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Yorkshire Air 999
Yorkshire Air 999 (2024) S03E01
Yorkshire Air 999 (2024) Season 3 Episode 1
Yorkshire Air 999 (2024) S03E01
Yorkshire Air 999 (2024) Season 3 Episode 1
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FunTranscript
00:01Yorkshire.
00:03Breathtaking,
00:06but unforgiving.
00:09And when the landscape turns dangerous...
00:11Patients still breathing but doesn't sound good on the phone, mate.
00:14...and lives hang in the balance...
00:18...the crews of the air ambulance are often the first and only lifeline.
00:23Hello, we're coming to help. You okay, buddy?
00:25Delays in getting your patient to hospital
00:27can literally be the difference between life and death.
00:30He's injured his brain.
00:31Just try and get a little drip in your arm, Kian, all right?
00:34Can you remember anything about us putting your leg into us then?
00:37No.
00:38No?
00:39The jobs that we're going through can be quite catastrophic.
00:42If we weren't there, then the situation could be much worse.
00:45Bringing critical care by air.
00:48That's it. Good lad. Good lad.
00:50You're not allergic to anything.
00:52Pain.
00:54This is Yorkshire Air 999.
01:01At the air ambulance headquarters near Wakefield,
01:04Paramedic Matty is on the air desk listening in to a 999 call.
01:08I've turned my tractor over and I'm underneath it.
01:13And have you lost any blood?
01:15I can't see because my arm is under the wheel.
01:19The tractor is overturned and the patient's underneath it.
01:22Very good, my friend.
01:23Lay burnt.
01:24He's trapped by his shoulder, apparently really short of breath.
01:27I've been here for an hour.
01:30I've only got my...
01:32And out of my pocket.
01:34We're getting the help of Wayne for you, okay?
01:38Paramedic Wayne and Dr Steve are being scrambled to the man who is trapped in a remote valley,
01:4450 miles away in the middle of the Yorkshire Dales.
01:479-8, receive him.
01:48Yeah, so it's a 59-year-old male who's reported to be trapped underneath an overturned tractor.
01:55He's reported to be short of breath but he's definitely trapped by his shoulder.
01:59And arm over.
02:019-8, roger that.
02:02Do we have fire on him for this?
02:04Yes, we'll get fire and rescue to go.
02:06But the reason for allocating merit is if this turns out to be a prolonged entrapment,
02:11they'll have blood and FFP if things change towards anything more serious like an amputation.
02:16Over.
02:17When we have patients that are trapped or pinned,
02:20a heavy weight on the tissue can cause parts of the tissue to die,
02:23which releases toxins into the bloodstream.
02:25So the longer someone's pinned, the more worried we are.
02:30I'll just try it.
02:31Yeah.
02:32Clear down your side here, yeah?
02:33Good on my side, yeah.
02:34Yeah.
02:35Stephen Wayne will be the first on scene to reach the man,
02:38who's at the top of an isolated valley over half a mile down a rough track.
02:43He's been alone and pinned beneath the tractor by his arm for over 90 minutes.
02:48We've landed about 50 yards away, Matty, and I'm just making my way to scene now.
02:52Yeah, roger, Steve.
02:54Patient's still breathing but doesn't sound good on the phone, mate.
02:57Yeah, it's getting carbon monopside poison.
03:00The tractor's engine is still running, and its fumes may be poisoning the patient with carbon monoxide.
03:06Hello.
03:07We're coming to help you, okay, buddy?
03:09How are we?
03:10How are we turn this off?
03:12Dead man's switch.
03:13Dead man's switch.
03:14Okay, though.
03:15I'm joking up.
03:16Yeah.
03:17Yeah, that's it.
03:18Pull it.
03:19Don't go up for that.
03:20What's your name, mate?
03:21Stephen.
03:22Hi, I'm Wayne.
03:23I made a Stephen mistake.
03:24What happened?
03:25Had to change the gear.
03:26Okay.
03:27And of course, tractor's rolled back.
03:28Okay.
03:29That's it.
03:30Nine-year-old Steve Rathbone was reversing his vintage tractor down a slope when the brake failed.
03:36It struck a stone and flipped over, pinning him underneath.
03:39My whole arm is underneath it.
03:41Yeah, I can see that here, mate.
03:42Have you got any pain anywhere else?
03:43I imagine my shoulder blade's bugged up.
03:45Okay.
03:46I'm going to try and get in, mate, and give you an assessment.
03:48Is that all right?
03:49Yeah.
03:50Don't just get this thing lifted off me.
03:51Yeah, we've got the fire brigade coming, mate, all right?
03:53Yeah, arm, shoulder and hand, mate, on this leper.
03:56It's wrapped under the wheel.
03:58Yeah.
03:59And it hurts.
04:00I bet it does, buddy.
04:02There's lots of folk coming to help you.
04:04Okay, Steve.
04:05So, lots of combustible stuff around, petrol and whatever.
04:08Diesel, sorry.
04:09Diesel.
04:10Is everything out?
04:11There's oil and all sorts.
04:12So, just thinking about oxygen use, just something to be aware of.
04:15There is a fire risk.
04:17Alex, would you be able to get a fire extinguisher from the aircraft?
04:20Have it nearby.
04:21Can you feel me touching your hand?
04:23No, I can't feel you touching it, but I have a sense of it.
04:26I mean, he's trapped significantly under this wheel and this wheel arch here.
04:30Injuries top to toe.
04:31Looks like an isolated, obviously, pinned shoulder, left arm, hand.
04:35Possible neurovascular compromising the hand here.
04:38Yeah.
04:39We're going to get a drip in and give you some painkillers.
04:41Okay.
04:42Steve's hand is trapped under the wheel and is losing blood flow and nerve function.
04:47Thank the Lord you're here.
04:49Yeah.
04:50So, this is going to be a bit tight while I have a look to get a load.
04:52Yeah.
04:53You know what?
04:54What's that?
04:55My phone was in the pocket under the wheel.
04:57Oh, crikey.
04:58And I thought, this is it.
04:59I'm done for.
05:00A fire and rescue crew member has come ahead to assess how they can free Steve.
05:05Yeah.
05:06Legs are free.
05:07Pelvis is free.
05:08Chest is free.
05:09Just the arm.
05:10All right.
05:11Best form of attack I think we need to do is lift it all up from this side.
05:15It's going to be delayed getting the gear up here though.
05:17Yeah.
05:18So, we're going to give you some medication, Steve.
05:19Yeah.
05:20One of them is going to keep some clots formed in your body in case you're bleeding anywhere.
05:24Yeah.
05:25And we'll just start you on some paracetamol.
05:26Oh.
05:27And then we can top you up with a bit of morphine.
05:29Steve's accident has happened at the top of a steep and remote valley.
05:33A local farmer is helping to carry the rescue equipment up to them.
05:37I think the bucket is currently supporting it where it is.
05:40If we take the bucket off, it's going to drop onto it further.
05:43If we get something under here, lift the bucket, chop the wheel as it comes up,
05:47we might just create enough wiggle to get out.
05:50Fire and rescue will be using high pressure airbags,
05:53which when filled with air, can lift up to 60 tonnes.
05:57Steve, we're all around you, planning now to get you out.
05:59OK, buddy?
06:05Yeah, super. Cheers, Mark. Cheers, Al.
06:09How are you feeling, Steve?
06:11I'm feeling very tired.
06:13Yeah.
06:14Probably the adrenaline dropping off because you know help's coming.
06:17Yeah, exactly.
06:19Steve did start to say he felt quite tired.
06:22We see this sometimes.
06:23It's a phenomenon that's been described as peri-rescue collapse
06:26when it seems that they're safe, they can take a turn for the worse.
06:29So I was worried in my mind that actually Stephen
06:32had been holding his own for some significant time,
06:35but with us there on scene, we start to relax a little bit
06:38and we'd be more at risk of deterioration.
06:42Steve has now been under the tractor for over two hours.
06:45OK, Steve, we're going to start moving now, OK, buddy?
06:48Rest, rest, rest, rest, rest, rest, rest, rest.
06:54Right, knock all that off. Knock it all off.
06:57As the tractor is tilting, its mudguard is pushing into Steve's chest,
07:01so they need to stop.
07:03All it did was swing it that way.
07:05It was shifting, yeah, I could feel it.
07:07It's relieving me that it's pushing...
07:09On your chest.
07:11However, they can now access Steve more easily
07:13to provide him with additional medication.
07:16Er, Wayne, I think we might trickle some calcium in now, you know.
07:19It's a big area of crush.
07:22When your tissues are crushed, they can start breaking down
07:25and they release something called potassium.
07:27And potassium can actually be toxic to the heart.
07:30As we release the weight off of Stephen, there was a risk
07:33that that potassium could go flooding into his circulation
07:36and cause his heart to stop.
07:38Calcium is a medicine that we can administer
07:40to offset the effects of potassium.
07:43We've changed that plan now, so we're not going to push it towards you now.
07:45We're going to try and lift it off you.
07:47Yeah.
07:48All right.
07:49I'm suddenly feeling very hot. Is that the morphine?
07:52That's the medicine we've just given you, the calcium.
07:54Fire and Rescue have repositioned the airbags
07:57and are making a second attempt at lifting Steve free.
08:00Ah!
08:01Wait, it's coming in the back corner.
08:03It's really pushing into my chest now.
08:05Are you ready, Steve?
08:07It's anyway, guys.
08:09Fill those voids.
08:11It's coming up as well.
08:13Ah!
08:14You all right?
08:15Steve, is that new pain?
08:16It's pressing into my chest.
08:18Passing into my chest.
08:19OK, I'll do that.
08:21Ah!
08:22Ah!
08:23Ah!
08:24The airbags are moving the body of the tractor,
08:27but the wheel is still stuck on Steve's hand.
08:29Ah!
08:30Press!
08:31Ah!
08:32Pressing into me.
08:33Can we get the airbag under that wheel?
08:35Ah!
08:36It's moving down and tilting a little bit that way.
08:38I can a bit more feet.
08:39Yeah.
08:40It's not going anywhere quicker than that.
08:42We kind of need to speed it up, yeah.
08:44We're nearly there.
08:47I think we just need another inch.
08:49Yeah.
08:50And we'll get enough space to move, Steve.
08:52Go!
08:57That's good.
08:58Keep going.
08:59Keep chocking, guys.
09:00OK, we might have enough.
09:01Try moving that arm now.
09:03Yeah.
09:04Nearly.
09:05Keep going, guys.
09:06Keep lifting.
09:07Steve, put your right arm down, mate.
09:09Chock where we are and snatch grab out that side.
09:13Let me know when I can get him.
09:14Right, Steve.
09:15Steve.
09:16Look at me.
09:17Nice and slowly.
09:18Yeah.
09:19Don't rush this.
09:20Nice and slowly.
09:21Let's go.
09:22Give me your arm.
09:23Right.
09:24Push your legs.
09:25Push your legs.
09:26Push.
09:27Steve.
09:28What's up?
09:29Ah!
09:32That's it, Steve.
09:33Good lad.
09:34That's it, Steve.
09:36Good lad.
09:37That's it.
09:38That's it.
09:39Let's watch those wires.
09:40Are they free?
09:41It's me coming out first.
09:42Right, you out first, mate.
09:43Nice and steady.
09:44Nice and steady.
09:45With only a few inches of space, Wayne and the team are pulling Steve out from under the
09:50tractor's mudguard.
09:51Right, on the head then.
09:52You ready to move on slide?
09:53Yeah.
09:54Ready, sir.
09:55Slide.
09:56Well done, Steve.
09:57Monitoring.
09:58Less than two hours after making the 999 call, Steve is finally free from beneath the one
10:03and a half tonne tractor.
10:05Thank you very much, everybody.
10:06Anything around here?
10:07Yeah?
10:08Like that?
10:09No?
10:10Ah!
10:11Yeah, I know, mate.
10:12Ah!
10:13Nice and steady, mate, for monitoring.
10:15Steve, take a deep breath in, mate, if you can.
10:20Yes, you can.
10:21We've got that oxygen back on, guys.
10:23Obvious left side and rib fractures, mate.
10:25Yeah.
10:26Oh, glad to be away from that.
10:27You've got your step hands, mate.
10:28You're out now, Steve.
10:31I am.
10:32Thank you so much.
10:33Any pain up here, mate?
10:35Well, ah, ah, ah, ah, ah.
10:39Yeah, possible humorous, that.
10:41How's that pain now we've got you released, mate?
10:43It's a lot bigger.
10:44It's a lot better.
10:45It's better than having a tractor on you.
10:46So, at the minute, we've got left shoulder fracture, left mid-shaft humeral fracture.
10:51Yeah.
10:52Possible radial fracture.
10:53Yeah.
10:54And multiple anterior rib fractures on the left side.
10:56Yeah, we'll go with that.
10:57What we'll do is get you wrapped up nice and warm, Steve.
11:00And then we'll get you up to James Cook, OK?
11:02Three, two, one.
11:03Ah!
11:04There we go.
11:05You think I've broken some ribs?
11:07If you've not, I'll be surprised.
11:09But you've probably made a tough stuff if you made it this far, my friend.
11:14The local mountain rescue team have arrived to help carry Steve to the helicopter, whilst
11:18Dr Steve calls ahead to the hospital.
11:21Hello.
11:22I've got a trauma pre-alert for you.
11:24We're bringing you a 59-year-old male who's been trapped underneath a tractor for two hours.
11:30He looks reasonably well oxygenated.
11:32He's moving both sides of his chest, but we're suspecting some chest injuries.
11:36He's remained relatively stable throughout the period he's been with us and will probably
11:42be about 25 minutes from now to yourselves.
11:46Coming via air.
11:47Coming via air.
11:48Yep.
11:49He's been, in some respects, very lucky that it didn't impact right in the middle of his
11:56chest, just the side of him.
11:57He's been able to get his phone off for an hour, which, you know, you can't imagine how
12:00uncomfortable he must have been for that time.
12:02Managed to give him some pain relief, some drugs to stabilise him, fire service worked
12:06incredibly hard to get him out.
12:08Partners in mountain rescue have brought him up to the aircraft, so, yeah, we're in a
12:11good position to be able to take him to hospital now.
12:16Steve will be flown across the Dales to the major trauma centre at the James Cook Hospital
12:21in Middlesbrough.
12:24Where Stephen was trapped, no one was going to walk past and find him.
12:29He wasn't on a public footpath, and he was up on top of the moors.
12:33Had he not been able to get his mobile phone out of his pocket and call for help, he would
12:37have been there for hours and hours and possibly even succumb to his injuries.
12:44Steve.
12:46Yeah.
12:47You all right there, dude?
12:48Hello there.
12:49Right, we'll get you onto the A&E trolley and take you down to the emergency department
12:52and get you sorted out.
12:54I feel like royalty.
12:58Ready, steady, lift.
13:00Two and a half hours after making the 999 call that may have saved his life, Steve is
13:06stable and safely delivered to a waiting critical care team.
13:10Every year the Air Ambulance Paramedics have to undergo a physical competency assessment.
13:31And today Danny is giving Sam a refresher on the on-site gym equipment.
13:36Welcome to the Health and Wellbeing Suite.
13:38I don't go to the gym that much, as you can probably tell.
13:41This is me going to the gym.
13:43But the session will have to be cut short as a job is coming.
13:48Is he actually falling off the horse?
13:49Yeah.
13:50Broken ankle.
13:51Feel left, please.
13:52Feel left.
13:53Back to the right.
13:54Lifting.
13:559-9.
13:56Lifting.
13:57They're being scrambled to a farm 30 miles away near North Allerton, where their patient
14:06has a suspected broken ankle.
14:08Hey, this is from 9-9.
14:09We are airborne with a five-minute ATA.
14:13I believe the patient is down a track from the location.
14:18Roger.
14:20I'm going to an 18-year-old who's fallen off a horse, reported to be conscious but has a broken ankle with the bone sticking out.
14:27The crew's just got there and she's down a track, I believe, so they are requesting our help.
14:33Sometimes with fractures you can get impingement of the nerves and the blood vessels that supply the sort of the extremity.
14:39If you cut off the blood flow significantly or completely, and if it's left long enough like that, ultimately you can lose that limb if it's bad enough.
14:47That's the farm there.
14:49Yeah.
14:50But we'll see where they are.
14:51There are loads of horses around us.
14:52Pilot Owen is mindful that there could be loose horses near where he wants to land.
14:57There's the DCA, mate.
14:58It's in that field at the far back of that stable that's going east to west, mate.
15:02Right, the wind's brisk, but it's not too brisk, so this is closer than there.
15:05Go.
15:06And we're down.
15:07Can you clear about 12 o'clock, please?
15:09I did.
15:10Local paramedics have arrived ahead of them and are waiting to hand over.
15:16How are we doing?
15:17All right?
15:18Yeah, thank you.
15:19This is an 18-year-old Maddie.
15:20Hi, Maddie.
15:2145 minutes ago and the horse is trying to be falling off until the right start.
15:26It's got an obvious open fracture here.
15:28Mm-hm.
15:29Just an engine up at the moment.
15:30Just try and get out of line and just see what we can do.
15:32Student Maddie landed badly on her ankle after the horse she was riding reared up, throwing her off.
15:38Is it Maddie?
15:39Hello.
15:40Hi, I'm Sam.
15:41There's Dan over there as well.
15:42Can I just pop a little needle in this hand as well?
15:44Just so we've got two in there.
15:45Is that all right?
15:47Maddie was still laying on the floor.
15:48She was taking Entonox given by the crew just to try and help that pain.
15:51Although we couldn't quite see because the boot was still on.
15:54It was just too painful to take off at that point.
15:56We knew that Maddie was injured.
15:58Maddie works at the stables and rides these horses every day.
16:01This is Mum on the phone.
16:03Yeah.
16:04Hi, Mum on the phone.
16:05Mum's a doctor, which is why she's trying to go.
16:07All right, OK.
16:08Do you want me to speak to your Mum, Maddie?
16:10No, no.
16:11We're just going to get her some pain relief.
16:12So her ankle is an open fracture, essentially.
16:15So we're just going to give her some ketamine to be able to relocate it and pop it in a splint
16:19and go to James Cook.
16:20So with an open fracture, it creates more risk.
16:23You increase the infection risk because you've now got open tissue exposed to the environment.
16:27Not only that, though, you've got nerves which are impinged and blood vessels,
16:30which, you know, normally if it's a closed fracture, you can bleed into a solid compartment
16:36and the blood can't escape, particularly.
16:38With it being an open fracture, then the blood can just continue to bleed, essentially.
16:42So stopping the bleeding and making sure you relocate the fracture is really important.
16:48Maddie, my name is Danny, one of the paramedics for the Air Ambulance.
16:51Do you remember exactly what happened then?
16:53Talk us all the way through it, yeah?
16:54Yeah, the horse, he was jumping about.
16:56Yeah.
16:57And I sat quite a bit of it, to be fair.
16:58Okay.
16:59And then he just reared up and I tried to pump that.
17:01He just went round and then just came back on top of me.
17:04Did you...
17:05Consciousness, do you think, at all?
17:06No, no, no.
17:07I don't think I did.
17:08Have you got any pains anywhere else other than your ankle at the moment?
17:10My knee, but that's it.
17:11Your knee? On the same leg?
17:12Yeah.
17:13Okay.
17:14We need to have a really good look at that ankle and see what we're dealing with.
17:16But we'll make sure that you've got adequate pain relief before we do all that.
17:19Do you want to keep on going with that gas and air for the time being?
17:22Big breaths in and out for me.
17:25And out.
17:26That's it.
17:27Breathe in and out.
17:28You will feel a little bit lightheaded.
17:31Gas and air works fast, but it doesn't last long.
17:34It'll keep Maddie's pain under control until the team can give her something stronger.
17:39So, Maddie, the plan is we're going to give you some strong pain relief.
17:44You might feel a little bit funny with it.
17:46What tends to happen when we give this sort of pain relief is that you don't tend to remember
17:49anything that's happened, but it'll keep you nice and relaxed.
17:52If you see unicorns, then that's good.
17:54Right, just pop that arm nice and straight for you, Maddie.
17:57Sam's giving Maddie ketamine, the strongest drug they carry.
18:01How are we feeling, Maddie?
18:02I feel like it just really hurts.
18:04Yeah.
18:05You won't remember much about it shortly, Maddie, and you'll be completely pain-free.
18:09If you imagine a bone normally, it would be in natural alignment and everything's connected.
18:14If you've got a fracture, then the bone isn't connected, and it can sometimes be out of
18:18alignment at a funny angle, which was the case with Maddie.
18:21So, being able to relocate it or reduce it, as we call it, is essentially pulling the
18:25limb straight or moving it back into neutral alignment.
18:28So, you're getting that bone as straight as possible to how it normally would be without
18:32a fracture there.
18:33With the ketamine taking effect, Danny can now attempt to straighten Maddie's leg.
18:38She might scream and things like that, but she won't remember anything about it.
18:41It's just an aspect of the drug.
18:45You all right, Maddie?
18:47Yeah?
18:48Yeah.
18:49The sock's, like, stuck in the bone.
18:52Her broken bone is pierced through the skin of her ankle.
18:55Hold on, Maddie.
18:57And there's the bone.
18:58One.
18:59Yeah.
19:00I'm just going to pull it straight.
19:04All right, Maddie.
19:05I'm giving it some traction, but it doesn't seem to be putting back in.
19:10I think it's caught on the bottom of the skin.
19:11So, what we need to do is we need to bend a leg at the knee and then you need to put it
19:16back in there, because that will ease it with the muscle a little bit to be able to get it
19:19back into place.
19:20Bend it at the knee?
19:21Back into place.
19:22Sometimes reducing a fracture can be nice and easy, and if the patient's nice and relaxed
19:26and there isn't too much muscle tension, it can go back to where it needs to be quite
19:29quickly.
19:30With this case, obviously, we've given Maddie some analgesia in the form of ketamine.
19:35That can make everything a little bit tense.
19:37And often when the leg's straight, the muscles are quite tense and they're stretched.
19:40So, when you're trying to reduce an injury or relocate that fracture, there's not much
19:45stretch.
19:46One thing you can do is you can just bend the knee and that just helps relieve the muscles
19:49a little bit, loosen them, shorten them, giving you a little bit more room for movement
19:53to put the bone back where it needs to be.
19:55All right, Maddie.
19:56Let's see if we can get it back in.
19:57You can lift this leg up a little bit.
19:58Okay.
19:59Just bend your knee, Maddie.
20:00The aim now is to manipulate the two pieces of broken bone back into place.
20:04Do you want to go out and then back in?
20:06Do you want to go out?
20:07I'm ready.
20:08I'm ready.
20:09I'm ready.
20:10I'm ready.
20:11I'm ready.
20:12I'm ready.
20:13I'm ready.
20:14I'm ready.
20:15I'm ready.
20:16I'm ready.
20:17I'm ready.
20:18There we go.
20:19You want to do that?
20:20Yeah.
20:21The bones in Maddie's ankle are now back in alignment, but it's crucial they stay in place until
20:25she reaches hospital.
20:26Okay.
20:27If you keep pulling traction on that, then we can get this tight so it doesn't pop back.
20:33All right.
20:34All done, Maddie.
20:35It's back into where it needs to be, okay?
20:39Maddie, slow your breathing down.
20:43I'm just breathing down.
20:50Danny is removing air from inside the vacuum splint
20:53to create a mould around her leg.
20:59All right, Maddy. How's that pain doing now?
21:08It's all normal.
21:10Steady, roll.
21:13So, you need to let us know if you start to feel any different.
21:16All of the stuff that we've done, that's the bad stuff out of the way.
21:19Can you remember anything about us putting your leg into a splint?
21:24No.
21:25There we go.
21:28You were here before you put it into a splint?
21:31Yeah.
21:32Really?
21:33And you can't remember?
21:34No.
21:36Right, pop this back in your nose there a second.
21:38Have you been in a helicopter before?
21:40Yes, I have, actually.
21:42Oh, when?
21:43My rich friend took me on holiday with her.
21:45Your rich friend took you on holiday with her?
21:47Yeah.
21:48Italy to...
21:51I can't remember where we went.
21:52Why do you have to go spoil our fun like that?
21:54Because it's not the same in Yorkshire, is it?
21:56Italy's more exciting.
21:57I've never been in an air ambulance though.
21:59OK, well there we go.
22:00There we go.
22:01First for everything.
22:03Pop you in this, I promise it's not a body bag.
22:05Ah!
22:08Right then, we'll go and lift then.
22:09Ready?
22:10Lift.
22:12Going by helicopter to the nearest major trauma centre in Middlesbrough will take less than ten minutes.
22:17All right, Maddy, pop these on for you.
22:20Doug, pop your head down, you're all right.
22:22There we go.
22:24OK, lifting slowly because of the crosswind.
22:279-9 lifting, rooting to James Cook.
22:33No, no, Roger, thanks.
22:34Did Maddy say 64 kilos?
22:37Yeah, I think about 64.
22:39Oh, OK.
22:40She might have had a big breakfast then because of struggling to the climb here.
22:42Thought you were not.
22:45We're managing though, we're managing.
22:47I bet your Italian pilot wasn't that cheeky, was he?
22:50All right, official James Cook.
22:53Haven't I got visual security, mate?
22:569-9 finals for James Cook.
22:58Right now, Maddy?
22:59Yeah?
23:00The aircraft vibrated a little bit as we come to the harbour.
23:03It's just what helicopters do.
23:05It's not my fault, I promise.
23:06OK.
23:07It's not me being a rubbish pilot.
23:08Do we clap when you land?
23:10Well, the guy in the back normally do.
23:11I don't give too much of an ego.
23:12And then we all get the ick.
23:14You clap, we normally just take a sigh of relief.
23:19That's better there.
23:20We have the trees a bit smoother.
23:22Right.
23:24That wasn't bad.
23:25That was a good landing.
23:26I'll take that.
23:27All right, lovely jumping.
23:30Right, Maddy, we're going to move, OK.
23:31On slide, ready, steady, slide.
23:36Oops, sorry.
23:38Whilst Maddy will be taken for surgery,
23:40paramedic Sam will be enjoying a little light refreshment.
23:43Could I have a oat milk latte, please?
23:45With vanilla syrup?
23:47Thanks.
23:48At the headquarters in West Yorkshire, paramedics Mattie and Tom are preparing for the shift ahead.
24:04Is the blood on, please?
24:05It's a hot summer's day.
24:09And the pace is picking up on the air desk.
24:12Hello, Yorkshire rats.
24:14A call's come in about a motorbike accident on a remote track in the Yorkshire Walt.
24:18If it is as inaccessible as it sounds anyway, I'm hoping that we might be able to land rather closely and then get him in anyway.
24:26Cool.
24:27I will allocate them now.
24:28No worries.
24:29I'll see you.
24:30All clear there.
24:40Clear right, lifting.
24:44Pilot Owen is flying them 34 miles towards Driffield, in the east of the county.
24:49Ah, it's over 200 feet, all clear, I'll turn around as I go.
24:54If we do think about ketamine, say he's a 100 kilo patient, I'll just throw up 10 mils of ket.
25:04I mean, I don't even know what injuries he's got.
25:07Just that he's in pain, then he's big.
25:11On the way to this job, we had limited clinical information about what the presenting complaint was with his patient.
25:16We knew that they were a motorcyclist, that they'd been riding on green lanes and they'd had an accident.
25:21That's as much as we knew.
25:22Location-wise, it was quite rural, it was quite remote as well.
25:25So, it's a really good asset to have a helicopter to be able to help you manage these patients.
25:28It gets them quickly.
25:30Oh, it just feels like that main road, isn't it?
25:32Yeah.
25:33From the left to the road, right?
25:34Somewhere.
25:35Yeah, it just feels there.
25:36Well, sort of the left, if you know what I mean.
25:39There it is.
25:40No, that's over here.
25:41Okay, well, it looks it's a bit further down.
25:42So, where did you see the people down there?
25:44Yeah.
25:45So, at the end of the tree line.
25:46Yeah.
25:47It feels like this feels flatter than that one.
25:48Yeah, isn't it?
25:49There's fire as well.
25:50Fire service on scene.
25:51Okay.
25:52All right, I'm going to go tail left in a second, then go with the valley.
25:57Yeah, you're on clear left.
25:58It does drop away quite well, doesn't it?
26:02We're going to quite a few motorcycle accidents.
26:05They tend to be on the road, but people are off-roading as well.
26:08So, the injuries you get can be from minor injuries, minor noctal bruises to something that's really life-thecning as well.
26:13Getting a lot of grass all the way from the intake to under the land on.
26:15Hiya mate.
26:16Yeah, initially just a difficult extrication really, so we asked for fire to come and assist, but he's got bone crepitus on his right ribs.
26:35We think he's busted a few ribs on his right side.
26:37Okay.
26:38We think he's busted his clavicle, he's complaining of clavicle pain.
26:40We give him 20 morphine, a gram of IV paracetamol, and every time we try and move him or do anything, he's absolutely screaming in agony.
26:46Okay, no problem.
26:47What's his name?
26:48Big Mark.
26:49How are you doing?
26:50I'll just come in there just so I can get him.
26:51He's all right.
26:5255-year-old Mark Hunter was out with friends greenlading, or riding unsurfaced country roads, when he lost control of his motorbike.
27:00Hiya Mark.
27:01Hello mate.
27:02My name's Tom.
27:03I've got Matty here as well.
27:04Sounds like you're still in quite a lot of pain when they try and move you.
27:06Yeah.
27:07Are you comfy as best you can in that position as you are there?
27:10Yeah.
27:11Okay, so I think that's probably quite a go.
27:12We can just keep him there.
27:14So if you were to tell me where this pain is, and I even told that colleague, just remind me again where it is.
27:19Ribs and shoulder.
27:22Ribs and shoulder, all on your right hand side.
27:24Yeah.
27:25And what made you lose control of the bike?
27:28Just lost the front end.
27:31Okay, just lost the front end.
27:33He's come round this bend, and he's hit a rut.
27:37Just lost the front end, and it's obviously spat him off the bike.
27:40Me and Gaz have come, found him laid on the floor, tried to make him comfortable.
27:43Now obviously we're here just trying to sort him out.
27:46In terms of combating, I think keeping him left lateral is the right way to go.
27:50Because you've got him on it, and there's no point moving him.
27:52He's completely saturated.
27:54Have a listen to his chest, get him on nasal specs.
27:57Yeah, I'll get that.
27:58Is that all right?
27:59When we first arrived on scene, he obviously sustained a quite significant chest injury.
28:04He was quite agitated, a bit distressed, probably in quite a lot of pain as well.
28:08He was having some difficulty breathing.
28:10He's probably got a number of injuries, potentially broken ribs, and there may have been some internal bleeding as well.
28:15Mark, I know you've got this pain in your shoulder and your chest.
28:19We just want to make sure that there's no other injuries that have sort of become apparent since you've had that pain relief, all right?
28:25So we're going to try and move some of these clothes.
28:30So the sacks have come from 99 down to 93 with a good waveform.
28:36Mark, what we're going to do, we're going to get a few pairs of hands,
28:39and we're going to try and get you onto our stretcher, into the back of the aircraft, okay?
28:44It might be very uncomfortable when we try to do that, okay?
28:48And we're going to need a few hands just to try and position you.
28:51If at any point we think it's not safe, then we'll stop, and we'll get you into the ambulance.
28:56We're going to give you some stronger pain relief, and that might make you feel a little bit weird,
29:00but that's perfectly normal.
29:02But I'll explain everything to you before we give you that strong medicine.
29:05Does that sound okay?
29:07Yeah?
29:09Ketamine is a fast-acting pain relief.
29:11It's only used outside of hospitals in the most serious cases.
29:14We're quite fortunate that we get to carry ketamine, which is this really strong pain relief.
29:19The land amateurs don't carry that, so there is potential that some of our colleagues
29:22won't have seen us administer ketamine before.
29:25He may start acting a bit strange and a bit weird and might start shouting out.
29:29So things we can do to combat that is just have a nice and quiet environment.
29:33And what we'll do is we'll just have a chat before we give it to him,
29:35because I'll explain to him that he's probably going to start feeling really weird.
29:38But he won't remember anything that we're doing to him.
29:40The danger of giving a little bit of ketamine is that we might start vomiting
29:43and he might start having excessive saliva.
29:45So we're just going to go nice and steady.
29:48Guys, when we start giving him this medicine,
29:50I know it's quite tempting to look after your friends and want to help them,
29:53but all I'm going to ask is that everybody's really quiet,
29:56and we're just going to let Tom speak to him and nobody else.
29:59He might start shouting and stuff, but that's normal.
30:01He won't remember any of it.
30:02OK, so I know you're probably concerned,
30:05but I just need everybody to be really quiet, OK?
30:10Open your eyes. Hello, mate.
30:11So we're going to give you a medication,
30:12and then we're going to give you this strong pain relief, OK?
30:14It's really important that you just relax.
30:17Let's do what we need to.
30:19Try and go with the flow.
30:20Think happy thoughts when we give it to you, all right?
30:23Might make you feel a little bit weird, a bit spaced out, but that's OK,
30:25because that's actually what you want to be, OK?
30:27That's how it's going to work.
30:29All right.
30:32Nice, happy thoughts. You're doing really well.
30:41Well done, mate.
30:43You all right there?
30:44Yeah? Is that helping?
30:46Yeah? Good man.
30:49Take a breath.
30:51Think I feel all right? A bit better?
30:54With no adverse reaction to the Kettleman,
30:57the crew can now start to move Mark to the helicopter.
31:00Just as many hands as we can, then, please, guys.
31:02Grab the A2.
31:03If somebody can do the monitor as well, that would be really helpful.
31:09Is everybody ready?
31:10OK, you'll be on lift.
31:12Ready, set, lift.
31:15All right, Mark, here we go.
31:17Let's get you on.
31:18That's it. You're doing really well, Mark.
31:23We're halfway there.
31:25Watch your head.
31:26Watch your head, please.
31:29Get out.
31:33Mark, you all right?
31:34Open your eyes for me, fella.
31:35Good man.
31:36So we're going to fly you to Hull.
31:39Just because of the injury you've got to your chest.
31:42We're just going to get you hooked up to our machines
31:44and then I'll give you something for that pain.
31:49Good man, you're doing really well.
31:51Good man.
31:52OK, good.
31:53OK, clear.
31:54We're right.
31:55OK, good.
31:56Good.
32:01Coming to wind now.
32:02That's why I like it.
32:04I know I can't hear him, but he looks relatively comfortable
32:07compared to how he was on scene.
32:11They asked speed, but I wasn't sure on the...
32:13So I asked his mates and they said about 20 miles an hour.
32:16The flight time to Hull Royal Infirmary is 15 minutes.
32:20Without the air ambulance, Mark's journey would be over an hour.
32:24All right, that's us now on finals.
32:27Call on the visa call to LBP.
32:29Look at this.
32:30Now that's finals.
32:37This is a class two kind of clear area.
32:39OK.
32:40Yeah?
32:41Yeah.
32:42Fire with gentle for the guy in the back.
32:43Thanks, mate.
32:44Tom.
32:45Class back, Tom.
32:46Thank you, Owen.
32:47Yeah.
32:48Mark.
32:49Hello, mate.
32:50We're in the hospital now.
32:51So we're going to keep you on this stretcher
32:53and then we'll get you out the back of the helicopter.
33:04Can you bring this arm to hold onto your other one?
33:06Yeah.
33:07OK.
33:08Ready, set it, slide.
33:09Ah.
33:10Ah.
33:11Ah.
33:12Just a couple of bumps as we wheel you into the hospital, Mark.
33:16Mark will be taken to a waiting trauma team who will carry out scans to get a clearer picture
33:22of his injuries.
33:23It's been a busy shift and paramedic Chris and the team are giving the very muddy helicopter a deep clean.
33:41Leanne is on the air desk and has spotted a job.
33:48A 999 call has come in for a two-year-old who is struggling to breathe.
33:54Hello, job.
33:55Job.
33:56OK.
33:57Not great.
33:58Yes.
33:59She's scrambling Chris and paramedic James from the Topcliffe base, which is nearer to the patient.
34:05It's in this.
34:06It's asthmatic, unconscious, no degree then.
34:09The UK has one of the highest emergency admission and death rates for childhood asthma in Europe.
34:14Well, if the same departure as it has been every other time, it seems to be straight ahead.
34:18Helimed 99 will make the journey to rural Thirsk in just three minutes.
34:22Tells come round your way.
34:24Oh, that's nice.
34:25Everything else is looking good inside.
34:27It's a two-year-old.
34:29I'm not really too sure what's happening.
34:31The information we got from the air desk was quite limited.
34:34The only information we had was attending a two-year-old who had a history of asthma,
34:39who was having quite significant breathing difficulties and reported to have been unconscious at some point.
34:46Asthma is the most common long-term illness in children in the UK, affecting about one in eleven
34:52and claiming a life every four weeks.
34:55It's one of those houses on the road that matches the grid location.
35:00Hopefully there's a gate there as well.
35:02The little girl is on her family farm and the surrounding fields are proving difficult for pilot Harry to land in.
35:09I reckon you can go through a gap in the hedge just there opposite that grey gate.
35:13Yep.
35:14Happy with that?
35:15There's not a big ditch, but we'll soon cry about.
35:17Yep.
35:24Two-year-old Enola is being looked after by her mum and auntie.
35:28We'll go straight onto the ambulance.
35:29We'll have a look at her.
35:30Have a look at her.
35:32A land ambulance has also arrived, providing a space to examine her properly.
35:39I'm her auntie, but I'm a nurse.
35:40I'm the mum.
35:41Yeah, she's the mum.
35:43She began struggling to breathe as she sat down to eat with her family.
35:46But when I went in, I listened to her chest.
35:48She stopped by lack of a reason.
35:50Okay.
35:51Right.
35:52Her heart rate was about 200.
35:53So you'll sit on the end there because she'll be familiar with you so she can see you.
35:56Yeah.
35:57Hi, baby.
35:58What's her name?
35:59Enola.
36:00Enola.
36:01And what's her history?
36:02About four weeks ago, she had pneumonia.
36:05Okay.
36:06She started on a salviet mal inhaler.
36:08Yep.
36:09She was out playing all day with us.
36:10Yep.
36:11And about 20 minutes ago, she just went downhill, didn't she?
36:14The young girl's aunt, who said she was a nurse, had explained to us that she had quite
36:19a noticeable wheezing coming from both sides of her chest.
36:23That's an indication that there is an acute problem relating to the asthma and the wheezing
36:28is caused by the small air tubes in the lungs going into spasm and making it difficult
36:33to breathe.
36:34And she also said that she had a heart rate of 200, which was quite significant.
36:38A child of that age, you would expect the heart rate to range between around 90 and 110.
36:43Any cyanosis or...?
36:44Yeah, I could see her jugular.
36:45Okay.
36:46All right.
36:47I could see her jugular going.
36:48Okay.
36:49Can I have another listen at your chest, do you think?
36:50Is that all right?
36:51Yeah.
36:52Yeah.
36:53You're all very good, aren't you?
36:54This might be a little bit cold.
36:55So I apologise.
36:56I did do her sats earlier, they were 87 at one point.
37:01Okay.
37:02But after the inhaler, we got them up to 95.
37:05So, any recession or anything like that when she was breathing?
37:08She had a lot of recession.
37:09Okay, all right.
37:10And she was losing confidence.
37:11Yeah.
37:12I think that's why you got here with the air ambulance.
37:14Yeah.
37:15The chest recession potentially indicates, particularly children, are in some sort of respiratory distress.
37:21When the child's breathing in, it looks almost as though the chest is moving in an opposite
37:25direction to how it should be.
37:27There's an increased effort to try and get as much air in as possible.
37:30Good little girl, aren't you?
37:32Oh, you know what's going on, don't you?
37:34Good girl.
37:35And you say, this colour's not normal for her.
37:37No, she doesn't.
37:38Yeah.
37:39Yeah.
37:40Mottled skin, when accompanied with breathing difficulties, can be the sign of an asthma attack
37:44or chest infection.
37:46You want to sit up a little bit more, because that doesn't look comfortable.
37:48And that's it.
37:49Good girl.
37:50Right.
37:51We'll see what your oxygen levels are and just see if we need to do anything else
37:54with regard to giving her a bit more salbutamol.
37:56Yeah.
37:57Salbutamol is a medication that relaxes the muscles of the airways, making it easier
38:02to breathe.
38:03She's actually getting more mottled.
38:05Yeah, I was going to say, it is still bobbing along that heart rate.
38:08It's probably still accurate.
38:09Yeah.
38:10So, strip up to hospital.
38:11Yeah.
38:12Mmm.
38:13The cause of Enola's breathing difficulties is still unclear, so she'll need to go to
38:18hospital for further assessment.
38:21Enola's dad, Brian, has rushed back to the farm from work.
38:24She's got quite a high temperature, so I think probably some infection of some sort is going
38:29on somewhere.
38:30So, she's going to be going in the ambulance, up to James Cook.
38:34You're such a clever darling Enola.
38:36Have you got everything you need to go?
38:38Yeah, Brian's.
38:39Yeah, Brian's packed your bag.
38:40Yeah?
38:41Okay.
38:42But they don't quite have everything they need for the trip to hospital.
38:45Dolly.
38:46She needs Dolly.
38:47Oh, look who's this.
38:48Wee!
38:49Wee!
38:50Are you going to have a little trip up to hospital then with Mummy?
38:53Go see the doctors.
38:54Again.
38:55Again.
38:56Are they on first name terms these last few weeks?
38:58Pretty nice.
38:59Super.
39:00Ed F99.
39:01Go ahead.
39:02Yeah, that's just clear.
39:03Patient stable.
39:04Going with the DCA crew there to James Cook.
39:08Enola is being taken to the paediatric unit at James Cook Hospital in Middlesbrough.
39:14The cause of her condition is still unknown.
39:1655-year-old Mark Hunter spent 10 days in hospital after coming off his motorbike whilst greenlaning.
39:27All right, Mark. Here we go. Let's get you on.
39:30He suffered seven broken ribs, a broken collarbone, and punctured his lung.
39:35After several months recovery, he got back on his bike and recently enjoyed a biking holiday through France.
39:41The cause of two-year-old Enola's breathing difficulties is still being investigated.
39:49But doctors believe it could be related to her previous chest infection.
39:53Can I have another listen at your chest, do you think? Is that all right?
39:56She stayed in hospital for one night, happily accompanied by her beloved Dolly.
40:02Is it Maddy?
40:05Hello.
40:06Oh, I'm Sam.
40:0719-year-old Maddy needed surgery on her broken ankle after coming off Rebel, the horse she was riding.
40:13The morning of the accident, it was just a typical kind of day.
40:17I was mucking out the horses. I'd ridden another two.
40:20Then I'd got onto Rebel, the horse that I had the accident on.
40:23So he was my third ride of the day and my last.
40:27How's that pain doing now?
40:28When it first happened, I think it was more shock.
40:31I couldn't process anything. I just remember looking at my ankle and being like, God, this doesn't look right.
40:37Maddy's been riding since she was two years old, but it will be some time before she can get back on the horse.
40:43I'm a very active person. I'm constantly out riding and seeing my sisters kind of hack out on the horses, especially my horse.
40:51It's been quite difficult, but I think once the pain got better, I felt a lot better about getting more active and getting out in the sun and trying to make the most of the situation that I'm in at the moment.
41:03Because as soon as the cage is off, I'm getting on a horse.
41:06I mean, I don't want to put myself at risk, but I'm definitely going to do it the first opportunity I get because I miss it so much.
41:13Hello. We're coming to help. You okay, buddy?
41:23Steve Rathbone was in hospital for 12 days after being trapped by his overturned tractor for two and a half hours.
41:30Suddenly I find I'm moving backwards. I'm moving faster and faster down the hill and I come bouncing to a stop.
41:38And suddenly I realise here I am with this tractor on me.
41:41I had a phone, but I couldn't get to it. And then, of course, my heart slightly sank at that point, thinking, well, I'm really quite reliant on somebody seeing me or missing me.
41:51And I knew that it was very unlikely they were going to miss me in the time that was probably going to be available to me as this weight was squashing down on my chest and my arm.
42:00So it was quite an alarming scenario to be in, obviously.
42:03Can you feel me touching your hand?
42:05The amazing thing was after about an hour of just sitting there trying to process what I was going to do, how I was going to get out of it,
42:11I suddenly realised I had movement within the lower part of my body.
42:15But it gave me, I felt, a few centimetres of wiggle room to be able to get my hand right round and under, to pull the phone out very slowly, which I did.
42:25And I finally was able to get to 999.
42:29And that moment, of course, there's a great relief that now, actually, I don't have to contemplate dying on the hill, which is what I've been doing up until that point.
42:39Steve broke eight ribs, his shoulder and sternum, and suffered a punctured lung.
42:45There were a lot of people that came out that day to save my life.
42:49Slide, well done, Steve.
42:50Right, do you monitor it?
42:52I was just so impressed that everybody had been able to get there relatively quickly to this obscure part of the Yorkshire Dales.
42:58And then to work together with military precision to get me out of that pickle that I got into with my old classic tractor,
43:04I shall always be so grateful to everybody.
43:07Since this happened, I've not been anywhere near tractors.
43:11The tractor involved, a dear old Massey Ferguson 35, is in a barn currently being repaired.
43:17As much as I'm fond of it, I think it's going to be up for sale because it's actually in remarkable condition.
43:22It took a few dints, but actually I think it came out of it better than I did.
43:45Transcription by CastingWords
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