Episode 4 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.

SIREN BLARES

And when things go wrong,

the emergency services race to the rescue.

This chap here 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.

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 have been cannabis being used.

..paramedics saving lives.

BABY CRIES

..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...

In Cornwall,

air ambulance crew fight to save a man with a critical heart condition.

His aorta could burst at any minute,

and I'm guessing it's probably starting to leak

right at this moment.

On the Isle of Man, a young girl is struggling to breathe.

And it's motocross mayhem in Shropshire,

when paramedics race to a rider with suspected spinal damage.

What do you mean, it has gone?

Cornwall, in Britain's extreme south-west.

With its 400 miles of coastline,

sandy beaches and sheltered coves,

it's the best place in the country to catch some rays.

And flying over this sun-dappled county is Cornwall Air Ambulance.

It's the lifeline that speeds to medical emergencies

wherever they happen.

We've got a patient that has fallen, potentially, seven metres.

The sooner we can get there, the sooner we can do what we do.

They fly around 700 rescue missions every year.

Paramedic Mark Fuzzard is an essential member of the team.

It is a very rewarding job,

being able to kind of get to people really quickly,

and deliver a high quality of care

to the patients when they need it most.

But even in Cornwall,

the great British weather can still put a dampener on your day.

At the Cornwall Air Ambulance base at Newquay airport,

a blanket of mist and rain has descended.

The helicopters are grounded.

At the moment, the weather is looking pretty rubbish again.

Low cloud, drizzle.

Things that cause us not to fly.

Until the weather improves, they can't fly to any emergency calls.

We don't know what the long-term forecast is yet, we haven't had the brief from the pilot,

so, hopefully, he'll give us a good brief in the second and we will,

hopefully, get to the patients that might need our help and skills.

It's 2.30 and the cloud is lifting.

PHONE RINGS And just as it does...

Hiya, Nick.

Hi. Yeah, good.

..an emergency call comes in.

An 83-year-old is at risk of going into cardiac arrest.

Unlike a heart attack,

in which there's an interruption of the blood supply

to part of the heart,

in a cardiac arrest, the heart stops beating altogether.

Bye.

It's a critical case.

Miraculously, the weather has improved just enough

and they're given the OK to take off.

If you're all good for a start, fly confirm, please.

-Confirm.

-Cool, OK.

Cloud's coming in. We're going to come up on the spot initially.

The casualty is in the town of St Austell 12 miles away,

or nine minutes by helicopter.

The casualty's condition is life-threatening.

A rapid response vehicle is already on-scene.

The RRV has deemed that he may go into cardiac arrest

at any point now so we need to get there fairly quickly

and get him into hospital really quickly.

Less than one in ten patients in cardiac arrest outside

hospitals survive.

They must get there fast. But the weather is still an issue.

There could be an issue with the weather.

We are...

We have got some low cloud in the area.

Hopefully, we should be able to do this.

There should be a window.

They'll be forced to land if the cloud base drops any lower.

This time of year, the roads are pretty chocked up,

especially on a day like today when they're not down the beach.

They're going to be milling around trying to find something to do.

It's going to take a long time for a land ambulance to get to

hospital from St Austell.

With the weather holding, the crew need a safe place to land.

Low down on the nose. You see the

-big solitary tree in the middle of the park?

-Yeah.

-I'm guessing that's where they want us, Mark. Is that right?

-Yeah, I think so.

Just passing that tree on the right

-and then the aircraft's turning to the right.

-Yeah.

Your tail's well clear. Forwards and down.

And we're just going to come straight down on this spot here.

Pilot Dan lands close to the casualty, who's in the ambulance.

Mark is briefed by the ground crew.

It's not it cardiac arrest,

but a life-threatening condition called an abdominal aortic aneurysm,

or Triple A.

83-year-old Frank and his wife Margaret were driving

when he felt unwell and pulled over.

Guys, what's the history?

With a medical background, Frank knows his condition is critical.

While the team prepare to move Frank to the helicopter,

Mark reassures his wife, Margaret.

We're bringing him out now. He's all right. We'll look after him, OK?

We'll get him in, we'll get the doctors

to look at him pretty quickly.

-OK.

-All right?

Frank was looking really uncomfortable.

Not nice for his wife to see that.

His wife was obviously really upset

and concerned about what was going on.

But we tried to reassure her

and tried to tell her that he was in good hands.

He's got what we call a Triple A,

which is an abdominal aortic aneurysm.

It's a bit like a hosepipe that has got a kink in it

and just about to burst.

So we really need to get him to theatres to get it checked out.

The largest vessel from Frank's

heart is swelling dangerously with blood.

If it bursts, it will cause massive internal bleeding.

Everything is looking OK at the minute,

but we have got what we call a pulsatile mass that we

need to kind of get the docs to look at, really,

and the surgeons to be ready.

If the pulsatile mass, or swelling, does burst,

it's likely to be fatal.

Time is crucial, but the bad weather is, again, threatening to close in.

Hi, A & E. It's Mark on the helicopter.

Just to let you know we're coming in. Going to be landing direct

in about 10-15 minutes time.

We have 83-year-old male with a Triple A.

The Isle of Man.

Its 85,000 residents live life at their own pace.

It's a place that's tranquil and calm.

But it isn't just somewhere you come to slow down.

It's also where a lot of folk go to speed up.

ROCK MUSIC PLAYS

Many of the island's roads have no speed limit.

Making it a paradise for petrolheads.

But when trouble strikes, teams from the 42 front-line staff

of the Isle Of Man Ambulance Service

are always ready to speed to any emergency.

On shift today are paramedic Graham Skinner

and technician Joanne Surridge.

Graham's a veteran.

He's worked on the Isle Of Man ambulances for 27 years.

I retired two years ago and

was persuaded to come back as and when needed.

Sickness and holidays, and a little bit of extra pocket money.

I'm getting a bit too old for this job. Aches and pains.

Joanne's based at the ambulance station in Douglas,

the largest town on the island.

Just coming up for six years in January, I'll have been here.

Every day you don't know who you're going to meet

or where you're going to go. So, it keeps you on your toes.

Like coiled springs, hey, Graham?

Maybe you, I don't know about me.

My coil is getting pretty weak these days!

But spring into action they do.

They've had a 999 call.

We're going to a motorbike RTC now.

SIREN WAILS

They're speeding from Douglas to the crash site,

seven miles away on the road to Peel.

But the roads are busy.

Even in the Isle Of Man, every year, there's more and more traffic.

It is a slower pace of life and an easier pace of life,

but there's more and more traffic.

Just about on it now.

Biker next to the side of the road.

Bike on its side.

Gone into the back of a car, by the looks of it.

A motorcyclist has been thrown from his bike.

Pete Smith, our duty officer,

arrived a couple of seconds ahead of us.

We actually got to the patient at the same time

who was lying on the floor.

The police officer was holding his head, keeping him nice and still.

Joanne first checks for spinal injuries.

-I'm just going to have a little feel of the back of your neck.

-Yeah.

And without shaking your head, I just want yes or no.

-Is there any pain where I'm touching?

-No.

Let's take this helmet off you there.

Shall we sit you up and then you can whip it off.

-Oh, there you go.

-Are these reading glasses?

-No.

-Could do with a pair now.

THEY LAUGH

-Right, what do we call you?

-John.

I'm just going to sit you up, John.

-How's that doing?

-Yeah, no. That's all good.

Right, just sit still just for a minute.

Get your bearings.

Right, when you crashed, have you been up on your feet since?

-No, no.

-You haven't. So this is the position that you've landed in.

-OK. Were you unconscious at all?

-No.

Can I have a little feel your pulse?

-You've gone into the back of the car, have you?

-Yeah.

-Yeah. OK.

Looks like John's been lucky.

The per capita rate of road traffic death in the Isle Of Man

is higher than it is in the UK mainland.

And the other one?

Need our help?

How does that feel? Any aches or pains?

Yeah, no, that's fine.

Fine, just get your bearings.

And then what we'll do is we'll pop you in the back of the ambulance

and we'll just check you over.

-Check you over.

-OK?

-All right.

-All right?

We'll get a couple of plasters for your bike, as well.

We've got them in the back of the car.

Yeah, we've got plenty of plasters.

So, were you thrown up over the car

or have you just hit it and fallen off?

Just sit back for me, John,

so I can have a little listen to your chest.

In and out through your mouth for me.

Joanne checks for hidden injuries.

Have you got any new aches and pains anywhere?

OK, so your neck's still OK and everything, as it was before,

-when I checked it. Yeah.

-Yeah, it's fine.

Turns out, John was fouled by a bird.

It looks like there was a pheasant going across the road

and then all the other traffic had slammed on and he's gone

straight into the back of a car and then come off his bike.

So, you've done well not to have ripped any of your clothes

-or anything. You've got no...

-It's still all bike stuff.

-Are these biker jeans, are they?

-Yes, Kevlar jeans.

The outside hoodie is Kevlar.

Well, it shows it pays to have that kind of gear.

All your observations that we've done, completely normal.

Not worried about you at all.

Your blood pressure is a tiny bit raised,

but that's totally to be expected.

With the all-clear, John's free to deal with the other casualty -

his bike.

Traffic accidents account for over 150 callouts a year

for the Isle of Man Ambulance Service.

But getting to some casualties doesn't require a vehicle at all.

Joanne's been called to an urgent patient in the GP surgery

right next to the ambulance station in Port Erin.

Seven-year-old Tia's breathing is fast and laboured.

Her worried mum, Shareen, has rushed her to the GP.

This is Tia who's come in today, a bit wheezy,

had a history of using inhalers in the past.

Her oxygen levels are down a bit,

I think she really needs to go into hospital.

Right, Tia, if you come with us

we'll get you in the back of the ambulance.

In a patient this young, breathing problems are a real worry.

Tia needs to get to hospital fast.

In Cornwall...

..the crew of the Air Ambulance Service

are still treating 83-year-old Frank.

You all right, Frank? You all right?

Get on. Is there anything we can do to help with that?

Paramedics Paul Simons and Mark Fuzzard

prepare Frank for the journey to hospital.

Frank's wife, Margaret, will travel by road.

Frank, just lift your arm up just a touch for me.

He's got what we call an abdominal aortic aneurysm,

which means his aorta could burst at any minute, and

I'm guessing it's probably starting to leak right at this moment.

-Are we good?

-Yes.

-Let's crack on.

The aneurysm is a dangerous swelling in the largest vessel

from Frank's heart. If it does burst, he's likely to die.

The team know only surgery will save him.

They're racing from the town of St Austell

to the Royal Cornwall Hospital on the outskirts of Truro,

a journey of 11 critical minutes.

But the weather is still a worry.

If the cloud base descends too far, visibility will drop

and the helicopter will be forced to land.

The weather does change very quickly down in Cornwall,

or it can do, especially on days like today,

and if we have to land, our concern is for Frank.

Paul and Mark watch Frank closely.

Frank was quite poorly chap really.

His blood pressure was dropping, he was looking quite clammy

and looking really uncomfortable with it.

With such low blood pressure,

Frank's too vulnerable to be given morphine.

They do all they safely can to make him comfortable.

Roger, thank you.

The weather holds

and they make it to the Royal Cornwall Hospital.

Good, yeah, we're down.

Cool. I'll keep the monitor in, if you're happy, dude.

Yes, more than happy. Keep him on the pads, as well.

Yeah, that's what I meant.

Frank's taken straight to emergency care.

Handover complete, Frank will go to surgery.

So lucky we were able to get Frank here quickly.

The weather was good on the journey in,

and in only the 15 minutes that we've been in hospital

the weather's turned to quite nasty again,

so in that little short window of opportunity we managed to get

over to St Austell, get Frank to hospital really quickly,

just in time for it to clamp in again and become unflyable for us.

But he's in the best place now so surgeons can do their stuff

and hopefully get Frank on the mend again.

Shropshire,

on a sunny late summer's day.

It doesn't get much more idyllic.

The only thing that could improve it...

..170 revved up bikers, battling to be the fastest wheels in town.

This is motocross.

When you want off-road bike racing down and dirty,

this is where you come -

Hazeley Grange, near the small town of Cleobury Mortimer.

With this many motorbikes hurtling round the treacherous track,

having skilled emergency medics on site is a must.

Leading a team of specialist private event paramedics

and ambulance technicians is Pat Mahan.

His team are ready for any crisis.

Today at Warfield Motocross, we've got an ambulance based here.

We're staged here and further down the track, we've got a 4x4

what can get to patients fast and effectively.

We can have everything from a cut finger to broken bones,

the list goes on. Anything can happen at a motocross.

Hopefully, fingers crossed, we have a quiet day, but only time can tell.

Behind the wheel of the 4x4 are advanced technician

Sean Marshall and paramedic Amy Siddaway.

They're ready to race across the course to any injured riders.

Just going into the middle of the track where the 4x4

will be stationed for the event.

It's easier for the 4x4 to get access to any accidents

and incidents that might occur on the track itself

than it is for the ambulance,

which remains positioned at the top of the track.

Yeah, Sean to Pat, we're in position.

Now, they keep a lookout for any raised flags,

a system used by race stewards to signal for help.

They have various flags on the track.

They have the blue and white flag

usually means that part of the track needs repairs, such as the fencing.

They have the yellow flag, which is an obstruction on the track.

The red flag is when they're stopping the race, and the flag

for medical is the white flag with the red cross through the middle.

Before the race starts the riders have some practice runs.

And there's already a call.

All we've been told at the moment is that we have a red flag

up at the top of the track by where our ambulance is positioned.

The medics from the ambulance are making their way over on foot.

A rider has come off his bike.

Hello.

26-year-old Barney has aggravated an existing injury.

What happened?

OK, so it's gone whilst riding?

Amy and Sean need to get Barney to the ambulance,

but that means stopping the race to cross the track.

Just got to wait for the red flag to come

so we can cross the track. We never cross a live track.

So, as soon as this lap's finished we'll be going back across,

take the patient to the ambulance and give him a full assessment.

A mate's brought Barney's bike to the ambulance just in case.

While the ambulance crew give Barney the once over,

the real racing begins.

So, it's straight back to the action for Amy and Sean.

We're hoping for a nice, safe ride,

but if anything happens we're here and we're ready.

Like Barney,

most motocross riders won't let a crash get in the way of the race.

We find most of the riders will just get back up,

get back on their bike and finish their racing.

Yeah, they're tough old cookies, these.

But all those bikes, going hell for leather on today's dry ground,

means the track's getting churned up...

..and causing riders to fall.

The whole corner's getting them, they seem to be digging in.

I don't know whether it's...

Whether it's a bit soft

or it's just chewing up a bit I think, isn't it?

There's quite a few falls now.

The condition of the track is a bit unstable at the moment

so I think they're going to sort it before the next race.

Track resurfaced, another race begins.

And soon another rider's down.

What you mean it's gone?

This time it's more serious.

But with the rider on the track...

..and bikes speeding past,

the paramedics are in danger until this race is stopped.

From a rider down...

..to a ride to hospital.

Push yourself back.

-Bring your bum back.

-Bring your bum back into there.

On the Isle of Man, paramedic Graham Skinner and technician

Joanne Surridge are with seven-year-old Tia,

who's having breathing problems.

The more you're sat up, the easier it is to breathe, all right?

All right, my love, can I have a little listen to your chest?

Breathe in and out through your mouth for me, darling.

Tia's being taken to Noble's Hospital with mum, Shareen,

and sister Macy.

It should take around 30 minutes.

Oh, yes, we're a bit wheezy, aren't we?

Tia's previously had breathing difficulties,

but has never been diagnosed with any condition.

How long since the last episode like this?

Um, it's been a few years since she's been to hospital.

She had a productive cough or bringing anything up?

-She was sick on the way here, we had to stop the taxi.

-OK.

Graham and Joanne fear Tia's having an asthma attack.

Right, sweetie, I'm just going to put this over your mouth

and it will just help with your breathing. OK? OK?

Pop that there, out of the way. OK?

Via a mask called a nebuliser, Joanne gives Tia salbutamol,

a drug to relax the muscles in her airways.

One in 11 children in the UK has asthma.

It's important to keep young patients like Tia relaxed and calm.

What have I got here?

Just take your mind off it whilst we're on our way to hospital.

This is a leaflet and it's all about Alistair The Ambulance

and it's what he does every day.

And there's some puzzles and some colouring-in in the back.

And would you like a sticker? Yes. Pop it on your T-shirt.

Shall I pop it there?

Shall I give one to your sister? Yeah?

Would you like a sticker like your sister?

That says you've been in an ambulance.

How are you doing, Tia?

Are you tired, sweetheart? Yeah?

Are you feeling a little bit better?

No?

Mummy's just sat behind you, OK?

All right, darling?

Are you warm enough?

Tia's becoming less responsive.

Joanne's concerned.

'Well, her breathing was getting faster, her respiratory rate,

'she was quite tired and hadn't improved with the first nebuliser.'

Joanne increases Tia's dose of salbutamol

and adds another drug to increase airflow to the lungs.

All right, sweetheart, I'm going to give you some more medicine now.

I'll tighten that up on you again

because it keeps slipping off past your lovely hair.

Are you all right, sweetheart?

Let's put your hair back up, out of the way.

This medicine will help even more than the medicine did before, OK?

But the new dose still isn't improving Tia's breathing.

I'm not happy at all. Can you pull over, please?

I'm wondering if we should give her some hydrocortisone.

Her respiratory rate is increasing greatly

and she's not with it at all.

We're just going to stop and let Graham have a little

look at her and possibly give her some other medicine.

As a paramedic, Graham is more highly qualified

than technician, Joanne, and can administer a greater range of drugs.

-She's well over 40 a minute now, but really struggling.

-Blood pressure?

Her blood pressure is 125.

She's had 250 of atrovent, but she doesn't feel like it's

helping her at all at the moment.

Do you feel any better?

OK.

Right, what we're going to do is we going to put the lights

and sirens on, and we're just going to get to hospital quicker but we're

not going to go to the children's ward, we going to go to A & E, OK?

Graham wants to get Tia to hospital fast.

This is now a blue-light job.

Joanne calls ahead to ensure emergency help is on standby.

We're coming in with a girl from Southern Group Practice.

We're on our way to children's ward with her.

She's gone a bit downhill since we've been en route though.

Her respiratory rate's increasing.

I would feel happier if we brought her direct to A & E.

OK, yes, we're coming in on lights. Thank you. Bye.

At A & E, Tia will be seen by a doctor immediately.

You all right, sweetheart? How are you feeling now?

A little bit better? Or the same

or little bit worse?

You don't know?

Just ten minutes later, they're at Noble's, the island's main hospital.

No improvement at all on the breathing.

Right, my love, let's get you in.

It's over to Dr Sudip Ghosh.

I'll give you the nice, pink medicine now. OK?

We'll take that off, open your mouth

and give you some pink medicine.

-Well done.

-Well done!

Keep it in. Down, down, down.

It's not very nice, is it?

He gives her steroids to calm her inflamed airways.

Now they must hope and wait for Tia's breathing to return to normal.

150 miles south-east of Douglas,

in the heart of England...

..a team of paramedics and technicians

are at work at a busy motocross race event in Shropshire.

A rider has been thrown from his bike.

What you mean it's gone?

28-year-old Ed is still lying on the track, with bikes speeding past.

Paramedic Amy Siddaway is trying to stabilise him.

We're going to pop you on a board and a collar, OK?

Just because you're complaining of pain in your neck and in your hips.

When Ed was thrown off his 105kg bike it landed on top of him.

Keep your neck nice and still for me, sweetheart,

don't move your head.

If you can give the pain a score, one to ten,

-ten being the worst pain you've ever experienced?

-It's about seven.

About seven. The pain in your back, Ed, whereabouts is it?

With the race still running, the team can't properly assess Ed

or get him off the track, it needs to be stopped.

The main concern is to stop the track, make sure myself

and my colleagues and the patient is all safe. That's my main concern.

-Don't move your head.

-Stay still.

Hang on, Amy, I'll bed down.

Are you OK there, Ed?

Any pains anywhere else?

Just your back.

Right leg, right shoulder, and your neck.

Pains in his neck and back can be warnings of spinal damage -

injuries that can cause serious impairment and even paralysis.

It's going to be a bit uncomfortable, OK?

They are not designed for comfort.

If Ed has injured his spine, the brace they fit

will prevent further damage as the medics move him.

Right then, Ed, we're going to be rolling you, OK?

We don't want you to do anything, just go with us,

-keep nice and still, OK?

-Righto.

We're going to go on "roll". Ready, steady roll.

His fellow riders look on.

-On your shout again, Sidds.

-Going to go on "roll". Ready, steady roll.

OK, nearly done. Nearly done.

On Amy's shout again.

We're going to go down and then up.

-Yes, so we going to come down.

-Yes.

-Yes.

OK? On "slide". Ready, steady, slide.

Over 1,000 people suffer a spinal injury each year in the UK

and Ireland. Sports accidents are the third highest cause.

On the count of three, we're going to go up. One, two, three.

In the ambulance, Amy updates her colleague,

A & E nurse Helen Cumberland.

Front wheel's dug into the rut.

He's gone over the handlebars and the bike's landed on him.

Complaining of pain in his C1, C2 area.

Also complaining of lower back pain.

He's complaining of numbness, numbness sensation in both legs.

Damage to the C1 and C2 areas at the top of the spine can cause

the most devastating injuries.

Can you feel me touching you here?

Does it feel the same on both sides?

In what way does feel different?

Here?

Same again, right side feels different?

And down here?

In what way?

A bit tingly.

Outside Ed's dad, Peter, waits for news.

He saw the moment his son was thrown from his bike.

OK?

He just come round the corner and went straight over the bars.

The bike locked and he went straight over the bars

and the bike came up and hit him,

landed on him and then the guy ran to him and pulled the bike off him

and he was complaining of back pain then straightaway so...

And that's when the paramedics come then.

It's OK, we're giving him something for the pain.

Just carrying on with our assessment now

and about to hand over to West Midlands Ambulance Service.

Ed will need more scans and tests.

Ready, set, go.

But the team's ambulance must stay on site.

He'll be taken the 30 miles to hospital in Hereford

by West Midlands Ambulance Service.

OK, are you happy there?

-Everybody happy?

-Yes.

-Yes.

-I'll take the head on my own there.

-Cool.

He'll be assessed by doctors, just to see what's going on with him

and they'll assess the scans and take it further from there.

I've swapped details with Dad

so hopefully Dad's going to contact me when he knows what's

happening with the patient and give us all an update.

Hopefully, fingers crossed, good news.

And, as for the race, it may be one man down,

but these speed demons won't let that put them off.

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

Biker Ed had a very lucky escape.

He suffered a badly bruised spine, liver and kidney,

but didn't do any permanent damage.

And just a few weeks later he was back on his bike.

On the Isle of Man, after four days in hospital,

Tia was diagnosed with asthma.

After treatment, she's now back at home.

And in Cornwall, Frank was rushed into life-saving surgery

where a team operated on his aneurysm.

After ten weeks in the ward he was transferred

to his local hospital to recuperate.

He's now back home with his wife, Margaret.

And you thought it was quiet in the countryside!