0:00:02 > 0:00:05Shetland, the most remote part of the UK.
0:00:06 > 0:00:09Here you're closer to the Arctic Circle then you are to London,
0:00:09 > 0:00:13and nearer Norway than you are to Edinburgh.
0:00:13 > 0:00:16There are more puffins than people,
0:00:16 > 0:00:18and more seals than supermarkets.
0:00:20 > 0:00:24But this wild landscape is also home to 23,000 islanders...
0:00:25 > 0:00:30..and so far from the mainland that when things go wrong...
0:00:30 > 0:00:32A&E, can I help you?
0:00:32 > 0:00:35..from helicopter rescues and spinal injuries...
0:00:35 > 0:00:38We're all here to make sure that you're OK.
0:00:38 > 0:00:40..to serious medical mysteries...
0:00:40 > 0:00:43Can we get assistance in, please? Something's not right.
0:00:43 > 0:00:48Shetland's island medics have to be ready for anything and everything.
0:00:48 > 0:00:50- What happened? - I had a fight with a seagull.
0:00:50 > 0:00:52- This was sheep shears, was it?- Yes.
0:00:54 > 0:00:57It means the tight-knit team of medics, volunteers
0:00:57 > 0:01:00and emergency services have a special bond...
0:01:00 > 0:01:02This might tickle!
0:01:04 > 0:01:06..and they know just how to keep each other going...
0:01:06 > 0:01:07Wee treat for night shift.
0:01:08 > 0:01:11..so they're always ready for any island emergency.
0:01:20 > 0:01:24Today, a fisherman is rescued from his trawler in the North Sea...
0:01:25 > 0:01:28..a schoolteacher has a unique piercing problem...
0:01:28 > 0:01:31Dangers, dangers of ear piercings, yes?
0:01:31 > 0:01:34..and a patient needs to be medivacked to Aberdeen
0:01:34 > 0:01:36for urgent coronary care.
0:01:37 > 0:01:40I think the worst weather was over 100mph gales.
0:01:47 > 0:01:51For centuries, fishing has underpinned the Shetland economy.
0:01:51 > 0:01:55And though there's been a decline in the industry since the 1970s,
0:01:55 > 0:01:58whether commercial or recreational...
0:01:58 > 0:01:59Not bad.
0:02:01 > 0:02:04..fishing is a special part of Shetland culture...
0:02:05 > 0:02:07..and a livelihood for many.
0:02:15 > 0:02:19Surrounded on all sides by some of the most treacherous seas in the UK,
0:02:19 > 0:02:22it's no wonder that emergency services are no stranger
0:02:22 > 0:02:24to fishing-related incidents.
0:02:26 > 0:02:30In Lerwick, Shetland Coastguard HQ have been alerted to an incident
0:02:30 > 0:02:32on a fishing trawler in the North Sea.
0:02:32 > 0:02:35We have Coastguard rescue helicopter,
0:02:35 > 0:02:38he's evacuated a crewman from a fishing vessel.
0:02:38 > 0:02:42He's inhaled chemicals and had a reaction,
0:02:42 > 0:02:46so they are now airborne and taking him
0:02:46 > 0:02:49to an emergency landing site in the town.
0:02:49 > 0:02:52The helicopter's currently here.
0:02:53 > 0:02:56Just transiting up to Lerwick.
0:02:56 > 0:03:00While the fisherman is evacuated, in the Gilbert Bain Hospital
0:03:00 > 0:03:03in Lerwick, nurses Kathy Duffus and Thelma Irvine
0:03:03 > 0:03:05have been alerted to their imminent arrival.
0:03:05 > 0:03:08We've just received a call from the Coastguard to say that
0:03:08 > 0:03:11there's a fisherman suffering from headache and breathing difficulties.
0:03:11 > 0:03:14And we're just waiting for them to land just any minute, really.
0:03:16 > 0:03:19With Resus prepped and a consultant notified,
0:03:19 > 0:03:23an ambulance with paramedic Emma Davies on board has been dispatched.
0:03:23 > 0:03:27So we're on our way to a male of an unknown age
0:03:27 > 0:03:29that works on board a fishing boat.
0:03:29 > 0:03:32He's inhaled some sort of chemical and is having, well,
0:03:32 > 0:03:35it says he's got a compromised airway and difficulty breathing.
0:03:35 > 0:03:38So this is landing at the Clickimin site,
0:03:38 > 0:03:41which is just two seconds from the hospital.
0:03:41 > 0:03:44So we'll see what we get when we get there.
0:03:46 > 0:03:49The Shetland island search and rescue Coastguard helicopter lands
0:03:49 > 0:03:53on three main sites. When it's considered life-threatening
0:03:53 > 0:03:56they'll always land here - the Clickimin playing fields,
0:03:56 > 0:03:58just across from the hospital.
0:04:00 > 0:04:03Unsure if the patient might quickly deteriorate,
0:04:03 > 0:04:05the Coastguard aren't taking any chances.
0:04:08 > 0:04:11The Coastguard winchman and paramedic John Thompson gives
0:04:11 > 0:04:15the ambulance team an update before they leave for the hospital.
0:04:28 > 0:04:31Thankfully, it seems the patient is stable.
0:04:31 > 0:04:34But having inhaled toxic fumes on board the trawler,
0:04:34 > 0:04:36he's still having discomfort breathing...
0:04:37 > 0:04:40..and is a long way from being given the all clear.
0:04:48 > 0:04:51To open up his airways and ease his breathing Brian's been given
0:04:51 > 0:04:54salbutamol as well as a nebuliser.
0:04:54 > 0:04:56Both will help open his airways.
0:04:56 > 0:04:58How are you feeling now?
0:04:59 > 0:05:02Not too bad. Still finding it difficult?
0:05:05 > 0:05:09That's fine. The hospital is just one minute away so we'll just,
0:05:09 > 0:05:10we'll just go, OK?
0:05:12 > 0:05:15We can hear the helicopter taking off from here,
0:05:15 > 0:05:18so once it takes off it won't take them long to get the patient here.
0:05:18 > 0:05:21Were you working with the chemicals for quite a while?
0:05:26 > 0:05:31So you weren't actually in contact with them for an awful long time?
0:05:31 > 0:05:32OK.
0:05:35 > 0:05:37OK, OK.
0:05:39 > 0:05:42Chair, so that's a good sign.
0:05:42 > 0:05:45It is reassuring for nurse Thelma and nurse Kathy
0:05:45 > 0:05:48to see a patient arrive in a chair and not on a stretcher.
0:05:48 > 0:05:51But they'll only know if there's any lasting damage from
0:05:51 > 0:05:54the chemical fumes once they run a series of tests.
0:06:07 > 0:06:11Fishing is big business in Shetland,
0:06:11 > 0:06:13and it's also a recreational pastime.
0:06:13 > 0:06:16A variety of fishing injuries come through the doors of A&E.
0:06:19 > 0:06:22Recently, retired Grace and her husband were fishing near their home
0:06:22 > 0:06:26in Burra and Grace seems to have got more than she bargained for.
0:06:27 > 0:06:31Well, we were catching that many fish it was hard to go ashore.
0:06:33 > 0:06:36- A good catch today, then? - Yep, plenty of mackerel.
0:06:36 > 0:06:38Oh, well, the fish were too good to come in.
0:06:38 > 0:06:43Oh, no, we got in and went home and put on a clean pair of trousers!
0:06:43 > 0:06:45Just sit tight for a moment
0:06:45 > 0:06:48and we'll get the doctor to come and have a look.
0:06:48 > 0:06:52Casting her eye over the injury is Shetland native Doctor Jennifer Briggs.
0:06:52 > 0:06:55- We'll just get set up here. - Yes, yes, that's good.
0:07:00 > 0:07:03I'll just explain to you what we're planning to do.
0:07:03 > 0:07:06I'll just put in a bit of local anaesthetic round where its come out
0:07:06 > 0:07:10- and then we'll just continue going...- Go back that way.
0:07:10 > 0:07:12Because yon barb on the end of the tip,
0:07:12 > 0:07:14if I try to come back it's going to drag...
0:07:14 > 0:07:17- Take it this way then?- Yes.- Yes.
0:07:17 > 0:07:20Shetlanders are a sturdy breed,
0:07:20 > 0:07:23and tend to take these things in their stride.
0:07:23 > 0:07:26I tried to take them out myself with ice but it didn't work.
0:07:26 > 0:07:28Good try. Good try.
0:07:28 > 0:07:32- This might sting.- Yes, well, it's only a sting.
0:07:32 > 0:07:35I was here ten weeks ago with a broken elbow.
0:07:35 > 0:07:36- OK.- Same room!
0:07:36 > 0:07:38THEY LAUGH
0:07:38 > 0:07:40You're a frequent flyer!
0:07:40 > 0:07:43I'm just going to nip this off here.
0:07:43 > 0:07:45If it's very uncomfortable, let me ken.
0:07:49 > 0:07:51- Oh.- Oh!
0:07:51 > 0:07:52Where did he go?
0:07:53 > 0:07:56- Are you OK? Can you feel anything? - No, no, that's fine.
0:07:56 > 0:07:59I'll tell you something, it's well and truly stuck.
0:07:59 > 0:08:02I think the barb is just under the skin here.
0:08:02 > 0:08:06- Yes.- It's just really catching and I cannae get him curled out.
0:08:06 > 0:08:08It could be a new fashion trend.
0:08:08 > 0:08:10One of these new fashionable piercings.
0:08:10 > 0:08:12No, I think I'll not bother.
0:08:12 > 0:08:15No, no. When the infection sets in, it won't be very attractive.
0:08:17 > 0:08:20Using medical pliers, the hook is delicately removed.
0:08:23 > 0:08:25- Yay.- Well done.
0:08:25 > 0:08:27Good for you. Well done.
0:08:29 > 0:08:31Give him a bit of a clean-up.
0:08:31 > 0:08:34- Would you like to keep this hook as a souvenir?- No, thank you.
0:08:34 > 0:08:37So, patient Grace is off the hook.
0:08:37 > 0:08:39OK. Good.
0:08:48 > 0:08:51At the Gilbert Bain Hospital, patients are given
0:08:51 > 0:08:55as much care as possible, but sometimes they need to move on
0:08:55 > 0:08:58to more specialised care on the mainland.
0:08:58 > 0:09:01Every year, there are up to 500 organised patient transfers from the
0:09:01 > 0:09:05Gilbert Bain to the mainland and it's not just getting to hospital
0:09:05 > 0:09:06that's unusual on Shetland.
0:09:06 > 0:09:10Transferring to another is just as much of a challenge.
0:09:10 > 0:09:14Patients are often transferred to Aberdeen or Glasgow for specialist
0:09:14 > 0:09:17treatment, and when the call comes to send the patient off Shetland,
0:09:17 > 0:09:20it's the responsibility of the medical team
0:09:20 > 0:09:22to prepare the patient for transport...
0:09:22 > 0:09:23on an aeroplane.
0:09:25 > 0:09:28I'll go and grab the stuff that I need, OK?
0:09:30 > 0:09:33Nurse Emma Williamson will often work on call
0:09:33 > 0:09:36as a patient transfer nurse when she's not working in A&E.
0:09:36 > 0:09:38Have we got any flushes?
0:09:40 > 0:09:42What have we got here?
0:09:43 > 0:09:44A few bits and bobs.
0:09:44 > 0:09:46We'll just draw a couple up, Amanda.
0:09:46 > 0:09:49Today, there's gentleman needing to get to the core coronary care unit
0:09:49 > 0:09:52in Aberdeen as quickly as possible.
0:09:52 > 0:09:54So Emma's been called in.
0:09:54 > 0:09:57I've been called in. I was actually in the middle of a circuit class,
0:09:57 > 0:09:59so that's why I look so sweaty and minging.
0:09:59 > 0:10:03And it's urgent transfer because this gentleman's had
0:10:03 > 0:10:05an inferoposterior MI and we need to get him to CCU.
0:10:06 > 0:10:11Alec was brought in this morning with a heart problem from Sumburgh in the south of the island.
0:10:11 > 0:10:15He's been under the care of nurse Amanda Brown and has received
0:10:15 > 0:10:17treatment to decrease the risk of a heart attack.
0:10:19 > 0:10:21I've been doing a lot of walking this summer cos it's the first year
0:10:21 > 0:10:23since I retired, and I felt...
0:10:25 > 0:10:26I felt just uncomfortable.
0:10:26 > 0:10:30Quite a lot of pain between the shoulder blades and both arms.
0:10:30 > 0:10:32Completed the walk, and went home,
0:10:32 > 0:10:34and when I got up this morning
0:10:34 > 0:10:38I was making some tea and toast and then it just started again,
0:10:38 > 0:10:43exactly the same. So my wife took me in here very quickly.
0:10:43 > 0:10:45The plan is the air ambulance to Aberdeen and they'll have
0:10:45 > 0:10:47a look at me there and decide what...
0:10:49 > 0:10:51It looks like a stent, I think,
0:10:51 > 0:10:54so I think that what they've done here appears to be,
0:10:54 > 0:10:57it's had a very good effect.
0:10:58 > 0:11:00It's been a clot that's...
0:11:00 > 0:11:04The drugs that they've given me, they've reduced it,
0:11:04 > 0:11:07so it sounds very good.
0:11:07 > 0:11:11Yeah, he came in this morning and had an ECG
0:11:11 > 0:11:15and some bloods done, and it showed ST elevation,
0:11:15 > 0:11:18so he's had a posterior MI,
0:11:18 > 0:11:21so they had to get the doctor immediately and
0:11:21 > 0:11:23the consultant informed,
0:11:23 > 0:11:26and we got him thrombolysed in the connect place.
0:11:26 > 0:11:28So it's a clot buster.
0:11:29 > 0:11:32Alec's heart problem can only be fully treated by a coronary specialist.
0:11:37 > 0:11:40With the procedures he'll need, the best course of action is
0:11:40 > 0:11:43to send him to the nearest specialist unit in Aberdeen.
0:11:43 > 0:11:45So what I'm doing is I'm just preparing.
0:11:45 > 0:11:48I'm getting painkillers ready, some anti-sickness.
0:11:48 > 0:11:50Fingers crossed, nice day for flying,
0:11:50 > 0:11:54so hopefully we'll just get him there ASAP, safe and sound.
0:11:55 > 0:11:58The patient transfer works on a voluntary basis,
0:11:58 > 0:12:01When nurses opt in to take part in their spare time.
0:12:01 > 0:12:04I don't ken how many of us. There's not actually that many of us.
0:12:04 > 0:12:07There's about six of us maybe that volunteer, seven, Amanda?
0:12:07 > 0:12:09- Yeah.- You don't have to do this, if you work here.
0:12:09 > 0:12:13It's kind of your choice.
0:12:13 > 0:12:15Aha! Isoprenaline.
0:12:15 > 0:12:18I thought it was in the fridge. OK.
0:12:18 > 0:12:22Having trained in Aberdeen and worked in larger medical centres,
0:12:22 > 0:12:26Emma has a wealth of experience, built up from years of working as a nurse.
0:12:26 > 0:12:30When I did my training, going back to 20-odd years ago now,
0:12:30 > 0:12:33so I chose to do general nursing.
0:12:33 > 0:12:36So when I picked that, then I thought I would be going
0:12:36 > 0:12:39and looking after adults, so that's what I went off and did,
0:12:39 > 0:12:41in the big hospital at ARI.
0:12:41 > 0:12:46I think we have a really sort of broad spectrum of experience,
0:12:46 > 0:12:49the staff here. And lucky that we have a lot of nurses,
0:12:49 > 0:12:52with a lot of years of experience.
0:12:52 > 0:12:55The Gilbert Bain is well-equipped for general care
0:12:55 > 0:12:58but serving a population of just 23,000 people,
0:12:58 > 0:13:01the hospital can't cater for every level of specialist care.
0:13:01 > 0:13:07165 miles from the mainland and 230 from Aberdeen airport,
0:13:07 > 0:13:10Alec will be flown direct to the Aberdeen Royal Infirmary.
0:13:10 > 0:13:15We don't have the services here that we'd have on the mainland.
0:13:15 > 0:13:19Here we have to get him stabilised
0:13:19 > 0:13:22and then get him down to the next level of care,
0:13:22 > 0:13:23which is coronary care.
0:13:23 > 0:13:26Needing to get Alec to coronary care in Aberdeen,
0:13:26 > 0:13:29Amanda has requested an air ambulance.
0:13:29 > 0:13:32They're going to be at Sumburgh, which is a 30-minute drive,
0:13:32 > 0:13:3740-minute drive with the ambulance from the hospital down to Sumburgh,
0:13:37 > 0:13:40and then it will be about 45 minutes on the plane.
0:13:42 > 0:13:46So what we do when we look at blood results.
0:13:46 > 0:13:50For an MI there's a thing called Troponin I.
0:13:50 > 0:13:53So when you're looking at the blood results you're looking at
0:13:53 > 0:13:57the Troponin, I which is a specific enzyme to the cardiac muscle,
0:13:57 > 0:13:59and the bigger that rise is,
0:13:59 > 0:14:02then the bigger really the extent of the damage.
0:14:02 > 0:14:06He's had a rise, so that's just confirming
0:14:06 > 0:14:09that has done a wee bit of damage there to the muscle,
0:14:09 > 0:14:13but the sooner we get him to Aberdeen and he gets
0:14:13 > 0:14:17the investigation and the procedures
0:14:17 > 0:14:19then the better for his, like, heart.
0:14:21 > 0:14:24So we'll just get the ambulance sorted and we'll be offski.
0:14:24 > 0:14:28So a few things to prepare before Alec can get on his way to Aberdeen.
0:14:31 > 0:14:34Emma is Shetland born and bred,
0:14:34 > 0:14:36and has been working at the Gilbert Bain for ten years.
0:14:38 > 0:14:43It was the lifestyle of being a Shetlander that pulled Emma back home.
0:14:43 > 0:14:45I went to school here, so when I went away,
0:14:45 > 0:14:47like, a lot of my friends were nurses.
0:14:47 > 0:14:49But when I came back to Shetland,
0:14:49 > 0:14:52then all my friends were the friends I had before I did nursing.
0:14:53 > 0:14:55The schools are good.
0:14:55 > 0:14:59Definitely I would say it's a lifestyle choice for folk coming here.
0:14:59 > 0:15:01The summer is fantastic.
0:15:01 > 0:15:05The winters are long, and they're dark and they're cold
0:15:05 > 0:15:10and wet and I would say if folk do probably more than three winters,
0:15:10 > 0:15:12then they might stay.
0:15:12 > 0:15:14A wife, mum and nurse,
0:15:14 > 0:15:17Shetland and the Gilbert Bain is where the future lies.
0:15:18 > 0:15:21I think I would struggle not to be by the sea as well.
0:15:21 > 0:15:26But my kids absolutely love it here as well, and all my family is here.
0:15:26 > 0:15:30I'd actually find it weird to live somewhere with trees now, I think!
0:15:33 > 0:15:35When she does get a break from the hospital,
0:15:35 > 0:15:39Emma likes to take advantage of the best of what Shetland has to offer.
0:15:41 > 0:15:42Like many Shetlanders,
0:15:42 > 0:15:46Emma's choice of relaxation is enjoying wild swimming
0:15:46 > 0:15:48along the rugged coastline.
0:15:48 > 0:15:52On those rare days off, she can be found dipping her toes
0:15:52 > 0:15:55in the North Sea with her sister-in-law and friend.
0:15:55 > 0:15:57I'm going for it.
0:15:57 > 0:15:58Woo!
0:15:58 > 0:16:04It's just good, wild swimming, just to come here and be in the water,
0:16:04 > 0:16:06feel pretty wild, just helps clear your mind.
0:16:11 > 0:16:14I actually found the best sport ever,
0:16:14 > 0:16:17because you actually need to be reasonably fat, I think,
0:16:17 > 0:16:19to swim in the water,
0:16:19 > 0:16:20cos otherwise you'll freeze,
0:16:20 > 0:16:23cos it is cold, I won't lie.
0:16:23 > 0:16:25Yeah!
0:16:30 > 0:16:34As is the case for most nurses, the long hours can take their toll,
0:16:34 > 0:16:37but getting in the water makes it all worthwhile.
0:16:37 > 0:16:40Time out, nobody nagging me with, "Mum, can you do this?
0:16:40 > 0:16:42"Mum, can you do that?"
0:16:42 > 0:16:44No phones, no nothing.
0:16:44 > 0:16:45It's a fine day.
0:17:02 > 0:17:04Another special part of Shetland,
0:17:04 > 0:17:07and the reason that so many people love to visit here,
0:17:07 > 0:17:09is its rich diversity of wildlife.
0:17:10 > 0:17:13And, just like the tourists they attract,
0:17:13 > 0:17:16sometimes these animals get into trouble and need rescuing.
0:17:16 > 0:17:20Since 1987 it's been down to the Hillswick Wildlife Sanctuary
0:17:20 > 0:17:24to care for those animals that need it. Husband-and-wife team
0:17:24 > 0:17:28Pete and Jan Bevington have been running the charity, where they
0:17:28 > 0:17:32patch up the island's injured otters, and care for orphaned seals.
0:17:33 > 0:17:34Have you seen an otter?
0:17:38 > 0:17:42Today they've been called out to Vidlin, 22 miles north of Lerwick.
0:17:42 > 0:17:46There's a pilot whale that's been spotted in one of the inlets,
0:17:46 > 0:17:47and it's behaving strangely.
0:17:47 > 0:17:50Its behaviour's rather strange, you know, to be coming up
0:17:50 > 0:17:54and popping up like this every 15-20 seconds or so.
0:17:54 > 0:17:59Rather than swimming normally, it's spy hopping, going up and down,
0:17:59 > 0:18:01which can be a cause for concern.
0:18:02 > 0:18:06It's come so far inland that we're worried now that
0:18:06 > 0:18:07it's going to strand, you know.
0:18:07 > 0:18:10If we could just get it out to sea, it should be fine.
0:18:10 > 0:18:12But there's some bad news.
0:18:12 > 0:18:15The boat they were relying on has broken down.
0:18:15 > 0:18:18So, now, we're just desperately trying to find someone,
0:18:18 > 0:18:20because that's far too close in.
0:18:20 > 0:18:23It looks like he might strand, if we don't try to nudge him out.
0:18:23 > 0:18:26We just hope and pray that we can find something.
0:18:28 > 0:18:33You don't know anyone with a boat that could help us push him out?
0:18:33 > 0:18:35- I don't, no.- No.- Do you know anybody with a boat nearby?
0:18:36 > 0:18:40We would need two or three boats. Even one would help.
0:18:40 > 0:18:43The shallower water it gets into, the less likely we are to get it out.
0:18:47 > 0:18:52But on Shetland it's never too long before someone reaches out with a helping hand.
0:18:53 > 0:18:56They're going to come around and see if they can...
0:18:57 > 0:19:00..er, lead the whale out.
0:19:03 > 0:19:05Come on, boys.
0:19:05 > 0:19:08Come on, the boys, they can do it!
0:19:11 > 0:19:13Despite the best intention of the boat owners,
0:19:13 > 0:19:16the whale can't be persuaded to move away.
0:19:19 > 0:19:22Please go. Please go.
0:19:22 > 0:19:25Being close to the shore affects the whale's echolocation,
0:19:25 > 0:19:27causing it to become confused.
0:19:27 > 0:19:30With the pilot whale, they don't arrive in slowly.
0:19:30 > 0:19:32It'll come so far in,
0:19:32 > 0:19:36and then they panic and then they just hit the beach like torpedoes.
0:19:37 > 0:19:41When everything looks hopeless, there's more help on the horizon.
0:19:42 > 0:19:45I hope they are coming to us - I think they must be.
0:19:45 > 0:19:47Two kayakers have come to help.
0:19:53 > 0:19:56The main thing we want is to make some kind of...
0:19:56 > 0:20:00blockade to stop him circling ever and ever closer.
0:20:06 > 0:20:08It seems to be doing the job.
0:20:08 > 0:20:10Splash the paddles a bit, maybe.
0:20:10 > 0:20:12That's it, that's perfect.
0:20:12 > 0:20:14Oh, no, he's gone by you.
0:20:15 > 0:20:18Careful. Yeah, but he'll get frightened.
0:20:18 > 0:20:21Come away. I think you ought to come back. Come back.
0:20:21 > 0:20:23It's a delicate operation.
0:20:23 > 0:20:27The kayakers don't want to accidentally scare him closer to the shore.
0:20:27 > 0:20:31Still dangerous, Pete, because he could use that tail.
0:20:31 > 0:20:33He could panic and use that tail.
0:20:41 > 0:20:43Thank you, boys!
0:20:44 > 0:20:47They've helped to move him away, but with night falling,
0:20:47 > 0:20:51Jan and Pete have a nervous wait to see if he'll swim out to sea.
0:20:59 > 0:21:01Hardy folk they might be,
0:21:01 > 0:21:05but often the severity of an injury or accident means no amount
0:21:05 > 0:21:08of Shetland grit can prevent someone from coming in to A&E.
0:21:10 > 0:21:14- Hello, Mr Johnson. - Hello.- How are you doing?
0:21:14 > 0:21:15I'd be better if I wasn't here.
0:21:15 > 0:21:18- Better if...! - SHE LAUGHS
0:21:18 > 0:21:21Fisherman Brian has been evacuated from a trawler
0:21:21 > 0:21:23after inhaling chemical fumes onboard.
0:21:27 > 0:21:32First to assess Brian is the senior medical consultant, Dr Tuma.
0:21:32 > 0:21:36At about six o'clock, Brian's been working with...
0:21:36 > 0:21:38Bilgex? Bilgex.
0:21:38 > 0:21:40..and he's accidentally mixed it with chlorous,
0:21:40 > 0:21:42which has given off hazardous...
0:21:42 > 0:21:44He reckons he was only sort of in contact with it
0:21:44 > 0:21:47in a confined space for about 15 seconds.
0:21:47 > 0:21:49- OK.- But he's had shortness of breath,
0:21:49 > 0:21:53pain from his throat down to his sternum.
0:21:53 > 0:21:57Brian has mixed two chemicals which have given off noxious fumes.
0:21:57 > 0:22:00Though he was exposed only for a short time, the team
0:22:00 > 0:22:04still need to assess if there's any long-term damage to his airways.
0:22:05 > 0:22:07How is that right now? How is your breath?
0:22:07 > 0:22:09Is it much the same or is it a little bit better than it was?
0:22:09 > 0:22:12- A slight bit better.- OK.
0:22:12 > 0:22:15- And still you feel any pain or anything here in the...?- Yeah.
0:22:15 > 0:22:17Swap masks.
0:22:17 > 0:22:20Nurse Cathy needs to check his breathing and circulation
0:22:20 > 0:22:22before running a number of tests.
0:22:22 > 0:22:24Have you ever used one of these before?
0:22:24 > 0:22:27As hard and as fast as you can.
0:22:27 > 0:22:31Junior doctor Saul Wilson has arrived to help with Brian's assessment.
0:22:32 > 0:22:34Yeah, we need to... Go for it, just do your best.
0:22:37 > 0:22:39That's fine.
0:22:39 > 0:22:41So, 220.
0:22:41 > 0:22:45Having requested a number of tests, including an ECG and a chest X-ray,
0:22:45 > 0:22:48the consultant hands over to Dr Wilson.
0:22:49 > 0:22:51The team's first priority, though,
0:22:51 > 0:22:54is to work out just how toxic the chemicals are.
0:22:55 > 0:22:58So, he was working with Bilgex, which I guess is like a...
0:22:58 > 0:23:00- Bilgex.- I guess that's like a brand-name.
0:23:00 > 0:23:03..and then he's mixed it with chlorous, by accident.
0:23:04 > 0:23:06OK, I'll go and do that.
0:23:06 > 0:23:10One chemical is a grease and scum removing product.
0:23:10 > 0:23:15And chlorous is granulated chlorine, used to control bacteria and algae.
0:23:15 > 0:23:18What no-one knows is how they react together.
0:23:18 > 0:23:21So, a call to the experts is needed.
0:23:23 > 0:23:25I'll phone...
0:23:25 > 0:23:28the Poisons Information Service,
0:23:28 > 0:23:30and see what we should be doing.
0:23:31 > 0:23:33OK.
0:23:33 > 0:23:36- Thank you.- Thank you. - See you later.- See you later.
0:23:36 > 0:23:39Hi, I'm Dr Wilson, one of the junior doctors here.
0:23:39 > 0:23:42Do you mind if I take blood first from your wrist?
0:23:42 > 0:23:45- No.- So, we'll just swap hands and I'll take it off.
0:23:45 > 0:23:49The blood tests are vital to show if there are any unusual chemicals present in his blood.
0:23:51 > 0:23:53He's about to get an X-ray shortly, yeah.
0:23:56 > 0:23:58He's had a blood... He's getting a blood test done -
0:23:58 > 0:24:00it's in the machine as we speak, yeah.
0:24:02 > 0:24:04I've done a peak flow, yeah.
0:24:05 > 0:24:07It was 320, so a little bit low, but...
0:24:09 > 0:24:10The consultant is aware of that.
0:24:15 > 0:24:20Poisons are saying chest X-ray, EBG, peak flow,
0:24:20 > 0:24:23ECG and monitor him for four hours.
0:24:23 > 0:24:26We have to watch out for increasing wheeze, if he starts drooling,
0:24:26 > 0:24:28any difficulty swallowing.
0:24:28 > 0:24:31If there's swallowing difficulties he'll need an endoscopy.
0:24:31 > 0:24:34- OK.- So, they're saying maybe be a bit more cautious
0:24:34 > 0:24:37than what they're saying, because it's a bit unknown.
0:24:37 > 0:24:40- Yeah. Right.- This was really the
0:24:40 > 0:24:43sort of chlorine-type inhalation they were going with.
0:24:43 > 0:24:45- Yeah.- So, just the ECG.- The ECG.
0:24:45 > 0:24:47Yeah, and the X-ray.
0:24:47 > 0:24:50Unsure of the exact effects of these chemicals together,
0:24:50 > 0:24:54the Poisons Information Service advises close monitoring of the patient.
0:24:56 > 0:24:59Not out of danger yet, Brian still has an anxious wait
0:24:59 > 0:25:03to see if the test results will show any permanent damage.
0:25:14 > 0:25:17Lerwick is the largest town on Shetland.
0:25:17 > 0:25:20The capital of the islands, it has an industrial heart to it,
0:25:20 > 0:25:22the foundation of its fishing heritage.
0:25:24 > 0:25:26But it's not always fish hooks and fisherman coming through
0:25:26 > 0:25:29the doors of the town's hospital.
0:25:29 > 0:25:31Can you feel that at all, is it very painful?
0:25:31 > 0:25:32It's not painful, no.
0:25:32 > 0:25:36In treatment room two, Dr Aideen Carroll and Nurse Thelma
0:25:36 > 0:25:38are having a rather tricky problem with an ear piercing.
0:25:38 > 0:25:41- You can see the opening there, if you...- Yeah.
0:25:41 > 0:25:44You're tolerating that better than you did.
0:25:44 > 0:25:45Yeah, I'm not feeling that.
0:25:49 > 0:25:52I just don't know... It's a ball?
0:25:52 > 0:25:53Yeah.
0:25:56 > 0:26:00Is there a ball on each side? A bit like a tummy piercing?
0:26:00 > 0:26:04Two months ago, local primary school teacher Jennifer had her ear pierced.
0:26:04 > 0:26:07Since then, it's got infected,
0:26:07 > 0:26:09and the skin has grown over the back of the earring.
0:26:11 > 0:26:12It's very close to the surface.
0:26:12 > 0:26:14- OK.- But obviously, because it's a bit...
0:26:14 > 0:26:16it's not a little ball, it's more like a back.
0:26:16 > 0:26:19What I'm going to do is I'm going to have a quick chat with my senior
0:26:19 > 0:26:22about the best way to get it out. It's very close to the surface.
0:26:22 > 0:26:25- Right, OK.- And we'll go from there.
0:26:25 > 0:26:28- OK.- I'll just get things ready for you.
0:26:32 > 0:26:34This lady has had her ear pierced,
0:26:34 > 0:26:36and it's gotten a little bit infected,
0:26:36 > 0:26:39and you can see the area is swollen.
0:26:39 > 0:26:42So, what we need to do is, we need to...
0:26:43 > 0:26:46..reveal that end of the earring
0:26:46 > 0:26:48and then try and remove that end of it
0:26:48 > 0:26:51so we can get the earring out. What we've done so far is,
0:26:51 > 0:26:53we've put some local anaesthetic cream on -
0:26:53 > 0:26:56what we would use when somebody's getting a cannula, Ametop cream,
0:26:56 > 0:26:59to try and numb the area a wee bit for her.
0:26:59 > 0:27:01So we're probably going to need to make a little incision
0:27:01 > 0:27:03to remove the earring.
0:27:03 > 0:27:06Dr Aideen is a third-year junior doctor,
0:27:06 > 0:27:08and although she's fully qualified,
0:27:08 > 0:27:11this type of piercing problem is a first for her.
0:27:12 > 0:27:15As the senior A&E and surgery doctor,
0:27:15 > 0:27:18Kushik Lalla is on hand to support her during the procedure.
0:27:18 > 0:27:21- So, you actually...- So, it's the back end that has embedded itself.
0:27:21 > 0:27:24Exactly. And we can't get it. And the front unscrews,
0:27:24 > 0:27:27- but the back is embedded.- Aha.
0:27:27 > 0:27:31Make a small nick at the back, and then unscrew the front and just...
0:27:31 > 0:27:33- Push it.- Push it out. - That's no nice way to do it, really.
0:27:33 > 0:27:37- I'm just like, this is a bit brutal. - No, there is no nice way to do it.
0:27:38 > 0:27:41It's quite common. We see it every so often.
0:27:41 > 0:27:43Er...
0:27:43 > 0:27:48But it's a fairly common occurrence, this, where earrings get embedded.
0:27:51 > 0:27:56We do see some unusual piercings that go wrong every so often, yeah.
0:28:00 > 0:28:02- Hello.- Hi.- Jennifer.
0:28:02 > 0:28:04- Yes.- Hi there.- Hi.
0:28:04 > 0:28:07Dangers. Dangers of ear piercings, yeah?
0:28:07 > 0:28:09Oh, I've had the lecture from my husband!
0:28:09 > 0:28:10Right. When did you do this?
0:28:10 > 0:28:13- When did I get it pierced?- Yeah. - About six or seven weeks ago.
0:28:15 > 0:28:16Right, OK.
0:28:17 > 0:28:19If you just look at me...
0:28:19 > 0:28:23With Dr Lalla overseeing, it'll be up to junior doctor Aideen
0:28:23 > 0:28:26to perform the procedure for the very first time.
0:28:35 > 0:28:38In Resus, patient Alec has a problem with his heart
0:28:38 > 0:28:42and is preparing to be transferred to the Aberdeen coronary care unit.
0:28:43 > 0:28:46The air ambulance patient transfer service is responsible
0:28:46 > 0:28:49for transporting patients off the island.
0:28:49 > 0:28:53The service is supported by nurses working at the Gilbert Bain.
0:28:53 > 0:28:56It's their job to chaperone patients to hospitals on the mainland.
0:28:56 > 0:29:00But, as always, travelling on and off Shetland brings with it
0:29:00 > 0:29:05weather concerns for Nurse Emma, who'll be travelling with Alec.
0:29:05 > 0:29:08I think the worst weather was over 100mph gales.
0:29:08 > 0:29:11Flying from Sumburgh, and we were like, "Will we go, will we go, will we go?"
0:29:11 > 0:29:14And then eventually there was a break in the wind and we went.
0:29:14 > 0:29:15But it was pretty...
0:29:15 > 0:29:17It wasn't for the faint-hearted, that was for sure.
0:29:17 > 0:29:21It was looking very nice coming up this morning anyway.
0:29:21 > 0:29:23It's actually, the...
0:29:23 > 0:29:26- The sun is just threatening to come through.- Is it?
0:29:26 > 0:29:28Yeah. Hint of blue sky.
0:29:28 > 0:29:30- Good.- So...
0:29:30 > 0:29:33I was going to plant beetroot today, so this has got me out of that!
0:29:35 > 0:29:37Emma, are you going to connect him to your own monitoring
0:29:37 > 0:29:40- or do you want...? - No, I'd like your staff...
0:29:40 > 0:29:42- Do you want us to take it in and connect it?- Yes.
0:29:42 > 0:29:45So we're just on the trolley, all connected up and ready to go,
0:29:45 > 0:29:47- that would be good.- OK.
0:29:48 > 0:29:50To get Alec on the ambulance stretcher,
0:29:50 > 0:29:53the team need to transfer his ECG monitoring.
0:29:54 > 0:29:56That's just if you have any pain,
0:29:56 > 0:30:00then when we can print off a picture and kind of see what's going on.
0:30:00 > 0:30:04- Yeah.- Plus, I've got painkillers in my bag that I can give you, OK?
0:30:04 > 0:30:07- Mm-hm.- OK!- Okey doke.
0:30:08 > 0:30:11Obviously, we're moving him around and things like that,
0:30:11 > 0:30:14and we're putting him under a bit more stress,
0:30:14 > 0:30:16just cos we're going to Aberdeen.
0:30:16 > 0:30:19So, we'd just like to keep a really close eye on this patient.
0:30:19 > 0:30:22So, the nursing and ambulance staff just need to get Alec transferred
0:30:22 > 0:30:25and ready for his journey to Sumburgh airport.
0:30:25 > 0:30:28- Just towards Sam a wee bit, that's it.- OK.
0:30:28 > 0:30:32- How does that feel, Alec, there? - That's good.
0:30:32 > 0:30:34We'll just phone his wife once you leave.
0:30:34 > 0:30:37So she kens? Yeah. So...
0:30:37 > 0:30:41- Inferior...- Inferoposterior MI, being thrombolysed,
0:30:41 > 0:30:47had all the goodies, and been accepted to CCU for probably angios,
0:30:47 > 0:30:50hopefully today. Hopefully, hopefully.
0:30:50 > 0:30:53Before we go, are you still feeling OK, Alec?
0:30:53 > 0:30:55Yeah? Yeah.
0:30:55 > 0:30:57- All the best.- Thank you very much.
0:30:57 > 0:30:59- Thank you.- I'll phone you, ladies.
0:30:59 > 0:31:01- Let us know how you get on, Alec. - Thanks.
0:31:01 > 0:31:03- I'll give you a...- Yeah.
0:31:08 > 0:31:11- Shall we shout to them? - Yeah, let's go.
0:31:11 > 0:31:13Yeah, good, good. Yeah. I've got me kit.
0:31:13 > 0:31:16I actually quite like once you're on the air ambulance cos,
0:31:16 > 0:31:18especially if it's a fine...
0:31:18 > 0:31:20- Yeah, yeah.- It's quite smooth.
0:31:20 > 0:31:24A lot of the bairns that we get in that need to fly out,
0:31:24 > 0:31:27they can... Some of them are a complete handful in A&E,
0:31:27 > 0:31:30and then you get them on the air ambulance and it must be
0:31:30 > 0:31:33- just the hum and the...- Mm-hm. - They have a bit of a...
0:31:33 > 0:31:35and then they just usually fall asleep.
0:31:35 > 0:31:38- But it'll be fine to get you to Aberdeen.- Yeah, yeah.
0:31:38 > 0:31:42And you might be, well, depending how fast when we go in,
0:31:42 > 0:31:45- they might be waiting to tach you. So...- Yeah, yeah.
0:31:45 > 0:31:47Yeah. Sometimes, I think it might even be faster is
0:31:47 > 0:31:51- if you're right on the outskirts of Aberdeen.- Yeah, yeah.
0:31:54 > 0:31:57Sumburgh airport is located in the south of mainland Shetland.
0:31:57 > 0:32:00With the drive to the airport taking 30 minutes,
0:32:00 > 0:32:03there's plenty of time for Emma to keep reassuring Alec
0:32:03 > 0:32:05and put him at his ease.
0:32:05 > 0:32:09If you get your angios, and if the blockage is stentable,
0:32:09 > 0:32:12basically, what it is is,
0:32:12 > 0:32:16kind of inside of a biro, where the ink sits,
0:32:16 > 0:32:18- that's the kind of size that you're looking at.- Mm-hm.
0:32:18 > 0:32:21And it's like a tiny bit of chicken wire,
0:32:21 > 0:32:23that's what it looks like. It's still that they're using.
0:32:23 > 0:32:27And what they do is, they just go in through the arm now,
0:32:27 > 0:32:29and they'll just open that up
0:32:29 > 0:32:31and that'll just sort of squish the blockage.
0:32:31 > 0:32:34Safely on the tarmac at Sumburgh airport,
0:32:34 > 0:32:37Emma and the crew can get Alec on the plane.
0:32:37 > 0:32:39- How are you doing? - Fine, how are you?
0:32:39 > 0:32:42- Haven't seen you for ages!- I know. - I've been cruising around the isles
0:32:42 > 0:32:45in the summer, sorry. Yeah, really fine.
0:32:45 > 0:32:48Blood pressure is still a bit low, but his heartbeat is good.
0:32:48 > 0:32:50He looks well, his colour is good.
0:32:50 > 0:32:53So, yeah, pleased, up until now. So...
0:32:53 > 0:32:55With the sun shining,
0:32:55 > 0:32:58there's no sign of those famous Shetland winds.
0:32:58 > 0:33:02You can imagine what it's like in 100mph winds, pouring with rain.
0:33:03 > 0:33:05Today, it's like luxury.
0:33:08 > 0:33:12With Alec loaded and his wife Marjorie ready to board,
0:33:12 > 0:33:15the first part of the patient transfer is complete.
0:33:15 > 0:33:19The 230-mile flight to Aberdeen will normally take around 45 minutes.
0:33:19 > 0:33:24With engines warmed up and a short taxi for the air ambulance,
0:33:24 > 0:33:27Emma, Alec and the crew can get on their way.
0:33:40 > 0:33:42Commercial fisherman Brian was airlifted
0:33:42 > 0:33:46to the Gilbert Bain Hospital after inhaling poisonous fumes.
0:33:47 > 0:33:50Although stable in Resus, there's still concern that
0:33:50 > 0:33:52the chemicals may have caused long-term damage.
0:33:54 > 0:33:56Brian's ECG results are back.
0:33:56 > 0:33:58Dr Wilson checks them over.
0:33:59 > 0:34:01It looks fine to me, he's not complaining of chest pain,
0:34:01 > 0:34:04so we're not worried about any sort of cardiac event.
0:34:04 > 0:34:09Sometimes chemical abnormalities can cause some abnormalities
0:34:09 > 0:34:12on the ECG reading, but there's no sign of that at the moment.
0:34:12 > 0:34:16But we'll probably have to repeat that to see if there's any changes later on.
0:34:16 > 0:34:21With the ECG looking clear, Brian is now having the last of his tests.
0:34:33 > 0:34:35A chest X-ray will show if the chemical inhalation
0:34:35 > 0:34:38has caused fluid to leak onto his lungs.
0:34:39 > 0:34:41OK, if you breathe in now...
0:34:41 > 0:34:42Hold your breath.
0:34:43 > 0:34:45And breathe away normally again.
0:34:56 > 0:34:58OK. That's you all done.
0:34:59 > 0:35:01With the scans complete and back in Resus,
0:35:01 > 0:35:03Brian is going to be moved onto the ward overnight.
0:35:05 > 0:35:09He'll continue to be monitored, but so far, all the team's
0:35:09 > 0:35:12investigations, including the chest X-ray, have come back satisfactory.
0:35:14 > 0:35:16It's quite likely that he could be discharged tomorrow.
0:35:16 > 0:35:19It depends... If he stays like this, certainly,
0:35:19 > 0:35:21I'm sure he'll be fine to go.
0:35:21 > 0:35:24We'll have a chat with the consultant tomorrow, though,
0:35:24 > 0:35:27just to see whether he wants to do a repeat X-ray, for example,
0:35:27 > 0:35:29or repeat the bloods to see if there's any abnormalities.
0:35:29 > 0:35:32But, clinically, if he remains like this,
0:35:32 > 0:35:34he should be OK to get away tomorrow.
0:35:34 > 0:35:38He's all done and dusted as far as we're concerned,
0:35:38 > 0:35:39so he can just go up to the ward
0:35:39 > 0:35:41and the nurses will observe him overnight up there,
0:35:41 > 0:35:43and keep giving him his fluids, and...
0:35:44 > 0:35:46..hopefully he'll get some sleep.
0:35:46 > 0:35:50With any luck, after a peaceful night's sleep on dry
0:35:50 > 0:35:53land and a few final checks tomorrow, Brian will be free
0:35:53 > 0:35:56to get back to his fishing trawler in the morning.
0:36:06 > 0:36:09In consulting room two, senior doctor Kushik Lalla is supervising
0:36:09 > 0:36:14a delicate and awkward procedure for junior doctor Aideen Carroll.
0:36:15 > 0:36:19Having had a piercing six weeks ago, local primary school teacher
0:36:19 > 0:36:22Jennifer has come in to have it removed,
0:36:22 > 0:36:25after it became infected over the past couple of days.
0:36:25 > 0:36:28What we're going to do is just turn the ear over like that.
0:36:28 > 0:36:30- Mm-hm.- Yeah? And we'll work with it like that.
0:36:30 > 0:36:34- Now, Jennifer, I'm just going to raise you a little bit. So...- OK.
0:36:34 > 0:36:35..don't try rolling off!
0:36:38 > 0:36:40Just go to one side, if you go to the...
0:36:40 > 0:36:45Yeah, down there. And go fairly superficial, so don't point down.
0:36:45 > 0:36:47Yeah.
0:36:47 > 0:36:48OK. A bit stingy now.
0:36:48 > 0:36:50Sharp scratch.
0:36:52 > 0:36:53Go in more. Go in more.
0:36:55 > 0:36:58Don't go deep, go parallel to the skin.
0:36:59 > 0:37:01Lower your needle.
0:37:01 > 0:37:03And come all the way out now.
0:37:03 > 0:37:05- Yeah.- Because she won't feel very much now.
0:37:05 > 0:37:06And then... So...
0:37:08 > 0:37:11..like I said. Yeah, that's a good blood supply. Yep.
0:37:11 > 0:37:16So that will be the ear well anaesthetised now, just in this area.
0:37:16 > 0:37:18Right, so that's the worst of it done.
0:37:18 > 0:37:20OK.
0:37:20 > 0:37:21With the anaesthetic administered,
0:37:21 > 0:37:24it's time for Dr Carroll to start the procedure.
0:37:24 > 0:37:27Single incision. Yeah.
0:37:27 > 0:37:30Go from one edge of the lump to the other.
0:37:30 > 0:37:31- You're doing really well.- Mm-hm.
0:37:31 > 0:37:33Yeah. Keep going, keep going.
0:37:36 > 0:37:37That's it.
0:37:37 > 0:37:39That's it.
0:37:39 > 0:37:40- Sore if I do that?- Yeah.
0:37:40 > 0:37:41Yeah.
0:37:42 > 0:37:45- I'm just putting the local in. - Nice deep breaths.
0:37:47 > 0:37:49You're doing really well.
0:37:51 > 0:37:53So...
0:37:53 > 0:37:56Now that we've got that one controlled here...
0:38:05 > 0:38:06Is it coming off?
0:38:09 > 0:38:11And...
0:38:11 > 0:38:13Put it on the back over here.
0:38:13 > 0:38:14Clip it on.
0:38:16 > 0:38:18Yeah. Clip it.
0:38:18 > 0:38:21Just trying to secure the bit at the back, cos it's not going.
0:38:21 > 0:38:22Yeah.
0:38:34 > 0:38:36Put that over there. Good.
0:38:36 > 0:38:38So, that's the earring out now.
0:38:38 > 0:38:39OK, that's good.
0:38:39 > 0:38:44Give it a clean. Give it a clean and then just squeeze with a dry swab.
0:38:44 > 0:38:47- Mm-hm.- And then... - Just for haemostasis?- Yeah.
0:38:47 > 0:38:51And then Thelma will fashion one of her executive dressings!
0:38:55 > 0:38:58Having eventually unscrewed the earring and removed it,
0:38:58 > 0:39:01Dr Carroll can tick another procedure off the list.
0:39:02 > 0:39:05That was fine, that was your first one.
0:39:05 > 0:39:07- It was tricky. - You know, as time goes on,
0:39:07 > 0:39:11you're just giving the local, make your incision, that's it.
0:39:11 > 0:39:13The tricky bit is actually holding on to both of them...
0:39:13 > 0:39:16- It was holding both of them together and unscrewing them.- ..without it...
0:39:16 > 0:39:22And for Jennifer, it might be some time before she'll be visiting a body piercing studio again.
0:39:22 > 0:39:24Glad it's over.
0:39:24 > 0:39:27I thought getting the piercing was bad enough, but...
0:39:27 > 0:39:29getting it out is even worse!
0:39:40 > 0:39:43In Vidlin, 22 miles north of Lerwick,
0:39:43 > 0:39:46Jan and Pete from Hillswick Animal Sanctuary have been battling
0:39:46 > 0:39:50to save a pilot whale which has become confused and disoriented.
0:39:50 > 0:39:53It's come so far inland
0:39:53 > 0:39:56that we're worried now that it's going to strand.
0:39:56 > 0:40:00They've tried to shepherd the whale out to sea with the help of local boat owners.
0:40:00 > 0:40:03You don't know anyone with a boat that could help us, do you?
0:40:03 > 0:40:05Thanks to a pair of kayakers,
0:40:05 > 0:40:08they've been able to move the whale away from the shore,
0:40:08 > 0:40:10preventing it from beaching itself overnight.
0:40:16 > 0:40:18Have we got a signal...?
0:40:18 > 0:40:19A new dawn.
0:40:19 > 0:40:21No new luck.
0:40:21 > 0:40:23The whale still appears confused.
0:40:23 > 0:40:27We got a phone call at four o'clock this morning to say that
0:40:27 > 0:40:30the whale had stranded on the slipway,
0:40:30 > 0:40:33and when we got here, it was swimming about further in,
0:40:33 > 0:40:36but now it's just doing constant circles.
0:40:36 > 0:40:38They have one boat,
0:40:38 > 0:40:41but Jan isn't convinced it's enough to drive the whale out to sea.
0:40:41 > 0:40:45What we need is more than one boat, preferably three or four,
0:40:45 > 0:40:48to try and get it out into the open sea.
0:40:48 > 0:40:52Because if it carries on just lying here, circling,
0:40:52 > 0:40:54it's not going to be a happy ending.
0:40:54 > 0:40:56And Jan's prayers have been answered.
0:40:56 > 0:40:59A second inflatable boat has arrived.
0:40:59 > 0:41:01A second boat, hooray!
0:41:01 > 0:41:04Whether we'll even manage it with two, I don't know,
0:41:04 > 0:41:07but I know I want to be able to walk away from here saying
0:41:07 > 0:41:09we did everything we could for it.
0:41:09 > 0:41:12The pilot whale rescue team get on the water.
0:41:13 > 0:41:15Here we go.
0:41:15 > 0:41:20But even with two boats, the whale's proving impossible to usher out of the marina.
0:41:23 > 0:41:26Wherever Jan and Pete position the boat, they can't seem
0:41:26 > 0:41:30to guide the whale around the headland and into the open water.
0:41:30 > 0:41:33But to add wind to their sails,
0:41:33 > 0:41:35three local lads appear in a rowing boat,
0:41:35 > 0:41:37and are immediately pressed into service.
0:41:37 > 0:41:39You boys, could you go in the corner
0:41:39 > 0:41:42and try and keep him out of the shallow bit?
0:41:44 > 0:41:47Good lads. Sit there, that's it, sit there.
0:41:47 > 0:41:49Careful, guys.
0:41:49 > 0:41:51Oh, it's coming in again.
0:41:51 > 0:41:54It's a delicate operation.
0:41:55 > 0:41:57Does not want to go out of there.
0:41:57 > 0:42:00The boats are so close to the whale, they're in danger of it
0:42:00 > 0:42:04swimming into a propeller, which could cause a serious injury.
0:42:06 > 0:42:09Off you go, off you go. Off you go.
0:42:12 > 0:42:15Thankfully, with a bit of encouragement...
0:42:15 > 0:42:18- Come on! - ..the whale finally gets the idea.
0:42:20 > 0:42:22Hooray!
0:42:22 > 0:42:25After two days of persuasion,
0:42:25 > 0:42:29now it's just a matter of guiding it back out towards the open water.
0:42:38 > 0:42:40Hooray! Hooray!
0:42:40 > 0:42:44The rescue operation is a success, with the whale safely out to sea.
0:42:50 > 0:42:52Well, we did it!
0:42:55 > 0:42:57After spending the night in Lerwick,
0:42:57 > 0:43:01Brian made it back to his fishing trawler the next day.
0:43:01 > 0:43:05School teacher Jennifer doesn't have any plans for a new ear piercing.
0:43:05 > 0:43:08And after spending eight weeks in Aberdeen Royal Infirmary,
0:43:08 > 0:43:10Alec had a successful triple heart bypass,
0:43:10 > 0:43:13and is now safely back home on Shetland.