0:00:02 > 0:00:06From the Highlands of Scotland to the coast of Cornwall,
0:00:06 > 0:00:09the Great British countryside is spectacular.
0:00:11 > 0:00:14But we work and play in it at our peril.
0:00:17 > 0:00:19And when things go wrong,
0:00:19 > 0:00:22the emergency services race to the rescue...
0:00:22 > 0:00:23This chap is having a heart attack
0:00:23 > 0:00:26and we need to get him in quickly.
0:00:26 > 0:00:30You're under arrest for failing to stop for police.
0:00:30 > 0:00:33..going hundreds of miles against the clock,
0:00:33 > 0:00:35battling the elements
0:00:35 > 0:00:36and braving the weather.
0:00:38 > 0:00:39Lower the winch.
0:00:40 > 0:00:43From fields and forests
0:00:43 > 0:00:45to cliffs and country roads,
0:00:45 > 0:00:48we'll be right at the heart of the action.
0:00:49 > 0:00:51With police fighting crime...
0:00:51 > 0:00:54I've got suspicions that there might be cannabis being used.
0:00:54 > 0:00:56..paramedics saving lives...
0:00:56 > 0:00:58BABY CRIES
0:00:58 > 0:01:01..and wardens safeguarding our lakes...
0:01:01 > 0:01:03Come out of the way!
0:01:04 > 0:01:07..we're there as the emergency services pull together
0:01:07 > 0:01:10to pick up, patch up and protect the public.
0:01:13 > 0:01:15This is Countryside 999.
0:01:34 > 0:01:38Coming up - three mountain bikers are seriously injured.
0:01:38 > 0:01:41Try not to move your neck, all right?
0:01:41 > 0:01:43And their rescuers are fast running out of fuel.
0:01:43 > 0:01:47Probably get the worst one, yeah, and then maybe do a refuel.
0:01:47 > 0:01:51Paramedics on the Isle of Man try to slow a racing heart.
0:01:52 > 0:01:53STEADY BEEP
0:01:53 > 0:01:56Your heart's playing games at the moment.
0:01:56 > 0:02:00And Tenbury's only police officer tackles a major car crash.
0:02:07 > 0:02:09The West Midlands.
0:02:12 > 0:02:15Home to some of England's most majestic scenery.
0:02:17 > 0:02:20From the Malvern Hills to the Peak District.
0:02:26 > 0:02:27But well off the beaten track
0:02:27 > 0:02:30and surrounding the market town of Tenbury Wells...
0:02:34 > 0:02:36..is the Team Valley, a remote group
0:02:36 > 0:02:38of over 50 hamlets and villages.
0:02:40 > 0:02:43Tenbury really is in the middle of nowhere, in the back of the sticks.
0:02:43 > 0:02:45We are so far away from the major towns, which is Worcester
0:02:45 > 0:02:47and Herefordshire -
0:02:47 > 0:02:50probably about the same distance to each...each one.
0:02:50 > 0:02:52There's no other major towns out here.
0:02:52 > 0:02:57Here's no dual carriageways, there's no major A roads as like.
0:02:57 > 0:03:00We do have the A49, which is over at Leominster,
0:03:00 > 0:03:02but it's all B roads, country lanes.
0:03:02 > 0:03:04Some of the lanes you can barely get a car down.
0:03:08 > 0:03:10And the man in charge...
0:03:10 > 0:03:12I'm PC 1189,
0:03:12 > 0:03:15Nick Prosser, attached to Tenbury Police Station.
0:03:15 > 0:03:19PC Nick Prosser, known to the locals as the Sheriff of Tenbury.
0:03:21 > 0:03:24You're under arrest, on suspicion of possession of cannabis.
0:03:30 > 0:03:33Challenges out here are massive for the police.
0:03:33 > 0:03:35Totally different to what the city is.
0:03:35 > 0:03:38I'm not going to say our challenges are greater. Individually, for me,
0:03:38 > 0:03:40I feel they're greater because if I need help
0:03:40 > 0:03:43and press my little red button, it's 40 minutes,
0:03:43 > 0:03:4550 minutes before anybody gets to me.
0:03:49 > 0:03:51A country boy himself,
0:03:51 > 0:03:55Nick knows rural policing presents some unique challenges.
0:03:55 > 0:03:59Neighbourhood disputes, rows over cattle grids,
0:03:59 > 0:04:03sheep escaping on the road, "I've lost my dog."
0:04:03 > 0:04:07We've even had jobs - "Get the police here quick!
0:04:07 > 0:04:11"I've just had an ostrich run past my kitchen window!"
0:04:13 > 0:04:17But one of the biggest challenges is keeping the roads safe.
0:04:17 > 0:04:20Injuries is always the first thing that you think of,
0:04:20 > 0:04:23how far away it is and where the nearest patrol is coming from.
0:04:23 > 0:04:25What type of road it is.
0:04:25 > 0:04:28What the weather conditions are, am I going to need another officer
0:04:28 > 0:04:31there because there might be a build-up of traffic.
0:04:31 > 0:04:34SIREN WAILS
0:04:34 > 0:04:37It's 11:30pm.
0:04:37 > 0:04:39Due to go off shift, Nick's called to an accident
0:04:39 > 0:04:43where the driver's vehicle has overturned.
0:04:43 > 0:04:47Car on its roof and female occupant bleeding from the head.
0:04:47 > 0:04:50We need to get there as quickly as we can.
0:04:50 > 0:04:53Obviously with a head injury it's very serious.
0:04:54 > 0:04:58The accident scene is 14 miles from Tenbury on a back lane,
0:04:58 > 0:05:01between the villages of Stanton Lacy and Ludlow.
0:05:04 > 0:05:06But getting there means battling the elements.
0:05:06 > 0:05:09It's dark, wet, it's raining... other road users.
0:05:13 > 0:05:16Try and get there to establish the level of injury.
0:05:17 > 0:05:21Obviously with a head injury, you're going to be very concerned,
0:05:21 > 0:05:23I want to get there as quickly as I can
0:05:23 > 0:05:26and it was very wet that night and the roads were slippy,
0:05:26 > 0:05:28so I've got to make sure that I'm driving carefully
0:05:28 > 0:05:33because if I don't get there in one piece, I become part of the problem.
0:05:33 > 0:05:35Nick arrives on scene...
0:05:35 > 0:05:371189 time on.
0:05:40 > 0:05:42..just a few minutes behind a fast response team.
0:05:52 > 0:05:55I think we're probably going to be all right, I think.
0:05:55 > 0:05:59She's conscious and breathing.
0:05:59 > 0:06:01Paramedics are just assessing her at the moment.
0:06:01 > 0:06:03One side of the carriageway is blocked.
0:06:03 > 0:06:06Once we've got a police car round to the other side,
0:06:06 > 0:06:09I think we can probably manage it between us.
0:06:09 > 0:06:11We were faced with a car on its roof.
0:06:11 > 0:06:13It was blocking one side of the carriageway.
0:06:13 > 0:06:16There was a lot of glass everywhere.
0:06:16 > 0:06:19The female was actually sat in another vehicle.
0:06:23 > 0:06:2524-year-old Stevie was driving home from work
0:06:25 > 0:06:28when she lost control.
0:06:30 > 0:06:33She had glass, fragments of glass stuck in the top of her head
0:06:33 > 0:06:36which was causing her great amounts of discomfort.
0:06:36 > 0:06:39Nick, do you want me to try and get my vehicle?
0:06:42 > 0:06:43And she started being sick,
0:06:43 > 0:06:47and with a head injury if somebody's being sick, it...
0:06:47 > 0:06:50alarm bells are going. You think about fractured skull,
0:06:50 > 0:06:52fractured bones, things like that
0:06:52 > 0:06:55that you can't see with the naked eye.
0:06:55 > 0:06:57While the paramedic treats Stevie's injuries,
0:06:57 > 0:07:01Nick tries to establish what caused her car to overturn.
0:07:01 > 0:07:04Was there anybody else in the vehicle?
0:07:04 > 0:07:06OK. What's your first name, chick?
0:07:06 > 0:07:08Sorry? Stevie?
0:07:08 > 0:07:11Can you remember what happened at all, Stevie?
0:07:11 > 0:07:14She's saying it was wet, she come round the corner,
0:07:14 > 0:07:16lost control, tried to re-correct it
0:07:16 > 0:07:19and just lost control of the vehicle.
0:07:19 > 0:07:22The roads are slippy.
0:07:22 > 0:07:24Difficult driving conditions.
0:07:25 > 0:07:29She's lost...lost control and hit the verge over here and
0:07:29 > 0:07:31vehicle's landed on its roof.
0:07:34 > 0:07:35Stevie seems coherent,
0:07:35 > 0:07:38but a head injury is still a strong possibility.
0:07:41 > 0:07:43Fortunately, family members have arrived on the scene,
0:07:43 > 0:07:47and an ambulance is just a few minutes away.
0:07:47 > 0:07:49Don't believe anybody else is involved,
0:07:49 > 0:07:52so now it's just a case of making sure she's OK, and then getting
0:07:52 > 0:07:55the road clear as quickly as we can,
0:07:55 > 0:07:57and making sure that no other road users are affected
0:07:57 > 0:07:59or get involved in this.
0:07:59 > 0:08:03Obviously cos it's, it's wet and the roads are slippy at the moment,
0:08:03 > 0:08:06we need to get the vehicle removed and get the road clear
0:08:06 > 0:08:08and back open as soon as we can.
0:08:08 > 0:08:11And that means taking a hands-on approach.
0:08:14 > 0:08:17There is a lot, yeah. Luckily, nobody was coming the other way.
0:08:17 > 0:08:20If the casualty's conscious, breathing,
0:08:20 > 0:08:24I can then start moving on to the next thing, which is getting
0:08:24 > 0:08:27the road safe, making sure emergency vehicles, fire engines,
0:08:27 > 0:08:29paramedics can get in or out safely,
0:08:29 > 0:08:31and that nobody else is going to come round the corner
0:08:31 > 0:08:33and plough into us and take us all out.
0:08:34 > 0:08:37Moments later, the ambulance arrives.
0:08:37 > 0:08:39- How you doing, all right? - Yeah, not so bad.
0:08:41 > 0:08:44The crew's priority is to assess Stevie's head injury.
0:08:47 > 0:08:49But first Nick must breathalyse her.
0:08:50 > 0:08:54We just need to make sure that she hasn't been drinking.
0:08:54 > 0:08:56Room for one wet police officer?
0:08:56 > 0:08:59Unfortunately, we do have drink drivers out here
0:08:59 > 0:09:01just because of the remoteness of the area.
0:09:01 > 0:09:04There's a large amount of pubs, a lot of them out in the sticks,
0:09:04 > 0:09:07and we do make, on average, probably about an arrest a week.
0:09:07 > 0:09:09- We have to do a breath test. - Yeah, sure.
0:09:09 > 0:09:11Have you had any alcohol in the last...
0:09:11 > 0:09:13I've had a bottle of cider when I left work.
0:09:13 > 0:09:15How many hours ago was that?
0:09:19 > 0:09:21OK. Wrap your mouth around that, create a seal,
0:09:21 > 0:09:24take a deep breath like you're blowing up a balloon,
0:09:24 > 0:09:26blow into it for a couple of seconds.
0:09:27 > 0:09:30Keep going, that's it, smashing.
0:09:31 > 0:09:33Looking for a zero. That's what we'd like, ideally.
0:09:36 > 0:09:37As long as it's under 35.
0:09:44 > 0:09:46The Isle of Man...
0:09:46 > 0:09:4936 miles off England's west coast.
0:09:49 > 0:09:52During summer it sees a host of events...
0:09:53 > 0:09:54..and an influx of visitors.
0:09:54 > 0:09:58'The pit lane will be open so you can test your speed limiters.'
0:10:02 > 0:10:04So 24 hours a day...
0:10:04 > 0:10:06What's the pain like at the moment?
0:10:06 > 0:10:08..at three ambulance stations...
0:10:08 > 0:10:12Just keep that breathing nice and easy for me.
0:10:12 > 0:10:16..42 paramedics and technicians ensure teams are always on call.
0:10:21 > 0:10:25For Jason Banks and Kerry McShane, it's business as usual.
0:10:26 > 0:10:30Generally, if I can, if I know I'm working with Kerry,
0:10:30 > 0:10:33I'll either...go sick or swap the shift,
0:10:33 > 0:10:34but, yeah, yeah, today,
0:10:34 > 0:10:37I didn't realise until the last minute.
0:10:37 > 0:10:39No way of changing it round.
0:10:41 > 0:10:43He takes the mickey a little bit.
0:10:43 > 0:10:45Particularly out of my accent and...
0:10:45 > 0:10:47out of everybody generally that's around him.
0:10:47 > 0:10:50But that's good because that helps alleviate, you know,
0:10:50 > 0:10:52tension as well.
0:10:52 > 0:10:54Kerry will get tortured all day long.
0:10:55 > 0:10:58I try to utilise humour wherever I can.
0:10:58 > 0:11:00I'm sure my colleagues would disagree with that,
0:11:00 > 0:11:02but it puts the patient at more ease.
0:11:02 > 0:11:05SIREN WAILS
0:11:05 > 0:11:06A call's come in.
0:11:06 > 0:11:09Just been called to an emergency down at a GP practice.
0:11:09 > 0:11:13Patient has presented with... sounds like cardiac chest pain,
0:11:13 > 0:11:17so there's potential this patient's having a heart attack.
0:11:22 > 0:11:26The GP practice is next door to their base in Port Erin,
0:11:26 > 0:11:28but it will take another 30 minutes
0:11:28 > 0:11:30to get the patient to Noble's Hospital.
0:11:31 > 0:11:33A heart attack is when
0:11:33 > 0:11:36you get an occlusion in one of the coronary arteries,
0:11:36 > 0:11:39and that effectively starves blood to the heart muscle.
0:11:39 > 0:11:42And it can lead to a cardiac arrest,
0:11:42 > 0:11:45and you need to unblock that artery, which we've got the drugs
0:11:45 > 0:11:48and the capability of doing that in the ambulance.
0:11:48 > 0:11:50And a cardiac arrest is where...
0:11:50 > 0:11:53the heart is physically stopped pumping blood round the body.
0:11:56 > 0:11:58Either way, there isn't a moment to lose.
0:12:05 > 0:12:08So have you any heart problems at all?
0:12:08 > 0:12:11- A heart murmur.- Right, OK.
0:12:11 > 0:12:13I think that's what they told me.
0:12:14 > 0:12:1784-year-old Valerie passed out at home,
0:12:17 > 0:12:22before coming to her GP complaining of chest pain and dizziness.
0:12:22 > 0:12:24Take a nice deep breath in and out.
0:12:25 > 0:12:27OK, just sit forward for me a sec.
0:12:35 > 0:12:38Managed to wash all right, then I felt...
0:12:39 > 0:12:43..as I said before, I got a little bit dizzy and had to lie in bed.
0:12:43 > 0:12:45A normal resting heart rate
0:12:45 > 0:12:48is between 60 and 100 beats per minute.
0:12:48 > 0:12:49Valerie's is pushing 120.
0:12:49 > 0:12:53- Are you feeling dizzy at the moment, Valerie?- Yes.
0:12:53 > 0:12:55But then it drops dramatically.
0:12:55 > 0:12:56STEADY BEEP
0:12:56 > 0:12:58Jason, there's long periods of...
0:13:01 > 0:13:03Take a big breath for me.
0:13:06 > 0:13:08- Do you feel faint now?- No.
0:13:11 > 0:13:14Your heart rate is playing games at the moment.
0:13:14 > 0:13:19To be honest, any...anybody that looks at the flatline
0:13:19 > 0:13:22would usually associate the patient as being dead.
0:13:24 > 0:13:27So I immediately looked back up to Valerie,
0:13:27 > 0:13:29who was still sitting talking quite happily.
0:13:29 > 0:13:32Were you feeling palpitations in your chest?
0:13:32 > 0:13:35Not quite palpitations but sort of fluttering all the time.
0:13:37 > 0:13:40She was having what was called ventricular standstills,
0:13:40 > 0:13:43where there was periods of no activity in the heart.
0:13:47 > 0:13:52And she was feeling faint, and she looked acutely unwell.
0:13:52 > 0:13:56It's a relatively rare condition, but if untreated it can be fatal.
0:13:56 > 0:13:59- Sorry, what did you say, you feel...?- Feel slightly light-headed.
0:14:01 > 0:14:04Jason asks Dr Blackwell for a second opinion.
0:14:06 > 0:14:10When I checked her pulse, it was irregular and slow, I thought.
0:14:12 > 0:14:14Just going to try some atropine, just try,
0:14:14 > 0:14:17see if that'll stop her from going down as low.
0:14:17 > 0:14:20Chest pain was about three o'clock this morning,
0:14:20 > 0:14:25lasted about half an hour so we need to get her up to A & E.
0:14:25 > 0:14:27Both agree the best course of action
0:14:27 > 0:14:32is to give Valerie atropine, a drug that increases the heart rate.
0:14:36 > 0:14:39But it's a short-term solution at best.
0:14:41 > 0:14:46The ventricular standstills were going on and it was concerning,
0:14:46 > 0:14:47and in situations like that,
0:14:47 > 0:14:49a pacemaker generally will always be fitted.
0:14:49 > 0:14:52- How are you feeling now? - I feel all right.
0:14:52 > 0:14:55- Bit frightened, probably. - Slightly.
0:14:55 > 0:14:58Yeah, OK, well, you're in good hands here.
0:14:58 > 0:14:59We'll get you up to Noble's.
0:15:01 > 0:15:04There's periods where your heart's beating quite slow,
0:15:04 > 0:15:08and that's when you're saying that you're feeling dizzy.
0:15:08 > 0:15:12I mean, at the minute it, it's beating at...
0:15:12 > 0:15:14Normal.
0:15:14 > 0:15:17Well, it hasn't been normal since we've been with you.
0:15:17 > 0:15:18Oh, really?
0:15:18 > 0:15:20No. It started really, really fast.
0:15:20 > 0:15:21Yes.
0:15:21 > 0:15:24And it's gone the other way now.
0:15:24 > 0:15:26OK, we're going to pop you in the ambulance
0:15:26 > 0:15:29- and take you up to Noble's. - That's it.
0:15:31 > 0:15:33So if I get you to sit on there.
0:15:34 > 0:15:36Faced with a 30-minute journey,
0:15:36 > 0:15:40Jason needs to monitor Valerie's heart rate every step of the way.
0:15:51 > 0:15:54Do you feel any brighter now?
0:15:54 > 0:15:57I'm certainly not fainting every two minutes, anyway.
0:15:57 > 0:16:00Good, good. No, we don't want any of that malarkey.
0:16:01 > 0:16:05There were periods she was up at the 150, 160 mark.
0:16:05 > 0:16:08I used a manoeuvre called the Valsalva manoeuvre
0:16:08 > 0:16:11where she was blowing on to a syringe.
0:16:13 > 0:16:16OK, that's fine.
0:16:16 > 0:16:19And that stimulates one of your nerves to suppress the heart rate.
0:16:20 > 0:16:22And the other way to calm a patient?
0:16:22 > 0:16:24Simple conversation.
0:16:24 > 0:16:26Birthday next month, isn't it?
0:16:26 > 0:16:29- Yes. 18th of October.- Next month.
0:16:30 > 0:16:33I'm sure you will.
0:16:37 > 0:16:39On arrival...
0:16:39 > 0:16:42Come on, let's get this into...
0:16:42 > 0:16:45Jason and Kerry transfer Valerie to Accident & Emergency.
0:16:45 > 0:16:47Do you want my hand?
0:16:47 > 0:16:48Thank you.
0:16:48 > 0:16:51Mad situation, I don't know what's going on here.
0:16:51 > 0:16:53She woke up this morning with chest pain.
0:16:54 > 0:16:57Got up, she fainted, felt generally unwell.
0:16:58 > 0:17:01While Valerie's placed under close observation,
0:17:01 > 0:17:06it's not long before Jason and Kerry are on their next call.
0:17:16 > 0:17:19Yes, yes, all received.
0:17:27 > 0:17:29From a heartbeat to a rural beat.
0:17:32 > 0:17:34In south Shropshire, PC Nick Prosser
0:17:34 > 0:17:37is still attending a dramatic car accident.
0:17:38 > 0:17:40The vehicle has completely overturned,
0:17:40 > 0:17:43bringing this remote country lane to a close.
0:17:45 > 0:17:48Driver Stevie could have a serious head injury,
0:17:48 > 0:17:50but now must undergo a breath test.
0:17:52 > 0:17:55Blow into it for a couple of seconds.
0:17:56 > 0:17:57Keep going.
0:17:57 > 0:17:59That's it, smashing.
0:17:59 > 0:18:02We're looking for a zero. That's what we'd like, ideally.
0:18:04 > 0:18:06As long as it's under 35.
0:18:07 > 0:18:08OK, zero.
0:18:10 > 0:18:12She blew zero. She was absolutely fine.
0:18:12 > 0:18:16She did say that she'd had a small bottle of cider after...after work,
0:18:16 > 0:18:20but it didn't register on the procedure just because it was so many hours on.
0:18:20 > 0:18:23And that's great, that's what we want to see.
0:18:27 > 0:18:31Now paramedic Trish Johnson can examine Stevie's injuries.
0:18:31 > 0:18:33I'll grit my teeth...
0:18:33 > 0:18:37Irrigate, yeah... Stevie, I'm going to irrigate that,
0:18:37 > 0:18:40You definitely have a bit of glass in there.
0:18:40 > 0:18:43- OK.- OK? Get you up to Shrewsbury.
0:18:46 > 0:18:48Because she's vomited,
0:18:48 > 0:18:51we have to be quite cautious
0:18:51 > 0:18:55and make sure that she's not developing a head injury.
0:18:55 > 0:18:59So although we might banter on the way up,
0:18:59 > 0:19:02we'll be keeping a really sharp eye on her obs,
0:19:02 > 0:19:05making sure that nothing develops.
0:19:05 > 0:19:08Take her up. Have her checked out.
0:19:08 > 0:19:11Get this piece of glass out, bit of glue.
0:19:14 > 0:19:15STEVIE GROANS
0:19:15 > 0:19:17All right, sweetheart.
0:19:18 > 0:19:20One of the signs and symptoms
0:19:20 > 0:19:24of potential developing head injuries is vomiting.
0:19:25 > 0:19:29So anyone who's been in a... in a...
0:19:29 > 0:19:33crash like that we'd monitor fairly carefully anyway, because
0:19:33 > 0:19:37they get safety-belt compression injuries and all sorts of things.
0:19:39 > 0:19:43For Stevie, it's been a fortunate escape.
0:19:45 > 0:19:48Every day in Britain, three people are killed on country roads.
0:19:48 > 0:19:51Another 25 are seriously injured.
0:19:53 > 0:19:56But Stevie's not out of the woods yet.
0:19:56 > 0:19:59Bend your knees. Push your legs up.
0:19:59 > 0:20:01I don't want to. My hip hurts.
0:20:03 > 0:20:05The pain's becoming more acute
0:20:05 > 0:20:08and she's still suffering bouts of nausea.
0:20:10 > 0:20:11Yeah.
0:20:11 > 0:20:14Big adrenaline rush, isn't it? Leaves you very shaky afterwards.
0:20:14 > 0:20:19It's quite normal because your body's used up all its adrenaline
0:20:19 > 0:20:23and afterwards, you have this really weird feeling after you've
0:20:23 > 0:20:27had a big adrenal rush, you know, makes you feel pretty ropey.
0:20:28 > 0:20:30You're upright, pink and talking
0:20:30 > 0:20:34and in our office, that's a really good, thing, OK?
0:20:34 > 0:20:37- OK.- Upright, pink and talking people are good for us.
0:20:37 > 0:20:39OK.
0:20:39 > 0:20:41I'll get you some pain relief.
0:20:41 > 0:20:42OK, thank you.
0:20:45 > 0:20:47All I remember literally is thinking,
0:20:47 > 0:20:50"I need to counter-steer,"
0:20:50 > 0:20:54and then hitting my head and then just the noise.
0:20:54 > 0:20:57It's just the noise of the glass,
0:20:57 > 0:21:00grinding and the metal grinding,
0:21:00 > 0:21:02and I remember the roof getting closer but not realising
0:21:02 > 0:21:06I was upside down, I just remember the roof was getting closer to me.
0:21:06 > 0:21:12And then, yeah, I sort of stopped, my car started screaming at me,
0:21:12 > 0:21:14so I turned the engine off.
0:21:14 > 0:21:16Turned the lights off to stop it screaming
0:21:16 > 0:21:18and tried to work out the best exit from the car.
0:21:18 > 0:21:23Couldn't work out if I could fit through the window, or had to open the door. Yeah.
0:21:23 > 0:21:26Decided the door was the best option
0:21:26 > 0:21:29cos I'm a bit big to go through a window at the best of times.
0:21:35 > 0:21:38As Stevie's taken to the hospital...
0:21:39 > 0:21:42..the Sheriff of Tenbury, AKA Nick Prosser,
0:21:42 > 0:21:44needs to get the road reopened.
0:21:44 > 0:21:48While we're waiting for the recovery truck to come, we're going to
0:21:48 > 0:21:51open the one lane and send whatever traffic up that end through.
0:21:51 > 0:21:53We've cleaned as much of the glass off the road as we can.
0:21:53 > 0:21:57Just get the road open and get the traffic flowing again,
0:21:57 > 0:22:00and get everybody on their way.
0:22:00 > 0:22:03Hopefully it won't be too long, and then once that's...
0:22:03 > 0:22:06the car's gone, we can get out of here and move on to the next one.
0:22:08 > 0:22:11Before long, recovery arrives on scene.
0:22:11 > 0:22:14Get the vehicle out the way and then I'll have to get the broom out
0:22:14 > 0:22:17and put the back into it.
0:22:17 > 0:22:19Have to make sure there's no fluids leaked
0:22:19 > 0:22:21from the vehicle onto the road.
0:22:21 > 0:22:23Oil, fuel, things like that.
0:22:23 > 0:22:26And if there is, perhaps have to get Highways to come and...
0:22:26 > 0:22:31put some magic sand on it and... just so the road isn't slippy.
0:22:31 > 0:22:34But we won't be able to asses that, really, until the car's been moved.
0:22:34 > 0:22:36We'll just get the last fragments of glass
0:22:36 > 0:22:38and the grass off the road and we'll be away.
0:22:47 > 0:22:49Ready to go.
0:22:50 > 0:22:52Luckily, she wasn't hurt and, luckily,
0:22:52 > 0:22:54there wasn't a car coming the other way
0:22:54 > 0:22:58because then we would have had a much more serious incident.
0:23:00 > 0:23:04To come out with a bit of glass in your head is...
0:23:04 > 0:23:07you're walking away all right, I think that's not too bad.
0:23:12 > 0:23:15Very lucky indeed. I'd play the Lottery if I was her.
0:23:29 > 0:23:31Across the British Isles...
0:23:34 > 0:23:38..from the majestic mountain ranges of Scotland
0:23:38 > 0:23:40to Northern Ireland...
0:23:42 > 0:23:45..the Isle of Man, and down to the Lake District...
0:23:47 > 0:23:51Royal Navy Search and Rescue Squadron HMS Gannet
0:23:51 > 0:23:54is called to around 300 emergencies a year...
0:23:55 > 0:23:59..saving lives in some of our most remote locations.
0:24:10 > 0:24:13Our patch at Gannet, it covers 92,000 square miles
0:24:13 > 0:24:17and that's predominantly mountainous terrain and mountains, you know.
0:24:17 > 0:24:20They separate the men from the boys when it comes to flying helicopters.
0:24:20 > 0:24:23That's what attracts a lot of our guys to come up to Gannet
0:24:23 > 0:24:27because it is probably the most challenging place in the UK to fly.
0:24:30 > 0:24:34Lieutenant Commander Jon Green is the unit's second-in-command.
0:24:34 > 0:24:37Keep going left, please.
0:24:37 > 0:24:41He's flown more than 250 rescue missions.
0:24:41 > 0:24:43There's a huge amount of satisfaction
0:24:43 > 0:24:45that you've rescued that casualty. You know that
0:24:45 > 0:24:48you've saved that guys life and that, that's unique.
0:24:48 > 0:24:52Today, Jon's en route to the most southern edge of his patch
0:24:52 > 0:24:54to conduct a training exercise
0:24:54 > 0:24:57with a local Mountain Rescue Team, or MRT.
0:25:00 > 0:25:03Joining him are fellow pilot, Jamie Ross...
0:25:05 > 0:25:08..winch operator observer, Chris Flynn,
0:25:08 > 0:25:12and winchman paramedic Mike Henson, known as H.
0:25:13 > 0:25:14There you go. Happy.
0:25:18 > 0:25:20From their base in Prestwick,
0:25:20 > 0:25:23they're flying 100 miles, to a remote spot
0:25:23 > 0:25:25near Broughton-in-Furness.
0:25:27 > 0:25:29On the ground,
0:25:29 > 0:25:34Mountain Rescue Team leader Mike Margison has rallied the troops.
0:25:34 > 0:25:36We've got 40 team members,
0:25:36 > 0:25:38and, you know, we're trying to keep the majority of them trained
0:25:38 > 0:25:41so that they can work with the aircraft, cos you know,
0:25:41 > 0:25:44they never know which team members you're going to have on a call-out.
0:25:45 > 0:25:48Duddon And Furness is one of 12 volunteer squads
0:25:48 > 0:25:50in the Lake District,
0:25:50 > 0:25:53an area which attracts over 16 million visitors a year.
0:26:01 > 0:26:05The training that day involved a scenario where we
0:26:05 > 0:26:09put a casualty in quite a difficult place on one of the hills and we
0:26:09 > 0:26:11made it so that we weren't able to winch,
0:26:11 > 0:26:15so we then manoeuvred Mountain Rescue personnel up to an area
0:26:15 > 0:26:20where they could go and attend a casualty.
0:26:26 > 0:26:29But barely an hour into the exercise, real life intervenes.
0:26:31 > 0:26:34THREE BLASTS ON A WHISTLE
0:26:34 > 0:26:37We'd just dropped the first members on the top of the mountain
0:26:37 > 0:26:39when they called us and they said they could hear someone
0:26:39 > 0:26:41crying for help and blowing a whistle.
0:26:41 > 0:26:43THREE BLASTS ON A WHISTLE
0:26:43 > 0:26:45We took a couple of moments
0:26:45 > 0:26:49just to make sure this wasn't part of our exercise.
0:26:49 > 0:26:52About three series of three whistle blasts beyond the crag there,
0:26:52 > 0:26:54so we think there's somebody needs help.
0:26:54 > 0:26:58While Mountain Rescue search the ground,
0:26:58 > 0:27:01the team from HMS Gannet sweep the area from above.
0:27:04 > 0:27:08It was quite dense with trees, so it made it particularly
0:27:08 > 0:27:12challenging to try and find where the cries for help were coming from.
0:27:12 > 0:27:15Unable to establish a visual from the air,
0:27:15 > 0:27:18it's the Mountain Rescue lads who find the walker -
0:27:18 > 0:27:21an elderly man suffering from exhaustion.
0:27:39 > 0:27:41Though as the training continues....
0:27:44 > 0:27:47..it's not long before there's another emergency.
0:27:55 > 0:27:57Three injured mountain bikers on the Isle of Man.
0:27:57 > 0:28:01We were the closest asset at the time, so it was up to us
0:28:01 > 0:28:03to go and see how we could help.
0:28:06 > 0:28:08From their location in the Lake District,
0:28:08 > 0:28:11the team need to race 56 miles to a remote clearing
0:28:11 > 0:28:14close to the Greeba River, on the Isle of Man.
0:28:17 > 0:28:19The cyclists are in a serious condition.
0:28:19 > 0:28:22One has a suspected broken collar bone,
0:28:22 > 0:28:24another possible spinal damage.
0:28:28 > 0:28:32But the team face a more immediate problem.
0:28:32 > 0:28:35After doing quite...quite some time flying, we were low on fuel.
0:28:40 > 0:28:44Ultimately the Search and Rescue and aircraft commander will...
0:28:44 > 0:28:48will have the final call.
0:28:48 > 0:28:51We had two options, we either went straight to the scene itself or
0:28:51 > 0:28:53we get fuel at the airport,
0:28:53 > 0:28:56probably adding on a good 20-30 minutes before we got on scene.
0:28:58 > 0:29:00Given the serious nature of the injuries,
0:29:00 > 0:29:03even a few minutes could make all the difference.
0:29:13 > 0:29:15Back on the Isle of Man,
0:29:15 > 0:29:17paramedics Jason Banks and Kerry McShane
0:29:17 > 0:29:19are responding to another call.
0:29:28 > 0:29:30A 13-year-old boy has been seriously injured
0:29:30 > 0:29:33during a school rugby match.
0:29:33 > 0:29:35Yes, yes, all received.
0:29:37 > 0:29:39From their current location in Douglas,
0:29:39 > 0:29:42they're travelling 15 miles to Ramsey Grammar School.
0:29:46 > 0:29:48Hello, mate. So where are you hurting?
0:29:50 > 0:29:51Your ankle.
0:29:51 > 0:29:55Tell you what, son, I'm going to grab hold of your ankle,
0:29:55 > 0:29:58bring it round here and I'm going to have a look at it.
0:29:58 > 0:30:01OK? Have you got pain over these bones here?
0:30:04 > 0:30:08Which one, the left or the right? This one here.
0:30:08 > 0:30:13Children have a one in ten chance of being injured playing rugby.
0:30:13 > 0:30:17James is reluctant to take any pain relief.
0:30:17 > 0:30:20This gas here, you breathe it in through this little mouthpiece,
0:30:20 > 0:30:21you put that in your mouth.
0:30:21 > 0:30:24It might make you feel a little bit woozy,
0:30:24 > 0:30:25but it might help with the pain.
0:30:25 > 0:30:28- There's no need to be brave now, mate.- And if you don't like it,
0:30:28 > 0:30:31once you stop taking it, it wears off quite quickly.
0:30:31 > 0:30:33It's free, it's good.
0:30:33 > 0:30:37His mum told us that he kind of hid his emotions a little bit,
0:30:37 > 0:30:40and...and that he'd told her
0:30:40 > 0:30:44and confessed to her that he was actually in a lot of pain.
0:30:44 > 0:30:47Having persuaded James, Kerry gives him Entonox,
0:30:47 > 0:30:50more commonly known as laughing gas.
0:30:50 > 0:30:54Big breath in. Good, that's perfect.
0:30:54 > 0:30:56And you can breathe out.
0:30:56 > 0:30:58Big sucks.
0:30:58 > 0:31:00That's it, now you're getting it.
0:31:00 > 0:31:02Deeper if you can.
0:31:04 > 0:31:09It does start to take effect and make you feel woozy fairly quickly.
0:31:09 > 0:31:14But pain relief, it might take a few minutes to really help.
0:31:14 > 0:31:16OK?
0:31:19 > 0:31:24With James's pain under control, Jason can now work on his ankle.
0:31:24 > 0:31:27Because he couldn't stand, and it was causing him discomfort,
0:31:27 > 0:31:31the safer thing to do is to immobilise the ankle.
0:31:32 > 0:31:34We used what's called a vacuum splint,
0:31:34 > 0:31:37so I popped the vacuum splint around him
0:31:37 > 0:31:40and then what you do is you suck all the air out of it, and it
0:31:40 > 0:31:45forms a very temporary cast around his ankle and stabilises it.
0:31:48 > 0:31:52But with a long ambulance ride ahead over bumpy country roads,
0:31:52 > 0:31:55Kerry wants James to take stronger pain relief.
0:31:56 > 0:31:58What we've got to bear in mind is that
0:31:58 > 0:32:01if we're going down to Noble's, we're probably 20,
0:32:01 > 0:32:0725 minutes, OK? So that's a long time sucking on this gas, OK?
0:32:07 > 0:32:12You might get a bit tired of that, so you might...
0:32:12 > 0:32:14You're better with something else
0:32:14 > 0:32:16because also it can be a little bit bumpy.
0:32:16 > 0:32:18But it's up to you what you want to do, OK? We're not going to
0:32:18 > 0:32:21force you to take anything you don't want to, OK?
0:32:21 > 0:32:23I guess I'll have it.
0:32:23 > 0:32:25You're going to try it? OK.
0:32:25 > 0:32:27I'll ask Jason when he comes back.
0:32:27 > 0:32:29Don't you worry, we'll sort it out.
0:32:30 > 0:32:32Jason returns with the stretcher.
0:32:34 > 0:32:39Jason, he's changed his mind - give him the oromorph.
0:32:39 > 0:32:42OK, yeah.
0:32:42 > 0:32:45It tastes very sweet, OK.
0:32:47 > 0:32:52I'll give you that and just... I need you to get that down.
0:32:52 > 0:32:53That's it, all in.
0:32:53 > 0:32:56That was quick, weren't it? Good lad.
0:32:56 > 0:32:58Yep, I can do that.
0:32:58 > 0:32:59I'll take that, thank you.
0:32:59 > 0:33:02- Do I still do this?- Yeah, yeah. - Do that as well, absolutely, yeah.
0:33:02 > 0:33:07Right, son, you're a big fella, you've got two options -
0:33:07 > 0:33:11you can get yersen up here, or I can chuck you over my shoulder
0:33:11 > 0:33:13and lift you on. What do you want?
0:33:13 > 0:33:15- I think I can get up with a bit of help.- Good lad.
0:33:15 > 0:33:20It's a big deal to a child to have two strangers come up to them and be
0:33:20 > 0:33:24taken away in an ambulance in front of all of his friends, you know,
0:33:24 > 0:33:28and try to not cry and be seen to being, you know,
0:33:28 > 0:33:30showing any weakness.
0:33:30 > 0:33:31Good man.
0:33:31 > 0:33:35We try just to help them just to admit that they need a little
0:33:35 > 0:33:37bit of help and just to let us do that.
0:33:39 > 0:33:42James is soon on his way to hospital.
0:33:47 > 0:33:51There Jason hands him over to nurse, Lisa Smith.
0:33:51 > 0:33:54Today he has been involved in a rugby tackle
0:33:54 > 0:33:59and he's gone over on his right ankle.
0:33:59 > 0:34:01- Can you feel me touching here? - Yeah.
0:34:01 > 0:34:04And there? Fabulous.
0:34:04 > 0:34:07Kerry meanwhile gets an update on 84-year-old Valerie,
0:34:07 > 0:34:11whose heart rate was fluctuating wildly.
0:34:11 > 0:34:13You feeling dizzy with that now, are you?
0:34:15 > 0:34:18After being placed under close observation, she passed out
0:34:18 > 0:34:22two more times and was then transferred to Critical Care.
0:34:23 > 0:34:28Jason thought that Valerie would need a pacemaker fitted,
0:34:28 > 0:34:33and, ultimately, that is what was planned for Valerie
0:34:33 > 0:34:37when she got transferred to CCU, so he was right.
0:34:37 > 0:34:39Go on, get over there.
0:34:39 > 0:34:42I don't say it very often if I can help it, yes,
0:34:42 > 0:34:46because Jason's head does not need to be any bigger than it already is.
0:34:50 > 0:34:53Then again, it may be too late.
0:34:53 > 0:34:55You know the difference between you and me, Kerry?
0:34:55 > 0:34:57What's that?
0:34:57 > 0:34:58I make this look good.
0:35:15 > 0:35:18More than 50 miles away, over the Irish Sea,
0:35:18 > 0:35:23the crew from HMS Gannet is also heading to the Isle of Man.
0:35:26 > 0:35:30As the closest rescue helicopter, they've been called to transport
0:35:30 > 0:35:33three critically injured mountain bikers,
0:35:33 > 0:35:35one with a possible broken neck.
0:35:35 > 0:35:38Even a trip in an ambulance over that type of ground can be
0:35:38 > 0:35:41detrimental, so we can get them there as fast as possible
0:35:41 > 0:35:45and minimise the risk of any further injury or complications to them.
0:35:45 > 0:35:47But there's another problem.
0:35:47 > 0:35:49Rescue 177.
0:35:49 > 0:35:52The dwindling fuel supply.
0:35:59 > 0:36:02Our intention, because we were so low on fuel, was to drop me off
0:36:02 > 0:36:05so I could attend to the casualties and then
0:36:05 > 0:36:08the aircraft would go and get fuel and then come back and pick me up.
0:36:16 > 0:36:19The three casualties were taking part
0:36:19 > 0:36:21in the End To End Mountain Bike Challenge.
0:36:23 > 0:36:25The biggest event of its kind in Europe,
0:36:25 > 0:36:28it attracts close to 2,000 riders.
0:36:31 > 0:36:34And covers a punishing course of 47 miles.
0:36:37 > 0:36:39They're just before the halfway mark,
0:36:39 > 0:36:42roughly five miles from the hospital in Douglas.
0:36:42 > 0:36:47Rescue 177 request, have the casualties been packaged?
0:36:47 > 0:36:50Have the casualties been packaged? Rescue 177.
0:37:02 > 0:37:04One to the right. Half to the right.
0:37:08 > 0:37:09Racing to the scene,
0:37:09 > 0:37:14Paramedic Mike Henson is briefed by emergency services on the ground.
0:37:14 > 0:37:16Not an easy land, is it?
0:37:31 > 0:37:32Right, OK.
0:37:33 > 0:37:38With fuel running low, Mike doesn't have a moment to lose.
0:37:38 > 0:37:40Are any of them needing to go right now? Because...
0:37:40 > 0:37:44- Fellow up there.- Well, I'll tell you, we've got five minutes.- OK.
0:37:44 > 0:37:47Sometimes ground personnel's five minutes is, you know, sort of 10,
0:37:47 > 0:37:4915 minutes and we didn't have that flex.
0:38:02 > 0:38:05In a matter of seconds, Mike must make his assessment.
0:38:11 > 0:38:13On the stretcher is 37-year-old Sean,
0:38:13 > 0:38:15who has a suspected broken collarbone.
0:38:16 > 0:38:18- Everybody right?- Yep.
0:38:19 > 0:38:22But the bigger concern is 40-year-old Thomas,
0:38:22 > 0:38:24who was thrown from his bike headfirst
0:38:24 > 0:38:27and is drifting in and out of consciousness.
0:38:29 > 0:38:30If the neck's injured,
0:38:30 > 0:38:32if the spinal cord gets injured there,
0:38:32 > 0:38:34then somebody could be quadriplegic.
0:38:34 > 0:38:35Also the nerves that control
0:38:35 > 0:38:38our breathing come from quite high up in the neck, so if that area
0:38:38 > 0:38:42gets damaged, then the person will never breathe on their own again.
0:38:46 > 0:38:50It's important that, if you can, anyone with any serious neck
0:38:50 > 0:38:54injuries that you keep them as still as possible.
0:38:56 > 0:38:58In five minutes flat,
0:38:58 > 0:39:02Mike has both Sean and Thomas safely aboard the chopper.
0:39:02 > 0:39:06It would have been nice to take time with the casualties,
0:39:06 > 0:39:08especially with the injuries that they had,
0:39:08 > 0:39:11but coming into our decision making
0:39:11 > 0:39:14was this fuel, so we had to hurry them along.
0:39:14 > 0:39:17With the third man still refusing to board and time ticking,
0:39:17 > 0:39:20the team sets course for Noble's Hospital in Douglas.
0:39:24 > 0:39:27But fuel is still a major concern.
0:39:34 > 0:39:38To save time, Mike briefs hospital staff mid-flight.
0:39:38 > 0:39:41What we've got is we've got one casualty,
0:39:41 > 0:39:4335C spine injuries.
0:39:43 > 0:39:44Possible pneumothorax, right side.
0:39:44 > 0:39:47However, he's got good air entry at the moment.
0:39:47 > 0:39:51And also we've got, he's got a collarbone gone.
0:39:51 > 0:39:54Five minutes later, pilot Jon
0:39:54 > 0:39:58and his crew touch down at a landing pad across from the hospital.
0:40:07 > 0:40:10Paramedic Mike disembarks with the casualties,
0:40:10 > 0:40:12while the rest of his crew head for fuel.
0:40:15 > 0:40:19Both Thomas and Sean are taken directly to the waiting consultant.
0:40:34 > 0:40:37Two weeks later, Thomas is back home in Ramsey
0:40:37 > 0:40:40and making a good recovery.
0:40:41 > 0:40:45Still got a stiff neck, still can't...still not got full movement,
0:40:45 > 0:40:48but, you know, the doctor did tell me it'll be a little while
0:40:48 > 0:40:50before you're back to normal, so I can't complain.
0:40:50 > 0:40:54I didn't break my neck so I can't complain, can I?
0:40:54 > 0:40:57But the memories of the crash will stay forever.
0:41:01 > 0:41:05When I actually crashed, when I went over, I was slightly side on,
0:41:05 > 0:41:08so I went over,
0:41:08 > 0:41:11over my neck on an angle, if you like, so
0:41:11 > 0:41:15had I been...had I been completely full-on, I think that would
0:41:15 > 0:41:17have been a different story,
0:41:17 > 0:41:19so I was pretty lucky, really, you know.
0:41:21 > 0:41:24I just remember going over on my neck and feeling
0:41:24 > 0:41:28the pain in my neck. There was another rider stopped, see if
0:41:28 > 0:41:32I was OK and apparently he'd heard the crunch of my neck as well.
0:41:35 > 0:41:38Fortunately, help was quickly on hand.
0:41:40 > 0:41:42It was my first time in the... in a helicopter, yeah, so
0:41:42 > 0:41:46I was a bit gutted cos I could only see the roof as well.
0:41:46 > 0:41:48Try not to move your neck, all right?
0:41:48 > 0:41:50The other rider, he knocked himself unconscious
0:41:50 > 0:41:53and broken his collarbone, so he was in a pretty...
0:41:53 > 0:41:57pretty sore way as well, like, and he was actually being physically
0:41:57 > 0:42:01sick on the side of the, on the side of the track as well and...
0:42:01 > 0:42:04and he was having a conversation with the doctors
0:42:04 > 0:42:09and two minutes later couldn't... couldn't remember speaking to them.
0:42:09 > 0:42:12But the experience hasn't put Thomas off.
0:42:12 > 0:42:15I'll be back next year, definitely, yeah, yeah.
0:42:15 > 0:42:18It's great, it's a brilliant race. I love it, yeah.
0:42:28 > 0:42:33It's been all go for the emergency services across the British Isles.
0:42:33 > 0:42:37In South Shropshire, Stevie suffered post concussion syndrome,
0:42:37 > 0:42:39but is now back behind the wheel.
0:42:39 > 0:42:41On the Isle of Man, James's bruised tendon had him
0:42:41 > 0:42:44off his feet for four weeks.
0:42:44 > 0:42:46He's now back playing sport at school.
0:42:48 > 0:42:50While Valerie's pacemaker is on hold.
0:42:50 > 0:42:54Doctors found the problem lies with her blood pressure medication,
0:42:54 > 0:42:57meaning Jason wasn't so right after all.
0:42:58 > 0:42:59As for the other injured men
0:42:59 > 0:43:03from the End To End Mountain Bike Challenge, both are on the mend,
0:43:03 > 0:43:05and Sean, who suffered a broken collarbone,
0:43:05 > 0:43:08plans on entering the race next year.
0:43:10 > 0:43:13And you thought it was quiet in the countryside.
0:43:16 > 0:43:19Subtitles by Ericsson