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00:00Yorkshire sprawls across three million acres, the biggest county in Britain.
00:11All of it covered by the crews of its two dedicated air ambulances.
00:21This job has two sides to it. You fly around in a helicopter and you have the time of your life.
00:31And then there's the flip side to it, where it's awfully stressful.
00:43We get sent to some pretty horrific things.
00:46She's probably going to need blood to be fair.
00:51That's it, we're done.
00:52From the remote dales, to the rocky coast.
01:01Six million people depend on them.
01:06No job is ever the same, no people are ever the same.
01:12We see a lot of carnage on scene, we see a lot of destruction and people's lives turned upside down.
01:18Sorry, sorry, sorry.
01:20From hardy locals hurt at work,
01:25to tourists trapped in the beautiful but hostile landscape.
01:31It does make you appreciate that life's for living.
01:35This is life on the cutting edge of emergency medicine.
01:39Couldn't imagine anything's been the top, being part of this team.
01:49Yorkshire Dales, Australia
01:55It's a dry summer's day in the Yorkshire dales,
01:58where the high, winding roads are perfect for bikers.
02:10But on a remote rural track, one of them is about to run into serious trouble.
02:19Fiona, Yorkshire Dales, Australia
02:24Oh, f***.
02:29F***.
02:37At Air Ambulance HQ, Fiona is on the dispatch desk.
02:42So, this patient's now unconscious in layburn.
02:44He's now unconscious?
02:45Yes.
02:46Do you want us to get him?
02:47Yeah.
02:51Dr. Paul and paramedic Terrian are on their way.
03:05Pilot Josh is flying his medical crew 46 miles north to the injured biker.
03:17House Reservoir.
03:20Is it a motorbike?
03:21I think it's a dirt bike.
03:22It's just on a, like a dirt track, isn't it?
03:27It's got a mast in the 1 o'clock. It's on the high ground.
03:29Roger.
03:33It looks like we can land fairly close to where it's plotting as a grid.
03:37OK.
03:38Air desk update, patient now has chest pain.
03:40We can't feel their arm.
03:42The thing, looking at the map, is sort of, you know, as we channel there,
03:46it's sort of between the two sections of high ground.
03:48Yeah.
03:52The crew are flying to Arkleside Moor in the Yorkshire Dales,
03:55a vast stretch of untamed wilderness, high above remote Coverdale.
04:00Looks promising, doesn't it?
04:01Yeah, I think so.
04:02Yeah, that looks like us.
04:05Yeah, cool. That looks good.
04:06I'll do a left-hand turn and then I'll park next to the road.
04:10Do you want a camera, Josh?
04:11Yeah, please, Mike.
04:14That bike's still coming.
04:20There we go. That should be OK.
04:21Yeah.
04:30Hi.
04:31Hiya, you all right?
04:32Hello.
04:34This is John.
04:35Hiya, John.
04:36I'm Terry-Anne, this is Paul.
04:38What's happened?
04:39He came over that jump there, he landed nose first,
04:42went over the handlebars, so he'd come a fair distance.
04:46Yeah.
04:47Can I get your coat, sorry?
04:48It only cost him 50 quid ten years ago.
04:50Oh, my God.
04:55What's your name again, buddy?
04:57What's your name again, mate?
04:58Oh, John.
04:59John?
05:00Yeah.
05:01Just going to get you a little drip in this right arm.
05:02Are you allergic to anything?
05:03No, not at all.
05:04Have you got any pain anywhere else?
05:06It's just my arm.
05:07Just your arm?
05:08Nothing, only my arm.
05:10Right.
05:11And no pain in your tummy?
05:12No.
05:13You can move your legs?
05:14Yeah.
05:15Yeah.
05:16And you've not been unconscious?
05:17Yes, he has.
05:18He has been unconscious?
05:19Just shave a minute.
05:21Tried to keep him talking, but he just couldn't keep him talking,
05:25but then he was, he came back to us.
05:29John Ballantyne was thrown from his motorbike.
05:32The first priority for Dr Paul and Terry-Anne
05:34is to give him pain relief.
05:37Right.
05:38So, nice long suck on there.
05:40It works quickly.
05:41It might make you feel a bit dizzy,
05:42but it stops working quickly as well,
05:44so you just need to keep going.
05:46He was in a lot of pain.
05:48He was holding his arm really still and supporting his arm.
05:51I think one of the things that we have to consider in these situations
05:54is, for him, that's something that we might call a distracting injury.
05:57So, obviously, the significant pain in his arm
05:59is the main thing that he'll be thinking about,
06:01so we don't want to get focused on this really painful injury.
06:04We want to have a look at him as a whole
06:06and make sure we're not overlooking
06:07any other more significant medical issues.
06:09So, we're just going to put a little cannula into your hand
06:12and get you some pain relief.
06:13OK?
06:14Yeah, yeah, yeah, yeah.
06:16Pull quite tight with this, buddy, all right?
06:19Ooh, burn.
06:20I've got pain up here.
06:21You should get some morphine, John,
06:22that way they can get rid of the EPA.
06:24Yeah, we'll do some fentanyl if you want,
06:26and then he'll still get rid of the EPA.
06:27Yeah, he'll have to.
06:28Just keep your arm just there for me, mate, all right?
06:30Get you this little drip and then we can get you some pain killers.
06:33It's coming, mate, keep this arm still for me.
06:35Keep sucking on that.
06:39Keep sucking.
06:44John, that's just because the end's not,
06:45because it means it's working.
06:46Suck it again.
06:47Big, deep breath.
06:49Right.
06:50Have you ever had morphine or anything like that before?
06:53No.
06:54OK.
06:55A land ambulance team has arrived to support the helicopter crew.
06:59Hello.
07:00I'm Torianne, this is Paul.
07:01This is John.
07:03This spot is inaccessible to all but 4x4 vehicles,
07:06so they've left their ambulance further down the dale and walked.
07:10He's normally pretty well, this gentleman.
07:12No medication or anything, no allergies.
07:15We've just got a line in here, we're just getting a blood pressure.
07:18It's his isolated left shoulder.
07:21I have a good feel of his chest.
07:22I don't think there's anything else.
07:23He's moving everything apart from his left shoulder.
07:26So I think he's just getting on top of his pain relief
07:28and going with you guys.
07:30You don't have to talk to me.
07:31I'm just going to have a quick look at this shoulder, mate.
07:33All right.
07:36It could well be dislocated,
07:37but often we see fractures break really high up in that bone as well.
07:42If it had happened before and if it was definite,
07:44I'd say, do you know what, we'll just try and put it back in joint here.
07:47But if it's broke, the last thing he needs is me pulling around on his arm.
07:50All right.
07:51So we'll just get it strapped up and get an X-ray at the hospital.
07:54How far have you guys been today?
07:57Not very far.
07:58We set off from Learburn and then over Skye, yeah.
08:01We haven't come far.
08:03John's feeling the effects of the Entonox.
08:06Oh, the arm's coming back.
08:08Oh, is it?
08:09The arm's coming back.
08:10Has it come back?
08:11Magic, innit?
08:12Terry-Ann must immobilise John's arm and shoulder
08:15before he can be taken to hospital.
08:17Keep breathing.
08:19Keep it.
08:20That's it.
08:21That's it.
08:22Well done.
08:23Nearly there, mate.
08:24Nearly there, nearly there.
08:26Relax.
08:27There we go.
08:31He's in a lot of pain,
08:32and one of the things we need to think about with this particular type of injury
08:36is that it's quite renowned for causing significant damage to the nerve,
08:39and that can cause a lot of pain, something we call neuropathic-type pain.
08:43That's pain that's specifically coming from the nerve
08:45that can give severe shooting pain or really severe gnawing-type pain
08:49that can be incredibly difficult to get on top of.
08:51Now John's arm is secured in a sling,
08:53he's ready to be moved.
08:55What's the plan then, Terry-Ann?
08:57Are we setting him up and then wrapping that around him
08:59and being done, is that the plan?
09:01Yeah, I thought he might walk, but I don't know if he will.
09:08I've got your arms up.
09:15Get your feet on the floor.
09:16There we go.
09:17He's up.
09:18You all right?
09:19Just give him 30 seconds.
09:23John, any other pain anywhere now apart from your shoulder?
09:25It's not really sore, it's like elbow down.
09:29I'm sorry, but I'm sorry.
09:31Come on.
09:32That way.
09:33That way.
09:34We're going to go up to that track there, John, all right?
09:36Yeah, yeah.
09:37And we're going to walk on to the helicopter, all right?
09:39Get in.
09:41Oh, you ****.
09:42Just...
09:43You all right?
09:44Yeah, I'm all right.
09:45I'm all right.
09:47John will be flown down the dale to meet the land ambulance.
09:51He'll go to hospital by road.
09:59See you later, John.
10:06Cool.
10:08Cool.
10:25Do you want a second before you go?
10:26No, no, no.
10:27Go for it.
10:28Sure?
10:29There you go.
10:30You're down.
10:31For this gentleman, we think this is an isolated arm injury.
10:34At the moment, he's in quite a lot of pain.
10:36We know these injuries are really sore and really painful,
10:38and often getting on top of the pain can be quite challenging.
10:41He's just had a sling put on at the moment
10:43just to try and keep his arm immobilised
10:45and to try and keep it still,
10:46just so the broken ends of the bone don't rub together too much.
10:50What we think at the moment
10:51is that he's likely to have a broken humerus,
10:53which is the upper arm bone.
10:55The ends of that bone can rub together
10:57and every time he moves his arm, breathes in and out,
10:59it moves that bone and the bone fragments rub together,
11:01and that can be really, really painful and really, really sore.
11:04So it's a difficult fracture to treat.
11:06All right, nice to meet you.
11:28At the team's northern base at RAF Topcliffe,
11:31it's a rare moment of downtime.
11:34Does it smell like it's burning?
11:35No, I think it's the chocolate.
11:37Paramedics Sam and Sammy are testing out the crew's brand-new air fryer
11:41with a cake recipe.
11:45Oh!
11:46Oh, it did singe a bit.
11:50It's got a slightly burnt aroma.
11:52Yes.
11:54Pilot Harry and Richie are chief taste testers.
11:58I would give it a three.
12:00Three out of ten.
12:07Take some chewing.
12:10PHONE RINGS
12:12A call comes in from the air desk.
12:15What part of Ross?
12:16Ross has stood on her, she can't move,
12:18she's in a load of pain.
12:24They're heading 36 miles east
12:26to the village of Harwood Dale, near Scarborough.
12:31Yeah, that's my line, lovely.
12:34What is it we're going to?
12:36Shall we go to a female that's potentially come off a horse
12:39and been kicked in the face?
12:41We don't have a great deal of information yet,
12:44so there is an ambulance running,
12:46but we're probably going to be first on scene for this one.
12:49The crew get a bird's-eye view of the North York moors,
12:52500 square miles of heather and bracken
12:55stretching all the way to the coast.
12:59Hello, Hawcombe.
13:02Nice little walk around here.
13:04Yeah.
13:06It should be just this little habitation after this ridgeline.
13:09Yeah.
13:10Air desk 990, head scene.
13:12That was pretty slow there as well.
13:14Right, so this field that we're in
13:16looks like the only horse-free field.
13:18Yeah, yeah.
13:19So that kind of makes me inclined to go and land in that one.
13:22You've got domestics that go on the furthest edge of the field
13:25going across.
13:26Gotcha.
13:27Doesn't really look like an exit out the bottom there,
13:30but maybe I'll climb over the fence.
13:32Yeah.
13:33Lovely.
13:35This looks pretty good to me.
13:37Yeah, clear to strap.
13:38Clear to go.
13:42Yeah.
13:44Yeah.
13:46It's a scramble to reach the patient
13:48who's fallen in a livery yard.
13:55Hi, everybody, my name's Andy.
13:5729-year-old young lady.
13:59She was riding a horse.
14:01Gate was closed and apparently started to jump the fence.
14:05One of the injuries we're looking at is bilateral arms.
14:09This one's sort of mid-shaft.
14:13Oh, yeah.
14:14Wow.
14:15We've done a number, haven't we?
14:17Oh, yeah.
14:18How are you doing?
14:19Hi, George, my name's Andy.
14:20Not that fantastic.
14:21Not that fantastic?
14:23No.
14:24No, you've had better days, I'm assuming.
14:26Yeah, normally.
14:27Yeah, normally.
14:28So, potential open radius ulna,
14:31and then we've got a closed proximal.
14:33No other injuries.
14:34Allergic to anything?
14:35Mushroom.
14:36Mushroom?
14:37Well, we don't give that anymore.
14:38No penicillin, then?
14:39Are you allergic to penicillin?
14:41No.
14:42OK.
14:43When we arrived, we carried out a full assessment.
14:45We identified that George had some arm fractures.
14:48She had an open fracture to her right arm
14:50and a dislocated elbow to her left arm.
14:52So, we're not compromising in any way, shape or form,
14:55so I'm happy we'll just blimp, scoop, get on there,
14:57we'll reassess, get some pain relief.
14:59I'm not good with needles.
15:00You're not good with needles?
15:01No.
15:02Me neither, so we'll both close our eyes at the same time.
15:04So, no, the needle's here, I haven't got it.
15:06That's just a band.
15:08Georgia, you've done the uncomfortable bit, falling off.
15:12I don't remember anything falling off.
15:15Georgia will tell you before we do anything.
15:18Georgia has breaks to both arms.
15:21The open fracture has already been bandaged
15:23by the land ambulance team, but it's at risk of infection.
15:27She needs both intravenous antibiotics
15:29and pain relief urgently.
15:32Unfortunately, Georgia, there's going to be needles
15:34regardless of where we do it,
15:35whether it's here in the ambulance or hospital.
15:38Are you happy if I just put a little needle into your arm?
15:41No.
15:42Georgia, just slow that breathing down.
15:46Georgia, slow that breathing down.
15:47Right, listen, Georgia, we're not going to do anything
15:49you don't want to do, all right?
15:51Sam's explained, you will need a needle at some point,
15:54but right now, right,
15:56if we can just get your pain managed with this stuff.
15:59Take super deep breaths for me.
16:01If you try to force it down to the bottom of your lungs,
16:04all right?
16:05Everyone has different phobias and different things
16:07that they're worried about,
16:08but one of the most common that we come across
16:10is people who just have an innate fear of needles.
16:13You know, they don't want anything to be put into a vein.
16:16I don't suppose it's so much of a painful procedure,
16:18but it's just that thought of that needle puncturing the skin.
16:22She responded really well to Entonox.
16:24She would just give us some more.
16:25She went out a little bit with Entonox.
16:27Georgia's badly broken arm needs to be immobilised
16:30in a vacuum splint before she can be moved safely.
16:34This will have to be done
16:35without the stronger intravenous pain relief.
16:37Keep sucking.
16:39Georgia, stop screaming.
16:42Georgia, suck on that chain.
16:44Keep sucking. Keep sucking.
16:48Georgia, breathe and suck. Come on.
16:50It's really, really important we give you some antibiotics, OK?
16:54Because both of your arms have fractures to them
16:57and the bone's exposed to infection, OK?
16:59OK.
17:00Georgia, do you give them permission?
17:04SHE SCREAMS
17:06Keep sucking.
17:07Can we give you some proper needle
17:09and we can get rid of all this pain?
17:11Well, you've just got to go at my own time.
17:13That's fine.
17:14When will you let them?
17:15It just takes me a minute to kind of calm down when I know there's a...
17:19SHE SCREAMS
17:20..needle near me.
17:21Is there a needle near you?
17:22No, when they put a needle in me, I will start panicking.
17:25I will start having a panic attack
17:27and they just have to give me a minute just to calm down and just...
17:30But will you let them put the needle in?
17:32Yeah, they have to do it at my time.
17:34We do need to start looking at moving.
17:36The faster we get access, the faster we can get this antibiotics in you.
17:40She's in a lot of pain, isn't she?
17:42Do you want to see?
17:43You don't want to see, Georgia?
17:45I do need to see.
17:46Are you happy for this little scratch then, Georgia, OK?
17:48It's all right, Georgia.
17:49You can scream but don't move your arm, OK?
17:51Scream as much as you like.
17:53Scream as much as you want.
17:55Georgia, it's done. It's in, it's out.
17:57It's done.
17:58Pain relief-wise, are we thinking ketamine and morphine?
18:02Yeah.
18:03Right, Georgia, that's...
18:06..everything's stuck down.
18:08Can you turn that off?
18:10Turn it what off?
18:11Are you all right with it off?
18:12I'm going to give you some good, strong medication, all right,
18:15for when we move you.
18:16But you won't know about it,
18:17cos I'm going to give you loads and loads of medications, all right?
18:21Are you still with me?
18:22Georgia, she's having seizures.
18:25Georgia!
18:26I think you might be having a little seizure.
18:29Don't worry, don't worry.
18:30She's going into shock.
18:32Don't worry, just breathe for me. It's OK.
18:34It's OK. It's OK.
18:35Just breathe.
18:36Breathe.
18:38Seizures come in different shapes and forms.
18:40Sometimes it can be as a result of a knock to the head.
18:43Seizures can be completely normal in that circumstance.
18:46But at the same time,
18:47we just need to rule out the potential causes for that
18:50and have a heightened suspicion
18:51that there may be something going on inside her head,
18:54causing those seizures.
18:55Right, so, I'm going to give her some small doses of ketamine, all right?
18:59I need you to just go round this side for me.
19:02As soon as I give this and we start going under,
19:05what I want you to do is try your best
19:07to pull the limb as straight as you can for me, all right?
19:10And we'll reduce that one.
19:12And then what we'll do is scoop her and we'll... Yeah.
19:16Originally developed as a horse tranquiliser,
19:18ketamine is one of the most powerful drugs the air ambulance carries.
19:23Georgia, you're going to start feeling...
19:25Georgia, listen to me.
19:26Right, what I need everyone to do is just be nice and calm.
19:35OK.
19:37Right, we'll scoop her now,
19:38cos I think she keeps having seizures, which isn't a good thing.
19:42This will be deteriorating a little bit.
19:44One, two, three.
19:45SHE SCREAMS
19:46She will scream, she will scream.
19:50That's it.
19:51So, she's got a right-sided posture,
19:53her eyes keep drifting off to one side and the eyes are flickering,
19:57so she's having, like, a focal seizure.
20:00Georgia, hey-up, you all right?
20:05Think we're good to go, mate? Yeah.
20:08What we're going to do,
20:09we just need all hands round the stretcher if possible.
20:11We just need to lift her onto this.
20:12Ready, steady, lift.
20:14OK, so nice and steady, nice and slow.
20:20Just watch your noggins, everyone.
20:28Keep coming.
20:29You are.
20:32You've never been in a helicopter?
20:36Well, happy first time in a helicopter.
20:39It can be a little bit shaky and a bit loud
20:42because you haven't got any headphones on OK.
20:45That's all completely normal.
20:47Andy's going to be sat next to you,
20:49and if you need anything, just shout or something like that,
20:53and he'll be able to see you all right.
20:59NS99L routing James Cook.
21:0399L lifting.
21:13It's 31 miles up the coast to the major trauma centre
21:17at the James Cook Hospital in Middlesbrough.
21:21Are you sure we're James Cook?
21:23Roger.
21:25NS99L, James Cook.
21:2899L, James Cook.
21:34NS99L.
21:37NS99L.
21:45Georgia will be assessed by the trauma team and taken for X-rays.
22:07High over North Yorkshire, Helimed 99 is returning to base.
22:16While at air ambulance headquarters in West Yorkshire,
22:19a 999 call is coming into the air desk.
22:27Dispatcher Helen radios to divert the crew.
22:36We're heading towards Settle, please, over.
22:45Thank you. It's Sierra Delta 81246.
22:49We've got a crew on scene.
22:51Sounds like patient is fast test positive,
22:53ready to go to a stroke unit.
22:55I'm just going to speak to the crew now
22:57just to establish exactly what's going on,
22:59but I'll set you off in the meantime, over.
23:02It's an immediate turnaround for Helimed 99.
23:06It's a three-peaked area, isn't it, bud?
23:08It looks like they're on a footpath just outside the town.
23:10Yeah, it looks like it, mate.
23:14They're flying 34 miles to their patient, and time is critical.
23:21We are off to somebody out in the hills.
23:25It's come through as a report of the fast positive,
23:28so they're potentially having a stroke.
23:32The FAST acronym aims to remind people of the key signs of a stroke.
23:36Face, arms, speech and time to call 999.
23:41So when we got a call to a stroke patient,
23:44we used the old mantra, time is tissue.
23:47The longer we leave a stroke patient without interventions,
23:50the more damage that their brain's suffering.
23:52So it's really important for us to ask them where they are,
23:55how quick we can get to them
23:57and where our nearest hyper-acute stroke unit is
23:59in order to get them the specialist care they need.
24:03You've got 12 minutes, just so you know.
24:06The team are flying to Penny Ghent in the Yorkshire Dales,
24:09one of the iconic three peaks.
24:12Am I right? Off this grid, it's tracking us the footpath in Houghton and Ribblesdale.
24:16That's the one, mate, yeah. Just out of the town, yeah.
24:19Yeah. Well, we'll look for the ambulance then for that.
24:22Yeah, cos they've probably had to walk in, haven't they?
24:26Is that the track to the right we're going to? I'm not sure.
24:29Yeah, so he's not too far out of the town, to be honest with you, mate.
24:32He's this side of the river.
24:34Ambulance, 12 o'clock, is it? Just here on the side of the farm complex?
24:37Oh, yeah, I've seen, yeah. OK.
24:39No, no, he's overhead.
24:42Where are you thinking of putting us down, Colin?
24:44Well, that planks in the field, I think.
24:46Up it is, your best move.
24:48We are clear.
24:51He's guiding you in, Colin. He's guiding you in.
24:54I've got some stones here.
24:56A couple of big rocks there beneath us, Colin.
24:58Yeah, just going to go forward.
25:00Are you happy for me to go and get a handover, mate?
25:02I'll just run down. I'm not going to take anything with me.
25:05I'll just go and see what's going on, get a handover off the crew.
25:10The local mountain rescue team has moved the patient into a rescue vehicle
25:14to wait for the helicopter crew to arrive.
25:17Hello. Hello, I'm Julia.
25:19Hi, I'm Stu. This is Megan. Hi.
25:22Hello, Megan. Megan is up on hold here from Derbyshire,
25:24out with the family this morning, being absolutely fine.
25:27Set her hop here, was exerted,
25:29and then next thing you look round, she's collapsed.
25:32She's got a new deficit, left-sided weakness,
25:36left-sided droop, dysphagia.
25:39She thinks she's fine.
25:41So your classic symptoms of the stroke are,
25:43your people get the facial droop,
25:45one side of the mouth might drop.
25:47They may get a weakness in any of the limbs,
25:50perhaps notably in their arms.
25:52Their speech may become different, they may get their words muddled up,
25:55and those are your classic signs.
25:58Oh, yeah, she's definitely got a left-side injury.
26:0269-year-old Megan Biggam collapsed on a hillside footpath 40 minutes ago.
26:07My name's Stu, I'm one of the helicopter paramedics.
26:10How are we doing? We've got right-sided disconjugation as well.
26:13Do you know where you are right now?
26:15Yeah, here I feel. You are, darling.
26:17Do you know what's happening?
26:20I think you might be having something neurological.
26:23You might be having a bit of a stroke or something.
26:25No, I'm not.
26:26What I'm going to do is I'm going to get you on the helicopter
26:29and I'm going to fly you to the hospital for the doctor to have a look at you, OK?
26:32I'm all right, there's nothing wrong.
26:34I know you think that, darling, but I wouldn't be here if there was nothing wrong.
26:38When people have disruption to their blood supply to the brain,
26:41it's quite common for the brain to not recognise it itself.
26:47So in this case, there were no internal symptoms for the patient.
26:51She felt as if she was OK because her brain was normalising these symptoms,
26:55whereas to anybody looking from the outside,
26:57you could see that something wasn't quite right.
27:01Around 100,000 people have strokes every year in the UK.
27:05It's one of the country's leading causes of death.
27:08How are you doing, Megan? All right.
27:10All right. Give my hands a squeeze.
27:13And with this hand...
27:15OK.
27:16Right, I'm just going to wire you up for sound, all right,
27:19and just because it's so noisy on the aircraft,
27:21I'm not going to be able to hear you very well.
27:24And I'm from Lancashire, so I speak funny anyway.
27:26Everyone ready? Yep.
27:28Ready, brace, lift.
27:31Have you been in a helicopter before, Megan? No.
27:34First time for everything, eh?
27:37The air ambulance crew have been on the ground less than 20 minutes.
27:41The race is now on to get Megan to specialist hospital care.
27:45Can you hear me, Megan?
27:47Slow it far up, do you? Yeah.
27:49So this noise is all normal, OK?
27:51We're just going to start up,
27:53and it's going to feel like you're going up in a lift,
27:55and then we'll be at the hospital in about ten minutes, OK?
27:58All right.
27:59If you start feeling unwell, let me know and I can deal with it, OK?
28:04There it is, no noise lifting.
28:07The crew are flying Megan 24 miles to the Royal Lancaster Infirmary.
28:13It's a darestone up there, isn't there?
28:16They cross the county border into Lancashire on the way.
28:20Right, we've got escape invasion drills in case we go down in enemy territory.
28:26I can negotiate your release, mate.
28:28Can you translate as well?
28:30Yeah, I'm like a god to these folks.
28:33How are we doing, Megan?
28:35Are you still with me? All right, darling.
28:38I'm all right, I'm all right.
28:40You are OK.
28:41Like I say, you're showing signs of a stroke and you're Michael's concerned.
28:45He says you're not quite yourself.
28:47I'm all right.
28:48I know, you feel all right, darling.
28:50Yeah, so I think that's the school building over there.
28:52You can see, like, an AstroTurf tennis court.
28:54Oh, yeah, I feel it.
28:55I feel it.
28:56I feel it.
28:57I feel it.
28:58I feel it.
28:59I feel it.
29:00AstroTurf tennis court.
29:01Oh, yeah, I feel it.
29:02I think it's the one this side of it.
29:03Yeah, the bigger one.
29:04No, no, it's finals.
29:09You know, it's part of DCA, was I right?
29:11Yeah, well, something down the back there, yeah.
29:15No, no, it's landed.
29:18The Royal Lancaster doesn't have a helipad,
29:20so a land ambulance team is meeting them nearby
29:23to transport Megan onto the hospital.
29:26Hey, team.
29:27Arms wide, she's looking really, really stable.
29:29Cheers, Sue. Thanks for that, man.
29:34Just an hour after she collapsed,
29:36Megan will be in the hands of the specialist stroke team.
30:00What have you got your sunglasses on for us?
30:03Sensitive eyes.
30:05Sensitive eyes?
30:07Sensitive eyes?
30:11Oi!
30:13Who's splashing me?
30:18Might have to put some glasses on to protect my eyes.
30:21At air ambulance headquarters near Wakefield,
30:23paramedic Sammy is on dispatch duties.
30:25Love it, love it, love it.
30:27Oh, no! Ooh, what are they?
30:31Busy two Percy pigs.
30:37Ooh! Ooh, no.
30:39They're not a Percy pig.
30:44Hi, there. It's Sammy speaking.
30:46She has a job for the crew at Topcliffe.
30:48OK, I'll be there in a minute.
30:50Hi, there. It's Sammy speaking.
30:52She has a job for the crew at Topcliffe.
30:54OK, I'll have a look. See you. Bye.
31:04Fuel. We've got 585. Visual the key.
31:08They're being scrambled 50 miles to the east coast
31:11where a walker has been injured in a fall.
31:13Engines both to flight. They are. They're guarded.
31:15Confirm. Doors, harnesses and stretcher.
31:18Close and secure, all right?
31:19Close and secure in the rear.
31:20Nine-nine, lifting.
31:27Bloomington traffic. Bloomington traffic.
31:29Heli-Med, nine-nine-alpha, H145 helicopter,
31:32just lifted from Topcliffe, routing eastbound towards Bloomington.
31:38Flying at speeds of up to 160 miles an hour,
31:41Heli-Med nine-nine can reach 90% of Yorkshire within 20 minutes.
31:46We're after somebody with a fractured ankle.
31:48Not sure if it's an open-closed fracture,
31:51but they appear to be in the middle of nowhere.
31:53They've sent a walk-free words to the ambulance service
31:56and they don't think an ambulance is going to be able to get to it.
31:59So, essentially, it's a location access issue as well as a rolled ankle.
32:05So, essentially, I might need a vacuum. It's Bloomington, mate.
32:08Vacuum's doing a bit of interlocks here.
32:10I'll grab those, then, eh? Thanks, mate.
32:16The co-ordinates are plotting close to the towering chalk cliffs
32:20north of Flamborough Head.
32:22It's almost a bit sunshine. I know.
32:26Heli-Med, nine-nine, Humber Coastguard, over.
32:28Heli-Med, nine-nine-alpha, on task for the detail you just described.
32:32We are actually only two minutes out.
32:35Heli-Med, nine-nine-alpha, this is Humber Coastguard, roger, many thanks.
32:39Coastguard, out.
32:41The crew will be landing close to Bempton Cliffs,
32:44a popular spot for walkers.
32:47Now, in the corner, just down there.
32:49Yeah. I'm just going to come in to the right
32:52and then a circuit left to avoid overfly,
32:55the cliff-top area, for birds and such like.
32:58Head-S, nine-nine, overhead.
33:01It's quite a slow piece now.
33:05Nine-nine, landed.
33:14Hello.
33:16Hi, I'm Tom. I've got Andy here. What do I call you?
33:19Gillian.
33:20Gillian. Tell me what's happened today.
33:22We were just walking back along the cliff path and I slipped
33:25and I don't even know what's wrong with my ankle.
33:28They're all broken, I think.
33:30But, by the way, I'm going now.
33:32Yeah.
33:33It's sore and I'm miserable.
33:36So, we're going to look at putting a little needle in your arm
33:39and then giving you some pain relief
33:41and then we'll get that ankle and we'll give you lots of pain relief
33:44and then we'll straighten it and we'll put it in a splint.
33:47Gillian Whiteford is 66.
33:50She suffered a severe ankle fracture
33:52after slipping on a narrow cliff-top path
33:54while walking with husband Jack.
33:57Gillian, have you had gas and air before?
33:59No.
34:00OK. Some big, deep breaths.
34:03That's it. And then you can just breathe out with this still in your mouth.
34:07It was bent at an angle and it didn't feel as though,
34:09although she had some movement,
34:11there was a bit of sensation that was lacking there,
34:13so we're concerned about blood flow and nerve damage.
34:16So, the sooner that we can get that nice and straight,
34:18then it'll be better for Gillian.
34:24Oh, my God, there's more people.
34:26It wasn't your fault, but you didn't exactly fall
34:28in the easiest place for us to get to either,
34:30so that's why there's a few more people.
34:32Coastguards have arrived to support the air ambulance crew.
34:35What are you thinking, mate, in terms of analgesia?
34:38I think, possibly, look at getting a line,
34:40and probably want some PrEP, I think, for that,
34:42just because we're going to have to manipulate it back into place.
34:45Gillian, the pain in your ankle, you had to score it for me.
34:48What would you say it is currently?
34:50Five or six.
34:51Five or six. OK.
34:52I think the internox is doing its job.
34:54Gillian will be given ketamine
34:56so that the paramedics can straighten her ankle where she lies.
34:59We're going to give you some more medicine,
35:01so we're going to go into the vein and we're going to give you some more medicine.
35:04We're going to let that work, and then we're going to get your boot off,
35:07and then we're going to get your ankle nice and straight,
35:09a splint, just to keep it nice and still,
35:11and that'll help with the pain, all right?
35:13But we'll tell you everything that we're doing as we go along.
35:16So we're just getting our stuff ready for the moment.
35:19We were out looking, some birdwatching, looking for some puffins.
35:23I was in front, so all I heard was this scream,
35:25and the next thing I looked, she's lying down where she is just now,
35:29and I just saw her ankle in the wrong shape.
35:31I dialed 999.
35:33The paths are usually quite narrow, quite wet, quite muddy,
35:37so you're trying to watch your feet the whole time.
35:40So this medicine we're going to give you is really good.
35:42It's going to make you what we call disassociate,
35:45so you're going to think about something really nice when we tell you to,
35:49and then you're going to kind of feel as though we're moving your ankle,
35:53but it's not going to cause you any pain.
35:55I'm a little worried now.
35:57Don't get worried.
35:58We need to move her, we need to get her onto our scoops,
36:01which is what we're going to use to extricate her to the helicopter,
36:03and at that point as well we're also going to move her legs.
36:06We're going to try and do a couple of things all together
36:08to get her nicely packaged, to get her legs straight,
36:11and get her ready so we can lift her and put her in the back of the helicopter.
36:16What time did it happen?
36:18I don't know.
36:20Are you all right? Don't get worried.
36:22I'm still sore.
36:24That's all right. Keep going on that gas.
36:27She's going to come and hold your hand.
36:29You're going to think nice thoughts, okay?
36:33All right, ready, mate?
36:37Right, so he's meditating, so nice thoughts,
36:39so it's just going to start taking effect.
36:41Make sure this leg's all right.
36:43You're going to be fine.
36:45Yeah, you are.
36:46Match that feeling a bit odd.
36:48There you go. Let me hold on to it for you.
36:50I'm happy for them helmets to go.
36:56What's happening?
36:57No, we're just giving you this pain relief.
36:59Oh, God.
37:01You're doing really well.
37:03Gillian.
37:04Nice and chilled.
37:05Nice and slow there, breathing.
37:07Sometimes what happens with the patient is they can have
37:09a bit of a bad experience with ketamine.
37:11They can become quite frightened and a bit agitated with it,
37:14and if we can control the environment around that
37:16then hopefully we can stop that.
37:18I feel like grabbing a couple of you guys.
37:20We're going to take the scoop behind her.
37:22And as we roll, me and Will will deal with the ankle.
37:24Yeah, no problem.
37:26We'll just give it a go.
37:34While Gillian is being rolled onto the scoop stretcher,
37:37Andy will pull her ankle back into alignment.
37:40Me and you will take the ankle.
37:41If you'll take this leg.
37:44We'll just go for it on the scoop, mate.
37:46Let's just go.
37:47We're just going to move her. Big deep breaths.
37:49There we go.
37:51Just relax.
37:59Well done.
38:02Right, and if we get her out of the mud,
38:04are we all right to grab round her and lift her somewhere flat out of the mud?
38:06Everybody got a grip? Ready, steady, lift.
38:09Right, are we all right top end, mate?
38:11Yeah, yeah, still got capnography.
38:13Her ankle's staying in line on all on its own.
38:17We're just going down now, Gillian.
38:19I'm just going to put you in a nice big warm sleeping bag.
38:21I don't know what I'm doing.
38:23You're doing really well.
38:29Andy is using a vacuum splint which will mould to the leg
38:32and prevent the fractured ankle from moving.
38:35I can't see anything.
38:39Right, guys, if you put some scoop straps over,
38:42pop this over your head.
38:44There you go.
38:46So three round that side, three round this side.
38:48Is everybody ready? Yep.
38:50On lift, ready, set, lift.
38:52Are you all right there, Gillian?
38:54I don't know.
38:56I'm going to take that as a maybe and a yes.
38:59You're doing well.
39:01Gillian will be flown to hospital.
39:03How are you feeling, mate?
39:05I don't know where I am.
39:07You're in that helicopter just off the coast of Brillington.
39:10OK, happy to lift to the back.
39:12Yes, we are.
39:18Airbus 99, that's us airborne to Scarborough.
39:21It's 17 miles to Scarborough
39:23and just seven minutes in the helicopter.
39:26Are you OK, Gillian?
39:28I don't know what I'm doing here.
39:30This is bizarre.
39:32Do you remember what happened to you when you were walking on the footpath?
39:34I fell. You fell, yeah.
39:36Oh, it's painful.
39:38Can you take some breaths? That's it.
39:40Keep going on that.
39:44Scarborough Hospital, official landing site.
39:46Looks like there might be a DCA waiting.
39:48Gillian, we're just going to go and land in the hospital now.
39:5199 final, Scarborough.
39:55At the helipad in the grounds of Scarborough Hospital,
39:58Gillian will be loaded into the land ambulance
40:00for the short transfer to A&E.
40:06We're giving you a drug called ketamine.
40:08It can kind of make you feel as though you're sort of here but not here.
40:12We'll get you warmed up as well.
40:14We'll slide you out that way.
40:18You're all right, you're doing really well.
40:20You can't remember it, it's just a bit weird.
40:22So Harry's going to pull the stretcher out the back,
40:24but you're nice and safe on it, all right?
40:26You're nice and safe.
40:28Oh, thank you.
40:34There we go.
40:36So she's been out walking with friends,
40:38witnessed no LAC, just like a low slide,
40:41but unfortunately had fractured it.
40:43It is closed, it was angulated.
40:45Realigned it, splintered it.
40:47Hobbs-wise, unremarkable.
40:49So she's a lot more orientated, compliant now.
40:52She was quite disorientated on the flight.
40:54There's some more blankets for you.
40:56I'll see you at hospital, all right?
40:58Oh, you're welcome.
40:59Thanks very much. Cheers, guys.
41:07She's collapsed.
41:09Checks at a specialist stroke centre found Megan Bigham
41:12had a blood clot to her brain which triggered a stroke.
41:16Surgeons removed the clot in theatre.
41:18Her chances of a full recovery are much improved thanks to her swift rescue.
41:27After falling on a clifftop path,
41:29Gillian Whiteford underwent surgery to pin and plate her badly fractured ankle.
41:35It will be at least six months before she's fully recovered.
41:41We've done a number, haven't we?
41:43Georgia Smith underwent immediate scans in hospital
41:46after fracturing her arms and suffering seizures
41:49following a fall from a horse.
41:51I remember prior to the accident going over the gate,
41:54going, this is going to hurt.
41:56In and out of consciousness in hospital,
41:58almost as soon as I got there, they rushed me down into theatre
42:01because my right arm was an open fracture,
42:04left arm was full elbow dislocations.
42:09Come on, Key!
42:10They've estimated around a year for things to start to settle down
42:15and go back to normal.
42:16The strength level's not there, the mobility level's not there,
42:19but it will come in time.
42:25Try to raise my left arm, and that's when the pain hits.
42:29It's the worst pain I've ever, ever been in.
42:32Oh!
42:33Doctors found John Ballantyne had dislocated his shoulder
42:36after coming off his motorbike.
42:38They popped it back in.
42:40That was just the beginning of the problems.
42:42The consultant said that I've done major, major, major nerve damage.
42:47I've got no control from my elbow to my wrist.
42:52Because it's nerves, I just can't do anything about it.
42:54I can't go to any physio or anything to make it work faster.
42:59The most annoying thing at the moment is my hand.
43:02It's just constantly numb.
43:07But I will get back on the bike.
43:09It's just going to be a long process.
43:22For more information, visit www.FEMA.gov