Episode 16 Real Rescues


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Episode 16

Nick Knowles and Louise Minchin follow the work of the emergency services. In this episode, a woman falls off her bike and ends up with a serious head injury.


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Today, horror for a mum out on a family bike ride.

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Now a whole team of medics are fighting to save her life.

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Our plan is to give her some medication, get her stable,

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then put her to sleep, take her to hospital, get her head scanned

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to see if there's serious damage.

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A runaway tanker turns upside down, leaking over 1,000 litres

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of hazardous kerosene. But there's a further 5,000 litres

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still inside, and it could explode at any moment.

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Welcome to Real Rescues. This is the Abingdon control room

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for the Thames Valley Police.

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Any kind of emergency can come through to this room.

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They have all the kit they need to deal with 999 calls,

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but we'll see later on how a little local knowledge goes a long way.

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But first, cyclist Caroline has crashed head-first

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over her handlebars deep in the woods.

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She's very distressed, and so badly injured

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that she's unable to speak.

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Medics have driven as close as they can,

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and now they race on foot to help. They know her sudden lack of speech

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could mean a serious brain injury.

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Forced to leave their vehicle behind,

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critical-care doctor Paul Rees

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and his colleague, paramedic Brian Hardy

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are heading off-road to find a patient

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who sounds in a bad way.

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We've been called to some woods near Southampton

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where a mountain biker has come off their bike.

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They've got a head injury and might have significant brain injury,

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so we're going to see what can be done before we get them out.

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Half a mile later, they reach an extremely distressed Caroline.

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She's come off her bike, hitting her head very hard on the ground.

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Ambulance medic Gareth is already there,

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and Caroline's partner Richard is holding her head

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-and attempting to comfort her.

-Caroline, I'm a doctor. Hello.

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SHE MOANS AND WAILS Open your eyes for me.

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Caroline, open your eyes nice and wide.

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How are you feeling? SHE MOANS INCOHERENTLY

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It's sore on that side. That's OK.

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That's something we can... That's something we can fix.

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SHE CONTINUES TO MOAN You're having a job speaking.

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OK. That's all right.

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Incoherent, Caroline can only point to the pain in her face.

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Losing the ability to talk is a sign she could have a brain injury.

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The speech difficulty might be due to swelling or bleeding in the brain,

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in a similar way to a patient having a stroke

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might have some speech difficulties.

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Pressure, bleeding or swelling in the brain could cause the same symptoms.

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With no time to lose, the team get to work.

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Get that attached. Get a line in her and we'll see what we need to do.

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Information from these tests will be vital

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in allowing Paul to decide on the best treatment.

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Can you move this arm for me, squeeze my fingers?

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Is there some weakness there? SHE MOANS INCOHERENTLY

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We're going to lie you flat in a minute,

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give you something to make you feel relaxed and take you to hospital.

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My plan is to get her flat,

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give her some drugs to make her feel less distressed.

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Brian takes temporary control of Caroline's head.

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As she's lowered,

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it's essential her neck and back remain completely straight.

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OK. Well done. SHE MOANS

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Lovely. Do you mind doing that again? You were doing a very good job.

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Just gently support her head.

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It's hard to comprehend how a family day out has ended up like this.

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Earlier, Caroline had set out on her first-ever bike ride

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with Richard and their ten-year-old daughter Cecilia.

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Just ten minutes in, things went badly wrong.

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Behind her, Richard saw it all,

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but could do nothing to stop it happening.

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Just before I was setting off to follow them,

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I heard Caroline sort of shout, "I can't stop."

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Caroline went over the handlebars and landed hard on her face and arm.

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She tried to get up, and said, "Let's go home."

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And after that, that was the last thing that she said.

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Almost immediately she started sort of groaning and wailing,

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and pointing to her arm and her eye and her leg,

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and scratching on the gravel.

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The fact that she wasn't able to talk

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and she was just in this incoherent state,

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was the most worrying thing, yes.

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Two helpful passers-by have taken young Cecilia to one side

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while the team treat her mother.

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This lady's come off her mountain bike and sustained a head injury.

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It's not clear how serious that is. The main problem we're having

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is communicating with her, so we'll get her stable,

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put her to sleep, take her to hospital, get her head scanned

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and see if there's any serious damage.

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To safely get Caroline out of the woods,

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Paul will have to fully anaesthetise her right here, right now.

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It's a procedure that is only attempted in the most serious cases.

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The best way to manage a patient with a head injury

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and with signs of swelling inside their brain

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is to get control of their airway and breathing,

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give them the right amount of oxygen and control their blood pressure,

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and the only way is to give them a general anaesthetic

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and put them onto a breathing machine.

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The air ambulance has also been sent for,

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but the surrounding trees means it has to land some distance away.

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Before he can anaesthetise Caroline, Paul will need the extra hands

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of the helicopter crew.

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Give them a quick ring and ask them to bring monitoring and drugs

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from the helicopter before they leave it. Thanks.

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To put Caroline to sleep, they must first get a line into her vein

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so they can give drugs. Although she can't speak,

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Caroline is managing to communicate with the help of Richard.

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Has she got a lot of pain, ask her.

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SHE CONTINUES TO MOAN

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As Paul administers some fast-acting pain relief,

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the paramedics from the air ambulance arrive.

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Hello, there, my darling. My name's Vicky.

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All right, Caroline. You may feel a little bit queasy.

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OK. Just take some nice deep breaths for us.

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You're doing really well, my darling. Well done.

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The tranquillising effects of the painkiller kick in.

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Soothed, Caroline has stopped groaning and trying to speak.

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She may be calmer on the surface,

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but what's going on inside is still a mystery.

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That really is an example of how important

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critical-care doctors like Paul are.

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He's effectively taking a hospital emergency room out on the road,

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and we'll see the incredible level of treatment he can give Caroline

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in just a few minutes. Louise.

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Kirsten has always managed to shield her son from her epilepsy -

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that is, until the day they were alone together at home

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and she fell on the floor having a fit in front of him.

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Luckily, though, young James had seen an advert on TV

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about dialling 999, so he picks up the phone and makes the call

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that saves her life.

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And remember, this is something he has never seen before.

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Despite that, James now tries very hard

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to do exactly as he's told,

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even resorting to some quite unusual tactics.

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Well, Joan, who is the paramedic who arrived with the ambulance

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is here with us now, as is James and Kirsten.

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James, first of all, well done. That was brilliant.

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Just describe to us a bit about what had been happening that day.

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Um...

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Well, she just went a bit...

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She just stood still and then fell on the floor.

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OK. And what was she doing when she fell on the floor?

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-Shaking.

-Shaking.

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And how did you know to call 999?

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Er, after a stroke advert.

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-So there was a stroke advert on the TV?

-Yeah.

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Brilliant. And what did it show you?

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How did you know it was the right thing to do, to call them?

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-I don't know.

-You don't know. It was brilliant that you knew that.

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We'll come to you in a minute, Kirsten.

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Joan, the fact that he made that call,

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-did he potentially save her life?

-He did, yeah. Yeah.

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He, um... She was in status epilepticus.

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-Which is a very serious...

-It is a serious condition

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where they don't actually recover from the seizure.

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They go back into another seizure and they need medical treatment

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-as quickly as possible.

-Obviously, while he's on the phone,

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-you don't remember any of that.

-No.

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But he'd given you lots of key bits of information.

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-What sort of things did he tell you?

-When we first arrived on scene,

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we like to get as much history about the patient as possible,

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whether there's any conditions she has got.

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He was able to tell us she was epileptic.

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He was able to tell us where she kept her medication,

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which was a great help, able to tell us her name and everything.

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And also importantly, you opened the door for them when they arrived.

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Had you gone and got yourself dressed? What had you been doing?

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Um, I just opened the door in my pyjamas.

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-THEY LAUGH

-He was incredibly well prepared.

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He was. I'm really, really proud of him,

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and he did really, really well, I have to say.

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I... I am just very, very proud of him.

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And you were in a really serious situation, weren't you?

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-So very lucky that he managed to do what he did.

-Yes.

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Yes. Um... I have to say thank you to Joan,

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and I have to say that it was unusual

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for him to be left alone with me,

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and what he did was pretty incredible,

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and I'm just very pleased he did the right thing, really.

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-And...I don't know.

-And proud as well.

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What's it like for you to see Kirsten?

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When she was in the ambulance, the situation was quite different.

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It's been really good to actually find out that she's recovered

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-and that she's doing well now.

-Brilliant. Thank you very much.

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-I know you want to thank the Epilepsy Society as well.

-I do.

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They've given you lots of help. James, well done.

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Thank you very much.

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It's amazing. Time and time again, we find out

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children are capable of so much more than we think.

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What an amazing little boy that is! Moving on, a tanker has turned over

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in a country lane, its load of kerosene flooding the road.

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It could cause a huge fire and pollute the local water supply.

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A call goes out to the emergency services.

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Police and fire crews are streaming towards the village

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of East Meon. They have a messy situation on their hands.

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On its side, a fuel tanker is completely blocking a country lane.

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It rolled down the hill after the driver jumped out of the cab

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without applying the parking brake.

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The impact has also caused its main tank to rupture,

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and the kerosene it was carrying is spilling out.

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Thankfully nobody has been hurt, but to make sure it stays that way,

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fire crews, including group manager Al Murray,

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need to deal with the truck's dangerous cargo,

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which continues to flow down the road.

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It was leaking kerosene out of the lid at the top of the tanker.

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Because it was on its side, the lids were supposed to shut off,

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but this lid didn't, and it is explosive in large amounts,

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and it's the vapours that can ignite. It would create quite a big fireball.

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Time for some extra protection.

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It's not the most fetching get-up,

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but these biohazard suits will allow the firefighters

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to get close enough to try and stem the flow of the fuel.

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The chemical suits were worn because the fuel oil can be toxic

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to a certain extent, if it's in high volumes,

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so it can affect your breathing, and if it's on your skin,

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it is an irritant as well.

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As well as the fear of combustion,

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the fire crews are aiming to prevent an environmental disaster.

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If the fuel got into the soil, it would get into the water courses,

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and that is the drinking water for the people in that area.

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But also there was the issue of local fisheries

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about half a mile down the road, and the water for the fisheries

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is also fed from the underground water courses.

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The two firefighters have filled in the leak on the truck,

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and, at the lower end of the cordoned-off road,

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PC Gerry Lyon is hopeful that the spread of the kerosene

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has been curtailed.

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Basically they lost about a thousand litres of fuel,

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which has now come down the hill and is collecting at its base.

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Luckily, with the lanes and the hedges

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and burn on the side, it's actually kept on the road,

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so there's no drains that we're aware of at the moment.

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So it's currently contained, and they have stopped the leaking.

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But there's still a lot of fuel inside and outside the tanker.

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Effectively it's a bomb waiting to go off,

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so they can't take any chances. With the aid of the police helicopter,

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Sergeant Paul Diamond has been coordinating the operation

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to evacuate local residents.

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These aerial photographs show the size of the area

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affected by the accident.

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At the moment we're just waiting for the experts who've turned up

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to assess what they're going to do with the vehicle,

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how they're going to get the material, product out,

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how they're going to do that without impacting on the environment any more

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than has happened at the moment.

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The stricken tanker has lost a quarter of its load,

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but there's another 5,000 litres of flammable fuel

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left inside. Any sparks created by trying to move the vehicle

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could potentially ignite it.

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They'll tell you how the rescue's going to be implemented,

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because if they've got to drag it,

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they're looking at vapours and sparks and...

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To solve the problem, the oil company send in a special vehicle

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to remove the fuel.

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Looking at where the vehicle's located

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and how difficult it is to get it out,

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they're going to cut some holes in the side,

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which is now the top of the tanker, and decant the product

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out through the top, which is the safest method of getting it.

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As darkness draws in, the expert team carefully siphon the fuel out

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of the damaged tank and into a new one,

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while out of sight, further down the road,

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fire crews soak up the fuel with special pads and pumps.

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We have got a list of how much is in each tank.

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About 3,000 in the other tanks, I think,

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so it should take a little less time,

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but they need to drill again just to depressurise it.

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A few hours later the job is done,

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and the vehicle-recovery team can move in to shift the tanker.

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Basically all we need to do now is get it righted.

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Not a problem.

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Using the powerful hydraulic crane,

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they meticulously lift and twist the truck inch by inch,

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until it's the right way up.

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The tanker's now back on its wheels,

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and the Highways will keep the road shut till the morning

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till a further investigation can be made,

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so from our point of view, we're making up and going now.

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Late evening, and the now-empty tanker can be towed away.

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It's taken all day to sort out the mess,

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but finally local residents can get back to their homes

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and back to normal.

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A delicate and very lengthy operation,

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but fortunately a complete success.

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Still to come on Real Rescues,

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taking the emergency department out on the road.

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Dr Paul Rees gives cyclist Caroline intensive medical treatment

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right where she fell, buying crucial time

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before the journey to hospital.

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Once they decided to anaesthetise her,

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I realised that it was a fairly serious situation.

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And paramedic Chris is treating a broken ankle,

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but his patient becomes hysterical. This will take some tough love.

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SHE MOANS AND WAILS

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Frankie? Right, Frankie, listen to me.

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Listen. Put your arms down. Listen. Calm yourself down. OK?

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The operators here all have the latest maps and technology

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to locate people, but sometimes just a little bit of local knowledge

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and quick thinking can make all the difference,

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and Lyn has had a call like that from a man who was fitting

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near a churchyard, as far as you knew.

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-And what did he tell you?

-All the information we had

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was that a male was fitting in a church in Banbury,

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so I put "church" into my computer,

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and that came up with six pages, a hundred items.

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So you then need to use your local knowledge.

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So I had his phone number. I rang him.

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Immediately I knew that he'd been away from home for 50 minutes.

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Just trying to gauge how far he'd been able to walk.

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He didn't have his medication.

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All he could see was a clock that was lit up.

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-That's not terribly helpful.

-No. A clock that was lit up.

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I ascertained from him, did he think that he was still in Banbury.

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He told me where he was going to. Working on the local knowledge,

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and he was still in Banbury, I believed it to be St Mary's Church

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in Horsefair, and where he could see, I suppose, it lit up,

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would be to the west of Banbury Cross.

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And this is because you live near here?

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Yes. I know the area. And he gave me one vital bit of information,

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that he could see "For sale, to let, with 20 parking spaces",

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and within Banbury town centre that's very limited,

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so I knew it would be off West Bar Street,

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so the units in between were directed, put their sirens on,

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and I was listening through the mobile phone,

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and we found him laid on the ground behind the veterinary surgery.

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And that's just because you know the area so well

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-that you can guess where it is.

-Yes. Mmm. Yeah.

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-Brilliant. I understand you got a commendation for it.

-Yes, I did.

0:20:190:20:22

-Congratulations.

-Thank you.

-Thank you.

0:20:220:20:25

Now, back to the woods near Southampton

0:20:250:20:28

where medics are treating a cyclist who has a serious head injury.

0:20:280:20:31

They need to give her a general anaesthetic,

0:20:310:20:34

something normally only done in a hospital,

0:20:340:20:36

not on a path in the woods.

0:20:360:20:39

Led by critical-care doctor Paul Rees,

0:20:400:20:43

a group of highly skilled medics from air and ground ambulances

0:20:430:20:47

are now treating Caroline in the middle of the wood.

0:20:470:20:50

They've been joined by an off-duty A&E nurse, Alan Charter,

0:20:500:20:53

-who lives nearby.

-Keep your head nice and still.

0:20:530:20:56

Caroline is a lot calmer now the painkilling drugs have kicked in,

0:20:560:21:00

and that's a comfort for her partner Richard.

0:21:000:21:03

As soon as the pain relief came, and I could see she was free of pain,

0:21:030:21:07

that was when the kind of relief to me came,

0:21:070:21:10

because I knew that then she was no longer in distress.

0:21:100:21:13

A local fire crew has cut through a locked gate

0:21:140:21:18

to allow an ambulance access to the forest.

0:21:180:21:21

Keep you nice and still. Nice and still, that's right.

0:21:210:21:25

At this stage it's impossible to know

0:21:250:21:27

just how serious a brain injury Caroline may have suffered.

0:21:270:21:30

The safest thing to do is treat her as though she has,

0:21:300:21:33

and put her to sleep so we can take control of her breathing,

0:21:330:21:36

optimise the flow of oxygen to her brain,

0:21:360:21:38

get her circulation how we want it and get her off to hospital,

0:21:380:21:41

where we can scan her brain.

0:21:410:21:43

Caroline is still conscious, but the drugs have eased her pain.

0:21:430:21:48

They're now getting everything in place ready to anaesthetise her.

0:21:480:21:52

It's something that would normally only be done in hospital.

0:21:520:21:55

The procedure has three main phases. First you get the patient prepared,

0:21:550:21:59

getting plenty of oxygen into the patient,

0:21:590:22:01

making sure you've got access to the circulation by means of drips

0:22:010:22:05

so you can give fluid and drugs. The second phase is giving anaesthetic,

0:22:050:22:09

a dose of anaesthetic drug into the vein,

0:22:090:22:11

followed by a muscle relaxant to make the muscles go floppy

0:22:110:22:14

and allow us access to the airway. We then put a tube into the windpipe

0:22:140:22:18

and get control of the breathing. Once the tube is in,

0:22:180:22:21

the third phase is making the patient stable enough to move,

0:22:210:22:24

and then off to hospital.

0:22:240:22:27

Richard is just grateful the medics reached her in time.

0:22:270:22:31

Once they decided to anaesthetise her,

0:22:310:22:34

I realised that it was a fairly serious situation.

0:22:340:22:38

But in terms of my own feelings,

0:22:380:22:41

I was happy that these guys knew what they were doing,

0:22:410:22:45

and that Caroline was in good hands.

0:22:450:22:47

OK, ready, steady, lift.

0:22:470:22:50

That's it. And ready, steady, move.

0:22:500:22:52

With Caroline on a stretcher, Paul briefs everyone on their role

0:22:560:22:59

in this delicate operation to give her a general anaesthetic.

0:22:590:23:03

Here, Brian. Come round here. If you just do the head from there.

0:23:030:23:06

-Immobilise the neck, Vicky.

-All right, Caroline.

0:23:060:23:09

Just relax, my darling. It's just a mask on your mouth

0:23:090:23:12

just to help with your breathing, OK?

0:23:120:23:14

Once we've given the muscle relaxant,

0:23:140:23:16

the patient will stop breathing by themselves.

0:23:160:23:19

We get access to the airway, put the tube in,

0:23:190:23:21

make sure it's in the right place, secure it properly

0:23:210:23:24

and take over breathing for them.

0:23:240:23:27

You got it? Good. Everybody else stay in position.

0:23:290:23:32

Thanks. 24. That's fine. Everybody else stay put.

0:23:320:23:36

Lovely. And take the CO2.

0:23:360:23:38

The tube has been successfully inserted down Caroline's throat.

0:23:380:23:42

Now he's in sole control of her breathing,

0:23:420:23:45

Paul has to press the bag 12 times every minute

0:23:450:23:48

to provide her with air.

0:23:480:23:50

What we're doing is giving her a chemically induced coma,

0:23:500:23:54

stopping the clock, allowing us some time to stabilise her,

0:23:540:23:57

get her to hospital, establish what her injuries are,

0:23:570:24:00

then get her definitive surgical treatment for those.

0:24:000:24:03

Paramedic Vicky will travel by road ambulance with Paul

0:24:080:24:11

to help monitor Caroline's condition.

0:24:110:24:14

On the way, they alert A&E

0:24:140:24:16

that they're bringing in a very serious trauma case.

0:24:160:24:19

We've got a 40-year-old female who's got a blunt head injury

0:24:190:24:23

following a fall in some woods.

0:24:230:24:25

We're about 20 minutes out from the hospital.

0:24:250:24:28

She's GCS 12, some right-sided facial weakness,

0:24:280:24:31

right-sided facial injuries, so she's been RSI'd,

0:24:310:24:35

intubated and ventilated.

0:24:350:24:36

'I've handed Caroline over to the emergency-department team.'

0:24:430:24:46

They're stabilising her, and the intensive-care team have come down

0:24:460:24:50

to take her to the CT scanner for a brain scan.

0:24:500:24:52

If anything there needs an operation,

0:24:520:24:55

she'll go straight from the scanner to fix that,

0:24:550:24:57

and if not, she'll go up to ICU where they'll look after her.

0:24:570:25:01

Inside, Richard must wait to find out what the brain scans will show.

0:25:010:25:06

A brain swelling and bleed could mean an injury

0:25:060:25:09

that Caroline may never fully recover from.

0:25:090:25:12

Richard can recall the consultant's warning.

0:25:120:25:15

I remember his comment quite strongly,

0:25:150:25:17

that "this will be the longest 24 hours of your life".

0:25:170:25:20

And I'm pleased to say that Caroline is well enough to join us here

0:25:220:25:26

to talk about that fateful day.

0:25:260:25:29

You were quite emotional, watching that.

0:25:290:25:31

Yes, very emotional. Very, very.

0:25:310:25:34

It was a very frightening thing at the time.

0:25:340:25:36

Looking back on it now, it's awoken all those feelings again.

0:25:360:25:40

Things I can't remember at all, so to watch it again

0:25:400:25:45

-is just a bit scary.

-Yes, I'm sure it is.

0:25:450:25:48

Um, er... Now, can we ask how you're feeling now,

0:25:480:25:52

because you've made an amazing recovery,

0:25:520:25:54

given the seriousness of the injury that you had.

0:25:540:25:57

But there are still a few problems.

0:25:570:25:59

Yes, I do. I have... My throat. I can't actually talk properly,

0:25:590:26:03

but this will go eventually, so...

0:26:030:26:06

It's not hurting you to talk to us now, is it?

0:26:060:26:09

It's fine, as long as you can hear me.

0:26:090:26:12

We can hear you very well. You're doing very well.

0:26:120:26:14

-And you have problem with one of your eyes?

-Yes,

0:26:140:26:18

but in time it will recover.

0:26:180:26:20

-Have you got no sight, or some?

-A little bit of sight.

0:26:200:26:23

A little bit of sight. Richard, emotional watching that back.

0:26:230:26:27

Both of you finding it emotional, that day.

0:26:270:26:29

Difficult to... You said in the film

0:26:290:26:32

that you felt confident because they were so good at their jobs,

0:26:320:26:35

but there is a feeling of helplessness.

0:26:350:26:38

There is, but as I said in the film, you're in expert hands.

0:26:380:26:43

The people are there looking after Caroline,

0:26:430:26:46

and that kind of gives you confidence

0:26:460:26:48

that everything that can go wrong has already gone wrong,

0:26:480:26:52

and from that point on everything can just get better.

0:26:520:26:54

Let's move forward. Let's think in positive terms as well,

0:26:540:26:58

because the people who looked after you were amazing.

0:26:580:27:01

-This is not the first time that we've met.

-No.

0:27:010:27:03

-I met you nine and a half years ago.

-When I was pregnant with Cecilia.

0:27:030:27:08

And here it is. Let me show you this.

0:27:080:27:11

I'm coming round this side to introduce you to Caroline

0:27:110:27:14

and Sue of course, Sue Marshall. Morning. How are you?

0:27:140:27:17

-Not bad.

-Can we have a listen to your baby as well?

0:27:170:27:20

-Yeah, you can.

-Listen.

-HEARTBEAT PULSES OVER MONITOR

0:27:200:27:23

Extraordinary!

0:27:230:27:25

On City Hospital, I met you when you were suffering with pre-eclampsia,

0:27:250:27:28

and we were all very worried about whether the baby was going to be OK.

0:27:280:27:32

Would you like to meet the baby? Come in, Cecilia.

0:27:320:27:35

Come and join us over here. This is Cecilia, who's now...

0:27:350:27:39

Let's show you a picture of you when you were little.

0:27:390:27:41

-There we go. That's you!

-Oh, you're sweet.

0:27:410:27:46

Amazing. Mother and baby. You guys look great.

0:27:460:27:49

I looked a lot younger. What happened to me in nine years?

0:27:490:27:53

-Look how big I was, though!

-Really?

-I was three times bigger then.

0:27:530:27:57

Cycling has become a bit of a family thing.

0:27:570:28:00

-Will you be doing it again?

-Definitely not.

0:28:000:28:03

-Definitely not.

-Definitely not more cycling.

0:28:030:28:05

-How about horse-riding?

-I did fall, so definitely not.

0:28:050:28:09

-You've fallen off a horse as well?

-Yes.

0:28:090:28:12

Obviously on foot is the only way forward.

0:28:120:28:14

-Yes?

-Oh, I may try car races,

0:28:140:28:18

so I'll keep on my car and walking.

0:28:180:28:22

Thanks. Nice to meet you, Cecilia. We never got to talk before.

0:28:220:28:26

-No.

-All right. Thanks.

-Thank you.

0:28:260:28:28

Rescuing a trapped horse is often dangerous for the horse,

0:28:280:28:32

but more so for the crews trying to help.

0:28:320:28:34

On this callout for the animal-rescue specialists,

0:28:340:28:36

there's an added complication, because it soon becomes clear

0:28:360:28:40

that this horse is heavily pregnant.

0:28:400:28:42

This pony's distress is clearly visible.

0:28:420:28:46

She's shaking and soaked to the skin.

0:28:460:28:49

No-one knows how she ended up in this newly dug clay pit,

0:28:490:28:53

or how long she's been there.

0:28:530:28:55

It could have been all night.

0:28:560:28:58

West Sussex Fire Service have been called in to try and get her out.

0:29:000:29:03

First consideration is always the simplest method.

0:29:050:29:08

Is it possible to, say, dig out one side of the hole

0:29:080:29:11

so that we can simply lead the horse out?

0:29:110:29:14

Although there was an excavator on site

0:29:140:29:16

that had been used to dig the hole, the size of the hole meant

0:29:160:29:19

bringing the excavator bucket in very close to the horse.

0:29:190:29:22

The pony's called Poppy, and there's every chance

0:29:220:29:25

the attempt to get her out will distress her further.

0:29:250:29:28

The West Sussex team have had to call on their Hampshire neighbours

0:29:280:29:32

who will arrive with their specially adapted crane

0:29:320:29:35

to try and lift Poppy onto dry land.

0:29:350:29:37

The pony seems very calm now, but a lot is about to happen,

0:29:370:29:42

and she could easily get stressed and kick out.

0:29:420:29:45

She'll need to be sedated to make her safe to work around.

0:29:450:29:48

Vet Stuart Wallis needs to get very close

0:29:480:29:52

to inject right into a vein.

0:29:520:29:54

'I climbed down into the water, and she gave a little bit of a...'

0:29:540:29:57

She looked like she wanted to climb out of the ditch,

0:29:570:30:00

and I was worried I might get squashed,

0:30:000:30:03

but she settled very quickly and allowed me to clean her neck

0:30:030:30:06

and get the injection in.

0:30:060:30:08

It's impossible for Stuart to examine Poppy's legs

0:30:080:30:12

under the water, so he's also giving her some painkiller

0:30:120:30:15

in case she injured herself when she fell.

0:30:150:30:18

By now Poppy's owner has been contacted,

0:30:180:30:21

and there's a complication. This mare is pregnant,

0:30:210:30:24

with just over a month to go.

0:30:240:30:26

Luckily the drugs she's been given so far

0:30:260:30:28

are no danger to the unborn foal.

0:30:280:30:31

But the fire crews will have to be very careful

0:30:340:30:37

how they place the lifting straps around her.

0:30:370:30:40

There are only two positions you can safely hold a horse,

0:30:400:30:44

and one is to put the strap in underneath the armpits,

0:30:440:30:47

so the very front of the chest, and the second is as far back

0:30:470:30:50

near the hips as you possibly can, and in those two positions,

0:30:500:30:53

you don't cause any undue compression of the abdomen or the chest.

0:30:530:30:57

The clay in the water will make it difficult to use their usual tools

0:30:570:31:01

to guide the strops into position,

0:31:010:31:03

but luckily they've got the long arm of the fire service on their side.

0:31:030:31:07

Mick, very tall guy, very long arms,

0:31:070:31:10

was able to safely get in quite close to where the horse was,

0:31:100:31:14

and actually use his hands to pass the strops underneath the horse

0:31:140:31:18

and get them in place that way.

0:31:180:31:20

Just extend it.

0:31:220:31:24

Strops in place, the crane can now be brought close

0:31:240:31:27

and attached ready for the lift.

0:31:270:31:29

It's a tense moment as Poppy starts to come up.

0:31:330:31:36

'The difficulty comes as soon as you start to lift.'

0:31:360:31:39

There's a tendency for the straps to slip.

0:31:390:31:42

The rigid yellow bar should help keep Poppy balanced

0:31:420:31:46

as she's lifted high over the bushes,

0:31:460:31:48

and despite being almost 15 feet in the air,

0:31:480:31:51

remarkably there's no sign of panic from this mum-to-be.

0:31:510:31:55

It's the first chance Stuart has had to examine Poppy's legs.

0:31:550:31:58

If they're injured and she can't stand,

0:31:580:32:00

she could just crash to the floor when she's released.

0:32:000:32:03

The last thing I wanted her to do was either fall over

0:32:030:32:06

or half lie down, then try and stand up and cause herself more harm.

0:32:060:32:12

And also I was concerned that, although the straps are OK,

0:32:120:32:15

they are putting pressure on where the foal is,

0:32:150:32:18

and we don't want to have too much pressure on there for too long.

0:32:180:32:21

'So we just paused her there for a couple of seconds.

0:32:210:32:24

'She showed no inclination to want to take her weight whatsoever.

0:32:240:32:27

'Looking at her head and eye, she was still very sleepy and placid.'

0:32:270:32:31

He finds no sign of serious leg injuries,

0:32:330:32:36

but Poppy doesn't seem to want to support herself.

0:32:360:32:39

Er, no. Right down, right down. Right down.

0:32:390:32:43

So Stuart decides it's safest to lie her down.

0:32:430:32:46

'She was very cold in her extremities, her nose and ears.'

0:32:460:32:50

So at that point I was thinking about things

0:32:500:32:52

that we now needed to do to resuscitate her,

0:32:520:32:56

because if she showed no inclination to try and stand

0:32:560:32:59

after about 15 to 20 minutes, then it was going to be hypothermia

0:32:590:33:03

that was stopping her from wanting to fully recover.

0:33:030:33:06

The next few hours will be critical for Poppy and her unborn foal.

0:33:100:33:14

She'll be rubbed down and kept warm,

0:33:140:33:16

but she will need to get back on her feet

0:33:160:33:19

if she and the foal are to have a chance of survival.

0:33:190:33:23

And if you're wondering how Poppy is now,

0:33:230:33:26

she's a very proud mum

0:33:260:33:28

with a fit and healthy foal.

0:33:280:33:30

Ahh! Now, moving on -

0:33:330:33:34

Thames Valley Police cover 196 miles of motorway,

0:33:340:33:37

more than any other force. This is Inspector Pete Edwards.

0:33:370:33:40

He's the one in control when there's a major incident.

0:33:400:33:43

We've noticed, when an incident kicks off in a control room,

0:33:430:33:47

-there's a sudden change in atmosphere.

-That's correct.

0:33:470:33:50

Say, for example... Let's pick an incident between junctions 10 and 11

0:33:500:33:54

on the M4, which you can see behind us here.

0:33:540:33:56

A big articulated lorry has gone across the central reservation,

0:33:560:34:00

and 30, 40 cars were involved. What's the first indication you get?

0:34:000:34:03

The first indication is a screen up there on the wall

0:34:030:34:06

which indicates when calls are starting to come in on the 3-9,

0:34:060:34:10

-emergency calls.

-Zero means nobody's waiting at the moment.

0:34:100:34:13

-That'll bounce up - what? Ten, 15 calls?

-Absolutely.

0:34:130:34:16

You'll soon see that change. We're next to some call-takers here.

0:34:160:34:20

You'll soon hear the chatter as they type the keyboards,

0:34:200:34:23

take details from the people reporting an emergency,

0:34:230:34:26

and whilst they're taking those details,

0:34:260:34:29

this will get moved over to the operators on the motorway desk.

0:34:290:34:34

So you've got them taking details of an incident here,

0:34:340:34:38

and they'll read the details of the incident

0:34:380:34:40

and start to call up roads-policing officers close to that location.

0:34:400:34:44

They'll see the maps and send people there as quickly as possible.

0:34:440:34:48

And you want to get a look at it as soon as possible.

0:34:480:34:50

They can use the cameras, which are all over the motorway.

0:34:500:34:53

Would you look to see if you could get a helicopter up?

0:34:530:34:57

There's a whole host of things, including the helicopter.

0:34:570:35:00

We'll inform people from all different services -

0:35:000:35:03

ambulance, fire service, Highways Agency,

0:35:030:35:05

who work on the same channel as us, so we'll inform them.

0:35:050:35:08

Myself, when I'm situated in the corner of the control room...

0:35:080:35:12

That's the inspector's desk. You've got your own feed for pictures.

0:35:120:35:16

There's an empty desk. I've always wondered what goes on here.

0:35:160:35:19

It's reserved for when we have a major incident,

0:35:190:35:22

so you start to have people move from other locations,

0:35:220:35:25

to have an incident channel to deal with it.

0:35:250:35:27

That's what happens. The place comes to life

0:35:270:35:30

-the moment something comes in. Thank you very much.

-Thank you.

0:35:300:35:34

I'm in the custody suite a couple of floors below Nick right now,

0:35:350:35:39

with Inspector Mary Cooper, who's in charge.

0:35:390:35:42

-And you've got about 30 cells.

-Correct, yeah.

0:35:420:35:44

You run this now, but you've had to rescue people

0:35:440:35:47

-before you arrested them.

-Yes, and I think that's quite common.

0:35:470:35:51

When I was a sergeant, we had an incident

0:35:510:35:54

whereby some offenders did what's known as a vamoose burglary.

0:35:540:35:58

A vamoose burglary? What did they do?

0:35:580:36:00

At the same time as burgling the house

0:36:000:36:03

they stole the car. And we had intelligence.

0:36:030:36:06

-We suspected who it might be, so we...

-Did a stakeout.

0:36:060:36:09

-Exactly.

-Found them, and they all ran off in different directions.

0:36:090:36:13

Exactly. And myself and my team, we followed different groups,

0:36:130:36:18

and myself and the dog handler followed one along the canal bank,

0:36:180:36:22

and he disappeared. And we were sort of almost giving up,

0:36:220:36:27

and then we heard some cries, and he'd actually jumped into the canal.

0:36:270:36:30

So you've got to pull him out, I guess.

0:36:300:36:33

Well, yes, because it was very cold, it was deep, and he couldn't swim,

0:36:330:36:37

so he was actually struggling. So first of all we got him out,

0:36:370:36:41

then obviously the ambulance attended and confirmed he was OK,

0:36:410:36:45

-and then he was arrested.

-Thank you very much!

0:36:450:36:48

Things have moved on since you first started here.

0:36:480:36:51

This is called the documentation room. Beth is in here.

0:36:510:36:54

When Mary first started, this is how they used to do fingerprints,

0:36:540:36:58

on a piece of paper, but you don't do that any more.

0:36:580:37:01

-No.

-Very sophisticated computer.

0:37:010:37:03

A little bit earlier you took my fingerprints.

0:37:030:37:06

What I'm interested in, you took the sides of my hand, didn't you?

0:37:060:37:09

You can see them here. Why did you do that?

0:37:090:37:12

That part of the hand is what I call peeping-Tom hands.

0:37:120:37:15

That part is what's left on the glass if somebody's looking in.

0:37:150:37:19

-It sounds silly, but it's incredibly useful.

-Yes.

0:37:190:37:22

Brilliant. Thank you. I hope you're going to take them off the computer!

0:37:220:37:26

-Yes.

-OK.

0:37:260:37:28

A case of tough love now.

0:37:280:37:30

17-year-old Frankie has a minor injury,

0:37:300:37:33

but it very quickly gets too much for her.

0:37:330:37:35

Some stern words are going to be needed to talk her round.

0:37:350:37:39

Paramedic Chris Kirby is taking details from Control

0:37:410:37:44

about a teenage girl who's fallen over.

0:37:440:37:47

Do you want us to go on red, if she's in that much pain? OK.

0:37:470:37:51

Technician Jason Harrap gets going on blue lights.

0:37:510:37:54

SIREN WAILS

0:37:540:37:57

The girl's in a lot of pain with her ankle.

0:37:570:38:00

They need to get there quickly to make sure there's no threat to her foot.

0:38:000:38:03

Looks like the second left past the college.

0:38:030:38:06

They find Frankie crumpled on the pavement

0:38:100:38:13

in the care of a police community officer.

0:38:130:38:15

-When you fell, you didn't bang your head or anything?

-No.

0:38:150:38:19

And the reason you fell over was mechanical, was it?

0:38:190:38:22

-I don't know. I...

-You tripped over that. OK.

0:38:220:38:25

Where's most of the pain?

0:38:250:38:27

Right down at the bottom. Any pains in your knee at all?

0:38:270:38:31

I'm just going to feel down your leg. You tell me where the pain starts.

0:38:310:38:35

-Just say "now".

-There.

0:38:350:38:37

-On that bit?

-Yeah.

-OK. All right.

0:38:370:38:40

-The 17 year old is very upset.

-I have phoned her mum.

0:38:400:38:44

Her mum is aware. She will meet her at the hospital.

0:38:440:38:48

Right. OK.

0:38:480:38:49

Frankie is scoring her pain highly, putting it at nine out of ten.

0:38:490:38:53

To make her more comfortable, Chris administers gas and air.

0:38:530:38:56

Breathe through the tube, deep into your lungs.

0:38:560:38:58

But breathe normally, OK? Don't hyperventilate.

0:38:580:39:01

And slowly out through your nose. Big breath down.

0:39:010:39:04

That's going to make you feel a little bit wobbly,

0:39:040:39:07

but it'll take the edge off the pain you've got in your leg.

0:39:070:39:10

The next step is getting her on the trolley.

0:39:100:39:13

One, two, three... OK. Lovely.

0:39:130:39:15

Lovely. There we are.

0:39:150:39:18

Once she's up, the effect of the gas suddenly leads to a change in mood.

0:39:180:39:22

-My trousers!

-SHE LAUGHS

0:39:220:39:25

-OK. You got her?

-Hop to the left.

0:39:260:39:28

We can't hold you here. That's it, love.

0:39:280:39:31

Well done.

0:39:310:39:33

Has that taken the edge off any of the pain? It has? Good girl.

0:39:330:39:37

In the ambulance, Chris takes a closer look at the ankle.

0:39:370:39:40

Well done. Brilliant. Keep going, darling.

0:39:400:39:44

Keep going. SHE SOBS

0:39:440:39:46

Right. Just drop your leg down for me.

0:39:460:39:49

It's swollen, and will need X-rays at the hospital.

0:39:490:39:53

But it's Frankie's reaction which is worrying Chris more.

0:39:530:39:57

-I want my mum!

-I know you do, hon.

0:39:570:39:59

SHE SOBS Frankie, listen, darlin'.

0:39:590:40:01

You're quite safe, all right? You're quite safe.

0:40:010:40:05

The influence of the gas, and the shock of the pain,

0:40:050:40:07

is becoming too much for her. She's getting overwrought.

0:40:070:40:11

-A little tough love is required.

-SHE WAILS

0:40:110:40:14

Frankie? Right. Frankie? Listen to me.

0:40:140:40:16

Listen. Put your arms down. Right. Listen. Calm yourself down.

0:40:160:40:21

-OK.

-Mm-hm!

0:40:210:40:22

All you've done, all right, is at very most...

0:40:220:40:25

done a small fracture in your ankle, at very least a sprain. All right?

0:40:250:40:28

-OK.

-There's no need to get yourself worked up

0:40:280:40:31

to the point where you go hysterical. You're quite safe.

0:40:310:40:35

You're in a nice warm ambulance. Nobody's going to hurt you.

0:40:350:40:38

OK? We're here to look after you, OK?

0:40:380:40:40

You couldn't be anywhere safer than where you are now.

0:40:400:40:43

All right? Mum's going to meet us at the hospital.

0:40:430:40:46

All right? She'll be there to help you.

0:40:460:40:49

It seems to do the trick. Jason gives her some more painkillers

0:40:490:40:53

while Chris puts the ankle in a splint.

0:40:530:40:55

This is going to support your leg, so when it's moving around

0:40:550:40:59

-when we're driving, it won't hurt.

-All right?

0:40:590:41:02

At very most, all right, like I said, it could be a tiny fracture.

0:41:020:41:06

But you're moving it, all right, which is all good signs.

0:41:080:41:11

Moments later, and Frankie is much more relaxed.

0:41:140:41:17

The painkillers and Chris's jokes turn her tears to laughter.

0:41:170:41:20

Can I take my hair clip out, because it's really...

0:41:200:41:23

Jason will do your hair if you want. He used to be a hairdresser.

0:41:230:41:27

-SHE LAUGHS

-What did you say that for?

0:41:270:41:30

We can make some money on the side. Just go with it.

0:41:300:41:33

She's under the Entonox. She won't know the difference.

0:41:330:41:36

I promise you we really are ambulance people.

0:41:380:41:41

-How much pain are you in now?

-Hardly any.

0:41:410:41:44

-So we're doing our job right, are we?

-Yeah.

0:41:440:41:47

Are you sure you don't want your hair doing?

0:41:480:41:51

Jason sets off for the hospital. Chris keeps Frankie entertained

0:41:510:41:55

as he fills out the paperwork.

0:41:550:41:58

So, you were walking along. How fast to you think you were going?

0:41:580:42:01

Oh, no. That's a car accident. You were walking.

0:42:010:42:04

That's fine.

0:42:040:42:07

By the time they reach the hospital, Frankie is revived from her ordeal.

0:42:080:42:12

You hate hospitals? So do we, and they keep making us come back here!

0:42:120:42:17

THEY LAUGH

0:42:170:42:19

She's survived the accident as well as the onslaught of jokes.

0:42:190:42:23

Chris is confident her stay at hospital will be a short one.

0:42:230:42:26

Fingers crossed it is just a sprain.

0:42:260:42:29

If not, and it's a fracture, she'll be plastered,

0:42:290:42:33

but she'll certainly be going home today.

0:42:330:42:36

That shows that it's not just their medical skills, is it?

0:42:360:42:40

-It's their personal skills.

-Very calm and kind, aren't they?

0:42:400:42:43

-Join us next time for more Real Rescues. See you then.

-Bye-bye.

0:42:430:42:47

Subtitles by Red Bee Media Ltd

0:42:530:42:57

A woman falls off her bike and ends up with a serious head injury, and a seven-year-old makes a 999 call to save his mum's life.