Episode 9 Countryside 999

From the Highlands of Scotland to the coast of Cornwall,

the Great British countryside is spectacular.

But we work and play in it at our peril.

And when things go wrong,

the emergency services race to the rescue.

This chap is having a heart attack and we need to get him

in quickly.

SIREN WAILS

There's no police courses for this.

Going hundreds of miles against the clock.

Battling the elements and braving the weather.

From fields and forests

to cliffs and country roads,

we'll be right at the heart of the action.

With police fighting crime...

Could seize the dogs, could seize the van,

but I'm going to summon the order to court.

..paramedics saving lives...

BABY CRIES

..and wardens safeguarding our lakes.

Come out of the way!

We're there as the emergency services pull together

to pick up, patch up and protect the public.

This is Countryside 999.

Coming up,

a call to a casualty with a time-critical condition turns

into a search and rescue mission for the Cornwall Air Ambulance.

In Shropshire, the rugged terrain

at a motocross race challenges the riders and paramedics.

And when a traveller horse fair springs up,

it means emergency measures for the County Durham cops.

The watchword here really is about engagement.

There has been some community fear on the lead-up to this.

Cornwall, famous for its sun, sea, surf

and miles upon miles of stunning coastline.

Inland from the beaches lie 1,300 square miles of wild

moorland and remote rural farms.

Crisscrossing this rolling countryside

is a network of single-track roads that make life challenging

for the emergency services.

Right, sir, we need to get you onto the helicopter.

For paramedics in Cornwall, the air ambulance is a vital

way of transporting the injured and sick to hospital.

How bad is the pain? Give it a number out of ten.

-It's about four at the moment.

-About four, OK.

Air paramedic Stu Croft

has spent half his working life on the ground with the land crews.

He sees first-hand the difference a helicopter makes.

Working in this area as an ambulance clinician is very rewarding.

And being on a helicopter is just, you know, to me,

the best job in the world.

It's being able to help people, to be able to get them

to hospital quickly in areas that can be very frustrating.

Actually, the helicopter can come and move your patient quickly.

It can make all the difference.

At their base in Newquay...

That's fine. How old is this patient, sorry?

..Stu's taking an emergency call.

Yeah, that's brill, thank you. Cheers. Bye-bye.

Somebody's collapsed in the woods unconscious

and she's got a history of having strokes in the past,

so we've got no more details on that.

In just five minutes, they're airborne.

OK, let's go between the bowser and the mast.

In the chopper, Stu and his colleagues aren't just medics,

they're a vital part of the flight crew.

Up front, Stu's navigating.

Eyes in the back - paramedic Mark Fuszard.

This time we've been tasked to an incident in Lostwithiel.

We've got reports of a 59 year old with a history of strokes

has collapsed in a wooded area,

and that's pretty much all we know at the minute.

Lostwithiel is 20 miles away from their base.

A rapid response vehicle has also been dispatched from Liskeard.

The air crew will take just eight minutes to get there.

But they then have to find the patient in over 30 acres

of woodland.

Pretty much we make it up as we go along with

this sort of incident because... A, we don't know exactly what we're

going to, and we don't know exactly where we're going to,

so we're kind of having to second-guess, look at maps,

look at wooded areas around the rough grid reference

that we've been given, and look at access and egress at 8:30.

And we may or may not be able to land anywhere near the patient.

We won't know until we get there.

Locating the collapsed patient could lose valuable minutes.

Minutes that a patient with a suspected stroke can't spare.

Comparing it to a heart attack, where there's a part of the heart

starved of oxygen, then you could call this a bit of a brain attack,

where a little bit of brain tissue is starved of oxygen.

We've got five miles to run.

Every minute that that tissue in the brain is starved without oxygen,

then that's more tissue lost that's never going to be fully recovered.

So, you could say, time is tissue.

Pilot Sam Tompkins alerts the crew they're close.

Yeah, all right. OK.

The clock's ticking on this job. Everyone's eyes are vital.

We don't have any thermal imaging or magnifying cameras,

or anything like that at all, it's really just locating the patient

as best as you can.

We were looking on the ground, just trying to get glimpses

of anybody trying to attract our attention

or anything that looks like it could be a patient.

To make matters worse, the weather's closing in.

They spot the rapid response vehicle on the ground,

struggling to get near.

But there's still no sign of the casualty.

With the clock ticking, there's relief all round

when Stu spots something.

It's not a good landing site.

But, with no vehicle access for the response car,

the helicopter has little choice.

They head for the top of the hill.

-I'll make an approach to the big field.

-Yeah.

Then we'll see what they can do.

I'll pop across and just have a gander, if you like.

-Yeah, that sounds like a plan.

-OK.

-BEEPING

-'100 feet.'

The tail is now clear of the trees that were behind us.

OK, brilliant, ta.

It's only on landing that they actually spot the casualty,

luckily, right beside them.

-Is that good, Sam?

-OK, gents, yeah, clear out.

-Fantastic.

Despite the extensive search,

they've landed just 17 minutes after being scrambled.

Hello there. You all right? You OK?

Stu races over and discovers the casualty's an older woman

called Lynne.

-Were you with the lady?

-Well, I was.

I was in the other field and I found her like this.

So, we don't actually know how long she's been here.

It must be about 30 minutes since I found her.

I was only in the next field there.

Her dog came over. I said, "Come on, we'll go and find Mum."

She could have been on the floor

-five, ten minutes before I got here.

-OK.

Lynne's already been lying here for over half an hour

and she's barely responding to Stu.

He must work fast.

Tranquil meadows

and gentle, rolling hills -

the quiet, rural idle of Shropshire.

A peaceful paradise, you might think.

Well, think again.

Just kicked off - one of the UK's most dangerous

and physically demanding motor sports,

revving up for a weekend

of action-packed, adrenaline-fuelled racing.

The location?

Hazeley Grange, near Kidderminster.

Motocross.

160 riders ripping up a mile-long track of sharp bends

and thrill-seeking jumps.

The more mud and ruts, the better.

With these speeds and conditions, injuries are inevitable.

Drafting in a team of highly trained medical professionals is essential.

In his fifth year of attending these competitions,

paramedic Terry Purslow is an old hand.

Motocross events such as today,

we'll be expecting possibly fractures, long bone fractures,

fractured wrists, legs, dislocated shoulders, head injuries,

spinal injuries.

Hopefully, we'll get none of it, but some days we get it all.

Coming off your bike isn't in itself too dangerous.

Obviously the heavier you fall, the more chance of an injury.

But today, it's a very, very soft track, lots of mud.

The biggest danger today will be from other bikes -

if a rider falls, the bikes following, hopefully,

won't collide with the fallen rider, but it does happen.

Today, Terry's joined on site by two other technicians

and newly qualified paramedic Emily Harris.

We are going to a spot that we can see because the track is so big,

we can't... If we stay up there, we can't see this part.

13 miles from the nearest hospital,

an ambulance is permanently on scene.

But moving casualties around the hilly site on rough ground

means a four-wheel drive response car's essential.

The nastiest bend here is there.

So, it's where they'll all sort of come off, and the one at the top.

But one of the biggest problems can be getting the injured

to stop racing long enough for treatment.

The thing is with motocrossers, they are so used to this.

They're on the floor and they're up.

They just want to get back on the bike, they want to finish the race.

They're not really bothered.

The amount of times we have people come up to the ambulance after

and say, "I think I've done something to my leg."

But there're quite brave, really.

I wouldn't do it.

We're looking out for yellow flags.

Yellow flag is an indication there's an obstruction on the track,

which can be a broken motorcycle, it could be a faller.

We watch that yellow flag intently.

If it changes to a red or a white flag,

that means they require first aid.

We don't move anywhere until we've seen the first aid flag.

And with the racing going surprisingly smoothly...

..the morning turns into a waiting game.

HE YAWNS Don't catch me yawning.

For Emily, it's useful studying time.

I've just qualified as a paramedic,

so now I've got to do my LGV theory to drive an ambulance.

Cos it's a bigger vehicle than my car,

so I've got to do my theory test and then go and do my C1 exam.

So I'm just revising for that really so that I can get on the road.

But before they get too comfortable...

..a call comes in.

CRACKLED SPEECH ON RADIO

To what?

Roger that.

Somebody is down around the other side

and the first aid flag has gone up.

Emily has reached the fallen rider first.

Bruised biker Dan will no doubt be back for the next race.

But the difficult terrain is taking its toll.

With their only means of transporting casualties

seriously hampered...

..and with five hours of racing to go...

Ooh! BLEEP.

..the day is about to get a lot more challenging...

Got a patient with an injury, mate.

..for everyone.

-HE GROANS

-Don't. Please, don't.

-OK.

In Cornwall, after an intensive search,

the helicopter has just landed by a casualty,

collapsed at the edge of a remote wood near Lostwithiel.

Hello there. You all right? OK?

The paramedics have limited information,

but they do know the patient, Lynne, may have suffered a stroke.

You're fine, it's absolutely fine. What's your name?

-It's Lynne.

-OK, Lynne, I'm Stuart.

I'm a paramedic from the helicopter, OK?

I'm going to pop you down to the hospital to get you checked over.

Stu swiftly follows the check list for a stroke.

Can you squeeze my hands?

Squeeze my hands for me. Both of them.

Both of them.

We talk about a patient being FAST positive.

F is for face - if anybody has got a sudden facial droop.

Can you speak to me?

Arms - the inability to raise arms.

Can you squeeze my fingers with your left hand?

Speech - any sort of slurring of words or difficulty speaking.

How about the right hand? Can you move your right hand?

SHE WHIMPERS It's OK.

The T then is for time. It's time to act.

We don't actually know how long she's been here.

59-year-old Lynne had been out in the woods

with her friend Kath.

It must be about 30 minutes since I found her.

I was only in the next field there.

-Yes.

-Cos we were blackberry picking and we were wandering around.

She could have been on the floor

-five, ten minutes before I got here.

-OK.

Come on, open your mouth. Open your mouth.

Open your mouth for me. Come on.

It was quite... Obviously, she was having difficulty speaking.

Deep breaths. Well done, well done.

Her arms are very weak and these are signs of a possible stroke.

So we just got her as quick as we could off the wet floor.

OK, I'm just going to lift you onto our stretcher onto the dry...

There we go. We're on the driest ground now.

And into the helicopter just to make sure

we could do a good assessment in the warmth and get some more observations

and a better picture, a better history of what was going on.

Searching for better blackberries,

Lynne had wandered out of sight of Kath.

We were up here blackberry picking and walking the dogs.

And then the next minute, her dog came over to me

and I thought, "Oh, that's not like him."

So I followed the dogs back and I found her on the floor.

And I thought, well, I can't leave her, but I've got to get help.

In we go.

All right?

She came to a little bit.

I told her dog to stay with her.

I covered her in my coat and I ran to the nearest house.

Lynne, can you open your eyes for me, Lynne?

Lynne, can you open your eyes?

It's looking like this lady's had some sort of neurological event,

possibly another stroke.

We need to warm her up, observe her on the way down,

take her temperature and just get her to hospital really quickly.

We're going to take this lady to Treliske.

They can deal with strokes very well,

and we're a lot closer to Treliske than we are to Derriford.

Stu gets as much information as he can from Kath

about Lynne's medical history.

Do you know when she had her last stroke?

It must be two...maybe three years ago now.

-OK. And...

-She had a full stroke.

She didn't have the use of her right arm, I think it was.

She's got that back and she's had several TIAs

since then, which she gets on quite a regular occurrence,

-but she deals with those.

-Yeah.

TIAs are like mini-strokes,

but Stu has no way of knowing the severity of Lynne's symptoms.

It's impossible to say at that stage what it is.

She's got a history of stroke, she's got signs and symptoms of a stroke,

she'll get treated as a stroke and, for her,

that treatment is waiting in the hospital 30 miles away,

and she needs to be in there as fast as she can

for a scan just to ascertain what they're going to do.

Message to PD.

All right, Claire? It's Stuart from helicopter.

She's collapsed in the woods in the last half-hour,

she's FAST positive on difficulty speaking, facial droop.

OK. So we're just about to lift from the field.

We're only going to be ten minutes.

Lynne will soon be on her way to hospital,

while her anxious dog, Giz, stays with Kath.

He's as good as gold, he is.

He won't leave her if something's wrong.

She'll be fine, sweetheart. She'll be fine. You'll be down my house.

Beautiful. Lovely stuff. Rock and roll.

Lynne's symptoms could deteriorate rapidly.

The nearest hospital in Truro is ten minutes away by helicopter.

Job's like that, it's certainly... In these remote locations,

it's absolutely essential if you're talking for a couple of hours,

if everything had to be done by road.

But with the weather closing in, time is of the essence.

Northern England boasts some of the most dramatic countryside in the UK.

Far from major cities, this wild landscape

can have as few as a 160 people per square mile.

But tucked away communities and remote villages

don't always think they're safer out in the country.

It's an issue Police Inspector Kevin Tuck, based at Barnard Castle,

deals with on his patch.

Yeah, well, I've got 500 square miles of rural County Durham.

There's less crime per thousand population in a rural area,

but sometimes that doesn't equate to the way people feel,

and sometimes you can have more fear in a rural area even though

the occurrence of crime is lower.

As neighbourhood inspector,

part of Kevin's job is to reassure local residents, particularly

during the summer months when the region gets flooded with visitors.

Today, Kevin's on his way to the village of Sedgefield

where around 100 travellers have turned up to hold the horse fair.

The fair had taken place over ten or 12 years in the east of the county,

and there'd been pressure for it not to happen there.

I think the local authority had done their best to try

and find some land where the thing could take place

with some legitimacy.

That couldn't be organised in time

and, at short notice, it appeared in the Sedgefield area.

These horse fairs are nothing new.

Dating back to the 17th century,

they're a chance for travellers to trade horses

and for this scattered community to get together.

Organised fairs like Appleby in Cumbria

and Stow Fair in the Cotswolds are regulars in the calendar.

But smaller, unofficial gatherings, such as Sedgefield's,

can pop up at a moment's notice, leaving locals nervous.

When there's an unauthorised encounter,

I think people's concerns can grow quite quickly.

There can be a concern about trespassing,

there can be a concern about mess being left behind, crime, disorder.

We've got to try and get some balance.

We've got to be there to police everybody

and be there for everybody's support.

When you get a bit of speed like this, then come talk to us.

Travellers like Thomas believe nearby communities

get all worked up about nothing.

We're not troublemakers, we're not a gang of people

that's going to go around and cause damage.

We're just friendly people who will... We'll talk to anybody.

Anybody that wants to come and have a crack,

we'll have a crack with them.

We're not cheeky, we don't abuse the place.

We look after the village,

plus we bring a lot of money into the village

cos we've obviously got to buy food and drink.

Today, 28 caravans and numerous horses

have set up on the derelict site of an old hospital.

It's not just the police who've responded quickly.

We look at these things... And these things are not just for the police.

The local authority have got a big part today.

They've looked at things like toilet provision on the unauthorised site

to reduce environmental matters.

And the RSPCA have come along to make sure that there's no

horse...animal welfare issues.

And they're very experienced at this sort of thing.

And we link in with them for other horse fairs

across the north of England.

RSPCA Inspector Ian Smith is a regular at horse fairs.

The sort of things we're looking out for are injuries,

sores to the sides and the legs from the traps,

and anything that causes a problem to the animal's welfare.

He's also there to keep an eye on the traditional six-mile trot

that will take place at noon.

There's a circuit. From here, they'll go left out the gate

up to Fishburn and on a circuit.

It's a chance for the travellers to show off their horses

before some buying and selling in the afternoon.

It's meant to be a leisurely affair, but it can turn into a race.

The worry is that the roads are open - they're still public roads -

and there is the potential for an accident.

The trot is also a concern for the police.

Some in the community think that there has to be

some sort of special order.

And whilst it might present some dangers

because you have a long procession of horse and carts,

there's an ancient right of passage on horseback,

so nobody is committing any offences

by being out on a horse and cart today.

And what we want to do is make sure that it

goes round the six- to seven-mile route, that there's no

major congestion, that there's no necessary accidents but,

if there is any pinch points or flare-ups,

we're there or thereabouts to defuse things and keep everybody happy.

Two hours before the trot takes place,

the police meet at their base for a briefing.

All right. Good morning, everybody.

We're here today to police Operation Sola, which is our response to

the traveller horse fair which has sprung up here in Sedgefield

over the last few days.

The idea today basically is to have a hassle-free, trouble-free trot.

The main thing for me is that they know that there's no road closure,

and they have to give way, and they have to follow the rules

as if they were out normally on the highway.

The watchword here really is about engagement

and it's about how we talk to people.

There has been some community fear on the lead up to this.

And we did some updates on Facebook on Saturday morning because

there was comments about robberies and about crime.

The word was rocketing.

Well, I can tell you, there have been no robberies,

crime has not rocketed and it's actually one of the quietest

weekends in Sedgefield and Fishburn for recorded crime,

I would suggest, for some time.

At midday, the horses and traps start their procession.

Ian is already in position.

This is them. They are just coming round that top corner now.

And they actually are overtaking on the carriageway

down this street, so they should behave in a normal manner

like any piece of road traffic.

They're still governed to the same rules.

And we're just really quite concerned

that there might be an accident.

All 44 riders pass along the most dangerous

section of the trot safely.

One or two have sort of overtaken down the road,

but the road was quiet.

Yeah, it went all right, really, yeah. No concerns, really.

One or two of them sweating up, a few fat horses,

but, yeah, it went fine.

Happy the horses are safe, if a little chubby, Ian's job is done.

But for the travellers, next stop - the village green...

HORSE NEIGHS

..where, despite misgivings, everyone's getting on fine.

We're a very welcoming village.

HE LAUGHS

I was a bit apprehensive about it at first,

but I feel it's gone quite well and I think a lot of the people

in the village have taken to them and there hasn't been any damage.

Well, we only knew it by local hearsay, if you like,

and when we spotted the camping out down at Fishburn,

we were just wondering what it was all about.

It just seems to be a kind of surprise to everybody, you know.

That's the whole thing.

And, to be fair, from what people have told me,

the people can see they're all very good.

There's been no trouble with them reported ever, you know.

As I say, quite often, their reputation seems to precede them.

Even though the event was unexpected,

locals have taken it in their stride.

-I think it's good for Sedgefield.

-Something different.

Yeah, it's good for Sedgefield, isn't it? It's a good village.

Look at it here,

that's all of your damage you could manage to the green.

But you get the medieval fair, you get the Ball Game,

you get Sedgefield Show, so what's...

-There's other events can put a couple of ruts on the green.

-Of course.

With his first job complete, Kevin's now onto number two.

You know, we've had one or two people complain about horse mess

on the road.

And it's just one of those things, I'm afraid.

And I would say to the people of Sedgefield,

"If you grow roses, why not get out with a bucket and spade?

"You might be able to enhance the situation." Thank you.

200 miles away in Shropshire, as the afternoon races kick off

at the motocross track, Terry's been joined by fellow paramedic

Mark Renton.

They're on guard for injuries and fallen riders,

but with a flat tyre, the 4x4 response car

is struggling on the rough ground.

Reaching and transporting casualties will have to be done

with the damaged wheel until a spare arrives.

But then...

..a call comes in.

Got a patient with an injury, mate.

-Sorry?

-Got a patient with an injury over by the race control.

All right.

They spot the casualty, Tobias, in a blue T-shirt.

After a nasty fall, he's seriously damaged his leg.

But, in true motocross spirit,

he refuses a stretcher.

There we go.

Brave Tobias also turns down pain medication

but getting into the car is torture.

Yeah.

No, no, don't touch it!

With this terrain...

..and knowing his casualty's in agony,

Terry tries to take the hill gently.

Oh, down!

But it's not easy with a flat tyre.

With the track cleared...

..the next race starts.

An ambulance positioned on site acts as a first aid centre.

-Which one is it, mate? That one?

-Left, yeah.

Tobias can get properly assessed here...

..if he can get out of the car.

Gently slide your bum off.

With his pain now really kicking in...

..gas and air - a mix of nitrous oxide and oxygen -

brings some relief.

Despite his knee injury, he insisted on standing and walking.

And I think, more than anything, it was adrenaline

and a bit of bravado that made him think that he could walk.

He was offered a stretcher, but he declined that.

Again, the old machismo - "I can walk."

Managed to get him into the ambulance,

where he was promptly treated.

Do you want some Entonox now? Because...

That's it. Lie back. Nice deep breaths.

It was the rutted track that caused Tobias to come of his bike.

After a shot of morphine....

..Mark checks for broken bones.

You keep sucking that stuff, son, you're all right.

This ambulance has to stay on site. Another one's been called.

Tobias waits in agony while Dad, Paul, tries to help.

Just say when.

Righto.

Dad, don't take them away.

Is that any better?

-You need to put them underneath...

-Yes, I know, son.

..to stop it. No, no, Dad.

Dad, the way you're doing it... Put it down.

Do you want it moving at all?

Excuse me, mate.

Oh, you look to be in more trouble now.

I don't know, but can you put all of it under my ankle?

Under your ankle?

He'll be all right, he's a survivor.

Tobias is carefully transferred into the ambulance

when it arrives 20 minutes later.

-Argh! Please, don't.

-OK, OK.

No, no, no, no.

No, no, no. You can't.

Safely on his way to Worcestershire Royal A&E,

Tobias won't be racing again for a while.

And, for the paramedic team,

there's still one casualty left to attend to.

-What use is that?

-It was already off.

-Yeah, look what he's doing.

-Let me have a look.

It's heavy.

The spare has finally arrived.

It does look a bit bigger than the other one, you know.

I'm sure there's a joke here

about how many ambulance men does it take to change a wheel.

225 five miles south in Cornwall, bad weather is closing in.

After collapsing in the woods from a suspected stroke,

the team know they need to get 59-year-old Lynne

to hospital as fast as possible.

A stroke is a time-critical illness.

As time goes on, the patient will get worse,

so they need treatment really quickly.

Paramedics Stu and Mark observe her all the way,

thankfully keeping ahead of the bad weather.

They reach the Royal Cornwall Hospital in Truro within

ten minutes, where they hand Lynne over to the medical team.

We managed to get mobile, take the call, fly, find the scene,

find the patient, land, assess them, package them,

take them off to hospital and get them into the scanner

within 48 minutes, which is pretty good going.

Strokes are the third-largest cause of death in the UK.

Getting Lynne to treatment quickly was vital.

With every second counting...

..everyone had a role to play.

OK, Lynne, I'm Stuart, paramedic from the helicopter. OK?

It must be about 30 minutes since I found her.

I was only in the next field there.

But collapsing out of sight of her friend,

it was Giz who raised the alarm.

We were up here blackberry picking and walking the dogs.

And then, the next minute, her dog came over to me.

I thought, "Oh, that's not like him."

So I followed the dogs back and I found her on the floor.

She came to a little bit. I told her dog to stay with her.

I covered her in my coat and I ran to the nearest house.

He won't leave her if something's wrong.

Kiss. Get your ball. Keep up. Here, see. Kiss.

Good boy!

A month later...

Go on. What's this? Good boy.

..Lynne is recovering well at home with her special hero.

Well, Giz, he was just amazing.

He was constantly barking

and running backwards and forwards, backwards and forwards

to make sure that Kath was aware that she had to follow him.

And I'm just amazed at the fact that he actually

instinctively knew to go and get help.

Sit. Wait.

Ready?

And Giz laid down at the side of me, you know,

while we were waiting for the air ambulance to arrive.

And he really didn't want to leave me at all.

His role that day was vital,

um...because, without him,

Kath would never have known there was something wrong with me.

I'm just so grateful to him.

I think he's pretty amazing, really,

and he's a very special dog.

Lynne spent just one night in hospital

away from her faithful friend.

But she knows she wouldn't be home as quickly without

the skill of the emergency services too.

Ready, set, lift.

Without the air ambulance, they'd have had to carry me for half a mile

before they could have even got me to the nearest road.

Landing a helicopter in a field is no easy job.

And I would just...

If I could say anything,

it would be thank you.

It's been all go for the emergency services across rural Britain.

Two days after the horse fair in Sedgefield, all the travellers

had left the site...

tidier than it had been before.

Tobias was released from hospital the same day

but three weeks later, still in pain,

was re-admitted and diagnosed with a broken tibia.

And, whilst Lynne waits for test results

to get to the bottom of her collapse,

she's enjoying time at home, spoiling Giz.

And who said it was quiet in the countryside?