risky decision to leave the patient in the hands of the ambulance crews so that he is free for other patients. It isn鈥檛 long before this decision pays off and he is on his way to another cardiac arrest, where Dr Matt鈥檚 clinical skills will be essentially in giving the patient the best chance of survival.

The next patient of the shift for Jenny and Ellis is for a male who is intoxicated and believed to be homeless. The patient is struggling outside in the cold, but once in the warmth of the ambulance and given some food he is able to talk about escaping his present life with Ellis.

As the shift draws to a close it gives Dr Matt a chance to reflect on his role as a doctor in the service.

This episode shows the profound humanity of the staff and crews of the ambulance service as they make life-saving decisions and confronts us with the very different ways the spark of life burns in all of us, bringing to life the real human stories behind the sirens in the depths of winter.

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