Episode 14 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 stop for police.

DOG BARKS

..going hundreds of miles against the clock,

battling the elements and braving the weather.

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...

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 -

chest pains lead to a blue light call on the Isle of Man.

What would you score your pain on a scale of nought to ten?

Nought being no pain and ten being the worst pain you've ever had.

Windermere's lake wardens

have an environmental crisis on their hands.

You can see sort of oil and scum coming out of the engine already.

And a serious head injury is a serious worry

for the Royal Navy Search and Rescue Team.

The Isle of Man.

50 miles off the coast of Cumbria,

famous for its 100 miles of rugged coastline...

..its picturesque rural communities...

..and more than 300 miles of scenic winding roads.

The island has just over 300 residents per square mile,

less than half the population density of the rest of the UK.

So when there's an emergency call, getting to critical cases in time

is a challenge for the emergency services.

HE KNOCKS

Hello? It's the Ambulance Service.

The Isle of Man Ambulance Service is a vital lifeline.

They're ready to respond 24 hours a day.

Right, what we'll do, we'll put you in the ambulance and we'll

pop down to Noble's to get this pain sorted out for you, all right?

Paramedic Jason Gorns has worked for the Ambulance Service

for seven years.

I've seen quite a lot in the years I've done, but

there's always something that surprises you out the blue.

You get a call, you just never know what you're going to.

Even what they tell you're going to can sometimes turn out to be something completely different.

This evening, Jason's working the 12-hour night shift with

ambulance technician, Danielle Sims.

It's seven o'clock now, we're just doing vehicle checks.

And we're on all night until 6:30 in the morning.

Night shifts do generally tend to be a little bit quieter,

though they can be busy as well.

It's quite a rural area so we do cover a wide variety,

so things can change by the minute, really.

Just two hours into the shift,

a 999 call has come in from a patient complaining of chest pains.

SIREN WAILS

Just going to a chest pain now

and that's the only information we've got at the moment.

Chest pain, normally what you tend to think is cardiac cases,

but there can be numerous things for causing chest pains, so that's

probably the worst out of all of the eventualities, really,

so we'll speak to the patient, ask some questions

and we'll try and determine whether it's cardiac related,

like a heart attack or anything like that.

With the possibility of a serious heart problem,

it's important they get to the scene fast.

From their ambulance station in Port Erin, they're driving over

14 miles of country roads to the patient in the town of Douglas.

-Can you bring the little defib bag?

-Yeah.

In just over 20 minutes they arrive to find 33-year-old Kevin

in agony at his front door.

-Are you on your own?

-Yeah.

-So what's happened to you, then? Have you got some pain?

-Yeah.

-Your chest, your stomach or...?

-Just...

-Just there.

Any pain like this before?

-You've had three heart attacks? At your age?

-Yeah.

-Right.

Up to 10% of heart attacks occur before the age of 45.

Jason probes further.

You say you've had three heart attacks.

When was your last one, how long ago?

12 months ago.

What would you score your pain on a scale of nought to ten?

-Can you give it a score for me?

-Yeah.

Can you manage?

Are you a bit tired?

Does this feel like the heart pain you've had before?

You don't think it's to do with your heart, it feels totally different?

With Kevin's worrying medical history, Jason's taking no chances.

Let's pop you on this stretcher. Just take your time.

In the ambulance, Jason can monitor Kevin's heart

with an electrocardiogram

and do further tests.

Just going to have a listen to your chest.

Just take a deep breath in and out for me.

Right, let's do your blood pressure.

Have you taken any painkillers at all?

Nothing?

You say it's been slowly getting worse all day, has it?

You felt something pop.

-You say you've never had a hernia or anything like that, have you?

-No.

No?

Do you have problems with your blood pressure normally?

-Has it been quite high in the past, then?

-Yes.

What else was it you say you suffer with?

Right.

ECG looks fine. That's good.

You don't want any Entonox or anything to try?

Kevin turns down the offer of gas and air for his pain.

But with his history of heart and liver problems

and high blood pressure,

Jason's keen to get him to hospital as quickly as possible.

Right. Your blood pressure's fine at the moment.

A little bit high, if anything. That can sometimes make you feel

a bit strange and dizzy but, if you do, you're monitored anyway

and you're on a stretcher so you're not going anywhere, all right?

Well, we'll see.

See what the doctors find when we get you up there.

They've got a lot more equipment than we've got, so...

In just five minutes, they're at Noble's Hospital,

Accident & Emergency ward.

Is it a bit like your second home up here, then?

Right, Kevin, do you think you're able to shuffle yourself across there? Just take your time.

Here, they can run more tests.

You look familiar, Kevin. Have you been in before?

-Only about 20 times.

-20 times.

-At least.

There's so many things that can go wrong with the abdo, really.

You know, we bring them to the hospital for the doctors to do scans

and other tests and things, and hopefully they'll find something that's causing his pain.

For Danielle and Jason, it's back on the road.

With just three island ambulances on call, night-time can be busy,

and in just two hours this team are on another blue light.

Responding to...I think it was a 32-year-old male

that's been hit in the face with steel toe-cap boots, apparently.

The police are in attendance as well

so we'll see what we get when we get there.

From blue lights on the Isle of Man, to blue skies in Cumbria.

The stunning Lake District

attracts more than 16 million visitors a year,

generating more than £1 billion of revenue.

On Windermere, England's largest and longest lake,

tourists flock to enjoy the watersports

and leisure pursuits the area offers.

Martin Dodgson is one of Windermere's six lake wardens

employed by South Lakeland District Council.

Right. Avanti.

From their high-powered patrol boats,

Martin and his colleagues keep the tourists

and the local residents around Windermere safe and sound.

They also guard the lake's diverse natural environment.

Well, the lake is a very, very magical place.

I'm lucky enough to be born and bred on Windermere.

I love it.

It's always nice to see people enjoying themselves.

This lake warden's job is such a varied, varied job.

I mean, you can do anything. If anything can happen on land,

it can happen on water, and we have to end up dealing with it.

And this morning's no different.

We've just had a report that there's a vessel

that looks like it's taken a little bit of water.

The stricken boat is half a mile from their Bowness base

on the west side of the lake.

Thankfully, no-one's on board,

but it could still spell disaster for the lake.

This does happen on a regular basis.

The cover gets ripped off in the wind, rainwater goes in,

fills it up, starts sinking,

which then in turn

could cause an environmental issue

with all the engine oils and the fuels coming out of it.

And as you can see, the floor's collapsed in it.

The cover's gone.

Full of water. Everything's porous.

You can see sort of oil and scum coming out of the engine already.

Oil is responsible for 16% of all UK water pollution incidents

and can be a catastrophe for local wildlife.

It needs to be mopped out correctly, basically.

The oil needs to be taken off.

People need to take responsibility for their vessels.

It's... There can be big, heavy fines by the Environment Agency

for polluting waterways, which Windermere is obviously

the largest one in England.

We don't want pollution on our lake.

Or on MY lake, even. My lake.

Martin fetches a motor pump to bail out the boat.

Seems he's found a friend, too.

I've got my good buddy, Ronnie Muggeridge.

He's the head Lake District National Park ranger.

We work closely together, which is always good.

-We work even closer together when we go like this.

-THEY LAUGH

Yeah, I've known Ronnie just through this job. He's a good lad...

some say.

I've asked if I can borrow their little petrol pump to do this job

cos our pump, we have a big RNLI trash pump, which is very heavy.

Now to put his antipollution plan into action.

So basically, it's going to be an improvised filter.

So we've got a lovely container here with a few little holes in it.

That's to let the water drain out, obviously.

Some oil-absorbent pads.

There's a few already in the bottom of it. So that is going to

catch any contamination. Fasten that to the bow of our boat.

That's now sucking away nicely.

Any spilled oil will form a thin layer on the lake,

stopping oxygen transfer between air and water.

It can lead to suffocation for plants and wildlife,

so it's a good thing this pump's doing its job...

for now.

PUMP STOPS

Ohhh!

He's broken the pump!

Come on, lads. Give it some wellie.

Poor old girl's struggling.

Normal service will resume shortly.

We're simply having technical difficulties.

From a bumpy day on the Lakes,

to a busy night on the Isle of Man.

Paramedic Jason Gorns and technician Danielle Sims

are still working their 12-hour night shift.

They're responding to another 999 call and it sounds like trouble.

We're responding to...I think it was a 32-year-old male

that's been hit in the face.

I think the police

are in attendance as well, so we'll see what we get when we get there.

From their ambulance station in Port Erin,

the call's taking them eight miles to the village of Ballasalla.

It's nearly midnight and a late-night call like this

rings alarm bells for Jason.

There'll be alcohol involved, I've got a pretty good idea,

but we could be wrong.

You can walk through an area in the daytime, it look quite

picturesque and nice,

but night times it can just be a completely different environment.

It sounds like a violent incident but it's unclear how serious it is,

so the police are blue-lighting to the scene, too.

It can be a bit worrying.

It's always nice to have the police there. The Isle of Man police

are normally quite good, actually, normally very quick to respond.

With our job, it is very unpredictable

and you can go into a situation that you think is quite safe

and it can suddenly change, you know, at a second's notice, really,

so you just need to be on your guard all the time.

-Is that the police there?

-Is that them there?

-Is it?

-Is it police?

-Yeah, yeah, yeah.

The casualty, 32-year-old Paul, made the 999 call.

He's waiting with the police officer.

Pop yourself in the ambulance and let's have a look at you.

Put your fag out, then.

Stretcher, Danielle, pop him on there.

Right, sit yourself on the stretcher, matey.

What's happened to you, then?

Thrown at your face? So you weren't kicked by anybody? Right.

So he's been booted in the head,

but thankfully not in the conventional way.

Was you knocked out at all?

-No.

-Not at all. Have you got...? Keep your head still for me.

Have you got any pain in your neck at all in the centre.

-No.

-No. Just sit...

Right, sit yourself forward for me.

-Any pain in your back anywhere?

-No.

-So when I feel down your back there's no pain?

-No.

-Nothing at all. You say you wasn't knocked out?

-No.

As head injuries can be serious, Jason checks for complications.

Just look straight at my nose.

I'm just going to shine a light in your eyes.

Have you had any alcohol tonight or anything?

How much have you had, a lot or...?

Eight or ten pints.

'Somebody that appears intoxicated

'could actually have had a head injury and the signs and symptoms

'could solely be down to the head injury, not just the alcohol,

'so you have to treat them for the worst case.'

Pop this on your arm, we'll do your blood pressure.

It's not particularly bleeding greatly at the moment, so we'll leave well alone.

You've got no pain anywhere else at all, then, just your head, is it?

But Paul's got another headache.

PC Robin Arnold has something else to add.

But before he's taken in for questioning,

Paul needs to be taken in for treatment.

Obviously, your wellbeing is the first priority,

so we're going to get that sorted first.

Yeah, would that not be...?

I'm not going to talk to you about it, Paul. You're under caution.

-There's a time and a place to talk about it and it's not here.

-OK.

It's all right, you've got blood all over you, mate.

I know, but... Thanks anyway.

It's an easy drive back to A & E.

No pain relief given or anything?

No, he's not really asked for anything

and he seems fairly OK in himself.

-I'll just get some times for that and I'll bring it back.

-No worries.

OK, thanks very much. All the best, mate. You take care.

All right.

Nurse Malcolm Diash cleans Paul's wounds up...

ready for Dr Eva Longworth.

Just going to feel your head now.

Any tenderness there?

-Yes. Yeah, that's...

-And here as well?

-Yeah, yeah, yeah.

If you look at my finger, any double vision or anything?

No.

-And it's sore here?

-Yeah.

-OK.

-Yeah.

Concerned about fractures, the doctor's being cautious.

-What I'd like you to do is come back in the morning for X-rays.

-OK.

What we'll try to do is glue it

and then give the other gentleman some advice when to bring you back

-and we'll see you back in the morning.

-OK.

All right, thank you.

Malcolm patches up Paul's head.

This might sting just a little bit.

That feel OK?

Yeah.

But there's no rest for this lad.

Yeah, is there the chance of a transport from A & E

up to headquarters, please?

Now he's taken in for questioning...

Thanks, guys.

Cheers. Thanks very much. Bye.

..and a late night visit to the local nick.

Scotland.

Over 30,000 square miles of towering mountains...

..storm-battered coastline

and remote farmland.

Living in this isolated wilderness can be wonderful,

but when tragedy strikes,

reaching critically injured casualties is a hard task.

But it's a task taken up by the best -

HMS Gannett.

Covering 98,000 square miles of the UK,

this Royal Navy Search and Rescue Team

provide a lifesaving service, vital for rural communities.

Today, Lieutenant Commander Florry Ford is briefing the team.

The first one is winch training.

Once they're ready and we've risk assessed with a winch transfer...

This morning they're working on a special

Royal Navy training exercise.

Today's training exercise is to work with a couple of warships,

and we're going to practise winch training with them.

There is a potential for us to be tasked to an incident,

because we're already airborne, so providing we have the fuel

and we're going to be the quickest unit,

then potentially we could be called out later on today.

They've left their base at Prestwick,

to fly 31 miles northwest to the Firth of Clyde.

There they'll rendezvous and train with two naval warships.

Important training manoeuvres like these keep everyone's skills

at the highest level.

Mike H Henson is the team's winchman and paramedic.

He'll be lowered down to the deck of a warship.

I won't put him out till we get over the top,

and then we'll get him down quick.

Winching from a hovering helicopter to a moving target

is the sort of challenge these boys relish.

That will be affirmative. Ready to winch. Out he gets.

Go back and right, half past three, 40 yards.

Good line. 30 yards.

And lowering.

Go back right, four o'clock.

Easy...easy. And steady.

Four yards. Clear back and right.

Steady. On the deck, with the gear.

Raise the winch, and move back to the left.

This morning's training has gone well for winchman Mike.

The most satisfying things, I find, is the teamwork,

A, within the aircraft, but B, with all the multiagencies.

RNLI, Mountain Rescue, Health Service,

other emergency service personnel,

all coming together to achieve an end.

Easy, easy. Steady is the touch. Raise is clear.

Move back and right now to clear the vessel.

Level with the step.

Level with the door.

And bringing him onboard.

As training takes the team further north, a call comes in.

From their current position near Arrochar,

the team head full-power to the casualty on a farm

near Strathaven in Lanarkshire,

about 40 miles as the crow flies.

Rescue 177's en route.

Echo Tango Alpha is 1155 UTC, over.

Roger out.

By road, the journey's almost 70 miles.

In this powerful Sea King Mk5 chopper,

it'll take just 20 minutes.

A farm worker has suffered a serious head injury,

while operating machinery.

The skull is a closed vault,

so any bleeding or any swelling in there, it ends up compressing

the brain, as opposed to swelling out the way,

which causes some significant and serious complications.

Almost every three minutes,

a head injury patient is admitted to a British hospital.

In severe cases, the consequences can be fatal.

It's vital these patients get the best care, fast.

OK, clear and dispatch. Do I have the clear door?

You are clear door.

Doctors from the Emergency Medical Retrieval Service

are already at the farm.

They're specialists in emergency care.

They only attend the most serious of cases.

A quick brief from the doctors reveals the situation is critical.

64-year-old Daniel's head injury is life-threatening.

His wife May is at the scene.

We've arrived at the scene. Clearly there's a full medical team here.

The guy's got a head injury.

Farming, by its very nature, is a dangerous occupation.

Accidents happen, but they generally happen in remote, inaccessible

areas, which is where helicopter services come to their own.

They can get to places where ambulances can't get.

The doctors have anesthetised Daniel

and need to urgently transport him to hospital.

That's where the HMS Gannet team can help.

For the safety of the patient, the doctors anesthetise

the casualty, and take over their breathing.

They don't have enough room in the Air Ambulance

to work on the patient safely,

so the doctors decided to call us cos we've got such

a big aircraft that they get the benefit of being able to anesthetise

the patient, work on them and get them to hospital fairly rapidly.

One, two, three.

It's all hands on deck for the emergency services

to get Daniel to the chopper and hospital quick.

Back on Windermere, in Cumbria, lake warden Martin Dodgson

is trying to prevent an environmental incident.

A sinking boat is threatening to pollute the lake with oil.

You can see, sort of, oil and scum are in,

coming out of the engine already.

Determined not to spill any oily drop,

Martin is bailing it out.

But as the first pump broke...

ENGINE SPLUTTERS

Normal service will resume shortly.

We're simply having technical difficulties.

Yep. On to there. Let me get on.

Martin and national park ranger Ronnie Muggeridge

have found a replacement.

Take two!

We've now got our huge pump,

I'm positive will do the job.

If it doesn't, I'm going home...

to get a bucket and do it by bailing by hand, the old-fashioned way.

It'll take a little bit of rigging up, but we'll get there.

I have an idea.

As Baldrick would say, "I have a cunning plan."

Right!

Put that into the bucket for us.

This is terrible. It's very noisy and very smoky, by the way.

ENGINE ROARS

RONNIE COUGHS

The reason why we're doing this, is we really want to avoid

a major pollution incident.

Cos this could have a potential of, say, 100 litres of oil in it.

Just five litres of oil will disperse to cover an area

the size of two football pitches.

As you can see,

we've got very little pollutants coming into the lake

through this lovely filter system, which we've improvised on.

But the gentlemen really does need to come and get his boat sorted out.

Can't carry on like this.

It's becoming a home to various bits of wildlife,

it's that neglected.

So I'm surprised that there hasn't actually been an otter,

or a mink actually boarding it and sleeping on it

and making its den.

If I'm not mistaken, that's what they make.

Sitting here with its deckchair, eating its fish lunch every day.

Bottle of prosecco, a nice fish lunch, a few olives.

Crack on. Job's a good'un.

Cos that's what I'll be doing tonight.

Job done and the Windermere environment's safe again.

But Martin's not getting that glass of prosecco just yet.

We've just had a report that apparently there's a car

somewhere up in our car park, that seems to have run off the car park.

He's down an embankment.

They may end up having a tow out of the woods.

Oh, dear.

-Is it yours?

-No. It's his, over there.

-What happened?

You live and learn. I'll never do that again.

I reversed and I just never bothered parking in the first place.

What, were you trying to turn around or something?

Visitor Stuart's car has sunk into the grass verge.

There was two or three cars parked there and I just went in next to the rest of them.

I couldn't find a space anywhere and now we're three-foot deep in mud.

Give me five minutes. I'll walk back down, get the tractor and...

We'll... We'll...

-We'll get you out. Worry ye not.

-MARTIN LAUGHS

Time for another of Martin's cunning plans.

ENGINE RUMBLES

ENGINE PURRS

ENGINE RUMBLES

But the car's not shifting for some reason.

Oh, and tell him to take the handbrake off,

cos that back wheel's locking.

VEHICLE BEEPS

Come on, lads.

Right. Now put the lock in, and go.

ENGINE ROARS

That's it.

-Don't lose that.

-Right, thanks very much for that.

-No worries, fella.

-Cheers.

-Eh?

Now Martin can drive off into the sunset

and uncork that long-awaited bottle of fizz.

SIREN WAILS

Events are much more serious in Strathaven, Lanarkshire, where

farm worker Daniel is being carried to the HMS Gannet helicopter.

His head injury is life-threatening.

We've arrived at the scene,

and clearly there's a full medical team here.

The guy's got a head injury.

They need to get Daniel to a specialist trauma hospital

in Glasgow, quickly.

Gannet's paramedic, Mike Henson,

knows that choosing the right hospital for Daniel is crucial.

Some serious injuries can only be dealt with by

the appropriate consultants,

so choosing the right hospital, and getting them to

the correct hospital in the appropriate time is...

Prehospital care is priority.

HELICOPTER WHIRS

The hospital is at Glasgow.

The huge new centre up there is staffed by some of

the most phenomenal people I've ever had the pleasure to work with,

so I knew getting the casualty to that particular facility

would give him the best chance.

Right, move right one o'clock four. Steady, good position.

You are clear, right behind and below.

-Clear left.

-Go down slowly. Go down.

This hospital is Scotland's leading centre for

brain and spinal injuries.

Thanks for holding. The lever's fully down.

We just dropped the casualty off at Glasgow University Hospital,

with the retrieval team,

and now he's on his way into the Emergency Department.

They'll fully assess him and take it from there,

so, erm, we're just heading back now.

With Daniel in the best hands, they're heading back to base...

..but Lieutenant Commander Florry Ford takes another emergency call.

This is the second serious head injury of the day.

They're speeding back to the Firth of Clyde,

where they trained this morning -

this time to the naval base at Faslane on Gare Loch.

The 25-year-old casualty has suffered a head trauma

while playing football in the gym of the naval base.

It's the most closely guarded naval facility in the UK,

and home to the Trident Nuclear Defence System.

-Visual of Faslane.

-177, copy your last. You are clear to land.

The casualty, James, was kept alive by his Navy mates performing

first aid until trauma doctors got to the scene,

but he's in a serious condition.

He's transferred straight onto the chopper.

Once again, medics from the Emergency Medical Retrieval Service

are on scene and have anesthetised James.

Oh, right.

Yeah, that's Air Sea Rescue 177. We've departed Faslane.

We're now eight souls onboard,

endurance two hours, and routing to Glasgow University Hospital.

We have an Echo Tango Alpha 1623 UTC, over.

They're flying back to Queen Elizabeth University Hospital

in Glasgow - an hour's journey by road, but 15 minutes by air.

HELICOPTER WHIRS

James is transferred into the care of the specialists

at this state-of-the-art facility.

What started as a training day for HMS Gannet rapidly

turned into an intense challenge for this elite rescue unit,

but despite their efforts the outcome is not always positive.

Sadly, farm worker Daniel passed away in hospital,

ten days after his accident.

His family wanted his story to be told,

to highlight the vital work done by rural emergency services...

..and their work IS vital.

Four weeks after being picked up by Gannet,

Royal Navy Marine Engineer James is recuperating at home

with his dog Jack.

He's had 13 days of intensive hospital care since he played

that fateful game of five-a-side in the gym at his naval base.

I remember running after the ball and colliding with my mate,

and flying into the wall,

and that's all I can remember of the game.

It was only when I was in hospital and I woke up

and I was completely confused of where I was,

and I was calling for the nurse,

and that's when she revealed what happened and I was just...

Wow.

I was completely...so...

so confused, so dizzy, didn't know where I was.

Horrendous.

At one stage, erm, my kidneys were failing,

and they weren't quite sure what the problem was

or why it was happening,

and they've just put it down to the shock of the whole thing.

And there was constant...

I couldn't eat or drink and I lost... I had no appetite.

Any time I'd had a sip of water,

I was throwing it back up again, and food.

I didn't eat for about a week. It was... Or didn't...

I didn't move for about a week.

James didn't know the full story of what had happened to him in

the gym until his naval colleagues came to visit him in hospital.

They came to the hospital, come to see us,

and they were explaining what happened,

and they were just saying it was absolutely horrific, like.

Erm, like, they seen it - there was blood everywhere.

There was... There was some guy trying to perform, erm, like,

first aid on us.

It was something out of Black Hawk Down or something.

He was like, "We're losing him! We're losing..."

Honestly, it was... When they was telling us,

I was like, "What on earth's going on?" Just...

Yeah, they were extremely worried, like.

When I left the hospital, they pretty much told me to take it easy,

so all I've been doing, really, is walking the dog for 20 minutes,

half an hour a day, and just chilling at home.

I'll probably go back to work and play loads of fives again,

but I'll probably be wearing a helmet.

James is looking forward to getting back to work at Faslane soon,

but there's one other naval unit he won't forget in a hurry.

People from HMS Gannet,

thank you very much for coming to my...my rescue.

I can't...

My life's in your debt, you know.

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

On the Isle of Man, Kevin still suffers from high blood pressure

and heart problems.

He's been referred to a specialist cardiac unit in Liverpool,

where he'll undergo further tests.

Paul was released without charge and his wounds healed well.

As for the person who threw the boots -

he received a police caution.

And you thought it was quiet in the countryside.