Yorkshire Air 999 Season 3 Episode 5

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Transcript

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

00:26getting your patient to hospital can literally be the difference between life

00:29and death. He was injured his brain. Just try and get a little drip in your arm,

00:32Kian, alright? Can you remember anything about us putting your leg into a splint?

00:36No. The jobs that we're going through can be quite catastrophic. If we weren't

00:43there, then the situation could be much worse. Bringing critical care by air.

00:47That's it. Good lad. Good lad. You're not allergic to anything. Hey!

00:52This is Yorkshire Air 999.

00:59We'll pretend this casualty is someone who's got a pneumothorax. Between jobs, the air ambulance

01:10teams practice life-saving medical procedures they may need to perform on scene. The best

01:15thing to do is get their arms outstretched. They're on a trolley, but if it's a traumatic

01:20situation, traumatic categories, they're going to be on the floor. Today at the Nostal Base

01:24in West Yorkshire, Dr David and paramedic Danny are doing some training with one of David's

01:29homemade dummies. So what I'm doing this morning is going through with Danny on essentially doing

01:35finger thoracops. So get putting your fingers in chest to try and release massive air leaks. We're

01:40using this as one of the models that I've made at home in my garage. I've got quite a few of these

01:44and they often complement using our Simbody trauma mannequins that we have on base. We just need to make

01:50sure we can do these procedures and so practice makes perfect. I can't cook. No good at that, but I can

01:56make models in the garage. It's great. How does that sound? Are you happy with that? Good.

02:06Each day a dedicated dispatcher or one of the paramedics monitors the 999 calls coming in from

02:12across Yorkshire. And he's spotted a number of calls coming in about a multi-vehicle incident on the M18.

02:22The helicopter is having its weekly service, so Wayne is sending the team in the rapid response

02:31vehicle, which carries all the same drugs and equipment as the aircraft.

02:35Hey there, medical, could you send the drop down to the car again? Roger.

02:41Within minutes of the first 999 call, Dr David and paramedic Gemma are en route to Doncaster.

02:47We're essentially going into a lorry crash on the motorway. A 50-year-old male is purported ground

02:52conscious. A lorry travelling at 40 miles an hour has crashed into the back of a stationary lorry.

02:58Information update from highways is driver does need extricating at the minute the condition of the

03:03patient's not known. I presume you've got the blood on you. I said that you have over. Affirmative,

03:09got blood positive. Land ambulances don't carry blood or ketamine,

03:13but the rapid response vehicle does, and they could be vital. It sounds like it's still in

03:18traps, so we thought I've had much access. Just have a little look? Yeah, clearly, clearly. Traffic is

03:24already backed up for miles on the M18, where the two lorries have collided. It's easier when you just fly,

03:31isn't it? You can't go very fast because somebody always gets out and has a bit of a

03:35leg stretch. Yeah, there's a fire engine. There's a car there. Yep. Step in. Air desk, medic 3. Just

03:42arriving at scene. You're all right. Firefighters are attempting to release 63-year-old Dave Bean

03:50from the crushed lorry cab. He was returning from a waste removal job, carrying 18 tons of soil when he

03:57crashed into a lorry that had stopped in traffic. The combined weight of both vehicles added to the force

04:03of the collision, crushing the cab. I've just tried to decompress his chest on the right side, Dave.

04:09Yeah, all right, mate. He's got reduced air entry in his right hand side. Yeah. His abdomen's tender,

04:14his right side of his chest tender. He's broken his left arm, but he's complaining of worsening

04:19shortness of breath at the minute. When I first got to the vehicle, I could just about see his head

04:25in the lorry cabin, and he looked pale and he was sweating. He looked in discomfort. The handover that

04:32we'd been given that he was struggling. He was concerned about his chest and his abdomen,

04:37and that's enough for me to get concerned. Why is that person struggling with his breathing?

04:42Why is it painful? It is a potential bleeding that we can't deal with.

04:47What I'll do, Gemma's getting the blood ready. Whilst we're getting that, I'll just draw

04:51all the parasite stuff and get scalpers ready. An RSI is essentially where we give strong sedative

05:01medication and pain relief to a patient so they feel so relaxed they fall asleep, and then put a

05:05breathing tube from the mouth through the vocal cords into lungs, and then we actually, we have to

05:11breathe for the patient with either an ambi bag or a ventilator. I will prepare blood here. Okay,

05:20you sort your RSI stuff, and when you've done that, I'll just quickly get the airway bag out.

05:27Let's put ambulance back to get screens on. Are you happy with that? Just keep it there,

05:31because we need that space. It's actually quiet at this side, isn't it?

05:36An RSI requires a specific combination of drugs, and must be done by a doctor.

05:41Dr. David is preparing the drugs while firefighters attempt to get Dave out.

05:46It's not getting any better than what it happened.

05:48Should we get a lorry ratchet down that bar, up there, where the streggers are holding now,

05:53and we can tether it at front and hold it back?

05:56Ratchet's trapped then. Have we got a bag of ratchets?

06:00Dave has been trapped for an hour, and Dr. David and Gemma are concerned that he could have

06:05extensive internal bleeding. If someone is deteriorating in front of you,

06:09you've got to verbalise that to the fire rescue team leader, because they'll have a plan to get

06:15somebody out safely, to try and prevent any further injury. But sometimes if someone is

06:19deteriorating so swiftly, you have to accept that, actually, we need that person out quickly.

06:24It may not be the ideal way, but sometimes if we don't, then the patient could come to harm.

06:29Dave, Gemma, you're going to be coming out of that side quick and dirty quite soon, okay?

06:35Right, right, right. We've got access to the legs now.

06:37I can scoop on this platform quick and dirty using these firefighters just out of the ship.

06:48Right, it's coming out now.

06:52Using ratchet straps, firefighters have managed to pull back the buckled metal,

06:57and can finally free Dave.

06:58Okay, sit forward then again.

07:00Yep.

07:01Right, sit forward for me, Dave, good matter.

07:06I'm just going to squeeze over towards you a little bit.

07:07Yeah.

07:08Oh, funny Dave.

07:09After three, what are you doing?

07:10Watch his arm, watch his arm.

07:11Okay.

07:14We'll just move it ever so slightly to the side, so we can get either side.

07:19You'll be all right to get, if you get down, because you can slide it all right, that's fine.

07:23Keep going, keep going.

07:24Stop, that's lovely, brilliant.

07:27Magic. Thank you very much, gents.

07:29You've done really well, Dave.

07:31With Dave out of the lorry, Dr. David can finally assess his injuries.

07:35Hiya, what's your name?

07:37So, Dave.

07:38Dave, I'm a Dave as well.

07:39Just take a breath in, sunshine.

07:41Is it sore to breathe in?

07:44Is that sore?

07:47Is that sore there?

07:49We'll burn this left side.

07:51No, right?

07:52Left side?

07:53The right side, the right side.

07:55So, he's answering all your questions, so we're happy he doesn't need to go to sleep.

08:00We didn't RSI him, we felt once we got him out that actually he was

08:04comfortable enough to breathe and he wasn't deteriorating enough with his breathing, that

08:08meant we had to do it there and then. So, it felt it was safer just to package him,

08:13give the blood transfusion and just start moving towards the major trauma centre.

08:17We gave a blood transfusion because we recognised that he was probably bleeding quite significantly

08:21internally. We were worried, has he got a liver injury?

08:24Livers can bleed quite badly. Equally, there's lots of other things in the abdomen that can bleed

08:29from a sudden impact.

08:30He's sweating.

08:32He's sweating.

08:32Once the TXA's in, we'll get him on board and we'll move this blood across.

08:36Sorry, sunshine.

08:36Are we happy with that, yeah?

08:39As well as a blood transfusion, they're giving Dave tranexamic acid, a drug that controls blood

08:44loss.

08:45Can I make a suggestion? Once that's gone in and you're happy that you've moved him across,

08:49we start to move towards the ambulance and then we can do everything else en route, can't we?

08:54Yeah, that can go in.

08:58Nice one. Right, are we happy to move, guys?

09:04Dave's blood loss remains a major concern, so Dr David and Gemma will join him in the land ambulance

09:10to Sheffield Northern General Hospital, 15 miles away.

09:14I think all the obs are on. Who's the person that's going to drive?

09:18Trish is probably going to drive. Do you think that you'd be able to drive our car?

09:22Yes. Is that all right?

09:25So our car is all the way down the back end of everybody, if that's all right,

09:28but if you follow us down to Nordgen, is that all right?

09:34Whenever you're ready, aren't we happy to keep to go, to get moving?

09:37Can you open your eyes for me? That's it, well done.

09:40We're just going to give you a little bit more for your pain, is that all right?

09:44You need a drink.

09:45I can't do anything other than maybe just wet your lips with some water.

09:49Can we do that, just to wet your mouth?

09:52I know you do, but I can't give you anything just now,

09:54so I'm going to syringe something into your mouth just to wet your lips,

09:57to make you a bit more comfortable, yeah?

09:58I'm going to put a syringe in your mouth, I just want you to suck on it, it's just water,

10:03okay? Just suck through it a little bit. It's better than nowt, isn't it?

10:08Have you got any chest pain at all?

10:10Can you just tell me, you know when the accident happened, was there any, did you have any pain

10:16before the accident? Any dizziness? Any chest pain? Do you know what happened in the act,

10:22what caused it? I'm just trying to work out, is it your heart that might have given you a problem,

10:26or no? Okay, that's fine.

10:28David is trying to establish whether a medical event like a heart attack

10:33could have caused Dave to crash. Hi, hello Sheffield Northern General,

10:38can I give you a trauma pre-alert please? Yep, we've got a mid-60s gentleman, lorry driver RTC,

10:48lung force trauma, a prolonged extrication, injury-wise he's awake and conscious and talking,

10:56he's got a very tender abdomen, in particular right upper quadrant, I'm thinking of intra-abdominal bleeding.

11:03I'd like to activate the massive hemorrhage protocol, I think this guy is bleeding and

11:07probably need blood on arrival. Our ETA is 21 minutes, cool thank you, bye-bye.

11:15So that's pretty much through, so we'll lock that off. Dave is being given O negative blood,

11:22which can be given to patients of any blood type in an emergency. He's having some blood because we know

11:27we think he's bleeding internally from his abdomen, he's got some chest injuries which I think is probably

11:33got some broken ribs. So he's having a blood, he's on his second unit of blood. Unfortunately we can't

11:39do much about that, we need to get him in the CT scanner where we can see any actually bleeding,

11:43if the liver or spleen or any organs are damaged or the vessels in there are bleeding. Just trying to

11:49give him, keep him stable will be the best thing we can. Dave I'm just going to put a little something

11:55cold on your chest, it's just an ultrasound, just have a look at your chest. Dr David is using a portable

12:01ultrasound carried in the ambulance and rapid response vehicle to check for signs of a pneumothorax

12:08or punctured lung. Yeah I mean there's no black space.

12:12It's possibly a small pneumothorax, every small pneumothorax on the right side, on the left side.

12:21We're just getting into the hospital complex, David. I might just put the blankets over just

12:25because there'll be other members of the public and elderly.

12:28Do we make them plus, do we Dave? No.

12:32Dave will be taken straight to Resos, where a specialist trauma team are briefed and waiting.

12:37Dave will be taken straight to Resos, where a specialist trauma team will be taken.

13:05At the RAF base in North Yorkshire,

13:07paramedics Becky and Leanne are restocking the helicopter in preparation for a busy shift.

13:13Could you pass the blood in?

13:14They carry multiple supplies on board, replenishing them throughout the day when needed.

13:23Hello?

13:27Can you hear me?

13:28On the air desk, Andy is listening in to a 999 call coming in from Tan Hill in the Yorkshire Dales.

13:34Hello.

13:35Hello, how are you? I thought what actually happened.

13:37He was riding, descending down a hill.

13:41Yeah.

13:41And then he might hit a stone and he got thrown over the handlebars.

13:45Right.

13:45Yeah.

13:46The man has crashed his motorbike on a remote stretch of the Pennine Way.

13:53The crew are being scrambled to the scene 35 miles away.

13:57North Island Structure, first school front right.

14:01Let's go right.

14:01Let's go left.

14:03999 lifting.

14:05You always get a job right after you've eaten, don't you?

14:07Yeah.

14:08Yeah.

14:08What else are you eating?

14:09Yeah.

14:09Tan Hill is a high point in the Yorkshire Dales, near the borders of County Durham and Cumbria,

14:15500 metres above sea level and far away from any major hospitals.

14:20James Cook will be just over 20 minutes.

14:22You've got Preston, again, similar sort of distance.

14:26It really is remote.

14:27When we're on route to a rural motorbike accident, we consider the kind of injuries that might have

14:32been accrued in that kind of location. Going at a fast speed on windy roads can often mean that

14:37patients get head injuries, spinal injuries, internal bleeding, pelvic injuries and broken bones,

14:42and if they're really unlucky, all of the above.

14:44999 calling.

14:46Yeah, just to let you know, we're currently with a nine minute zero, nine minute ETA.

14:51Do we have any further updates from the scene and if any resources have been allocated?

14:55Over.

14:55No, negative at this time, very minimal details. It's a biker out on a stony track.

15:03All we've got so far is a DCA allocated with a 52 by a two minute ETA.

15:08Yeah, that's cool. That's what we do. Roger.

15:11With the nearest ambulance almost an hour away,

15:13Becky and Leanne will be the first paramedics to reach the patient's side.

15:17Right, anyone trying to attract our attention?

15:20Ah, we could be actually on here.

15:22Yeah, it's someone sitting down in a grass blue T-shirt on.

15:2599 overhead.

15:30Finals.

15:31Yeah, hang on.

15:33We'll get you out and then we don't have to worry about you too much then.

15:37The terrain is uneven, but they're able to land on the road.

15:44Some passers-by stopped to help them out.

15:50Brad Woodhorn is 28 or 29, coming along here with his mate behind him.

15:55We don't know how he did it, but the bike ended up here.

15:57He got up and moved on his back.

16:01He's complaining of pain in his left upper ribcage, middle of his back.

16:07Okay.

16:07He's pale, but his pulse is okay.

16:10He's okay.

16:12We'll go have a look.

16:17Hello.

16:18You all right?

16:19Hi, hi, hi.

16:20Hiya.

16:20Is it Brad?

16:21Yeah.

16:22Hi Brad, I'm Becky.

16:23This is Leanne.

16:25Sorry we make a lot of noise.

16:2729-year-old Brad Woodhead was on a ride with his friend when he crashed after misjudging a

16:32bend in the road.

16:33So, come off your back down there.

16:36I've walked up here.

16:37I've pained your upper left side and your back.

16:42Any pain in your neck at all?

16:43No.

16:43No?

16:44Oh, just my back.

16:45There, just take a deep breath in and fall in.

16:47No, I can't.

16:48Okay.

16:49All right.

16:49Just the best you can.

16:50No, that's it.

16:51And it hurts more in the back?

16:53Yeah, in the back.

16:54How did you land?

16:55I don't know.

16:56He's come at speed there.

16:58His bike's gone into the ditch.

17:00He's been thrown from there to here and he did quite a few.

17:03So, he flew up in the air.

17:04How did he land, you know?

17:06I'm not sure.

17:07He was on his back, like.

17:08Quite clammy.

17:10Clamminess could indicate Brad's blood pressure has dropped,

17:13meaning his blood isn't circulating through his body as it should.

17:16Should we have a listen to your chest, just to make sure there's nothing going on,

17:18and we'll have a look at your back when we move you a bit more.

17:23Just take normal breaths.

17:25Well, good air entry.

17:27Is there any other pain at all anywhere else?

17:29No.

17:30Brad and his friend Tom were riding up to

17:32the Tannhill Inn, the highest pub in Britain, when the accident happened.

17:37He's just come round this corner here and just come off and just use a bit of a divot,

17:43and he's just hit a ditch and bike and Brad have done a few flips and landed where he is.

17:48Initially had no signal and he was out, so someone came past and quite a few bikers,

17:53so one of them went down to the village down there and obviously they were able to secure a connection with you guys.

17:59You don't know what happened?

18:01When you got to him, were he?

18:03He was out.

18:03He was breathing.

18:05He was breathing just like, as he is now, but up here.

18:08And then, yeah, he came round after about two, three minutes.

18:11What we'll do is we'll get you some pain relief in nice and soon.

18:14All right.

18:15So when we do move you to have a look at your back, all right, it'll be less painful then.

18:20I'm just going to start him with three just to see how he goes.

18:22Yeah.

18:22He's really clammy.

18:24He's quite pale.

18:25Is he quite pale for him?

18:26Er, yes.

18:27Is he?

18:28He seems quite pale to me.

18:29He does have a pale complexion, but it's not this bad.

18:31I don't know, he's quite clammy.

18:34Not usually this pale, are you?

18:35No.

18:36He was really quite quiet.

18:37He was laying really still and he was really pale to look at.

18:41We get quite concerned when patients present as pale or clammy because it can be a sign of internal bleeding.

18:46You have had some pain relief started, my love.

18:49All right.

18:49I've got you an important job here, so this one's for you.

18:53You're going to be the glorified holder.

18:54You're not having any leukazade, love.

18:58It's better than leukazade this day.

18:59We don't really know what's happened with you at the moment.

19:03Well, other than that, we know that bit.

19:06We knew that before we got here, actually.

19:08He said he had to be home for three, so.

19:10Oh, I'm not sure that's going to happen.

19:14Brad's wife and two young children are expecting him home.

19:19Is it more further into your back?

19:21Yeah, towards my spine.

19:23Towards your spine.

19:24Does it feel like it's wrang on your spine or more ribs?

19:27It's a hard question, I know.

19:28Around the spine.

19:32Can you do me a favour, then?

19:34Can you just wiggle this butt a little bit?

19:36Don't move it too much.

19:37Yeah, lovely.

19:38And then this one.

19:41Becky is looking for signs of a spinal injury,

19:44but there's only so much they can see from where Brad is lying.

19:47So they need to move him.

19:48When we come to move you, if it's too much, just let us know,

19:50because we can't, we've got some other drugs that we can give you.

19:53Kind of like a jaw, hold this in between your lips.

19:55Big deep breaths on that.

19:56Makes you feel a bit funny, drunk, basically.

20:00All right, are you all right?

20:01We're going to need that on this side, then, aren't we?

20:02If we're going to roll.

20:03We're going to roll towards you.

20:06Because it looks like his legs are better positioned to that

20:08and this is his bad side.

20:09Yep.

20:10So on roll.

20:10Ready, steady, roll.

20:12Go!

20:14All right.

20:14OK.

20:15Right, just hold there.

20:17Hold there.

20:18Well, yeah.

20:19Yeah.

20:19Where is it bad?

20:20Ah!

20:21Don't touch it all the way down.

20:22Yeah, yeah, you just touch.

20:23Here?

20:24No, that's left.

20:25Well, I've tried both sides.

20:27Yeah, yeah, yeah.

20:27Right.

20:28Ah!

20:29So it is more to the left of his right side.

20:33Yeah.

20:33What we'll do is we'll pop you on this and we'll try and spin him this way,

20:36but it's to his right side, not his left.

20:37Oh, he's lacking.

20:38OK.

20:39Ah!

20:40Right, so this is going to be a bit uncomfortable.

20:42Ready.

20:42Steady, roll.

20:45That's it.

20:45And there's as good as we've got.

20:47Ah!

20:48All right, all right, fella.

20:50Keep taking that gas in there.

20:51Keep going.

20:53Keep going on this.

20:54It's here, love.

20:54There we go.

20:58Rad had come off his bike and flipped quite a significant way away from the road.

21:02That always makes us concerned about spinal injuries, especially with how still he was laying.

21:07Spinal injuries can be really serious because they can lead to life-changing paralysis

21:11within your limbs and even cause death.

21:15Hello, Brad.

21:16Sorry about this.

21:19Brad's crashed on one of the most isolated roads in the Yorkshire Dales.

21:23The local mountain rescue team has arrived to help carry him to the helicopter.

21:27Ready.

21:27Steady.

21:28Lift.

21:28All right.

21:30Oh, I thought it was so good.

21:31Yeah.

21:33Yeah, go up there.

21:34Keep coming.

21:35Keep coming.

21:37Get the straight in.

21:39There you go.

21:39Yeah, thank you very much.

21:43What's up?

21:45Need to be on a motorbike.

21:47We'll do a helipad from here about.

21:48We're going to point that way there.

21:50The wind's from the right, but then to rescue.

21:52So they sort of close the road whilst we lift, don't they?

21:54OK, they have to clear rights.

21:58Nine-eyeing lifting, booting to LGI.

22:05Oh, they've had a bit of rain then.

22:07Oh, can I give you that TXA?

22:10Yeah.

22:10Q is definitely under that one.

22:12924, yeah.

22:14Brad's being taken to Leeds General Infirmary,

22:17which is just 20 minutes by air.

22:20Need telemed 9-9 funnels for the LGI.

22:22We'll call again lifting.

22:25All right, let's approach at 500 feet.

22:31Compromise with that wind slightly.

22:33No, no, I'm landed.

22:44Safely down on the helipad,

22:46Brad will be handed over to a waiting trauma team

22:49who will fully assess the extent of his injuries.

23:03So we're just doing the morning ventilator checks.

23:10It's 9am.

23:11Dr Paul is beginning his 12-hour shift at the Nostal Base near Wakefield.

23:16So this bit of equipment is something that we would use to breathe for the patient

23:20if they were unable to breathe for themselves for any reason.

23:23You know, every shift's completely different, isn't it?

23:25We just don't know what we're going to go to next.

23:26I guess that's the excitement, the interest in doing the job, really.

23:34Hello, air desk.

23:35And over on the air desk...

23:36Hello.

23:37Gemma's got their first job of the day.

23:39Paul and paramedic Tom are heading to Cantley, near Doncaster,

23:46where a roofer has fallen 18 feet while working on a house.

23:499-8, you're going to a man who's fallen from a roof.

24:00That's Cantley, Doncaster.

24:02He is conscious and breathing with a leg and head injury, I believe.

24:06The race course is really close, guys, but I don't think they'll get...

24:09We'll get through the back yardage, but we'll just have to have a look.

24:11Pilot Phil and technical crew member Will are searching for a landing site

24:16close to the housing estate where it happened.

24:18So, WhatsApp update, fallen from a roof, said you couldn't listen to the fall,

24:24but it's more than three metres with head and leg injurers.

24:27There's a technician crew three minutes away,

24:30so by the time we get overhead Phil, there'll probably be a crew in the vicinity.

24:34Last year in the UK, 37,000 people were seriously injured after a fall from height at work.

24:41I'm fairly sure that there's no big fences running around the race course.

24:45If we landed on the track, he'll probably get through, I think.

24:48Yep.

24:49Down and overhead.

24:51So, on the end of the house.

24:52Should be the same, where the builder's van is.

24:54Yeah, and there is a gate.

24:55There's a scaffold in there as well, isn't there?

24:57There is a gate in the back garden.

24:59Yeah, so we'll just go on the race course.

25:01They're landing on Doncaster race course, just behind the property.

25:05Will has identified an access point into the garden.

25:08The patient was repairing the roof when he slipped on a tile and fell.

25:19The owner of the house has come to meet them.

25:21How are you doing?

25:22Down the side of the house here.

25:23Oh, okay.

25:25What's his name?

25:26Dave.

25:27Dave.

25:27Out of his leg.

25:29He's landed on his head.

25:30I think it's his leg, his right leg, which is the problem.

25:34Right.

25:34A land ambulance crew is all ready with the patient.

25:37He's talking to me.

25:38Yeah.

25:39Remember the members of the window.

25:40No obvious head injuries.

25:42We're just putting him straight on into notes.

25:44That's cool.

25:44I've had a good feel down his back.

25:46He's got pain just around the seat centre.

25:49And obviously, I've got to his back here and looked at his leg.

25:51Yeah, and as you can see...

25:53He's got a deformity, yeah.

25:54Deformity there.

25:5558-year-old Dave Parks's leg is badly deformed and potentially broken.

26:00So, are you going to carry on doing the assessment down here?

26:02If I get to the head end, we can look at getting a line in.

26:05Yeah.

26:05And we'll get some pain relief on board.

26:07And then we can get these shifted as well.

26:10That's where you go.

26:12It was really difficult to get access to them because there's a load of rubble bags.

26:15So, three people, myself, the paramedic and the patient,

26:18there's not a lot of space to do anything else.

26:20It does make it tricky in how you're going to assess them and the injuries you can find.

26:24And what you need to do is come up with a plan about how you're going to extricate this patient.

26:28Hi, Dave.

26:29My name's Tom.

26:29I'm just going to step across.

26:31You stay there.

26:33Are you normally fitting well?

26:34Yeah, yeah.

26:34Do you have any allergies to any medicines?

26:36Yeah.

26:37So, at the moment, it looks like you've broken your thigh bone.

26:40I haven't got it.

26:40Yeah.

26:41So, the plan is to give you a little bit of pain relief through here.

26:45And then we need to assess you as well, because you've got this neck pain.

26:48You might have hurt your pelvis.

26:49You're in a very tight situation, all right?

26:51That's funny.

26:51No, no.

26:52We like a challenge.

26:54Plan A, if it works with you guys, is I'll use your drag sheet.

26:58There's probably a gap out here where we could get him dragged down to the bit behind us.

27:04Yep.

27:04And then after that, the scoot you'll fit all the way around the side of the property in a straight line,

27:08all the way to the helicopter.

27:10Dave needs painkillers so the team can slide a sheet under him and pull him out of the narrow space

27:15where he's trapped.

27:17We're going to give you some stronger stuff, a bit of ketamine.

27:20Before we do that, we're going to put you a little oxygen mask on, just so we can monitor you.

27:24All right.

27:25It's obviously in a bit of a tight spot.

27:27And then the scaffolding around the building makes it a bit tricky to get you out.

27:30All right.

27:30Carry on with that gas there, and then we're going to put you on a little sheet,

27:34get you around the corner where it's a bit more space,

27:36so we're going to get a little splint put on your leg and go from there.

27:39All right, buddy.

27:40Paul's concerned about Dave's broken leg.

27:43It needs to be straightened.

27:44But there's no space where he's fallen, so he needs to be moved first.

27:56Before they move Dave, he'll be given painkillers.

27:59Tom's giving him ketamine, the strongest drug they carry.

28:05Dave's son was working with him when the accident happened,

28:08and called Dave's partner, Helena.

28:11I think he broke his leg.

28:11Yeah.

28:12That's probably the top and bottom of things.

28:14You would do.

28:15Yeah.

28:15I think he knew that straight away.

28:18Because it's a bit tight in there, it's a bit tricky to have good luck at him top to toe,

28:21so I think we'll get him out here first,

28:23and then we'll have another look at him, just to make sure we're not missing anything.

28:26Yeah.

28:27Respiratory rate's 24, mate.

28:29It's all good.

28:31I think he's going to, yeah, he's going to need enough ket to be able to get him onto there,

28:34and through this gap, mate.

28:35There's a step to go up as well, so there is going to be a bit of moving.

28:40So we're limited for options just because of how confined the spaces were when we're trying

28:44to get Dave out, so the best option we came up with was something called a carry sheet.

28:48So it's quite a flexible sheet.

28:49We can put this underneath Dave, and then we can just use the handles just to gently extricate him

28:54by pulling him out and putting him on the ground, and then we can assess him from there.

28:57If someone gets his head, I'll try and go in the middle and show it underneath.

29:01With the ketamine taking effect, Tom and Paul can move Dave onto the carry sheet,

29:07keeping him in the position in which he fell.

29:11Are you ready, Paul?

29:12Yeah.

29:15Step.

29:16Give me a bit more.

29:17One, two, three.

29:18Good.

29:19One more.

29:19One, two, three.

29:21Stop there.

29:26Well done, mate.

29:26You're doing really well.

29:27So he's just sleepy because of the ketamine we've given him,

29:30but it's helped us to get him out without him knowing about it.

29:32With Dave finally out of the three-foot gap, the team roll him onto his back to check him over.

29:38Just going to move you again, buddy, okay?

29:40Well done.

29:41Doing really well.

29:44So although now we've got Dave out and we're able to kind of get what we call 360 access around him,

29:49we're still concerned about his femur.

29:51There's potential that it can bleed into his leg, into those tissues,

29:55there can be damage to the muscle, there can be damage to the nerve as well.

29:58So what we need to do is straighten that and keep it in place to kind of bring those boneheads

30:03together to stop those vessels bleeding as much and to reduce his pain.

30:08Not any more cats, Tom?

30:10Yep.

30:11Give him 20.

30:12That'll take him to 60 and they've still got another three left.

30:15So binder's going on.

30:17KTD strap is already on the groin.

30:20We'll measure it out.

30:21Binder, leg, reassess.

30:22Yeah.

30:23And then, yeah, go from there.

30:25That's right.

30:25Yeah.

30:28So we use the Kendrick traction device, which looks like a ski pole.

30:32And the idea is that you attach it to the patient's hip and then you attach it to the patient's foot.

30:36Right, ready for traction to come on.

30:38And then you put some traction on it and it pulls that leg back into what we call anatomical alignment.

30:44So the leg should be the same length as the unbroken one.

30:47And that helps keep that bone in place.

30:52Yeah, that looks pretty good.

30:53Yeah.

30:57Dave, do you remember you've broken your leg?

31:00Yeah.

31:02Don't apologise.

31:03We're going to fly you to the Northern General Hospital so they can have a look at your leg, all right?

31:09We gave you this really strong leg so that's why you're feeling weird and spaced out, okay?

31:15I'm doing absolutely fine.

31:17All right, mate.

31:17You're happy, right?

31:19You're the boss.

31:19Right, he says, let's do it.

31:20I'm in charge.

31:21You're in charge.

31:22Go on then.

31:22Let's have a cup of tea.

31:23All right, we'll have a cup of tea in a minute.

31:25You tell us how we can lift you up.

31:27Can we lift you up, yeah?

31:27Yeah, yeah, yeah.

31:28Right, I'll move.

31:29Ready, steady.

31:30Move.

31:36Right, you're on a stretcher.

31:38We're going to wheel you around to the helicopter now, all right?

31:42You're happy, remember that?

31:43Yeah, you're happy.

31:44Hey, Oop.

31:45Hey, Oop.

31:45You all right?

31:46What's happening?

31:50What do you like?

31:53Okay, ready, steady, lift.

31:57Right, we're going to put you in a little sleeping bag.

32:01Hey, Oop.

32:02Me again.

32:03We're going to put you in a little sleeping bag and put you on the helicopter, all right, buddy?

32:06Yeah, okay.

32:07Yeah, perfect, perfect.

32:09I'm not, Dave.

32:10You're not, Dad.

32:11You're not, Dad.

32:14He is doing well.

32:15You're all right, Dave.

32:22I know it's all a bit confusing, but it will come back to you.

32:24It's just the strong pain relief we've given you.

32:26It's just a six-minute flight to the Northern General Hospital in Sheffield, where Dave's family are heading to.

32:40He'll be taken straight for x-rays and CT scans to assess what additional treatment he may need.

32:46We need to make sure we stay hydrated, need to make sure we eat properly.

33:02It's the start of paramedic Stu's 12-hour shift during an uncharacteristically hot spell in Yorkshire.

33:08Summer is normally really busy with people doing outdoor activities.

33:13Certain groups of people, young, the elderly, don't cope with the heat very well.

33:17So if we get a sunrise in temperature, they can deteriorate really, really quickly.

33:21We'll stick some sun cream on in a minute and make sure we're ready for the day.

33:27And as Stu prepares for the heat, Terry-Ann is phoning through from the air desk with a job for him.

33:32He's got chest pain at the moment. He's 47 years old. He's had two MIs before.

33:38A month ago, he had a cardiac arrest. He's got nine out of ten pain now.

33:41And he's in the middle of nowhere. He's got a DCA 40 minutes away.

33:44All right. Thank you. Bye.

33:51Uh, stowing door of harnesses and striptured. Secure from right.

33:54Head F99 lifting.

33:58Paramedic Chris is on shift with Stu today.

34:01They're flying 10 miles to Beedale, on the edge of the Yorkshire Dales,

34:05where a man with a history of heart trouble has collapsed with chest pains.

34:10We'll pop it here. Looks like a nice spot.

34:13Nine-nine London.

34:18Their patient is at a Christian festival and is being looked after by the on-site medical staff.

34:24This is Owen. Owen is a 47-year-old gentleman.

34:27He presented with us today with a central cushion chest pain.

34:32And recently, Owen has had two cardiac arrest this year alone.

34:34Last before, it's in June.

34:3647-year-old father of four, Owen Wright, was in the worship tent when he started to feel unwell.

34:43That pain you've got at the minute, Owen, is it still there?

34:47Oh, yeah.

34:47OK.

34:50Just in your chest? Go in anywhere else?

34:51No.

34:54OK.

34:55It's not going up to your jaw, not going into your arms?

34:57It's just going to be in the shoulder as well.

34:59OK.

35:00OK.

35:01I'm sure that you've got a car sat right on you.

35:03I'm up here.

35:03Yeah.

35:04Both of them will start making you feel a bit better.

35:06When a patient's got a significant cardiac history and they've had a collapsing episode,

35:11it could be that they're going to have another event that could potentially be of the same kind of magnitude.

35:18What's going on, mate?

35:19OK.

35:21Talk to me.

35:21Nice.

35:22OK.

35:23Thank you very much.

35:23Thanks.

35:24Yeah, it's not going to give up.

35:25Not once we're here.

35:26So the good thing is there's nothing jumping out on your ECG that's saying heart attack at the moment.

35:34But, as you know, that only gives us a limited picture blood test of the way ahead.

35:41An ECG is an electrocardiogram.

35:43It involves us sticking ten probes across the body and they will give us electronic pictures of

35:49what's going on with different areas of the heart.

35:51Owen's ECG seems to be normal.

35:54However, that doesn't really mean that there's nothing going on.

35:57It just means that there's nothing disturbing the electrical activity.

36:01How's that pain?

36:01Give us a score out of ten again, mate.

36:05Still a nine.

36:07Stu is inserting a cannula ready to give Owen pain relief.

36:11I'll get a sailboat.

36:12Yeah, sure.

36:13Scratch coming up, all right.

36:18First arrow.

36:18Yeah.

36:19You're a bad lad.

36:21Like a sniper with these things, mate.

36:24Just keep the ham nice and still for me.

36:28You eating and drank today?

36:31Yeah?

36:32What have you been drinking, though?

36:33What?

36:34Ah, come on.

36:35I thought halfway through a festival there might have been a couple of years.

36:38It's a dry patch.

36:39How's that pain doing, mate?

36:43It's not a big deal.

36:43It's still there.

36:45It's still the worst pain ever.

36:46Oh, yeah.

36:47Oh.

36:49I'm just going to give you a little bit of morphine slower.

36:53You've got morphine before?

36:54It's not good.

36:55It's not good stuff.

36:58They're giving Owen morphine, a drug used to treat severe pain, but it can slow the heart rate

37:04and lower blood pressure, so he'll need to be monitored closely.

37:08How are you doing, Owen?

37:11Chest.

37:12Trust your chest.

37:15Nine-nine medic to a desk.

37:17Patient is GCS 15, has chest pain, is a good colour.

37:21ECG is showing nil-acute querying non-STEMI.

37:26Sometimes ECGs don't give us the full picture.

37:28You can have these non-STEMIs, which are ECGs that appear normal,

37:33but there is something underlying.

37:35So, Owen needed to be in hospital so that you could have some diagnostic blood tests

37:39that we can't do pre-hospitally that can look for things that we can't see.

37:43Sometimes you can get these, the blood vessels, the arteries,

37:46can squeeze and it can cause, like, a restriction.

37:49You got your hairspray on you?

37:51Hey.

37:52You haven't got your hairspray on you?

37:54Oh, not good.

37:56Poor drills, mate, poor drills.

37:59Heart sprays and inhalers, you should keep as many as you can,

38:01as many places as you can.

38:03So, I'll just give you one squirt of this, see if that helps.

38:06Hopefully, if it's anything heart-related, it'll relax the heart, relax the arteries.

38:11As you know, this might give you a bit of a headache, all right?

38:13So you're going to last that?

38:15Exactly.

38:16GTN, or glycerol trinitrate, is a fast-acting heart spray that's sprayed under the tongue

38:22to widen blood vessels and improve blood flow to the heart.

38:26I'll just give you one for now and see how that goes.

38:29It should work quite quick.

38:32We'll just send you up to James Cook, get some tests on, mate.

38:41A land ambulance crew has arrived to take Owen to hospital.

38:44Hello.

38:45All right.

38:45Hello, lovely.

38:47Right, what we're going to do is, slowly, slowly, I think, Chris,

38:50we're going to sit you up, all right?

38:52Ready?

38:54Just sit up nice and steady, don't you?

38:57Just have a minute, because that morphine might make me feel a little bit dizzy.

38:59Relax, mate.

39:00Relax.

39:01How are you feeling now?

39:02You're back upright.

39:05Anything changed?

39:05I'm going to get your legs underneath you, bud.

39:12You ready?

39:13Yeah.

39:13Get your feet underneath you.

39:15OK.

39:16On three.

39:17One, two, three.

39:18Big push.

39:19There we go.

39:20All right, just walk backwards there, Mason.

39:22There we go.

39:23Sit down.

39:28All right, I'm just going to weigh you up again.

39:29It's a bit cooler, isn't it?

39:32Yeah.

39:33We're going to give you the last taste of morphine.

39:35All right.

39:36Then we'll see where we go from now.

39:37All right.

39:38All right.

39:44I'm going to head back to the cab to sort some stuff around there.

39:46All right.

39:47All the best, Owen.

39:49Take care.

39:49All right.

39:50Nice to see you.

39:51Till now.

39:51Bye.

39:54In the space of a month, Owen has suffered a heart attack and a cardiac arrest.

39:59Now he'll be taken for blood tests to find out the reason behind today's incident.

40:08Just take a deep breath and falling.

40:10Oh, God.

40:1229-year-old Brad Woodhead spent over two weeks in intensive care

40:16after a motorbike accident in the Yorkshire Dales.

40:19Right.

40:19So this is going to be a bit uncomfortable.

40:21Ready?

40:21Steady.

40:21Roll.

40:25In hospital, they found a bleed on his brain, a ruptured kidney,

40:29and a laceration on his spleen.

40:31He also broke four ribs and three vertebrae.

40:35He's now back home recovering with his wife and children.

40:41I feel like you've got a cast that right on me.

40:44Still the worst pain ever.

40:45Oh, yeah.

40:46Blood tests in hospital revealed the 47-year-old Owen Wright's chest pains

40:51were caused by a significant drop in blood pressure, likely triggered by overexertion.

40:57His heart continues to be monitored regularly.

40:59Dave Park spent five days in hospital after falling from a roof and breaking his femur.

41:10I actually was walking up the roof and a tile broke underneath my foot, which threw me off balance.

41:18All happens in a second.

41:19One minute I'm on the roof, and the next minute I've hit a wall,

41:22I've hit the party wall between the neighbour's gardens, and I do remember the break.

41:28I've never broken a bone like that before, and I just, I felt it.

41:31Dave needed surgery to insert a titanium steel bar into his leg to connect the broken bones.

41:39It's been a challenging recovery, because I'm a busy person.

41:42I'm up and down a ladder all day and every day.

41:45I love being hands-on. I love being with lads on scaffolding and roofing away.

41:50But this is the second fall, and I think the third one, I might not be as lucky.

41:55So I say, I'll leave it to the young ones, and hopefully in a few weeks' time,

41:58I should be not back on a roof, but I should be back doing office work.

42:11I've just tried to decompress his chest on the right side,

42:13but he's complaining of worsening shortest breath at the minute.

42:17HGV driver Dave Bean was taken straight for CT scans at the Northern General

42:22after crashing into the back of a stationary lorry.

42:25I just seem to remember seeing back at lorry coming towards me at quite a rapid rate,

42:31and obviously I couldn't stop, I was fully loaded.

42:35And then it just seemed to go silent, and then I couldn't breathe,

42:38because obviously the steering wheel had gone into my abdomen.

42:41And then my phone were ringing, but I managed to answer it through the steering wheel at lorry,

42:46and it was my firm ringing me to tell me not to go onto the M18,

42:50because there had just been an accident, but unfortunately it was me.

42:54The crash closed the motorway for nine hours. Dave suffered a punctured lung,

42:59a tear to his kidney, a fractured vertebra, and five broken ribs.

43:03You know, I knew it were bad, but I didn't know how bad.

43:08After 40 years on the road, Dave now faces a lengthy recovery.

43:13It's had a massive impact on my life, to be fair, in every way, financial, mental.

43:19I'm not the person I was, but I've just got to deal with it now.

43:38Transcription by CastingWords

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