Episode 2 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.

You're under arrest for failing to stop for police.

Going hundreds of miles against the clock,

battling the elements and braving the weather.

-OVER RADIO:

-'Lower the winch.'

From fields and forests

to cliffs and country roads,

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

With police, fighting crime...

I've got suspicions that there might be cannabis being used.

..paramedics saving lives...

..and wardens safeguarding our lakes.

Get 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...

Every minute counts for Cornwall's air ambulance

as a life hangs in the balance.

Can you feel me touching this hand?

Paramedics on the Isle of Man try to solve a medical mystery...

Just painful?

..and the bobbies of South Warwickshire

crack down on dangerous driving...

Have you got your driving licence with you?

..finding no shortage of culprits.

Based on the status of the tax and the status of the vehicle

at the moment, the vehicle's going to have to be seized.

Cornwall.

Famous for its sandy beaches...

..wild moorlands...

..and rugged peninsula.

Every year, more than 4.5 million tourists

descend on this spectacular part of the country,

making its roads highly congested.

So, when lives hang in the balance,

the fastest way to give people the medical attention they need

is by air ambulance.

For the ambulance service as a whole, the workload significantly increases.

We're only served by one major hospital in Truro, in Cornwall,

which has a trauma unit with an emergency department there.

There are lots of places where it's up to 60-70 minutes by road,

and these sort of times can increase in the summer months

with the volume of traffic that's on the roads.

Every year, the men and women of Cornwall Air Ambulance

fly over 700 rescue missions.

Their average response time is just 12 minutes.

Today, a call's come in.

A holiday-maker in his 60s is displaying all

the symptoms of a severe stroke.

Thanks, bye.

-RADIO:

-'Airfield at Newquay, hello, basic service, 1015.'

'We are ten minutes out, Steve.'

Coming to the man's rescue are pilot Doug Pye...

'Tango 1015.'

..paramedic Paul Symonds,

and operations officer Steve Garvey.

From their base at Cornwall's Newquay Airport,

Steve and the crew are flying 25 miles

to St Keverne on the Lizard Peninsula.

And every moment counts.

Almost two million of the brain's nerve endings are destroyed

each minute after a stroke,

often affecting speech, vision and mobility.

'7050, receiving.'

RADIO:

The immediate problem is where to land.

This particular incident was in a small village in a bit of a valley.

So we wanted to get as close to him as possible.

The best landing site we identified as we went

into an orbit was the beach near to their holiday cottage.

'We may kick up a little bit of dust, just from the high-tide line.'

But a beach landing isn't without its hazards.

Fortunately for the gentleman, it was low tide

and we were able to select a suitable site on a rocky beach

and land well above the high-tide mark.

Once on the ground,

Doug keeps the engine running in case a fast takeoff is needed.

Steve heads straight to his patient.

A few hours earlier,

David had complained to partner Sandra of a headache.

Within minutes, the pain was excruciating.

Initially, his headache was put down to potentially a migraine or

just a generalised headache

and they'd correctly given him some analgesia for the headache.

When things weren't improving

and he seemed to take a turn for the worse

and had a little collapse, they phoned 999 straight away.

Steve's first priority is to test for signs of a stroke.

Dave, can I just drill you down on your headache a little bit?

Do you know where it seemed to originate from?

Just seems in the head.

In your head. Is that generalised all over,

or is it the front, the back, any one side?

In my head, it's quite...

I'm going...

There are various assessment processes and tools we can use

when trying to determine if someone's had a stroke,

one of these being a fast test.

Dave, can you just give me a big smile?

You might not feel like it at the minute. Big grimace, big smile?

So I was asking him if he could smile, getting him to speak

so I could try and assess whether his speech was slurred

or normal for him,

seeing if there was any facial weakness in the facial muscles.

David's responses mean a stroke is highly likely.

Did it affect your vision? Is it still affecting your vision at all?

For every minute David's brain was starved of oxygen,

it will have aged three weeks.

His chances of recovery depend on just one thing -

how quickly Steve gets him the treatment he needs.

South Warwickshire, in England's West Midlands.

Otherwise known as Shakespeare's County.

Here, rolling hills and beautiful vistas are dotted with more

than 50 small villages and hamlets.

It's the biggest rural area of Warwickshire, it's 150 square miles.

PC Craig Purcell's been in the force for 11 years

and now he leads the Safer Neighbourhood team

in Shipston-on-Stour.

There are a few main arterial routes through the area.

We've got the main Fosse Way coming through -

a lot of traffic flows straight through and doesn't stop.

It's also, unfortunately, because of that,

a route that criminals come through

and will pop off into the villages and towns.

So it's important that we're out and being seen to deter the crime

that's going on in the area, and also trying to catch the baddies.

Craig and his team must respond to every incident,

no matter how big...

That's him.

You're under arrest for failing to stop for police!

-..or how small...

-I saw a squashed hedgehog.

..though much of his time is dedicated to preventative policing.

We don't have too many rogues that actually live

within the 150 square miles, thankfully,

which means a lot of them are travelling through.

To travel through and to get away from,

once they've committed the crime, this rural area,

they need a vehicle, so my style of policing is to get out there

and look at vehicles, basically.

More often than not, it leads to other things.

Today, Craig is conducting random checks of motorists,

starting at one of his favourite vantage points.

This is a nice spot where two roads intersect. Two of our main A roads.

So we can sit up here

and just look for any vehicles that might be travelling through.

Have a look at the driver, check it on the Police National Computer

and see if there's anything we might need to stop it for.

Heading along the A3400 towards the village of Alderminster,

it doesn't take Craig long to spot his next appointment.

We ran it through the computer and it was notified off-road,

so somebody's advised the DVLA

that the vehicle shouldn't be on the road at the moment.

-Hello.

-Hi!

-You hat's better than mine!

It's nothing to worry about. As your vehicle's come past,

I've checked it through the Police National Computer

and it's coming up as notified off-road,

meaning that somebody's advised the DVLA

that it shouldn't be on the road at the moment.

-OK. So just go around onto the pavement.

-Yeah, sure.

Who bought the car?

Okey dokey. It's in your name.

And who sorted out the insurance for it?

OK. Have you got your driving licence with you at the moment?

But it's registered to you?

When the lady got out of the car and I started talking to her,

I could see that she had a...

flamboyant, I suppose would be the word, hat on.

She at some point mentioned that she was Wiccan, a witch of some sort.

I'm not sure on the exact terminology for it,

I believe she said the word witch.

And today, she's headed for toil and trouble.

Your licence is listed as expired at the moment.

And to make matters worse, it expired 11 years ago.

Way back. 2004.

You were disqualified from driving for totting up,

or something like that, was it?

No?

We've got you disqualified until the 7th of October 2004 for...

It doesn't explain the reason for it.

Have you got a photograph licence or an old one, paper one?

No photograph card?

Her driving licence had been revoked just over ten years ago,

11 years ago.

She had been driving around all that time, from what she said to me,

having not been stopped by police.

And then I come along in little rural Alderminster,

get her vehicle stopped, and she finds out she's got quite

a major problem because she can't drive the vehicle.

Turns out the driver's moved house and failed to inform the DVLA.

In itself, a potential £1,000 fine.

If there's an issue with your driving licence, or if you've...

If there are any points or something

and the DVLA were trying to get in contact with you,

they would write to you at your current driving licence address.

Would anybody be able to get in contact with you there, at that address?

If letters went there, would a family member forward them

on to you or anything like that?

Let me have a look and see why...

But the disqualification happened so long ago,

Craig can't find a reason on record.

According to this, you haven't had a driving licence since 2004.

Given the circumstances, the fact that she wasn't a criminal,

she wasn't out using the vehicle to commit offences,

I do believe that it was a genuine mistake on her part,

albeit an 11-year mistake.

With no tax and no licence,

this driver faces potential penalties of over £1,000.

And Craig could seize her vehicle as well.

Fortunately, he's in a compassionate mood.

She seems quite genuine.

I don't think she's going to get in the car after what she's discovered.

I do think she's genuinely just discovered the issue

with the tax and her driving licence.

It's very rare. The fact that it's 2004,

she's been driving around effectively since 2004...

You've got to be a specific type of person to do that on purpose,

so it seems very genuine.

But while she can hang onto the car,

she's not allowed to drive it home.

Basically, my husband's going to come and fetch me.

It's a day this motorist won't forget in a hurry.

It's been a bit of a shock, to be honest.

I've been driving for ten years with no licence, by the sound of it!

Which is... I didn't know!

If you haven't updated your driving licence address or vehicle address,

you may never know that points, fines, disqualifications,

things like that have been issued, and that can have

a severe impact when you are finally stopped by me or other officers.

If it's at that point you find that there's an issue

with your driving licence, it's too late by then.

More then 260 miles southwest of Warwickshire

on Cornwall's Lizard Peninsula,

it's suspected 63-year-old David is having a stroke.

Air ambulance paramedic Steve Garvey is completing his assessment.

Dave, with what's occurred this morning,

we want to take you up to the local hospital.

I'm numb in my right-hand side.

You know that you're not right.

For David's partner Sandra, it's her worst fear come true.

I was panicking,

because he was shouting that he'd lost the use on one side

and I was thinking, "It's a stroke.

"It's a stroke, what's going to happen next?"

I knew we'd got to get him medical attention as fast as possible.

We were in a tiny, remote area,

I was really scared how long it was going to take.

I was just so worried that this could be something that would kill him,

because you do hear of people having strokes and dying immediately.

Steve needs to get David to hospital, fast.

We've formulated a little plan.

We've got a little chair for you to sit on, mate,

and we're going to take you out to the helicopter.

The patient was presenting with a slight weakness

down his right-hand side,

which could've potentially pointed towards a stroke, in this case.

More alarmingly, David's symptoms suggest a bleed in his brain -

the most serious type of stroke.

Ready, set, lift.

Either way, it's rapid transfer to hospital and CT scanning.

Only a scan will confirm if David has a bleed or a blood clot.

But with no space in the chopper,

Sandra will have to make the 26-mile journey by road.

-I'm going to get the car ready.

-OK.

-And I'll see you in a bit.

I wasn't sure at that point how much he understood what was happening

because, obviously, he was panicking

and had been very distressed about what had happened to him,

and I just wanted to be with him.

That was quite upsetting

because I didn't want to leave him on his own, really.

The team race to the Royal Cornwall Hospital in Truro.

Steve radios ahead to brief the medical team.

And just 15 minutes later...

There we are, sir.

..David's rushed to clinical imaging.

This is the place where he can get rapid scanning of his brain to

determine what's caused the collapse and the headache this morning,

and see what's the best form of treatment.

Ready, set, slide.

The initial scan reveals Steve's suspicions are correct.

David has had a stroke, caused by a blood clot in his neck.

For him and his family, the next few days are critical.

As for Steve and his team, there's no let-up.

In summer, the county's population swells by an extra 200,000 people.

The extra visitor numbers places a huge strain on

the ambulance service in terms of call volume,

which is significantly increased in this time of year.

A call's come in.

Fortunately, travelling 140mph has its advantages.

The team are travelling 28 miles to Boscrege, near Helston,

where a woman's been thrown from her horse.

Early reports suggest a broken pelvis.

Steve and his team are called to around 70 horse falls per year,

often with potentially life-threatening injuries.

But the challenges facing Steve, fellow paramedic Paul Symonds

and pilot Doug Pye aren't only medical.

Today, access is also a problem.

Coming in to treat these patients with a helicopter, we have obviously

got concerns about the lay of the land and where it can be.

We need to be aware that all animals are away from the scene,

and we aim to land as far away from them as possible.

-You able to spin it round at all?

-Yeah, can do.

Landing almost a quarter mile from the accident,

the team must continue on foot...

..with Steve carrying essential medical equipment and supplies,

weighing a backbreaking 25 kilos.

If there is a significant break to the pelvis,

a lot of the body's blood volume can be lost in that area.

So it is potentially a significantly serious injury,

so we were prepared for the worst case scenario in this incident.

From one Celtic kingdom to another.

The Isle of Man, 34 miles off England's west coast,

is renowned for both its independence

and its breathtaking scenery.

It's also home to a population just shy of 85,000

who, in case of emergency, rely on their own,

independent ambulance service.

With a staff of more than 40 people and a fleet of 23 vehicles,

it's the first response to any medical emergency.

Paramedics Kerry McShane and Mark Dodd

have been called to an elderly man who's been suffering intense pain

in the neck and back.

The man's home is in Douglas, where Kerry and Mark are also based.

But even on this small island, there are traffic problems.

In five minutes,

Kerry and Mark arrive at the home of 85-year-old Peter.

He lives alone and hurt himself a week ago.

You've seen nobody since the fall?

While the fall could explain Peter's discomfort,

it could also point to an underlying issue.

Just painful?

When you turn your head.

Obviously, the first thing that we wanted to do was assess

whether or not he had injury to his neck,

or whether it was muscular pain that he had.

And when Mark palpated it was more to the right side,

I think, of his neck.

So it seemed to be more muscular in origin to us,

the source of his pain.

Peter's neck is a concern.

But with the cause of his fall a mystery too,

Mark makes a call to transport him to A&E.

Shall we pop you along to hospital

-and let the doctor have a look at you?

-Yes.

Do you want something for the pain?

To help with the pain?

-Yeah.

-OK.

KERRY LAUGHS

Well, we can help with one of those.

But given Peter's age, even easing his pain isn't straightforward.

Did they have trouble getting blood from you?

We offered him some pain relief, but I was unable to cannulate

due to his poor veins.

So we went for the alternative and gave him some oramorph,

which is a morphine, and he just takes it orally

which seemed to relax him a little bit.

Gently, Mark helps Peter to the ambulance.

Is that pain constant? Is it there all the time?

Before they depart,

he and Kerry build up their patient's medical history.

You've got a little mark on your hand,

was that when you fell in the garden?

Oh, yes, I see.

Any detail, no matter how small, could help explain why Peter fell.

Previous surgery?

What did you have done?

-A bypass.

-A bypass?

-21 years ago.

-21 years ago?

-Was it a triple or quadruple?

-Triple.

-Triple.

-And no strokes in the past?

-No.

-Nothing like that?

Peter's next stop, Noble's Hospital.

There, he'll be X-rayed and given further tests

in the hope this medical mystery can be solved once and for all.

I drove us into hospital.

Doddy, as we call him, he was attending that day,

so he stayed in the back with Peter.

-How's that pain, after that morphine I've given you?

-It's helped.

It's helped a lot, has it?

We do repeat observations on the way in before we get into hospital,

just to make sure everything is still stable, nothing has changed.

Kerry and Mark get Peter checked in.

Welcome to A&E.

-Can I help you with your legs?

-Yes, please.

OK, here we go, ready?

85 years of age, history of a fall, one week ago.

Peter is seen by Dr Rashid,

who soon figures out the reason behind the fall.

He came in with neck pain, but when I examined him he looked quite pale.

So we did some blood tests and some X-rays.

His neck X-ray was OK, just showed wear and tear.

But his haemoglobin, which is the blood test, was lower than normal.

So he has been losing blood from somewhere

and that's why I think he felt dizzy and had a fall.

While this means Peter requires more tests,

he should now get the treatment he needs.

The neck injury, actually, highlighted a deep problem,

so it's a good thing that he was admitted.

Otherwise, if we sent him home just with a neck injury,

he would have fallen again.

All going to plan, Peter's medical mystery will soon be solved.

Back in South Warwickshire,

rural bobby Craig Purcell is still cracking down on drivers.

Have you got your driving licence with you, by any chance?

Residents want me to be out there, protecting the roads,

making sure they can travel to and from work

and go about their business within the villages

and on the road network and feel safe.

This shouldn't be on the road. Is it yours?

And what's so far been a busy shift

is showing no sign of slowing down.

SIREN

Craig's run a courier's vehicle through the police database

and it's showing as uninsured.

While the driver can prove he's fully insured,

there's another problem.

The MOT's in order, but there is no tax on it either,

so I'll check another system.

Unfortunately, the result is the same.

-Are you still in Warwick, your address?

-Yes, yes.

-OK.

The courier may have to back pay his tax,

plus an additional 50% as a penalty.

And Craig's spotted another issue.

You can see, just stood over from a few feet away,

that looks like it's pretty bald. And coming up and examining it

just with my fingers, the centre's slick,

and the outside, when I get the measuring tool out,

that's going to be under the legal limit as well.

So I'll have a look at the rest of the vehicle, see if there's any other issues with it.

One of the tyres was bad, the other was ridiculous -

it shouldn't have been on the road.

And as I was examining them, he actually commented to me,

the driver, that he was aware that the tyres were in that state.

I'll be honest, I have two tyres that aren't great.

I know you're a courier.

Based on the status of the tax and the status of the vehicle

-at the moment, the vehicle's going to have to be seized.

-Right.

Have you got somebody else that could come along,

unload, get that into something else so that we're not taking everything that's in there as well?

-I'll phone someone.

-Thank you.

What seems like a little thing to that driver potentially could

have a big impact if he is involved in a collision,

an impact on the person he's crashing into,

an impact on his own life.

So while the courier contacts HQ, Craig calls for a recovery truck.

The vehicle will be seized, initially for the tax reason.

We don't seize a vehicle...

Or I wouldn't seize a vehicle purely for the tyres.

But that, coupled with the fact that tax is out so far - it's almost

12 months - it'll be seized for the DVLA to deal with that matter.

I will complete paperwork for the two bald tyres.

Because there are two it won't be a straightforward, single ticket -

the matter will go to court, basically, for the magistrates to deal with.

And to top it off, Craig's required to breathalyse the driver as well.

How old are you?

Today?

-No, no.

-I was going to say.

OK, I'll keep a hold of the machine. If you can take a nice, deep breath.

Don't blow as hard as you can, just steady until I say stop.

Deep breath, and blow.

That's it.

Thank you.

Zero, no problem there.

Even so, it's fair to say it hasn't been a good day at the office.

Stops the whole job for the day, so not great.

The DVLA will require the back tax to November.

Whether they impose a fine or not as well, I'm not sure.

I think that is likely.

But the main offences on top of that, the two tyres...

I don't really need to measure this one for evidence

because you can see it's slick.

There's absolutely no tread on there whatsoever on the outside.

..the magistrates will issue points for one of the tyres and a fine.

And then the second tyre, they don't double up the points, so if you

have four bald tyres, you don't end up with three points for each one.

They tend to then issue a fine for every secondary offence after

the initial tyre.

Slick at the front, slick at the rear, and the no tax.

It shouldn't be on the road, it's dangerous.

The cavalry soon arrives to transport the cargo

and its courier back to base.

He phoned his boss or a colleague who came out in another van,

which was all in order.

Checked that through as well, because you'd be surprised how many

people turn up to pick up people from vehicles that've been seized

and they've got no insurance or they've got other issues,

and they try and complain, "I was only coming to pick him up

"and do him a favour, you can't do me for this."

You know, the excuses are endless.

Meanwhile, this van's off the road

with its driver facing some costly fines,

leaving Craig free to catch his next unsuspecting motorist.

From country coppers to country choppers.

In Cornwall, the air ambulance has been dispatched to a woman who's

been thrown from her horse.

She may be suffering from a broken pelvis.

It's a journey paramedic Steve Garvey has had to finish on foot,

and with 25 kilos of kit on his back.

-What's your name?

-Katie.

-Hi, Katie.

-Laity.

Katie Laity?

That's a name.

I'm Steve.

Just going to pop a little machine on,

I'll do your blood pressure and your heart rate.

So you weren't expecting all this attention, then, today.

Well, these things happen.

Upon talking to her,

she was more concerned about the embarrassment of it -

having so many people around, having a police officer,

having a helicopter, having other road ambulance paramedics there -

than she was about any potential injuries or pains she might have.

Even so, Steve's taking no chances.

Well, I fell off and heard a bit of a crack here.

On my leg, on the inside of my calf, feels grazed or something.

And my arm's grazed. But this bit, something did make a noise.

So something made a noise when you landed?

-You haven't tried to stand up?

-No.

Steve's ruled out a broken pelvis,

but needs to examine Katie more thoroughly.

-Meet Katie Laity!

-LAUGHTER

-Hi, how are you?

-OK.

This is Pauly Wally.

I'm a firm believer in that humour is a great aid to suffering

and discomfort as much as any drug.

So if it helps to ease the patient's condition with

a bit of TLC along the way...

We want to get you out this awkward position that you're in,

-get you scooped up and off the road, which is not very comfy.

-Obviously, I'm a bit in the way.

I'm not worried about the traffic, I'm worried about it's not very comfortable for you

-to be lying there. Get you on the stretcher and we can have a look at you.

-OK.

She has felt some discomfort in her right hip.

She was initially sat up and she's managed to move both legs around,

so we're treating her as a non-time-critical patient at this stage.

We're just going to gently scoop her off the road,

keep her more comfortable, and we can further assess her in the back

of the ambulance and decide the best method of taking her to hospital.

I mean, at this stage Katie's declined any analgesia,

so she's not in too much pain at the moment.

But then, ladies are quite tough, particularly the horse riders.

Katie, if you want any painkillers or that position changes,

just let us know.

-If it hurts, I'll tell you.

-OK, definitely.

As the team prepares to move Katie, sure enough,

the pain starts to come back.

How you've got that odd sensation,

we can't rule anything out here at the scene.

So I think we'd prefer to take you to hospital just so that

can be checked over and see if you potentially need an X-ray on that.

Steve and the team always err on the side of caution.

It is a fair old journey back up to Truro -

anything up to 45 minutes, an hour in an ambulance.

Five-minute flight for us.

It's kind of a no-brainer, really.

Sometimes we have to prepare for the worst scenario.

But if we're greeted with a more positive outcome

and less serious injuries, that's a welcome change.

Ready, set, lift.

-You all right there, Katie?

-Yeah.

-Nothing's changed?

-Don't need any pain relief?

-No.

Katie being a local lady that rides horses,

I'm sure she's of tough stock.

And I'm pretty sure she'll be back on her horse in no time at all.

Katie is just one of up to 800 patients

Cornwall Air Ambulance is called to every year.

-Right, Katie, wish you all the best.

-Thank you very much for helping me.

In the majority of cases, the injuries are life-threatening.

63-year-old stroke victim David was in a critical condition.

My name's Steve, I'm a medic with the helicopter.

Ready, set, slide.

He went from scene to scanner in just 15 minutes,

a journey that took his partner Sandra more than an hour by road.

A lot had happened by the time we actually got to the hospital,

so the time we'd been, less than an hour,

they could come back and tell us that the stroke

had been caused by a clot as opposed to a bleed on the brain.

Clots are the cause of 85% of all strokes.

David's was the result of a damaged artery in his neck.

Treatment began immediately.

I was just so worried.

It was really, then, wait and see what damage that stroke had

done to Dave, and how much he was going to recover.

We didn't know whether he would be able to walk properly,

use his arm, and it affected his eyesight quite a lot, but we didn't

know how or why, and what long-term effects that was going to have.

David underwent multiple scans and a lumbar puncture.

For Sandra and family, the days that followed were tough.

But after five days of critical care, finally David was able

to return home to Stourbridge in the West Midlands.

Initially, I couldn't brush my teeth.

If I lifted my hand up like that it just fell down,

which was quite surreal, really.

Now I can do all of that.

I can hold things, I can grip things.

It's now been just over five weeks since David's stroke.

My head is...

It's quite...

I've gone...

He's still experiencing problems with vision and mobility,

but his recovery has exceeded expectations.

I feel as though I'm going in the right direction,

and most of that will, I'm told, should come back.

I'm just going to have to be patient for the first time in my life.

But he'll never forget that fateful day on Lizard Peninsula.

It was so sudden. The whole thing was just so sudden.

One second I was sitting outside, talking with our friends,

the next second my head just went.

Can you feel me touching this hand?

I'm spending a life where I've done everything, really,

that I've wanted to do, within reason.

Run marathons, played football, climbed mountains

and all these type of things...

..to thinking, "That might all have come to an end now."

Even so, he feels he owes his survival to the team

at the Cornwall Air Ambulance.

If we get a chance to see any of those people again,

I would just say a really big thank you to them.

Top of their game, really. Nothing but admiration for them.

It's been all go for the emergency services across the British Isles.

In South Warwickshire, three months after being stopped,

the local witch still hasn't got her licence...

..while the courier who had no tax and two bald tyres

is still waiting to hear the outcome of his case.

On the Isle of Man, Peter got home after six days,

though his tests were inconclusive.

And in Cornwall,

Katie Laity's back in the saddle after a month of physio.

And you thought it was quiet in the countryside!