0:00:02 > 0:00:05From the Highlands of Scotland to the coast of Cornwall...
0:00:06 > 0:00:09..the Great British countryside is spectacular.
0:00:11 > 0:00:14But we work and play in it at our peril.
0:00:15 > 0:00:17SIREN WAILS
0:00:17 > 0:00:19And when things go wrong,
0:00:19 > 0:00:22the emergency services race to the rescue.
0:00:22 > 0:00:25This chap is having a heart attack and we need to get him in quickly.
0:00:28 > 0:00:30There's no police courses for this.
0:00:30 > 0:00:32Going hundreds of miles against the clock.
0:00:33 > 0:00:35Battling the elements
0:00:35 > 0:00:37and braving the weather.
0:00:38 > 0:00:39HE GROANS
0:00:40 > 0:00:42From fields and forests...
0:00:43 > 0:00:45..to cliffs and country roads,
0:00:45 > 0:00:48we'll be right at the heart of the action.
0:00:49 > 0:00:51With police fighting crime.
0:00:51 > 0:00:53I could seize the dogs, I could seize the van,
0:00:53 > 0:00:55but I'm going to summon you all to court.
0:00:55 > 0:00:57Paramedics saving lives...
0:00:57 > 0:00:59BABY CRIES
0:00:59 > 0:01:02..and wardens safeguarding our lakes.
0:01:02 > 0:01:03Come out of the way.
0:01:04 > 0:01:08We're there as the emergency services pull together
0:01:08 > 0:01:10to pick up, patch up,
0:01:10 > 0:01:11and protect the public.
0:01:13 > 0:01:15This is Countryside 999.
0:01:33 > 0:01:34Coming up...
0:01:34 > 0:01:38In Dumfries and Galloway, a patient in acute pain
0:01:38 > 0:01:40means a blue light call out for the paramedics.
0:01:48 > 0:01:51In Yorkshire, the pressure's on when air paramedics rescue
0:01:51 > 0:01:54an 83-year-old woman injured in a fall.
0:01:54 > 0:01:57She had to crawl and sort of pass me the keys through the door.
0:01:57 > 0:01:59I can't believe you've been down on the floor since yesterday.
0:01:59 > 0:02:02And in the Lake District, holiday-makers call for help
0:02:02 > 0:02:05when they run aground with disastrous results.
0:02:05 > 0:02:08Smashed a prop and bent the prop shafts underneath.
0:02:08 > 0:02:10They've been a bit too close to the shore.
0:02:16 > 0:02:18Dumfries and Galloway,
0:02:18 > 0:02:21with farmland and forest as far as the eye can see.
0:02:24 > 0:02:27A vast county of beautiful rolling countryside
0:02:27 > 0:02:29and only 60 people per square mile.
0:02:33 > 0:02:37The sparse population is linked by 2,500 miles of rural roads.
0:02:41 > 0:02:44For the ambulance paramedics based at Lockerbie,
0:02:44 > 0:02:46long trips cross-country come with the job.
0:02:51 > 0:02:54Paramedic Paul Votier started out in the building trade.
0:02:56 > 0:02:59Before I became a paramedic, I was a roofer.
0:02:59 > 0:03:01The whole building trade collapsed.
0:03:01 > 0:03:04I was out of work, I had to go to the unemployment office,
0:03:04 > 0:03:07and they informed me there and then that the London Ambulance Service
0:03:07 > 0:03:10was recruiting, would I be interested? And I said,
0:03:10 > 0:03:13"Yes, I'll give that a go." And here I am 25 years later.
0:03:13 > 0:03:16I'll do his knee. Just keep still for two seconds for me, Robert.
0:03:17 > 0:03:20One of the best things about this job is you don't know
0:03:20 > 0:03:23what you're going to come across, who you're going to see or meet.
0:03:23 > 0:03:25We'll get you to the edge of the bed first. You sit yourself up.
0:03:25 > 0:03:28What effect you are going to have on someone's life.
0:03:28 > 0:03:31You know, you can come in and not turn the wheel,
0:03:31 > 0:03:34or there's other days you can go out and you're out all day,
0:03:34 > 0:03:35or there's just the one job and you go...
0:03:37 > 0:03:39..and you've made a big difference in someone's life.
0:03:42 > 0:03:45This morning, Paul and his colleague Cormac O'Neill
0:03:45 > 0:03:46are on an emergency call out.
0:03:47 > 0:03:51We're on our way to a doctor's surgery.
0:03:52 > 0:03:56We're going to a 59-year-old female,
0:03:56 > 0:03:58and the doctor's diagnosing chest pains.
0:03:58 > 0:04:02The GP has also requested a 999 response for this lady.
0:04:05 > 0:04:08If a GP's called them, Paul knows it must be critical.
0:04:09 > 0:04:12A heart attack can turn into a cardiac arrest.
0:04:12 > 0:04:15We know that the GP has assessed the patient, and it's a patient they need
0:04:15 > 0:04:17to get in pretty quickly if you know they're unhappy
0:04:17 > 0:04:20with their condition, or a concern for their condition.
0:04:24 > 0:04:27They're blue lighting from their base in Lockerbie,
0:04:27 > 0:04:3017 miles to the doctor's surgery in Moffat.
0:04:34 > 0:04:38Every six minutes, someone dies of a heart attack in the UK.
0:04:38 > 0:04:41One in three people don't make it to hospital.
0:04:41 > 0:04:44Paul and Cormac race there as fast as they can.
0:04:44 > 0:04:45Whoa!
0:05:07 > 0:05:10In 15 minutes, they reach the surgery in Moffat.
0:05:12 > 0:05:13Hello.
0:05:16 > 0:05:19GP Shona Gillies quickly explains that chest pain
0:05:19 > 0:05:23is just one symptom of many for her critically-ill patient, Jane.
0:05:23 > 0:05:2559-year-old insulin-dependent diabetic
0:05:25 > 0:05:27who has very brittle diabetes.
0:05:27 > 0:05:30She was due to come for a review, to see me today.
0:05:30 > 0:05:33She appeared with her sister, staggering along.
0:05:33 > 0:05:35I've not seen her as bad as this with it
0:05:35 > 0:05:37but I think she needs to be going
0:05:37 > 0:05:39- down there as fast as we can get her.- Certainly.
0:05:39 > 0:05:44Like three million people in the UK, Jane has diabetes.
0:05:44 > 0:05:47She has a very severe form of type-one diabetes.
0:05:47 > 0:05:49Her body is unable to produce insulin
0:05:49 > 0:05:51to control her blood sugar levels.
0:05:51 > 0:05:53How does your chest feel?
0:05:53 > 0:05:54Is it still quite sore?
0:05:56 > 0:05:58All right. Jane, do you recognise this pain at all?
0:05:58 > 0:06:01Have you had this pain before? Yeah?
0:06:01 > 0:06:02SHE GASPS
0:06:02 > 0:06:05All right. Does this normally come on when your diabetes is playing up?
0:06:08 > 0:06:11It's becoming clear that Jane may not have just one medical
0:06:11 > 0:06:13emergency but two.
0:06:13 > 0:06:16Not only does she have worrying chest pains
0:06:16 > 0:06:18but her diabetes is out of control.
0:06:20 > 0:06:23Her blood sugars were very, very high.
0:06:23 > 0:06:25The blood glucose monitor wouldn't even read,
0:06:25 > 0:06:26it was just screaming at us.
0:06:26 > 0:06:28It was high. You know, it was too high.
0:06:28 > 0:06:31Jane, we're going to shut these back doors and do another ECG.
0:06:31 > 0:06:33We're going to put more sticky pads on you.
0:06:33 > 0:06:35We was unsure whether the main problem was the cardiac pain,
0:06:35 > 0:06:37she was having an heart attack,
0:06:37 > 0:06:39or it was her high, high blood sugar levels
0:06:39 > 0:06:41that were causing the main problems.
0:06:44 > 0:06:46Going to step like that.
0:06:47 > 0:06:50Now in the ambulance, Paul attaches electrodes
0:06:50 > 0:06:53linked to an ECG machine in the hope of getting a heart trace.
0:06:57 > 0:06:59Jane, your pain at the moment,
0:06:59 > 0:07:03if I gave you the scale of zero being no pain,
0:07:03 > 0:07:05ten being the most excruciating pain,
0:07:05 > 0:07:07where would you put your pain at the moment
0:07:07 > 0:07:08on that scale?
0:07:09 > 0:07:11About eight now, is it?
0:07:13 > 0:07:15Pain started to come back as well now.
0:07:17 > 0:07:21The ECG machine will give a false reading if Jane moves,
0:07:21 > 0:07:24but in terrible pain, she can't stay still.
0:07:24 > 0:07:26It's come back pretty quick that pain, hasn't it?
0:07:26 > 0:07:29Jane, we need to keep as still as you can for me.
0:07:32 > 0:07:35The results from the heart monitor are inconclusive.
0:07:37 > 0:07:38Yes.
0:07:40 > 0:07:42It's too much shaking on the machine at the moment.
0:07:42 > 0:07:45We'll get this pain fixed for you, OK?
0:07:46 > 0:07:47Don't apologise.
0:07:49 > 0:07:52This lady's pain, it was such an intense pain, it couldn't keep still
0:07:52 > 0:07:55and she was getting quite breathless and upset and distressed with it.
0:07:55 > 0:07:57So then we had to treat that pain.
0:07:57 > 0:07:59The problem we had was this patient
0:07:59 > 0:08:01was a very difficult patient to cannulate.
0:08:04 > 0:08:06Jane is so ill her veins have collapsed.
0:08:17 > 0:08:21A cannula is a small tube that goes into the vein
0:08:21 > 0:08:24where then we can administer drugs.
0:08:24 > 0:08:26It's a direct route into the patient's body
0:08:26 > 0:08:30so we can give any pain-relieving drugs, any life-saving drugs.
0:08:33 > 0:08:35And if we haven't got access to the patient's body,
0:08:35 > 0:08:37well, we're bit stumped, really.
0:08:37 > 0:08:40Right, Jane, I'm sorry, I'm going at your foot here.
0:08:40 > 0:08:42OK? How's that pain?
0:08:45 > 0:08:47Just coming, just coming.
0:08:47 > 0:08:49Sharp scratch, Jane. Sharp scratch.
0:08:52 > 0:08:54- Yeah, we're in.- We're in.
0:08:54 > 0:08:56Unable to get a needle into her arm,
0:08:56 > 0:08:59GP Shona finds a vein in Jane's ankle.
0:09:06 > 0:09:08Morphine, 10mg. 10?
0:09:08 > 0:09:11- 10mg, yeah.- And just go down, yeah? - Yeah.
0:09:12 > 0:09:16The small cannula allows them to finally administer some morphine.
0:09:44 > 0:09:47OK, thanks a lot now. Cheers. All right.
0:09:48 > 0:09:50- Can we go, Paul, yeah?- Yeah, just get us going, mate.- Dead on, yeah.
0:09:52 > 0:09:56Now it's a 20-mile journey to hospital in Dumfries.
0:09:56 > 0:09:59As soon as that pain starts coming back, Jane, let me know,
0:09:59 > 0:10:00we'll get you some more.
0:10:00 > 0:10:02It's going to be a little bit bumpy as well.
0:10:02 > 0:10:05SHE WHIMPERS All right, you just try and relax.
0:10:08 > 0:10:10Battling constant pain,
0:10:10 > 0:10:13for Jane the journey can't be over fast enough.
0:10:15 > 0:10:18Jane, if that pain comes back, you shout, all right? You holler.
0:10:18 > 0:10:20I'll give you some more.
0:10:37 > 0:10:40Yorkshire is the largest county in the UK.
0:10:40 > 0:10:43It spans some 5,500 square miles,
0:10:43 > 0:10:46from dense urban areas in the west...
0:10:46 > 0:10:49across wild countryside of outstanding beauty...
0:10:51 > 0:10:54..to 45 miles of remote coastline in the east.
0:11:00 > 0:11:03Providing rapid emergency medical treatment around the clock for this
0:11:03 > 0:11:06vast region are the crews of the Yorkshire Air Ambulance service.
0:11:12 > 0:11:17With a population of five million, their two choppers are in demand.
0:11:17 > 0:11:20But today their workload just got a lot heavier.
0:11:21 > 0:11:23'BBC Radio Humberside.
0:11:23 > 0:11:25'News at 1.'
0:11:27 > 0:11:30- NEWSREADER:- 'The union representing ambulance staff in Yorkshire says
0:11:30 > 0:11:32'they're being forced to strike.
0:11:32 > 0:11:36'They'll walk out at 3.00 this afternoon for five hours.'
0:11:39 > 0:11:42With land ambulance crews on strike throughout the county,
0:11:42 > 0:11:44the pressure's on Yorkshire Air Ambulance
0:11:44 > 0:11:46to attend the sick and injured this afternoon.
0:11:48 > 0:11:53Our grid is Tango Alpha 201474.
0:11:53 > 0:11:57At their base near Wakefield, air paramedic Andy Armitage
0:11:57 > 0:12:00has just received confirmation of a female casualty on the east coast.
0:12:02 > 0:12:04Thank you, mate. Right, see you later.
0:12:09 > 0:12:13Andy and fellow paramedic Matt Syratt get mobilised quickly...
0:12:14 > 0:12:16..with pilot Gary Brasher.
0:12:19 > 0:12:21- OK, doors, please.- No problem, mate.
0:12:23 > 0:12:25'Good afternoon. Helimed 99 Alpha.'
0:12:25 > 0:12:28'Helimed 99 Alpha, good afternoon.'
0:12:30 > 0:12:34The casualty is in Hornsea, a 50-mile flight from their base,
0:12:34 > 0:12:35cross-country to the coast.
0:13:02 > 0:13:05A thigh bone injury can be serious and very painful.
0:13:05 > 0:13:09Going by chopper means medical treatment is just minutes away.
0:13:11 > 0:13:1313 miles to run.
0:13:13 > 0:13:14THEY SPEAK OVER RADIO
0:13:15 > 0:13:19Hornsea is a coastal seaside town.
0:13:19 > 0:13:21Really, really remote.
0:13:21 > 0:13:24Cut off and isolated, really, from everywhere else,
0:13:24 > 0:13:27which made it just even more important that the aircraft attended
0:13:27 > 0:13:28this job, because, otherwise,
0:13:28 > 0:13:31this lady would have been there hours and hours.
0:13:36 > 0:13:39With the ambulance station in Hornsea closed due to the strike,
0:13:39 > 0:13:43a Rapid Response Paramedic has been sent to the scene.
0:13:43 > 0:13:46He's found the casualty is an elderly woman on her own.
0:13:52 > 0:13:54At speeds of up to 150mph,
0:13:54 > 0:13:57it takes just 20 minutes to reach Hornsea.
0:14:08 > 0:14:12They're hoping to spot the rapid response vehicle at the location.
0:14:22 > 0:14:25But the nearest they can land to the patient's town-centre home
0:14:25 > 0:14:26is half a mile away.
0:14:31 > 0:14:33- Ernest 99 on the ground. - It'll be fine.
0:14:36 > 0:14:39We'd put down in a small field, you know,
0:14:39 > 0:14:41just big enough for the aircraft to fit in.
0:14:42 > 0:14:44Purely because we knew the importance of getting there
0:14:44 > 0:14:46and helping this lady.
0:14:47 > 0:14:52It still meant a walk, a climb over a wall, over a stile and barbed wire.
0:14:52 > 0:14:53Don't fall now.
0:14:56 > 0:14:59Yeah, Lee, it's getting back to the landing site that's going
0:14:59 > 0:15:00to be the problem.
0:15:00 > 0:15:02We've had to land quite a distance away.
0:15:07 > 0:15:09- Hello?- 'Hello!'
0:15:09 > 0:15:10Hello. I'll just come in.
0:15:13 > 0:15:14This is Iris.
0:15:14 > 0:15:16Hi, Iris. How are we doing?
0:15:16 > 0:15:17Iris had a fall yesterday.
0:15:17 > 0:15:20She's been on the floor since yesterday morning.
0:15:23 > 0:15:27Shockingly, 83-year-old Iris fell over 24 hours ago.
0:15:28 > 0:15:32With her nearby family away, she's been on a cold floor,
0:15:32 > 0:15:33in pain, all night.
0:15:35 > 0:15:38It was very, very cold.
0:15:38 > 0:15:42I couldn't get my blankets off the bed or out of the cupboards,
0:15:42 > 0:15:44you see.
0:15:44 > 0:15:45She's been here since yesterday?
0:15:45 > 0:15:48She had to crawl and sort of pass me the keys from the door.
0:15:48 > 0:15:50She's been crawling around the kitchen...
0:15:50 > 0:15:53- She's been over 24 hours on the floor?- Yes, on the floor, yeah.
0:15:53 > 0:15:54Can't believe it.
0:15:54 > 0:15:57I've been crawling about on my stomach and my back, you see.
0:15:57 > 0:15:58I know, it looks like...
0:15:58 > 0:16:01I can't believe you've been down on the floor since yesterday.
0:16:01 > 0:16:03- OVER RADIO:- '99...' - I've got it, Andy.
0:16:05 > 0:16:06Turning up to a lady like this...
0:16:06 > 0:16:09You know, I've got a grandparent at a similar age
0:16:09 > 0:16:11and I would be horrified if I found out she'd been
0:16:11 > 0:16:17there for over 24 hours, lying on the floor in pain, nobody to help her.
0:16:18 > 0:16:21You know, I'd be... It is a quite upsetting scene, actually.
0:16:25 > 0:16:29With her son away, Iris hadn't wanted to bother her neighbours.
0:16:29 > 0:16:32She only dialled 999 when the pain became too much.
0:16:32 > 0:16:35By then, the ambulance strike had started.
0:16:35 > 0:16:38She's not probably spoke to anybody for quite a number of hours
0:16:38 > 0:16:41and we're the first people she comes into contact with.
0:16:41 > 0:16:45So, you know, we've got to treat this with some urgency,
0:16:45 > 0:16:49especially with the nature of the injury and her signs and symptoms.
0:16:52 > 0:16:54Andy monitors Iris' heart.
0:16:54 > 0:16:57He needs to rule out a cardiac problem as the cause of her fall.
0:16:58 > 0:17:01- Were it just a fall, or did you collapse, or...?- No.
0:17:01 > 0:17:03It was just a fall. But I want to just...
0:17:03 > 0:17:06I want to put some leads on your chest just to make
0:17:06 > 0:17:07sure your heart's OK, all right?
0:17:07 > 0:17:10When did you last have something to eat and drink?
0:17:11 > 0:17:12- Monday.- Yesterday... Monday?!
0:17:16 > 0:17:18Iris may have broken her thigh bone,
0:17:18 > 0:17:22but the ordeal has also left her weak and possibly hypothermic.
0:17:22 > 0:17:2567 elderly people died from hyperthermia last year
0:17:25 > 0:17:27in England and Wales.
0:17:27 > 0:17:30Iris needs hospital treatment urgently.
0:17:31 > 0:17:35Before Paul gave you some medication, were it quite painful?
0:17:35 > 0:17:37- (Yeah.)- Yeah.
0:17:38 > 0:17:41To get Iris to the chopper means carrying her for
0:17:41 > 0:17:45half a mile in pain and negotiating a barbed-wire fence.
0:17:46 > 0:17:49If they do make it to Hull Royal Infirmary,
0:17:49 > 0:17:52it's several hundred metres from the helipad to A & E.
0:17:52 > 0:17:57With the strike in full swing, there are no vehicles to transfer her.
0:17:57 > 0:17:59Andy and Matt will have to improvise.
0:18:12 > 0:18:16200 miles north, the paramedic team are on the move.
0:18:16 > 0:18:18Cormac and Paul are racing
0:18:18 > 0:18:20to Dumfries and Galloway Royal Infirmary.
0:18:23 > 0:18:25Jane has diabetes.
0:18:25 > 0:18:27Her blood sugar levels have rocketed.
0:18:27 > 0:18:31But it's her severe chest pains that continue to worry Paul the most.
0:18:40 > 0:18:42The pain could be a sign of a heart attack.
0:18:53 > 0:18:58Jane still has another agonising 18 miles of the journey to go.
0:18:58 > 0:19:00Paul gives her more pain relief.
0:19:00 > 0:19:02Just given the last 5mg of morphine.
0:19:02 > 0:19:04Start going away again in a minute, Jane, OK?
0:19:06 > 0:19:08We've now giving Jane 20mg.
0:19:08 > 0:19:12That's the maximum dose we can give in the back of an ambulance.
0:19:12 > 0:19:16So, hopefully this five will keep the pain away until we get to Dumfries
0:19:16 > 0:19:18where the doctors can give her some more.
0:19:19 > 0:19:20I know.
0:19:20 > 0:19:23Paul tries to reassure Jane.
0:19:23 > 0:19:26Even that's not easy in the back of a speeding ambulance.
0:19:26 > 0:19:28It's very difficult. It's all about balance at the moment.
0:19:28 > 0:19:30Trying not to land on Jane.
0:19:32 > 0:19:33I don't know...
0:19:34 > 0:19:38He still can't get a reading from the ECG heart monitor.
0:19:38 > 0:19:40There's a lot of interference as well, we call it artefacts.
0:19:40 > 0:19:44You know, false readings that are coming out on the machine.
0:19:44 > 0:19:48It happened on the doctor's surgery, it's happened on ours as well.
0:19:48 > 0:19:51So, I mean, we can take a certain amount of information from that.
0:19:52 > 0:19:54But the information we really wanted to know was
0:19:54 > 0:19:56whether Jane was experiencing a heart attack or not,
0:19:56 > 0:19:58but we can't really tell, so...
0:20:00 > 0:20:03We're talking about you, darling, as if you're not here. I'm sorry.
0:20:06 > 0:20:09Just coming into the hospital now.
0:20:09 > 0:20:11I'll get you to sit on your lap once.
0:20:22 > 0:20:26As soon as they arrive, Jane's taken straight to the resuscitation room.
0:20:31 > 0:20:34Her blood sugar is above high at the moment, reading well above 30.
0:20:34 > 0:20:36Also getting central chest pain into the neck
0:20:36 > 0:20:39but it's the jaw that is giving her the most intense pain
0:20:39 > 0:20:40rather than the chest.
0:20:40 > 0:20:42Sitting about four at the minute, the pain.
0:21:00 > 0:21:03Senior Doctor Rory Hodge takes over.
0:21:03 > 0:21:05I'll just quickly examine you.
0:21:05 > 0:21:07We're going to get another heart trace in, OK?
0:21:07 > 0:21:09'Jane is quiet unwell.'
0:21:09 > 0:21:11Her diabetes is quite out of control,
0:21:11 > 0:21:13her blood sugar is very high,
0:21:13 > 0:21:16she's in pain from this chest pain going into her neck.
0:21:16 > 0:21:19We are quite concerned about whether it is coming from her heart
0:21:19 > 0:21:21so at the moment there is two
0:21:21 > 0:21:24medical emergencies going on that we are trying to manage.
0:21:24 > 0:21:26And then we need to find a bigger vein to get
0:21:26 > 0:21:30a drip into your arm so we can give you fluids.
0:21:31 > 0:21:32We need to get some blood tests
0:21:32 > 0:21:36but more importantly we need to have an intravenous cannula.
0:21:36 > 0:21:39The ambulance guys have managed to get one in the foot
0:21:39 > 0:21:42but we needed something a little bit bigger.
0:21:42 > 0:21:45Using specialist equipment, Dr Hodge looks for a bigger vein.
0:21:48 > 0:21:53Often with diabetes, the veins are difficult to find and also
0:21:53 > 0:21:58when you are very unwell the veins shut down.
0:21:58 > 0:22:02So we've got gadgets here that can help us.
0:22:02 > 0:22:06The ultrasound machine allows me to quickly scan the arm
0:22:06 > 0:22:10and find a suitable vessel to insert a cannula into.
0:22:12 > 0:22:16With a vein found, the team can start tests and treatment.
0:22:25 > 0:22:29Finally able to do blood tests, the medical team are a step closer
0:22:29 > 0:22:32to diagnosing what is causing Jane's extreme symptoms.
0:22:42 > 0:22:46The Lake District - dramatic and beautiful
0:22:46 > 0:22:49and England's largest national park.
0:22:52 > 0:22:53This stunning scenery attracts up
0:22:53 > 0:22:56to 15 million visitors every year.
0:22:58 > 0:23:03And with 16 lakes to choose from, many strike out on the water.
0:23:07 > 0:23:11At 10.5 miles, Windermere is the longest and busiest
0:23:11 > 0:23:14with as many as 2,000 people on its waters
0:23:14 > 0:23:16every day over the summer months.
0:23:18 > 0:23:22And keeping them safe, South Lakeland Council's six lake wardens.
0:23:23 > 0:23:26And remember, no weeing in the lake!
0:23:26 > 0:23:28HE LAUGHS
0:23:28 > 0:23:31We'll see you a little bit later, don't worry. OK, take care.
0:23:33 > 0:23:34Helping those in trouble....
0:23:34 > 0:23:37As long as you're free and everybody's all right, no injuries.
0:23:42 > 0:23:45They clock up around 1,000 hours on patrol every year.
0:23:53 > 0:23:58On duty today is Travis Spraske.
0:23:58 > 0:24:01'I moved up here from Norwich, which is where I'm from originally,
0:24:01 > 0:24:04'in 1985, worked on or around the lake ever since.
0:24:04 > 0:24:07'It's getting on for 30 years.'
0:24:07 > 0:24:10I just took to it like a duck to water.
0:24:10 > 0:24:12Excuse the pun.
0:24:12 > 0:24:14HE LAUGHS
0:24:14 > 0:24:18Warden 1 to base. Just to advise heading south at the moment.
0:24:18 > 0:24:23'Our duties cover anything and everything that happens on the lake.'
0:24:23 > 0:24:28We work a 12 hour day from 9am to 9pm and then we're also on call
0:24:28 > 0:24:32out of hours with a pager from the coastguards.
0:24:32 > 0:24:35How do? You all right?
0:24:35 > 0:24:38'Because you never know what you're going to get from day-to-day,
0:24:38 > 0:24:42'it makes the job interesting, it also can make it challenging.'
0:24:42 > 0:24:45So any idea what's up with it or just...?
0:24:49 > 0:24:52If something happens, if it's dealt with swiftly
0:24:52 > 0:24:56and efficiently then it can't escalate into something more serious.
0:24:56 > 0:24:58We're under tow now. Making our way
0:24:58 > 0:25:01back to the Old England jetties in Bowness Bay.
0:25:01 > 0:25:03Four adults and two children on board.
0:25:05 > 0:25:10So a broken down boat drifting across the lake is dealt with quite
0:25:10 > 0:25:14easily as opposed to it ending up being on the shore
0:25:14 > 0:25:17and getting bashed up and down by the waves.
0:25:17 > 0:25:22People start to panic, the boat could end up whole, for example.
0:25:22 > 0:25:25Getting the job done and hopefully everybody goes home smiling.
0:25:28 > 0:25:30Just watch those ropes for a second.
0:25:30 > 0:25:32Thanks very much.
0:25:32 > 0:25:34No problem at all. No worries.
0:25:37 > 0:25:40A boat out of fuel can quickly become a hazard
0:25:40 > 0:25:43but the situation escalates if it's damaged.
0:25:43 > 0:25:46Back on patrol, Travis takes a call.
0:25:46 > 0:25:50'It's on the west of the shore down to the pier
0:25:50 > 0:25:54'via a little island so I'm guessing it's Lingholme.'
0:25:54 > 0:25:58Yeah. Roger. We'll make our way south and have a look.
0:25:58 > 0:26:03We've just had a report come in of a boat that's possibly hit some
0:26:03 > 0:26:06rocks or has gone aground in an area south of here
0:26:06 > 0:26:10so we're going to make our way down there and see what's happening.
0:26:10 > 0:26:14From near his base in Bowness, Travis heads three miles south.
0:26:17 > 0:26:22After just five minutes, he spots the stricken boat.
0:26:22 > 0:26:24Yeah, Roger. I think this is the one. Just want to confirm.
0:26:24 > 0:26:26How we doing? All right?
0:26:26 > 0:26:30Thankfully, owner Paul and his family managed to row to a jetty.
0:26:41 > 0:26:43Well, it happens sometimes.
0:26:44 > 0:26:47Paul suspects the rocks have caused serious damage.
0:26:53 > 0:26:55Oh, well done. OK.
0:26:56 > 0:26:59Now they need help to get home.
0:26:59 > 0:27:01OK, that's fine. We'll get you back.
0:27:01 > 0:27:03Have you got a buoyancy aid or life jacket
0:27:03 > 0:27:05that you guys could just pop on?
0:27:05 > 0:27:07If not, I'll sort you one out.
0:27:07 > 0:27:10What we're going to do is we'll just get a tow line set up
0:27:10 > 0:27:12and I'll get one of the chaps to stay on board the boat.
0:27:12 > 0:27:15He can keep checking it as we tow up the lake.
0:27:15 > 0:27:17It's a bit rough today so we're going to tow it stern
0:27:17 > 0:27:19rather than alongside.
0:27:19 > 0:27:21And just want to make sure that it doesn't start taking on
0:27:21 > 0:27:24any water as we're travelling.
0:27:24 > 0:27:26Just an update for you, this ski boat,
0:27:26 > 0:27:28I'm going to be towing it back.
0:27:28 > 0:27:31Registration number 66542.
0:27:31 > 0:27:32Three occupants.
0:27:32 > 0:27:34Towing it back to ferry now.
0:27:34 > 0:27:38Paul's wife Caroline hops on board with Travis
0:27:38 > 0:27:40for the journey back to the marina.
0:27:40 > 0:27:42OK, as I say, if you just sit tight.
0:27:45 > 0:27:48Meanwhile, Paul and son Charlie put their feet up.
0:27:49 > 0:27:52Thumbs up. They're happy, which is good.
0:27:52 > 0:27:55The boat's badly damaged but in this case it's only
0:27:55 > 0:27:57the owner's pride that's injured.
0:27:57 > 0:28:00I think they're looking OK. No signs of panic.
0:28:00 > 0:28:03I think they're just a little bit embarrassed, unfortunately.
0:28:07 > 0:28:10It's an unfortunate thing.
0:28:10 > 0:28:13Just got a little bit close to the shore.
0:28:13 > 0:28:15It's not the best start to Caroline
0:28:15 > 0:28:17and Paul's wedding anniversary holiday.
0:28:25 > 0:28:27And I have it on good authority
0:28:27 > 0:28:30that he didn't listen to his other half, so...
0:28:30 > 0:28:32Men drivers!
0:28:36 > 0:28:38All right, no problem at all.
0:28:38 > 0:28:41Back on dry land, Paul's learned the hard way.
0:28:44 > 0:28:46Just shows to prepare and be careful, doesn't it?
0:28:46 > 0:28:49When you're in waters that you're not used to.
0:28:49 > 0:28:50We just missed...
0:28:50 > 0:28:53There was the circle of red buoys and I thought the rock would be
0:28:53 > 0:28:57in the middle but we went to the left and it was there.
0:28:57 > 0:29:00- It's underneath. - Let's see what the damage is then.
0:29:03 > 0:29:06- Prop's gone.- Prop's knackered.
0:29:06 > 0:29:09Yeah, you can see the damage at the front of the hull here
0:29:09 > 0:29:11where he's hit the rock
0:29:11 > 0:29:14so he's actually damaged the integrity of the hull...
0:29:14 > 0:29:17So obviously it makes it too dangerous to use again on the lake.
0:29:17 > 0:29:20There is a risk that that could worsen
0:29:20 > 0:29:22and then possibly a big leak into the boat.
0:29:22 > 0:29:25At least, at the end of the day, everybody is all right.
0:29:25 > 0:29:27HE CHUCKLES
0:29:29 > 0:29:34Kind of ignored the advice of his son and wife who both thought
0:29:34 > 0:29:37he was a little bit close
0:29:37 > 0:29:40but unfortunately these things happen.
0:29:40 > 0:29:42Yes, it will be a walking holiday now, won't it?
0:29:42 > 0:29:44Normal countryside pursuits.
0:29:45 > 0:29:49Made slightly less miserable with an unexpected consolation prize.
0:29:49 > 0:29:52There you go. Happy anniversary.
0:29:52 > 0:29:53Happy anniversary.
0:30:09 > 0:30:12In East Yorkshire, the emergency case for the Yorkshire Air Ambulance
0:30:12 > 0:30:14team is ongoing.
0:30:15 > 0:30:19In Hornsea, 83-year-old Iris has been lying on the floor of her home
0:30:19 > 0:30:23with a suspected broken thigh bone for over 24 hours.
0:30:23 > 0:30:26I've been crawling about my stomach and my back, you see.
0:30:26 > 0:30:31I know, I can't believe you've been down on the floor since yesterday.
0:30:32 > 0:30:36Her blood pressure was extremely low and she was hypothermic, as well.
0:30:38 > 0:30:43She needs to get to hospital but the chopper is half a mile away.
0:30:43 > 0:30:45Too far to carry frail Iris.
0:30:46 > 0:30:50We landed in this field. We had to climb over stiles
0:30:50 > 0:30:52and walls and barbed wire.
0:30:52 > 0:30:54We just knew that by getting this lady out, there was
0:30:54 > 0:30:56going be no point taking her back
0:30:56 > 0:30:58the whole journey that we'd just done.
0:30:58 > 0:31:01It wouldn't have been safe, it wouldn't have been comfortable.
0:31:02 > 0:31:04Going by road is the only option
0:31:04 > 0:31:07but air paramedics Andy and Matt have a problem.
0:31:09 > 0:31:11Everybody's on strike and there's no ambulances.
0:31:11 > 0:31:14Poor Iris has been sat here two days.
0:31:14 > 0:31:16Granted, she didn't phone anybody and we've not found her
0:31:16 > 0:31:19until today but we're going to have to accost
0:31:19 > 0:31:21an ambulance to take her into Hull.
0:31:21 > 0:31:24Hornsea's ambulance station is minutes away.
0:31:24 > 0:31:28It might be closed but Matt checks if it has a spare vehicle
0:31:28 > 0:31:31that Rapid Response Paramedic Paul could commandeer.
0:31:40 > 0:31:42Iris, what we're going to do,
0:31:42 > 0:31:45Paul's going to go get the big ambulance from Hornsea station
0:31:45 > 0:31:48because he is just in a car, a Rapid Response Vehicle.
0:31:48 > 0:31:51Our plan of action is, because when we flew over this area
0:31:51 > 0:31:54we noticed there was an ambulance outside the station.
0:31:54 > 0:31:56The rapid responder's going to go to that station,
0:31:56 > 0:31:59he's going to be ten minutes and that is our plan, to go get the big
0:31:59 > 0:32:02ambulance and drive her down nice and smoothly down to Hull.
0:32:04 > 0:32:08They wait whilst Paul tries to get into the ambulance station.
0:32:08 > 0:32:10What's we going to do is we'll get you on our stretcher
0:32:10 > 0:32:12- and we'll put a nice big blanket on you.- OK.
0:32:12 > 0:32:14OK, and keep you warm that way.
0:32:14 > 0:32:17Iris asks Matt to contact her family.
0:32:17 > 0:32:21- Is it all right if Matt has a look for the number?- Yes.
0:32:21 > 0:32:23- Roy is it, you say?- Yeah.
0:32:23 > 0:32:25All right. No worries.
0:32:29 > 0:32:32If it's not got a touch-screen, forgot how to use these.
0:32:32 > 0:32:35I'm looking for her son's phone number.
0:32:37 > 0:32:39He's called Roy.
0:32:39 > 0:32:43I found two Roys in here but neither of them are her son.
0:32:43 > 0:32:44I'm just trying to find it.
0:32:44 > 0:32:48Paul has managed to commandeer the strikebound ambulance.
0:32:49 > 0:32:53- Hello, mate. How you doing? Are you successful?- We are.- Very good.
0:32:53 > 0:32:57For Iris, rescue is very close.
0:32:57 > 0:33:00- Right, how are we going to get her out?- But there's one more problem.
0:33:00 > 0:33:04- Not sure the Combi will go through that gap.- Let's try it.
0:33:04 > 0:33:05Think you're right.
0:33:09 > 0:33:12I think you're right, mate. It's not going to go, is it?
0:33:12 > 0:33:15We need some jiggery-pokery.
0:33:15 > 0:33:16It's going to have to be, isn't it?
0:33:16 > 0:33:20Listen, Iris. We're going to have to move you very shortly.
0:33:20 > 0:33:24Now, we wanted you, we wanted to get you out pretty flat
0:33:24 > 0:33:26but because of the angle of the doorway,
0:33:26 > 0:33:28it's going to be difficult.
0:33:28 > 0:33:33- So what we're going to have to do is put you on a chair.- Yeah.
0:33:33 > 0:33:35It's going to be quite uncomfortable
0:33:35 > 0:33:38and you might feel a little bit of pain
0:33:38 > 0:33:41- but at the moment we're giving you everything we can.- I know you are.
0:33:41 > 0:33:44So we'll be as gentle and as quick as we can with you
0:33:44 > 0:33:47and we'll get you comfortable on the bed on the ambulance.
0:33:47 > 0:33:49Use this to sit her forward, can't we?
0:33:51 > 0:33:54Very gently, they ease her onto a chair.
0:33:54 > 0:33:56- Ooh, sweetheart. - There we go, darling.- Ah!
0:33:56 > 0:33:59I know.
0:33:59 > 0:34:03After 25 hours, Iris is finally on her way to hospital.
0:34:03 > 0:34:06Okey-dokey!
0:34:06 > 0:34:07Going up in the world.
0:34:14 > 0:34:18By road, the 20-mile trip from Hornsea to hospital in Hull
0:34:18 > 0:34:20will take more than half an hour
0:34:20 > 0:34:23but at least Iris will now be driven to the doors of A & E.
0:34:23 > 0:34:25All right? Is that better?
0:34:25 > 0:34:29- Oh, yes.- Just tuck your arms in.
0:34:29 > 0:34:31And we can zip this bag right up so you're warm.
0:34:32 > 0:34:36Sometimes it's not straightforward and you've got to think on your feet.
0:34:37 > 0:34:40Now we're in an ambulance, I think we're best staying in one
0:34:40 > 0:34:43now we've got one and just take her down to Hull A & E
0:34:43 > 0:34:46and let the docs have a look at her down there, get some X-rays done.
0:34:47 > 0:34:49Air paramedic Andy jumps ship
0:34:49 > 0:34:52to look after Iris in the back of the vehicle
0:34:52 > 0:34:55while Matt heads back to the chopper.
0:34:55 > 0:34:56You take care.
0:34:56 > 0:35:00You'll not see me again, all right. I'm going in the aircraft.
0:35:00 > 0:35:03You have a nice journey down to Hull, OK?
0:35:08 > 0:35:11With a possible fracture and hypothermia after her
0:35:11 > 0:35:13overnight ordeal on the floor,
0:35:13 > 0:35:16Iris needed someone to get her into hospital fast.
0:35:20 > 0:35:23You get all the way out here to realise there's absolutely nobody.
0:35:23 > 0:35:26Even if there were somebody available in Hull,
0:35:26 > 0:35:29you're talking 35-40 minutes just to get here.
0:35:30 > 0:35:33It all adds to the time that poor Iris has been lying on the floor.
0:35:33 > 0:35:36We picked an ambulance up that was doing nothing
0:35:36 > 0:35:40and just took it down and Iris is getting to hospital a lot
0:35:40 > 0:35:42quicker than she would do normally.
0:35:45 > 0:35:48In theory, we pinched an ambulance from Hornsea station.
0:35:48 > 0:35:50HE LAUGHS
0:35:50 > 0:35:52You know, if that ambulance wouldn't have been there,
0:35:52 > 0:35:56we would have had a lot of difficulties, so, you know,
0:35:56 > 0:35:59there's a lot of things that came together on that job quite nicely.
0:36:13 > 0:36:16200 miles from Hornsea, in Dumfries and
0:36:16 > 0:36:19Galloway Royal Infirmary, critically ill patient Jane waits
0:36:19 > 0:36:21while the medical team run tests.
0:36:26 > 0:36:28Push the blood in.
0:36:28 > 0:36:30Dr Rory Hodge and the team need to find out
0:36:30 > 0:36:32if Jane's having a heart attack
0:36:32 > 0:36:36or if it's diabetes causing her agonising symptoms.
0:36:36 > 0:36:38She's got this chest pain as well
0:36:38 > 0:36:41so we need to make sure she's not having any heart attack.
0:36:41 > 0:36:44Her blood sugar is very high, 25,
0:36:44 > 0:36:47and she's acedotic, 68.
0:36:48 > 0:36:54Her bicarbonate is very low so that fits with diabetic ketoacidosis.
0:36:57 > 0:37:00The results from the blood gas analyser show Jane has
0:37:00 > 0:37:03a life-threatening diabetic condition.
0:37:03 > 0:37:07The blood tests we've taken, we've been able to process
0:37:07 > 0:37:11and show that she is having what we call diabetic ketoacidosis,
0:37:11 > 0:37:16so, a diabetic emergency where Jane just isn't able to metabolise
0:37:16 > 0:37:19the sugar and her sugar level goes very high
0:37:19 > 0:37:20and she becomes very unwell.
0:37:22 > 0:37:26Left untreated, poisonous chemicals called ketones will start
0:37:26 > 0:37:28to build up in Jane's body.
0:37:28 > 0:37:30Without insulin, it can be fatal.
0:37:33 > 0:37:36OK, so the blood test shows you are having DKA.
0:37:36 > 0:37:40Your diabetes is out of control so we need to give you fluids very
0:37:40 > 0:37:45quickly and give your body the insulin it needs.
0:37:45 > 0:37:48We'll set that up in an infusion, OK.
0:37:48 > 0:37:51We'll keep an eye on your heart with the heart tracings.
0:37:55 > 0:37:59The pain sounds like it could be coming from the heart.
0:37:59 > 0:38:01We'll get you some morphine now
0:38:01 > 0:38:03to try and help that pain.
0:38:08 > 0:38:11The second of two ECG tests is encouraging
0:38:11 > 0:38:13but Jane's chest pain is still a concern.
0:38:15 > 0:38:19A heart attack is difficult to rule out at this stage.
0:38:19 > 0:38:22We've done a heart tracing which looks to be normal at the moment
0:38:22 > 0:38:25but, unfortunately, that doesn't rule out heart attack.
0:38:25 > 0:38:28We need to do further blood tests to achieve that.
0:38:28 > 0:38:32But we're treating her at the moment as if she has had a heart attack
0:38:32 > 0:38:36with appropriate medication, oxygen and pain relief.
0:38:36 > 0:38:39We'll put some oxygen on just now
0:38:39 > 0:38:40- You OK if we do that?- Yeah.
0:38:42 > 0:38:44We know roughly what's going on now.
0:38:44 > 0:38:47We've started the emergency treatment.
0:38:48 > 0:38:52Jane's receiving the life-saving medication she needs now. But her
0:38:52 > 0:38:55treatment began with the paramedics who were first on scene,
0:38:55 > 0:38:57administering pain relief and
0:38:57 > 0:38:59running tests in difficult conditions.
0:39:03 > 0:39:06We've got it easy here compared to the ambulance crew.
0:39:06 > 0:39:11The ambulance crews do a great job but it is a lot easier for us
0:39:11 > 0:39:13in the light of day,
0:39:13 > 0:39:17not in the back of an ambulance to do observations and heart tracings.
0:39:17 > 0:39:21She'll be taken up to high dependency medical ward where they'll
0:39:21 > 0:39:26continue to manage her diabetes and be analysing the heart tracings
0:39:26 > 0:39:28and looking at blood tests to see
0:39:28 > 0:39:30whether she has had a heart attack or not.
0:39:36 > 0:39:40Jane's diabetes finally stabilised after five days.
0:39:42 > 0:39:45Thankfully, after another week on the ward her chest pain was
0:39:45 > 0:39:48diagnosed not as heart failure
0:39:48 > 0:39:51but as acute angina brought on by the diabetic attack.
0:39:55 > 0:39:57Now, six weeks later...
0:39:57 > 0:39:59Come on then.
0:40:01 > 0:40:03..Jane's recovering at home.
0:40:03 > 0:40:05Come on. Good girl.
0:40:05 > 0:40:09'I have good weeks, I have bad weeks.'
0:40:09 > 0:40:13I try and control my diabetes, it's hard
0:40:13 > 0:40:16and when it gets away from the you, there's nothing stopping it.
0:40:16 > 0:40:21It just, you feel ill with it.
0:40:21 > 0:40:24Come on. Up.
0:40:24 > 0:40:29Jane's severe form of diabetes means her blood sugar can spike rapidly.
0:40:29 > 0:40:31Sophie.
0:40:31 > 0:40:34That fateful morning it caused terrifying symptoms.
0:40:36 > 0:40:38Just trying to get something into your arm
0:40:38 > 0:40:42- so that we can give you something else for the pain.- Nothing there.
0:40:43 > 0:40:47It was a heavy feeling, I was starting to sweat and this
0:40:47 > 0:40:52terrible pain come up from my neck,
0:40:52 > 0:40:56from my jaws, right down here.
0:40:56 > 0:40:57My throat.
0:40:58 > 0:41:01And then I couldn't breathe. I just...
0:41:01 > 0:41:05That was the scary part. I just couldn't breathe.
0:41:07 > 0:41:11The emergency service of Dumfries and Galloway, you can't fault them.
0:41:12 > 0:41:14It doesn't take them long to come out.
0:41:14 > 0:41:17When Shona phoned for 999 they were
0:41:17 > 0:41:21there before you could blink, really. They were really fast.
0:41:21 > 0:41:24I've not seen her as bad as this with it.
0:41:26 > 0:41:30Paul was really concerned in the ambulance.
0:41:30 > 0:41:32He knew when the pain was
0:41:32 > 0:41:34starting to come back.
0:41:34 > 0:41:36We're not far, we'll be there soon.
0:41:36 > 0:41:38And he talked...
0:41:38 > 0:41:40He never stopped talking all the way
0:41:40 > 0:41:42to Dumfries. Just calming me down.
0:41:42 > 0:41:44We're just coming into the hospital now.
0:41:48 > 0:41:51Developing diabetic ketoacidosis could have proved fatal.
0:41:54 > 0:41:57If I didn't get help that morning,
0:41:57 > 0:42:01I would probably go into a coma
0:42:01 > 0:42:05and eventually die.
0:42:05 > 0:42:09If I didn't get help that day.
0:42:12 > 0:42:17I can't praise them enough. The paramedics and the hospital staff.
0:42:17 > 0:42:20Brilliant. I can't fault them.
0:42:20 > 0:42:23They were really exceptionally nice,
0:42:23 > 0:42:24so they were.
0:42:24 > 0:42:25I can't praise them enough.
0:42:33 > 0:42:38It's been all go for the emergency services across rural Britain.
0:42:41 > 0:42:44In Yorkshire, hospital staff diagnosed Iris with
0:42:44 > 0:42:45a dislocated hip.
0:42:45 > 0:42:49She's since had a hip replacement and is recovering well.
0:42:51 > 0:42:54In Dumfries and Galloway, Jane continues to control her
0:42:54 > 0:42:57diabetes whilst recuperating at home.
0:42:58 > 0:43:01And with their boat still undergoing repairs, Paul and
0:43:01 > 0:43:03Caroline will have to wait until next summer
0:43:03 > 0:43:06to celebrate their wedding anniversary on the water.
0:43:08 > 0:43:11And who said it was quiet in the countryside?