- 3 hours ago
Yorkshire Air 999 - Season 3 Episode 1 -
Tractor Trauma
Tractor Trauma
Category
😹
FunTranscript
00:00Yorkshire. Breathtaking, but unforgiving. And when the landscape turns
00:10dangerous... Patients still breathing but doesn't sound good on the phone, mate.
00:14...and lives hang in the balance, the crews of the air ambulance are often the
00:20first and only lifeline. Hello, we're coming to help. You okay, buddy? Delays in getting
00:26your patient to hospital can literally be the difference between life and death.
00:30If he's injured his brain, let's try and get a little drip in your arm, Pian, alright?
00:33Can you remember anything about us putting your leg into us then?
00:36No. The jobs that we're going through can be quite catastrophic. If we weren't there,
00:43then the situation could be much worse. Bringing critical care by air.
00:47That's it. Good lad. Good lad.
00:49You're not allergic to anything. Hey.
00:52This is Yorkshire Air 999.
01:01At the air ambulance headquarters near Wakefield, paramedic Matty is on the air desk listening
01:06in to a 999 call. I've turned my tractor over and I'm underneath it.
01:12And have you lost any blood? I can't see because my arm is under the wheel.
01:18A tractor is overturned and the patient's underneath it. Very good to my friend.
01:23Lay burnt. He's trapped by his shoulder, apparently really short of breath.
01:27Paramedic 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.
01:46988, receive him. Yeah, so it's a 59-year-old male who's reported to be trapped underneath an overturned tractor.
01:54He's reported to be short of breath, but he's definitely trapped by his shoulder.
01:59And arm over.
02:00988, roger that. Do we have fire on him to this?
02:04Yes, we'll get fire and rescue to go, but 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. Over.
02:17When we have patients that are trapped or pinned, a heavy weight on the tissue can cause parts of the tissue to die,
02:23which releases toxins into the bloodstream. So the longer someone's pinned, the more worried we are.
02:28I'll just try it. Clear down your side here. Good on my side, yeah, out there.
02:34Stephen Wayne will be the first on scene to reach the man, who's at the top of an isolated valley
02:40over half a mile down a rough track. He's been alone and pinned beneath the tractor by his arm
02:45for over 90 minutes. We've landed about 50 yards away, Matty, and I'm just making my way to scene now.
02:52Yeah, roger, Steve. Patient's still breathing, but doesn't sound good on the phone, mate.
02:56Yeah, it's getting carbon monoxide poisoning. The tractor's engine is still running,
03:02and its fumes may be poisoning the patient with carbon monoxide. Hello. We're coming to help you,
03:08okay, buddy? How do we turn this off? Dead man's switch.
03:14Dead man's switch. Okay, though. Yeah. Yeah, that's it. Pull it. Don't go up to that.
03:19What's your name, mate? Stephen. Hi, I'm Wayne. I'm ready to take...
03:24What happened? I had to change the gear. Okay.
03:26And, of course, the tractor's rolled back. Okay. That's it.
03:2959-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. Yeah, I can see that here, mate.
03:42Have you got any pain anywhere else? I'm opening my shoulder blades bugged up.
03:45Okay. I'm going to try and get in, mate, and give you an assessment. Is that all right?
03:48Yeah. Don't try to get this thing out of it. Yeah, we've got the fire brigade coming, mate,
03:52all right? Yes, arm, shoulder, hand, mate, on this leather.
03:56It's trapped under the wheel. Yeah. And it hurts.
04:00I bet it does, buddy. There's lots of folk coming to help you. Okay, Steve.
04:05So, lots of combustible stuff around, petrol and whatever. Diesel, sorry.
04:09Diesel. Is everything out? There's oil and all sorts. So, just think about oxygen use. Just something to be
04:15aware of. There is a fire risk. Alex, would you be able to get a fire extinguisher from the aircraft?
04:20Have it nearby. Can 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. It looks like an isolated, obviously,
04:33pinned shoulder, left arm, hand, possible neurovascular compromise on the hand here.
04:39We're going to get a drip in and give you some painkillers. Okay.
04:41Steve's hand is trapped under the wheel and is losing blood flow and nerve function.
04:47Thank the Lord you're here. So, this is going to be a bit tight,
04:50we'll have a look to get a load. Yeah. You know what? What's that?
04:53My phone. I borrowed that. Was in the pocket under the wheel. Oh, crikey.
04:57And I thought, this is it, I'm done for. A fire and rescue crew member has come ahead
05:02to assess how they can free Steve. Yeah. Legs are free, pelvis is free, chest is free,
05:07just the arm. You just see the knuckles out that side. Best form of attack I think we need to do is
05:13lift it all up from this side. It's going to be a delay getting the gear up here though.
05:16Yeah. So, we're going to give you some medication, Steve. Yeah.
05:20One of them is going to keep some clots formed in your body in case you're bleeding anywhere,
05:24and we'll just start you on some paracetamol, and then we can top you up with a bit of morphine.
05:28Steve's accident has happened at the top of a steep and remote valley. A local farmer is
05:34helping to carry the rescue equipment up to them. I think the bucket is currently supporting it where
05:40it is. If we take the bucket off, it's going to drop onto it further. If we get something under here,
05:44lift the bucket, chop the wheel as it comes up, we might just create enough wiggle to get out.
05:50Fire and rescue will be using high pressure airbags, which, when filled with air,
05:55can lift up to 60 tonnes. Steve, we're all around you planning out to get you out. Okay, buddy?
06:00All right. Mark, just put them in the centre. Yep, super. Cheers, Mark. Cheers, Al.
06:09How are you feeling, Steve? I'm feeling very tired. Yeah.
06:13He's tired. And with the adrenaline dropping off,
06:15as you know, help's coming. Yeah, yeah.
06:19Steve did start to say he felt quite tired. We see this sometimes. It's a phenomenon that's been
06:24described as peri-rescue collapse. When 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 had been holding his own for some
06:33significant time. But 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.
06:46Okay, Steve, we're going to start moving now. Okay, buddy?
06:48First, first, first, first, first, first, first, first. Right, knock all that off. Knock it all off.
06:57As the tractor is tilting, its mudguard is pushing into Steve's chest, so they need to stop.
07:03All it did was swing it that way. It was shifting, yeah, I did spot that.
07:07It's relieving me that it's pushing... On your chest.
07:11However, they can now access Steve more easily to provide him with additional medication.
07:16Wayne, 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 and they release something called
07:27potassium, and potassium can actually be toxic to the heart. As we release the weight off of
07:31Stephen, there was a risk that that potassium could go flooding into his circulation and cause
07:37his heart to stop. Calcium is a medicine that we can administer to offset the effects of potassium.
07:43We've changed that plan now, so we're not going to push it towards you now. We're going to try and
07:46lift it off you. Yeah. All right.
07:49And suddenly feeling very hot. Is that the morphine? That's the medicine we've just given you the calcium.
07:54Fire and rescue have repositioned the airbags and are making a second attempt at lifting Steve free.
08:00Ah!
08:01Wait, it's from the back corner. Yeah, this needs chocolate.
08:03Really pushing against my chest now. Are you ready, Steve?
08:08It's anywhere, guys. Fill those voids.
08:11It's coming up as well. Ah!
08:13Is it all right? Steve, is that a new pain?
08:15I don't know. It's pressing intellectuals.
08:18It's pressing intellectuals.
08:20OK, I'll do that.
08:21Ah!
08:22Ah!
08:23Ah!
08:24The airbags are moving the body of the tractor, but the wheel is still stuck on Steve's hand.
08:33Can we get an airbag under that wheel?
08:35It's moving down and tilting a little bit that way.
08:38I'm getting a bit more feet.
08:39Yeah.
08:40Because it's not going anywhere quicker than there.
08:42We kind of need to speed it up, yeah.
08:46We're nearly there. I think we just need another inch.
08:49Yeah.
08:49And we'll get enough space to move, Steve.
08:52A bit further.
08:52Right, let's go.
08:56That's good.
08:57Keep going.
08:58Keep chocking, guys.
08:59That's it.
09:00OK, we might have enough.
09:00Try moving that arm now.
09:02Keep going, guys. Keep lifting.
09:06Steve, put your right arm down, mate.
09:09Chock where we are and snatch grab out that side.
09:12Let me know when I can get him.
09:14Right, Steve.
09:15Steve.
09:15Look at me.
09:16Nice and slowly.
09:19Don't rush this.
09:19Nice and slowly.
09:20Let's go.
09:21Give me your arm.
09:21Right, push your legs.
09:23Push your legs.
09:24Push.
09:24Steve.
09:25Get down.
09:26What's up?
09:26That orange thing there.
09:31That's it, Steve.
09:32Good lad.
09:33How about the noise?
09:35That's it.
09:36Good lad.
09:36Right, that's it.
09:39Just watch those wires.
09:40Are they free?
09:41It's me coming out first.
09:42Right, you out first, mate.
09:43Nice and steady.
09:44With only a few inches of space,
09:46Wayne and the team are pulling Steve out
09:49from under the tractor's mudguard.
09:51Right, on the head then.
09:52Ready to move on slide?
09:53Ready, sir.
09:54Slide.
09:54Well done, Steve.
09:55Right.
09:56Monitoring.
09:56Monitoring.
09:57Less than two hours after making the 999 call,
10:01Steve is finally free from beneath the one and a half tonne tractor.
10:05Thank you very much, everybody.
10:06Any pain around here?
10:08Yeah?
10:08Like that.
10:09No?
10:10Ah!
10:11Yeah, I know, mate.
10:12Ah!
10:13Nice and steady, mate, for monitoring.
10:17Steve, take a deep breath in, mate.
10:20If this you can.
10:21We've got the oxygen back on, guys.
10:23Obvious left-sided rib fractures, mate.
10:25Yeah.
10:26Ah, glad to be away from that.
10:27You've got your step-hands, mate.
10:30You're out now, Steve.
10:31I am.
10:32Thank you so much.
10:34Any pain up here, mate?
10:35Well, ah, ah, ah, ah, ah, ah.
10:39Yeah, possible humerus, 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,
10:49left mid-shaft humeral fracture.
10:51Yeah.
10:51Possible radial fracture.
10:52Yeah.
10:53And multiple anterior rib fractures on the left side.
10:55Yeah, we'll go with that.
10:57What we'll do is get you wrapped up nice and warm, Steve,
10:59and then we'll get you up to James Cook, OK?
11:01Oh!
11:02Three, two, one.
11:03Ah!
11:03There we go.
11:04All right, all right.
11:05Do you think I've broken some ribs?
11:06If you've not, I'll be surprised, but you've probably made a tough stuff
11:11if you made it this far, my friend.
11:13The local mountain rescue team have arrived to help carry Steve to the helicopter,
11:18whilst Dr Steve calls ahead to the hospital.
11:21Hello, I've got a trauma pre-alert for you.
11:23We're bringing you a 59-year-old male who's been trapped underneath a tractor for two hours.
11:29He looks reasonably well-oxygenated.
11:31He's moving both sides of his chest, but we're suspecting some chest injuries.
11:38He's remained relatively stable throughout the period he's been with us,
11:41and will probably be about 25 minutes from now to yourselves.
11:47Coming via air, yep.
11:48He's been, in some respects, very lucky that it didn't impact right in the middle of his chest,
11:56just the side of him.
11:57He's been able to get his phone off for an hour, which, you know,
11:59you can't imagine how uncomfortable he must have been for that time.
12:02Managed to give him some pain relief, some drugs to stabilise him.
12:05Fire service worked incredibly hard to get him out.
12:07Partners in mountain rescue have brought him up to the aircraft,
12:10so, yeah, we're in a good position to be able to take him to hospital now.
12:13Steve will be flown across the Dales to the major trauma centre
12:20at the James Cook Hospital in Middlesbrough.
12:24Where Stephen was trapped, no-one was going to walk past and find him.
12:28He 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,
12:37he would have been there for hours and hours and possibly even succumb to his injuries.
12:41Steve?
12:46Yeah?
12:46You all right there, dude? Hello 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.
12:55I feel like royalty.
12:58Ready, steady, lift.
13:01Two and a half hours after making the 999 call that may have saved his life,
13:05Steve is stable and safely delivered to a waiting critical care team.
13:11Every year, the air ambulance paramedics have to undergo a physical competency assessment.
13:30And 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.
13:42But the session will have to be cut short as a job is coming.
13:48Have they actually fallen off the horse?
13:50Yeah, broken ankle.
13:54Feel left, please. Feel left.
13:55Right, right, lifting.
13:57999, lifting.
14:01They're being scrambled to a farm 13 miles away near North Allerton,
14:05where their patient has a suspected broken ankle.
14:08Hey, this is 999.
14:09We are airborne with a five-minute ATA.
14:13I believe the patient is down a track from the location.
14:18Roger. Thank you.
14:19We're going to an 18-year-old who's fallen off a horse.
14:23Reported 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,
14:29so they are requesting our help.
14:33Sometimes with fractures, you can get impingement of the nerves
14:35and the blood vessels that supply the sort of the extremity.
14:39If you cut off the blood flow significantly or completely,
14:42and if it's left long enough like that,
14:44ultimately, you can lose that limb if it's bad enough.
14:47That's the farm there.
14:48Yeah.
14:49But we'll see where they are.
14:50We'll have loads of horses around us.
14:52Pilot Owen is mindful that there could be loose horses near where he wants to land.
14:57Right, there'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,
15:03so this is a closer than their goal.
15:05And we're down.
15:07Can you clear about 12 o'clock, please?
15:08There we go.
15:09Five, six.
15:12Local paramedics have arrived ahead of them and are waiting to hand over.
15:16How are we doing?
15:17All right.
15:18Yeah.
15:18This is an 18-year-old maddie.
15:20Hi, buddy.
15:2145 minutes ago, the horse is practically falling off until a nice start.
15:26It's got quite an obvious open fracture here.
15:27Mm-hmm.
15:28I've shown Entonox at the moment to try and get a little line and just see what we can do.
15:32Student Maddie landed badly on her ankle after the horse she was riding reared up,
15:37throwing her off.
15:38Is it Maddie?
15:39Hello.
15:40Hey, I'm Sam.
15:40There's Dan over there as well.
15:42Can I just pop a little needle in this hand as well, just so we've got two in there.
15:45Is that all right?
15:46Maddie 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, it was just too painful
15:54to take off at that point.
15:55We knew that Maddie was injured.
15:58Maddie works at the stables and rides these horses every day.
16:01This is mum on the phone.
16:03Hi, mum on the phone.
16:05Mum's a doctor, which is why she's trying to go.
16:07All right, okay.
16:08Do you want me to speak to your mum, Maddie?
16:10No, no.
16:10We're just going to get some pain relief.
16:11So 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 and go to James Cook.
16:20So with an open fracture, it creates more risk.
16:22You 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 normally if it's a closed fracture, you can bleed into a solid compartment
16:35and the blood can't escape particularly.
16:37With 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 parameters for the air ambulance.
16:50Yeah.
16:51Do you remember exactly what happened then?
16:52Talk us all the way through it, yeah?
16:54Yeah, the horse.
16:54He was jumping about and I sat quite a bit of it to be fair.
16:57Okay.
16:58And then he just reared up and I tried to pump that.
17:00He just went round and then just came back on top of me.
17:04Did you... Consciousness, do you think at all?
17:05No, no, no.
17:06I don't think I did.
17:07Have you got any pains anywhere else other than your ankle at the moment?
17:10My knee, but that's it.
17:11On the same leg?
17:12Yeah.
17:13Okay, we 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, breathe 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.
17:38It's all right, so you know it's okay.
17:40So, Maddie, the plan is we're going to give you some strong pain relief.
17:44You might feel a little bit funny with it.
17:45What tends to happen when we give this sort of pain relief is it
17:48you don't tend to remember anything 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 ketten, the strongest drug they carry.
18:01How are we feeling, Maddie?
18:02I feel like it just really hurts.
18:04Yeah.
18:04You 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.
18:13If you've got a fracture, then the bone isn't connected and it can sometimes be out of alignment
18:18at 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 limb straight
18:25or moving it back into neutral alignment.
18:27So you're getting that bone as straight as possible to how it normally would be without a fracture there.
18:32With the ketamine taking effect, Danny can now attempt to straighten Maddie's leg.
18:37She might scream and things like that, but she won't remember anything about it.
18:40It's just an aspect of the drug.
18:45Are you all right, Maddie?
18:47Yeah?
18:48Yeah.
18:48It sucks like stuck in the mouth.
18:51Her broken bone is pierced through the skin of her ankle.
18:56Hold on, Maddie.
18:57And there's the bone.
19:02Yeah, I'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.
19:09I 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.
19:15And then you need to put it back in there, because that will ease it with the muscle a little bit
19:18to be able to get it back into place.
19:20Bend it at the knee.
19:20Back into place.
19:21Sometimes reducing a fracture can be nice and easy.
19:24And if the patient's nice and relaxed and there isn't too much muscle tension,
19:27it can go back to where it needs to be quite quickly.
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.
19:36And 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,
19:44there's not much stretch.
19:45One thing you can do is you can just bend the knee,
19:47and that just helps relieve the muscles a little bit.
19:49Loosen 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.
19:55Let's see if we can get it back in.
19:56You can lift this leg up a little bit.
19:58OK. Just 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?
20:17There we go.
20:20The bones in Maddie's ankle are now back in alignment,
20:23but it's crucial they stay in place until she reaches hospital.
20:26OK, if you keep pulling traction on that, then we can get this tight so it doesn't pop back.
20:35All done, Maddie.
20:37It's back into where it needs to be, OK?
20:39Yeah.
20:39Come on, Maddie.
20:41Maddie, slow your breathing down.
20:43All right.
20:45Just keep steadying that breathing.
20:50Danny is removing air from inside the vacuum splint to create a mould around her leg.
20:58All right, Maddie.
20:59How's that pain doing now?
21:01It's an attachment.
21:02It's cool.
21:03I'm like, I'm just, I'm just so confused.
21:06Yeah.
21:06I don't know what this happens.
21:08It's all normal.
21:09Ready, steady, roll.
21:10So, 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.
21:18All right.
21:19Can you remember anything about us putting your leg into a splint?
21:22No.
21:23No?
21:24No?
21:25There we go then.
21:26So, you're going to put your leg pressure and stuff back on and I'll just put the air in.
21:28You were here before you put your leg into a splint?
21:31Yeah.
21:31Really?
21:32And you can't remember?
21:33No.
21:35Right, pop this back in your nose there a second.
21:38You've been in a helicopter before?
21:40Yes, I have, actually.
21:41Have you?
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.
21:47Italy to, um, I can't remember where we went.
21:52Why do you have to go spoil our fun like that?
21:53Because 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, there we go.
22:01First for everything.
22:03Pop you in this, I promise it's not a body bag.
22:08Right, then we'll go and lift, then.
22:11Going by helicopter to the nearest major trauma centre in Middlesbrough
22:15will take less than ten minutes.
22:18All right, Maddy, pop these on for you.
22:20Oh, pop your head down, you're all right.
22:22There we go.
22:23OK, 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.
22:38Oh, OK, she might have had a big breakfast then
22:41because we're struggling to the climb here.
22:42Thought you'd are.
22:45We're managing, though, we're managing.
22:46I bet your Italian pilot wasn't that cheeky, was he?
22:50All right, official James Cook.
22:53I think I've got visual security, mate.
22:559-9 finals for James Cook.
22:58Right, now, Maddy,
22:59the aircraft vibrates a little bit as we come to the hover.
23:03It's just what helicopters do.
23:04It's not my fault, I promise.
23:05OK.
23:06Yeah, it's not me being a rubbish pilot.
23:08Do we clap when you land?
23:09Well, the guy in the back normally do.
23:10Don't give too much of an ego.
23:11And then we all get the ache.
23:14You clap, we normally just take a sigh of relief.
23:19That's better there.
23:20Behind the trees, a bit smoother.
23:23That wasn't bad.
23:24That was a good landing.
23:25Yeah.
23:26I'll take that.
23:27All right, lovely jumping.
23:29Right, Maddy, we're going to move.
23:30OK, on slide, ready, steady, slide.
23:36Oops, sorry.
23:37Whilst Maddy will be taken for surgery,
23:40paramedic Sam will be enjoying a little light refreshment.
23:43Could I have an oat milk latte, please?
23:45With vanilla syrup?
23:47Thanks.
23:58At the headquarters in West Yorkshire,
24:00paramedics Mattie and Tom are preparing for the shift ahead.
24:04Is the blood on, please?
24:07It's a hot summer's day.
24:10And the pace is picking up on the air desk.
24:14A call's come in about a motorbike accident
24:16on a remote track in the Yorkshire Walt.
24:19If it is as inaccessible as it sounds anyway,
24:21I'm hoping that we might be able to land relatively closely
24:24and then get him in anyway.
24:26Cool.
24:27I will look at them now.
24:28No worries, I'll see you.
24:30All clear there, clear right, lifting.
24:44Pilot Owen is flying them 34 miles towards Driftfield,
24:47in the east of the county.
24:49Oh, it's over 200 feet.
24:50Okay, I'll turn right as I go.
24:54If we do think about ketamine,
24:58say he's a 100 kilo patient,
25:00I'll just throw up 10 mils of ket.
25:03Okay.
25:03I mean, I don't even know what injuries he's got.
25:06Just that he's in pain and he's big.
25:08On the way to this job, we had limited clinking information about what the presenting complaint
25:15was with his patient.
25:16We knew that they were a motorcyclist, that they'd been riding on green lanes and they'd
25:19had an accident.
25:20That's as much as we knew.
25:22Location-wise, 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.
25:29Oh, it's just through the side of that main road, isn't it?
25:32From the left of the road, right?
25:34Somewhere.
25:34Yeah, just beyond there, I'm also the left of that way.
25:38There it is, no, I don't know.
25:40Okay, well, it looks it's a bit further down.
25:42So where did he see?
25:43There were people down there.
25:44Yeah, so at the end of the tree line.
25:46Yeah.
25:46It looks like this feels flatter than that one beyond.
25:48Yeah, isn't it?
25:49There's fire as well.
25:50Fire service on scene.
25:51Okay.
25:52All right, so I'm going to go tail left in a second and go with the valley.
25:57Yeah, you're all clear left.
25:59It does drop away quite really, doesn't it?
26:03We're going to quite a few motorcycle accidents.
26:05They tend to be on the road, but people are off-roading as well.
26:07So the injuries you get can be from minor injuries, minor noctual bruises,
26:11to something that's really life-thetting as well.
26:13Okay, I'm going to grab a little away from the intake till I'm going to land on.
26:27Hiya, mate.
26:28Yeah, initially just a difficult extrication really, so we have some fire to come and assist,
26:32but he's got a bone of crepitus on his right ribs.
26:35We think he's bust a few ribs on his right side.
26:37Okay.
26:37We think he's bust his clavicle.
26:38He'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,
26:44he's absolutely screaming in agony.
26:46Okay, no problem. What's his name?
26:48Big Mac.
26:48How are you doing? I'll just come in there just so I can get him to see if he's all right.
26:5255-year-old Mark Hunter was out with friends greenlading, or riding unsurfaced country roads,
26:58when he lost control of his motorbike.
27:00Hiya, Mark. Hello, mate. My name's Tom. I've got Matty here as well.
27:03Sounds like you're still in quite a lot of pain when they try and move you.
27:06Yeah.
27:06Are you comfy as best you can in that position as you are there?
27:09Yeah.
27:10Okay, so I think that's probably quite a go. We can just keep him there.
27:13So if you were to tell me where this pain is, I know you've told that colleague,
27:16just remind me again where it is.
27:22Ribs and shoulder, all on your right hand side.
27:24And what made you lose control of the bike?
27:31Okay, just lost the front end.
27:33He's come around this bend and he's hit a rut, just lost the front end,
27:38and it's obviously spat him off the bike.
27:40Me and Gaz have come, found him laid on the floor,
27:42tried to make him comfortable.
27:43Now, obviously, we're here just trying to sort him out.
27:46In terms of conveying, I think keeping him
27:48left lateral is the right way to go.
27:50Yeah, because you've got him on it and there's no point moving him.
27:52He's sitting pretty saturating.
27:54Have a listen to his chest, get him on the nasal specs.
27:59When we first arrived on scene, he obviously sustained
28:02a quite significant chest injury.
28:04He was quite agitated, a bit distressed,
28:06probably in quite a lot of pain as well.
28:08He was having some difficulty breathing.
28:09He's probably got a number of injuries, potentially broken ribs,
28:12and there may have been some internal bleeding as well.
28:16Mark, 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
28:21that have sort of become apparent
28:23since you've had that pain relief, all right?
28:24So we're going to try and move some of these clothes.
28:30So the sats 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
28:41into the back of the aircraft, OK?
28:44It might be very uncomfortable when we try to do that, OK?
28:47And we're going to need a few hands just to try and position you.
28:50If at any point we think it's not safe, then we'll stop
28:54and we'll get you into the ambulance.
28:55We're going to give you some stronger pain relief
28:58and that might make you feel a little bit weird,
29:00but that's perfectly normal.
29:01But I'll explain everything to you
29:03before we give you that strong medicine.
29:05Does that sound OK? Yeah?
29:08Ketamine is a fast-acting pain relief.
29:10It's only used outside of hospitals in the most serious cases.
29:14We're quite fortunate that we get to carry ketamine,
29:17which is this really strong pain relief.
29:19The land amateurs don't carry that, so there is potential
29:21that some of our colleagues won't have seen us administer ketamine before.
29:25He may start acting a bit strange and a bit weird
29:28and might start shouting out.
29:29So things we can do to combat that is just have a nice and quiet environment.
29:32And what we'll do is we'll just have a chat before we give it to him,
29:34because I'll explain to him that he's probably going to start feeling really weird.
29:37But he won't remember anything that we're doing to him.
29:39The 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, OK?
30:02So I know you're probably concerned, but I just need everybody to be really quiet, OK?
30:07So we're going to give you a medication, then we're going to give you this strong pain relief, OK?
30:14It's really important that you just relax. Let's do what we need to.
30:19Try and go with the flow. Think happy thoughts when we give it to you, all right?
30:22It might 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? That's how it's going to work.
30:28All right. Nice, happy thoughts. You're doing really well.
30:42Well done, mate. Are you all right there? Yeah? Is that helping?
30:47Yeah? Good man. Take a breath. I feel all right? A bit better?
30:53With no adverse reaction to the Kettleman, the 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. If somebody could do the monitor as well, that'd be really helpful.
31:09Is everybody ready? OK, you'll be on lift. Ready, set, lift.
31:15All right, Mark. Here we go. Let's get you on.
31:20That's it. You're doing really well, Mark.
31:23We're halfway there. Watch your head. Watch your head, please.
31:33Mark, are you all right? Open your eyes for me, fella.
31:35Good, man. So we're going to fly you to Hull,
31:39just because of the injury you've got to your chest.
31:42I'll give you some... We'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.
31:51OK, good. OK, clear this. We're all right.
31:53Staying further.
31:56What do you want to tell us on this? Good.
32:01Coming into the wind now, that's why I like it.
32:03I know I can't hear him, but he looks relatively comfortable compared to how he was on sea.
32:08They asked speed, but I wasn't sure on the...
32:13First, he's maintenance at 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.
32:23All right, that's us now on finals.
32:27Call on the vehicle to LBP.
32:29Look at this. Now that's finals.
32:36This is a class two kind of clear area.
32:38OK.
32:39Yeah.
32:40Yeah.
32:42Thanks, mate.
32:43Tom.
32:44Yeah, Tom. Class back, Tom.
32:45Thank you, Owen.
32:46Mark, hello, mate. We're in the hospital now, so we're going to keep you on this stretcher,
32:53and then we'll get you out of the back of the helicopter.
33:04Can you bring this arm to hold onto your other one?
33:06Yeah.
33:06OK. Ready, Sally. Slide.
33:13There's just a couple of bumps as we wheel you into the hospital, Mark.
33:16Mark will be taken to a waiting trauma team,
33:19who will carry out scans to get a clearer picture of his injuries.
33:36It's been a busy shift.
33:37Paramedic Chris and the team are giving the very muddy helicopter a deep clean.
33:41It's been a busy shift.
33:46Leanne 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.
33:53Hello, job.
33:54OK. Not great.
33:56Yes.
33:58She's scrambling Chris and Paramedic James from the Topcliffe base, which is nearer to the patient.
34:04It isn't this. It'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, with disabled departure, it has been every other time. It seems to be straight ahead.
34:17HeliMed 99 will make the journey to Rural Thirsk in just three minutes.
34:22Tell us come round your way.
34:23OK, it's nice.
34:24Everything else is looking good inside.
34:26Is a two-year-old? I'm not really too sure what's happening.
34:31The information we got from the air desk was quite limited. The only information we had was
34:36attending a two-year-old who had a history of asthma, who was having quite significant
34:40breathing difficulties and reported to have been unconscious at some point.
34:46Asthma is the most common long-term illness in children in the UK,
34:50affecting about one in 11 and claiming a life every four weeks.
34:54It's one of those houses on the road as they matches the grid location.
35:00Yep.
35:00Hopefully there's a gate there as well.
35:02The little girl is on her family farm and the surrounding fields are proving
35:07difficult 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.
35:13Happy with that?
35:14I think there's not a big ditch, but we'll soon find out.
35:17Yep.
35:17Two-year-old Enola is being looked after by her mum and auntie.
35:27We'll go straight onto the ambulance.
35:29Yeah.
35:29We'll have a look on her.
35:32A land ambulance has also arrived, providing a space to examine her properly.
35:36She 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's got bilateral wheezing.
35:50Okay.
35:50Right.
35:51Heart rate was about 200.
35:52So you'll sit on the end there, because she'll be familiar with you, so she can see you.
35:55Yeah.
35:56Okay, so let's...
35:56Hi, baby.
35:57What's her name?
35:58Enola.
35:59Enola.
36:00And what's her history?
36:01Enola.
36:02About four weeks ago, she had pneumonia.
36:05Okay.
36:06They started on a salveic mal inhaler.
36:07Yep.
36:08She 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
36:18a noticeable wheezing coming from both sides of her chest.
36:22That's an indication that there is an acute problem relating to the asthma and the wheezing's
36:28caused by the small air tubes in the lungs going into spasm and making it difficult to
36:33breathe.
36:33And she also said that she had a heart rate of 200, which was quite significant.
36:38A child of that age, she would expect the heart rate to range between around 90 and 110.
36:43Any cyanosis or...?
36:44Yeah, I could see her jugular.
36:46Okay.
36:46I could see her jugular going.
36:47Okay.
36:48Can I have another listen at your chest, do you think?
36:50Is that all right?
36:51Yeah.
36:51You're all very good, aren't you?
36:53This might be a little bit cold, so I apologise.
36:55I did do her sats earlier.
36:58There were 87 at one point.
37:01Okay.
37:01But after the inhaler, we got them up to 95.
37:05So, any recession or anything like that when she was breathing?
37:07She had a lot of recession.
37:08Okay, all right.
37:09A lot of recession and she was losing contact.
37:12I think that's why you got here with the air ambulance.
37:14Yeah, yeah.
37:14The chest recession potentially indicates particularly children are in some sort of respiratory distress.
37:20When the child's breathing in, it looks almost as though the chest is moving in an
37:24opposite direction to how it should be.
37:26There's an increased effort to try and get as much air in as possible.
37:29You're not a girl, aren't you?
37:32Oh, you know what's going on, don't you?
37:34And you say this colour's not normal for her.
37:37No, she looks quite...
37:38Yeah.
37:38Yeah.
37:39Mottled 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 I like it.
37:49Good girl.
37:50Right, we'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.
37:56Salbutamol is a medication that relaxes the muscles of the airways, making it easier to breathe.
38:02She's actually getting more mottled.
38:04Yeah, I was going to say, it is still bobbing along that heart rate.
38:08It's probably still accurate.
38:09Yeah.
38:10So a trip up to hospital.
38:11Yeah.
38:13The cause of Enola's breathing difficulties is still unclear, so she'll need to go to hospital
38:18for further assessment.
38:20Enola'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
38:28is going on somewhere.
38:29What's the time?
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 in?
38:38Yeah, Brian's packed your bag.
38:40Yeah? Okay.
38:41But they don't quite have everything they need for the trip to hospital.
38:45Dolly.
38:45She needs Dolly.
38:46Oh, look who's this.
38:49Dolly.
38:49Dolly.
38:50Are you going to have a little trip up to hospital then with Mummy?
38:52Go see the doctors.
38:54Again.
38:54Again.
38:55Are they on first name terms this last few weeks?
38:57Pretty nice.
38:58Super.
38:59Hey, death 99.
39:03Yeah, that's just clear.
39:04Patient stable.
39:05Going with the DCA crew there to James Cook.
39:09Enola is being taken to the paediatric unit at James Cook Hospital in Middlesbrough.
39:14The cause of her condition is still unknown.
39:2155-year-old Mark Hunter spent 10 days in hospital after coming off his motorbike whilst greenlating.
39:28All right, Mark.
39:29Here we go.
39:29Let'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.
39:40The 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?
39:55Is that all right?
39:56Yes.
39:57She stayed in hospital for one night, happily accompanied by her beloved Dolly.
40:01Is it Maddie?
40:06Hello.
40:06Hey, I'm Sam.
40:0719-year-old Maddie 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. I was mucking out the horses. I'd ridden another two.
40:19Then I'd got onto Rebel, the horse that I had the accident on. So 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. I couldn't process anything.
40:33I just remember looking at my ankle and being like, God, this doesn't look right.
40:38Maddie's been riding since she was two years old, but it will be some time before she can get back on the horse.
40:44I'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
40:57and 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. I mean, I don't want to put myself at risk,
41:08but I'm definitely going to do it the first opportunity I get because I miss it so much.
41:12Hello. We're coming to help you. Are you OK, buddy?
41:22I'm OK.
41:23Steve Rathbone was in hospital for 12 days after being trapped by his overturned tractor for two and a half hours.
41:31Suddenly, I find I'm moving backwards. I'm moving faster and faster down the hill,
41:35and I come bouncing to a stop, and 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,
41:45thinking, well, I'm really quite reliant on somebody seeing me or missing me. And I knew
41:51that it was very unlikely they were going to miss me in the time that was probably going
41:54to 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,
42:09how I was going to get out of it, I 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
42:22and under to pull the phone out very slowly, which I did. And I finally was able to get to 999.
42:29And that moment, of course, there's a great relief that now, actually,
42:32I don't have to contemplate dying on the hill, which is what I've been doing up until that point.
42:36Steve 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.
42:52I was just so impressed that everybody had been able to get there relatively quickly to this obscure
42:56part of the Yorkshire Dales. And then to work together with military precision to get me out
43:01of that pickle that I got into with my old classic tractor, I shall always be so grateful to everybody.
43:08Since this happened, I've not been anywhere near tractors. The tractor involved, the dear old
43:13Massey Ferguson 35, is in a barn currently being repaired. As much as I'm fond of it, I think it's going
43:19to be up for sale, because it's actually in remarkable condition. It took a few dints,
43:23but actually I think it came out of it better than I did.
43:53Right now...
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