0:00:02 > 0:00:05RADIO: '..CareFlight... Fall from a tree.'
0:00:05 > 0:00:08It's one of the most beautiful but dangerous places on earth...
0:00:08 > 0:00:12My name's Helen. I'm one of the doctors. Any pain in there?
0:00:12 > 0:00:14Any teeth loose or anything like that?
0:00:14 > 0:00:16..and when Australians call out the flying doctor...
0:00:16 > 0:00:18Coming round.
0:00:18 > 0:00:20..they're likely to be British,
0:00:20 > 0:00:24and so is the pilot, paramedic and crew men.
0:00:24 > 0:00:27We'll see lots of sharks, 200, 300 metres out.
0:00:27 > 0:00:29I think they get the idea when we go like that.
0:00:29 > 0:00:32'Lifesaver 24...'
0:00:32 > 0:00:35'They said they got the bends from coming up too quickly.'
0:00:35 > 0:00:38From shark attacks on surfing beaches
0:00:38 > 0:00:41to exploding barbecues in the Sydney suburbs,
0:00:41 > 0:00:45these are the Brits who can make the difference between life and death
0:00:45 > 0:00:46down under.
0:01:09 > 0:01:12James Milligan is an NHS consultant
0:01:12 > 0:01:14working at Leeds General Infirmary.
0:01:14 > 0:01:16How's that tummy pain now?
0:01:16 > 0:01:17Now, like hundreds of medics
0:01:17 > 0:01:21- every year, he's swapping rainy Britain...- It's wet.- It is wet.
0:01:21 > 0:01:23..for a life in the sun.
0:01:23 > 0:01:26We're living right by the ocean, it's a beautiful spot,
0:01:26 > 0:01:29work's nice and relaxed, the atmosphere's great -
0:01:29 > 0:01:31life probably couldn't be much better.
0:01:31 > 0:01:35But it's a place where the nearest hospital can be 200 miles away
0:01:35 > 0:01:37and the wildlife can kill you.
0:01:38 > 0:01:42Are you ready? Can I listen to your heart?
0:01:42 > 0:01:45Welcome to one of the world's most extreme health services.
0:01:47 > 0:01:50Today the flying medics come to the aid of a surfer who's been
0:01:50 > 0:01:52smashed against the rocks...
0:01:52 > 0:01:56Treachery Beach, woman dumped in the surf - head injuries.
0:01:56 > 0:01:59..a famous Aboriginal singer with kidney failure needs
0:01:59 > 0:02:01air-lifting to hospital...
0:02:01 > 0:02:04He looks, certainly, on that ECG, all over the place.
0:02:04 > 0:02:07..and an adventurous teenager is injured falling from a tree.
0:02:07 > 0:02:09Someone's waving at us down here.
0:02:09 > 0:02:11Oh yes, there it is. They're all waving down there.
0:02:20 > 0:02:23It's the hottest summer for decades on the Australian coast.
0:02:23 > 0:02:28In Sydney they've just recorded the hottest day since records began.
0:02:28 > 0:02:32Not surprisingly, people are flocking to the water to cool down.
0:02:34 > 0:02:38It's 48 degrees Celsius, or 118 degrees Fahrenheit,
0:02:38 > 0:02:42and former Royal Navy officer Mike de Winton is sweating it out
0:02:42 > 0:02:44in his flying kit.
0:02:45 > 0:02:47Mike is the chief pilot of the rescue helicopter
0:02:47 > 0:02:51based at Newcastle, 100 miles North of Sydney.
0:02:51 > 0:02:54Treachery Beach, woman dumped in the surf - head injuries.
0:02:54 > 0:02:56Basically, we're on call here 24/7,
0:02:56 > 0:02:59so unfortunately as chief pilot, my job is to wait for the phone to ring
0:02:59 > 0:03:02to come out and sort another problem out.
0:03:02 > 0:03:05CREW TALK OVER RADIO
0:03:09 > 0:03:11It looks nice and clear, which is good.
0:03:11 > 0:03:15Yeah, it's 48 degrees on the pad in the aircraft.
0:03:15 > 0:03:17So the air-con's not going to work very well.
0:03:17 > 0:03:21Today Westpac 2 has been scrambled to a remote beach north of
0:03:21 > 0:03:25Newcastle. Surfing accidents are common on this coast,
0:03:25 > 0:03:27especially among foreign holidaymakers.
0:03:27 > 0:03:30All we've got on this is a girl with a neck injury,
0:03:30 > 0:03:32maybe a head injury, from being dumped on a rock by the wave.
0:03:32 > 0:03:35It won't be a very big wave.
0:03:35 > 0:03:39That is why Leggy reckons it's either an English tourist or a Swedish...
0:03:39 > 0:03:42Local paramedics have reached the patient.
0:03:42 > 0:03:44They're going to drive her to a nearby bowling club where
0:03:44 > 0:03:47the helicopter can land more easily.
0:03:47 > 0:03:49Just as soon as we land, can you guys hop out?
0:03:49 > 0:03:53Cos there's normally a lot of people there, just to access safety.
0:03:53 > 0:03:54Yep, copy.
0:03:55 > 0:03:58VOICES MUFFLED OVER RADIO
0:03:58 > 0:04:01It's going to be a steep descent down because we're going to
0:04:01 > 0:04:02drop down into that area.
0:04:07 > 0:04:10Extreme heat makes handling a helicopter difficult.
0:04:10 > 0:04:13It reduces the power of the engines and creates turbulence,
0:04:13 > 0:04:16especially close to the ground.
0:04:16 > 0:04:20Yeah, that's it. That's a bit more. That's a bit better.
0:04:20 > 0:04:22- MUFFLED VOICE ON RADIO - ..on the left-hand side.- Yep.
0:04:27 > 0:04:32The aircraft's working close to its limits here, and also you can tell by
0:04:32 > 0:04:35the weather here, it's very, very windy and quite gusty, which makes it
0:04:35 > 0:04:39difficult, especially around the high trees,
0:04:39 > 0:04:42so it's a bit of a challenge, but you get used to it.
0:04:42 > 0:04:45We're going to assess the patient, who I believe is a 24-year-old
0:04:45 > 0:04:50female with spinal injuries from being dumped in the surf.
0:04:50 > 0:04:53So, medically, if she has neurological deficits related to
0:04:53 > 0:04:58a spinal injury, then we can fly to a more spinal-specific hospital
0:04:58 > 0:05:01in Sydney if we need to - Royal North Shore Hospital -
0:05:01 > 0:05:03for advanced specialist treatment.
0:05:05 > 0:05:08Holidaymaker Dominique Doyle was surfing with her family
0:05:08 > 0:05:11when she was hurled onto rocks by a freak wave.
0:05:11 > 0:05:15She has a nasty head injury, but its the pain in her neck,
0:05:15 > 0:05:19shoulder and back that's most concerning the paramedics.
0:05:19 > 0:05:22Can you grab both my hands for me and give them a squeeze?
0:05:22 > 0:05:26Fantastic. All right, good. Can you feel both your hands OK?
0:05:26 > 0:05:30All right. I understand you'd be nervous. That's fine.
0:05:30 > 0:05:32That's normal, OK?
0:05:32 > 0:05:35'We work as a team. That's the reason we succeed -
0:05:35 > 0:05:37'because we are a team when we fly.
0:05:37 > 0:05:41'That linked in with the paramedics doing their job
0:05:41 > 0:05:44'and then the hospital doing their job. That makes the whole thing
0:05:44 > 0:05:47'part of that...you know, final result.'
0:05:47 > 0:05:50In the helicopter it's really noisy and it's a little bit hot,
0:05:50 > 0:05:52so the way we're going to communicating is I'm going to be
0:05:52 > 0:05:55sitting right next to you and I'm going to give you a tap
0:05:55 > 0:05:58every now and then, and give me a thumbs-up if everything's all right.
0:06:00 > 0:06:03It's in Australia's enormous open spaces that air ambulances
0:06:03 > 0:06:05come into their own.
0:06:05 > 0:06:10For us to drive from here all the way down to Newcastle is quite
0:06:10 > 0:06:11a treacherous drive.
0:06:11 > 0:06:13It's bumpy, hilly, and the roads aren't very good at all,
0:06:13 > 0:06:17so for her it's not going to be a good outcome
0:06:17 > 0:06:19if we have to go all that way,
0:06:19 > 0:06:22thinking that she might have some major injuries.
0:06:22 > 0:06:24That's why we initiate the helicopter.
0:06:28 > 0:06:32MUFFLED VOICE OVER RADIO
0:06:35 > 0:06:37Dominique's being flown direct
0:06:37 > 0:06:41to the John Hunter regional trauma centre in Newcastle,
0:06:41 > 0:06:43100 miles North of Sydney.
0:06:43 > 0:06:46She's still complaining of pain in her head, neck and shoulder.
0:06:46 > 0:06:50They're what we call possible distracting injuries,
0:06:50 > 0:06:53that might be masking something more serious with her central
0:06:53 > 0:06:56cervical spine, which is an important area not to damage,
0:06:56 > 0:06:58so we're taking all the precautions,
0:06:58 > 0:07:01but she is certainly within good parameters with her blood
0:07:01 > 0:07:05pressure and heart rate, and we'll just continue to monitor her.
0:07:05 > 0:07:08She is lucky, because this kind of injury can cause paraplegia
0:07:08 > 0:07:11and worse spinal injuries.
0:07:15 > 0:07:18For British pilot Mike, that's another hour's flying added
0:07:18 > 0:07:21to the 10,000 already in his log book.
0:07:23 > 0:07:27The distances between major centres in Australia, together with
0:07:27 > 0:07:30year-round better weather, mean pilots down under spend more
0:07:30 > 0:07:34time in the air than most of their counterparts in the UK.
0:07:34 > 0:07:37I'd say that this is closest to the military-style flying,
0:07:37 > 0:07:39without being shot at.
0:07:39 > 0:07:44We're a small cog in a big wheel and the results say it themselves -
0:07:44 > 0:07:47we get the patients to hospital on time, and treated well.
0:07:48 > 0:07:51And today's patient, Dominique, got all the tests and scans
0:07:51 > 0:07:54she needed at John Hunter Hospital.
0:07:54 > 0:07:55She's now back working as a lawyer,
0:07:55 > 0:07:59although she says she doesn't plan on surfing again for a while.
0:08:16 > 0:08:20For some, the true scale of Austraila's vast expanse
0:08:20 > 0:08:25only really becomes apparent when they try to cross it by land.
0:08:29 > 0:08:32If you drove it non-stop, it would take you two days
0:08:32 > 0:08:36to get from Sydney in the south-east to Darwin in the north.
0:08:40 > 0:08:43In the bushlands of the Northern Territory which surround Darwin,
0:08:43 > 0:08:46the huge distances and sparse population
0:08:46 > 0:08:50mean the majority of the emergency medical transport is done by air.
0:08:50 > 0:08:53The countryside, particularly when you see it from the plane,
0:08:53 > 0:08:57is absolutely outstanding, and when I was first arrived I was really,
0:08:57 > 0:09:01really surprised at how green it actually was.
0:09:01 > 0:09:03Dr Sarah McNeilly is an anaesthetist
0:09:03 > 0:09:06and intensive care trainee from London.
0:09:06 > 0:09:10She's working in Australia for a year before returning to the UK.
0:09:10 > 0:09:15Medicine out here is relatively similar within a hospital,
0:09:15 > 0:09:18and then, obviously, you can fairly easily get a retrieval job out here,
0:09:18 > 0:09:21which are often much harder to get at home.
0:09:21 > 0:09:25Today Dr Sarah and the team have taken a call about a diabetic man
0:09:25 > 0:09:28with kidney failure, who's suffering complications.
0:09:28 > 0:09:32CareFlight 22. Request taxi. Two nine.
0:09:33 > 0:09:37The majority of our patients are the indigenous population,
0:09:37 > 0:09:39and they have quite unique health issues.
0:09:39 > 0:09:43A lot of the diseases that you do see - for example, diabetes,
0:09:43 > 0:09:46kidney failure, heart disease - seem to happen here also
0:09:46 > 0:09:50but in much younger patients.
0:09:50 > 0:09:54It turns out the patient she's going to see is a famous musician.
0:09:54 > 0:09:58Mandawuy Yunupingu is the lead singer of the indigenous band
0:09:58 > 0:10:00Yothu Yindi.
0:10:00 > 0:10:03SINGS IN NATIVE LANGUAGE
0:10:07 > 0:10:09Just days ago, Mandawuy received
0:10:09 > 0:10:12a lifetime achievement award at the ARIAs,
0:10:12 > 0:10:15which is the Australian version of the BRIT Awards.
0:10:18 > 0:10:21Mandawuy lives in an Aboriginal community on the Gove Peninsula.
0:10:26 > 0:10:30It's 400 miles away from Darwin, and during the wet season,
0:10:30 > 0:10:34which lasts from November to April, the only way to get there is by air.
0:10:36 > 0:10:38Lovely. Good man.
0:10:38 > 0:10:41At Gove District Hospital, Mandawuy Yunupingu
0:10:41 > 0:10:44and his wife have been waiting for the CareFlight team.
0:10:44 > 0:10:49Can I have a wee look at you? Is that all right? Can I examine you?
0:10:49 > 0:10:52Is that OK? Let me just pop this across for a second.
0:10:52 > 0:10:55So how long have you been feeling crook?
0:10:55 > 0:10:57This morning.
0:10:57 > 0:10:59Just since this morning? You were OK yesterday?
0:11:01 > 0:11:04And I believe I'm treating a celebrity - is that right?
0:11:04 > 0:11:08And you felt OK when you were having dialysis, or not so good then?
0:11:08 > 0:11:11- I felt all right. - You felt all right then.
0:11:11 > 0:11:14We've had a little look at the condition of our patient over here,
0:11:14 > 0:11:18and feel that it's stable enough to move him as he is.
0:11:18 > 0:11:20It's a very small world up here
0:11:20 > 0:11:23You just never know who you might come across, but yeah,
0:11:23 > 0:11:26it's one of the delights of working up here.
0:11:26 > 0:11:28It's very interesting.
0:11:28 > 0:11:30- They're quite different, aren't they?- They are.
0:11:30 > 0:11:35And he looks, certainly on that ECG, all over the place.
0:11:35 > 0:11:37This gentleman has an infection
0:11:37 > 0:11:40and we're not entirely sure where at the moment.
0:11:41 > 0:11:45His heart rate's going quite fast and it's quite irregular,
0:11:45 > 0:11:48which often makes monitoring his blood pressure with the cuff -
0:11:48 > 0:11:50particularly moving in the plane and the ambulance -
0:11:50 > 0:11:53quite difficult, so we're going to put a drip in the artery in his
0:11:53 > 0:11:55wrist, which will monitor his blood pressure continuously,
0:11:55 > 0:11:57and that just gives me better control and better idea
0:11:57 > 0:12:01of what's happening as we're moving him back to Darwin.
0:12:01 > 0:12:05And can you bend your hand back for me? That's fabulous.
0:12:05 > 0:12:08Perfect position.
0:12:08 > 0:12:10Oh, just try and keep really still for me.
0:12:10 > 0:12:13Is it all right if I just help you try and stay still there?
0:12:13 > 0:12:17That's it. This is going to sting a bit. Well done.
0:12:19 > 0:12:23- Sorry, I know this is...- That's totally numb after this - all right?
0:12:23 > 0:12:25Diabetes and kidney failure are common problems
0:12:25 > 0:12:27in Aboriginal communities.
0:12:28 > 0:12:32We can just monitor this very carefully, in this one,
0:12:32 > 0:12:36and also give certain drugs in case he needs it.
0:12:36 > 0:12:38OK.
0:12:41 > 0:12:42..down,
0:12:42 > 0:12:45while wife keeps you in check.
0:12:45 > 0:12:47Which one?
0:12:47 > 0:12:49Second one.
0:12:49 > 0:12:50Second one.
0:12:50 > 0:12:52THEY LAUGH
0:12:53 > 0:12:57I think the doctors here have discussed his microbiology,
0:12:57 > 0:12:59antibiotics, with the guys in Darwin,
0:12:59 > 0:13:01because he's a little bit complicated,
0:13:01 > 0:13:04and he's had all the antibiotics that have been suggested
0:13:04 > 0:13:08and he's got two lines in and we were going to bring him back
0:13:08 > 0:13:09like that.
0:13:09 > 0:13:12- Thank you very much for your help, guys.- Bye-bye.
0:13:12 > 0:13:15Mandawuy and his wife, Yalmay, have just come back
0:13:15 > 0:13:17from the ARIA Music Awards in Sydney,
0:13:17 > 0:13:22where he gave a speech about the devastating effects of his illness.
0:13:22 > 0:13:25My husband's band, Yothu Yindi,
0:13:25 > 0:13:28they got inducted to the Hall of Fame.
0:13:28 > 0:13:34It was really a proud moment for the band and their family.
0:13:34 > 0:13:38'He's in a fluid restriction.
0:13:38 > 0:13:42'He loves his tea. He likes drinking tea.
0:13:44 > 0:13:46I can't make him stop drinking tea.
0:13:46 > 0:13:49He's got to...
0:13:49 > 0:13:50He's got to do it himself.
0:13:53 > 0:13:58The indigenous population is one of the oldest cultures in the world,
0:13:58 > 0:14:01so, obviously, they have this enormous background and heritage
0:14:01 > 0:14:04that I didn't know the huge amount about before coming out here
0:14:04 > 0:14:07and working with patients like that, and it's actually
0:14:07 > 0:14:09really interesting.
0:14:09 > 0:14:12Mandawuy's kidney failure means he has to have five hours of dialysis
0:14:12 > 0:14:15three times a week or he'll die.
0:14:15 > 0:14:17His condition also leaves him
0:14:17 > 0:14:20vulnerable to infections that other people might just shake off.
0:14:20 > 0:14:24His recent trip to the ARIA Awards may have been too much for him.
0:14:27 > 0:14:29He's not looking too bad, actually.
0:14:29 > 0:14:32He, obviously, has got a bit of infection somewhere,
0:14:32 > 0:14:35so he'll need some tests and investigations to see
0:14:35 > 0:14:37if we can find out where that infection is.
0:14:37 > 0:14:40His heart rate has settled down with some treatment, and I think
0:14:40 > 0:14:43overall he's looking a little bit better and feeling a bit better.
0:14:46 > 0:14:48Mandawuy will have to stay in hospital
0:14:48 > 0:14:51while those tests are completed, but whatever they reveal,
0:14:51 > 0:14:54he says he wants to get back home as soon as he can.
0:15:07 > 0:15:09In Sydney, the CareFlight team is called
0:15:09 > 0:15:13when someone is unconscious or has a suspected head injury.
0:15:15 > 0:15:18The helicopter has to be airborne in less than two minutes.
0:15:20 > 0:15:23Air crew officer John Legge, known as Leggy,
0:15:23 > 0:15:26is the last on board. He's got the map co-ordinates for the pilot.
0:15:26 > 0:15:2995, 6, 7.
0:15:29 > 0:15:33Leggy is a former RAF crew man from Liverpool.
0:15:33 > 0:15:35He did six tours of Afghanistan,
0:15:35 > 0:15:38airlifting wounded soldiers out of the battlefield.
0:15:38 > 0:15:41You do get the same kind of feeling. You still have that same sense
0:15:41 > 0:15:43of urgency. Somebody needs your help
0:15:43 > 0:15:45and so you want to get there as quickly as you can.
0:15:45 > 0:15:47In that respect, it is very similar.
0:15:47 > 0:15:50You are still in a helicopter at the end of the day, so you still
0:15:50 > 0:15:54have the same considerations whether you're in Afghanistan or whether
0:15:54 > 0:15:57you'd be in Sydney, but obviously you don't have the same threat levels.
0:15:57 > 0:16:00Today, Leggy and the medical team have been called out
0:16:00 > 0:16:04to a park in Sydney where a child has fallen out of a tree.
0:16:04 > 0:16:07CareFlight. There's a 12-year-old male fallen.
0:16:07 > 0:16:09- OVER RADIO: - Affirmative, CareFlight.
0:16:09 > 0:16:12Further information, fall from a tree, head injury.
0:16:12 > 0:16:14Fallen six metres.
0:16:14 > 0:16:17LEGGY'S VOICE MUFFLED OVER RADIO
0:16:17 > 0:16:20There's no park coming up, so we'll just head there.
0:16:20 > 0:16:23It's Leggy's job to navigate for the pilot and help him
0:16:23 > 0:16:25find a good place to land.
0:16:25 > 0:16:27It's just inside the zone, mate.
0:16:27 > 0:16:29Just on the other side of this headland here.
0:16:29 > 0:16:32'There's a few things that I have to think about -
0:16:32 > 0:16:35'the distance it is and the bearing. If we're going to go into the city
0:16:35 > 0:16:38'then I'll need to tell air-traffic control before we go.'
0:16:38 > 0:16:41OK, it's this park, at 12 o'clock.
0:16:41 > 0:16:44- Someone's waving at us down here. - Oh, yeah, there it is.
0:16:44 > 0:16:45They're all waving down there.
0:16:47 > 0:16:50Unlike on most British air ambulances, the doctor
0:16:50 > 0:16:53and the paramedic physically hang out of the aircraft,
0:16:53 > 0:16:54looking for the patient.
0:16:54 > 0:16:57'We train up our paramedics to be able to do conning,
0:16:57 > 0:16:59'which is a type of voice marshalling,
0:16:59 > 0:17:03'so we'll keep the doors open at the back, and it just helps us
0:17:03 > 0:17:04'with going into tight spaces.'
0:17:04 > 0:17:08You do have a power pole. It's just on the right-hand side.
0:17:08 > 0:17:10As long as there's no cross wires...
0:17:10 > 0:17:1430 below to the ground. Free to go down 20.
0:17:17 > 0:17:19Five, four, three, two, one.
0:17:19 > 0:17:22VOICE MUFFLED OVER RADIO
0:17:29 > 0:17:33Just six minutes after getting the call, the CareFlight Team is on
0:17:33 > 0:17:37the ground in one of Sydney's oldest parks, in the suburb of Cabarita.
0:17:39 > 0:17:42- Hi there.- G'day.- We might just get a bit of space back if we can.
0:17:42 > 0:17:44Just Mum... Mum or Dad here?
0:17:44 > 0:17:47He fell from a fair way up in the tree. Fell on his bottom.
0:17:47 > 0:17:49He's actually feeling quite a bit of a pain.
0:17:49 > 0:17:51Well, he said he can't feel his bottom right now.
0:17:51 > 0:17:54- Hi, Danial. Can you talk to me?- He banged his head on the tree too.
0:17:54 > 0:17:58- We're just going to have a look at you and see how you are, OK?- OK.
0:17:58 > 0:18:01My son, you know, he likes climbing and he just was climbing the tree.
0:18:01 > 0:18:04I think he was on the second branch, and he just fell
0:18:04 > 0:18:08and hit the back of his head and fell on the floor,
0:18:08 > 0:18:11and, yeah, everybody got panicked and they called an ambulance
0:18:11 > 0:18:13and everything. Hopefully, he's OK.
0:18:13 > 0:18:15- And where are you hurting at the moment, mate?- My bottom.
0:18:15 > 0:18:19- Just your bottom? Did you hit your head at all, buddy?- I'm not sure.
0:18:19 > 0:18:20You're not sure.
0:18:20 > 0:18:23- OK, and the main pain is just around your bottom region, is it?- Yeah.
0:18:23 > 0:18:27OK, we're just going to have a look at your back and your bottom
0:18:27 > 0:18:30and we're just going to press on you. I just want you to tell me
0:18:30 > 0:18:33- if it's sore as the doctor pushes on you just gently, OK?- OK.
0:18:35 > 0:18:38Ben Southers has been a paramedic for 12 years
0:18:38 > 0:18:41and Dr Andrew Weatherall is a paediatric specialist,
0:18:41 > 0:18:45so 13-year-old Danial could not be in better hands.
0:18:45 > 0:18:48So, Danial, you've probably done a whole lot of breathing
0:18:48 > 0:18:49- before in your life, yeah?- Yeah.
0:18:49 > 0:18:52I just need you to do that again. There's no special tricks.
0:18:52 > 0:18:55I'm going to listen to your chest while you do it. You go right ahead.
0:18:57 > 0:19:00It's almost like you practice that most days of your life.
0:19:01 > 0:19:02Fantastic.
0:19:03 > 0:19:06Can you tell me exactly which branch he was on?
0:19:06 > 0:19:10He was right up the top and then he was just making his way down.
0:19:10 > 0:19:13- I think it might have been that one.- So maybe that one.
0:19:13 > 0:19:15So maybe two to four metres.
0:19:15 > 0:19:17- Yeah.- He sort of came down that way, hitting his back
0:19:17 > 0:19:19and then maybe the back of his head.
0:19:19 > 0:19:21So, Danial, what we're going to do is roll you to the side.
0:19:21 > 0:19:24Ben's going to count to number three to prove he can,
0:19:24 > 0:19:25and then we'll all roll you.
0:19:25 > 0:19:27You do lots of nothing.
0:19:27 > 0:19:29Just put arms across your chest like this for me.
0:19:29 > 0:19:32And while we're doing this, I'm going to have a little feel
0:19:32 > 0:19:35along your back, and I just need you to tell me if it's sore when I feel.
0:19:35 > 0:19:39- OK?- OK.- That's all you've got to do. You just speak to me. Easy?- Yes.
0:19:39 > 0:19:43- We're going to roll on three. One, two, three.- OK.
0:19:43 > 0:19:45So I'm going to have a little look along the back.
0:19:45 > 0:19:48Can't see anything that looks nasty, so that's good.
0:19:48 > 0:19:51- Get one of the coppers, then, to help us, do you reckon?- Yeah.
0:19:52 > 0:19:55Can we've some police officers to give us a hand? Thanks.
0:19:57 > 0:19:59At the moment he looks completely stable.
0:19:59 > 0:20:02He's had a reasonable fall, and the witnesses who were there
0:20:02 > 0:20:04on the scene actually saw him hit the back of his head
0:20:04 > 0:20:06on the way down on the branch of a tree,
0:20:06 > 0:20:09but he remembers the whole thing, hasn't passed out at any stage and
0:20:09 > 0:20:11at the moment is just complaining a bit of pain in his back,
0:20:11 > 0:20:14so as a precaution we're going to take into the kids' hospital,
0:20:14 > 0:20:17but I suspect it'll just be a boring afternoon for him
0:20:17 > 0:20:18of getting checked out.
0:20:20 > 0:20:22The journey from Cabarita Park to the children's hospital
0:20:22 > 0:20:25takes at least 30 minutes by land ambulance.
0:20:25 > 0:20:29The CareFlight chopper will cover the same distance in five.
0:20:29 > 0:20:33Good afternoon, Mandy. We're departing the scene, trans 41,
0:20:33 > 0:20:37paediatric fall, to West Main kids. ETA five minutes.
0:20:39 > 0:20:43At the children's hospital, Danial is scanned and X-rayed.
0:20:43 > 0:20:46Luckily for him, his bump on the head hasn't caused
0:20:46 > 0:20:47any lasting damage.
0:20:49 > 0:20:52Just hours later, he's back at home with his parents
0:20:52 > 0:20:53and his sister, Sophia.
0:20:55 > 0:20:59I couldn't even remember how it happened, how I fell.
0:20:59 > 0:21:02I just remember seeing a woman and Mum crying,
0:21:02 > 0:21:04and then I saw you crying, and then...
0:21:05 > 0:21:07I felt shocked,
0:21:07 > 0:21:12and scared, and the pain was a lot in my bottom. It hurt.
0:21:12 > 0:21:15Yeah, I was on the ground and everybody was surrounding me.
0:21:15 > 0:21:18My mum was crying and everybody was crying.
0:21:18 > 0:21:22Then my friend's dad called the ambulance. He said...
0:21:22 > 0:21:25I think he said that he's unconscious and he's on the ground.
0:21:25 > 0:21:27He just had fallen out of the tree.
0:21:27 > 0:21:32I had a few British doctors, and they were talking in British accents,
0:21:32 > 0:21:34and they were really nice to me,
0:21:34 > 0:21:40and no one's treated me that special before, cos they treated me so well.
0:21:41 > 0:21:43I got to experience my first helicopter ride.
0:21:43 > 0:21:46It was nice but I couldn't really see the view.
0:21:46 > 0:21:49It was so far. They got us in the helicopter,
0:21:49 > 0:21:52and then two minutes later I was on the ground.
0:21:53 > 0:21:55I was amazed at how fast the trip was.
0:21:59 > 0:22:02The pain in my tailbone, it still hurts quite a lot,
0:22:02 > 0:22:05and I can't really sit down on hard objects,
0:22:05 > 0:22:09or if I get tackled or something to do with that,
0:22:09 > 0:22:14I might have to go to hospital again, but besides I feel better now.
0:22:20 > 0:22:23At the Ambulance Service's main helicopter base in Sydney,
0:22:23 > 0:22:26the medical team is on a mission which is very rarely
0:22:26 > 0:22:29carried out by air in the UK.
0:22:29 > 0:22:32They're bringing in a patient with an acute viral infection,
0:22:32 > 0:22:35who's being kept alive by a machine which is doing
0:22:35 > 0:22:37the work of his heart and lungs.
0:22:37 > 0:22:39This patient has come in in respiratory failure.
0:22:39 > 0:22:42Don't know exactly why but they're presuming it's some
0:22:42 > 0:22:45kind of infection - possibly viral, possibly bacteria - so they're
0:22:45 > 0:22:48treating him with antibiotics as well.
0:22:48 > 0:22:52Dr Helen Oliver is an anaesthetist from London. She's working
0:22:52 > 0:22:56in Australia for a year to get more experience of pre-hospital care.
0:22:56 > 0:23:01He's on ECMO, which stands for extracorporeal membrane oxygenation,
0:23:01 > 0:23:04so basically his lungs are not working,
0:23:04 > 0:23:07so what they're doing is they're oxygenating his blood outside
0:23:07 > 0:23:09of the body, using this circuit which you can see here.
0:23:09 > 0:23:14That blood we want to sort of be coming out, pointing towards...
0:23:14 > 0:23:19There's a very large cannula that's going into one of the major veins
0:23:19 > 0:23:22in his neck. You can see the two tubes coming out.
0:23:22 > 0:23:24One is carrying blood away from the body -
0:23:24 > 0:23:27it's going through the machine, being oxygenated,
0:23:27 > 0:23:29and the other tubes are carrying the oxygenated blood
0:23:29 > 0:23:32back into his system, so it's basically bypassing his lungs.
0:23:32 > 0:23:35It's doing the job of the lungs for him.
0:23:35 > 0:23:38This stripped-down ECMO machine was developed
0:23:38 > 0:23:41by the New South Wales Ambulance Service
0:23:41 > 0:23:43during the SARS outbreak of 2009.
0:23:43 > 0:23:47I've certainly never seen anything like this before.
0:23:47 > 0:23:50Back home, routinely, all ECMO transfers are done by road.
0:23:50 > 0:23:53In very special circumstances, they can be done by air,
0:23:53 > 0:23:56but the military would take care of the aero-medical side of things,
0:23:56 > 0:23:59so the medical retrieval service wouldn't get involved,
0:23:59 > 0:24:02but it's quite standard here to do these sort of transfers by air,
0:24:02 > 0:24:05just given the massive distances that we're dealing with
0:24:05 > 0:24:06here in Australia.
0:24:06 > 0:24:09Again, it's something new for me to see.
0:24:10 > 0:24:14Moving an ECMO patient requires a large medical team.
0:24:14 > 0:24:17The patient's going to St Vincent's, which is one of the ECMO centres
0:24:17 > 0:24:22in Sydney, so we've got the ECMO team from St Vincent's,
0:24:22 > 0:24:26who are basically in charge of establishing the system
0:24:26 > 0:24:28and then maintaining it during the transfer.
0:24:28 > 0:24:32The paramedics that are going to be driving the MPV vehicle
0:24:32 > 0:24:36that you see, and then our retrieval team - our doctor and paramedic -
0:24:36 > 0:24:37are with him as well.
0:24:37 > 0:24:39Putting patients on the ECMO machine as soon as possible
0:24:39 > 0:24:42has been shown to keep more people alive,
0:24:42 > 0:24:45but like all medical procedures, it doesn't always work.
0:24:46 > 0:24:49The patient in this case died in hospital.
0:24:56 > 0:24:59In the Northern Territory, on the tip of the Gove Peninsula
0:24:59 > 0:25:02400 miles from Darwin, lies the community of Yirrkala.
0:25:08 > 0:25:12This is ancient Aboriginal land and is owned by indigenous families.
0:25:14 > 0:25:17Yirrkala is home to Mandawuy Yunupingu,
0:25:17 > 0:25:19the famous singer-songwriter.
0:25:19 > 0:25:23He has chronic renal failure as a result of diabetes,
0:25:23 > 0:25:25which is not uncommon amongst Aboriginal people.
0:25:26 > 0:25:30He has to have dialysis at his community clinic three times a week
0:25:30 > 0:25:31to stay alive.
0:25:31 > 0:25:35I'm just going to check your blood pressure, Mandawuy.
0:25:35 > 0:25:38Ten days ago, Mandawuy got an infection
0:25:38 > 0:25:41and had to be flown to Darwin.
0:25:41 > 0:25:43The doctors and nurses at the...
0:25:45 > 0:25:47..main hospital in town
0:25:47 > 0:25:54thought I would be better going to Darwin,
0:25:54 > 0:25:58and they flew me on the CareFlight.
0:26:00 > 0:26:05The doctor who flew with Mandawuy was Sarah McNeilly from London.
0:26:05 > 0:26:09And then can you bend your hand back for me? That's fabulous.
0:26:09 > 0:26:15She was an OK doctor, for a British one.
0:26:15 > 0:26:17HE LAUGHS
0:26:17 > 0:26:21She was quite friendly,
0:26:21 > 0:26:23and I liked her.
0:26:23 > 0:26:27'Pretty much all the patients up here are really nice patients to treat.'
0:26:27 > 0:26:32They're generally really, you know, friendly, receptive, open.
0:26:32 > 0:26:36Occasionally you get a grumpy patient but it do at home as well, you know.
0:26:36 > 0:26:37When you're not feeling very well,
0:26:37 > 0:26:39nobody particularly wants to be charming.
0:26:39 > 0:26:40School's finished?
0:26:42 > 0:26:45Mandawuy's infection clears up
0:26:45 > 0:26:49and within days he's back into his routine at home in Yirrkala,
0:26:49 > 0:26:51under the watchful eye of his dialysis nurse, Rowena,
0:26:51 > 0:26:52who's also British.
0:26:54 > 0:26:57I've been in Australia over 30 years.
0:26:57 > 0:26:59My dream, when I went into nursing,
0:26:59 > 0:27:01I wanted to be in the Royal Flying Doctor Service.
0:27:01 > 0:27:03I thought it was very glamorous.
0:27:03 > 0:27:05But when I came to Australia I got stuck into the city life,
0:27:05 > 0:27:08so I think now I'm realising my dream of actually getting out
0:27:08 > 0:27:10to the real Australia, into the bush.
0:27:10 > 0:27:13When you come out to the communities, you see the people
0:27:13 > 0:27:15where they should be. They're in their home.
0:27:15 > 0:27:19And it's been a revelation for me, coming up to the Northern Territory.
0:27:23 > 0:27:27There are obvious dangers in this part of the world, but one of the
0:27:27 > 0:27:31biggest health risks for Aboriginal people is chronic renal failure
0:27:31 > 0:27:33resulting from diabetes.
0:27:33 > 0:27:36Indigenous people are three or four times more likely
0:27:36 > 0:27:40to develop diabetes than the rest of the Australian population,
0:27:40 > 0:27:44and then their kidneys are ten times more likely to stop working.
0:27:44 > 0:27:47Renal failure's a problem
0:27:47 > 0:27:52in most indigenous communities.
0:27:52 > 0:27:58I think it's important for people like me
0:27:58 > 0:28:01to spread the message.
0:28:01 > 0:28:04Part of that message is that Aboriginal people with renal failure
0:28:04 > 0:28:08need dialysis machines and nurses in their communities
0:28:08 > 0:28:11so they don't have to move away to get treatment.
0:28:11 > 0:28:15Mandawuy has been our first patient. We are still very new.
0:28:15 > 0:28:18It's only been going three, four months.
0:28:18 > 0:28:22And so he's my sort of guinea pig, and so we're learning together.
0:28:22 > 0:28:25Family is everything to the Aboriginal people.
0:28:25 > 0:28:28They're with their children and their grandchildren
0:28:28 > 0:28:31and the family is kept together, and it's just so important to them.
0:28:46 > 0:28:49Subtitles by Red Bee Media Ltd