Episode 12 Countryside 999

Rural Britain has some of the most challenging environments

in the world. In Scotland, the mountains, lochs and coastline

encourage tourists and locals to get out into the wild.

But with that, comes danger.

Are there any injuries with those in your party?

The emergency services north of the border have to deal with

extreme challenges every day.

..someone who believes he has been systematically poisoning trees.

From severe weather in treacherous terrain...

Can you feel it cracking?

..to covering huge distances on country roads with time against them.

We know it's an emergency... it's the highest category.

They work around the clock,

battling against some of the most difficult situations.

We'll be right at the heart of the action -

side-by-side with air rescue, saving lives,

on the road with paramedics caring for the injured,

and following the police fighting crime, as the emergency services

work together to pick up, patch up

and protect the public in rural communities.

This is Countryside 999.

Coming up...

The Royal Navy helicopter crew rescue an injured rock climber...

Argh!

..rural A&E treat a teenager who's been badly hurt by a firework.

And firefighters tackle obstacles in the pitch black

to reach a blazing field.

When we got here, about six or seven of the bales were alight.

Living in the countryside in Britain is a dream for many people.

But aspects of country living can be difficult.

For the elderly in more isolated locations,

medical help can feel further away in times of need.

In Dumfries and Galloway, the ambulance covers a huge area.

The scattered population has, on average,

only 60 people per square mile.

SIREN BLARES

Today, German-born paramedic of nine years,

Michael Harmjanz, is on shift with David Irving.

They've received an urgent call from a house close to base in Dumfries.

An 80-year-old woman with chest pains, so it's an emergency.

It could be a heart attack, so they need to get there fast.

SIREN SOUNDS

She's either been seen by a GP or she phoned a doctor.

Just here.

80-year-old Mary is in severe pain.

Her husband and son-in-law are by her side.

Michael and David administer oxygen to help her breathe,

while they set up an ECG to find out what's happening with her heart.

Right, Mary, let's take your temperature.

That's a bit high.

The ECG shows it's not a heart problem.

It doesn't look like it's coming from your heart, the pain.

It's more likely from your lungs.

OK, so if you take a deep breath in, it's painful, isn't it?

Right, OK.

So, we have to take you up to the hospital, anyway,

to get maybe a chest X-ray.

Let's free you from all these cables. OK.

Elderly people are most at risk from serious bronchial conditions,

such as pneumonia.

Mary's age means she must get to hospital quickly.

Just have a quick listen to your chest.

And give us a cough. OK. Oh, yes.

I can't see any damage of the heart muscle on the ECG,

but we confirm this with a blood sample,

and a chest X-ray, find out what the cause for the pain is.

We think it's coming from your chest

because you had a cold for so many weeks.

It's put a strain on your lungs.

So, maybe got some fluids and some infection going on there.

Probably need a chest X-ray, maybe have to put you on some antibiotics.

Mary's daughter and granddaughter have rushed to meet her at the hospital.

Michael and David hand Mary over to the A&E team at her local

hospital, Dumfries and Galloway's Royal Infirmary.

Good morning.

Good morning.

You just sit tight. We'll move you across onto our trolley.

Right, on slide. Ready, steady, slide.

In A&E, the team get to work.

How are you feeling just now? Have you got pain just now?

-Just, see that...

-Right in the centre.

Dr Mike Quigley takes charge of Mary's care.

OK. No, that's fine, that's cool. Thank you, cheers.

He examines her X-rays.

The findings are as we would expect from what we...

when we listened into her, she looks as if

she's got signs of infection down at the bottom of her right lung.

So that'll probably be contributing to her pain and her cough.

Mary does have a nasty chest infection,

but thankfully it's not pneumonia.

On your X-ray, I've seen there's probably a little bit

of infection at the bottom of that lung and a little bit of fluid.

And that hopefully will clear away with some antibiotics.

But the reason why you need to go into hospital is probably cos

you need a little bit of oxygen. It may be for a short period of time

but we'll get you feeling a bit more comfortable. Is that OK?

The fact that she needs some oxygen to keep her oxygen levels up

is the main reason for bringing her into hospital,

so hopefully, two to three days will see her ready for home again.

In the north east of Scotland, Elgin in Moray is home

to one of Grampian Fire and Rescue Service's three full-time stations.

Altogether, they watch over more than 500,000 people,

in an area of over 3,000 square miles.

Watch manager, Davie Farquharson, has been a firefighter for ten years

and as it's bonfire weekend,

he's on hand to put out the town's official bonfires.

During bonfire night there's an organised fireworks display

and bonfire in Cooper Park in Elgin,

and during the evening the fire service,

they take the fire engine down and stood by and dampen down the fire,

just so the organisers can then go and leave it, safely.

But it's tackling unofficial bonfires that can make it

their busiest time of the year.

In 2011, Grampian Fire Service were called out

to 153 incidents on 5th of November.

It's just before bonfire night, and the crew get a 999 call.

There's a fire on a farm bordering a housing estate.

Red Watch has just started the night shift, and they've been called

to join their colleagues, Blue Watch, on the farm.

First, they have to get to the blaze,

but it's in the middle of a 60-acre field.

So it's not going to be easy...

..especially since it's pitch black.

Are you OK coming across here?

The actual fire itself, obviously, was in an awkward place.

It was at the back of a housing scheme, and then to get to

the actual fire itself, we had to cross a burn.

Luckily enough, a tree had fallen down and was going across the burn,

so that was the only access we could get through

without going through any kind of water.

When the first crew arrived, several bales were on fire.

Luckily, someone raised the alarm.

Obviously, somebody must have seen smoke in the distance

and they called the fire brigade.

When they got here, there was about six or seven of the bales alight.

The farmer come down, as well, to try and help out.

With the terrible harvest this year, hay and straw are valuable assets.

Even more serious is the risk of the fire spreading through

the field, and possibly into the housing estate.

Within 15 minutes,

Red Watch has extinguished the remaining bales.

It's back over the makeshift bridge,

and a return to the station to prepare for the next call.

What's happened is that when we're out at a countryside fire

or anything like that, a lot of the equipment gets really dirty.

So we have to wash it when we get back, sort of thing.

So, now we're just rolling up the hose and getting everything clean again for hopefully the next shout.

But their next shout is the last straw.

Time is critical for all the countryside emergency services,

whether they're putting out fires, rescuing casualties,

or treating patients.

Earlier, Dr Mike Quigley took care of Mary,

who was suffering chest pains.

Now, Dr Niall Campbell is on shift in the same rural A&E.

OK, there's not too much waiting.

Good. OK.

Over a quarter of the population in Dumfries and Galloway

are pensioners.

Getting critical care to the elderly in rural areas can be challenging.

Niall's next patient, Wilma, was rushed to hospital by her daughter.

She recognised the signs of a potentially serious condition.

I've been asked by the nurses to have a look at an 87-year-old lady

who may have had a stroke.

Hello, my name's Doctor Campbell, I'm one of the A&E consultants.

I understand you've had some problems with your hand, is that right?

-Yes.

-Can you tell me about that?

Well, I'd a tingling in my left hand,

and that's what happened when I had the stroke the last time.

When was that?

That would be...'96.

Every five minutes, someone in the UK has a stroke.

The sooner they receive medical attention,

the better their chance of recovery.

'With suspected stroke patients,'

speed is of the essence,

because there is a small group,

where giving them a clot-busting drug,

can have a dramatic effect on their outcome.

When did this all start today?

About three o'clock, I think, today.

Knowing her mum's medical history, Wilma's daughter, Patricia,

brought her to hospital straight away.

And when you got to her was there any obvious change in her

that you'd noticed?

My mum's normally quite pale coloured, but she was very flushed.

She wasn't moving so I couldn't

-have said anything about her walking or anything like that.

-OK.

And she was making sense, her speech was OK?

She was making sense.

Niall examines Wilma for classic symptoms of a stroke.

Can you give me a big smile? You're doing it already.

Good. Can you raise your eyebrows up for me?

Good. Can you hold your two arms out in front of you for me?

And if you hold them straight up, and straight out in front.

Kind of lift up. Yeah.

-OK, that hand looks a bit weaker. Is that...

-Yeah, it is.

We're just keeping an eye on her.

She had some blood tests sent earlier

so we'll wait on those results

and make sure that she stays as she is

with just this tingling in the hand.

Wilma's blood pressure has stabilised,

and thankfully, her blood tests are all clear.

So, I think with an absence of any obvious signs of a new stroke,

with blood pressure having settled down,

that we probably should let you escape.

But you did exactly the right thing

and if the same thing happened again, where you were

-noticing things change, do the same, you come straight back here.

-Right.

And if it's difficult to get someone to come and take you in, when

you're worried if you might have had a stroke, you can dial 999.

-That's a good use of 999, OK?

-OK.

And as I say, any problems, you know where we are.

We are always open.

The Royal Navy Search and Rescue team from HMS Gannett

are on call 24/7, and cover an area of 94,000 square miles.

They help injured climbers and seriously ill patients

on remote islands in need of emergency care.

It's 1:30pm,

and the Navy unit is en route to a call that's just come in.

Angela Lewis, as observer, is guiding the crew.

The incident is in the stunning Glen Nevis,

just a few minutes from Britain's highest mountain, Ben Nevis.

A young man has been rock-climbing.

He reached for a hand hold and slipped, dislocating his shoulder.

The remote location makes the Navy helicopter by far the quickest means of getting him to hospital.

You've got the steeper bit on the right as you approach it.

Lochaber Mountain Rescue Team, or MRT, were first on the scene.

Made up entirely of volunteers, they carry out up to 100 rescues every year,

and today they've brought a mountain rescue team medic.

Winchman Andy Firth is sent down to prepare the climber and medic for uplift.

Angela must simultaneously guide the pilot into a hover position

and control the speed and direction of Andy on the winch.

The casualty, 19-year-old Jordan, is in a lot of pain.

He is given pain relief

and strapped onto a stretcher by medic Mark Fair.

Andy gets Mark up first so he can look after Jordan during the flight.

Then he straps the 245-ft winch to the stretcher.

'We used a high line technique.

'The high line is a very valuable piece of equipment.'

Effectively, it's a steadying line. In that situation,

there was quite a lot of low-level turbulence from the position,

and that will spin the stretcher.

If you've got a disorientated, distressed casualty, the last thing

you want to do is put him in the worst fairground ride of his life.

But even with the high line,

the strong turbulence causes the winch to spin.

It's rocking the stretcher and knocking Jordan's shoulder,

and the only available pain relief is entonox, or gas and air.

Good position. Good position.

You take winch control.

Bring him inward and then bring the high line back.

You're clear behind, clear to the right.

They're only a few miles from the nearest hospital in Fort William.

The Sea King helicopter lands just outside the town,

where it's met by an ambulance.

It's straight to hospital for Jordan

and back to base for the Gannet crew.

Our rural emergency services face adverse weather,

long distances and hard to reach locations.

In north east Scotland, Elgin's Fire and Rescue Service

do their best to prevent fires.

But it's malicious fires that cause the most trouble.

It's bonfire weekend

and the team have already put out a deliberate fire in a field.

When they got here, there's about six or seven bales were well alight.

It's one of the busiest times for fire services across the UK,

and in Elgin it's no different.

So Will Ford and the Blue Watch are taking preventative measures.

There's a set area we need to go out, look at, round a route.

Maybe normal things like industrial estates, housing estates,

things... Public fields and things

where people might be looking to build fires.

Make sure there's no build-up of refuse or rubbish, wood etc.

If there is, we can let authorities know or take them down ourselves.

Unofficial bonfires can get out of control quickly, so searching

for potential hot spots could reduce the number of call-outs.

We've not seen anything that looks at any risk to being a bonfire.

So we can only just keep looking, I suppose.

Until their next emergency call comes in.

Do you know how to get there, aye?

We've just received a call

to somewhere we were yesterday. A farm with some bales on, a fire.

It's deja vu for Watch Manager Davie Farquharson and the team.

Kids suspected of setting the bales of straw ablaze

the night before may have returned to the scene of the crime.

Of course we knew where we were going,

it was the same crew that had been on duty the day before.

Everyone knew the risks and hazards associated with the access problems,

how to get across the bridge in the first place.

The first five minutes of a fire are crucial

so the guys hurry back over the fallen tree bridging the river.

The same makeshift bridge they had to negotiate the night before.

OK? Are you OK coming across here?

This time, it was only one bale on fire

but it had just been very recently set on fire.

The fire has only just been started so it's small and easy to contain.

But if the call hadn't come so soon,

the flames could have swept through the field.

Wilful ignition

or deliberating fire-raising has serious consequences

and it wastes a lot of time.

In the last two months, you could maybe say

maybe 30% of the fire calls we've had have been wilful fires.

Now, we're talking about obviously two incidents

we've just talked about where it was on the farmland,

but then we can look at wheelie bin fires, rubbish fires,

which people set...and the cause

always goes back as wilful because they don't go on fire by themselves.

But bonfires and fireworks don't just keep the fire department busy.

Britain's A&E departments

treat around 1,000 firework injuries every year.

Dr Pete Armstrong is heading up Dumfries and Galloway's A&E tonight.

With 13 years' experience, Pete's a consultant in emergency medicine.

Good news for his next patient, who's being blue-lighted

from Lincluden, ten minutes away.

OK, it's a 14-year-old

with a firework injury and partial amputation to their hand.

-AMBULANCE:

-'Stand well clear. Vehicle reversing.'

Around half of all firework injures affect children under 17,

and this 14-year-old boy Anthony has done serious damage to his hand

with a lit firework, taking off the tips of two fingers.

It's a very nasty injury and he's been given painkillers

so it doesn't feel as bad as it looks.

Right, Anthony. And we'll roll it over in just a wee second.

Anthony, I'm just going to have a wee feel.

-Can you feel me touching you there?

-Yes.

-Good, can you feel me touching you there?

-Very slightly.

-What about down there?

-Yes.

-OK.

-Don't. Cos I'll shake...

-But you can feel it there?

-Yeah.

-Good.

-There?

-No.

-There? No. And there, no?

-Can't feel a thing.

OK, that's fine.

Photos are taken to send to the specialists, and as soon as Pete

has assessed the damage, Anthony is X-rayed to check for broken bones.

We're giving him some antibiotics because one of the things is,

with a firework exploding, bits of paper, debris, explosive,

can be driven under the skin which could introduce infection.

The best way to manage that is to wash it out and to get rid of

any debris in there, but antibiotics will help with that as well.

The nearest specialists for hands and plastic surgery

are an hour-and-a-half away in Glasgow.

Anthony's given antibiotics and anti-tetanus injections.

Now they need to disinfect and clean the wound thoroughly

with a litre of saline.

If you want to hold the hand, do you want to get in there

and give it good wash.

Just that's a few of us being despatched and... Hold this.

You know, you've got some nasty injuries.

You've got some nasty cuts to your hand.

You've lost the top of your middle and your ring finger.

I mean, I can't do anything about those

and you've broken a couple of bones down in here.

-It's all right.

-Will I get a cast when it's all repaired?

Yeah, you'll be in a plaster cast,

you're probably going to have a couple of wires put into your hand

as well just to hold the bones straight.

Anthony's badly injured hand

needs dressing to lower the risk of infection.

The consequences of the accident are sinking in.

It was a firework I found a few days ago in the street.

Some idiot left it there, and me being me, I picked it up.

And today, like, I lit it and it went out,

finished...it went back on by itself.

So I tried to... Tried to run to the toilet and put it in there

so it would stop.

And then it went "boom". Right when I was in the hallway.

I didn't realise what happened, what I did to my hand,

until five minutes later when my big brother came up.

The safest thing to do with an unexploded firework is to

soak it in a container of water but always wear gloves and goggles.

With the wound cleaned and dressed,

Anthony's sent on the 80-mile journey to hospital in Glasgow.

There, specialists will repair the damage.

See you, guys. Good trip.

It's been all go for the emergency services in Scotland's rural areas.

Despite the joint efforts of the emergency services,

Elgin's mystery fire-starters were never found.

And specialists got to work on Anthony's hand.

He's getting physiotherapy to help his recovery.

And you thought it was quiet in the countryside.