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 > 0:00:10My name's Helen, I'm one of the doctors.
0:00:10 > 0:00:14Any pain in there, any teeth loose or anything like that?
0:00:14 > 0:00:17And when Australians call out the flying doctor...
0:00:17 > 0:00:18Keep coming 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 crewman.
0:00:24 > 0:00:27We'll see lots of sharks. 200, 300 metres out.
0:00:27 > 0:00:30I think they get the idea when we go like that.
0:00:30 > 0:00:32- RADIO:- 'Over 20 forward...'
0:00:32 > 0:00:35They say they've 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 > 0:00:42Went round you?
0:00:42 > 0:00:45..these are the Brits who can make the difference
0:00:45 > 0:00:46between life and death down under.
0:01:09 > 0:01:14James Milligan is an NHS consultant working at Leeds General Infirmary.
0:01:14 > 0:01:16How's that tummy pain now?
0:01:16 > 0:01:19Now, like hundreds of medics every year, he's swapping rainy Britain...
0:01:19 > 0:01:23- It's wet.- It is wet. - ..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 > 0:01:38and the wildlife can kill you.
0:01:38 > 0:01:41Are you ready? Can I have a listen to your heart?
0:01:41 > 0:01:45Welcome to one of the world's most extreme health services.
0:01:46 > 0:01:50Today, there's a tricky rescue after a woman plunges down a cliff.
0:01:50 > 0:01:53You look down and there's 200 feet below you.
0:01:53 > 0:01:56It does make you think about the wire and how strong it is.
0:01:56 > 0:01:59A baby needs a life-saving flight to hospital in Sydney.
0:01:59 > 0:02:03Yes, you're fine. You're just fine.
0:02:03 > 0:02:06And, in the mountains, a man is badly injured falling out of a tree.
0:02:06 > 0:02:09You can always walk to the hospital if you prefer.
0:02:09 > 0:02:11Yeah, I was going to get my daughter to drive me there.
0:02:20 > 0:02:24Australia is a young country in more ways than one.
0:02:24 > 0:02:29It has a more youthful population than the UK and a higher birth rate.
0:02:29 > 0:02:32But the size of this vast continent means premature
0:02:32 > 0:02:37and sick babies can be born hundreds of miles from specialist care.
0:02:40 > 0:02:42At the headquarters
0:02:42 > 0:02:45of the Newborn and Paediatric Emergency Transport Service,
0:02:45 > 0:02:49or NETS for short, an urgent call has just come in.
0:02:52 > 0:02:54RADIO: 'Basically, a six-week-old baby
0:02:54 > 0:02:56with congenital myotonic dystrophy.
0:02:56 > 0:02:58'Got several other issues as well.
0:02:58 > 0:03:00'The reason they're calling for her transfer to
0:03:00 > 0:03:04the Children's Hospital Westmead is, she's had two significant
0:03:04 > 0:03:09episodes of desaturation down to the seventies over the weekend.
0:03:11 > 0:03:13The reason that we're picking the baby up is because
0:03:13 > 0:03:16if the baby deteriorates any further,
0:03:16 > 0:03:20it's currently in a unit where they can't really stabilise
0:03:20 > 0:03:22or give an added level of support,
0:03:22 > 0:03:25so we're transferring to a more tertiary centre where they can,
0:03:25 > 0:03:28and also where they can investigate the baby further.
0:03:30 > 0:03:33Dr Shalika Shetty's the new girl around here...
0:03:33 > 0:03:35Hi, I'm Sharli, nice to meet you.
0:03:35 > 0:03:37..fresh from her air crew training.
0:03:38 > 0:03:41This baby has basically been fairly stable
0:03:41 > 0:03:44over the last 48 hours. Already clear with antibiotics.
0:03:44 > 0:03:48Apart from those two desaturations, hasn't been significantly unwell.
0:03:48 > 0:03:51Desaturation means there's been a decrease in the oxygen
0:03:51 > 0:03:53circulating in the baby's bloodstream.
0:03:57 > 0:03:59It's just a fortnight since Dr Shalika
0:03:59 > 0:04:02swapped a quiet children's ward in London
0:04:02 > 0:04:06for the back of a noisy Bell Helicopter, a modern version
0:04:06 > 0:04:10of the choppers that flew American troops in the Vietnam War.
0:04:18 > 0:04:21Ahead of Dr Shalika and British flight nurse Emma Cooke
0:04:21 > 0:04:25is a 150 mile flight to the rural hospital.
0:04:28 > 0:04:32This is a baby who seems to be having problems.
0:04:32 > 0:04:36Had a couple of vomits before these drops in saturation,
0:04:36 > 0:04:39so what's on the back of everyone's mind is, has the baby
0:04:39 > 0:04:41kind of inhaled the vomit,
0:04:41 > 0:04:43aspirated its vomit into its lungs?
0:04:43 > 0:04:46That's definitely a possibility.
0:04:48 > 0:04:51Over. Begin your approach. Ground visual.
0:05:00 > 0:05:04Local hospital staff have done all they can for the team's patient.
0:05:04 > 0:05:06Now she needs specialist care.
0:05:06 > 0:05:07BABY CRIES
0:05:08 > 0:05:11Sorry, sweetheart.
0:05:11 > 0:05:13Baby Kayleigh has muscular dystrophy,
0:05:13 > 0:05:15a genetic disorder.
0:05:15 > 0:05:18She'll be flown to Sydney in an incubator that will feed
0:05:18 > 0:05:21oxygen-enriched air into her tiny lungs.
0:05:21 > 0:05:26Transporting babies is a complicated process that cannot be rushed.
0:05:26 > 0:05:30It normally takes at least an hour, really, for a stable patient, even.
0:05:30 > 0:05:33It's just the process of switching over the fluids and switching
0:05:33 > 0:05:37over the monitoring and getting your handover and assessing the patient.
0:05:37 > 0:05:40And so even all of that can still take an hour
0:05:40 > 0:05:42for a fairly basic patient.
0:05:42 > 0:05:45Inhaling vomit is dangerous for newborns.
0:05:45 > 0:05:48It can lead to lethal complications and, in the noisy environment
0:05:48 > 0:05:51of a helicopter, they can be difficult to diagnose.
0:05:51 > 0:05:54Yeah, you're fine. You're just fine.
0:05:54 > 0:05:56BABY CRIES
0:05:56 > 0:06:01Dr Shalika won't relax until her patient's safely in Sydney.
0:06:01 > 0:06:05Oxygen by mouth, she should be stable for the transfer.
0:06:05 > 0:06:07Because you're going up in the air,
0:06:07 > 0:06:09there's certain things that can change.
0:06:09 > 0:06:13A patient might need more oxygen, so you just keep a close eye on
0:06:13 > 0:06:17observations and we've put in a lot of external monitoring gear as well.
0:06:17 > 0:06:20Obviously, you monitor the clinical status as well, as you go along.
0:06:20 > 0:06:23So that would be the main thing in a baby like this.
0:06:24 > 0:06:28The team's tiny patient is leaving her parents behind.
0:06:28 > 0:06:32They have Kayleigh's brothers and sister to care for.
0:06:32 > 0:06:35The next hour will be critical for their daughter.
0:06:45 > 0:06:50With a price tag of £60 million each, Sydney's air ambulances
0:06:50 > 0:06:54are equipped to rescue anyone anywhere, day or night.
0:06:55 > 0:06:59And that means crews have to be trained to use the winch cable
0:06:59 > 0:07:02that can pluck survivors out of the sea or lower
0:07:02 > 0:07:05a paramedic into mountain ravines.
0:07:05 > 0:07:07It's a dangerous job.
0:07:09 > 0:07:13Dangling on the wire is not quite part of the medical school syllabus,
0:07:13 > 0:07:14so it's a little bit different
0:07:14 > 0:07:17and it's something that's quite specialised to this service
0:07:17 > 0:07:21and a few other Australian services as well.
0:07:21 > 0:07:25It means we can take our skills to patients that
0:07:25 > 0:07:28ordinarily wouldn't be easily accessed.
0:07:28 > 0:07:31It means we can resuscitate them, get them back to the helicopter
0:07:31 > 0:07:34and get them to hospital as quickly as possible.
0:07:35 > 0:07:38In the city of Newcastle, the capital of Australia's
0:07:38 > 0:07:42Hunter Valley wine growing region, a 000 call has come in.
0:07:42 > 0:07:45It's the local version of 999.
0:07:47 > 0:07:50We've got a report, there's a 60-year-old woman
0:07:50 > 0:07:54that's fallen down a ten metre cliff somewhere up between Tinonee
0:07:54 > 0:07:57and Wingham, up sort of northwest to Taree.
0:07:58 > 0:08:01They don't know any injuries. They can just see her there.
0:08:01 > 0:08:03Don't know how long she's been there for.
0:08:03 > 0:08:05The team knows that, to reach the woman,
0:08:05 > 0:08:08it will probably have to use the chopper's winch.
0:08:08 > 0:08:10It could be a tricky rescue.
0:08:10 > 0:08:12People are able to yell out to her,
0:08:12 > 0:08:14but not able to hear what she's saying,
0:08:14 > 0:08:17so, presuming she's seriously injured, ten metres is a fair way,
0:08:17 > 0:08:20we're going to actually take some gear with us
0:08:20 > 0:08:23just in case we need to abseil down to this patient.
0:08:23 > 0:08:27Basically, we're just covering for all contingencies,
0:08:27 > 0:08:31which is a bit hard, sometimes, when we're so far away,
0:08:31 > 0:08:33but it's what we need to do.
0:08:35 > 0:08:39The Westpac rescue helicopter, which is partly funded by the state,
0:08:39 > 0:08:42covers this part of New South Wales.
0:08:44 > 0:08:46- RADIO:- No further info at this stage.
0:08:46 > 0:08:49'It will probably require a winch out.'
0:08:49 > 0:08:51- Copy that.- Copy.
0:08:51 > 0:08:55'She has what appears to be a right hip or pelvic fracture,
0:08:55 > 0:08:59'head injury, GCS of 13.
0:08:59 > 0:09:01'Blood pressure is at 100 systolic.
0:09:01 > 0:09:06'Pulse of 87. Saturation of 84%.'
0:09:06 > 0:09:11Air control, Westpac Two, copy your report, thank you.
0:09:11 > 0:09:14The rescue helicopter is heading 100 miles up the coast
0:09:14 > 0:09:17to the hills around the town of Taree.
0:09:17 > 0:09:21At this stage, we've been informed the vehicles are able
0:09:21 > 0:09:24to get to the top of the cliff where the patient is.
0:09:24 > 0:09:28We have been informed that one rescue worker has
0:09:28 > 0:09:29got down to the patient.
0:09:29 > 0:09:33We've had some information on the patient's condition.
0:09:33 > 0:09:36At this stage, it doesn't sound too good.
0:09:36 > 0:09:38Sounds like she may have some chest injuries
0:09:38 > 0:09:40on top of a fractured leg, or something.
0:09:41 > 0:09:44It's going to be a difficult rescue.
0:09:44 > 0:09:48The patient is lying at the bottom of a cliff in a deep ravine.
0:09:48 > 0:09:51Trees make winching even harder than usual.
0:09:53 > 0:09:55If you just nose out over the cliff,
0:09:55 > 0:09:57we can get a better look at the area.
0:09:57 > 0:10:00The crew is preparing to lower the winchman,
0:10:00 > 0:10:04to help local paramedics already treating the woman.
0:10:04 > 0:10:08Five, four, three, two, one. And hold.
0:10:08 > 0:10:11- Bring the guys down to the door. Your reference?- OK.
0:10:11 > 0:10:13First two's coming out the door.
0:10:13 > 0:10:14Take out the slack.
0:10:17 > 0:10:21- OK, he's out onto the skids. Good hoist.- Good hoist.
0:10:21 > 0:10:22Give thumbs up on the way down.
0:10:22 > 0:10:24Height's good, air position's good.
0:10:24 > 0:10:26Just maintain your height. Got high ground.
0:10:35 > 0:10:37- Got a rope?- You can use this one if you want.
0:10:37 > 0:10:40- Yeah, is that all right? - Yeah. I'll attach it.
0:10:40 > 0:10:43In rural New South Wales, the emergency services
0:10:43 > 0:10:48rely heavily on volunteers to cope with incidents like this.
0:10:48 > 0:10:51The local voluntary rescue association has turned out
0:10:51 > 0:10:53to help the helicopter team.
0:10:53 > 0:10:56Its members are unpaid, but well trained.
0:10:56 > 0:10:59The VRA, who are what we call vertically trained,
0:10:59 > 0:11:02in other words they can rope down cliff faces,
0:11:02 > 0:11:05they've taken a Stokes litter down there
0:11:05 > 0:11:08to help extricate the patient.
0:11:08 > 0:11:12Flying paramedics like Dave Reid are highly qualified
0:11:12 > 0:11:15and abseiling is one of his skills.
0:11:15 > 0:11:18All right, see you later.
0:11:18 > 0:11:19- See you, good luck.- See you soon.
0:11:21 > 0:11:24Dave's going to abseil down, set up the stretcher, so we come in
0:11:24 > 0:11:27and we actually are only going to do one winch total.
0:11:27 > 0:11:29It looks very thin, the wire.
0:11:29 > 0:11:31It's about the size of your little finger
0:11:31 > 0:11:35and when you look down and there's 200 feet and not a lot below you,
0:11:35 > 0:11:39it does make you think a little bit about the wire and how strong it is.
0:11:49 > 0:11:52You're aware that the guy controlling the winch has
0:11:52 > 0:11:54a cutting device which is probably about an inch
0:11:54 > 0:11:56away from his finger at any time.
0:11:56 > 0:11:59So, if do things do go wrong, you may get jettisoned.
0:11:59 > 0:12:01Obviously these guys are professionals, they don't do that,
0:12:01 > 0:12:03but it's something to think about.
0:12:10 > 0:12:13In Britain, only the military or the Coast Guard
0:12:13 > 0:12:15can perform rescues like this.
0:12:15 > 0:12:19In Australia, this operation is being carried out by medical staff
0:12:19 > 0:12:21and partly funded by charity.
0:12:28 > 0:12:30The patient's now on her way to hospital.
0:12:30 > 0:12:33She has serious pelvic injuries.
0:12:33 > 0:12:36Looks like she's been there for quite some time,
0:12:36 > 0:12:38so she's quite lucky.
0:12:38 > 0:12:42Looks like her injuries could have been a lot worse, but we can't tell.
0:12:42 > 0:12:45From here she needs to go for a full assessment.
0:12:45 > 0:12:49The woman is detained in hospital in the coastal city
0:12:49 > 0:12:53of Newcastle for several weeks before being released.
0:12:57 > 0:12:59It's the end of another working day
0:12:59 > 0:13:03and Sydney's commuters are on their way home to the suburbs.
0:13:03 > 0:13:06But there's one group of workers just starting their jobs.
0:13:06 > 0:13:09The British flying doctors must work nights too
0:13:09 > 0:13:12and clocking on here requires more than just a white coat.
0:13:12 > 0:13:15The first part of our gear is our Nomex flight suit...
0:13:15 > 0:13:18Registrar Richard Smith trained in Swansea,
0:13:18 > 0:13:21but has spent the last six months working in Australia.
0:13:21 > 0:13:24Put that on over the top. Obviously, that's to protect us
0:13:24 > 0:13:27in the event of any fire on the aircraft.
0:13:27 > 0:13:29The next thing we have to put on is our harness,
0:13:29 > 0:13:32so that if we need to be winched on the aircraft, we can be.
0:13:32 > 0:13:34And we always put it on.
0:13:34 > 0:13:37We need to make sure all these straps are all done up.
0:13:37 > 0:13:40The next layer to go on is our Switlik,
0:13:40 > 0:13:42which is essentially our life jacket.
0:13:42 > 0:13:48So it's a flat type aviation jacket that will then inflate.
0:13:48 > 0:13:51And, last but not least, we put on our helmet.
0:13:51 > 0:13:55And the last thing is a set of Nomex flight gloves. So let's go and fly.
0:14:03 > 0:14:07As the sun starts to set over Sydney, Dr Richard
0:14:07 > 0:14:10and the crew of the rescue helicopter are heading out.
0:14:10 > 0:14:13MUFFLED RADIO
0:14:13 > 0:14:17They're off to a remote island, south of the city.
0:14:17 > 0:14:2022, estimating about 2015.
0:14:20 > 0:14:23All they know is that a woman has fallen from a moving car
0:14:23 > 0:14:25and she's got a serious head injury.
0:14:25 > 0:14:27Just the other side of the river.
0:14:29 > 0:14:32Oh, yeah. Just on the other side of the river there.
0:14:33 > 0:14:35We're right in the middle of wires.
0:14:35 > 0:14:37We've got wires about two miles to the east and west,
0:14:37 > 0:14:39so that should be all right.
0:14:39 > 0:14:40But there might be little wires,
0:14:40 > 0:14:42so we'll keep a real good eye out for them.
0:14:46 > 0:14:48There's nowhere to land on the island, so Richard is
0:14:48 > 0:14:52taken by ambulance on a short cable ferry to get to his patient.
0:14:55 > 0:14:59But, despite having a serious head injury,
0:14:59 > 0:15:02the woman is refusing to be treated, or go to hospital.
0:15:02 > 0:15:06Dr Richard phones a senior consultant for advice.
0:15:07 > 0:15:10I want to have a chat to you about a patient.
0:15:10 > 0:15:16It's a middle-aged lady who has somehow come out of the vehicle.
0:15:16 > 0:15:19It appears she might have opened the door and jumped out herself.
0:15:19 > 0:15:22About 25 kilometres an hour.
0:15:22 > 0:15:26She has got a significant sort of boggy swelling
0:15:26 > 0:15:27to the back of her head.
0:15:27 > 0:15:29And basically, she won't let us near her.
0:15:29 > 0:15:33Not in a combative head injury way, but more in a drunk way.
0:15:33 > 0:15:35She just wants to go home.
0:15:35 > 0:15:37I'm a bit stuck, really.
0:15:37 > 0:15:40The paramedics here say they're quite happy for her to be
0:15:40 > 0:15:44forcibly taken to hospital under Section 20 of the Mental Health Act.
0:15:44 > 0:15:47At the moment, the only way we're going to get near her is
0:15:47 > 0:15:51literally hold her down and try and get some intravenous access.
0:15:51 > 0:15:54The thing is, we need to give you just...
0:15:56 > 0:16:00..something to stop you from vomiting, OK?
0:16:01 > 0:16:05In the end, persuasion works and Dr Richard doesn't have to use
0:16:05 > 0:16:06the powers of the Mental Health Act
0:16:06 > 0:16:08to force this woman to go to hospital.
0:16:08 > 0:16:12Well done. You might feel a little bit sleepy with that injection,
0:16:12 > 0:16:13but it will stop you feeling sick.
0:16:15 > 0:16:22- RADIO: 'G22.'- Thank you, we're now departing with one patient,
0:16:22 > 0:16:25to Westmead Hospital.
0:16:25 > 0:16:29We've just given a bit of pain relief. Her obs are all OK.
0:16:30 > 0:16:33But, other than the boggy mess at the back of her head,
0:16:33 > 0:16:37and being intoxicated,
0:16:37 > 0:16:41GCS now is approximately 14.
0:16:41 > 0:16:43It's certainly an unusual case.
0:16:43 > 0:16:46Dr Richard still doesn't exactly know how
0:16:46 > 0:16:50she fell from the car or why, but his priority is that she doesn't get
0:16:50 > 0:16:55any worse over the next 30 minutes before she arrives in hospital.
0:16:55 > 0:16:58You've got the crane, it's off to the left. You see that?
0:16:58 > 0:17:00Yeah, I've got it.
0:17:00 > 0:17:02We don't want to catch her on anything.
0:17:02 > 0:17:05'That was quite a challenging case,
0:17:05 > 0:17:08'not necessarily for the medical reasons,'
0:17:08 > 0:17:12but more for the issues around
0:17:12 > 0:17:16treating patients when they don't want to be treated.
0:17:16 > 0:17:19Obviously, the law in Australia is different to in the UK.
0:17:19 > 0:17:23We could have compelled her to be treated against her will.
0:17:23 > 0:17:26But given that she had hit the back of her head,
0:17:26 > 0:17:29we can't rule out that she could have a head injury as well.
0:17:29 > 0:17:31So now she's delivered
0:17:31 > 0:17:34to the emergency department here at Westmead,
0:17:34 > 0:17:39and I suspect they're going to get her a CT scan of her head
0:17:39 > 0:17:44and we shall see what transpires when we follow the case up tomorrow.
0:17:44 > 0:17:46The scans showed that the woman does have a small
0:17:46 > 0:17:48haemorrhage near her brain.
0:17:48 > 0:17:51But after spending a couple of nights in hospital, she's sent home.
0:17:56 > 0:17:59Every day brings a new intake of patients
0:17:59 > 0:18:01for Sydney's big emergency hospitals,
0:18:01 > 0:18:04often from hundreds of miles away.
0:18:05 > 0:18:08Straight ahead, clear of the crane.
0:18:08 > 0:18:09We go around.
0:18:13 > 0:18:162,000 feet above the suburbs of Sydney,
0:18:16 > 0:18:19a very special patient is on final approach to the children's hospital.
0:18:22 > 0:18:26MUFFLED RADIO
0:18:28 > 0:18:30On the ground, Westmead.
0:18:30 > 0:18:34Six-week-old Kayleigh has serious complications, made worse
0:18:34 > 0:18:39by muscular dystrophy, an inherited disease she's had since birth.
0:18:39 > 0:18:43For flying Dr Shalika, this is a moment of relief.
0:18:47 > 0:18:50Now her patient is in the care of some of Australia's
0:18:50 > 0:18:52top paediatric specialists.
0:18:53 > 0:18:57In the dimly-lit baby unit, Shalika must tell them
0:18:57 > 0:18:59Kayleigh's troubled medical history.
0:19:01 > 0:19:05Required resuscitation at birth due to poor respiratory effort.
0:19:05 > 0:19:08Had 30 seconds of cardiac compressions and,
0:19:08 > 0:19:13after that, had a return of circulation and heart sounds.
0:19:14 > 0:19:18She has a systolic heart murmur, but echo here was normal.
0:19:18 > 0:19:21Examination-wise, she has fixed flexion deformities,
0:19:21 > 0:19:24lower limbs, and also a fixed extension deformity
0:19:24 > 0:19:25of both her feet, as well.
0:19:27 > 0:19:32Kayleigh is very ill. But the NETS team now must leave her.
0:19:32 > 0:19:35One day, Shalika hopes she'll be well enough to be flown home.
0:19:35 > 0:19:39Now she's in a centre that can investigate the issues that she's
0:19:39 > 0:19:45been having and, hopefully, once that's all done,
0:19:45 > 0:19:48and she remains stable for a period of time, she'll be transferred
0:19:48 > 0:19:52back to her home hospital where she is closer to her parents, as well.
0:19:52 > 0:19:54So, yes, our bit is done for now.
0:19:58 > 0:20:03Baby Kayleigh is 150 miles from her home, her mum and her dad.
0:20:03 > 0:20:06The vast distances between cities in Australia present
0:20:06 > 0:20:09the parents of sick children with some terrible dilemmas.
0:20:09 > 0:20:13But, as well as the helicopter, the Aussies have a clever solution.
0:20:17 > 0:20:20Meet Gwen Hillier, the ward granny.
0:20:20 > 0:20:24Good morning. How are you?
0:20:25 > 0:20:28Are you fast asleep?
0:20:28 > 0:20:31Gwen moved to Sydney from Bath 30 years ago.
0:20:31 > 0:20:32Now she's a volunteer,
0:20:32 > 0:20:35caring for babies whose parents can't be with them.
0:20:35 > 0:20:38Every day, she visits Kayleigh to play with her.
0:20:38 > 0:20:41Got your little boots on.
0:20:41 > 0:20:43Keep your feet warm.
0:20:43 > 0:20:46'I enjoy it very much.
0:20:46 > 0:20:50'I just come in and I talk to them. I sing to them.
0:20:50 > 0:20:53'They don't mind me singing to them.'
0:20:55 > 0:20:59MOBILE PLAYS MUSIC: "Winnie the Pooh Theme Song" by Robert B. Sherman
0:21:04 > 0:21:07- How has she been, all right?- Yeah.
0:21:07 > 0:21:09Behaved herself last night?
0:21:10 > 0:21:15'It's important, because Mum feels happy because I'm here.
0:21:15 > 0:21:17'Because she comes from a country town,
0:21:17 > 0:21:19'they can't be here all the time, especially
0:21:19 > 0:21:24'if they've got other children, and so we stand in for the mother.'
0:21:24 > 0:21:26You push it, don't you?
0:21:27 > 0:21:29'You read to your child'
0:21:29 > 0:21:33and sing to your child and they love it.
0:21:33 > 0:21:35Even young babies,
0:21:35 > 0:21:38their face lights up when you're interact....
0:21:38 > 0:21:42It's cos you're interacting with them, that's really what it is.
0:21:42 > 0:21:44# Rock-a-bye baby
0:21:44 > 0:21:46# On the tree top... #
0:21:47 > 0:21:52Having cared for hundreds of babies during ten years as a ward gran,
0:21:52 > 0:21:56Gwen it used to being compared with another well-known English nanny.
0:21:56 > 0:22:00'I don't see myself as Mary Poppins.'
0:22:00 > 0:22:02Everybody says I sound like Pam Ayres.
0:22:02 > 0:22:05She'd be upset, wouldn't she?
0:22:06 > 0:22:07Are you looking at me?
0:22:07 > 0:22:10Kayleigh's now on the mend and will be soon flown back home,
0:22:10 > 0:22:13once again in the care of a NETS doctor.
0:22:20 > 0:22:2540 miles west of Sydney stand the spectacular Blue Mountains,
0:22:25 > 0:22:28what was once an impenetrable wall separating Australia's
0:22:28 > 0:22:32fertile West Coast from its barren interior.
0:22:33 > 0:22:36They cover 10,000 square kilometres
0:22:36 > 0:22:40and 150 rare plants are only found here.
0:22:40 > 0:22:43But today a rather more common species is taking
0:22:43 > 0:22:47the ambulance service helicopter out into the mountains.
0:22:48 > 0:22:51MUFFLED RADIO
0:22:51 > 0:22:53A man has fallen from a tree in his back garden.
0:22:57 > 0:23:01The doctor on board today is Toby Fogg. He's British
0:23:01 > 0:23:05and works at the Royal North Shore Hospital in Sydney.
0:23:05 > 0:23:06I still feel British.
0:23:06 > 0:23:10I do miss England, family and friends that are there.
0:23:10 > 0:23:12I'm lucky enough to be able to go back
0:23:12 > 0:23:13about once a year, sometimes more.
0:23:13 > 0:23:19But there are some quintessentially British things that we all miss.
0:23:19 > 0:23:21For me, I suppose, it's the pint of bitter
0:23:21 > 0:23:23in a country pub on a Sunday afternoon.
0:23:26 > 0:23:30Dr Toby and the team are heading for a tiny town called Buxton,
0:23:30 > 0:23:3350 miles southwest of Sydney.
0:23:37 > 0:23:41There's a park in the middle of town which hopefully
0:23:41 > 0:23:43we can find as a landing point.
0:23:43 > 0:23:46Their patient, Terry Rossi, has fallen several metres
0:23:46 > 0:23:49while clearing his back garden and the land ambulance is
0:23:49 > 0:23:53bringing him to meet the helicopter in a local playing field.
0:23:53 > 0:23:5552-year-old male fallen from a fence,
0:23:55 > 0:23:57approximately three to four metres.
0:23:57 > 0:24:01Landed heavily on his left leg, which he ended up breaking.
0:24:01 > 0:24:03He's got a tib-fib compound fracture.
0:24:03 > 0:24:05Because of the distance to hospital,
0:24:05 > 0:24:08we get the helicopter guys in to take him up.
0:24:10 > 0:24:12Toby's the doctor here.
0:24:12 > 0:24:15Pop your arms down for us. Is everyone ready?
0:24:15 > 0:24:17One, two, three.
0:24:21 > 0:24:24And back down. One, two, three.
0:24:24 > 0:24:28So we're about an hour's drive from Sydney,
0:24:28 > 0:24:31down at the southwest in a small country town.
0:24:31 > 0:24:32Terry's been up a tree.
0:24:32 > 0:24:35I don't know exactly what he was doing up a tree,
0:24:35 > 0:24:36but about four metres.
0:24:36 > 0:24:39'He fell down, on his way down he caught his leg on this
0:24:39 > 0:24:42'steel fence, hit the ground.
0:24:42 > 0:24:45'It looks like he's only got an injury to his lower leg.'
0:24:45 > 0:24:47Stretcher out.
0:24:47 > 0:24:49Three sets of wheels, just let it roll in.
0:24:49 > 0:24:51And peel away.
0:24:51 > 0:24:53'He's got a nasty fracture
0:24:53 > 0:24:55'and he's going to have to go to hospital',
0:24:55 > 0:24:58get that operated on. There may be other injuries.
0:24:58 > 0:25:00He may have hurt his pelvis or his neck,
0:25:00 > 0:25:02so he's got precautionary neck collar
0:25:02 > 0:25:06and a binder to hold his pelvis nice and snug,
0:25:06 > 0:25:08but we think it's really only his leg that's the problem.
0:25:08 > 0:25:11You can always walk to the hospital if you prefer?
0:25:11 > 0:25:14I was going to get my daughter to drive me there, only the pain
0:25:14 > 0:25:15and the swelling went up...
0:25:15 > 0:25:18'We use helicopters a lot, especially in this rural area,'
0:25:18 > 0:25:21where it's over an hour to get to a major trauma hospital,
0:25:21 > 0:25:22which is what he needs.
0:25:25 > 0:25:28Deep breath.
0:25:28 > 0:25:29And out.
0:25:31 > 0:25:33In. Out.
0:25:33 > 0:25:37Dr Toby is using an ultrasound scanner to check that there
0:25:37 > 0:25:40isn't any blood in the cavity around Terry's lungs,
0:25:40 > 0:25:42a potentially fatal condition.
0:25:42 > 0:25:47It's rare to see this equipment on UK air ambulances, but the ability
0:25:47 > 0:25:51to carry out life-saving checks in the air is vital in Australia.
0:25:52 > 0:25:55'The far-flung reaches that we go to, right in the country,
0:25:55 > 0:26:00'New South Wales, amazingly small towns, very limited resources.
0:26:00 > 0:26:05'It may be just a local GP who runs a clinic who is doing his best
0:26:05 > 0:26:09'to look after some incredibly unwell patients.
0:26:09 > 0:26:10'They need a lot of help.
0:26:10 > 0:26:13'No matter how well-trained they are, they just need more resources.
0:26:13 > 0:26:15'And that's what we are.
0:26:15 > 0:26:19'We'll fly an intensive care system to the patient.'
0:26:19 > 0:26:22Patient maintains a GCS of 15.
0:26:22 > 0:26:25He's haemodynamically stable.
0:26:25 > 0:26:28Blood pressure 130 over 80.
0:26:28 > 0:26:29Sats 100%.
0:26:29 > 0:26:33We'll be at your department in 20 minutes.
0:26:33 > 0:26:36'There probably was only one ambulance service in that
0:26:36 > 0:26:40'local area, and if they were then taking this chap all the way
0:26:40 > 0:26:44'to Liverpool, who else is looking after the local population?'
0:26:45 > 0:26:49Liverpool is one of five major trauma centres serving
0:26:49 > 0:26:52the 7.2 million people who live in New South Wales.
0:26:53 > 0:26:56All five hospitals are in the Greater Sydney area,
0:26:56 > 0:26:59where 60% of the state's population live.
0:26:59 > 0:27:02So we're going to slide you across onto this bed in a moment.
0:27:02 > 0:27:03We'll slide him over.
0:27:03 > 0:27:05'They'll take other X-rays to make sure
0:27:05 > 0:27:08'he hasn't fractured his pelvis from falling from such a height,'
0:27:08 > 0:27:12because that's probably the most dangerous consequence for him
0:27:12 > 0:27:13if he had uncontrolled
0:27:13 > 0:27:15'haemorrhaging in his pelvis.
0:27:15 > 0:27:17'So they will take X-rays, make sure that's still stable,
0:27:17 > 0:27:21'and then they will proceed to move him up to theatres probably'
0:27:21 > 0:27:24sometime this afternoon to have his leg operated on and
0:27:24 > 0:27:26'he'll probably come out with a whole lot of
0:27:26 > 0:27:28'screws and plates, I'd imagine.'
0:27:33 > 0:27:36Thanks to big city medical technology,
0:27:36 > 0:27:40the team's patient is soon sent back home to the Blue Mountains.
0:27:40 > 0:27:43I'm not sure which one I was standing on that broke
0:27:43 > 0:27:47when I fell, but I think it was that top one, there. This one.
0:27:49 > 0:27:51I wasn't that high up either, you know?
0:27:51 > 0:27:54That's only three or four metres.
0:27:54 > 0:27:55The tree isn't even Terry's,
0:27:55 > 0:27:57it belongs to his neighbour,
0:27:57 > 0:28:01but birds were sitting on the branches, making a mess in his yard.
0:28:01 > 0:28:05I just decided to get up there the best way I could,
0:28:05 > 0:28:08thinking I was 21, you know and He-Man.
0:28:08 > 0:28:10Get up there and cut some of the branches down,
0:28:10 > 0:28:13but one of the ones I was standing on broke
0:28:13 > 0:28:16and I came straight down and I landed on my feet,
0:28:16 > 0:28:20which broke the tibia and fibula,
0:28:20 > 0:28:23that sort of come out of the side,
0:28:23 > 0:28:26out of the side of the leg there.
0:28:26 > 0:28:28I've never seen nothing like it.
0:28:28 > 0:28:31Terry says he'll leave tree surgery to the professionals in the future.
0:28:31 > 0:28:34It will be many months before he can properly walk again,
0:28:34 > 0:28:36never mind climb trees.
0:28:44 > 0:28:47Subtitles by Red Bee Media Ltd